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Background: There are numerous national efforts to determine and develop research priorities of medical education in Saudi Arabia. These priorities were first proposed in 2010 by 'Dr Al-Khuli's Chair for Developing Medical Education in Saudi Arabia'. The proposed priority domains were: curriculum, students, faculty, and quality assurance and accreditation. Aim: To investigate publications in medical education at the national and international levels in areas relating to these proposed priorities. Methods: Electronic search within PubMed database for papers relating to each domain of priority was conducted at national and international levels in the last three years, using the same keywords as the priority domains, but only confined to undergraduate medical education. Results: Out of 3145 articles retrieved when searching with keyword as broad as 'undergraduate medical curriculum' only 81 articles worldwide and 3 articles from Saudi Arabia were dealing with curriculum related issues as a whole. Further search on the sub-domains 'effective strategies to manage undergraduate curriculum' and 'undergraduate medical education models', resulted in the retrieval of few articles worldwide and none from Saudi Arabia. At the national level, there were 63 publications from Saudi Arabia that were either course (topic)-specific or could not be classified under the four domains specified by Dr Al-Khuli's Chair. Conclusion: Research activities in medical education in Saudi Arabia in the last 3 years showed diversity and lack of focus in the research priorities. Efforts of academic and research centers should continue to monitor and encourage these activities toward achieving the recommended priorities. [ABSTRACT FROM AUTHOR]

Purpose: To better understand the steps undertaken by medical specialties to develop and implement undergraduate national, and international, educational guidelines for use in medical schools, and to find what makes them successful in terms of uptake and knowledge. Methods: Systematic review of databases to find inter- and nationally-created undergraduate medical specialty guidelines, and descriptions of development and analysis, from 1998 to January 2015. Results: Ninety six eligible papers were found, covering 59 different guidelines in 32 specialties. Five documented from development to revision. Development often required multiple stages and methods, 10 using the Delphi technique. Twenty two guidelines mapped to recommended government standards. Twenty papers analyzed curricula. No guideline was used in every relevant medical school. Conclusions: This is a comprehensive review of the processes involved in creating international and national guidelines, with emphasis of key points for those considering similar undertakings. These include thorough needs analysis of multiple groups involved in the delivery of the curriculum; and engagement of relevant parties throughout development, to ensure relevance and increase buy-in. Flexibility is important, to allow use in medical schools with different methods of teaching. Ongoing evaluation and update are also critical steps that must not be forgotten. [ABSTRACT FROM AUTHOR]

The twenty-first century higher education sector has come a long way after undergoing continuous metamorphosis from pedagogy to andragogy. Most of the educational approaches adopted in medical schools are directed towards developing more of competencies and less of capability, which is the ability to use competencies in novel contexts. Competencies alone are not sufficient to thrive in the present day work place as medical profession subsumes complex contexts; it is in this scenario that, medical educators are entrusted with the challenging task of developing “capable learners”. In the heutagogical approach, learners are required to decide upon what to learn and how to learn and therefore the control of the learning process is on the learner and the role of the teacher becomes that of a navigator. This paper highlights the current higher educational practices based on heutagogy, considers its application in the context of Problem-based learning and also discusses a few challenges in incorporating this approach in the existing undergraduate medical curriculum. The article proposes the use of social media in order to support learner autonomy, which in turn improves learners’ cognitive engagement with content and tasks, thereby assisting the development of attributes associated with capability. [ABSTRACT FROM PUBLISHER]

Background: Global health educational programs within U.S. medical schools have the opportunity to link their 'global' focus with local circumstances by examining the challenges underserved communities face in the United States. Aim: Students in Weill Cornell Medical College's Global Health Clinical Preceptorship (GHCP) learn history-taking and physical examination skills while gaining exposure to local health care disparities and building cultural competency. Methods: First-year medical students in the program are placed in the office of a physician who works with underserved patient populations in New York City. Students receive an orientation session, shadow their preceptors one afternoon per week for seven weeks, complete weekly readings and assignments on topics specific to underserved populations, attend a reflection session, and write a reflection paper. Results: In three years, 36% of first-year students (112 of 311) opted into the elective GHCP program. Students reported gaining a better understanding of the needs of underserved patient populations, being exposed to new languages and issues of cultural competency, and having the opportunity to work with role model clinicians. Conclusions: The GHCP is a successful example of how global health programs within medical schools can incorporate a domestic learning component into their curricula. [ABSTRACT FROM AUTHOR]

Medical educators must prepare for a number of challenges when they decide to implement a competency-based curriculum. Many of these challenges will pertain to three key aspects of implementation: organizing the structural changes that will be necessary to deliver new curricula and methods of assessment; modifying the processes of teaching and evaluation; and helping to change the culture of education so that the CBME paradigm gains acceptance. This paper focuses on nine key considerations that will support positive change in first two of these areas. Key considerations include: ensuring that educational continuity exists amongst all levels of medical education, altering how time is used in medical education, involving CBME in human health resources planning, ensuring that competent doctors work in competent health care systems, ensuring that information technology supports CBME, ensuring that faculty development is supported, ensuring that the rights and responsibilities of the learner are appropriately balanced in the workplace, preparing for the costs of change, and having appropriate leadership in order to achieve success in implementation. [ABSTRACT FROM PUBLISHER]

Background: The continuing decline in clinician scientists is a global concern. This paper reports on a two-fold rationale to address this decline by increasing the number of students on a formal pathway to an academic research career, and building a 'teaching-research nexus' using the research intensive environment at our University. Methods: The University of Queensland has implemented a research intensive program, the Clinician Scientist Track (CST), for a select cohort of students to pursue a part time research Masters degree alongside their full time medical degree. To this end, the support of clinical academics and the research community was vital to achieve a 'teaching-research-clinical nexus' - most appropriate for nurturing future Clinician Scientists. Results: In three years, the CST has 42 enrolled research Masters' students with the majority (90%) upgrading to a PhD. Research represents 33 different areas and over 25 research groups/centres across this University and internationally. Conclusions: Other research intensive institutions may similarly build their 'teaching-research nexus' by purposeful engagement between their medical school and research community. The CST offers a feasible opportunity for outstanding students to build their own 'field of dreams' through an early start to their research career while achieving a common goal of rejuvenating the ethos of the clinician scientist. [ABSTRACT FROM AUTHOR]

The high prevalence of physician burnout is of great concern and may begin with observed declines in empathy and increases in stress and burnout in medical and health professions students. While underlying causes have been described, there is less certainty on how to create effective interventions in curricula and workplace. In October 2015, The Center for Innovation and Leadership in Education (CENTILE) at Georgetown University, together with MedStar Health, Georgetown’s clinical partner, and six academic institutions sponsored a conference in Washington, DC. The goal was to discuss the current state of stress and burnout in the health professions, and to share best practices on strategies to promote resilience, empathy and well-being in students, residents, faculty and practitioners across health professions. In this issue of Medical Teacher, three articles address pertinent themes of the conference. Maslach and Leiter provide insights into burnout and strategies to alleviate it. Ekman and Krasner discuss various types of empathy and how neuroscience can be used to effectively cultivate empathy. In the third paper, Kreitzer and Klatt highlight three successful curricular interventions that foster self-awareness and boost resilience. Ultimately, effective strategies will be needed to address this issue at both the individual and organizational levels. [ABSTRACT FROM PUBLISHER]

This paper examines a recent medical graduate’s perspective on how undergraduate education tends to focus on imparting medical knowledge with little reference to the human aspects in clinical medicine. This is problematic because medicine is both about people and practiced by people. Students often have minimal exposure to the humanities prior to and in medical school and are frequently unaware of the societal trends that impact their view of medical practice. Familiarity with the humanities is a crucial means to understanding human nature, recognizing personal sociocultural biases, and practicing patient-centered medicine. This gap in knowledge may be due to the increase in medical information and optimistic ideologies related to medical progress. Philosophical paradigms and historical examples are considered to demonstrate the relevance of both fields in the humanities in understanding the role of moral human agents in applying medical knowledge. Educational changes in the humanities are proposed as a potential solution to our current deficits. Informal changes include mentorship relationships and shifting the general underpinning attitude in medical culture. Formal changes include specific courses teaching a critical approach to medicine. Changes in competency-based education and admissions are also suggested. These amendments are proposed to practice a fuller, truly human medicine. [ABSTRACT FROM PUBLISHER]

An opinion piece is presented in which the author examines whether or not revolutionary changes are needed in medical education. Topics discussed include changes that took place in Russian medical education in the 20th century, a document written by American educator Horsley Gantt that described this revolution, and the role of communism in Russian medical education.

The emergence of the e-patient has resulted in many medical practitioners' being ill-equipped to deal with the 21st-century medical practice. This Guide is a teaching guide for medical educators so that they can prepare their students for the new environment that has resulted from the emergence of the e-patient. Within the context of theoretical perspectives, the Guide begins by defining the concept, and examining the history of the e-patient, detailing typical e-patient activities and some complexities raised by these activities. Finally, the Guide details the topic areas that should be covered in a course aimed at preparing medical students for e-patients. The result is a theoretical and practical teaching Guide that equips medical teachers and their students with the necessary background information, and also assists teachers in the teaching of that information so that their students may become health practitioners fully equipped to deal with the problems and potential of the e-patient. [ABSTRACT FROM PUBLISHER]

Purpose:The “educational alliance” concept articulates a collaborative framework to facilitate effective feedback through transparency of opportunities aligned with learner stage and intended educational outcomes. Using this framework, we evaluated feedback across a 5 year undergraduate medical program to support embedding a successful learner – teacher “educational alliance”. Method:A comprehensive mapping exercise used an iterative action research process of source documentary analysis, consultations with key curriculum stakeholders and qualitative analysis. The “educational alliance” model provided a critical lens through which to ensure feedback opportunities aligned with intended learning outcomes and developmental progression. Results:Key information about the type, frequency and timing of feedback opportunities was identified within 188 curricular components. The purpose and intended learning outcomes were mapped, aligning with the stage of learning and with an expectation of supporting learners’ capacity for self-regulation. This focus providing clear articulation of feedback opportunities supported the longitudinal developmental curricular review, and facilitated enhanced awareness of dialogic feedback within the “educational alliance”. Conclusions:Explicit alignment of learning intentions between learner and educator is key to forming a successful “educational alliance”. The feedback map provides clarity ensuring mutual understanding of intended learning outcomes. The iterative process additionally certified feedback aligned with maturing learner developmental needs across the program. [ABSTRACT FROM PUBLISHER]

The introduction of case-based learning (CBL) by the School of Medicine at Cardiff University has encouraged innovation in medical teaching and learning. During years one and two of the modernized MBBCh program, students complete 17 cases as part of the newly developed C21 curriculum that emphasizes a patient-oriented and student-centered approach to learning. The mental health case, which is presented in year 2, incorporates a number of novel teaching resources that aim to enhance the students’ learning experience and to further reinforce the patient-oriented and community-based philosophy of C21. These include the use of fictionalized video diaries, virtual patient cases, e-learning workbooks, an interactive practical session, and community placements. Novel teaching methods and resources were evaluated by students in terms of effectiveness and value as learning resources through the administration of a structured mixed questionnaire. The results revealed that students valued the inclusion of these resources, which they evaluated as having contributed to their understanding of the subject area. Furthermore, the case was found to have had an impact on student interest in psychiatry as a specialty as well as a career choice. The positive student evaluation of this case supports the innovations in teaching delivery inspired by C21. [ABSTRACT FROM PUBLISHER]

Aim:To assess the feasibility and utility of measuring baseline professional identity formation (PIF) in a theory-based professionalism curriculum for early medical students. Methods:All 132 entering students completed the professional identity essay (PIE) and the defining issues test (DIT2). Students received score reports with individualized narrative feedback and wrote a structured reflection after a large-group session in which the PIF construct was reviewed. Analysis of PIEs resulted in assignment of a full or transitional PIF stage (1–5). The DIT2 score reflects the proportion of the time students used universal ethical principles to justify a response to 6 moral dilemma cases. Students’ reflections were content analyzed. Results:PIF scores were distributed across stage 2/3, stage 3, stage 3/4, and stage 4. No student scores were in stages 1, 2, 4/5, or 5. The mean DIT2 score was 53% (range 9.7?76.5%); the correlation between PIF stage and DIT score was ρ =  0.18 (p = 0.03). Students who took an analytic approach to the data and demonstrated both awareness that they are novices and anticipation of continued PIF tended to respond more positively to the feedback. Conclusions:These PIF scores distributed similarly to novice students in other professions. Developmental-theory based PIF and moral reasoning measures are related. Students reflected on these measures in meaningful ways suggesting utility of measuring PIF scores in medical education. [ABSTRACT FROM PUBLISHER]

Background: Anatomy is a subject essential to medical practice, yet time committed to teaching is on the decline, and resources required to teach anatomy is costly, particularly dissection. Advances in technology are a potential solution to the problem, while maintaining the quality of teaching required for eventual clinical application. Aim: To identify methods used to teach anatomy, including those demonstrated to enhance knowledge acquisition and retention. Methods: PubMed, CINAHL, ERIC, Academic OneFile, ProQuest, SAGE journals and Scopus were search from the earliest entry of each database to 31 August 2015. All included articles were assessed for methodological quality and low quality articles were excluded from the study. Studies were evaluated by assessment scores, qualitative outcomes where included as well as a modified Kirkpatrick model. Results: A total of 17,820 articles were initially identified, with 29 included in the review. The review found a wide variety of teaching interventions represented in the range of studies, with CAI/CAL studies predominating in terms of teaching interventions, followed by simulation. In addition to this, CAI/CAL and simulation studies demonstrated better results overall compared to traditional teaching methods and there is evidence to support CAI/CAL as a partial replacement for dissection or a valuable tool in conjunction with dissection. Conclusions: This review provides evidence in support of the use of alternatives to traditional teaching methods in anatomy, in particular, the use of CAI/CAL with a number of high quality, low risk of bias studies supporting this. [ABSTRACT FROM AUTHOR]

Stress and burnout of healthcare providers has become a major healthcare issue that has implications for not only workforce projections, but the cost and quality of care and the lives of healthcare providers and their families. Burnout, characterized by loss of enthusiasm for work, feelings of cynicism and a low sense of personal accomplishment is associated with early retirement, alcohol use, and suicidal ideation. Healthcare professional “wellbeing” or “care of the caregiver” is a topic that has not been significantly addressed in the education of healthcare professionals. The culture that has dominated much of education has been one where students have been expected to forego personal needs, endure stressful environments, and emerge from highly competitive and often dysfunctional environments to work in care settings where health and wellbeing is also largely ignored. Three curricular innovations are highlighted that target pre-professional students, students enrolled in health professions education and practicing health care professionals. Strategies are highlighted that both help individuals cultivate resiliency and wellbeing in their personal and professional lives and that address system issues that contribute to unhealthy learning and work environments. [ABSTRACT FROM PUBLISHER]

The aim of this Guide is to support teacher with the responsibility of designing, delivering and/or assessing diversity education. Although, the focus is on medical education, the guidance is relevant to all healthcare professionals. The Guide begins by providing an overview of the definitions used and the principles that underpin the teaching of diversity as advocated by Diversity and Medicine in Health (DIMAH). Following an outline of these principles we highlight the difference between equality and diversity education. The Guide then covers diversity education throughout the educational process from the philosophical stance of educators and how this influences the approaches used through to curriculum development, delivery and assessment. Appendices contain practical examples from across the UK, covering lesson plans and specific exercises to deliver teaching. Although, diversity education remains variable and fragmented there is now some momentum to ensure that the principles of good educational practice are applied to diversity education. The nature of this topic means that there are a range of different professions and medical disciplines involved which leads to a great necessity for greater collaboration and sharing of effective practice. [ABSTRACT FROM AUTHOR]

Background:Assessment serves as an important motivation for learning. However, multiple choice and short answer question formats are often considered unsatisfactory for assessment of medical humanities, and the social and behavioural sciences. Little consensus exists as to what might constitute ‘best’ assessment practice. What we did:We designed an assessment format closely aligned to the curricular approach of problem-based learning which allows for greater assessment of students’ understanding, depth of knowledge and interpretation, rather than recall of rote learning. Conclusion:The educational impact of scenario-based assessment has been profound. Students reported changing their approach to PBL, independent learning and exam preparation by taking a less reductionist, more interpretative approach to the topics studied. [ABSTRACT FROM PUBLISHER]

Introduction: The General Medical Council (GMC) expects that medical students graduate with an awareness of how the diversity of the patient population may affect health outcomes and behaviours. However, little guidance has been provided on how to incorporate diversity teaching into medical school curricula. Research highlights the existence of two different models within medical education: cultural competency and cultural humility. The Southampton medical curriculum includes both models in its diversity teaching, but little was known about which model was dominant or about the students' experience. Methods: Fifteen semi-structured, in-depth interviews were carried out with medical students at the University of Southampton. Data were analysed thematically using elements of grounded theory and constant comparison. Results: Students identified early examples of diversity teaching consistent with a cultural humility approach. In later years, the limited diversity teaching recognised by students generally adopted a cultural competency approach. Students tended to perceive diversity as something that creates problems for healthcare professionals due to patients' perceived differences. They also reported witnessing a number of questionable practices related to diversity issues that they felt unable to challenge. The dissonance created by differences in the largely lecture based and the clinical environments left students confused and doubting the value of cultural humility in a clinical context. Conclusions: Staff training on diversity issues is required to encourage institutional buy-in and establish consistent educational and clinical environments. By tackling cultural diversity within the context of patient-centred care, cultural humility, the approach students valued most, would become the default model. Reflective practice and the development of a critical consciousness are crucial in the improvement of cultural diversity training and thus should be facilitated and encouraged. Educators can adopt a bidirectional mode of teaching and work with students to decolonise medical curricula and improve medical practice. [ABSTRACT FROM AUTHOR]

The concept of the learning landscape is used to explore the range of learning environments needed at multiple scales to better align with changes in the medical education curriculum. Four key scales that correspond to important types of learning spaces are identified: the classroom, the building, the campus and the city. 'In-between' spaces are identified as growing in importance given changing patterns of learning and the use of information technology. Technology is altering how learning takes place in a wider variety of types of spaces as it is interwoven into every aspect of learning. An approach to planning learning environments which recognizes the need to think of networks of learning spaces connected across multiple scales is proposed. The focus is shifted from singular spaces to networks of inter-connected virtual and digital environments. A schematic model comprising the networked learning landscape, intended as a guide to planning that emphasizes relationships between the changing curriculum and its alignment with learning environments at multiple scales is proposed in this work. The need for higher levels of engagement of faculty, administrators and students in defining the briefs for the design of new kinds of medical education environments is highlighted. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the 2014 article "Twelve tips for teaching with ultrasound in the undergraduate curriculum" published in issue 36 of the journal by M.J. Griksaitis, M.P. Scott, and G.M. Finn.

Background: Nowadays, there is an increasing interest in practicing evidence-based medicine (EBM) to provide valid and up-to-date information about health problems and procedures for solving these problems. However, studying EBM among other medical education disciplines remains unsatisfactory. Aim: To design and pilot a basic course on EBM for undergraduate medical students in order to raise the awareness of the Saudi medical education community about this discipline. Subjects and methods: The developed course targeted undergraduate Year 4 medical students at Ibn Sina National College for Medical Studies in Jeddah, Saudi Arabia. The course was integrated longitudinally into ?Integrated Multisystem Module? of Year 4. Students and faculty perceptions were evaluated for program evaluation purposes. Course design was based on Kern et al. six-step approach for curriculum development. Results: Students overall perception of this course was positive except for some points related to the time allocated and their training on using evidence databases. Faculty members who participated in implementing the course perceived it positively. Conclusions: Teaching EBM is recommended and applicable. It is not resource-intensive, and can be conducted through developing and integrating EBM courses in the undergraduate medical curriculum. Students and teachers agree upon the need and importance of teaching such discipline. [ABSTRACT FROM AUTHOR]

Objective:To explore the potential, challenges and needs for internship research activities in achieving scholar outcomes among graduates. Methods:A qualitative general needs assessment and evaluation of an internship research program was conducted at King Abdulaziz University, Faculty of Dentistry (KAUFD), KSA, from December 2014 to February 2015 using focus groups and interviews. The participants included: administrates, faculty, and internship students. Data were transcribed and analyzed following the grounded theory. Results:The participants were two administrative personnel, 21 faculty members, and 16 internship students. Results were clustered around five main domains; curriculum design, faculty, students, administrative, and institutional domain. Reported potentials included: a multi-faceted educational intervention approach, and building evidence-based skills and inquiry minds among graduates. Time, load, and incentives were major challenges reported by faculty. Interesting and achievable research topics were major challenges reported by students. Areas that needed development included: equipped research personnel, aligned administrative and institutional support, faculty skills, students’ knowledge and skills, aligned curriculum, and clear program goals, objectives, and outcomes. Conclusion:Curriculum design, faculty and students’ skills; as well as administrative and institutional support were found to play major roles in the success of the current internship research program at KAUFD. [ABSTRACT FROM PUBLISHER]