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Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes. [ABSTRACT FROM AUTHOR]

Psychomotor skill performance is central to effective clinical practice across health professions. These complex skills are challenging to teach, particularly in the novice learner. As many health professions programs have increased blended course offerings, educators must establish best practices for teaching psychomotor skills in this evolving learning environment. The purpose of this paper is to describe the innovative application of an evidence-based framework to teaching psychomotor skills to novice learners in a blended learning environment. Using a modified 9-step framework, two novice clinical skills courses in a Doctor of Physical Therapy Program were redesigned to teach psychomotor skills in a blended format, using online and in-person class sessions. Online coursework consisted of synchronous and asynchronous learning activities that preceded an immersive lab experience. Formative and summative assessments occurred during lab immersion. The learning framework provided a central evidence-based pillar for novel course design, guiding development of learning activities for teaching psychomotor skills to novice learners in a blended learning environment. Initial student outcomes appear favorable when compared with previous traditional course structures and satisfaction was high. These preliminary findings align with prior research using similar frameworks for learning complex skills and provide an archetype curricular model for a blended learning environment. [ABSTRACT FROM AUTHOR]

We sought to design a micro-curriculum to structure supervised clinical placements for junior medical students within a variety of community-based settings of differing clinical disciplines. Given the gaps in the literature, this paper reflects on the opportunities and challenges of our design, implementation, and evaluation strategies in constructing an integrated task-based micro-curriculum for interprofessional community-based learning in year 2 of a four-year graduate entry program. The design was informed by a systems thinking framework and guided by contemporary curricular theories on self-directed and interprofessional learning. Extensive consultations with stakeholders were undertaken. Alignment with relevant national level documents and curricular frameworks was ensured. The systems thinking approach provided first, an experience of applying thinking tools for a deeper understanding of how various parts of this micro-curriculum and subsystems should be integrated. Second, applying the toolkit uncovered tension points on which leverage could optimise future enhancements. Eighteen types of health professions were recruited including 105 general practitioners and 253 healthcare practitioners from a range of disciplines. Systems thinking allows for the identification of various interacting elements within the curriculum to be considered as part of an integrated whole. Insights from this model could inform the design of similar innovative curricula. [ABSTRACT FROM AUTHOR]

Healthcare experiences of mistreatment are long standing issues, with many not knowing how to recognise it and respond appropriately. Active bystander intervention (ABI) training prepares individuals with tools and strategies to challenge incidences of discrimination and harassment that they may witness. This type of training shares a philosophy that all members of the healthcare community have a role to play in tackling discrimination and healthcare inequalities. We developed an ABI training programme for undergraduate medical students, after recognising the need for this given the students' adverse experiences on clinical placements. From longitudinal feedback and robust observations of this programme, this paper intends to provide key learning lessons and guidance on how to develop, deliver and support faculty in facilitating these types of trainings. These tips are also accompanied by recommended resources and suggested examples. [ABSTRACT FROM AUTHOR]

The international movement to competency-based medical education (CBME) marks a major transition in medical education that requires a shift in educators' and learners' approach to clinical experiences, the way assessment data are collected and integrated, and in learners' mindsets. Learners entering a CBME curriculum must actively drive their learning experiences and education goals. For some, this expectation may be a significant change from their previous approach to learning in medicine. This paper highlights 12 tips to help learners succeed within a CBME model. [ABSTRACT FROM AUTHOR]

Aim: While diversity, equity, and inclusion are much proclaimed aspirational goals in education programs, the clinical learning environment (CLE) frequently falls short of meaningful incorporation of these concepts in processes, policies, and local culture. In this paper, we explore how inclusion, diversity, and equity can and should be defined and operationalized within medical education. Methods: Three cases, organized around Hafferty's curricular framework (formal, informal, and hidden), we illustrate lapses and potential best practices in inclusion in the CLE. Results: The essential "best-practice" of programs inclusive of diverse individuals is the design of policies, processes, and behavioral norms co-creatively with all community members. Potential pitfalls to greater inclusion include nostalgic reference to "the past", a neutrality that is operationalized without the rudder of explicit values and not recognizing that ethical obligations between teachers, learners, and programs are at the heart of the discussion of how inclusive learning and work environments are built. Conclusion: Inclusive CLE's provide space for co-creation, understand the need to ensure the voices of the vulnerable (i.e. learners) are heard and valued and through this promote the flourishing of diverse human capital, in keeping with a model that views diversity as a key attribute or organizational excellence. [ABSTRACT FROM AUTHOR]

Introduction: The hidden curriculum, commonly described in negative terms, is considered highly influential in medical education, especially in the clinical workplace. Structured approaches to address it are limited in number and scope. Methods and results: This paper presents a practical, value-neutral method called REVIEW (Reflecting & Evaluating Values Implicit in Education in the Workplace), to facilitate reflection and discussion on the hidden curriculum by faculty members and trainees. REVIEW approaches the hidden curriculum as a reflection of the professional microculture of a clinical team. This microculture results from collective problem solving and mutual negotiation when facing different, often conflicting, demands and interests, and their underlying values in daily clinical practice. Using this nonjudgmental conceptual framework, REVIEW employs a series of 50 culture statements that must be prioritized using Q-sort methodology, reflecting how the culture in a particular clinical context (e.g. ward or department) is perceived by faculty members and trainees. This procedure can be done individually or in groups. Most important is the resulting team discussion after the exercise - a discussion about perceptions of actual team culture and the culture desired by the team. Discussion and conclusions: Our early experiences suggest that REVIEW can be a useful tool for addressing the hidden curriculum. [ABSTRACT FROM AUTHOR]

Flipped classrooms have become popular as a student-centered approach in medical education because they allow students to improve higher-order thinking skills and problem-solving applications during in-class activities. However, students are expected to study videos and other class materials before class begins. Learning analytics and unsupervised machine learning algorithms (clustering) can be used to examine the pre-class activities of these students to identify inadequate student preparation before the in-class stage and make appropriate interventions. Furthermore, the students' profiles, which provide their interaction strategies towards online materials, can be used to design appropriate interventions. This study investigates student profiles in a flipped classroom. The learning management system interactions of 375 medical students are collected and preprocessed. The k-means clustering algorithms examined in this study show a two-cluster structure: 'high interaction' and 'low-interaction.' These results can be used to help identify low-engaged students and give appropriate feedback. [ABSTRACT FROM AUTHOR]

Mistreatment in medical school is a wicked or complex problem demonstrating inter-relatedness and dynamicity of factors that affect students. Many studies have outlined the causes, perceptions, and negative consequences of mistreatment; however, a comprehensive mental model of public humiliation, the most common type of mistreatment, is still incomplete. This study aims to provide insight into the reasons why public humiliation in medical school continues to be a problem despite existing for decades, and to propose a shift in paradigm that potentially improve these incidents. A systems thinking approach is used to conceptualize related components of public humiliation and student behavior. System dynamics modeling was conducted through narrative review, developing a causal loop diagram (CLD), and validation of results with 60 medical students and 40 medical educators. Findings from the narrative review outlined key variables, interconnections and five emerging themes: etiology, eustress, motivation, distress, and self-esteem. The themes were conceptualized and constructed into feedback loops as a basis for the CLD. Finally, the mental model proposes three major systems underlying the consequences. The "No Pain, No Gain" illustrates the perception that stress positively drives learning, while "Stress Overload" displays the negative consequences of public humiliation. Lastly, "The Delayed Side Effect" refers to long-term side-effects on self-esteem. The mental model illustrates how public humiliation has both immediate and delayed side-effects, simultaneously succeeding and failing at motivating student growth. Therefore, public humiliation requires continuous changes in perspective along with multiple interventions to overcome the vicious cycle. [ABSTRACT FROM AUTHOR]

In medical education, the use of flipped classrooms is on the increase. The complex, interdependent active- and social learning activities often built into the 'in-class' phase of this new approach may, however, cause cognitive overload, impeding learning. Computer-supported collaborative learning could play a role in reducing such cognitive load. The current study investigated how four constituent factors of 'in-class' scenarios for 'flipped' classrooms affect the intrinsic, germane and extraneous cognitive load for students. After participating in a computer-supported 'in-class' scenario for a radiology training course that combined face-to-face individual activities, small-group work and class-wide activities, undergraduate medical students (n = 135) completed a questionnaire rating the cognitive load perceived. Computer support comprised a program for radiology assessment and a learning dashboard that captured and visualized the assessment results. Total intrinsic load, germane load, and extraneous load (EL) were calculated from the results obtained. The 'high' intrinsic load, 'high' germane load, and 'low' EL indicate that the computer-supported 'in-class' scenario was cognitively challenging but that sufficient mental effort could be spent on task performance and learning. We attribute the successful management of the cognitive load imposed by this complex in-class scenario to the specially designed learning dashboard. [ABSTRACT FROM AUTHOR]

Purpose: Medical Massive Open Online Courses (MOOCs) are of interest for campus education. With growing interest in integrating medical MOOCs, their quality must be ensured. This however, has not been studied. We investigated if medical MOOCs meet the instructional design principles: problem-centeredness, activation, demonstration, application, integration, collective knowledge, collaboration, differentiation, authentic resources, feedback, and goal-setting. Methods: An overview of medical MOOCs and inclusion criteria were developed. Out of 410 MOOCs, 33 were selected. A data collection tool was compiled and calibrated. Investigators enrolled in selected MOOCs and coded presence of instructional design principles after examination of all course pages. Results: Application, authentic resources, problem-centeredness, and goal-setting were found to be present in many of the courses. Activation, collective knowledge, differentiation, and demonstration were present in less than half of the courses. Finally, integration, collaboration, and expert feedback were present in less than 15% of the courses. Conclusions: Medical MOOCs meet these principles in varying degree. Certain principles might be scarcely present due to a problematic fit with the MOOC concept or a need for further development in online settings. Assessment of instructional design quality is desired before integrating so that MOOC quality can be considered in relation to the quality of existing campus education. [ABSTRACT FROM AUTHOR]

Purpose: Medical Massive Open Online Courses (MOOCs) have been integrated into formal campus teaching by several universities. However, teaching attributes of medical MOOCs have not been systematically investigated. Additionally, guidelines are needed to inform integration practices. This study systematically investigated the available teaching modes and social-epistemological dimensions of medical MOOCs. Methods: An overview of MOOCs on a medical topic was compiled and inclusion criteria were developed. A data collection tool was composed and calibrated. For data collection, out of 410 MOOCs 33 were selected based on these criteria. Investigators enrolled in selected MOOCs and analyzed teaching modes after examination of all course pages. Teaching modes were categorized in social-epistemological dimensions according to the Teaching Approach Framework. Results: Twenty-nine different teaching modes were found, showing wide distributions. Analysis of social-epistemological dimensions showed medical MOOCs focus on constructivist and individual teaching modes as opposed to objectivist and group modes. Conclusions: Medical MOOCs do not have a universal teaching mode profile. They contain a rich variety of teaching modes for integration in campus education of which videos, discussion boards, and multiple choice questions are used regularly. Constructivist teaching modes are readily available in medical MOOCs and can support educational innovation of formal campus teaching when integrated. [ABSTRACT FROM AUTHOR]

Aim: This perspective is part of a series of articles that are outcomes of a consensus conference, that seek to offer a comprehensive examination of the clinical learning environment (CLE), using different academic disciplines and areas of focus termed "avenues." The education dimensions of the CLE are discussed in detail in this perspective, along with critical linkages to the other avenues. Methods: Using iterative presentations, discussion and small group work, in October 2018, the consensus conference participants explored the education, psychological, sociocultural, diversity and inclusion, digital and architectural aspects of the CLE. Results: The education avenue of the CLE includes elements of teaching and learning such as the curriculum, clinical experiences, the assessment system, educational program governance, trainee selection, faculty development, and program evaluation and improvement. Within the educational domain, we focus on organizational and personal/social aspects of the CLE, including (1) curriculum design and deployment, including placement of trainees in clinical settings, organizational culture, practices and policies, and accreditation and regulatory requirements from the organizational domain (2) the education system, including assessment, program evaluation and organization and governance; and (3) elements from the personal and social domains, including peer-to-peer, trainee-faculty, and trainee-patient relationships that influence how and what postgraduate trainees learn, trainee selection, informal and hidden curricula, and trainees' perceptions of their learning environment. Conclusions: We provide suggestions for further research and recommendations for addressing challenges and facilitating improvement in the educational aspects of the CLE, along with actionable practice points. [ABSTRACT FROM AUTHOR]

Background: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students. Aim: To compare IT skills, uses and preferences for education between traditional and PBL medical students’. Method: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University. Results: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p = 0.34), YouTube (90.7 vs. 92.2%, p = 0.83) and PubMed (83.7 vs. 86.7%, p = 0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p = 0.0001) and Smartboard use (40.7 vs. 23.3%, p = 0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%). Conclusions: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended. [ABSTRACT FROM AUTHOR]

There is increased interest in longitudinal integrated clerkships (LICs) due to mounting evidence of positive outcomes for students, patients and supervising clinicians. Emphasizing continuity as the organizing principle of an LIC, this article reviews evidence and presents perspectives of LIC participants concerning continuity of care, supervision and curriculum, and continuity with peers and systems of care. It also offers advice on implementing or evaluating existing LIC programs. [ABSTRACT FROM PUBLISHER]

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]

Palestine has a short history of medical education: the first medical school opened in 1994 and a further three have opened since. Doctors are trained against a backdrop of military occupation and ineffective governance, complicating the development and delivery of effective education. Postgraduate education is a particular weakness, with disorganised residency programmes prioritising service provision over the training of specialists, leading to poorer patient care and low morale. This unfavourable learning environment leads into a situation where opportunities for continuing professional development are scarce. Links between healthcare and education providers in Palestine and countries with advanced health systems have great potential for allowing best practice in medical education to be shared and to provide high quality training opportunities that address gaps in Palestine's health education system. [ABSTRACT FROM AUTHOR]

The authors discuss a report about teaching environmental sustainability in healthcare. Topics mentioned include the use of disposable equipment packaged in copious amounts of plastic, the need for timetabling to minimize journeys further or incentives for public transport, and general practice as an ideal placement to explore environmental determinants of health and discuss climate change with patients across many generations.