Search

Introduction: Theory papers have been the most commonly employed method to assess learning outcomes in medical education. In these papers, both recall abilities and higher‑order cognitive functions need to be assessed giving proper weightage as per relevance. Hence it becomes necessary that valid assessment methods are employed to evaluate the required objectives/competencies. The objective of the study was to develop a method for analyzing postgraduate question papers of various specialties. Methodology: A rubric matrix was created with three broad objective criteria to assess framing and layout of the questions in each paper, analysis of different sets for same examination, and finally an overall assessment of all the papers for each subject. Results: A total of 28 specialty papers were available. A total number of papers analysed = 340. The overall mean score out of total 60 marks was 38.64 ± 4.5. It was seen that the majority (60%) of the departments have been graded as fair on analysis of the theory papers. None of the departments were graded as very good, while 7% of them were graded as good. Although a very minuscule percentage of the papers had grammatical errors and duplication of questions in the sets, only 57% of the departments had done a proper moderation and 21% had used higher domains of learning for assessment. Conclusion: Analysis of postgraduate question papers showed that the questions asked for postgraduates are more recall‑based instead of higher taxonomy of cognitive domain. [ABSTRACT FROM AUTHOR]

Context: A growing number of health professions schools have implemented programmes for community-based education (CBE) for their students. There are indications, however, that particularly in developing countries, CBE programmes are not always optimally implemented or sustained. Objective: To test the suitability of an established method for curriculum evaluation, combined with a set of generic objectives for CBE programmes, for evaluation of CBE programmes. Methods: As a case study, Coles and Grant's model for curriculum evaluation was applied to the CBE programme of the Medical Faculty of Diponegoro University (MFDU) in Semarang, Indonesia. Document analysis yielded information on the programme on paper; participatory observation and staff interviews on the programme in action. In addition, MFDU's CBE programme was evaluated against a set of generic objectives for CBE programmes recently designed by us. Results: MFDU has created great opportunities for its CBE programme in which, however, also significant weaknesses were revealed. (1) In the community, much time was spent on formal teaching; (2) Students' work in the community was not jointly identified with community members regarding the community's felt health needs; (3) There was rarely continuity, and evaluation or follow-up of the students' work in the community; and (4) No systematic programme evaluations are carried out. Discussion: This evaluation study showed shortcomings in the implementation of MFDU's CBE programme. The major weaknesses identified point at an underutilization of the opportunities and potential jeopardization of the facilities in the community. On the other hand, more time is needed in the CBE programme to establish the health needs to be addressed jointly with the community and to assess the impact of activities undertaken. A thorough review of the CBE programme, perhaps taking the outcomes of this study into account, could turn MFDU's CBE programme into a fine example for other medical schools in Indonesia and beyond. Conclusion: Coles and Grant's method for curriculum evaluation proved suitable for evaluation of a CBE programme in a developing country. After additional comparison with a reference list of objectives for CBE programmes, reasoned suggestions for programme can be made. [ABSTRACT FROM AUTHOR]

Presents the position paper of The Network: Towards Unity for Health (TUFH), an initiative of the World Health Organization (WHO) and the Network, on primary care. Developments in primary care; Best evidence regarding health benefit of primary care; Primary care goals of the initiative; Attributes of primary-care oriented Academic Health Centers (AHC); Primary care innovations of the initiative.

Focuses on multiprofessional education in the health profession. Increasing demands of an elderly population; Emergence of infectious and complex diseases such as HIV/AIDS; Advantages of collaborative learning; Barriers to implementing interprofessional and multiprofessional education, practice and research.

Focuses on the role of problem-based learning in medical education. Community-based medical education; Student-centered inquiry process; Adoption of professional behavior and attitudes.

BACKGROUND: Research in family medicine is important. The objectives of this study were to explore the contribution of family physicians, their attitudes and practice, and the barriers to research in family medicine in Saudi Arabia. MATERIALS AND METHODS: This study was conducted on Saudi family physicians in 2021. A self-administered questionnaire was sent to family physicians through WhatsApp and email. Information sought included demographic data, scientific profile, number of publications, reasons for conducting research, barriers to the conduct of research, attitudes and skills for the conduct of research, and priority areas of research. Data were analyzed using SPSS version 15. Descriptive statistics included mean and standard deviation for continuous variables and frequencies and percentages for categorical variables. Student's t-test was used to compare the means of two groups of physicians. Chi-square test and logistic regression analysis were performed to determine the association between categorical variables. RESULTS: A total of 313 family physicians filled the questionnaire; majority were male (65%), were married (90%), and worked under the Ministry of Health (73%). The total number of publications since graduation was 1165 papers with an average of 3.8 papers per physician. More than 70% were interested in conducting research, and more than two-thirds considered research important to the advancement of family medicine. One-third of the family physicians were currently involved in conducting research, while 30% were supervising at least one research project. The top five areas of priority were chronic diseases, mental health, health promotion, quality of healthcare, and medical education/training; whereas the top five obstacles to the conduct of research were the lack of time, lack of research environment, lack of financial and technical support, and the absence of skills. CONCLUSION: Saudi family physicians make a good contribution to research. The researchers and research bodies should focus on identifying the priority areas for research in family medicine in the next few years and provide support to achieve some of the objectives of the National Vision of 2030. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To provide a cost-saving innovative audience response system (ARS) that permits typing texts and compare its efficiency to the paper-based method in case-based learning (CBL). MATERIALS AND METHODS: Orthodontic clinical cases were presented to 149 undergraduate dental students for discussion among teammates. Responses were collected using ARS-based and paper-based. ARS was constructed from an online survey platform (Google forms) then QR code was created for easy and fast access. Students used their cellphones to scan code, view questions, discuss, type, and submit answers within 10 minutes. Feedbacks were collected using a feedback survey. Outcome measures included the number of words, spelling mistakes, time required by the instructor to read submissions, and activity time compliance. RESULTS: The average number of words submitted by females in ARS-based 47 ± 8 was significantly higher than 35 ± 16 paper-based, and male ARS-based 36 ± 18 (P < 0.05). ARS-based submissions required significantly less time to read compared to paper-based among whole group, females, males (P < 0.001, P < 0.05, P < 0.001), respectively. Spelling mistakes were lower 1 ± 1 in ARS-based compared to paper-based 2 ± 2. The ARS-based first submission was (-4.28) minutes before the deadline, while paper-based last submission was (+2.19) minutes after (P < 0.05). ARS-based submissions were 12.5 seconds faster to read than paper-based (P < 0.001). Out of 56.4% of respondents, 63.1% preferred using ARS-based and 80% agreed that it provided immediate feedback, with high overall satisfaction. CONCLUSIONS: This innovated ARS was found to facilitate CBL. It is superior in time and cost-saving to paper-based and other ARSs. It could be useful in distance learning especially during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Presents abstracts of articles on health education. 'Implementing a communication skills programme in medical schools: needs assessment and programme change,' by Toni Suzuki Laidlaw, Heather MacLeod, David M. Kaufman, Donald B. Langille and Joan Sargeant; 'The effectiveness of a computer-assisted instruction programme on communication skills of medical specialists in oncology,' by Robert L. hulsman, Wynand J.G. Ros,Jacques A.M. Winnbust and Jozien M. Bensing.

This article discusses the importance of statistical analysis in medical research and explores the current state of statistical analysis in research papers published in the Indian Journal of Anaesthesia (IJA). The study found that collaboration with statisticians is widespread among authors, with 36% involving the statistical department of their institutes and 40% engaging private statisticians. However, a significant number of authors (72%) lacked formal training in statistics, highlighting the need for enhanced statistical education in medical research. The study also revealed varying levels of confidence among authors in interpreting and communicating statistical results, emphasizing the importance of targeted training and support. The article concludes that effective collaboration between authors and statisticians can lead to more robust research outcomes and higher-quality publications. [Extracted from the article]

The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250--500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state. [ABSTRACT FROM AUTHOR]

Presents abstracts on Academic Medicine, Medical Education, Medical Teacher and Teaching and Learning in Medicine publications. Factors facilitating the development of community-academic partnership; Establishment of programs for the unity of health professionals and communities; Deterioration of doctor-patient relationship.

Introduction: Quality improvement and performance evaluation have become today's mainstream medical issues, whereas in many areas of medical care, the quality of care services is less than desirable. Objective: To determine a conceptual model for practice-based learning and improvement (PBLI) competency in medicine. Methods: This study was conducted using Walker and Avant's theoretical synthesis method. Articles related to the concept of PBLI were searched using the keywords of practice-based learning and improvement, quality improvement, core competency, medical education, practice-based learning in English, separately and combined in google, google scholar, and Pubmed databases. After identifying the theoretical blocks and variables of each block and communicating them, a visual model of PBLI was presented. After a focused search for each block, a total of 229 full papers were studied and the PBLI model was developed in six conceptual blocks. Results: The visual model that presented in this study shows the relation among six theoretical blocks of PBLI including: Block of approach to PBLI, PBLI process triggers block, gap bridging solutions, PBLI infrastructure block, PBLI sub-competencies block, PBLI academic development block. Conclusions: Nowadays, PBLI is one of the inevitable qualities of medicine that ensures the quality of medical practice, which, in addition to individual requirements, requires a series of technical, strategic, structural, and cultural infrastructures. By utilizing this capability, a physician will be able to discover the knowledge, skills, and performance gaps, and will be able to cope up with their appropriate approaches, thereby improving the quality of their medicine and the care provided and the patient's safety. It can provide satisfaction and trust in society. The model presented in this paper makes it easy to understand the relationships between the various components of this competency. [ABSTRACT FROM AUTHOR]

Objective: There has been an observable trend towards developing medical competency frameworks across the globe. These competency frameworks are intended to improve societal trust in the medical education system in developing appropriately competent medical practitioners. A framework developed by the Royal College of Physicians and Surgeons; Canada has been widely accepted by several institutions across the world. Medical Council of India has also published a similar framework of medical competencies. Most of these frameworks does not consider ancient Indian frameworks which have existed for several thousand years. Current paper examines the medical competency frameworks from ancient India and compares it with current frameworks. Method: A review of literature available in reputable libraries and online on the medical competency framework from ancient India has been attempted. Key words including 'competency framework, medical framework, ancient India and fully equipped physician' were used. Results: A medical competency framework was written and implemented more than two thousand years ago. The framework identified key competencies including: Medical expertise, Communication skills, Scholar, Health advocacy and Professionalism. This framework was used for medical practitioners at the time and used during the training and subsequent medical practice. Conclusion: There is striking similarity between ancient Indian and current model of competency framework. Teachings and wisdom from ancient India can prove invaluable while developing future medical competency frameworks. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The McNamara fallacy refers to the tendency to focus on numbers, metrics, and quantifiable data while disregarding the meaningful qualitative aspects. The existence of such a fallacy in medical education is reviewed in this paper. Competency-based medical education (CBME) has been introduced in India with the goal of having Indian Medical Graduates competent in five different roles – Clinician, Communicator, Leader and member of the health care team, Professional, and Lifelong learner. If we only focus on numbers and structure to assess the competencies pertaining to these roles, we would be falling prey to the McNamara fallacy. To assess these roles in the real sense, we need to embrace the qualitative assessment methods and appreciate their value in competency-based education. This can be done by using various workplace-based assessments, choosing tools based on educational impact rather than psychometric properties, using narratives and descriptive evaluation, giving grades instead of marks, and improving the quality of the questions asked in various exams. There are challenges in adopting qualitative assessment starting with being able to move past the objective–subjective debate, to developing expertise in conducting and documenting such assessment, and adding the rigor of qualitative research methods to enhance its credibility. The perspective on assessment thus needs a paradigm shift – we need to assess the important rather than just making the assessed important; and this would be crucial for the success of the CBME curriculum. [ABSTRACT FROM AUTHOR]

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, ‘What will be the three top public health priorities in India to support family resilience in the 21st century?’ as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master’s in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable. [ABSTRACT FROM AUTHOR]

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them. [ABSTRACT FROM AUTHOR]

Background: Childhood pneumonia is one of the leading causes of mortality among under-five children. It is responsible for 15% of all deaths of children U5, killing 808,694 children in 2017 (1). Traditional visual inspection and manual count method is used to detect and classify fast-breathing, a key indicator of Pneumonia. In response to UNICEF's call for a reliable diagnostic tool, Philips was the first to respond with the Children's Automatic Respiratory Monitor for measuring fast breathing objectively. Aim: UNICEF and Philips Foundation initiated a field study to test the acceptability, usability and efficacy of the Automatic Respiratory Monitor in Determining Fast Breathing in low resource setting environments. Settings and Design: Philips Foundation partnered up with the Directorate of Medical Education in West Bengal, India to conduct the field study amongst community healthcare workers and beneficiaries in a rural district of West Bengal. In collaboration with North Bengal Medical College & Hospital, a community-based study was conducted in a tribal tea garden of Naxalbari block. Methods and Material: Acceptability and usability of the device was assessed through structtured interviews and dialogues with community health workers (CHWs), caregivers and local healthcare practitioners. Efficacy of the device was represented by the inter-rater agreement between the traditional visual inspection and manual count method and the device reading. Statistical Analysis Used: A descriptive community based mixed method study was conducted. Satisfaction among community healthcare workers (CHWs) and beneficiaries was found to be promising across all study parameters. Results and Conclusions: The paper captures the study methods, statistical analysis of the data, the conclusions, areas of further research and recommends community-wide use of the device in objectively measuring fast breathing among children under the age of five years. [ABSTRACT FROM AUTHOR]

Cultural competency is a wide notion with a variety of academic bases and differing perspectives on how it should be implemented. While it is widely acknowledged that cultural competency should be an element of general practise, there is a paucity of literature in this area. It has been commonly claimed that cultural competency is a fundamental prerequisite for working well with persons from different cultural backgrounds. Medical students must learn how to connect successfully with patients from all walks of life, regardless of culture, gender, or financial background. Hence, National Medical Council (NMC) has included cultural competence as a course subject in the curriculum of medical education. The opportunities and concept of Competency Based Medical Education, the inclusion of cultural competency in medical course by NMC, various models and practice skill of cultural competence in medical education are discussed in this paper. This study will be useful to researchers who are looking at cultural competency as a research variable that influences study result. [ABSTRACT FROM AUTHOR]

The knowledge and the beliefs on medical education influence the teaching-learning approach used by medical educators and their perception of students' ability to be active learners. This paper highlights the student-centred teaching methods used by the medical educators of the Faculty of Medicine and Defence Health, National Defence University of Malaysia for undergraduate medical student teaching, their medical education approach in teaching and their perception on students' performance. [ABSTRACT FROM AUTHOR]

Almost every institution and academic medical center has its own simulation center today. It seems to have become a prerequisite and is incorporated into the guidelines of setting up new centers as well as in the upgrading and enhancement plans of existing institutions. In considering this, it is critical to consider the needs and demands of the healthcare population and staff the center will be serving. Setting up a simulation center is not an endeavor to be undertaken lightly. It entails a sustainable commitment in terms of political will, professional, educational and financial commitments. On the other hand, setting up a simulation center can be the most worthwhile and rewarding experience if the objectives and goals are met and effective learning occurs. The latter is an important element to be considered in the step toward nurturing an effective healthcare practitioner. In this paper, the principle author, who is the Director of the SingHealth Duke NUS Institute of Medical Simulation (SIMS) in Singapore, shares her views and experience of leading a world-class simulation facility. She has been involved in SIMS from its conception and is a strong advocate of medical education and lifelong learning. At the end of this paper, she shares a Checklist which puts together all the important considerations for anyone or any institution what is looking at setting up a simulation facility, a simulation-based training program, or even upgrading and upscaling their current simulation centre. [ABSTRACT FROM AUTHOR]

Caregivers, or persons who provide unpaid support to a loved one who could not manage to live independently or whose health or well-being would deteriorate without this help, are increasingly common. These rates have only increased with the COVID-19 pandemic forcing many to care for sick family members in the short or long term. Unfortunately, caregiving is associated with significant burden and health risks, not only for caregivers themselves but also for the care recipients of overwhelmed caregivers. These risks have also been exacerbated by the social isolation of the COVID-19 pandemic. Although interventions exist which have been proven to reduce caregiver burden, education on these interventions is lacking, partly because there has not been a memorable framework on how to care for caregivers. In this paper, an innovative framework to teach clinicians about caring for caregivers is introduced, the C.A.R.E. framework: Caregiver well-being, Advanced care planning, Respite, and Education. This simple framework will help providers become aware of caregiver needs, comfortable in addressing their needs, and able to suggest interventions proven to reduce caregiver burden. Knowledge of this framework should start with medical students so that they can incorporate this critical aspect of primary care into their clinical practice early on in their careers. If providers can simply remember to perform these four interventions, to C.A.R.E. for our caregivers, then they will make a significant impact on the lives of both our patients and their loved ones, during the present COVID-19 pandemic and thereafter. [ABSTRACT FROM AUTHOR]

Background: Properly constructed single best-answer multiple choice questions (MCQs) or items assess higher-order cognitive processing of Bloom's taxonomy and accurately discriminate between high and low achievers. However, guidelines for writing good test items are rarely followed, leading to generation and application of faulty MCQs. Materials and Methods: During lockdown period in 2020, internal assessment was taken through online mode using Google Forms. There were 60 'single response type' MCQs, each consisting of single stem and four options including one correct answer and three distractors. Each item was analyzed for difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE). Results: The mean of achieved marks was 42.92± (standard deviation [SD], 5.07). Dif I, DI, and DE were 47.95± (SD 16.39) in percentage, 0.12± (SD 0.10), and 18.42± (SD 15.35), respectively. 46.67% of the items were easy and 21.66% were of acceptable discrimination. Very weak negative correlation was found between Dif I and DI. Out of total 180 distractors, 51.66% were nonfunctional one. Conclusion: Item analysis and storage of MCQs with their indices provides opportunity for an examiner to select MCQs of appropriate difficulty level as per the need of assessment and decide their placement in the question paper. [ABSTRACT FROM AUTHOR]

The uncertainty in all spheres of higher education due to the COVID-19 pandemic has had an unprecedented impact on teaching–learning and assessments in medical colleges across the globe. The conventional ways of assessment are now neither possible nor practical for certifying medical graduates. This has necessitated thoughtful considerations in making adjustments to the assessment system, with most institutions transitioning to online assessments that so far have remained underutilized. Programmatic assessment encourages the deliberate and longitudinal use of diverse assessment methods to maximize learning and assessment and at present can be utilized optimally as it ensures the collection of multiple low-stake assessment data which can be aggregated for high-stake pass/fail decisions by making use of every opportunity for formative feedback to improve performance. Though efforts have been made to introduce programmatic assessment in the competency-based undergraduate curriculum, transitioning to online assessment can be a potential opportunity if the basic tenets of programmatic assessment, choice of online assessment tools, strategies, good practices of online assessments and challenges are understood and explored explicitly for designing and implementing online assessments. This paper explores the possibility of introducing online assessment with face-to-face assessment and structuring a blended programmatic assessment in competency-based medical education. [ABSTRACT FROM AUTHOR]

Written examinations are a predominant part of the assessment in Indian medical colleges and are used in the assessment of all types of learning or cognitive knowledge. Written tests are used to provide feedback and to measure the sufficiency of learning to proceed in the curriculum. It is best used to assess on "Knows" and "Knows how" of Miller's Pyramid. Traditional short- and long-essay items are not structured; there is no cross-checking of the set paper by the subject expert. There is a problem of undersampling or oversampling of content and items do not test the problem-solving abilities of students. Usually, questions are based on simple recall and knowledge is not tested in depth. Subjective scoring, rater bias, bluffing, flawed format, and idiosyncratic jargons are the other threats to the validity. This article describes the solutions to address limitations of traditional written examination based on the review of the current literature. Structuring long and short essay questions, preparing blueprint of the content, scoring rubrics, model answers, training the subject experts, and using multiple subject expert raters are the most important steps to address the validity threats and to make assessment more objective and focused. Uniform, bias-free assessment boosts confidence and results in positive impact on the academic performance of students. [ABSTRACT FROM AUTHOR]

Presents selected abstracts of papers from various health journals published as of November 2002. 'Our Compact With Tommorow's Doctors,' by Jordan J. Cohen, published in 'Academic Medicine'; 'Understanding Social Influence in Medical Education,' by Michael Wilkes and Bertram H. Raven, published in the 'Academic Medicine.'

Relationships do matter! In fact, medicine cannot be learned without them, and community-based medical education (CBME) curricula that ignore them or take them for granted do so at their students peril! Could these assertions provide a key to quality in CBME curricula? In a previous paper, I provided evidence for a simple model of four key relationships, the four Rs, to act as a framework to analyse CBME. These four Rs are the relationships between (1) clinicians and patients, (2) health service and university research, (3) government and community, and (4) personal principles and professional expectations. In this paper I describe a key to discerning quality in this model. This key is integrity - that coalition of soundness and interdependence that enables the quality of the whole to be greater than the sum of the parts. I will also discuss the implications of this model for CBME with particular reference to reform of student selection, curricular goals, course structure, and assessment. Whilst further research based on this model is needed, as a result of this synthesis of the current medical education literature, I propose that it is its capacity to produce clinical, social, institutional and interpersonal integrity in its graduates that makes communitybased medical education such an attractive alternative. Relationships do matter! [ABSTRACT FROM AUTHOR]

This paper discusses the impact of the community-based medical school on mental health services. The Gezira mental health programme represents a collaborative work involving the university, the community and the government. It aims at achieving specified objectives: (1) to modify community concepts, attitudes and practices concerning mental health, (2) to ensure community involvement and participation, (3) to extend mental health services, (4) to train PHC staff, and (5) to encourage research. The programme was implemented in three phases: preparatory, implementation, and evaluation. In the evaluation of the impact of the programme on changing community attitudes, the training of staff, the extension of mental health services, and on research, qualitative assessment, through interviews, focus group discussion, supervision visits, and review of reports are used. There is an overall agreement that the programme helped in raising public awareness regarding the concept of mental health, the care of the mentally ill and community participation. Members of the health team who received training as part of the programme reported a better understanding of mental health problems and an improvement in their handling of the mentally disturbed patients. Teachers reported an increased awareness of mental health problems in school children and a better collaboration with those involved in the handling of such problems. Social workers and psychologists updated their knowledge and skills and were well prepared to participate in the programme. Members of the different sectors involved reported a better standard of collaboration regarding mental health activities. These findings indicate that this programme, by providing a new model for health services in this field, has induced a large policy change within the Sudan. The community-based activities at the FMUG have resulted in a major change in the delivery of mental health services in Gezira State. The programme has resulted in a major shift in mental health services being provided by central hospitals to PHC settings. In addition it has stimulated research, thereby providing much original information that will help in preparing for future plans. [ABSTRACT FROM AUTHOR]

Introduction: A key concept for general practice nowadays is that of patient-centred medicine. In this model the physician's aim is to integrate the patient's experience of illness with the conventional understanding of disease, trying to reconcile the patient's agenda with his/her own. This paper describes a preliminary experience of a CME course on patient-centred medicine in Italy. Aim and Methods: The article focuses on a 7 hour course for teaching patient-centred medicine to Italian general practitioners. Assessment of the course was done both in terms of learner satisfaction and efficacy. Learner satisfaction was evaluated by a questionnaire with a 6-point Likert scale and course efficacy by a pre/post-paper-and-pencil test. Findings and Discussion: The pilot course on patient-centred medicine seems to obtain high satisfaction in participants. Furthermore, an increase in competence with regards to patient-centredness resulted after the course. The pilot study represents the first Italian CME seminar on patient-centred medicine. Results obtained both in terms of satisfaction and efficacy suggest that the CME course is a valid educational tool. The opportunity to extend the experience to a higher number of participants is therefore recommended. [ABSTRACT FROM AUTHOR]

There is increased awareness and anxiety in conducting research for publication and at the same time ignorance about getting Ethical Committee clearance at least in Anatomy Departments among Basic Medical Sciences. While people are actively presenting papers, collect data, Indian Council for Medical Research guidelines does not cover aspects pertaining to Anatomy oriented research activities. This review article is an eye opener for fraternity in the medical field, especially in anatomy. [ABSTRACT FROM AUTHOR]

The authors comment on the decision of the Medical Council of India (MCI) to require the publication of research in the promotion of medical faculty. They discuss ways on how medical faculty can engage in research, highlight the MCI's revised guidelines for academic promotion, and suggest the removal of ambiguities in the new guidelines. The belief that the quality of teaching improves when medical teachers are involved in research is cited.

Journal Impact Factor (JIF) has been used in assessing scientific journals. Other indices, h- and g-indices and Article Influence Score (AIS), have been developed to overcome some limitations of JIF. The aims of this study were, first, to critically assess the use of JIF and other parameters related to medical education research, and second, to discuss the capacity of these indices in assessing research productivity as well as their utility in academic promotion. The JIF of 16 medical education journals from 2000 to 2011 was examined together with the research evidence about JIF in assessing research outcomes of medical educators. The findings were discussed in light of the nonnumerical criteria often used in academic promotion. In conclusion, JIF was not designed for assessing individual or group research performance, and it seems unsuitable for such purposes. Although the g- and h-indices have demonstrated promising outcomes, further developments are needed for their use as academic promotion criteria. For top academic positions, additional criteria could include leadership, evidence of international impact, and contributions to the advancement of knowledge with regard to medical education. [ABSTRACT FROM AUTHOR]

Competency-based medical education curriculum (CBME) has received traction worldwide. However, its adoption and implementation have significantly varied across the globe. The National Medical Commission, India (2019) has adopted CBME to improve the quality and content of training of medical students. However, the ongoing COVID-19 pandemic has spawned several challenges implementing the CBME. Therefore, there is a need to reflect on using novel teaching and assessment methods to enrich medical and psychiatric training. In this paper, we aimed to study global trends and characteristics of competency-based psychiatry training programs and how these experiences can be utilized to overcome challenges and facilitate the implementation of CBME in Psychiatry in the Indian context. A literature search was conducted using PubMed and Google Scholar databases. The findings are presented narratively. Psychiatry training for medical students greatly vary across the globe. High-income countries mainly have implemented CBME and have incorporated psychiatry training during the foundation/pre-clerkship period itself. There is more reliance on skill development and flexible and learning-based training vs. time-based training. Various enrichment activities have been incorporated into the medical curriculum to promote and strengthen psychiatry training for medical students, particularly in developed nations, which have yielded positive results. Although the COVID-19 pandemic has adversely affected the medical student's training, it has reiterated the significance of skill-based education and opened novel avenues for implementing the CBME. Medical educationists need to adapt themselves to provide CBME to the students. Making structural, curricular changes, orienting teachers, and students about the CBME, mentoring teachers, adopting novel training and assessment methods, utilizing enrichment activities, collaborating with educational institutions and technology providers, periodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. In addition, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives.eriodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. Additionally, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives. [ABSTRACT FROM AUTHOR]

Teaching anatomy is an important but expensive part of the medical curriculum, potentially more than many countries can afford. In the search for efficient methods, cost‑effectiveness is of utmost importance for such countries. The aim of this contribution is to provide a review of the literature on anatomy teaching methods, evaluating these for feasibility in resource‑deprived countries. Methods: A literature review was carried out to identify distinct approaches to anatomy teaching published in the period 2000–2014, using the databases of PubMed, Wiley Online Library, Elsevier, HINARI, Springer, and ERIC. The approaches found were compared against their conceptual, operational, technical, and economic feasibility and Mayer's principles of effective instruction. Results: Our search yielded 432 papers that met the inclusion criteria. We identified 14 methods of teaching anatomy. Based on their conceptual feasibility, dissection and technology enhanced learning approaches appeared to have more benefits than others. Dissection has, besides benefits, many specific drawbacks. Lectures and peer teaching showed better technical and economic feasibility. Educational platforms, radiological imaging, and lectures showed the highest operational feasibility. Dissection and surgery were found to be less feasible with regard to operational, technical, and economic characteristics. Discussion: Based on our findings, the most important recommendations for anatomy teaching in seriously resource‑deprived countries include a combination of complementary strategies in 3 different moments, lecturing at the beginning, using virtual learning environment (for self‑study), and at the end, using demonstration through prosected specimens and radiological imaging. This provides reasonable insights in anatomy through both dead and living human bodies and their virtual representations. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to determine the validity and reliability of a questionnaire tool for measuring students' attitudes toward components relevant to research training programs in the Kingdom of Saudi Arabia. Materials and Methods: The paper reports the responses of 564 Saudi Arabian students from seven government universities to the questionnaire comprising 16 items on 3 conceptual subscales, which measured students' attitude to research activities in the college; students' opinion of faculty involvement in research; and infrastructural facilities in the college. The results of this study provide the final scale, with all the 16 items of the initial Likert scale, for which strong evidence was obtained. Results: Results indicated that the students' attitude toward the research (SAR) scale had three latent factors, which explained 62% of the variance: The three subscales measured includes: (i) Research activities offered in the college, (ii) students' opinion of faculty involvement in research, and (iii) infrastructural facilities offered in the college for research. The full scale including three subscales had good internal consistency (rs = 0.72 and α = 0.77 for full scale; and a between 0.71 and 0.79 for three subscales). Conclusion: This study provides evidence of reliability and validity of the SAR scale for the measurement of students' attitudes toward research training programs in Saudi Arabian Universities. The research findings will provide the basis for further research on health science students. [ABSTRACT FROM AUTHOR]

Background: The Dubai Residency Training Program (DRTP) is a structured postgraduate educational training program started on 1992 to improve healthcare in the United Arab Emirates (UAE) through education and training; align doctors' training in the UAE with internationally recognized standards; deliver educational best practice; and achieve a balance between clinical service delivery and continuing professional development. The aim of this paper is to review the experiences, challenges and outcomes of the DRTP over the last 25 years. Methods: All documentation relating to the DRTP was reviewed and reevaluated. Results: The DRTP has become a very solid foundation; yet, one of the major challenges we are facing is containing the balance between the health service and education. Another challenge is that our capacity for training is limited, in spite of demand, we are not yet able to open all specialties needed in the UAE. Finally, there is a mandate to separate the educational body from service to better govern the education. Conclusions: The time has come, however, for the UAE to have its own medical specialty board. This would further support high quality, comprehensive specialty training to deliver the bespoke workforce required by the Dubai Health Authority. The concept of structured training where the resident knows what, when, and how to learn the required knowledge and skills is already established, and the UAE has the required numbers of highly trained professionals to form the board. Nevertheless, we should neither be complacent nor underestimate the challenges that remain to deliver the UAE specialty board. [ABSTRACT FROM AUTHOR]

Acquiring adequate resources for anatomy education has represented a challenge throughout the discipline's long history. A significant number of collections housed in anatomy departments contain human tissue of unknown provenance with some obtained in morally dubious ways. This paper outlines the history and future prospects of one such anatomical assemblage - the Burns Anatomical Collection, currently housed at the University of Maryland (UM). The collection originally contained more than 1000 anatomically prepared mummified human remains. They were produced by the renowned Scottish anatomist Allan Burns in Glasgow in the late eighteenth and early nineteenth centuries. The prepared cadavers became a commodity and after Burns' death, were acquired by his pupil Granville Pattison, who later sold them to the UM. While the origin of these human remains is unknown, historical data suggests that most of the cadavers for the collection were obtained through grave robbing. While intensely used in anatomy teaching in the nineteenth century, specimens from the collection should now be treated primarily as historical artifacts, appropriate only for teaching medical history and ethics. Other perspectives may include repatriating and reburying the human remains and providing a memorial service. Most importantly, this collection and others similar to it should initiate dialog and reflection on the ethical aspects of the past and present medical practice. [ABSTRACT FROM AUTHOR]

The quality of training is a major contributor to workforce proficiency in healthcare, and there is a definite need to achieve a uniform level of knowledge and skill in medical education programmes. There is a paucity of literature comparing postgraduate anaesthesia medical education training structure and requirements across the globe. In a zeal to achieve uniform competencies and technical skills, the strengths and scope of training programmes need to be identified. In this article, we describe the core elements of postgraduate training in various countries while proposing an amalgamation of strengths of each programme and providing a roadmap to evolve further the competency-based comprehensive curriculum proposed by the National Medical Commission of India. [ABSTRACT FROM AUTHOR]

The National Board of Examinations was established to boost the quality of medical education by laying down exclusive norms, uniform standards and a national level evaluation for the postgraduate medical courses. The content and context of the training curriculum is well updated as per advances in the field and current requirements. Diplomate of National Board (DNB) courses are considered to be at par with the postgraduate and post doctorate degrees for all intents and purposes. The introduction of a formative assessment with objective evaluation pattern has improved the scope of the board. Moving on to a competency-based training with emphasis on novel research can maximise the quality of training to international standards. Training DNB teachers and assessors in the newer teaching and assessment methods can improve the calibre of residents. Stringent monitoring and review of the training can increase the credibility of the courses and the board can be expected to cater for students abroad. [ABSTRACT FROM AUTHOR]

Purpose: The coronavirus disease (COVID)-19 pandemic put medical residency programs in a predicament, impacting clinical attention and surgical practice. This study aims to describe the adjustments applied in an ophthalmology residency program to overcome the COVID-19 pandemic restrictions. Materials and Methods: An observational, comparative, and descriptive study was performed in an ophthalmology residency program to analyze the adaptations and innovations implemented to overcome the medical attention and training restrictions enforced by the sanitary authorities due to the COVID-19 pandemic in the year 2020. The residents' record folders were analyzed yearly for academic, research, clinical, and surgical activities from 2018 to 2020. An online survey was applied to residents for congress attendance, research publications, time spent on classes, lectures, clinical cases, journal club, and surgical videos sessions during the pandemic. Results: Compared to years 2018 and 2019, during 2020, there was a significant increase in the hours destined per week to academic activities (6.04 vs. 16.42 h, P < 0.001); the monthly hours of journal club sessions (0.5 vs. 3.41 h, P < 0.001); and the number of published articles involving residents (0.4 vs. 2.52, P < 0.001). On the contrary, the hours of outpatient consultation (8 h/day vs. 4 h/day) and the number of cataract surgeries performed per resident decreased (48 vs. 15, P < 0.001) from 2019 to 2020. Conclusions: Prompt reaction and innovation were required to overcome the educational and training barriers imposed by the COVID-19 pandemic. While remote academic activities increased significantly, online patient consultation and surgical simulation were necessary to avoid hindering patient's attention and surgical training. [ABSTRACT FROM AUTHOR]

As medicine grows in complexity, it is imperative for physicians to update their knowledge base and practice to reflect current standards of care. Postgraduate training offers a golden opportunity for resident physicians to create a strong foundation of concepts in medicine. There is a need for assessing the knowledge of residents regarding established clinical practice guidelines and their perceptions regarding patient care and management. In this paper, we review how questionnaire surveys can be designed and applied to identify significant gaps in resident knowledge and inappropriate attitudes and beliefs. This evaluation has important implications for program directors who can then initiate measures to improve resident education. Such efforts during residency training have the potential of improving patient outcomes. We discuss the design of the questionnaire, its pre-testing and validity measures, online distribution, efficient response collection, data analysis, and possible future research. Finally, we illustrate this method of educational research with a questionnaire survey designed to measure the awareness of chronic kidney disease among internal medicine residents. [ABSTRACT FROM AUTHOR]

The article presents a paper on the initiative on curriculum development of the community-oriented medical education curriculum in Pakistan. The paper describes the procedure used in developing the curriculum, training of faculty, and the main features of the curriculum. The medical colleges, stakeholders, Pakistani Ministry of Health, World Health Organization, the Community-Oriented Medical Education project collaborated in designing the curriculum. Emphasis was given on conducting undergraduate medical education at primary and secondary healthcare facilities.

Context: Emergence and burgeoning of specialized health care structures have contributed to the diversity in health services. Inadvertently, the separation and resultant independent functioning of health and rehabilitation organizations have impeded opportunities for health care workers to interact with one another. Consequently, providers may lack knowledge on available health services within communities in which they preside. Educational approaches that can assist health professionals improve awareness of services across organizational divides are needed. Objectives: The new International Classification of Functioning Disability and Health (ICF), offers a multidimensional view of health, which can be used in education sessions to increase provider awareness of how health is mediated across health paradigms. This paper explores the conceptual basis of the ICF and its use in promoting a broader view of health essential for treating consumers with complex health problems and enhancing knowledge sharing amongst professionals. Methods: A single case study design is used to demonstrate how the ICF's conceptual framework offers providers a means to promote mutual understanding of differences in health services and to assist them in sharing knowledge on the services provided with others. Conclusion: Conceptually, the ICF can be used as a basis for structuring interorganizational educational initiatives to increase knowledge sharing amongst organizations and health care workers. In addition, introducing health professionals to a multidimensional view of health can assist them to understand the breadth of health services in the community and to consider a more comprehensive set of health determinants and dimensions in caring for consumers. [ABSTRACT FROM AUTHOR]

Context: Written communications have a long history in medicine. Today, doctors spend a significant part of their work time completing paper work. Although the importance of accurate written communications is acknowledged, medical curricula rarely include focused teaching on this topic. Objectives: The aim of this paper is to assess the feasibility of a teaching session for second-year medical students aimed at raising their awareness of written communications in the context of health care. Methods: Immediately after the session, students and tutors completed written evaluations of their experiences. Four months after the session the entire cohort completed a knowledge test, and scores of attendees and non-attendees were compared. Findings: Three of four learning objectives were completely met by at least half of the students and the exercises were rated as helpful. Students' and tutors' comments identified specific aspects of the session that require improvement, in particular, developing the exercise on patient-centred written communications. Students who attended the session scored significantly higher in a relevant knowledge test than non-attendees. Discussion: The session provided students with the knowledge to identify patient-centred written communications and other features of effective writing in the context of medical care. Conclusions: Introducing the topic early in the medical curriculum may prove valuable in establishing effective practice. Providing students with opportunities to revisit this important topic throughout their medical education may also be beneficial. The long-term impact of the session needs to be evaluated. [ABSTRACT FROM AUTHOR]

This paper assumes the reader (1) has little knowledge about program evaluation, and (2) is interested in evaluation to improve a community-based health professions education program. There are other important and useful approaches that can be used to address an evaluation of a community-based health professions education program, and readers are encouraged to explore them - they appear in health education, public health education, in evaluation, and in program theory literature. The paper is organized around a group of questions as a reference or organizer for the reader. These include topics like why evaluation is wanted, what kinds of questions can be addressed through evaluation, who stakeholders are, who should conduct the evaluation, what methods can be used, and how to analyze data and report results from the evaluation. In the paper, I have attempted to include examples that are related to community-based health professions programs. Finally, the paper ends with the recognition that there is much more to learn in the field of evaluation and suggestions for ways to continue pursuit of knowledge in this topical area. [ABSTRACT FROM AUTHOR]

This paper outlines a case for a new approach to the education of future professionals. The magnitude and potential seriousness of changes to be anticipated in the first half of the new century challenge institutions of higher education to prepare their students to become able to adapt themselves to change and to participate in the management of change - not only in relation to their own profession, but more widely for the benefit of society at large. The Network of Community-Oriented Educational Institutions for Health Sciences is planning three major programs which are designed to help meet this challenge in the 21st century. The first of these programs will set out to identify generic competencies that are needed for adapting to change and for participating in managing change. This is to include not only profession-specific changes, but also changes that affect the well-being of society as a whole. The second program will address the related need to develop educational interventions that are designed to foster competencies for interprofessional and intersectoral collaboration. The third of these programs accepts that serious attention to effective education for the professions will require institutionalization of recognition and reward of creativity and commitment in education. [ABSTRACT FROM AUTHOR]

Background: Health professional students from high-income countries increasingly participate in short-term experiences in global health (STEGH) conducted abroad. One common criticism of STEGH is the inherent power differential that exists between visiting learners and the local community. To highlight this power differential, this paper explores perceived benefits as described by volunteer and community respondents and applies Maslow's hierarchy of needs to commonly identified themes in each respondent group. Methods: A semistructured survey was used to collect qualitative responses from both volunteers and community members located in a Dominican Republic community, that is, a hotspot for traditionally conducted STEGH. Thematic analysis identified themes of perceived benefits from both respondent groups; each group's common themes were then classified and compared within Maslow's hierarchy of needs. Results: Each respondent group identified resource provision as a perceived benefit of STEGH, but volunteer respondents primarily focused on the provision of highly-skilled, complex resources while community respondents focused on basic necessities (food, water, etc.) Volunteer respondents were also the only group to also mention spiritual/religious/life experiences, personal skills development, and relationships as perceived benefits. Applying Maslow's hierarchy thus demonstrates a difference in needs: community respondents focused on benefits that address deficiency needs at the bottom of the hierarchy while volunteers focused on benefits addressing self-transcendence/actualization needs at the top of the hierarchy. Conclusions: The perceived difference in needs met by STEGH between volunteers and the host community within Maslow's hierarchy may drive an inherent power differential. Refocusing STEGH on the relationship level of the hierarchy (i.e., focusing on partnerships) might help mitigate this imbalance and empower host communities. [ABSTRACT FROM AUTHOR]