Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

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Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study

BMC Medical Education ◽

10.1186/s12909-021-03085-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Maximiliano Servin-Rojas ◽

Antonio Olivas-Martinez ◽

Michelle Dithurbide-Hernandez ◽

Julio Chavez-Vela ◽

Vera L. Petricevich ◽

...

Keyword(s):

Medical Education ◽

Public Schools ◽

Medical Students ◽

Private Schools ◽

Clinical Training ◽

Online Survey ◽

Medical Training ◽

Clinical Instruction ◽

Cross Sectional ◽

The Impact

Abstract Background The COVID-19 pandemic has brought unprecedented changes to medical education. However, no data are available regarding the impact the pandemic may have on medical training in Mexico. The aim of our study was to evaluate and identify the medical school students’ perceptions of the changes in their clinical training due to the pandemic in Mexico. Methods This was a cross-sectional study where a previous validated online survey was translated and adapted by medical education experts and applied to senior medical students from March to April of 2021. The 16-item questionnaire was distributed online combining dichotomous, multiple-choice, and 5-point Likert response scale questions. Descriptive and multivariate analyses were performed to compare the student’s perceptions between public and private schools. Results A total of 671 responses were included in the study period. Most participants were from public schools (81%) and female (61%). Almost every respondent (94%) indicated it was necessary to obtain COVID-19 education, yet only half (54%) received such training. Students in private schools were less likely to have their clinical instruction canceled (53% vs. 77%, p = 0.001) and more likely to have access to virtual instruction (46% vs. 22%, p = 0.001) when compared to students from public schools. Four out of every five students considered their training inferior to that of previous generations, and most students (82%) would consider repeating their final year of clinical training. Conclusions The impact of the COVID-19 on medical education in Mexico has been significant. Most final-year medical students have been affected by the cancellation of their in-person clinical instruction, for which the majority would consider repeating their final year of training. Efforts to counterbalance this lack of clinical experience with virtual or simulation instruction are needed.

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Medical educators’ beliefs about teaching, learning, and knowledge: development of a new framework

BMC Medical Education ◽

10.1186/s12909-021-02587-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marleen W. Ottenhoff- de Jonge ◽

Iris van der Hoeven ◽

Neil Gesundheit ◽

Roeland M. van der Rijst ◽

Anneke W. M. Kramer

Keyword(s):

Medical Education ◽

Faculty Development ◽

Medical Schools ◽

Structural Basis ◽

Educational Beliefs ◽

Beliefs About Teaching ◽

Medical Educators ◽

Teaching Learning ◽

New Framework

Abstract Background The educational beliefs of medical educators influence their teaching practices. Insight into these beliefs is important for medical schools to improve the quality of education they provide students and to guide faculty development. Several studies in the field of higher education have explored the educational beliefs of educators, resulting in classifications that provide a structural basis for diverse beliefs. However, few classification studies have been conducted in the field of medical education. We propose a framework that describes faculty beliefs about teaching, learning, and knowledge which is specifically adapted to the medical education context. The proposed framework describes a matrix in which educational beliefs are organised two dimensionally into belief orientations and belief dimensions. The belief orientations range from teaching-centred to learning-centred; the belief dimensions represent qualitatively distinct aspects of beliefs, such as ‘desired learning outcomes’ and ‘students’ motivation’. Methods We conducted in-depth semi-structured interviews with 26 faculty members, all of whom were deeply involved in teaching, from two prominent medical schools. We used the original framework of Samuelowicz and Bain as a starting point for context-specific adaptation. The qualitative analysis consisted of relating relevant interview fragments to the Samuelowicz and Bain framework, while remaining open to potentially new beliefs identified during the interviews. A range of strategies were employed to ensure the quality of the results. Results We identified a new belief dimension and adapted or refined other dimensions to apply in the context of medical education. The belief orientations that have counterparts in the original Samuelowicz and Bain framework are described more precisely in the new framework. The new framework sharpens the boundary between teaching-centred and learning-centred belief orientations. Conclusions Our findings confirm the relevance of the structure of the original Samuelowicz and Bain beliefs framework. However, multiple adaptations and refinements were necessary to align the framework to the context of medical education. The refined belief dimensions and belief orientations enable a comprehensive description of the educational beliefs of medical educators. With these adaptations, the new framework provides a contemporary instrument to improve medical education and potentially assist in faculty development of medical educators.

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Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison

Human Resources for Health ◽

10.1186/s12960-021-00629-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Wafa Aftab ◽

Mishal Khan ◽

Sonia Rego ◽

Nishant Chavan ◽

Afifah Rahman-Shepherd ◽

...

Keyword(s):

Medical Education ◽

Health Systems ◽

Clinical Training ◽

Medical Training ◽

Grey Literature ◽

Analytical Framework ◽

Online News ◽

Country Comparison ◽

Education Delivery ◽

The Right

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.

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Health student regard for substance-using patients as measured by the Medical Condition Regard Scale: a systematic review

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2017.8 ◽

2017 ◽

Vol 34 (3) ◽

pp. 183-196 ◽

Cited By ~ 1

Author(s):

K. Ducray ◽

M. Pilch

Keyword(s):

Clinical Training ◽

Medical Condition ◽

Personal Exposure ◽

Ethical Practice ◽

Clinical Placements ◽

Health Practitioners ◽

Mental Health Difficulties ◽

Drug Problems ◽

The Impact

ObjectivesAs clinical impartiality is an accepted basic principle of ethical practice, any proactive exercises that may inform selection, training, clinical placements, and other interventions, which promote future positive and equitable professional conduct, thus guarding against future discriminatory attitudes are germane. Within this context, the purpose of this review was to identify trends and patterns in health student, namely future practitioners’, regard for substance-using patients using the Medical Condition Regard Scale.MethodsSix electronic databases were systematically searched for studies that used the Medical Condition Regard Scale as an outcome measure in assessing health student regard for drug-using patients. Academics who had published in this area were also consulted to recommend texts that would complement the above citation sourcing process. Following an elimination of duplicates, the application of inclusion and exclusion criteria, as well as conducting citation searches, 16 studies were incorporated in the final review. Although the quality of all included studies was satisfactory, no study was free from a potential source of bias.ResultsThis review found that patients with drug-use problems were consistently held in the lowest echelons of regard by trainee health practitioners. The impact of sex, age, year of course, and personal exposure to mental health difficulties in predicting negative regard was unclear.ConclusionsUnless addressed, patients with drug problems may have a high potential for future treatment marginalisation by tomorrow’s health professionals. This scenario needs to be proactively managed by all stakeholders through a greater investment in educational and clinical training placement opportunities.

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Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners

Canadian Medical Education Journal ◽

10.36834/cmej.71149 ◽

2021 ◽

Author(s):

Allison Brown ◽

Aliya Kassam ◽

Mike Paget ◽

Kenneth Blades ◽

Megan Mercia ◽

...

Keyword(s):

Medical Education ◽

Medical Training ◽

Well Being ◽

World Health ◽

Future Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The World ◽

Geographic Regions ◽

The Impact

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training. Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic. Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety. Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.

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IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

Jurnal Pendidikan Kedokteran Indonesia The Indonesian Journal of Medical Education ◽

10.22146/jpki.48759 ◽

2019 ◽

Vol 8 (3) ◽

pp. 153

Author(s):

Rachmadya Nur Hidayah

Keyword(s):

Medical Education ◽

Quality Assurance ◽

Patient Safety ◽

Focus Groups ◽

Patient Care ◽

Medical Schools ◽

Theory Approach ◽

High Stakes ◽

Teachers And Students ◽

The Impact

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

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Using narratives for medical humanities in medical training

Illness Narratives in Practice: Potentials and Challenges of Using Narratives in Health-related Contexts ◽

10.1093/med/9780198806660.003.0011 ◽

2018 ◽

pp. 129-139

Author(s):

Alexander Kiss ◽

Claudia Steiner

Keyword(s):

Medical Education ◽

Medical Humanities ◽

Medical Training ◽

Narrative Medicine ◽

Illness Narratives ◽

Evidence Based ◽

Good Doctor ◽

The University ◽

Based Medicine ◽

Humanities Curriculum

The University of Basel, Switzerland has developed a longitudinal medical humanities curriculum based on illness narratives and narrative medicine. The ultimate learning goal of medical humanities as taught in Basel is to foster narrative competence. A good doctor needs to be a good listener, a good storyteller, and should ideally be able to co-create an illness narrative together with a patient. Medical humanities consist of mandatory and optional elements. Blending evidence-based medicine, which is based on larger numbers of patients with similar characteristics, with narrative-based medicine, which is based on patients’ uniqueness, this programme provides medical students with the opportunity to develop and practice narrative medicine over the course of the six years of medical studies. This chapter discusses the programme and its place in medical education.

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Web-Based Information for Patients and Providers

Advances in Medical Technologies and Clinical Practice - Impacts of Information Technology on Patient Care and Empowerment ◽

10.4018/978-1-7998-0047-7.ch002 ◽

2020 ◽

pp. 19-33

Author(s):

Izabella Lejbkowicz

Keyword(s):

Health Information ◽

Web Sites ◽

Information Technologies ◽

The Internet ◽

Online Health Information ◽

World Population ◽

Web Based ◽

Access To Health ◽

The Impact

The exponential development of Information Technologies revolutionized healthcare. A significant aspect of this revolution is the access to health information in the Internet. The Internet World Stats estimates that 56.8% of the world population used the Internet in March 2019, an increase of 1,066% from 2000. According to The Pew Research Center survey of 2012 81% of Americans used the internet and 72% of them searched for health information. Even though there is a lack in more recent data on the percentage of online health information seekers, it is clear that this trend is on the rise. This chapter focuses on the characteristics of the search for online health information by patients and providers, investigates features related to the quality of health web sites, and discusses the impact of these searches on healthcare.

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A Hyperconnected Smart City Framework

Australasian Journal of Information Systems ◽

10.3127/ajis.v24i0.2531 ◽

2020 ◽

Vol 24 ◽

Author(s):

Naureen Naqvi ◽

Sabih Ur Rehman ◽

Zahidul Islam

Keyword(s):

Smart City ◽

Smart Cities ◽

Security And Privacy ◽

Directed Network ◽

Web Based ◽

Sustainable Environment ◽

Processing And Storage ◽

The Impact ◽

And Storage

Recent technological advancements have given rise to the concept of hyper-connected smart cities being adopted around the world. These cities aspire to achieve better outcomes for citizens by improving the quality of service delivery, information sharing, and creating a sustainable environment. A smart city comprises of a network of interconnected devices also known as IoT (Internet of Things), which captures data and transmits it to a platform for analysis. This data covers a variety of information produced in large volumes also known as Big Data. From data capture to processing and storage, there are several stages where a breach in security and privacy could result in catastrophic impacts. Presently there is a gap in the centralization of knowledge to implement smart city services with a secure architecture. To bridge this gap, we present a framework that highlights challenges within the smart city applications and synthesizes the techniques feasible to solve them. Additionally, we analyze the impact of a potential breach on smart city applications and state-of-the-art architectures available. Furthermore, we identify the stakeholders who may have an interest in learning about the relationships between the significant aspects of a smart city. We demonstrate these relationships through force-directed network diagrams. They will help raise the awareness amongst the stakeholders for planning the development of a smart city. To complement our framework, we designed web-based interactive resources that are available from http://ausdigitech.com/smartcity/.

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