Medical Teacher最新文献

Over the last decade there has been tremendous growth in the development of accelerated MD pathways that allow medical students to graduate in three years. Developing an accelerated pathway program requires commitment from students and faculty with intensive re-thinking and altering of the curriculum to ensure adequate content to achieve competency in an accelerated timeline. A re-visioning of assessment and advising must follow and the application of AI and new technologies can be added to support teaching and learning. We describe the curricular revision to an accelerated pathway at NYU Grossman School of Medicine highlighting our thought process, conceptual framework, assessment methods and outcomes over the last ten years.

Singapore, located strategically at the meeting point of the Malacca Strait and the South China Sea, has established itself as a global financial and economic hub. Despite its small geographical size, Singapore is home to over 5 million people from diverse cultural backgrounds. The city-state's medical education landscape has evolved significantly over the past century. Originally, Singapore had only one undergraduate medical school, the NUS Yong Loo Lin School of Medicine, established in 1905. Over time, this institution has grown into Singapore's largest and oldest medical school. NUS Medicine's vision centres on developing highly competent, values-driven, and inspired healthcare professionals to transform the practice of medicine and improve health worldwide. A curriculum overhaul in 2020 introduced new educational components to prepare future healthcare professionals for the challenges of Singapore's resilient healthcare system. This includes proficiency in integrated care, collaboration across disciplines, and leveraging AI and data science in clinical decision-making. The introduction of a common curriculum in August 2023 for Medicine, Nursing, Dentistry, and Pharmacy undergraduates further aligns with Singapore's 'Healthier SG' vision, ensuring that graduates are well-equipped to meet the evolving needs of the healthcare landscape. The common curriculum aims to address professional hierarchies and foster interprofessional collaboration among students from diverse academic backgrounds. By promoting frequent interaction and a team-oriented mindset, the curriculum seeks to instil a collective approach to healthcare, emphasising the importance of interprofessional practice in achieving the broader goals of healthcare delivery. This paper describes the reforms that took place and how the challenges were mitigated in a research-intensive top-ranked academic medical institution. This strategic alignment of medical education with national healthcare priorities underscores NUS Medicine's commitment to transforming medical practice and improving health outcomes in Singapore and beyond.

Aim: To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works.

Methods: We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies.

Results: Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies.

Discussion: Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.

Background: The content and delivery of a health professions' curriculum is often regarded as 'intuitive' and 'self-defining', based on commonly encountered professional roles, detailed knowledge of human structure, function and pathology, and opportunities to acquire necessary clinical and communication skills.  However, a curriculum tends to develop, sometimes in unexpected ways, due to scientific advances, changes in teaching faculty and variations in clinical placement experience. Trends come and go, often without careful scrutiny and evaluation. A common result is curriculum 'creep', where learning may drift away from the original plan.

Methods: A review of available curriculum models produced several descriptions that appear to be based primarily on professional norms and traditions and not linked strongly to learning theories or expectations of employers and the community. Regulators accept variety in curriculua so long as agreed outcomes are achieved. Unless planned and maintained carefully, a curriculum may not necessarily prepare graduates well for a.

Results and discussion: Health professions curricula are required to produce graduates not only with higher education qualifications but also capable of providing healthcare services needed by regulators, employers and their communities. The design includes curriculum content, curriculum delivery and assessment of learning, topics often listed separately in standards but in fact closely intertwined, ideally demonstrating constructive alignment that sends consistent messages and facilitates achievement of graduate outcomes. Purposeful design is a systematic approach to defining, developing, and assessing learning that produces competent graduates who will maintain currency throughout their careers. Just as with the human body, everything is connected so a change anywhere is likely to have implications for other parts of the curriculum ecosystem. The role of clinical cases, level of integration, balance of assessment tasks, use of technology, on-site or remote delivery, and choice of assessment methods are important considerations in curriculum design. Any changes should be strategic and aligned with vision, mission, and graduate outcomes. This paper provides a framework analogous to the human body that may facilitate purposeful design of health professions curricula.

This paper explores personal and professional development (PPD) as a key learning domain for the future of medical education and person-centered care. Guided by existing curriculum development models and lessons learned in practice, scenarios from academic and clinical learning environments will guide a theory-driven discussion of concepts and competencies that humanize the practice of medicine, such as emotional intelligence, professional identity formation, lifelong learning and inclusive practice. Factors contributing to contemporary curriculum implementation will be informed by a case study of a PPD program delivered to post-graduate medical students in Australia and propose an action-focused series of next steps to connect past, current and future directions for medical schools and graduates. Through reflections on iterative stages of program development and the incorporation of emerging concepts in PPD, this paper advocates for the true valuing of personal growth and professional development in medical education. If future doctors are to graduate as compassionate, socially informed, and critically reflective practitioners, they need dedicated PPD learning, opportunities to practice and active encouragement to remain curious towards and beyond their own experience.

Purpose: The ability to perceive assessments as learning instruments calls upon flexible perspective taking and flexible responding. We investigated the maturation of the student perspective on assessment as learning and explored the (in)flexibility of student responses during their development towards graduation.

Methods: In a longitudinal study with an extensive 6-year timeframe, we tracked the development of 12 medical students. We used a mixed-methods research design with consecutive association tests, focus group interviews and a concluding open-ended questionnaire to obtain a balanced and comprehensive dataset. Results from discourse analysis were integrated and connected to explore existing viewpoints and applied behaviours.

Results: During the first year of college, assessments often coincided with rigid perspective taking and inflexible responses. As students progressed, workplace-learning stimulated them to embrace assessment as a valuable tool for enhancing their learning experiences thereby broadening their behavioural repertoire. However, high-stakes summative assessments during the clinical rotations challenged this adaptive behaviour.

Conclusion: Undergraduate students tended to perceive their environment as controllable, avoiding or dismissing unwanted thoughts and feelings. In order to develop and maintain adaptive behaviour during high-stakes assessments, future research should focus on teaching our students skills for effective and flexible responding, enabling them to reach their full potential.