Applying the Panarchy Framework to Examining Post-Pandemic Adaptation in the Undergraduate Medical Education Environment: A Qualitative Study.

Phenomenon: The COVID-19 pandemic necessitated an abrupt shift to online medical education, disrupting learning across knowledge, skills, and social connections. Post-pandemic, medical schools must evaluate how these disruptions shaped student experiences to optimize the return to in-person learning. Approach: This cross-sectional qualitative study explored medical students' perceptions of their learning environment during the post-pandemic reintegration period in Oman. Fifty-four preclinical and clinical students participated in six focus group interviews. Content analysis identified key topics characterizing students' perceptions of change and change processes in the post-pandemic learning environment. The panarchy framework, developed to characterize complex adaptive systems in nature, was used to frame the results. Findings: The return to in-person environments presented a mix of renewed connectivity, involving collaborative benefits alongside transitional adjustment strains. Five major topics characterizing student perceptions of change and change processes in their post-pandemic learning environment were identified: learning skills, developing clinical competence, faculty interactions, physical atmosphere, and social connections. Managing academic schedules and cognitive load as the learning environment opened challenged students' learning skills. Learners valued a renewed opportunity for interactive application of knowledge through collaboration, patient contact, and empathy skill-building to feel prepared for future practice. Returning to in-person instruction renewed a sense of community and peer support networks disrupted by pandemic isolation. Some students continued to struggle with study-life imbalance and felt ill-equipped to handle post-pandemic demands. Improved access to student support and wellness services was emphasized to ease transitional stresses. Students defined an ideal learning climate as supportive, active, personalized, relevant, challenging, accessible, and collaborative. Insights: While pandemic disruptions posed challenges, they provide opportunities to strengthen the educational system's resilience moving forward. Our findings highlight an opportunity for medical educators and learners to capitalize on the innovations that emerged during this period, integrating technology with interactive learning activities and reconnecting students with the core values of the medical profession. Applying the panarchy framework to frame this adaptive process could enable the tracking of multi-level interactions within the medical education environment and the evaluation of interventions targeted at identified areas of concern. Further exploration to achieve complete mapping of specific environmental domains onto the panarchical cycles merits future investigation to build integrated resilience frameworks.

Crossing horizons: unraveling perspectives on enhancing medical students' success through at-risk factor exploration.

BACKGROUND: Medical universities often face the ongoing challenge of identifying and supporting at-risk students to enhance retention rates and academic success. This study explores a comprehensive analysis of perceived at-risk factors impeding academic and career aspirations and compares the perspectives of students and faculty in a medical school. METHODS: We focused on first and second-year medical (MBBS) students and teaching faculty in an international medical college offering a twinning program in India and Malaysia. Our investigation involved a comprehensive assessment of 25 at-risk factors through Likert-type questionnaires distributed to 250 MBBS students and 50 teaching faculty. RESULTS: Our findings revealed distinct disparities in perceptions between faculty and students regarding mean scores of classroom engagement (p = 0.017), procrastination (p = 0.001), unrealistic goals (p = 0.026), emotional/behavioral problems (p = 0.008), limited key social skills (p = 0.023), and a non-supportive home environment (p = 0.001). These differences underscore the need for increased communication and understanding between faculty and students to address these risk factors effectively. In contrast, no significant disparities were observed among faculty and students' perceptions concerning mean scores of various potential at-risk factors, including academic unpreparedness, cultural/language barriers, individual guidance/mentoring, limited communication skills, racism/sexism, self-confidence, self-respect, self-concept, motivation, underprepared for current academic challenges, self-discipline, negative social network, negative peer culture, transportation time, college financial cost, college evaluation culture bias, broken college relationships, teaching methodology, and learning disabilities. However, varying degrees of influence were perceived by faculty and students, suggesting the importance of individualized support. CONCLUSION: This study contributes to the academic community by shedding light on the multifaceted nature of at-risk factors influencing student success. It underscores the need for proactive measures and tailored interventions to enhance student retention in higher education and academic achievement, fostering a sustainable foundation for lifelong learning and growth.

Regulatory system to promote the culture of quality at Indian medical schools: Are we doing enough?

The replacement of the Medical Council of India (MCI) with the National Medical Commission (NMC) was an important change in regulatory oversight to bring about transparency in regulatory procedures for improving quality of medical education and meeting the needs of healthcare in India. Similarly, due to globalization of medicine including migration of health workforce and desire to raise standards of medical education and healthcare, efforts have progressed well towards transnational regulation and establishment of an overarching body, which recognizes regulatory agencies for their adherence to good practices. We describe the global collaborative efforts to improve the quality of medical education by the promotion of accreditation through the recognition programme of the World Federation of Medical Education (WFME), the publication of the expert consensus standards across the continuum of medical education and the Guidelines for Accreditation of Basic Medical Education. We also highlight that many medical schools across the world have adopted the WFME standards and many regulatory and accrediting agencies have achieved recognition status. Based on appraisal of the NMC Act and notification on minimum standard requirements (MSRs) for medical colleges, we point out the gaps between the intent stated in the preamble of the NMC Act and the notification on MSRs. We recommend a way forward to develop a regulatory model and approaches that match NMC's stated intent and meet the requirement for medical schools in India to gain international recognition.

Revitalizing journal clubs: Millennial perspectives for enhancing student learning and engagement.

Background: Current trends in health professions education are aligned to meet the needs of the millennial learner. The aim of this study was to identify learners' perceptions of an ongoing journal club (JC) activity in the optometry curriculum and evaluate the utility and efficiency of this method in promoting student learning. Methods: A qualitative approach with a phenomenological research design was adopted. The perceptions of undergraduate and postgraduate optometry students about JCs were captured using focus group discussions. A narrative thematic analysis was done using the verbatim transcripts and moderator's notes. Results are reported using "consolidated criteria for reporting qualitative research" guidelines. Results: A total of 33 optometry students participated in the study. Data analysis revealed three major themes related to (i) The ongoing practice of JC, (ii) student perceptions of JC and its relevance in facilitating student learning, and (iii) suggestions for modification of JC for achieving optimal educational outcomes. Discussion: Student feedback indicates that an instructional redesigning of JC is necessary, considering the characteristics and expectations of the current generation of learners and the rapid strides made in the field of educational technology. The recommendations provided are likely to resurrect an age-old approach that still has educational relevance if blended with collaborative learning formats and appropriate technology.

Interprofessional simulation education to enhance teamwork and communication skills among medical and nursing undergraduates using the TeamSTEPPS® framework.

BACKGROUND: Learning in silos during the undergraduate years results in ineffective collaborative practice leading to adverse events. Simulation training using the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)® framework has been shown to be effective in enhancing teamwork skills among healthcare professionals. This study aims to evaluate an interprofessional simulation education (IPSE) module for undergraduate medical and nursing students on teamwork and communication skills using the TeamSTEPPS® framework. METHODS: An IPSE module was developed by an interprofessional team of faculty. A convenient sample of medical and nursing undergraduate interns participated in trauma simulation scenarios before and after a didactic session on interprofessional education (IPE) and TeamSTEPPS® 2.0. The pre-post performance was assessed by faculty and pre-post self-assessment of the IPSE training and interprofessional education collaborative (IPEC) competencies by the participants. Quantitative data were analysed using a paired t-test of the mean scores and analysis of variance. The themes that emerged from audio recordings of the debriefing, and written reflections of the participants, yielded data for qualitative thematic analysis. RESULTS: The scores of team performance, self-assessment of IPSE training, and IPEC competencies revealed statistically significant values. Themes that emerged included the need for IPSE in the curriculum, impact of structured tools for communication on patient safety, and awareness of the roles and responsibilities in interprofessional teamwork. A survey conducted two weeks after completion of the module showed positive feelings among participants about interprofessional collaboration. CONCLUSION: The study specifically assessed the effectiveness of an IPSE module based on TeamSTEPPS® guidelines in improving communication and teamwork skills among medical and nursing undergraduates.

Interprofessional Modules for Teaching Skills in Skill Labs.

Clinical skills laboratories are educational facilities that have the potential benefit for undergraduate and postgraduate medical students and medical staff. They provide a safe and protected environment in which the learner can practice clinical skills before using them in real clinical settings. These skills laboratories help to ensure that all students acquire the necessary techniques and are properly assessed before practicing on real patients. In addition, they support the acquisition, maintenance and enhancement of the clinical skills of students in the healthcare profession. Teaching skills in skill lab require a standardized module for each skill that can be applied to all the students universally. The study was started with the aim to solve a problem that has arisen as National Medical Council (NMC) has announced implementation of Competency based medical education (CBME) a new syllabus for medical education from 2019 MBBS batch that includes skill teaching. Faculty in various Medical colleges is not trained in developing modules and teaching skills to students in skill lab. There are no standardized teaching modules for skills training in skill laboratories. As part of the project we decided to develop modules for the two competencies to be taught in the skill lab for the subject Otorhinolaryngology i.e. Otoscopy and Anterior Nasal packing; NMC guidelines being the benchmark in developing these modules. Later modules were also to be implemented on sample students to get a feedback on the structure of the module for further improvement. These modules developed as part of the project will help as a baseline tool for developing other modules in different subjects by various Institutes. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04568-0.

Factors Causing Variation in World Health Organization Surgical Safety Checklist Effectiveness-A Rapid Scoping Review.

INTRODUCTION: This review was conducted to determine what factors might be responsible for prejudicing the outcomes after the implementation of a World Health Organization Surgical Safety Checklist (WHO SSC), grouping them appropriately and proposing strategies that enable the SSC a more helpful and productive tool in the operating room. METHODS: It was a rapid scoping review conducted as per Preferred Reporting Items for Systematic Review and Meta-analyses extension guidelines for scoping reviews (PRISMA-Scr). Comprehensive search on MEDLINE and Embase was carried out, to include all relevant studies published during last 5 years. Twenty-seven studies were included in analysis. The barriers to SSC implementation were classified into 5 main groups, with further subdivisions in each. RESULTS: The results of review revealed that there are 5 major barriers to SSC at the following levels: organizational, checklist, individual, technical, and implementation. Each of these major barriers, on further evaluation, was found to have more than one contributing factors. All these factors were analyzed individually. CONCLUSIONS: This rapid scoping review has consolidated data, which may pave the way for experts to further examine steps that might be taken locally or globally in order that the WHO SSC to successfully achieve all its desired goals.

Fostering critical thinking and collaborative learning skills among medical students through a research protocol writing activity in the curriculum.

PURPOSE: This intervention was aimed to analyse the effect of academic writing and journal critiquing as educational approaches in improving critical thinking and collaborative learning among undergraduate medical students. METHODS: A research proposal writing format was created for the 4th year medical students of Melaka Manipal Medical College, Malaysia during their ophthalmology clinical postings. The students worked in small groups and developed research protocols through an evidence based approach. This was followed by writing reflective summaries in academic portfolios about the activity undertaken. A mixed methods study was designed to explore the possible role of collaborative research proposal writing in enhancing critical thinking and collaborative learning. RESULTS: Analysis of reflections submitted by 188 medical students after the intervention indicate that majority of them found an improvement in their skills of critical thinking and collaborative learning as a result of research protocol writing. All participants agreed that the model helped in applying concepts to new situations in the form of designing their own study, which reflected in enhanced higher order cognitive skills. CONCLUSION: This study shows that the introduction of a structured module in the core medical curriculum that focuses on research writing skills embedded with collaborative and reflective practices can enhance collaborative learning, critical thinking, and reasoning among medical students.

Interprofessional Education: An Approach to Improve Healthcare Outcomes.

Interprofessional education (IPE) approach allows learners from different health professions viz. - medical, dental, nursing, physiotherapy, psychotherapy, psychology etc., learn from, learn with, and learn about, each other. The scope of learning depends upon the requirements and curriculum. Interprofessional education can help in creating a workforce that learns to perform collaborative practice thereby ensuring better health-care outcomes. Medical educators' and practitioners' understanding about teaching, learning, and assessment of IPE is rudimentary. Strategies to incorporate IPE in regular curricula need to be debated and barriers associated with its implementation require to be identified. This review highlights the teaching-learning and assessment tools for IPE and discusses potential challenges in its implementation.

Evaluation of a personal and professional development module in an undergraduate medical curriculum in India.

The study aimed at evaluating the personal and professional development (PPD) module in the undergraduate medical curriculum in Melaka Manipal Medical College, India. PPD hours were incorporated in the curriculum. A team of faculty members and a faculty coordinator identified relevant topics and students were introduced to topics such as medical humanities, leadership skills, communication skills, ethics, professional behavior, and patient narratives. The module was evaluated using a prevalidated course feedback questionnaire which was administered to three consecutive batches of students from March 2011 to March 2013. To analyze faculty perspectives, one to one in-depth interviews and focus group discussions were conducted by the coordinators with faculty members who conducted the PPD classes. Analysis of the course feedback form revealed that majority (80%) of students agreed that the module was well prepared and was "highly relevant" to the profession. Faculty found the topics new and interdisciplinary and there was a sense of sharing responsibility and workload by the faculty. PPD modules are necessary components of the curriculum and help to mould students while they are still acquiescent as they assume their roles as doctors of the future.