Experiencing art creation as a therapeutic intervention to relieve anxiety - a case study of a university's ceramic art course.

Background: University students are anxiety prone. Due to their changing their social roles, the proportion of university students with anxiety is relatively high. In this study, using the simple random sampling, we surveyed 53 university students, including sophomores, juniors, and seniors. Aims: This paper examines the relationship between art creation and anxiety. Methods: This study uses the Self-Assessment Anxiety Scale (SAS). The test form measures the presence and extent of their anxiety problems through a series of questions. We tested the effects of an art creation process on SAS scores and suggest best practices for course settings and teaching methods for art-related subjects. Results: Art therapy intervention reduced anxiety. The most effective technique was found to be slapping the clay board during the creation process. Other actions relieved anxiety as well. Results suggest that the art creation process is an application of art therapy effective in relieving anxiety in university students. Conclusion: Key actions in the process of creating art are closely related to the treatment approaches used in art therapy interventions. This has the potential to not only improve mental health, but also to promote the health and well-being of students. Implications for future research: Rapid societal changes increasing competition for employment creates work and life pressures. University students face challenges with learning, peer competition, and employment, often resulting in anxiety. A diversified curriculum can alleviate anxiety through proper curricular planning and design. Based on this, the university's arts courses should be able to study how to improve and optimize the existing teaching and learning outcomes and can be integrated with the university's general education curriculum planning. Through appropriate teaching content and learning methods, the courses of university general education can play a role in reducing students' anxiety and promote physical and mental health, thus contributing to sustainable development of the society.

Integrating Shared Decision-Making into Undergraduate Oncology Education: A Pedagogical Framework.

The integration of shared decision-making (SDM) into undergraduate oncology education represents a critical evolution in medical pedagogy, reflecting the growing complexity and patient-centric focus of contemporary healthcare. This paper introduces a comprehensive pedagogical framework designed to embed SDM within the undergraduate medical curriculum, particularly in oncology, where the multiplicity of treatment options and their profound impact on patient life underscore the necessity of this approach. Grounded in a systematic literature review and aligned with established educational theories, this framework proposes twelve strategic approaches to cultivate future physicians proficient in both clinical acumen and patient-collaborative decision-making. The framework emphasizes real-world clinical experience, role-playing, case studies, and decision aids to deepen students' understanding of SDM. It advocates for the development of communication skills, ethical deliberation, and cultural competence, recognizing the multifaceted nature of patient care. The inclusion of patient narratives and evidence-based decision-making further enriches the curriculum, offering a holistic view of patient care. Additionally, the integration of digital tools within the SDM process acknowledges the evolving technological landscape in healthcare. The paper also addresses challenges in implementing this framework, such as curricular constraints and the need for educator training. It underscores the importance of continual evaluation and adaptation of these strategies to the dynamic field of medical education and practice. Overall, this comprehensive approach aims not only to enhance the quality of oncological care but also to prepare medical students for the complexities of modern medicine, where patient involvement in decision-making is both a necessity and an expectation.

Development of low back pain curriculum content standards for entry-level clinical training.

BACKGROUND: The management of low back pain (LBP) is highly variable and patients often receive management that is not recommended and/or miss out on recommended care. Clinician knowledge and behaviours are strongly influenced by entry-level clinical training and are commonly cited as barriers to implementing evidence-based management. Currently there are no internationally recognised curriculum standards for the teaching of LBP content to ensure graduating clinicians have the appropriate knowledge and competencies to assess and manage LBP. We formed an international interdisciplinary working group to develop curriculum content standards for the teaching of LBP in entry-level clinical training programs. METHODS: The working group included representatives from 11 countries: 18 academics and clinicians from healthcare professions who deal with the management of LBP (medicine, physiotherapy, chiropractic, osteopathy, pharmacology, and psychology), seven professional organisation representatives (medicine, physiotherapy, chiropractic, spine societies), and one healthcare consumer. A literature review was performed, including database and hand searches of guidelines and accreditation, curricula, and other policy documents, to identify gaps in current LBP teaching and recommended entry-level knowledge and competencies. The steering group (authors) drafted the initial LBP Curriculum Content Standards (LBP-CCS), which were discussed and modified through two review rounds with the working group. RESULTS: Sixty-two documents informed the draft standards. The final LBP-CCS consisted of four broad topics covering the epidemiology, biopsychosocial contributors, assessment, and management of LBP. For each topic, key knowledge and competencies to be achieved by the end of entry-level clinical training were described. CONCLUSION: We have developed the LBP-CCS in consultation with an interdisciplinary, international working group. These standards can be used to inform or benchmark the content of curricula related to LBP in new or existing entry-level clinical training programs.

Block learning: Evaluation of a new teaching approach for nursing and midwifery education.

AIM: The aim is to present outcome and engagement data from the initial years of the implementation of a new teaching approach in entry to practice nursing and midwifery education. BACKGROUND: The Block Model (TBM) is a teaching approach that involves studying one unit of study at a time over a four-week period, as opposed to the traditional semester model. This paper presents data revealing the impact of TBM on student engagement and overall experience in entry to practice Bachelor of Nursing and Midwifery programs. DESIGN: The evaluation retrospectively compared key indicators pre- Block Model implementation with outcomes for nursing and midwifery students using TBM approach using standard data sets and external comparators such as the Student Experience Survey and National Employability Survey. METHODS: The study presents a comparative analysis of key indicators and graduate outcomes for students. We use reportable data and two external comparators, the Student Experience Survey and the National Employability Survey, to gauge student learning and graduate employability. The evaluation was conducted in a tertiary institution in Australia with for nursing and midwifery students who completed their studies using TBM approach at the university. RESULTS: The implementation of TBM in nursing and midwifery programs resulted in improvements in learner engagement, retention rates and pass rates. Improvements were also noted graduate outcomes, with an increase in full-time graduate employment. CONCLUSIONS: The results suggest the Block Model is a promising new teaching approach in nursing and midwifery education, with potential benefits for learner engagement, retention and pass rates.

Teaching, assessment and best practice in undergraduate psychiatry education in the UK: cross-sectional survey.

AIMS AND METHOD: We conducted a cross-sectional survey to examine how undergraduate psychiatry is taught and assessed across medical schools in the UK that have at least one cohort of graduated students. RESULTS: In total, 27 medical schools completed the survey. Curriculum coverage of common mental disorders, assessment skills and mental health law was broadly consistent, although exposure to psychiatric subspecialties varied. Significant variation existed regarding the duration of psychiatry placements and availability of enrichment activities. Small-group teaching, lectures and e-learning were the most frequent teaching modalities and various professionals and lived experience educators (patient and/or carers) contributed to teaching. Objective structured clinical examinations and multiple-choice questions dominated assessments. CLINICAL IMPLICATIONS: Medical schools should consider increasing students' exposure to different psychiatric subspecialties and integrating physical and mental health training to address comorbidity and promote holistic care. Future research should explore whether specific undergraduate experiences promote greater career interest and skills in psychiatry.

Development of the essential learning outcomes for the midwifery student continuity of care learning model: A Delphi study.

BACKGROUND: In Australia, midwifery students are required to undertake at least ten Continuity of Care Experiences (CoCE) during their education. The learning outcomes of this experience have never been explicit or standardised resulting in inconsistent assessment. AIM: To develop and identify standardised learning outcomes for the CoCE. METHODS: A modified Delphi survey was conducted with an expert panel. Intended learning outcome statements were developed, reflecting the learning objectives identified in a previous study. Bloom's taxonomy levels of thinking complexities guided the wording of the outcomes. Participants were asked to rank and rate their level of agreement with each statement over two survey rounds. FINDINGS: Round one was completed by 32 participants, with 92.5% of the 40 statements reaching consensus. The second round was completed by 23 participants, with 70.7% of the 33 statements reaching consensus. Content analysis of participant comments from each round identified duplicates that were removed and informed refining the wording of some statements. A final set of 15 learning outcomes were agreed upon. The outcomes were broadly grouped within the themes of accountability, advocacy, and autonomy. DISCUSSION: This study has identified agreed learning outcomes for midwifery students undertaking CoCE. The consensus agreement of experts reinforced the learning model enables the development of woman-centred practice that is underpinned by accountability, advocacy, and autonomy. CONCLUSION: Purposeful learning outcomes for the CoCE have been developed, informing how the model can be embedded in curricula, guide student learning and assessment to standardise the pedagogy of the model to prepare future midwives.

Graduate competencies, employability and the transnational Radiography workforce shortage: A systematic literature review of current pre-registration Radiography education and training models.

INTRODUCTION: Transnational mobility of the Radiography workforce is challenged due to issues with standardisation of current education and training models which has added to the workforce shortage. To address the growing volume, scope and complexity of clinical Radiography service delivery, educational models need to be given a critical look for transnational relevance in modern times. This study aims to synthesise the characteristics of current pre-registration radiography educational programmes linked with effective knowledge, skill acquisition, and graduate employability to address the current workforce challenges through the development of newer training models. METHODS: Using a mixed methods systematic review approach, secondary data was obtained from an EBSCOhost search involving key databases including MEDLINE, CINAHL, Academic Search Ultimate, ScienceDirect, and SCOPUS. Themes were developed following a result-based convergent data synthesis. RESULTS: Forty articles met the predefined inclusion criteria following the study identification and screening phases. The included studies were conducted from across diverse settings including both low- and middle-income countries (LMIC) and high-income countries (HIC). Two broad themes were developed from the findings including: 1. Factors influencing graduate employability and 2) Radiography education and training programme characteristics. CONCLUSION: The findings highlight and advocate for an innovative model for Radiography education and underscores the significance of graduates possessing multi-modality skills, varied competencies, and effective accreditation processes for training. Prioritising alignment with industry needs and holistic skill development is vital to closing the employability gap, ultimately improving graduate skills and competencies to address workforce shortage while improving patient care outcomes. IMPLICATIONS FOR PRACTICE: Radiography training institutions should explore the development of new innovative models for multi-modality pre-registration education. This should offer adaptable routes that align seamlessly with the evolving regulatory, technological, and clinical trends.

Teaching ultrasound in osteopathic medical schools.

CONTEXT: An important diagnostic tool, ultrasound (US) has been incorporated into the curriculum of medical schools for more than 20 years. In the last decade, the interest in US educational research has experienced exponential growth but mostly from Medical Doctor (MD)-granted schools. The extent to which US is embedded in the curricula of the colleges of osteopathic medicine (COM) still requires a comprehensive evaluation. OBJECTIVES: This survey is designed to evaluate the current status of US teaching in COMs with an emphasis on the inclusion of the US in osteopathic manipulative medicine (OMM) training. METHODS: An anonymous, voluntary, 22-question online survey was created and administered to all COMs to collect data about the current state of US teaching. A descriptive analysis was performed to describe and summarize the final data. Fisher's exact test was utilized for the comparison of study variables. RESULTS: We received responses from 36 of the 43 (83.7 %) COMs invited to participate in the survey, all of which had US training within their curriculum, most commonly integrated into the year 1 curriculum (86.1 %). Focused US training is incorporated into 83.3 % of these schools (30 of 36). Focused US training is covered in 83.3 % of schools (30 of 36). US is mostly taught in the anatomy course (38.8 %). US is incorporated in the OMM course in 12 of 36 schools (33.3 %). The majority of respondents feel that US training will make osteopathic students more competitive in the job market (88.9 %) and want more US in their curriculum (86.1 %). The idea that US is useful for a better understanding of the key OMM concepts is believed by 62.9 % of respondents. The major obstacle to the implementation of US in the curriculum is having appropriately trained faculty (86.1 %). The majority of the respondents did not feel that an adequate budget is a handicap to implementing US in the curriculum. CONCLUSIONS: US is included within the curriculum of all respondents to our survey, a third of whom included US within their OMM curriculum. US is treated as a useful and important skill for future osteopathic physicians. The majority of COMs desire more US training in the curriculum. The main barrier to implementing US in the curriculum is the lack of appropriately trained faculty.

The Need for Improved End-of-Life Care Medical Education: Causes, Consequences, and Strategies for Enhancement and Integration.

End-of-life (EOL) care is a unique area of medicine that emphasizes holistic patient-centered care. It requires clinicians to consider a patients' mental, emotional, spiritual, social and physical comforts and engage patients and their families in complex discussions and decisions. It is an area of medicine that requires sensitivity in communication in order to respond to a wide range of emotions from patients and their families. Given these intricacies, it is essential that healthcare professional trainees are exposed early in their careers so they can be better equipped to address EOL situations effectively. While many medical schools have integrated this important element in pre-clinical education, a formalized and standardized curriculum could allow for students to better engage in EOLcare scenarios that they will face as future physicians. In this editorial, we discuss potential strategies to incorporate EOL care didactics and experiential learning earlier in medical education as well as the consequences of inadequate EOL care education, particularly in medical schools, in its current state.

Planetary health in nursing curricula: How one school transformed nursing curricula as they integrated planetary health concepts with the 2021 AACN essentials.

BACKGROUND: Human health and the health of the planet are inextricably interconnected. The human impact on the environment and likewise the impact of the environment on human health is well documented across various areas of study. Climate change, air and water pollutants, land usage, vector borne illness, and other examples demonstrate this relationship. Nurse educators would be negligent if this knowledge was not integrated and aligned with AACN Essentials competencies to demonstrate acquisition of knowledge. METHODS: The five domains of the Planetary Health Education Framework were mapped to the AACN Essentials competency based framework. RESULTS: Crosswalks were developed for Level 1 and Level 2 Domains, Competencies, and Sub- Competencies with the Planetary Health Domains. Specific Planetary Health outcomes were identified with supporting resources. Exemplars demonstrate the application of the Planetary Health domains to classroom activities and learning objectives. CONCLUSIONS: In order for graduates to be practice ready, practice to the full scope of their license, and practice from a holistic perspective, nursing education programs must address the reciprocal impacts of planetary health and human health as it is imperative for the health of all.

Anesthesia in medical school: A simulation-based curriculum proposal

Introduction Most medical students are not familiar with Anesthesiology, as it is infrequently addressed properly in medical school curricula. However, anesthesiology skills are widely practiced across specialties and commonly performed by general practitioners. Currently, anesthesia curricula are often based on shadowing and lectures without emphasizing relevant skills, behaviors, and attitudes, whereas simulation-based curricula enable a holistic evaluation of the trainee. Objective To implement and assess the perceptions of students and professors of a novel simulation-based anesthesiology curriculum. Methods A descriptive study was planned for evaluating the new proposal. A simulation-based 3-week curriculum was organized using a blended course with skill laboratories. We designed flipped classroom-based lectures (2 weeks) combined with activities using standardized patients, manikins, and hybrid scenarios (1 week). After each activity, feedback was given by an anesthesiologist, as well as individual grading and a survey based on the Kirkpatrick levels. Results From June to November 2020, 53 students were enrolled in the clerkship. Each week, every group of 6-8 students was assigned to the same specialist to perform the activities and track individual progress. The response rate of the survey was 83%. Across the levels of Kirkpatrick, there was an excellent opinion of the activities, as well as a high similarity between the perception of both students and professors. Conclusion Our simulation-based curriculum, which was highly appraised by students and professors, was found to be feasible, appealing, and offered a good introduction to the principles and practices of anesthesiology to medical students.

Introducción: La mayoría de los estudiantes de medicina no están familiarizados con la Anestesiología, ya que la materia pocas veces se aborda adecuadamente en el programa académico de la facultad de medicina. Sin embargo, las habilidades en anestesiología son ampliamente utilizadas por los médicos generales. En la actualidad los currículos de anestesiología suelen basarse en prácticas y conferencias donde no se enfatizan las destrezas pertinentes, las conductas y las actitudes, mientras que los currículos basados en simulación permiten una evaluación integral del aprendiz. Objetivo: Implementar y evaluar las percepciones de estudiantes y de los profesores de un novedoso plan de estudios de anestesiología basado en la simulación. Métodos: Se diseñó un estudio descriptivo para valorar la nueva propuesta. Se organizó un plan de estudios de 3 semanas, basado en simulación, utilizando un curso mixto con habilidades de laboratorio. Diseñamos conferencias basadas en el modelo de aula invertida (2 semanas), combinadas con actividades basadas en pacientes estandarizados, maniquíes y escenarios híbridos (1 semana). Luego de cada actividad, un anestesiólogo ofrecía su retroalimentación, así como calificaciones individuales y una encuesta basada en los niveles de Kirkpatrick. Resultados: Se inscribieron 53 estudiantes en la pasantía de junio a noviembre de 2020. Cada semana se asignaba un grupo de 6-8 estudiantes a un mismo especialista para llevar a cabo las actividades y hacer un seguimiento al progreso alcanzado de manera individual. La tasa de respuesta de la encuesta fue de 83%. En todos los niveles de Kirkpatrick, hubo una excelente opinión sobre las actividades y una elevada similitud en la percepción, tanto de los estudiantes como de los profesores. Conclusión: Nuestro currículo basado en simulación fue muy bien valorado por estudiantes y profesores y se consideró factible, atractivo y que ofrecía a los estudiantes una buena introducción a los principios y prácticas de la anestesiología.

Development and Implementation of a Medical School Course Integrating Basic, Clinical, and Health Systems Sciences.

OBJECTIVE: In recent years, significant steps have been made in integrating basic science and clinical medicine. There remains a gap in adding the third pillar of education: health systems science (HSS). Core clerkships represent an ideal learning venue to integrate all three. Students can experience the value of integrating basic science as they learn clinical medicine in environments where HSS is occurring all around them. METHODS: We outline the creation of Sciences and Art of Medicine Integrated (SAMI), a course that runs parallel with the clerkship year and integrates basic science and HSS with clinical medicine. A complete description of the planning and implementation of SAMI is provided. We include the participants and educational setting, the goals and objectives, and the structure of each session. To encourage the integration of basic science, HSS, and clinical medicine, students utilize a series of tools, described in detail. Examples of each tool are provided utilizing a case of a patient presenting with obstructive sleep apnea. RESULTS: We successfully implemented this course with positive reception from students. CONCLUSION: This course represents a step not only toward the integration of HSS with basic science and clinical medicine but also an advancement in training future clinicians to provide high-value care. Future curricular development must consider the validation of a measure of clinical reasoning that assesses a student's ability to think in a cognitively integrated fashion about basic science, HSS, and clinical medicine demonstrated by enhanced justification of clinical reasoning and a more holistic approach to planning patient care.

Healthcare Profession Students' Motivations for Learning About Community Organizing: A Thematic Analysis.

Background Medical care now emphasizes community health, prevention, health promotion, and collaboration. Integrating medical students into community health initiatives enhances their community health and student skills. In an aging multicultural population, the involvement of healthcare professionals in community health management is vital. However, medical education in Japan lacks sufficient exposure to community health issues. A program in Shimane Prefecture aimed to address this gap by revolutionizing medical education through community organizations. Methods This study employed a reflexive thematic analysis based on relativist ontology and constructivist epistemology. Participants aspiring to be healthcare professionals from Japanese high schools and universities were recruited from rural Shimane Prefecture. Computer-based questionnaires were used to collect data on participants' reasons, motivations, and visions for community-organizing education. The thematic analysis followed Braun and Clarke's approach and involved systematic coding, theme identification, and refinement. Results Three themes emerged from the analysis. In expanding hopes for unknown potential, participants sought improved communication skills, real-world understandings, and fresh perspectives and aimed to promote personal growth through community engagement. In acquiring activeness and new perspectives through connections with peers, hands-on learning and collaboration with peers with shared interests were motivating factors. Participants sought to generate inquiries and discover their activities. Regarding the desire to connect with diverse individuals driven by a strong curiosity about the community, participants aimed to learn community engagement techniques, understand community involvement methods, and explore the relationship between social issues and health. Conclusion Community-organizing education plays a pivotal role in shaping future healthcare professionals. Our analysis underscores the need for curriculum reform, including experiential learning and peer interaction, to facilitate a comprehensive understanding of health and community dynamics. Future studies should assess the long-term impacts of these experiences on students' careers and community health to contribute to advancements in medical education and community-oriented healthcare professionalism.

A quality improvement approach to integrating social determinants of health objectives into pediatric simulation.

Background: Health disparities and the unequal distribution of social resources impact health outcomes. By considering social determinants of health (SDH), clinicians can provide holistic and equitable care. However, barriers such as lack of time or understanding of the relevance of SDH to patient care prevent providers from addressing SDH. Simulation curricula may improve learners' ability to address SDH in practice. Objectives: The primary objective was to increase the percentage of pediatric emergency simulations that included SDH objectives from 5% to 50% in 12 months at one institution. As a balancing metric, we examined whether trainees approved the incorporation of SDH objectives. Methods: Using the Model for Improvement approach, we conducted interviews of residents and simulation facilitators to identify challenges to integrating SDH objectives into the simulation curriculum. Review of interviews and visual representation of the system helped identify key drivers in the process. A team of simulation leaders, residents, and fellows met regularly to develop simulation cases with embedded SDH objectives. Using a plan, do, study, act approach, we tested, refined, and implemented interventions including engaging residency program and SDH leadership, piloting cases, providing facilitators concise resources, inviting SDH-specific experts to co-debrief, and eliciting and incorporating learner and facilitator feedback to improve cases. SDH topics include homelessness, undocumented status, and racism. Results: Prior to the start of the quality improvement work, SDH were rarely incorporated into emergency simulations for pediatric residents. A p-chart was used to track the percentage of monthly cases that incorporated SDH topics. During the study period, the percentage of simulations including SDH topics increased to 57% per month. Most trainees (94%) welcomed incorporating SDH objectives. Conclusions: Using the Model for Improvement, we incorporated SDH objectives into pediatric resident emergency simulations. Next steps include examining effectiveness of the curriculum, dissemination to additional learners, and examining sustainability in practice.

Measuring group function in problem-based learning: development of a reflection tool.

BACKGROUND: Problem-based learning (PBL) is a pedagogy involving self-directed learning in small groups around case problems. Group function is important to PBL outcomes, but there is currently poor scaffolding around key self-reflective practices that necessarily precedes students' and tutors' attempts to improve group function. This study aims to create a structured, literature-based and stakeholder-informed tool to help anchor reflective practices on group function. This article reports on the development process and perceived utility of this tool. METHODS: Tool development unfolded in four steps: 1) a literature review was conducted to identify existent evaluation tools for group function in PBL, 2) literature findings informed the development of this new tool, 3) a group of PBL experts were consulted for engagement with and feedback of the tool, 4) four focus groups of stakeholders (medical students and tutors with lived PBL experiences) commented on the tool's constructs, language, and perceived utility. The tool underwent two rounds of revisions, informed by the feedback from experts and stakeholders. RESULTS: Nineteen scales relating to group function assessment were identified in the literature, lending 18 constructs that mapped into four dimensions: Learning Climate, Facilitation and Process, Engagement and Interactivity, and Evaluation and Group Improvement. Feedback from experts informed the addition of missing items. Focus group discussions allowed further fine-tuning of the organization and language of the tool. The final tool contains 17 descriptive items under the four dimensions. Users are asked to rate each dimension holistically on a 7-point Likert scale and provide open comments. Researchers, faculty, and students highlighted three functions the tool could perform: (1) create space, structure, and language for feedback processes, (2) act as a reference, resource, or memory aid, and (3) serve as a written record for longitudinal benchmarking. They commented that the tool may be particularly helpful for inexperienced and poor-functioning groups, and indicated some practical implementation considerations. CONCLUSION: A four-dimension tool to assist group function reflection in PBL was produced. Its constructs were well supported by literature and experts. Faculty and student stakeholders acknowledged the utility of this tool in addressing an acknowledged gap in group function reflection in PBL.

Mapping of Iranian midwifery curriculum according to the International Confederation of midwives competencies.

BACKGROUND: Evaluating the curriculum based on its success rate in preparing skilled midwives proficient in performing professional skills is a fundamental component of the midwifery education system. This study aimed to evaluate the content, strengths, and weaknesses of the midwifery curriculum in Iran based on the most recent ICM midwifery education standards in all competence areas, as well as to obtain expert feedback on the necessary courses or lessons for the curriculum using the Delphi method. METHODS: This research was conducted in two phases: comparative analysis and the Delphi method. In the comparative analysis, the curriculum mapping tool was used to compare Iran's midwifery curriculum for bachelor's degrees to the international standards for midwifery education proposed by ICM in 2019 by a four-point Likert scale (adequate- relatively adequate- relatively inadequate- inadequate). Two individuals evaluated the curriculum independently for the presence of theoretical and clinical courses for attaining each relevant competency. In case of disagreement, the opinion of a third person was used. After identifying the academic deficiencies and weaknesses of the curriculum, the Delphi technique was used with the cooperation of the midwifery board members and directors of midwifery groups from across the country to collect feedback about new courses or lessons that need to be incorporated into the curriculum. RESULTS: After a comparative analysis, 24 out of 315 essential competencies for ICM in the midwifery curriculum were found to be inadequate or relatively inadequate based on the three experts' opinions after reviewing the programmatic courses and lessons in the curriculum. In 79.5% of the knowledge area and 71.6% of the skill area, the curriculum for midwifery in Iran corresponded to ICM essential competencies. After surveying expert members during multiple Delphi rounds, the members agreed to add some lessons to the midwifery curriculum, design a new course, and hold related workshops to cover the competencies identified as inadequate or relatively inadequate in the comparative analysis. CONCLUSION: The Iranian midwifery curriculum for acquiring 24 items of ICM essential competencies was deemed inadequate or relatively inadequate. Therefore, it seems in addition to revising Iran's midwifery curriculum following ICM competencies, providing midwifery policymakers with infrastructure and additional support to develop and implement effective midwifery training programs is necessary to ensure that midwives are trained and equipped with the necessary competencies for practice.

A program quality framework: a collaborative teaching team approach to quality assurance, quality enhancement and staff capacity building.

A global shortage of registered nurses provides a further impetus to retain nursing students and graduate safe nurses. While various frameworks support curriculum design and describe the need for ongoing curriculum evaluation and monitoring, there is little in the literature to support the enactment and ongoing quality enhancement of curricula. Translation of the curriculum plan into the delivered curriculum relies on academics who may or may not be adequately prepared for course writing and teaching in higher education settings, despite their discipline expertise. Additionally, there are well recognized issues of curriculum drift where curriculum innovations and changes are whittled away over time by incremental changes to courses that interfere with the integrity of the accredited curriculum. We propose an evidence-based Program Quality (ProQual) Framework that takes a holistic, collaborative, and systematic approach to monitoring and enhancing curriculum quality and program delivery over the life of the curriculum while developing staff capability and scholarship.

'We are in for a culture change': continuing professional development leaders' perspectives on COVID-19, burn-out and structural inequities.

INTRODUCTION: The COVID-19 pandemic positioned healthcare systems in North America at the epicentre of the crisis, placing inordinate stress on clinicians. Concurrently, discussions about structural racism, social justice and health inequities permeated the field of medicine, and society more broadly. The confluence of these phenomena required rapid action from continuing professional development (CPD) leaders to respond to emerging needs and challenges. METHODS: In this qualitative study, researchers conducted 23 virtual semistructured interviews with CPD leaders in Canada and the USA. Interview audiorecordings were transcribed, deidentified and thematically analysed. RESULTS: This study revealed that the CPD leaders attributed the pandemic as illuminating and exacerbating problems related to clinician wellness; equity, diversity and inclusion; and health inequities already prevalent in the healthcare system and within CPD. Analysis generated two themes: (1) From heroes to humans: the shifting view of clinicians and (2) Melding of crises: an opportunity for systemic change in CPD. DISCUSSION: The COVID-19 pandemic increased recognition of burn-out and health inequities creating momentum in the field to prioritise and restrategise to address these converging public health crises. There is an urgent need for CPD to move beyond mere discourse on these topics towards holistic and sustainable actionable measures.

Forming Physicians: Evaluating the Opportunities and Benefits of Structured Integration of Humanities and Ethics into Medical Education.

This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students' perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be "in" medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training.

Clínicas Integradas em Odontologia, desafios, oportunidades e perspectivas: uma revisão de literatura

As clínicas integradas em Odontologia constituem em um desafio para o ensino superior na formação do profissional, que deverá aprender a tratar as condições orofaciais de seu paciente de forma diferenciada no futuro próximo, aliando cada vez mais a Odontologia e as novas tecnologias. Objetivou-se com este estudo de revisão discutida entender o conceito de clínica integrada e suas perspectivas em consonância com as Diretrizes Curriculares Nacionais. Foi realizado um levantamento bibliográfico sistematizado nos bancos de dados eletrônicos: Lilacs, PubMed e Scielo. Os termos em português e inglês "Educação em Odontologia" (Dental Education), "Clínicas Odontológicas" (Dental Clinics), "Graduação" (Undergraduate Program), "Prestação Integrada de Cuidados de Saúde" (delivery of health care, integrated) e "Currículo" (Curriculum) foram utilizados como palavras-chave. Foram eleitos 23 artigos para esta revisão e extraídas as ideias principais dos textos tendo como base as metodologias utilizadas e os principais resultados. Os autores foram unânimes em ressaltar que as clínicas integradas em Odontologia exercem influência na formação e no preparo do egresso generalista através do treinamento sobre um planejamento global, inter e multidisciplinar como pilar essencial para um currículo integrativo e inovador.

ntegrated clinics in Dentistry present a challenge for higher education in the training of professionals, who must adapt their approach to treating orofacial conditions in the near future, increasingly incorporating Dentistry and new technologies. This review study aimed to comprehend the concept of integrated clinics and its alignment with the National Curricular Guidelines. A systematic bibliographic survey was conducted in the following electronic databases: Lilacs, PubMed, and Scielo. The search employed keywords in both Portuguese and English, including "Education in Dentistry" (Dental Education), "Dental Clinics", "Graduation" (undergraduate program), "Integrated Provision of Health Care" (delivery of health care, integrated), and "Curriculum." Approximately 23 articles were selected for this review, and the primary ideas within the texts were extracted based on the employed methodologies and the principal results. The authors unanimously emphasized that integrated dentistry clinics significantly impact the training and preparation of generalist graduates. This influence stems from emphasizing global, inter, and multidisciplinary planning as an indispensable foundation for an integrative and innovative curriculum.