Achieving 'something that everybody has invested in': perspectives of diverse stakeholders during co-creation of a transition to residency curriculum.

Co-creation of education within the context of student inclusion alongside diverse stakeholders merits exploration. We studied the perspectives of students and teachers from different institutions who participated in co-creating a transition to residency curriculum. We conducted post-hoc in-depth interviews with 16 participants: final-year medical students, undergraduate, and postgraduate medical education stakeholders who were involved in the co-creation sessions. Findings build on the Framework of Stakeholders' Involvement in Co-creation and identify the four key components of co-creation with diverse faculty: immersion in positive feelings of inclusivity and appreciation, exchange of knowledge, engagement in a state of reflection and analysis, and translation of co-creation dialogues into intended outcomes. Despite power dynamics, participants valued open communication, constructive feedback, mutual respect, and effective moderation. The study broadened our understanding of the co-creation process in diverse stakeholder settings. Incorporating key elements in the presence of power relations can enrich co-creation by leveraging wider expertise.

Sailing the boat together: Co-creation of a model for learning during transition.

PURPOSE: Medical students' transition to postgraduate training, given the complexity of new roles and responsibilities, requires the engagement of all involved stakeholders. This study aims to co-create a transition curriculum and determine the value of involving the key stakeholders throughout such transition in its design process. METHODS: We conducted a mixed-methods study involving faculty/leaders (undergraduate/postgraduate), final-year medical students, and chief residents. It commenced with eight co-creation sessions (CCS), qualitative results of which were used to draft a quantitative survey sent to non-participants, followed by two consensus-building CCS with the original participants. We applied thematic analysis for transcripts of all CCS, and mean scores with standard deviations for survey analysis. RESULTS: We identified five themes: adaptation, authenticity, autonomy, connectedness, and continuity, embedded in the foundation of a supportive environment, to constitute a Model of Learning during Transition (MOLT). Inclusion of various stakeholders and optimizing their representation brought rich perspectives to the design process. This was reinforced through active students' participation enabling a final consensus. CONCLUSIONS: Bringing perspectives of key stakeholders in the transition spectrum enriches transition curricula. The proposed MOLT can provide a guide for curriculum designers to optimize the final year of undergraduate medical training in preparing students for postgraduate training with essential competencies to be trained.

A qualitative assessment of medical students' readiness for virtual clerkships at a Qatari university during the COVID-19 pandemic.

BACKGROUND: This study aims to qualitatively examine the readiness of medical students to change to virtual clerkship (VC) during the pandemic, from both the faculty and students' perspectives. METHODS: A qualitative study was conducted based on the framework of readiness to change. Focus group discussions with students, and semi-structured interviews with clinical faculty members were done using appropriate online platforms. Transcripts were then analyzed using inductive-deductive approach. RESULTS: Twelve themes emerged which are (1) Perceptions about the university's decision and its communication to students, (2) A Perceived lack of clinical experience, (3) Students' role as members of the medical team facing the pandemic, (4) Student safety, (5) Quality and design of VC and the skills it offered, (6) Belief in own ability to succeed in the VC, (7) Confidence that VC would reach its goals, (8) New enhanced learning approaches, (9) Preparing students for new types of practice in the future (10) Acquired skills, 11) Academic support and communication with faculty and college, and 12) Psychological support. Medical students showed limited readiness to undertake a virtual clerkship and not play their role as healthcare professionals during the pandemic. They perceived a huge gap in gaining clinical skills virtually and asked for a quick return to training sites. CONCLUSION: Medical students were not ready for virtual clerkships. There will be a need to integrate novel learning modalities such as patient simulations and case-based learning in order to meet future demands of the medical profession and enhance the efficiency of virtual clerkships.

A program evaluation reporting student perceptions of early clinical exposure to primary care at a new medical college in Qatar.

BACKGROUND: Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students' experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced. METHODS: We conducted a cross-sectional study of three student cohorts in 2017-19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students' perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students' perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire. RESULTS: One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues. CONCLUSIONS: Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students' perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.

Reshaping experiential education within Qatar University's Health Programs during the COVID-19 pandemic.

Health professions programs heavily depend on experiential learning to prepare learners for practice within the healthcare system. Learners acquire a significant proportion of patient care skills as they participate in experiential learning activities. As the coronavirus disease 2019 (COVID-19) pandemic disrupts education globally, educators have been challenged to reexamine existing teaching approaches to minimize the impact on experiential educational outcomes. This article describes how educators from the College of Pharmacy and College of Medicine at Qatar University utilized nontraditional teaching methods to ensure the continuation of experiential learning despite the disruption due to the pandemic.

Measuring medical students' professional competencies in a problem-based curriculum: a reliability study.

BACKGROUND: Identification and assessment of professional competencies for medical students is challenging. We have recently developed an instrument for assessing the essential professional competencies for medical students in Problem-Based Learning (PBL) programs by PBL tutors. This study aims to evaluate the reliability and validity of professional competency scores of medical students using this instrument in PBL tutorials. METHODS: Each group of seven to eight students in PBL tutorials (Year 2, n = 46) were assessed independently by two faculty members. Each tutor assessed students in his/her group every five weeks on four occasions. The instrument consists of ten items, which measure three main competency domains: interpersonal, cognitive and professional behavior. Each item is scored using a five-point Likert scale (1 = poor, 5 = exceptional). Reliability of professional competencies scores was calculated using G-theory with raters nested in occasions. Furthermore, criterion-related validity was measured by testing the correlations with students' scores in written examination. RESULTS: The overall generalizability coefficient (G) of the professional competency scores was 0.80. Students' professional competencies scores (universe scores) accounted for 27% of the total variance across all score comparisons. The variance due to occasions accounted for 10%, while the student-occasion interaction was zero. The variance due to raters to occasions represented 8% of the total variance, and the remaining 55% of the variance was due to unexplained sources of error. The highest reliability measured was the interpersonal domain (G = 0.84) and the lowest reliability was the professional behavior domain (G = 0.76). Results from the decision (D) study suggested that an adequate dependability (G = 0.71) can be achieved by using one rater for five occasions. Furthermore, there was a positive correlation between the written examination scores and cognitive competencies scores (r = 0.46, P < 0.01), but not with the other two competency domains (interpersonal and professionalism). CONCLUSIONS: This study demonstrates that professional competency assessment scores of medical students in PBL tutorials have an acceptable reliability. Further studies for validating the instrument are required before using it for summative evaluation of students by PBL tutors.

Exploring the challenges of virtual internships during the COVID-19 pandemic and their potential influence on the professional identity of health professions students: A view from Qatar University.

Introduction: COVID-19 has imposed many shared limitations on medical and health education. Just like other health professions programs at most institutions, the Qatar University health cluster (QU Health) applied a containment approach and shifted all learning online, and onsite training was replaced by virtual internships (VIs) during the first wave of the pandemic. Our study aims to explore the challenges of virtual internships during the COVID-19 pandemic and their influence on the professional identity (PI) of the health cluster students from the College of Medicine, the College of Health Sciences, and the College of Pharmacy at Qatar University. Methods: A qualitative approach was employed. In total, eight focus groups with students (N = 43) and 14 semi-structured interviews with clinical instructors from all the health cluster colleges were conducted. Transcripts were analyzed following the inductive approach. Results: The major challenges reported by students were mainly related to the lack of the required skills for navigating the VI, professional and social stressors, the nature of VIs and the quality of learning, technical and environmental issues, and the development of students' professional identity in an alternative internship environment. The challenges relating to the development of professional identity included: limited clinical (practical) experience, a lack of experience in fighting a pandemic, a lack of communication and feedback, and a lack of confidence in meeting the internship's goals. A model was constructed to represent these findings. Discussion: The findings are important in identifying the inevitable barriers to virtual learning for health professions students and provide a better understanding of how such challenges and different experiences would be affecting the development of their PI. Hence, students, instructors, and policymakers alike should strive to minimize these barriers. Since physical interactions and patient contact are indispensable components of clinical teaching, these extraordinary times demand innovations involving technology and simulation-based teaching. There is a need for more studies that are focused on determining and measuring the short- and long-term effects of the VI on students' PI development.

Health sciences students' and instructors' perceptions of the emergency switch to virtual internship amid the COVID-19 pandemic: A case from Qatar.

In efforts to contain the COVID-19 pandemic, health colleges at Qatar University shifted their clinical training to virtual internships (VI) and project-based learning (PBL). The shift was new to students and faculty alike, and a major change that posed many challenges. This study aimed to explore the experience of changing to VIs during the pandemic from both the clinical instructors' and health sciences students' perspectives. A qualitative study was conducted based on the framework of readiness to change. It involved focus group discussions with students from the departments of Public Health and Human Nutrition and in-depth interviews with clinical instructors using appropriate online platforms. A total of 4 focus groups with 20 students and 4 interviews with instructors were conducted. Transcripts were analyzed following the inductive-deductive approach. The major themes that emerged from the analysis described students' and clinical instructors' perceptions of the necessity and efficiency of the switch to VI; the design of the VI and the extent of the clinical/field experience and skills that it offered; confidence in the ability to succeed in this type of internship and confidence about reaching expected goals; academic and moral support from clinical faculty and coordinators and the communication process with faculty and preceptors; and finally, the benefits gained and how employers would view this type of internship. Health sciences students' readiness for VI was generally low. Several student and faculty needs have to be addressed, specifically regarding the design of the program and the level of preceptors' communication with students. The findings would direct health programs, clinical instructors, and preceptors to better understand students' needs and efficiently plan for virtual internships during not only emergencies but also whenever there is a need to deliver online experiential learning courses.

Group OSCE (GOSCE) as a formative clinical assessment tool for pre-clerkship medical students at the University of Sharjah.

OBJECTIVES: Continuous formative assessment with appropriate feedback is the pillar of effective clinical teaching and learning. Group Objective Structured Clinical Examination (GOSCE) has been reported as a resource-effective method of formative assessment. The present study aims to describe the development and evaluation of GOSCE as a formative assessment for pre-clerkship medical students. METHODS: At the University of Sharjah, GOSCE was introduced to medical students in Years 1, 2, and 3. The GOSCE was conducted as a formative assessment in which groups of 4-5 students were observed while they performed various clinical skills, followed by structured feedback from clinical tutors and peers. GOSCE was evaluated both quantitatively and qualitatively and appropriate statistical analysis was applied to evaluate their responses. RESULTS: A total of 232 students who attended the GOSCE responded to the questionnaires. Most of the students and clinical tutors preferred formative GOSCE over individual feedback. Both students and clinical tutors valued the experience as it helped students to identify gaps and to share knowledge and skills among group members. CONCLUSION: This study found that formative GOSCE provided a valuable and feasible educational opportunity for students to receive feedback about their clinical skills.