Cultural Appropriation for Improved Knowledge Acquisition in Medical Education.

Background: Culture is an essential component that governs all aspects of human behavior. Superstition is an irrational belief observed in almost all cultures. It is linked to one or more factors like supernatural powers, good luck, bad omen, fiction, illegitimate activity, absurd narration, folk tales, or practice without any rational basis. Methods: A cross-sectional social experiment was conducted to evaluate the effect of cultural appropriation as a tool to enhance medical knowledge acquisition and attitudinal development in medical education. The experiment was designed to target a non-medical population. Four superstition-oriented videos were developed with 20 scientific pieces of information related to forensic medicine. A data collection sheet was developed on Microsoft form with 16 questions was distributed on the participants. Results: Out of the 986 participants, 763 (77.5%) watched the whole set of videos. About 55-95% of responders demonstrated knowledge acquisition of all the questions. There was a statistically significant difference between those who watched the videos and those who did not. When participants were asked about the most important information they remember from the videos, their answers fell into two main categories; information related to core scientific knowledge (80% of participants) and information not related to the core knowledge (16% of respondents). The top three areas for the reasons why people wanted to watch the videos were curiosity, knowledge, and career. A change in attitudes was reported among the participants where 80% of responders demonstrated curiosity to know more about this world, 46% responders reported developing more respect for the forensic physician and 43% revealed their ignorance about this great hidden world. Conclusion: Cultural appropriation could be a needed strategy to accommodate for upscale in education. Learners might validate that learning happens through a door that adopts not only honours their culture and adapts to it.

Perception of online and face to face microbiology laboratory sessions among medical students and faculty at Arabian Gulf University: a mixed method study.

BACKGROUND: The COVID-19 pandemic has impacted all spheres of society including medical education and healthcare systems. In response to the pandemic, there has been a transition in medical education practice from traditional forms of teaching to online instruction delivery and virtual learning. Effective clinical microbiology education involves a combination of 'hands-on' practical learning and instructional delivery of scientific knowledge. Microbiology practical laboratories are critical learning environments offering 'hands-on' learning experiences that cannot be replicated through online learning. We conducted a mixed-methods study to understand the perception of online and face-to-face microbiology laboratory sessions among the medical students and microbiology faculty at Arabian Gulf University (AGU). METHODS: The study participants were third and fourth-year undergraduate medical students and faculty involved in delivering microbiology labs at AGU. The questionnaire consisted of questions ranging from perceived learning style to attitude towards online delivery of microbiology curriculum. After the questionnaire administration (google form), focus group discussion (FGD) was conducted for students and microbiology faculty separately. RESULTS: Among 168 students, 50.6% preferred face-to-face lab sessions as compared to 30.4% who preferred online labs, and 51.8% considered online labs to be an essential addition to face-to-face labs. Among the faculty, 85.7% preferred the face-to-face mode of teaching. All the faculty (100%) disagreed that all the microbiology labs teaching should be online. 57.2% considered online labs to be an essential addition to traditional face-to-face labs. Both faculty and students hold that a blended mode of instructional delivery is vital and indispensable for the transfer of skills and knowledge for microbiology students. CONCLUSION: The blended mode of delivering microbiology laboratory sessions in medical school is successful and well-received by both students and faculty. Students take the responsibility for furthering their own learning and understanding of concepts. Instructors have also noticed that blending learning strategies also successfully enhances the development of cognitive skills and problem-solving abilities in students. A review of the microbiology lab curriculum is necessary to identify content areas that can be delivered effectively through online, face-to-face lab sessions, or both, supported with appropriate tools and infrastructure.

A guide to best practice in faculty development for health professions schools: a qualitative analysis.

BACKGROUND: This is a practice guide for the evaluation tool specifically created to objectively evaluate longitudinal faculty development programs (FDP) using the "5×2 -D backward planning faculty development model". It was necessary to create this tool as existing evaluation methods are designed to evaluate linear faculty development models with a specific endpoint. This backward planning approach is a cyclical model without an endpoint, consisting of 5 dynamic steps that are flexible and interchangeable, therefore can be a base for an evaluation tool that is objective and takes into account all the domains of the FDP in contrast to the existing, traditional, linear evaluation tools which focus on individual aspects of the program. The developed tool will target evaluation of longitudinal faculty development programs regardless of how they were planned. METHODOLOGY: Deductive qualitative grounded theory approach was used. Evaluation questions were generated and tailored based on the 5 × 2-D model followed by 2 Delphi rounds to finalize them. Based on the finalized evaluation questions from the results of the Delphi rounds, two online focus group discussions (FGDs) were conducted to deduce the indicators, data sources and data collection method. RESULTS: Based on the suggested additions, the authors added 1 new question to domains B, with a total of 42 modifications, such as wording changes or discarding or merging questions. Some domains received no comments, therefore, were not included in round 2. For each evaluation question, authors generated indicators, data sources and data collection methods during the FGD. CONCLUSION: The methodology used to develop this tool takes into account expert opinions. Comprehensiveness of this tool makes it an ideal evaluation tool during self-evaluation or external quality assurance for longitudinal FDP. After its validation and testing, this practice guide can be used worldwide, along with the provided indicators which can be quantified and used to suit the local context.

Validation of academic motivation scale among medical students using factor analysis and structural equation modeling: Middle Eastern perspective.

BACKGROUND: Demanding careers like medicine requires a lot of motivation and the Academic Motivation Scale (AMS) developed by Vallerand et al. (1992) is an instrument to measure motivation. This study evaluated the validity and reliability of AMS among medical students in the Middle East. MATERIALS AND METHODS: This was a methodological research utilizing a convenient sampling technique. AMS scale comprising 28 items subdivided into seven subscales was administered to 900 students (281 students returned the filled AMS). Data were analyzed using the descriptive statistics, one-way ANOVA, and t-tests. Exploratory factor analysis and Cronbach's alpha were used to evaluate the validity and reliability of the scale, respectively. RESULTS: There was a statistically significant difference between both genders in overall scores (P = 0.015*), two subscales, namely "Identified Regulation" (P =0.017*) and "Stimulating Experience" (P = 0.015*), with females showing higher value. Second-year students (n = 91) had significantly higher score (10.9 ± 4.1) for "Amotivation" (P =.001*) and first-year students (n = 48) had significantly higher score (16.2 ± 3.0) for "Achievement" subscale (P =.014*). P < 0.05 was considered statistically significant with 95% confidence interval. No statistically significant difference was observed between the groups based on nationality or age. Bartlett's test of sphericity was significant (Chi-square: 2988.010; df = 278; P < 0.001). Kaiser-Meyer-Olkin was 0.890. Principal component analysis with varimax rotation extracted seven factors corresponding to the original items of AMS questionnaire. All subscales correlated positively except "amotivation." Structural equation modeling revealed the relation between observed and unobserved variables. DISCUSSION: This study demonstrated that AMS is valid and reliable for application among Middle East medical students, without needing any modification. AMS has widespread application in medical education as it impacts learning outcomes. CONCLUSION: This study demonstrated that AMS is valid and reliable for application among the Middle East students without needing any modification.

Validation of Internal structure of Self-Directed Learning Readiness Scale among Indian Medical Students using factor analysis and the Structural equation Modelling Approach.

BACKGROUND: The Self-Directed Learning Readiness Scale (SDLRS) is a tool that helps in the assessment of the readiness of the students to pursue Self-Directed Learning (SDL). There are no documented studies on the validation of internal structure of the SDLRS among Indian medical students. Hence, the objective of this study is to validate the internal structure of SDLRS among Indian medical students using factor analysis and the Structural Equation Modelling (SEM) approach. METHODS: We administered Fisher's 40-item SDLRS to 750 students after receiving the ethics clearance and the author's permission and taking written informed consent from all the study participants (response rate: 92%). The exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha were performed using SPSS version 25 and the Lavaan package of R version 3.1.2. RESULTS: The values of the comparative fit index (CFI), standardised root-mean-square residual (SRMR), and root mean square error of approximation (RMSEA) were ≥ 0.9, ≤ 0.08, and ≤ 0.08, respectively, for a model fit to be acceptable. EFA showed that except for Q2 (loading score: 0.210), Q12 (loading score: 0.384), Q13 (loading score: 0.362), and Q25 (loading score: -0.219), all the items loaded well. After the exclusion of the aforementioned items, the factor loading scores for the items in the self-management, desire for learning, and self-control factors ranged from 0.405 to 0.753 (Cronbach α: 0.775), 0.396 to 0.616 (Cronbach α: 0.730), and 0.427 to 0.556 (Cronbach α: 0.799), respectively. The updated model was used for CFA, which displayed a good model fit. CONCLUSIONS: The resultant model consisting of 36 items is shown to have internal structure validity for Indian version of SDLRS, which can be used to assess medical students.

Validation of Metacognitive Awareness Inventory from a Private Medical University in India.

BACKGROUND: Metacognition is the awareness and the capability to regulate one's own thinking process. Metacognition is critical in medical education for clinical reasoning and management. Hence, the objective of this study is to evaluate the construct validity and reliability of the Metacognitive Awareness Inventory (MAI) among first-year medical and dental students, from a private medical university in India, using confirmatory analysis and internal consistency method. MATERIALS AND METHODS: This was a cross-sectional study using convenient sampling. Fifty-two-item MAI was administered to 933 first-year medical and dental students from a private medical university in India. Exploratory factor analysis (EFA), principal component analysis, Cronbach's α, and confirmatory factor analysis with global fit indices were performed. Structural equation modeling (SEM) was performed to evaluate the relationship between the structural path and factors using AMOS version 22. RESULTS: During EFA, 12 items with <0.40 factor loadings were trimmed sequentially. The remaining items with respective factors had a good internal consistency of ≥ 0.9. Comparative fit index (0.78), goodness-of-fit index (0.8), adjusted goodness of fit index (0.77), Tucker-Lewis index (0.7), standardized root mean square residual (0.06), and root mean square error of approximation (0.09) values showed that six-factor model fits to satisfactory. Pearson's correlation coefficient was found to be high between factors (>0.80). SEM for each item (observed) and factor (unobserved) illustrated the hypothesized model. CONCLUSION: The resultant 40-item model based on MAI designed by Schraw is a valid and reliable tool for assessing the metacognitive awareness of Indian students. Employing a valid and reliable tool in assessing the metacognitive awareness will help the academicians in incorporating appropriate curricular interventions.

Development and validation of a structured feedback questionnaire from postgraduates on various elements of postgraduate medical curriculum.

BACKGROUND: Medical Council of India, introduced the Post Graduate (PG) curriculum as 'Competency Based Medical Education' (CBME). Feedback from the end users is a vital step in curriculum evaluation. Therefore, the primary objective of this study was to develop and validate a Structured Feedback Questionnaire (SFQ) for postgraduates, encompassing all the components of the PG-CBME curriculum. METHODS: SFQ was developed with 23 Likert based questions and four open ended questions. Content validation was done by Lawshe method. After getting institutional ethics clearance and informed consent, SFQ was administered to 121 final year PGs (response rate 100%). We performed Principal component analysis (PCA), Structural equation modeling (SEM), Chi squared test (χ2/df); goodness-of-fit index (GFI); adjusted GFI; comparative fit index (CFI) and root mean square error of approximation (RMSEA). Cronbach's alpha was done for estimating the internal consistency. RESULTS: The validation resulted in a three-factor model comprising of "curriculum" (42.1%), "assessment" (28%), and "support" (18.5%). Chi squared test (χ2/df ratio) < 2, CFI (0.78), GFI (0.72) and RMSEA (0.09) indicated superior goodness of fit for the three-factor model for the sample data. All the extracted factors had good internal consistency of ≥0.9. CONCLUSION: We believe that this 23 item SFQ is a valid and reliable tool which can be utilized for curriculum evaluation and thereby formulating recommendations to modify the existing curriculum wherever required, facilitating enriched program outcomes.

Evaluation of Curricular Adaptations Using Digital Transformation in a Medical School in Arabian Gulf during the COVID-19 Pandemic.

BACKGROUND: Several institutions adopted innovative approaches to ensure continued learning for their students during the COVID-19 pandemic. All curricular innovations should undergo curriculum evaluation; hence, the objective of this paper was to share the salient features of evaluation using faculty and student's feedback on curricular adaptations implemented through digital transformation in a Medical School in Arabian Gulf during the COVID-19 pandemic, using a structured questionnaire. METHODOLOGY: After getting informed consent, feedback about acceptability and limitations regarding various aspects of curricular adaptations was obtained from students and faculty, using a structured and validated questionnaire. The response rate from faculty and students was 90% and 60%, respectively. The qualitative responses were analyzed using thematic analysis. RESULTS: About 97% agreed that Modular Object-Oriented Dynamic Learning Environment, ZOOM, and Examsoft platforms were effective for curriculum delivery and assessment. 85% agreed that they were able to maintain online interactivity and 92% conveyed their willingness to continue to use these digital innovations even after the end of pandemic. "Lack of interactivity," "missed clinical training," "live sessions were more engaging than recorded ones" were the prominent themes emerged out of thematic analysis. All faculty and students expressed concern over the lack of clinical training involving real patients. All of them expressed appreciation to the university and faculty for their enormous efforts. CONCLUSION: Innovative ways should be considered to start clinical teaching with real patients, during pandemic. The learning outcomes of digital learning should be validated across all institutions. New indicators related to "digital learning" should be considered for accreditation of medical schools.