Beyond the surface: unraveling global health curriculum insights through interviews of learners and educators using the CIPP model.

PURPOSE: Our study aimed to delve beyond a surface-level understanding and explore the various dimensions of the global health curriculum from the perspective of both learners and educators using the Context, Input, Process, and Product (CIPP) model. METHODS: From 2020 to 2021, interviews were conducted with a total of 10 individuals, including five students who had taken at least one elective course and at least one elective research course, three teaching assistants (TA), and two faculty members who had taken more than four global health courses in multiple phases in the global health curriculum. Semi-structured interview questions based on the CIPP model were used and qualitative data were analyzed through content analysis. RESULTS: The study identified 12 sub-themes. Students held idealized views of global health careers and sought to bridge the gap through global health classes. They desired early exposure to global health courses, emphasizing both pre-medical and clinical phases. Challenges in adjusting course difficulty and recruiting faculty were identified, along with a preference for interactive teaching methods and offline discussions. The curriculum promoted reflection on medicine's essence, expanded career perspectives, and emphasized competencies like altruism, communication skills, and crisis management in the evolving global health landscape. CONCLUSION: This study showed that a comprehensive approach is possible from the perspective of learners and educators by identifying strengths, weaknesses, and the value of the curriculum's goals, plans, implementations, and results through the CIPP model. For optimal curriculum design, a sequential approach from basic to advanced courses is essential, promoting hands-on global health experiences for students.

Outcome Evaluation of a Transnational Postgraduate Capacity-Building Program Using the Objective Structured Clinical Examination.

Previous studies have applied interview-oriented self-reported or peer-centered evaluation methods, rather than an objective and quantitative method, to evaluate outcome of a postgraduate capacity-building program and have mainly focused on the cognitive level. To investigate the feasibility of the objective structured clinical examination (OSCE) in an international setting and report the results of the outcome evaluation for the behavioral aspect. A case-control study. Ninety examinees divided into 2 case-control groups: 17 program-experienced doctors and 17 control doctors in the first group, and 28 mentees of the program-experienced doctors and 28 control doctors in the second group. A six-station OSCE was implemented. The OSCE scores were measured to evaluate (1) the direct educational effect regarding learning in the first group and (2) the indirect educational effects regarding transfer in the second group. Written questionnaire and interview data were collected for qualitative analysis. The quantitative results of the overall or subcomponent OSCE scores indicated no significant differences in the comparisons of the first and second case-control groups. The qualitative data indicated that the program improved participants' medical knowledge, skills, and self-confidence, however, it also revealed limited learning environment provided by the program. This transnational study has demonstrated the process for introducing and successfully completing the testing of an OSCE in Laos. Discrepancy in the goals of the OSCE and the education program limited the usefulness of OSCE as an assessment tool, leading to the lack of significant differences in its results.

Is it feasible and effective to provide faculty development programs online for clinical teachers?

PURPOSE: Seoul National University College of Medicine operates a faculty development program for clinical teachers at multiple affiliated teaching hospitals. In 2020, the program was moved online due to coronavirus disease 2019. The purpose of this study was to determine whether it is feasible and effective to provide faculty development programs online in terms of clinical teachers' participation and satisfaction in comparison with offline programs. METHODS: Clinical teachers participated in the clinical teaching methods programs offline in 2019 and online in 2020. We analyzed participation rate and satisfaction level. All surveys items were rated on a 5-point Likert scale. We also interviewed instructors about the advantages and drawbacks of the online program. RESULTS: The participation rate of the online program (89.5%) was significantly higher than that of the offline program (67.8%). The overall satisfaction level for the online program (4.37) was similar to that for the offline program (4.50). CONCLUSION: Faculty development programs online are feasible and effective in medical education. We need to design training content that fits online programs, consider various online training methods to reinforce the strengths of online programs, and support participants to make good use of these programs.

The socio-economic transition and health professions education in Mongolia: a qualitative study.

BACKGROUND: Former socialist countries have undergone a socio-economic transition in recent decades. New challenges for the healthcare system have arisen in the transition economy, leading to demands for better management and development of the health professions. However, few studies have explored the effects of this transition on health professions education. Thus, we investigated the effects of the socio-economic transition on the health professions education system in Mongolia, a transition economy country, and to identify changes in requirements. METHODS: We used a multi-level perspective to explore the effects of the transition, including the input, process, and output levels of the health professions education system. The input level refers to planning and management, the process level refers to the actual delivery of educational services, and the output level refers to issues related to the health professionals, produced by the system. This study utilized a qualitative research design, including document review and interviews with local representatives. Content analysis and the constant comparative method were used for data analysis. RESULTS: We explored tensions in the three levels of the health professions education system. First, medical schools attained academic authority for planning and management without proper regulation and financial support. The government sets tuition fees, which are the only financial resource of medical schools; thus, medical schools attempt to enroll more students in order to adapt to the market environment. Second, the quality of educational services varies across institutions due to the absence of a core curriculum and differences in the learning environment. After the transition, the number of private medical schools rapidly increased without quality control, while hospitals started their own specialized training programs. Third, health professionals are struggling to maintain their professional values and development in the market environment. Fixed salaries lead to a lack of motivation, and quality evaluation measures more likely reflect government control than quality improvement. CONCLUSIONS: Mongolia continues to face the consequences of the socio-economic transition. Medical schools' lack of financial authority, the varying quality of educational services, and poor professional development are the major adverse effects. Finding external financial support, developing a core curriculum, and reforming a payment system are recommended.

Applying a mixed methods design for needs assessment of an international fellowship training program for Mongolian health professions.

PURPOSE: Continuing professional development is essential for improving health care services, especially in developing countries. Most of the training programs in Mongolia were not based on a targeted needs assessment. Therefore, we aimed to apply a mixed methods design to assess the training needs of Mongolian health professions. METHODS: We conducted a needs assessment using a convergent parallel mixed methods design in two steps. The survey and interview questions were developed to identify priority areas, targeted trainees, and effective training methods. A survey on 60 respondents, 15 individual interviews, and a focus group interview with 14 participants were conducted in the first step. In the second step, 12 representatives of key stakeholders were invited to a second focus group interview. RESULTS: Current health policy areas, areas related to future national plans, and areas not currently receiving governmental or international support were suggested as the main priorities. The stakeholder suggested that trainees should be selected based on their professional experience and language level, as well as each hospital's needs. Building teams including various professions, such as nurses, technicians, and biomedical engineers, was recommended as a way to exchange ideas with each other and to build teamwork for future collaboration. CONCLUSION: Medical training needs are dynamic and complex; therefore, a deep understanding of the context and setting is necessary. In this study, we assessed the targeted training needs of Mongolian health professions through a mixed methods design, which could be an effective way to conduct needs assessments for training programs.

Evaluation of Medical Humanities Course in College of Medicine Using the Context, Input, Process, and Product Evaluation Model.

BACKGROUND: Seoul National University College of Medicine has provided a new educational curriculum on basis of the competency-based curriculum since 2016. The new curriculum included the medical humanities course (MHC) to potentiate humanities of medical students. The present study applied the context, input, process and product (CIPP) evaluation model to the MHC in order to confirm the feasibility of the CIPP model and to improve the MHC by questionnaire survey and analysis of teaching materials. METHODS: This study analyzed the MHC provided to the freshmen in 2016 and to the freshmen and sophomores in 2017 by the CIPP model. Firstly, evaluation criteria and indicators were developed according to the CIPP classification. The materials collected from the course were analyzed by quantitative and qualitative analysis according to the evaluation criteria. In the quantitative analysis, an independent sample t-test was performed to verify the difference in the responses between the students (n = 522) and the professors (n = 22). In addition, content analysis was conducted for qualitative evaluation. RESULTS: There were significant differences in perceptions of MHC between students and professors about the results of almost all objective survey questions through the t-test, such as score 3.64 in students and 4.48 in professors in response to the item of 'provision of appropriate feedback.' As a result of the content analysis, 7 categories and 20 subcategories were derived. There were the most responses to various instructional methods (students, 20%; professors, 21.5%). CONCLUSION: The CIPP evaluation model was acceptable for the MHC analysis. The first task is to raise students' awareness of the MHC in order to improve the MHC quality.

Investigating the effects of interprofessional communication education for medical students.

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in 'communication between healthcare professionals in the clinical field' training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION: From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

How to execute Context, Input, Process, and Product evaluation model in medical health education.

Improvements to education are necessary in order to keep up with the education requirements of today. The Context, Input, Process, and Product (CIPP) evaluation model was created for the decision-making towards education improvement, so this model is appropriate in this regard. However, application of this model in the actual context of medical health education is considered difficult in the education environment. Thus, in this study, literature survey of previous studies was investigated to examine the execution procedure of how the CIPP model can be actually applied. For the execution procedure utilizing the CIPP model, the criteria and indicators were determined from analysis results and material was collected after setting the material collection method. Afterwards, the collected material was analyzed for each CIPP element, and finally, the relationship of each CIPP element was analyzed for the final improvement decision-making. In this study, these steps were followed and the methods employed in previous studies were organized. Particularly, the process of determining the criteria and indicators was important and required a significant effort. Literature survey was carried out to analyze the most widely used criteria through content analysis and obtained a total of 12 criteria. Additional emphasis is necessary in the importance of the criteria selection for the actual application of the CIPP model. Also, a diverse range of information can be obtained through qualitative as well as quantitative methods. Above all, since the CIPP evaluation model execution result becomes the basis for the execution of further improved evaluations, the first attempt of performing without hesitation is essential.

Developing a core competency model for translational medicine curriculum.

PURPOSE: This study aimed to develop a core competency model for translational medicine curriculum in the Korean graduate education context. METHODS: We invited specialists and key stakeholders to develop a consensus on a core competency model. The working group composed of 17 specialists made an initial draft of a core competency model based on the literature review. The initial draft was sent to the survey group by email to ask whether they agreed or disagreed with each core competency. The working group simplified, merged, or excluded the competencies that received less than 80% agreement among the 43 survey respondents. The working group also reorganized the order of the domains and competencies based on the survey results, and clustered the domains into four major areas. RESULTS: The final core competency model has four areas, 12 domains, and 34 core competencies. The major areas are theory-based problem assessment and formulation, study design and measurement, study implementation, and literature review and critique. CONCLUSION: This new core competency model will provide guidance for the competency based education of translational medicine in Korea.

Process-oriented evaluation of an international faculty development program for Asian developing countries: a qualitative study.

BACKGROUND: Non-English-speaking developing countries in Southeast Asia have been provided only limited opportunities for faculty development in the education of health professions. Although there exist a few programs that have been shown to be effective, they are frequently presented with few explanations on how and why the programs work due to their outcome-oriented nature. This study explores the process of the Lee Jong-Wook Fellowship for Health Professional Education, an international faculty development program designed for capacity building of educators of health professions in Southeast Asian developing countries. METHODS: Fellows were from Cambodia, Myanmar, and Laos. Qualitative data were collected from two types of semi-structured interviews - group and individual. Thematic analysis was conducted to explore the factors related to the effectiveness of the program, framed by four components of faculty development, which included context, facilitators, program, and participants. RESULTS: From the thematic analysis, the authors identified a total of 12 themes in the four components of faculty development. In the context domain, the resource-poor setting, a culture that puts emphasis on hierarchy and seniority, and educational environment depending on individual commitment rather than broad consensus emerged as key factors. In the facilitators domain, their teaching methods and materials, mutual understanding between teacher and learner, and collaboration between facilitators mainly influenced the learning during the fellowship. In the program domain, the key advantages of the fellowship program were its applicability to the workplace of the fellows and enough allowed time for practice and reflection. Finally, in the participants domain, Fellows valued their heterogeneity of composition and recognized cognitive as well as non-cognitive attributes of the participants as essential. CONCLUSIONS: This process-oriented evaluation reveals the diverse factors that contributed to achieving the intended outcomes of the fellowship. Although much evidence from best practices in faculty development are still valid, the findings suggest that the selection strategies, learning environment, and English communication should be given more consideration when organizing a program targeting these people and cultures. A comprehensive understanding of the process would contribute to developing tailored strategies for educators of health professions in developing countries in similar settings.

Institutional factors affecting participation in national faculty development programs: a nation-wide investigation of medical schools.

BACKGROUND: Medical schools have used faculty development programs as an essential means to improve the instruction of faculty members. Thus far, however, participating in such programs has been largely voluntary for individuals even though a certain degree of participation is required to achieve practical effectiveness. In addition, the learning behaviors of faculty members are known to be influenced by organizational contexts such as a hidden curriculum. Therefore, this study explored the organizational characteristics of medical schools affecting attendance at faculty development programs. METHODS: Forty medical schools in South Korea were included in this study. In total, 1,667 faculty members attended the faculty development programs at the National Teacher Training Center for Health Personnel between 2007 and 2015. For independent variables, information on the basic characteristics and the educational states was collected from all the medical schools. Themes were identified from their educational goals and objectives by inductive content analysis. RESULTS: The number of nine-year cumulative attendees from medical schools ranged from 8 to 104. The basic characteristics of the medical schools had little influence on faculty development program attendance, while several themes in the educational goals and objectives, including "cooperation", "serving various societies", and "dealing with a changing future" showed a significant difference in participation. The number of full-time faculty showed a significant positive correlation when it was smaller than the median, and the proportion of alumni faculty showed a significant negative correlation when it was higher than 50%. CONCLUSIONS: This study adds to existing knowledge on factors affecting attendance at faculty development programs by identifying related institutional factors that influence attendance. While the variations depending on the basic characteristics were minimal, the organizational environment surrounding medical education significantly contributed to attendance. Addressing institutional as well as individual factors could contribute to improving participation by faculty members in faculty development programs.

Transnational collaboration for faculty development in health professions education in Mongolia.

PURPOSE: The Mongolian National University of Medical Sciences is the only national university in Mongolia and has produced more than 90% of health professionals in the country. Experts from Mongolia and Korea embarked on a collaborative effort to develop educational programs for faculty development based on the personal and professional needs of faculty members. This study aimed to evaluate the outcomes of those educational programs to determine whether this transnational collaboration was successful. METHODS: A needs assessment survey was conducted among 325 faculty members. Based on the results of this survey, the joint expert team developed educational programs on seven core topics: clinical teaching, curriculum development, e-learning, item writing, medical research, organizational culture, and resident selection. Surveys evaluating the satisfaction and the attitudes of the participants were conducted for each program. RESULTS: Throughout the 17-day program, 16 experts from Korea and 14 faculty members from Mongolia participated as instructors, and a total of 309 participants attended the program. The average satisfaction score was 7.15 out of 8.0, and the attitudes of the participants towards relevant competencies significantly improved after each educational program. CONCLUSION: The faculty development programs that were developed and implemented as part of this transnational collaboration between Mongolia and Korea are expected to contribute to the further improvement of health professions education in Mongolia. Future studies are needed to evaluate the long-term outcomes of these educational programs.

Evaluation of a continuing professional development training program for physicians and physician assistants in hospitals in Laos based on the Kirkpatrick model.

PURPOSE: Medical professionals from Korea and Laos have been working together to develop a continuing professional development training program covering the major clinical fields of primary care. This study aimed to evaluate the effectiveness of the program from 2013 to 2014 using the Kirkpatrick model. METHODS: A questionnaire was used to evaluate the reaction of the trainees, and the trainers assessed the level of trainees' performance at the beginning and the end of each clinical section. The transfer (behavioral change) of the trainees was evaluated through the review of medical records written by the trainees before and after the training program. RESULTS: The trainees were satisfied with the training program, for which the average score was 4.48 out of 5.0. The average score of the trainees' performance at the beginning was 2.39 out of 5.0, and rose to 3.88 at the end of each section. The average score of the medical records written before the training was 2.92 out of 5.0, and it rose to 3.34 after the training. The number of patient visits to the district hospitals increased. CONCLUSION: The continuing professional development training program, which was planned and implemented with the full engagement and responsibility of Lao health professionals, proved to be effective.

Etiquette for medical students' email communication with faculty members: a single-institution study.

BACKGROUND: Email is widely used as a means of communication between faculty members and students in medical education because of its practical and educational advantages. However, because of the distinctive nature of medical education, students' inappropriate email etiquette may adversely affect their learning as well as faculty members' perception of them. Little data on medical students' competency in professional email writing is available; therefore, this study explored the strengths and weaknesses of medical students' email etiquette and factors that contribute to professional email writing. METHODS: A total of 210 emails from four faculty members at Seoul National University College of Medicine were collected. An evaluation criteria and a scoring rubric were developed based on the various email-writing guidelines. The rubric comprised 10 items, including nine items for evaluation related to the email components and one item for the assessment of global impression of politeness. Three evaluators independently assessed all emails according to the criteria. RESULTS: Students were identified as being 61.0% male and 52.8% were in the undergraduate-entry program. The sum of each component score was 62.21 out of 100 and the mean value for global impression was 2.6 out of 4. The results demonstrated that students' email etiquettes remained low-to-mediocre for most criteria, except for readability and honorifics. Three criteria, salutation (r=0.668), closing (r=0.653), and sign-off (r=0.646), showed a strong positive correlation with the global impression of politeness. Whether a student entered a graduate-entry program or an undergraduate-entry program significantly contributed to professional email writing after other variables were controlled. CONCLUSIONS: Although students in the graduate-entry program demonstrated a relatively superior level of email etiquette, the majority of medical students did not write emails professionally. Educating all medical students in email etiquette may well contribute to the improvement of student-faculty relationships as well as their email writing.

Evaluation of an international faculty development program for developing countries in Asia: the Seoul Intensive Course for Medical Educators.

BACKGROUND: The issue of collaboration in medical education is becoming prominent. Some faculty development programs have suggested an approach for promoting collaboration on a global level. However, non-English-speaking developing countries in Asia, especially in Southeast Asia, do not take advantage of them due to their unique context, such as language and culture. To address these issues, Seoul National University College of Medicine initiated a 6-week international faculty development program called the "Seoul Intensive Course for Medical Educators" for 16 fellows from five Asian countries (Cambodia, Laos, Mongolia, Myanmar, and Vietnam). The aim of this study is to report the evaluation results of the outcome of the program and discuss better ways of collaborating with developing countries. METHODS: Three levels of collaboration-intraorganizational, intranational, and international-were central initiatives of the program. Prior to setting up the program details, we first established four design principles, following which the contents, materials, and facilitators were determined to maintain consistency with the design principles. The evaluation of the program was done with Kirkpatrick's four-level model. Most of the evaluation data for level 1 were collected by two questionnaires, the post-module survey and the post-program survey. Portfolios and progress reports were mainly used to collect outcome data for levels 2 and 3, respectively. RESULTS: The reaction was generally positive throughout the program and there was a significant correlation between satisfaction and relevance to one's job or needs. Despite the fellows' propensity for overestimating themselves, both the evaluators and fellows reported that there was significant improvement in learning. Opinions on the impact or urgency of the topics were slightly different from country to country; however, the answers regarding feasibility were fairly similar. Moreover, we could observe from the post-program progress reports that the transfer of learning was actively in progress, mainly for topics that were highly feasible. CONCLUSIONS: These results show that the program was successful in terms of its effectiveness. Consistent and timely support is essential for the sustainable development of the medical education systems in these countries. Further understanding of the underlying factors on transfer (level 3) could improve the effectiveness of faculty development programs for developing countries.

[Research and development of evaluation criteria for premedical curriculum].

PURPOSE: The purpose of this study was to develop criteria to evaluate a premedical curriculum to ultimately improve the quality of premedical education. METHODS: The first draft of the evaluation criteria was developed through a literature review and expert consultation. The Delphi survey was conducted to ensure the validity of the draft. RESULTS: The final premedical curriculum criteria consisted of three evaluation areas (curriculum development, curriculum implementation, and curriculum outcome), five evaluation items (educational objective, organization of curriculum, instructional method, class management,and educational outcome), and 18 evaluation indicators. CONCLUSION: There should be further discussion on the evaluation questionnaire and the content for each evaluation indicator with regard to its practical application. Also, a concrete evaluation system, including evaluation standards and rating scales, should be developed.

The Effect of Formative Program Evaluation on Continuous Program Improvement: A Case Study of a Clinical Training Program in Lao PDR.

This study aimed to evaluate the effect of the formative program evaluation on the continuous improvement of a clinical training program for Lao health professionals. The training program was conducted 4 times consecutively for total 48 health professionals, and the formative program evaluation was carried out during the whole process. To evaluate the satisfaction and the transfer of the trainees, the questionnaire survey, the focus group interview, and the trainees' medical records were used. After the end of each batch of the program, the evaluation data were analyzed, and its results were shared with the training management committee and the trainers, who, based on the results, reached a consensus on how to improve the program. The evaluation results and the comparison of them among the four batches of the program showed that there was a continuous increase of the satisfaction and the transfer of the trainees, especially in the early period of the program. The formative program evaluation which was conducted during the whole process of the clinical training program had a positive effect on the improvement of the program, especially in the early phase, by increasing the satisfaction and transfer of the trainees.

[What is the current orientation of undergraduate medical education in Korea?].

PURPOSE: The educational purpose of a medical school is important, because it guides educational decisions in an individual organization and projects the image of the doctors that we are generating. By analyzing the educational goals of entire medical schools, this study aimed to examine the current orientation and future direction of undergraduate medical education in Korea. METHODS: Educational goals were collected from the website of each medical school and subjected to inductive content analysis. After identifying categories and themes, we examined the differences between medical school subgroups and compared the categories with competencies that have been suggested by the "Korean Doctor's Role." RESULTS: Thirteen themes were identified: medical expertise, professionalism, contribution to various levels of society, self-management and development, basic educational ideology, research ability, cooperation, leadership, dealing with future change, respect for life, creativity, problem-solving ability, and ability to educate. There was a significant difference in educational goals between medical schools when grouped by geographic location and affiliation of research-driven hospitals. Of the 16 competencies that are suggested by the Korean Doctor's Role, 12 had one or more corresponding categories. CONCLUSION: Per their current educational purposes, Korean medical schools pursue a broad variety of competencies that need cultivating during the course of undergraduate medical education. Further research is needed to determine how best to apply these educational purposes in actual institutions and ultimately lead them to become part of the competency of a graduate.

Effects of an online problem-based learning program on sexual health care competencies among oncology nurses: a pilot study.

PURPOSE: The purpose of this study was to test the effectiveness of an online problem-based learning (e-PBL) program that offers multimedia scenarios to develop sexual health care competencies. METHOD: A pretest­posttest control group design was used with two randomized groups in one Korean tertiary hospital. The sample included 32 RNs who cared for oncology patients. The intervention group completed an e-PBL cycle consisting of eight tutorials. RESULTS: Nurses in the intervention group scored significantly higher on knowledge than did those in the control group. The intervention group exhibited no significant differences in attitude and practices following the intervention. CONCLUSION: The results show the potential of e-PBL to enhance traditional PBL by offering multimedia scenarios in an interactive and flexible learning environment.