Polarity Based Model for Guiding Medical School Strategy During Crisis - A Cross Sectional Qualitative Study.

BACKGROUND: Crises in academia can best be dealt with as a polarity that needs to be leveraged rather than a problem that needs to be solved. This work aimed at utilizing the Polarity Approach for Continuity and Transformation (PACT)™ to establish a guide for medical schools during times of crisis to minimize the effect of crisis-driven decisions on strategic growth. SUBJECTS AND METHODS: A qualitative study following the 5-Steps of the PACT process was conducted. A virtual mapping session was held with 108 medical educators from 22 countries to determine the upsides and downsides of strategic orientation and crisis management subsequently. RESULTS: Four polarity maps were generated identifying four tension areas; University reputation, mission, teams, and individuals followed by a 72-item assessment and another mapping session to map the warning signs and action steps. A comparison between private school scores and the whole cohort of respondents showed that private schools had the least problems in team-oriented work. CONCLUSION: This study highlighted the importance of taking measures to communicate the mission and supporting team functions inside universities either by enhancing resources or utilizing time and effort-saving strategies.

Rationales and uncertainties for aspirin use in COVID-19: a narrative review.

OBJECTIVES: To review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19. DESIGN: Narrative review. SETTING: The online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance. PARTICIPANTS: Not applicable. RESULTS: A review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable. CONCLUSION: The authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40-70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin's protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.

A toolbox for conducting an online OSCE.

This toolbox highlights the lessons learned and the tools used to run the online OSCE at the College of Medicine and Medical Sciences, Arabian Gulf University (CMMS-AGU) using Zoom™ï¸. The examiners considered the examination to be valid in assessing all clinical skills except for psychomotor skills and students found it to be highly acceptable. We describe three phases. Planning and preparation phase in which situation analysis, aligning stakeholders, mobilizing resources, creating a shared vision, and ownership of the exam project take place. For successful implementation of examinations, detailed plans are needed including manpower, timings, number of stations and detailed description of the steps of the examination process. We provide a set of guiding questions for proper decision making related to online clinical exams. Implementation Phase in which piloting is very useful to apply improvements to the original plan and to outline the needed capacity building of the participating staff. We give a detailed description of the guiding documents, means of communication and features of ZOOM that were used. Evaluation phase we provide a guide for evaluating the process and outcome, including a list of key performance indicators.

Model for utilizing distance learning post COVID-19 using (PACT)™ a cross sectional qualitative study.

BACKGROUND: COVID - 19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression. AIM OF THE WORK: This work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning. METHODS: This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole. RESULTS: Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method. CONCLUSION: In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.

Step-by-step Guide to Create Competency-Based Assignments as an Alternative for Traditional Summative Assessment.

This article was migrated. The article was marked as recommended. The sudden, prolonged COVID-19 lockdown has offered a great challenge to the medical school. This was not only at the level of learning and curricular design but also the level of assessment. The traditional summative assessment tools have collapsed during this Pandemic. Herein, we provide a five-step guide for designing competency-based E-assignments for summative assessment. Innovative assignments designs are crucially required for fair summative assessment of the medical students, mainly in the pre-clerkship phase. These need to be innovative, engaging, competency-based, well-designed, with defined rubrics, integrated, and interdisciplinary whenever possible. These should also enforce the concepts of self-assessment and student peer assessment. Including the students in the formulation and design enhances their self-motivation where there is no face-to-face education. Designing an assignment with a quality product as an outcome increases the students' enthusiasm and self-confidence. A brief case-study is included as an example. Teaching after the pandemic era will greatly change with inevitable changes in the dogmatic concepts. Formative and summative assessments are probably changing seats which might be sustained for some time post-COVID-19.