Deconstructing the professional identity formation of basic science teachers in medical education.

PURPOSE: The role of basic science teachers (BSTs) in medical education has been changing dynamically. Less is known, however, about how BSTs perceive their professional identity and what factors influence its formation. This study aims to explore how the professional identity of BSTs is formed and what factors influence this professional identity formation (PIF) using the 4S ("Situation, Self, Support, Strategies") Schlossberg framework. METHOD: A qualitative descriptive study using focus groups (FGs) was conducted. Maximum variation sampling was used to purposively select BSTs. A rigorous thematic analysis was completed, including independent thematic analysis, intermittent checking and iterative discussions among researchers, and member checking. RESULTS: Nine FGs, involving 60 teachers, were conducted. The findings highlighted four major themes reflecting the 4S framework: the self as internal driver, early-career events and opportunities, individual and institutional support, and active participation in continuing professional development. Both the "Self" and the "Situation" components prompted the BSTs to utilize supports and enact strategies to become professional teachers. Although the BSTs in this study were primarily internally driven, they relied more on existing support systems rather than engaging in various strategies to support their growth. CONCLUSION: It is important to address the PIF of BSTs given their dynamic roles. Looking through the lens of the 4S framework, PIF is indeed a transition process. A structured, stepwise faculty development program, including mentorship, reflective practice, and a community of practice designed to foster BSTs' identities, should be created, taking into consideration the diverse factors influencing the PIF of BSTs.

Collaborative clinical reasoning learning using an integrated care pathway in undergraduate interprofessional education: An explorative study.

Collaborative clinical reasoning (CCR) is part of interprofessional collaborative practice and aims to negotiate and manage patient problems. An integrated care pathway (ICP) can be used as a framework for developing comprehensive patient care, typically in a clinical setting. This study aims to explore the CCR process in undergraduate interprofessional teams and the use of ICP as guidance in discussing a patient's problem and its comprehensive management. This is a qualitative study following phenomenology and was performed in an interprofessional education (IPE) program held by Health Science Cluster Universitas Indonesia. A total of four observations involving 40 students and four focus-group discussions involving 18 students from different health professions backgrounds were conducted to explore the CCR process using the ICP framework. In-depth interviews with four tutors from different health professions backgrounds and document analysis were also conducted as triangulation processes. This study shows that CCR was held in two stages - individual and group. The ICP framework could be used as a guiding tool in the CCR process to discuss the patient's management and discharge plan. This study also demonstrates that there are several challenges in this learning process, including the clinical case used in the discussion, the need for prior knowledge and previous exposure to IPE and the ICP framework, and health professions' dominance during the discussion. This study provides evidence on learning of CCR using the ICP framework as a guiding tool in a pre-licensure IPE program. This approach is useful for preparing students to develop an interprofessional, comprehensive, and holistic health care plan and to help them understand the roles of each profession.

Evaluation of Situational Judgment Tests in student selection in Indonesia and the impact on diversity issues.

BACKGROUND: Internationally, medical selection relies heavily on prior academic attainment which has an adverse impact on the diversity of selected students. Since non-academic attributes are also important, this study aims to evaluate the use of a Situational Judgment Test (SJT) for selection and the impact on student diversity relating to gender, ethnicity and socio-economic status. Previous SJT research has almost entirely originated from a Western context and this study focuses on new evidence in a South East Asian context with a different demographic profile. METHODS: Thirty faculty members developed 112 SJT scenarios assessing professionalism, communication and self-awareness domains. The scenarios underwent a concordance stage where stakeholder input was sought on the content appropriateness, to define the item scoring key, followed by an initial psychometric evaluation with first and second year medical students (N = 436). Based on these results, 30 scenarios, consisting of 128 nested items, were selected for pilot testing and evaluation regarding diversity issues with two cohorts of applicants in 2017 (N = 446) and 2018 (N = 508). RESULTS: The SJT demonstrated good internal consistency (Cronbach's alpha of 0.80 and 0.81 respectively). There were significant differences in SJT scores based on gender in both years, where females consistently outperformed males (p = .0001). However, no significant differences were found based on high school origin, parental educational background or ethnicity. CONCLUSIONS: This is the first study to evaluate the use of an SJT in Indonesia, which has a unique diversity profile compared to Western countries. Largely, the preliminary results replicate previous studies of the potential diversity benefits of using an SJT as a tool for medical student selection and has the potential to level the playing field regarding socio-economic status and ethnicity. Further studies exploring more variables representing diversity are warranted to confirm the early results in this study.

Professional identity formation of medical teachers in a non-Western setting.

INTRODUCTION: Understanding and supporting professional identity formation (PIF) among medical teachers has become increasingly important in faculty development programs. In this study, we explored medical teachers' PIF in Indonesia. METHODS: We conducted a qualitative descriptive study using focus group discussions (FGDs) at four medical schools in Indonesia. Basic science and clinical teachers from four different schools were selected to participate. Data were transcribed, coded, and analysed to develop themes and subthemes. RESULTS: Seventeen FGDs were completed, involving 60 basic science and 59 clinical teachers. Four major themes regarding the formation of medical teachers' professional identity emerged: an internal dialogue between intrinsic values and external influences, empowerment through early socialization, experiential workplace learning, and envisioning the future. The PIF process was similar for basic science and clinical teachers. CONCLUSION: Our findings suggested that PIF among medical teachers in a non-Western setting is a continuous and dynamic process that is shaped by key socialization factors (e.g. role models, workplace learning, peer support), with significant influences from religious beliefs, family values, and societal recognition. Faculty development programs should consider the dynamic and continuous nature of PIF among medical teachers and encourage clinicians and basic scientists to explore their values and beliefs, realize their goals, and envision their future.

Measuring the interprofessional collaborative competencies of health-care students using a validated Indonesian version of the CICS29.

The objectives of this study are to validate an Indonesian version of the Chiba Interprofessional Competency Scale (CICS29) and measure the interprofessional competencies of undergraduate health-care students following their completion of an interprofessional education (IPE) course. This study used a cross-sectional design and was preceded by a cross translation of the instrument and a confirmatory factor analysis (CFA), which confirmed that the Indonesian-version CICS29 has good internal consistency comparable to the original model. The Indonesian version was then administered to 723 health-care students who had completed a community-based IPE course. Based on data gathered from 707 respondents (97.8%), it was found that their interprofessional competency was relatively good (mean score: 127.9 out of 145, 88.2%). The dental students scored consistently lower compared to students of other faculties, both in the overall CICS29 and all five of its subscales, three of which are specifically related to teamwork. The study has provided support for cross-cultural validity of undergraduate health-care students' interprofessional competency measures using CICS29. Further efforts are necessary to ensure that the students understand their roles and internalize the collaborative values and practices of all health professions.

Development of e-portfolio in undergraduate clinical dentistry: How trainees select and reflect on evidence.

INTRODUCTION: Self-reflection is a fundamental part of health professional development, especially in the unstructured clinical stage of dentistry, medical and health profession education, since it plays important role in experiential learning. A portfolio-both conventional and digital-records various aspects of knowledge, skills and attitudes over a long period of time to help students develop their professionalism by conducting self-reflection. This study aims to explore the process of selecting and reflecting on professionalism evidence recorded in e-portfolios during undergraduate clinical dentistry training. METHOD: This pilot study is a qualitative study with a phenomenological design. The selection of respondents was conducted using a maximum variety sampling method. Following a 6-week pilot programme, a total of six in-depth interviews and five focus group discussions were conducted with undergraduate students representing different clinical rotations to explore the process conducted by undergraduate clinical dentistry students in e-portfolio development. The study of documents was also conducted on the respondents' reflective writing from the e-portfolio back-end data to explore their self-reflection skills. RESULT: The results of the present study highlighted two different approaches used amongst trainees in developing a reflective e-portfolio: selective and non-selective. The observed reflective e-portfolio utilisation frequency and trainees' self-reflection skills were low, with several affecting factors identified. These identified factors consisted of external factors, such as the undergraduate clinical dentistry programme curriculum, the hidden curriculum, the availability of feedback, the availability of role models, and features of the e-portfolio and internal factors, such as understanding the self-reflection concept, the availability of time and mood, cultural factors, and understanding the content reflected. CONCLUSION: Through the process of independently selecting and recording learning activities in e-portfolios as well as repeatedly conducting self-reflection, trainees can improve their overall reflective abilities. However, producing a systematic approach to forming a reflective learning environment is necessary to aid the implementation of reflective e-portfolios, especially at the early stage of e-portfolio implementation.

Dealing with negative role modelling in shaping professional physician: an exploratory study.

OBJECTIVE: To explore negative role modelling by medical teachers in developing professionalism. METHODS: The qualitative study using a transcendental phenomenology design was conducted at at Tanjungpura University, Indonesia, from December 2017 to February 2018, and comprised of 6 medical students from academic phase, 6 medical students from clinical phase, 8 medical teachers, 4 clinical teachers, 6 alumni and 5 programme managers. Data was collected through 5 focus group discussions and 5 in-depth interviews. Thematic analysis was applied to explore negative role modelling in the pre-clinical and clinical phase of the learning process. Data was analysed using the steps for coding and theorisation method. RESULTS: There were 30 respondents in five focus group discussions and 5 interviews were held with programme managers. There were three themes identified: medical teacher as a role model, process of role modelling, and nurturing medical professionalism. The presence of negative role modelling was evident in the discussions. Both positive and negative role modelling could influence the medical professionalism. Negative role modelling of medical teachers is a phenomenon often found in medical professionalism development. CONCLUSIONS: Negative role modelling requires a more active process to develop professionalism.

Unveiling the Hurdles in Cultivating Humanistic Physicians in the Clinical Setting: An Exploratory Study.

BACKGROUND: The importance of cultivating a humanistic physician has gained attention in medical education. Humanistic values are established in early education and medical schools should provide a suitable environment to nurture and grow these values into professional identity. The clinical setting has a significant impact due to its direct involvement of students in real-life situations. OBJECTIVES: The present study aims to explore the hurdles in cultivating humanistic physicians in the clinical setting. METHODS: We conducted a qualitative study involving medical students in the clinical phase, as well as residents, clinical teachers, and module administrators in the clinical setting under study. RESULTS: Respondents from different groups of stakeholders shared the same definition for 'humanistic physician': a physician who provides patient-centred care while demonstrating empathy, respect, compassion, integrity, knowledge, competence and a collaborative spirit. Despite changes in the healthcare system and technological advancements, humanistic physicians are still needed. CONCLUSION: Cultivating humanistic physicians is a complex process, requiring various methods and assessments. Role models play a significant role in this process, which included not only clinical teachers but also peers. Feedback from peers was perceived as an important factor. The key hurdles identified were negative role models, and a less humanistic learning environment and the students' personal backgrounds.

Formulating a Need-Based Faculty Development Model for Medical Schools in Indonesia.

BACKGROUND: The focus of medical schools in developing countries is on fulfilling a quantity of faculty members. A faculty development model will help formulate programmes that accommodate faculty members' needs as well as institutional demands. This study aims to formulate a faculty development model relevant for medical schools in developing countries, specifically Indonesia. METHODS: This is a qualitative study with a phenomenological approach. It starts with a literature review using large databases, followed by interviews with 10 representative experts from medical schools in Indonesia. RESULTS: Based on the 10 studies retrieved, several components of faculty development were identified as the basis for the model. Ten experts gave input for the model. Components of the model can be grouped into: (i) content, which is materials that need to be delivered; (ii) process components, which depict aspects related to the preparation, execution and evaluation of sustainable faculty development; and (iii) components in the educational system that affect faculty development implementation. CONCLUSION: A comprehensive review and development process has likely made this faculty development model suitable for medical schools in Indonesia. Breaking the model into components may help medical schools to prioritise certain aspects related to faculty development programmes.

Measuring medical students' reflection on their learning: modification and validation of the motivated strategies for learning questionnaire (MSLQ).

BACKGROUND: Reflection on learning is an essential component of effective learning. Deconstructing the components of reflection on learning using a self-regulated learning (SRL) framework, allows the assessment of students' ability to reflect on their learning. The aim of this study was to validate an instrument to measure medical students' reflection on their learning. METHODS: A systematic search was conducted to identify the most suitable instrument to measure students' reflection on their learning based on the theoretical framework of SRL. The search identified the Motivated Strategies for Learning Questionnaire (MSLQ) which contained five subscales: internal goal orientation, self-efficacy, critical thinking, metacognitive/self-regulation, help seeking and peer learning. Using the original MSLQ as the foundation, we carried out three phases of a research program to develop a useful set of items: an expert panel's review of items, a substantial pilot study, and a factor analysis of ratings of a modified set of items by preclinical and final year medical students. RESULTS: The factor analysis of the Modified MSLQ extracted four subscales with reasonable internal consistency: self-orientation, critical thinking, self-regulation and feedback-seeking. Each subscale correlates highly with the Modified MSLQ score, with modest inter-correlations between the subscales suggesting that they are measuring different components of the total score. CONCLUSION: Medical students and their educators need to be able to monitor their learning in their complex academic and clinical environments. The Modified MSLQ provides a means of investigating and tracking individual medical students' reflections on their learning.

Undergraduate Medical Students' Perceptions on Feedback-Seeking Behaviour.

BACKGROUND: The concept of feedback-seeking behaviour has been widely studied, but there is still a lack of understanding of this phenomenon, specifically in an Indonesian medical education setting. The aim of this research was to investigate medical students' feedback-seeking behaviour in depth in one Indonesian medical school. METHODS: A qualitative method was employed to explore the feedback-seeking behaviour of undergraduate medical students in the Faculty of Medicine at Universitas Lampung. Focus group discussions (FGDs) were conducted with four student groups and each group consisted of 7-10 students from the years 2012, 2013 and 2014. Data triangulation was carried out through FGDs with teaching staff, and an interview with the Head of the Medical Education Unit. RESULTS: Study findings indicated that the motivation of students to seek feedback was underlain by the desire to obtain useful information and to control the impressions of others. Students will tend to seek feedback from someone to whom they have either a close relationship or whose credibility they value. The most common obstacle for students to seek feedback is the reluctance and fearfulness of receiving negative comments. CONCLUSIONS: Through the identification of factors promoting and inhibiting feedback-seeking behaviour, medical education institutions are enabled to implement the appropriate and necessary measures to create a supportive feedback atmosphere in the learning process.

Exploring H5P Interactive Content in Supporting Learning Through Self-Paced MOOCs on Healthy Aging: A Cross-Sectional Pilot Study.

BACKGROUND: The rapidly aging population and the growth of geriatric medicine in the field of internal medicine are not supported by sufficient gerontological training in many health care disciplines. There is rising awareness about the education and training needed to adequately prepare health care professionals to address the needs of the older adult population. Massive Open Online Courses (MOOCs) might be the best alternative method of learning delivery in this context. However, the diversity of MOOC participants poses a challenge for MOOC providers to innovate in developing learning content that suits the needs and characters of participants. OBJECTIVE: The primary outcome of this study was to explore students' perceptions and acceptance of HTML5 Package (H5P) interactive content in a self-paced MOOCs and its association with students' characteristics and experience in using MOOCs. METHODS: This study used a cross-sectional design, combining qualitative and quantitative approaches. Participants, predominantly general practitioners from various regions of Indonesia with diverse educational backgrounds and age groups, completed pre-tests, engaged with H5P interactive content, and participated in forum discussions and post-tests. Data were retrieved from the online questionnaire attached to a selected MOOC course. Students' perceptions and acceptance of H5P interactive content were rated on a 6-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Data were analyzed using SPSS to examine demographics, computer literacy, acceptance, and perceptions of H5P interactive content. Quantitative analysis explored correlations, while qualitative analysis identified recurring themes from open-ended survey responses to determine students' perceptions. RESULTS: In total, 184 MOOC participants agreed to participate in the study. Students demonstrated positive perceptions and a high level of acceptance of integrating H5P interactive content within the self-paced MOOC. Analysis of mean ± SD value across all responses consistently revealed favorable scores (greater than 5), ranging from 5.18 ± 0.861 to 5.45 ± 0.659 and 5.28 ± 0.728 to 5.52 ± 0.627, respectively. This finding underscores widespread satisfaction and robust acceptance of H5P interactive content. Students found the H5P interactive content more satisfying and fun, easier to understand, more effective, and more helpful in improving learning outcomes than material in the form of common documents and learning videos. There is a significant correlation between computer literacy, students' acceptance, and students' perceptions. CONCLUSIONS: Students from various backgrounds showed a high level of acceptance and positive perceptions of leveraging H5P interactive content in the self-paced MOOC. The findings suggest potential new uses of H5P interactive content in MOOCs, such as interactive videos with pop-up questions, to substitute for synchronous learning. The study underscores the significance of tailored educational strategies in supporting the professional development of healthcare professionals.

Looking beyond the COVID-19 pandemic: the recalibration of student-teacher relationships in teaching and learning process.

BACKGROUND: Given the various novel educational approaches and online interactions following the pandemic, it is timely to identify lessons learned for post-pandemic student and teacher relationships within the 'new normal' teaching learning processes. This study aims to explore the dynamics and to what extent the disruption influences student-teacher relationships in teaching and learning process following the COVID-19 pandemic. MATERIALS AND METHODS: A qualitative descriptive approach was employed to explore individual reflections and perspectives from 28 medical teachers and 35 medical students from different institutions who participated in 10 focus groups. Data were analyzed thematically using steps for coding and theorization (SCAT) approach. The emerging themes were then further analyzed and regrouped into the relationship-centered leadership framework based on emotional intelligence. RESULTS: The identified themes described three elements representing student-teacher relationships in the teaching learning processes. The self as the center of the diagram consists of the co-existing role of the self as teachers and as students, which to some extent, is related to their personal and professional development, motivation, and struggles to maintain work-life balance. The middle layer represents the dynamic of student-teacher relationship, which showed that despite the increased number of teaching opportunities, the trust among teachers and students was compromised. These changes in the self and the dynamic relationship occurred in a broader and more complex medical education system, pictured as the outer layer. Thorough curriculum improvements, contents, and new skills were emphasized. CONCLUSIONS: Our findings emphasized the need to recalibrate student-teacher relationships, taking into account the intrapersonal, interpersonal, and the system factors. The pandemic has reemphasized the aim of teachers' roles, not only to nurture students' competencies, but also to nurture meaningful interpersonal reciprocal relationships through responding towards both teachers' and students' needs as well as supporting both personal and professional development.

Translation, adaptation, validity and reliability of Multidimensional Emotion Questionnaire for Indonesian forensic psychiatry context.

Objective: Emotion is essential in psychiatrists' clinical decision-making in conducting forensic psychiatric evaluations. However, psychiatrists may not be aware of their own emotions and thus prone to the risk of bias in their evaluations. An English version questionnaire was previously developed to assess emotional response and regulation. This study aims to assess the validity and reliability of the translated and adapted Indonesian version of The Multidimensional Emotion Questionnaire (MEQ) among Indonesian general psychiatrists in forensic psychiatry settings. Method: This is a cross-sectional study that translated and adapted The Multidimensional Emotion Questionnaire (MEQ) designed by Klonsky et al. This study was conducted between August 2020 and February 2021, involving 32 general psychiatrists across the country who represented general psychiatrists from different educational backgrounds, clinical experiences, and workplace settings. The translation process was done by a certified independent translator and tested for validity by Item-Level Content Validity Index (I-CVI), Scale-Level Level Content Validity Index (S-CVI), and corrected item-total correlation. Cronbach's alpha values measured reliability aspects. Results: The MEQ was valid and reliable, with an I-CVI score of 0.97-1, an S-CVI score of 0.99, and Cronbach's alpha values of 0.85-0.98 for each emotion. The majority of items had a corrected item-total correlation of higher than 0.30. Conclusion: A proper and available tool to measure general psychiatrists' emotions in evaluating forensic psychiatric cases is essential in enhancing evaluators' awareness of their own emotions to eventually mitigate bias. The Multidimensional Emotion Questionnaire (MEQ) was valid and reliable for Indonesian forensic psychiatry contexts.

Defining the tasks of clinical reasoning in forensic psychiatric evaluation: Psychomedicolegal analysis competency.

Objective: Inconsistency in the quality of forensic psychiatry report has been criticized for several years. Yet, there are limited guidelines to provide minimally satisfactory forensic psychiatry evaluation conducted by psychiatrists. In addition to the impact towards the forensic psychiatry service, this lack of standardized guidelines may impact the relevant competency development and its various teaching methods of forensic psychiatry among general psychiatrists. Therefore, this study aims to identify components of psychomedicolegal analysis competency as a form of clinical reasoning in forensic psychiatry. Methods: A comprehensive literature review and expert panel discussions were conducted simultaneously to formulate an initial list of psychomedicolegal analysis competency. A total of fourteen experts were chosen based on their expertise in different disciplines that have intersections with forensic psychiatry and the general psychiatry curriculum (e.g. general psychiatrist, forensic psychiatrists and psychologist, law practitioner, and medical education director). The expert panel were instructed to score and provide feedbacks on the items of the initial list. Four-point Likert scale were used in order for the experts to express the relevancy of the core competence to forensic psychiatry practice until it reached the consensus. Results: The final 60 items of psychomedicolegal analysis competency were developed after three rounds of Delphi technique and reached a consensus (>70% and medians score of at least 3,25). These competency then categorized into four steps 1) preparing the case (Item 1-11), 2) conducting the evaluation (Item 12-41), 3) writing the report (42-51), and 4) giving expert opinion in court (Item 52-60). Conclusion: We developed 60 items of psychomedicolegal analysis competency that can be used as a standardized guide for psychiatrists to conduct forensic psychiatry evaluation, write the report and provide expert opinion in court. Implementation of this guideline can be used to shape further forensic psychiatry education for general psychiatrist and psychiatry residency.

Burnout and quality of life of medical residents: a mixed-method study.

PURPOSE: Currently there are a limited number of comprehensive studies exploring in more depth the relationship between burnout and quality of life (QoL) of medical residents during residency training. This study aims to examine the correlation between burnout and residents' QoL and explore the factors associated with burnout in residency training. METHODS: This was a mixed-method study. The first stage was a quantitative study using cross-sectional design to administer the Maslach Burnout Inventory Human Service Survey and World Health Organization Quality of Life-BREF instruments to 86 medical residents, followed with the qualitative study through 10 in-depth interviews. RESULTS: Twenty-seven residents (31.4%) experienced severe emotional exhaustion (EE), 22 (25.6%) experienced severe depersonalization (DP), and 40 (46,5%) experienced low personal accomplishment (PA). Factors increasing the likelihood of experiencing burnout were being surgical residents for EE (2.65 times), dealing with difficult/rare cases for DP (1.14 points), and working hours for PA (1.03 points). The QoL was influenced by the three burnout domains, marital status, education level, gender, age, type of residency, night shift, difficult/rare cases, working hours, and number of emergency cases. Factors influencing burnout, both intrinsic and extrinsic, were identified and divided into causative and protective factors. CONCLUSION: The current study has examined the relationship between burnout and QoL and identified factors affecting residents' burnout. Both intrinsic factors, such as spirituality, and extrinsic factors which include duration of shift, work facilities, and teacher-senior-junior relationships, affect burnout. Supervision and academic regulation are some of the solutions expected by the residents to minimize burnout.

Piloting a constructive feedback model for problem-based learning in medical education.

PURPOSE: Constructive feedback is key to successful teaching and learning. The unique characteristics of problem-based learning (PBL) tutorials require a unique feedback intervention. Based on the review of existing literature, we developed a feedback model for PBL tutorials, as an extension of the feedback facilitator guide of Mubuuke and his colleagues. This study was aimed to examine the perceptions of students and tutors on the feedback model that was piloted in PBL tutorials. METHODS: This study employed a qualitative research design. The model was tested in nine online PBL sessions, selected using the maximum variation sampling strategy based on tutors' characteristics. All sessions were observed by the researcher. Afterwards, tutors and students in the PBL sessions were interviewed to explore their perceptions of the model. RESULTS: Three themes were identified based on the perceptions of the tutors and students: cognitive changes, behavioral changes, and challenges of the use of the feedback model. Both tutors and students benefited from improved cognition and behavior. However, the use of the feedback model still encountered some challenges, such as limited sources of feedback data, flexibility and adaptability of the model, content of feedback delivered, students' characteristics and performance, tutors' characteristics and self-perceptions, and supportive infrastructure. CONCLUSION: The model can be used as a reference for tutors to deliver constructive feedback during PBL tutorials. The challenges identified in using the constructive feedback model include the need for synchronized guidelines, ample time to adapt to the model, and skills training for tutors.

The Practice of Feedback in Health Professions Education in the Hierarchical and Collectivistic Culture: a Scoping Review.

The global trend in student assessment is moving towards outcome-based assessment that requires multiple systematic data points and continuous feedback. However, in hierarchical and collectivistic cultures, one-way communication is practised more often, leading to less dialogical feedback. This scoping review explored feedback practice in Asian educational setting. Based on the 17 articles selected, the findings were categorised into four themes, i.e. inhibiting or facilitating factors of feedback, influences of cultural factors on feedback, discrepancies between students' and teachers' perceptions of feedback and impact of feedback. Hierarchical and collectivist cultural aspects, such as preference for group feedback, are pertinent to feedback practice, which likely influence the readiness for programmatic assessment.

Clinical teachers' professional identity formation: an exploratory study using the 4S transition framework.

OBJECTIVES: The aim of this study was to explore factors that may influence the formation of professional identity in clinical teachers, specifically during the transition period from practitioner to teacher. METHODS: This was a descriptive qualitative study. We used Schlossberg's 4S framework to explore influential factors comprised of the following: situation, self, support, and strategies. This study was conducted in teaching hospitals of a relatively new private medical school in Bali, a province in Indonesia. The participants were 30 clinical teachers who were selected using a maximum variation sampling strategy based on length of work experience, gender, specific educational roles as coordinators, and clinical specialty. Data were derived from three focus-group discussions and 13 in-depth interviews. A thematic analysis method was used to analyse the data. RESULTS: The thematic analysis revealed that 12 subthemes related to the 4S framework influenced the development of clinical teachers' identity. It was also shown that reflective ability and community of practice, which was included in the self and strategy factors, respectively, were the two most important factors during the transition period in the development of professional identity. CONCLUSIONS: Factors, both within and outside the self, can either support or hinder the formation of professional identity in clinical teachers. We suggest that when faculty development programs are designed, these factors should be incorporated, such as including a community of practice as part of the formal faculty development programs and the development of a teaching portfolio that nurtures reflective practice.

Are we ready to collaborate? The interprofessional collaborative competencies of healthcare professionals in the Global South context.

Background: Current evidence of interprofessional collaboration suggests the importance of measuring and identifying the current state of the health professions' interprofessional competencies. Therefore, this study was aimed at measuring the interprofessional competencies of health professionals in the Global South context using the validated CICS29. Materials and methods: This was a cross-sectional study involving 300 healthcare professionals of a newly established teaching hospital. Prior to the measurement of interprofessional competencies, the 29-items CICS29, which has been translated into Indonesian language, was revalidated using a confirmatory factor analysis (CFA). The 29 items of CICS29 were grouped into six subscales and each item was measured using a 5-point Likert scale. Data on gender, age, type of profession, and the length of working experience was also collected to identify whether discernible differences between grouping variables exists. Results: Prior to measuring the interprofessional competencies, the validity of the instrument was established. Based on the CFA, the same six-factor model was found in the current study. The Indonesian CICS29 was reliable, with Cronbach alpha values of 0.921 for the whole instrument and that of each subscale ranged between 0.656 and 0.726. The mean total score of CICS29 was 128.53 (out of 145), ranged from 123 to 133.40 obtained by pharmacists and dentists respectively. No significant differences of CICS29 scores were found between grouping variables. Conclusion: The current study has revealed relatively good interprofessional competencies of healthcare professionals working in a newly established teaching hospital in the Global South healthcare context. Measuring the interprofessional competencies serves as baseline for further intervention to nurture and maintain collaborative practice. In addition, the current study has further proven the cross-cultural validity of CICS29, thus appropriate to be utilized in different setting and context.