The influence of different curriculum designs on students' dropout rate: a case study

The process of harmonizing competency-based curricula for medicine and nursing degree programmes: A Multi-institutional and multi-professional experience from Tanzania

In many low- and middle-income countries, there seems to be a mismatch between graduate skills and healthcare industry requirements due to variability in curricula. With the current increased global demand for competent health profession graduates, harmonizing competency-based curricula (CBC) is necessary to address this mismatch. This paper describes how three health professions training universities in Tanzania and their two long-standing United States partners embarked on developing harmonized CBC for undergraduate medicine and nursing degrees. The main goal of the activity was to develop templates to harmonize curricula that would support graduates to acquire mandatory national Graduate Minimum Essential Competencies (GMEC) irrespective of the institution of their training. The paper describes the processes of engaging multiple institutions, the professions of medicine and nursing and various stakeholders to develop mandatory curricula generic competencies, creating milestones for assessing competencies, training faculty at each of the three partnering institutions in curriculum delivery and assessments, resulting in the adoption of the curricula by the University leadership at each institution. Ultimately the Tanzania Commission for Universities (TCU) a regulatory body required all schools of medicine and nursing in the country to adopt the curricula, thus creating a harmonized national standard for teaching medicine and nursing beginning October 2022.

Pre-service medical education course completion and drop-out rates

INTRODUCTION

The "Global strategy on human resources for health: Workforce 2030" was adopted by the 69th World Health Assembly. Among its objectives is the strengthening of data on human resources for health, to inform evidence-based policy decisions. These data include the course completion and drop-out rates, to inform mechanisms that support recruitment and retention.

OBJECTIVE

This paper sought to evaluate trends in course completion and drop-out rates of health workforce students. However, original data were only obtained for pre-service medical students, but no other health worker occupational groups.

METHODS

A mixed method approach was employed to obtain data presented in this paper. A structured questionnaire was sent out to targeted medical training institutions, regulatory bodies, and National Medical Associations, supplemented by a web and literature search for existing studies or data reports. Data were analyzed using IBM SPSS Statistics version 21.0 (Chicago, IL, USA) and Microsoft Excel 2010.

RESULTS

Eight previously published studies were identified originating from six countries, with course completion rates ranging from 84% in Pakistan to 98.6% in the United States of America, while the drop-out rates ranged from 1.4% in the United States of America to 16% in Pakistan. An analysis of pre-service medical students in Australia and New Zealand, revealed average course completion rates of 93.3% and 96.9%, respectively, and average drop-out rates of 6.7% and 3.1%, respectively. An analysis of pre-service medical students from Nigeria, revealed an average course completion rate of 88.3%, and an average drop-out rate of 11.7%. Data were not readily available for most countries targeted during the research, either because of lack of existing mechanisms for collation of required data or restrictions making such data publicly unavailable and inaccessible.

CONCLUSIONS

Drop-out rate for pre-service medical students varies across countries with some countries recording higher drop-out rates, which raise significant concerns about the capacity of such countries to scale up production of human resources for health. Data that monitor both course completion and drop-out rates, and seek to provide insight into reasons for observed numbers, can inform mechanisms to address the causes of course drop-out and support student retention.

Differences between high- and low-achieving pre-clinical medical students: a qualitative instrumental case study from a theory of action perspective

BACKGROUND

Poor academic performance and failure can cause undesired effects for students, schools, and society. Understanding why some students fail while their peers succeed is important to enhance student performance. Therefore, this study explores the differences in the learning process between high- and low-achieving pre-clinical medical students from a theory of action perspective.

METHODS

This study employed a qualitative instrumental case study design intended to compare two groups of students-high-achieving students (n = 14) and low-achieving students (n = 5), enrolled in pre-clinical medical studies at the Universiti Malaya, Malaysia. Data were collected through reflective journals and semi-structured interviews. Regarding journaling, participants were required to recall their learning experiences of the previous academic year. Two analysts coded the data and then compared the codes of high- and low-achieving students. The third analyst reviewed the codes. Themes were identified iteratively, working towards comparing the learning processes of high- and low-achieving students.

RESULTS

Data analysis revealed four themes-motivation and expectation, study methods, self-management, and flexibility of mindset. First, high-achieving students were more motivated and had higher academic expectations than low-achieving students. Second, high-achieving students adopted study planning and deep learning approaches, whereas low-achieving students adopted superficial learning approaches. Third, in contrast to low-achieving students, high-achieving students exhibited better time management and studied consistently. Finally, high-achieving students proactively sought external support and made changes to overcome challenges. In contrast, low-achieving students were less resilient and tended to avoid challenges.

CONCLUSION

Based on the theory of action, high-achieving students utilize positive governing variables, whereas low-achieving students are driven by negative governing variables. Hence, governing variable-based remediation is needed to help low-achieving students interrogate the motives behind their actions and realign positive governing variables, actions, and intended outcomes.Key MessagesThis study found four themes describing the differences between high- and low-achieving pre-clinical medical students: motivation and expectation, study methods, self-management, and flexibility of mindset.Based on the theory of action approach, high-achieving pre-clinical medical students are fundamentally different from their low-achieving peers in terms of their governing variables, with the positive governing variables likely to have guided them to act in a manner beneficial to and facilitating desirable academic performance.Governing variable-based remediation may help students interrogate the motives of their actions.

Assessment of dropout rates in the preclinical years and contributing factors: a study on one Thai medical school

BACKGROUND

The highest dropout rate for medical students is during the preclinical years of education. Several studies have reported possible contributing factors, however, studies regarding the dropout rate from medical education among Thai medical students and its associated factors are still lacking. This study aimed to identify the prevalence of dropout from medical education within the preclinical period and its associated factors among Thai medical students.

METHODS

We collected data from preclinical medical students who entered one medical school in Bangkok, Thailand, between 2017-2019. Demographic data, admission program, pre-admission mental health status assessed by the Thai Mental Health Indicator 66, mental health records from the faculty-based counseling services, and academic achievement were extracted. Data were reported in a descriptive fashion. We analyzed the association between dropout and these factors by robust Poisson regression.

RESULTS

In total, 914 students were recruited. Dropout was only 1.5%, which was lower than the previous studies. Regression analysis showed a significant association between dropout and mental health problems [Prevalence ratio (PR) 58.20, 95%CI 13.72- 246.95] but not admission program [PR 0.32, 95%CI 0.09 - 1.16] or failing examinations [PR 0.59, 95%CI 0.18 - 1.90]. However, other contributing factors such as financial status, family problems, medical illness, and students' motivation, were not evaluated in this study.

CONCLUSIONS

Mental health problems during medical education were associated with dropout after adjusting for other confounding variables. Further longitudinal studies are needed to identify the impacts of academic failure on dropout in higher clinical years.

How Do Curricular Design Changes Impact Computer Science Programs?: A Case Study at San Pablo Catholic University in Peru

Computer science is a dynamic field of study that requires constant review and updating of the curricular designs in academic programs—in general, measuring the impact of plan changes has been little explored in the literature. In most cases, it focuses only on structuring its curricula, leaving aside several factors associated with important events or facts such as student dropout, retention, and inclusion. However, these features provide academic institutions with many opportunities to understand student performance and propose more effective preventive/corrective actions to avoid dropouts. This work focuses on the curricular changes’ influence on student gender imbalance, socioeconomic provenance, and dropout. Specifically, we employ three different approaches for our analysis: (i) a longitudinal study of four curricula from informatics engineering to computer science transition at San Pablo Catholic University, (ii) an exploratory analysis for identifying essential features that determines the events mentioned above, and (iii) a survival analysis to estimate the probability that a student will stay (not dropout) before graduate, and calculate the average permanence time per curricula. Our analysis shows that the female student rates decreased, student rates from lower socioeconomic provenance increased, and the dropout rates were reduced with updates towards an internationally standardized curriculum. This is even strongly evidenced when the program changes its name. Finally, the set of techniques employed in this work composes a statistical mechanism that can be replicated/adapted to any other program in computer science aiming to extract valuable insights to support the decision-making process in educational institutions.

The do's, don'ts and don't knows of redressing differential attainment related to race/ethnicity in medical schools

INTRODUCTION

Systematic and structural inequities in power and privilege create differential attainment whereby differences in average levels of performance are observed between students from different socio-demographic groups. This paper reviews the international evidence on differential attainment related to ethnicity/race in medical school, drawing together the key messages from research to date to provide guidance for educators to operationalize and enact change and identify areas for further research.

METHODS

Authors first identified areas of conceptual importance within differential attainment (learning, assessment, and systems/institutional factors) which were then the focus of a targeted review of the literature on differential attainment related to ethnicity/race in medical education and, where available and relevant, literature from higher education more generally. Each author then conducted a review of the literature and proposed guidelines based on their experience and research literature. The guidelines were iteratively reviewed and refined between all authors until we reached consensus on the Do's, Don'ts and Don't Knows.

RESULTS

We present 13 guidelines with a summary of the research evidence for each. Guidelines address assessment practices (assessment design, assessment formats, use of assessments and post-hoc analysis) and educational systems and cultures (student experience, learning environment, faculty diversity and diversity practices).

CONCLUSIONS

Differential attainment related to ethnicity/race is a complex, systemic problem reflective of unequal norms and practices within broader society and evident throughout assessment practices, the learning environment and student experiences at medical school. Currently, the strongest empirical evidence is around assessment processes themselves. There is emerging evidence of minoritized students facing discrimination and having different learning experiences in medical school, but more studies are needed. There is a pressing need for research on how to effectively redress systemic issues within our medical schools, particularly related to inequity in teaching and learning.

El estado de la investigación en educación en cirugía general en Colombia (2000-2020): un análisis bibliométrico

Introducción. Se desconoce el estado de la investigación en educación médica en cirugía general (IEMC) en Colombia en el siglo XXI. El objetivo de esta revisión bibliométrica de la literatura es realizar un análisis de las publicaciones relacionadas con la IEMC en Colombia a partir del año 2000. Métodos. Se incluyeron artículos originales, escritos en español o inglés, publicados por grupos de investigación que cuentan al menos con un investigador colombiano como autor principal o coautor. Se definieron variables demográficas e indicadores bibliométricos para cada estudio y autor. Resultados. Un total de 63 estudios fueron incluidos. Estas publicaciones se enfocaron predominantemente en investigación sobre bienestar, enseñanza clínica y simulación a nivel de postgrado. El 36 % de los artículos sobre IEMC fueron publicados en revistas sin indexación (ISI/SCOPUS); 13 artículos (20,6 %) fueron publicados en revistas en el cuartil 1 (Q1). El promedio de citas por artículo fue 9,3. Discusión. La producción intelectual en educación en cirugía en Colombia tiene bajo impacto a nivel internacional. Los hallazgos encontrados pueden ser utilizados para organizar y priorizar la investigación en educación quirúrgica en el país.

Se hace camino al andar: Educación médica de pregrado en el Departamento de Cirugía

La educación en cirugía en Colombia esta experimentando una acelerada transformación. No obstante, la documentación de la transformación educativa en el país es limitada. En este estudio se presenta una revisión cronológica de la enseñanza en el Departamento de Cirugía de la Universidad de la Sabana. La revisión se focaliza en las estrategias e hitos alcanzados en el pregrado, luego de transformar el modelo de enseñanza tradicional de principios de siglo XXI. La revisión esta basada en la síntesis de una serie de estudios originales, los cuales ofrecen evidencia sobre las intervenciones realizadas en el departamento, y sobre sus resultados. Finalmente, se presenta una reflexión en torno a los retos futuros.  

Recommendations for integration of foundational and clinical sciences throughout the pharmacy curriculum

INTRODUCTION

Pharmacy faculty have the often difficult task of translating and incorporating existing concepts and advances from the foundational sciences into the clinical sciences and practice. This commentary focuses on content integration as a curricular and educational strategy, outcomes data from integration, and recommendations for programs employing or considering curricular integration.

COMMENTARY

Integration of foundational and clinical sciences across the curriculum has been emphasized in accreditation standards but met with mixed reactions by faculty across different disciplines in the academy. Many pharmacy programs have already incorporated some level of integration in didactic courses. However, most report coordination of curricular delivery rather than higher levels of integration in which different disciplines work together to design and deliver instructional materials across the entire curriculum.

IMPLICATIONS

Curricular integration models should be optimized to minimize or eliminate the risks of marginalization of foundational sciences in pharmacy curricula. A significant problem in implementing curricular integration is determining the appropriate balance between foundational and clinical sciences. Well-designed curricular integration with ongoing reinforcement that builds in complexity over time could enhance knowledge retention, critical thinking abilities, and clinical decision making. Further research is needed into the outcomes achieved from various integrated curricular approaches in pharmacy education.