1
|
Masava B, Nyoni CN, Botma Y. Usability of Standards for Scaffolding in a Health Sciences Programme: A feasibility Study. BMC Nurs 2024; 23:309. [PMID: 38715024 PMCID: PMC11075252 DOI: 10.1186/s12912-024-01975-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, they are socially constructed and could result in varied interpretations by users. Reports of varied implementation of standards in health professions education underscore the need to test the developed standards for scaffolding in health sciences programmes. Usability entails determining whether a product like standards works as intended under the expected conditions and contexts. This study aimed to describe the usability of standards for scaffolding in a health sciences programme through a pilot study. METHODS A multi-method design employing user and expert-based usability evaluation techniques sought to describe the usability of the standards for scaffolding in a three-year pre-registration nursing programme. The user sample of nurse educators drawn from the programme, conducted a self-assessment on scaffolding practices in the programme using a developed standards checklist. For the expert sample, three-panel members with an understanding of the discipline and programme context were purposively sampled. These panelists studied the users' self-assessment reports before completing an author-generated heuristics checklist to support or refute any of the standards. Descriptive statistics, comparative and content analysis were applied to analyse data from users' interviews and expert's completed heuristics checklist, determining the standards' usability, and identifying the usability flaws or strengths. RESULTS The users had three or more years of teaching experience in the competency-based curriculum for nursing. The experts shared an average of 16 years of experience in teaching in higher education, and seven years of experience in quality assurance and programme accreditation. The four standards had a usability score of above average (68%). Seven usability strengths and four usability flaws were identified. Usability flaws related to misinterpretation of some criteria statements and terminologies, multiple meanings, and users' challenges in generating evidence for some criteria. CONCLUSIONS The pilot study revealed the context-based 'truth' regarding the fidelity of a health sciences programme evaluation on scaffolding, as well as identifying the ideal contextual conditions in which the standards for scaffolding health sciences programmes would work best. The identified usability flaws highlighted the need for further revisions of the standards. Future research on the feasibility of the standards in other health sciences programmes and contexts is recommended.
Collapse
Affiliation(s)
- Beloved Masava
- School of Nursing, University of the Free State, P.O. Box 339, 9300, Bloemfontein, South Africa.
| | - Champion N Nyoni
- School of Nursing, University of the Free State, P.O. Box 339, 9300, Bloemfontein, South Africa
| | - Yvonne Botma
- School of Nursing, University of the Free State, P.O. Box 339, 9300, Bloemfontein, South Africa
| |
Collapse
|
2
|
Rashid MA, Naidu T, Wondimagegn D, Whitehead C. Reconsidering a Global Agency for Medical Education: Back to the Drawing Board? TEACHING AND LEARNING IN MEDICINE 2023:1-8. [PMID: 37724805 DOI: 10.1080/10401334.2023.2259363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023]
Abstract
Issue: The World Federation for Medical Education (WFME) was established in 1972 and in the five decades that followed, has been the de facto global agency for medical education. Despite this apparently formidable remit, it has received little analysis in the academic literature. Evidence: In this article, we examine the historical context at the time WFME was established and summarize the key decisions it has taken in its history to date, highlighting particularly how it has adopted positions and programmes that have seemingly given precedence to the values and priorities of countries in the Global North. In doing so, we challenge the inevitability of the path that it has taken and consider other possible avenues that such a global agency in medical education could have taken, including to advocate for, and to develop policies that would support countries in the Global South. Implications: This article proposes a more democratic and equitable means by which a global organization for medical education might choose its priority areas, and a more inclusive method by which it could engage the medical education community worldwide. It concludes by hypothesizing about the future of global representation and priority-setting, and outlines a series of principles that could form the basis for a reimagined agency that would have the potential to become a force for empowerment and global justice in medical education.
Collapse
Affiliation(s)
- Mohammed Ahmed Rashid
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK
| | - Thirusha Naidu
- Department of Behavioural Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Cynthia Whitehead
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Shankar PR, Azhar T, Nadarajah VD, Er HM, Arooj M, Wilson IG. Faculty perceptions regarding an individually tailored, flexible length, outcomes-based curriculum for undergraduate medical students. KOREAN JOURNAL OF MEDICAL EDUCATION 2023; 35:235-247. [PMID: 37670520 PMCID: PMC10493402 DOI: 10.3946/kjme.2023.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE The perception of faculty members about an individually tailored, flexible-length, outcomes-based curriculum for undergraduate medical students was studied. Their opinion about the advantages, disadvantages, and challenges was also noted. This study was done to help educational institutions identify academic and social support and resources required to ensure that graduate competencies are not compromised by a flexible education pathway. METHODS The study was done at the International Medical University, Malaysia, and the University of Lahore, Pakistan. Semi-structured interviews were conducted from 1st August 2021 to 17th March 2022. Demographic information was noted. Themes were identified, and a summary of the information under each theme was created. RESULTS A total of 24 (14 from Malaysia and 10 from Pakistan) faculty participated. Most agreed that undergraduate medical students can progress (at a differential rate) if they attain the required competencies. Among the major advantages mentioned were that students may graduate faster, learn at a pace comfortable to them, and develop an individualized learning pathway. Several logistical challenges must be overcome. Providing assessments on demand will be difficult. Significant regulatory hurdles were anticipated. Artificial intelligence (AI) can play an important role in creating an individualized learning pathway and supporting time-independent progression. The course may be (slightly) cheaper than a traditional one. CONCLUSION This study provides a foundation to further develop and strengthen flexible-length competency-based medical education modules. Further studies are required among educators at other medical schools and in other countries. Online learning and AI will play an important role.
Collapse
Affiliation(s)
| | - Tayyaba Azhar
- Department of Medical Education, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
| | - Vishna Devi Nadarajah
- IMU Centre for Education, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Hui Meng Er
- IMU Centre for Education, Faculty of Medicine Health, International Medical University, Kuala Lumpur, Malaysia
| | - Mahwish Arooj
- Department of Medical Education, University College of Medicine and Dentistry, Lahore, Pakistan
| | - Ian G. Wilson
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
4
|
Li S, Su K, Li P, Sun Y, Pan Y, Wang W, Cui H. Public availability of information from officially accredited medical schools in China. BMC MEDICAL EDUCATION 2022; 22:414. [PMID: 35641929 PMCID: PMC9158399 DOI: 10.1186/s12909-022-03491-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Medical education accreditation in China has been conducted by the Working Committee for the Accreditation of Medical Education (WCAME) and 129 medical schools have completed accreditation by December 2021. Despite studies on the standards, process and effectiveness of accreditation, the actual information transparency of accredited medical schools in China has not been examined. The study investigated the status of publicly available information from WCAME-accredited medical schools in China, and whether public availability of information had significant differences among different types of universities. METHODS The 129 medical schools' official websites were reviewed for the 21 criteria of the WFME Global Standards for Quality Improvement: Basic Medical Education. Dichotomous method was used to record information as presence or absence. SPSS was utilized for descriptive and ANOVA analyses. RESULTS The mean of the publicly available information on the 21 criteria was 13.77 ± 3.57, and only 5 (3.9%) accredited medical schools had all relevant information available. Publicly available information on Governance (100%) and Administration (100%) was the most, whereas information on Assessment in support of learning (16.3%) was the least. Public availability of information differed significantly among schools accredited with higher (18.15 ± 2.16), medium (13.69 ± 3.41) and lower results (12.79 ± 3.19) (F = 14.71, p < 0.05). Medical universities and comprehensive universities did not show significant differences in their overall information availability (F = 0.25, p > 0.05). Central government funded universities had a remarkably larger amount of publicly available information than local government funded universities (17.86 ± 1.98 vs. 12.75 ± 2.93, p < 0.05). CONCLUSION Public availability of information from the accredited medical schools in China needs to be improved to promote transparency and continuous quality improvement, especially with regard to information on curriculum, assessment and quality assurance. Explicit information availability requirements need to be considered to include in medical education standards, and further studies are warranted to explore which information elements should be made publicly available.
Collapse
Affiliation(s)
- Shaowen Li
- Medical Education Collaboration and Medical Education Research Center, Hebei Medical University, Shijiazhuang, 050017, China
- Foreign Language Education Department, Hebei Medical University, Shijiazhuang, 050017, China
| | - Kun Su
- Second Surgery Department, Hebei Provincial Hospital of Chinese Medicine, Shijiazhuang, 050013, China
| | - Peiwen Li
- Law School, University of International Business and Economics, Beijing, 100029, China
| | - Yifei Sun
- Medical Education Collaboration and Medical Education Research Center, Hebei Medical University, Shijiazhuang, 050017, China
| | - Ying Pan
- Medical Education Collaboration and Medical Education Research Center, Hebei Medical University, Shijiazhuang, 050017, China
| | - Weimin Wang
- Peking University Health Science Center, Beijing, 100191, China.
| | - Huixian Cui
- Medical Education Collaboration and Medical Education Research Center, Hebei Medical University, Shijiazhuang, 050017, China.
| |
Collapse
|
5
|
Hu WCY, Nguyen VAT, Nguyen NT, Stalmeijer RE. Becoming Agents of Change: Contextual Influences on Medical Educator Professionalization and Practice in a LMIC Context. TEACHING AND LEARNING IN MEDICINE 2022:1-12. [PMID: 35465797 DOI: 10.1080/10401334.2022.2056743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Medical educators are particularly needed in Low- and Middle-Income Countries (LMIC), where medical schools have grown rapidly in size, number, and global outlook in response to persistent health workforce shortages and increased expectations of quality care. Educator development is thus the focus of many LMIC programs initiated by universities and governments of high income countries. While signs of medical educator professionalization such as postgraduate qualifications, specialized units, and professional associations have emerged in LMIC, whether these relate to programs originating from outside LMIC contexts is unknown. This study investigated the contextual influences on the long-term impact of an international faculty development program a decade after its delivery in a LMIC context - Vietnam. Ten years after an international aid program to develop clinical skills teaching expertise in Vietnam, we conducted in-depth qualitative interviews with eight medical educators from all eight participating medical schools. Selected for their leadership potential, each participant had completed the Maastricht Masters in Health Professions Education during the program. Interview transcripts underwent thematic analysis, using the Theory of Practice Architectures as a conceptual lens to highlight the contextual influences on professional practice. Four themes were identified: Careers and Practices before, during, and after the program, Unrecognized and Unseen practice, Structural Restraints on individual advancement and collective activity, and the Cultivation of Connections through social traditions. Participants reported being in well-established teaching delivery roles. However, the absence of professionalizing discourses and material resources meant that practice was restricted and determined by institutional leadership and individuals' adaptations. Informed by the theory of practice architectures, we found that change in medical education practice will falter in contexts that lack supporting discursive, material-economic, and socio-political arrangements. While there were emerging signs of individual agency, the momentum of change was not sustained and perhaps unapparent to Western framings of educational leadership. Practice architectures offers a framework for identifying the contextual features which influence practice, from which to design and deliver sustainable and impactful interventions, and to advance context-relevant evaluation and research. Our findings suggest that faculty development delivered across diverse contexts, such as in distributed or transnational medical programs, may have more effect if informed by a practice architectures analysis of each context.
Collapse
Affiliation(s)
- Wendy Chung-Ya Hu
- Medical Education Unit, School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Van Anh Thi Nguyen
- Department of Medical Education and Skills Laboratory, Hanoi Medical University, Hanoi, Vietnam
| | - Nga Thanh Nguyen
- Learning Futures, Western Sydney University, Parramatta, Australia
| | - Renée E Stalmeijer
- Department of Educational Development and Research, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
6
|
Choa G, Arfeen Z, Chan SCC, Rashid MA. Understanding impacts of accreditation on medical teachers and students: A systematic review and meta-ethnography. MEDICAL TEACHER 2022; 44:63-70. [PMID: 34455898 DOI: 10.1080/0142159x.2021.1965976] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Accreditation is widely used by medical schools around the word to evaluate their curricula and educational processes, although its impacts on those involved in the 'frontline' of medical education receive little attention. This study systematically identified and synthesised qualitative studies that have explored medical teachers' and students' experiences of accreditation. METHODS Four databases (Pubmed, EMBASE, ERIC, and PsychINFO) were searched for relevant published articles. Synthesis was performed using meta-ethnography. RESULTS Eighteen articles were included in the final synthesis with 1017 individual participants from 10 countries. Findings were categorised into four domains, including navigating power differentials, evaluating credibility, influencing medical programmes, and culture and behaviour. The synthesis demonstrates divergent views on the value of accreditation in medical schools from students and staff including both positive and negative impacts on medical education programmes and stakeholders. CONCLUSIONS Although accreditation is perceived to have many benefits, it also has a number of unintended consequences, including on staff morale, student-teacher relationships, and teacher workloads. Medical teachers also have a number of concerns about the credibility of accreditation standards, assessors, and processes. Regulators and policymakers should consider the views of teachers and students as they seek to improve current accreditation practices.
Collapse
Affiliation(s)
- George Choa
- Bedfordshire Hospitals NHS Foundation Trust, London, UK
- University College London Medical School, University College London, London, UK
| | - Zakia Arfeen
- University College London Medical School, University College London, London, UK
| | | | | |
Collapse
|
7
|
Khan AW, Sethi A, Wajid G, Yasmeen R. Challenges towards quality assurance of Basic Medical Education in Pakistan. Pak J Med Sci 2020; 36:4-9. [PMID: 32063922 PMCID: PMC6994875 DOI: 10.12669/pjms.36.2.1319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/07/2019] [Accepted: 12/07/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE There are growing concerns towards the quality of medical education in Pakistan. To help strengthen accreditation processes, this study identifies the challenges towards quality assurance of Basic Medical Education in Pakistan. METHODS A qualitative case study was carried out from March to August 2018. Participants included inspectors from various disciplines in both public and private medical colleges, and medical educationists from Pakistan. Semi-structured interviews were conducted with 12 inspectors, while focus group discussion included 10 medical educationists. All the interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted to capture the intricacies of meaning within the data. RESULTS Data identified 14 sub-themes grouped under three major themes. Challenges towards quality assurance included mounting political influence, commercialism in medical education, weak regulatory capacity of accrediting body, violation of rules, lack of valid accreditation standards and skilled inspectors. CONCLUSION Quality assurance of Basic Medical Education in Pakistan involves various systemic, resource and personnel related challenges. The accrediting body needs to bring major reforms in its accreditation system and strengthen its regulatory and technical educational capacity to ensure the quality of medical education in nearly 168 medical and dental colleges of the country.
Collapse
Affiliation(s)
- Abdul Waheed Khan
- Dr. Abdul Waheed Khan, MBBS, MSC, MPH, MHPE. Department of Medical Education, Riphah International University, Islamabad, Pakistan
| | - Ahsan Sethi
- Dr. Ahsan Sethi, BDS, MPH, MMEd, FHEA, MAcadMEd, PhD Medical Education, Assistant Professor, Institute of Health Professions Education and Research, Khyber Medical University, Pakistan
| | - Gohar Wajid
- Dr. Gohar Wajid, MBBS, MSc, MPH, PhD Medical Education. Consultant, Health Professions Education, Department of Medical Education, Riphah International University, Islamabad, Pakistan
| | - Raheela Yasmeen
- Prof. Raheela Yasmeen, BDS, DCPS-HPE, JMHPE, MHPE. Department of Medical Education, Riphah International University, Islamabad, Pakistan
| |
Collapse
|