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Solano J, Zuniga Gutierrez M, Pinel-Guzmán E, Henriquez G. Barriers and Solutions to Successful Problem-Based Learning Delivery in Developing Countries - A Literature Review. Cureus 2023; 15:e43187. [PMID: 37692650 PMCID: PMC10485879 DOI: 10.7759/cureus.43187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Problem-based learning (PBL) was introduced in the 1960s as an alternative to traditional teacher-centered and discipline-based preclinical medical education. A literature review was conducted to explore the barriers and solutions to successful PBL uptake and delivery in developing countries. The review involved the search of articles and scientific studies on PubMed, The Lancet, and Scielo. The review focused on the medical education literature, using as a primary search criterion "problem-based learning" in combination with "developing countries" and "education". The search was limited to articles in Spanish and English published between 2011 and November 2021, except for three articles due to their relevance to the subject. Faculty development programs are the cornerstone when implementing a new methodology in developing countries. Early career development, PBL methodology, and the available assessment options should be the primary learning objectives of these programs. Stakeholders will need to plan using available resources following the experience of other countries and institutions encouraging collaborative development. Evaluation and assessment will be crucial to understand the impact of PBL, and considerations should be taken to implement an integrated curriculum. Medical Education Research should be encouraged, appraised, and disseminated to improve evidence-based decision-making, creating a constant development cycle. PBL is innovative and represents many unanswered questions that will develop in the following decade as more schools implement new methodologies and Research on PBL.
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Affiliation(s)
- Jhiamluka Solano
- Cardiology, Scunthorpe General Hospital, North Lincolnshire, GBR
- Research and Development, Asociación de Educación Médica Hondureña, Tegucigalpa, HND
| | | | | | - Génesis Henriquez
- Medicine, Universidad Nacional Autónoma de Honduras, Tegucigalpa, HND
- Medicine, Asociación de Educación Médica Hondureña, Tegucigalpa, HND
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Jünger J, Pante SV, Ackel-Eisnach K, Wagener S, Fischer MR. Do it together! Conception and long-term results of the trans-institutional Master of Medical Education (MME) program in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc33. [PMID: 32566735 DOI: 10.3105/zma0001326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 09/30/2019] [Accepted: 01/31/2020] [Indexed: 05/26/2023]
Abstract
Medical education has the responsibility to react to developments and changing demands in healthcare. This implies the need for experts in the area of medical education as well as nationally coordinated initiatives. An innovative model based on trans-institutional cooperation and nationwide consensus for establishing a master's degree course in Medical Education (MME) and long-term results are presented here to other countries and other programs, facing similar challenges. A MME program with the following goals was implemented at the Medical Faculty of Heidelberg University, Germany, in 2004: Qualification of leaders in medical faculties, professionalization and improvement of teaching quality, promotion of nationwide and international exchange, and stimulation of research in medical education. Since then, 15 cohorts with a total of 380 participants have started their studies, 179 participants have graduated and 90 publications resulted from the master's theses (as at November 2018). Evaluation and survey data revealed a very high degree of satisfaction among the participants and a lasting development to medical education experts. Our concept shows that the bundling of regional expertise into a clearly structured trans-institutional network can be a driving force for nationwide comprehensive changes, in order to address changing demands in healthcare systems and transfer it into medical education programs.
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Affiliation(s)
- Jana Jünger
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
- Institute of Medical and Pharmaceutical Proficiency Assessment, Mainz, Germany
| | - Saskia V Pante
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
| | | | - Stefan Wagener
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
| | - Martin R Fischer
- University Hospital, LMU Munich, Institute for Medical Education, Munich, Germany
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Jünger J, Pante SV, Ackel-Eisnach K, Wagener S, Fischer MR. Do it together! Conception and long-term results of the trans-institutional Master of Medical Education (MME) program in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc33. [PMID: 32566735 PMCID: PMC7291385 DOI: 10.3205/zma001326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 09/30/2019] [Accepted: 01/31/2020] [Indexed: 05/06/2023]
Abstract
Medical education has the responsibility to react to developments and changing demands in healthcare. This implies the need for experts in the area of medical education as well as nationally coordinated initiatives. An innovative model based on trans-institutional cooperation and nationwide consensus for establishing a master's degree course in Medical Education (MME) and long-term results are presented here to other countries and other programs, facing similar challenges. A MME program with the following goals was implemented at the Medical Faculty of Heidelberg University, Germany, in 2004: Qualification of leaders in medical faculties, professionalization and improvement of teaching quality, promotion of nationwide and international exchange, and stimulation of research in medical education. Since then, 15 cohorts with a total of 380 participants have started their studies, 179 participants have graduated and 90 publications resulted from the master's theses (as at November 2018). Evaluation and survey data revealed a very high degree of satisfaction among the participants and a lasting development to medical education experts. Our concept shows that the bundling of regional expertise into a clearly structured trans-institutional network can be a driving force for nationwide comprehensive changes, in order to address changing demands in healthcare systems and transfer it into medical education programs.
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Affiliation(s)
- Jana Jünger
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
- Institute of Medical and Pharmaceutical Proficiency Assessment, Mainz, Germany
- *To whom correspondence should be addressed: Jana Jünger, Heidelberg University, Medical Faculty of Heidelberg, MME program, Im Neuenheimner Feld 672, D-69120 Heidelberg, Germany, phone: +49 (0)6221/56-4592, Fax: +49 (0)6221/56-4365, E-mail:
| | - Saskia V. Pante
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
| | | | - Stefan Wagener
- Heidelberg University, Medical Faculty of Heidelberg, MME program, Heidelberg, Germany
| | - Martin R. Fischer
- University Hospital, LMU Munich, Institute for Medical Education, Munich, Germany
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Heide S, Pante SV, Fleig A, Möltner A, Leis S, Fritz AH, Jünger J, Fischer MR. Individual and institutional influencing factors on completion rates in a medical education master's program in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc75. [PMID: 31844647 PMCID: PMC6905360 DOI: 10.3205/zma001283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/14/2019] [Accepted: 09/09/2019] [Indexed: 05/22/2023]
Abstract
Background: The increasing significance of didactic aspects in medical education has also led to the development of special postgraduate programs. Completion rates represent an important outcome criterion for these programs of study. Up to today, detailed studies on what factors influence these completion rates have been lacking. Methods: Within the framework of outcomes research, a semi-structured online survey of students was conducted in the Master of Medical Education Germany program. Of the 90 items, 21 referred to the master's thesis that is required for graduation. Results: 157 out of 246 (63.8%) of students from classes 1-10 of the program (study period 2004-2014) participated in the survey. 109 participants had submitted a master's thesis, whereas 45 participants had not completed their studies by submitting a master's thesis. Influencing factors of successful completion were, among other things, little difficulty in choosing the topic, retention of the originally chosen topic, general support by the program administration in the modules and ensuring timely feedback from the advisor, and the provision of temporal, staff and financial resources by the home faculty. The failure to turn in the project report and a lengthy interruption of master thesi's work could be identified as critical parameters. Conclusion: Taking into account these results can contribute to increasing completion rates in medical education graduate programs. Systematic outcomes research leads, moreover, to quality assurance. Such studies should be conducted in a standardized manner in the future, in order to facilitate comparisons between medical education programs.
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Affiliation(s)
- Steffen Heide
- University of Halle-Wittenberg, Medical Faculty, Department of Forensic Medicine, Halle (Saale), Germany
- *To whom correspondence should be addressed: Steffen Heide, University of Halle-Wittenberg, Medical Faculty, Department of Forensic Medicine, Franzosenweg 1, D-06112 Halle (Saale), Germany, Phone: +49 (0)345/5571-885, Fax: +49 (0)345/5571-587, E-mail:
| | - Saskia V. Pante
- Heidelberg University, Medical Faculty, MME program, Heidelberg, Germany
| | - Andreas Fleig
- Heidelberg University, Medical Faculty, Center of Excellence for Assessment in Medicine, Heidelberg, Germany
| | - Andreas Möltner
- Heidelberg University, Medical Faculty, Center of Excellence for Assessment in Medicine, Heidelberg, Germany
| | - Stefan Leis
- Paracelsus Medical University, University Clinic of Neurology, Salzburg, Austria
| | - Angelika Hiroko Fritz
- University of Duisburg-Essen, Medical Faculty, Network Simulation Patient Program North Rhine-Westphalia, Essen, Germany
| | - Jana Jünger
- Heidelberg University, Medical Faculty, MME program, Heidelberg, Germany
- Institute of Medical and Pharmaceutical Proficiency Assessment, Mainz, Germany
| | - Martin R. Fischer
- Heidelberg University, Medical Faculty, MME program, Heidelberg, Germany
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
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Matthes J, Giesler M, Wagner-Menghin M, Himmelbauer M, Preusche I, Schüttpelz-Brauns K. Publication activity in medical education research: A descriptive analysis of submissions to the GMS Zeitschrift für Medizinische Ausbildung in 2007-2015. GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc32. [PMID: 28890923 PMCID: PMC5569980 DOI: 10.3205/zma001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 06/01/2017] [Accepted: 06/26/2017] [Indexed: 06/07/2023]
Abstract
Objectives: The significance of medical education research has increased internationally. In this context we investigated whether, and if so, how the quantity and quality of scientific papers reviewed and/or published by the GMS Zeitschrift für Medizinische Ausbildung (GMS Z Med Ausbild) changed. Methods: The quantity and ratio of original papers, project reports and reviews submitted to or published in the GMS Z Med Ausbild were analysed. Published scientific articles were investigated in regard to the quality features "study type" and "mode of data collection" as well as the background (university affiliation) of the last authors. The citation frequency within the first five years after PubMed listing was compared to the one of BMC Medical Education in the corresponding period. Results: The number of submitted scientific manuscripts increased steadily. Most of the submissions and publications are original papers. For publications explorative studies and prospective data collection are most common. A shift over time is not observed. 16% of the published works come from one and 36% from four of the in total 39 universities represented by the last authors. The development of the citation frequency of articles published in GMS Z Med Ausbild is similar to that of BMC Medical Education. Conclusion: The rising number of submissions indicates an increasing significance of medical education research in German-speaking countries. The development of the number of citations reflects the growing appreciation of GMS Z Med Ausbild also indicated by the increasing number of online accesses. Our findings that study type and mode of data collection did not change has to be interpreted with caution since among other things choice and correct application of adequate methods are crucial regarding a scientific work's quality, too. These aspects, however, were not investigated in this paper.
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Affiliation(s)
- Jan Matthes
- University of Cologne, Institute II, Center for Pharmacology, Cologne, Germany
| | - Marianne Giesler
- University of Freiburg, Medical Faculty, Office of Student Affairs, Centre for Evaluation of Teaching in Medicine Baden-Württemberg, Freiburg, Germany
| | | | | | - Ingrid Preusche
- University of Veterinary Medicine, Teaching Center, Vienna, Austria
| | - Katrin Schüttpelz-Brauns
- University Medicine Mannheim, Medical Faculty Mannheim at Heidelberg University, Department of Undergraduate Education and Educational Development, Mannheim, Germany
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Dreyhaupt J, Mayer B, Keis O, Öchsner W, Muche R. Cluster-randomized Studies in Educational Research: Principles and Methodological Aspects. GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc26. [PMID: 28584874 PMCID: PMC5450430 DOI: 10.3205/zma001103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/17/2016] [Accepted: 12/29/2016] [Indexed: 05/11/2023]
Abstract
An increasing number of studies are being performed in educational research to evaluate new teaching methods and approaches. These studies could be performed more efficiently and deliver more convincing results if they more strictly applied and complied with recognized standards of scientific studies. Such an approach could substantially increase the quality in particular of prospective, two-arm (intervention) studies that aim to compare two different teaching methods. A key standard in such studies is randomization, which can minimize systematic bias in study findings; such bias may result if the two study arms are not structurally equivalent. If possible, educational research studies should also achieve this standard, although this is not yet generally the case. Some difficulties and concerns exist, particularly regarding organizational and methodological aspects. An important point to consider in educational research studies is that usually individuals cannot be randomized, because of the teaching situation, and instead whole groups have to be randomized (so-called "cluster randomization"). Compared with studies with individual randomization, studies with cluster randomization normally require (significantly) larger sample sizes and more complex methods for calculating sample size. Furthermore, cluster-randomized studies require more complex methods for statistical analysis. The consequence of the above is that a competent expert with respective special knowledge needs to be involved in all phases of cluster-randomized studies. Studies to evaluate new teaching methods need to make greater use of randomization in order to achieve scientifically convincing results. Therefore, in this article we describe the general principles of cluster randomization and how to implement these principles, and we also outline practical aspects of using cluster randomization in prospective, two-arm comparative educational research studies.
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Affiliation(s)
- Jens Dreyhaupt
- Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
- *To whom correspondence should be addressed: Jens Dreyhaupt, Ulm University, Institute of Epidemiology and Medical Biometry, Schwabstr. 13, 89075 Ulm, Germany, Phone: +49(0)731/50-26895, Fax: +49(0)731/50-26902, E-mail:
| | - Benjamin Mayer
- Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
| | - Oliver Keis
- Ulm University, Office of the Dean of Studies for Medicine, Ulm, Germany
| | - Wolfgang Öchsner
- Ulm University, Office of the Dean of Studies for Medicine, Ulm, Germany
- University Hospital Ulm, Department of Cardiac Anesthesiology, Ulm, Germany
| | - Rainer Muche
- Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
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Prediger S, Harendza S. Analysis of educational research at a medical faculty in Germany and suggestions for strategic development - a case study. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc71. [PMID: 27990467 PMCID: PMC5135420 DOI: 10.3205/zma001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 07/07/2016] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
Background: Evidence-based medical education is playing an increasingly important role in the choice of didactic methods and the development of medical curricula and assessments. In Germany, a growing number of educational research projects has accompanied an ongoing change in the medical education process. The aim of this project was to assess medical education research activities at one medical faculty to develop procedural recommendations for the support and development of best evidence medical education. Methods: Using a newly developed online questionnaire, the 65 institutes and departments of the medical faculty of Hamburg University at Hamburg University Medical-Center (UKE) were asked to report their medical education research and service projects, medical education publications, medical education theses, financial support for educational projects, and supportive structures that they would consider helpful in the future. The data were grouped, and a SWOT analysis was performed. Results: In total, 60 scientists who were involved in 112 medical education research publications between 1998 and 2014 were identified at the UKE. Twenty-five of them had published at least one manuscript as first or last author. Thirty-three UKE institutions were involved in educational service or research projects at the time of the study, and 75.8% of them received internal or external funding. Regular educational research meetings and the acquisition of co-operation partners were mentioned most frequently as beneficial supportive structures for the future. Conclusion: An analysis to define the status quo of medical education research at a medical faculty seems to be a helpful first step for the development of a strategy and structure to further support researchers in medical education.
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Affiliation(s)
- Sarah Prediger
- University Hospital Hamburg-Eppendorf, III. Medical Clinic, Hamburg, Germany
| | - Sigrid Harendza
- University Hospital Hamburg-Eppendorf, III. Medical Clinic, Hamburg, Germany
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