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Maheshwari K, Shigli K, Tiwari B, Bukya D, Oberoi SS, Ansari MWF, Mondal T. Introduction and Effectiveness of Early Clinical Exposure Among Dental Students in Pre-clinical Prosthodontics. Cureus 2024; 16:e66126. [PMID: 39229438 PMCID: PMC11370813 DOI: 10.7759/cureus.66126] [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: 08/04/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. MATERIALS AND METHODS A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. RESULTS A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students. Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. CONCLUSION Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.
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Affiliation(s)
- Komal Maheshwari
- Department of Prosthodontics, Employees State Insurance Corporation (ESIC) Dental College and Hospital, New Delhi, IND
| | - Kamal Shigli
- Department of Prosthodontics, D. Y. Patil Dental School, Pune, IND
| | - Bhawana Tiwari
- Department of Prosthodontics, Employees State Insurance Corporation (ESIC) Dental College and Hospital, New Delhi, IND
| | - Dwarakananda Bukya
- Department of Prosthodontics, Employees State Insurance Corporation (ESIC) Dental College and Hospital, Gulbarga, IND
| | | | - Mohammad Waseem Faraz Ansari
- Department of Community Medicine, Employees State Insurance Corporation (ESIC) Dental College and Hospital, Chennai, IND
| | - Tanushree Mondal
- Department of Community Medicine, Radha Gobinda Kar Medical College and Hospital, Kolkata, IND
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Kalusopa VM, Katowa-Mukwato P, Chitundu K, Mvula M, Nzala S, Kabinga-Makukula M, Mwiinga C, Mwila EM, Kampata L, Mumba MK, Chiguntap M, Sichone J, Kwaleyela C, Phiri P, Mutemwa S, Zulu M, Mwaba-Siwale C, Wahila R, Nawa M, Wamunyima MM, Makondo F, Syatalimi C, Kafumukache E, Goma F. Experiences of Early and Enhanced Clinical Exposure for Postgraduate Neonatal Nursing Students at the University of Zambia, School of Nursing Sciences: Lessons and Implications for the Future. OPEN JOURNAL OF NURSING 2023; 13:352-367. [PMID: 37655296 PMCID: PMC10469329 DOI: 10.4236/ojn.2023.136024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background and Objectives Early and Enhanced Clinical Exposure immediately places postgraduate students in a clinical setting and incorporates continual hands-on instruction throughout their studies. It aims to motivate students by strengthening their academics, improving clinical and communication skills, and increasing their confidence. The underlying principles are to provide a clinical context and to ensure that the patient remains the centre of learning. The School of Nursing Sciences implemented this model in 2021 to produce hands-on Masters-level neonatal practitioners who can work in multidisciplinary clinical contexts. Therefore, this study explored the experiences of postgraduate nursing students on the Early and Enhanced Clinical Exposure model and draw implications for the future. Methods A phenomenological study design was utilized at the University of Zambia, School of Nursing Sciences and comprised of eight Master of Science Neonatal Nursing students in their second year. Convenience sampling was used to select the study site and participants. Data was collected between 15th January 2023 and 31st January 2023 using an in-depth interview guide. Audio recording and notes were transcribed immediately after data collection. Data analysis was conducted using thematic analysis and codes and themes were constructed from the coded data. Ethical clearance and permission were sought before conducting the study. Results Four major themes emerged from the study: identity and role confusion, challenging and hectic experiences, positive educational experiences, and personal and professional growth. These themes contributed to the promotion of evidence-based practice by helping students to assess, diagnose, and treat various conditions, as well as gain interest, experience, knowledge, and exposure. Conclusion The model has a significant impact on motivation to learn, as evidenced by reported increased skill level with potential for use in clinical practice. It is recommended that it be implemented in all postgraduate programs for full-time students.
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Affiliation(s)
| | | | - Kabwe Chitundu
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Manasseh Mvula
- School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
| | | | | | | | | | - Linda Kampata
- School of Public Health, University of Zambia, Lusaka, Zambia
| | | | | | - James Sichone
- School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Concept Kwaleyela
- School of Medicine and Health Sciences, Mulungushi University, Kabwe, Zambia
| | - Phadaless Phiri
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Suzan Mutemwa
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Mildred Zulu
- School of Medicine, University of Zambia, Lusaka, Zambia
| | | | - Ruth Wahila
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Mukumbuta Nawa
- School of Public Health and Environmental Studies, Levy Mwanawasa Medical University, Lusaka, Zambia
| | | | | | | | | | - Fastone Goma
- School of Medicine, University of Zambia, Lusaka, Zambia
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Ewnte B, Yigzaw T. Early clinical exposure in medical education: the experience from Debre Tabor University. BMC MEDICAL EDUCATION 2023; 23:252. [PMID: 37069522 PMCID: PMC10111732 DOI: 10.1186/s12909-023-04221-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The idea of early clinical exposure in Ethiopian medical schools is a young concept. Old and newly established universities across the nation are shifting towards incorporation of early clinical exposure (ECE) in their curricula. Debre Tabor University introduced ECE in undergraduate medical education from inception. This study generated evidence on students' experience and academic leaders' reflection on early clinical exposure implementation. OBJECTIVE This study was carried out to investigate medical students' perception towards early clinical exposure and its implementation process by instructors in undergraduate medical education at Debre Tabor University. METHOD A cross-sectional survey design that combines quantitative and qualitative methods was conducted in 2021. We asked fifth year medical students (42) to complete a self-administered questionnaire on 5-point Likert scale. The data were supplemented by semi-structured interview with 6 purposively selected academic leaders on the factors that facilitate or impede early clinical exposure implementation. The quantitative data were entered and analyzed using SPSS 20 to compute frequency, median and interquartile range. The qualitative data were analyzed thematically. RESULTS The study findings suggest that early clinical exposure (ECE) has a positive impact on the development of students' professional knowledge, problem-solving skills, motivation, active learning, and community orientation. Specifically, 64.3% of the surveyed students believed that ECE was effective in constructing their professional knowledge, while 52.4% felt that it improved their problem-solving skills and facilitated constructive/active learning. Additionally, 57.1% of students reported that ECE improved their motivation and 50% noted that it facilitated community orientation. The study also identified several barriers to the implementation of ECE, with the heavy workload being the most commonly mentioned (78.6%). Other challenges included a loose linkage between academic and healthcare institutions (59.5%) and a lack of orientation on the implementation process (35.7%). Academic leaders reflected that ECE was beneficial in familiarizing students with the clinical environment, but staff commitment was crucial for its successful implementation. The study also found that heavy workload, lack of assessment dedicated to ECE on the curriculum, and poorly oriented staff about the program impeded its implementation. CONCLUSION AND RECOMMENDATIONS The findings of this study suggest that early clinical exposure was beneficial learning method. Teachers' commitment to their roles with adequate preparation, and the contribution of curriculum in providing the learning objective and cases for each session were factors that facilitate effective implementation of ECE. Heavy workload and poor orientation about the program could impede ECE implementation.
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Alfazari AS, Naim Ali HA, Alessa A, Magzoub ME. Assessing relational coordination and its impact on perceived mental health of students, teachers and staff in a clinical skills program during the COVID-19 pandemic. BMC MEDICAL EDUCATION 2022; 22:773. [PMID: 36357937 PMCID: PMC9647241 DOI: 10.1186/s12909-022-03828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The global spread of the COVID-19 virus caused unprecedented interruptions in medical education. This paper evaluates Relational Coordination (RC): communicating and relating for task integration; between the distinct stakeholders responsible for scheduling,delivering and receiving clinical teaching in the wake of the pandemic. METHODOLOGY Using a cross-sectional design, the level of Relational Coordination was assessed between twelve groups within a Clinical Skills Program at a Medical School in the United Arab Emirates. It also measures three relevant mental health factors: namely, Job satisfaction, Work Engagement, and Burnout. RESULTS Overall, RC scores were moderate (3.65 out of 5.00). Controlling for participants' position, RC was found to positively and significantly increase both job satisfaction (β = 1.10, p < 0.001) and work engagement (β = 0.78, p < 0.01)., Additionally, RC was significantly associated with lower burnout (β = -0.56, p = 0.05). Fifty percent of participants experienced high job satisfaction, with a mean score of 5.0 out of 7.0, while 73% reported being enthusiastic about their job, with a mean score of 6.0 out of 7.0. About a third of participants (27%) reported feeling burnout. CONCLUSIONS During times of disruption and crisis, medical education can benefit from higher levels of relational coordination. Our study shows the significant impact of relational coordination on mental health measures like job satisfaction and work engagement. To achieve the full potential and benefits of excellent levels of relational coordination in this program, we recommend six interventions focusing on improving communication, work processes, regular meetings, education innovations, capacity building, and the establishment of coaching and counseling programs for students and faculty.
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Affiliation(s)
- Ali S. Alfazari
- Medical Simulation Center, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hebatallah A. Naim Ali
- The Heller School for Social Policy and Management, Brandeis University, Waltham Massachusetts, USA
| | - Awad Alessa
- Department of Medical Education, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohi Eldin Magzoub
- Department of Medical Education, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Undergraduate Medical Education Reform in Viet Nam for a Primary Health Care Workforce. Ann Glob Health 2022; 88:100. [DOI: 10.5334/aogh.3755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
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Mindaye ET, Tesfay GK. Clinical Competence and Perception of Medical Students after Early Clinical Exposure through Pre-clerckship Education at an Ethiopian Medical School: A Cross-sectional Study. Ethiop J Health Sci 2022; 32:1211-1220. [PMID: 36475252 PMCID: PMC9692162 DOI: 10.4314/ejhs.v32i6.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/01/2022] [Indexed: 12/13/2022] Open
Abstract
Background Conventional medical curriculum is the mainstay in the long history of modern medical education. Innovative integrated medical curriculum attracted significant attention in improving conventional curriculum. In the integrated curriculum, basic sciences are incorporated horizontally with each other, and students are exposed early to clinical settings. This is expected to improve students' knowledge and skills in clinical medicine by the time they start their clerkship rotation. Method the study aims to make a baseline assessment on the overall knowledge and skills of medical students towards clinical medicine. An institution-based cross-sectional study was conducted from March to April of 2020 using 91 third year medical students (convenience sampling). A three-section self-administered survey instrument, short written MCQ exam, and practical (OSCE) students' examination were used for this survey. Result participants tend to exhibit better knowledge on basics of history taking and physical examination with an average score of 79%. Comparatively, the score for average physical examination skill was low (56.3%). Students' perception on ECE showed, over 50% of participants believe ECE increases burden on their overall workload. Even then, the majority (92.3%) still think that ECE has positive impact on their clerkship education. Taken together, it appears more hands-on interventions is needed to further improve skills of medical students in physical examination with particular emphasis on the clinical examination of breast, thyroid, musculoskeletal, and neurologic systems.
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Affiliation(s)
| | - Goytom Knfe Tesfay
- Department of Surgery, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Shenoy R, Jain A, K B, Shirali A, Shetty SB, Ramakrishna A. A task-based learning strategy in preclinical medical education. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:192-199. [PMID: 34591690 DOI: 10.1152/advan.00173.2020] [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: 09/16/2020] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
Preclinical task-based learning (TskBL) is a simulated learning approach in which the focus for students is a real task done by a medical professional. TskBL includes standardized patient encounters and is helpful to provide early clinical exposure. Our study aimed at planning, implementing, and assessing TskBL among first-year medical students and comparing it to the conventional method of tutorials in the physiology MBBS curriculum. This is a nonequivalent group quasi-experimental study approved by the institutional ethics committee. TskBL was conducted for seven topics among first-year medical students of Kasturba Medical College, Mangalore for three academic years. Participants were divided into a TskBL group and a control group. Both groups attended the theory classes in physiology, practical sessions, and clinical examinations concerning the tasks. After this, the TskBL group underwent TskBL, and the control group underwent tutorials. Pretest and posttest assessments were conducted by using a multiple choice question (MCQ) test and objective structured clinical examinations (OSCEs).The mean TskBL scores for MCQ (exception: hypertension, myasthenia gravis, and chronic obstructive pulmonary disease) and OSCE (exception: anemia and hypertension) were significantly higher than the tutorial group. Pretest and posttest scores revealed significantly higher MCQ and OSCE scores for TskBL (exception: MCQ score for hypertension and chronic obstructive pulmonary disease). The tutorial group did not show a significant improvement in test scores for all the tasks. The TskBL strategy could be used for topics that are likely to be encountered by the students during clinical attachments. Small group teaching can include TskBL in preference to tutorials to provide early clinical exposure in medical schools.
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Affiliation(s)
- Roopashree Shenoy
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Animesh Jain
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Medical Education, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhagyalakshmi K
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Medical Education, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arun Shirali
- Department of Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Medical Education, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sneha B Shetty
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anand Ramakrishna
- Department of Respiratory Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Medical Education, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Narapureddy BR, Patan SK, Deepthi CS, Chaudhuri S, John KR, Chittooru C, Babu S, Nagoor K, Jeeragyal D, Basha J, Nell T, Reddy RS. Development of a community orientation program (COP) as a community-based medical education method for undergraduate medical students: an experience from India. BMC MEDICAL EDUCATION 2021; 21:626. [PMID: 34949199 PMCID: PMC8697537 DOI: 10.1186/s12909-021-03069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Intra-regional cultural and linguistic differences are common in low- and middle-income countries. To sensitise undergraduate medical students to the social and contextual determinants of health to achieve the 'health for all' goal, these countries must focus on innovative teaching methods. The early introduction of a Community Orientation Program (COP) as a Community-based Medical Education (CBME) method could be a game changing strategy. In this paper the methods, evaluation, and implication of the COP in an Indian setting are described. METHODS The curriculum of the COP was developed based on the analysis, design, development, implementation, and evaluation (ADDIE) model for educational intervention. In this learner-centric and supervised educational program, the key aim was to focus on developing students' communication skills, observation power and enhancing their motivation for learning through collaborative learning. To meet the objectives of the COP, a situated learning model under the constructivism theory was adopted. RESULTS Between 2016 and 2019, 557 students were trained through the COP by visiting more than 1300 households in ten villages. To supplement the students' observations in the community, more than 150 small group discussions, a health education programme for the community and summary presentations were conducted. The students' feedback indicated the need to improve the clinical examinations demonstration quality and increase the number of instruments for clinical examinations. More than 80% of students felt that the program would assist them to improve their communication skills, their understanding of the various socio-demographic factors associated with the common diseases, and it will enable them to respect the local culture during their clinical practice. CONCLUSIONS Early initiation of the COP as a CBME method in the undergraduate medical curriculum in an Indian setting has shown promising results. Further evidence is required to adopt such a program routinely for under-graduate medical teaching in the low- and middle- income settings.
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Affiliation(s)
- Bayapa Reddy Narapureddy
- College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
- Apollo Institute of Medical Sciences and Research, Chittoor, India
| | | | | | | | - K. R. John
- Apollo Institute of Medical Sciences and Research, Chittoor, India
| | | | - Surendra Babu
- Apollo Institute of Medical Sciences and Research, Chittoor, India
- ESIC Medical College, Hyderabad, India
| | | | - Devika Jeeragyal
- Apollo Institute of Medical Sciences and Research, Chittoor, India
| | - Jawahar Basha
- Apollo Institute of Medical Sciences and Research, Chittoor, India
| | - Theo Nell
- Connect To Grow, Yzerfontein, South Africa
| | - Ravi Shankar Reddy
- College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
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Ramanathan R, Shanmugam J, Sridhar MG, Palanisamy K, Narayanan S. Exploring faculty perspectives on competency-based medical education: A report from India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:402. [PMID: 34912938 PMCID: PMC8641753 DOI: 10.4103/jehp.jehp_1264_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/09/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Medical education in India is experiencing a paradigm shift from traditional curriculum to competency-based medical education (CBME). It de-emphasizes time-based training and promises greater accountability, flexibility, and learner centeredness. Faculty development is integral in the context of CBME. Considering faculty perceptions toward the new CBME and addressing the difficulties will play a vital role in successful implementation. MATERIALS AND METHODS A cross-sectional study was carried out among 297 teaching faculty in 91 medical colleges across 20 states all over India between February and July 2020. A structured validated questionnaire on CBME was used to collect the responses through Google forms and was exported and analyzed in Microsoft Excel. RESULTS More than 80% opined that Faculty members in departments are not adequate for successful CBME implementation. Reflective learning, early clinical exposure, and elective posting were accepted by 60.2%, 70.4%, and 45.5% of the faculty, respectively. Around 81.8% welcomed horizontal integration, whereas only 54.2% favored vertical integration during the Phase I MBBS. CONCLUSION Few reforms such as curtailing the duration of foundation course, sensitization of all medical teachers through faculty development programs, better synchronized vertical integration, increasing the strength of faculty in each department, and adequate infrastructure for skills laboratory can be undertaken as per faculty suggestions.
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Affiliation(s)
- Rashmi Ramanathan
- Department of Physiology, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Jeevithan Shanmugam
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | | | - Kalaniti Palanisamy
- Department of General Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Seetharaman Narayanan
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
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Norris ME, Cachia MA, Johnson MI, Martin CM, Rogers KA. Are Clerks Proficient in the Basic Sciences? Assessment of Third-Year Medical Students' Basic Science Knowledge Prior to and at the Completion of Core Clerkship Rotations. MEDICAL SCIENCE EDUCATOR 2021; 31:709-722. [PMID: 34457921 PMCID: PMC8368550 DOI: 10.1007/s40670-021-01249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 06/13/2023]
Abstract
Basic sciences are a cornerstone of undergraduate medical education (UME), yet research indicates that students' basic science knowledge is not well retained. Many UME curricula are increasing the integration between the basic and clinical sciences with the goal of enhancing students' knowledge levels; however, the impact of clerkship training on students' basic science knowledge remains inconclusive. Thus, using clerkship directors' expectations as framework, we aimed to assess third-year medical students' basic science knowledge during clerkship training and evaluate the influence of clerkship training on their basic science knowledge. Using concepts deemed necessary by clerkship directors, we created a basic science assessment for each clerkship rotation. Assessments were distributed to third-year medical students as a pre- and post-test to assess their basic science knowledge prior to and at the completion of each rotation. On average, students retained ≥ 60% of relevant basic science knowledge from pre-clerkship, and neither clerkship rotation order, nor the basic science discipline being assessed, impacted students' basic science knowledge levels. Post-test data revealed that students, on average, reinforced fundamental concepts during clerkship. Interestingly, even though lower-performing students demonstrated the greatest post-test improvement, they still left each rotation with knowledge deficits compared with their highest-performing peers, suggesting that the clinical experience of clerkship appears to be particularly beneficial for lower-performing students, in regard to enhancing their basic science knowledge. Overall, results indicate that earlier exposure to clinical learning in UME, along with integration of basic science education into clerkship, could promote students' basic science knowledge acquisition and retention.
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Affiliation(s)
- Madeleine E. Norris
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON Canada
| | - Mark A. Cachia
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON Canada
| | - Marjorie I. Johnson
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON Canada
| | - Charys M. Martin
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON Canada
| | - Kem A. Rogers
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON Canada
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Seif AA, Eldamanhoury HM, Darahim K, Boulos DNK, Bahaa N, A M C, Velladath SU, Kamath MG. EE-6S: an integrated approach for introducing early clinical exposure in the new Egyptian medical curriculum. ADVANCES IN PHYSIOLOGY EDUCATION 2021; 45:109-120. [PMID: 33544038 DOI: 10.1152/advan.00166.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/11/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
The electrocardiogram (ECG) is the primary diagnostic tool in cardiovascular diseases. Hence its interpretation is a core competency in medicine, where obvious deficiencies have been reported among learners. The aim of this study was to introduce the fundamentals of ECG knowledge and interpretation through early clinical exposure (ECE) based on a six-step approach for preclinical students (n = 110) and to study its influence on their knowledge and interpretation skills thereafter. The first step employed a blended learning format using didactic lectures on normal and pathological ECGs, each preceded by preinstructional videos. The second step focused on psychomotor skills and utilized laboratory exercises for ECG recording and interpretation. The third step focused on vertical integration, where the clinical relevance of the procedure was established with integrated lectures. The fourth step used the Moodle platform, where opportunities for peer interactions and clarifications by clinical faculty were made available. The fifth step incorporated clinical and diagnostic reasoning through cardiology ward visits and interpretation of patient ECGs. The sixth step was designed for critical thinking and problem solving through case-based discussions with peers and faculty. Students were assessed with multiple-choice questions and objective structured practical examination. Learner perceptions of the approach were evaluated with a feedback questionnaire and focus group discussion. Statistical analysis showed that ECE through a six-step approach significantly enhanced knowledge and interpretation of ECG as evidenced by the pre- and posttest scores. Analysis of the focus group data revealed that learner engagement and skills of critical thinking were enhanced along with diagnostic and clinical reasoning.
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Affiliation(s)
- Ansam Aly Seif
- Department of Physiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hayam M Eldamanhoury
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Khaled Darahim
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina N K Boulos
- Department of Public Health, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nevine Bahaa
- Department of Histology and Cell Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ciraj A M
- Department of Microbiology, Melaka Manipal Medical College, and Manipal FAIMER International Institute for Leadership in Interprofessional Education (M-FIILIPE), Manipal Academy of Higher Education, Manipal, India
| | - Saleena Ummer Velladath
- Department of Medical Laboratory Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - M Ganesh Kamath
- Department of Physiology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India
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Ramanathan R, Shanmugam J, Gopalakrishna SM, Palanisami K, Narayanan S. Exploring the learners' perspectives on competency-based medical education. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:109. [PMID: 34084856 PMCID: PMC8150072 DOI: 10.4103/jehp.jehp_866_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/14/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND A novel innovation in medical education was initiated by the Medical Council of India after 21 years. Competency-based medical education (CBME) is an effective outcome-based strategy, which requires integration of knowledge, attitude, skills, values, and responsiveness. The aim was to assess the students' perspectives on competency-based medical curriculum. MATERIALS AND METHODS This cross-sectional descriptive study was conducted among 1st year MBBS students (2019-2020 batch). A validated questionnaire was administered through Google link among phase I medical students of various medical colleges across India by multistage sampling. RESULTS A total of 987 students from 74 medical colleges in India responded. Nearly three-fourths opined that foundation course (FC), attitude ethics communication module, and early clinical exposure were necessary. Horizontal integration was more appreciated to vertical integration. Maintaining log books was perceived as time-consuming and cumbersome. CONCLUSION The CBME when meticulously adopted will inspire student enthusiasm for learning. Few reforms such as curtailing the duration of FC, diffuse sessions on stress and time management, better synchronized vertical integration, and an exemplary implementation of adult learning techniques can be undertaken.
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Affiliation(s)
- Rashmi Ramanathan
- Department of Physiology, KMCH Institute of Health Science and Researches, Coimbatore, Tamil Nadu, India
| | - Jeevithan Shanmugam
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
- Address for correspondence: Dr. Jeevithan Shanmugam, Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India. E-mail:
| | | | - Kalaniti Palanisami
- Department of General Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Seetharaman Narayanan
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
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Gupta K, Gill GS, Mahajan R. Introduction and Implementation of Early Clinical Exposure in Undergraduate Medical Training to Enhance Learning. Int J Appl Basic Med Res 2020; 10:205-209. [PMID: 33088745 PMCID: PMC7534714 DOI: 10.4103/ijabmr.ijabmr_270_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 11/22/2022] Open
Abstract
Context: Conventional medical curricula have created an impenetrable wall between the preclinical and clinical years of training, thus submerging relevance of basic sciences in clinical setup. Recently, the Medical Council of India has introduced a number of changes and updates in the medical education, including “early clinical exposure” (ECE) in newly proposed competency-based medical education. ECE does not replace the basic and clinical sciences but enriches and contextualizes that learning, therefore motivating the students to develop a better insight into medical profession. Aims: (1) To develop a protocol for the introduction of ECE in undergraduate medical training, (2) to validate and to deliver it to the 1st year MBBS students and assess their perceptions. Settings and Design: It was a prospective, nonrandomized, interventional study. Subjects and Methods: After taking permission from the institutional research committee and institutional ethical committee, a protocol for the introduction of ECE in Biochemistry was developed. The feedback questionnaire for the students and the faculty and retro-preself-efficacy questionnaire for the students were designed and validated. The ECE protocol was delivered to 143 1st-year MBBS students, and perceptions of concerned were collected and analyzed. Statistical Analysis Used: Collected data were analyzed in terms of percentages, medians, and satisfaction index and were represented in graphs. Results: Students reported that the ECE session was an enjoyable, satisfactory, and effective learning tool, with the improvement in knowledge, retention, attention, and motivation. Students also reported that this method of teaching–learning should be implemented in other topics as well as in other subjects of the first professional course. Conclusions: ECE protocol was perceived as very satisfactory by the students, and it helped in improvement of knowledge and to understand the relevance of preclinical subject in clinical setup.
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Affiliation(s)
- Kapil Gupta
- Department of Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Gurpreet Singh Gill
- Department of General Surgery, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Rajiv Mahajan
- Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
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Seale J, Knoetze M, Phung A, Prior D, Butchers C. Commencing Technical Clinical Skills Training in the Early Stages of Medical Education: Exploring Student Views. MEDICAL SCIENCE EDUCATOR 2019; 29:173-179. [PMID: 34457465 PMCID: PMC8368689 DOI: 10.1007/s40670-018-00657-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Medical schools are increasingly introducing technical clinical skills training from year 1. However, little research has determined students' views of such training. This study compared the perceptions of student groups which received different levels of technical skills training during the early years of their undergraduate medical degree. METHODS Medical students from King's College London's Stage curriculum (n = 184) receiving 48 h of technical skills teaching and Phase curriculum (n = 94), receiving 12 h, voluntarily participated. A mixed methods design using a questionnaire and focus groups explored students' views. Stage and Phase student questionnaire responses were compared using Mann Whitney U tests. Focus group transcripts underwent thematic analysis. RESULTS The majority of Stage (n = 169) and Phase (n = 68) students identified year 1 as the best time to commence technical skills training. For the majority of the technical skills taught, Stage compared to Phase students reported feeling more prepared to perform them. Thematic analysis identified three main themes: Role of technical skills teaching in the early stages of medical education, impact on students' learning and factors to consider when designing a medical undergraduate technical clinical skills programme. CONCLUSIONS The wide student support and positive impact of technical skills training on students' perceived preparedness for carrying out the techniques taught advocates its addition to the first year of the undergraduate medical curriculum. The identification by students of specific components considered to be fundamental in the effective teaching of technical skills provides guidance when designing future undergraduate clinical skills training.
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Affiliation(s)
- Josephine Seale
- GKT School of Medical Education, Simulation and Interactive Learning (SaIL) Centre, King’s College London, Shepherds House, London, SE1 1UL UK
| | - Madeleine Knoetze
- GKT School of Medical Education, Simulation and Interactive Learning (SaIL) Centre, King’s College London, Shepherds House, London, SE1 1UL UK
| | - Anita Phung
- GKT School of Medical Education, Simulation and Interactive Learning (SaIL) Centre, King’s College London, Shepherds House, London, SE1 1UL UK
| | - David Prior
- GKT School of Medical Education, Simulation and Interactive Learning (SaIL) Centre, King’s College London, Shepherds House, London, SE1 1UL UK
| | - Colin Butchers
- GKT School of Medical Education, Simulation and Interactive Learning (SaIL) Centre, King’s College London, Shepherds House, London, SE1 1UL UK
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Vanichnatee T, Sitticharoon C, Maprapho P, Keadkraichaiwat I, Charoenngam N, Praditsuwan R. Impact of an early clinical exposure project conducted by senior clinical students compared between participating and nonparticipating students. ADVANCES IN PHYSIOLOGY EDUCATION 2018; 42:619-625. [PMID: 30303412 DOI: 10.1152/advan.00122.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An early clinical exposure project conducted by clinical students aimed to promote direct clinical experience to preclinical students. The aim of this study was to determine the effects of the project on academic achievement and study attitudes and habits between participating and nonparticipating students before ( test 1) and after the project ( test 2) in the second preclinical year and at the end of the first semester of the first clinical year ( test 3), with a subgroup analysis of the first (lowest) to third (highest) tertile of the score. Questionnaires were sent to the first clinical year students at test 3 and asked the information retrospectively at test 1 and test 2 in second year preclinical and currently at test 3, with 83.86% (265/316) being returned. Mean percentile of scores was higher at test 2 compared with test 1 in the first tertile group of participating students. Motivation to study medicine (motivation), realization of application of preclinical knowledge to clinical study (application), understanding of clinical environment (environment), and lesson review after class (review) were higher for participating than nonparticipating students at test 2 and/or test 3. Searching additional study information was higher at test 2 compared with test 1 only for participating students. This project could effectively promote application, motivation, environment, and review for participating vs. nonparticipating students at test 2 and/or test 3. Effortless, intimate, and effective communication between clinical and preclinical students and a direct experience in early clinical exposure might be key success factors.
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Affiliation(s)
- Thanapat Vanichnatee
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Chantacha Sitticharoon
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Punyapat Maprapho
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Issarawan Keadkraichaiwat
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Nipith Charoenngam
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Rungnirand Praditsuwan
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
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Bhattacharrya H, Medhi GK, Pala S, Sarkar A, Kharmujai OM, Lynrah W. Early community-based teaching of medical undergraduates for achieving better working skills in the community. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:161. [PMID: 30693298 PMCID: PMC6332666 DOI: 10.4103/jehp.jehp_153_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/22/2018] [Indexed: 05/13/2023]
Abstract
INTRODUCTION It has been perceived that there is a lack of community exposure and active learning in the community for the first-year undergraduates in Community Medicine. This study is designed to evaluate an early community exposure given to the students to help overcome these lacunae. METHODOLOGY In this study, the first-year students (n = 44) were provided an early community exposure and evaluated to understand their perceptions by a prevalidated, pre- and post exposure questionnaire. The community exposure was given to the students by allocating them families in community with designated tasks A core group of mentors monitored the students and scored the students on every visit. Attendance of students, scores marked by the mentors, and pre- and postexposure responses were used to evaluate the impact of community exposure. RESULTS A total of 44 students were evaluated in this study. A total of 22 h (36.6%) were dedicated to community-based learning in the 1st year. A positive response was observed in the postexposure responses with regard to the understanding of the subject and interest in the subject in comparison to preexposure responses (P < 0.05). A statistically significant difference was observed in the first and final visit scores by the mentors with respect to communication skills, elicitation of history, team spirit, and attitude toward community (P < 0.00001). CONCLUSIONS Students were exposed to the concept of community service and inculcated an interest in public health. Early community exposure of medical undergraduate students is important in developing better working skills in the community.
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Affiliation(s)
- Himashree Bhattacharrya
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Gajendra Kumar Medhi
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Star Pala
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
- Address for correspondence: Dr. Star Pala, Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong - 793 018, Meghalaya, India. E-mail:
| | - Amrita Sarkar
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Ophelia Mary Kharmujai
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Wallambok Lynrah
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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