Adapting undergraduate paediatric medical education to the challenges of COVID-19 pandemic: perspective of NUS Medicine

COVID-19 significantly impacted the teaching-learning-assessment activities in many medical schools. In this article, we discuss the impact of COVID-19 on the Yong Loo Lin School of Medicine, National University of Singapore, focusing on paediatric training and the adaptations of the system and the people. The school developed strategies to promptly disseminate information and safety measures to protect all its staff and students. By leveraging on the school’s infrastructure for technology-enabled learning, good-quality medical training and reliable assessments were able to be carried out swiftly. The paediatric curriculum was crafted based on these principles, and it provided distance-based learning with live and interactive sessions to teach core clinical skills. The faculty also tapped on standardised patients to provide consistent and life-like scenarios. Measures were implemented to minimise challenges with technology-enabled learning. Collectively, efforts from the staff, support from the leadership and students’ adaptations tremendously helped to ease the transition.

46 The Hidden Truth About Gender Bias in Surgery. A Systematic Review

Introduction

Gender discrimination remains pervasive in surgery, significantly impacting current and future surgeons and population health. This study analyses the gender barriers and critical retention factors for female surgeons and trainees in surgery.

Method

Five electronic databases were searched till May 2020. Titles and abstracts were sieved, followed by a full text review. Data synthesis and inductive thematic analysis were conducted using the Thomas and Harden methodology.

Result

14 articles were included, involving 528 participants. Four themes were generated–unfavourable working environment, male-dominated culture, societal pressures and progress towards gender equality. Females in surgery often faced harassment, disrespect and perceptions of incompetence, resulting in hostile work conditions, which were aggravated by the inadequate support and mentorship. The persistence of male-dominated cultures was observed, with females facing prejudice and exclusion from professional and social circles. Differential treatment and higher expectations of female surgeons also arose from entrenched societal pressures. Despite these, increased acceptance of motherhood and greater recognition of contributions by female surgeons were reported, indicating some progress in gendered culture.

Conclusions

There is a need to increase female surgical leadership and allocate resources to address the deep-rooted causes of biased surgical culture and ingrained perceptions, to achieve greater gender equality in surgery.

131 Concerns of The Unheard: A Qualitative Systematic Review on The Preoperative Concerns of General Surgery Patients

Aim

Method

CINAHL, Medline, PsycINFO, and Web of Science were searched, and articles related to patients’ preoperative concerns were included. Key quotes were extracted, coded, and thematically analyzed according to Thomas and Harden’s methodology.

Results

Three themes were generated from the 27 included articles; lead-up to surgery, the postoperative recovery process, and HCP care provision. Patients were uncertain and concerned about the impact the surgery or disease may have on them while they waited for their surgery to occur. Additionally, perceived inadequate provision of care by patients led to them doubting their HCPs’ ability, heightening their preoperative anxiety. Lastly, postoperative recovery processes were often unclear, leading to increased distress as patients wonder if they could recover from the disease and/or surgery.

Conclusions

Unresolved preoperative concerns increase patients’ anxiety and uncertainty, negatively affecting their postoperative recovery. A combination of individualized preoperative education and complementary therapy can be implemented by HCPs to alleviate these concerns, leading to better postoperative outcomes.

Developing clinical competency in crisis event management: an integrated simulation problem-based learning activity

This study aimed to evaluate the integration of a simulation based learning activity on nursing students' clinical crisis management performance in a problem-based learning (PBL) curriculum. It was hypothesized that the clinical performance of first year nursing students who participated in a simulated learning activity during the PBL session would be superior to those who completed the conventional problem-based session. The students were allocated into either simulation with problem-based discussion (SPBD) or problem-based discussion (PBD) for scenarios on respiratory and cardiac distress. Following completion of each scenario, students from both groups were invited to sit an optional individual test involving a systematic assessment and immediate management of a simulated patient facing a crisis event. A total of thirty students participated in the first post test related to a respiratory scenario and thirty-three participated in the second post test related to a cardiac scenario. Their clinical performances were scored using a checklist. Mean test scores for students completing the SPBD were significantly higher than those who completing the PBD for both the first post test (SPBD 20.08, PBD 18.19) and second post test (SPBD 27.56, PBD 23.07). Incorporation of simulation learning activities into problem-based discussion appeared to be an effective educational strategy for teaching nursing students to assess and manage crisis events.

Students' perception of problem-based learning in the medical curriculum of the Faculty of Medicine, University of Colombo

INTRODUCTION

Problem-based learning (PBL) is used as an instructional method in the system-based modules of the new innovative curriculum of the Colombo Medical Faculty in Sri Lanka. This study was undertaken to assess whether objectives of having PBL to facilitate acquisition of desirable learning skills and generic skills had been achieved. The perceived advantages and disadvantages of PBL were also studied.

MATERIALS AND METHODS

The study population comprised third year medical students who had completed 12 PBL sessions. A self-administered questionnaire, which measured learning outcomes and acquisition of generic skills on a 5-point Likert rating scale, was used.

RESULTS

The response rate was 87.2% (n = 188). Eighty per cent of students were aware of the rationale for having PBL and of learning from recommended material. Seventy-five per cent knew the competencies that could be acquired from PBL and two-thirds knew about the importance of small group discussions. PBL had helped to improve communication skills in 57% and problem solving skills in 52%. The main disadvantage was that it was time-consuming. Only 46.6% were satisfied with the participation of colleagues in the group. Seventy-six per cent felt that PBL could be better conducted.

CONCLUSION

Awareness of concepts of PBL, reasons for its inclusion in the curriculum and educational advantage was high. The main disadvantage perceived was that it was time-consuming. There is a need to improve the conduct of PBL and, provide guidance and awareness programme for students.