Establishing a new medical school: A contemporary approach to personalizing medical education

Abstract

Objective: To borrow a public health concept, there has been a global outbreak, perhaps a pandemic, of new medical schools during the last 20 years, resulting in a diverse range of programs in many different contexts. The question posed was: how should the task of establishing a new medical program be approached in 2018?

Methods: Based on involvement with several new medical programs, this paper presents a highly idealistic commentary on what a new medical program might look like. The paper adopts the organizational structure of the World Federation of Medical Education Basic Medical Education standards as a scaffold, because accreditation both locally and globally is intended.

Results: The program design reflects both progress in learning technology and the challenges faced in a changing world, where disruption appears inevitable, and innovation may be necessary to produce the medical graduates needed to improve the health status of an expanding, ageing and ailing global population.

Conclusion: The program model described represents a combination of educational design, emerging technology and a focus on future health care needs.     

Nurses in medical education: A unique opportunity

Medical students are expected to learn certain procedural skills in addition to clinical skills, such as assessment and decision making. There is much literature that shows proficiency in procedural skills translated to improved outcomes and cost-saving. Given the time constraints placed by increasing clinical demands, physicians have less time to work with students in teaching technical skills. There is a unique opportunity to utilize nurses in clinical clerkships to teach procedural skills. A dedicated nurse educator can provide a consistent curriculum, work with learners to achieve proficiency, and provide measurable outcomes. Future research should explore the role played by nurses in medical education and the comparison of instructional effectiveness.     

Eye-tracking technology in medical education: A systematic review

Background: Eye-tracking technology is an established research tool within allied industries such as advertising, psychology and aerospace. This review aims to consolidate literature describing the evidence for use of eye-tracking as an adjunct to traditional teaching methods in medical education.

Methods: A systematic literature review was conducted in line with STORIES guidelines. A search of EMBASE, OVID MEDLINE, PsycINFO, TRIP database, and Science Direct was conducted until January 2017. Studies describing the use of eye-tracking in the training, assessment, and feedback of clinicians were included in the review.

Results: Thirty-three studies were included in the final qualitative synthesis. Three studies were based on the use of gaze training, three studies on the changes in gaze behavior during the learning curve, 17 studies on clinical assessment and six studies focused on the use of eye-tracking methodology as a feedback tool. The studies demonstrated feasibility and validity in the use of eye-tracking as a training and assessment method.

Conclusions: Overall, eye-tracking methodology has contributed significantly to the training, assessment, and feedback practices used in the clinical setting. The technology provides reliable quantitative data, which can be interpreted to give an indication of clinical skill, provide training solutions and aid in feedback and reflection. This review provides a detailed summary of evidence relating to eye-tracking methodology and its uses as a training method, changes in visual gaze behavior during the learning curve, eye-tracking methodology for proficiency assessment and its uses as a feedback tool.     

A call to action: The controversy of and rationale for competency-based medical education

Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families around the world. These issues reflect on our current model of medical education and raise the question: Are physicians being adequately prepared for twenty-first century practice? Multiple reports have concluded the answer is “no.” Concurrent with this concern is an increasing interest in competency-based medical education (CBME) as an approach to help reform medical education. The principles of CBME are grounded in providing better and safer care. As interest in CBME has increased, so have criticisms of the movement. This article summarizes and addresses objections and challenges related to CBME. These can provide valuable feedback to improve CBME implementation and avoid pitfalls. We strongly believe medical education reform should not be reduced to an “either/or” approach, but should blend theories and approaches to suit the needs and resources of the populations served. The incorporation of milestones and entrustable professional activities within existing competency frameworks speaks to the dynamic evolution of CBME, which should not be viewed as a fixed doctrine, but rather as a set of evolving concepts, principles, tools, and approaches that can enable important reforms in medical education that, in turn, enable the best outcomes for patients.     

The anatomy and physiology of conflict in medical education: a doorway to diagnosing the health of medical education systems

This qualitative study uses data from students, teachers and administrators to deepen our understanding of conflict in medical education, its nature and its consequences. It especially looks at systemic issues which may foster or hinder the health of an educational system or of any organization. Its intention is to provide better understanding of the medical education system so that this knowledge can be used to enhance the health of future medical education systems. It is preliminary to a study that would focus on ways of improving the healthiness of future systems. The findings underline the importance of moral education in the training of our future physicians (McWhinney, 1986). The importance of example by faculty and staff and moral development of the physician flows from the authors' data and their interpretation of its meaning. Also, it further underlines the importance of faculty and medical educators modeling both caring and exemplary moral behavior within our educational institutions. Bandura (1986) developed the notion of modeling and showed that, 'even at a preconscious level, we learn moral behaviors through observing and imitating authority figures and/or significant others' (Crysdale, 2006). This is especially important because caring, or compassionate presence, is so essential to healing.