Journal of Advances in Medical Education & Professionalism
Volume:9 Issue: 1, Jan 2021

As future health professionals, medical students should be aware of their social accountability and their role in the society. The aim was to assess the attitudes and awarenessof medical students regarding the social accountability and to identify the factors determining their attitudes and possible levers for action.

Online survey among undergraduate students at the medical school in 2019 (N=2128). The data collection tool was developed based on the literature review, the principles of social accountability SR and the toolkit (The development of the Students’ Toolkit on Social Accountability of Medical Schools was a collaboration between the International Federation of Medical Students’ Associations (IFMSA) and the Training for Health Equity Network (THEnet). The data were collected inDecember by LimeSurvey software version 1.90 and analyzed by SPSS version 16 according to the usual descriptive and bivariate. The Fisher test was used to compare two percentages and theStudent t-test to compare two means on two independent samples (significance level was 0.05). The verbatims were grouped and analyzed.

271 students participated (response rate=12.7%). The mean age was 20.6±2.6 years (N=257). The Female/Male ratio was 1.85. Only 33.5% had heard of social accountability. It waslinked to “commitment to the community” in 75.1% of cases, “to be a good citizen” in 66.1% and “to be responsible for one’s actions” in 56.4%. Nearly 79% thought that students did not really have a role in society and that they should focus on their studies. Being a member of an association was a factor determining the positive attitude towards the SA (82.1% versus 65.2%, P=0.031). Students believed that the school had some strategies of social accountability. The results of the verbatim emphasize the need to multiply the practices and opportunities for interaction with thesocial environment for students.

The level of knowledge of the concepts by the students seems to be average. It would be necessary to look for the means to plead in favor of reinforcing our school strategies to concretize the principles of SR while training the students.

Case based teaching (CBT) has been accepted as an effective interactive learning strategy. Digital portals allow the students to learn the content at their own pace, explore variousresources and finally enable them to discuss within group and build team work approach, which is a prime focus in the health care professional field. The aim of this study was to assess theperception and learning outcome of first year medical students towards CBT using e-learning approach.

This is a non-randomized, interventional study on first year undergraduate medical students from 2017-18 batch (43) and 2018-19 batch (41) of Sumandeep Vidyapeeth University. They weredivided into a group of 8-10 members, who attended six sessions of case-based teaching via Google group. Learning outcome was analyzed by comparing the students who participated in thesessions and those who did not. Feedback survey questionnaire was analyzed by Mann Whitney ranking test and focus group discussion by thematic analysis for qualitative analysis manually.

A P<0.01 was considered statistically significant for post-test by e-learning tool for CBT. Participants agreed that CBT is a good way to conceptualize applied aspect of basic science,enhance critical thinking, and explore varied resources. Thus, they confirmed that team building approach and leadership qualities for managing the group contributed to better understanding of thecourse and would be useful to them in near future.

Usage of Google group technology for CBT allowed medical students to explore clinical application of basic sciences course from the first year of the program, going beyond the classroom, thus developing self-directed learning and team building approach.

Small group teaching is an educational strategy that may be used to facilitate learning. Tutorials enable an adult approach toward learning where students take responsibility for their own learning. We aimed to investigate the students’engagement and perceptions of small group tutorial classes among undergraduate medical students.

A cross‑sectional, descriptive survey was conducted at the Subbaiah Institute of Medical Sciences, where we collected the data from 300 undergraduate students using conveniencesampling method. A self‑administered questionnaire consisting of 22 items which was piloted on 20 students, and six experienced medical educators were consulted for face validation. The internalconsistency of the questionnaire measured by Cronbach’s alpha reliability test was 0.80. It was used to measure the students’perception on the effectiveness of tutorials with regard to learningexperience, teamwork, confidence, communication skills, and role of the teacher. Statistical analyses included mean and standard deviation for the description of each item, t‑test to compare the mean scores for gender and class year, and one‑way analysis of variance between groups for age group comparisons using SPSS version 24 software.

Students’ overall perceptions of small group teaching effectiveness showed that tutorials were beneficial to their learning process (mean: 3.61±0.50). The majority of the students havepositive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.72±0.68) and teamwork (mean: 3.36±0.59). A significant difference was found between year 1 and year 2 students with regards to learning experience (P<0.001), teamwork (P<0.05), communication skills (P<0.05), and the role of the tutor (P<0.001). Additionally, the mean scores, measuring overall effectiveness of tutorials, for the 2nd year students were significantly higher than that for the 1st year students (3.70±0.41and 3.50±0.57, (P<0.001).

The data of this study show that tutorial is an effective small group teaching method for medical students compared to large group teaching.

The COVID-19 Pandemic brought clinical placements to a halt for many UK medical students. A University Hospitals Trust offered clinical phase students the opportunity to support the National Health Service (NHS) in newly defined roles as Doctors’ Assistants (DAs). This study evaluates the experience of students working in a single NHS Trust. To our knowledge, thisis the first report of medical students’ perspectives on taking up a novel clinical role in the UK. An anonymised novel electronic survey was sent to all 40 DAs across a single University Hospitals Trust via email to determine student perceptions of several aspects of the role, including its value to learning and development, impact on wellbeing, and benefit to the clinical environment. A formal statistical analysis was not required. Of the total cohort participating in the programme, 32 DAs responded (80% response rate). The experience was considered valuable to multiple aspects of learning and development, particularly familiarisation with the role of a Foundation doctor. Levels of confidence in training and supportwere high, and most DAs felt valued as part of the clinical team, and experienced no mental health issues resulting from their role. 53% of the participants felt their work was necessary or valuableto the team, and all reported a positive experience overall. A new role allowed medical students to effectively provide clinical assistance during the COVID-19 pandemic. This provided immediate support to clinical teams as well as learningopportunities for the participants without detriment to their mental well-being, and could be a model for effective retention of medical students in clinical environments in the face of resurgence ofCOVID-19.

Training in operating rooms is challenging. Specifically, surgical residents often experience a stressful environment in training arenas that, in turn, might affect their ability in the acquisition of the required qualifications. This study aims at the qualitative explanation of how the surgical residents acquire the surgical skills in operating rooms.

This qualitative study was conducted in 2019-2020 using the conventional content analysis method. Participants were selected using purposive sampling. Data were collected through 25 semi-structured in-depth interviews. Then, the interview transcriptions were analyzed in MaxQDA2 software using the content analysis method.

The data were classified into two main categories, namely challenges/obstacles and strategies for dealing with the challenges. The data in the first category were further classifiedinto four subcategories, including burnout, confusion in technique selection, unequal learning opportunities, ignorance, and responsibility misassignment. Similarly, four subcategories of establishing communication channels with chief residents and faculty members, learning by the non-surgeon pathway, covert progress in the learning path, and taking advantage of force from a position of power in the learning path were considered for the second category.

Based on the findings of the study, surgical residents face serious challenges and obstacles in their training course. To address these challenges, the curriculum of the surgical course needs to be improved with the emphasis on the balanced responsibility assignment and enhanced human communication.

Bedside teaching plays a crucial role in acquiring essential clinical skills. Therefore, the main aim of this study is assessing the validity and reliability of the Persian version of German bedside teaching (BST) instrument. This instrument was specially developed for evaluation of bedside teaching.

The present cross-sectional study was conducted on 150 last year medical students, using convenience sampling. The Persian version of the bedside teaching (BST) was used for datagathering. To calculate the reliability of the questions, Cronbach’s alpha was used and to determine the construct validity of the questionnaire, confirmatory factor analysis was used. All analyseswere performed in LISREL 10 and SPSS 21 software.

Cronbach’s alpha indicated excellent reliability for each subscale (α=0.77–0.85). All of the value of the questions are more than a significant number of 1.96 and concluded to be significant. There was an acceptable fit between the hypothetical model and the data and all comparative fit indices (CFI, NFI, RFI, IFI) showed good model fitness. BST is a valid and reliable instrument for the assessment of clinical teaching at bedside. It has 18 items with 5 point Likert scales.

The findings suggest that the Persian version of the BST questionnaire is a valid and reliable tool for the evaluation of teachers and providing feedback in a clinical setting. However,more studies should be conducted in other cities in Iran.

Teachers need to follow adult learning principles and students need to have discussion and problem-solving skills for the use of active learning methods in classroom. We aimed to find out whether MBBS freshers had group discussion and problemsolving skills. A free group discussion session for problem-solving using adult learning principles was held during the foundation course for MBBS freshers. The task for group discussion was to give suggestions to improve the situation indicated by the given general medical professional problem. Qualitative deductive thematic analysis was used to analyze suggestions which could be grouped under the themes of seven roles of CanMEDS PhysicianCompetency Framework. The results of deductive thematic analysis of suggestions of student groups are described under seven themes of the roles of the CanMEDS Physician Competency Framework. MBBS freshers showed excellent group discussion, plenary presentation, and problem-solving skills for the given problem. They also had relevant general knowledge about medical profession. Their problem-oriented thinking skills were facilitated using adult learning principles. It is recommended that the use of group discussion for problem-solving with facilitation by using adult learning principles should be emphasized in undergraduate medical education to promote the use of active learning methods in classroom.

Management reasoning is a paradigm whereby learning occurs in a context bound fashion on analysing the biophysical factors existing in the clinical learning environment. In the contemporarymedical education forums, much importance is being laid on clinical reasoning and this warrants the appropriate usage of the biomedical knowledge in arriving at the diagnosis. We perceive that clinical reasoning, in pure sense, often doesn’t solve the purpose of rendering the best management plan to the patient. This holds stronger when the case is non-linear and highly complex in nature.  Management reasoning fills the gap between hypotheses generation, i.e. accomplishing diagnosis and devising management plan. Indeed, it is a complex activity relying on several factors including the physician’s perceptual abilities and situated cognition derived from formal and informal learningexperiences. In contrast to clinical reasoning, which can be taught using structured scenarios, management reasoning necessitates analysing multitude of factors revolving around a patient andprioritizing those in order to titrate the best possible management plan. This commentary spotlights different dimensions of management reasoning, emphasizes the need of teaching it in the current scenarios, enlists the ways it can be taught, and opens the platform for discussing further on this underemphasized topic.