Journal of Advances in Medical Education & Professionalism
Volume:10 Issue: 4, Oct 2022

Change is a multifaceted and challenging process. Due to the growing and increasing volume of technologies and organizational processes, there is a need to adapt to these changes because adaptation to changes is essential for the organization survival. The purpose of this study was to investigate change management in medical education in order to identify and categorize the strategies, barriers, and other important issues related to change management.

A systematized review of the related studies was carried out according to the Khan et al.’s guideline. Fivebibliographic databases and search engines including Cochrane Library, Eric, PubMed, SCOPUS, and Web of Sciences were searched. The following keywords were used with a period constraint of 2017 to March 2021 to search various online data sources: change management and medical issues. Advanced search options and Boolean operator (AND) were also used to find out more relevant records.

Overall, 498 records were identified. After removing duplicate records and those with irrelevant titles, abstracts, or full texts, we selected 40 articles for data extraction. The Kotter model is frequently used to manage change. Also, consideration of resistance to change and having a plan for it have been important elements of change management.

In most cases, resistance to change was observed, and several ways for resolution merged. Resistance to change and coping strategies are considered as one of the most important factors that must be considered in change situations. Awareness of change management principles and utilization of available models can pave the way for management of the change.

Adaptation to the “Competency-based Medical Education” (CBME) is a major challenge faced by medicalcolleges all over India. Hence, the present study aimed to evaluate the mechanisms adopted in the process of implementation of CBME in Phase I at our institution. In this qualitative study, 12 faculty members including professors, associate professors, assistant professors, and tutors from preclinical departments of the first professional year participated as the study participants. Focus Group Discussion were conducted with the participants regarding the strategies adopted and the challenges faced in implementation of CBME. Gap analysis was done based on the guidelines from CBME modules. In depth interview was conducted with the heads of the pre-clinical departments to propose appropriate action plans. The interviews were audio-recorded and thematic analysis of the transcripts was done. The crucial areas identified were the implementation of early clinical exposure, AETCOM, integrated, and skill modules during the COVID pandemic. The faculty expressed lack of clarity in designing the sessions for “Self-Directed Learning”. Tapering the content relevant to basic sciences was a major challenge faced in the integrated sessions. The faculty members requested sensitization to different student centric instructional methods for small group teaching and guidelines for valid assessment strategies.
Acquisition of competencies is enhanced by appropriate instructional methods and effective assessmentstrategies. Frequent and constant hands-on training on the CBME modules through “Faculty Development Programs” plays a crucial role in the successful implementation of CBME.

The tutor’s role has been changing in the active learning methods in comparison to the traditional ones. Tutors are encouraged to become facilitators and to guide the students to construct a new knowledge by making bridges with the old one. Tutor’s expertise in the active methods has been discussed with different results. The aim of this study was to assess the impact of tutor expertise on the students’ scores in active learning methods.

The authors conducted this meta-analysis under the guidelines of a critical tool for systematic reviews (AMSTAR2). PubMed, Embase, Cochrane library, Scopus and Science Direct were the databases used for searching. The articles included compared students’ learning scores according to tutor expertise between 2 groups of students with an active method of learning. The Review Manager software 5.3 was used to conduct this metaanalysis. We considered the mean difference as the effect size.

3169 students and 222 learning groups of 5 to 10 students were included in this study. The combined mean difference reached 0.84 with 95% CI [0.22, 1.46]. A significant difference between the two groups was observed in favour of the non-expert group (P=0.008). The heterogeneity I-square was evaluated to 98%. The Funnel plot reflected no publication bias (P=0.21). A sub-group analysis was performed taking into account the studies dealing with medical curriculum and the assessment methods used. It showed a significant difference between the two groups in favour of non-expert tutors (P<0.05).

Even if the results of this meta-analysis couldn’t be conclusive and can’t induce recommendations, they highlighted the tendency of non-expert tutors to be more student-centred. The heterogeneity observed can be decreased by establishing consensual definitions of expertise and assessment tools in further research studies in order to reflect the validity and efficiency of different tutoring styles in active learning methods.

Medical institutions around the world are exploring various newer modes of teaching and assessmentmethods to incorporate into the teaching curriculum. In this changing situation, e-learning methods are being widely used. For determining the effectiveness of a new learning method, assessment should be done since learning and assessment are intricately associated. One such newer method of testing practical anatomy knowledge is online spotter examination. The present study was conducted to correlate the students’ performance between traditional and online spotter exam and analyse the students’ perception about both exam patterns. A cross-sectional descriptive study was conducted among 120 first year medical students after obtaining ethical approval from the Institute Research and Ethics committee. Students were selected using simple random sampling method. Two modes of practical examination, traditional and online spotter, were conducted. After the examination, mean scores of OSE and TSE were compared using independent sample t-test. A questionnaire was given to collect data on their perception about the exam pattern, and the responses were scored using Likert scale.
The performance mean score in online spotter exam was higher compared to traditional spotter exam. Analysis of the students’ perception about the exam pattern revealed that they preferred the online examination. This could be attributed to advantages of online teaching and learning using audio-visual aids with good quality images (84=70%), easy to answer in multiple choice question (78=65%), quick results (108=90%), absence of bias in evaluation (108=90%), easy for future online postgraduate entrance exams (114=95%), and overall time limit and its advantages (84=70%);the only drawback was anxiety about internet connectivity (96=80%). Online spotter exam can be conducted for routine formative assessment under controlled conditions to improve the students’ knowledge and enhance their confidence and adaptability for future online exams.

Critical appraisal skills are presumed to perform a principal part in evidence-based health education and practice methods. This study aimed to design an educational intervention around critical appraisal in this context, evaluate the efficacy of the teaching methods, and investigate critical appraisal skills training to undergraduate medical students. In this prospective Randomized Control Trial (RCT), 256 sixth-year undergraduate medical students from Shiraz University of Medical Science, Shiraz, Iran, participated. 124 of the students were not taught critical thinking methods as a control group, and 132 participants were taught critical thinking methods by multimedia and attended an online Critical Appraisal Skills (CAS) training workshop as an intervention group. We used the Critical Appraisal Skills Programme (CASP) questionnaire to evaluate students’ knowledge, attitude, confidence, and appraisal skills. This questionnaire was translated into Persian for the first time in Iran by Shokooh Varai, et al. They investigated its validity and reliability,the reliability of the questionnaire being obtained by the Richardson Index (0.75), and the validity being confirmed by some faculty members of Tehran Nursing and Midwifery School. To compare both control and intervention groups, we used an independent t-test and a Chi-Square test at a significance level of 5%, and to analyze the demographic information, we applied some descriptive statistics: frequency, frequency percentage, mean and standard deviation. Allof the statistical approaches were analyzed, using SPSS 22.
In all dimensions of the critical appraisal skills, medical students who completed the critical appraisal multi-media training and workshop performed better than those who did not (control group), and this difference was statistically significant (P<0.05). Moreover, the Chi-Square test results showed no statistical relationship between the groups regarding the demographic variables (P>0.05). Also, the Cohen’s D effect size values in the knowledge and confidencedimensions were greater than 0.5; this meant a large effect. Regarding the attitude and appraises Skill dimensions, the effect size was between 0.2 and 0.5, which meant a medium effect. Teaching critical appraisal skills through multi-media and CAS online workshops to medical students effectively improves the students’ knowledge and confidence in appraising articles. This teaching also indicated a medium effect on students’ attitudes and behavior. Our findings can justify implementing critical appraisal skills teaching modules in the undergraduate medical education curriculum.

The concept of professional ethics of academic educational leaders is an abstract concept for which severalhighly context-dependent definitions have been provided in the literature. The analysis of this concept is critical to reaching a shared understanding, developing behavioral standards, and designing evaluation measures at universities of medical sciences. This study aims to provide a comprehensive definition of professional ethics among educational leaders of universities of medical sciences. To explain the concept of professionalism among academic educational leaders, Walker and Avant eight-stageconcept analysis method was adopted. After an extensive review of resources, 37 articles were included and the antecedents, attributes, and consequences of the concept were extracted. An examination of the resources and concept analysis revealed that professionalism in academic educational leaders has three main attributes of care ethics, justice-oriented ethics, and ethics of criticism, and its formation depends on personal characteristics, professional capabilities, and having a systemic view. The identification of components and professional characteristics of professionalism among academic educational leaders provides a shared understanding of professionalism and is a basic step towards designing measures to evaluate this concept.

Continuous evaluations of clinical education and learning in nursing require the use of valid and reliableinstruments. The present study aimed to evaluate the validity and reliability of the CLECS questionnaire (a questionnaire for assessing the clinical learning environment) in nursing students. This is a psychometric study conducted on 118 nursing students. Through email correspondence with the corresponding author, permission was obtained from the developer to translate, validate, and use the CLECS. The CLECS was translated into Persian. The psychometric process was performed after the translation and cultural adaptation steps. Cronbach’s alpha was used to assess the reliability. The instrument validity was assessed through convergent, discriminant, and confirmatory factor analysis. We used AMOS 18 for confirmatory factor analysis and SPSS-20 for reliability, convergent, and discriminant validity. A total of 118 nursing students participated in the study. The Cronbach’s alpha value of the questionnaire was 0.942. Convergent validity was obtained in all dimensions above 0.4. The confirmatory factor analysis results confirmed the fit of the final model and showed that the present questionnaire was 6-dimensional. Most of the questions in the questionnaire did not have a good differential validity. The highest and lowest means were related to the nursing process and holism dimensions, respectively. Based on the findings of this study, CLECS, except in the discriminant validity, has good validity and reliability, which can be considered to examine the learning environment of undergraduate nursing students.