Acta Medica Iranica

Navigating the Global Landscape of Social Obligation in Medical Education: An Independent Comprehensive Exploration

Sucheta P. Dandekar, Nirmala Rege, Farzana Mahdi — Sat, 16 Nov 2024 08:37:32 +0330

This paper examines social accountability in medical education, focusing on its potential to address health inequities. Social accountability, as defined by the World Health Organization, encourages medical institutions to align education, research, and service activities with community health priorities. Through frameworks like ASPIRE and CARE, medical schools worldwide are incorporating social accountability, with notable examples such as Northern Ontario School of Medicine (NOSM) and Patan Academy of Health Sciences serving under-resourced communities. However, challenges remain, including the absence of standardized assessment metrics, resource limitations, and varied interpretations of social accountability across regions. International efforts underscore the importance of community collaboration in developing socially accountable curricula. In India, social accountability initiatives address healthcare challenges through community placements, telemedicine, and collaborations with global partners. The Competency-Based Medical Education (CBME) model presents an opportunity to integrate social responsibility across training and patient care. Despite advancements, there is a need for adaptable frameworks and tools to measure the impact of social accountability in diverse contexts. This paper advocates for a unified yet context-sensitive approach, allowing institutions to respond effectively to local health needs while contributing to broader global health goals. Limitations include the study’s focus on existing global practices, without detailing novel, region-specific strategies for implementing and assessing social accountability programs.

Curriculum Definition Revisited

Nasim Gheshlaghi Azar, Fakhrosadat Hosseini — Sat, 16 Nov 2024 08:53:01 +0330

The definition of "curriculum" has been the subject of scholarly debate for decades. This commentary revisits one of the most widely accepted definitions of curriculum in health profession education and offers a revised definition. The authors aim to emphasize the importance of planned and unplanned learning experiences in the definition of curriculum. Also, the key role of students’ support to help students make the most of their learning from the un-planned experiences is highlighted. In cases where the holistic learning experiences are neglected, the school is unlikely to achieve its ultimate goals.

Using Lesson Study to Enhance the Quality of Teaching and Learning in Health Professions Education

John Sandars, David Allan — Sat, 16 Nov 2024 08:57:09 +0330

Lesson study (LS) offers a systematic, but flexible, approach for enhancing the quality of teaching and learning in Health Professions Education (HPE). There is increasing global use of LS in primary, secondary and higher education, with studies highlighting its impact on enhancing the quality of both teaching and learning through the professional development of teachers. During LS, teachers collaboratively research their own practice with a variety of stakeholders, including students, subject specialists and education experts. The article describes how LS can be practically adapted and implemented in a variety of both academic and clinical settings across the continuum of HPE.

Effective Academic Leadership in Clinical Departments of Medical Universities: A Grounded Theory

Sat, 16 Nov 2024 09:05:33 +0330

Universities of Medical Sciences as the organizations that provide human resources for the health systems need effective leaders who can promote the medical status of the countries. In this regard, the present qualitative grounded theory study is an attempt to design an effective leadership model for departments of clinical education. The study identified causal conditions, background, confounding variables, consequences, and the central theme of “belief in effective leadership” to determine formation process of effective leadership. Based on the study findings, effective leadership model was designed for clinical education departments of medical universities. The distinguishing aspect of this model compared to the previously presented models of academic leadership is creation of the belief of effective leadership in medical sciences universities. This distinguishing factor emphasizes the academic leader’s recognition of their immediate environment, university, department and their selves.

Enhancing Student Engagement in Electronic Platforms: E-Gallery Walk

Nazdar Ezzaddin Alkhateeb, Shoaleh Bigdeli, Fakhrosadat Mirhosseini Mirhosseini — Sat, 16 Nov 2024 09:08:31 +0330

The COVID-19 pandemic was one of the most challenging situations that affected all aspects of humans’ life including education and active face to face teaching and learning methods. Engaging learners in the teaching and learning process, teaching faculty members, and employing technologies to enhance teaching and learning requires adapting instructional methods based on diverse situations, especially in crises and force majeure. This study was an attempt to design and implement an electronic gallery-walk (e-gallery-walk) based on Gagne’s Nine Events of Instruction. A teacher training e-course was designed, developed, and implemented during COVID-19 era at the Center of Pedagogical Training and Academic Development at Hawler Medical University, Iraq. Moreover, for the purposes of this study different formative assessment tools were designed and implemented. Thirty-eight MSc and PhD graduates from different medical specialties who were university instructors participated in this study and their learning was assessed via the designed assessment tools. This hands-on-experience indicates that a carefully designed and implemented e-gallery walk enhances student-centered activity in an online faculty development program. This approach by improving student engagement results in more meaningful discussion and peer instruction. The e-gallery walk gives teachers and students a valuable experience of using technological advances and digital tools to modify face-to-face activities. These tools ensure successful teaching and learning practice in critical conditions when remote activities are deemed necessary. The study findings indicate that peer and teacher immediate feedback is highly influential on the quality of teaching and learning and a modified e-gallery walk could be a suitable choice to improve the process in virtual settings.

An Outdoor Educational Experience in Health Professions Education: Beyond a Focus Group Study

Mandana Shirazi, Maryam Karbasi Motlagh, Nazila Zarghi, Jonas Nordquist — Sat, 16 Nov 2024 09:20:12 +0330

Outdoor learning can relate students with environment, community, society and themselves. It can benefit students of all ages and successful in a variety of settings. Furthermore, it can enrich the curriculum and improve educational attainment. So, the present study has tried to explore experience of PhD candidates in Medical Education through a focus group. Data were collected from PhD students in medical education after participating in an outdoor session through a focus group which is frequently used as a qualitative approach to gain an in-depth understanding of social issues. Data were analyzed through conventional content analysis approach. Fifteen PhD candidates participated in focus group. Most of them aged above 35. The majority of them were working at Education Development Center (EDC), the rest were clinical practitioner, faculty member and people involved with educational activities. As to conventional content analysis of data, two main categories of instructional and inspirational sides of outdoor learning had emerged with three (Different physical space, Environmental distractors, and Innovative teaching method) and four subcategories (Informal communication, Attractive learning environment, inducing reflection, and making a new viewpoint) respectively. It is recommended to include the outdoor learning experience to provide situations for research and practice. It should be noted that curriculum reform might be necessary for planning the Outdoor learning environments and associated teaching learning methods.

Evaluating Inter-Rater Reliability: Transitioning to a Single Rater for Marking Modified Essay Questions in Undergraduate Medical Education

Shahid Hassan, Malanashita Ganeson, Ismail Abdul Sattar Burud — Sat, 16 Nov 2024 09:23:34 +0330

Modified Essay Questions (MEQs) are often included in high-stakes examinations to assess higher-order cognitive skills. If the marking guides for MEQs are inadequate, this can lead to inconsistencies in marking. To ensure the reliability of MEQs as a subjective assessment tool, candidates’ responses are typically evaluated by two or more assessors. Previous studies have examined the impact of marker variance. Current study explores the possibility of assigning a single assessor to mark the students' performances in MEQ based on statistically drawn evidence in the clinical phase of the MBBS program at a private medical school in Malaysia. A robust evaluation method was employed to determine whether to continue with two raters or shift to a single-rater scheme for MEQs, using the Discrepancy-Agreement Grading (DAG) System for evaluation. A low standard deviation was observed across all 11 pairs of scores, with insignificant t-statistics (P>0.05) in 2 pairs (18.18%) and significant t-statistics (P<0.05) in 9 pairs (81.81%). The Intraclass Correlation Coefficient (ICC) results were excellent, ranging from .815 to .997, all with P<0.001. Regarding practical effect size (Cohen’s d), 1 pair (9.09%) was categorized as having a strong effect size (>0.8), 7 pairs (63.63%) as having a moderate effect size (0.5-<0.8), and 3 pairs (27.27%) as having a weak effect size (0.2-<0.5). The data analysis suggests that it is feasible to consider marking MEQ items by a single assessor without negatively impacting the reliability of the MEQ as an assessment tool.

From Challenge-Based Learning to Relational Coordination: An Interdisciplinary Educational-Research Collaboration in Medical Journalism Education

Nasrin Sayfouri, Ehsan Shokri, Shadi Asadzandi — Sat, 16 Nov 2024 09:28:58 +0330

Interdisciplinary collaboration (IDC) faces several long-standing challenges including poor teamwork, resistance to socialization, inadequate attention given to learners' abilities, incomplete reporting, lack of quality methodology, and vague understanding of reflexivity. In an attempt to tackle these challenges, the purpose of this case study was to report an interdisciplinary educational-research collaboration (IDERC) involving two faculty members (NS and SA) from different departments who were simultaneously instructing a master’s student (St) in two separate courses. The methodology involved addressed the learning needs of St in two concurrent courses as well as fulfilling particular research activities. A few different reflection-gathering tools were adopted to elicit the two participants’ (SA and St) views on the impacts of the IDERC. Thematic analysis of SA’s interview concerning her experiences with the IDERC indicated that she was motivated by a range of personal, educational, and research factors. It also showed her positive outlook on how a similar IDERC could benefit faculty members and students as well as knowledge development. SA also went through the reasons why educators may be hesitant or resistant to deal with IDC. When probing St’s experiences with the IDERC incorporated inside his class tasks and an open-ended questionnaire, he not only highlighted the educational and research outcomes he gained, but also mentioned how he was influenced by the instructors' socialization behavior. Regarding the requirements of an IDC, St's main focus was on successful implementation and prioritizing efficiency. Suggestions are provided as to how this collaboration can be extended to larger contexts.