|Year : 2011 | Volume
| Issue : 3 | Page : 756-757
Co-Editors' Notes 24:3
M Glasser, D Pathman
Co-Editors, Education for Health
|Date of Web Publication||26-Sep-2012|
Co-Editors, Education for Health
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Glasser M, Pathman D. Co-Editors' Notes 24:3. Educ Health 2011;24:756-7
This issue of Education for Health is the last to be published under the direction of Marie-Louise Panis, our managing editor for the past 12 years – see our Editorial for our expressions of gratitude to her and to Maastricht University, the journal's home base. It is fitting that this last issue to be assembled under Marie-Louise's guiding hand is a full and rich one. As always, we trust you will find much to learn and think about in this issue of EfH.
In terms of Original Research, from Marmara School of Medicine, Kalaca and Gulpinar administered a Turkish version of Vermunt's Inventory of Learning Styles to over 500 medical students. Their findings, reported in 'A Turkish Study of Medical Student Learning Styles,' indicated a predominant intermediate position for Turkish students on a teacher-regulated to student-regulated learning continuum. Based on their findings, Turkish medical schools can plan a more student-centered education by reducing the support of external regulation of students as they advance from their pre-clinical to the clinical phase of education. The medical educators concluded that a variety of teaching methods and learning activities should be provided in order to address medical students' range of learning styles.
Yang et al., in their paper 'A Program to Interest Medical Students in Changhua, Taiwan in the Incorporation of Visual Arts in Medicine,' present outcomes from the initiation and evaluation of a visual arts program involving 110 students. The purpose was to give the students a short review of visual arts and to interest them in the incorporation of arts in medicine. Qualitative analysis of the data revealed that students found the course interesting. Themes that emerged included the program's helpfulness to students in interpreting paintings, enhancing empathy, increasing cultural awareness, enhancing teamwork, reducing stress and enhancing students' listening, observational and communication skills.
In 'Effectiveness of Educational Interventions in Improving Clinical Competence of Residents in an Internal Medicine Residency Program in Pakistan,' Tariq and colleagues aimed to assess the effect of a quality improvement cycle approach in using various educational interventions within the residency. Effects were measured on the key educational outcomes of residents' medical knowledge, skills and professional attitudes, using results of postgraduate examination with both written and clinical skills components as outcomes. Postgraduate exam pass rates were 59.2% before the intervention and 86.4% after (p=0.002). Overall, the study describes a number of interventions that were successful in bringing about an improvement in the performance of residents.
Dongre et al., in their paper 'The Benefits to Medical Undergraduates of Exposure to Community-based Survey Research,' point out that in India there has been little effort to teach medical students about public health research. Little is known about how such an activity would affect students in India or how they would apply what they learn. The investigators implemented and evaluated a systematic, hands-on experience in the public health research process with medical undergraduates in Puducherry, India. The initial implementation of a program exposing the medical students to the community survey research process was well-received. The investigators conclude that early exposure of medical undergraduates to the survey research process may help them become better clinicians, who are able to understand and use field level data.
In 'Career Intentions of Medical Students Trained in Six Sub-Saharan African Countries' Burch and multiple colleagues address an issue previously the subject of an EfH editorial: the brain drain of health professionals in Africa1. The group reports that sub-Saharan Africa is the world region that is most adversely affected by physician migration. Their purpose was to identify reasons why medical students wish to stay in or leave Africa, hoping to assist policy makers in developing strategies that favor retention of graduates. The authors surveyed senior year students from medical schools in South Africa, the Democratic Republic of Congo, Kenya, Nigeria, Tanzania and Uganda. The response rate was 78.5%; 990 of 1,260 students. Most (97.4%) of the responding students were African by birth. The top three specialty choices were surgery (20%), internal medicine (16.7%) and pediatrics (9%); few were interested in family medicine (4.5%) or public health (2.6%) or intended to practice in rural areas (4.8%). Many students (40%) planned to train abroad; 21% intended to relocate outside sub-Saharan Africa. Overall, the career intentions of African medical students were not aligned with the continent's health workforce needs.
In 'Integration of Geriatrics into a Spiral Undergraduate Medical Curriculum in Pakistan: Evaluation and Feedback of Third-Year Medical Students,' Sabzwari et al. report that prior to their project none of the 50 medical schools in Pakistan taught geriatrics in undergraduate or postgraduate training. Their paper discusses the development and implementation of the first geriatric curriculum in a medical school of Pakistan and demonstrates its positive effect on knowledge and attitudes of third-year medical students. Their data support this low cost, spiral geriatrics curriculum model in a medical education for Pakistan.
Kalish et al. in 'Raising Medical Student Awareness of Compassionate Care through Reflection on Annotated Videotapes of Clinical Encounters' designed and conducted an outpatient rheumatology patient-partner exercise that integrated the assessment of student compassionate care into an outpatient clinical skills training exercise. Eleven third-year medical students were videotaped performing a medical history with a patient volunteer. Students, the preceptor and a fourth-year medical student independently observed the videotape, tagged segments demonstrating observed or missed compassionate care opportunities and completed a compassionate care questionnaire. Students also participated in a focus group and 10 patients completed a questionnaire. The exercise proved to be an effective format for promoting student reflection on and self-assessment of compassionate care.
From the United States, Kobetz et al. in 'Perceptions of HPV and Cervical Cancer among Haitian Immigrant Women: Implications for Vaccine Acceptability' report on results from their ongoing Community-Based Participatory Research (CBPR) efforts. The researchers conducted a series of focus groups with Haitian immigrant women in Little Haiti, the predominantly Haitian neighborhood in Miami, Florida, USA. The women indicated strong preferences for obtaining health information through trusted sources, such as Haitian physicians, Haitian Community Health Workers, and especially Kreyol-language audiovisual media. Findings indicate the need for culturally and linguistically appropriate educational initiatives to promote awareness of HPV and its role in cervical cancer.
Amico and colleagues, in 'Capacity Building through Focus Group Training in Community-Based Participatory Research,' describe the logistics and lessons learned from building community research capacity for focus group moderation in the context of a Community-Based Participatory Research (CBPR) partnership. In an ethnically diverse community in Rochester, Minnesota, USA, 27 community and academic members were recruited through established relationships for training in focus group moderation, note-taking and report compilation. Focus group training led to increased trust among community and research partners while empowering individual community members and increasing research capacity for CBPR.
In a Practical Advice paper, 'Adapting the World Federation for Medical Education Standards for Use in a Self-Audit of an Eye Care Training Programme,' Tousignant and Du Toit describe a Postgraduate Diploma in Eye Care (PGDEC) for mid-level health personnel. The program was initiated in Papua New Guinea in partnership with The Fred Hollows Foundation New Zealand, the local government and Divine Word University. The educators adapted the World Federation for Medical Education (WFME) standards to use in a self-audit to evaluate nine areas and 38 subareas of program structure, processes and implementation. The WFME-adapted, self-audit program provided a simple, yet systematic and largely objective evaluation, and proved to be beneficial in further program development, highlighting both strengths and areas for improvement.
In the first of two Review Articles, AlAlwan et al., in 'The Progress Test as a Diagnostic Tool for a New PBL Curriculum,' evaluated the performance of Saudi Arabian medical students at various years within the curriculum through a USMLE-based test that focused on basic medical and clinical sciences topics. The investigators found a good correlation between progress test results and students' GPA. The investigators conclude that the results of the progress test proved to be a useful indicator for both basic medical sciences and clinical sciences curricula, and results are being used to make appropriate changes.
Aguilar and colleagues, in 'Assessing Students' Professionalism: Considering Professionalism's Diverging Definitions,' contend that while most health education programs assess students' professionalism, there is little clarity or uniformity within the health education literature on the definition of professionalism. The authors conducted a literature review to clarify professionalism by bringing together diverging definitions from a number of health disciplines, and discuss the complexities and limitations of these definitions. They found that the literature variably defines professionalism as upholding professional values, as demonstrating professional attitudes or demonstrating professional behaviors. The authors conclude that health professions educators should ideally assess all three perspectives of professionalism; however, this may not be realistic given an already full curriculum and the many other demands on students and educators. Instead, educators may decide to only assess one perspective and given its advantages, the attitudes perspective may be a useful starting point.
This issue of EfH features a Position Paper by Wear and colleagues, 'Teaching Fearlessness: A Manifesto.' In this very interesting piece, two faculty members' experiences and observations are discussed in the context of the reactions of a medical student to her own experiences and reflections on the learning process. The authors contend that negative role modeling is a plague medical education fights once students enter the clinical arena. The literature is replete on the fact that students routinely encounter faculty who display attitudes and behaviors inconsistent with the values taught throughout the medical curriculum. Invoking Papadimos and Murray's use of 'fearless speech' derived from Foucault's thinking on parrhesia, the authors build a case that students should be encouraged to expose and challenge inequities on behalf of their patients, themselves and the profession at large. They conclude that medical educators should model and provide students with opportunities to develop and use 'fearless speech' as a way to reshape the culture of medical education and patient care.
Hilliard Jason, MD, EdD, former EfH editor and current member of the journal's Editorial Board, provides a brief Commentary on Wear and colleagues' contribution by first asking whether or not such a paper should appear in a research journal. We will not give away his final answer here, but urge you to look at Dr. Jason's response and questions for further reflection by health professions educators.
There are a number of Brief Communications in this issue. Jennings, in 'Assessing Educational Needs of Potential Hepatitis C Patients at a Veterans Affairs Medical Center,' presents results of a pilot study. She provides data on strategies to most effectively meet the patients' educational needs. In 'SMILE: Simple, Mental Health Initiative in Learning and Education,' Ward describes and summarizes the results of a program at Southern Cross University, Australia, aimed to improve the knowledge and skills of third-year nursing students participating in their first clinical placement in mental healthcare. The author found that students participating in SMILE reported an improved understanding of mental healthcare issues and expressed a developing knowledge base and improved practical skill level. From Nepal, Butterworth et al. in 'Remote and Rural: Do Mentors Enhance the Value of Distance Learning Continuing Medical Education?' examined the potential benefits and practical implications of providing mentors for distance learning CME in a low technology setting. They found that mentored doctors seemed to show a higher quality of reflection on learning, but contact between mentors and mentees was difficult. Both mentors and mentees felt that optimal use of the system was not made. From India, Supe in 'Interns' Perspectives about Communicating Bad News to Patients: A Qualitative Study' used focus groups and a grounded theory approach to identify common themes and concepts related to: (1) barriers to communicating bad news; (2) interns' confidence in communicating bad news; (3) interns' perceptions about their need for such training; and (4) interns' suggested methods for training. Supe concludes that interns in Mumbai reported inadequate training and low comfort and skill in communicating bad news and expressed need for focused training. Finally, Montoya et al., in 'Validation of the Transition of an Instrument to Measure Reliability of Written Information on Treatment Choices: A Study on Attention Deficit/Hyperactivity Disorder (ADHD),' sought to validate the Spanish translation of the DISCERN instrument – originally designed to help patients assess the reliability of written information on treatment choices – to assess the reliability of web-based information on treatment choices for ADHD. The researchers conclude that the validation process showed that the quality of DISCERN translation was high, validating the comparable language of the tool translated on assessing written information on treatment choices for ADHD.
As usual, associate editor Jan van Dalen provokes our thinking in his In the News! piece on 'Scientific Conduct?'. The top 10 list of scientific frauds are presented. Speaking of 'Teaching Fearlessness': van Dalen tells us 'It is high time to thoroughly revise our way of thinking and our current practice in the scientific community.'
We conclude this issue with a very thought-provoking poem by Jamsheer Talati 'Working with the Poor against Poverty' – with its concluding refrain 'The battle of health had begun!'
Michael Glasser, Ph.D.
Donald Pathman, M.D., MPH
Co-Editors, Education for Health
1. Glasser M, Pathman D. Global Poverty, Human Development, and the Brain Drain. Education for Health. 2007; 20(3):140. Available from: http://www.educationforhealth.net/articles/subviewnew.asp?ArticleID=140