Internationalization of Medical Education - Motivations and Formats of Current Practices

Blind spots in medical education - International perspectives

BACKGROUND

All individuals and groups have blind spots that can create problems if unaddressed. The goal of this study was to examine blind spots in medical education from international perspectives.

METHODS

From December 2022 to March 2023, we distributed an electronic survey through international networks of medical students, postgraduate trainees, and medical educators. Respondents named blind spots affecting their medical education system and then rated nine blind spot domains from a study of U.S. medical education along five-point Likert-type scales (1 = much less attention needed; 5 = much more attention needed). We tested for differences between blind spot ratings by respondent groups. We also analyzed the blind spots that respondents identified to determine those not previously described and performed content analysis on open-ended responses about blind spot domains.

RESULTS

There were 356 respondents from 88 countries, including 127 (44%) educators, 80 (28%) medical students, and 33 (11%) postgraduate trainees. At least 80% of respondents rated each blind spot domain as needing 'more' or 'much more' attention; the highest was 88% for 'Patient perspectives and voices that are not heard, valued, or understood.' In analyses by gender, role in medical education, World Bank country income level, and region, a mean difference of 0.5 was seen in only five of the possible 279 statistical comparisons. Of 885 blind spots documented, new blind spot areas related to issues that crossed national boundaries (e.g. international standards) and the sufficiency of resources to support medical education. Comments about the nine blind spot domains illustrated that cultural, health system, and governmental elements influenced how blind spots are manifested across different settings.

DISCUSSION

There may be general agreement throughout the world about blind spots in medical education that deserve more attention. This could establish a basis for coordinated international effort to allocate resources and tailor interventions that advance medical education.

Identifying International Leadership Competencies in Medical Education

Internationalization of medical education must be a part of medical education, in order to ensure that worldwide healthcare issues can be solved collaboratively. To date, medical educators have not agreed upon what skills students should obtain via internationalization of medical education. Medical leadership skills are of increasing importance in both academia and clinical practice. In medical education, very little has been reported about international leadership competencies. While leadership skills are outlined for national settings, international leadership skills in medicine require a more expansive set of competencies. Adapted from recommendations for the framework of health-professional competencies, they can be divided into international specialized knowledge and integrated leadership competencies presented in this article.

The quality of group interactions in medical problem-based learning in China: the roles of intercultural sensitivity and group ethnic composition

BACKGROUND

Chinese universities are increasingly recruiting foreign students, and problem-based learning (PBL) is an effective approach to integrating those students. This study focuses on the role of intercultural sensitivity and group ethnic composition on the quality of group interaction in medical problem-based learning in China.

METHODS

This paper reports an investigation of the differences in three types of group interaction (exploratory questions, cumulative reasoning, and handling conflict) among 139 s-year medical undergraduates from two backgrounds (Chinese and foreign) in a PBL setting. The roles of intercultural sensitivity, group ethnic composition, and students' personal characteristics including age, gender and ethnicity on students' perceptions of the three types of interaction were quantitatively analyzed. A 35-item questionnaire and demographic survey were administered to second year medical undergraduates.

RESULTS

The results indicated that group ethnic composition was a significant negative predictor while intercultural sensitivity was a strong positive predictor of group interactions involving exploratory questions and cumulative reasoning. In addition, group heterogeneity in terms of age and ethnicity were significant predictors of group interaction.

CONCLUSIONS

The findings of this study provide insights for strategically designing effective multiethnic group learning environments that encourage interaction and collaboration.

Implications of internationalisation of medical education

Internationalisation of medical education encompasses the integration of global dimensions and intercultural experiences into medical practices. This process is planned to prepare globally conscious, culturally competent medical workforce that can efficiently address international health challenges. This article describes the impact of internationalisation of medical education on students, teachers and patients.

Reshaping internationalization of medical education in 2023

The global COVID-19 pandemic has shown the need for internationalization of medical education, in order to facilitate global collaborative problem solving in healthcare. In 2023, it is time to reshape IoME within the context of our time, and share new visions, ideas, and formats. This collection of articles reports on theories and actions in IoME.

Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics

INTRODUCTION

 A junior doctor teaching program delivered by near-peers can foster collaboration in a less-pressured and conducive learning environment. The aim of this study was to provide an analysis of an orthopedic teaching program in a high-resource environment utilizing readily available tools and resources that are potentially available in most hospitals globally.  Methods: This study involved the utilization of an outcome-based learning approach with regular formal feedback. An anonymized Google Forms survey using a 10-point Likert scale was conducted after a 30-week period. The survey tool was sent out to 28 doctors and two senior nurse practitioners who participated in the program either as tutors, learners, or both. A total of 19 out of 30 respondents completed the survey giving a 63% survey completion rate. The setting for this study was the trauma and orthopedics department in a United Kingdom district general hospital.

RESULTS

 Learners' confidence in their orthopedic knowledge and skills pre-program had a median response of eight with a mode of seven whereas confidence following engagement on the program improved with a median response of nine and a mode of 10. At an alpha level of 0.05, this observed improvement was statistically significant using the Mann-Whitney U test (p=0.466). Tutors' perception of the usefulness of the teaching feedback had a median response of nine with a mode of 10. Relevance of the selected topics had a median response of nine and a mode of 10. Inclusion in the teaching program to cater to learner diversity had a median response of nine and a mode of 10. The effectiveness of a blended approach for learning had a median response of nine and a mode of 10.  Conclusion: This study has provided evidence of the benefits of a near-peer teaching program. This is especially important in the post-coronavirus disease (COVID) pandemic recovery period where easily accessible and well-grounded educational programs will be useful to complement the deanery teachings for trainees. This is important as this may be the main source of formal teaching for non-trainee junior doctors in many hospital settings. Additional research will be needed to further explore the pros and cons of such programs within a surgical specialty like orthopedics with an emphasis on the various pedagogical approaches to teaching and learning for junior doctors working in a busy clinical setting.