Early internationalization of students in a German medical school in the former German Democratic Republic

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.

Internationalization of Medical Education - Motivations and Formats of Current Practices

PURPOSE

The COVID-19 pandemic has demonstrated the importance for medical professionals to engage in work transcending national borders and to deeply understand perspectives of health in other countries. Internationalization of medical education can play a key role to that end, by preparing culturally competent and globally conscious medical healthcare professionals.The aim of this scoping review is to identify current practices and formats in internationalization in medical education, which to date has received sparse academic attention. The need for this review is heightened amid COVID-19 where a clearer understanding of current internationalization efforts can inform more effective practice. We also explore if the motivations driving internationalization activities in medicine align with current practice and formats based on a framework of thematic categories found in the field of international higher education. In addition, we identify gaps in existing research.

METHODS

Using a scoping review, an international and interdisciplinary research team employed a comprehensive search strategy to identify publications on existing efforts in IoME, published from January 1, 2000, to December 31, 2020, in Scopus, PubMed/Medline, Google Scholar, and Web of Science. Inclusion/exclusion criteria were applied to identify relevant data from publication titles, abstracts, and main texts, which were subsequently summarized. Coding schemes were developed based on models for comprehensive internationalization in higher education.

RESULTS

350 articles met the inclusion criteria. Most articles originated from the high-income countries of the Global North and accounted for a literature base favoring perspectives and understandings that were typically representative of this region. Whereas motivations for internationalizing medical curricula in high-income countries were generally rooted in a model of social transformation/justice/health equity, drivers relating to competition and workforce preparation were common in the low- and middle-income countries.Importantly, the motivations driving internationalization activities generally did not align well with reported internationalization formats, which included student mobility, international curricula at home, and global partnerships. There was a disconnect between what medical curricula/professionals hope to accomplish and the reality of practice on the ground.

DISCUSSION AND CONCLUSION

There is a need for a common definition of internationalization of medical education and a more balanced and unbiased literature base, capturing the full spectrum of internationalization activities existing in both the Global North and South. International partnership frameworks need to equally benefit institutions of both the Global North and Global South. Currently, institutions in the low- and middle-income countries generally cater to the needs and interests of their high-income counterparts. There are concerns about student mobility from high-income countries to low- and middle-income countries. Finally, medical education should be more inclusive and all medical students should gain access to international perspectives and experiences.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01553-6.

The influence of mixing international and domestic students on competency learning in small groups in undergraduate medical education

BACKGROUND

Medical curricula are increasingly internationalized, with international students being mixed with domestic students in small group learning. Small group learning is known to foster competency learning in undergraduate medical education, specifically Communication, Collaboration, Leadership, and Professionalism. However, it is unclear what happens with the learning of competencies when international students are introduced in small groups. This study explores if students in international small groups master the competencies Collaboration, Leadership and Professionalism at the same level as students in domestic groups in an undergraduate medical curriculum.

METHOD

In total, 1215 Students of three academic year cohorts participated in the study. They were divided into four learning communities (LCs), per year cohort, in which tutor groups were the main instructional format. The tutorials of two learning communities were taught in English, with a mix of international and Dutch students. The tutorials of the other two learning communities were taught in Dutch with almost all domestic students. Trained tutors assessed three competencies (Collaboration, Leadership, Professionalism) twice per semester, as 'Not-on-track', 'On-track', or 'Fast-on-track'. By using Chi-square tests, we compared students' competencies performance twice per semester between the four LCs in the first two undergraduate years.

RESULTS

The passing rate ('On-track' plus 'Fast-on-track') for the minimum level of competencies did not differ between the mixed and domestic groups. However, students in the mixed groups received more excellent performance evaluations ('Fast-on-track') than the students in the homogenous groups of Dutch students. This higher performance was true for both international and Dutch students of the mixed groups. Prior knowledge, age, gender, and nationality did not explain this phenomenon. The effect could also not be explained by a bias of the tutors.

CONCLUSION

When students are educated in mixed groups of international and Dutch students, they can obtain the same basic competency levels, no matter what mix of students is made. However, students in the mixed international groups outperformed the students in the homogenous Dutch groups in achieving excellent performance scores. Future research should explore if these findings can be explained from differences in motivation, perceived grading or social network interactions.

An International Partnership of 12 Anatomy Departments - Improving Global Health through Internationalization of Medical Education

Background

At a time of global interconnectedness, the internationalization of medical education has become important. Anatomy as an academic discipline, with its close connections to the basic sciences and to medical education, can easily be connected with global health and internationalization of medical education. Here the authors present an international program based on a partnership between twelve anatomy departments in ten countries, on four continents. Details of a proposed plan for the future direction of the program are also discussed.

Objective

The aim is to improve global healthcare by preparing future global healthcare leaders via early international networking, international collaboration and exchange, intercultural experience, and connecting two seemingly distant academic disciplines - anatomy and global health - via internationalization of medical education.

Methods

Based in the anatomy course, the program involved early international collaboration between preclinical medical and dental students. The program provided a stepwise progression for learning about healthcare and intercultural topics beyond pure anatomy education - starting with virtual small groups of international students, who subsequently presented their work to a larger international audience during group videoconferences. The above progressed to in-person visits for research internships in the basic sciences within industrialized countries.

Findings

Students appreciated the international and intercultural interaction, learned about areas outside the scope of anatomy (e.g., differences in healthcare education and delivery systems, Public and Global Health challenges, health ethics, and cultural enrichment), and valued the exchange travel for basic sciences research internships and cultural experience.

Conclusions

This unique collaboration of international anatomy departments can represent a new role for the medical anatomy course beyond pure anatomy teaching - involving areas of global health and internationalization of medical education - and could mark a new era of international collaboration among anatomists.