1
|
Zainal H, Xiaohui X, Thumboo J, Kok Yong F. Digital competencies for Singapore's national medical school curriculum: a qualitative study. MEDICAL EDUCATION ONLINE 2023; 28:2211820. [PMID: 37186901 DOI: 10.1080/10872981.2023.2211820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Studies have shown that national-level initiatives to equip medical students with relevant digital competencies carry many benefits. Yet, few countries have outlined such competencies for clinical practice in the core medical school curriculum. This paper identifies current training gaps at the national level in digital competencies needed by students in the formal curricula of all three medical schools in Singapore from the perspectives of clinical educators and institutional leaders. It bears implications for countries that intend to implement standardized learning objectives for training in these digital competencies. Findings were drawn from in-depth interviews with 19 clinical educators and leaders of local medical schools. Participants were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis. Thirteen of the participants were clinical educators while 6 were deans or vice deans of education from one of the three medical schools in Singapore. While the schools have introduced some relevant courses, they are not standardized nationally. Moreover, the school's niche areas have not been leveraged upon for training in digital competencies. Participants across all schools acknowledged that more formal training is needed in digital health, data management, and applying the principles of digital technologies. Participants also noted that the healthcare needs of the population, patient safety, and safe procedures in the utilisation of digital healthcare technologies should be prioritized when determining the competencies needed by students. Additionally, participants highlighted the need for stronger collaboration among medical schools, and for a stronger link between current curriculum and clinical practice. The findings highlighted the need for better collaboration among medical schools in the sharing of educational resources and expertise. Furthermore, stronger collaborations with professional bodies and the healthcare system should be established to ensure that the goals and outcomes of medical education and the healthcare system are aligned.
Collapse
Affiliation(s)
- Humairah Zainal
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Xin Xiaohui
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Fong Kok Yong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| |
Collapse
|
2
|
Chiu HY, Chiang CM, Kang YN, Chen CC, Wu CC, Chiu YH, Tang KP, Kao CC, Wei PL. Development of a social cognitive career theory scale for measuring the intention to select surgery as a career. Heliyon 2023; 9:e21685. [PMID: 38027609 PMCID: PMC10665719 DOI: 10.1016/j.heliyon.2023.e21685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Surgeon shortages have emerged as a prominent global issue. Although various studies have explored the factors that influence medical students in choosing surgery as a career, addressing the need for surgeons requires a multifaceted approach. However, there is currently a lack of a theoretically grounded scale to evaluate the effectiveness of surgical career development or policy promotion. Thus, this study aimed to develop a questionnaire for assessing the preference for a surgical career by adopting the Social Cognitive Career Theory (SCCT). Materials and methods The study aimed to develop the Social Cognitive Career Theory Scale toward Surgery (SCCTSS) by adopting the framework of SCCT. The questionnaire was created through expert consensus and the content validity index (CVI) calculation. Subsequently, a pilot version of the SCCTSS was administered to 222 medical students in their clinical clerkships, and the collected data underwent item analysis. Additionally, the validation of the SCCTSS by gender was performed. Results The SCCTSS comprised 16 items that passed expert panel evaluation, with a CVI >0.8, mean ≥ 3.00, and an interquartile range ≤1. Item analysis demonstrated that the quality of the SCCTSS met the qualifying threshold. Furthermore, the SCCTSS questionnaire effectively validated gender differences in surgical career preference. Conclusions We developed an internally consistent and reliable scale and validated it through an expert panel method and feedback from medical students. Further research is required to evaluate the targeted interventions that may assist in recruiting medical students into the field of surgery through the application of the SCCTSS.
Collapse
Affiliation(s)
- Hsin-Yi Chiu
- Division of Thoracic Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, No. 252, Wuxing St, Xinyi District, Taiwan
- Department of Medical Education, Taipei Medical University Hospital, Taipei, No. 252, Wuxing St, Xinyi District, Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Department of Animal Science and Technology, National Taiwan University, No. 50, Lane 155, Section 3, Keelung Rd, Da'an District, Taipei, Taiwan
| | - Chi-Ming Chiang
- Department of Orthopedics Surgery, Cardinal Tien Hospital, New Taipei City, No.15, Chezi Rd., Xindian Dist., 23155, Taiwan
- Professional Master Program for Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing St, Xinyi District, Taipei, Taiwan
| | - Yi-No Kang
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Department of Education, Wan Fang Hospital, Taipei Medical University, No. 250, Wuxing St, Xinyi District, Taipei, Taiwan
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing Health Sciences, No.365, Ming-Te Rd, Peitou District, Taipei City, Taiwan
| | - Chia-Che Chen
- Department of Medical Education, Taipei Medical University Hospital, Taipei, No. 252, Wuxing St, Xinyi District, Taiwan
- Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, No. 252, Wuxing St, Xinyi District, Taipei, Taiwan
| | - Chien-Chih Wu
- Department of Medical Education, Taipei Medical University Hospital, Taipei, No. 252, Wuxing St, Xinyi District, Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Division of Urology, Taipei Medical University Hospital, No. 252, Wuxing St, Xinyi District, Taipei, Taiwan
| | - Yu-Han Chiu
- Division of Epidemiology, Department of Public Health Sciences, Penn State University College of Medicine, Hershey, No. 410, Boucke Building, University Park, Pennsylvania, USA
| | - Kung-Pei Tang
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, No.134, Sec. 2, Heping E. Rd., Da-an District, Taipei, 106, Taiwan
| | - Chih-Chin Kao
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, No. 252, Wuxing St, Xinyi District, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
| | - Po-Li Wei
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, No. 250, Wuxing St, Xinyi District, Taiwan
- Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, No. 252, Wuxing St, Xinyi District, Taipei, Taiwan
- Graduate Institute of Cancer Biology and Drug Discovery, Taipei Medical University, No. 250, Wuxing St, Xinyi District, Taipei, Taiwan
| |
Collapse
|
3
|
Zainal H, Xiaohui X, Thumboo J, Yong FK. Exploring the views of Singapore junior doctors on medical curricula for the digital age: A case study. PLoS One 2023; 18:e0281108. [PMID: 36862708 PMCID: PMC9980755 DOI: 10.1371/journal.pone.0281108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/16/2023] [Indexed: 03/03/2023] Open
Abstract
This study aims to explore the perspectives of medical trainees on the impartation of digital competencies in Singapore's medical school curricula. It also considers how the medical school experience can be strengthened in order to bridge potential gaps in the integration of these competencies in the local curricula. Findings were drawn from individual interviews with 44 junior doctors from Singapore's public healthcare institutions including hospitals and national specialty centers. House officers and residents from different medical and surgical specialties were recruited using purposive sampling. Data was interpreted using qualitative thematic analysis. The doctors were in their first to tenth year of post-graduate training. Thirty of them graduated from the three local medical schools whereas 14 others were trained overseas. Overall, they felt insufficiently prepared to utilize digital technologies in view of their limited exposure to such technologies in medical school. Six key reasons were identified: lack of flexibility and dynamism within the curriculum, dated learning style, limited access to electronic health records, gradual uptake of digital technologies in the healthcare sector, lack of an ecosystem that promotes innovation, and lack of guidance from qualified and available mentors. Equipping medical students with skills relevant to the digital age would benefit from a concerted effort from multiple stakeholders: medical schools, medical educators and innovators, as well as the government. This study bears important implications for countries that seek to bridge the 'transformation gap' brought about by the digital age, which is defined as the sharp divergence between innovations that healthcare providers recognize as important but for which they feel insufficiently prepared.
Collapse
Affiliation(s)
- Humairah Zainal
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Xin Xiaohui
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Fong Kok Yong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- * E-mail:
| |
Collapse
|
4
|
Zainal H, Xin X, Thumboo J, Fong KY. Medical school curriculum in the digital age: perspectives of clinical educators and teachers. BMC MEDICAL EDUCATION 2022; 22:428. [PMID: 35659212 PMCID: PMC9164471 DOI: 10.1186/s12909-022-03454-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/03/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND There is a need to reexamine Singapore's medical school curricula in light of the increasing digitalization of healthcare. Notwithstanding Singapore's digital competitiveness, there is a perceived gap in preparing its medical students for the digital age. Furthermore, limited research has evaluated the extent to which skills in using digital technologies should be taught to medical students in Asian medical schools to prepare them for future clinical practice- a gap that is filled by this study. Using Singapore as a case study, it explores the views of some local clinical educators and teachers towards the need to impart skills in digital technologies to medical students. It also offers recommendations on ways to balance the clinicians' concerns about these technologies with the digital competencies needed for clinical practice. METHODS Findings were drawn from individual interviews with 33 clinical educators and teachers from Singapore's public and private healthcare sectors. They were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis. RESULTS Participants included vice deans of education from all three local medical schools and senior consultants from a wide variety of disciplines. Overall, they acknowledged two benefits of equipping students with skills in digital technologies including promoting the culture of innovation and improving work efficiency. However, they also highlighted four main concerns of imparting these skills: (i) erosion of basic clinical skills, (ii) neglect of a generalist approach to healthcare characterized by holistic management of patients, inter-professional collaboration, and commitment to breadth of practice within each specialty, (iii) rapid pace of technological advances, and (iv) de-personalisation by technology. CONCLUSIONS The findings show that medical students in Singapore would benefit from a curriculum that teaches them to use digital technologies alongside core clinical skills.
Collapse
Affiliation(s)
- Humairah Zainal
- Health Services Research Unit, Singapore General Hospital, SingHealth Tower Level 16, 10 Hospital Boulevard, Singapore, 168582 Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, SingHealth Tower Level 16, 10 Hospital Boulevard, Singapore, 168582 Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, SingHealth Tower Level 16, 10 Hospital Boulevard, Singapore, 168582 Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, SingHealth Tower Level 16, 10 Hospital Boulevard, Singapore, 168582 Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, SingHealth Tower Level 16, 10 Hospital Boulevard, Singapore, 168582 Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| |
Collapse
|
5
|
Jiang H, Vimalesvaran S, Wang JK, Lim KB, Mogali SR, Car LT. Virtual Reality in Medical Students' Education: Scoping Review. JMIR MEDICAL EDUCATION 2022; 8:e34860. [PMID: 35107421 PMCID: PMC8851326 DOI: 10.2196/34860] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education. OBJECTIVE The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research. METHODS We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR. CONCLUSIONS Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-046986.
Collapse
Affiliation(s)
- Haowen Jiang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Sunitha Vimalesvaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Jeremy King Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Kee Boon Lim
- School of Biological Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | | | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| |
Collapse
|
6
|
Scahill EL, Oliver NG, Tallentire VR, Edgar S, Tiernan JF. An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp. Adv Simul (Lond) 2021; 6:15. [PMID: 33902742 PMCID: PMC8074238 DOI: 10.1186/s41077-021-00157-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/07/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Simulation-based mastery learning (SBML) is an effective, evidence-based methodology for procedural skill acquisition, but its application may be limited by its resource intensive nature. To address this issue, an enhanced SBML programme has been developed by the addition of both pre-learning and peer learning components. These components allowed the enhanced programme to be scaled up and delivered to 106 postgraduate doctors participating in a national educational teaching programme. METHODS The pre-learning component consisted of an online reading pack and videos. The peer learning component consisted of peer-assisted deliberate practice and peer observation of assessment and feedback within the SBML session. Anonymised pre- and post-course questionnaires were completed by learners who participated in the enhanced programme. A mixture of quantitative and qualitative data was obtained. RESULTS Questionnaires were distributed to and completed by 50 learners. Both sections of the pre-learning component were highly rated on the basis of a seven-point Likert scale. The peer learning component was also favourably received following a Likert scale rating. Peer observation of the performance and assessment process was rated similarly by first and second learners. The thematic analysis of the reasons for which peer-assisted deliberate practice was considered useful showed that familiarisation with equipment, the rehearsal of the procedure itself, the exchange of experiences and sharing of useful tips were important. The thematic analysis of the reasons why peer observation during 'performance, assessment and feedback' was useful highlighted that an ability to compare a peer's performance to their own and learning from observing a peer's mistakes were particularly helpful. CONCLUSION The SBML programme described has been enhanced by the addition of pre-learning and peer learning components which are educationally valued and allow its application on a national scale.
Collapse
Affiliation(s)
| | | | | | - Simon Edgar
- Medical Education Directorate, NHS Lothian, Edinburgh, UK
| | | |
Collapse
|