Exploring Glocalization in the Construction and Implementation of Global Curricula

Cultural Considerations in the Formal Process of Simulation Curriculum Adaptation: A Scoping Review

SUMMARY STATEMENT

Transborder curriculum partnerships in health professions education have been increasing in numbers in recent years. These partnerships present unique challenges when transferring curricula from one context to another. It has been noted that cultural differences between institutions, faculty, staff, and learners can have profound effects on collaboration. Given the significant need for context and fidelity (especially relative to cultural considerations) in healthcare simulation education, there are gaps that need to be addressed in the transfer of these curricula. A scoping literature review was conducted examining recently published articles with relevance to simulation curriculum design or adaptation in transborder contexts to determine to what extent cultural elements are considered in the design and adaptation of simulation-based education in transborder curriculum partnerships. This review resulted in 19 studies requiring full-text review. Studies represented every region of the world with both near and distant proximity of partnering parties. From the reviewed studies, 8 categories related to curriculum adaptation were identified. These categories, when compared with the themes present in Campinha-Bacote's model of cultural competency, showed complete overlap with the 5 themes of the model plus an additional theme complementary to the model. This scoping review demonstrates that cultural considerations clearly play a role in the adaptation of simulation curricula in transborder healthcare curricular partnerships, but further research is needed to further define the exact nature of that relationship.

"Glocalization" in medical education: A framework underlying implementing CBME in a local context

BACKGROUND/PURPOSE

The implementation of competency-based medical education is a social construction process within a local and cultural context. However, little is known about the process of adaptation to different systems, known as "glocalization". We analyzed the documents in the development of a milestone project from adapting global standards into a local context and identified a framework underlying this process.

METHODS

Taiwan Society of Emergency Medicine (TSEM) had developed learning milestones based on the ACGME's version through series of consensus methods including committee work, nominal group technique (NGT), and a modified Delphi method. We applied qualitative content analysis to characterize the evolution of the three versions of TSEM and the original ACGME milestones documents and to explore the meaning behind the differences revealed by the glocalization process.

RESULTS

We found 48 differences between ACGME and TSEM milestones. Among these differences, one was made by committee work, 44 came from NGT, and 3 were from the modified Delphi process. Two themes and seven sub-themes emerged from the coding process to explain the contextualization process of the milestones.

CONCLUSION

We identified a framework that incorporates local expression and local needs into the process called glocalization through which global models of competency-based standards could be optimally implemented in a local context with different systems and cultures.

Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

OBJECTIVES

The global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives.

DESIGN

We conducted a document analysis to examine authorship of recent publications to explore current international representation.

DATA SOURCES

The table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase.

ELIGIBILITY CRITERIA

The journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis.

DATA EXTRACTION AND SYNTHESIS

The table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable).

RESULTS

A total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time.

CONCLUSIONS

Diversity in health professional education scholarship, as marked by nation of authors' professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.

Exploring implementation of the ESTRO Core Curriculum at the national level

BACKGROUND AND PURPOSE

Global curricula exist across medical specialties however, the factors which influence their implementation are not well understood. The purpose of this study is to report the perceived factors that impact the implementation of the ESTRO Core Curriculum.

METHODS

An anonymous, 37-item, survey was designed and distributed to the Presidents of the National Societies who have endorsed the ESTRO Core Curriculum (n = 29). The survey addressed perceptions about implementation factors related to context, process and curriculum change. The data was summarized using descriptive statistics.

RESULTS

Twenty-six (90%) National Societies completed the survey. One respondent perceived that the values of the training system of their country would be incompatible with the proposed ESTRO Core Curriculum. The most common contextual barriers to implementation was a lack of support from the government (57%), a lack of internal organizational support (35%) and a 'poor fit' between the ESTRO Core Curriculum and the broader political and economic context (35%). Perceived implementation process barriers included insufficient numbers of faculty (44%), poor coordination between the government and training institutions (48%), and a lack of an influential person leading the implementation (44%). Two barriers related to curriculum change were a lack of funding and lack of assessment tools.

CONCLUSIONS

The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. Barriers to curricular implementation are identified at the organizational and systems level and include insufficient teaching faculty, lack of coordination and the need for influential leadership.