Dataset Information

Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model.

ABSTRACT:

Background

Traditional medical education in much of the world has historically relied on passive learning. Although active learning has been in the medical education literature for decades, its incorporation into practice has been inconsistent. We describe and analyze the implementation of a multidisciplinary continuing medical education curriculum in a rural Nepali district hospital, for which a core objective was an organizational shift towards active learning.

Methods

The intervention occurred in a district hospital in remote Nepal, staffed primarily by mid-level providers. Before the intervention, education sessions included traditional didactics. We conducted a mixed-methods needs assessment to determine the content and educational strategies for a revised curriculum. Our goal was to develop an effective, relevant, and acceptable curriculum, which could facilitate active learning. As part of the intervention, physicians acted as both learners and teachers by creating and delivering lectures. Presenters used lecture templates to prioritize clarity, relevance, and audience engagement, including discussion questions and clinical cases. Two 6-month curricular cycles were completed during the study period. Daily lecture evaluations assessed ease of understanding, relevance, clinical practice change, and participation. Periodic lecture audits recorded learner talk-time, the proportion of lecture time during which learners were talking, as a surrogate for active learning. Feedback from evaluation and audit results was provided to presenters, and pre- and post-curriculum knowledge assessment exams were conducted.

Results

Lecture audits showed a significant increase in learner talk-time, from 14% at baseline to 30% between months 3-6, maintained at 31% through months 6-12. Lecture evaluations demonstrated satisfaction with the curriculum. Pre- and post-curriculum knowledge assessment scores improved from 50 to 64% (difference 13.3%?±?4.5%, p?=?0.006). As an outcome for the measure of organizational change, the curriculum was replicated at an additional clinical site.

Conclusion

We demonstrate that active learning can be facilitated by implementing a new educational strategy. Lecture audits proved useful for internal program improvement. The components of the intervention which are transferable to other rural settings include the use of learners as teachers, lecture templates, and provision of immediate feedback. This curricular model could be adapted to similar settings in Nepal, and globally.

SUBMITTER: Mehanni S

PROVIDER: S-EPMC6383231 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model.

Mehanni Stephen S Wong Lena L Acharya Bibhav B Agrawal Pawan P Aryal Anu A Basnet Madhur M Citrin David D Dangal Binod B Deukmedjian Grace G Dhungana Santosh Kumar SK Gauchan Bikash B Gupta Tula Krishna TK Halliday Scott S Kalaunee S P SP Kshatriya Uday U Kumar Anirudh A Maru Duncan D Maru Sheela S Nguyen Viet V Paudel Jhalak Sharma JS Rimal Pragya P Saleh Marwa M Schwarz Ryan R Swar Sikhar Bahadur SB Thapa Aradhana A Tiwari Aparna A White Rebecca R Wu Wan-Ju WJ Schwarz Dan D

BMC medical education 20190220 1

<h4>Background</h4>Traditional medical education in much of the world has historically relied on passive learning. Although active learning has been in the medical education literature for decades, its incorporation into practice has been inconsistent. We describe and analyze the implementation of a multidisciplinary continuing medical education curriculum in a rural Nepali district hospital, for which a core objective was an organizational shift towards active learning.<h4>Methods</h4>The inter ...[more]

PMID: 30786884

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Project description:BackgroundEducation in Japan and other Asian countries advocates the stereotypical passive learning style where students are limited in their breadth of knowledge dismissing anything not imparted by their teachers. With globalized education, professions are becoming very competitive, embracing student-centeredness compelling them to introduce active learning activities. A study funded by Japan's Ministry of Education conducted a needs analysis, proposed a solution, and implemented an active learning approach. Since the latter is still new in the Japanese teaching-learning environment, this current study aimed at assessing the willingness of undergraduate students of dental medicine to participate in active learning activities rather than the typical passive-style teaching-learning educational process.MethodsThree active implementation-learning activities, namely International Group Discussions (IGD), Student-Teacher Experience (STE) and Role Play Activities (RPA) were included in the Dental English course in a classroom setting at a dental school in Japan. Students had to choose between participating in the activity or taking the final examination. Two hundred and three third-year undergraduate dental students participated over a 5-year period from October 2013 to March 2017. For IGD, the researchers assigned students to a topic and grouped them with visiting international exchange students. For STE, researchers gave students teacher-prepared presentation slides on basic dental topics, which they presented in front of their classmates. For RPA, students had to do prepared role-play and impromptu role play. Peer and teacher feedbacks of the activities were given to all students. At the end of the course, the students evaluated the active learning activities and wrote their comments in a free entry survey.ResultsAll 203 students participated in the active learning activities confirming the changing learning needs of Japanese students in this dental school. The most common comment was that the class was interesting, fun, an easy-to-understand way to learn dental terms, and a safe way to express themselves in the English language.ConclusionThe majority of Japanese students preferred the active learning style. The study revealed that students reported greater engagement and better learning with proper guidance and time to prepare for the activities.

Project description:BackgroundThe increasing number of vulnerable populations served by the emergency department (ED) calls for developing and implementing curricula aimed at training residents to deliver quality care for the most marginalized groups.ObjectiveWe aimed to address this by developing and piloting a curriculum to introduce the unique challenges and disparities encountered by our diverse ED patient population using an experiential learning approach.MethodsWe engaged community partners in designing and implementing a curriculum for incoming interns. This curriculum addresses specific populations encountered within the ED including patients with psychiatric illness, patients with cognitive disabilities, intoxicated patients, violent patients, patients of various cultural backgrounds, non-English-speaking patients, and LGBTQ patients. Experiential and active learning sessions with content experts and site visits to area organizations were arranged. Pre-, post-, and time-delayed surveys were deployed to evaluate the pilot of this curriculum.ResultsThirteen incoming interns participated in the orientation curriculum. Residents' comfort with each of these various patient populations as well as familiarity with community and ED resources was assessed before, after, and 1 year delayed from each session (response 13/13, 100%). Their scores increased significantly from baseline in the postsurvey and were maintained 1 year later (p < 0.05). Residents additionally provided narrative responses regarding what they learned and what was most helpful after completing their intern year.ConclusionsThis pilot curriculum demonstrates that implementing an experiential learning curriculum and engaging community leaders and resources is key to training residents to address health disparities within their unique ED patient population. As such, it is imperative that we seek to immersively introduce trainees to the unique needs of the patient population they will serve early in training.

Dataset Information

Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model.

Background

Methods

Results

Conclusion

Publications

Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model.

Similar Datasets

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