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Radical reform of the undergraduate medical education program in a developing country: the Egyptian experience.

ABSTRACT: Medical educators are in a continuous quest to close the gap between the needs of medical practice and the rising expectations of the communities in their countries. During the past two decades, competency-based medical education has been evolving as an appealing strategy to close this gap. In 2017, the Egyptian medical education authorities mandated all medical schools to change their curricula to comply with revised national academic reference standards, which changed from outcome-based to competency-based. In parallel, they also changed the timeline of all medical programs for six years of studentship and one-year internship to five years and two years, respectively. This substantial reform involved the assessment of the existing situation, an awareness campaign for the proposed changes and an extensive national faculty development program. Monitoring the implementation of this substantial reform was performed through surveys, field visits and meetings with students, teaching staff and program directors. In addition to the expected challenges, the COVID-19-associated restrictions presented a significant further challenge during the implementation of this reform. This article presents the rationale for and steps of this reform, the challenges faced and how they were addressed.

SUBMITTER: Badrawi N

PROVIDER: S-EPMC9983512 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Radical reform of the undergraduate medical education program in a developing country: the Egyptian experience.

Badrawi Nadia N Hosny Somaya S Ragab Lamis L Ghaly Mona M Eldeek Bassem B Tawdi Ahmed F AF Makhlouf Ahmed M AM Said Zeinab N A ZNA Mohsen Lamiaa L Waly Amira H AH El-Wazir Yasser Y

BMC medical education 20230303 1

Medical educators are in a continuous quest to close the gap between the needs of medical practice and the rising expectations of the communities in their countries. During the past two decades, competency-based medical education has been evolving as an appealing strategy to close this gap. In 2017, the Egyptian medical education authorities mandated all medical schools to change their curricula to comply with revised national academic reference standards, which changed from outcome-based to com ...[more]

PMID: 36869307

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Project description:BackgroundIntra-regional cultural and linguistic differences are common in low- and middle-income countries. To sensitise undergraduate medical students to the social and contextual determinants of health to achieve the 'health for all' goal, these countries must focus on innovative teaching methods. The early introduction of a Community Orientation Program (COP) as a Community-based Medical Education (CBME) method could be a game changing strategy. In this paper the methods, evaluation, and implication of the COP in an Indian setting are described.MethodsThe curriculum of the COP was developed based on the analysis, design, development, implementation, and evaluation (ADDIE) model for educational intervention. In this learner-centric and supervised educational program, the key aim was to focus on developing students' communication skills, observation power and enhancing their motivation for learning through collaborative learning. To meet the objectives of the COP, a situated learning model under the constructivism theory was adopted.ResultsBetween 2016 and 2019, 557 students were trained through the COP by visiting more than 1300 households in ten villages. To supplement the students' observations in the community, more than 150 small group discussions, a health education programme for the community and summary presentations were conducted. The students' feedback indicated the need to improve the clinical examinations demonstration quality and increase the number of instruments for clinical examinations. More than 80% of students felt that the program would assist them to improve their communication skills, their understanding of the various socio-demographic factors associated with the common diseases, and it will enable them to respect the local culture during their clinical practice.ConclusionsEarly initiation of the COP as a CBME method in the undergraduate medical curriculum in an Indian setting has shown promising results. Further evidence is required to adopt such a program routinely for under-graduate medical teaching in the low- and middle- income settings.

Project description:PurposeThe disruption of undergraduate medical education (UME) by the COVID-19 pandemic has sparked rapid, real-time adjustments by medical educators and students. While much is known about online teaching in general, little guidance is available to medical educators on how to adapt courses not originally designed for the online environment. To guide our faculty in this transition we conducted a needs assessment of students enrolled in virtual courses across all 4 years of UME training.MethodsUsing a mixed-methods approach, we conducted a single-institution virtual learning needs assessment in May and June of 2020. We developed and disseminated a survey to assess student experiences with virtual learning. We conducted quantitative and qualitative analysis of responses (n = 255 or 39%) to identify emergent themes.ResultsWe identified six interdependent themes that need to be met for medical students to fully reach their learning potential: access to stable internet and quiet study spaces, flexible course design with asynchronous, self-paced components, clear expectations for engagement with content and each other, a sense of connectedness with faculty and peers, synchronous classes that maximize interactivity, and assessments that foster a sense of learning over performance. Interpersonal relationships with faculty and peers affected students' sense of learning more than any other factor.ConclusionsBased on our findings we propose a hierarchy of needs for virtual learning that provides guidance on adapting existing medical school courses to the remote setting and overcoming common challenges. We highlight opportunities for how virtual elements may enrich in-person courses going forward, including in the clinical setting. Although the solutions required to meet the threshold of need at each level may differ based on the context, attending to these same fundamental needs can be extrapolated and applied to learners across a range of environments beyond the virtual.

Project description:BackgroundSierra Leone, a low-income and post-conflict country, has an extreme shortage of qualified medical doctors. Given the complex challenges facing medical education in this country and the need for context-specific knowledge, the aim of this paper is to explore the undergraduate medical education experience in Sierra Leone through qualitative interviews with recent graduates.MethodsIn-depth interviews were conducted with purposively sampled junior doctors (n = 15) who had graduated from the only medical school in Sierra Leone. Additionally, semi-structured interviews were held with senior teaching staff at the School (n = 7). Interviews were conducted in October 2013. Results were thematically analysed.ResultsThe analytical framework consisted of four themes. Medical school experiences (Theme 1) were described as 'stressful and tedious' but also 'interesting and enjoyable'. Various constraints were experienced linked to the Medical school capacity (Theme 2), including human (limited number of teachers, teaching skills), organisational (departmental differences, curriculum related challenges), physical (lacking teaching facilities on campus, transportation problems) and financial capacity (inadequate remunerations for teachers, most students receive scholarships). Medical school culture (Theme 3) was by some participants perceived as fearful and unfair. Findings suggest various coping strategies (Theme 4) were used at school ('creatively' hire extra teaching staff, teaching schedule upon availability of staff), staff (juggle multiple roles, teach flexibly), and student levels (comply with 'hidden' rules, negotiate teaching support from less qualified health personnel).ConclusionsThis study has provided an insight into the student perspective on medical education in Sierra Leone. Numerous capacity related concerns were identified; which are unsurprising for an educational institution in a low-income and conflict affected country. While the School, staff and students have found creative ways to deal with these constraints, participants' accounts of stress imply more is needed. For example, findings suggest that: students could be better supported in their self-directed learning, more effort is required to ensure basic needs of students are met (like shelter and food), and the power imbalance between staff and students could be addressed. Also better alignment amongst learning objectives and assessment methods will likely diminish student distress and may, consequently, reduce exam failure and possibly drop-out.

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Radical reform of the undergraduate medical education program in a developing country: the Egyptian experience.

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Radical reform of the undergraduate medical education program in a developing country: the Egyptian experience.

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