Innovations in Global Health Professions Education

Doctors as mediators between two worlds: Biomedicine and socioeconomic realities in Arab societies (A reading through literary texts)

2019-04-10T02:04:00-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Confidentiality, partner notification and ethical issues: A qualitative research on people living with HIV in Istanbul

2019-04-10T02:04:04-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

The great medical questions—and beyond: A medical-humanities curriculum

2019-04-10T02:04:04-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

A reflective space: Supporting local and expatriate patients, developing culturally sensitive mental health practices

2019-04-10T02:04:03-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Preparing medical students for the writing of history of present illness: Marching from short story reading and the practice of visual art

2019-04-10T02:04:03-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

"Sparkling Moments": Graphic medicine as a reflective tool for self-efficacy and motivation

2019-04-10T02:04:02-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Brontë's work relating to Sufism

2019-04-10T02:04:02-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

A view from the cuckoo's nest: The value of teaching sociology in medical schools

2019-04-10T02:04:02-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Factors associated with spirit possession: A cross cultural systematic literature review

2019-04-10T02:04:01-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Ethics of occupational medicine in Qatargas

2019-04-10T02:04:01-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Anatomy of Melancholy: An Arabic take on an English classic

2019-04-10T02:04:00-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Art therapy for grief and self-care in medical settings

2019-04-10T02:03:59-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

The Zar (Bori) Cult: A proposed integrated psychotherapy module

2019-04-10T02:03:59-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

The importance of communication that keeps at its core emotional states: Evidence from the Middle East

2019-04-10T02:03:59-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Doctors with borders: The White Helmets and radical political medicine

2019-04-10T02:03:58-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Impact of fluorescent color temperature on attention deficit hyperactivity disorder (ADHD) subjects: A FMRI study

2019-04-10T02:03:58-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Islamic bioethical discourse in incidental findings: Research genetic context

2019-04-10T02:03:57-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Narrating Arab women's voice and disability: Notes on the Flesh, a biomythography

2019-04-10T02:03:57-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Storytelling for trauma and the global health humanities

2019-04-10T02:03:56-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Listening to your patient, a key factor for successful consultations in a clinical setting

2019-04-10T02:03:56-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

The pursuit of balance

2019-04-10T02:03:55-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Witnessing cancer: The voices that accompany me

2019-04-10T02:03:55-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Editorial

2019-04-10T02:03:54-07:00

Editorial accompanying the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

The various faces of genomics in Islamic bioethics

2019-04-10T02:03:55-07:00

Abstract from the Proceedings of the 1st International Conference on Medical Humanities in the Middle East; 2018 Nov 17-18: Doha, Qatar.

Psychological effects of war: A role play

2019-07-02T05:10:32-07:00

The practice of psychiatry, perhaps more than any other specialty, is largely affected by culture. The medical student psychiatry curriculum often fails to incorporate this reality. In the Middle East currently, because of the endemic violence and warfare, the topic of the Psychological Effects of War should be an integral part of the psychiatry curriculum. Unfortunately, this topic is often neglected or poorly addressed in most psychiatric textbooks or curricula. A group of three students at WCM-Q in Doha took matter in their own hands to fill this gap. They used role play to illustrate three different conditions that are associated with the psychological effects of war in three different scenarios: anxiety, depression and PTSD. They made a video of the scenes with other fellow students participating in the discussion. This innovative approach is a good example of peer-to-peer education to cover an important topic that is frequently missing in standard curricula.

Self-monitoring checklists: A tool for connecting training to practice

2019-07-10T05:31:27-07:00

A limitation of training is the gap between the knowledge learned in training and the behavior put into practice. Skills checklists are helpful for reducing errors and increasing adherence to safety and may be one tool useful for bridging that gap. There is little research examining the role of skills checklists with self-reflection completed independently, or “self-monitoring checklists,” for increasing knowledge and improving skills in areas requiring attentional behavior in healthcare. Two randomized controlled studies incorporated self-monitoring checklists along with online training in cultural competence and integrated care, respectively, for health professionals. At least ninety percent of participants in both studies found self-monitoring checklists to be helpful. Healthcare educators and practitioners should consider self-monitoring checklists as an additional tool for online training when developing educational strategies for healthcare professionals.

Clinical international experiences during medical school: medical students’ perspective

2018-11-26T09:03:12-08:00

Migration and cultural interconnection has been one of the major contributors to globalization of disease. This is often a challenge physicians face as they encounter illnesses that they have not seen before while working in dissimilar environments to their training. Given this, international experiences are trending among medical professionals to be cognizant and proficient in dealing with such situations. In this paper, we will briefly reflect on our international exchange experiences as students and how such experiences can contribute to developing stronger global health knowledge and enrich our medical education experience as future physicians. We will also discuss some of the challenges medical students face while pursuing such opportunities, and how such challenges could be overcome.

Cameos of Compassion: Exploring compassionate care using secondary analysis of digital patients’ stories

2018-11-26T09:33:20-08:00

Patient stories have been identified as a powerful tool to improve quality of care. Healthtalk.org is a digital resource (specific health-related website) presenting patients’ experiences of illness and healthcare through trigger films, videos and articles. Data have been generated from narrative interviews conducted by experienced researchers, based at the Health Experiences Research Group (HERG), University of Oxford. Our project explored the potential use of secondary analysis of digital sources as a methodological innovation to develop as a tool for teaching compassion to nursing students. For that, a purposive sample of transcripts from the HERG archive were selected for secondary analysis. Patients expressed both positive and negative experiences of care. Positive themes included: continuity of care and attentiveness to the fundamentals of care. Negative themes were related to poor quality of care; ignoring patient and family needs; and not being available for patients and family when needed. We concluded that secondary analysis of narrative interviews provides a powerful resource for identifying positive and negative patient experiences for learning and teaching. These can be designed into a digital toolkit and used as a learning and teaching resource to develop staff and students’ reflexivity in relation to the values and leadership behaviours associated with compassionate care and positive practice.

The Power of an Iterative Approach to Clinical Competence Assessment

2018-11-26T09:26:55-08:00

Many residency programs struggle with effective and efficient methods for their program to synthesize and analyze data to create robust milestones-based assessment of residents. Residents and faculty in the Pediatric Residency at Dartmouth-Hitchcock Medical Center collaborated to design an innovative iterative process for resident assessment using rotation-based Milestones reports, faculty sub-committees, and discussion with the resident. Time spent and frequency of Milestones determinations made at each phase of assessment process were tabulated and feedback summarized from faculty, residents, and administrators. Our new process integrated milestones determinations into our existing committee review structure without any additional time added to the process. Faculty perceived that the system was efficient and provided more insight about each resident. The program director used the sub-committee summaries for semi-annual reviews and letters of reference. Residents appreciated the fairness of all residents being reviewed by the same faculty. Milestones determinations were made by: evaluations alone (69%), CCC sub-committee (18%), full CCC (7%), and additional data or PD decision (6%). The full CCC was needed more frequently for professionalism and systems-based practice Milestones determinations. Iterative assessment systems have the potential to save valuable faculty time without compromising the quality of assessments.

Cardiac rehabilitation programs: An investigation into the reasons for non-attendance in Qatar

2018-11-26T00:16:44-08:00

Despite the many benefits of cardiac rehabilitation programs, participation of eligible patients in these programs can be low. Understanding the factors that prevent cardiac patients from attending these programs can provide healthcare professionals with insights on how to reduce the barriers and increase participation. The purpose of this quantitative descriptive study was to investigate the reasons why patients residing in Qatar do not attend cardiac rehabilitation (Phase 11). The target population were 850 patients who were referred to cardiac rehabilitation during an eight-month period in 2015, but who did not attend Phase 11 of the program. Individuals were invited to complete a phone survey which included socio-demographic questions and a pre-existing instrument called the Cardiac Rehabilitation Barriers Scale. Forty-six participants completed the phone survey in 2016. The most frequently reported barriers were: work responsibilities (56.5%), time constraints (50%), already exercising at home/community (39.1%), distance to program (39.1%), travel out of country (32.6%), and not needing cardiac rehabilitation (32.6%). Results of this study can be used to inform the development of new policies that will reduce the barriers and promote attendance. Future qualitative research can be done to gain deeper insights into the reasons for non-attendance.

Embracing Wikipedia as a teaching and learning tool benefits health professional schools and the populations they serve

2018-11-26T00:14:29-08:00

To paraphrase Jimmy Wales, Wikipedia co-founder, “Imagine a world where all people have access to high quality health information clearly written in their own language.” I believe that most health professional students endorse that goal, as do individuals who volunteer to contribute to Wikipedia’s health-related content. Bringing these two communities together inspired my team’s efforts: a course for medical students to earn academic credit for improving Wikipedia. Here I describe the evolution of that course between 2013 – 2017, and highlight ongoing partnerships with Wikiproject Medicine, Translators Without Borders, and Wikipedia Zero. These collaborations align with health professional schools’ local service missions. If more faculty and schools embrace Wikipedia as a teaching and learning tool for tomorrow’s health professionals, those local service missions suddenly expand into a truly global network—accelerating fulfillment of Wikipedia’s audacious goal. In this manuscript, I reflect on my experiences embracing Wikipedia as a medical educator, and speculate about potential implications for the future of health professional education globally.

Neuropsychiatric symptoms in dementia

2018-11-26T00:10:01-08:00

Neuropsychiatric symptoms (NPS) are very common in people with dementia-related disorders, and are responsible for a large share of the suffering of patients and caregivers. Current evidence suggests that non-pharmacological treatments are promising solutions to NPS. However, a critical factor in the treatment success is represented by the involvement of professional and family caregivers. Here we briefly present “No panic in the nursing home”, an educational “serious game” designed for healthcare professionals working in nursing homes. Based on an educational program previously designed by our group, “No Panic in the Nursing Home” teaches professional caregivers how to deal with NPS of dementia. The player takes the role of a nursing home nurse, and is confronted with practical situations in which he/she needs to decide how to behave. Results collected in three nursing homes suggest that the game is considered as very interesting by nursing home healthcare professionals, even by persons with no previous experience with videogames.

The role of global bioethics in medical pedagogy

2018-11-26T00:12:24-08:00

The study of global biomedical ethics warrants the attention, scholarship, and commitment afforded to the study of general medical ethics. While it is difficult to precisely define the field, it basically comprises the ethical provision of healthcare and investigation across borders, which takes into account disparate societal and individual normative values. Medical ethics is primarily patient-centric; global biomedical ethics is focused on patients insofar as they comprise communities. Global biomedical ethics eschews imperialist approaches. Instead, the field seeks to promote approaches that comport with relevant principled approaches.

Ultimately, the field of global biomedical ethics orients the integrity of the medical profession within society. Global biomedical ethics is important for all clinicians and investigators, and should not be relegated to those who address disease that affects people in a region where the physician does not reside. The field contextualizes the practice of medicine and research within the world community. Global biomedical ethics inexorably enhances the doctor’s own propioperception of his profession and his place within the world.

First Middle Eastern Conference on Interprofessional Education Doha, Qatar, December 4 to 6, 2015

2018-11-26T00:06:58-08:00

A collection of keynotes, oral presentations, and workshops from the 2015 Middle Eastern Conference on Interprofessional Education, in Doha, Qatar.

First Middle Eastern Conference on Interprofessional Education Doha, Qatar, December 4 to 6, 2015

2018-11-26T00:01:26-08:00

A collection of poster abstracts from the 2015 Middle Eastern Conference on Interprofessional Education, in Doha, Qatar.

Technology Innovations in Global Medical Education

2017-11-29T06:08:33-08:00

The loss of 400,00 lives annually due to preventable, adverse outcomes is believed to be the third leading cause of death in the United States, after heart disease and cancer^{1, 2}.

The leadership of the University of South Florida, Center for Advanced Medical Learning and Simulation (CAMLS) has heard this concern and developed a national model for improving medical education and patient safety, as well as aggressive and needed healthcare solutions through the use of cutting edge technology, innovation, and simulation.

CAMLS’ goal is to use technology, simulated environments, and team training to transition medical education from an apprenticeship model to an evidence-based competency model that improves patient outcomes and reduces medical errors.

The processes used at CAMLS are reflective of the instructional design process and team training approach used successfully in aviation and the military.

Learning through Osmosis: A Collaborative Platform for Medical Education

2017-11-29T06:06:54-08:00

Formative assessment has been shown to improve medical student performance and retention, but many learners lack access to formative assessments because faculty members have limited time to create such resources, and acquiring existing commercial review banks is expensive. In response, we developed a collaborative learning platform for medical student self-assessment called Osmosis (http://osmosis.org/). Osmosis is a web- and mobile-learning platform that provides free access to thousands of crowd-sourced, high-yield practice questions and explanations. The quality of these questions and resources is enhanced through a unique social rating and commenting feature.

During the first year Osmosis was launched at the Johns Hopkins School of Medicine in January 2012, approximately 250 students in the first and second year classes spent over 2,400 hours answering more than 5,000 questions close to half-a-million times (~2,000 questions answered/student). In addition, over 1,000 Creative Commons-licensed images and YouTube videos have been shared. Usage data and reception by students indicate that the platform fits well into busy schedules and that participants value its role in promoting collaboration and self-assessing knowledge gaps.

We are currently developing additional features for the Osmosis platform related to knowledge retention and curricular design. Since the vast majority of questions and resources on Osmosis are shared under non-restrictive licenses, such as Creative Commons, we are making Osmosis available to peer institutions. It is our hope that more students and faculty members will benefit from, and contribute to, the Osmosis library.

Engaging a Global Community of Learners and Practitioners in the Care of the Critically Ill Child

2017-11-29T06:05:53-08:00

The traditional methods of education, while once revolutionary, are failing to keep pace in the 21^st Century. OPENPediatrics^TMhas created an interactive, virtual training and knowledge exchange platform to enhance the quality of pediatric critical care. It revolutionizes the existing post-graduate medical education model. Designed by experienced physicians at Boston Children's Hospital, in collaboration with IBM Interactive, it offers asynchronous interactive learning and various avenues for knowledge sharing outside the walls of individual institutions. It is creating a digital, global community, based on adult learning principles, provided at no cost to the user.

Perspective: Transforming Medical Education through Informatics

2017-11-29T06:04:58-08:00

In the United States and around the world there have been massive changes in the way that health care is evolving – the way that we deliver care, the models of care, the concept of the interprofessional team, the system of care as a network that extends increasingly outside of the hospital much more than in, population and global care, and evidence-based medicine. We are challenged to keep up with our education system’s "adaptivity" in this dynamic environment.

At the same time the disruptive effects of technology advances are dramatically accelerating and will challenge the way that healthcare providers, schools teaching young doctors, and patients themselves will experience and understand clinical data. There are emerging technologies that will be implemented around the world, almost instantly; whereas, these analogs in the past took decades to spread globally.

Global Collaboration and Team-Building through 3D Virtual Enviroments

2018-11-19T22:44:10-08:00

Certain aspects of healthcare education are difficult to teach in real world environments or in isolated classroom settings. These include, but are not limited to, collaboration and interdisciplinary teamwork skills that are necessary for improved team performance and patient care outcomes. Virtual simulation is a growing field for training and continuous professional development activities and is conducive to local and international clinical training and collaborative projects. The authors examine theories of collaboration applied to virtual worlds, along with case studies, to demonstrate virtual simulation’s applicability to a variety of teaching environments. In addition, virtual environments have applications to interprofessional healthcare training and team formation. International partnerships for education can benefit from using virtual environments to foster team-building activities without geographic boundaries. Virtual environments have been instrumental in the growth and sustainability of international networks of educators and, when feasible, should be utilized as a tool for the development of international partnerships.

Editorial

2017-11-29T06:02:54-08:00

As medical and health education becomes increasingly globalized, we have unique and exciting opportunities to benefit from judicious use of technology-based pedagogy and to carefully evaluate its transformative potential for changing healthcare for many generations to come. The world's population is becoming less restricted by individual country borders, and healthcare professionals have more freedom to choose appropriate opportunities for practice in their fields; consequently, training has a global mandate to be easily accessed and be of consistently high standards across the globe, with technology the great equalizer.

Innovations in Global Medical and Health Education Forum

2018-11-25T23:43:42-08:00

A collection of poster and oral abstracts from the January 18, 2015 Conference.

Implementation of Pediatrics Residency Accredited Program in Singapore

2018-11-25T23:26:30-08:00

In 2009, Singapore began replacing the British-based specialist training that constituted its postgraduate medical education with a United States-based Residency program, which is more structured. Singapore is the first country outside the United States to be accredited by the Accreditation Council for Graduate Medical Education — International (ACGME-I). This paper reviews the recent changes in the context of the Pediatrics program at the KK Women’s and Children’s Hospital, one of the five specialties chosen to launch the new residency programs. Most of the changes were made for accreditation purposes, so as to align with the requirements set by ACGME-I; however, local content and Ministry of Health (MOH) stipulations were also taken into account when designing the new pedagogical and training curriculum. Areas discussed include faculty numbers and development, concurrent training of trainees from the previous system, selection of residents, resident training, resident duty hours, mentors, curriculum, rotations, continuity clinics, scholarly activity, postgraduate exams, remediation, and chief residents.

Implementing Residency Programs and its Challenges

2018-11-25T23:29:00-08:00

The exponential growth of Singapore’s population from the influx of migrants over recent years, coupled with an aging population, has resulted in a need to increase the number of doctors and, in addition, raise their expertise. The British-based system of specialist training was inherited by Singapore and it consisted of two time-based phases: Basic Specialist Training and Advanced Specialist Training. However, in June 2010, the United States-based Residency system was adapted because it was curriculum-based with a more structured framework. This change in systems has resulted in a number of problems such as: (a) additional faculty to train; (b) adequate manpower backfill; (c) adequate resources for residents, including new infrastructure to facilitate learning, and (d) the usual anxiety associated with such a major change, especially from those who did not see the need to change the current system.

Since manpower backfill was a key issue, overseas specialist staff and non-specialist doctors were recruited to facilitate protected training time for residents. In addition, there was a redesign of service work for healthcare personnel. Although these solutions have helped to alleviate many of the problems, the challenge facing the program now is its sustainability since it has proven to be resource intensive.

Open Osmosis: Library of Open Educational Resources (OER) for Medical Education

2018-11-25T23:22:52-08:00

Many resources currently available for graduate and undergraduate medical education are fragmented, difficult to access, and costly. Osmosis, a web- and mobile-based platform, was developed to create a shared and easily accessible repository of curated clinical educational resources. We have recently launched “Open Osmosis” - a public-facing portal that has become one of the largest databases of Creative Commons-licensed questions, among other open educational resources (OER), for medical education. Initially created for use at the Johns Hopkins School of Medicine, Osmosis spread to recruit and involve medical students, physicians, and clinical content advisors from dozens of countries and hundreds of institutions. These individuals have served various roles, including as question-writers (“Medical Contributors”), content organizers (“Medical Scholars”), and expert reviewers (“Clinical Advisors”). Here we describe our experience developing Open Osmosis as a case study for crowdsourcing medical education content, and to comment on potential future development of this platform.

Using the CTC tool in establishing Mid-Levels of Expanded Outcomes Framework - A CME Provider Perspective

2018-11-25T23:39:58-08:00

Existing gaps in the quality of healthcare have led to calls for change by Continuing Medical Education (CME) providers around the world to plan and implement continuing medical education activities based on improving physician competence and performance. This article offers the use of the commitment to practice change (CTC) tool at mid-levels of the expanded outcomes framework using post-only design, for inquiring and promoting physicians’ commitment to practice change, and for assessing the impact of the educational activity.

Mentorship in Pediatric Arab Board Postgraduate Residency Training Program: Qatar Experience

2018-11-25T23:34:53-08:00

Background

Mentorship can be defined as developmental assistance offered to a junior employee or trainee by someone more senior and experienced in the field or work place. Mentorship in our pediatric residency training program has existed for years. However, no study has been done to evaluate perspectives, attitudes, and practice of mentorship in this accredited residency program.

Objectives

To assess faculty and residents views and satisfaction about the mentorship process overall. Accordingly, to try to discern some recommendations in order to improve the practice and fill in the gaps.

Methodology

The study was conducted using mailed, two mirror-side sets of questionnaires to both residents and faculty staff members involved in the mentoring program in pediatric residency training. Results were then recorded and analyzed manually.

Results

There is a large discrepancy in the views of residents and faculty staff in regard to their perception and practice of mentorship.

Conclusions

Teaching and direct meeting sessions are obviously needed to train both faculty and residents about the appropriate mentorship culture and implementation.

Commentary: Open Access Publishing in Healthcare

2018-11-25T23:19:12-08:00

We at Innovations in Global Health Professions Education decided that our periodical would be ‘platinum’ open access (OA)—free to access and free to publish. Does this mean we are just jumping on the bandwagon in “the unstoppable rise of open access”?

Editorial: A Global Platform for Innovations in Health Professions Education

2018-11-25T23:52:24-08:00

Strengthening health systems and building capacity through effective workforce

development and health professional education are the cornerstones for

improving global health. Since the Lancet Commission’s 2010 landmark report1,

“Health professionals for a new century: transforming education to strengthen

health systems in an interdependent world,” there has been a groundswell of

excitement and activities among health professions educators to carry the

momentum forward. Notable major recommendations in the Commission’s report

validated the needs for a global outlook, alignment with healthcare delivery, an

inclusive multi-professional/trans-professional orientation, a systems-based

approach, and new instructional and institutional strategies. A broad receptivity

worldwide for such a paradigm-changing approach to health professions

education has been facilitated by general dissatisfaction with current healthcare

and education globally. There remains a chasm between skill sets needed for

providing high quality healthcare and the current fragmented and outdated

curricula of health professional education.

Three Global Adaptations of the American Medical Education Model

2017-11-29T05:45:51-08:00

Following the movement toward globalization demonstrated by patients, providers, and healthcare institutions, the era of borderless medical education programs has finally arrived. Some well-known United States medical schools recently have established medical education programs overseas, while several others are currently being planned. This article describes three adaptations of the standard American Medical Education model outside the United States that are currently graduating Medical Doctors meeting highest international standards. The reports from these institutions demonstrate clearly that the Standard American Model of medical education has been successfully adapted into diverse cultures. While their individual methodology might differ, they share and demonstrate common objectives of producing high quality graduates comparable to United States medical graduates based on standardized assessments.

Engaging with others to improve Global Medical Care through International Board Certification

2017-11-19T11:56:09-08:00

This commentary, based on comments made by Lois Margaret Nora, MD, during the Globalization of Medical Education panel at the 2012 Annual Meeting of the Association of American Medical Colleges, provides information about the American Board of Medical Specialties (ABMS), ABMS, International (ABMS-I), and the ABMS Board Certification process. The ABMS was founded near the beginning of the Twentieth century and has a long history of protecting the public through rigorous standards of physician certification. This article highlights the reasons that ABMS and ABMS-I are engaging with the international community to explore international board certification and provides one current example of such a collaboration.

Graduate Medical Education across National Boundaries

2017-11-19T11:55:42-08:00

The Accreditation Council for Graduate Medical Education (ACGME) is a professional organization that accredits over 9,300 graduate medical education (residency and fellowship) programs in the United States. It receives no funds from any other corporate entity; it is funded solely through its accreditation services. After receipt of numerous requests to accredit programs outside the United States, ACGME created the Accreditation Council for Graduate Medical Education - International (ACGME-I) to work with educational programs and institutions in other countries. ACGME-I accreditation incorporates many of the structural elements of ACGME accreditation, while being mindful of local customs, societal issues, and history in which the international program resides. It does not intend to place a United States model in other countries, but rather to adapt what we have learned to the local educational environment. The ACGME believes that its work, along with that of others, can help improve world health through physician education.

International Assessment of Medical Students: Should it matter anymore where the school is located?

2017-11-19T11:55:14-08:00

With assessment systems that are adequate, robust, comprehensive, as well as responsive to local and regional needs, should the location of the medical education institution be irrelevant? Adequate assessment is determined by local needs, along with accepted minimum global standards of practice. If an assessment system is robust, it should be able to predict future behavior and performance to some degree. A comprehensive system would include assessment of all relevant competencies. In order to achieve comprehensiveness, new approaches are needed to demonstrate mastery of competencies that is now inferred from medical school and graduate medical education participation. These are likely to require a novel approach to assessment – gathering natural, real world data longitudinally rather than only through point-in-time tests. Increasingly the world of assessment may be able to provide tools and data that offer individualized assurances of competence.

The Globalization of Medical Education

2017-11-19T11:54:51-08:00

Healthcare providers are moving more freely across borders than at any time in our history, and healthcare and academic institutions are establishing clinical facilities around the world. A new kind of migration is emerging, due to rising cost and other factors, in which students from developed countries are seeking education and training opportunities abroad. Medical education is undergoing rapid globalization, with several well-known United States institutions establishing programs and facilities around the world. A generation of 20 to 30 year-olds in the United States, referred to as the “First Globals,” see themselves as citizens of the world and seek to train anywhere and live anywhere. Consequently, there are methods under development to benchmark physician competence at a much more granular level, regardless of where the student is trained and practices.

Globalization of Medical Education: Educational Commission for Foreign Medical Graduates (ECFMG) Concerns and Initiatives

2017-11-19T11:54:21-08:00

The Educational Commission for Foreign Medical Graduates (ECFMG) certifies international medical graduates (IMGs) for entry into United States graduate medical education. It also promotes medical education through programmatic and research activities. Physician migration is changing and the ECFMG responds to the needs of IMGs coming to the United States to study and to those searching for training opportunities in other countries. It seeks to provide information about national and international medical schools' accreditation status and other similar data. For ECFMG purposes, accreditation of an international medical school by an agency recognized by the Federation for Medical Education (WFME) will meet its new requirement for certification, effective in 2023.

Editorial: Welcome to IGMHE

2017-11-19T11:53:57-08:00

Welcome to the inaugural issue of Innovations in Global Medical and Health Education. This first issue, with Robert Crone, M.D. as Guest Editor, consists of articles based on presentations at a symposium, “Globalization of Medical Education”, organized at the November 12, 2012 annual meeting of the American Association of Medical Colleges (AAMC) in San Francisco. We are indebted to the AAMC and its Global Health Learning Opportunities (GHLO™) program for its vision in hosting this event.

With the arrival of the era of global medical and health education, we anticipate competing arguments from two major schools of thought: those who are in favor of exactly replicating admission policies, curricular standards, and promotion and graduation processes from well-established, parent institutions in the West; and those who argue for maintaining the central objective of producing the highest quality graduates while flexibly using innovations that cater to local needs. We find ourselves leaning toward those espousing the latter point of view. Further, we hope that innovations introduced globally and tested successfully, will increasingly become a part of the mainstream medical and health education in the West. While not bold enough to predict this as yet, we venture to guess that such reciprocal exchange would lead to reduced costs of medical education and even improvement in certain areas at well-established schools.

Our philosophy is firmly rooted in our own personal experience in establishing (VD) or running (JIS) medical schools overseas that are producing world-class graduates while introducing innovations that have contributed greatly to their success. However, we are mindful that this process has just begun. Internationally accredited, culturally adapted, postgraduate medical training programs have recently been initiated in Singapore and Qatar. In time, these will lead to certification by internationally recognized bodies, to be followed by appropriate infrastructure preparing practicing physicians for maintenance of certification (MOC). Similar processes would apply broadly to health education outside the narrow domain of medical education. Finally, achieving these objectives will require paradigm shifts, innovations, the use of online and interactive pedagogical methods, globally accepted assessment methodologies and standards, and a much greater emphasis on inter-professional learning and collaborations.

In the first article, Drs. Crone and Samaan set the stage by identifying major trends in global medical education and pointing out the workforce challenges for the US healthcare system that such trends portend. They stress the need for standardized assessment and benchmarking of physician competence regardless of where the student is trained and practices.

In the second article, Drs. Sheikh, Badr, Kamei, and Arayssi present a case study of three successful adaptations of the standard American model in diverse cultures. Their article makes a strong claim that the graduates of these programs are not only of high quality, but they also will be trail blazers for “One World, One Medicine” in which every person would have access to high quality care and the providers could cross borders freely to practice a consistently high standard of medicine irrespective of location.

The third article by Dr. Cassimatis describes how the globalization of medical education is changing the mission of the Educational Commission for Foreign Medical Graduates (ECFMG) that was originally established to assess and certify the quality of international medical graduates (IMGs) for US-based residency education. Now ECFMG is broadening its scope to include support for those individuals searching for training opportunities in other countries and to develop a new system of accreditation for medical schools that reflects changing needs in the field.

Dr. Melnick, President and CEO of the National Board of Medical Examiners (NBME), describes the innovations needed to adjust the assessment systems to align their robustness with local needs. These changes would entail developing a more comprehensive assessment of mastery of competencies, using naturalistic data longitudinally to simulate real world patterns of skills and competencies.

The article by Dr. Nasca addresses how Accreditation Council for Graduate Medical Education (ACGME), which currently accredits about 9200 residency education programs in the US, is responding to globalization of medical education by creating ACGME-International (ACGME-I).

Finally, Ms. Albee and Dr. Nora provide the context on the founding of the American Board of Medical Specialties (ABMS) and delineate its mission. They then provide a strong rationale for expanding their efforts internationally and elaborate on ABMS-International's (ABMS-I's) recent efforts in Singapore and how such efforts will contribute to advancement of global standards for medical care.

We believe that we are in the beginning phases of a movement that will gain momentum with each passing year. By providing a platform for a healthy debate about the achievements, challenges, and innovations in global medical and health education, this journal intends to be in the vanguard of this paradigmatic shift.