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Emerging Trends in Medical Education. Khalid Bin Abdulrahman, MD Professor of Family Medicine & Medical Education Dean, College of Medicine Al-Imam University, Riyadh. Saudi Arabia. Emerging Trends. Changes. Emerging trends . Previous state. Reasons Status .

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emerging trends in medical education

Emerging Trends inMedical Education

Khalid Bin Abdulrahman, MD

Professor of Family Medicine & Medical Education

Dean, College of Medicine

Al-Imam University, Riyadh. Saudi Arabia

emerging trends
Emerging Trends

Changes

Emerging trends

Previous state

Reasons

Status

emerging trends in medical education3
Emerging Trends in Medical Education

Changes

Emerging trends in medical curriculum

Traditional medical curriculum

Reasons

Status

How/Problems

new trends in
New Trends in:
  • curriculum development
  • faculty development
  • teaching & learning
  • clinical training
  • student selection
  • student assessment
  • student support
  • leadership & management
the key challenges in health reform
The Key Challenges in Health Reform
  • Relevance:
  • Quality:
  • Cost-effectiveness:
  • Equity:
historical update what brought us to where we are today
Historical update … What brought us to where we are today

"[Medical Schools have] the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve. The priority health concerns are to be identified jointly by governments, health care organizations, health professionals and the public."

World Health Organization, 1995

slide7
Dr. Charles Boelen, Chief Medical Officer for WHO's

Programme on Educational Development of Human Resources for Health in Geneva,

published an article entitled "The Five Star

Doctor" in the June 1993 issue of the WHO Journal of "Changing Medical Education and Medical Practice".

the emerging of the five star doctor
The Emerging of the FIVE-STAR DOCTOR

The five-star doctor is;

  • Care provider
  • Decision-maker
  • Communicator
  • Community leader
  • Manager
emerging trends in uk
Emerging Trends in UK

Strong partnerships between universities and NHS

Education Institutes rather than departments

Authentic Clinical Skills Labs

Vertical Integration of Basic Sciences

Support for all Transitions

European Option

con’t…

emerging trends in uk11
Emerging Trends in UK

Portfolio Assessments

Links with Public and International Health

High % of community-based teaching

Few full-time staff, multiple individual contracts for teaching

new curriculum models
New curriculum models
  • Defined by organization of content
    • integrated, organ-based curriculum
    • integrated, clinical presentation/task-based curriculum
    • age-based developmental curriculum
  • Defined by teaching/learning method
    • problem based curriculum
    • case based curriculum
new curriculum models17
New curriculum models
  • Defined by teaching/learning approach
    • core and optional model
  • Defined by learning objectives
    • competency/outcome based curriculum
  • Defined by social responsibility
    • community oriented curriculum
curriculum models
Curriculum models
  • Discipline based curriculum
  • Coordinated thematic curriculum
  • Problem-based curriculum
  • Task-based curriculum
  • Outcome-based curriculum
  • Competency oriented curriculum
  • Objective-based curriculum
slide19

years

years

6

6

Clinical

Sciences

5

5

4

4

Basic

Sciences

3

3

2

2

1

1

Traditional curriculum

Revised curriculum

Clinical

sciences

Basic

sciences

slide21

Year

C o n t e n t

1

Emergency care and regulatory systems

2

Stages of life and diagnostics

3

Chronic disorders

4

Small disciplines

5

Clerkships

6

Participation in research and patient care

New curriculum structure

Practice

Theory

Independent learning

Dependent learning

slide22

The SPICES Model

  • Student-centered vs Teacher-centered
  • Problem-based vs Subject-based
  • Integrated vs Discipline-based
  • Community-based vs Hospital-base
  • Elective vs Standard program
  • Systematic vs Opportunistic

Harden RM, Sowden S. Educational strategies in curriculum development: The SPICES model. Med Educ 1984;18:284-297.

slide24

The Spiral Curriculum

Linking the previous three years at a higher academic level

Decision making and

assessment of quality

Tools of research methods

and critical appraisal

Basic sciences and

understanding of health

keys to success
Keys to Success
  • All sessions should be internally coherent and also link to each other.
keys to success26
Keys to Success
  • All sessions should be internally coherent and also link to each other.
diagram of linkage across the courses in preclerkship years 1 and 2
Diagram of linkage across the courses in PreClerkship (years 1 and 2)

Course in year 1

Course in year 2

Minor gaps and fills will remain

diagram of linkage across the courses in clerkship years 3 and 4
Diagram of linkage across the courses in Clerkship (years 3 and 4)

Course in year 3

Course in year 4

Minor gaps and fills will remain

diagram of linkage across the courses in clerkship years 3 and 429
Diagram of linkage across the courses in Clerkship (years 3 and 4)

Course in year 1

Course in year 2

Course in year 3

Course in year 4

sir william osler 1919
Sir William Osler 1919

“The art of medicine is to be

learned only by experience, ‘it is not an inheritance; it cannot be revealed. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you become an expert”

a simple model of competence
A simple model of competence

Does

Behavior

Shows how

Professional authenticity

Knows how

Cognition

Knows what

six core competences
Six core competences
  • Medical Knowledge
  • Patient Care
  • Interpersonal & Communication Skills
  • Professionalism
  • Practice-based Learning
  • Systems-based Practice
types of faculty development areas for further work
Types of Faculty DevelopmentAreas for Further Work
  • Instructional development
  • Professional development
  • Leadership development
  • Organizational development

Irby, 1995,

slide35

Roles of Faculty

Facilitator

Assessor

Role model

Planner

Information provider

Resource developer

new trends in student selection
New Trends in Student selection
  • High validity & reliability test
  • Student maturity
  • The target students
new trends in student support
New Trends in Student Support
  • The learning styles.
  • Facilitate learning
  • Life-long learning & SDL
  • Counseling services
  • Study skills courses
  • Need-based learning
julian tudor hart
Julian Tudor Hart
  • “My medical education began three times. What I learnt at medical school was no use in the hospital. What I learnt in the hospital was no use in general practice.”
  • Julian Tudor Hart (paraphrased)
slide41
Multiple longitudinal components
      • Knowledge
      • Clinical skills
      • Professional behavior
      • Portfolio assessment
  • Tailored block evaluations (cocktail of methods)
  • Overall more qualitative and descriptive evaluations, longitudinally monitored, using a portfolio and mentoring system with an emphasis on reflection and meta-cognitive skills
conceptual of teaching
Teacher-centered

Content oriented

Teacher: sage on the stage

Focus: transmit knowledge

Learner: passive, receive, learn information

Example: lecture

Learner-centered

Learner oriented

Teacher: Guide on the side

Focus: Guide understanding

Learner: active, construct, learn to think

Example: case based

Conceptual of teaching
why use patient simulation
Why Use Patient Simulation?

Pyramid of Learning and Retention

simulation modalities
Simulation Modalities

Low-tech

» Simple 3-D organ models

» Basic mannequin / Skill trainers models

» Animal models / Human cadavers

» Simulated / standardized patients (SPs)

High-tech

» Screen-based simulators (software / web)

» Realistic procedural simulators

» Realistic interactive patient simulators

» Virtual reality / Surgical simulators

slide54

Debriefings with video allows discussion of alternatives and pros & cons of CRM behaviors & technical choices

trends in medical education
Trends in medical education
  • student-activating instructional methods (PBL; case-based; task-based learning)
  • integration of basic sciences and clinical disciplines in teaching and assessment
  • emphasis on clinical and communication skills
  • broadening of clinical training settings (community-based teaching; skills laboratories)
  • increasing validity and reliability of assessment systems (standardized patients; OSCEs)
future of medical education
Future of Medical Education
  • adaptive curricular planning (tailored to the individual student)
  • virtual university approach
  • multi-professional concept of training
  • integration of basic and postgraduate medical education (early specialization)