Zubair Amin

Technology-enabled assessment of health professions education: Consensus statement and recommendations from the Ottawa 2010 conference

The uptake of information and communication technologies (ICTs) in health professions education can have far-reaching consequences on assessment. The medical education community still needs to develop a deeper understanding of how technology can underpin and extend assessment practices. This article was developed by the 2010 Ottawa Conference Consensus Group on technology-enabled assessment to guide practitioners and researchers working in this area. This article highlights the changing nature of ICTs in assessment, the importance of aligning technology-enabled assessment with local context and needs, the need for better evidence to support use of technologies in health profession education assessment, and a number of challenges, particularly validity threats, that need to be addressed while incorporating technology in assessment. Our recommendations are intended for all practitioners across health professional education. Recommendations include adhering to principles of good assessment, the need for developing coherent institutional policy, using technologies to broaden the competencies to be assessed, linking patient-outcome data to assessment of practitioner performance, and capitalizing on technologies for the management of the entire life-cycle of assessment.

Case studies in outcome-based education

Outcome-based education is one of the most significant global developments in medical education in recent years. This paper presents four case studies of outcome-based education from medical schools in different parts of the world; Scotland; USA; Pakistan; and Singapore. The outcome-based curricula have either been in place for some time, are evolving or are at the planning proposal stage. The outcomes, change process and implementation of the outcome-based approach are described. Variation in the extent to which each medical school has implemented outcome-based education is discussed and key points for successful implementation are highlighted. This paper is based on the pre-conference symposium “outcome-based curricula: global perspectives” presented by the authors at the 4th Asia Pacific Medical Education Conference (APMEC) in Singapore, 8–11 February, 2007.

Addressing the needs and priorities of medical teachers through a collaborative intensive faculty development programme

Faculty development in medical education is crucial for developing and sustaining quality education in medical schools. However, examples of successful intensive programmes based on experiential and collaborative learning are generally lacking in the literature. The Medical Education Unit of National University of Singapore conducted a three-day intensive programme on core competences in medical education. This paper highlights the process of programme development, programme structure, challenges faced and strategies adopted. It also describes the approach taken to educational programme evaluation along with the results. The programme structure was based on experiential and collaborative learning models. Participants contributed to all activities and emerged as facilitators and learners to gain first-hand experience of the complex educational processes. Each individual session was sequential with a brief plenary, demonstration, practicum and reflection. Pre-programme needs assessment showed that even the experienced teachers perceived a need to further improve their educational competencies.

Attitudes, Practice and Educational Preferences Towards Evidence-Based Medicine among Physicians in a Large Teaching Hospital

Evidence-based medicine (EBM) is an emerging must-know topic for today’s physicians. The present literature is inadequate in identifying the attitudes, practice, and educational needs and preferred interventions of EBM. The objectives of this survey were to identify a) the attitude toward and practice of EBM among physicians, b) perceived benefits of EBM in daily practice, c) barriers to EBM practice, and d) preferred educational interventions. Methods: This was a questionnaire-based cross-sectional survey of physicians in a single large teaching hospital. Results: Overall, 56% of the physician respondents described the attitude towards EBM in their institution as positive. A similar number of physicians also reported the attitude of their colleagues towards EBM as favourable. 67% of the physicians believed EBM was useful in daily management of patients. In contrast, only 45% of the physicians actually practiced EBM in their daily patient management. The factors that discouraged them from actual practice include a lack of time, lack of exposure to EBM during their undergraduate curriculum, lack of endorsement, and fear of criticism by seniors. Physicians preferred less time consuming and less rigorous educational interventions such as clinical practice guidelines, journal club, and case review and discussion for teaching and learning EBM. Interpretation: There are disconnects between belief and actual practice and between preferred and ideal educational interventions of EBM among physicians surveyed. Keywords: Evidence-Based Medicine, Faculty’s Perception, Singapore

Should non-expert clinician examiners be used in objective structured assessment of communication skills among final year medical undergraduates?

Background: Adoption of the objective structured clinical examination may be hindered by shortages of clinicians within a specialty. Clinicians from other specialties should be considered as alternative, non-expert examiners. Aims: We assessed the inter-rater agreement between expert and non-expert clinician examiners in an integrated objective structured clinical examination for final year medical undergraduates. Methods: Pairs of expert and non-expert clinician examiners used a rating checklist to assess students in 8 oral communication stations, representing commonly encountered scenarios from medicine, paediatrics, and surgery. These included breaking bad news, managing an angry relative, taking consent for lumbar puncture; and advising a mother on asthma and febrile fits, and an adult on medication use, lifestyle changes and post-suture care of a wound. 439 students participated in the OSCE (206 in 2005, 233 in 2006). Results: There was good to very good agreement (intraclass coefficient: 0.57–0.79) between expert and non-expert clinician examiners, with 5 out of 8 stations having intraclass coefficients ≥0.70. Variation between paired examiners within stations contributed the lowest variance to student scores. Conclusion: These findings support the use of clinicians from other specialties, as ‘non-expert’ examiners, to assess communication skills, using a standardized checklist, thereby reducing the demand on clinicians’ time.

Motivation, study habits, and expectations of medical students in Singapore.

Objectives: To determine the motivation and incentives in education, learning experience and teaching techniques, and expectations about future careers among medical students from a multi-ethnic Asian country. Methods: Pre-validated questionnaire-based survey with stratified random sampling among medical students. The questionnaire combined qualitative responses with semi-quantitative measures of available alternatives. Results: The response rate was 83.1%. The most important factor for pursuing university study was ‘prospect of finding an interesting challenging job’ (rank 1–75%). Family made a significant contribution in decision making. Given the chance, a majority (67.2%) of respondents would prefer to study overseas. The main deterring factors were cost (67.7%), distance from home (28%), and local opportunity for post-graduation (23.4%). Despite their inclination of study overseas, the majority (73.9%) of the respondents indicated they were either very satisfied or satisfied with their current choice of university study. Only 20% of students were comfortable in asking questions in classroom as asking questions was deemed ‘too risky’ and ‘unnecessary to get better grades’. Students adopted strategies related to assessment and competition to monitor their study. Senior students reported university education as less relevant to their future careers as compared to junior students (p = 0.002). Conclusions: Students’ learning behaviour is determined by complex factors such as educational incentives, learning support, assessment and competition. Among several external factors, family, job prospects and expectations about the future play a critical role in education.

Medical Education in Bangladesh

Bangladesh shares many socio-cultural, financial, and health issues typical of developing countries. Despite some encouraging developments in health measures at grass-roots level, medical education in Bangladesh faces many challenges. This article provides a snapshot of the current situation of undergraduate and post-graduate medical education with particular emphasis on pedagogical issues, highlighting challenges faced and suggesting an immediate five-point action plan.

Low cost infant monitoring and communication system

This paper proposes a low-cost, mobile-based monitoring and advisory system that continuously monitors the baby and remotely updates the mother on child status. This technology involves continuous measuring of the temperature, heart rate and motion and send it to a server where the data is processed. The server analyzes the received data and sends the processed biological information of the baby to the mother and generates an alert system if the conditions of the baby are found abnormal. These alert messages are transmitted to support systems and nearby health clinics in emergency situations. Also, advisory first-aid information is sent to the mother in order to take immediate action. Thus, this ubiquitous system would enhance mothers awareness of their baby health status.

A multi-institutional survey on faculty development needs, priorities and preferences in medical education in an Asian medical school.

Abstract Background: Faculty development in medical education is crucial for maintaining academic vitality. The authors conducted a needs assessment survey in Singapore to determine the educational needs and priorities of clinical faculty. Methods: This study implemented a questionnaire-based, anonymous, multi-institutional survey with stratified random sampling. Each question was anchored with two statements on a 9-point scale. Respondents were asked to determine their current knowledge and the knowledge they would need in future. Results: The response rate was 81.9%. Overall, the participants’ current knowledge was rated either “modest” (scale 4-6) or “substantial” (scale 7-9), irrespective of teaching experience. Participants reported higher knowledge in areas related to teaching and modest knowledge in educational concepts and assessment. They reported a need for higher knowledge in most areas to function well as a teacher. Conclusion: The need for faculty development is universal and independent of teaching experience in this group. Teaching faculty from the institutes studied understood the need for improved knowledge in pedagogical knowledge.

The AMEE Research Committee: Initiatives to stimulate research and practice

The past two decades have seen tremendous changes in medical education. Examples include the increasing emphasis on clinical skills assessment, more appropriate methods for teaching and learning using theory-driven practice, greater emphasis on the development and assessment of competencies relevant to the real world of healthcare and a strong emphasis on professionalism to name but a few. We believe that we are developing a new, and perhaps, better breed of health professionals as a result of these and other developments. However, are we sure or do we know if that is true, are we confident in the new methods and innovations introduced, can they be improved or, indeed, may they be producing something different from what we intend? We would contend that much progress has been made in terms of collecting evidence to underpin medical education but much of what we did in the past, and still do now, was or is not based on substantial research or the use of specific theories (Gibbs et al. 2011). Gaps still remain and some of the research to date still provides more questions than answers. To gather further evidence, we need further research. According to Norman (2002):