Emerging Trends in Medical Education

1. Emerging Trends inMedical Education Khalid Bin Abdulrahman, MD Professor of Family Medicine & Medical Education Dean, College of Medicine Al-Imam University, Riyadh. Saudi Arabia

2. Emerging Trends Changes Emerging trends Previous state Reasons Status

3. Emerging Trends in Medical Education Changes Emerging trends in medical curriculum Traditional medical curriculum Reasons Status How/Problems

4. New Trends in: • curriculum development • faculty development • teaching & learning • clinical training • student selection • student assessment • student support • leadership & management

5. The Key Challenges in Health Reform • Relevance: • Quality: • Cost-effectiveness: • Equity:

6. 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

7. 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".

8. The Emerging of the FIVE-STAR DOCTOR The five-star doctor is; • Care provider • Decision-maker • Communicator • Community leader • Manager

10. 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…

11. 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

13. New Trends in Curriculum Development

16. 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

17. 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

18. Curriculum models • Discipline based curriculum • Coordinated thematic curriculum • Problem-based curriculum • Task-based curriculum • Outcome-based curriculum • Competency oriented curriculum • Objective-based curriculum

19. 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

21. 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

22. 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.

23. Where does GCC Medical Schools located in the SPICES Model?N=27 Colleges

24. 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

25. Keys to Success • All sessions should be internally coherent and also link to each other.

26. Keys to Success • All sessions should be internally coherent and also link to each other.

27. 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

28. 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

29. 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

30. 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”

31. A simple model of competence Does Behavior Shows how Professional authenticity Knows how Cognition Knows what

32. Six core competences • Medical Knowledge • Patient Care • Interpersonal & Communication Skills • Professionalism • Practice-based Learning • Systems-based Practice

33. New Trends in Faculty Development

34. Types of Faculty DevelopmentAreas for Further Work • Instructional development • Professional development • Leadership development • Organizational development Irby, 1995,

35. Roles of Faculty Facilitator Assessor Role model Planner Information provider Resource developer

36. New Trends in Student selection • High validity & reliability test • Student maturity • The target students

37. New Trends in Student Support • The learning styles. • Facilitate learning • Life-long learning & SDL • Counseling services • Study skills courses • Need-based learning

38. 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)

39. New Trends in Student Assessment

41. 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

42. New Trends in Teaching & learning

45. 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

46. New Trends in Clinical Training

47. Why Use Patient Simulation? Pyramid of Learning and Retention

48. 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

50. Simulation Modalities