It is time to plant a flag in the White soil of academic journal publishing and declare, “This di... more It is time to plant a flag in the White soil of academic journal publishing and declare, “This discourse includes the cultural voices of Indigenous People”.
Transforming health professionals' education. By - Fortunato Cri... more Transforming health professionals' education. By - Fortunato Cristobal, Paul Worley.
ABSTRACT The goal of global equity in health care requires that the training of health-care profe... more ABSTRACT The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs. Rural and remote medical education (RRME) happens in rural hospitals and rural general practices, singly or in combination, generally for periods of 4 to 40 weeks. An effective RRME programme matches the context of the local health service and community. Its implementation reflects the local capacity for providing learning opportunities, facilitates collaboration of all participants and capitalises on local creativity in teaching. Implementation barriers stem from change management, professional culture and resource allocation. Blending learning approaches as much as technology and local culture allow is central to achieving student learning outcomes and professional development of local medical teachers. RRME harnesses the rich learning environment of communities such that students rapidly achieve competence and confidence in a primary care/generalist setting. Longer programmes with an integrated (generalist) approach based in the immersion learning paradigm appear successful in returning graduates to rural practice and a career track with a quality lifestyle.
In this thesis, I argue that an emerging alignment of disruptive pedagogies and technologies may ... more In this thesis, I argue that an emerging alignment of disruptive pedagogies and technologies may change the face of medical education, including the learning of basic medical sciences, and call into question the future role and relevance of current staff, structures and institutional venues. The Disruptive Pedagogies of Social Accountability-the Power of the Local As we move through the second decade of the twenty-first century, health professional education is increasingly being evaluated through a social accountability lens [1]. The WHO defines social accountability in medical education as "the obligation to orient education, research, and service activities towards priority health concerns of the local communities, the region and/or nation one has a mandate to serve. These priorities are jointly defined by government, health service organisations, and the public" [2]. This lens is evident in position statements by organisations such as the Training for Health Equity Network (THEnet) [3], the World Federation for Medical Education [4], and the Global Consensus on Social Accountability in Medical Education [5], and by the Association for Medical Education in Europe including social accountability as one of only three categories for their awards for excellence in medical education (the ASPIRE initiative [6]).
Introduction The longitudinal integrated clerkship is a model of clinical medical education that ... more Introduction The longitudinal integrated clerkship is a model of clinical medical education that is increasingly employed by medical schools around the world. These guidelines are a result of a narrative review of the literature which considered the question of how to maximize the sustainability of a new longitudinal integrated clerkship program. Method All four authors have practical experience of establishing longitudinal integrated clerkship programs. Each author individually constructed their Do’s, Don’ts and Don’t Knows and the literature that underpinned them. The lists were compiled and revised in discussion and a final set of guidelines was agreed. A statement of the strength of the evidence is included for each guideline. Results The final set of 18 Do’s, Don’ts and Don’t Knows is presented with an appraisal of the evidence for each one. Conclusion Implementing a longitudinal integrated clerkship is a complex process requiring the involvement of a wide group of stakeholders...
Introduction: Flinders University in Australia has had a rural longitudinal integrated clerkship ... more Introduction: Flinders University in Australia has had a rural longitudinal integrated clerkship for selected medical students, the Parallel Rural Community Curriculum, since 1997. The Northern Ontario School of Medicine (NOSM) in Canada introduced a similar clerkship for all NOSM students in 2007. An external evaluation of both programs was conducted in 2006 and 2008, respectively. The aim of this article was to analyse the similarities in and differences between these two rural programs and determine key factors that could inform others interested in creating similar programs. Methods: The evaluation took the form of a cross-sectional descriptive study conducted in each school using focus group and individual interviews, involving students, faculty, preceptors, health service managers and community representatives. Interviews were analysed for emerging themes based on a grounded theory approach, and common themes were tabulated and validated. The themes for the two sites were compared and contrasted to assess similarities and differences. Results: Individual interviews were conducted with 87 people at Flinders and 39 at NOSM; focus groups included 45 students at Flinders and 7 at NOSM. All participants felt that the programs produce confident and skilled students. The educational value of the programs was expressed in terms of continuity of care, longitudinal exposure, development of relationships, mentoring, team work, and participatory learning. Common concerns related to issues of standardisation, ensuring exposure to all specialist disciplines, communication, support for students and preceptors, isolation, dealing with personal issues, and the process of site selection.
Relationships do matter! In fact, medicine cannot be learned without them, and community-based me... more Relationships do matter! In fact, medicine cannot be learned without them, and community-based medical education (CBME) curricula that ignore them or take them for granted do so at their students ’ peril. As CBME is becoming more popular, there is a need to develop appropriate frameworks for describing quality in CBME to ensure that it remains a principle-driven, not format-driven, initiative. In this paper, I provide evidence for a simple model of four key relationships, the four Rs, in which the medical student must be immersed to facilitate high quality learning. These four Rs are the relationships between (1) clinicians and patients, (2) health service and university research, (3) government and community, and (4) personal principles and professional expectations. As a result of this synthesis of the current medical education literature, I propose that this model of clinical, social, institutional and interpersonal relationships is a valid framework for articulating the importan...
It is time to plant a flag in the White soil of academic journal publishing and declare, “This di... more It is time to plant a flag in the White soil of academic journal publishing and declare, “This discourse includes the cultural voices of Indigenous People”.
Transforming health professionals' education. By - Fortunato Cri... more Transforming health professionals' education. By - Fortunato Cristobal, Paul Worley.
ABSTRACT The goal of global equity in health care requires that the training of health-care profe... more ABSTRACT The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs. Rural and remote medical education (RRME) happens in rural hospitals and rural general practices, singly or in combination, generally for periods of 4 to 40 weeks. An effective RRME programme matches the context of the local health service and community. Its implementation reflects the local capacity for providing learning opportunities, facilitates collaboration of all participants and capitalises on local creativity in teaching. Implementation barriers stem from change management, professional culture and resource allocation. Blending learning approaches as much as technology and local culture allow is central to achieving student learning outcomes and professional development of local medical teachers. RRME harnesses the rich learning environment of communities such that students rapidly achieve competence and confidence in a primary care/generalist setting. Longer programmes with an integrated (generalist) approach based in the immersion learning paradigm appear successful in returning graduates to rural practice and a career track with a quality lifestyle.
In this thesis, I argue that an emerging alignment of disruptive pedagogies and technologies may ... more In this thesis, I argue that an emerging alignment of disruptive pedagogies and technologies may change the face of medical education, including the learning of basic medical sciences, and call into question the future role and relevance of current staff, structures and institutional venues. The Disruptive Pedagogies of Social Accountability-the Power of the Local As we move through the second decade of the twenty-first century, health professional education is increasingly being evaluated through a social accountability lens [1]. The WHO defines social accountability in medical education as "the obligation to orient education, research, and service activities towards priority health concerns of the local communities, the region and/or nation one has a mandate to serve. These priorities are jointly defined by government, health service organisations, and the public" [2]. This lens is evident in position statements by organisations such as the Training for Health Equity Network (THEnet) [3], the World Federation for Medical Education [4], and the Global Consensus on Social Accountability in Medical Education [5], and by the Association for Medical Education in Europe including social accountability as one of only three categories for their awards for excellence in medical education (the ASPIRE initiative [6]).
Introduction The longitudinal integrated clerkship is a model of clinical medical education that ... more Introduction The longitudinal integrated clerkship is a model of clinical medical education that is increasingly employed by medical schools around the world. These guidelines are a result of a narrative review of the literature which considered the question of how to maximize the sustainability of a new longitudinal integrated clerkship program. Method All four authors have practical experience of establishing longitudinal integrated clerkship programs. Each author individually constructed their Do’s, Don’ts and Don’t Knows and the literature that underpinned them. The lists were compiled and revised in discussion and a final set of guidelines was agreed. A statement of the strength of the evidence is included for each guideline. Results The final set of 18 Do’s, Don’ts and Don’t Knows is presented with an appraisal of the evidence for each one. Conclusion Implementing a longitudinal integrated clerkship is a complex process requiring the involvement of a wide group of stakeholders...
Introduction: Flinders University in Australia has had a rural longitudinal integrated clerkship ... more Introduction: Flinders University in Australia has had a rural longitudinal integrated clerkship for selected medical students, the Parallel Rural Community Curriculum, since 1997. The Northern Ontario School of Medicine (NOSM) in Canada introduced a similar clerkship for all NOSM students in 2007. An external evaluation of both programs was conducted in 2006 and 2008, respectively. The aim of this article was to analyse the similarities in and differences between these two rural programs and determine key factors that could inform others interested in creating similar programs. Methods: The evaluation took the form of a cross-sectional descriptive study conducted in each school using focus group and individual interviews, involving students, faculty, preceptors, health service managers and community representatives. Interviews were analysed for emerging themes based on a grounded theory approach, and common themes were tabulated and validated. The themes for the two sites were compared and contrasted to assess similarities and differences. Results: Individual interviews were conducted with 87 people at Flinders and 39 at NOSM; focus groups included 45 students at Flinders and 7 at NOSM. All participants felt that the programs produce confident and skilled students. The educational value of the programs was expressed in terms of continuity of care, longitudinal exposure, development of relationships, mentoring, team work, and participatory learning. Common concerns related to issues of standardisation, ensuring exposure to all specialist disciplines, communication, support for students and preceptors, isolation, dealing with personal issues, and the process of site selection.
Relationships do matter! In fact, medicine cannot be learned without them, and community-based me... more Relationships do matter! In fact, medicine cannot be learned without them, and community-based medical education (CBME) curricula that ignore them or take them for granted do so at their students ’ peril. As CBME is becoming more popular, there is a need to develop appropriate frameworks for describing quality in CBME to ensure that it remains a principle-driven, not format-driven, initiative. In this paper, I provide evidence for a simple model of four key relationships, the four Rs, in which the medical student must be immersed to facilitate high quality learning. These four Rs are the relationships between (1) clinicians and patients, (2) health service and university research, (3) government and community, and (4) personal principles and professional expectations. As a result of this synthesis of the current medical education literature, I propose that this model of clinical, social, institutional and interpersonal relationships is a valid framework for articulating the importan...
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