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In many low- and middle-income countries, there seems to be a mismatch between graduate skills and healthcare industry requirements due to variability in curricula. With the current increased global demand for competent health profession graduates, harmonizing competency-based curricula (CBC) is necessary to address this mismatch. This paper describes how three health professions training universities in Tanzania and their two long-standing United States partners embarked on developing harmonized CBC for undergraduate medicine and nursing degrees. The main goal of the activity was to develop templates to harmonize curricula that would support graduates to acquire mandatory national Graduate Minimum Essential Competencies (GMEC) irrespective of the institution of their training. The paper describes the processes of engaging multiple institutions, the professions of medicine and nursing and various stakeholders to develop mandatory curricula generic competencies, creating milestones for assessing competencies, training faculty at each of the three partnering institutions in curriculum delivery and assessments, resulting in the adoption of the curricula by the University leadership at each institution. Ultimately the Tanzania Commission for Universities (TCU) a regulatory body required all schools of medicine and nursing in the country to adopt the curricula, thus creating a harmonized national standard for teaching medicine and nursing beginning October 2022.

Aim: Curriculum reform in medical schools continues to be an ever-present and challenging activity in medical education. This paper describes one school's experiences with specific curricular innovations that were developed or adapted and targeted to meet a clear set of curricular goals during the curriculum reform process. Those goals included: (a) promoting active learning and learner engagement; (b) establishing early professional identity; and (c) developing physician competencies in an integrated and contextual manner while allowing for individualized learning experiences for the millennial student., Methods: Six specific innovations championed by the school are described in detail. These included Themes in Medical Education, Translational Pillars, Stony Brook Teaching Families, Transition Courses, Educational Continuous Quality Improvement Processes, and our Career Advising Program. Development of the ideas and design of the innovations were done by faculty and student teams., Results: We discuss successes and ongoing challenges with these innovations which are currently in the fourth year of implementation., Conclusions: Our curriculum reform has emphasized the iterative process of curriculum building. Based on our experience, we discuss general and practical guidelines for curriculum innovation in its three phases: setting the stage, implementation, and monitoring for the achievement of intended goals.

Commercial-off-the-shelf learning platforms developed for medical education (herein referred to as MedED-COTS) have emerged as a resource used by a majority of medical students to prepare for licensing examinations. As MedED-COTS proliferate and include more functions and features, there is a need for an up-to-date review to inform medical educators on (a) students' use of MedED-COTS outside the formal medical school curriculum, (b) the integration of MedED-COTS into the formal curriculum, and (c) the potential effects of MedED-COTS usage on students' national licensing exam scores in the USA. Due to the limited number of studies published on either the use or integration of MedED-COTS, a focused review of literature was conducted to guide future research and practice. Data extraction and quality appraisal were conducted independently by three reviewers; with disagreements resolved by a fourth reviewer. A narrative synthesis was completed to answer research questions, contextualize results, and identify trends and issues in the findings reported by the studies included in the review. Results revealed consistent positive correlations between students' use of question banks and their licensing exam performance. The limited number of integration studies, combined with a number of methodological issues, makes it impossible to isolate specific effects or associations of integrated commercial resources on standardized test or course outcomes. However, consistent positive correlations, along with students' pervasive use and strong theoretical foundations explaining the results, provide evidence for integrating MedED-COTS into medical school curricula and highlight the need for further research. Based on findings, we conclude that students use exam preparation materials broadly and they have a positive impact on exam results; the literature on integration of MedED-COTS into formal curriculum and the use by students of resources outside of exam preparation is scant. [ABSTRACT FROM AUTHOR]

Background: This paper describes the curriculum and impact of an innovative resident-as-teacher course at the University of Massachusetts Medical School. The intent of the course is to prepare students across undergraduate and graduate medical education for their roles as teacher, learner and leader during residency. Method: The elective introduces teaching skills curricula during year two of medical school and integrates it into residency years. The course was developed with the premise that integrating facets of graduate and undergraduate medical education offers students diverse perspectives of the teaching/learning process. Students completed a pre-/post-course questionnaire and an end-of-course evaluation, from which data were gathered to determine course impact. Results: Students reported increased confidence levels in their teaching skills from pre- to post-test. Post-test data indicated that 88% of students 'agreed' and 12% 'strongly agreed' that the course equipped them with 'skills which will enable [them] to provide teaching that supports effective learning', an increase from pre-test data which indicated that 50% 'agreed' and 50% 'disagreed'. Conclusion: Results indicate the course did effect a change in students' attitudes to teaching as evident from comments such as, 'I will be a better teacher because I have been given the appropriate tools'. [ABSTRACT FROM AUTHOR]

Rationale: Public health and preventive medicine (PHPM) has been recognized internationally as a physician specialty, but national parallels and differences exist between training contexts. This paper reviews PHPM training and employment in Canada, France, Italy, Japan, the United Kingdom, and the USA. Methods: Information gathered from relevant accreditation bodies and literature searches was used to create descriptive profiles of national training demographics and structure and a narrative outlining trends and challenges facing the specialty. Results: Notable similarities and differences exist between national contexts. Key themes were differences in training strategies and practice scope, specialty stakeholders, certification structure, and funding. Recognition challenges faced the specialty across all six countries. Other challenges included unclear competencies and training strategies and a need for PHPM specialists to highlight their role in combating population health threats. Additional differences existed between comparator countries on the structure of training, funding sources for training programs, availability of training posts, and linkages with other physician specialties. Conclusion: Highlighting these themes is a first step to fostering training collaborations between PHPM specialist physicians to augment transnational action on global public health challenges and also supports PHPM physician educators with innovative solutions from abroad that might address domestic specialty challenges. [ABSTRACT FROM AUTHOR]

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.

Medical school curricula frequently contain gaps in the areas of abortion and sexual health. A group of first- and second-year medical students at the authors' institution organized a collaborative, multidisciplinary elective course to address such omissions in the preclinical curriculum. This paper describes the process of creating and implementing the elective. Medical students identified curricular gaps in the areas of abortion, sexual assault, lesbian/gay/bisexual/transgender health, and HIV counseling. Clinical faculty and community-based professionals were invited to address these topics in a weekly lecture series organized by students. The course also included a half-day experience shadowing at a local abortion clinic. Collaboration with several student groups helped broaden student interest in and increase financial support for the elective. Some 37% of all first- and second-year students enrolled in the elective and received institutional credit for the course. Written and verbal evaluations confirmed student satisfaction with the lectures and the clinical experience. Dynamic and well-prepared speakers who presented interesting medical content received the highest ratings from students. Student leaders identified several challenges in implementing the elective. Ultimately the elective proved to be a successful collaboration among students, faculty, and healthcare providers, and resulted in permanent changes in the standard medical school curriculum. Challenges for student-initiated electives include difficulty in finding administrative support, securing funding and ensuring sustainability. This paper aims to make this process accessible and applicable to other students and faculty interested in addressing curricular gaps at their respective medical schools.

There is no current centralized database of structured global health programs at U.S. medical schools and no published review in the past decade. This study aims to describe the prevalence, characteristics, and requirements of non-degree, longitudinal, structured global health programs in U.S. allopathic and osteopathic medical schools. In July 2021, the authors performed a web-based review of existing structured global health programs for the 154 U.S. allopathic medical schools and 35 U.S. osteopathic medical schools established prior to 2019. Of 189 institutions examined, 74 (39%) had online information about a structured global health program. Forty-three (53%) programs reported coursework requirements, 44 (54%) required a global health experience, and one program required demonstration of language or cultural knowledge. More internally administered programs required experiential work, while more externally administered programs required didactic work. There were few differences in program requirements between allopathic and osteopathic medical schools. There has been a 75% increase over the past ten years in the number of U.S. allopathic medical schools with websites for structured global health programs. There appeared to be little standardization in their structure and requirements. The findings support the need for a web-based central repository for updated information regarding medical school global health curricula. [ABSTRACT FROM AUTHOR]

Background: Socially-accountable health professional education (SAHPE) is committed to achieving health equity through training health-workers to meet local health needs and serve disadvantaged populations. This research assesses the biomedical and socially-accountable competencies and work-readiness of first year graduates from socially-accountable medical schools in Australia, the United States and Sudan. Method: A self-administered survey to hospital and community health facility staff closely associated with the training and/or supervision of first year medical graduates from three SAHPE medical schools. Main outcome measure: Likert scale ratings of key competencies of SAHPE graduates (as a group) employed as first-year doctors, compared to first year doctors from other medical schools in that country (as a group). Findings: Supervisors rated medical graduates from the 3 SAHPE schools highly for socially-accountable competencies ('communication skills', 'teamwork', 'professionalism', 'work-readiness', 'commitment to practise in rural communities', 'commitment to practise with underserved ethnic and cultural populations'), as well as 'overall performance' and 'overall clinical skills'. Interpretation: These findings suggest SAHPE medical graduates are well regarded by their immediate hospital supervisors, and SAHPE can produce a medical workforce as competent as from more traditional medical schools, but with greater commitment to health equity, working with underserved populations, and addressing local health needs. [ABSTRACT FROM AUTHOR]

The authors discuss a report that describe the transition of medical education towards adaptive learning and implementation of the adaptive curriculum in two U.S. medical schools. Topics mentioned include the benefits of frequent testing, application of a summative assessment format by the medical curriculum through progress testing, and introduction of integrated undergraduate syllabuses in line with General Medical Council guidance.

Background: Key features examinations (KFEs) have been used to assess clinical decision making in medical education, yet there are no reports of an online KFE-based on a national curriculum for the internal medicine clerkship. What we did: The authors developed and pilot tested an electronic KFE based on the US Clerkship Directors in Internal Medicine core curriculum. Teams, with expert oversight and peer review, developed key features (KFs) and cases. Evaluation: The exam was pilot tested at eight medical schools with 162 third and fourth year medical students, of whom 96 (59.3%) responded to a survey. While most students reported that the exam was more difficult than a multiple choice question exam, 61 (83.3%) students agreed that it reflected problems seen in clinical practice and 51 (69.9%) students reported that it more accurately assessed the ability to make clinical decisions. Conclusions: The development of an electronic KFs exam is a time-intensive process. A team approach offers built-in peer review and accountability. Students, although not familiar with this format in the US, recognized it as authentically assessing clinical decision-making for problems commonly seen in the clerkship. [ABSTRACT FROM PUBLISHER]

Despite growing recognition of the need to increase cultural diversity undergraduate education in the UK, the US and Canada, there is a lack of cohesion in the development and delivery of cultural diversity teaching in medical schools in these three countries. This article highlights 12 tips for developing cultural diversity education in undergraduate medical programmes by integrating it in institutional policies, curriculum content, faculty development and assessment. These tips can be used to help ensure that students gain needed knowledge, skills and attitudes consistent with a view of patients as complex individuals with unique needs. [ABSTRACT FROM AUTHOR]

Background: The Stanford Faculty Development Center (SFDC) at Stanford University developed a teaching improvement course for medical teachers that has been widely disseminated using a train-the-trainer model. We were curious to see if cultural factors might influence the applicability and impact of the course when delivered to non-American participants by a facilitator from that culture. Methods: A Swedish anaesthesiologist at Uppsala University Hospital, Sweden, was trained in October 2004 at Stanford University. From January 2005 to March 2007 he delivered five faculty development seminar series at Uppsala University Hospital to 40 physicians from different departments. Participants rated the usefulness of the seminar series and retrospective pre- and post-seminar ratings were used to assess effects on participants' teaching skills and behaviours. Results: Participants rated the seminars as highly useful (M = 4.8, SD = 0.4). Participants' ratings of their teaching ability indicated significant increases across a variety of clinical and non-clinical teaching settings (p < 0.001), and positive changes in teaching behaviours were found for all seven educational categories assessed (p < 0.001). Conclusions: This faculty development model is highly transportable to medical teachers in Sweden, and capable of producing positive results, consistent with those found in the United States. [ABSTRACT FROM AUTHOR]

In 1991, the College of Human Medicine at Michigan State University, E. Lansing, MI, USA implemented a curriculum that married a lecture-based first-year program with a problem-based curriculum in the second year. The achievement of the original curricular goals was evaluated using student surveys, alumni surveys, residency director surveys, and student performance measures. The preponderance of indicators demonstrates that this unusual curricular structure was successful in improving students' perceptions of and performance in basic sciences without sacrificing the school's tradition of a strong psychosocial orientation. Based on constructivist views of learning theory, it is hypothesized that the curriculum promotes solid knowledge construction by providing the introduction to each basic science discipline in the first year upon which integrated conceptions are more readily built during the second year. [ABSTRACT FROM AUTHOR]

Describes the supportive educational programs instituted at the University of Missouri-Kansas City (UKMC) and Brown University in Rhode Island. Physical plant; Student partnership system; Role of the docent; Evaluations of the docent system; Brown Medical School affinity group program; Implications for other medical schools.

Discusses the computerization of the curriculum of Albuquerque's University of New Mexico School of Medicine in the fall of 1993. Hardware base; Use of computers to strengthen the cognitive process; Self-constructed database; Improvement of student and teacher communication; Computers as evaluation tools.