CanMEDS curriculum in Saudi Arabian context: lessons learned and way forward

Background: Saudi Commission for Health Specialties [SCFHS] has adopted CanMEDS competency framework for developing curriculum for postgraduate training programmes

Purpose: The purpose of this paper is to share the process of developing postgraduate curricula under SCFHS's patronage and to identify potential barriers to implement newly developed curricula and suggest strategies to overcome the barriers

Methods: The process of consensus building started with one-one interview with key stakeholders, review of literature, and comparison of various curricular models. A prototype curriculum was developed with inputs from international advisors. The proposal for the curriculum development and outcomes was reviewed amongst SCHS education committee members and approved. Two medical education experts have been involved in coordinating the process of curriculum development

Results: Over the last two years, SCFHS has been working with several residency and fellowship programmes to develop formal curricula. The goal is to complete formal curriculum for all residency and fellowship programmes using CanMEDS competency frameworks

comprehensive, multi-modal evaluation of the assessment system of an undergraduate research methodology course: translating theory into practice

To evaluate assessment system of the 'Research Methodology Course' using utility criteria [i.e. validity, reliability, acceptability, educational impact, and cost-effectiveness]. This study demonstrates comprehensive evaluation of assessment system and suggests a framework for similar courses. Qualitative and quantitative methods used for evaluation of the course assessment components [50 MCQ, 3 Short Answer Questions [SAQ] and research project] using the utility criteria. Results of multiple evaluation methods for all the assessment components were collected and interpreted together to arrive at holistic judgments, rather than judgments based on individual methods or individual assessment. Face validity, evaluated using a self-administered questionnaire [response rate-88.7%] disclosed that the students perceived that there was an imbalance in the contents covered by the assessment. This was confirmed by the assessment blueprint. Construct validity was affected by the low correlation between MCQ and SAQ scores [r=0.326]. There was a higher correlation between the project and MCQ [r=0.466]/SAQ [r=0.463] scores. Construct validity was also affected by the presence of recall type of MCQs [70%; 35/50], item construction flaws and non-functioning distractors. High discriminating indices [> 0.35] were found in MCQs with moderate difficulty indices [0.3-0.7]. Reliability of the MCQs was 0.75 which could be improved up to 0.8 by increasing the number of MCQs to at least 70. A positive educational impact was found in the form of the research project assessment driving students to present/publish their work in conferences/peer reviewed journals. Cost per student to complete the course was US$164.50. The multi-modal evaluation of an assessment system is feasible and provides thorough and diagnostic information. Utility of the assessment system could be further improved by modifying the psychometrically inappropriate assessment items

The knowledge-attitude dissociation in geriatric education: can it be overcome?

<p><b>INTRODUCTION</b>A knowledge-attitude dissociation often exists in geriatrics where knowledge but not attitudes towards elderly patients improve with education. This study aims to determine whether a holistic education programme incorporating multiple educational strategies such as early exposure, ageing simulation and small group teaching results in improving geriatrics knowledge and attitudes among medical students.</p><p><b>MATERIALS AND METHODS</b>We administered the 18-item University of California Los Angeles (UCLA) Geriatric Knowledge Test (GKT) and the Singapore-modified 16-item UCLA Geriatric Attitudes Test (GAT) to 2nd year students of the old curriculum in 2009 (baseline reference cohort, n = 254), and before and after the new module to students of the new curriculum in 2010 (intervention cohort, n = 261), both at the same time of the year.</p><p><b>RESULTS</b>At baseline, between the baseline reference and intervention cohort, there was no difference in knowledge (UCLA-GKT Score: 31.6 vs 33.5, P = 0.207) but attitudes of the intervention group were worse than the baseline reference group (UCLA-GAT Score: 3.53 vs 3.43, P = 0.003). The new module improved both the geriatric knowledge (UCLA-GKT Score: 34.0 vs 46.0, P <0.001) and attitudes (UCLA-GAT Score: 3.43 vs 3.50, P <0.001) of the intervention cohort.</p><p><b>CONCLUSION</b>A geriatric education module incorporating sound educational strategies improved both geriatric knowledge and attitudes among medical students.</p>

Does the introduction of a third examiner and global marking improve the generalisability of the surgical long case?

<p><b>INTRODUCTION</b>Planning a high-stake clinical examination requires the evaluation of several psychometric and logistical variables. The authors conducted generalisability and decision studies to answer the following research questions in the context of the surgical long case: (1) Does the addition of a third examiner have any added benefit, vis-à-vis reliability, to the examination? (2) Is global marking more reliable than an itemised marking template? (3) What would be the impact on reliability if there was a reduction in the number of examinees that each panel of examiners is required to assess?</p><p><b>METHODS</b>A third examiner and global marking were introduced. Separate generalisability and decision studies were carried out for both the two- and three-examiner models as well as for itemised and global scores.</p><p><b>RESULTS</b>The introduction of a third examiner resulted in a modest gain of reliability by 0.05-0.07. Gain in reliability was higher when each candidate was allowed to undertake a higher number of clinical cases. Both the global and itemised scores provided equivalent reliability (generalisability coefficient 0.74-0.89).</p><p><b>CONCLUSION</b>Our results showed that only a modest improvement in reliability of the surgical long case is achieved through the introduction of an additional examiner. Although the reliability of global scoring and the itemised marking template was comparable, the latter may provide opportunities for individualised feedback to examinees.</p>