What are the perceptions of faculty and academic leaders regarding the impact of accreditation on the continuous quality improvement process of undergraduate medical education programs at Caribbean medical schools?

BACKGROUND: Accreditation and regulation are meant for quality assurance in higher education. However, there is no guarantee that accreditation ensures quality improvement. The accreditation for Caribbean medical schools varies from island to island, and it could be mandatory or voluntary, depending on local government requirements. Caribbean medical schools recently attained accreditation status to meet the Educational Commission for Foreign Medical Graduates (ECFMG) requirements by 2024. Literature suggests that accreditation impacts ECFMG certification rates and medical schools' educational processes. However, no such study has examined accreditation's impact on continuous quality improvement (CQI) in medical schools. This study aims to gather the perceptions and experiences of faculty members and academic leaders regarding the impact of accreditation on CQI across Caribbean medical schools. METHODS: This qualitative phenomenological study inquiries about the perceptions and experiences of faculty and academic leaders regarding accreditation's impact on CQI. Purposive and snowball sampling techniques were used. Participants were interviewed using a semi-structured interview method. Fifteen participants were interviewed across ten Caribbean medical schools representing accredited medical schools, accreditation denied medical schools, and schools that never applied for accreditation. Interviews were audio recorded, and thematic data analysis was conducted. RESULTS: Thematic analysis yielded six themes, including accreditation and CQI, CQI irrespective of accreditation, faculty engagement and faculty empowerment in the CQI process, collecting and sharing data, ECFMG 2024 requirements, and organizational structure of CQI. CONCLUSIONS: There is ongoing quality improvement at Caribbean medical schools, as perceived by faculty members and academic leaders. However, most of the change process is happening because of accreditation, and the quality improvement is due to external push such as accreditation rather than internal motivation. It is recommended that Caribbean medical schools promote internal quality improvement irrespective of accreditation and embrace the culture of CQI.

Did the students' satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?

INTRODUCTION: Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program's governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine. METHODS: A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test. RESULTS: The ratings for the basic science students' survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students' surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values. CONCLUSIONS: The pre-accreditation preparation and the self-evaluation process while correcting the program's deficiencies are essential triggers for the quality improvement process associated with accreditation.

The impact of accreditation on continuous quality improvement process in undergraduate medical education programs: A scoping review.

Background: Accreditation in medical education has existed for more than 100 years, yet the impact of accreditation remains inconclusive. Some studies have shown the effects of accreditation on student outcomes and educational processes at medical schools. However, evidence showing the impact of accreditation on continuous quality improvement of undergraduate medical education programs is still in its infancy. This scoping review explores the impact of accreditation on continuous quality improvement (CQI). Methods: This scoping review followed the methodology of the Preferred Reporting Items of Systematic Reviews and the Meta-Analysis extension for scoping reviews (PRISMA-ScR) checklist outlined by Arksey and O'Malley (2005). Databases, including PubMed, Medline, ERIC, CINHAL, and Google Scholar, were searched to find articles from 2000 to 2022 related to the accreditation of undergraduate medical education programs and continuous quality improvement. Results: A total of 35 full-text articles were reviewed, and ten articles met our inclusion criteria. The review of the full-text articles yielded four themes: Accreditation and its standards in general, Accreditation and its impact on student outcomes, Accreditation and its impact on medical school's educational processes, Accreditation and CQI. However, the literature evidence suggesting the impact of accreditation on CQI is minimal. The quality assurance approach is based on meeting the standards of accreditation. The quality improvement approach is based on striving for excellence. Literature suggests a requirement to move from student outcomes to CQI measures. CQI requires everyone in the organization to take responsibility and accountability, considering quality as the result of every single step or process and leaders supporting improvements in data collection and data analysis for quality improvement. Conclusions: The literature on accreditation and CQI are limited in number. More research studies are required to enhance undergraduate medical education accreditation practices' value to medical students, educators, academic leaders, programs, and the public. It was recommended that medical schools embrace the culture and vision perpetuated by the CQI process.

Medical Education Electives Can Promote Teaching and Research Interests Among Medical Students.

Introduction: Although all residents routinely teach medical students, not all residents are involved in teaching or trained in teaching during undergraduate medical school, as accreditation bodies do not mandate the promotion of teaching skills to undergraduate medical students. With relatively inadequate formal training and residents' intrinsic time constraints, tactically incorporating formal medical education elective experiences in medical school curricula is understandable. This study explores if medical education electives at Avalon University School of Medicine (AUSOM) can enhance medical students' interest in teaching and research. Methods: The medical education elective at AUSOM was developed to give interested medical students an elective experience. The course modules include accreditation/regulation, curriculum development, learning theories, assessments, and research methodology. Students can choose any one of the modules. We offered the medical education elective to twenty-five students in the year 2021. All of them gave feedback at the end of the elective. The data was analyzed qualitatively through framework analysis, which includes familiarization, generating initial codes, searching for themes, reviewing, and defining and naming themes. Results: Different themes emerged, enhancing the interest in academic medicine, understanding research methodologies, supporting learners, and awareness of learning theories. Conclusion: Doing medical education electives at AUSOM enhanced students' interest in teaching, and students reported that they could understand research methodologies, especially those related to medical education. Medical students should have opportunities for electives in medical education, and more research is required to evaluate the effectiveness of medical education electives across medical schools.

Cross-Border Accreditation in the Caribbean: A Potential Threat to the Integrity of the Accreditation Process?

According to the World Directory of Medical Schools, the Caribbean region hosts around 100 medical schools, leading to variations in education programs and student performance. Accreditation is crucial for maintaining educational standards. The proliferation of accrediting agencies recognized by the World Federation of Medical Education (WFME) has led to cross-border accreditation practices and market-driven competition. Concerns about the integrity of accreditation processes in the Caribbean region have raised questions about educational quality and global implications. Establishing a framework and scrutiny of the WFME regarding cross-border accreditation is essential to preserve educational standards and prevent global implications. ECFMG's intervention is urgently needed to investigate and restore the integrity of medical school accreditation in the Caribbean, setting a precedent for global accreditation standards.

Perspectives on Medical Education in an Increasingly Globalized Society: Recognizing and Embracing Our Diversity.

Medical curricula around the globe are diverse, accommodating the social, political, cultural, and health needs in each country. Every medical school has the responsibility to educate graduates capable of providing quality medical care to their communities. Yet true globalization of medical education is a challenge. Little is known about the intrinsic variations which impact curricula in countries around the world. There are unique, often historical reasons that explain the challenges in attaining a genuine globalization of the medical curricula. This perspective provides a glance and general comparison of traditions, economic, and socio-political influences on medical education across seven countries.

Is Emergency Remote (Online) Teaching in the First Two Years of Medical School During the COVID-19 Pandemic Serving the Purpose?

Purpose: COVID-19 pandemic and closure of campuses have required a significant and rapid shift in teaching and training methods across health professions education, including remote teaching replacing face-to-face teaching. This study aims to investigate if emergency remote teaching implemented in the first two years of the medical school at Avalon University School of Medicine served the purpose during the COVID-19 pandemic. The effectiveness of emergency remote teaching and on-campus teaching were compared using course evaluations (students' feedback) and students' performance in assessments. Methods: This is a concurrent mixed research method. The quantitative data collected are course evaluations and students' performance in assessments between the two semesters September 2019 (on-campus teaching) and May 2020 (emergency remote teaching). There are three semesters in the first year and two semesters in the second year of the medical program. Each semester has around 10-20 students at any given time. Quantitative data were analyzed for p-values and statistical significance using a t-test. The qualitative data were analyzed using thematic analysis. Results: Results have shown no statistically significant difference (p<0.05) between two semesters (between on-campus teaching and emergency remote teaching) for course evaluations. Even if there is any difference, the mean values were better in May 2020 semester with emergency remote teaching. There was no statistically significant difference (p<0.05) even on students' performance in assessments between two semesters (between on-campus teaching and emergency remote teaching) except for two courses. The thematic analysis of interviews revealed the advantages and disadvantages of online teaching. Conclusion: Emergency remote teaching served the purpose in the first two years of medical school during the COVID-19 pandemic. The advantages of online teaching are flexibility and comfort, and students can save time. The disadvantages are technical challenges, students lacking motivation, lack of personal interaction, and limitations on lab and hands-on experiences.

Impact of accreditation on Caribbean medical schools' processes.

BACKGROUND: Caribbean graduates contribute significantly to the US healthcare workforce. The accreditation requirements of local governments vary from one Caribbean island to another island. The Educational Commission for Foreign Medical Graduates (ECFMG) requirement that all future applicants be graduates from accredited medical schools drove Caribbean medical schools to seek accreditation. Accreditation has been found to significantly impact the educational processes of Canadian medical schools. Our study aims at investigating Caribbean medical school leaders' perceptions of the impact of accreditation on their school's processes. METHODS: This qualitative study and data analysis were done using a framework analysis. Academic leaders and faculty members from three different types of Caribbean medical schools (accredited, denied-accreditation schools, never applied for accreditation) were interviewed using semi-structured interviews. RESULTS: A total of 12 participants from six different Caribbean medical schools participated in the interview process. Themes of processes influenced by accreditation at Caribbean medical schools were similar to those found in the Canadian context and align with best practices of Continuous Quality Improvement (CQI). CONCLUSIONS: Caribbean medical schools are changing their educational processes as a result of accreditation requirements. Some processes are not maintained in a continuous manner, raising questions about the development of a true CQI culture.

CONTEXTE: Les diplômés des Caraïbes contribuent de manière significative au personnel de santé Américain. Les exigences des gouvernements Caraïbes en matière d'agrément varient d'une île à l'autre. L'Educational Commission for Foreign Medical Graduates, ECFMG (Commission de l'éducation pour les diplômés en médecine étrangers), exige que les candidats soient diplômés de facultés de médecine agréées, ce qui a incité les facultés de médecine des Caraïbes à solliciter l'agrément. Il a été démontré que l'agrément affectait de manière importante les processus éducatifs des écoles de médecine canadiennes. Notre étude vise à examiner les perceptions des directions des facultés de médecine des Caraïbes quant aux répercussions de l'agrément sur leurs processus. MÉTHODES: La présente étude qualitative et l'analyse des données ont été réalisées selon la méthodologie du cadre logique. Les responsables universitaires et les membres du corps professoral de facultés de médecine des Caraïbes se trouvant dans trois cas de figure différents (facultés agrées, facultés auxquelles l'agrément a été refusé et facultés n'ayant jamais sollicité l'agrément) ont été interrogés par le biais d'entretiens semi-structurées. RÉSULTATS: Douze participants de six facultés de médecine de la région des Caraïbes ont participé aux entretiens. Des thèmes similaires se dégagent en ce qui concerne les processus influencés par l'agrément dans les facultés de médecine caribéennes et canadiennes, en particulier l'adoption des pratiques exemplaires en matière d'amélioration continue de la qualité (ACQ). CONCLUSIONS: Les facultés de médecine des Caraïbes modifient leurs processus éducatifs afin de remplir les exigences d'agrément. Certains processus ne sont pas maintenus de manière continue, ce qui soulève des interrogations quant à l'implantation d'une véritable culture de l'ACQ.

Medical Education during COVID-19: Response at one medical school.

INTRODUCTION: The COVID-19 pandemic has caused a significant toll on healthcare across the globe. The pandemic caused many other consequences, including economic implications and teaching consequences, notably in higher education throughout the world. COVID-19 and the resulting closure of university campuses have had many impacts on Health Professions Education (HPEd), affecting all aspects, including teaching methods, assessment methods, curricula, student-teacher relationships, student selection processes, and student well-being. It has had significant effects on the setting in which students are required to learn more skills such as psychomotor skills. This manuscript aims to investigate the changes implemented in medical education during the pandemic and describe one medical school's response to medical education changes during the pandemic. METHODS: This study was a combination of a case study done by in-depth investigation of the current context at one medical school during the pandemic and action research done by gathering information to change a condition in a particular place. RESULTS: Many changes were implemented in medical education, including online teaching for basic science courses (first two years of the program) and online assessments (video-based remote proctoring) in the program's first two years. Such courses as Clinical Skills are using telemedicine/telehealth concepts in training. There were changes such as video-based remote proctoring of NBME shelf-examinations even in the assessments of clerkships/clinical rotations. CONCLUSIONS: Adaptations of medical education during this pandemic is highly dependent on technology. Most of the changes will be practiced until the campuses are open. We need to understand that these changes were made over this unprecedented period, i.e. the pandemic as an emergency rather than as a normal change process.

Lack of Patient Knowledge Regarding the Adverse Effects of Analgesics With High Doses Leading to Elevation of Creatinine and Major Consequences - A Case Report.

We present a case of a 49-year-old male with complaints of back pain and not being able to urinate. The patient was suffering from back pain for the last four days and followed up with the chiropractor, but the pain persisted. The patient took eight ibuprofen tablets (1600 mg) within those four days to relieve the pain. Lab workup showed a blood urea nitrogen (BUN) of 175 mg/dL, creatinine level of 32.87mg/dL, and an anion gap metabolic acidosis. With close monitoring and dialysis in the hospital, the creatinine came down to 11.92mg/dL. Ultrasound-guided renal biopsy showed that the patient developed acute interstitial nephritis. The patient was treated with prednisone and later discharged with a creatinine level of 8.60mg/dL. Before he was discharged, he was declared to have end-stage renal disease and placed on outpatient dialysis. Only a few case reports are recorded in the literature with such a high elevation of creatinine levels.

Epidemiological Differences of COVID-19 Over the World.

Background Coronavirus disease 2019 (COVID-19), originally, from Wuhan, China, has now spread to most countries across the globe and devastated global healthcare systems. The impact of this disease has, however, shown baffling variations in prevalence in different regions of the world. The aim of this short review is to identify differential national COVID-19 prevalence of COVID-19, as well as to suggest these epidemiological differences.  Methods A review of studies was conducted using PubMed and Google Scholar search engines. Search tactics were centered on COVID-19 ("COVID-19" AND "coronavirus") and BCG vaccination ("BCG vaccination" OR "Bacillus Calmette-Guérin" OR "vaccine") Results It is found that national prevalence differences may be linked with BCG childhood immunization history. A statistically insignificant difference was observed in COVID-19 prevalence when comparing countries with a BGC policy and countries without it (P> 0.05). This inconclusivity suggests the influence of confounders in this study. Conclusions National differences in COVID-19 cases can be attributable to immunologic regulations, such as BCG vaccination protocols. Caution should be taken in establishing a correlation between COVID-19 prevalence and BCG vaccination, partly due to the weak quality of statistical data on COVID-19 related to poor testing rates in countries with BCG vaccination policy. Nonetheless, the analysis of the epidemiological aspects of COVID-19 will shed light on future efforts towards effective control and prevention.

The systematic approach to faculty development activities for biomedical educators.

INTRODUCTION: The term continuing professional development encompasses competencies required to practice the high quality medicine, including medical, managerial, ethical, social, and personal skills, whereas continuing medical education refers only to expanding the knowledge and skills required by physicians. The competencies for basic science faculty identified are management and administration, teaching, assessments, curriculum development, and research. This study aimed to evaluate the outcomes of faculty development initiatives at Avalon University School of Medicine and examine the optimal approach to faculty development activities. METHODS: This is a survey-based quantitative study. A cross-sectional survey was conducted after implementing the faculty development activities. We took thirteen basic science faculty members as a unit and recruited them for different faculty development activities from 2015. Faculty members were involved in various faculty development courses, workshops, and training sessions. A survey was conducted among faculty members using a questionnaire on the Likert scale to identify if there are any increased knowledge or skills on teaching and assessment methods, educational scholarship, and scholarly activities after implementing faculty development initiatives. The faculty responses were tabulated and quantified in the Excel sheet and analyzed by SPSS software. RESULTS: All thirteen faculty members responded to the questionnaire (100% response rate). There was an increased self-reported knowledge and skills of faculty members. 70% of the faculty agreed that they are able to get involved in designing their course learning objectives. 100% of the faculty were aware of different teaching methods, and 93% of them were implementing different types of teaching methods, including small group discussions, flipped classrooms, standardized patient-based teaching, and problem-based learning. 100% of the faculty were aware of different assessment methods and implementing them. There were self-reported and observed behavioral changes. CONCLUSIONS: Faculty development activities at Avalon University School of Medicine have shown to be effective. At larger institutions, the department chair can lead the faculty development activities.

Effectiveness of Small Group Discussions for Teaching Specific Pharmacology Concepts.

Small group discussions are used in medical education to reinforce learning and to promote the application of knowledge. Small group discussions can involve a variety of tasks, such as critical thinking, self-directed learning, problem-solving, and brainstorming. The objective of this study is to find out if small group discussions can improve students' learning of specific pharmacology topics and students' performance on assessments. In the present study, small group discussions were utilized for six unique topics in the pharmacology course, and knowledge-based tests were administered before and after small group discussions to examine their efficacy. Statistically significant improvement in knowledge gains was observed for antimicrobials and neuropharmacology topics, but not for anticancer agents. Students' performance in topics that had group discussions was better on summative assessments compared with the overall performance on the summative assessment in the pharmacology (study group; summer 2018). Students' (study group; summer 2018) overall grade on the summative assessment of the pharmacology course was better than overall pharmacology grade on the summative assessment of students who had no group discussions (control group; winter 2018). Students' perceptions of the small group discussions were satisfactory, suggesting group discussions may be an enjoyable way to improve students' performance in some pharmacology topics.

Understanding the health risks in basic science medical students: a cross sectional survey.

This article was migrated. The article was marked as recommended. Background Medical students are usually subjected to a high workload environment and stress is one of the most important health risks that medical students encounter. The negative impact of stress on the student's mental and general health in basic science has often been under reported. Methods and Materials A cross-sectional questionnaire survey was performed in Avalon University School of Medicine (AUSOM), Curacao, amongst the first to fourth semester basic science students with an objective to explore and understand their perspectives on different health risks. ResultsMore than ⅔ of the students (79.61%, n=82) were feeling stressed out during their basic sciences. The mean stress level among the basic science students was 7.42 ± 2.13 (scale:1-10). Common health issues encountered by the students were: sleep problems, impaired concentration, low mood, mood swings, difficulty in making decisions, emotional distress, anxiety, substance abuse, and abnormal weight gain. Conclusion Although lack of sleep and behavioral problems are the most common health issues encountered by the pre-clinical medical students. There is an urgent need to implement health promotion strategies in medical curriculum for mental and physical well-being of the students.

The hybrid model of clinical skills teaching and the learning theories behind it.

INTRODUCTION: There are two popular methods of clinical skills teaching. One is Peyton's method, and the other one is Robert Gagne's method. A hybrid model which is a combination of both teaching methods is developed and implemented at Avalon University School of Medicine in Clinical Skills. The aim of the study was to evaluate the hybrid model of clinical skills teaching. METHODS: This is a quasi-experimental study where a control group with a sample size of 26 was compared with two study groups; one group included 24 participants, and as the other one consisting of 16 subjects selected without randomization. All students in the class were included in the study, except for those withdrew voluntarily. The quantitative data were gathered in the form of a questionnaire on the Likert scale which was collected as the end of course evaluations. The quantitative data for the responses on the Likert scale was analyzed for descriptive statistics: Mean, Median, and Mode. The quantitative data also included the students' performance on assessments of clinical skills which was analyzed using ANOVA test. The qualitative data were gathered in the form of open-ended questions in the end of course evaluations. The qualitative data were also collected from the faculty members who were the examiners for the clinical skills course as the feedback taken from them. RESULTS: There was a significant improvement in the feedback of students (end of course evaluations) after implementing the hybrid model of clinical skills teaching which was shown by increased Mean, Median, Mode for the most pointers on the Likert scale. Also, there was a notable improvement in the performance of students with a significant p-value (p<0.05) on ANOVA test. CONCLUSION: The hybrid model is very effective in teaching clinical skills. This teaching method can be evaluated by replicating this study at larger institutions with more number of students.

Implementation of standardized patient program using local resources in Avalon School of Medicine.

INTRODUCTION: The standardized Patient Program (SPP) is a standard educational training method which provides the pre-clinical students a better clinical foundation by linking the realm of clinical medicine to basic sciences. It incorporates a modern simulation technique and enhances the ability of the students wherein they can practice, apply and learn the basics of patient encounter. The main objective of this study was to analyze the implementation and efficiency of the SPP in Avalon University School of Medicine (AUSOM). METHODS: A quasi-experimental "before-and-after" study design was conducted among the 3rd Semester (MD3) medical students at AUSOM. 24 students voluntarily participated in the study. The effectiveness of the program was evaluated after comparing the summative examination scores before and after implementation of the SPP (graded in 100 points system). Mean scores were calculated and a comparison of the change in scores was made, using a paired t-test in Stata (ÓStata corp). RESULTS: The mean final summative clinical skills examination scores of the students before and after the introduction of the SPP were 78.46 ± 6.62 (SEM: 1.35, range: 89-70) and 86.54±6.41 (SEM: 1.31, range: 98-65), respectively. There was a statistically significant increment (t=5.5058, p=0.0001) in the scores of the students after the introduction of the SPP. CONCLUSION: Introduction and implementation of SPP at AUSOM at preclinical years increased the overall students' performance in clinical skills. It is necessary that medical schools implement SPP early in preclinical years to strengthen learning and inoculate necessary clinical skills in medical students.

Integrated curriculum and the change process in undergraduate medical education.

INTRODUCTION: This study is aimed at explaining the change process followed for the implementation of the new curriculum at Avalon University School of Medicine and its evaluation. BACKGROUND: Self-evaluation at Avalon University School of Medicine identified the need for a change in the curriculum. The main reasons for the change are isolated disciplines and overcrowded curriculum leading to less self-study time for students. The new curriculum is aimed to have an integrated curriculum and to avoid redundancies. The new curriculum is designed, implemented, and evaluation of the same is in place. Evaluation methods and materials: After implementation, quantitative (results from exams) and semi-quantitative (self-administered questionnaire) evaluation methods are being used to evaluate the new curriculum. Feedback is also taken by having discussions with teachers and students to find out what they like and where modifications are needed. In this article, we are presenting the results of course evaluations (semi-quantitative methods) for two courses. The course evaluations were taken from the sample class size of 30 students. RESULTS AND DISCUSSION: The course evaluations demonstrated an improvement. The main reason for the improvement is due to collaborative efforts of the faculty members from different disciplines in teaching, assessments, and providing feedback to the students. CONCLUSIONS: The well-approached change process is required for the successful implementation of the new curriculum. The idea of ownership among all stakeholders is required for a well-managed change process.

Implementation of formative assessment and its effectiveness in undergraduate medical education: an experience at a Caribbean Medical School.

This article was migrated. The article was marked as recommended. BACKGROUND: Two types of assessments used in the medical education are summative and formative assessments. Summative assessments evaluate a student's learning progress and typically provide concrete grades or pass/fail decisions. The main purpose of the formative assessments is to provide the feedback and improve the learning behavior of the students. However, it is less known about the impact of the formative assessments on overall student's performance in summative assessments. This study is intended to study the effects after the implementation of formal formative assessments on students overall performance in summative assessments or any changes in the total grade point average in a Caribbean Medical School which is a low resource context. MATERIALS AND METHODS: A longitudinal cohort study was conducted among the basic sciences students at AUSOM in May 2017. The study was supported by quantitative data, quantitative and qualitative questionnaires to address the objectives of the study. Data collected and analyzed with Stata (Stata 15). RESULTS: 58, among 67 total students took part in the study. The mean grade point average (GPA) with and without formative assessment was 2.83 (SD±.624745) and 2.29 (SD±.76575) respectively. There was a significant improvement in the overall GPA after the introduction of the formative assessments t (58) = 0.000567, p < .001. CONCLUSION: There was a significant improvement in the student's academic performance after the implementation of formative assessments. Formative assessments consolidate the learning and reinforce the learning behavior. It is necessary that formative assessments should be incorporated into the regular assessment system for the optimal educational output.

Students' perceptions on community-based education at Avalon University School of Medicine during the first two years of the program.

This article was migrated. The article was marked as recommended. Objectives The socio-cultural learning theory can be divided into a social and cultural process. Learner's learning occurs within the context rather than anticipating and preparing for the future context. It may happen in the workplace through apprenticeship, experiential learning, or community-based learning. Community-based education and community services have always been part of the students' volunteer services at Avalon University School of Medicine. The importance of community-based education has led to its recent integration into the curriculum. The objective of this study is to observe the community services in the field and to record the perceptions of students regarding community-based education at Avalon University School of Medicine. Methods This is a qualitative study. The research was conducted in the form of an observational study and framework analysis was done. The community-based education and community services were observed and recorded along with individual interviews. Students from different semesters were selected randomly for the interviews. The interviews were audio-recorded and transcribed. Results All interviewed students (100%) reported that they are involved in community services. 53.8% of students were not able to recognize the health issues of Curacao. 84.6% of students recognized and acknowledged the local health issues after reminding them of the activities conducted in the community services. 84.6% of students believed community services enhanced their clinical skills and increased their confidence in communication skills. Conclusion Community-based education enhances the competency of future physicians in clinical and communication skills.