Implementation and evaluation of a mentorship program in clinical master in family medicine during the COVID-19 pandemic at the Arabian Gulf University: a longitudinal study.

BACKGROUND: We implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance. METHODS: We conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk. RESULTS: The follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree. CONCLUSION: The mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic.

Knowledge, awareness, and attitudes towards epilepsy among elementary schoolteachers in the Kingdom of Bahrain.

BACKGROUND: Teachers' awareness of epilepsy and attitudes toward students with epilepsy (SWE) largely affect their health, behavior, and academic performance. This study aimed to assess elementary schoolteachers' background knowledge and attitudes toward epilepsy in the Kingdom of Bahrain. METHODS: A 23-item online questionnaire was distributed to elementary school teachers in all public schools in Bahrain between September 2022 and February 2023. The questionnaire included three sets of questions about teachers'1) demographics and teaching experience, 2) knowledge and experience with epilepsy, and 3) attitude towards SWE. RESULTS: Three hundred and sixty-seven teachers responded to the questionnaire. Only 82 participants (22.3%) thought they had enough information about epilepsy. Approximately 25% had previously taught SWE. Even though 9.3% have witnessed a seizure before, only 2.2% received seizure first aid training courses. Most respondents (68.7%) knew that epilepsy is caused by abnormal brain electrical activity and is not contagious (95.1%). Regarding seizure types, 76.6% were aware of uncontrollable jerky movements, while staring spells were recognized by 45%. Most first-aid responses were inappropriate, as 59.7% would open the patient's mouth. Only 39.5% agreed on patient transfer to the hospital if the seizure lasted ≥5 min. Epilepsy was thought to cause mental retardation by 32.4%. Also, the belief that SWE were more prone to bullying was reported by 57.2%. CONCLUSION: The knowledge and attitudes of schoolteachers in Bahrain towards epilepsy are relatively good but with remaining improvement potential. They do not fully grasp all seizure types nor adequate first-aid measures promoting future epilepsy educational programs.

Best Practices of the World Health Organization Collaborating Centres (WHOCCs) in the Eastern Mediterranean Region.

Background: World Health Organization Collaborating Centres (WHOCCs) cooperate with the WHO on a range of strategic areas such as nursing, nutrition, mental health, chronic diseases, education, and health technologies, depending on their speciality areas. As of 2021, WHO has 47 CCs in the Eastern Mediterranean Region (EMR) collaborating on diverse areas. Four CCs in the EMR located in Egypt, Kingdom of Bahrain, Sudan, and Pakistan focus primarily on medical education (ME). Objective: The objective of this review of the literature is to describe the best practices in ME based on published research from the four WHOCCs in EMR. The secondary objective is to classify them based on the level of Kirkpatrick's model (KM) of educational outcomes. Methods: The contributions of WHOCCs are categorised in to five domains namely "Curriculum Development and Course Design", "Student Assessment", "Quality, Accreditation, and Program Evaluation", "Teaching and Learning" and "Innovation in Medical Education". Initial extraction yielded 96 articles for review, while the second level of analysis reduced the number of publications to 37 based on the date of publication within the last 5 years. Numerous best practices in ME emerged from the recently published works of these WHOCCs in the areas of learning and teaching, curriculum development, innovations in medical education, quality, and assessments in medical education. Literature from the WHOCCs on assessment and curriculum design are limited, possibly indicating opportunities for additional research. Conclusion: The researchers conclude that the WHOCCs in the EMR show transformational impact on all principal areas of research and at multiple levels.

Predictive validity of admission criteria in predicting academic performance of medical students: A retrospective cohort study.

Introduction: Admission to medical school is one of the most competitive entry points in higher education. Medical school admissions committees need accurate and precise screening tools to select among well-qualified applicants. This study explores data from a cohort of graduated medical students over 6 years to offer a critical perspective on predictive validity in medical school admissions. Methods: A retrospective cohort study of 160 students was performed to identify the predictive validity of admission criteria for medical students to predict academic performance over 6 years for a cohort of all students enrolled in the medical program during the academic year 2013-2014. Results: The main results indicated that there was a statistically significant positive correlation between the admission criteria and Students' performance in Year 1, Year 4, B.Sc. (Bachelor of Medical Science) exam, and Medical Doctor (MD) exam across the 6 years of the medical program, except for the English Test, which showed that there was no significant correlation with average MD exam scores for students who enrolled directly in Year 1. The results related to students who were admitted to the Foundation Program showed that there was no significant correlation between high school Grade Point Average (HSGPA) and their academic performance in Year 1, Year 4, B.Sc. exam, and MD exam. The overall results related to all study samples indicated that all predictor variables correlate significantly with all outcome variables (academic performance), and the results showed that Science test scores demonstrated 27.7, 15.0, 19.7, and 12.6% of variation in Students' performance in Year 1, Year 4, B.Sc. exam, and MD exam, respectively. Conclusion: Science test scores were found to be more predictive of academic performance compared to other predictors. Not all the admission criteria used for student selection are good indicators of their achievement in the medical program. It is recommended that other valid and reliable admission tools, such as the multiple mini-interviews and the questionnaire for a candidate's suitability to follow a problem-based learning curriculum, should be considered.

Adaptations of Clinical Teaching During the COVID-19 Pandemic: Perspectives of Medical Students and Faculty Members.

Background: The COVID-19 pandemic had serious implications on medical schools' programs that necessitated lots of adaptations of teaching, learning, and assessment to guarantee continuity of education in medical schools. Our study aimed to evaluate perspectives of clerkship students and faculty members regarding clinical teaching adaptations implemented during the COVID-19 pandemic. Methods: A descriptive, cross-sectional, survey-based study was conducted and targeted 5th and 6th year clerkship students and full- and part-time clinical faculty. The survey explored (1) perception of the degree of contribution of implemented adaptations to student achievement of expected clinical competencies, (2) degree of confidence regarding students' achievement of expected clinical competencies through such adaptations, and (3) perception of the effect of implemented educational adaptations on students' learning. Descriptive statistics were used, and statistical significance level was set at p < 0.05. Results: The survey exhibited high internal consistency. Both students and faculty members felt that most of the adaptations had moderate to high contribution to student achievement of expected clinical competencies. On a 5-point scale, the highest score was given by faculty members to "Interpretation of investigations" (3.93±0.84) while the lowest scores were given by faculty members (3.10±1.21) and students (2.57±1.36) to "Performing clinical procedures". Students and faculty members agreed that the adaptations had positive effect on students' learning except for the statement "Students were able to easily monitor their academic progress" where students gave less scores than faculty members, with a statistically significance difference (p=0.029). Conclusion: Students and faculty members had similar perspectives regarding the implemented adaptations and their impact and contribution to student learning and achievement of the basic clinical competencies. Both of them agreed on the need for and importance of the implemented adaptations. Our findings recommend such adaptations during the times of crises, which can be conducted through integrating online teaching with face-to-face teaching.

Evaluation of the Utility of Online Objective Structured Clinical Examination Conducted During the COVID-19 Pandemic.

Background: The COVID-19 pandemic led to profound restrictions on the face-to-face learning and assessment in all educational institutions, particularly the medical schools. The College of Medicine and Medical Sciences of the Arabian Gulf University (CMMS-AGU) conducted the final exams, both theoretical and clinical components, for its MD students online. This study was conducted to evaluate the utility of online clinical exams held at CMMS-AGU. Methods: This is a cross-sectional, mixed method study that included samples from final year medical students, examiners, and heads of clinical departments. Data were collected through surveys, structured interviews, documents' review, and calculation of online examination's psychometrics. Descriptive statistics were used. Quantitative data were presented in the form of means and standard deviations. Responses of heads of clinical departments in the structured interview were transcribed and analyzed thematically based on three pre-established themes. Results: Quantitative and qualitative data on the utility (validity, reliability, acceptability, educational impact, and cost and feasibility) of online objective structured clinical examination (OSCE) were collected. Content validity of the online clinical examination was established through high mean scores of content representativeness, which was confirmed by the heads of clinical departments regarding the proper coverage of clinical skills. Criterion validity was established through a high correlation between clinical and theoretical exam results (r = 0.75). Reliability of the exam was established through an acceptable Cronbach's alpha value (0.70 to 0.78) over the four days of the examinations. The examinations were perceived as highly acceptable by both students and examiners. High educational impact was inferred from students' responses and review of documents. The examination was found to be feasible and of reasonable cost. Conclusion: Online OSCE might be a good alternative of conventional clinical assessments in times of crises and impossibility of having in-person contact between students, examiners, and patients. An important major drawback is still present in such initiatives, which is the inability to assess students' physical examination skills.

Online, Face-to-Face, or Blended Learning? Faculty and Medical Students' Perceptions During the COVID-19 Pandemic: A Mixed-Method Study.

BACKGROUND: COVID-19 pandemic forced educational institutions to adopt online methods which were inevitable to keep continuity of education across all academia after suspension of traditional educational systems. The aim of this study was to explore the experience of faculty and students of online and face-to-face learning, and their preference of the mode of learning after the pandemic. METHODS: This is a mixed-method study. Quantitative data was collected through a survey from 194 medical students and 33 faculty members, while qualitative data was collected through two focus group discussions with 9 students and another two with 13 faculty members. Quantitative variables were presented as means and standard deviations. Paired samples t-test and Chi-square test were used. Thematic analysis of qualitative data was used to code, interpret, and make sense of data. RESULTS: Mean scores of responses of faculty members and students were higher for face-to-face and blended learning compared to online learning in all survey statements with statistically significant differences. More than half of the students (53.1%) preferred the face-to-face mode of learning, while most of the faculty members (60.6%) preferred the blended mode of learning. Qualitative analysis identified five themes, namely: "Transforming the way theoretical teaching sessions are given," "Face-to-face teaching at campus cannot be replaced for some types of education," "Interaction in online sessions is limited," "Problems and challenges of online examinations," and "Technical issues and challenges of online education." It revealed suggestions that at least 30% of the curriculum could be taught online post-COVID-19. Some aspects of clinically oriented teaching including history taking and case discussions can also be delivered online in the future. Faculty members and students reported that dealing with online education was not difficult, although the transition was not smooth. CONCLUSION: Medical students and faculty members were in favor of face-to-face and blended modes of learning. However, they perceived online mode of learning as an acceptable adaptation in theoretical teaching and in some clinically oriented teaching including history taking and clinical case discussions. Although face-to-face education in medicine is irreplaceable, the blended mode of learning remains an acceptable and practical solution for the post-COVID era.

Developing, Validating, and Implementing a Tool for Measuring the Readiness of Medical Teachers for Online Teaching Post-COVID-19: A Multicenter Study.

BACKGROUND: While online education is by no means a new concept, it was recently thrust into the spotlight after school campuses all over the world were forced to close because of the COVID-19 pandemic. The sudden need to shift revealed emerging challenges to online teaching, both logistic and personal. One important challenge is the ability to assess the readiness of educators for online teaching, so that appropriate and specific feedback/training can be offered to those in need. This study aims at developing, validating, and implementing a tool to measure the teachers' readiness for online teaching in three medical schools from three different countries. METHODS: This was a multi-center, cross-sectional study that involved developing a survey through review of literature and previous studies, item development and revision, and pilot testing. The survey was then distributed electronically to a convenient sample of 217 teaching faculty members of different academic ranks from three medical schools in Egypt, Saudi Arabia, and Bahrain. Exploratory factor analysis and reliability study were performed. Descriptive statistics were applied, and the statistical significance level was set at 0.05. RESULTS: Factor analysis produced the following five factors: "Online Teaching and Course Design Skills", "Digital Communication", "Basic Computer Skills", "Advanced Computer Skills" and "Using Learning Management Systems". The tool showed high reliability (alpha = 0.94). Survey results showed highest mean scores for Basic Computer Skills with lower scores for Online Teaching and Course Design Skills and Using Learning Management Systems. ANOVA revealed statistically significant differences between the three studied schools regarding Digital Communication (F=5.13; p=0.007) and Basic Computer Skills (F=4.47; p=0.012) factors. CONCLUSION: The tool proved to be reliable and valid. Results indicated an overall acceptable readiness in the three involved schools, with a need for improvement in "Online Teaching and Course Design" and Using Learning Management Systems.

A guide for evaluation of online learning in medical education: a qualitative reflective analysis.

BACKGROUND: With the strike of Covid-19, an unprecedented rapid shift to remote learning happened worldwide with a paradigm shift to online learning from an institutional adjuvant luxury package and learner choice into a forced solo choice. This raises the question of quality assurance. While some groups have already established standards for online courses, teaching and programs yet very little information is included on methodology of their development and very little emphasis is placed on the online learning experience. Nevertheless, no work has been done specifically for medical education institutions. AIM: To develop a set of descriptors for best practice in online learning in medical education utilizing existing expertise and needs. METHODS: This work utilizes a qualitative multistage approach to identify the descriptors of best practice in online learning starting with a question guided focus group, thematic analysis, Delphi technique and an expert consensus session done simultaneously for triangulation. This was done involving 32 institution in 19 countries. RESULTS: This materialized into the development of a set of standards, indicators, and development of a checklist for each standard area. The standard areas identified were organizational capacity, educational effectiveness, and human resources each of which listed a number of standards. Expert consensus sessions identified the need for qualification of data and thus the development of indicators for best practice. CONCLUSION: Standards are needed for online learning experience and their development and redesign is situational and needs to be enhanced methodologically in axes that are pertaining to the needs of the education community. Taking such axes into consideration by educators and institutions will lead to planning and implementing successful online learning activities, while taking them into consideration by the evaluators will help them conduct comprehensive audits and provide stakeholders with highly informative evaluation reports.

Using Appreciative Inquiry to explore the effect of COVID-19 on student trust: medical students' perspective.

This article was migrated. The article was marked as recommended. Background Students' anxiety due to the COVID-19 pandemic was expressed by some medical students in the form of anger and mistrust. This study aims to explore the reasons for mistrust between students and faculty among medical schools in Egypt that have flared during the pandemic. Methodology This is a three-phase exploratory qualitative study depending on thematic emergence from appreciative interviews (AI) sessions. Phase 1 online Appreciative Inquiry (AI) session followed by thematic content analysis. Phase 2 The themes were approached by a smaller cohort of students using a design that relied mostly on the psychometric free association test. Phase 3 The themes were tested on a larger number of students through an online survey. Results Students are revealed to be very well educated regarding contemporary medical education concepts. The most important factors from the student perspective were the presence of a well-designed assessment system aligned with the learning outcomes and teaching methodologies and the presence of extracurricular activities and soft skills, respectively. A balanced student life respecting their mental health was found important to increase trust. Conclusion A roadmap to enhance the student trust must be planned on several pivots: curriculum structure, extracurricular life, communication strategies, and identifying student roles in their learning and decision-making.

A Step-by-Step Guide to Managing the Educational Crisis: Lessons Learned from COVID-19 Pandemic.

BACKGROUND: Medical education is facing great challenges and uncertainties amidst the COVID-19 pandemic. AIMS AND OBJECTIVES: This article aims to provide tips that can provide a guide for medical education leaders to coordinate crisis management referring to the Egyptian context. MATERIALS AND METHODS: This work was done using a reflection on the COVID-19 response by Egyptian universities and analysis of such responses. RESULTS: Medical Education Institutions are required to build a taskforce team for crisis management. These should be committed to supporting sudden online education transition, academic support, and the psychological well-being of students, staff members, health care professionals, paramedics, and faculty administration. As the situation evolves, the taskforce has to monitor the challenges and provide appropriate plans, guidance, and solutions. Leaders in medical education have a crucial role in response to the pandemic crisis in securing a successful educational process while ensuring the mental and psychological well-being of the stakeholders. CONCLUSION: Crisis management is the skill of the future and more investment needs to be placed in designing crisis response and in enabling universities to accommodate this response.

Use of Short Videos for Faculty Development in Adaptation of Interactive Teaching Strategies for Virtual Classroom.

The threat associated with physical interaction in teaching and learning timed with the COVID-19 pandemic has rendered faculty in a situation that they were not entirely prepared for. This paper describes a case study where educational videos were used in short format to help faculty progress in their adaptation to virtual teaching. The initiative describes the adaptations done to the videos and making them ore accessible to faculty. The channel experienced a 300% increase in viewership. There is an inherent need for training on using virtual classroom tools and adapting teaching strategies to these virtual tools. Using 5-7 minute videos proved useful in this area.

Evaluation of Curricular Adaptations Using Digital Transformation in a Medical School in Arabian Gulf during the COVID-19 Pandemic.

BACKGROUND: Several institutions adopted innovative approaches to ensure continued learning for their students during the COVID-19 pandemic. All curricular innovations should undergo curriculum evaluation; hence, the objective of this paper was to share the salient features of evaluation using faculty and student's feedback on curricular adaptations implemented through digital transformation in a Medical School in Arabian Gulf during the COVID-19 pandemic, using a structured questionnaire. METHODOLOGY: After getting informed consent, feedback about acceptability and limitations regarding various aspects of curricular adaptations was obtained from students and faculty, using a structured and validated questionnaire. The response rate from faculty and students was 90% and 60%, respectively. The qualitative responses were analyzed using thematic analysis. RESULTS: About 97% agreed that Modular Object-Oriented Dynamic Learning Environment, ZOOM, and Examsoft platforms were effective for curriculum delivery and assessment. 85% agreed that they were able to maintain online interactivity and 92% conveyed their willingness to continue to use these digital innovations even after the end of pandemic. "Lack of interactivity," "missed clinical training," "live sessions were more engaging than recorded ones" were the prominent themes emerged out of thematic analysis. All faculty and students expressed concern over the lack of clinical training involving real patients. All of them expressed appreciation to the university and faculty for their enormous efforts. CONCLUSION: Innovative ways should be considered to start clinical teaching with real patients, during pandemic. The learning outcomes of digital learning should be validated across all institutions. New indicators related to "digital learning" should be considered for accreditation of medical schools.