Impact of art and reflective practice on medical education in the emergency department.

OBJECTIVES: There is heightened intrigue surrounding the application of arts-based pedagogy in medical education. Art encompasses multiple forms of expression and is used to convey specific meaning and emotion, whereas provoking critical reflection. Our aim was to explore the effectiveness of art and reflective practice in medical education, in the context of the ED. METHODS: Longitudinal methodological study design. Prior to the first, and after the final clinical practicum, medical students watched a 3-min film: 'The Art of the ED'. Written reflections focused on changing perceptions towards the film during their medical education programme. Data were thematically analysed. RESULTS: Three themes were collected from 25 written reflections and included: 'professional growth' exploring personal and professional development across the medical programme; seeing 'patients are people'; and the purpose, structure and function of an ED exposed in 'the reality of ED'. Results highlight that arts-based pedagogy can facilitate meaningful and critical reflection in medical students, whereas also fostering professionalism. Reflecting on the film broadened their perspective into a realm of new possibilities, challenging them to identify implicit bias around ED, and promote professional identity formation. CONCLUSIONS: The combination of art and reflection in medical education enhances reflective learning and can lead to transformative change, including the development of core doctoring values of service, empathy and respect for patient. There are clear benefits to medical education incorporating more arts-based pedagogy that promotes reflective exploration and interpretation of the psychosocial context of health and illness, delivery of more holistic models of care and their role as doctors.

Exploring the career maze: An investigation of career intentions of medical graduates in Pakistan: A qualitative study.

BACKGROUND & OBJECTIVES: Pakistan faces a number of challenges in medical education. While there is an increase in the number of medical schools across the country, there is a dearth of practicing doctors in rural areas as well as a shortage of specialists in various fields specially in surgical specialties. Similarly, the number of doctors migrating overseas is also increasing due to security concerns. This requires investigation of the factors that influence career intentions of medical graduates in Pakistan. As there is no validated instrument available within Pakistani context, this qualitative study was designed to examine medical graduates' reasons for their career intentions in light of Ajzen's Theory of Planned Behavior (TPB). METHODS: Five focus group discussions were conducted in two cities of Pakistan i.e. Karachi and Hyderabad during November - December 2012. These were then transcribed and were coded into the three primary attributes of TPB i.e. behavioral, normative and control beliefs by comparing similarities and differences. RESULTS: The results suggest that there is a variation in the factors that influence the career intentions of the medical students. In addition a number of new themes were identified which have not been reported earlier in studies elsewhere and are specific to this region. This needs further examination by stakeholders for intervention. CONCLUSION: The analysis of data from the focus groups confirms the theoretical framework and identifies a range of influencing factors, at different stages of education and practice. As the study was limited to a smaller number of graduates and all except one graduate wanted to continue practice, a larger sample may be required for the purpose of generalization of the findings reported in this study.

Capturing the 'art' of emergency medicine: Does film foster reflection in medical students?

OBJECTIVE: Integrating arts and humanities-based pedagogy into curricula is of growing interest among medical educators, particularly how it promotes reflection and empathy. Our aim was to explore whether a 2.50 min film titled 'The Art of the ED' stimulated reflective learning processes in a group of first year medical students. METHODS: The film was shown prior to their first clinical placement in an ED. Student participation was voluntary and not assessable. Using an exploratory qualitative research approach, this study drew on data collected from students' individual written reflections, exploring their perceptions towards clinical experience in an emergency medicine (EM) attachment. RESULTS: A total of 123 (51% of 240) students submitted a reflection. The qualitative data revealed three main themes: the opportunity for students to preview EM ('While watching the film, I felt like I was the patient and the doctor all at once, in that I was living the experience both from within and as an observer …'); exposed the reality of ED; and fostered a growing awareness of the fragility of human life. CONCLUSIONS: These findings highlight how visual methodologies (like film) create a safe, non-threatening space to access, experience and process emotion around their perceptions towards EM, and to anticipate and emotionally prepare for their impending clinical experience in the ED. These data support the use of visual methodologies to foster reflective processes that assist medical students to integrate the 'art' of EM, and the development and commitment of core doctoring values of empathy, service and respect for patients.

Enhancing Capabilities in health professions education.

OBJECTIVE: This article documents the results of ongoing summative program evaluation of a suite of postgraduate courses at The University of Western Australia designed to enhance the educational capabilities, academic leadership and scholarly output of health professionals. METHODS: Commencing students were invited to participate in this descriptive, longitudinal study that surveyed students at commencement and subsequently over a seven year period. Data was collected at baseline and follow-up in relation to the respondents' educational leadership responsibilities, promotions, involvement in new educational programs, and recognition for contributions towards student learning, educational scholarly outputs and involvement in training programs. RESULTS: The respondents came from a wide range of health professions and worked in various roles, with a quarter already holding leadership positions. During the follow-up period, half reported receiving a new promotion or moving to new positions requiring educational leadership. Those identifying as being involved with the development of new educational programs doubled and 34% received a new teaching award. Scholarly productivity doubled with 45% giving an oral presentation related to education, 21% publishing and 29% being successful in obtaining funding related to an education project. CONCLUSIONS: These postgraduate courses in health professions education appear to be positively influencing graduates' capabilities, especially in the areas of educational leadership skills and scholarly productivity. For those looking to develop a community of leaders in health professions education, the authors offer some suggestions.

Developing learning outcomes and integrated curricula across a health sciences faculty.

Every student should have a clear understanding of what is expected of them during their course of study and at the time of graduation. Improving the clarity for both students and teachers of the intended learning outcomes using outcome-based- education (OBE) will increase the relevance of learning opportunities and additionally provide a framework to help unify a curriculum. This paper describes how the Faculty of Medicine, Dentistry and Health Sciences at the University of Western Australia approached the specification and documentation of learning outcomes for its undergraduate courses, using examples from the Medicine course. It discusses how the Faculty began the journey of shifting the culture of the learning environment towards one focused on learner outcomes. The challenges faced and successes experienced offer insights into the adoption of OBE for others.