The impact of the Systematic Assessment for Resilience (SAR) framework on students' resilience, anxiety, depression, burnout, and academic-related stress: a quasi-experimental study.

BACKGROUND: Medical students face significant psychological stress, impacting their academic performance and well-being. The Systematic Assessment for Resilience (SAR) framework is designed to enhance resilience and mitigate stress among medical students, addressing the need for interventions within the assessment system in medical education. The aim of this study was to evaluate the implementation of SAR framework on medical students' resilience, anxiety, depression, burnout, and academic stress. METHODS: This study employed a quasi-experimental design with pre- and post-testing. It involved the training of course coordinators in implementing the SAR framework and its integration into the daily learning activities. Fourth-year medical students were assessed before and after the intervention using standardized measures of resilience, anxiety, depression, burnout, and academic stress. Data were analyzed using quantitative methods and thematic analysis for qualitative feedback. RESULTS: Post-intervention, students demonstrated a significant increase in resilience scores (p < 0.001) and a notable decrease in measures of anxiety, depression, and academic stress (p < 0.001). The burnout types were also statistically different (p < 0.001) except client-related burnout (p > 0.05). Qualitative feedback of the course coordinators highlighted an improved learning environment, increased coping strategies, and a more supportive academic culture. CONCLUSION: The SAR framework significantly contributes to enhancing medical students' resilience and reducing psychological distress. Its implementation suggests a promising approach to fostering a supportive educational environment that not only addresses the psychological challenges faced by medical students but also enhances their academic performance and overall well-being. Further research is warranted to explore the long-term impacts of SAR across different medical education contexts.

Psychometric properties of the Persian version of the Engaged teachers Scale (ETS).

BACKGROUND & AIM: Teacher engagement can be defined as the teachers' effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS). MATERIALS & METHODS: A total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22. RESULTS: Of the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30-40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach's alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98. CONCLUSION: The Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.

Integrating the social determinants of health into curriculum: AMEE Guide No. 162.

The World Health Organization (WHO) defines the Social Determinants of Health (SDOH) as the non-medical factors influencing health outcomes. SDOH is associated with conditions in which people are born, grow, work, and live. Medical schools and licensing bodies are increasingly recognizing the need for doctors and healthcare professionals to be aware of their patient's social context and how it impacts their states of health and disease. However, there is considerable variation in the approaches of different institutions and countries to incorporating SDOH into their curricula. In order to allow clinicians to adopt a holistic approach to patient health, equipping them with extensive knowledge of SDOH would give learners the confidence, skills, knowledge, and attitudes needed to effectively engage with patients and their families. This approach aids health professionals with knowledge of the influence of the social context and cultural factors that affect patients' behaviors in relation to health. Incorporating the SDOH in medical and health professional school curricula would contribute towards adequately preparing future healthcare practitioners to provide effective, comprehensive, and equitable care, especially to marginalized and underserved populations. The Guide will take an evidence-based approach grounded in the available contemporary literature and case studies. The focus will be on integrating SDOH into undergraduate and postgraduate medical curricula to promote an understanding of the social factors that influence patients' and communities' health. Ultimately, this guide seeks to contribute to the reduction of inequalities in health.

The framework of Systematic Assessment for Resilience (SAR): development and validation.

BACKGROUND: Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. METHODS: We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. RESULTS: The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. CONCLUSIONS: The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).

Does Curriculum Analysis in Clinical Residency Training Need to be Different?

OBJECTIVES: Curriculum analysis is an essential process in exploring the validity of assumptions behind the curriculum and judging its perspectives, goals, and objectives. This study analysed the curriculum of the Internal Medicine Residency Programme at the Sudan Medical Specialisation Board, exploring the programme's strengths, weaknesses, and areas for improvement. MATERIALS AND METHODS: A qualitative descriptive analysis method using Harden Ten Questions framework was used, implemented through document analysis. Thematic analysis was used to categorise the findings following the Harden Ten Questions framework. RESULTS: The analysis of this curriculum using Harden Ten Questions framework revealed that it is built on needs assessment, with clear objectives and contents, good organisation of the contents and a precise management process. However, there is a need to improve the areas related to training strategies, training methods, assessment methods and the learning environment. CONCLUSIONS: This study showed that the curriculum is built to meet the needs of the Sudanese community. The contents fit for internal medicine clinical residency and the methods of training are likely to foster long-life learning. The curriculum needs some improvement particularly in the following areas such as clinical teaching, trainee assessments, and learning environments. Harden Ten Questions framework for curricula was practical to some degree in analysing the postgraduate curriculum. However, some suggestions have been made regarding the original framework to make it more adaptable to curriculum analysis at postgraduate level. The systematic analysis is transferable to the analysis of other undergraduate or postgraduate medical curricula in Sudan.