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.

Perceptions and Factors That Influence the Choice of Pathology as a Career Among Medical Students in Saudi Arabia.

Introduction Pathologists play a pivotal role in diagnosing diseases and improving patient care. Nonetheless, research indicates that a mere fraction of medical school graduates opt for a career in pathology, ranging from 1% to 3%. Diverse factors influence students' perceptions of pathology, encompassing lifestyle, patient interaction, and income. Aim The aim of this study was to assess the perceptions and factors that influence students' selection of pathology as a career in Saudi Arabia. Methodology A cross-sectional, self-administered electronic questionnaire was distributed among students from various regions of Saudi Arabia. The questionnaire encompassed both quantitative and qualitative data. To ensure statistical rigor, a confidence level of 95%, response distribution of 10%, and margin of error of 5% were applied. Accordingly, the recommended sample size of 150 participants was determined. Data analysis was performed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY), with the chi-square test applied at a significance level of P < 0.05. Results Among the 664 participating students, 130 (19.6%) indicated an interest in pathology, of whom only 19 (2.9%) regarded it as their primary choice. No statistically significant difference was found between the male and female students or between the students in foundational and clinical years. Conclusions The female students generally held a more favorable perception of pathology, acknowledging its clinical significance and role in diagnosis, prognosis, and patient management. The absence of nocturnal calls emerged as the most encouraging factor, while limited patient interaction emerged as the primary deterrent in choosing pathology.

From generosity to gratitude: Exploring Islamic views on body donation, human dissection, and honoring the gift of life.

Human dissection is an ancient pedagogical method that is still relevant in modern anatomy curricula. The body procurement process for dissection purposes has undergone significant evolution from the medieval era until now, whereby body donation has become the main source for human bodies in medical education. The appreciation ceremony for body donors is an excellent way to promote a body donation program, whereby both dissection and appreciation ceremonies are effective in inculcating professional behaviors and altruism among medical students. Despite the benefits of dissection and such ceremonies, conflicting ideas about the acceptability of these methods exist among Muslim scholars and students. Hence, this article provides a theological Islamic interpretation of human dissection, body donation, and appreciation ceremonies from four sources of Islamic law-the Qur'an, Hadith, Idjmaa, and Qiyas-to justify Muslims' involvement in the aforementioned. It is important to note that the fundamentals of Islam are submission to the will of the one and only God, Allah Subhanahu wa ta'ala (SWT) and recognition of Prophet Muhamad (peace be upon him) as the last messenger of God. Therefore, the actions of a Muslim are strongly based on faith and virtue.

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).

The implementation of social accountability in medical schools in Eastern Mediterranean region: A scoping review.

Objectives: Social Accountability is a relatively new approach in medical education, Information about its implementation is scarce in the Eastern Mediterranean Region. The objective of this scoping review was to investigate the patterns and trends in reporting the social accountability (SA) of medical schools in the Eastern Mediterranean region (EMR). Methods: Using the Arksey and O'Malley approach, we conducted literature searches between 1995 and 2022 in the following databases: Scopus, Web of Sciences, CINAHL, PubMed, and Google Scholar using the search terms social accountability, medical school, faculty of medicine, Eastern Mediterranean Region, EMRO region. Using qualitative theme analysis, the extracted, coded, and analyzed data were reported. Results: The screening of various databases revealed 164 articles, 26 articles were finally included in the review. The 26 included articles originated from only seven out of the 22 EMR countries: Iran, Sudan, Kingdom of Saudi Arabia (KSA), United Arab Emirates, Egypt, Morocco, and Pakistan. The articles included were categorized under six themes: defining the SA and compliance with SA values and concepts, accreditation, educational program, perceptions of faculty and students, admission of students, and measurement of social accountability. Conclusions: The publications related to SA from the EM regions countries revealed similarities with other parts of the world in that the SA concept is not effectively translated into real day-to-day activities in medical schools. More work is needed from leaders in education and health systems to examine SA enablers and improve the uptake of the concept.

10 years of experience in adopting, implementing and evaluating progress testing for Saudi medical students.

Objectives: The progress test (PT) is a comprehensive examination that is designed to match the knowledge acquisition necessary at graduation and monitors progress during the entire period of an undergraduate program. Qassim College of Medicine (QCM) began using the multi-institutional PT in the Kingdom of Saudi Arabia (KSA). This study aimed to determine if the PT can be utilized to assess the progress of medical students at different Saudi medical colleges with different educational approaches, as well as whether this testing modality could be accepted by other colleges. Methods: Beside the establishment of a PT committee, comprehensive blueprinting was crafted to sample 200 A-type multiple choice questions (MCQs) from different disciplines. The PT is a paper-and-pencil model and is answered in a 4-h period. All PT items followed a uniform design. Results: In total, 13 rounds of the progress test have been conducted. The number of participating colleges increased from three (with 285 students) in the first test (May 2012) to more than 20 (with >6000 students) in the ninth round (February 2017). The average % scores for first-year students ranged from 3.0% to 7.9% while the average scores for fifth-year students ranged from 34.0% to 43.0%. Conclusion: The conduction of this meticulously crafted test to evaluate knowledge achievement at medical graduation is a fruitful tool and helps to provide constructive feedback for test-takers and other stakeholders relating to their relative positions among other fellows at the national level.

Promoting more future-ready anatomy education after the Covid-19 pandemic: A scoping review.

The coronavirus disease 2019 (Covid-19) pandemic caused an abrupt transition from face-to-face to online anatomy teaching, learning, and assessment. Although online education has ensured the continuity of anatomy education during the pandemic, its implementation has been challenging, and its effectiveness has been questioned. Therefore, literature pertinent to online anatomy education during the pandemic is crucial to explain Covid-19's disruptions to this field. Accordingly, this scoping review explored changes, disruptions, and gaps in anatomy teaching and assessment during Covid-19 using an enhanced version of Arksey and O'Malley's six-stage protocol. Five online databases were searched for articles that described changes and disruptions in anatomy education. Three independent researchers were involved in titles, abstracts, and full texts screening, while another four researchers were independently involved in data extraction, charting, and synthesis. This review revealed six themes: immediate strategic plans and actions, teaching and learning changes, online assessment practice, students' and educators' receptivity and adaptability, online learning and assessment effects, and future directions. It also revealed four gaps: non-future-ready curricula, learning obstacles, administrative and teaching challenges, and online education ethical issues. The results were reported in tabular and narrative forms, following the PRISMA Extension for Scoping Reviews (PRISMA-ScR guidelines). Understanding the evolution and gaps in anatomy education during the Covid-19 pandemic will help anatomists design future-ready, adaptable curricula.

What makes a medical school socially accountable? A qualitative thematic review of the evaluation of social accountability of medical schools in the Eastern Mediterranean Region.

Background: The World Health Organization Regional Office for the Eastern Mediterranean Region established social accountability as one of its strategic directions for medical education in 2015, and individual countries have been contributing to ongoing social accountability endeavours. Aims: This study aimed to identify themes related to compliance with social accountability concepts in the countries of the Eastern Mediterranean Region (EMR) based on published papers. Methods: Thematic analysis of qualitative studies was done following a scoping review of published papers in the EMR over the period 1995-2021. CINAHL, Google Scholar, PubMed, Scopus, and Web of Sciences were searched along with a manual search for articles from reference lists. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research ENTREQ statement guided the review. Results: The reviewed studies (n = 3) were from 3 countries in the EMR: Egypt, Saudi Arabia, and Sudan. These studies identified 7 key themes: mission and governance, communication with stakeholders, a community-oriented and community- based curriculum, provision of health services, responding to emerging community health needs, impactful faculty and student research and gaps to be addressed. Conclusions: Despite the call to reorient health profession schools to be responsive to the community and health system needs, only 3 countries in the EMR reported their efforts to move towards social accountability. Urgent action needs to be taken by medical education leaders in the Region to support colleges in their compliance with social accountability concepts.

Factors affecting test anxiety: a qualitative analysis of medical students' views.

BACKGROUND: Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students' insights into TA and their suggestions on how to reduce it. METHODS: We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines. RESULTS: Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The "students" theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, "academic recources" into heavy curriculum vs. facilitative curricular aids, and "examiner" into criticism vs. feedback and strict vs. kind approaches. CONCLUSION: This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.

Web-based and paper-based examinations: Lessons learnt during the COVID-19 pandemic lockdown.

OBJECTIVES: This study describes the process of remote assessment in medical education during the COVID-19 lockdown and shares data-driven experiences in resolving emerging concerns. METHODS: We analysed the data of end-of-course paper-based exams (PBEs) and web-based exams (WBEs) conducted during the academic year 2019/2020. Twelve end-of-block exams were included. There were four exams each for the first-, second-, and third-year students. Eight exams were conducted as PBEs, and four were administered as WBEs. We compared the mean scores of PBEs and WBEs between exams and batches. Additionally, we compared the PBE and WBE scores obtained by 10 high-performance and 10 lowest-achieving students. RESULTS: Variations were found in the scores of students from each of the three batches in PBEs or WBEs. In a few instances, the difference was statistically significant. No specific trend or pattern was detected in the difference between the scores of PBEs and WBEs. The mean score for the WBEs was intermediate among the means of PBEs for the first- and second-year students, but lower for the third-year students. Individual students' marks in different exams consistently showed a positive correlation. The correlation was always high for PBEs (r = 0.782, 0.847). CONCLUSION: The present study showed that average and individual scores in WBEs and PBEs are comparable. Although there were some variations between the results of the two assessment modalities, no remarkable trend or pattern was observed. WBEs offer an ideal approach for formative assessment, progress testing, and the low-weight, but frequent, nature of continuous assessment.

Twelve tips for introducing the concept of validity argument in assessment to novice medical teachers in a workshop.

This article was migrated. The article was marked as recommended. Background: Misconceptions have been observed in the application of validity by faculty and in the reporting of validity in a significant amount of published work in the field of students' assessment. As a result, actions concerning the dissemination of information about the concept of validity in relation to assessments, especially among novice medical teachers, is needed. Aim: This work aims to guide how the concept of validity argument in assessments is delivered to novice medical teachers in a workshop. Methods: Critical reflection and a careful review of relevant literature were used to develop these tips. Results and Conclusion: Twelve tips were introduced to support instructors conducting workshops on introducing the concept of validity, especially to novice medical teachers.

Curriculum delivery in Medical Education during an emergency: A guide based on the responses to the COVID-19 pandemic.

This article was migrated. The article was marked as recommended. The spread of coronavirus (COVID-19) has led the majority of countries worldwide to implement emergency lockdown plans to limit the spread of the virus; this has resulted in the interruption of on-campus school and university instruction. Responses to the COVID-19 pandemic in medical education have varied from country to country, from closures of medical schools to online/distance learning approaches to abiding by country-specific measures such as social distancing to stop the spread of the disease. The sudden transition from on-campus learning to exclusively distance learning is challenging for both faculty and students and has required a lot of preparation and other efforts in a short time. This paper aims to share the experiences of four authors in the middle east that have dealt with the sudden transition from ordinary teaching and learning to fully online teaching. The process of Curriculum delivery in Medical Education during an emergency has included; establishing a sense of urgency, establishing working teams, conducting needs assessments, developing implementation plans, communicating the curriculum content, capacity building, managing students' stress, finding tools to be used, managing student engagement and motivation, student assessment, anticipating challenges and planning for how to overcome them, and monitoring and evaluation of curriculum implementation and continuous improvement. The proposed process will hopefully assist the medical schools in response to the current pandemic (COVID-19) and when facing similar situations.

The assessment clock: A model to prioritize the principles of the utility of assessment formula in emergency situations, such as the COVID-19 pandemic.

This article was migrated. The article was marked as recommended. Many concerns have been raised regarding the impact of the changes to medical education as a result of the coronavirus disease 2019 (COVID-19) pandemic, particularly the impact of these changes on student assessments. This paper suggests an assessment clock as a conceptual model to enable medical educators to decide which assessment method is suitable under challenging circumstances, such as the COVID-19 pandemic. The assessment clock has five numbers, representing the five principles of the utility of assessment formula, which are arranged from the principle with the lowest weight (cost = 1) to the principle with the highest weight (validity = 5). The numbers are repeated in each half of the clock, and the clock is placed in the middle of two overlapping axes. The vertical axis is related to exam stakes (high or low). The low stakes condition, which represents the normal situation of running assessments at the beginning of each academic year, is placed at the top of the clock. The horizontal axis is related to the type of situation (normal or crisis). The high stakes condition is placed at the bottom of the clock. The right half of the clock represents the normal situation of planning and conducting assessments, while the left half represents an emergency situation, such as the current COVID-19 pandemic. The assessment clock offers assessment planners insights into how to determine the most important assessment principles on which they should focus during a crisis situation. Moreover, it provides practical guidance for educators to help them decide which assessment tool is suitable for use in which situation.

Internet Use and Addiction Among Medical Students in Qassim University, Saudi Arabia.

OBJECTIVES: This study aimed to measure the prevalence of Internet use and addiction and determine its association with gender, academic performance and health among medical students. METHODS: This cross-sectional study was conducted between December 2017 and April 2018 at the College of Medicine, Qassim University, Buraydah, Saudi Arabia. The validated Internet Addiction Test questionnaire was distributed by simple random methods to medical students (N = 216) in the pre-clinical phase (first-, second- and third-years). A chi-square test was used to determine significant relationships between Internet use and addiction and gender, academic performance and health. RESULTS: A total of 209 student completed the questionnaire (response rate: 96.8%) and the majority (57.9%) were male. In total, 12.4% were addicted to the Internet and 57.9 had the potential to become addicted. Females were more frequent Internet users than males (w = 0.006). Academic performance was affected in 63.1% of students and 71.8% lost sleep due to late-night Internet use, which affected their attendance to morning activities. The majority (59.7%) expressed feeling depressed, moody or nervous when they were offline. CONCLUSION: Internet addiction among medical students at Qassim University was very high, with addiction affecting academic performance and psychological well-being. Suitable interventional and preventive measures are needed for proper Internet use to protect students' mental and physical health.

Comparison of Smoking and Khat Chewing Habits between Medical and Non-Medical Female Students at UST, Sana'a, Yemen.

BACKGROUND: Smoking is a worldwide problem that kills millions of people. Women smoke much lower than males but the numbers of smoker women are growing up. The objectives of this study were to assess the prevalence of smoking and khat chewing in medical and non-medical female students at University of Science and Technology (UST), Sana'a, Yemen. METHODS: We used self-administrated questionnaire to collect cross-sectional data from a randomly selected sample of medical and non-medical female students of UST in 2012-2013. Overall, 480 students completed and returned the questionnaire, of them medical students represented 50% of them. RESULTS: The prevalence of smoking was significantly low among female medical students (P=0.045), however, not significantly difference was found between medical and non-medical female students in khat chewing habits (P=0.083). Non-smoker medical female students who tried smoking (45.6%) were significantly lower than non-medical students (54.4%), and curiosity was the main reason for trying smoking. Water pipe was the most common type of smoking among smoker students (78.6%). Out of 26 female students who smoke and chew khat, 18 students reported that they smoke more while they chew khat. CONCLUSIONS: Our study highlights the need for increased health education, awareness, and knowledge of the risks of smoking and particularly khat chewing to reduce these habits among female university students especially in non-medical female students.

Screening for PCDD/Fs and dl-PCBs in local and imported food and feed products available across the State of Kuwait and assessment of dietary intake.

A total of 318 local and imported meat, milk, eggs, fish, and animal feed samples collected in Kuwait were analyzed by cell-based reporter gene assay (Dioxin-Responsive Chemical Activated LUciferase gene eXpression DR-CALUX) for PCDD/Fs and dl-PCBs. The bioanalytical equivalents (BEQs) obtained by DR-CALUX bioassay were compared with the official maximum limits according to the European Commission (EC) regulations. Suspected and randomly chosen negative samples were analyzed by gas chromatography-high resolution mass spectrometry (GC-HRMS). The results showed that among suspected samples, one sample was confirmed to be non-compliant. The positive sample was of imported origin. The correlation coefficient of 0.98 between DR-CALUX and GC-HRMS was found. Moreover, the average daily intakes of PCDD/Fs and dl-PCBs for the Kuwaiti population were estimated. Results obtained in this study were discussed and compared with other published data.