Using contribution analysis to evaluate health professions and health sciences programs.

Introduction/background: Course evaluation in health education is a common practice yet few comprehensive evaluations of health education exist that measure the impact and outcomes these programs have on developing health graduate capabilities. Aim/objectives: To explore how curricula contribute to health graduate capabilities and what factors contribute to the development of these capabilities. Methods: Using contribution analysis evaluation, a six-step iterative process, key stakeholders in the six selected courses were engaged in an iterative theory-driven evaluation. The researchers collectively developed a postulated theory-of-change. Then evidence from existing relevant documents were extracted using documentary analysis. Collated findings were presented to academic staff, industry representatives and graduates, where additional data was sought through focus group discussions - one for each discipline. The focus group data were used to validate the theory-of-change. Data analysis was conducted iteratively, refining the theory of change from one course to the next. Results: The complexity in teaching and learning, contributed by human, organizational and curriculum factors was highlighted. Advances in knowledge, skills, attitudes and graduate capabilities are non-linear and integrated into curriculum. Work integrated learning significantly contributes to knowledge consolidation and forming professional identities for health professional courses. Workplace culture and educators' passion impact on the quality of teaching and learning yet are rarely considered as evidence of impact. Discussion: Capturing the episodic and contextual learning moments is important to describe success and for reflection for improvement. Evidence of impact of elements of courses on future graduate capabilities was limited with the focus of evaluation data on satisfaction. Conclusion: Contribution analysis has been a useful evaluation method to explore the complexity of the factors in learning and teaching that influence graduate capabilities in health-related courses.

Lessons learned from piloting mHealth informatics practice curriculum into a medical elective.

Introduction: This case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers. Results: The students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon. Assessment by mHealth informatics champions supported the students' independent learning. Lessons learned: Promotion of mHealth curriculum must be transparent and clear. Our elective delivery was hampered by a lack of suitable mobile device ownership and limited availability of useful, free apps. Technological jargon required clarification. Educators require particular mHealth informatics and educational expertise to support mHealth pedagogies. This learning helps to prepare medical curriculum designers for addressing evolving mHealth practice horizons.

Governance and assessment in a widely distributed medical education program in Australia.

The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes.

The influence of language family on academic performance in Year 1 and 2 MBBS students.

OBJECTIVES: Generally, in most countries around the world, local medical students outperform, in an academic sense, international students. In an endeavour to understand if this effect is caused by language proficiency skills, we investigated academic differences between local and international MBBS students categorised by native language families. METHODS: Data were available and obtained for medical students in their first and second years of study in 2002, 2003, 2005 and 2006. Information on social demographics, personal history and language(s) spoken at home was collected, as well as academic assessment results for each student. Statistical analysis was carried out with a dataset pertaining to a total of 872 students. RESULTS: Local students performed better than international students in first- (p < 0.001) as well as second-year (p < 0.001) assessments. In addition, there was a main interaction effect between language family and origin in the first year (p < 0.05). For international students only, there was a main effect for language in the second year (p < 0.05), with students from Sino-Tibetan language family backgrounds obtaining higher mean scores than students from English or Indo-European language family backgrounds. CONCLUSIONS: Our results confirmed that, overall, local students perform better academically than international students. However, given that language family differences exist, this may reflect acculturation rather than simply English language skills.