OBJECTIVES: To evaluate the relevance, usefulness, applicability, responsiveness, acceptability, efciency, overall impact and sustainability of the Master of Science in Epidemiology-Clinical Epidemiology (MSE-CE) curriculum.

METHODS: The context, input, process and product evaluation (CIPP) design was used. Of 106 alumni and students, 100 were contacted and 80 participated in a survey. Key informant interviews, direct observation and focus group discussions with faculty members, present and past administrators, selected alumni and students, and review of data were done. The results were analyzed using descriptive statistics and content analysis.

RESULTS: Context evaluation revealed that MSE-CE responded to the need to train physicians to use research evidence in clinical decision-making. Despite some reservations among other UP colleges, the program pushed through due to support from local and international sponsors. Alumni and students appreciated the effectiveness of their teachers and complementing instructional resources. The range of work by its graduates, the networks established, and the expansion of the Department of Clinical Epidemiology (DCE, the UP department ofering the MSE-CE program) prove that the MSE-CE is a sustainable post-graduate program.

CONCLUSION: The MSE-CE institutionalized clinical epidemiology as a distinct discipline among medical colleges in the Philippines.

Human ; Male ; Female ; Clinical Decision-making ; Philippines ; Program Evaluation ; Faculty ; Curriculum ; Students

INTRODUCTIONAs of 2001, the Philippines ranks 7th among the world's 22 countries with a heavy tuberculosis (TB) burden. As the country accelerates its campaign to control the global epidemic, the Philippine Tuberculosis Initiatives for the Private Sector (PhilTIPS) joined the efforts to combat it through the Directly Observed Treatment Short-course (DOTS) strategy and brought it to the level of medical schools. PhilTIPS commissioned this work to develop an evidence-based medical curriculum with strong and conscious integration of TB-DOTS.

MATERIALS AND METHODSIn the needs assessment, curricula, sample tests, and syllabi were reviewed. Deans and curriculum committee chairs were also asked to answer a questionnaire dealing with how TB, TB control and DOTS were taught. Based on the needs assessment, the TB control-DOTS core curriculum was developed. Ten months after its implementation, a monitoring evaluation was conducted through questionnaires, review of records and key informant interviews.

DISCUSSIONRepresentative samples of 18 out of 32 schools participated in the needs assessment and monitoring phase. Data revealed that the biomedical and clinical aspects of TB are emphasised in all schools. But only 7 out of 18 (38.89%) actually dealt with DOTS. A competency-based, integrated, and interactive TB-DOTS curriculum was then developed. The competencies around which the curriculum was designed were: (1) a thorough understanding of TB as a biomedical and social phenomenon; (2) the management of TB patients; and (3) an adherence to DOTS in managing TB patients. The curriculum was reviewed by local and international panelists, and implemented in 2003 to 2004. Monitoring evaluation 10 months later revealed that this curriculum was minimally to moderately integrated by medical schools. The study exhorts all medical schools to empower their graduates with competence in TB-DOTS.

Curriculum ; Directly Observed Therapy ; Humans ; Philippines ; Population Surveillance ; Program Development ; Public Health ; Schools, Medical ; Surveys and Questionnaires ; Tuberculosis ; prevention & control

Background and Objective: Peer-assisted learning (PAL) is an established concept in which students obtain mutual benefits by teaching and learning from each other. In the clinical environment, this often occurs intentionally or unintentionally in various formats such as same level or cross level peer tutoring, peer mentoring, cooperative learning and the like. This study determined the effectiveness of Peer Assisted Learning in achieving identified program outcomes in the curriculum for clerks and postgraduate interns rotating in Otorhinolaryngology specialty. Methodology: Study has 2 parts. Part 1 was a one-group pre-test and post-test design that involved teaching training of 16 PGI to be peer tutors in Otorhinolaryngology Physical Examination (ORL PE) to clerks. Video recorded pre-training baseline and post-training actual skills demonstrations of the PGI were rated. Scores were compared using Wilcoxon Signed Ranks test with p value at 5% level of significance. Part 2 was a randomized controlled single-blind trial of Peer-Led vs. Expert Faculty-Led ORL PE training of 55 clerks. Tutees performed a post training video-recorded skills demonstration assessed by a faculty rater who was blinded as to who among the clerks underwent the PAL-Led or Expert Faculty-Led training. Scores of the tutees in the 2 models of instruction were compared using the Mann-Whitney U-test at 5% level of significance. Results: Part 1 results showed significant improvement in the post-training scores of the 16 PGI in the identified micro skills and ORL PE skills. For Part 2, 33 and 22 clerks underwent PAL-Led and Expert Faculty-Led instruction respectively. Comparison of performance scores of the clerks in the 2 models of instruction showed no significant difference. Conclusion Teaching training for PGI improved their knowledge, skills and attitude in teaching ORL PE skills to clerks. There was no significant difference in the performance outcomes between clerks that underwent PALLed and Expert Faculty-Led model of instruction.
Teacher Training ; Peer Group

Background: Clinical competency depends on student's knowledge of basic sciences including the learned concept in Anatomy. But what if students forget the learned knowledge of human anatomy? Objectives: This research investigated knowledge gain post instruction, knowledge retention (or loss) of basic and clinical concepts five months after. It also compared the effect of delayed-multiple testing and delayedsingle testing in the retention of acquired knowledge. Methodology: This is an experimental study conducted among first year medical students who underwent neuroanatomy module and later followed-up after five months using a 32-item test-retest. Items were categorized as basic knowledge and clinical correlation. Participants were randomly assigned into two groups; delayed-multiple and delayed-single testing. Mean difference in scores between the 2 testing periods (end-ofmodule and terminal delayed test) were analyzed using paired samples t-test while mean difference between basic and clinical correlation were analyzed using independent samples t-test. The degree of knowledge loss was determined using the computed Knowledge Loss Percentage (KLP). Results: Knowledge gain was noted at the end of instruction (p value<0.001). Knowledge loss is higher among basic knowledge (p value<0.001) and demonstrated a higher computed KLP. Repeated testing demonstrates a higher retention (KLP=4.34) compared to those administered with a single test only (KLP=26.73). Conclusion Knowledge loss occurs post instruction and more pronounced among basic concepts. Clinical correlation and frequent testing demonstrate a significant retention capability. To reduce the effect of knowledge loss among basic concepts, this study recommends the implementation of multiple testing.
Knowledge

Background and Objectives: To learn technical skills in Medical Technology schools, laboratory experiments are made individually or in groups. The nature of student participation and effect of group work in laboratory skills and attitudes of students have not been well studied. The study compared individual work, working in groups of three, and working in groups of six in terms of skills and attitudes toward learning, motivation to learn, responsibility, helpfulness, and teamwork. Methodology: Experimental study was used that employed a counter-balance design among thirty-six thirdyear medical technology students who were instructed to learn laboratory skills in three settings and were rotated in six experiments. Performance examination and questionnaires were formulated by the researcher and used for gathering data. One-way ANOVA was used to determine the significant differences among practical exam scores of the three laboratory settings while Kruskal-Wallis H and Mann-Whitney U test were used to determine differences in rating scores of the attitude questionnaire. Results and Conclusions There were no significant differences in students' skills F(2, 213)=1.97, (p=.142) and in their attitude toward learning, helpfulness and teamwork among the laboratory settings. Students have higher motivation when working in groups (H(2)=14.413, p=.001) and assumed more responsibility when working alone than when working groups. When students worked individually or in groups of three, they perceived ending up doing most of the work.
Learning ; Attitude ; Technology

Background: Professionalism is a core competency of physicians, identified as one of the learning outcomes for the Doctor of Medicine program. In all the efforts geared towards supporting students develop high standards of professionalism through the 4-year course of medical education, perhaps the greatest gap is in assessment. Objectives: The study aimed to determine how attitudes towards professionalism among medical students change during clinical clerkship, which attitudes change, and if these changes are associated with certain demographic factors and specific clinical rotations. Methodology: This is a cohort study with a baseline and three consecutive measurements of attitudes towards professionalism among students in a medical school as they rotated in the different clinical departments for the first semester of AY 2018-2019. A 36-item questionnaire based on a validated instrument was used. Frequency counts, means, percentages, paired t-tests, analysis of variance, and chi-square were used to analyze the data. Results: Overall, the attitudes towards professionalism among medical students were positive at baseline and did not significantly change through three consecutive clinical rotations. The scores were highest and most stable for altruism, accountability, and excellence. No association was found between any change in attitudes and certain demographic factors including age, gender, and pre-medical course, and specific clinical rotation. Conclusion No significant change in attitudes towards professionalism was found among fourth year medical students as they rotated through three consecutive clinical rotations. While many factors should be considered, this finding should prompt a comprehensive look at how clinical clerkship experiences actually educate for professionalism.
Professionalism ; Clinical Clerkship ; Attitude

Objectives. The Association of Philippine Medical Colleges (APMC) responded to the global call for transformative learning by conducting a series of Faculty In-service Training. This study was commissioned to determine faculty trainees' perceptions of the program in terms of relevance, comprehensiveness, and quality. It also described their applications of the program in their delivery of instruction, assessment, organization, and management skills.

Methods. This is a sequential explanatory mixed-method research. The quantitative phase refers to the analysis of the rating scale accomplished by participants as feedback. The qualitative phase includes analysis of focus group discussion results and actual course syllabi used by selected participants, including medical schools' documents. Both data were integrated using a combination of descriptive statistics, measures of central tendency and dispersion, as well as joint displays.

Results. APMC conducted six in-service trainings from 2015 to 2018. Themes focused on medical teachers' roles as instructional designers, facilitators, assessors of learning, and as leaders and managers. Respondents perceived the programs as most relevant, comprehensive, and interesting. The syllabi, instructional resources, and assessment instruments and practices were consistent with the standards of the Commission on Higher Education. Medical teachers showed that they use innovative teaching and assessment strategies, and are dealing with medical education's continuous challenges.

Conclusion. Faculty participants perceived the APMC in-service training programs most favorably for capacitating them to enhance their teaching skills and inculcate the culture of quality in medical schools. APMC's training also reflects the organization's commitment to social accountability.

Education, Medical

Background: Andragogy, the theory of adult learning is relevant to medical education especially in the clinical internship learning context. It focuses on the students, faculty, and patients interacting together while developing competencies as future practitioners. Medical interns are active adult learners, enhancing their development of knowledge, skills, and positive attitudes, and pursuing professionalism as they participate in case-based discussions (CBD). Objectives: The study sought to identify the basic principles of andragogy while medical interns participate in case-based discussions including the end-of-course satisfaction. It also determined the selected demographic factors associated with the andragogic principles. Methodology: Respondents included 80 interns by convenience sampling who rotated at the Department of Ophthalmology and Visual Sciences in a tertiary referral hospital. The study used a combination of descriptive quantitative and qualitative research design. A valid instrument using the Adult Learning Principles Design Elements Questionnaire (ALPDEQ) was used to measure the medical intern's andragogic orientation as well as end-of-course satisfaction. A direct, non-participant observation of case-based discussions conducted at the department was done by the researcher and research associate. Results and Conclusion The occurrence of andragogic principles specifically motivation, experience, need to know, readiness, and self-directedness was observed during the conduct of case-based discussion. There was no association between principles of andragogy and demographic factors such as age, gender, civil status, medical school, preparatory medical course, and place of origin. CBD is an effective learning strategy, which provides medical interns adequate venues to be self-directed and apply the principles of andragogy in a workplace-based setting.
Internship and Residency