Curriculum ; Education, Medical ; methods ; Internationality

This study assessed the effectiveness of education reforms on student-reported learning outcomes at the end of the 5-year medical school (M5) and 1-year internship (HO) in 2006, 2007 and 2008. A self-administered anonymous survey with 17 learning outcomes assessed, derived from Harden's Three-Circle Outcomes Model for outcomes-based education, was administered to 683 students at the end of medical school (M5) and internship (HO) from 2006, 2007 and 2008. We identified learning outcomes which changed significantly for internship (Cohorts A, B and C) and medical school (Cohorts B, C and D) between cohorts from 2006 to 2008, and compared learning outcomes between medical school and internship within cohorts (i.e. Cohort B which was M5 in 2006 and HO in 2007; Cohort C which was M5 in 2007 and HO in 2008). The proportion of students who agreed that medical school helped them achieve learning outcomes increased significantly from 2006 to 2008 for 15 out of 17 learning outcomes assessed. The proportion of students who agreed that internship helped them achieve learning outcomes increased significantly from 2006 to 2008 for 6 learning outcomes assessed. For Cohorts B and C, internship was more effective than medical school in achieving 8 learning outcomes. Cohort C reported that internship was more effective than medical school in 3 additional learning outcomes than Cohort B: patient management, humility and dedication. We conclude that a successful journey of education reform is an ongoing process that needs to comprehensively address multifaceted components such as faculty, administration and curriculum.
Clinical Competence ; Curriculum ; Education, Medical, Graduate ; Education, Medical, Undergraduate ; Humans ; Internship and Residency ; Schools, Medical ; Singapore ; Surveys and Questionnaires

Purpose: There are relatively few student-led medical conferences worldwide. A group of medical and nursing students from Yong Loo Lin School of Medicine, National University of Singapore, organized an annual student-led faculty-supported inter-professional Student Medical-Nursing Education Conference (SMEC), which consisted of plenary talks, lectures and workshops, and a scientific competition. This research focused on the evaluation of workshops conducted during the 8th SMEC 2012. Method: The authors used various process variables to survey the conference participants on the educational value of the 4 plenary lectures and 20 workshops, half of which were run by experienced healthcare professionals and the other half by current seniors or recent graduates. Results: A total of 270 medical and nursing students completed the survey. Good to excellent educational value was reported for most of the workshops. Higher educational value was associated with use of props (correlation coefficient, r=0.733 and 0.568), adherence to workshop topic/focus (r=0.608 and 0.815) and openness of presenter to questions (r=0.555 and 0.453). Conclusion: A student-led, faculty-supported interprofessional conference organized by medical and nursing students had good to excellent self-reported education value in helping their fellow medical and nursing students learn about various healthcare disciplines and prepare for medical and nursing school.

INTRODUCTIONThis study aimed to examine the impact of housemanship and cohort effect on the perceptions of what constitutes a "role model physician" between 2 cohorts of medical students.

MATERIALS & METHODSFinal year medical students of the Yong Loo Lin School of Medicine, National University of Singapore, from the classes of 2005 (pre- and post-housemanship) and class of 2009 (pre-housemanship) responded to an anonymous 25-statement questionnaire reflecting Fones et al's 25-item characterisation of a "role model" doctor. Qualitative data was also collected on student's perceived qualities of a role model doctor.

RESULTSFor the 2005 cohort pre- and post-housemanship, only 3 of the 25 items had increased in importance post-housemanship. However, when comparing the 2005 and 2009 cohorts pre-housemanship, the latter cohort placed significantly greater importance on 12 of the 25 items. Willingness to teach was identified via qualitative analysis as a new important quality of a role model doctor for medical students.

CONCLUSIONThe importance placed on characteristics of "role model" physicians were relatively unchanged by housemanship within the same cohort but increased with time between 2 cohorts 5 years apart. This suggests that professional standards of an "ideal" doctor expected and aspired to by medical students may not be eroding as feared by the medical profession and society.

Attitude of Health Personnel ; Humans ; Mentors ; Physician's Role ; Physicians ; standards ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires

Background and Objective: Physician adherence to the recommended management of patients with heart failure with reduced ejection fraction (HFrEF) at the outpatient setting is crucial to reduce the burden of subsequent rehospitalization, morbidity, and mortality. Recently updated guidelines recommend early and rapid titration to optimal doses of medications in the first 2 to 6 weeks of discharge. In the absence of local data, our study evaluates physician adherence to guideline-recommended treatment in this setting. Methods: This is a retrospective cross-sectional study among post-discharge HFrEF patients at the outpatient department from December 2022 to May 2023 with a follow-up within three months. Clinical profile and treatment were extracted from medical records. Adherence to the 2021 ESC Guidelines Class I recommendations, among eligible patients, is measured as quality indicators. Data are presented using descriptive statistics. Results: A total of 99 patients were included in the study. Overall, adherence to prescription of beta-blockers (94.8%), ACEI/ARNI/ARBs (88.5%), and diuretics (100%) were high. Prescription of mineralocorticoid receptor antagonists (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) were 67% and 57.3%, respectively. Over three months of follow-up, improvement in the quality of care was demonstrated with ACEI/ARNI/ARBs (81.8% to 90.9%), MRA (68.7 to 81.2%), and SGLT2i (58% to 67.7%). Beta-blocker use is consistently high at 97%. In the 3rd month post-discharge, titration to optimal doses was achieved in only 26.4%, 15%, and 6.25% for those on beta-blockers, ACEI/ARNI/ARB, and MRA, respectively. For non-pharmacologic management, referral to HF specialty was made in 30% and cardiac rehabilitation in 22.2%. Conclusion Among patients with HFrEF seen at the outpatient, there is good physician adherence to betablockers, ACEI/ARNI/ARBs, and diuretics. MRA and SGLT2i prescription, referral to HF specialty and cardiac rehabilitation, and up-titration to optimal doses of oral medications for HF need improvement. Hospital pathway development and regular performance evaluation will improve initiation, maintenance, and up-titration of appropriate treatment.
Human ; outpatients