BackgroundDesigners of undergraduate medical education (UME) need to address the exponentially expanding volume and variability of scientific knowledge, where by didactic teaching techniques need to be augmented by innovative student-centric pedagogical strategies and implementation of milieus, where information, communication and technology-enabled tools are seamlessly integrated, and lifelong information gathering, assimilation, integration and implementation is the ultimate goal. In UME, the basic sciences provide a solid scaffold allowing students to develop their personal critical decisional framework as well as define the understanding of normal human physiology, pivotal for the identification, categorization and management of pathophysiology. However, most medical schools confine themselves to “stagnant curricula”, with the implementation of traditional “teacher centered” pedagogical techniques in the dissemination of the courses pertaining to basic sciences in UME.MethodTo tackle the above paucity, we present a novel “6D-Approach” for the dissemination of concepts in basic sciences through mentored journal-clubs. The approach is informed by a teaching principle derived from Constructivism. The technique in which the 6D-approach can be implemented in UME, is shown using an example from a first-year course of Molecular Biology and Principles of Genetics at our medical school. A reflection on the impact of 6D-Approach for students as well as instructors is also presented.ResultThe 6D-approach was positively received by the students and the formal feedback for the course: Molecular Biology and Principles of Genetics, where the approach was repeatedly employed, indicated that students expressed satisfaction with the teaching strategies employed in the course, with ~ 89% of the students in the cohort strongly agreeing with the highest grading score “extremely satisfied”. Further, the approach through the use of mentored journal clubs encourages retention of knowledge, critical thinking, metacognition, collaboration and leadership skills in addition to self-evaluation and peer feedback.ConclusionHence, through the 6D-Approach, our attempt is to initiate, advance and facilitate critical thinking, problem-solving and self-learning in UME, demonstrated by graduating accomplished, competent and safe medical practitioners.

BackgroundResistance to change is customary and is expected in any organization. However, most of the downsides of change can be avoided if the organization/individual prepares for the change by acknowledging guided strategies. In healthcare, change is the state of nature, which has also translated to medical education (ME). ME in the current era has undergone a shift from a traditional content-based curriculum to a competency-based curriculum. Recently, however, the broader social-accountability movement has accelerated this rate of transformation. One of the key challenges to educators harbingering this transformation to competency-based medical education (CBME) is to redesign the processes of teaching.AimHere we define a framework designed using Mento’s model of change that will totally agree with introducing positive change in teaching in an institution undergoing transformation from a traditional content-based curriculum to a competency-based curriculum.MethodologyUsing Schein’s “unfreezing” as a guide term we critically reflected on the popular change-management models, to home in on Kotter’s model of change to transform organizations. However, Kotter’s change-model draws from Situational and Contingency Leadership Theories, which may not agree with academic organizations involved in ME. As such organizations adhere to Transactional and Transformational Leadership archetypes, where Leadership is constructively executed by “The Leader Team”, we decided to adopt Mento’s change-model for our study. Mento’s model not only draws from the precepts of Kotter’s model, but also incorporates axioms of Jick’s and GE’s change-models.ResultsUsing Mento’s model a framework was blueprinted to implement active learning (AL) strategies in CBME. Here we have elaborated on the framework using the exemplar of flipped teaching. The development of this framework required the design and execution of a faculty development program, and a step by step guidance plan to chaperon, instruct and implement change in teaching to harbinger CBME. Further, we have also reflected on the change process using Gravin’s framework.ConclusionTo our knowledge this is the first report of the use of Mento’s model of change in medical education. Also, the blueprinted framework is supported by acknowledged leadership theories and can be translated to implement any curricular change in CBME.

Discrepancy creation is a form of self-regulated learning which can be used to improve individual performance. Discrepancy can be created as a result of comparison against an occupational standard or when an individual strives to achieve higher personal goals. This study explores the process of discrepancy discovery and reduction following simulation sessions. Second year under-graduate nursing students undertook three simulation sessions over a one year period. After each session the participants completed a series of visual analogue scales to rate their own performance and the perceived performance of peers, final year student and a newly registered nurse. Once discrepancy had been identified, participants were asked to produce a short written action plan on how the discrepancy could be addressed and to work on this action plan between sessions. A total of 70 students completed discrepancy scores for all three scenarios. The most common areas of discrepancy were understanding physiology, understanding medicines and pharmacology, patient assessment and handover (hand off). Wilcoxon Signed Ranks suggested a statistically significant difference between student scores in all areas with the exception of team-work. All of the participants used peers as their comparator when identifying discrepancy. There was also a statistically significant difference in the scores following each simulation session suggesting improved performance.

One of the fundamental problems facing providers and commissioners of health services is how to maintain the skills and knowledge of the workforce during the initial development and implementation of home care services. This small-scale project sought to ascertain if it was possible to use human patient simulation scenarios to educate community nurses about how to recognize when care at home is appropriate and when it is not. A series of scenarios were developed and delivered to small groups of community nursing staff. A total of 18 qualified nurses took part in the project. Participants were asked to report their level of confidence in the diagnosis, management and recognition of patient deterioration for each of the scenarios prior to and after the session. The results show increased confidence across all participants in each of the scenarios.

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