Longitudinal data can provide important evidence with the potential to stimulate innovation and affect policies in medical education and can serve as a driving force for further developments in medical education through evidence-based decisions. Tracking and observing cohorts of students and graduates using longitudinal data can be a way to link the past, present, and future of medical education. This study reviewed practical methods and technical, administrative, and ethical considerations for the establishment and operation of a longitudinal database and presented examples of longitudinal databases. Cohort study design methods and previous examples of research using longitudinal databases to explore major topics in medical education were also reviewed. The implications of this study are as follows: (1) a systematic design process is required to establish longitudinal data, and each university should engage in ongoing deliberation about this issue; (2) efforts are needed to alleviate “survey fatigue” among respondents and reduce the administrative burden of those conducting data collection and analysis; (3) it is necessary to regularly review issues of personal information protection, data security, and ethics regarding the survey respondents; and (4) a system should be established that integrates and manages a longitudinal database of medical education at the national level. The hope is that establishing longitudinal data and cohorts at individual medical schools will not be a temporary phenomenon, but rather that they will be well utilized at the national level to innovate and implement ongoing changes in medical education.
The structures and processes of medical education have changed little since the publication of Flexner’s report, which stressed the scientific orientation of medical education and the curricular structure of 2 years of formal knowledge education and 2 years of clinical experience. However, the previous perspectives on medical education are facing challenges, and these call for new pedagogy and theories on which to base medical education practice. Considering that social dimensions of learning have been emphasized in practice, perspectives that integrate these aspects are needed. Among the various learning theories, social cognitive theory refers to the theoretical framework which contends that learning occurs within interactions with others and environments. From a social cognitive standpoint, learning through observation is a critical component in human functioning. Indeed, observational learning has particular significance in medical education in that it provides the context for which the importance and meaning of role models can be understood. In addition, as theoretical constructs such as self-efficacy and outcome expectations allow us to establish an effective learning environment, exploring the concepts of the theory could be beneficial to medical education practice. In this context, the present review article aims to provide a glimpse of the fundamental assumptions and theoretical concepts of social cognitive theory and discusses the implications the theory has on teaching and learning. Further, a review of previous studies could help explain how the theory has informed medical education practice. Finally, the author will conclude with the implications and limitations of applying social cognitive theory in medical education.
Research suggests that medical students frequently experience mental health problems such as stress, burnout, and depression, which may, in turn, affect suicidal ideation and behaviors. Since mental health problems profoundly impact academic achievement and professionalism, it is vital to understand factors influencing students’ mental health and identify strategies to provide the necessary support. Some relevant influencing factors range from the personal level, including gender, personality traits, perfectionism, and social support, to the environmental level, including the grading system, educational phases, exposure to patients’ death, mistreatment, and culture of medicine. In this regard, a comprehensive mental health support system that encompasses environmental interventions, as well as personal-level support, is needed. Simultaneously, proactive approaches that address the improvement of self-care and alleviation of systemic burdens are essential, together with the predominant reactive approaches focusing on problems and deficits. Altogether, we proposed a framework for enhancing mental health constructed by four categories (personal-reactive, environmental-reactive, personal-proactive, environmental-proactive) based on the intervention level and goal of support. All four categories have important implications, and one cannot replace the other, but expanding environmental-proactive support will allow more students to learn how to pursue health independently. We expect that this comprehensive framework for enhancing mental health could expand support systems for medical students’ personal and professional development.
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