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Medical Education

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GY Mustafa Alsheikh
added a research item
Until the 1970s, the only available postgraduate study opportunities for Iraqi physicians was through working/studying in the United Kingdom, and to a lesser degree, in the United States of America.3 After obtaining the medical degree (M.B.Ch.B.) from an approved medical college in Iraq, doctors progress through an internship (2 years) and rural service/senior residency before applying to higher specialisation programs from the Boards of Medical Specialisations. The establishment of the Arab Board of Health Specializations in 1978 by the Council of Arab Ministers of Health marked a new era of medical postgraduate education and training in the participating Arab countries....etc
GY Mustafa Alsheikh
added a research item
Practical approach to train and assess professional behaviour of medical students. Abstract The gradual decline of doctor-patient communication skills and professional attitudes and behaviour have steadily been observed in all countries across the globe. This deterioration has resulted in repeated and renewed demands to make medical schools more aligned to the necessity to train professional behaviours in undergraduate medical study. Medical educators have been criticised for not effectively training and rigorously assessing these skills. Training of behaviour has been abstracted in teaching of ethics and communication skills which in most of the cases is based on theoretical "preaching" lectures and use of book/guide and in some cases, training using supervised role-playing sessions at the best of options. Although good communication skills are essential for an optimal doctor-patient relationship and certainly contribute to improved health outcomes, still other aspects of behaviour are not covered. Furthermore, while the need for training on professional behaviour is specified as a requirement in the adopted graduate outcomes, formal training in these skills has been fragmentary and not clearly addressed in curriculum documents of the medical colleges in Iraq. A practical approach is here proposed to support medical colleges to bridge this gap. The methods of design, construction and use of standardised checklists for training medical students and assessing their acquisition of behavioural (affective) skills is described
GY Mustafa Alsheikh
added a research item
Dornan and colleagues' article provides a diagnostic overview of some of the shortcomings of medical education in the UK. 1 The shift to competency based training 2 moved students away from being passive recipients of teaching to experiential learners, driven by inquiry. As stated in the article, readiness to practise safely does not mean demonstrably safer practice. This may be linked to how learning and assessments are organised. Miller's pyramid of clinical competence comprises four layers. There is currently a focus on the third layer, "Shows how," which falls short of the tip of the pyramid, "Does." 3 Tackling "Does" requires a critical review of medical school curriculums. There is a need to focus on experiential learning opportunities rather than passive learning activities (such as shadowing in clinics, ward rounds, theatres). Repeated curricular experiential opportunities covering intellectual, clinical, and behaviours skills will strengthen the competencies acquired and encourage students to develop experience. This will in turn prepare the newly qualified doctor for real clinical practice rather than a baptism of fire. Such opportunities allow students repeatedly to practise and attain competence in decision making, patient assessment, peer assessment, self-assessment, self-management, team management, and time management. Programmes based on deductive, inquiry driven learning for novice students, and inductive learning for senior students, provide ample repeated opportunities for practice. 3 Gradual exposure to these opportunities through the medical school study years allows for increasing competencies and experience together, increasing independence, and gradual reduction of supervision. In summary, doctors trained in an inquiry driven, experiential learning curriculum will develop capabilities, play an effective role in teams, deliver high quality care, and recognise and evaluate their own limitations while being coached and supervised. Ultimately, this will instigate the required changes to improve quality of care for patients.
GY Mustafa Alsheikh
added a research item
Article on interviews with number of students on their experience and opinion on the new PBL curriculum adopted by Tikrit University College of Medicine (TUCOM) since its foundation in 1988. The article was published, in Arabic language, in the Iraqi weekly magazine "Alif-Ba" in 1993.
GY Mustafa Alsheikh
added 2 research items
Background: Medical students receiving a lot of controversial data from different sources like media, academia and the international and local reports, and they have a lot of questions regarding the current novel corona virus disease 19 interpreting the epidemiological data to more conclusive information. This issue needs an epidemiological reasoning skill. Objective: The aim of this study is to assess the epidemiological reasoning skills of medical students of Hadramout University in Yemen toward the current novel corona virus diseases. Methodology: A cross-sectional study was conducted among a convenience sample of Hadramout University medical students from different departments and years. A self administered structured questionnaire was designed to collect relevant data from students. Results: Most of student's answers about the incubation period is more than 7 days (45%) but most of students did not know the exact period of communicability (51%). About86% of students recognized that the main route of transmission is air droplet and the susceptibility is universe (72%). Most of students know that there is no specific treatment nor specific vaccine for COVID19 (77%).Most of students consider COVID 19 is epidemic (50%); the transmission is from person to person (81%), the causative agent is new agent (46%) and mode of transmission is already known but they consider the geographic distribution of the current diseases is worldwide (55.6%). As the data were collected in February 2020; and according to their knowledge and reasoning skills, students expec that the disease will continue up to months (69%), will spread globally (57%) and the deaths will increasing (77%), they expected the spread of the disease will affect negatively on the international trade (96%) and on the international tourism (95%) Observations and Result: The left lateral ventricle was larger than the right one and both were larger in males and largest in sixth and seventh decade. Conclusion: University students have good epidemiological reasoning skills if provided with updated knowledge.
In medical education, the curriculum passes through at least four stages between vision and learning of students namely: "intended" to "planned" to "implemented" to the "learned" curriculum. The most important safeguard for keeping these formats compatible is the quality of the aims and objectives. This editorial describes the hierarchy of the educational objectives, their importance, types, sources, and qualities and best ways to formulate effective learning objectives that link learning and outcomes to the vision and consequent aims. Also, the article highlights the common misjudgements and misuses of the learning objectives which may produce different and certainly poorer outcomes than those planned for .
GY Mustafa Alsheikh
added a research item
The latest Reform of ME in USA, Carnegie Foundation 2010 (CR-2010) 100 years after Flexner's reform. A presentation based on CR-2010 by: Ghanim Alsheikh, WHO CC Public Health Education and Training, Imperial College London. 2010. A copy of this presentation (as ppt.) can be obtained from GA on this ResearchGate page.
GY Mustafa Alsheikh
added a research item
Introduction: Pharmacy practice witnessed dramatic significant changes over the past years worldwide. The traditional role of the pharmacist involving preparation, dispensing and selling of medications is no longer adequate. This has evolved into direct involvement of the pharmacist in the design, implementation, and monitoring of therapeutic plans to produce specific care outcomes. The Bachelor degree in pharmacy at the University of Aden, Yemen, witnessed scarce reviews or evaluation studies on graduates and curriculum introduced in 1995 and unchanged till 2018. Objectives: To (1) assess perception of pharmacists, working in Aden, of their pre-service education and its relevance to current work and (2) analyze the available benchmarks and propose educational strategies that could be addressed in designing and adopting a reformed pharmacy pre-service curriculum in light of results of the study. Methods: A self-administered questionnaire distributed to 220 pharmacists working in urban Aden city with response rate 86% (n=189). Questions covered general personal information; perception of pre-service educational subjects/courses and their relevance to current job; status of respondents' practice of skills and attitudes acquired during their study. Analysis of the 7-star role of pharmacist is done based on results of the study. Results: Practicing pharmacists work in 5 different settings in Aden, in community pharmacy, hospital pharmacy, industrial pharmaceutics, management of medicines and medical supplies and academic pharmacy. Majority marked existence of weak linkage between preservice curriculum and daily work demands. 16 out of the 17 basic sciences were not used in work and to a lesser degree, similar results of pharmaceutical sciences, skills and attitudes. Accordingly, seven educational strategies are proposed. Conclusion: The study showed that pharmacists working in Aden, Yemen, need different knowledge, skills and attitude to be able to perform the current job demands. The results also showed weak link between education and job practice. One of the main challenges facing pharmacy education is the adoption of educational strategies that respond to lack of active acquisition of the needed competencies to produce a "fit-for-purpose pharmacy graduate."
GY Mustafa Alsheikh
added a research item
Governance and communication represent the foundations for effective impact on the level of institutional performance in higher education colleges, including medical schools. Governance encompasses the frameworks of structures, relationships, and processes ongoing in the college. It is recognized that medical schools in Iraq lack the adoption of a clear mechanism in this field. This article aims to present a proposed protocol for the development of governance and institutional communication in Iraqi medical colleges whose components have been formulated according to the needs of these colleges. The proposal reviews the components, benefits, and foundations of governance according to a number of targeted values, thus presenting a proposed framework for the components of an institutional system for governance and communication. This proposal allows ample discussions among college stakeholders which leads to revision and implementation to fill the gap towards achieving effective and efficient governance that enables the achievement of college goals. The framework addresses number of elements including at least: neutrality in the work and decisions of councils and their strategic and operational roles, the absence of a strategy for senior management, institutional and individual periodic planning, standard operation procedures, job description, key performance indicators, human resource management policies and documentation concepts, and in the forefront of them digital documentation and communication via the Internet and databases.
GY Mustafa Alsheikh
added a research item
Communication Skills (CS) are essential to health workforce to conduct effective professional-patient interaction. In Iraq, majority of newly graduated health professionals are engaged in provision of direct health services. However, undergraduate curricula preparing these professionals include no distinct component to train them on CS. This study aims at assessing the status of CS among Health Professions Education (HPE) graduates of University of Duhok (UoD) and estimating the perception of their patients toward those skills. This cross-sectional study was conducted in 2014. Data on communication skills was obtained, from samples of different health professionals which included: medical doctors (junior residents, nurses, dentists and pharmacists) who recently graduated from different colleges at the UoD. Also, data from was obtained, their patients, to assess their satisfaction of the professionals' CS. For assessing core CS, a specially designed checklist was adopted from Calgary-Cambridge Guide. Also, senior clinicians were asked on CS performed by their junior residents. Results show that 88% of the senior academic staff regarded CS as "highly essential" and 66% of them were not satisfied with interns' conduct and suggested that CS should clearly be included in the medical curricula. The basic CS were perceived by patients as either not practiced or wrongly practiced. Patients were unsatisfied with the CS of their attending HPs during observed consultation sessions. The study shows obvious lack of CS among HPE graduates of UoD with patients' dissatisfaction of their CSs. It seems legitimate to propose that relevant training elements to be designed and incorporated within training modules are needed to realize as a core element of the curriculum of all HPE colleges at the UoD.
GY Mustafa Alsheikh
added a research item
This is a United Nations Development Group Technical Working Group Report (2001) on Iraq's Health Sector, Medicine and Medical Education. The report describes the status of educational programme at Tikrit Medical College (TUCOM) as of 2001. The report can be obtained from: http://iraq.undg.org/index.cfm?Module=Document&Page=Document&Category=56&Type=background
GY Mustafa Alsheikh
added a research item
This is a preliminary presentation of results a thorough evaluation of training of medical students on basic competencies as seen by graduates of Iraqi medical colleges from 1965 to 2015. Also covered is a review of medical education development since 1927 when first school for modern medical education was established.
GY Mustafa Alsheikh
added a research item
Book available from http://bit.ly/iraqimededucation “Preparing Tomorrow’s Doctors: A Call for Reform of Iraqi Medical Curricula” book is written in Arabic and includes a 72-pages abridged part written in English. Although addressing the reform in Iraq, the book is useful for any country looking for reform of the curricula of medical schools operating there. The book briefly reviews the history of medical schools in Iraq since the establishment of the first faculty of modern medicine in Baghdad in 1927 with the adoption of a curriculum which kept being copied by the colleges established after that. These started with the second college, which opened in Mosul in 1959 and then by the third in Basra in 1967. The total number of operating medical colleges in Iraq as of 2018 is twenty-nine colleges (with other 2 in preparation). The book reviews the evolution of medical education curricula in the western world, particularly in North America where most of the educational research and innovation is conducted and applied. The methods that the colleges in Iraq are currently applying are then reviewed and analysed. Internationally approved benchmarks and comparison tools are used in the book to examine the adopted teaching methods used, the quality and effectiveness of the educational strategies, and the methods of training and assessing the required student abilities and competencies required for graduation. The book aims, in particular, to show which methods provide sufficient opportunities for student to obtain the required competencies needed with emphasis on applied, clinical and behavioural skills. Also, it focuses on opportunities for the student to practice ways to create a spirit of inquiry, in-depth thinking and the ability to pursue lifelong learning. The book provides decision-makers and teaching staff with a simple but adequate guide on how to develop and adopt the steps described in the book in analysing the current methods of teaching and learning using the tools mentioned therein. Two sets of graduate outcomes are presented here for the Iraqi colleges to adapt. The book presents a practical way of analysis of the outcomes (Task Analysis) into knowledge, skills and attitudes to reach the right content for their curriculum. In addition, tools for analysing Iraqi standards of accreditation to reach and formulate the required educational strategies of curriculum, are also presented. The process of selecting and applying the best approach to reform a curriculum is certainly the responsibility of all departments in the medical college. The student who has been accepted to study at the medical college this year 2017-2018, will probably contribute to the health services until 2070, when s/he will be 70 years of age. Let us imagine that the foundations adopted by the college today and the methodology used to educate and equip this student with the knowledge, skills and professional actions that suits such long service. What sort of education such a student needs to empower her/him to face all the changes that will take place for the next 50 years? Would this education feed this student with a fish whenever feeling hungry or provide opportunities to practice how to fish to feed own hunger? Book available from http://bit.ly/iraqimededucation
GY Mustafa Alsheikh
added a research item
A guide to reform and develop educational programs at the Iraq's 28 medical colleges. It evaluates the currently adopted model and proposes the best reliable, effective and relevant educational strategies to contribute to the quality graduate outcomes that can make a change in the national health system. The book is written in Arabic and will be followed by an English version in near future.
GY Mustafa Alsheikh
added 2 research items
Evaluation of the Curricula of Iraqi medical colleges in light of innovation of medical education. (In Arabic with Abstract and references in English). Ghanim Alsheikh; Omar Mustafa, Talib Jwad Kadhim, Riyadh Sayhoud Alzubaidi, Mousa Muhsin Alalak, Injam Ibrahim Rowandozi. Abstract : This review article aims at studying the curricula of Iraqi medical colleges since the establishment of the first college in Iraq in 1927 to date. It attempts to analyse the medical education programmes using known tools of measurement and global in comparison with the steady development of medical curricula in the world. The article shows the evolution of the Iraqi curriculum across the past century and especially during the last three decades. At present time there are three types of curricula that are currently applied in the twenty-five colleges operating in Iraq. The first curricular approach is based on separate scientific and clinical subjects (the Subject Based Curriculum); the second is the integrated curriculum and the third is the problem-based approach. The first approach is characterized by the adoption of the educational process that totally depends on the teacher through lectures and practical lessons (Teacher Centred), including clinical training and the examinations are focused on information more than skills and professional behaviour. The other two methods, however, are based on student in active role in the learning process with varying degrees of implementation. The last two approaches use enquiry-learning methods to investigate student’s learning needs. The integrative approach uses inductive methods of reasoning starting from first year of study, while the problem-based approach uses deductive reasoning in the early years of the study and later uses the inductive reasoning in the rest of the years. This work concludes the inappropriateness of the method of inductive reasoning in the first years of university study as this approach is known to be used by experts and hence students, using this approach, need to be already equipped with ample and relevant information which they can learn better in using the deductive reasoning in the first three years of the six-year medical study. Keywords: Medical education. Iraqi Medical colleges. Inductive Reasoning. Deductive Reasoning. Problem Based Curriculum. Integrated Curriculum. Subject based Curriculum.
Ali Esmail Al-Snafi
added an update
Research on student learning has shown that the different approaches lead to qualitatively different learning outcomes(1). Traditional education has long focused on teaching students to give a correct answer. Teachers too often ask students to recite, define, describe or list facts. They are less frequently asked to analyse, infer, synthesize, evaluate, think and rethink (2).
However, problem-based learning (PBL) is a student-centered pedagogy in which students learn about a subject through the experience of solving an open-ended problem. In PBL, small groups of students are presented with contextual situations and asked to define the problem, decide what skills and resources are necessary to investigate the problem and then pose possible solutions(3).
Many studied were carried out to evaluate the efficacy of PBL. In studying the efficacy of PBL in comparison with the traditional learning system, in Fatima Jinnah Medical College for Women in Lahore, Tayyeb found that PBL is an effective instructional tool to foster critical thinking and problem solving skills among medical students(4). Imanieh et al., found that problem-based learning method leads to a significant increase in learning and recalling output compared to the traditional method(5). Olivares-Olivares and López-Cabrera found that the students’ perceptions were higher in the pattern recognition and application of general strategies for problem solving(6). Shamsan and Syed evaluated the PSL in college of medicine, Qassim university, Saudi Arabia. They found that PSL system helps developing student skills particularly problem solving skills and help sharpening analytic skills(7). Professor Mustafa Alsheikh, the founding dean of two community oriented PSL medical schools [Tikrit- Iraq (TUCOM) and Hadhramout- Yemen (HUCOM)] carried out many evaluating programs. In comparison among students of four medical colleges in Iraq, the students educated by community oriented PSL programme (TUCOM) showed higher score especially in deep learning(8). Furthermore, Mustafa Alsheikh also found that PSL positively affected the behaviour and personality of the students(9).
In General, PBL is an effective way of delivering medical education in a coherent, integrated program and offers several advantages over traditional teaching methods, include development of long-term knowledge retention, use of diverse instruction types, continuous engagement, development of transferable skills and improvement of teamwork and interpersonal skills. PBL may position students to optimally function using real-world experiences. By harnessing collective group intellect, differing perspectives may offer different perceptions and solutions to a problem (10). However, the major disadvantages that PSL system requires more staff to take an active role in facilitation and group-led discussion, it requires more physical space and more accessible computer resources to accommodate simultaneous smaller group-learning. Students may not have access to teachers who serve as the inspirational role models that traditional curriculum offers (3, 10).
References:
1-Ramsden P. Learning to teach in higher education. 2nd Edn. London: Routledge 2003.
2-Albanese MA, Mitchell S. Problem based learning: a review of the literature on its outcomes and implementation. Acad Med 1993; 68:52-81.
3-Wood D. ABC of learning and teaching in medicine. British Medical Journal 2003; 326: 328–330.
4-Tayyeb R. Effectiveness of problem based learning as an instructional tool for acquisition of content knowledge and promotion of critical thinking among medical students. Journal of the College of Physicians and Surgeons Pakistan 2013; 23 (1): 42-46.
5-Imanieh MH, Dehghani SM, Sobhani AR and Haghighat M. Evaluation of problem-based learning in medical students education. J Adv Med Edu Prof 2014; 2(1): 1–5.
6-Olivares-Olivares SL, López-Cabrera MV. Self-assessment of problem solving disposition in medical students. Journal of Biomedical Education 2014, http://dx.doi.org/10.1155/2014/161204
7-Shamsan B and Syed AT. Evaluation of problem based learning course at college of medicine, Qassim University, Saudi Arabia. Int J Health Sci (Qassim) 2009; 3(2): 249–258.
8- Mustafa Alsheikh GY. Student’s learning style as an indicator for quality assessment of the educational program. International conference on quality assessment in health professions education with special emphasis on social accountability: The 9th Biennial General Network Meeting, Manila, the Philippines, November 26- December 1, 1995.
9- Mustafa Alsheikh GY. The effect of curriculum on the behaviour and personality of students: Tikrit experience. Scientific Journal of Tikrit University / Medical Section 1:82-86.
10- Terry B. The problem‐based learning process as finding and being in flow. Innovations in Education and Teaching International 2010; 47 (2): 165–174.
Wells SH, Warelow PJ, Jackson KL. Problem based learning (PBL): A conundrum. Contemporary Nurse 2009; 33 (2): 191–201.
 
GY Mustafa Alsheikh
added 10 research items
Mustafa-Al-Sheikh GY and Almallah ZY. 1984. Evaluation of effectiveness of audiovisual aids in teaching undergraduate medical students: an intervention study. J. Faculty Med. Baghdad 26: 42-45. ISSN: 00419419. In a Neurosciences lecture, second year Basra medical college students (180) were divided into 2 groups A and B. Group A received leaflets with blank figures of different sections of brain. The lecturer will project these figures on screen using OverHead Projector (OHP) and will describe, discuss and label and add notes on the displayed figures. Group B of students did not receive leaflets as the normal procedure during lectures. A quiz on the topic of the lecture composed of 10 MCQ of analytical nature was conducted. There was a significant statistical difference in achievement of the students in the two groups in favour of group A. Further study is needed to test the long-term effect of use of such AVL on students learning achievement.
Al-Sheikh GYM. 1991. Study on the participants’ attitude towards training methods in management course for mid-level leadership. Typed dissertation deposited at Library, National Centre for Management and Leadership Development, Baghdad. The dominant teaching and training method was lecturing. However, with a few lecturers, some open discussions were conducted. In addition, there was an individual research project assigned to each of the 18 participants. In some instances, external experts from industry, finance and othe government distinguished professionals presented their own experience and ways of leading their successful firms. The study showed that almost all participants supported the notion to improve the outcome of the course by introducing modern adult learning strategies and methodologies where self-learning, field work, problem structured solving, assignments with more open and structured discussion sessions to mark the teaching and training sessions.
GY Mustafa Alsheikh
added 9 research items
In 2008, “The Network TUFH” published an update on a medical education discussion forum established in the Easter Mediterranean Region and supported by WHO/EMRO to exchange experiences and ideas on the innovation in medical education in the region. Ghanim Alsheikh, then Regional Adviser at the WHO raised a question on the pace on propagation of innovation among the region’s medical education institutes in the region. Some feedback from leaders in the regions was reported in this brief.
1995. The effect of curriculum on the behaviour and personality of students: Tikrit experience. Scientific Journal of Tikrit University / Medical Section 1:82-6. ISSN: 16831813. By: Al-Sheikh GYM, Sulaiman ND. In Tikrit University College of Medicine (TUCOM) a Problem-Based Learning (PBL) program was adopted since establishment in 1989. The study showed that such program positively affected the behaviour and personality of students after 4 years of study.
A new clinical training module based on complaint rather than discipline and disease was introduced for first time in fourth year in Tikrit University College of Medicine (TUCOM) in 1992. I believe this was the first kind of Clinical Presentation Curriculum (CPC) introduced in Calgary years later. TUCOM adopted a fully integrated problem based curriculum since its foundation in 1989. In 2004, attempts were on agenda of veterans of Harvard Medical School to add TUCOM to the HMS partners because of similarity of curricular approach. I was the dean of TUCOM 1988-1999 and will try to upload some more articles we published locally.