IMPROVEMENT OF METHODS OF MANAGEMENT OF MEDICAL EDUCATION. REVIEW
Introduction: The continuous striving to improve the quality of medical education always remains a relevant and debatable issue in the field of healthcare, since the provision of highly qualified medical care depends directly on the competence of practicing physicians, which in turn is a consequence of the work of the general personnel training system. Medical education requires closer attention every day, so that specialists at the end of training possess all the necessary skills for the implementation of a common medical mission. Over the past five years, the “safety” of patients has been a leader in healthcare policy around the world and is a key component of the quality of medical services. In connection with the foregoing, the demand for the development of new curricula has increased, taking into account patient safety criteria for doctors of various specialties at all stages of medical care, which creates additional responsibilities for teachers of medical schools.
Purpose: To analyze publications devoted to the study of the current state of management methods in medical education.
Search strategy: literature search was carried out in the electronic databases PubMed, Google Scholar and e-library by keywords (medical education, management, evaluation, design thinking. Relevant works reflecting the characteristics of the problem were accepted for description in the review.
Results: Based on the results of the reviewed studies in the field of management in medical education, the evolution of assessment methods, including the problem-based learning method and the competency-based approach, as well as various variations of project and design thinking, are considered. Particular attention was paid to “digitalization”, as e-learning allows you to use affordable IT-technologies to provide a wide range of educational services.
Conclusions: Studying the effectiveness of education is complex, but we must be able to carry out studies of higher quality than those discussed here, especially when comparing management methods. As our review has shown, it is necessary to better define the teaching method and control what actually happens in educational practice. We found several relevant studies of varying quality. In our work, we consider several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful selection and training of experts. In addition, the review notes that in order to realize its potential as a driving force in the development of interns, quality care and patient safety, effective management of information and documentation, as well as continuous consideration of ways to improve the assessment system, are required.
Maksut T. Senbekov 1, https://orcid.org/0000-0003-3954-1317
Gulnara J. Tokmurzieva 2
1 Kazakh National Medical University named after S.D. Asfendiyarova,
Almaty, Republic of Kazakhstan.
2 Almaty branch of the National Center for Public Health,
Almaty, Republic of Kazakhstan.
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11. Berkson L. Problem-based learning: have the expectations been met? Academic medicine. 1993. С. 579–588.
12. Berwick D.M., Finkelstein J.A. Preparing medical students for the continual improvement of health and health care: Abraham Flexner and the new “public interest”. Acad Med. 2010. 85: 556–65.
13. Bhatti N.I., Cummings C.W. Competency in surgical residency training: defining and raising the bar. Academic Medicine. 2007. № 82(6). Р. 569–7.
14. Bordage G., Harris I. Making a difference in curriculum reform and decision-making processes. Medical Education. 2011. № 45(1). Р. 87–94.
15. Bouhnik D., Marcus T. Interaction in distance‐learning courses. Journal of the American Society for Information Science and Technology. 2006. Т. 57. №.3. С. 299-305.
16. Brown T. et al. Design thinking. Harvard business review. 2008. Т. 86. №. 6. С. 84.
17. Calhoun J.G., Davidson P.L., Sinioris M.E., Vincent E.T., Griffith J.R. Toward an understanding of competency identification and assessment in health care management. Quality Managemant in Health Care. 2002. № 11(1). Р. 14–38.
18. Cantoni V., Cellario M., Porta M. Perspectives and challenges in e-learning: towards natural interaction paradigms. J Vis Lang Comput. 2004. Oct: 333-345.
19. Carraccio C., Wolfsthal S. D., Englander R., Ferentz K., Martin C. Shifting paradigms: from Flexner to competencies. Academic Medicine. 2002. № 77(5). Р. 361–367.
20. Carraccio C.L., Englander R. From Flexner to competencies: Reflections on a decade and the journey ahead. Acad Med. 2013; 88: 1067–1073.
21. Carroll C., Booth A., Papaioannou D., Sutton A., Wong R. UK health-care professionals' experience of on-line learning techniques: a systematic review of qualitative data. J Contin Educ Health Prof. 2009, 29(4):235-241.
22. Сhmiedgen J., Spille L., Köppen E., Rhinow H., Meinel C. Measuring the impact of design thinking. In: Design thinking research: Springer International Publishing; 2016. p. 157–170.
23. Chodorow S. Educators must take the electronic revolution seriously. Academic medicine. 1996. Т.71. №.3. С. 221-226.
24. Clark D. Psychological myths in e-learning. Medical teacher. 2002. Т. 24. №. 6. С. 598-604.
25. Colliver J.A. Effectiveness of problem-based learning curricula: research and theory. Acad Med. 2000. 75: 259–266.
26. Cook D.A., Levinson A.J., Garside S., Dupras D.M., Erwin P.J., Montori V.M. Instructional design variations in internet–based learning for health professions education: a systematic review and meta-analysis. Acad Med. 2010, May. 85(5). 909-922.
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28. Cross N. Designerly ways of knowing. Berlin: Springer; 2006, Brown T, Wyatt J. Design thinking for social innovation. Stanford Soc Innov Rev. 2010;8:31–5.
29. David T.J., Dolmans D.H., Patel L., van der Vleuten C.P. Problem based learning as an alternative to lecture-based continuing medical education. J R Soc Med. 1998. 91: 626–630.
30. Davis D., O'Brien M.A., Freemantle N., Wolf F.M., Mazmanian P., Taylor-Vaisey A. Impact of formal continuing medical education. Do conferences, workshops, rounds, and other traditional continuing education activities change physician behaviour or health care outcomes? JAMA. 1999. 282: 867–874.
31. Davis N., Davis D., Bloch R. Continuing medical education: AMEE Education Guide No 35. Med Teach 2008. 30(7): 652-666.
32. Deichmann D. Design thinking: making user happiness the metric for success. RSM Discovery-Management Knowledge. 2017. Т. 29. №. 1. С. 18-19.
33. Dolmans D., Schmidt H.G. The advantages of problem-based curricula. Postgrad Med J. 1996. 72: 535–538.
34. Facione N.C., Facione P.A. The Health Sciences Reasoning Test. Millbrae, CA: Insight Assessment; 2006. 359 c.
35. Farrell R., Hooker C. Design, science and wicked problems. Des Stud. 2013. 34(6): 681–705.
36. Fraser H. Turning design thinking in design doing. In: Roger M, Roger M, Karen C, editors. Rotman on design: the best on design thinking from Rotman magazine. Toronto, ON: University of Toronto Press; 2013. p. 116–21.
37. Gibbons A., Fairweather P. Computer-based instruction. In: Tobias S, Fletcher J (eds). Training & Retraining: A Handbook for Business, Industry, Government, and the Military. New York: Macmillan Reference USA, 2000:410–42.
38. Greenhalgh T. Computer assisted learning in undergraduate medical education. Br Med J, 2001. Jan 6; 322(7277): 40-44.
39. Grol R., Jones R. Twenty years of implementation research. Fam Pract. 2000, 17: S32–S35
40. Iby D.M., Cooke M., O’Brien B.C. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85:220–7.
41. Jolly B. Shining light on competence. Medical Education. 2012. № 46(4). Р. 346–8.
42. Jornet A., Roth W.M. Imagining design: transitive and intransitive dimensions. Des Stud. 2018;56:28–53.
43. Kahlke R., White J. Critical thinking in health sciences education: considering “three waves”. Creative Education. 2013; 4(12): 21–9.
44. Kim S.H., Myers C.G., Allen L. Health care providers can use design thinking to improve patient experiences. Harvard Business Review. 2017. Т. 95. №.5. С.222-229.
45. Ku B., Shah A., Rosen P. Making design thinking a part of medical education. NEJM Catalyst. 2016. Т. 2. №.3. С.115-121.
46. Leung W.C. Competency based medical training: review. BMJ. 2002;325:693–96
47. Lockyer J. et al. Core principles of assessment in competency-based medical education. Medical teacher. 2017. Т. 39. №. 6. С. 609-616.
48. Manzini E. New design knowledge. Design studies. 2009. Т. 30. №. 1. С. 4-12.
49. Masic I. E-learning as new method of medical education. Acta Inform Med. 2008; 16(2):102-117.
50. McLaughlin J.E. et al. A qualitative review of the design thinking framework in health professions education. BMC medical education. 2019. Т. 19. №. 1. С. 98.
51. Messick S. Validity. In R. Linn (Ed.), Educational measurement, (3rd ed.). Washington DC: Oryx Press. (1989).
52. Moberg T.F., Whitcomb M.E. Educational technology to facilitate medical students' learning: background paper 2 of the medical school objectives project. Acad Med. 1999, 74: 1146–50.
53. Nair B.R., Finucane P.M. Reforming medical education to enhance the management of chronic disease. Med J Aust. 2003, 179: 257–59.
54. Niccum B.A. et al. Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis. Medical education online. 2017. Т. 22. №. 1. С. 1360722.
55. Norcini J.J., McKinley D.W. Assessment methods in medical education. Teaching and teacher education. – 2007. Т. 23. №. 3. С. 239-250.
56. Norcini J.J. Current perspectives in assessment: The assessment of performance at work. Medical Education, 2005. 39, 880–889.
57. Norman G.R., Schmidt H.G. Effectiveness of problem-based curricula: theory, practice and paper darts. Med Educ. 2000; 34: 721–728.22.
58. Norman G.R., Schmidt H.G. The psychological basis of problem-based learning: a review of evidence. Acad Med. 1993; 6. 7.
59. Oz ah PO. Undergraduate medical education: thoughts on future challenges. BMC Med Educ. 2002, 2: 8–10
60. Ratzan S.C. Commissioned paper integrating health literacy into primary and secondary prevention strategies. Washington, DC: Institute of Medicine Roundtable on Health Literacy. 2009. С. 77-101.
61. Rosenberg M.J., Foshay R. E‐learning: Strategies for delivering knowledge in the digital age. Performance Improvement. 2002. Т. 41. №. 5. С. 50-51.
62. Roth M.T., Mumper R.J., Singleton S.F., Lee C.R., Rodgers P.T., Cox W.C., et al. A renaissance in pharmacy education at the University of North Carolina at Chapel Hill. NC Med J. 2014. 75(1):48–52.
63. Royalty A., Roth B. Developing design thinking metrics as a driver of creative innovation. In: Design thinking research: Springer International Publishing; 2016. p. 171–83.
64. Ruiz J.G., Mintzer M.J., Leipzig R.M. The impact of e-learning in medical education. Academic medicine. 2006. Т. 81. №. 3. С. 207-212.
65. Sanci L.A., Coffey C.M., Veit F.C., Carr-Gregg M., Patton G.C., Day N., et al. Evaluation of the effectiveness of an educational intervention for general practitioners in adolescent health care: randomised controlled trial. BMJ, 2000. 320: 224–230.
66. Schön D.A. The reflective practitioner: how professionals think in action. New York, NY: Basic Books; 1983. С.615-621.
67. Schuwirth L., Cantillon P. The need for outcome measures in medical education. Academic medicine. 2005. С.211-213.
68. Shavelson R.J., Webb N.M. Generalizability theory: A primer. – Sage, 1991. Т. 1. С.521-532
69. Simon H.A. The sciences of the artificial. – MIT press, 2019. С.96-110
70. Sinclair P.M. et al. The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: a systematic review. International journal of nursing studies. 2016. Т. 57. С. 70-81.
71. Smits P.B., Verbeek J.A., De Buisonje C.D. Problem based learning in continuing medical education: a review of controlled evaluation studies. Bmj. 2002. Т. 324. №. 7330. С. 153-156.
72. Storrar N., Hope D., Cameron H. Student perspective on outcomes and process–Recommendations for implementing competency-based medical education. Medical teacher. 2019. Т. 41. №. 2. С. 161-166.
73. Triola M.M., Huwendiek S., Levinson A.J., Cook D.A. New directions in e-learning research in health professions education: report of two symposia. Med Teach 2012, 34(1):e15-e20.
74. van de Grift T. C., Kroeze R. Design thinking as a tool for interdisciplinary education in health care. Academic Medicine. 2016. Т. 91. №. 9. С. 1234-1238.
75. van der Vleuten C.P., & Schuwirth L.W. Assessing professional competence: From methods to programmes. Medical Education, 2005. 39(3), 309–317.
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Senbekov M.T., Tokmurzieva G.J. Improvement of methods of management of medical education. Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 1, pp. 27-38. doi:10.34689/SH.2020.22.1.003Related publications:
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