Abstract Objective The James Cook University (JCU) medical school has a mission to produce gradua... more Abstract Objective The James Cook University (JCU) medical school has a mission to produce graduates committed to practising with underserved populations. This study explores the views of final-year students regarding the influence of the JCU medical curriculum on their self-reported commitment to socially-accountable practice, intentions for rural practice, and desired postgraduate training pathway. Methods Cross-sectional survey of final year JCU medical students (n = 113; response rate = 65%) to determine whether their future career directions (intentions for future practice rurality and postgraduate specialty training pathway) are driven more by altruism (commitment to socially accountable practice/community service) or by financial reward and/or prestige. Results Overall, 96% of responding students reported their JCU medical course experiences had cultivated a greater commitment towards 'socially-accountable' practice. A commitment to socially-accountable practice over financial reward and/or prestige was also significantly associated with preferring to practise Medicine in non-metropolitan areas (p = 0.036) and intending to choose a ‘generalist’ medical discipline (p = 0.003). Conclusions The findings suggest the JCU medical curriculum has positively influenced the commitment of its graduating students towards more socially accountable practice. This influence is a likely result of pre-clinical teachings around health inequalities and socially-accountable medical practice in combination with real-world, immersive experiences on rural and international placements.
Background The Australian Medical Council, which accredits Australian medical schools, recommends... more Background The Australian Medical Council, which accredits Australian medical schools, recommends medical leadership graduate outcomes be taught, assessed and accredited. In Australia and New Zealand (Australasia) there is a significant research gap and no national consensus on how to educate, assess, and evaluate leadership skills in medical professional entry degree/programs. This study aims to investigate the current curricula, assessment and evaluation of medical leadership in Australasian medical degrees, with particular focus on the roles and responsibilities of medical leadership teachers, frameworks used and competencies taught, methods of delivery, and barriers to teaching leadership. Methods A self-administered cross-sectional survey was distributed to senior academics and/or heads or Deans of Australasian medical schools. Data for closed questions and ordinal data of each Likert scale response were described via frequency analysis. Content analysis was undertaken on free ...
Health system reform models since the early 1990s have recommended leadership training for medica... more Health system reform models since the early 1990s have recommended leadership training for medical students, graduates and health workers. Clinicians often have leadership roles thrust on them early in their postgraduate career. Those who are not well trained in leadership and the knowledge that comes with leadership skills may struggle with the role, which can impact patient safety and create unhealthy working environments. While there is some literature published in this area, there appears to be little formal evaluation of the teaching of leadership, with scarcely any discussion about the need to do so in the future. There are clear gaps in the research evidence of how to teach and assess medical leadership teaching. In this paper, three leadership frameworks from Australia, Canada and the UK are compared in terms of leadership capabilities for a global view of medical leadership training opportunities. A literature review of the teaching, assessment and evaluation of leadership ...
The Australian Medical Council, the national standards body for basic medical education, recommen... more The Australian Medical Council, the national standards body for basic medical education, recommends that all medical students develop leadership skills. There is often little formal teaching of leadership skills in the core medical curriculum. Medical student clubs and societies (societies) offer one mechanism through which to develop leadership skills during higher education.
The Training for Health Equity Network (THEnet), a group of diverse health professional schools a... more The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection co...
Health professional schools are responsible for producing graduates with competencies and attitud... more Health professional schools are responsible for producing graduates with competencies and attitudes to address health inequities and respond to priority health needs. Health professional schools striving towards social accountability founded the Training for Health Equity Network (THEnet). This article describes the development of THEnet evaluation framework for socially accountable health professional education, presents the framework to be used as a tool by other schools and discusses the findings of pilot implementation at five schools. The framework was designed collaboratively and built on Boelen and Woollard's conceptualization, production and usability model. It includes key components, linked to aspirational statements, indicators and suggested measurement tools. Five schools completed pilot implementation, involving workshops, document/data review and focus group discussions with faculty, students and community members. Three sections of the framework consider: How does our school work?; What do we do? and What difference do we make? Pilot testing proved that the evaluation framework was acceptable and feasible across contexts and produced findings useful at school level and to compare schools. The framework is designed as a formative exercise to help schools take a critical look at their performance and progress towards social accountability. Initiatives to implement the framework more widely are underway. The framework effectively aids in identifying strengths, weaknesses and gaps, with a view to schools striving for continuous self-improvement. THEnet evaluation framework is applicable and useful across contexts. It is possible and desirable to assess progress towards social accountability in health professional schools and this is an important step in producing health professionals with knowledge, attitudes, and skills to meet the challenges of priority health needs of underserved populations.
Introduction/background: High levels of stress in young people studying medicine is a problem tha... more Introduction/background: High levels of stress in young people studying medicine is a problem that appears to be increasing in severity. Unfortunately it is not uncommon to see unhelpful or harmful coping strategies being employed by students to manage their study/life stress. The Australian Medical Students Association cite that medical students are three times more likely to commit suicide than the rest of the general population in their age range. Purpose/objectives: The purpose of the session is to discuss the widening issue of stress and self-harm amongst the student population, specifically medical students, and glean from each other what support strategies have been successful. Discussing responsibility, support, service and strategies with other expert healthcare educators will help illuminate and address the impact of student mental health and the serious impact this may have on their progression through the course. Issues/questions for exploration or ideas for discussion: ...
[Extract] The need to address the social determinants of health and to promote health equity has ... more [Extract] The need to address the social determinants of health and to promote health equity has become a top priority for various health care organizations (High-Level Commission on Health Employment and Economic Growth, 2016). Part of the solution lies in developing a workforce that understands and has the will to address these issues. Health professionals and health organizations must be socially accountable to the communities they serve. Thus, they need to be people centered and willing to engage in community services (WHO, 2016). Preparing a health workforce that provides holistic or integrated, people-centered care in communities where people live and work demands that educators critically appraise and adjust their educational vision and health care practices.
[Extract] The James Cook University School of Medicine and Dentistry is the only medical school i... more [Extract] The James Cook University School of Medicine and Dentistry is the only medical school in North Queensland. The School was established in 2000 with the mission to work with rural, remote, Indigenous (Aboriginal and Torres Strait Islander) and tropical populations. A significant proportion of the undergraduate learning at the School takes place in community settings, including fourteen weeks of rural placement across Years Two, Four and Six, and a one-week placement in an Aboriginaland Torres Strait Islander Community Control Health Service in Year Four. In 2010 the School of Medicine and Dentistry expanded its community engagement by developing a systematic process for conducting face-to-face consultations with local Indigenous health workers in remote communities. This study describes the process of how the School collaboratively established an Indigenous Reference Group with a cross-section of Indigenous (predominantly Aboriginal) health leaders, Elders and non-professional but highly valued community representatives in the remote North Queensland town of Mount Isa. The university's research team included Ms Glenda Duffy, Ms Simone Ross, Dr Torres Woolley and Associate Professor Sundram Sivamalai, along with Indigenous academics Mr Donald Whaleboat and Ms Priscilla Page, who assisted with data analysis and advice on the cultural integrity of the project. Resource support in the form of a meeting room and administration for the project was provided by the Mount Isa Centre for Rural and Remote Health (MICRRH). The Mount Isa Aboriginal and Torres Strait Islander Reference Group included Mr Ron Page, Ms Leanne Parker, Ms Nancy George, Mrs Renee Blackman, Miss Stephanie King, Mrs Caterina Walden, Mr Darren Walden, Mr Graham Page, Mrs Frances Page, Mrs Dolly Hankin, Ms Fiona Hill, Ms Kerry Major, Mr Shaun Solomon, Ms Elizabeth Dempsey and Mrs Mona Phillips.
[Extract] The James Cook University School of Medicine (JCU-SOM) (now the College of Medicine and... more [Extract] The James Cook University School of Medicine (JCU-SOM) (now the College of Medicine and Dentistry) was established in 2000 as the first new Australian medical school in over 20 years and the only school in the northern half of Australia. Northern Australia's population is dispersed over a huge geographical area, with no settlement larger than 200,000 people, and suffers from a maldistribution of health professionals. For example, in 2012, the ratio of doctors to population varied from one medical practitioner for every 246 people in major cities, to 1:425 in outer regional and remote areas (Australian Institute of Health and Welfare 2014b). Health status is in inverse proportion to this (Australian Institute of Health and Welfare 2014a).
Background The transition experience into university can be challenging for health profession stu... more Background The transition experience into university can be challenging for health profession students as they are required to rapidly learn diverse and adaptable problem solving skills and advanced reflective thinking processes which are necessary to address complex patient-care problems, particularly in the face of uncertainty within a dynamic and rapidly evolving learning environment. Methods A mixed-methods study was conducted to identify factors influencing this transition for first-year medical, dental, and pharmacy students at a regional Australian university. The Student Adaption to College Questionnaire (SACQ) examined participants’ levels of adjustment to university, while Schlossberg’s 4 S transition model was utilised in a framework analysis of the focus group and interview responses. Results Complete survey responses were obtained from 198 students, 17 of whom also participated in focus group discussions or interviews. Mean adjustment ratings obtained from the SACQ resp...
Introduction: Universal Health Care requires equal distribution of a health workforce equipped wi... more Introduction: Universal Health Care requires equal distribution of a health workforce equipped with competencies appropriate for local population needs. While health inequities persist in the Philippines, the Ateneo de Zamboanga University School of Medicine (ADZU-SOM) in Zamboanga Peninsula – an impoverished and underserved region – has demonstrated significant success retaining graduates and improving local health statistics. This study describes the qualitative evidence of ADZU-SOM students and graduates having positive impacts on local health services and communities, and the contextual factors associated with the school's socially-accountable mission and curriculum that contribute to these impacts.Methods: This qualitative study involved 41 one-on-one or group interviews conducted across seven participant groups (faculty, graduates, final-year students, health professionals, health workers, community members, community leaders). Gale et al's method for analyzing qualita...
Abstract Objective The James Cook University (JCU) medical school has a mission to produce gradua... more Abstract Objective The James Cook University (JCU) medical school has a mission to produce graduates committed to practising with underserved populations. This study explores the views of final-year students regarding the influence of the JCU medical curriculum on their self-reported commitment to socially-accountable practice, intentions for rural practice, and desired postgraduate training pathway. Methods Cross-sectional survey of final year JCU medical students (n = 113; response rate = 65%) to determine whether their future career directions (intentions for future practice rurality and postgraduate specialty training pathway) are driven more by altruism (commitment to socially accountable practice/community service) or by financial reward and/or prestige. Results Overall, 96% of responding students reported their JCU medical course experiences had cultivated a greater commitment towards 'socially-accountable' practice. A commitment to socially-accountable practice over financial reward and/or prestige was also significantly associated with preferring to practise Medicine in non-metropolitan areas (p = 0.036) and intending to choose a ‘generalist’ medical discipline (p = 0.003). Conclusions The findings suggest the JCU medical curriculum has positively influenced the commitment of its graduating students towards more socially accountable practice. This influence is a likely result of pre-clinical teachings around health inequalities and socially-accountable medical practice in combination with real-world, immersive experiences on rural and international placements.
Background The Australian Medical Council, which accredits Australian medical schools, recommends... more Background The Australian Medical Council, which accredits Australian medical schools, recommends medical leadership graduate outcomes be taught, assessed and accredited. In Australia and New Zealand (Australasia) there is a significant research gap and no national consensus on how to educate, assess, and evaluate leadership skills in medical professional entry degree/programs. This study aims to investigate the current curricula, assessment and evaluation of medical leadership in Australasian medical degrees, with particular focus on the roles and responsibilities of medical leadership teachers, frameworks used and competencies taught, methods of delivery, and barriers to teaching leadership. Methods A self-administered cross-sectional survey was distributed to senior academics and/or heads or Deans of Australasian medical schools. Data for closed questions and ordinal data of each Likert scale response were described via frequency analysis. Content analysis was undertaken on free ...
Health system reform models since the early 1990s have recommended leadership training for medica... more Health system reform models since the early 1990s have recommended leadership training for medical students, graduates and health workers. Clinicians often have leadership roles thrust on them early in their postgraduate career. Those who are not well trained in leadership and the knowledge that comes with leadership skills may struggle with the role, which can impact patient safety and create unhealthy working environments. While there is some literature published in this area, there appears to be little formal evaluation of the teaching of leadership, with scarcely any discussion about the need to do so in the future. There are clear gaps in the research evidence of how to teach and assess medical leadership teaching. In this paper, three leadership frameworks from Australia, Canada and the UK are compared in terms of leadership capabilities for a global view of medical leadership training opportunities. A literature review of the teaching, assessment and evaluation of leadership ...
The Australian Medical Council, the national standards body for basic medical education, recommen... more The Australian Medical Council, the national standards body for basic medical education, recommends that all medical students develop leadership skills. There is often little formal teaching of leadership skills in the core medical curriculum. Medical student clubs and societies (societies) offer one mechanism through which to develop leadership skills during higher education.
The Training for Health Equity Network (THEnet), a group of diverse health professional schools a... more The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection co...
Health professional schools are responsible for producing graduates with competencies and attitud... more Health professional schools are responsible for producing graduates with competencies and attitudes to address health inequities and respond to priority health needs. Health professional schools striving towards social accountability founded the Training for Health Equity Network (THEnet). This article describes the development of THEnet evaluation framework for socially accountable health professional education, presents the framework to be used as a tool by other schools and discusses the findings of pilot implementation at five schools. The framework was designed collaboratively and built on Boelen and Woollard's conceptualization, production and usability model. It includes key components, linked to aspirational statements, indicators and suggested measurement tools. Five schools completed pilot implementation, involving workshops, document/data review and focus group discussions with faculty, students and community members. Three sections of the framework consider: How does our school work?; What do we do? and What difference do we make? Pilot testing proved that the evaluation framework was acceptable and feasible across contexts and produced findings useful at school level and to compare schools. The framework is designed as a formative exercise to help schools take a critical look at their performance and progress towards social accountability. Initiatives to implement the framework more widely are underway. The framework effectively aids in identifying strengths, weaknesses and gaps, with a view to schools striving for continuous self-improvement. THEnet evaluation framework is applicable and useful across contexts. It is possible and desirable to assess progress towards social accountability in health professional schools and this is an important step in producing health professionals with knowledge, attitudes, and skills to meet the challenges of priority health needs of underserved populations.
Introduction/background: High levels of stress in young people studying medicine is a problem tha... more Introduction/background: High levels of stress in young people studying medicine is a problem that appears to be increasing in severity. Unfortunately it is not uncommon to see unhelpful or harmful coping strategies being employed by students to manage their study/life stress. The Australian Medical Students Association cite that medical students are three times more likely to commit suicide than the rest of the general population in their age range. Purpose/objectives: The purpose of the session is to discuss the widening issue of stress and self-harm amongst the student population, specifically medical students, and glean from each other what support strategies have been successful. Discussing responsibility, support, service and strategies with other expert healthcare educators will help illuminate and address the impact of student mental health and the serious impact this may have on their progression through the course. Issues/questions for exploration or ideas for discussion: ...
[Extract] The need to address the social determinants of health and to promote health equity has ... more [Extract] The need to address the social determinants of health and to promote health equity has become a top priority for various health care organizations (High-Level Commission on Health Employment and Economic Growth, 2016). Part of the solution lies in developing a workforce that understands and has the will to address these issues. Health professionals and health organizations must be socially accountable to the communities they serve. Thus, they need to be people centered and willing to engage in community services (WHO, 2016). Preparing a health workforce that provides holistic or integrated, people-centered care in communities where people live and work demands that educators critically appraise and adjust their educational vision and health care practices.
[Extract] The James Cook University School of Medicine and Dentistry is the only medical school i... more [Extract] The James Cook University School of Medicine and Dentistry is the only medical school in North Queensland. The School was established in 2000 with the mission to work with rural, remote, Indigenous (Aboriginal and Torres Strait Islander) and tropical populations. A significant proportion of the undergraduate learning at the School takes place in community settings, including fourteen weeks of rural placement across Years Two, Four and Six, and a one-week placement in an Aboriginaland Torres Strait Islander Community Control Health Service in Year Four. In 2010 the School of Medicine and Dentistry expanded its community engagement by developing a systematic process for conducting face-to-face consultations with local Indigenous health workers in remote communities. This study describes the process of how the School collaboratively established an Indigenous Reference Group with a cross-section of Indigenous (predominantly Aboriginal) health leaders, Elders and non-professional but highly valued community representatives in the remote North Queensland town of Mount Isa. The university's research team included Ms Glenda Duffy, Ms Simone Ross, Dr Torres Woolley and Associate Professor Sundram Sivamalai, along with Indigenous academics Mr Donald Whaleboat and Ms Priscilla Page, who assisted with data analysis and advice on the cultural integrity of the project. Resource support in the form of a meeting room and administration for the project was provided by the Mount Isa Centre for Rural and Remote Health (MICRRH). The Mount Isa Aboriginal and Torres Strait Islander Reference Group included Mr Ron Page, Ms Leanne Parker, Ms Nancy George, Mrs Renee Blackman, Miss Stephanie King, Mrs Caterina Walden, Mr Darren Walden, Mr Graham Page, Mrs Frances Page, Mrs Dolly Hankin, Ms Fiona Hill, Ms Kerry Major, Mr Shaun Solomon, Ms Elizabeth Dempsey and Mrs Mona Phillips.
[Extract] The James Cook University School of Medicine (JCU-SOM) (now the College of Medicine and... more [Extract] The James Cook University School of Medicine (JCU-SOM) (now the College of Medicine and Dentistry) was established in 2000 as the first new Australian medical school in over 20 years and the only school in the northern half of Australia. Northern Australia's population is dispersed over a huge geographical area, with no settlement larger than 200,000 people, and suffers from a maldistribution of health professionals. For example, in 2012, the ratio of doctors to population varied from one medical practitioner for every 246 people in major cities, to 1:425 in outer regional and remote areas (Australian Institute of Health and Welfare 2014b). Health status is in inverse proportion to this (Australian Institute of Health and Welfare 2014a).
Background The transition experience into university can be challenging for health profession stu... more Background The transition experience into university can be challenging for health profession students as they are required to rapidly learn diverse and adaptable problem solving skills and advanced reflective thinking processes which are necessary to address complex patient-care problems, particularly in the face of uncertainty within a dynamic and rapidly evolving learning environment. Methods A mixed-methods study was conducted to identify factors influencing this transition for first-year medical, dental, and pharmacy students at a regional Australian university. The Student Adaption to College Questionnaire (SACQ) examined participants’ levels of adjustment to university, while Schlossberg’s 4 S transition model was utilised in a framework analysis of the focus group and interview responses. Results Complete survey responses were obtained from 198 students, 17 of whom also participated in focus group discussions or interviews. Mean adjustment ratings obtained from the SACQ resp...
Introduction: Universal Health Care requires equal distribution of a health workforce equipped wi... more Introduction: Universal Health Care requires equal distribution of a health workforce equipped with competencies appropriate for local population needs. While health inequities persist in the Philippines, the Ateneo de Zamboanga University School of Medicine (ADZU-SOM) in Zamboanga Peninsula – an impoverished and underserved region – has demonstrated significant success retaining graduates and improving local health statistics. This study describes the qualitative evidence of ADZU-SOM students and graduates having positive impacts on local health services and communities, and the contextual factors associated with the school's socially-accountable mission and curriculum that contribute to these impacts.Methods: This qualitative study involved 41 one-on-one or group interviews conducted across seven participant groups (faculty, graduates, final-year students, health professionals, health workers, community members, community leaders). Gale et al's method for analyzing qualita...
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