BRIDGING
THE CHASM IN MEDICAL EDUCATION
Dr Nur Faraheen
Abdul Rahman

What is the status of medical education in the 21st century?

Where is the gap between teachers’, students’ and community expectations in medical education?

Why are clinical teachers’ roles in medical education becoming more important than ever?

How can clinical teachers effectively play their roles?

When is it best to enhance clinical teachers’ roles?

Doctors may not need in the future to undertake all their traditional roles, while other new roles may emerge instead

Globalisation:
Health care delivery

Globalisation:
Medical education

Reconceptualisation:
Outcome based medical curriculum

Clinical experience changing context

New learning technologies

Evolution of assessment

Recognition of professionalism and scholarship

Where is the gap?

Needs analysis

“The focus of healthcare has shifted from episodic care of individuals in hospitals to promotion of health in the community, and from paternalism and anecdotal care to negotiated care based on evidence of effectiveness and safety”.

Students’ expectations

Medical school fully prepares them for house jobs and beyond.

Jobs as doctors immediately after graduation.

Adaptation to local system after clinical training abroad

Post-graduate traineeship

Good life,
financial stability

Live happily ever after

Community expectations

Shifts in disease pattern and personal goals.

Longer life-expectancy

Cure for diseases.

Disruptive media

Lifestyle and healthcare related choices

Healing occurrence
at home

Teachers’ perceived expectations

Untitled Slide

• Parallel to those of students?
• What about the societies?
• What does teachers truly feel?

Teachers’ expectations:
The reality?

Status quo?

End-user?

Go-getter?

Trend-setter?

Co-creator?

The way students learn

Motivated by goal-orientation
(Spencer, 2003)

Guarded by resilience

Optimised by
self-regulated learning

Challenged by cognitive load for all learning materials

Supported by authentic learning environments
(Collins et al, 1989)

"Social constructivism in community of practice...
emphasised (the) collaboration between individuals within a group in a learning process each coming in with some form of prior knowledge."

Experiential learning

Situated learning

Social setting in which students’ learn to apply their knowledge.

Leading to highly meaningful situated cognition.

Enhancing transfer of knowledge in different setting.

Contextualised knowledge is powerful to help translate to concrete situations
(Orey & Nelson, 1994)

Teachers' roles in bridging the chasm

Stalmeijer et al, 2009

• Good clinical supervision
• Cognitive processes of experts: made explicit.
• Encouraging students to learn from the best.
• Making students feel respected
• Showing interests in students' learning.

Cognitive apprenticechip
(Collins et al, 1989)

Modelling

Coaching

Scaffolding

Articulation

Reflection

Exploration

Questions?

Thank you