Mulazim Hussain Bukhari  ( Principal Azad Jammu Kashmir Medical College Muzaffarabad, Pakistan )
Ali Abutiheen  ( Ali Abutiheen, College of Medicine, University of Kerbala, Iraq )
Fatema Jawad  ( Editor-in-chief, JPMA. )
Shahzad Anwar  ( Shahzad Anwar, Institute of Medical Sciences, Lahore, Pakistan )
Asad Ali Shah  ( Asad Ali Shah, Institute of Medical Sciences, Lahore, Pakistan )
Tabassum Zehra  ( Tabassum Zehra, Aga Khan University, Karachi, Pakistan. )
Shabih H Zaidi  ( Shabih H. Zaidi, Medics' International virtual university, London, UK. )

University of Karbala College of Medicine (UKCM), Iraq, conducted a three days’ workshop on Medical Education and medical writing. The UKCM is now transforming to conform with the latest trends of modern education. This will help to re-shape the future of medical education and produce capable doctors. This requires a strong faculty, which is sound in teaching, training, learning improvement, research capacity building, and leadership development. The capacity building of faculty at UKCM has been initiated in collaboration with Medics International at a local and government level and includes a series of workshops and online symposia. This educational activity was conducted after a delay of three years due to COVID-19. A three -day refresher course was conducted in the first week of August, 2022. Medical writing is another important feature which has been continuously covered by UKMM since many years with the collaboration of Al-Sadiq International Virtual University (SIVU) and Imamia Medics International (IMI).

 

Keywords: Assessment, AJKMC, IMI, Medical Education, Medical writings, OSCE, OSPE, Paper writings, Synopsis writings, SIMS, SIVU, UKCM, work place Assessment.

 

DOI: https://doi.org/

 

Introduction

 

Most of the medical institutions are now changing their curriculum from traditional to integrated system for undergraduate medical education. Each component of the curriculum has to be assessed for the change. The traditional system was based on evaluation via clinical examination through a long case, one or two short cases and viva voce. This whole system was subjective with a poor outcome. However, the new modular integrated system is now replacing this old traditional system and is based on formative and summative assessments. The integrated modular (commonly known as semester system), involves connecting the relevant curricular components with respect to knowledge, skills, attitudes and values.

University of Karbala College of Medicine (UKCM), Iraq, conducted a three- day International Conference on Medical Education and Medical Writing from August 2-4, 2022 in collaboration with Al-Sadiq International Virtual University (SIVU) headed by Professor Shabih Zaidi. The ‘Third International Conference on Medical Education’ was the latest innovation in a series of conferences held since 2018. This included one full day of virtual plenary sessions and two days of hands-on workshops. Speakers from across the globe were invited to deliver speeches on revolutionary topics in medical education. The hybrid conference was structured to foster discussion between participants around the core themes of medical education. This included curriculum development teaching and learning, accreditation, and assessments in clinical medical education. Registration for the Day 1 of the conference was open to UKMC medical college faculty, global academicians and clinicians via the Al- Sadiq International Virtual University (SIVU) Platform. With the expansion of the international speakers and the increasing number of virtual participants attending the plenary sessions, it was obvious that the event had evolved from a local  academic conference, into a ‘strategic retreat’ with workshops and eminent speeches.

 

Day-1: Tuesday 2nd August, 2022

 

Day-1 of the conference was conducted virtually (online). Participants from across the globe were connected via ZOOM. Academic think tank of SIVU and Medics International brought together practitioners and specialists in medical education from across the borders. About 70 participants attended this session online. Speeches of eminent international speakers in medical education were transmitted live globally.

One-day virtual symposium comprised of two plenary sessions, with four to six speakers per session. For each of the sessions, speaker was given 20-30 minutes to present on eminent topics. This was followed by Questions and Answers session. This was recorded on ZOOM.

Moderated by Dr Tabassum Zehra and assisted by Dr Ali Abutiheen, this session started with the recitation of verses from the Holy Quran, inauguration remarks by the Chancellor UKCM followed by the welcome address by the Dean UKCM, Professor Riyadh Zubaidi. The virtual speakers included Professor Shabih Zaidi (UK) with his talk on “The virtuous physician”,  Professor Hilal AlSafar (Baghdad) with his talk on “Curriculum reform: learned lessons” Prof Ali Tareq (Karbala) with his talk on “Threshold concepts in medical education curriculum: system thinking approach”.

Session Two: The second plenary session included international speakers. Professor Shoaleh Bidgeli (Iran) talked on “Gamification in Medical Education”. Mr. Hasnain Zafar  (Malaysia) gave the lecture on “Blended learning”, while Professor Gohar Wajid (WHO) talked on “Accreditation of Medical Colleges”, Professor Karim Qayyumi (Canada) spoke on “Cyber Patient” , Professor Shahid Hassan (Malaysia) gave a presentation on Psychometrics Assessment,  Professor Muhammed Tariq (Pakistan) talked on “Clinical Reasoning in Decision Making” and Dr Naveed Yousuf (AKU- Pakistan) spoke on, “Excellence in student assessment: Lifelong Journey”

The virtual session ended with many interesting form of questions and answers. The details are available on www.sivu.alsadiquni.com

 

Day-2: Wednesday, 3rd August, 2022.

 

Characteristics of a good examination includes validity, objectivity, reliability and feasibility.1 One of the important assessment tools in clinical education is the Objective Structured Clinical Examination (OSCE). However, it is considered less authentic due to broken contested stations and involvement of multiple examiners.  Objective Structured Teaching Exercise (OSTE) on simulated patients and Task Oriented Assessment of Clinical Skills (TOACS) are considered best outcome-based examinations but are not recommended for undergraduate students. Therefore, the modified OSCE system is being used for undergraduate students’ assessments called ‘Task Integrated Objective Structured Clinical Examination” (TIOSCE).2

There were two workshops held on Day-2 of the conference. The first workshop theme was “How to conduct OSCE/OSPE”. Moderated by Dr Ali Abutiheen and facilitated by Professor Shahzad Anwar (Prof of Urology; Chairman Department of Urology& Transplant surgery Services Institute of Medical Sciences, Lahore) and Dr Assad Ali Shah (SIMS). The main objective of this workshop was to discuss importance of OSCE/OSPE, what is OSCE/OSPE, How to Conduct OSCE/OSPE, post exam analysis and hands on conduction of OSCE. A number of participants attended this workshop.

The second workshop was related to Work- place Based Assessment (WPBA), MiniCEX and Direct Observation of Procedural Skills (DOPS). The Theme was “Clinical Teaching and Assessment of Competence at Work Place: MiniCEX and DOPS” facilitated by  Dr Tabassum Zehra and Dr Sana Saeed (Aga Khan University Hospital Karachi). Dr Sana Saeed joined via video link on ZOOM. WPBA involves the assessment of the practices of clinical skills in the workplace setting. It includes a wide range of assessment strategies to evaluate learners in the clinical settings and provide them feedback.

Clinical Teaching and Assessment of Competence at Work Place: MiniCEX and DOPS was introduced to familiarize the participants with the MiniCEX & DOPS tool, how to apply and demonstrate the use of MiniCEX & DOPS tool in different clinical settings and demonstrate effective feedback skills during the process of workplace-based assessment.1-3 This included interactive discussions and role plays. The workshop was attended by a number of faculty members from UKMC.

 

Day-3: Thursday 4th August, 2022.

 

This session started with  Instructions for Synopsis writing by Prof. Mulazim Hussain Bukhari. Synopsis writing and manuscript writing are two main pillars in medical research, clinical practice and medical education.

A proposed Research Project requires approval from competent authorities for which a synopsis is submitted. The details of the applicant with the name of the supervisor and the institution are mandatory. The title should be brief and reflect the purpose of the study. The abstract with the specified number of words is followed by the Introduction with a  specific, measurable, achievable, realistic and time bound objective. Methods come next and address the sample size calculation, sampling technique, inclusion and exclusion criteria followed by details of data collection and analysis. Informed consent is mandatory and description of pre-test and post-test procedures carried out as and when necessary should be stated. All methodologies should be supported by references quoted in the required style.4

A well-written synopsis on a relevant topic will convince the examiners and an acceptance letter will be handed out.

The session on medical writing was facilitated by Dr. Fatema Jawad, Editor, Journal of Pakistan Medical Association. Research results are shared through publishing  well written articles. Observing ethics is the basic requirement and following the Equator guidelines facilitates an excellent document. Authorship should be according to the International Committee of Medical Journal Editors (ICMJE) recommendations.5 The IMRAD Structure was discussed in detail with examples in this session. A simple and effective title of the article will attract readers.

Dr. Jawad explained that the Abstract offers a critical window and describes an article’s scope and significance and grasps the readers interest. It should be  written in a concise manner conveying the exact message. Six to eight MeSH keywords are required. The next section is the Introduction which has to portray the problem under investigation  and is discussed in the light of research literature. Purpose of the study and its scientific merits should be stated. Supporting references are necessary where required. The last sentence should provide the objective of the study.

The Methods are the most critical  section of the manuscript and describe how the study was carried out and what was exactly done. Included are the Subjects used, Study site, Study period, Sampling size and design, Data collection protocol, data analysis  and statistical procedures employed. Methodology should be exact to make it convenient for replication. Informed consent of the participant is mandatory which allows withdrawal from the study at any stage without being penalized. Stress was paid on  integrity in research which is essential for good outcome. Academic integrity based on respect for knowledge, truth and honesty, has to be preserved.6,7 Methodology should have sufficient details to help an investigator to replicate the study

The speaker stressed on avoiding publication misconduct as plagiarism, fabrication and falsification which are punishable. The importance of the prospective Institutional Review Board’s (IRB) approval letter for conducting the research and registration of a  Randomized Control Trial (RCT)8 with the concerned authority and the covering letter by the authors were given the due importance. Results require accurate and honest reporting and are followed by the Discussion, which begins by summarizing the principal findings of the study and comparing them with the results of other studies. This is followed by the Conclusion, which highlights the main findings.

Recent references should be included with local ones where indicated, written in the style recommended by the journal. Stating any Conflict of interest or a Disclaimer is obligatory. A well-written article will find its way to publication.

 

Closing Session

 

The three-days interactive course ended with the closing session with an impressive speech by the Prof Najem Abdulhussein Najem, Vice Chancellor for scientific affairs of University of Karbala, and Prof Riyadh Zubaidi Dean of UKCM, Prof Shabih H Zaidi, Professor Hassan Nasrullah, Mulazim Hussain Bukhari (AJKMU) and Prof Ali Abutiheen. The hosts delivered a vote of thanks and presented gifts to the entire teaching faculty. The participants provided very encouraging remarks on all the sessions.

 

Conclusion

 

The third consecutive Medical Educational and knowledge-building programme will facilitate in the faculty development for UKCM in health professions' Medical Education and Medical Writing to improve their educational capacities, to enhance their teaching and training practices to encounter future challenges in the medical and health care system

 

Acknowledgment: We are highly indebted to Prof Najem Abdulhussein Najem, Vice Chancellor for scientific affairs, Prof Shoaleh Bidgeli (Iran), Mr. Hasnain Zafar, Prof Gohar Wajid, Prof Karim Qayyumi (Canada) Prof Shahid Hassan, Prof Mohd Tareq and Prof Naveed Yousuf for participating in the online video conference. Prof Najem Abdulhussein Najem, Vice Chancellor for scientific affairs of University of Karbala, and Prof Riyadh Zubaidi Dean of UKCM are thanked for organizing this three day event.

The services of Ms. Esraa Zaman Sahib of CMUK are appreciated for the excellent IT system available for the course.

Special thanks are due to Dean Raid Umran, Dean of Kufa University for the logistic support in the virtual session and Dr Habeeb al Hasani for attending the workshop. Dr Mubbashir Iftekhar is acknowledged for organising the excellent Zoom links. The recordings of the conference are available on www.SIVU.alsadiquni.com.

 

Recommendations: There are many challenges faced by the section of medical education in Iraq. The rising global demand for good health practitioners in general and physicians, in particular, is a major requirement worldwide. The numbers of medical colleges in Iraq is increasing placing tremendous pressure on the government to provide an effective infrastructure and a highly qualified faculty, well trained in health professions' education. The requirement for more academic medical institutions needs careful planning, keeping in view that the education and training of teachers is a priority. In the present situation, medical education in Iraq is in a crucial phase. It needs gross changes with systematic planning that considers all potential challenges. These should be recognized and addressed. The current phase of reform and expansion must be coupled with accreditation and quality assurance procedures in order to ensure that each endeavor meets internationally acknowledged goals and standards.

Other issues which need to be prioritized are the increase in the seats of students / college with some shortage in Academic Medical Staff. And that Medical colleges in Iraq is in the middle of the process of Academic Accreditation were, Medical Education, assessment, Curriculum reform, and researches are within the core of the accreditation requirement.

 

Disclaimer: None.

 

Conflict of interest: None.

 

Funding disclosure: None.

 

References

 

1.      Bukhari MH, Abutiheen A, Jawad F, Anwar S, Nasrullah H, Mehdi A,et.al. Conference Report on First Certificate Course in Health Professions Education at College of Medicine, University of Kerbala, Iraq.(September 2019). J Pak Med Assoc. 2020 ;70:543-546.

 

 

2.      Khan KZ, Gaunt K, Ramachandran S, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part II: organisation & administration. Med Teach. 2013 ;35:e1447-63. doi: 10.3109/0142159X.2013.818635.

3.      Lörwald AC, Lahner FM, Mooser B, Perrig M, Widmer MK, Greif R, et.al. Influences on the implementation of Mini-CEX and DOPS for postgraduate medical trainees' learning: A grounded theory study. Med Teach. 2019;41:448-456. doi: 10.1080/0142159X.2018.1497784. Epub 2018 Oct 28.

4.      Format of CPSP synopsis. https://www.cpsp.edu.pk/files/rtmc/ synopsis.pdf. Cited on 12.8.2022.

5.      Defining the Role of Authors and Contributors. .International Committee of  Medical Journal Editors. Available at: https://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html  Cited on 12th September, 2022

6.      InfoSkills: Information Literacy and Academic Integrity Tutorial.21 Sept. 2005, Available at :http://www.newcastle.edu.au/services/ library/tutorials/infoskills/glossary.html .cited 20. September 2015

7.      Creating a culture of publication integrity together. Available at https://publicationethics.org/ Cited on 12, September, 2022

8.      How to register your study.US National Library of Medicine.Clinical Trials.gov Availabe at: https://clinicaltrials.gov/ct2/manage-recs/ how-register https://clinicaltrials.gov/ct2/html/images/ct.gov-nlm-nih-logo.png Cited on 12.September, 2022.