Contextually balanced medical education: realigning with global health care delivery

Wass, Val; Mole, Thomas B

doi:10.1111/medu.13360

Cited by 5 publications

(15 citation statements)

References 9 publications

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“…More aggressively paced rehabilitation may suit certain patients more than others, for example, those with elevated impulsivity14 may be predisposed to wanting short-term rewards, and therefore may engage better in single-session rehabilitation approaches if available. Where possible, interventions should be tailored to the person and their temperament15 and within reasonable limits of patient centredness16 so treatment is contextually balanced with the patient’s needs 17. Overall, this case challenges conventional postoperative pain management protocols that emphasise pharmacological analgesics and multi-session incremental physical activity.…”

Section: Discussionmentioning

confidence: 99%

Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?

Mole¹,

Mackeith

2018

BMJ Case Reports

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Postoperative neuropathic pain exacerbated by movement is poorly understood and difficult to treat but a relatively common complication of surgical procedures such as endoscopic thoracic sympathectomy. Here, we describe a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions. Though an incidental chance association is possible, the clear temporal proximity linking the swim with pain remission makes a causal relationship possible. We discuss plausible mechanisms that may underlie the relationship and discuss the potential implications for postoperative pain management and patient-centred mobilisation. We recommend further evaluation of cold forced open-water swimming as a mobility-pain provocation challenge to see if the observed unexpectedly positive outcome can be replicated. With the poor response to traditional management, there is a need for novel, curative interventions for postoperative neuropathic pain and associated impaired mobility.

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Section: Discussionmentioning

confidence: 99%

Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?

Mole¹,

Mackeith

2018

BMJ Case Reports

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“…Case reports written with input from the field journal and FNAT (Group C) show that the quality of assessment data is enhanced by a more reflective context (16,61). Indeed, successive versions of the FNAT tool became more informative as students became more familiar with their patients.…”

Section: Adding Value For the Students Through A Practical Programmentioning

confidence: 99%

“…It is virtually impossible to learn in a maximally meaningful way in a non-clinical setting." There is growing evidence, however, that students spend less time with patients than before (16,(81)(82)(83)(84)(85); further, students are rarely observed in their clinical encounters in medical school (86)(87)(88)(89)(90). Pre-clinical and basic science courses benefit from early clinical exposure and curricular topics of ethics, communication, and professionalism.…”

Section: Implications For the Wider Biomedical Curriculummentioning

confidence: 99%

“…Pre-clinical and basic science courses benefit from early clinical exposure and curricular topics of ethics, communication, and professionalism. Public and global health curricula readily lend themselves to practical learning from real patients, mitigating the limits of simulation, and adding depth to student learning (8,16,88). Learning within a practical curriculum "stimulates the students to learn from experience with the aim of facilitating integration of theory and practice" (91).…”

Section: Implications For the Wider Biomedical Curriculummentioning

confidence: 99%

“…This is the practice of global health, or put simply, just good medicine; just as clinical medicine is best learned at the bedside ( 8 – 12 ), global health is best learned in the community. Students need to share the experiences of their patients in the community ( 13 – 16 ) and medical schools should invest curricular time in the community and honor their social accountability obligations ( 17 – 20 ).…”

Section: Introductionmentioning

confidence: 99%

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Implementing a Practical Global Health Curriculum: The Benefits and Challenges of Patient-Based Learning in the Community

Biswas

Douthit

Mazuz

et al. 2020

Front. Public Health

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Background: A growing number of medical schools across the world have incorporated global health (GH) into their curricula. While several schools focus GH education on lecture-based courses, our premise is that global health education should embody a holistic approach to patient care and medical education in local communities. Medical students may learn global health by focusing on real patients, their families and communities as part of a practical curriculum. Aims and Objectives: A unique GH curriculum was devised to compare student learning outcomes on a practical vs. lecture-based course. The premise was that learning from patients would result in a greater breadth of coverage of the global health syllabus as compared to that from a lecture-based course. Methods: A teaching and learning program was developed over 3 years to provide medical students interaction with real patients in the community on a first-preclinical-year Introduction to Global Health and Medical Anthropology course. Learning outcomes on the practical vs. lecture-based course were compared using thematic analysis of the written assignments of both courses: global health case reports and literature reviews, respectively. All members of three cohorts of students undertaking the course in successive academic years were compared (Group A: literature review; Groups B and C: case reports; n = 87). Biswas et al. Practical Global Health Curriculum Results: Case reports provided evidence of a greater breadth of learning outcomes when compared to the literature review (p < 0.001). The writing of the case report was enhanced by completion of a field journal and family health needs assessment tool (p < 0.001). Students demonstrated a closeness to their patients that added depth, understanding and motivation to assist patients in health activities and advocate for their needs. Discussion: Placements with patients in the community provided students with a rich learning environment and facilitated the formation of relationships with patients to better understand the social determinants of health and advocate for improvements in their living and working conditions and access to healthcare. Conclusions: Global health may be better learned experientially by following patients rather than from frontal lectures. Patient-based learning inspires a commitment to the individual and facilitates medical schools in meeting their obligations to the communities they serve.

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Knowledge of obesity in medical residency programs. Realities, reflections and proposals

et al. 2021

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Contextually balanced medical education: realigning with global health care delivery

Cited by 5 publications

References 9 publications

Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?

Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?

Implementing a Practical Global Health Curriculum: The Benefits and Challenges of Patient-Based Learning in the Community

Knowledge of obesity in medical residency programs. Realities, reflections and proposals

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