Implementation of Critical Threshold Concept in Clinical Transplantation: A New Horizon in Distance Learning

Abstract

Background: While variations in medical practice are a norm and each patient poses a multitude of challenges, many clinicians are not comfortable in dealing with unexpected complex issues even though they may have enough knowledge as demonstrated by passing a number of tricky certifying (or exit)

Threshold concepts in medical education: A scoping review

“…Several papers evaluated teaching interventions in the context of the TCF 39,41,48,54,55 and one paper incorporated the TCF into curriculum design of a new course. 31 Other authors took a different approach and examined learning experiences associated with threshold crossing. 35,53 Students demonstrated a change in language, knowledge, and behaviour following a simulation session about dementia care, although the TCs students may have crossed were not discussed.…”

“…Thirty-six papers published between 2012 and 2021 were included in the final analysis (see Figure 1 for PRISMA flow diagram). Most papers originated in the United Kingdom (n = 15 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] ), North America (n = 11 [36][37][38][39][40][41][42][43][44][45][46] ) and Australasia (n = 7 47-53 ). Some papers focused on particular medical specialities and subject areas, including surgery (n = 5 21,23,41,47,54 ), medical physiology and biomedical science (n = 4 42,43,51,55 ), geriatric medicine and dementia care (n = 3 26,27,29 ), psychiatry (n = 2 24,35 ), general practice (n = 2 34,50 ), military medicine (n = 2 36,37 ), anaesthetics, 46 internal medicine, 39 neurology,…”

“…Some papers focused on particular medical specialities and subject areas, including surgery (n = 5 21,23,41,47,54 ), medical physiology and biomedical science (n = 4 42,43,51,55 ), geriatric medicine and dementia care (n = 3 26,27,29 ), psychiatry (n = 2 24,35 ), general practice (n = 2 34,50 ), military medicine (n = 2 36,37 ), anaesthetics, 46 internal medicine, 39 neurology, 40 paediatrics, 38 palliative care, 48 population health, 28 rheumatology 52 and transplant science. 30 A wide range of article types were identified (Table 3), the majority of which were qualitative research studies. A detailed summary of the papers is included in the Appendix S2.…”

“…40,42 Potential TCs were identified in relation to physiology and biomedical science, including secondary messenger systems, pressure gradients, preload and afterload, cell membrane potential and polarity. 40,42 Ventilation-perfusion (V/Q) mismatch 46 and an X-ray being a 2D representation of a 3D structure 32 Qualitative study 16 [21][22][23][24][25][26][27][36][37][38][39][40][47][48][49][50] Grounded theory study 5 21,24,36,38,39 Phenomenological study 2 23,26 Ethnographic study 1 22 Naturalistic enquiry 1 25 No specific research design stated 7 27,37,40,[47][48][49][50] Mixed method study 6 28,29,41,51,54,55 Quantitative study 2 30,52 Mixed (conceptual analysis and qualitative study)…”

The Good, the Bad, and the Ugly of Distance Learning in Higher Education

“…In this instance, computing technology will be an ideal solution to deal with the challenges of distance learning. ICT often reduces faceto-face interaction among students, which is one reason for the high dropout rates in distance education [33]. In distance-learning marginalized students, for example, the impaired and the economically disadvantaged ones may be further excluded from educational practices when ICT is used.…”