Winds of change in medical education in Singapore: what does the future hold?

Lum, Lionel; Poh, Kian‐Keong; Tambyah, Paul Anantharajah

doi:10.11622/smedj.2018142

Cited by 5 publications

(5 citation statements)

References 12 publications

(14 reference statements)

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“…Psychiatry residents who graduated from local medical schools appeared to have a relatively better knowledge of hypertension and dyslipidemia, while Psychiatry residents younger than 35 years tended to know more about managing hypertension. The local medical education system seems to have a more comprehensive approach [ 32 ]. In Singapore, there are three medical schools: Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), Duke-NUS Medical School, and Lee Kong Chian School of Medicine.…”

Section: Discussionmentioning

confidence: 99%

“…In Singapore, there are three medical schools: Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), Duke-NUS Medical School, and Lee Kong Chian School of Medicine. This creates an environment of friendly competition in Singapore medical education [ 32 ]. The good quality of the local medical education system may help Psychiatry residents to have better knowledge of hypertension and dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

“…The selection process for entry also does not require the potential resident to have completed a posting in Family Medicine prior to joining the psychiatry residency. In the late 2000s, Singapore shifted its postgraduate training program from the British basic and advanced specialty training system to the American residency system [ 32 , 33 ]. Interestingly, in the United States, there is a combined family medicine-psychiatry training program [ 34 – 37 ].…”

Section: Discussionmentioning

confidence: 99%

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Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training

Ying¹,

Wan

Sim

et al. 2021

BMC Med Educ

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Background Psychiatry and Family Medicine residents frequently see patients with comorbid mental and physical disorders. Little is known about the difference in knowledge of Psychiatry residents and Family Medicine residents regarding management of common conditions they encounter. This study aimed to assess the knowledge of Psychiatry and Family Medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia, as the findings could help to refine the training curriculum for residency training. Methods A cross-sectional survey design was used. Psychiatry and Family Medicine residents pursuing their residency in Singapore were recruited from November 2019 to June 2020. The survey questionnaire consisted of questions which assessed the knowledge regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia. Descriptive statistics were used to describe the demographic data; T-tests or Mann-Whitney U tests to compare the differences between groups; and multiple regression analyses to assess the factors associated with Psychiatry residents’ knowledge of hypertension, diabetes mellitus, and dyslipidemia. Results Fifty-seven out of 70 (81.4%) Psychiatry residents and 58 out of 61 (95.1%) Family Medicine residents participated in the study. The majority of Psychiatry residents encountered patients with hypertension (93.0%), diabetes mellitus (87.7%) and dyslipidemia (91.2%) on a daily to weekly basis. Psychiatry residents had higher scores on questions about schizophrenia versus Family Medicine residents (mean 50.70 versus 43.28, p < 0.001). However, Psychiatry residents scored lower on questions about hypertension (mean 33.86 versus 40.98, p < 0.001), diabetes mellitus (mean 45.68 versus 49.79, p = 0.005) and dyslipidemia (mean 37.04 versus 44.31, p < 0.001). Receiving undergraduate medical education locally, compared to receiving it overseas, was associated with better knowledge of hypertension (beta = 0.515, p = 0.009) and dyslipidemia (beta = 0.559, p = 0.005); while younger age (26–30 versus > 35 and 31–35 versus > 35) was associated with better knowledge of hypertension (beta = 1.361, p = 0.002 and beta = 1.225, p = 0.003). A significant proportion of Psychiatry residents (61.4%) did not agree that the training provided to manage hypertension, diabetes mellitus, and dyslipidemia was adequate. Similarly, majority of Family Medicine residents (62.1%) did not agree that they had adequate training to manage schizophrenia. Conclusions This study raises the awareness of Psychiatry residents’ sense of discomfort in managing hypertension, diabetes mellitus, or dyslipidemia and conversely Family Medicine residents in management of schizophrenia, which can be further addressed during the training postings within the residency programs. Future studies are needed to look at local (such as training curriculum) and systemic factors (such as practice trends and culture) in order to better align residency selection criteria and training foci with real world practice factors over time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training

Ying¹,

Wan

Sim

et al. 2021

BMC Med Educ

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“…Only studies over the past decade were chosen because the authors are keen to focus on evaluating more recent developments in teaching CR. 20 Another article has reviewed studies further in the past. 21 The exclusion criteria were (1) CR not in the field of medicine (e.g., nursing, physiotherapy); (2) papers that only addressed patient management; (3) not involving medical students; and (4) editorials/commentaries/letters.…”

Section: Study Selection Eligibility Criteriamentioning

confidence: 99%

Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

Ang

Soh

et al. 2021

J GEN INTERN MED

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BACKGROUND: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of these teaching methods during clinical training. METHODS: PubMed, Embase, Scopus, and ERIC were searched. The inclusion criteria for the review consist of articles describing (1) methods to enhance diagnostic reasoning, (2) in a clinical setting (3) on medical students. Articles describing original research using qualitative, quantitative, or mixed study designs and published within the last 10 years (1 April 2009-2019) were included. Results were screened and evaluated for eligibility. Relevant data were then extracted from the studies that met the inclusion criteria. RESULTS: Sixty-seven full-text articles were first identified. Seventeen articles were included in this review. There were 13 randomized controlled studies and four quasiexperimental studies. Of the randomized controlled studies, six discussed structured reflection, four self-explanation, and three prompts for generating differential diagnoses. Of the remaining four studies, two employed the SNAPPS 1 technique for case presentation. Two other studies explored schema-based instruction and using illness scripts. Twelve out of 17 studies reported improvement in clinical reasoning after the intervention. All studies ranked level two on the New World Kirkpatrick model. DISCUSSION: The authors posit a framework to teach diagnostic reasoning in the clinical setting. The framework targets specific deficiencies in the students' reasoning process. There remains a lack of studies comparing the effectiveness of different methods. More comparative studies with standardized assessment and evaluation of longterm effectiveness of these methods are recommended.

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“…Overall, this demanded greater accountability as well as documentation from both trainees and educators, while producing significant numbers of trainees who had completed the programme requirements. (11) With the adoption of the ACGME-I CBME framework, a protected time for training was introduced. Programme directors and core faculty members were also accorded protected time for their educational and administrative roles.…”

Section: Acgme-i and Competency-based Medical Education (Cbme)mentioning

confidence: 99%

Evolution of postgraduate medical education in paediatrics: the Singapore story

Shahdadpuri¹,

Lau²,

Chay³

2021

smedj

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Postgraduate paediatric education in Singapore has seen a seismic shift in the past 50–60 years, from a primarily time-based, passive, teacher-centric and apprenticeship model with hierarchical learning culture to a competency-based and learner-centric one. The postgraduate medical education system in paediatrics in Singapore will continue to evolve and adapt with best practices in evidence-based medical education, with the aim to train and develop the next generation of paediatricians who will strive to continually improve child and population health in Singapore.

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Winds of change in medical education in Singapore: what does the future hold?

Cited by 5 publications

References 12 publications

Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training

Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training

Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review

Evolution of postgraduate medical education in paediatrics: the Singapore story

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