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How Can We Improve Medical Education

Preprint · September 2022

DOI: 10.13140/RG.2.2.33038.64324

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Çağrı Barış Güneç

Sun Yat-Sen University
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How Can We Improve Medical Education

Name: Çağrı Barış Güneç

Institution: Zhongshan School of Medicine

Course: Clinical Medicine

Date: 12 September 2022

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How Can We Improve Medical Education

As doctors' fundamental sciences, clinical abilities, and professionalism continue to

develop, so too must medical education. It has evolved dramatically in the last 20 years (Patel,

2016). Every doctor must possess a core set of skills formally recognized in 1999 by the

Accreditation Council for Graduate Medical Education (ACGME). Professionalism, patient care,

medical knowledge, interpersonal and communication skills, system-based care, and practice-

based learning and development are the six pillars of the Accreditation Council for Graduate

Medical Education's (ACGME) core competencies. The ACGME has recently created milestones

as a development plan based on essential skills (Edgar et al., 2020). For that purpose, we want to

provide a narrative overview of state of the art in each area.

Traditional lecture-based teaching methods have failed to solve the problem of students

not learning or remembering what they were taught in medical school. McMaster University in

Hamilton, Ontario, Canada, is credited with pioneering the problem-based learning (PBL)

technique in 1969 (Joshi et al., 2021). The primary objective was to encourage student engagement

in education by utilizing independent and collaborative study. The idea of a teacher as the principal

educator was supplanted by this approach. In the PBL style, students are placed in small groups

and given cases meant to simulate real-world circumstances; this method is often employed in

medical schools. The students engage in the independent study followed by guided conversations

with a teacher or tutor (Joshi et al., 2021).

When doctors, nurses, and other medical experts from different fields talk to one another,

they may speed up the learning process and improve patients' health as a whole. Medical schools

must emphasize the importance of interpersonal communication to better prepare students for

careers in multidisciplinary teams (Tseli et al., 2020). When learning about medicine and doing it,
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patient care is a broad concept but essential to keep in mind. For instance, health practitioners

using the interprofessional multimodal pain rehabilitation (IMPR) method work together to

improve patients' physical and mental health while informing them about their condition and

treatment options. Accordingly, this methodical and careful strategy promotes patient care (Tseli

et al., 2020).

From the first day on the job, all medical professionals should strive to maintain the highest

standards of professionalism. The view that maturation is an inside occurrence lends credence to

the concept of professionalism as an amalgam of malleable human characteristics (Langendyk et

al., 2016). In 1991, the Association of American Medical Colleges (AAMC) published a collection

of examples meant to represent medical professionalism; other health professionals have since

utilized these examples as a standard by which to evaluate the professionalism of medical

educators (Joshi et al., 2021). However, its evaluation varies from institution to university.

Even if many evidence-based care treatment plans are produced for many medical

problems, they cannot be implemented without effective multidisciplinary teams. Planning,

collaboration, and a systematic management plan based on research that promotes patient care are

hallmarks of a system-based approach to healthcare (Joshi et al., 2021). Trainees in the medical

field are tasked with conducting systematic investigations and evaluations of their patient care and

the practice patterns of their workplaces to pinpoint areas for improvement as part of practice-

based learning and improvement. All of the adjustments and additions are made to make things

better. Thus the best methods are used and implemented. They are involved in teaching future

medical professionals, patients, and their loved ones (Dressler et al., 2006)). All of these fields

profoundly influence the improvement of medical training.

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Continuous education is linked to high-quality patient care via practice-based learning and

improvement (PBLI). It's a series of practical exercises that helps students identify their own and

workplace training priorities. Next, the trainees create and carry out strategies for personal

development and enhancing their respective practices. The healthcare system may benefit from the

gradual and steady implementation of minor adjustments to individual practitioners' work habits

and procedures (Joshi et al., 2021). In 2004, Ogrinc et al. (2004) found that internal medicine

residents who took a four-week PBLI elective had higher scores on the quality Improvement

Knowledge Application Tool than the control group. Other research by Varkey et al. (2009)

describes how incorporating PBLI, and systems-based practice into the Mayo Clinic's curriculum

led to an increase of 13% in the perceived ability to measure competency in systolic blood pressure

(SBP), no change in the perceived ability to measure competence in PBLI, an increase of 15% in

the ability to provide written documentation of competence in PBLI and a 35% increase in the

ability to provide written documentation of competence in SBP. As a side note, 70% of the locals

were involved in QI initiatives during that period (Varkey et al., 2009). As a result, all medical

schools must provide their students with a PBLI curriculum.

Collaboration with community groups, a self-management tool to monitor the patient's

progress, group cluster visits, and a diabetes flow sheet were the interventions in research

conducted in the United States of America to increase the quality of diabetes treatment in

community centers. Over eighty percent of those polled were interested in keeping up with the

interventions (Chin et al., 2004), and 95% were optimistic about the collaboration's efficacy.

Swedish research adopting a multi-modality approach to pain therapy for musculoskeletal pain

also demonstrated substantial post-intervention improvement that persisted at the 12-month

follow-up. A longer program length was not proven to be more effective than a shorter one (Tseli
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et al., 2020). Hush et al. found in their systematic review that the interpersonal characteristics of

caregivers and the way they interact with patients are crucial in determining whether or not a

patient is satisfied with their treatment. However, there was no correlation between patient

satisfaction and the actual result of therapy (Joshi et al., 2021).

Most medical professionals understand the significance of professionalism in teaching and

patient care (Joshi et al., 2021). Regarding questions concerning patient privacy and sexual

harassment, Japanese emergency medicine (EM) residents scored higher than EM doctors (Joshi

et al., 2021). In another study, students in clinical settings outperformed their preclinical

counterparts on a test of professionalism. However, the result was insignificant (Haque et al.,

2016). Ninety-five percent of Australian workers surveyed said that PPD courses helped them

advance in their careers. Students better understood the biopsychosocial element of medicine and

ethical behavior in clinical practice after conducting community-based interviews with patients

and writing from the patient's viewpoint (Langendyk et al., 2016). Professionals in the health care

industry who have the necessary knowledge to improve patient compliance and their work

environment are essential.

Many studies have proven system-based treatment (Ike et al., 2019)) to improve clinical

outcomes while reducing related hazards. Moreover, confidence and surgical abilities have been

bolstered by inter-specialty teamwork to handle complex and soft tissue injuries systematically

(Milne et al., 2020). American research, for instance, looked at how the Six Building Blocks

Program for treating patients on opioids for chronic pain affected primary care doctors and staff's

daily routines. After adopting the program, employees felt more at ease with their work-life

balance, their confidence and comfort in clinical areas, their ease in handling patients with chronic

pain, their comfort in work procedures and their position, and their ability to work together rose
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(Ike et al., 2019)). Therefore, the benefits of system-based care are twofold: improved patient care

and happier doctors.

Medical education is changing to keep up with developments in the fundamental and

clinical sciences. Intending to better education, the Accreditation Council for Graduate Medical

Education (ACGME) has approved six core competencies. According to the research, a higher

post-test score increases focus, and practical learning is a more precise indicator. The ability to

effectively communicate with others is a critical factor in improving efficiency in the workplace,

the quality of care provided, and the likelihood that patients will stick with their treatment plans.

A professional demeanor is appreciated by coworkers, which boosts productivity, and it's also a

vital quality for encouraging patients to stick with their treatment plans. Patients benefit from a

systematized approach to care in system-based medicine. Finally, in practice-based education,

medical students and residents learn to carefully assess the treatment pattern and use the most

effective modality to boost patient care and physician satisfaction. These fundamental skills should

be a part of every phase of medical education.

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