Saturday, June 19, 2021

Introduction, Draft 3 Scholarship of Integration and the future of Medical education and research

 (A) 

(A)ssessed Need for the chapter in the context of medical education research, practice, publication, or scholarship. Word limit suggested, 400 to 500 words:


Introduction:


For most medical students and teachers medical education begins with their entry to medical school and begins with an introduction to the dead body and the this cadaveric teacher bares it's innards for all budding health professionals to learn the various components of the individual human system even while they attend parallel classes on physiology and biochemistry to further learn how this anatomic structure functions in a living human in all it's fascinating internal molecular and cellular complexity. 


Again in the next year they learn pathology which describes how a body is structurally ravaged by illness at a cellular and molecular level often historically unravelled after death. Finally they are introduced to the whole alive human being in their later clinical years where they learn to apply the knowledge of yester years to a living complex human being with his her complex network of problems rooted either in his her environment or genes. 


However this was not always how medicine was historically learned and this current curricular methodology of putting dry factual content before the student gets to experience learning in the context of the entire human, undermines the very ethos of medical education which is essentially to help health professionals improve patient care outcomes. 

Consequently one main problem statement theme for this chapter is the current "disintegration of Medical education with practice" and the tool that it aims to resolve the problem with is scholarly integration of Medical education and research. 

The other problem that this chapter addresses with the same tool is the current issue of national medical  integration, which has reached a tipping point due to a reigining covid chaos that has fast tracked all diverse interventions with varying methodological backgrounds into battling one single disease. 

Very few people know what is "scholarship of Integration in medical education and research" and how it can be a tool to tackle the current problems in medical education and practice and one important need this chapter will address is to fill in that information gap. 

Very few people realize that Medical education research is a tool to eventually improve patient outcomes as patient is the ultimate beneficiary of Medical education and this chapter will again not only address this vital information gap but become instrumental in driving positive change in this direction. 

Scholarship of integration in Medical education and research : what it is and what it isnt:

Scholarship of integration in medical education and research makes connections within and between disciplines, locating knowledge in a broader context giving meaning to specific discoveries. It aims to distribute the fruits of academic discovery to benefit specific individual members of society aka patients who in turn help academics to multiply the construction of new knowledge translated into practice. (Reference: www.ncbi.nlm.nih.gov/pmc/articles/PMC1891293/#!po=75.3968)

It is vital that academic institutions and medical schools remain relevant in an era when the production of knowledge is increasingly recognized as a social collaborative activity. 

(www.ncbi.nlm.nih.gov/pmc/articles/PMC1891293/ )

In this article we address two important problems and it's subcategories with the tool of scholarly integration namely 

primarily around two broad categories and it's subcategories:

a) Current disintegration of Medical education and practice 

Medical student and faculty engagement in rote memorization through an arcane curriculum that promotes plagiarism and diminishes scholarship 

disconnected from 

Patients who continue to suffer due to lack of student and faculty engagement with them in a broader empathic meaningful manner. 

b) Long overdue National Medical integration of health care delivery through methodologically diverse streams of interventions:

India's traditional and tribal system of Medicine historically neglected due to undue hype created by a dominant Western mode of Medical education that engages our students and teachers as unquestioning slaves.

Although current West has moved on globally, we are unable to get over our colonial past that continues to haunt our education and practice. 


Our proposed tool of scholarly integration, enables shared knowledge through a participatory framework and includes practical methods to guide institutional change along with reporting and evaluating them.  

At the outset one must clarify that scholarship of integration is not the same as scholarship of teaching and learning aka SOTL and borrowing from an excellent recent editorial (Singh T, Gupta P, Can We Consider Scholarship of Teaching Learning Rather than Focusing Only on publications for Recognition of Medical teachers by National Medical Commission? Annals of the National Academy of Medical Sciences (India) 2021; 57(01): 01-02 DOI: 10.1055/s-0041-1728179) , SOTL as identified by Felten13 thrives on  five principles

(1) inquiry focused on student learning, 

(2) grounded in context, 

(3) methodologically sound, 

(4) conducted in partnership with students, and (

5) appropriately public. (Felten P. Principles of good practice in SoTL. Teaching and Learning Inquiry 2013;1(1):121–125).

TS et al's editorial contributes very interesting questions. 

"How such a scholarship can be evaluated? Should it focus on output or outcome?"

The answer to the first would be open access self publication in one's own online learning portfolio such as even an online question paper designed can be shared for evaluation among  peers as here: http://medicinedepartment.blogspot.com/2021/05/online-blended-bimonthly-assignment.html?m=1

The above link to our online test for the month of May 2021 is essentially a student user driven, real patient centered, experiential sharing of individual patient data in the form of patient centered questions for solving and helping those individuals.

The competencies tested are the usual (mentioned in the link above) although unlike last month it doesn't test the competencies for familiarity with Empathy, Humanities and ML AI. 

Q10 looks at another topical area and that is "medical education" itself where students are also encouraged to think about their learning process. 

The answer to the second would surely be outcomes but not just on student learning but also in the context of Medical education directed toward it's  ultimate beneficiaries, that is the patients themselves, through a framework that enables driving of patient outcomes through student learning outcomes and a real time clinical audit trail that allows us to join the dots between the two. 

The above would bring us closer to scholarship of integration in Medical education and research which is not just about integrating scholarship of teaching learning with the scholarship of discovery but is all about integration of patient centered societal goals with teaching and learning. 

Please click on the link below to get back to the first layer of the chapter:


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