Institute for Excellence in Health Professions Education (ieHPE)

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Digital Health for Supporting Precision Medicine in Pediatric Endocrine Disorders: Opportunities for Improved Patient Care
(2021) Zary, Nabil
Abstract: Digitalization of healthcare delivery is rapidly fostering development of precision medicine. Multiple digital technologies, known as telehealth or eHealth tools, are guiding individualized diagnosis and treatment for patients, and can contribute significantly to the objectives of precision medicine. From a basis of “one-size-fits-all” healthcare, precision medicine provides a paradigm shift to deliver a more nuanced and personalized approach. Genomic medicine utilizing new technologies can provide precision analysis of causative mutations, with personalized understanding of mechanisms and effective therapy. Education is fundamental to the telehealth process, with artificial intelligence (AI) enhancing learning for healthcare professionals and empowering patients to contribute to their care. The Gulf Cooperation Council (GCC) region is rapidly implementing telehealth strategies at all levels and a workshop was convened to discuss aspirations of precision medicine in the context of pediatric endocrinology, including diabetes and growth disorders, with this paper based on those discussions. GCC regional investment in AI, bioinformatics and genomic medicine, is rapidly providing healthcare benefits. However, embracing precisionmedicine is presenting some major new design, installation and skills challenges. Genomic medicine is enabling precision and personalization of diagnosis and therapy of endocrine conditions. Digital education and communication tools in the field of endocrinology include chatbots, interactive robots and augmented reality. Obesity and diabetes are a major challenge in the GCC region and eHealth tools are increasingly being used for management of care. With regard to growth failure, digital technologies for growth hormone (GH) administration are being shown to enhance adherence and response outcomes. While technical innovations become more affordable with increasing adoption, we should be aware of sustainability, design and implementation costs, training of HCPs and prediction of overall healthcare benefits, which are essential for precision medicine to develop and for its objectives to be achieved.
Identification of Key Factors for Optimized Healthcare Services: A Protocol for a Multi-phase Study of the Dubai Vaccination Campaign
(2022) Faroun, Hayette; Zary, Nabil; Gad, Kareem; Al Suwaidi, Hanan
Background: Mass vaccination of the global population against the novel coronavirus (COVID-19) posed multiple challenges, including effectively administering millions of doses in a short period of time while ensuring public safety and accessibility. The Government of Dubai launched a mass campaign in December 2020 to vaccinate all its citizens and residents, targeting the population over the age of 18 against COVID-19. The vaccination campaign involved a transformation of multiple commercial spaces into mass vaccination centers (MVCs) across the city of Dubai, the largest of which was the Dubai One Central (DOC) Vaccination Center. It was operational between 17 January 2021 and 27 January 2022. Objective: The multi-phase research study aims to empirically explore the opinions of multiple healthcare stakeholders, elicit the key success factors that can influence the effective delivery of emergency healthcare services such as COVID-19 MVCs, and explore how these factors relate to one another. Method: To understand more about the operations of the Dubai One Central vaccination center, the study follows a multi-phase design divided into two main sections. The study is conducted by the Institute for Excellence in Health Professions Education (ieHPE) at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) between December 2021 and January 2023. To elicit the key success factors that contributed to the vaccination campaign administered at DOC, the research team conducted 30 semi-structured interviews (SSI) with a sample of staff and volunteers who worked at the DOC vaccination center. Stratified random sampling was used to select the participants, and the interview cohort included representatives from the management team, team leaders, administration and registration team, vaccinators, and volunteers. A total of 103 people were invited to take part in the research study and 30 people accepted to participate in the SSI interviews. To validate the participation of various stakeholders, the second phase analytically investigated one’s subjectivity through Q-methodology and empirically investigating the opinions obtained from the research participants during phase 1. Results: As of July 2022, 30 semi-structured interviews were conducted with the research participants. The expected results from the project's first phase will be the identification of key success factors, enablers, and barriers of the design and operation of the Covid-19 vaccination center at DOC. While the expected results from the study's second phase will identify patterns of similarities and differences in the ranking of the Q-sets. The final set of results from this dataset will quantitatively interpret the common answers amongst participants and the correlation between the selected success factors relating to the study. Conclusions: The study will provide a comprehensive two-phase approach to obtaining the key success factors that can influence the delivery of high-quality healthcare services such as emergency services launched during a global pandemic. The study's findings will be translated into key factors that could support designing future healthcare services utilizing evidence-based practice. In line with future plans, a study will use data, collected through the One Central vaccination center, to develop a simulation model outlining the process of the customer journey and center workflow.
Imagining the Future of Learning in Healthcare: The GAME 2019 #FuturistForum
(2021) Zary, Nabil
Abstract: The GAME 2019 #FuturistForum involved an exchange of ideas and perspectives on the future of learning in healthcare and necessary evolutions to sustain future health systems. This event allowed for reflection and discourse around a) what medical learning or learning in healthcare may look like 10–15 years from now, b) how technology would impact that evolution, and c) what collaborative roles distinct stakeholders would play. Seventy-five (75) key stakeholders, experts from various fields, participated in the two-day event. Four multifaceted themes were uncovered from the qualitative analysis, which are: learning will be lifelong and outcome-based, the health system will follow a preventive care model, technology will be an enabler of evolution in education and health systems, and that multi-level collaboration will support and sustain future progress. Future implications, exacerbated by the ongoing COVID-19 pandemic, and study limitations are described.
Introducing the 4Ps Model of Transitioning to Distance Learning: A convergent mixed methods study conducted during the COVID-19 pandemic
(2021) Otaki, Farah; Zaher, Shroque; Du Plessis, Stefan; Lakhtakia, Ritu; Zary, Nabil; Inuwa, Ibrahim M.
Abstract: Significant concern has been raised regarding the effect of COVID-19 on medical education. This study aimed to shed light on the distance learning experiences of medical students and their instructors at the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) in Dubai, United Arab Emirates. A convergent mixed methods approach was utilized. Qualitative and quantitative data was collected using a survey of closed-ended followed by open-ended questions. The percentage of the total average of satisfaction among stakeholders was 76.4%. The qualitative analysis led to developing the 4Ps Model of Transitioning to Distance Learning, which encapsulates four interrelated themes. It would be helpful to leverage the lessons learned to tailor blended medical programs with a reasonable me´lange of experiences. The study also contributes to the mixed methods research by showcasing a means of adapting it to evaluate critical situations reliably and rapidly.
Medical Students’ Perception and Perceived Value of Peer Learning in Undergraduate Clinical Skill Development and Assessment: Mixed Methods Study
(2021) Alzaabi, Shaikha; Nasaif, Mohammed; Hassan Khamis, Amar; Otaki, Farah; Zary, Nabil; Mascarenhas, Sharon
Background: The effectiveness of peer learning in clinical skill development is well recognized and researched, given the many benefits gained such as enhanced learning, alleviation of the burden on faculty, and early development of teaching skills for future doctors. However, little is known in terms of its effectiveness as an assessment tool and the extent to which peer assessment can be relied upon in the absence of faculty support. Objective: This study was conducted to assess medical students’ perception toward peer learning, which is based on self-regulated learning as a tool of assessment, and to compare peer evaluation with faculty evaluation of clinical skill performance. Methods: A cohort of 36 third-year medical students were exposed to peer learning (same-level) in clinical skills education for 3 months. A convergent mixed methods approach was adapted to collect data from 3 sources, namely, students’ perception of peer learning, performance scores, and reflective observational analysis. A 5-point Likert-type scale was used to assess students’ (n=28) perception on the value of peer learning. The students were asked to assess their peers by using a preset checklist on clinical skill performance, and scores were compared to faculty assessment scores. Reflective observational data were collected from observing video recordings of some of the peer learning sessions. The findings from all 3 sources were integrated using joint display analysis. Results: Out of 28 students, 25 students completed the survey and 20 students perceived peer learning as valuable in clinical skills education. The mean score of peer assessment was higher than that of faculty assessment. There was a significant difference in student performance between supervised teaching and peer learning groups (P=.003). Most students focused on the mastery of skill with little attention to the technique’s quality. Further, students were unable to appreciate the relevance of the potential clinical findings of physical examination. Conclusions: Peer learning in clinical skills education, based on self-regulated learning, empowers students to develop a more responsible approach toward their education. However, peer assessment is insufficient to evaluate clinical skill performance in the absence of faculty support. Therefore, we recommend that peer learning activities be preceded by supervised faculty-taught sessions.
Profiling of Learners in Medical Schools as a Move Toward Precision Education: Protocol for a Scoping Review
(2022) Salman, Hira; Powell, Leigh; Alsuwaidi, Laila; Nair, Bhavana; Tegginmani, Shakeel Ahmed; Mohamadeya, Jalal; Zary, Nabil
Background: Academic experiences seek to get the best out of learners, maximizing performance and developing the skills and competencies needed to foster lifelong learning. The more personalized and tailored the academic experience among learners, the better the outcome. Precision education is a novel approach to research and practice, which is concerned with identifying and tailoring education to the precise needs of the learner. An emerging area of precision education is using data to develop learner profiles for a better understanding of individual learners relative to the characteristics and competencies of lifelong learners. Objective: This scoping review aims to identify literature that reports on profiling learners within medical schools. Our review, as described in this paper, will describe the characteristics being measured, the methods and data sources used to generate profiles, and the resulting profiles that emerge. This review aims to provide guidance to those supporting medical school learners on the current state of learner profiling. Methods: This scoping review will use the Population, Concept, and Context framework, published by Joanna Briggs Institute, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The search strategy was developed in collaboration with a library specialist. An initial search was conducted in PubMed, ERIC, Google Scholar, Cochrane, CINAHL, and SCOPUS. Data will be extracted, and 2 authors will undertake the screening procedure using the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews checklist. Results: The database searches yielded 166 results, and title and abstract screening of 135 extracted articles is currently underway after eliminating 31 duplicates. We anticipate the scoping review to be completed in the first week of October 2022. The final scoping review will present the findings in a narrative and pictorial fashion. Conclusions: This review will help guide scholars looking to understand the current state of learner profiling within medical schools.
Rapid transition to distance learning due to COVID-19: Perceptions of postgraduate dental learners and instructors
(2021) Amir-Rad, Fatemeh; Otaki, Farah; Baqain, Zaid; Zary, Nabil; Al Halabi, Manal
Abstract: The outbreak of Coronavirus disease 2019(COVID-19) necessitated an abrupt transition from on campus, face-to-face sessions to online, distance learning in higher education institutions. The purpose of this study was to investigate the perceptions of postgraduate dental learners and instructors about the transition to distance learning, including the changes to the learning and teaching and its efficaciousness. A convergent mixed methods approach to research was utilized. All the instructors and postgraduate learners in a dental college were invited to participate in an online survey. Quantitative data was analyzed using descriptive and inferential analyses on SPSS for Windows version 25.0, and for the responses to the open-ended questions, multi-staged thematic analysis was utilized. Both groups of stakeholders: learners and instructors, were satisfied with the rapid transition to distance learning due to COVID-19. Instructors were significantly more satisfied than the learners. The stakeholders adapted well to the change. The perception of the stakeholders regarding the case based scenarios significantly influenced their level of satisfaction. As perceived by the stakeholders, the transition to distance learning entailed advantages and challenges. Going through the experience enabled the stakeholders to develop informed opinions of how best to sustain learning and teaching irrespective of how matters unfold in relation to the pandemic. In conclusion, the worldwide dental education community faced unprecedented challenges due to the onset of COVID-19. From a macro perspective, decision-makers must not miss out on the valuable opportunities, inherent in the experience, to reinforce curriculums, and maximize learning and teaching.
Shaping the future-ready doctor: a first-aid kit to address a gap in medical education.
(2020) Otaki, Farah; Naidoo, Nerissa; Heialy, Saba Al; John-Baptiste, Anne-Marie; Davis, David A; Senok, Abiola
To the Editor: With the advent of Industry 4.0 (i.e., the fourth industrial revolution) came a paradigm shift built on core work-related skills that further dictated the emergence of a "new" world, with diverse professional disruptors and innovators at the forefront. In an effort to address this new paradigm, recommendations in higher education for the "creation of more practical and applied curricula" and for enhancing "relationships between higher education institutions, employers, and other partners . . ." have been proposed. To create a level playing field for global healthcare sectors of the future, Morrison outlined the diverse roles a future-ready doctor will be expected to uphold. Thus, medical education has to evolve to mold a holistic future-ready doctor who can treat and continuously innovate. To this end, medical schools are challenged to amalgamate basic medical sciences with clinical sciences seamlessly and to adapt their curricula to yield millennial physicians who are able to respond to and act on cur-rent and emerging trends in healthcare. In addition to building on Flexner's legacy to ensure progressive pedagogical approaches, innovative means to incorporate the active components of human presence, comparable to that of core work-related attributes (i.e., heart - values, head - knowledge, mind - qualities, and hands - skills), need to be developed. However, it is undeniable that traditional classroom instruction alone cannot produce these characteristics of the future-ready doctor. (Continued)
Taking a Leap of Faith:A Study of Abruptly Transitioning an Undergraduate Medical Education Program to Distance-Learning Owing to the COVID-19 Pandemic
(2021) Du Plessis, Stefan; Otaki, Farah; Zaher, Shroque; Zary, Nabil; Inuwa, Ibrahim M.; Lakhtakia, Ritu
Abstract: The COVID-19 pandemic has forced universities worldwide to immediately transition to distance-learning. Although numerous studies have investigated the effect of the COVID-19 pandemic on universities in the Middle East, none have reflected on the process through which medical education programs for health professions underwent this transition. This study aimed to elucidate the rapid transition to distance-learning of an undergraduate medical program at the College of Medicine, Mohammad Bin Rashid University of Medicine and Health Sciences (Dubai, United Arab Emirates), owing to the COVID-19 pandemic. An action research approach constituted the foundation of this collaborative effort that involved investigations, reflections, and improvements of practice, through ongoing cycles of planning, acting, observing, and reflecting. Efforts of transitioning to distance-learning were grouped into four interrelated aspects: supporting faculty members in delivering the program content, managing curriculum changes, engaging with the students to facilitate distance-learning experiences, and conducting web-based assessments. Challenges included the high perceived uncertainty, need for making ad hoc decisions, lack of experiential learning and testing of clinical skills, and blurring of work-life boundaries. Our preliminary findings show the successful generation of a strong existing digital base, future prospects for innovation, and a cohesive team that was key to agility, rapid decision-making, and program implementation.

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