Background: International service-learning trips (ISLTs) are structured experiences in a different country where students interact and engage in cross-cultural dialog with others. Month-long ISLTs originating from North American or European medical schools enhance clinical acumen, cultural awareness, and global health familiarity. The impact of experiences shorter than 1 month or those that originate from Asia is unknown. We aimed to determine the impact of a short-term ISLT on medical students' clinical and cultural competence. Methods: At Duke-National University Singapore, we developed an ISLT incorporating peer-assisted learning and a 1-week on-site experience delivering supervised primary care, health screening, and health education in an underserved Southeast Asian community. Using a prospective controlled design, we assessed its impact on medical students' clinical and cultural competency using validated surveys. We compared medical students who participated in the ISTL (intervention group) to a control group of students before and after the ISTL experience. We analyzed responses using univariate analysis and the Kruskal–Wallis test. Results: Sixty-six students responded to the survey (100%). After the ISTL, the intervention group (n = 32) showed an increase in their ratings of clinical competency (preexperience mean = 3.39, postexperience mean = 3.81, P < 0.01) as well as an increase in their cultural competency domains (preexperience mean = 3.61, postexperience mean = 4.12, P < 0.01). Post the ISTL, students in the intervention group rated their clinical and cultural competency higher than the control group (n = 34) (clinical: intervention postexperience mean = 3.81, control postexperience mean = 3.30, P < 0.01; cultural: intervention postexperience mean = 4.12, control postexperience mean = 3.50, P < 0.01). After the ISTL, the intervention group reported increased ratings of self-efficacy (pre mean = 3.99, post mean = 4.29, P = 0.021), which were higher than the control group (pre mean = 4.29, post mean = 3.57, P < 0.01). Discussion: This short-term ISLT in an Asian medical school improved students' clinical and cultural competency and self-efficacy. Our findings suggest a positive impact of short-term ISLTs if designed and implemented with a student learning focus.

Background: Physician shortage in rural areas is a global problem that is one of the contributors to disparities in health indicators between rural and urban areas. The medical college to which the authors are attached has a 2-year mandatory rural service requirement which medical graduates are expected to fulfil. However, some students choose the option of paying off rather than completing the service requirement. The objective of this study was to explore the facilitating factors and barriers for MBBS graduates from the above medical college to complete the mandatory rural service requirement. Methods: This was a qualitative study in which data was collected through in-depth interviews with 15 alumni of the college who were pursuing their postgraduate courses or working as junior residents. The participants in the study comprised those who completed or partially fulfilled the rural service requirement as well as those who chose to opt out of it. Data collection and analysis were done in August and September 2016 after obtaining ethical clearance from the Institutional Ethics Committee. Purposive sampling was done to ensure the diversity of responses. A semi-structured interview guide was used to conduct the interviews after pilot testing. Transcripts of the interviews were then analyzed for emergent themes related to the objective of the study. Results: Certain themes were identified as both facilitating and inhibiting factors for completing the rural service requirement. These included financial aspects, utilization of time, and peer influences. Facilitating factors included the need to acquire clinical and practical skills, moral considerations, the influence of the college, and the need to broaden perspectives. Unforeseen exigencies served as a barrier. Discussion:: The identified facilitating factors and barriers will serve as a useful starting point to initiate measures to encourage MBBS graduates to work in rural areas.

Introduction: Members of the lesbian, gay, bisexual, transsexual, and queer/questioning (LGBTQ) community have specific health-care needs that are often overlooked by health-care providers due to education gaps and discrimination. Health-care inequality for this population has been researched and found to negatively contribute to poorer health outcomes for LGBTQ individuals. Background: There exists a critical need for LGBTQ health education at the undergraduate level for future health-care providers. Additionally, policy reform that establishes an LGBTQ-inclusive code of conduct and educates health-care workers on LGBTQ-specific health needs aims to reshape organizational culture. Recommendations: Curriculum-based education on LGBTQ health for students in health-care professions opens up conversations about the unique needs of this population and paves the way for improved provision of care and better relationships between providers and patients. Education and inclusive policy reform within organizations are critical for improving health outcomes for LGBTQ individuals. Conclusion: Increasing health-care providers' knowledge of this population's specific health needs and learning how to deliver culturally appropriate and sensitive care will lead to improved health outcomes for members of the LGBTQ community.

Background: Current trends in health professions education are aligned to meet the needs of the millennial learner. The aim of this study was to identify learners' perceptions of an ongoing journal club (JC) activity in the optometry curriculum and evaluate the utility and efficiency of this method in promoting student learning. Methods: A qualitative approach with a phenomenological research design was adopted. The perceptions of undergraduate and postgraduate optometry students about JCs were captured using focus group discussions. A narrative thematic analysis was done using the verbatim transcripts and moderator's notes. Results are reported using “consolidated criteria for reporting qualitative research” guidelines. Results: A total of 33 optometry students participated in the study. Data analysis revealed three major themes related to (i) The ongoing practice of JC, (ii) student perceptions of JC and its relevance in facilitating student learning, and (iii) suggestions for modification of JC for achieving optimal educational outcomes. Discussion: Student feedback indicates that an instructional redesigning of JC is necessary, considering the characteristics and expectations of the current generation of learners and the rapid strides made in the field of educational technology. The recommendations provided are likely to resurrect an age-old approach that still has educational relevance if blended with collaborative learning formats and appropriate technology.

Background: Near-peer teaching (NPT) has a longstanding history within medical education. While it is becoming increasingly recognized within medical curricula, its beginnings can be traced back to informal teaching among medical students. Informal NPT such as this is still commonplace. However, it is often overlooked within the literature and has remained hidden from the scrutiny of evidence-based education. There has been minimal research conducted surrounding NPT outside of formal teaching sessions. Methods: A scoping PubMed search was conducted after identifying appropriate search terms. Directly relevant and high quality articles were included. Results/Synthesis: Within this scoping review, we discuss the potential benefits and shortfalls of such teaching. Results: Benefits include the opportunity for tutors to consolidate their own learning while contributing to the medical school community. Their learners benefit from the opportunity for small group learning focused on a relevant level of knowledge. However, shortfalls include the lack of prerequites, lack of content monitoring, and lack of resources. These should be considered when discussing the efficacy of this teaching. Conclusion: We also explore the wider culture of this informal NPT within medical education. We hope to promote further thought into this area, considering how guidance can be given to support both the near-peer teachers and their learners.