Background: During the course of their education, medical students learn to attend to the quality of life of their patients. However, their own quality of life can begin to decrease early in medical school. The purpose of this study was to compare the quality of life of medical students to that of others their age, taking into account the medical school phase and gender. Methods: We used the short version of the World Health Organization Quality of Life Instrument to assess psychological well-being, physical health, social relationships and environmental conditions. The quality of life among 206 medical students was compared to that of 199 young people from a normative population using independent sample t- tests. In addition, the effects of medical school phase and gender on quality of life domains were also assessed by two-way between-groups analysis of variance. Results: Medical students showed worse psychological well-being and social relationships than young people in the normative sample. About one-half of the students revealed a low quality of life in the psychological and social domains and one-quarter showed a low quality of life in the physical health and environment domains. Medical school phase did not influence quality of life, however, gender had a large effect, where female students showed worse physical and psychological well-being than male students. Discussion: Poor psychological well-being and social relationships can have implications that exceed the doctor's personal well-being. Future doctors with a low quality of life may translate into their poorer performance, impairing patient care.

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Background: Social media can be part of the formal education of health professsionals and in their lifelong learning activities. The effectiveness of Facebook, an online social medium, application for educational purposes was evaluated in this study. It was used to serve as a teaching medium of a course in medical emergencies in dental practice (MEDP). Methods: Syrian dental students were invited to join a Facebook group “Medical emergencies in dental practice” during the second semester of the academic year 2013–2014. The group privacy settings were changed from an open group to a closed group after the registration period. Administrators of the group published 61 posts during the course period, which extended for one month. Students' progress in learning was evaluated using self-assessment questionnaires administered to the students before and after the course. These questionnaires also queried their opinions regarding the use of Facebook as an educational modality. Qualitative statistics, Wilcoxon signed ranks and Mann-Whitney U-tests were used to analyze the data. Results: Out of 388 students registered in this course, 184 completed it. Two-third of students agreed that Facebook was useful in education. Their impressions of this course were 17.4% as excellent, 52.2% as very good. P values of the self-assessment questions of Wilcoxon signed ranks test were <0.001, indicating self-assessed improvement in MEDP skills. Discussion: Facebook as a social medium provides a unique learning environment. It allows students to discuss topics more openly in a flexible setting with less rigid time and place constraints. In the light of this study it was found that Facebook may be useful in teaching medical emergencies in dental practice in its theoretical aspect.

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Background: Problem-based learning (PBL) and distance education (DE) have been combined as educational approaches in higher education. This combination has been called distributed PBL. In health professions education it has been called online PBL (OPBL). However, more research on the effectiveness of OPBL is needed. The present study aims at evaluating the effectiveness of an OPBL curriculum for training family medical doctors in Brazil. Methods: We used a pretest–posttest control group design in this study. Thirty family physician participants were non-randomly assigned to the experimental group and the same number to the control group. Three instruments for collecting data were used: A multiple choice question knowledge test, an Objective Structural Clinical Examination (OSCE) for assessing the ability to apply the Mini Mental State Exam (MMSE) and a test based on clinical cases for assessing the ability to make an adequate differential diagnosis of dementia. Multivariate Analysis of Variance (MANOVA) and univariate tests were conducted to see if the difference between the two groups was significant. The effect size was measured by Cohen's d. Results: A total of 50 participants completed the study. The results show significant effects of the course on participants' knowledge and diagnostic skills. Discussion: The results may indicate that innovative pedagogical approaches such as PBL can be effective in an online environment in a low-resources context, with the advantages of DE approach.

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Background: Many emergency service professionals and health professionals play important roles in the assessment and management of suicide risk but often receive inadequate mental health training in this area. A 'Suicide Awareness and Intervention Program' (SAIP) was developed for first year medical, paramedical and pharmacy students at the University of Tasmania, Australia. The program aimed to increase students' knowledge and awareness about suicide-related issues, develop interpersonal skills around suicide screening and increase awareness of available support services. Methods: A 5-hour experiential SAIP was embedded within the curriculum. A pre and post evaluation of knowledge, skills and attitudes was conducted, with an open-ended follow-up survey regarding use of what was learned in the program. Results: Pre and post SAIP surveys showed significant improvement inknowledge and practical skills. Feedback from students and the counselling service indicated enduring impact of the program. Discussion: Participation in the SAIP increased knowledge, skills and attitudes related to the assessment and management of individuals at risk for suicide, and the application of this ability to students' personal and professional lives.

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Background: Adapting to interprofessional education and practice requires a change of perspective for many health professionals. We aimed to explore the potential of scenario planning to bridge the understanding gap and framing strategic planning for interprofessional education (IPE) and practice (IPP), as well as to implement innovative techniques and technology for large-group scenario planning. Methods: A full-day scenario planning workshop incorporating innovative methodology was designed and offered to participants. The 71 participants included academics from nine universities, as well as service providers, government, students and consumer organisations. The outcomes were evaluated by statistical and thematic analysis of a mixed method survey questionnaire.Results: The scenario planning method resulted in a positive response as a means of collaboratively exploring current knowledge and broadening entrenched attitudes. It was perceived to be an effective instrument for framing strategy for the implementation of IPE/IPP, with 81 percent of respondents to a post-workshop survey indicating they would consider using scenario planning in their own organisations. Discussion: The scenario planning method can be used by tertiary academic institutions as a strategy in developing, implementing and embedding IPE, and for the enculturation of IPP in practice settings.

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Background: The primary goal of any assessment of students is to provide valid and reliable evaluations of students' knowledge and skills as well as provision of accurate feedback to students about their performance. Contrary to best practice guidelines for development of multiple choice questions (MCQs), however, items used within medical schools are often flawed. This disappoints students and discourages examiners from using in-house MCQ databases. Vetting and reviewing items can improve the quality of MCQs. In this paper, we describe our approach to standardize the format used for MCQ assessment and provide recommendations for quality enhancement of high-stakes assessment. Methods: A collaborative enhancement-focused vetting and review approach to development of high quality single best answer MCQs has been described. Results: Implementation of a collaborative strategy to blueprint, vet, review and standard set MCQ items for high stakes examinations can effectively contribute to assessment quality assurance. Similarly, shared responsibility for post examination analyses of items may reveal the psychometric properties of items in need of improvement and contribute to closure of the assessment outcomes feedback loop. Discussion: Devolving responsibility for implementation of assessment processes as an integral part of educational practices and values can maximize reliability and standards of assessment processes. We contend that while logistics and time constraints are of concern to busy faculty members, judicious utilization of resources to develop well-written MCQ items are well worth the effort to produce reliable and valid examinee scores. An enhancement-focused approach can be institutionally rewarding and lead to improved quality of high stakes assessments.

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Background: This paper describes a pioneering effort to introduce smoking cessation into Indonesia's medical school curriculum, and the first ever attempt to fully integrate tobacco control in all four years of medical school anywhere in Southeast Asia. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as the challenges that face implementation. Methods: In-depth interviews were conducted with medical school administrators and faculty in four medical colleges to determine interest in and willingness to fully integrate tobacco cessation into the college curriculum. A tobacco focused curriculum review, student focus groups, and a survey of medical students (n = 579) assessed current exposure to information about tobacco and interest in learning cessation skills. A modular tobacco curriculum was developed and was pretested, modified, piloted, and evaluated. Qualitative research was conducted to identify potential challenges to future curriculum implementation. Results: Fifteen modules were successfully developed focusing on the relationship between tobacco and specific organ systems, diseases related to smoking, the impact of tobacco on medication effectiveness, and information on how to explain to patients about effects of tobacco on their health condition. Lecturers and students positively evaluated the curriculum as increasing their competency to support cessation during illness as a teachable moment. Systemic challenges to implementing the curriculum were identified including shifts in pedagogy, decentralized curriculum decision-making, and frequent lecturer turnover. Discussion: A fully integrated tobacco curriculum for medical schools was piloted and is now freely available online. An important lesson learned in Indonesia was that a tobacco curriculum must be flexible enough to be adjusted when shifts in medical education take place. The curriculum is a resource for medical colleges and expert committees in Southeast Asia deliberating how best to address lifestyle factors undermining population health.

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Background: Nearly three million neonates die each year, largely from preventable illnesses in developing countries. Sub-Saharan Africa has disproportionately high neonatal mortality. Community health worker (CHW) programs are a promising intervention to reduce mortality rates. This research evaluates a CHW newborn home visitation program in rural Kenya by assessing the frequency of health service utilization and overnight hospitalization. Methods: This quasi-experimental study encompassed two consecutive years and compared the rate of medical service utilization for neonatal illness in an intervention group with that of a control group using a household survey. Severity of neonatal illness was assessed by need for overnight hospitalization. Household, maternal, and child characteristics were collected. Results: A total of 489 surveys were completed and showed that 35% of not-visited families reported taking their infant to a healthcare facility, compared with 21% of CHW-visited families (P < 0.01). Rates of overnight hospitalization were 6% for not-visited infants and 1% for visited infants (P < 0.01). Few significant differences were found in household, maternal, and child characteristics. Discussion: This study found that a CHW newborn home visitation program in rural Kenya significantly decreased rates of health service utilization and overnight hospitalization, but did not have the power to detect an effect on neonatal mortality.

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Background: Teaching Internal Medicine is mainly hospital-based. Chronic diseases are treated mostly in community-based ambulatory care. This study describes our experience during the first year of teaching Internal Medicine in the community, with a focus on chronic disease management. Methods: This was an observational study describing the content of clinical exposure and the feedback from students after a two-week clerkship in community health centers. Results: Over a period of three months, 54 students spent two weeks in health centers singly or in pairs. The disciplines covered were: Endocrinology, Gastroenterology, Pulmonology, Rheumatology and Geriatrics. In their feedback, the students most frequently noted knowledge acquired in the management of diabetes, infectious diseases and cardiology. The teaching content was determined by the case-mix of patients. The spectrum of conditions was wide. Students who were used to more structured hospital-based study found it difficult to cope with this mode of learning by discovery. Discussion: Future research should concentrate on the transition between the different modes of learning as students move from the hospital to the community setting.

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