The objective of this study was to develop consensus based on mix method study design of modified Delphi technique on contents, contact hours, assessment procedures and teaching strategies of Medical Education topics to be taught in the undergraduate medical & dental curriculum.
In this study consensus was reached on four key contents which were to be taught to the undergraduate medical and dental students that include an overview of medical education, learning theories, making effective PowerPoint presentations, and teaching various assessment tools.
In our study, two-thirds of the respondents agreed that medical education should be taught at the undergraduate level in the third year of Bachelor of medicine and Bachelor of Surgery(MBBS) and second year of Bachelor of Dental surgery(BDS). This may be attributed to the alignment of medical education at the start of clinical orientation classes for better understanding and comprehensions. This finding is similar to the findings of World Health Organization(WHO) recommended incorporating elements of medical education in the undergraduate curriculum but did not mention the year it should be taught (Neo, 2003; Cohen, 2006). This will be the first step forward for improving the old system of medical and dental curriculum. The students will learn to understand the subject and will help them to become self-learners and research-oriented individuals. This step will be just like Flexner’s recommendation to bring a revolution in the field of medical education (Ludmerer, 2010). However, their recommendations were based on the needs of undergraduate medical students.
The key content addressed in this study indicate that overview of medical education, learning theories, making effective PowerPoint presentations, and teaching various assessment tools should be incorporated in undergraduate curriculum to improve the performance of the medical graduates, as these are the very basic topics of medical education which will enhance the learning capabilities of the undergraduate students. These findings are similar to findings mentioned in the study done by Robert B Barr & John Tagg (Barr and Tagg, 1995).
The mean number of contact hours for key contents of medical education at undergraduate level on which the respondents agreed was three hours per week, for the contents on which the consensus was developed. It was also agreed that these identified key content areas should be taught by medical educationists exclusively. The respondents agreed that these key content areas should be taught in Small Group Discussion format, and is also mentioned by MT O Connell, JM Pascoe (Pawlina et al., 2006).
Majority of the respondents indicated that the topics of medical education taught at the undergraduate level should be evaluated in summative form pass/fail at the end of the year. The students will be better able to judge their strengths and weaknesses through self-directed learning (Beck, 2004) and getting sensitized about the importance of medical education. Pakistan Medical & Dental Council (PMDC) has attempted to include medical education in its curriculum but there is no policy to date regarding this proposal. This study strengthens the evidence for PMDC (Kazim, 2007) and sets a stepping stone for the inclusion of the contents of medical education at the undergraduate level. Teaching Medical education at the undergraduate level will not only enhance student capabilities to learn, but it will guide them to obtain proper professional attitudes (Dennick and Exley, 1997).
The preparation of power point presentation was also emphasized as the medical and dental students have to either present their clinical studies or knowledge sharing as they are considered, prospectively, to be the teachers of tomorrow. So it is essential to include a powerpoint presentation to deliver their thoughts and presentations in an efficient manner (Khalid, L. 2013; Franzoni et al.,1997; Khadjooi et al., 2011; Belfield, 2010).
However, in round one consensus was developed on teaching medical education to a large and small group format, but in round two, it did not make consensus because the response rate in round two was less comparative to round one. Though this apparently weak consensus in round one (71%) and in round two (63%) respectively, may be due to the drop of two respondents where the numerical value is sometimes exaggeratedly expressed in percent value than the actual frequency number. As the mean of contact hours has no extensive effect on the sample size in a study that is why no significant change was observed from the response frequency of the participants. Moreover, almost all of the participants were of the view that, instead of teaching the students all the eleven key contents of medical education, we should focus on teaching the undergraduate students the four medical education key contents which made consensus among the participants, to improve upon the skills and knowledge of the undergraduate students and also to promote deep learning.
The limitation of this study was that only the medical education graduates of Khyber Medical University Graduates were included in this study. The sample size was less and was not calculated accurately. All the medical and dental institutions were not included.
The strength of the study: It is the only study in my knowledge to study both the quantitative and qualitative aspects of contents, contact hours, assessment procedures and teaching strategies of Medical Education in the local setting.