Sharing stories about medical education in difficult circumstances: Conceptualizing issues, strategies, and solutions

Abstract

Background: Global economic forces, political decisions, and natural disasters are only some of the factors that affect contemporary healthcare education. Given the centrality of health in all settings, the future of healthcare education depends on how we overcome these difficult circumstances.

Methods: Through a series of collaborative activities involving healthcare educators from around the world and their attempts to overcome these difficulties, the authors have developed a conceptual model centered around the people involved, the impact of culture, and organizations and systems.

Results: The model can help to frame discussions and develop strategies about how best we, as a community of health professionals and educators, collaborate and share wisdom, experiences and resources to assist colleagues who might be struggling to deliver education. What has clearly emerged from this work is the centrality of leadership and management in effectively challenging and addressing difficult circumstances.

Conclusions: Contemporary health professions’ education leadership needs to be inclusive, mindful, compassionate and caring; echoing and role-modeling how we expect our students to be with patients and colleagues. This means being willing to confront unacceptable behaviors and speak out and challenge authority when needed. It also requires awareness and understanding of the complex systems in which healthcare education is provided.

Acknowledgments

The authors are very grateful to all those who have contributed through conversations and publications in the MedEdPublish theme and participants at all the workshops, especially those at the 2017 AMEE Conference workshop for assisting with the development of the conceptual model. Research was conducted internationally via AMEE activities.

Ethical considerations

At all stages of data collection, the purpose of the project was clearly articulated to all participants, either in written form (e.g. MedEdWorld survey) or at the AMEE workshops, where verbal consent was given to the authors to include the discussion in summaries and publications. In any publications relating to this project (e.g. MedEdPublish special issue submissions), the work has been duly acknowledged.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Judy McKimm, MBA, MA(Ed), BA(Hons), PGDip (HSW), SFHEA, FAcadMed, FAMEE – Judy’s current role is Director of Strategic Educational Development and Professor of Medical Education in the College of Medicine, Swansea University. Judy initially trained as a nurse and has an academic background in social and health sciences, education and management. She is program director for the Leadership Masters at Swansea and Director of ASME’s International Educational Leadership program. She has worked for many NGOs and aid agencies on improving healthcare and education around the world.

Michelle McLean, MSc, PhD, Med, FAMEE – Professor Michelle McLean is the Academic Lead for Problem-based Learning (PBL) in the undergraduate medical program at Bond University, Gold Coast, Australia. Having worked on three continents in three very different contexts, Michelle’s interests include diversity in learning and teaching and preparing the future medical workforce for an increasingly complex world. Her interest in “Medical Education in Difficult Circumstances” stems from growing up in South Africa during Apartheid and being in an academic position when transformation of higher education was required to address decades of inequity.

Trevor Gibbs, MD, SFHEA, DA. FAcadMED, MMedSc, FRCGP, FAMEE – Trevor is an independent Professor and Consultant in Medical Education and Primary Care. As Deputy Editor of Medical Teacher he has specific responsibility for the development of AMEE Guides, the BEME Guides, and the Medical Education Around the World series. His experience in General Practice and interest in medical education have given him the opportunity to develop curricula in many parts of the world, specifically in those regions in which medical and healthcare education is often a challenge. He has a special interest in the social accountability of medical schools.

Ewa Pawłowicz graduated from medical faculty of Medical University of Lodz, Poland in 2015, and is at present studying for a clinical PhD. As a student she was a member of International Federation of Medical Students’ Associations (IFMSA) and worked for Standing Committee on Medical Education, taking part in many international meeting and projects. She participated in clinical exchange programs in Sweden, USA, and Portugal. Since 2013, she has cooperated with Centre for Medical Education in Lodz with a focus on enhancement of student engagement in medical education in Poland.