Challenges and opportunities in cultivating medical students’ competencies: Participatory action research from a hierarchical cultural setting

Findyartini, Ardi and Syah, Nur Afrainin and Susilo, Astrid Pratidina and Nurokhmanti, Hikmawati and Qomariyah, Nurul and Greviana, Nadia and Ainin, Dina Qurratu and Claramita, Mora (2023) Challenges and opportunities in cultivating medical students’ competencies: Participatory action research from a hierarchical cultural setting. Medical Education Online, 28 (1). 2185122/1-13. ISSN 1087-2981

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Abstract

Backgrounds: Research concerning student-centered learning (SCL) recommends a comprehensive assessment of medical students’ competencies including their personal and professional characters. Accordingly, nurturing future doctors should be in a continuous mentorship program. However, in a hierarchical culture, communication is one- way with limited feedback and reflection. We aimed to explore challenges and opportunities for SCL implementation in medical schools in this cultural setting necessary for a globally interdependent world. Methods: Two cycles of participatory action research (PAR) were conducted, involving medical students and teachers in Indonesia. A national conference on SCL principles was conducted between the cycles, also the SCL modules were developed for each institution and feedback was shared. Twelve focus group discussions were conducted (before and after the module development), with 37 medical teachers and 48 medical students from 7 faculties of medicine across Indonesia at various levels accreditation. Following verbatim transcriptions, a thematic analysis was conducted. Results and Discussions: In cycle 1 PAR, some challenges in implementing SCL were identified: lack of constructive feedback, overloaded content, summative-based assessment, hierarchical culture environment, and teachers’ dilemma of committed time between patient- care and education. In cycle 2, several opportunities to approach the SCL were proposed: a faculty development program on mentorship, students’ reflection guides and training, a more longitudinal assessment system, also a more supportive government policy on the human resources system. Conclusions: The main challenge of fostering student-centered learning revealed in this study was a teacher-centered learning tendency in the medical curriculum. The weighting towards summative assessment and the national educational policy drive the curriculum like a ‘domino effect’, away from the expected student-centered learning principles. However, using a participative method, students and teachers could identify opportunities and articu- late their educational needs, i.e., a partnership-mentorship program, as a significant step toward student-centered learning in this cultural context.

Item Type:	Article
Uncontrolled Keywords:	Student-centered learning; mentorship in medical education; student-teacher relationship; summative- formative assessment; constructive feedback; student-reflection
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medical
Depositing User:	Ester Sri W. 196039
Date Deposited:	18 Aug 2023 04:41
Last Modified:	14 Sep 2023 05:11
URI:	http://repository.ubaya.ac.id/id/eprint/44778

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