Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Applying the Complexity Concept to Medical Education-a Randomised Controlled Trial in Thailand


Affiliations
1 Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
     

   Subscribe/Renew Journal


Objective: To compare small group learning using a complexity concept approach compared with a competency-based approach in terms of students' satisfaction with the whole curriculum performance and cognitive competency gain. Under the complexity concepts, learning is considered a result of a recursive process that facilitates self-organisation. Recursion refers to the end of one event which gives rise to the next, unlike repetition where the next event is the same as the previous one. To facilitate such learning, teachers help students by designing curricula and learning experiences that are contextually rich, recursive (iterative variations with reflection) and relational. Relational learning means to be able to access knowledge efficiently and judiciously.

Materials and Method: One hundred and sixty students were randomly allocated into 9 small groups of 17-18. A complexity concept approach was applied to one group (intervention group) and a competency based approach which is the usual practice to 8 other groups (usual groups). Two major sets of outcomes were compared i.e., students' overall satisfaction with the curriculum and staff performance; and students' cognitive achievement according to competency-based approach. The curriculum and staff performance were assessed by students rating on 5-point Likert scale. The competency was measured by paper-based cognitive assessment of the basic knowledge of epidemiology, biostatistics and health systems. In addition, the operating cost of using a small group process was compared between the intervention group and usual groups.

Result: An outstanding rating of the curriculum performance was found in the intervention group with statistically significant differences in 3 out of 7 dimensions(68.7% vs 28.2%,81.3% vs 50.7% and 100% vs 72.1%) and similar competency scores were obtained as compared with the competency based groups(29.5(SD3.63) vs 30.5(SD4.22), p value =0.27) . The operating cost of the small group process was similar between the intervention group (351.4 USD) and the competency based groups (332.6 USD).

Conclusions: The complexity concept approach seems to positively influence changes in students' satisfaction with the curriculum and staff performance without compromising cognitive competency gain compared to the competency-based approach.


Keywords

Thailand, Medical Education, Complexity Concept
Subscription Login to verify subscription
User
Notifications
Font Size


  • Frenk J, Chen L, Bhutta ZA et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, Volume 376, Issue 9756, Pages 1923 - 1958, 4 December 2010
  • Fraser SW, Greenhalgh T. Coping with complexity: educating for capability. BMJ 2001;323:799-803.
  • Kelso SJA. Dynamic Patterns: the Self- Organisation of Brain and Behaviour. Cambridge, MA: MIT Press 1995;1-95.
  • Doll WE Jr. A Post-Modern Perspective on Curriculum. New York, NY: Teachers College Press 1993;1-203.
  • Stewart Mennin. Self-organisation, integration and curriculum in the complex world of medical education. Medical Education 2010: 44: 20-30
  • A list of medical schools in Thailand(in Thai).(http://th.wikipedia.org/wiki/). Revised July 2012. Accessed August 1,2012.
  • Office of the higher education commission. A guideline of standard framework for qualification of higher education B.E.2552. http:// www.mua.go.th/users/tqf-hed/news/ FilesNews/FilesNews3/News328072552.pdf(in Thai). Revised July 2009. Accessed August 5,2012.
  • Hauer KE,Hirsh D, Ma I,Hansen L, Ogur B, Poncelet AN, et al. The role of role : learning in longitudinal integrated and traditional block clerkships. Medical Education 2012: 46: 698-710
  • The Medical Council of Thailand. A regulation for certifying examination of physicians. (http:/ /www.tmc.or.th/news04.php)(in Thai).Revised July 2010. Accessed August 8,2012.
  • Addelman, Sidney .The Generalized Randomized Block Design. The American Statistician 1969; 23 (4): 35-36
  • Bleakley A, Bligh J, Browne J. Medical education for the future:Identity, power and location. Dordrecht: Springer. 2011.
  • Norris TE, Schaad DC, De Witt D, Ogur B, Hunt D. Longitudinalintegrated clerkships for medical students: An innovation adopted bymedical schools in Australia, Canada, South Africa, and the UnitedStates. Acad Med. 2009; 84:902-907.
  • Strasser R, Hirsh D. Longitudinal integrated clerkships: Transformingmedical education worldwide? Med Educ. 2011; 45:436-437.
  • International Consortium on Longitudinal Integrated Clerkships. Consensus LIC definition 2007. Cambridge, MA: InternationalConsortium of Longitudinal Integrated Clerkships. 2007.

Abstract Views: 252

PDF Views: 3




  • Applying the Complexity Concept to Medical Education-a Randomised Controlled Trial in Thailand

Abstract Views: 252  |  PDF Views: 3

Authors

Paibul Suriyawongpaisal
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
Wichai Aekplakorn
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
Samkaew Wanvarie
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand

Abstract


Objective: To compare small group learning using a complexity concept approach compared with a competency-based approach in terms of students' satisfaction with the whole curriculum performance and cognitive competency gain. Under the complexity concepts, learning is considered a result of a recursive process that facilitates self-organisation. Recursion refers to the end of one event which gives rise to the next, unlike repetition where the next event is the same as the previous one. To facilitate such learning, teachers help students by designing curricula and learning experiences that are contextually rich, recursive (iterative variations with reflection) and relational. Relational learning means to be able to access knowledge efficiently and judiciously.

Materials and Method: One hundred and sixty students were randomly allocated into 9 small groups of 17-18. A complexity concept approach was applied to one group (intervention group) and a competency based approach which is the usual practice to 8 other groups (usual groups). Two major sets of outcomes were compared i.e., students' overall satisfaction with the curriculum and staff performance; and students' cognitive achievement according to competency-based approach. The curriculum and staff performance were assessed by students rating on 5-point Likert scale. The competency was measured by paper-based cognitive assessment of the basic knowledge of epidemiology, biostatistics and health systems. In addition, the operating cost of using a small group process was compared between the intervention group and usual groups.

Result: An outstanding rating of the curriculum performance was found in the intervention group with statistically significant differences in 3 out of 7 dimensions(68.7% vs 28.2%,81.3% vs 50.7% and 100% vs 72.1%) and similar competency scores were obtained as compared with the competency based groups(29.5(SD3.63) vs 30.5(SD4.22), p value =0.27) . The operating cost of the small group process was similar between the intervention group (351.4 USD) and the competency based groups (332.6 USD).

Conclusions: The complexity concept approach seems to positively influence changes in students' satisfaction with the curriculum and staff performance without compromising cognitive competency gain compared to the competency-based approach.


Keywords


Thailand, Medical Education, Complexity Concept

References