Systems thinking as the integrative competency in undergraduate Family Medicine education: a cross-sectional evaluation of an integrated primary care block
Background Family Medicine and Primary Health Care anchor effective health systems, yet undergraduate curricula have given them limited dedicated space. The COM353 Family Medicine and Primary Care block at Alfaisal University was created to give these areas more dedicated curricular space, combining didactic teaching, Primary Health Care Center (PHCC) visits, structured reflection, and explicit engagement with clinical uncertainty. Methods We conducted a single-institution, cross-sectional quantitative evaluation of third-year medical students who completed the block in January 2026. A 42-item Likert instrument, adapted from the Dundee Ready Education Environment Measure (DREEM) and the Groningen Reflection Ability Scale (GRAS) with block-specific items, captured perceptions across seven domains. Of 126 enrolled students, 96 responded (76.2%). Analyses included descriptive statistics, internal-consistency reliability, inter-domain correlations, and multiple linear regression. Reporting follows the STROBE guideline. Results Domain means ranged from 3.90 to 4.27 (of 5), with all domains exceeding the scale midpoint by large margins (Cohen’s d, 0.92 to 1.58). Agreement rates ran from 63.7 to 80.7%. Internal consistency was excellent (Cronbach’s alpha = 0.988 overall; 0.940 to 0.974 across domains). Family Medicine and PHC Competencies achieved the highest mean (4.27) and reflective practice the lowest (3.90). On a single global rating, 87.5% of students rated the block positively (mean 3.80, SD 1.13). Multiple regression with six domains predicting perceived block value explained 78.2% of variance; F(6, 89) = 53.25, p < 0.001. Three domains independently predicted overall evaluation: Systems Thinking (beta = 0.727, p < 0.001), Reflection (beta = 0.295, p = 0.002), and Learning Environment (beta = 0.293, p = 0.013). Despite producing the highest absolute scores, Family Medicine Competencies did not independently predict overall evaluation, likely reflecting shared variance with Systems Thinking (r = 0.874). Conclusion A purposefully integrated Family Medicine block joining community-based experience, reflective practice, and explicit work with uncertainty appears to produce favorable educational outcomes across multiple domains. Of these, perceiving healthcare as an interconnected system most strongly predicted students’ overall evaluation, suggesting that systems thinking acts as the integrative thread giving other curricular elements coherence.
Background. Interprofessional education (IPE) has been identified as a means of improving the readiness of health sciences students for interprofessional collaborative practice and promoting effective, patient-centred care. To prepare future healthcare professionals for interprofessional collaboration, academic leaders at health professions institutions recommend integrating IPE into the training of health sciences students.
Objectives. To assess the knowledge, attitudes and practices of final-year undergraduate health sciences students regarding IPE at a single institution in Gauteng, South Africa.
Method. A descriptive quantitative study was conducted among final-year health sciences students during the 2022 and 2023 academic years. A validated, self-administered Likert-scale questionnaire was used to collect data online and included three open-ended questions to provide additional context. There was an estimated total of 327 final-year students, and a minimum sample size of 177 was required. Purposive sampling was used to select students from eight health science programmes.
Results. Of the 327 distributed questionnaires, 177 were returned, giving a response rate of 54%. The overall mean (standard deviation) age was 24 (4.1) years. More than half of the participants (60%) indicated that they have prior experience of IPE. The Likert-scale questions showed that the majority had good knowledge (97.7%), attitudes (88.1%) and practices (75.7%) regarding IPE. The themes arising from the narrative responses to the open-ended questions revealed self-perceived benefits of IPE (e.g. understanding other students’ roles), barriers (e.g. timetable clashes) and opportunities to improve IPE (e.g. a need for planned and co-ordinated IPE activities).
Conclusions. The findings revealed that participants had good knowledge, attitudes and practices regarding IPE. However, challenges such as limited exposure to other healthcare programmes, timetabling constraints and a lack of co-ordinated IPE activities should be addressed to inform future IPE practice.
M. Morule, Mhpe, S. Singh et al.· African Journal of Health Pr...· 0 citations
The transition from traditional to competency-based medical curriculum within Indian medical institutions was motivated by regulatory bodies’ recognition of evolving disease patterns, socioeconomic conditions, and healthcare system expectations. Competency-based medical education (CBME) is “an approach to preparing physicians for practice that is fundamentally oriented to graduate outcome abilities and the organization around competencies derived from an analysis of societal and patient needs.”
This cross-sectional study was conducted among 230 2
nd
year (junior) and 3
rd
year (senior) medical students. Students pursuing CBME curriculum were included in the study. Questionnaire comprised of three sections which included sociodemographic details, perspectives on the CBME curriculum using Likert-scale items and an open-ended item asking participants to write their own suggestions for improving the current curriculum. Data were entered into Microsoft Excel and analyzed using Jamovi statistical software (version 2.7.9).
The mean age of the study participants was 21.7 ± 0.9 years. Regarding different teaching methods, 45 (19.6%) students were not familiar with any methods as such, 44.3% of the students are familiar with self-directed learning, 27.8% of the students are familiar with small group discussion. Juniors show higher odds of agreeing that the foundation course was beneficial. Juniors again have greater odds of agreeing that attitude ethics and communication was useful. Students consistently mentioned that more practical sessions, clinical exposure, and hands-on learning opportunities.
Overall, the study indicated that CBME curriculum is widely accepted and perceived as an improvement, but its effectiveness depends on careful calibration of workload, assessment design, clinical exposure, and support for student well-being.
J. R. John, G. Sandhya, Ashwin M. Suresh et al.· Current Medical Issues· 0 citations
Introduction Critical care competencies are increasingly relevant across specialties, yet structured exposure in undergraduate medical education (UME) remains variable. We describe the design, implementation, and early outcomes of a four-week, modular ICU clerkship. Methods We implemented a multidisciplinary ICU clerkship integrating clinical immersion, protected weekly didactics, asynchronous learning, high-fidelity simulation, health equity rounds, and palliative care debriefing. Objectives were aligned with Delphi-derived undergraduate critical care competencies and AAMC Entrustable Professional Activities. We compared student clerkship evaluation ratings (learner perceptions on a 5-point Likert scale) before and after a comprehensive curriculum redesign (July 2022–June 2024 vs July 2024–June 2025) using Welch two-sample t-tests. Results Approximately 95 students per year completed the clerkship. Following redesign, the largest improvements were observed in structural and organizational domains: orientation (+0.94), syllabus (+0.95), didactics (+0.85), and organization (+0.76) (all p < 0.001). Clinical skills (+0.36, p=0.01) and knowledge (+0.31, p=0.01) increased modestly and remained consistently high. Simulation ratings remained high (4.44 to 4.65, p=0.04). Overall clerkship rating improved from 4.00 to 4.51 (p=0.002). Discussion A modular ICU clerkship is feasible and adaptable across settings. Improvements were most pronounced in structural domains, while core clinical learning domains remained stable, suggesting that targeted curricular redesign can enhance learner experience while maintaining high perceived educational value.
Nicole Arkin, T. Ramaswamy, Bernadette Carvalho et al.· Advances in Medical Educatio...· 0 citations
INTRODUCTION
The implementation of advance care planning (ACP) has traditionally been confined to medical officers and specialist nurses. This study evaluated the effect of a multimodal Advance Care Planning Education (ACPEd) program for allied health professionals and generalist nurses.
METHODS
Conducted within a regional health service in Queensland, Australia, the study used a single-arm, explanatory sequential mixed methods design involving 30 participants completing a three-hour workshop, and a learning circle attended by 10 participants. Quantitative data were collected through preintervention and postintervention surveys assessing perceived confidence, knowledge, skills, and role legitimacy. Qualitative data from the learning circles explored changes in clinical practice and role identity.
RESULTS
Significant improvements were observed in confidence, t (29) = -7.820, P= <.001; knowledge, t (27) = -12.87, P= <.001; and skills, t (29) = -6.814, P= <.001. There was no significant change in perceived health professional roles, t (26) = 2.182, P= .19, indicating a strong belief that all health professional groups have a role in ACP. Three overarching themes emerged: prioritizing ACP, recognizing role legitimacy, and evolving perspectives on engagement. Despite persistent barriers including time constraints and team dynamics, participants demonstrated increased capacity and intent to initiate ACP discussions, with the ACP Tracker a key facilitator for clinical care.
DISCUSSION
The findings suggest that targeted, interprofessional education may support the development of role identity and legitimacy for ACP among allied health professionals and generalist nurses. The ACPEd program is a scalable model for embedding ACP into practice, with implications for policy and professional development.
W. Kinton, L. Chilman, C. Joyce et al.· Journal of Continuing Educat...· 0 citations
Self-reported prior IPE experience showed a clearer and more consistent association with perceived collaboration than did the single-item measure of self-rated IPE knowledge, whose association was small and less consistent across domains.
Viktorija Xharra, Rosario Caruso, Florian Spada et al.· Healthcare· 0 citations
This study evaluated the impact of a clinical prevention training module embedded within a clinical placement, aimed at enhancing pre-professional health students' perceived knowledge, skills and confidence in delivering clinical prevention and physical activity behaviour change support.
The training module consisted of two parts: an online theoretical component, and a mid-placement interprofessional activity involving case-based discussion and reflective practice. Conducted within a multidisciplinary student placement at Logan Healthy Living, a type 2 diabetes allied health service in Logan, Queensland, the mixed-methods evaluation included pre- (n = 44) and post- (n = 41) placement surveys, feedback surveys (n = 36) and semi-structured interviews with students (n = 15), clinical educators (n = 2) and key interest-holders (n = 2). Quantitative and qualitative data were analysed using appropriate non-parametric statistical tests and inductive thematic analysis, respectively.
Survey findings showed statistically significant improvements (p < 0.001) in students' perceived knowledge, skills, and confidence across all domains (clinical prevention; behaviour change; physical activity) following the training module. Qualitative insights highlighted the module's value in reinforcing interprofessional collaboration, enhancing clinical communication and supporting real-world application. Suggestions for improvement included diversifying case studies, simplifying materials, strengthening links between online content and clinical application and providing broader context beyond diabetes. Structural factors such as placement variability and organisational support emerged as critical for successful implementation of the training module.
The findings support the module's potential to contribute meaningfully to clinical prevention education for pre-professional health students but underscore the need for the training module to be modified to enable scalability and sustained engagement across varied clinical contexts.
Emily Lehman, Genevieve N. Healy, R. Forbes et al.· Health Education· 0 citations