Evidence based medicine (EBM) education is a modern method for medical students in clinical training based on the reasonable use of the best evidence in making decisions about individual patient’s treatment. EBM education syllabus teaches medical student how to integrate the clinical experience and patient examination with the simplest out-there analysis data for increasing the utilization of top quality clinical analysis in clinical deciding, this methodology requires new literature looking out and proof evaluating skills. Thus, replacing the recently educated method by EBM has more challenges, the new program ought to analysis fastidiously for evaluating the behavior changes, the development of clinical skills and analysis the ultimate examination score for evaluating the effectiveness of EBM program. The result show that active teaching proves to be statistically completely different and has robust impact toward the ultimate outcome. EBM educated method might improve clinical knowledge and application of PBL/EBM brings concerning higher scores compared to recently educated method.

The secret of educational success and splendid future with prosperous career lies in the constant hard work performed in a smart way. By that way, the change or modification in study methods, exam strategies, and learning techniques is necessity. Deriving from our own experience as medical students from some developing countries from all over the world, authors support some tips and methods to approach the medical field more productive.

A POSCE was developed and administered in 2015 to assess six professional attributes for the Family Medicine (FM) residents, University of Medicine and Pharmacy (UMP), Vietnam. This study aims at exploring inter-rater reliability in FM POSCE developed in this context when analytic rubrics were applied.

Background: Past POSCEs showed raters’ variability on applying the global marking items and holistic rating. Using analytic rubrics, unlike holistic type, will provide more rationale for assigning a certain score might influence raters’ variability. Nonetheless, it is little known to what extent switching to this rubric type might influence the inter-rater reliability of POSCE.  

Methods:  Before the FM professionalism module (pretest) and after this module (posttest), 36 and 42 FM residents took the POSCE respectively. The raters in the pretest included 12 teachers of FM training center. Four faculty members from different faculties were belatedly added to the post-test together with the 12 former raters.  Raters’ training occurred in two different times, the former took place only for the 12 FM raters before the pretest and the latter was before the posttest for the 4 belatedly-recruited. During the POSCE, one pair of raters observed all performances per station. Inter-rater reliability was measured by the differences in total scores between raters per pair using paired t-test and Pearson correlation coefficient.  

Results: In POSCE pretest, no significant difference was found between raters’ scores in most pairs of raters, contrasting with that in the posttest. Most differences were noticed in the pairs of raters, in which one of the raters was the belatedly-recruited. In the pretest, moderate to strong positive correlation between raters’ mean scores were found (r=0.55-0.85), similar range was seen in the post-test (r=0.47-0.87), however, the correlation slightly weakened.   

Discussion and conclusion: The FM POSCE has high inter-rater reliability on the utilization of analytic grading rubrics. An analytic rubric might help minimize the discrepancies among raters. Moreover, training raters might have been an alternative influential factor on the raters’ consensus.

Assoc. Prof. Dr. Tran Diep Tuan

President of University of Medicine and Pharmacy at Ho Chi Minh City, Department of Pediatrics - UMP

We are delighted to introduce the Special Issue for the medical education derived from the 1st National Vietnam Medical Education Conference: “Preparing the 21^st Century Physician”. The First Annual National Vietnam Medical Education Conference was held on 2-3 December, 2017, by the Vietnam Ministry of Health, University of Medicine and Pharmacy in Ho Chi Minh City, and the Improving Access, Curriculum and Teaching in Medical Education and Emerging Diseases (IMPACT-MED) Alliance, which is supported by United States Agency for International Development (USAID) and implemented by Partnership for Health Advancement Vietnam, a collaboration between Harvard Medical School, the Brigham & Women’s Hospital and the Beth Israel Deaconess Medical Center. It has attracted approximately 300 leaders in the medical education, faculties and students from Vietnam and around the world.

This conference comes at an exciting time in the socio-economic development of Vietnam. The Vietnamese health sector has made enormous strides in the control of communicable diseases, increasing the life expectancy and increasing access to the health care for its population over the past 40 years since the reunification of the country. In July 2017, Vietnam became a middle-income country, and with this new status comes new health challenges, which if not addressed, will impede the continued development of the country.  Non-communicable diseases, a rapidly aging population, emerge threats of pandemics, environmental pollution, and climate change are all at our doorstep. Additionally, an increasingly connected society that demands a high-quality healthcare, the government’s plan for Universal Health Care, and the desire for regional and an international integration all represent the challenges and opportunities that we must tackle. Addressing these challenges and opportunities starts with transforming the health workforce. There is an urgent need to update the country’s system of health education including university curricula and transforming approaches to teaching and learning to train health professionals who can adapt and react to the health challenges and realize the opportunities that are presented.

A comprehensive curriculum reform is difficult.  However, we can build upon the experience of previous, smaller-scale reform projects, and capitalize on the investments and support from the highest level of government to transform our health education system. We have built strong partnerships among the network of universities and colleges in Vietnam to support each other, and we also have support from international partners. Education reform is a necessity for Vietnam. The conversations and discussions that we have at this inaugural conference will pave the way towards the transformation of our health education system. The conference aims to provide a forum for sharing innovations and advances in the medical education, stimulate discussions among medical education leaders, inspire further innovations, and foster a community of medical educators invested in advancing medical education research and quality improvement.

This entire volume is devoted to select the manuscripts, which was generated from the conference. We hope that it will be productive, and you will be inspired, energized and motivated to continue the efforts towards health education reform for your university/college, and for the country of Vietnam.

Nowadays, pursuing postgraduate study abroad after completing a Medical Doctor (MD) degree in their home country is common among Vietnamese doctors. There are several challenges in studying overseas that international students need to overcome to ensure a favorable outcome of their learning journey. The presenting paper mainly discussed about the challenges related to English and academic writing skills and aimed to provide some tips for studying effectively in developed countries. Based on his own experiences as a postgraduate international student in Australia, the author found that a successful learning journey could be facilitated by (1) feeling free to ask, (2) making friends with the locals and other international students, (3) exploring the local life, (4) learning and using a reference management software, and (5) attending all free academic skills workshops and consultations provided by the university.

Background: Assessments of professional behaviors such as professionalism Mini clinical examination (PMEX) and OSCE (POSCE) are playing an important role in driving the practice professionalism in medical training. Simulation-based assessment or POSCE has been used to evaluate several professional attributes. However, few evidence of content validity proving that whether POSCE is really measuring specific professional attributes have been reported in medical education literature.

Methods:  The four-step process of developing FM POSCE was analyzed to highlight the validity evidence according framework of Downing (2003). Group of 5 independent FM experts from Vietnam, Boston University, US and Liege, Belgium evaluated the blueprints, scenarios and item lists on a scale (1-totally disagree to 5-totally agree) regarding to what extent test blueprint, cases and item lists were relevant to the content domains and cultural context. The results of their evaluation were considered as an evidence of content validity. The mean and standard deviation of the scores given by them were calculated using SPSS, 20.0.

Results: Important evidence of content validity were found in the process of developing POSCE. Content experts’ evaluation showed that all professional attributes represented medical professionalism. However, the adequacy of professional attributes to evaluate the broad construct of professionalism was controversial (M=3.75, SD=0.95). Cases are relevant to assess these professional attributes and culture. Only the cases of “Respecting the patient” and “Making altruistic decision” contained some inappropriate marking items (M=3.75, SD=0.95; M=3.00, SD=0.92).  

Discussion and conclusion: FM POSCE developed in Vietnamese context can assess six specific professional attributes. This study suggested a process of developing POSCE that has several features such as using both sources of expertise and medical literature to build up the content of POSCE to improve the content validity.

My first days of learning about ECG was during the summer of second year at the medical school. I went through the graduation test with very little knowledge about ECG. I started learning ECG by comparing the ECG tracings with the echocardiographic results. However, the echo could not help in case of arrhythmia. So I spent my time reading the “Marriott's Practical Electrocardiography” – kind of textbook of ECG. It was so boring and I quickly gave up the goal of finishing the book. Then I changed to another strategy. Every time I saw an arrhythmic case, I went back home reading a whole chapter about some entity. This strategy proved to be effective. Gradually my skill of interpreting an ECG was built up. From the point of reading an ECG superficially and making a quick diagnosis (which is erroneous most of the time), I became very tedious in finding subtle abnormal signs. When you work really hard, life always has some rewards. I had been selected to study abroad about cardiac electrophysiology.  Nowadays, being the Head of Cardiac Electrophysiology department in my hospital, my daily work is to deal with challenging arrhythmic cases. Interpreting elusive ECG tracings is always a passion for me.