D Davidson, Nicola Vasey, Adam Pattison Rathbone, Charlotte Lucy Richardson
Abstract Introduction Pharmacy education in the United Kingdom must adapt to produce independent prescribing pharmacists ready to join an evolving healthcare system. Current placement practices exclude approximately 21% of the population due to a lack of specific recommendations surrounding paediatric experience and knowledge within the MPharm programme.[1] In turn, studentsâ current experiences may be limited by lack of interaction with unique learning outcomes offered by some healthcare settings, such as paediatric hospitals.[2] To promote student exposure in an overlooked speciality, novel approaches to work-based learning can be utilised. Aim This study aimed to explore pharmacy studentsâ experiences of work-based learning in a paediatric hospital setting. Methods In October 2022, fourth-year MPharm students at one school of pharmacy were invited to undertake work-based learning sessions across one academic year. The sessions aimed to develop studentsâ paediatric consultations skills and knowledge. Sessions consisted of a briefing, ward activities, scaffolded consultations with children and carers, and debriefs with a clinical supervisor. Debriefs included students reporting clinical information, required action and learning outcomes. All debriefs provided by students were transcribed by a clinical supervisor using a spreadsheet which recorded the date, ward visited, patient details, student handover, follow-up (if required) and learning outcomes. Data was initially cleaned, quality checked, and underwent content analysis to identify patterns and key themes to describe student experiences. Results Seventy-four students took part in sessions and delivered 233 consultations covering the medical history of the patient (76%, n=177), with varied levels of completeness. Students were exposed to acute conditions (41%, n=96) and chronic conditions (33%, n=76), with 13% (n=30) still awaiting diagnosis. Forty-eight percent (n=81) of learning points related to the pathology, diagnosis and symptoms of conditions, 24% (n=41) to medicines, 15% (n=25) to patient care, 11% (n=18) to non-clinical experiences and 2% (n=4) to other outcomes. In addition to carrying out ward activities, students underwent the processing of experiences during post-session debriefs: âItâs uncomfortable seeing a child struggle to breatheâ [P131]. The process of active reflection was also evidenced in debriefs: âI felt very anxious, like a tightness in the chest, to hear that a child had a short life expectancyâ [P145]; âI realised they had zero cultural competence after seeing a patient from the Middle East with jaundiceâ [P233]. Conclusion The study demonstrates a proof of concept that students can be exposed to complex care needs and challenging consultations under indirect supervision, demonstrating the paediatric setting to be a suitable work-based learning host. However, findings are limited to a single cohort of students at a single site, meaning transferability may be limited. Future studies could focus on longitudinal educational and emotional outcomes of students by measuring clinical knowledge, competence and confidence. Utilising post-session debriefs with peers and supervisors created a space to share both pharmaceutical and emotional learning points, aiding in managing the cognitive load of students. This experience not only highlights the requirement of paediatric exposure in pharmacy education programmes to aid the studentsâ future practice, but the importance of supervised reflective activities following work-based learning experiences. References 1. Office for National Statistics. Ethnic group by age and sex, England and Wales: Census 2021. 2023. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/articles/ethnicgroupbyageandsexenglandandwales/census2021 2. Kerth J-L, van Treel L, Bosse HM. The Use of Entrustable Professional Activities in Pediatric Postgraduate Medical Education: A Systematic Review. Academic Pediatrics. 2022;22(1):21-8.
Abstract Background Medical laboratory professionals play vital role in healthcare. The growing demand for quality laboratory services and emerging technologies underscore the crucial need for Continuing Professional Development (CPD). However, there is limited information on CPD programs in Ethiopia. Thus, this study aimed to assess medical laboratory professionalsâ perceptions, attitudes, and challenges towards CPD and improve engagement to enhance diagnostic service quality. Methods this cross-sectional study enrolled 228 medical laboratory professionals in Ethiopia from July to October 2023. Using a mixed-methods approach that combined quantitative data from an online survey and qualitative data from interviews. SPSS version 28 was used for data analysis. Results the average age of the study participants was 32.6 Âą6.4 (SD) years, the majority were men (88.6%), and 44.3% have worked for more than ten years. Of the participants, 51% never had CPD training. About three-fourth of the participants perceived CPD as essential to their professional career. About 45.2% of the study participants perceived that the purpose of CPD course is to renew their license and gain knowledge and skills that are not covered in basic training. While the majority of participants had good attitudes towards CPD, about 10% of them stated that it is not important in their career growth. The majority of the study participants were not in support of the decentralized CPD system. A notable problem with finance, insufficient manpower, unsupportive employers, a lack of awareness by regulatory bodies, inadequate access to training close to their working area, were identified as significant challenges of the CPD program. Conclusion the study highlights the perception that CPD is crucial for enhanced laboratory practices and career advancement. The study highlights the need for targeted strategies to address the identified problems and increase the engagement of medical laboratory professionals in the CPD program.
Knowledge is power. Updates in any field are essential to know for oneâs professional growth in life. In Medical science, scientist and clinicians have to be updated on recent developments. Continuing Medical Education (CME) is one of the ways to update. Different programs like CME, seminars, webinars, symposiums, Continuous Professional Development (CPD), etc., are conducted from time to time. When multiple people come to one platform for sharing their knowledge with experience with other delegates, it takes the form of a conference. After attending the conference, clinicians not only improve their knowledge but also get credit points. Various state medical councils in India have made mandatory requirements of credit points for medical registration renewal. Not only in India but also many other countries have made it mandatory.[1-3] Before the COVID-19 pandemic, many organizations and groups organized conferences in offline or physical modes but after the pandemic, most CMEs, seminars, and conferences are being conducted and converted from offline to online mode.[4] After around a 2 to 2.5 years of gap, the government has permitted offline conferences but now doctors incline to attend in online mode because online conference participation does not have distance, health issues, or cost like factors. They can attend their duties simultaneously and saves commuting times also.[5] Many of us attended the CME or conferences during the pre-pandemic and post-pandemic eras. We also thought of conducting a conference in a hybrid mode. We hence write what is required to arrange a basic conference successfully. Last year we organized one national level conference. We share our experience of how to arrange a conference, which can help all to understand the basics behind arranging one such event successfully. Concept: We discuss what you should have in your mind the thinking about organizing the Conference. Before going full throttle, better to conduct an all-India feedback among faculty members and post-graduate students to decide the theme of the conference and sessions for pre-conference workshops. Then, the organizers can shortlist the best theme. A reward also needs to be given to the winner who suggested the best theme during the conference because arranging a conference is a tedious thing. The planning takes a long-time and needs full concentration for many days to months.[6] Plan: Once you have a concept in mind, you can start planning for the conference. Finalizing the mode of the conference is a key thing nowadays (Online/Offline/Hybrid). Making a checklist serves a lot. Note down everything from beginning to end including the smallest to biggest things in your list. This list keeps on upgrading till the last day. We suggest that you have to think about what you expected as a delegate or participant from the organizer in any of the past conferences that you attended. Take advice from your senior faculties as well as juniors from the same as well as other departments to conduct the conference. The date of the conference is a separate entity. Choose the date after a minimum of 6 months, so you can get enough time for preparation. Most of the conferences are held on weekends and it is around 2-3 days. Select the date as per your convenience but weekends are suggested to get a good number of participants/delegates. Also, while finalizing a date, we check the availability of the auditoriums, clashing of any other programs, examinations, festivals, etc.[2] Committee: Organizing a conference is complete teamwork. Start preparing the team, which is known as the organizing team. The team should have a chairperson, organizing secretary, advisor, and other committee members. Chairperson and organizing secretary are key persons and to ease their work you have to appoint their deputy too. This will help in smoothening things during their absence of them. Choose the person in a particular committee based on the skills they are good at. Like good conversation, skilled in computer and internet work, good managerial skills, well in decorative things and many more. Arrangements of accommodation, travel, hospitality, etc., can be preferably given to the male members of the department. Scientific committee work should be given to the senior members of the team. The Finance committee looks after the financial aspects, audits, budgeting, etc., After the organizing committee builds up, the real work begins.[7,8] Funds: Whenever any event is organized, the first and biggest challenge is finance. Funds are needed for purchase, rent, gift/prize, mementos/honorarium for speakers, helpers/labor, travel costs, online platform costs, etc., You can get a sponsorship from the companies (who have a stake in the topic being discussed), from management, and also from registration of the delegates. Making a good budget for the conference goes a long way in the successful management of funds. Keep more than 15% or more funds for miscellaneous or contingency plans, because you will have things that you have not planned earlier.[8] Session and speaker finalization: For good participation and interest generation, a good theme (ideally a current topic) is essential. That will determine the topics for sessions. Selection of speakers, if possible, should have a mix of international, national, and local level speakers from that field. Avoid repeating or intersecting topics in the same type of session in your conference that you read or attend in the near past. Inviting the speakers on appropriate topics is also important. If the speakers are not comfortable with the topic, either you have to choose the topic or you have to shuffle the topics and speakers too. Sometimes all the speakers may not be available for all day or slot timings of conferences. Arrange the sessions as per the convenience of the speakers, but in a manner that the logical flow is maintained.[9] Registration fees and their category: Registration fee is one of the ways to decrease the requirements of external funds. This will support reducing the financial burden of a conference, but it also comes with its share of challenges. You have to set the fees, which are appropriate to cover a certain proportion of expenses but should not be too high to discourage participation. You can set the slab of the fees in three ways: early bird registration (least fees), normal registration (moderate), and spot registration (higher fees) as per the key dates. Another one is fees for consultant/faculty, student/resident, paramedical staff, and member/non-member category type. Variations in these fees structure will help you to get good enthusiastic delegates for the conference. Opening a new bank account in the name of the conference helps you to manage all the expense accountability records in one place. The GST bills, PAN cards of the bank account, etc., are necessary for smooth transactions and auditing purposes. Taking the help of a chartered accountant is necessary for financial guidance.[9] Applying for credit points in medical council: Many medical councils are encouraging associations to organize CME and CPD for clinician knowledge upgradation. They support CME by approving the credit points to delegates, which are also of interest to delegates. Appropriate efforts should be taken well beforehand to get your conference approved for credit points. You have to fulfill the criteria for the credit point as per the individual medical council requirements. For details, you have to visit and read the guidelines of the individual medical councilâs website. The approval of credit points needs finance. The amount may vary based on credit points approved and also upon the number of delegates that have registered for the conference.[2] First announcement and brochure: Next step is information to the target delegates about the event. You can prepare the first announcement pamphlet if your complete brochure needs more time to design. The first announcement gives the first impression about the events. It is usually a teaser. So, reveal only a few interesting aspects of the conference here. It should be attractive, and informative as well as should make delegates eager to know full details of events. A new logo on the name/theme of the conference gives a unique identity. After finalizing the speakers, schedule, registration fees, and brochure design, distribution of the brochure to all stakeholders should be done. A unique e-mail ID with the name of the conference should be made which should be used for the conversation and queries related to conference matters. Give complete information regarding your key dates, registration methods, registration fees, and their categories, speakers, sessions, contact details (of organizing secretary), etc., in a brochure that can make delegates clear about your events. You can also keep details of some nearby tourist places to visit in the brochures.[7] It is worthwhile to conduct some quiz or online assignment for postgraduates and senior residents in online mode related to theme of the conference to keep them reminded of the upcoming conference. Advertisement with an invitation: First announcement or final brochure should be distributed to the medical fraternity and important dignitaries of the institute. You cannot get good numbers of delegates at your conference without reaching them. Before social networking platforms, it was difficult to reach the delegates personally but now it is relatively easy to reach people. Post a brochure on various social networking platforms and groups to spread information about your events in other medical fraternities. A humble invitation message with the brochure attracts the delegates to attend the events. Stationary printing: Apart from the information brochure, many more things are there you may have to print. Banners, delegates, speakers, and resource personâs badges with the string, each category certificates, various informative sign boards, note pads with the name of events, and many more things required to be printed. Venue arrangements: If you are organizing a virtual conference, not much worry about the venue is there, but if you are organizing a physical or hybrid conference, you have to take specific caution about the venue. The size of the hall or auditorium, registration area, welcome kit distribution area, a place for parking, stall for exhibition, poster/oral presentation hall, a dedicated area for breakfast/tea and lunch, dedicated seating arrangement for guests and speakers, and many other things have to be kept in mind. You have to manage all the things without making hurdles to other workplaces of the institute and also have to satisfy the delegates.[10] Food arrangement: Food variety and quality play one the major attractions for the delegates. A not too heavy breakfast, a working lunch, tea at least twice, and sometimes dinners or banquets needs to arranged in the conference. Food arrangements should be verified and confirmed at least before one day of events. Food items should reach to specific place a minimum of 30 minutes before the schedule which can give time to caterers to decorate and serve food on time. 2-3 designated persons should be moved around to take care of guests and speakers during the break and food time. A spread and portion size should be meticulously planned, taking into account the palate of all regions of people and also taking into account local flavors. Adequate time should be allotted to the dining time because a lot of interaction between people takes place at this time.[7] Audio/Visual planning: Audio-visual facility is one major area that needs to focus on properly, especially when you are organizing virtual or hybrid events. Good resolution of the speakerâs PowerPoint slides, clear voice with good audio transmission quality, good network connection for online delegates, and live interaction between online and offline delegates and speakers. A professional team needs to handle all these things. A dry run needs to be done a day or two before the actual event.[11] For virtual conference presentations, participants can be encouraged to share their recorded video presentations to address Internet-related issues and time management during presentation. Stage rehearsal: Stage etiquette and performance are also important. The selection of a master of ceremony, and script writing is an integral part. Coordination between anchors and other stage managers needs to be smoothened. Lamp lighting and inauguration ceremony should be rehearsed at least 2-3 times before the event which can make everyone confident on the event days. Welcoming the guest and speakers, anchoring the whole event, facilitating, and felicitation guests and speakers before and after sessions, delivering bouquets, mementos, and certificates to guests and speakers, and vote of thanks and the valedictory session should be finalized earlier. Rehearsals can make the whole event will go smoothly on the main day.[12] Abstract submission and result notification: One of the corollary events that take place in paper and poster presentations. The organizing team can call for papers and include them in competitions. Various institutes and places clinicians and students want to share their research work with others via conference. Organizers invite abstracts for the papers, posters, or both before the conference. Dates of submission, result notification, and paper/poster submission dates for presentation have to be announced well in advance with the brochure. The scientific committee and judges have to be decided beforehand for the abstract selection/rejection and judging the paper/poster presentation in the events. On the final day, the place/mode of presentation and AV aids need to be arranged. Format and criteria for judging need to be established well in advance.[11,13] Registration verification: In the information brochure, the link for registration and payment is given. But verification of the registration information with the account statement should be done to avoid financial problems in the future. You have to dedicate 1-2 persons for verifying those details and give confirmation to the delegates about registration via email, phone call, or message. You can set autoreply in the registration form or email but still you have to check it once to avoid any future problems. Miscellaneous: The day before the conference is usually very hectic. All last-moment preparations, checks, etc., go on. Preparing the delegates, speakers, and resource personsâ badges, welcome kit/folder preparation, sign board/banner sticking, stage arrangements, decoration of the venue, and other things going on. Have a good sleep at night.[6] On the day of the conference: On the day of the event all members have to do what they have been assigned. No work is small or less. Organizing committees have a big task to organize and all members have to fulfill their roles either in their work on stage or anywhere else. If each member does their best, no one can stop your event to be successful. Spot registration facility: People assigned to the registration counter should arrive early along with all delegate bags, batches, and signature/attendance forms. Turnout should be impressive as they are the face of the event. Some organizer keeps the spot registration facility. You can keep it but we suggest, donât keep it unless a lot of spots are vacant because it is extra work, starting from registration to certificate distribution.[9] If you have in-house speakers, you do not have to worry about being on time session starting. If your speakers are coming only for session time, try to take confirmation and arrange transportation before the session time. They should reach the venue at least 30 minutes prior, so they can get time to ready for the sessions. You have to schedule the questionâanswer session at the end of each lecture or session. But try to manage the time limit to avoid delay for the next lecture or session.[7] Conducting an Oral/Poster session: If in your conference, you inviting the abstract for either paper, posters, or both, you have to arrange the time slot with the venue for the presentation. You also have to coordinate with the participants about their time slots and share links for presentations. You have to invite the judges for judging the presentation. After completion of the presentation, have to collect the scores from judges and compile them for prize announcements.[7] Last-moment hurdles: All events may have been completed without any hurdles. Even those hurdles will make our events more memorable for us. Some accidental events like speaker illness, late supply of material, electricity and Internet problems, some environmental/weather-related situations, and other things can create problems at the last moment, think about those during the event planning to avoid trouble on the event day.[7] Untoward incidents on the event day: Sometimes it may fail or fall even after perfect arrangements and rehearsal. Donât panic on the event day, even after some mismanagement. Try to make it normal to maintain your team membersâ morale for successful event completion. Collecting the attendance and feedback from offline and online delegates: To engage the delegates with sessions, speakers can ask the question to delegates during the session. Organizers can take attendance on a paper sheet for physical delegates while collecting online feedback responses from all delegates to be sure of attendance. You can improve your event management, after evaluating the delegates and guest feedback.[7] After the completion of all lectures and valedictory sessions, the conference is almost complete. Delegates will leave the venue, but this is not the end of your work. You also have a lot of work which is known as post-conference work. Post-conference work: The certificate is proof of attendance for delegates and participants. In a physical conference, you can distribute the certificate at the end of the last session but for the virtual or hybrid conference, you have to send the delegates, speakers, and participants certificates to their email id. If you donât have good IT support, you will suffer to distribute them. you also have to announce the prize winnersâ names and distribute certificates with prize gifts, if you had the slot for poster/paper presentations. You also have to return the material to the supplier in the same condition which you received. Complete the task as per your checklist to avoid any troubles in the future.[14] After completion of the above work, prepare the list and make the brief reports of the conference. You have to prepare the reports with the delegate list as per the requirement of institutional management, state medical council, National Medical council, and other regulatory body requirements with their suggested formats. You also have to send the thanks email/letter to the speakers, sponsors, and institutional management team to support you and your team in organizing the event. Keep all the reports records along with the event photographs, videos, speakers/delegatesâ testimonials, presentations of lectures, feedback forms, etc. Future conference planning: After organizing one successful event, you can get a good experience for the future. You can plan the next event after a month, a year, or at your You can improve your work after evaluating feedback We that this will help all future event organizers to organize the conference. We are not to cover all the of organizing in one but we important things. from event is a new So, start from one day you will be successful in the future. support and sponsorship of interest are no of
In 2000, the first Academic Emergency Medicine consensus conference was convened. The topic, âErrors in Emergency Medicine,â was interposed between two well-known Institute of Medicine (IOM) reports of direct relevance: To Err is Human: Building a Safer Health System1 (1999) and Crossing the Quality Chasm: A New Health System for the 21st Century2 (2001). This foreshadowed the great degree of relevance and timeliness that would characterize future consensus conferences, each of which has as its primary goal the development of a research agenda that will guide the science of the topic at hand. This year, Academic Emergency Medicine convened its 11th consensus conference, âBeyond Regionalization: Integrated Networks of Emergency Care,â in conjunction with the annual meeting of the Society for Academic Emergency Medicine in Phoenix, Arizona. The proceedings will appear in the December issue of this journal. In this fashion, another timely research agenda will be developed, refined, and disseminated. These consensus conferences have not occurred in a vacuum. They have, to a demonstrable degree, had their intended effect of stimulating research. This monthâs issue of the journal is the first to be devoted primarily to dissemination of research and concepts that have grown from prior consensus conferences. There is every reason to believe that a new and useful tradition has been established. The topics of the prior AEM consensus conferences have been: 2000: Errors in Emergency Medicine 2001: The Unraveling Safety Net 2002: Assuring Quality 2003: Disparities in Emergency Care 2004: Emergency Medicine Information Technology 2005: Ethical Conduct of Resuscitation Research 2006: The Science of Surge 2007: Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake 2008: The Science of Simulation in Health Care: Defining and Developing Clinical Expertise 2009: Public Health in the Emergency Department: Surveillance, Screening, and Intervention 2010: Beyond Regionalization: Integrated Networks of Emergency Care A number of the consensus conferences have received significant financial support from Canadian, American federal, other public, and various private sources. Focusing on the conferences of 2007, 2008, and 2009 is illustrative. The 2007 conference received financial support from the Agency for Healthcare Research and Quality (AHRQ), and among the featured speakers who took time from their busy schedules to join us in Chicago was Carolyn Clancy, the director of the AHRQ since 2003. Support also came from the National Center for Research Resources, an organization promoting the Clinical and Translational Science Awards program within the United States National Institutes of Health, and the Knowledge Translation Workshops and Symposia Grant Program of the Canadian Institutes of Health.3 The 2008 conference received primary financial support from AHRQ, the Josiah Macy, Jr. Foundation, MedEdPORTAL (an electronic publication of the American Association of Medical Colleges), and the Risk Management Foundation of the Harvard Medical Institutions. Over 30 other medical organizations and academic departments nationwide provided smaller degrees of support. In addition, unrestricted educational grants were received from major manufacturers of medical simulator hardware and software.4 The 2009 conference was primarily supported by a grant from AHRQ and the National Institute on Drug Abuse of the National Institutes of Health, with secondary support from the National Institute of Mental Health; the National Institute on Alcohol Abuse and Alcoholism; the Substance Abuse and Mental Health Services Administration (SAMHSA); âJoin Togetherâ of the Boston University School of Public Health; and the Departments of Emergency Medicine of Boston University, Brown University, Emory University, George Washington University, Johns Hopkins University, the University of Maryland, the University of Michigan, and Yale University. This conference featured participation from Dr. Richard Denisco from the National Institute on Drug Abuse, Dr. Ralph Hingson from the National Institute on Alcohol Abuse and Alcoholism, Dr. Amy Goldstein from the National Institute of Mental Health, Dr. James Heffelfinger from the Centers for Disease Control and Prevention, Dr. Richard Saitz from Boston University, and Dr. Jack Stein, director of SAMHSAâs Center for Substance Abuse Treatment.5 Given the significant and continuing financial support of the agencies and foundations that have supported our consensus conferences, it seems prudent to provide them with proof that their efforts have been followed by meaningful responses to the numerous calls for research contained within the consensus conference summary statements and proceedings. In other words, this issue of our journal can be thought of as the first installment of a series of âitemized receiptsâ that will document how the financial support provided to enable the consensus conferences has been worthwhile. The first several consensus conferences did not enjoy such external financial support, but as the size and scope of the sessions grew, so did the need for funding. Our journal will continue to present these annual consensus conferences into the foreseeable future, and they will require the expenditure of significant resources of time and finances. To be able to document, from the pages of our own journal, that prior consensus conferences have had the desired effect of stimulating relevant research may increase the likelihood that the organizers of future conferences can continue to achieve similar external financial support. Looking forward, it is hoped that an even greater number of research efforts will be inspired by our consensus conferences and that much of that research will appear in our journal. It must be noted that not all of this monthâs articles were submitted by authors who had the express intent that they appear in this special consensus conference follow-up issue. The Associate Editors and Senior Associate Editors, as well as Kathleen Seal, our Technical Editor, have referred a number of manuscripts submitted to the journal, but not submitted specifically for appearance in this issue, to the attention of the consensus conference guest editors group. In other words, our work group had to âprime the pumpâ somewhat. It is hoped that this will not be necessary in the future and that a greater number of manuscripts will be submitted with the goal that they appear in the consensus conference follow-up proceedings. A suggestion going forward relates to the probability that the research agendas set forth at a given consensus conference may eventually become âdated.â Toward that end, it is possible that future consensus conference follow-up issues might only accept manuscripts inspired by consensus conferences of the past 3 to 5 years. This issue contains a total of 15 manuscripts, with the following representation: 2002: one manuscript 2003: two manuscripts 2004: two manuscripts 2005: zero manuscripts 2006: two manuscripts 2007: three manuscripts 2008: one manuscripts 2009: four manuscripts I would be remiss not to thank several people without whom this edition of the journal would not have been possible. The Guest Assistant Editors, who functioned most capably as decision editors, included Gail DâOnofrio, Nicole Deiorio, Lynne Richardson, and Terri Schmidt. I am indebted to them for their efforts. It would be misleading to state that this process evolved exactly as first envisioned, and I must also thank these Guest Assistant Editors for their patience with the evolving processes. David Cone gave me the opportunity to more truly understand the extreme degree of knowledge and organization he brings to his role as Editor-in-Chief. Finally, but most importantly, I thank Kathleen Seal for her most capable guidance and patience. I have learned to an even greater degree than before what a valuable resource she is to our journal.
This journal has recently adjusted its requirements for research papers, referring to the World Medical Associationâs Helsinki Declaration on Ethical Principles for Medical Research Involving Human Subjects.1,2 Many advances in medicine have been attained by research involving patients. Individual patientsâ best interests have sometimes been sacrificed for the benefit of future patientsâ health. Most countries have established legal regulations and procedures, based upon this declaration, along with institutional review boards (IRBs). Such universal requirements do not exist for education research or social science research in general. For this reason, many countries, but not all, have included medical education research in their ethical review procedures, which are designed for medical research. Human subjects here are usually students or residents, but teachers and patients can also be involved. This journal will now require proof of ethical research conduct before publication. This step can be considered to represent an advance in research standards and may be taken up by other journals in the field. Like patients, learners are potentially vulnerable subjects of research, specifically if the investigators simultaneously exercise power as teachers or examiners. The Netherlands is among those countries that do not require ethical approval for medical education research. Dutch IRBs typically respond to submitted requests for review of education projects with statements like âexempt from ethical reviewâ because, firstly, patients are not involved and, secondly, no medical interventions are applied. So far, journals have accepted and published such statements without further question. Researchers often find this a comfortable stance as it avoids the bureaucratic burden of approval that has seriously hampered research elsewhere.3â5 For instance, I saw the recent 3-month stay in the UK of one of my research staff end without the planned interview and questionnaire project carried out, only because of a late and negative response from the IRB. Not that the project was unethical; the application simply lacked the requisite paperwork, despite the fact that extensive written and oral information was supplied. The question here is not whether ethical review in medical education research is justified â of course it is â but whether existing IRB procedures are most suitable for medical education research.6 Dutch researchers find âexempt from ethical approvalâ a comfortable stance as it avoids bureaucratic burden Given the requirements journals will put upon submissions, in terms of providing other proof of ethical conduct of medical education research if institutional review is not possible,1,7 independent ethical review will also become important in those countries without relevant procedures, such as the Netherlands. In a recent survey about experiences with IRBs among clinical course directors in the USA, it was suggested that national guidelines for ethics review would enhance transparency and stimulate inter-institutional research collaboration.8 When suggesting that the Netherlands Association for Medical Education take the lead in devising such guidelines, I began to wonder what ethical review of education research should look like, vis Ă vis the Helsinki Declaration. I concluded that education differs from health care in a number of aspects that might affect how ethics review should take place. Patients usually need care because of ill health. They are often very dependent on doctors and hospitals for their essential wellbeing. Students are also dependent as they must abide by the regulations of an institution and its teachers to pass necessary examinations, but they themselves are responsible for whether or not they enrol in particular courses and for whether they attain their self-chosen goals in life. They are, by far, not as dependent as patients. Next, students determine to a large extent the outcome of educational interventions, much more so than patients can determine the outcome of medical interventions. Personal study effort is a major determinant of academic success; medical treatment successes are determined to a far greater extent by health care providers. Students determine the outcome of educational interventions far more than patients can determine the outcome of medical interventions Medical research may involve risks of harm to a patientâs health, which, in some cases, may be serious and irreversible. This type of research requires the utmost caution. Harm in education research may be defined as the risk that less than optimal education is provided, resulting in less acquiral of knowledge and skills, and harm to academic progress. Harm to progress can be serious. I have witnessed a financial claim by a medical student who argued that an examiner had caused loss of income as a result of failing this student on tests and thus extending the required course length. The claim was not sustained and in this case no research was involved, but an educational experiment could be envisioned to carry a risk for such potential harm. In other cases, harm may imply psychological stress and discomfort. Still, this type of harm does not compare with potential physical harm resulting from medical experiments. Potential harm resulting from educational experiments does not compare with potential harm from medical experiments Furthermore, there is no clear distinction between administration and research purposes in data collection on student progress and programme quality. Schools collect data on student progress and the quality of educational processes as part of their core business. This type of data collecting is usually not subject to ethical approval, as registering test results and, to a lesser extent, registering studentsâ opinions of education are unavoidable. Enrolment in education must represent the subjectâs tacit approval that his or her personal data are registered. These data serve both students and educational quality. Reports based on aggregated data of student progress and educational quality can be considered to serve a necessary research aim; indeed, not using these data to improve education could be considered unethical. The necessity of gaining ethical approval or informed consent to use these data as part of research results for publication in a journal is questionable if harm to students is clearly not at stake. Researchers now sometimes label investigations as âevaluationâ in order to avoid the burden and delay incurred by a review procedure, but this does not seem a proper way to go. Rather, clear specifications of the types of data collection and uses that require ethical approval should guide researchers in their ethical conduct. Education is a process that cannot easily be stopped. Programmes must be offered to enrolled students and schools should continue to aim to deliver high-quality curricula. Many medical schools evaluate and try to improve their curricula, either gradually or by instigating large innovations all at once. Viewed from a research perspective, an educational method can be considered an intervention, just as a medical treatment is an intervention. At variance with medicine, medical education is only at a very early stage in the development of evidence-based practice. Education research â still â offers only little evidence to support a claim that one method is superior to another, despite the growing medical education literature.9,10 One reason for this is that students themselves determine to a large extent the effect of education.11 The counterside of the coin is that institutions can change their educational methods if they feel the need to do this, with limited risk for damage to the curriculum or harm to students. Letâs now compare curriculum development with education research. Consider a complete overhaul of the medical curriculum for a new student cohort, say, from a traditional to a problem-based learning (PBL) format. Does this âexperimentâ require ethical approval? Not likely. Not even when national examination results are compared with those of the previous cohort and published in support of the new development. This holds true if the results of students from two medical schools with such different curricula are compared. Next, consider a complete overhaul of the second year of a curriculum for only part of a student cohort. Students could be randomly assigned to either a PBL or a traditional programme, and their scores on national examinations could be compared. Would this âexperimentâ require ethical approval? Most likely it would in most countries. But what is the difference in terms of potential harm to students? Probably none. In general, schools and curricula differ in their educational methods and it is often hard to claim that students are better off with one school or method than another. Twenty years of external review of the eight medical schools in the Netherlands have not raised any serious conclusions that one school is clearly superior to another. Of course, checklists were used and the scores calculated showed differences on points, but no sound basis has ever emerged in support of real qualitative differences in outcome. This example shows how close educational development is to education research. The difference may only be that one instance is considered research, as it has a systematic project description, labels a new method as an intervention, formulates outcome measures and analyses data. What actually happens with students â the basis for ethical review â may be the same in the other instance. This PBL example may not sound very experimental because the format of PBL has been researched extensively, but such research has usually happened only after PBL has been introduced into a curriculum, not before. In other words, is it logical to require ethical approval when methods are compared within cohorts, but not to do so with scientifically less sound approaches, such as historical or inter-institutional comparisons? Providing a completely new educational method to a new cohort without any comparison does not require ethical approval, but it is day-to-day practice in many schools. Why require ethical approval when methods are compared within cohorts, but not historically or inter-institutionally? One important element of ethical research conduct concerns the obligation to provide subjects with the option not to be involved in the investigation, so that potential candidates are asked to give their informed consent to participation and provided with options for withdrawal. In education research in a field setting, participation in research often equals participation in education. For example, introducing a new knowledge test â in fact, most knowledge tests in educational settings can be considered as ânewâ instruments if test items have not been used before â cannot include an option for non-participation when a pass/fail decision must be based on such a test. Informed consent can be sought, but often there is no alternative available. In conclusion, education research should be carried out ethically and the journals that publish such studies have a responsibility to stimulate ethical research conduct. This includes the proper protection of the interests of any human subjects. However, the criteria with which we may evaluate the ethical conduct of education research are not necessarily equivalent to those required in medical research involving patients. Ethical research requires the maintenance of a reasonable balance, between yin and yang, so to speak, or between the risks of harm to subjects and the expected scientific yield of the investigation. This balance may well differ between medical and education research.12 I believe it would help to formulate specific criteria with which we can evaluate the ethics of medical education research. Pugsley and Dornan cite a helpful list of 10 ethical questions for research involving students, formulated by Cardiff University.7 This might represent a starting point for the development of such criteria and could result in a review procedure that both upholds ethical research standards and stimulates, rather than discourages, teachers and students to engage in medical education research.
B. Balamurugan, T. Poongodi, M. R. Manu, S. Karthikeyan ¡ 5 authors
The moving image archive of the US Agency for International Development (USAID) includes a copy of the film The Double Day (1975), cataloged in the series Moving Images Relating to International Development Programs and Activities, 1979â1991, a collection of more than eight hundred titles âcreated to provide information on assistance programs supported by the Agency for International Development (AID).â1 Yet, The Double Day does not, in fact, directly depict or engage with any specific development or aid initiative. Instead, the filmâdirected by US-based Brazilian filmmaker Helena Solberg as part of the International Womenâs Film Project collective and described as âthe first Latin American feminist documentaryââexamines the gendered dynamics of paid and unpaid labor through the testimonies of women from Argentina, Bolivia, Venezuela, and Mexico.2 Its presence in the USAID archive is likely a consequence of its funding history, having received support from the Inter-American Foundation, a USAID-affiliated entity; the development agencies of Denmark, Norway, and Sweden; the United Nations Development Program; and US philanthropist Calvin Cafritz.3These transnational funding structures not only enabled the filmâs production but also determined its archival destination, which renders legible its place within the history of international development.4 The Double Dayâs institutional trajectory reflects the shifting configurations of aid, gender, and media during a historic moment when women were being repositioned at the center of what Arturo Escobar has described as developmentâs âregimes of visuality.â5 Especially relevant to The Double Dayâs production and exhibition was the international institutional framework of Women in Development (WID). Emerging in the early 1970s and culminating in United Nationsâ proclamation of 1975 as International Womenâs Year, WID emphasized womenâs participation in the global economy as both an index and mechanism of development. Indeed, The Double Day premiered at the World Conference of the International Womenâs Year, held in Mexico City.6 Within this context, the film forms part of a broader trajectory of media use by international organizations that intensified during the 1970sâas best exemplified by Media Habitat, a collection of 236 documentary films commissioned by the United Nations to represent urban and rural development initiatives for the 1976 Habitat Conference on Human Settlements in Vancouver. As a policy-shaping initiative, Media Habitat primarily featured films from the Global South intended not only to illustrate but also to help codify standardized audiovisual markers of âunderdevelopmentâ that determined access to the emerging global economic order and to international aid.7Framed in relation to these international institutions and their operations, The Double Day could similarly be considered âdevelopment mediaââexemplifying the type of nonfiction media produced and distributed outside of the commercial film circuits whose aspects and subcategories have been variously described in scholarship as nontheatrical, useful, sponsored, institutional, industrial, educational, or nonprofessional/amateur.8 Scholars working in this area have emphasized the institutional contexts of such mediaâs production and exhibition infrastructures as shaping its instrumentalized effects. From a feminist perspective, such an approach is crucial to grappling with the broader question of how âgender impacts [these worksâ] shape, content, and trajectories.â9 Yet we also argue that, taken in isolation, the institutional and infrastructural contexts are insufficient to account for the complex relationship between media and development, potentially not only limiting our understanding of the reach and impact of development but also distorting our interpretive conclusions. For example, to categorize The Double Day as âdevelopment mediaâ is to overlook the filmâs place within Solbergâs directorial oeuvre, as well as within the histories of both transnational womenâs filmmaking and radical Latin American documentary cinema to which it simultaneously belongs. Such exclusive framing is especially limiting given that women globally were disproportionately engaged in nonfiction production throughout the twentieth centuryâsometimes by political choice but more often due to structural exclusions from fiction filmmaking. Even in nonfiction historiography, however, institutional media has remained particularly marginal, reinforcing hierarchies that separate such works from the aesthetic and authorial frameworks through which film history has been constructed.10 This marginalization not only tends to erase womenâs contributions but also presumes a âweakâ or derivative authorship, rendering these films unworthy of the interpretive attention needed to apprehend their aesthetic and political complexity.11 The same dynamic is likely to structure assumptions about âdevelopment mediaâ as well.Categorizing The Double Day exclusively within this category would further prompt us to assume top-down institutional analyses that have been characteristic of both institutional media methodologies and the scholarship on development at large. This, in turn, would risk obscuring this filmâs radical Marxist approach to womenâs labor as well as its concrete contribution to activism and its attendant grassroot structures. In Mexico City, The Double Day became a catalyst for feminist solidarity in practice when one of the filmâs protagonists, Bolivian activist and trade unionist Domitila Barrios de Chungara, was invited to participate in the Tribune of Non-Governmental Organizations held alongside the official UN conference.12 There, Barrios de Chungara challenged Western feminist priorities by reframing the debate around labor, class, and imperialism, helping to articulate a shared Third World feminist agenda that significantly departed from the developmentalist vision of the United Nations and USAID.13 Seen through the lens of activist media, The Double Day helped forge transnational solidarity networks by enabling information exchange across the diverse voices that shaped its makingâfrom the women featured in the film to the activists who circulated itârevealing a considerably more dynamic interplay between institutional and grassroots or contingent media practices.Moreover, the filmâs Latin American contextâreflected in Solbergâs formation in Brazil as the only woman in Cinema Novo, its focus on women from across the region, and its premiere and key reception in Mexico Cityârequires grappling with the regional specificities of the very notion of development in its multiple iterations.14 Far from being an epistemological and political framework imposed solely by the Global North, both the practices of development and the theoretical foundations of developmentalism (understood as a broad and polysemic set of discourses) were shaped through the active participation of Latin American economists.15 Within this iteration, underdevelopment, as a constitutive notion of developmentalism, became central to a distinctly critical strand, which by the late 1960s became known as the dependency theory.16 This same approach is reflected in some of the best-known Latin American radical film manifestos of the time, arising precisely from the same milieus to which Solberg belonged.17These various considerations of the filmâs history illustrate the methodological challenges confronting feminist scholars seeking to assess the impact of development on media projects, theories, and practices. To disregard the developmentalist context of such works by emphasizing their political aesthetics and affects risks reproducing a romanticized narrative of heroic resistance (albeit from a feminist perspective). Yet to engage exclusively with their institutional and material infrastructures risks naturalizing developmentalismâs political and epistemological foundations at the expense of the goals and beliefs of the many women who participated in these projects. The contradictions and ambivalences that animate such histories call for feminist frameworks capable of holding both institutional complicity and radical possibility in view.This challenge resonates with ongoing debates about the politics of the archive and what Allyson Field has termed âthe practice of informed speculation.â18 As she reminds us, feminist, queer, and decolonial methodologies have long taught us to âpress at the limitsâ of the archive to âinoculate our scholarship against our evidenceâs afflictions.â19 The concern that the evidence we draw on in our analysis reproduces the very structures and blind spots of the dominant ideology and therefore shapes and delimits our interpretation becomes particularly urgent when engaging the developmentalist media corpus. Informed speculation offers an alternative by inviting the experimental, creative, and speculative rewriting of history, mobilizing the archive âin a project that runs counter to the original purpose, or the imperative to preserve, or the conditions that led to erasure.â20 Yet, as Field cautions, such speculative gestures must remain grounded in a deep and âintimate familiarity with the archiveâ that we are working with and against. Building on this imperative, we suggest that the developmentalist archive, in particular, demands expansion and critical reconsideration in ways that unsettle the very disciplinary frameworks through which it has been studied as well as the larger institutional contexts for such knowledge production.Our focus on The Double Day in the opening of this introduction thus foregrounds the entanglements of institutional and grassroots forces, local and international contexts, structural and interpersonal relations, and creative and economic factors that have shaped not only this film but the broader ecosystem of development media projectsâand their preservationâover time. Addressing such a constellation involves transgressing methodologically entrenched divisions between political economy and aesthetics, between material infrastructures and affective regimes; reckoning with divergent periodizations across film history and world economics; and situating these within the local specificities of womenâs movements and international institutional programs. It also demands attentiveness to the coexistence of multiple, and sometimes competing, understandings of developmentâeach historically, geographically, and ideologically situated.We imagine this special issue as an opening toward a critical dialogue, not only about how such an approach might be enacted in practice but also about the far-reaching ways development paradigms have shaped both our objects of study and the contours of the field itself. The decision to center institutionally sponsored films across all the essays in this issue is deliberate and enables us to highlight institutional critique as a vital methodological imperative within our analytical framework. Created within the frameworks of international organizations, state agencies, or NGOs, these filmsâ histories make legible the institutional logics that underwrite their production. Yet our critique does not stop at these specific entities. Rather, we argue for a broader interrogation of the political conditions and institutional infrastructures that shape media and knowledge production more generally. This includes contemporary corporations embedded in the digital platform economy, from streaming services to the rapid expansion of AI. Equally critical is a reflexive examination of academia itself, where departments of economics, political science, and centers for development have played a formative role in producing and legitimizing developmentalist theories and policy frameworks. While the humanities and arts have at times offered critical alternatives, they have also frequently mirrored and reinforced many of the same developmentalist assumptions. A feminist analysis of the nexus between development and media must therefore unsettle not only dominant archives but also the institutional and disciplinary foundations of our own scholarly practices.As scholars, we share the complex position of navigating the same tensions between institutional complicity and emancipatory aspiration as many of the media-makers whose work we study. Mirroring our subjects is also the transnational, collective mode of this special issueâs own production as it emerges from an ongoing informal working group we have sustained over several years. While relying on institutional and disciplinary affordancesâsuch as university funding for conferences or access to academic publishing platformsâwe have been working toward creating a community that exceeds, and often resists, the prevailing logics of our academic institutions. Our aim has been to create a space for shared inquiry and mutual support that pushes back against disciplinary siloing and technocratic neoliberal assessment modes of both labor and knowledge productionâand this certainly extends to our experience collaborating with the journal editors throughout the publication process. Our goal has been to examine both the persistence and variability of developmentalism, understood as what Gustavo Esteva calls a âpowerful but fragile semantic constellation,â as a conceptual formation that has historically inspired, legitimized, and mobilized media projects across Asia, Africa, and Latin America.21 And gendered biopolitics, from population control to gender mainstreaming, have remained integral to development policies and media practices, recurring across formats from institutional newsreels to film festivals.We share the conviction that, far beyond the history of nonfiction institutional media, development (as both a broad ideological project and a network of material and institutional practices) and developmentalism (as a set of discourses and theoretical models associated with development) have exerted a far-reaching influence on film and media cultures at large. As such, they must be treated as a major force in shaping global film and media systems and also the many ongoing assumptions behind their critical discourses. The discipline of communication studies was founded on modernization theory governed by Cold War goals of dissemination of Western liberal democracy around the world, while âan area studies framework allowed compartmentalizing Western and non-Western outcomes of technologies that were always claimed to be universal.â22 Despite critique from postcolonial and critical race studies, many of these frameworks have remained foundational for media theory.23 In historical scholarship, as we increasingly move beyond âmodernityâ as a dominant conceptual anchor, engaging with practices and discourses of development opens more precise analytical pathways. These film and mediaâs entanglements with the logics of and economic and the associated with as well as their conceptual underdevelopment, and impact in as diverse as and of media aesthetic and paradigms in film and film and funding are developmentalist assumptions to the they to underwrite the narrative and logics of and global media from the structure of the film to the cultures of argue that a examination of the historical entanglements between film and developmentalist aesthetics, modes of as well as infrastructures and critical the and that our contemporary media is a of the historical contours of development as a field of inquiry embedded within a of some of the methodologies by the featured in this special a of this complex history, to the larger at in media, development, and gender all its development a it as an of be with practices as divergent as and in In as we work on this the of the of the USAID the ideological that have the history of international the and of this on the global its a from development as a global practice and as an institutional and which over the has as a with its own media Yet or does not erase the historical impact of these the contradictions they have reflected and over the as the of development several crucial to the economic theories of development initiatives to and through the of the development an international policy framework at from the Global to the of the Global the by the political role of and the of the International the on was challenged by dependency theory and at development as global structural the neoliberal of the the Programs by the and World imposed and as conditions for and forms of assistance became known as the major markers for international development development has moving beyond economic to such as the Human Development and the Development and from international organizations such as the United Nations to a broader network of These frameworks increasingly of and liberal of and with what in many ways to various while the of the to developmentâs epistemological more scholarship has toward a of its and material the field has to a of and critical by and scholars, which development as a dynamic of conceptual and political to these the studies in this special issue call for sustained analysis in place of In we draw from a of and that in of of gender and to this special issue engage that and from Mexico to contemporary specific local historical of global distinctly feminist methodologies as well as attention to studies that this issue a in the global history of development on and documentary work in Mexico how early women infrastructures as of while US films an early of state and transnational on a outside the Global as the of developmentalist both the and markers of development media, its to the and Latin central grounded in archival also womenâs in transnational and the methodological of archives on study of the series to a a digital media not by but by women not as but as subjects and within circuits of neoliberal and the aesthetics and of how developmentâs has models of to contemporary neoliberal paradigms of and analysis how digital and gender and practices, discourses on and their of these essays the of some of the historical of developmentalist as the question of the role of the state within such on a notion of economic as a and the dominant of development that the state as the for and through infrastructural projects. This understanding of development was shared across both of the as well as in the Third The United and the increasingly mobilized international in the of the modes of international at the postcolonial of policy and ideological These programs were at the expansion of their and of while with the and decolonial of The conceptual between modernization and development that the Cold in of and hierarchies of that long and As an of postcolonial their role as of international aid concern about the of Western development projects. In alternative across the Global South that to structural between and through policies of and In many they were further the global structures. In Latin for example, this approach was through organizations such as the United Nations for Latin and the both developmentalist projects and their have taken many forms historically, and they have and they have been to a of projects, and postcolonial and development has been and in ways and with frequently political While many of these alternative frameworks the embedded in dominant Western they often technocratic and assumptions. gender and gender as for the of to be shaped by This becomes particularly in the media that of development where women frequently a crucial associated with and women were as both the subjects and of their participation in the and labor often as the index of In this study of from the 1970s how women were as of this as these about womenâs urban and recurring and of a within the own of and critique that official examination of archives and enables a feminist interrogation of their mobilizing a of the in the of contribution to this issue similarly the of a dynamic within as well as across ideological the of womenâs and the media of the and as active in labor and as integral to the technocratic women became of as their labor remained a of and analysis and archival with attention to the specific of and It also transnational that as a and affective a nexus of and practices through which gender, media, and developmentalism one film not as a but as part of the of alongside and work a broader concern of this special media as a of developmentalist projects. The debates the World and which international such as the United Nations and a critical historical for such primarily by postcolonial and of the for the of media and communication infrastructures in as to counter Western The a between and economic how systems of media and reinforced global hierarchies of and in an agenda that supported and alternative media infrastructures across postcolonial contexts, the framework gender as an analytical This âgender in the 1970s by of the Women in Development in relation to The Double its political critique of with its broader to center women in development policy through and This was also in of media, which was shaped by its international reach and audiovisual production and and and Yet, as WID institutional it also to the and of the womenâs development programs often by in These were by a of studies, and on and the to of womenâs presence and through the of their economic and In this on the filmmaker this history directly by the and of for women by the WID framework during the with and agencies the of and against Women in at the of the neoliberal turn, when institutional media often the only to access and support to projects. The an by this dynamic as of the from the Global South are to engage with the developmentalist assumptions funding models that their similarly the as a in developmentalist media history by the of and centers on the Film a between of and the attention toward the and labor by and work was foundational the of and the of audiovisual aid, as both a of development projects and a critical for their the in this issue argue for a with media, gender, and developmentalism as an field of that is and shaped by feminist and methodologies and that challenge the entanglements between academic knowledge production and and technocratic development And while methodological these dynamics at the structural the of feminist in media and cinema by this the very a