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Requirements for the undergraduate major in Hispanic literature and offerings of Spanish peninsular and Latin American literature courses surveying the canon, masterpieces, major works, major authors, major trends, or representative works at fifty-six selected US colleges and universities were examined for academic years 1990–91, 2002–03, 2013–14, and 2017–18. The number of literature survey courses at these institutions decreased during this 27-year period, as did the number of schools requiring such courses. The composition of the literature survey courses also changed, most notably to incorporate other cultural products and approaches.

Background: Medical student wellness, including physical health, emotional health, and levels of perceived stress, appears to decline during training, with students reporting high levels of depression, anxiety, and burnout as early as the first year of medical school. The impact of curricular changes on health and stress remains unclear, and a modified curriculum that compresses training of the foundational sciences and its effect on wellness has not been studied. Oregon Health & Science University School of Medicine has recently instituted a unique competency-based model, which provides an important opportunity to assess the effects of curricular change on student wellness. Objective: Assess the effects of curricular change on student wellness. Design: Medical students at a single institution were administered the SF-8, an 8-item health-related quality of life survey, as well as the Perceived Stress Scale, a 10-item scale that measures the degree to which life situations are appraised as stressful, at baseline (matriculation) and at the end of Year 1, 2 and 3. Individual variables were assessed over time, as well as a trend analysis of summary domain scores over the 4 time periods. Results: Physical, emotional, and overall health were highest at baseline and lowest at the end of Year 1, after which they improved but never again reached baseline levels. Physical health declined less than emotional health. Perceived stress levels did not change over time but remained moderately high. There were no differences in health or perceived stress based on demographic variables. Conclusions: In a competency-based curriculum, physical, emotional and overall health significantly worsened during Year 1 but improved thereafter, while perceived stress remained unchanged. Early in training, stress and poor overall health may be related to concerns about self-efficacy and workload. Although advanced students show improved wellness, concerns remained about emotional difficulties, such as anxiety and irritability, and feeling a lack of control.

Many countries struggle to effectively introduce Digital Education (DE) to all K-12 students as they lack adequately trained teachers. While cascade models of in-service teacher-professional development (PD) can rapidly deploy PD-programs through multiple levels of trainers to reach all teachers, they suffer from many limitations and are often ineffective. We therefore propose an adapted cascade model to deploy a primary school DE teacher-PD program throughout an administrative region. The model relies on teacher-trainers who (i) are active teachers in the region, (ii) have a prolonged trainer-PD with experts who piloted the teacher-PD program to acquire adult-trainer and DE-related competences, and (iii) are supported by the experts throughout the deployment. To validate the deployment model we used data from 14 teacher-trainers, the 700 teachers they trained, and 350 teachers trained by experts. The teacher-trainer findings demonstrate that the adapted cascade model effectively addresses most cascade models’ limitations. The teacher-related findings further validate the adapted cascade model in terms of perception, motivation and adoption which are at least equivalent to those obtained with the experts. To conclude, the adapted cascade model is an effective means of spreading primary school DE PD-programs at a large scale and can be used in other DE reforms.

Background Distributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments. Methods We used individual interviews to understand professionals’ experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education. Results Clustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession. Conclusions These themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the ‘broker’ role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.

Background The year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan’s Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students’ performance in objective structured clinical examinations (OSCEs). Methods We retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan’s largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical sub-internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their sub-internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their sub-internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.” Results Between November 2016 and July 2020, 361 undergraduates underwent clinical sub-internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p  < 0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p  = 0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p  = 0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p = 0.001). After clinical sub-internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p  = 0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p  = 0.492). Conclusions At the beginning of the sub-internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical sub-internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical sub-internship is crucial for the development of clinical skills and performance in the national OSCE.

Background In 2010, coincident with the 100th anniversary of Flexner’s sentinel report, the Carnegie Foundation published an updated review of North American medical education and challenged medical schools to initiate further educational reforms. Specific recommendations pertained to a) ensuring standardized outcomes while allowing for individualized processes, b) integrating foundational knowledge with clinical experience, c) cultivating habits of inquiry and innovation and d) professional identity formation. As we approach the 10-year anniversary of this latest report, we sought to determine what type of curricular revisions have been emerging within the past decade and what types of challenges have been encountered along the way? Methods In 2018, an electronic survey was sent to all 166 Liaison Committee on Medical Education (LCME) accredited North American Medical Schools, using the points of contact (educational deans) that were listed in a publicly available, Association of American Medical Colleges database. Free text comments were grouped into themes using the constant-comparative technique. Results Sixty unique responses yielding a 36.14% response rate. The distribution of responses was proportionally representative of the distribution of public vs. private, old vs. new vs. established North American medical schools. Self-reported curricular changes aggregated into five main themes: Changes in curricular structure/organization, changes in curricular content, changes in curricular delivery, changes in assessment, and changes involving increased use of technology/informatics. Challenges were predominantly focused on overcoming faculty resistance, faculty development, securing adequate resourcing, change management, and competition for limited amounts of curricular time. Conclusions Changes in curricular organization, content, delivery, assessment and the use of technology reflect reforms that are broad and deep. Empowering faculty to “let go” of familiar constructs/processes requires strong leadership, particularly when initiating particularly disruptive curricular changes, such as relocating the Step 1 examination or shifting to a competency-based curriculum. While North American medical schools are responding to the calls for action described in the second (2010) Carnegie Foundation report, the full vision has yet to be achieved.

Sustaining changes in teachers’ practices is a challenge that determines the success of curricular reforms, from which Digital Education (DE) is not exempt. As the literature on sustainability is considered “scarce” and “scattered”, long-term studies modelling the factors impacting teachers’ sustained uptake of DE pedagogical content are lacking. Thus, we investigate whether and how 287 in-service teachers sustained a primary school DE curricular reform over a year after they completed their two-year DE professional development program. We model the sustainability of the reform through Structural Equation Modelling, and identify critical sustainability-factors. The validated Sustainable Adoption of Digital Education (SADE) model confirms that sustainability in the fourth year of the reform depends on perceived usefulness of teaching the new content, ease of implementation, and access to sufficient support in schools. Such factors should thus be evaluated, accounted for in the implementation phase of the reform, and sustained over time. The findings confirm that the DE curricular reform model contributes to positive self-efficacy to teach DE, provides sufficient in-school support, and promotes increasing adoption over time. However, as teachers’ practices have not yet stabilised, and teachers may still adopt more to cover the breadth of DE-concepts, it is important to remain attentive to remaining sustainability barriers: lack of time, effort required to teach DE with teachers preferring to delegate, and lack of student-learning evidence, the latter being a significant challenge to address in the literature. These barriers must therefore be jointly addressed by researchers and practitioners in the field in order to promote the sustainability of the reform.

This article is a reflection on how the curricular space of the Social Sciences Seminar was implemented in secondary schools in the city of Rosario, after the curricular reform that took place in the province of Santa Fe in 2014. It proposes a round for the social sciences in school, the problem of interdisciplinarity in high school discipline and a look about how this space is worked in different schools. It historicizes how this articulated curriculum space arose, both in theory (analysis of national and provincial regulations, didactic conceptions that support it, provincial programs) and in practice (classroom analysis through interviews, surveys and planning). It is concluded that one of the reasons why the Seminar in Social Sciences presented serious difficulties for its implementation was the interdisciplinary nature proposed in a disciplinary school (and teacher training).

BackgroundEarly exposure to Computer Science (CS) and Computational Thinking (CT) for all is critical to broaden participation and promote equity in the field. But how does the introduction of CS and CT into primary school curricula impact learning, perception, and gaps between groups of students?MethodologyWe investigate a CS-curricular reform and teacher Professional Development (PD) programme from an equity standpoint by applying hierarchical regression and structural equation modelling on student learning and perception data from three studies with, respectively, 1384, 2433 and 1644 grade 3–6 students (ages 7–11) and their 83, 142 and 95 teachers.ResultsRegarding learning, exposure to CS instruction appears to contribute to closing the performance gap between low-achieving and high-achieving students, as well as pre-existing gender gaps. Despite a lack of direct influence of what was taught on student learning, there is no impact of teachers’ demographics or motivation on student learning, with teachers’ perception of the CS-PD positively influencing learning. Regarding perception, students perceive CS and its teaching tools (robotics, tablets) positively, and even more so when they perceive a role model close to them as doing CS. Nonetheless, gender differences exist all around with boys perceiving CS more positively than girls despite access to CS education. However, access to CS-education affects boys and girls differently: larger gender gaps are closing (namely those related to robotics), while smaller gaps are increasing (namely those related to CS and tablets).ConclusionThis article highlights how a CS curricular reform impacts learning, perception, and equity and supports the importance of (i) early introductions to CS for all; (ii) preparing teachers to teach CS all the while removing the influence of teacher demographics and motivation on student outcomes; and (iii) having developmentally appropriate activities that signal to all groups of students.

Background In 2013, Taiwan launched a curriculum reform—the 7-year undergraduate medical education program was shortened to 6 years. This study explored the evaluation results from students regarding the curriculum reform and investigated graduates’ perceptions regarding the curriculum organization of the two academic training programs affected by this curricular reform. Methods A cross-sectional survey was conducted from May 14 to June 12, 2019. The 315 graduates from both the 7-year and 6-year curriculum programs in the same medical school in Taipei were invited to participate in this study. In total, 197 completed questionnaires were received, representing a response rate of 62.5%. The results of the principal component analysis confirmed the validity of the constructs employed in this self-administered questionnaire. Results The t -test results yielded two main findings. First, the graduates from the 6-year program had significantly lower scores for preparedness for the upcoming postgraduate-year residency training than did their 7-year program counterparts. Additionally, the male graduates had significantly higher scores in terms of perceptions regarding curriculum organization and preparedness for postgraduate-year residency training than the female graduates. The results of stepwise regression also indicated that the sex difference was significantly correlated with graduates’ readiness for their postgraduate-year residency training. Conclusion To avoid sex disparities in career development, a further investigation of female medical students’ learning environment and conditions is necessary. In addition to the cross-sectional study of students’ perceptions, further repeated measurements of the objective academic or clinical performance of graduates in clinical settings are desirable.