Problems with curriculum implementation in in-service clinical education.

Area of Science:

• Medical Education
• Health Professions Education
• Curriculum Implementation

Background:

• Clinical training for foreign medical graduates (externs) in Hong Kong highlights challenges in professional education.
• In-service components in health professional education are common and present unique implementation hurdles.

Purpose of the Study:

• To identify causes of curriculum implementation failure in the clinical training of foreign medical graduates.
• To explore the impact of institutional needs versus educational needs on curriculum delivery.

Main Methods:

• Participant observation, questionnaires, and interviews were used to collect data.
• Data were gathered from 97 externs and 48 supervisors involved in clinical training.

Main Results:

• A significant proportion of externs (33-50%) did not receive the intended curriculum experiences.
• The type of hospital significantly influenced the externs' experiences, with some acting as observers rather than active participants.
• Supervisors' perceptions of extern capabilities varied based on the hospital setting.

Conclusions:

• Failure in curriculum implementation stems from a conflict between institutional demands and learner educational needs.
• Supervisor cooperation is essential for curriculum delivery, necessitating alignment between supervisor and learner roles and perceptions.
• Curriculum planners must consider the interplay of institutional and educational needs for successful program implementation.