TESOT: a teaching modality targeting the learning obstacles in global medical education

In higher education, it is a great challenge for instructors to teach international medical students (IMSs) efficiently. These students usually have different learning obstacles and learning style preferences from domestic students. Thus it is necessary to use teaching modalities targeting the specific characteristics of IMSs. Accordingly, we have developed a teaching modality composed of classical teacher-centered approach (TCA), enriched with components of student-centered approach (SCA) and online interactions targeting the learning characteristics of IMSs, which we defined as TESOT (an acronym made of the underlined words' initials). Aside from the online interactions that provide both answers to questions raised by students and guidance throughout a course, this modality contains additional in-classroom components (i.e., pre-lecture quiz, student-led summary, and post-lecture quiz). The effectiveness of this modality was tested in the nervous system module of the Physiology course for IMSs. The final exam scores in the nervous system module in the year taught with TESOT were higher than those earned by students taught with a classical TCA modality in preceding 2 yr. The improvement of teaching effectiveness is attributable to increasing communication, bridging course contexts, and meeting diverse learning style preferences. These results indicate that TESOT as an effective teaching modality is useful for enhancing efficiency of teaching IMSs.