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Simulation-based tools are increasingly used to improve procedural training in medical education. However, access to affordable and anatomically accurate models for teaching cardiac catheterisation remains limited. This study aimed to enhance medical education by developing a cost-effective three-dimensional-printed heart model for teaching basic cardiac catheterisation to medical students.
Methods:
This open-label, single-site randomised controlled trial was conducted at Fu Jen Catholic University. Undergraduate and postgraduate medical students were recruited and randomly assigned to either a three-dimensional model group with hands-on practice or a control group receiving slide-based instruction. The effectiveness of a custom-made three-dimensional-printed heart model in teaching cardiac catheterisation was evaluated. A total of 35 participants were enrolled, including 18 in the three-dimensional model group and 17 in the control group.
Results:
Overall posttest scores were comparable between groups. However, among undergraduate medical students, posttest scores were significantly higher in the three-dimensional model group than in the control group (P = 0.03). The production cost of each three-dimensional-printed heart model was capped at US$200, indicating that the model is a cost-effective educational tool.
Conclusion:
Three-dimensional-printed heart models provide a feasible and cost-effective approach for teaching cardiac catheterisation in medical education. Their educational benefits appeared more evident among undergraduate medical students. Integrating such models according to learners’ training stages and procedural complexity may further enhance training effectiveness.
Psychiatry is a rewarding career, but many medical students have limited exposure to the specialty. Extracurricular enrichment programmes aim to provide early exposure to psychiatry, promote positive attitudes and encourage early career interest.
Aims
To systematically review literature on extracurricular psychiatry enrichment programmes for undergraduate medical students.
Method
The review was registered with PROSPERO (CRD420251025990) and followed PRISMA guidelines. Four databases were searched using pre-determined search strings. Records were screened and data extracted independently by two authors. Quality was appraised using the Mixed Methods Appraisal Tool. A narrative synthesis summarised and consolidated findings.
Results
Of 731 articles screened, 65 full reports were assessed for eligibility and 27 were included. These studies were conducted across 10 countries, most commonly the USA and UK. Programme duration and format varied from single-day events (n = 2) to longitudinal mentoring schemes spanning medical school (n = 5). Summer schools were most common (n = 10). Other schemes included mentoring, elective courses, special study modules, student-led clinics and film/media-based activities. Student feedback was positive, particularly for mentoring and film/media initiatives. Most studies reported improved attitudes towards psychiatry and mental illness, with several reporting statistically significant improvements using validated tools. Of 18 studies assessing career intentions, 16 reported increased interest in a career in psychiatry, and six studies reported higher subsequent match rates into psychiatry specialty training.
Conclusions
The available literature on voluntary extracurricular enrichment programmes suggests that they may provide positive student experiences and are associated with improved attitudes and early interest in psychiatry through meaningful learning opportunities. However, the evidence base is limited as most studies were small, self-selected samples with short-term follow-up and predominantly self-reported outcomes.
Educating medical students in the core skills of psychiatric examination and the implications of psychiatric comorbidities to medical care is of critical importance, given the increasing prevalence of a number of mental disorders and their increasing comorbidity with medical conditions. This article outlines psychiatry education in three of Singapore’s medical schools, where it forms a small yet integral part of the undergraduate and postgraduate curricula.
Traditional lecture-based learning (LBL) is often insufficient for cultivating the practical decision-making skills required in high-stakes environments like Emergency Medical Response (EMR). While game-based learning (GBL) offers an immersive alternative, it can lack immediate expert guidance. This study addresses this gap by exploring the integration of generative Artificial Intelligence (AI) as an “intelligent tutor” within GBL. The objective was to evaluate and compare the effectiveness of LBL, GBL, and generative AI-powered game-based learning (AI-GBL) on medical students’ knowledge acquisition, retention, learning motivation, and cognitive load in an EMR course.
Methods:
A retrospective, comparative study was conducted with 86 medical students from three consecutive cohorts (2022-2024), each exposed to one of the three teaching modalities (n = 29 LBL, n = 28 GBL, n = 29 AI-GBL). Knowledge was assessed via pre-test, post-test, and final-test scores with a maximum score of 10 points. Student feedback was collected for learning motivation, cognitive load, and technology acceptance.
Results:
For immediate knowledge acquisition, both GBL (mean difference = 1.124/10 points; 95% CI [0.297, 1.952]; P = 0.008) and AI-GBL (mean difference = 0.897/10 points; 95% CI [0.076, 1.717]; P = 0.033) significantly outperformed LBL. For delayed knowledge retention, the AI-GBL group demonstrated significantly superior retention compared to both the GBL group (mean difference = 0.689 points; unadjusted 95% CI [0.080, 1.299]) and the LBL group (mean difference = 1.310 points; unadjusted 95% CI [0.706, 1.915]). The AI-GBL group also reported significantly lower cognitive load than the GBL group (mean difference = −0.273 points; unadjusted 95% CI [−0.456, −0.090]). Finally, students perceived the AI-powered approach as significantly more useful than the standard game-based approach (mean difference = 0.513 points; unadjusted 95% CI [0.137, 0.889]).
Conclusion:
The AI-enhanced GBL model for EMR training improves knowledge acquisition and retention while reducing cognitive load, representing a promising approach for developing proficiency in complex, high-stakes medical competencies.
To describe the perception of primary care (PC) among medical students from two universities in Peru.
Methods:
A cross-sectional study was conducted among third- to seventh-year medical students from two universities in Lima, Peru. A questionnaire was applied to evaluate perceptions of PC. Crude and adjusted prevalence ratios (aPR) with their 95% confidence intervals (95% CI) were calculated to assess factors associated with a favorable perception.
Results:
Data from 418 medical students were analyzed (women: 60.8%, mean age: 23.4 years). Only 2.2% expected to work in PC after graduation. Regarding perceptions of PC, 82% agreed or strongly agreed that PC is a preparatory step toward medical residency, 55% felt cases were less interesting, and 44% believed the income was lower compared to hospital work. Being enrolled at Universidad Peruana Unión (aPR: 3.35, 95% CI: 1.85–6.05) and having completed an external rotation in PC (aPR: 1.36, 95% CI: 1.03–1.80) were associated with a favorable perception.
Conclusion:
Among the assessed students, most viewed PC as a step toward residency, and nearly half considered cases less interesting and income lower compared to hospital work. A favorable perception was associated with university affiliation and having completed external rotations in PC during training.
Mental health disorders, including depression and anxiety, pose significant public health challenges globally, and in Saudi Arabia. Despite this, psychiatry suffers from a critical shortage of specialists. This study investigates factors influencing medical students’ career decisions in regard to psychiatry, aiming to enhance understanding of, and address workforce deficiencies in, mental healthcare.
Aims
This study aims to investigate the factors influencing medical students’ decision to choose psychiatry as a future career.
Method
This cross-sectional study conducted an online survey among Saudi Arabian medical students from 28 December 2023 to 28 April 2024, employing validated questions refined through pilot testing. Participant selection included male and female students across preclinical and clinical stages, excluding non-medical students and those outside Saudi Arabia.
Result
This study explores the perceptions and interest of 430 medical students in Saudi Arabia regarding psychiatry as a career. The majority were female (69.3%), with most in their preclinical years (60.2%). Key findings include limited personal connections to psychiatry (9.5% with a family psychiatrist), and primarily influenced by medical school (55.3%) and social media (42.1%). While 65.1% perceive psychiatry as mentally demanding, uncertainties exist about career prospects and stigma persists (39.1%). Gender differences were observed, with more females (34.6%) than males (22.7%) interested in psychiatry (P = 0.014). Early inspiration in medical education significantly increased interest (P = 0.001).
Conclusion
Early exposure, personal connections and gender-specific factors significantly influence medical students’ interest in psychiatry as a career. Integrating psychiatry education early in medical curricula and addressing stigma are critical for fostering positive perceptions and attracting diverse students to the field.
Targeted identification, effective triage, and rapid hemorrhage control are essential for optimal outcomes of mass-casualty incidents (MCIs). An important aspect of Emergency Medical Service (EMS) care is field triage, but this skill is difficult to teach, assess, and research.
Study Objective:
This study assessed triage efficacy and hemorrhage control of emergency responders from different professions who used the Sort, Assess, Life-Saving Treatment (SALT) triage algorithm in a virtual reality (VR) simulation of a terrorist subway bombing.
Methods:
After a brief just-in-time training session on the SALT triage algorithm, participants applied this learning in First VResponder, a high-fidelity VR simulator (Tactical Triage Technologies, LLC; Powell, Ohio USA). Participants encountered eleven virtual patients in a virtual scene of a subway station that had experienced an explosion. Patients represented individuals with injuries of varying severity. Metrics assessed included triage accuracy and treatment efficiency, including time to control life-threatening hemorrhage. Independent Mann-Whitney analyses were used to compare two professional groups on key performance variables.
Results:
The study assessed 282 participants from the ranks of EMS clinicians and medical trainees. Most (94%) participants correctly executed both global SALT sort commands. Participants triaged and treated the entire scene in a mean time of 7.8 decimal minutes, (95%CI, 7.6-8.1; SD = 1.9 decimal minutes) with a patient triage accuracy rate of 75.8% (95%CI, 74.0-77.6; SD = 15.0%). Approximately three-quarters (77%) of participants successfully controlled all life-threatening hemorrhage, within a mean time of 5.3 decimal minutes (95%CI, 5.1-5.5; SD = 1.7 decimal minutes). Mean time to hemorrhage control per patient was 0.349 decimal minutes (SD = 0.349 decimal minutes). Overall, EMS clinicians were more accurate with triage (P ≤ .001) and were faster at triage, total hemorrhage control (P < .01), and hemorrhage control per patient (P < .004) than medical trainees.
Conclusions:
Through assessments using VR simulation, it was observed that more experienced individuals from the paramedic (PM) workforce out-performed less experienced medical trainees. The study also observed that the medical trainees performed acceptably, even though their only formal training in SALT triage was a 30-minute, just-in-time lecture. Both of these findings are important for establishing evidence that VR can serve as a valid platform for assessing the complex skills of triage and treatment of an MCI, including the assessment of rapid hemorrhage control.
Storm Daniel struck northeastern Libya on September 10, 2023, causing severe infrastructure damage and significant human loss. Derna was the most affected city, with the University of Derna suffering extensive damage and the tragic loss of 37 medical students. Medical students face unique psychological and academic stressors, and tend to have higher rates of psychiatric disorders compared to their peers of the same age. This is the first study to investigate the storm’s psychological impact on medical students at the University of Derna. The study has a cross-sectional design and lasted from February 1 to March 1, 2024. We used the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety and the Patient Health Questionnaire-9 (PHQ-9) to assess depression, along with sociodemographic questions in our questionnaire. We included only active students enrolled in the 7-year undergraduate program at the University of Derna. Statistical tests such as the chi-square test and binary logistic regression were used in the analysis. About 225 students completed the survey. The means and standard deviations for GAD-7 and PHQ-9 scores were 9.2 (3.9) and 10.8 (5.0), respectively. The prevalence of anxiety was 42.2% for cases classified as moderate and severe (cut-off ≥10). Depression had a prevalence of 51.1% for cases classified as moderate, moderately severe and severe (cut-off ≥ 10). Suicidal ideation was reported at a rate of 48.9% for “several days” or more and at 16.5% for “more than half of the days” and “nearly every day.” Internal displacement following the storm was significantly associated with both anxiety (p = 0.033) and depression (p = 0.003). However, age, gender, year of study, monthly allowance and residence status (living with family or alone) did not show a statistically significant association with either anxiety or depression (p > 0.05 for all variables). Logistic regression analysis identified gender as the only significant predictor of anxiety (p = 0.041) and internal displacement as the sole significant predictor of depression (p = 0.023). Medical students at the University of Derna reported high rates of anxiety, depression and suicidal ideation following Storm Daniel. Internal displacement was significantly associated with both anxiety and depression. These results highlight the need for targeted interventions to address medical students’ mental health challenges and improve their overall well-being.
Moving to Edinburgh from Glasgow to study medicine at the age of 17. A brief description of teaching methods as they were then. My experience of psychiatry as a medical student, and a discussion of self-harm. Met my future husband, who was to spend a lot of his life as an agricultural economist, working in Mexico.
To determine the level of awareness of health technology assessment (HTA) and its predictors among clinical year medical students in public universities in Klang Valley, Malaysia.
Methods
A cross-sectional study using the stratified random sampling method was conducted among clinical year medical students in four public universities in Klang Valley, Malaysia. Data on the level of awareness of HTA and its associated factors were collected using a self-administered online questionnaire. Descriptive, bivariate, and multivariate analyses were performed using IBM SPSS version 27 to determine the level of awareness of HTA and its predictors.
Results
Majority (69 percent) of participants had a low level of awareness of HTA. The predictors of high-level awareness of HTA were attitude toward HTA (adjusted odds ratio (AOR) = 7.417, 95 percent confidence interval (CI): 3.491, 15.758), peer interaction on HTA (AOR = 0.320, 95 percent CI: 0.115, 0.888), and previous training on HTA (AOR = 4.849, 95 percent CI: 1.096, 21.444).
Conclusions
Most future doctors in public universities exhibit a low awareness of HTA. This study highlights the interplay between attitudes toward HTA, peer interaction, and previous training as influential predictors of HTA awareness. An integrated and comprehensive educational approach is recommended to cultivate a positive attitude and harness the positive aspects of peer interaction while mitigating the potential negative impact of misconceptions. Emphasizing early exposure to HTA concepts through structured programs is crucial for empowering the upcoming generation of healthcare professionals, enabling them to navigate HTA complexities and contribute to evidence-based healthcare practices in Malaysia and beyond.
In general, medical students perceive themselves as inadequately prepared to assist in disasters. This study evaluated the impact of a disaster preparedness curriculum and medical students’ views toward required preparedness education for health care professionals.
Methods:
A comprehensive disaster preparedness curriculum was evaluated on its effect on medical students’ views on preparedness education requirements, preparedness, and prior disaster training using self-report survey methodology.
Results:
Results provide evidence to support curricular effectiveness in significantly increasing initial participant views of health professionals’ education requirements, perceived preparedness for integrating professional roles into the emergency response system, and confidence in exposure risk assessment and triage skills. Most participants possessed limited recent prior disaster training and drill experience. Most interestingly, the majority consistently believed throughout the study that disaster preparedness training should be a medical license mandate.
Conclusions:
For those instructing current medical students in disaster preparedness, it is suggested that a curriculum be chosen that can create participant initial anticipation, awareness, and belief in the importance of and need for disaster preparedness training. Further investigation is recommended into the relationship between students’ perceived training importance and any future curriculum delivery efforts on behalf of required or mandatory preparedness offerings in continuing professional development.
Research is an important aspect of many students’ training. However, formal research training is rarely included in curricula. Thus, we developed an online, asynchronous series of modules to introduce trainees to multiple topics that are relevant to the conduct of research.
Methods:
Research 101 was utilized by first-year medical students and undergraduate students conducting mentored research projects. Students’ knowledge, confidence, and satisfaction were assessed using pre- and post-module surveys with five-point Likert scaled questions, open-ended text responses, and a final quiz.
Results:
Pre-module survey results showed that learners felt most confident with the Conducting a literature search and Race and racism in medicine modules and least confident with the Submitting an Institutional Review Board protocol at UC module. Post-module survey responses were significantly increased compared to pre-module results for all modules and questions (p < 0.0001). The response to “The content of this module met my needs” was endorsed across all modules (84.9% “yes” responses). A final quiz of 25 multiple-choice questions was completed by 92 participants who received a median score of 21. Content analysis of open-ended post-module survey responses identified several strengths and opportunities for improvement in course content and instructional methods.
Conclusions:
These data demonstrate that significant learning resulted from completion of Research 101, as post-module survey scores were significantly higher than pre-module survey scores for all modules and questions. Final quiz scores were positive but also highlighted opportunity for additional trainee learning and will guide evolution of future modules.
Studies on patient-student relationships have to date largely focused on student attitudes. This study explores attitudes of patients with psychiatric illness in Ireland, towards medical students. Patients’ experience of consent for student involvement is an area of concern in previous studies and is also quantified here.
Methods:
This was a mixed-methods cross-sectional survey of Irish adult psychiatric patients. Quantitative analysis was carried out using SPSS 22 (Statistical Product and Service Solutions, Version 22, IBM). Differences on Likert score between groups (male/female, hospital site, past experience with students/ no experience) were analysed using ordinal logistic regression with a p-value below 0.05 being significant. Qualitative data were analysed by thematic analysis using OpenCode 4.03
Results:
A total of 340 patients completed the survey. The mean age (sd) was 44.8 (16.3). 52.8% were female, 75.2% were outpatients. 24.3% had never met a medical student. Most patients were comfortable seeing students, but preferred students being passive observers. Patients with previous student experience had higher comfort levels and more positive attitudes. Although most patients (63.7%) strongly agreed they had been asked for consent, only 49.3% felt they had been given sufficient information. Qualitative data revealed preference for adequate information and notice of involvement. Patients felt pressured by student presence in certain circumstances.
Conclusions:
Psychiatric patients are comfortable with students but many feel inadequately informed. Patients recognise the benefits of interacting with students. More information is needed regarding circumstances in which patients give consent to involvement with students
Mental illness stigma is the most significant obstacle impeding the wellbeing of individuals with such conditions. Thus, research on determinants of mental illness stigma may be of crucial importance in avoiding these attitudes. Affective temperaments are thought to be present in up to 20% of the healthy general population. However, there are very few studies addressing the relationship between temperament and mental health-related stigma.
Objectives
Evaluate attitudes and behavioral responses of medical students towards individuals with a mental illness. Explore factors associated with stigma including temperament.
Methods
A cross-sectional study was conducted among students in medical universities.
All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.
Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA). Students were also asked to complete the TEMPS-A Scale.
Results
The sample consisted of 1028 respondents (9.3% of the total population). Females represented 78,3% of the study sample. A dominant affective temperament was found in 17% of the cases under study, represented mainly by depressive and irritable temperaments. Bivariate correlations performed to assess the association between temperament and mental illness stigma revealed that a positive relationship was identified between the MICA scale and hyperthymic temperament( p=0,04). There were no significant associations between the other type of temperaments and The MICA scale.
Conclusions
Students’ temperament should be considered in developing anti-stigma programs in undergraduate education. Further researches should be undertaken to disentangle the complex relationship among demographic features, personality traits, and attitudes toward people with a mental illness.
Psychiatry is still considerably ‘young’ compared to other positive sciences. Thus, it holds a huge potential for improvement of the current diagnostic and classification systems and modes of treatment particularly. For instance, the Research Domain Criteria Project will certainly generate novel research questions that will shed a light upon mechanisms, and processes for the expression of psychiatric phenomenology and develop psychiatric treatments. The new era of Digital Psychiatry/Telepsychiatry and real-time mobile monitoring are other approaches that have a lot to offer to advance the field of psychiatry. Despite these developments, the stigma around psychiatry is still a big obstacle to tackle with. Addressing and reducing stigma during medical education should benefit from training and experience co-facilitated by people living with mental illness ideally starting from the early years in medical school. Besides clinic rotations, student clubs, student scientific congresses, and clinical research that facilitate contact with the patients may be potential platforms to attract medical students’ attention to the work of psychiatry. The speaker will touch upon some examples and implementations from the medical schools in Turkey.
Stigma and discrimination can disrupt the lives of individuals with a mental illness, preventing their opportunities to become productive citizens. These Individuals must also face either an avoidant attitude by healthcare professionals or prejudices about their adherence to medications and the psychological nature of their physical symptoms.
Objectives
Assess stigma in terms of explicit and implicit attitudes among medical school students and junior doctors. Evaluate academic factors and interfering with these attitudes.
Methods
A cross-sectional study was conducted among students from medical schools in Tunisia.
All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.
Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA).
Results
The sample consisted of 1028 respondents. The respondents’ mean age was 24.54 years (SD=3.7). Post-clinical students scored higher than pre-clinical students in questions 2, 6, and 12 on the rating scale. A positive significant relationship was identified with specialization in psychiatry. Residents who were specialized in family medicine, emergency, and intensive care had a higher stigma level compared to other residents (Mean score>0.51). The completion of a psychiatry clerkship did not significantly reduce the level of stigma toward people with a mental illness ( p=0.8).
Conclusions
A combination of medical school experiences of psychiatry’s theoretical learning and clerkship are important factors that shape students. Awareness of this will enable educators to develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students’ attitudes towards psychiatry as a discipline and mental illness in general.
The COVID-19 pandemic has impacted medical students in many ways. They are not exempt from personal struggles caused by the health crisis, and many have faced similar challenges adapting to a new learning experience. The University of East Anglia (UEA) has initiatives in place to support medical students including the society Headucate UEA and the Wellbeing Champions scheme established by Norwich Medical School (NMS).
Objectives
Headucate aims to improve mental wellbeing by educational online webinars and social events aimed at university students. NMS Wellbeing Champions offer support and signpost students to resources and the wider student support system at the UEA.
Methods
Headucate was established in 2012 by NMS students that began running workshops at local secondary schools. Their work has expanded to include wellbeing workshops, social events for students and mental health first aid training, so members can provide peer support. Wellbeing Champions are medical student representatives responsible for completing mental health first aid training, communication between students and faculty, providing resources and signposting, creating mental health bulletin newsletters, and running socials exclusively for medical students.
Results
100% of Headucate workshop attendees who completed anonymous feedback agreed that they enjoyed it and that it was useful. No feedback has been collected regarding the success of the Wellbeing Champions. This should be carried out to assess and enhance the project further.
Conclusions
More data is needed to establish the success of the initiatives at NMS and their impact on medical student’s wellbeing.
Research is an important aspect of many medical students’ training. However, many medical students are not required to complete a scholarly project, and formal research training is often fragmented across the medical school curriculum. Thus, we developed an online, structured, asynchronous set of modules to introduce trainees to multiple topics relevant to the conduct of research.
Methods:
Research 101 was piloted by 27 first-year medical students at the University of Cincinnati College of Medicine. Students’ knowledge, confidence, and satisfaction were assessed using a final quiz and pre- and post-module surveys with five-point Likert-scaled questions and open-ended text responses.
Results:
Pre-module survey results showed that learners felt most confident in Conducting a literature search and least confident in Submitting an Institutional Review Board (IRB) protocol at UC. Post-module mean scores were significantly increased compared to pre-module results for all modules and questions (P < 0.05). The response to “The content of this module met my needs” was high across all modules with 236 (84.0%) “yes” responses. Thematic analysis of open-ended text responses from post-module surveys identified several improvements to individual modules and to the overall structure of Research 101. A final quiz of 25 multiple choice questions covering content from all required modules was required. The median score was 21.
Conclusions:
Comparison of post-module to pre-module survey scores provided clear evidence of improved learning across all topics. The modules developed were responsive to the students’ needs, and students provided additional improvements for subsequent iterations of Research 101.
This study seeks the opinions of qualified doctors on what they feel medical students should learn about otolaryngology. It aims to identify both the content deemed relevant and the performance levels for medical students in otolaryngology.
Methods
A national survey developed from a content analysis of undergraduate otolaryngology curricula from the UK was undertaken, accompanied by a review of the literature and input from an expert group. Data were collected from a wide range of doctors.
Results
Participants felt that graduating students should be able to: recognise, assess and initiate management for common and life-threatening acute conditions; take an appropriate patient history; and perform an appropriate examination for the majority of otolaryngology clinical conditions but manage only a select few.
Conclusion
This study reports performance levels for otolaryngology topics at an undergraduate level. Participating doctors felt that a higher level of performance should be expected of students treating life-threatening, acute and common otolaryngology conditions.
Edited by
Uta Landy, University of California, San Francisco,Philip D Darney, University of California, San Francisco,Jody Steinauer, University of California, San Francisco
In Ethiopia, graduates of the health profession lack the competencies required to provide reproductive health services before they entering practice. Since 2015 the Center for International Reproductive Health Training (CIRHT) supported ten higher teaching institutions to implement a new model that assures acquisition of competencies for reproductive health services focused on comprehensive abortion (CAC) and contraceptive care (CC) in pre-service (medical student and residency) education settings. A direct link with the departments of Gynecology and Obstetrics (GYNOBS) and schools of midwifery was established. The program included all levels of providers but targeted medical students, interns, residents and midwives. The multipronged approach of CIRHT focused on: 1) faculty development: ensuring up-to-date clinical knowledge and skills to teach and assess clinical andresearch skills; 2) establishing clinical simulation labs and comprehensive Sexual and Reproductive Health(SRH) (Michu)clinics 3) empowering students to become self-learners through the Peer Assisted Learning (PAL) program and engage in collaborative learning 4) strengthening systems support: work with the Ministry of Health(MOH), Ministry of education(MOE) and Professional societies in designingcompetency based curricula.