In war-torn and developing settings, being a Scholar is not just about academic knowledge—it is about learning continuously in unstable environments, adapting knowledge to limited resources, and translating learning into practical impact for patients and communities. Students must become self-directed learners, often without structured systems, and play a role in spreading knowledge to communities, correcting misinformation, and improving care practices.
1. Engage in life-long learning #
1.1 Identify personal learning needs and create a plan of action #
Students must actively identify gaps in their knowledge based on real patient encounters—for example, managing TB, recognizing malnutrition, or handling trauma cases. Since formal teaching may be inconsistent, students should create their own structured learning plans using available resources (guidelines, peers, online materials when accessible). Learning should be prioritized based on local disease burden and immediate clinical relevance, not just theoretical knowledge.
1.2 Identify opportunities for learning and improvement by regularly assessing performance using internal and external data #
Students should reflect after each patient encounter: What did I miss? What could I have done better? Feedback may come from supervisors, peers, or patient outcomes. In settings with limited formal evaluation, self-reflection becomes critical. Students should also observe patterns—such as repeated treatment failures or complications—to identify areas for improvement.
1.3 Engage in collaborative learning with colleagues and other health professionals #
Learning should happen through teamwork—discussing cases with peers, nurses, and senior clinicians. In many settings, knowledge is shared informally, and collaboration becomes a key learning tool. Students should actively participate in case discussions and learn from the experiences of others, especially those with practical field experience.
1.4 Review outcomes using quality improvement processes to identify items for analysis #
Students should look at patient outcomes—such as treatment success or failure—and ask why. For example, why are TB patients not completing treatment? Why are infections recurring? This helps identify system-level issues such as poor follow-up, lack of education, or medication shortages, and encourages students to think beyond individual cases toward improving care systems.
2. Participate actively in the education of self and others #
2.1 Recognize and address role modelling and impact of the informal or hidden curriculum #
Students must be aware that they learn not only from formal teaching but also from observing others. In some environments, they may witness poor practices or unethical behavior. It is important to critically evaluate what they observe, adopt good practices, and avoid replicating harmful ones. Students themselves also become role models for peers and junior learners.
2.2 Promote a safe learning environment for all #
Students should contribute to an environment where peers feel comfortable asking questions and admitting uncertainty. In high-pressure settings, fear of judgment can limit learning. Encouraging openness and mutual support improves both learning and patient care.
2.3 Plan and deliver personal, other professional and community lifelong learning activities #
Students should take initiative in teaching—whether it is explaining conditions to patients, educating families about disease prevention, or sharing knowledge with peers. Community education is especially important for addressing diseases like TB, malaria, and sanitation-related illnesses. Students act as a bridge between medical knowledge and public understanding.
2.4 Provide meaningful feedback for improvement to peers, mentors and programs #
Students should give constructive feedback to peers and teams to improve performance. In environments with limited formal systems, peer feedback is essential for maintaining standards and improving care.
2.5 Evaluate peers, teachers, and education programs using relevant tools and practices #
Students should reflect on the quality of teaching and learning environments and contribute suggestions for improvement. Even simple feedback can help improve training quality in resource-limited settings.
3. Integrate best available evidence into learning and decision-making #
3.1 Recognize personal and system knowledge gaps in patient care #
Students should acknowledge when they do not know something and actively seek answers. They must also recognize system limitations—such as lack of diagnostics or medications—and adapt accordingly.
3.2 Generate focused questions that address gaps #
Students should develop the habit of asking practical clinical questions, such as:
- What is the best treatment available here for TB?
- How do we manage dehydration without IV fluids?
These questions should be focused on real-world constraints.
3.3 Critically evaluate the integrity, reliability and applicability of research literature #
Students must understand that not all research applies to their setting. Treatments recommended in high-resource countries may not be feasible. Students should evaluate whether evidence is practical, affordable, and accessible in their context.
3.4 Integrate evidence into clinical decision-making #
Students should combine available evidence with clinical judgment and patient circumstances. For example, choosing treatments that are available locally, even if they differ from ideal guidelines, while still ensuring effectiveness.
3.5 Formulate well-structured questions and consult scholarly resources in confronting a patient care problem #
Students should use available resources—guidelines, textbooks, or digital tools when possible—to answer clinical questions. In limited-resource settings, efficient use of accessible knowledge sources is critical.
3.6 Discuss selecting the most appropriate action in the absence of evidence #
When evidence is lacking, students must rely on clinical reasoning, experience of senior clinicians, and patient context. This is common in low-resource settings and requires careful judgment and ethical consideration.
3.7 Interpret qualitative and quantitative knowledge using standardized practices that address bias, validity, barriers, and relevance to care #
Students should understand both numerical data (e.g., treatment success rates) and patient experiences (e.g., barriers to care). This helps in making decisions that are not only clinically sound but also practical.
3.8 Apply new knowledge and evaluate the impact on patient care #
Students should apply what they learn and observe whether it improves outcomes. For example, introducing better patient education for TB treatment and monitoring whether adherence improves.
4. Contribute to the creation and dissemination of knowledge applicable to health care #
4.1 Demonstrate an understanding of the scientific principles of research and the role of evidence and research in health care #
Students should understand basic research principles and how evidence improves care. This helps them critically evaluate information and apply it appropriately.
4.2 Identify ethical principles for research and incorporate them into obtaining informed consent, while considering potential harms, benefits and needs of vulnerable populations #
Students must ensure that any research or data collection respects patient rights, especially in vulnerable populations affected by conflict, poverty, or displacement.
4.3 Pose questions for inquiry, select methods to address them and share results #
Students should ask practical questions about their environment—such as why certain diseases are common—and explore ways to study and address them, even through simple observations or audits.
4.4 Communicate findings of relevant research and scholarly research to peers, other health professionals, communities, patients and families #
Students should translate medical knowledge into understandable information for different audiences. For example, explaining disease prevention strategies to communities in simple terms.
4.5 Generate original scholarly work for dissemination to broad or specific communities #
Students can contribute by documenting cases, identifying trends, or creating educational materials. Even small contributions—like community education programs or local audits—can have significant impact in improving healthcare.