BACKGROUND: Aimed at bridging the gap in continuing medical education (CME) resource availability in low- and middle-income countries (LMICs), the \"Continuing Medical Education on Stick\" (CMES) program introduces two technological solutions: a universal serial bus (USB) drive and the CMES-Pi computer facilitating access to monthly updated CME content without data cost. Feedback from users suggests a lack of content on tropical infectious diseases (IDs) and content from a Western perspective, which may be less relevant in LMIC settings.
METHODS: This quality improvement project was intended to identify areas for improvement of the CMES database to better meet the educational needs of users. We compared the CMES content with the American Board of Emergency Medicine (ABEM) Exam content outline to identify gaps. The curriculum map of the CMES library, encompassing content from 2019 to 2024, was reviewed. An anonymous survey was conducted among 47 global users to gather feedback on unmet educational needs and suggestions for content improvements. All healthcare workers who were members of the CMES WhatsApp group were eligible to participate in the survey.
RESULTS: The curriculum map included 2,572 items categorized into 23 areas. The comparison with the ABEM outline identified gaps in several clinical areas, including procedures, traumatic disorders, and geriatrics, which were represented -5%, -5%, and -4% in the CMES library compared with the ABEM outline, respectively. Free responses from users highlighted a lack of content on practical skills, such as electrocardiogram (ECG) interpretation and management of tropical diseases. Respondents identified emergency medical services (EMS)/prehospital care (81%), diagnostic imaging (62%), and toxicology/pharmacology (40%) as the most beneficial areas for clinical practice. In response to feedback from users, new content was added to the CMES platform on the management of sickle cell disease and dermatologic conditions in darkly pigmented skin. Furthermore, a targeted podcast series called \"ID for Users of the CMES Program (ID4U)\" has been launched, focusing on tropical and locally relevant ID, with episodes now being integrated into the CMES platform.
CONCLUSIONS: The project pinpointed critical gaps in emergency medicine (EM) content pertinent to LMICs and led to targeted enhancements in the CMES library. Ongoing updates will focus on including more prehospital medicine, diagnostic imaging, and toxicology content. Further engagement with users and education on utilizing the CMES platform will be implemented to maximize its educational impact. Future adaptations will consider local relevance over the ABEM curriculum to better serve the diverse needs of global users.

Introduction Traditional classroom teaching involves a process where knowledge is disseminated to students by the teachers through a one-way process. Such a learning environment makes students passive and muted, which can be improved by alternative teaching and learning (TL) methods like the flipped classroom (FC) technique. The FC approach involves a student-inclusive TL process. FC is a student-centered approach that benefits teachers and students by emphasizing the key information during the learning process. The present study aimed to understand the efficacy of the FC TL method and evaluate students\' perception of FC among underachieving first-year medical students in learning physiology. Methods This prospective, descriptive, and cross-sectional study was conducted on 100 underachieving first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students in the Department of Physiology at a tertiary care teaching hospital. All the participants were taught cardiovascular physiology through the FC method. The study subjects were asked to take a pretest including multiple choice questions a week before the study. The study period was four weeks, following which the students were asked to take a post-test. A questionnaire was used to understand the student\'s perception of FC. The responses to the questionnaire were graded based on the Likert scale.  Results The mean scores of the post-test (19.40±4.22) were significantly (p< 0.05) greater than those of the pre-test (12.43±4.26). Regarding the perception of FC, 68% (68/100) of students agreed that the objectives, methodology, and outcomes were well-defined. Around 39% (39/100) of students strongly agreed that the study material was adequate, relevant, and easy to learn. Nearly 58% (58/100) of the students agreed that the competencies are dealt with completely in every session. Roughly 16% (16/100) of students agreed that the classroom time is sufficiently utilized for peer-based learning. Many (61%, 61/100) students agreed that sufficient time was given for learning. About 34% (34/100) of the students strongly agreed that the assessment tools were relevant. About 56% (56/100) of students agreed and 21% (21/100) strongly agreed that the FC method helped them to improve their understanding of the subject. More than half (54%, 54/100) of the students agreed and 18% (18/100) strongly agreed that the FC promoted self-directed learning. Most students (71%, 71/100) believed FC to be an interesting and satisfactory learning experience. Conclusions The results indicate that most students believed FC was an effective and innovative TL technique. The FC method could help underachievers improve their cognitive skills and analytical thinking and enhance exam performance.