Introduction
Dr. Naglaa Atiah, an Egyptian professional based in Jeddah, Saudi Arabia, brings a rich and diverse background in healthcare and medical education. She began her career as a pharmacist in 2003, working in outpatient pharmacy, before transitioning into academia in 2005 as a pharmacy instructor and Head of Department in health science institutes. Over the years, she taught a wide range of subjects including pharmacology, physiology, and medical terminology, while also supervising field training in both outpatient and inpatient settings. In 2012, she advanced into the role of Medical Education Supervisor at IMC Academy, where she worked closely with national and international accreditation bodies such as the Saudi Commission for Healthcare Specialties and the Society of Critical Care Medicine. Her role involved designing, managing, and evaluating medical learning journeys, and later expanded into project and learning facilitation in 2022. Experiencing the FIRSTmed-ADLX framework influenced her approach toward designing learner-centered, impactful Learner eXperiences.
The need to design a Basic Surgical Skills learning journey emerged from the necessity to enhance the practical competencies of medical students, ensuring that learning goes beyond theoretical knowledge and leads to real performance. Traditional training approaches were not sufficiently focused on sustained engagement or deep skill acquisition, which highlighted the need for a more structured and learner-centered framework.
The participants were medical students in Jeddah, Saudi Arabia, aged between 20 and 25, including both male and female participants. These participants were in a critical stage of their medical education, requiring hands-on practice and active engagement to build confidence and competence in surgical skills. The learning environment emphasized practical sessions, with a clear focus on enabling participants to practice repeatedly and develop their skills in a supportive and structured setting.
eXperience Design and Sequence of Activities
The FIRSTmed-ADLX framework was chosen because it provides a comprehensive structure that ensures the learning journey is learner-centered, interactive, and performance-oriented. It supports the designer in considering the participants’ needs, building trust, and maintaining engagement while ensuring that learning leads to real application. The framework aligned well with the goal of designing a learning journey that emphasizes practice, continuous engagement, and meaningful learning outcomes.
Learning Outcomes
- Attitude:
To value continuous practice and active participation in developing surgical skills.
To appreciate the importance of precision and responsibility in clinical practice. - Skills:
To practice basic surgical skills with increasing confidence.
To engage in peer interaction and collaborative learning processes. - Knowledge:
To identify key concepts related to basic surgical procedures.
To recall essential principles required for safe surgical practice.
The learning journey was designed as a series of learning sessions focused primarily on practical application. The sessions were conducted in a face-to-face format, with a strong emphasis on hands-on practice to achieve the intended performance outcomes. The sequence of activities was structured to maintain continuous engagement, ensuring that participants remained active throughout the journey. Activities were selected carefully to match the participants’ needs, respect their level of experience, and maintain a balance between engagement and skill development. Cooperative learning strategies such as Think–Pair–Share were used to enhance interaction, alongside energizers to sustain motivation and attention. The overall flow of the journey ensured that participants moved progressively toward achieving the desired performance outcomes through repeated practice and active participation.
One Learning Activity Using RAR Model
For the Readiness Increase Stage, participants were invited to engage in a practical learning activity where they practiced surgical skills while interacting with peers and receiving continuous support. At the beginning of the activity, the environment was carefully prepared, with clear instructions provided and the setup organized to ensure that participants were ready to engage. This preparation helped participants feel comfortable and focused, allowing them to fully immerse themselves in the experience.
During the Activity Facilitation, participants actively practiced the required skills while being observed and supported. The facilitator maintained engagement by monitoring performance, motivating learners, and encouraging participation. Interaction was sustained through peer collaboration and continuous guidance, ensuring that all participants remained involved and supported throughout the process.
For the Reviewing Actively Stage, participants were guided to reflect on their experience. They explored what they had practiced and how they performed, then considered the importance of these skills in their future medical practice. This reflection helped them recognize the relevance of what they learned and how it connects to real clinical situations. Finally, they identified how they would continue practicing and improving these skills in future settings, reinforcing the transfer of learning beyond the session.
FIRSTmed-ADLX Framework Domains in Action
F – Focusing on Learner Behaviors
The experience was designed with a strong focus on understanding the participants’ backgrounds and needs. The facilitator made intentional efforts to know the participants’ previous experiences and create a personalized learning environment by addressing them by name and maintaining direct communication. Participants were given opportunities to participate actively and even facilitate parts of the experience, reflecting trust in their abilities. Continuous questioning and attentive listening ensured that participants’ voices were heard, while also allowing the facilitator to assess their progress and engagement.
I – Interacting within Positive Group Dynamics
The learning environment was structured as a collaborative and supportive space where participants engaged in cooperative learning strategies such as Think–Pair–Share. Positive and constructive feedback was consistently used to encourage participation and build confidence. Energizers were incorporated to maintain energy levels and create a positive atmosphere, ensuring that participants remained motivated and attentive throughout the sessions.
R – Reviewing Activities within RAR Model
The RAR model was applied consistently throughout the learning journey. Participants were prepared for each activity through clear instructions and proper setup, ensuring readiness. During activities, the facilitator actively monitored and supported learners, maintaining engagement and focus. Reflection was integrated by asking questions and encouraging learners to think about their experience, allowing them to deepen their understanding and connect learning to practice.
S – Sequencing within Learner eXperience
The learning journey was carefully structured to ensure a logical flow of activities that maintained engagement throughout. Activities were sequenced to align with the participants’ needs and the intended outcomes, with a strong emphasis on continuous engagement. The design ensured that learners remained actively involved from the beginning to the end of the journey, with smooth transitions and a clear progression toward skill mastery.
T – Transforming Learning into Performance
The course emphasized practical application, ensuring that participants continuously practiced the skills they were learning. This focus on practice allowed participants to move from learning to actual performance. The experience also contributed to empowering learners and supporting organizational performance objectives by developing competent and confident practitioners. Reflection on practice and continuous engagement supported the sustainability of learning beyond the learning sessions.
Conclusion
The implementation of the FIRSTmed-ADLX framework had a positive impact on both the participants and the facilitator. Participants experienced highly engaging and productive sessions, with a strong focus on practical application that supported the development of their surgical skills. Feedback from participants reflected appreciation for the quality of the training, while also highlighting a desire for extended practice time and additional resources to further support their learning.
For the facilitator, the experience reinforced the importance of designing learner-centered learning journeys that focuses on performance outcomes. The framework supported the creation of a structured yet flexible learning journey that enhanced engagement and effectiveness. The reflection on the pilot highlighted the success of the approach, while also identifying areas for improvement.
Overall, the course demonstrated how the FIRSTmed-ADLX framework can support the design of impactful, engaging, and performance-oriented medical learning journeys.