Growing demand for accountability, transparency, and efficiency in health professions education is expected to drive increased demand for, and use of, cost and value analyses. In this AMEE Guide, we introduce key concepts, methods, and literature that will enable novices in economics to conduct simple cost and value analyses, hold informed discussions with economic specialists, and undertake further learning on more advanced economic topics. The practical structure for conducting analyses provided in this guide will enable researchers to produce robust results that are meaningful and useful for improving educational practice. Key steps include defining the economic research question, identifying an appropriate economic study design, carefully identifying cost ingredients, quantifying, and pricing the ingredients consumed, and conducting sensitivity analyses to explore uncertainties in the results.

Health professions educators constantly make difficult choices about the allocation of finite resources. However, there is limited sound research available to guide their decision-making. The purpose of this study was to address this gap by establishing international consensus on research aims, considering diverse economic and cultural contexts. The authors conducted a three-round Delphi study, engaging an international panel of 73 experts in education research. Panelists were asked to identify (round 1), rank (round 2), and revise (round 3) research aims important for the study of cost and value in medical education. Round 3 results were discussed by an international steering group of nine medical education scientists actively involved in cost and value research, who finalized a list of 20 research aims. Steering group narratives were analyzed to identify additional conceptual insights. From 597 research aims suggested in round 1, 20 research aims were identified after steering group discussion. These were clustered into three categories: (1) funding mechanisms for medical education (e.g. financial policies, cost-effectiveness, and equity impacts); (2) cost and outcomes, e.g. how costs in health professions education relate to concrete outcomes; and (3) economic evaluation of teaching, assessment, and training approaches; e.g. designing and applying formal economic evaluation methods. Steering group discussions noted the limited integration of economic theories into medical education research and the need for foundational studies beyond immediate, practical priorities. They further noted lack of consensus on definitions of cost and value, and appropriate methodologies; underutilization of accepted health economics approaches; and infrequent interdisciplinary collaborations. These collectively act as barriers to advancing the field. The field of cost and value in health professions education remains theoretically and empirically underdeveloped. The research aims identified herein provide a strategic framework for addressing cost and value comprehensively.

Introduction: The medical school selection literature comes mostly from a few countries in the Global North and offers little opportunity to consider different ways of thinking and doing. Our aim, therefore, was to critically consider selection practices and their sociohistorical influences in our respective countries (Brazil, China, Singapore, South Africa and the UK), including how any perceived inequalities are addressed. Methods: This paper summarises many constructive dialogues grounded in the idea of he er butong ( 和而不同 ) (harmony with diversity), learning about and from each other. Results: Some practices were similar across the five countries, but there were differences in precise practices, attitudes and sociohistorical influences thereon. For example, in Brazil, South Africa and the UK, there is public and political acknowledgement that attainment is linked to systemic and social factors such as socio‐economic status and/or race. Selecting for medical school solely on prior attainment is recognised as unfair to less privileged societal groups. Conversely, selection via examination performance is seen as fair and promoting equality in China and Singapore, although the historical context underpinning this value differs across the two countries. The five countries differ in respect of their actions towards addressing inequality. Quotas are used to ensure the representation of certain groups in Brazil and regional representation in China. Quotas are illegal in the UK, and South Africa does not impose them, leading to the use of various, compensatory ‘workarounds’ to address inequality. Singapore does not take action to address inequality because all people are considered equal constitutionally. Discussion: In conclusion, medical school selection practices are firmly embedded in history, values, societal expectations and stakeholder beliefs, which vary by context. More comparisons, working from the position of acknowledging and respecting differences, would extend knowledge further and enable consideration of what permits and hinders change in different contexts.

This paper presents an energy-efficient 15.7-V-compliant current-mode stimulator with a proposed boost-based dynamic voltage supply that minimizes the stimulator’s voltage dropout. The boost uses a proposed 8-bit quantizer that measures the voltage ratio of its output to the input to digitally achieve the discontinuous conduction mode (DCM). A low-power high-voltage gate driver with a short switching transient time is proposed to improve energy efficiency. The converter achieves 90.2% peak efficiency, and up to 86% end-to-end energy efficiency is realized when a 6-mA biphasic stimulation is carried out. The stimulation IC is fabricated in 0.18 $\mu$m Bipolar-CMOS-DMOS (BCD) technology and occupies an area of 2.16 m$\mathrm{m}^{2}$. This stimulator consumes a low static power of 1.78 $\mu$W, promising battery-powered implants with a long lifetime and a small form factor.