Автор неизвестен - Mededworld and amee 2013 conference connect - страница 105

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Background: The training of postgraduate medical program managers (PGPM) is essential for the proper development of their programs. The aim of this study was to identify the main training needs of PGPM at the Pontificia Universidad Catolica de Chile Medical School

(PUCMS).

Summary of work: A mixed-methodology approach was implemented including focus group/interviews and the administration of the Program Managers Training Needs Assessment Questionnaire (PROMANAQ) developed by an expert panel with 59 items (two sections: relevance/performance-self-perception). Higher priority was assigned to items with high relevance and low performance.

Summary of results: Forty five PGPM completed the PROMANAQ (84.9% response rate). Both sections of PROMANAQ were highly reliable (Cronbach alpha of 0.95/0.974 for relevance/performance-self-perception, respectively). The items with higher priority value were evaluation of clinical educators, evaluation of teaching programs and accreditation of programs. Ten PGPM were included in the focus group (18.9% of the universe) and findings of the qualitative component were concordant with the areas explored in the questionnaire.

Conclusions: Qualitative and quantitative research offer complementary information. PGPM actively participated in both activities reflecting their interest in having a voice regarding their needs for further training. The PROMANAQ is valid and reliable to identify the training needs of PGPM and it could be helpful for faculty development in postgraduate programs in different specialties.

Take-home messages: The views of PGPM must be taken into account for faculty development planning. The PROMANAQ can be considered as a good instrument to use in faculty development initiatives.

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

8EE/14

Inter-professional learning communities of practice as a collaborative platform for faculty development among clinical teachers

Jer-Chia Tsai (Kaohsiung Medical University Hospital,

College of Medicine, Kaohsiung Medical University,

Department of Internal Medicine, 100 Shih-Chuan First

Road, Kaohsiung 807, Taiwan

Jo-Chu Yen (Kaohsiung Medical University Hospital,

Kaohsiung Medical University, Department of Clinical

Education and Training, Kaohsiung, Taiwan)

Yung-Yun Chang (Kaohsiung Medical University Hospital,

Kaohsiung Medical University, Department of Internal

Medicine, Kaohsiung, Taiwan)

Cheng-Yuan Wang (Kaohsiung Medical University

Hospital, Kaohsiung Medical University, Department of

Internal Medicine, Kaohsiung, Taiwan)

Yu-Chih Lin (Kaohsiung Medical University Hospital,

Kaohsiung Medical University, Department of Internal

Medicine, Kaohsiung, Taiwan)

Jeng-Hsien Yen (Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Department of Internal Medicine, Kaohsiung, Taiwan)

Background: Peer learning based on the concept of community of practice has been proposed as a new approach for faculty development. The aims of this study are (1) to investigate whether the community of practice model is feasible to encourage inter­professional peer learning and practice among clinical teachers, and (2) to analyze the characteristics of participants and the themes of health and educational issues among these projects.

Summary of work: From Jan. 2012 to Jan. 2013, Center for Faculty Development at Kaohsiung Medical University Hospital in Taiwan called for projects to invite inter-professional clinical teachers across different departments to form the learning communities of practice focusing on general medicine, clinical teaching, and personal development. Data analysis was performed based on the collections of proposals and reports.

Summary of results: Totally 574 of clinical teachers self-organized 58 projects of learning communities of practice. The majorities were physicians (35.7%), nurses (30.0%), laboratory technicians (30.0%), pharmacists (6.6%), and other health professionals (27.7%). Each team encompassed 2 to 5 disciplines of health professionals. First theme of general medicine included 24 projects (41.4%) on health quality, patient safety, infection control, medical communication, evidence-based medicine, and palliative care. Second theme of clinical teaching included 18 projects (31.0%) on teaching methods, assessment, course design, and teaching resource development. Third theme of personal development included 16 projects (27.6%) on research expertise, humanities, leadership, and career development.

Conclusions: Learning communities of practice have created a platform to promote peer learning among inter-professional clinical teachers.

Take-home messages: Inter-professional learning communities of practice provide a collaborative approach for faculty development.

8EE/15

The development and evaluation of the nursing preceptor's advanced teaching training program in Taiwan

Ling Shaw Fu (Taipei Veterans General Hospital, Nursing Department, No. 201, Shih-Pai Road, Sec. 2, Taipei 11217, Taiwan)

Background: The purpose of this study is to develop and evaluate the effects of an advanced teaching training program on the clinical nursing preceptors in Taiwan. Summary of work: A single-blind quasi-experimental pretest-posttest design was used. A total sample size of 60 preceptors (including OR, PACU, ER, Surgical and medical nurses) and their one to one preceptee the novice nurses were chosen from a medical center in Taipei, Taiwan from March. 1, to Jul. 31, 2011. The preceptors were divided randomly into an experimental group and a control group, which was consisted of 35 subjects and 25 subjects accordingly. The advanced teaching training program, which is a 3 times Objective Structured Teaching Exercise ( OSTE ) workshop, everytime the workshop including a 120-minutes 1-minute preceptor ( OMP) lecture and feedback discussion. Data were collected by pre and post OSTE evaluation and subjective structured questionnaires devised by the researchers, included a preceptor's self-evaluation questionnaire on teaching skill, and a novice nurse's self-evaluation to assess the benefit of the preceptor's teaching (Fig. 1). The data were analyzed by SPSS 19.0.

Summary of results: The results were as follows: The OSTE posttest and self-evaluation score of the experimental group were significant higher than the control group analysed by Generalized estimation equation (GEE). However, their preceptee the novice nurse's self-evaluation assessed the benefit of the preceptor's teaching did not make a difference between two groups.

Conclusions: The results show the advanced teaching training program in this study could enhance the teaching competency of the nursing preceptors. Take-home messages: The advanced teaching training program, including 1-minute preceptor (OMP) lecture, giving feedback, discussion and the Objective Structured Teaching Exercise (OSTE) may effective promote the teaching competency of the nursing preceptors in Taiwan.

8EE/16

E-portfolios - suggestions for successful implementation based on a survey of user experiences

Abbas Ghavam-Rassoul (St. Michael's Hospital, University of Toronto, Family and Community Medicine, 410 Sherbourne St., Toronto M4X1K2, Canada)

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

Shirley Lee (Mt. Sinai Hospital, University of Toronto,

Family and Community Medicine, Toronto, Canada)

Susanna Talarico (Hospital for Sick Children, University of

Toronto, Pediatrics, Toronto, Canada)

Helen Batty (Women's College Hospital, University of

Toronto, Family and Community Medicine, Toronto,

Canada)

Background: Use of portfolios in general and E-portfolios specifically have continued to expand in health professions education. Portfolios provide an opportunity for learners to document and reflect on their learning. Our faculty development program requires a fieldwork practicum of specific activities. These experiences are documented in an "E-portfolio" which is assessed by program preceptors. Learners are permitted to use an E-portfolio platform of their choice. Summary of work: To explore learner and faculty experiences in creating an "E portfolio", 60 graduates of our fieldwork practicum were surveyed by e-mail using a 10 item questionnaire consisting of open and closed ended questions. Research ethics approval was received in August 2012. Participants were asked about their experiences in creating portfolios. Summary of results: In general learners were able to use the platform of their choice without great difficulty. User friendliness, ease of use and adaptability of platforms were appreciated by participants. On the other hand participants disliked platforms that were time consuming to build and not adaptable. Concerns about privacy of information were raised about publically available platforms. Conclusions: Our program provided a real-life test of various platforms for learners to use to document their learning. Overall usability of the platform and adaptability were the most important factors in determining which portfolio platform was selected. Learners highlighted the learning curve in using a new platform and the importance of peer coaching and IT support.

Take-home messages: Our study demonstrates that it is possible to successfully implement an e-portfolio in a faculty development program and identifies areas where learners and faculty will need support.

8EE/17

Inspiring to follow Langdell's steps in an on-line faculty development course

Diana P Montemayor-Flores (Universidad Autonoma de Nuevo Leon, Physiology, Amazonas 217 oriente, col del Valle, San Pedro Garza Garcia 66220, Mexico Nancy E Fernandez-Garza (Universidad Autonoma de Nuevo Leon, Physiology, Monterrey, Nuevo Leon, Mexico)

Santos Guzman-Lopez (Universidad Autonoma de Nuevo Leon, Anatomy, Monterrey, Nuevo Leon, Mexico)

Background: At the end of the nineteen-century, Christopher Langdell introduced the Case Method in Harvard Law School. He believed that the most important intellectual activity is the study of real

situations in order to obtain own conclusions. He compiled his own Selection of Cases on the Law of Contracts and proposed the Socratic Method as a tool to ask questions and discuss facts and points of conflict. Summary of work: We design an on-line Faculty Development Course in order to invite our Basic Science professors to be inspired by Langdell, and design their courses based on a Selection of Cases instead of using lectures and memory training.

Summary of results: The experience of design cases as an instructional tool reaffirms the importance of teaching Basic Sciences in Clinical Scenarios using theoretical information in solving problems. The course participants took part in discussion forums and designing cases according with their academic programs. At the end of the course they uploaded evidences of their own experiences using cases and had a portfolios with their own Selection of Cases Conclusions: It's possible to teach Basic Sciences using a Selection of Cases.

Take-home messages: Cases are an ideal tool for medical professors and students.

8EE/18

Microteaching is a method of learning skills of teaching: Basic workshop by web based learning

R K Mishra (SMS Medical College, Microbiology, Jln

Marg, Jaipur 302017, India)

Lokendra Kumar Sharma (SMS Medical College,

Pharmacology, Jaipur, India)

R K Maheshwari (SMS Medical College, Microbiology,

Jaipur, India)

Background: Microteaching was devised by Allan on

1963

Microteaching is a method of learning skills of teaching. A trainee teacher can learn and master various teaching skills by this method whereas an experienced teacher can master his preexisting skills of teaching microteaching in a short session of teaching by a trainee teacher for a period of 5-7 minutes. The audience is a peer group who carefully observes the session and provide feedback to the trainee teacher at the end of the session. The cycle repeats till a satisfactory level is achieved.

Summary of work: To acquaint the medical teacher with this technique of microteaching and seek result and feedback on these experiences after being equipped with the technique. Workshops were conducted for medical teachers from junior middle level faculty under the auspices of the Medical Education Unit of SMS Medical College Jaipur.

Summary of results: An online feedback from trainees obtained a very positive reaction as the trainee teacher not only gained confidence in their teaching but also improved performance during classroom teaching. About 63 % of participants of the workshop responded to show positive improvement.

Conclusions: Despite the fact that medical teachers have acquired senior positions in their institutions, they have never been trained as teachers. Hence, the

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

shortcomings in their teaching skills persist throughout their carrier. They found microteaching an important tool for arming their teaching skills towards betterment of their teaching capabilities and the teaching programme in the medical college as a whole. The results are obvious with a strong positive note. Take-home messages: Microteaching is an important tool for arming their teaching skills towards betterment of their teaching capabilities and this can be added by web based learning.

8EE/19

The influence of residents' characteristics on their perception of faculty's teaching performance

SS Lases (Academic Medical Center, Professional Performance Research Group, Center for Evidence-Based Education, Meibergdreef 9, Amsterdam 1100 DD, Netherlands)

ORC Busch (Academic Medical Center, Department of

Surgery, Amsterdam, Netherlands)

MJ Heineman (Academic Medical Center, Board of

Directors/Professional Performance Research Group,

Center for Evidence-Based Education, Amsterdam,

Netherlands)

EGJM Pierik (Isala Klinieken, Department of Surgery, Zwolle, Netherlands)

E Heineman (University Medical Center Groningen, Department of Surgery, Groningen, Netherlands) MJMH Lombarts (Academic Medical Center, Professional Performance Research Group, Center for Evidence-Based Education, Amsterdam, Netherlands)

Background: In ensuring high quality residency training, residents' evaluations are widely used to assess faculty's teaching performance (TP). In this study we aim to evaluate the influence of residents' characteristics on their perception of faculty's TP. Residents' ratings of faculty's TP are collected using the well researched System for Evaluation of Teaching Quality (SETQ). Summary of work: From September 2012 to February 2013 a multicentre questionnaire study amongst 271 surgery and gynaecology residents was performed. In addition to completing the SETQ evaluations for faculty, residents were invited to fill out 4 standardized measures of work engagement, physician empathy, job satisfaction and specialty satisfaction. Analysis included (i) Pearsons' correlations coefficients and (ii) multiple linear regression to assess the associations between the 4 measures and faculty's total TP scores. Models correcting for TP score ranking will be presented. Summary of results: 204 (75.3%) residents completed the SETQ evaluations; 145 (53.5%) residents returned the engagement, empathy and satisfaction measures, and 129 (47.6%) residents completed all measures. There was a significant correlation between TP sumscores and residents' engagement (r=0.206; p=0.020), empathy (r=0.181; p=0.044) and job satisfaction scores (r=0.227; p=0.010). No significant correlation between TP and specialty satisfaction was measured. Higher levels of residents' empathy were associated with higher faculty's TP scores (beta=0.187;

p=0.034). There was no significant association between residents' job engagement or job satisfaction and TP scores.

Conclusions: When assessing faculty's teaching performance it is important to keep in mind that residents' empathy could be an influencing factor in their perception of faculty's performance.

8FF ePosters: Postgraduate Education 1

Location: North Hall, PCC 8FF/1

Can a multi-faceted programme of education improve prescribing and error reporting among Irish junior doctors?

Terence Smeaton (Royal College of Surgeons in Ireland, School of Pharmacy, 50 Quigley Park, Rathdowney Laois, Ireland)

Tom Branigan (Royal College of Surgeons in Ireland,

School of Medicine, Dublin, Ireland)

Muirne Spooner (Royal College of Surgeons in Ireland,

School of Medicine, Dublin, Ireland)

Judith Strawbridge (Royal College of Surgeons in Ireland,

School of Pharmacy, Dublin, Ireland)

Anne Marie Cushen (Beaumont Hospital, Integrated

Quality and Safety, Dublin, Ireland)

Gerry McElvaney (Royal College of Surgeons in Ireland,

School of Medicine, Dublin, Ireland)

Background: Medication errors can cause significant morbidity and mortality. Studies indicate that prescribing among junior doctors is sub-optimal and prone to error; however serious errors are often grossly under-reported by this cohort of prescribers. Summary of work: This study examined the prescribing of cardiovascular, anti-microbial, anti-psychotic, analgesic, anti-coagulant and hypoglycaemic agents by junior doctors in a national tertiary referral centre. Reportable errors were cross-referenced with the Medication Safety Coordinator to determine reporting compliance. A multi-faceted intervention strategy is being developed, based on the results, and will be delivered to prescribers. It will encompass feedback of the audit data, online tutorials, facilitated remediation and supervised prescribing. A re-audit will be performed to assess the impact of this intervention. Summary of results: 62% of medication orders (n=1569) contained at least one error. Technical errors in prescription writing were more common than errors in clinical judgement (90% vs. 10%). Cardiovascular drugs, analgesics and anti-microbials were most commonly implicated in error. 27 (1.72%, n=1593) reportable errors were detected, of which none were reported at time of analysis.

Conclusions: Junior doctors are our most frequent prescribers, and make errors regularly when prescribing, most commonly in the physical act of writing a prescription. Error reporting is poor. The planned intervention will educate junior doctors on human error theory, good prescription writing practices, the importance of documentation and the hospital's error reporting system. Re-audit will demonstrate if this proactive educational programme can improve prescribing and error reporting among junior doctors. Take-home messages: A multi-faceted educational intervention may improve prescribing and error reporting among junior doctors.

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

8FF/2

Better Training, Better Care: Changing the model of working to improve training and support for trainees and quality of care for patients

B Prathibha (East Kent Hospitals University NHS Foundation Trust, Directorate of Medical Education, Kennington Road, Willesborough, Ashford TN26 1HX, United Kingdom

S Kennedy (East Kent Hospitals University NHS Foundation Trust, Directorate of Medical Education, Ashford, United Kingdom) M Batchelor (East Kent Hospitals University NHS Foundation Trust, Directorate of Medical Education, Ashford, United Kingdom)

J Toms (East Kent Hospitals University NHS Foundation Trust, Directorate of Medical Education, Ashford, United Kingdom)

Background: Health Education England has sponsored East Kent Hospitals University NHS Foundation Trust as part of HEE's Better Training Better Care Project. EKHUFT's project has been to redesign the medical model of working.

Summary of work: The model was redesigned to give all trainees experience of 'hot' spells of emergency work and 'cold' spells of working on the wards. In addition, a multiprofessional weekend team was created to support the F1 doctor on the wards and ensure that the 'hot team' can focus on the admissions. This 'cold' weekend team consists of a medical registrar, a senior nurse and a healthcare assistant, in addition to the pre-existing F1 doctor.

Summary of results: Both quantitative and qualitative data show: Enhanced training opportunities; Improved handover; Improved supervision; Enhanced and consolidated learning around both the acutely ill and the stabilised patient; Timely and effective review of patients; Trends towards reduced length of stay, greater numbers of discharges, improved mortality rates - at weekends.

Conclusions: In addition to enhanced training and patient care, it was important to demonstrate cost-effectiveness to ensure sustainability and replicability. This pilot shows evidence of improvements to both training and patient care with the latter projecting potential savings.

Take-home messages: Separating emergency and ward working with a carefully designed model, enhances trainee experience and improves patient care.

8FF/3

The end of the surgical F1 - a justifiable proposition?

Charlotte Thomas (University Hospital of Wales, Department of Upper GI Surgery, Cardiff, United Kingdom)

Paul Blake (University Hospital of Wales, Department of Upper GI Surgery, Heath Park, Cardiff CF14 4XW, United Kingdom)

Areej Al-Maskari (Cardiff University, Cardiff, United Kingdom)

Alex Karran (University Hospital of Wales, Department of Upper GI Surgery, Cardiff, United Kingdom) Wyn Lewis (University Hospital of Wales, Department of Upper GI Surgery, Cardiff, United Kingdom)

Background: Surgical Foundation posts are under threat from plans to convert significant numbers into primary care in an effort to improve the educational experience offered. The aim of this study was to gather opinion from foundation doctors, to determine the contemporary educational value related to subspecialty interest.

Summary of work: One hundred and three F1 doctors working across a spectrum of surgical specialties in a single UK postgraduate deanery completed anonymous questionnaires related to their overall educational experience.

Summary of results: Seventy-six percent reported their overall experience was positive or strongly positive; 95% considered themselves adequately or excellently supported by their immediate senior, and 93% by both their SpRs and Consultants. Experience of elective surgical admissions was modest, but 91% of doctors clerked on average more than >5 emergency patients per week, and 78% gained operating theatre exposure. Procedural skills were also gained (86% performing ABGs, 73% suturing, and 57% performing minor surgery). Scholarly activity and academic interests were also well supported, with 88% reporting the opportunity to participate in audit projects or research. In contrast 45% of doctors were of the opinion that there was too little formal teaching provided. Opinion on EWTD was divided, with 68% in support of the restrictions. There were no significant differences in educational experiences relative to surgical specialty interest (p=0.98), and 91% would recommend their job to a final year student.

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