Автор неизвестен - Mededworld and amee 2013 conference connect - страница 118

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Summary of results: The highest area of understanding 5th year medical students had was in Medication Safety (77%) with Safe Surgery (62.83%). The lowest area of understanding 5th year medical students had was in Patient Care Process (50.28%). In actual practice Emergency Response was highest (88%) and Patient Care Process was second (81.85%). The lowest implementation was in Infection Control aspect

(63.75%).

Conclusions: Fifth year medical students demonstrated the lowest understanding of patient safety following S I M P L E strategy in Emergency Response aspect but had lowest implementation in real-life practice in Infection Control aspect.

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First Practical Evaluation of Patient Safety knowledge in Internal Medicine Clerkship in a Private School of Medicine (UNINOVE): evaluation using a Brazilian Validated Questionnaire

Helbert Minuncio Pereira Gomes (Universidade Nove de Julho, Medicine, Rua Tagua, 305, apto 1808, Sao Paulo 01508010, Brazil)

Leonardo Carvalho Serigiolle (Universidade Nove de

Julho, Medicine, Sao Paulo, Brazil)

Thiago de Oliveira Monaco (Universidade Nove de Julho,

Medicine, Sao Paulo, Brazil)

Iolanda Calvo Tiberio (Universidade Nove de Julho,

Medicine, Sao Paulo, Brazil)

Cinthya Cosme Gutierrez Duran (Universidade Nove de Julho, Medicine, Sao Paulo, Brazil) Renata Mahfuz Daud-Gallotti (Universidade Nove de Julho, Medicine, Sao Paulo, Brazil)

Background: Patient Safety (PS) is considered an essential field during undergraduate medical education. Very little attention has been driven to incorporate educational strategies for acquisition, assessment and evaluation of knowledge retention of PS-competencies. Summary of work: Before introducing a PS Program in clerkship of UNINOVE School of Medicine, we decided to evaluate the previous knowledge of the students. We used a recently validated questionnaire that focus on human error theories, incidents and adverse events epidemiology and disclosure (Daud-Gallotti et al; CLINICS 2011). At the end of 2012, we applied during an

OSCE, a scenario exclusively related to error disclosure (ED) and physician-patient relationship (PPR). Summary of results: The students (n=118) presented an OSCE performance in the Patient Safety Station of 76.7±1,75%. Students' performance in ED was lower than in PPR issues, with respectively 68.59±2.11 and 84.81±1.91,(p<0.001). Only 49.57% of students apologize. Less than 53% recognized the facilitating situations for the error. As much as 45.3 assumed blaming attitudes. There was a significant correlation between the ED and PPR scores (R=0.55, p<0.001). Conclusions: Students presented a high performance in PPR issues. However, insufficient performance was observed in error recognition and disclosure. Take-home messages: Students had the opportunity to perform practical activities in wards, ambulatories and in the emergency setting and have high performance in the physician-patient relationship score as well as some previous knowledge of Patient Safety competencies. However, these Patient Safety contents need to be reinforced by a formal program, including discussion of real cases selected by the students.

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Health Literacy in Patient Safety: a Medical Students' Project

Yasmine Shafik (College of Medicine, King Abdulaziz University, Department of Anesthesia & Critical Care, P.O. Box 80215, Jeddah 21589, Saudi Arabia) Afnan Samman (College of Medicine, King Abdulaziz University, Department of Anesthesia & Critical Care, Jeddah, Saudi Arabia)

Rotana Hammad (College of Medicine, King Abdulaziz University, Department of Anesthesia & Critical Care, Jeddah, Saudi Arabia)

Reema Hakim (College of Medicine, King Abdulaziz University, Department of Anesthesia & Critical Care, Jeddah, Saudi Arabia)

Abeer Arab (College of Medicine, King Abdulaziz University, Department of Anesthesia & Critical Care, Jeddah, Saudi Arabia)

Background: Health literacy has become a common serious safety concern worldwide (Williams, et al. 1995). Studies from Saudi Arabia found that the population's level of awareness regarding common diseases was low (Aljoudi, et al. 2009). Furthermore, the methods used to deliver health related information are limited and lack appeal. Therefore, the aim of this project was to utilize novel and appealing media modalities such as radio stations and social media networks as portals to patient education and hence patient safety. Summary of work: As part of the Patient Safety Module, a mandatory course for final year medical students at King Abdulaziz University, we brainstormed ideas for multiple radio advertisement sketches of which the best four were chosen to be executed. Colorectal cancer, breast cancer, and hypertension were addressed. The advertisements were designed to consist of two parts, an attractive scenario, followed by two to three sentences of simple narration about the desired disease.

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

The ads would then conclude with our motto (Awareness: Your Right, Our Duty) and reference to a Facebook page for further detailed reading. Afterwards, we prepared a budget proposal, gained sponsorship for producing the ads, and are currently working on the airing process. On the long run, we mainly aim for the project to be adopted nationally in order to ensure continuity and expansion, therefore, reflecting positively on the overall health literacy and on the quality of patient safety.

Conclusions: Small curriculum projects can blossom into altruistic services to the community with adequate nurturing.

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Mapping the Canadian Patient Safety Competencies to residency rotational objectives: the process, strengths and gaps

Andrea Hunter (McMaster University, Pediatrics, Hamilton, Canada)

Heather Bhan (McMaster University, Pediatrics, 51-100 Beddoe Dr., Hamilton L8P4Z2, Canada) Moyez Ladhani (McMaster University, Pediatrics, Hamilton, Canada)

Jonathan Gilleland (McMaster University, Pediatrics, Hamilton, Canada)

Pierrette Leonard (Canadian Patient Safety Institute, Canadian Patient Safety Institute, Ottawa, Canada) Nancy Winslade (McGill University, Pharmacy, Montreal, Canada)

Background: The Canadian Patient Safety Institute (CPSI) Safety Competencies (SC) are addressed in varying degrees within pediatric residency programs to create physicians who practice in a culture of patient safety. Through mapping to the CPSI SC, the strengths and gaps of the program's safety curriculum could be identified. Summary of work: Pediatric resident evaluation criteria for rotations and CanMEDS courses were mapped to the SC using software developed by CPSI. Educational sessions were not included as they do not include evaluation criteria.

Summary of results: 20 rotations were mapped over two days. Within the program there was strong emphasis on SC related to communication with team members, patient advocacy, and team collaboration. Gaps included patient safety core theories, defining and reporting adverse events and identifying safeguards in prescription writing. Mapping the evaluation criteria highlighted areas within the CPSI SC that are not assessed within our residency program; however, some of the gaps identified are taught in the educational sessions, but not specifically evaluated. Conclusions: Through mapping to the CPSI SC, strengths and gaps of resident assessment were identified. Inclusion of content taught in educational sessions is needed to comprehensively assess the completeness of the residency program safety curriculum. This mapping process may be helpful in analyzing residency program curriculum and assessment for other objectives, such as

CanMEDS.

Take-home messages: Mapping to the CPSI safety competencies can help identify strengths and gaps in residency safety curriculum and evaluation.

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Patient Safety: Knowledge and Attitude in Undergraduate Medical Students

MA Cuadrado Cenzual (Complutense University (UCM), Medicine, Madrid, Spain)

LR Collado Yurrita (Complutense University (UCM), Medicine, Madrid, Spain)

JA de Pedro Moro (Medicine University (USAL), Surgery, Madrid, Spain)

Background: Patient safety has emerged as an essential health care discipline and needs to be directed at future generations of health care practitioners. New educational programs for medical students about patient safety are required. The study aimed to assess medical students through the development of a questionnaire designed to measure the knowledge, attitudes and feelings relating to patient safety. Summary of work: A questionnaire was conducted on 1,2,5,6, Year medical students of Spanish Universities Madrid (UCM), Salamanca (USAL). The questionnaire included 33 patient safety items grouped in four sections: 1. Knowledge 2. Feelings about making errors. 3. Attitudes to patient safety 4. Safety in the workplace. Responses were graded (0=strongly disagree, 1=disagree, 2=neutral, 3=agree, 4= strongly agree). t-test was applied for differences in the mean scores between the two cohorts of Year 1,2 (cohort 1) and 5,6 Year (cohort 2) medical students. Summary of results: The questionnaire was conducted in October-December of 2012, involving 489 (Cohort 1) and 363 (cohort 2) medical students. There were significant differences in mean scores between the two cohorts in all sections: Knowledge of error and patient safety, P < 0.001. Section 2: First year students scored highest on average on the scale Feelings about making errors (cohort 1: mean = 3.9, cohort 2 mean = 3.1). Attitudes to patient safety: 86% of the students in two cohorts responded in a positive way (mean 3.2). Conclusions: Patient Safety Questionnaire is a valid instrument to assess the knowledge, feelings and attitudes of medical students to patient safety and medical error.

9CC Posters: Assessment: Clinical and

Work Based

Location: South Hall, PCC

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Does medical students' clinical performance affect their actual performance in medical internship?

Eui Ryoung Han (Chonnam National University Hospital, Office of Education and Research, 42 Jebong-ro, Dong-gu, Gwang-Ju 501-757, Korea, Republic of (South Korea)) Sun A Oh (Gwangju University, Center for Teaching and Learning, Gwang-Ju, Korea, Republic of (South Korea)) Eun Kyung Chung (Chonnam National University Medical School, Medical Education, Gwang-Ju, Korea, Republic of (South Korea))

Background: This study examined how medical students' clinical performance affected their actual performance as doctors.

Summary of work: The study subjects were 90 interns being trained at Chonnam National University Hospital, South Korea, 2012. We analyzed the relationship between interns' performance during 1-year medical internship and their clinical performance by the Clinical Performance Examination (CPX) and Objective Structured Clinical Examination (OSCE) in 4th-year of medical school. Interns' performance was evaluated by the faculties of each department periodically. CPX consisted of history taking, physical examination, patient education and counselling, and patient-physician interactions. OSCE was the test for technical skills on simulated patients or manikins. Summary of results: Intern performance was significantly positively correlated with student performance; clinical skills, patient-physician interactions, and technical skills. After stratifying intern performance scores into quartiles, patient-physician interaction scores in the top quartiles of intern performance were significantly higher than in the bottom two quartiles of intern performance. Conclusions: To foster competent doctors, medical students should practice developing good clinical performance through patient encounters or simulated manikins.

Take-home messages: Students' performance was related to their clinical performance as doctors.

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Validation of a clinical examination for Internationally Educated Nurses (IENs)

Debra Sibbald (CEHPEA (Centre for the Evaluation of Health Professionals Educated Abroad), Assessment Services, 80 BloorSt. W., Suite 902, Toronto M5S 2V1, Canada)

Background: This pilot tested the feasibility of an OSCE to screen IENs for eligibility to write the Canadian

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

Registered Nursing Examination (CRNE) by validating the scores generated.

Summary of work: 72 participants, 34 IENs and 2 controls (23 RNs, 17 students) were rated by 50 examiners in a 12 station OSCE (4 tracks am / pm). Summary of results: Valid cases were developed by content experts conforming to an Entry-to-Practice competency blueprint. Trained examiners rated the performance of items highly, pre and post OSCE, with tools validating content and competency scoring schemes. Validation: OSCE station and total test score psychometrics were acceptable. Total test score a-reliability was 0.904, which is higher than values reported with similar tests. Test results discriminated performance between and within three groups of candidates, IEN vs. 2 controls (construct validity). There were no significant track and/or session effects. Conclusions: The test performed exceptionally well in terms of the psychometric quality of results, and its ability to differentiate between and within the candidates with three levels of nursing training with a large enough participant number. Take-home messages: This clinical examination is intended to be offered to IEN candidates in lieu of traditional credential screening. The pilot design incorporated an understanding of parameters for the licensing exam and the appropriate measures to validate performance assessment. The results of the pilot validation study provide reasonable evidence of the feasibility of this test for screening IENs for eligibility for

the CRNE.

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Piloting DOPS for dental education in India

Gina Singh (Christian Medical College, Department of Dentistry, Brown Road, Ludhiana 141008, India)

Background: Dentistry is a procedure-intensive education yet there are very few opportunities for the students to be observed in a formal way and be provided developmental feedback based on that observation.

Summary of work: Direct observation of procedural skills (DOPS) was piloted in a dental school in north India in the specialty of Periodontia for undergraduates. The faculty were oriented to the concept and use of this modality during a one hour session, which included a video demonstration. The generic DOPS recording format was used for periodontal charting and status and scaling.

Summary of results: A total of 42 procedures were observed by 4 faculty members. Immediate feedback was provided to the students regarding the procedure and how to overcome shortcomings if any. Faculty found this mode feasible and non-intrusive in their clinical and teaching schedule. Students expressed happiness and acceptance of this modality and wanted it to be extended to other areas as well. Conclusions: DOPS can be incorporated in the training assessment of UG dental students and seems to have a good acceptability.

Take-home messages: DOPS should be implemented by dental educators in India. Faculty training will improve utility and acceptance.

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Establishing the DOPS Platform in Procedural Skills Assessment for Medical Technologist Core Competence Training

Kuo-Chien Tsao (Linkou Chang Gung Memorial Hospital, Laboratory Medicine, 5, Fu-Shing St., Kwei-Shang, Taoyuan 333, Taiwan)

Chung-Chih Hung (Linkou Chang Gung Memorial

Hospital, Laboratory Medicine, Taoyuan, Taiwan)

Hsien-Li Huang (Linkou Chang Gung Memorial Hospital,

Laboratory Medicine, Taoyuan, Taiwan)

Nan-Chang Lai (Linkou Chang Gung Memorial Hospital,

Laboratory Medicine, Taoyuan, Taiwan)

Bih-Er Wang (Linkou Chang Gung Memorial Hospital,

Laboratory Medicine, Taoyuan, Taiwan)

San-Jou Yeh (Linkou Chang Gung Memorial Hospital,

Department of Medical Education, Department of

Internal Medicine, Second Section of Cardiology,

Taoyuan, Taiwan)

Background: DOPS is a new method of competence assessment for Medical Technologists (MT) in Taiwan. This study aims to evaluate a newly-created DOPS system for competence assessment for MT. Summary of work: 23 structural DOPS forms were created for core competence assessment in clinical chemistry, hematology and microscopy for MT. The three main areas of assessment were knowledge, clinical skills and attitude. A 6-score scale was used for rating and scoring criteria are defined. The reliability of DOPS was validated and faculty training achievement was evaluated. 197 DOPS ratings have been collected since

2012.

Summary of results: The reliability of Cronbach's alpha was acceptable (higher than 0.7) for all DOPS forms. The Kendall's W test for inter-rater reliability was higher than 0.7 in 16 DOPS and between 0.4 to 0.7 in 7 DOPS during the first validation. Their values all increased to 0.7 after raters came to a consensus. The average rating score was 4.1 for new trainees' evaluation. MT competence was evaluated more effectively with DOPS compared to using traditional assessment for training achievement.

Conclusions: An objective and standardized structural DOPS assessment was established for MT for the first time in Taiwan. We validated its key features and conducted core competence assessment for MT trainee using DOPS and verified it to be effective. Take-home messages: Using structural DOPS for workplace-based assessment proved to be valuable for training quality improvement. Performance evaluation of knowledge, clinical skills and attitude can be achieved more objectively and reliably for MT.

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

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Alignment of learning goals with learners' educational needs resulting from Mini Clinical Evaluation Exercises (Mini-CEXs)

Anja Rogausch (University of Bern, Institute of Medical Education, Assessment and Evaluation Unit, Konsumstrasse 13, Bern 3004, Switzerland) Stephanie Montagne (University of Bern, Institute of Medical Education, Assessment and Evaluation Unit, Bern, Switzerland)

Christoph Berendonk (University of Bern, Institute of Medical Education, Assessment and Evaluation Unit, Bern, Switzerland)

Patrick Jucker-Kupper (University of Bern, Institute of Medical Education, Assessment and Evaluation Unit, Bern, Switzerland)

Christine Beyeler (University of Bern, Institute of Medical Education, Assessment and Evaluation Unit, Bern, Switzerland)

Background: Learning goals (LGs) developed during Mini-Clinical Evaluation Exercises (Mini-CEXs) should be aligned with learners' educational needs (ENs). Summary of work: In 2011, a compulsory number of Mini-CEXs were performed with 4th year students of the University of Bern during each of their clinical clerkships. Learners' ENs were operationalized as a relative minimum of performance ratings regarding the six Mini-CEX domains (e.g. history taking, professionalism, counselling). LGs were classified with respect to their specificity and the Mini-CEX domains. Content and frequency of ENs and LGs were compared descriptively. Summary of results: 1783 Mini-CEX were completed by 165 students. In 1167 (65%) of the assessments, both trainers and students detected one or more ENs. 'Clinical reasoning' (n=271 assessments [23%]), 'physical examination' (n=230 [20%]) and 'organisation/efficiency' (n=229 [20%]) were most often regarded as a relative minimum by both trainers and students. In 314 (18%) of the assessments, 'moderately specific' or 'specific' LGs were recorded. Most of these related to 'physical examination' (n=170 assessments [54%]) and/or 'history

taking' (n=82 [26%]).

Conclusions: 'Moderately specific' or 'specific' LGs were recorded in only about a fifth of the assessments and only partly covered the Mini-CEX domains most often regarded as a learner's deficit.

Take-home messages: To further increase the utility of formative workplace based assessment, instruction of students and trainers should emphasize the recording of specific LGs in alignment with ENs.

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Evaluation of medical students admitted in Obstetrics and Gynecology using the Mini-CEX. Perception of Feedback

Silvana Maria Quintana (Sao Paulo University - Faculty of Medicine of Ribeirao Preto, Gynecology and Obstetrics, Rodovia Anel Viario Km 312 casa 406,

Avenida dos Bandeirantes 3900, Ribeirao Preto 14021800, Brazil)

Valdes Roberto Bolella (Sao Paulo University - Faculty of Medicine of Ribeirao Preto, internal Medicine, Ribeirao Preto, Brazil)

Eliana Martorano Amaral (unICAMP, Gynecology and Obstetrics, Campinas, Brazil)

Background: The medical internship is characterized by 80% of the workload facing the patient, and from 2011 the Mini-CEX was introduced with the objective of assessing the performance of student activities in the area of Gynecology and Obstetrics. Summary of work: All students were informed that for 8 weeks they should accomplish three (first year) or four (second year) Mini-CEX with evaluators and different scenarios. A group of 20 tutors were trained to apply Mini CEX. At the end of the evaluation preceptors provided feedback to the students and the students answered a survey assessing their perceived participation in this process. Summary of results: During the study period 177 students were evaluated. Twenty preceptors conducted 626 Mini-CEX (mean 31/assessor). Students had 78.9% (494) of their evaluations classified as above expectations and 20.6% (129) reached the expectation. The questionnaire using a Likert scale was answered by 102 students. 77.4% agreed that the Mini-CEX contributed to its formation and the main positive point highlighted was the fact that they are evaluated in a real practical situation (70.6%). However, only 58.8% said that the feedback contributed to training compatible with their self-assessment (55.9%). This was the main criticism of students: feedback was examiner dependent, non-standardized and often inconsistent with their self-assessment. When asked about the continuity of Mini-CEX, 70.6% would like to continue to be evaluated in the 6th grade and 72.4% also in residency.

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