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Take-home messages: There is much to be gained from incorporating independent-sector knowledge of management and leadership into medical training.
Evaluation of a research capacity intervention for academic staff within the Appreciative Inquiry Framework
Anthea Rhoda (University of the Western Cape, Physiotherapy, Private Bag X17, Bellvillee 7100, South Africa)
J De Jongh (University of the Western Cape, Occupational therapy, Cape Town, South Africa) J Blitz (University of Stellenbosch, Centre for Health Professions Education, Cape Town, South Africa) J Frantz (University of Western Cape, Community and Health Sciences, Cape Town, South Africa)
Background: As a framework used for organisational change, Appreciative Inquiry is suitable for the evaluation of research capacity development interventions. The aim of the study was to explore faculty's experiences of a research capacity development intervention using the Appreciative Inquiry framework.
Summary of work: This study used a qualitative contextual exploratory design. Five academics volunteered to participate in a focus group discussion which explored their experiences of a research capacity intervention they participated in. An interview guide was used to collect the data. Content analysis using the Appreciative Inquiry framework was used to analyse the data. Ethical clearance was obtained from the University of the Western Cape's ethics committee. Summary of results: The themes that emerged from the focus group discussions are presented according to the appreciative inquiry phases. Within the discovery and description phase were active contextualisation of teaching and learning concepts, emotion based intrinsic factors related to the intervention and interaction with facilitators. Within the dream phase the participants visualised the need for continued mentorship and support. Within the designing and destiny phase were recommendations relating to the content and format of the intervention.
Conclusions: Appreciative Inquiry process can be used to evaluate academics experiences of interventions. Take-home messages: Analysis of the focus group discussion using the Appreciative Inquiry Framework highlighted that while the capacity development intervention had been a very positive experience, there was still room to develop post-intervention support initiatives to help faculty cope with the disablers encountered in their everyday work environment.
Trends of research purpose in the Asia-Pacific region in the last 5 years: a systematic review
WS Lim (Tan Tock Seng Hospital, Geriatric Medicine, Singapore)
ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730
KM Tham (Yong Loo Lin School of Medicine, Dean's Office, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore 119228, Singapore)
WC Wong (Tan Tock Seng Hospital, Geriatric Medicine, Singapore)
HY Neo (Tan Tock Seng Hospital, Palliative Medicine, Singapore)
Issac Lim (National Healthcare Group, Health Outcomes and Medical Education Research, Singapore) D Samarasekera (Yong Loo Lin School of Medicine, Medical Education Unit, Singapore)
Background: Little is known about the progress of medical education research in advancing the field through clarification studies situated within a strong conceptual framework. We aimed to determine if there is a trend towards increase in clarification studies as opposed to descriptive and justification research purposes (Cook et. al., 2008) in the Asia-Pacific region in the last 5 years.
Summary of work: We conducted a systematic review of eligible original research abstracts presented at the 2008, 2010 and 2012 Asia Pacific Medical Education Conferences (APMEC). We performed trended Chi-square tests with post-hoc pairwise comparisons followed by logistic regression adjusted for variables that are significant in bivariate analyses, to determine if there is a longitudinal trend towards increase in clarification studies.
Summary of results: Our sample comprised 517
abstracts (2008: 136; 2010: 195; 2012: 186). There was a
significant trend through the study period (Clarification studies: 4.4% vs 8.7% vs 12.9%; p=.001), with post-hoc analyses significant for clarification-descriptive (p=.004) but not clarification-justification (p=.19) comparisons. When adjusted for professional group, country of study, presence of clear study aims and non-descriptive study design, abstracts in 2012 were still significantly more likely to have a clarification research purpose compared
to 2008 (OR 2.74, 95% CI 1.04-7.23).
Conclusions: There is a trend towards increased rigor of research purpose in medical education research in the Asia-Pacific region in the last 5 years. Take-home messages: Our results affirm the progress made in the quality of medical education research in the Asia-Pacific region in the last 5 years.
The practice of Institutional Research in Chiba University School of Medicine and Chiba University Hospital (1): Framework of IR
Takashi Maeda (Chiba University, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba 260-8677, Japan)
Satoshi Okada (Chiba University, School of Medicine, Chiba, Japan)
Mayumi Asahina (Chiba University, School of Medicine, Chiba, Japan)
Shoichi Ito (Chiba University, School of Medicine, Chiba, Japan)
Izumi Usui (Chiba University, School of Medicine, Chiba, Japan)
Masahiro Tanabe (Chiba University, School of Medicine, Chiba, Japan)
Background: Functions of Institutional Research (IR) are to collect data, to analyze it and to report the result of analysis for improvement of own institution. IR in Chiba University School of Medicine and Chiba University Hospital was launched in April 2011 to assure the quality of our medical education and to support our students and residents.
Summary of work: The IR section is set up at the Office of Medical Education in Chiba University School of Medicine and Health Professional Development Center in Chiba University Hospital. The members of IR section are two researchers and two clerical assistants. The scope of database is data before school of medicine (score of entrance examination, achievement at high school, demographics, etc.), data during school of medicine (matriculating questionnaire, Grade Point Average (GPA), score of CBT, OSCE, and national exam for medical practitioners, graduation questionnaire, etc.), data after school of medicine (specialty, geographic location, place of working, follow-up questionnaire, etc.). We are constructing a centralized database.
Summary of results: We started to collect these data in
2011. We implemented graduation questionnaire in
2012. We are going to carry out matriculating questionnaire in 2013. By doing so, we are able to know the self-assessment of students, student satisfaction with curriculum and so on.
Conclusions: We can find out some problems with our medical education from these survey results. Take-home messages: Medical education should be improved on the basis of evidence. IR will play a key role in improvement and quality assurance of medical education.
The practice of Institutional Research in Chiba University School of Medicine and Chiba University Hospital (2): An analysis of Graduation Questionnaire
Satoshi Okada (Chiba University, School of Medicine, 18-1 Inohana, Chuou-ku, Chiba-shi 2608670, Japan) Takashi Maeda (Chiba University, Chiba University Hospital, Chiba-shi, Japan)
Mayumi Asahina (Chiba University, School of Medicine, Chiba-shi, Japan)
Shoichi Ito (Chiba University, School of Medicine, Chiba-shi, Japan)
Izumi Usui (Chiba University, School of Medicine, Chiba-shi, Japan)
Masahiro TANABE (Chiba University, School of Medicine, Chiba-shi, Japan)
Background: Institutional Research (IR) has recently attracted the attention of people involved in Japanese higher education. IR is "research conducted within an
ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730
institution of higher education to provide information which supports institutional planning, policy formation and decision making" (Saupe, 1990). Japanese universities are required to autonomously improve themselves because of changes in the managerial environment and various university reforms such as transformation of national universities into national university corporations and introduction of the certified evaluation system.
Summary of work: Chiba University School of Medicine started outcome-based medical education in 2008 and LISME project (Longitudinal Inohana Study of Medical Education) in 2011, which is aimed at investigating the effectiveness of OBE and getting a better understanding of our students. GQ (Graduation Questionnaire) is carried out as part of this project since 2011. The results of questionnaire are joint data of academic affairs and analyzed by institutional researchers. Summary of results: It is questioned in GQ that level of student satisfaction with curriculum, experiences in campus life, self-assessment of competencies, aspirations for the future career and so on. These results are analyzed in relation to test score (CBT, OSCE, national exam, etc.), grade point average (GPA) or demographic factor.
Conclusions: By doing so, we can understand what kinds of students have a high satisfaction level of curriculum and what kinds of experiences have effect on GPA. Take-home messages: These kinds of analyses are important in terms of not only understanding needs of students but also quality assurance of students, institutions and medical education.
SUGAM - An Innovative way of strengthening of medical education and health care outcome
Lokendra Kumar Sharma (SMS Medical College,
Pharmacology, 59 Incometax Colony 2, Jagatpura Road
Malviya Nagar, Jaipur 302017, India)
RK Mishra (SMS Medical College, Microbiology, Jaipur,
KSharma (SMS Medical College, Pharmacology, Jaipur, India)
Background: An online grievance redressal system "Sugam" was started on 12th May 2012 after the medical education unit received only 16% portal utilized by medical persons in Rajasthan. This is an innovative way to lodge grievances and objection against the medical education department and other administrative departments of Rajasthan. That will ultimately improve the health outcome.
Summary of work: Objective: To evaluate the utilization of this portal by medical teachers and students and others that will effect improvement in medical education and patient care. It is a retrospective evaluation of grievances received on the Sugam portal of Government of Rajasthan. Responses and feedback were taken from staff and doctors about this portal by online feedback method.
Summary of results: Use of the web portal was found to improve attitudes towards health related grievances information. Participants considered the web portal to have good utility, usefulness, and credibility. The intervention group showed 22% increase in the use of the portal after conduction of one day sensitization workshop and excellent feedback. Conclusions: Despite the fact that the study was underpowered, we found that the web portal may have a positive effect on attitudes towards health related grievances. Furthermore, participants considered the Sugam web portal to be a relevant tool. It is important to continue experimenting with web-based grievance redressal portal in order to increase user participation in health related grievances for decision-making. That will improve health care and it is Best Health Care Monitoring and feedback method. Take-home messages: This Sugam web portal was help to serve as a grievances redressal portal to improve the efficiency of medical teachers, doctors and students. This will help in improvement of the doctor-patient relationship and patient care.
Educating for quality - An evaluation of a workshop for new accreditation surveyors
Lise Dupere (Royal College of Physicians and Surgeons of Canada, Educational Standards Unit, Office of Education, Ottawa, Canada)
Glen Bandiera (University of Toronto, Emergency Medicine, Toronto, Canada)
Background: The Royal College of Physicians and Surgeons of Canada accreditation standards mandate residency programs to have regular, in-depth, on-site reviews of all aspects of the program. Surveyors involved in a formal Royal College review receive hands-on training about the process, intent, and content of an on-site review prior to their participation in the accreditation process.
Summary of work: We conducted a survey of 40 participants in a one-day workshop for new surveyors over the last two years. Results were compared to a pre-workshop needs assessment for new program directors as well as a post-workshop survey of participant's experiences as an on-site surveyor, linking program directors' preconceived needs with surveyors' post-hoc perceptions of the workshop and their preparedness for the survey.
Summary of results: Participants identified numerous positive aspects of the workshop and were able to link subsequent performance to lessons learned. Conclusions: Accreditation reviewers felt better prepared to conduct a program review once they had received training. The current training sessions offered by the Royal College fill an important need for accreditation reviewers. Take-home messages: Training of accreditation reviewers in an important part of the program review process.
ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730
E'QIP'ing Our Trainees for the Future - The LSSOG Leadership Programme
Alexandra Tillett (London Deanery, Specialty School of Obstetrics and Gynaecology, United Kingdom) Samiksha Patel (London Deanery, Specialty School of Obstetrics and Gynaecology, United Kingdom) Greg Ward (London Deanery, Specialty School of Obstetrics and Gynaecology, United Kingdom)
Background: Our objective was to embed modern leadership skills in training, to link trainees with trust management and facilitate the development of quality improvement projects (QIP's). Summary of work: This six day course provided a strategic overview of National Health Service structure and finances, training in different leadership styles and the medical leadership competency framework. Coaching, team working skills, career development and psychometric profiling underpinned the course. Participants attended Trust corporate meetings and shadowed clinical and managerial directors to provide 'hands-on' learning. They were required to conduct a QIP that was presented on the last day. Summary of results: Participants were from all specialties and ranged from FY1 to ST7. They developed a wide range of QIP's including the development of ambulatory clinics, "a hot surgical clinic", implementing national guidelines into practice, improving colonoscopy outcomes, improving efficiency of junior doctor rotas and inter-hospital transfers. When presented to the medical director, he commented "listening to presentations was one of the most invigorating days he had spent in the NHS in a very long time" Conclusions: Trainee evaluation concluded: "This course was more than a tick box exercise. It has been extremely valuable at fostering clinical leadership and promoting change in the work place. " "The timing of the course meant that meaningful reflection could take place during a busy clinical post helping to embed concepts into practice."
Take-home message: The management and leadership skills e'QIP'ed our participants with the support, knowledge and skills to engage in QIP's and make a valuable impact on clinical care and safety.
Academic Collaboration: Research on Benefits around Teaching in General Practice (ACROBAT-
Talvika Kooblal (Bond University, Medical Student, Gold Coast, Australia)
Fiona Burnell (Griffith University, Medical Student, Logan, Australia)
Christopher Harnden (Griffith University Medical School, General Practice, Logan, Australia) (Presenter: Jane Smith, Bond University Medical Program, General Practice, Level 2, Faculty of Health Science and Medicine, Gold Coast 4229, Australia)
Background: Development of national and international standards in healthcare education means different institutions are often working to achieve the same educational goals. With a growing numbers of students, workplace based placements are often shared. The close proximity of students can provide an opportunity for academic teaching staff from different universities to work together to achieve common goals. Institutions need to collaborate to achieve this. The Bond University and Griffith University general practice academic departments interact regularly to discuss and compare curricula and clinical placements for students, as well as mutual planning to support general practice teachers and create opportunities for research.
Evaluation results of our model of collaboration can inform future practice regarding the benefits and drawbacks of collaboration between university departments of General Practice. Currently qualitative information on this topic appears scarce. We provide an example of an inter-institutional collaboration that gives staff an opportunity to work together to achieve similar goals. The ACROBAT-GP study qualitatively analyses the experience of collaboration between these two universities Summary of work: Qualitative research methods are used to interview and analyse emergent topics and themes.
Summary of Results Themes concerning the perceived benefits to the academics, their students, the workplace teachers, and the universities involved in the collaboration will be presented at the conference. Perceived barriers to academic collaboration and the effects of knowledge exchange between the academics are also discussed.
Conclusions: The perceived benefits predominate Take-home messages: Academic Collaboration Creates An Interactively Made Educational Delight (ACROBAT-GP
9FF ePosters: Postgraduate Education 2
Location: North Hall, PCC
Teaching Transitions of Care through Analyzing Readmissions
Kara Bischoff (University of California, San Francisco School of Medicine, Medicine, 505 Parnassus Avenue, Box 0120, San Francisco 94143-0120, United States) Patricia O'Sullivan (University of California, San Francisco School of Medicine, Medicine, San Francisco, United
Sumant Ranjii (University of California, San Francisco School of Medicine, Medicine, San Francisco, United
Harry Hollander (University of California, San Francisco School of Medicine, Medicine, San Francisco, United
Patricia Cornett (University of California, San Francisco School of Medicine, Medicine, San Francisco, United
Background: Nearly 20% of Medicare patients are readmitted within 30 days of hospital discharge. Preventing readmission has become a nationwide priority; many centers have developed programs to improve transitions of care. However, residents have not been fully included in these efforts; better resident education methods are needed to further decrease readmissions.
Summary of work: Residents received didactic education about safe discharge practices. Thirty days following a wards month, residents received a list of patients who had subsequently been readmitted. Using a structured tool, residents collected follow-up information on four patients and contacted patients, their families, outpatient providers, and the readmitting team. Residents recorded in their portfolio patient outcomes, identified systems issues and reflected on how this review would impact their clinical practice. Summary of results: All residents believe that patient followup after discharge will lead to improvements in their care, most (73%) are motivated to pursue a system change based on their review and nearly all (91%) believe that this should be a required exercise. Through qualitative analysis of residents' portfolios, the commonly identified themes are medication issues, the importance of timely outpatient follow-up and the need for advance care planning.
Conclusions: Alignment of national patient quality goals with resident education is a high priority in graduate medical education. Our unique program provided a safe discharge educational curriculum that was reinforced by resident case review leading to learner engagement with systems improvement efforts. Take-home messages: This resident activity fills a current educational gap that can inform systems changes to improve care transitions.
ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730
Optimising programme design of regional competency based study days for paediatric trainees
Seema Sukhani (London Specialty School of Paediatrics and Child Health, London Deanery, London, United Kingdom
Melanie Menden (London Specialty School of Paediatrics and Child Health, London Deanery, London, United Kingdom)
Alex Brightwell (London Specialty School of Paediatrics and Child Health, London Deanery, London, United Kingdom)
Susie Minson (London Specialty School of Paediatrics and Child Health, London Deanery, London, United Kingdom) Mando Watson (London Specialty School of Paediatrics and Child Health, London Deanery, London, United Kingdom)
Background: Postgraduate training in the UK has moved towards a competency based curriculum. However, some competencies are difficult to acquire at local level. In response, the London School of Paediatrics developed a 2 year cycle of monthly regional study days to address such competencies.
Summary of work: To optimize delivery, each day was designed using specific competencies identified through curriculum mapping work. Inspiring and well renowned speakers from across the London were invited to speak. Introduction of workshops facilitated the direct application of acquired knowledge to clinically relevant cases. All study days were evaluated, focusing on learning outcomes and application of skills. Summary of results: Attendance rates at the study days were high. 98% of trainees reported that the days successfully addressed competencies that are difficult to achieve at local level. 83% perceived the workshops as useful and valued the opportunity to apply knowledge to cases. 95% expressed confidence in changing their own clinical practice. Follow-up qualitative data has shown that trainees have successfully used the learning from the study days to change their own clinical practice and implement changes in their local workplace. Conclusions: The London School of Paediatrics series of Study Days is unique in directly addressing the specific curriculum requirements of paediatric trainees in London, providing trainees with the confidence to improve clinical practice both on a personal and organisational level.
Take-home messages: Competency based regional study days successfully support learning in the workplace by addressing specific areas of the curriculum. It empowers trainees to drive local changes in practice thereby improving local standards of care.
Burnout in Run-through Specialty Trainees
Alexandra Tillett (London Deanery, Specialty School of Obstetrics and Gynaecology, Stewart House, 32 Russell Square, London WC1B 5DN, United Kingdom)
Samiksha Patel (London Deanery, Specialty School of Obstetrics and Gynaecology, London, United Kingdom) Caroline Elton (London Deanery, Professional Support Unit, London, United Kingdom)
Background: To examine whether first year trainees from 3 run-through specialties (Obstetrics and Gynaecology (O&G), General Practice (GP) and Paediatrics) suffer from burnout and to examine associations between burnout and specific personality and work related factors. Findings from this study will enable the development of trainee support services across the United Kingdom.
Summary of work: 604 London Deanery trainees in their first year of O&G, GP and Paediatric training completed online questionnaires. The 3 aspects of Burnout (Depersonalisation (DP), Emotional Exhaustion (EE) Personal Accomplishment (PA)) were measured using the Maslach Burnout Inventory. A 5 factor personality measure was used (detailing agreeableness, conscientiousness, extraversion, neuroticism and openness) and demographic data were collated. Data were held confidentially and reported anonymously. Statistical analysis was performed using SPSS. Summary of results: O&G trainees scored lowest on DP (10%), lowest on EE (29%) and highest on PA (94%) compared to GP and paediatric trainees. Neuroticism was significantly associated with elevated DP and EE scores whereas agreeableness and conscientiousness were significantly associated with lower DP and EE scores. The opposite pattern was obtained for PA. Conclusions: There were significant associations between certain personality factors and an increased likelihood of experiencing burnout in run-through training. The finding that trainees with post-foundation experience of the specialty were less burnt out than those who had gone straight from foundation into a run-through programme needs to be explored further in order to identify possible support strategies. Take-home messages: Trainees who had post-foundation experience in their chosen specialty prior to taking up their training number were less likely to experience burnout.