Автор неизвестен - Mededworld and amee 2013 conference connect - страница 15

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Physicians, Mercatorlaan 1200, Utrecht 3528 BL,

Netherlands)

Background: Supervising physicians make a significant contribution to the quality of doctors' training programmes. The majority of supervisors have not received competency-based training themselves and are inadequately equipped for providing competency-based training for doctors. The postgraduate training programme for elderly care physicians has developed a teaching programme for supervisors which is itself competency-based, so participants may learn about and experience skills development.

Summary of work: The training programme comprises an introductory course and four modules each covering a number of linked supervisors tasks (such as encouraging self-direction).

The training days work towards the "shows how" level in Miller's pyramid, using exercises, practical scenarios with an actor, and collegial observations with feedback.

Practical assignments are based on applying what has been learned to guiding trainee doctors in the workplace. Participants formulate learning objective and action plans and put together a portfolio. Supervisor assessment is via video recordings in practice as well as reflective reports.

Summary of results: Around 100 supervisors are currently participating on the course. Experiences of the course suggest it is both supportive and inspiring. Participants and teachers believe there has been a significant learning effect.

Conclusions: The experience of competency-based training enhances the intrinsic motivation of supervisors to provide competency-based guidance to doctors. Take-home messages: The experience of competency-based training encourages competency-based training.

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Development of an online self-administered questionnaire to self-assess learning outcomes of undergraduate medical education in paediatrics

Alexandros Makis (Ioannina University Medical School,

Child Health Department, Ioannina, Greece)

loannis Dimoliatis (Ioannina University Medical School,

Department of Hygiene & Epidemiology, University

Campus of Ioannina, Ioannina GR-45110, Greece)

Sofia Tsabouri (Ioannina University Medical School, Child

Health Department, Ioannina, Greece)

Aikaterini Siomou (Ioannina University Medical School,

Child Health Department, Ioannina, Greece)

Meropi Tzoufi (Ioannina University Medical School, Child

Health Department, Ioannina, Greece)

Antigone Siamopoulou (Ioannina University Medical

School, Child Health Department, Ioannina, Greece)

Background: The transition to clinical-based learning is critical, especially in paediatrics; a child requires specific skills. Learning outcomes (LO) at the school level (levels I and II) are increasingly used as a tool for improving undergraduate medical training. We went ahead one step further, developing specific pediatric LOs (levels III and IV) and transforming them into an online self-administered questionnaire for student self-assessment. We present our whole experience. Summary of work: All paediatric faculty worked collaboratively to specify the Tuning-Medicine level I and II LOs into paediatric level III and IV LOs, such as paediatric history taking, physical examination, differential diagnosis, child problem solving, initial management of common paediatric acute and chronic illnesses, family, community and society influence on child's health and disease. LOs were then transformed into the iCAN!-Paediatrics questionnaire, completed online by 22 sixth-year medical students at the beginning of their training.

Summary of results: Students completed 172 questions in about 22 minutes, in a pleasant and creative climate. Overall mean score was 55.3%, the best in "I can approach the child with anemia according to erythrocytic indices" (80%) and the worst in "I can explain the significance of Gowers' sign" (14.5%). At the

ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015

end of training, students will complete it again and added value could be estimated. Conclusions: iCAN!-Paediatrics self-assessment questionnaire can be implemented in medical schools to promote paediatric-specific LOs.

Take-home messages: Specific at a course-level LOs and tools should be prepared for informing both students and teachers on expected competences and for self-assessment at any time during student training.

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Medical students' views about the roles of paediatricians: Implications for setting outcomes and curricula for undergraduate paediatric education

Katsumi Nishiya (Nara Medical University, Department

of Pediatrics, 840 Shijo-cho, Kashihara 6348522, Japan)

Yasuyuki Suzuki (Gifu University, Medical Education

Development Center, Gifu, Japan)

Takuya Saiki (Gifu University, Medical Education

Development Center, Gifu, Japan)

Midori Shima (Nara Medical University, Department of

Pediatrics, Kashihara, Japan)

Background: Outcome-based medical education has been widely introduced into and accepted by various institutions, but data on the views of medical students about the roles of physicians are very limited. We could better meet medical students' learning needs if we could identify their views on the roles of physicians in health care, and the discrepancies between these views and the desired outcome of the education. Summary of work: We conducted a quantitative and qualitative questionnaire survey for 50 fifth-year medical students attending Nara Medical University, Japan. We asked them to describe, in as much detail as possible, the roles and attributes of paediatricians. These roles and attributes were then categorised into 5 groups, according to the outcomes set by the Japan Paediatric Society.

Summary of results: We obtained 284 comments regarding the roles and attributes of paediatricians. These comments were categorised into 14 themes and 5 outcomes: general practitioner for children (260 comments), health supporter of children and parents (14), scholar (11), coordinator (2), and advocator (0). Conclusions: Medical students strongly feel that the paediatrician must be exceedingly competent in general practice with children and have considerable knowledge and skills. However, it was difficult for the students to imagine the other roles of paediatricians, such as health supporter, scholar, coordinator, and advocator. These discrepancies should be helpful in establishing a new outcome-based curriculum.

Take-home messages: Students' views on the roles of physicians are useful for establishing outcome-based curricula.

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A checklist for practical skills competencies during clinical rotations at primary care improves medical students' knowledge of expected learning outcomes

Maria Magnusson (Uppsala University, Unit for medical

education, Medicine programme, c/o Studentservice,

Box 586, Uppsala 75123, Sweden)

Niclas Lewisson (Uppsala University, Department of

Surgical Sciences, Uppsala, Sweden)

Karin Bjorkegren (Uppsala University, Department of

Public Health and Caring Sciences, Uppsala, Sweden)

Jarl Hellman (Uppsala University, Department of Medical

Sciences, Uppsala, Sweden)

Jakob Johansson (Uppsala University, Department of Surgical Sciences, Uppsala, Sweden)

Background: Despite efforts to inform medical students about the expected learning outcomes (ELO) at their primary care rotations, student evaluations continuously highlighted the lack of knowledge of these learning goals. Based on the pedagogical concept of constructive alignment, we introduced a checklist related to the ELO for the practical skills competencies that should be acquired during the primary care rotation. Summary of work: The checklist was introduced to the medical students at Uppsala University (Sweden) in the middle of the autumn term 2012. A clinical teaching evaluation instrument, introduced in spring 2011, was used to evaluate students' own knowledge of the ELO and students' perceptions of the clinical supervisors' knowledge of ELO (Likert-scale 1-6). No information about the checklist was provided directly to the clinical supervisors during the autumn term. Summary of results: Before introducing the checklist, the mean [SD] score regarding students' knowledge of ELO for the three preceding semesters were 3.79 [1.37], 3.86 [1.34] and 3.83 [1.32] respectively (n=759). After the introduction of the checklist, the score increased to 4.19 [1.23] (n=254); p=0.002. Students did not perceive that the clinical supervisors' knowledge about the ELO

had increased, 4.53 [1.42] (before) and 4.57 [1.41] (after); p=0.63.

Conclusions: The medical students' knowledge of ELO during the primary care rotation increased after the introduction of a checklist for practical skills competencies.

Take-home messages: A checklist appears to be effective to increase students' knowledge of ELO. The existence of a checklist needs to be explicitly communicated to the clinical supervisors.

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Importance of Different Characteristics of a Surgeon as Defined by Non Surgeon Physicians and Patients

Carlos E Piccinato (Medical School of Ribeirao Preto, Surgery and Anatomy, Av.Bandeirantes, 3900, Campus USP, Ribeirao Preto 14048-900, Brazil)

ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015

Maria LV Rodrigues (Medical School of Ribeirao Preto, Ophthalmology, Otolaringology and Head and Neck Surgery, Ribeirao Preto, SP, Brazil) Tatiana V Nakamura (Medical School of Ribeirao Preto, Surgery and Anatomy, Ribeirao Preto - SP, Brazil) Luiz E A Troncon (Medical School of Ribeirao Preto, Internal Medicine/Gastroenterology, Ribeirao Preto - SP, Brazil)

Background: Knowing the importance of the qualities a surgeon should have is relevant for curriculum planning in both undergraduate medical education and residency training in Surgery. We therefore decided to evaluate the opinions of patients and non surgeon physicians, who often refer patients to surgeons, regarding the importance of different qualities of a surgeon. Summary of work: A previously published questionnaire (Frezza EE, Wachtel MS. Am Surg 2007;73:481-83) containing 14 items related to different qualities a surgeon should have was applied to 35 non surgeon physicians and to 35 outpatients from a private practice. Answers were expressed in a five-point Likert scale ranging from "non important" to "extremely important". Summary of results: Both physicians and patients agreed and attributed the highest degrees of importance to three surgeon qualities: efficiency, attention to the patient and reliability. Patients ascribed more importance than non surgeon physicians to the following surgeon characteristics: dependability (p=0.0008), confidence (p=0.0003), good appearance (p=0.0006), great knowledge (p=0.0001) and graduation from a fellowship (p=0.0001). Non surgeon physicians attributed less importance than patients to appearance of the facility the surgeon works. Conclusions: The surgeon qualities of efficiency, attention to the patient and reliability were regarded as extremely important by both non surgeon physicians and patients, which should be taken into account when planning educational activities. Take-home messages: Patients and non surgeon physicians agree in a number of qualities a surgeon should have, but the former tend to be more comprehensive when appraising these characteristics and regard humanistic qualities as more important.

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Curriculum changes and the key issues of development of competences in metacognition

Maria Jose Salles (State University of Londrina, Department of Biology, Prefeito Hugo Cabral Street, number 1065 ap 501 Londrina 86020918, Brazil) Marcia Hiromi Sakai (State University of Londrina, Public Health Department, Londrina, Brazil) Ruy Guilherme Souza (Federal University of Roraima, Center for Biological and Health Sciences, Boa Vista) Lea das Gracas Anastasiou (University of Western Santa Catarina, Center Pedagogical Support, Florianopolis, Brazil)

Katia Kiyomi Santos (Foundation to Support the Development of Technological, University Hospital of Northern, Londrina, Brazil)

Background: Preparing future healthcare professionals is one mission of Universities. These professionals should be reflective, critical and lifelong learners. In this way, Brazilian Universities have implemented student-centered curriculum in order to promote independent and problem solving learning. Metacognition is key issue to prepare critical and reflective professionals. This paper aimed at correlating the curriculum changes and the degree of development of competence in metacognition.

Summary of work: This study analyzed 46 Universities, of Brazil, supported by PROSAUDE. 118 undergraduate courses of health area answered a semi-structured questionnaire. Besides, we selected 6 Universities to conduct focus groups with teachers and students of nursing and medical undergraduate courses. Summary of results: We observed three different stages of development of metacognition ccompetences: (1) institutions in beginning of changes, students showed no evidence of metacognitive strategies, (2) institutions in intense process of change, students showed evidence of metacognitive strategies and (3) institutions in the consolidation phase of changes students are totally aware of metacognitive competence. The development of metacognition depends on the curriculum, teacher and student, highlighting the importance of faculty commitment and application of formative assessment, towards sustainability of curriculum change. Conclusions: The main issues observed in the development of metacognitive competence by the students depend on the teachers' role and the formative assessment.

Take-home messages: It is fundamental to implement an effective institutional development programme to value teaching and learning.

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Using a Delphi technique to develop learning objectives for a national cardiotocography education program

Line Thellesen (Rigshospitalet, Department of Obstetrics, Blegdamsvej 9, Copenhagen 2100, Denmark)

Background: With the aim to reduce the incidence of cerebral injury to newborns a Danish national cardiotocography (CTG) education program is under development. Using a Delphi technique we aimed to develop learning objectives for the CTG education program based on the opinions of experienced midwives and obstetricians from 21 maternity wards in Denmark. Summary of work: The research group stated six topics within CTG, based on national and international guidelines. In the first Delphi round the participants were asked to write 1-5 learning objectives within each of the topics. The responses were by directed content analysis and Bloom's taxonomy reduced, rewritten, and redistributed in a second and third round, in which the participants were asked to rank each objective on a 5-point scale according to relevance. Summary of results: Of the 42 included experts, 31 submitted 537 answers in the first round. These answers

were reduced to 41 learning objectives. 27 experts ranked the learning objectives (means: 2.0-5.0) in the second round. The third round is ongoing. Conclusions: In the attempt to achieve content validity of a nation based CTG education program expert opinions on learning objectives were collected and analysed using a Delphi technique. A prioritized list of the CTG learning objectives will be developed, which will constitute the content of the program, and clarify which topics to emphasize.

Take-home messages: A Delphi technique can be used to develop learning objectives for a curriculum and to provide information on the relevance of each objective.

2DD Posters: Assessment: General and Written

Location: South Hall, PCC

2DD/1

Correlating students' academic performance in core subjects with their professors' individual assessments

A Dominguez-Gonzalez (Westhill University, Evaluation, Av. Pacfico 355-7 Col. Pueblo La Candelaria, Coyoacan, Mexico City 04380, Mexico)

J M Rioboo Martin (Westhill University, Mexico City, Mexico)

M Lopez Cabrera (Westhill University, Principal, Mexico

City)

Background: Studying academic performance during the first two years of medical school could be considered significant in order to establish adequate regimes of study in the following years in order to have better prepared medical graduates.

Summary of work: Based on this pretext we decided to invest in researching the correlation between perceived attitudes by teaching staff on an individual student, and their academic performance. We conducted a global review of all students within the second year of medical training in our faculty, 86 students, over a one-month period, where we had their professors complete an assessment questionnaire on each individual student, a survey based on the Likert scale and designed for this effect. A total of 26 teachers were asked for their input. Summary of results: The attitudes shown by the students within the classroom setting were correlated with their academic performance at the end of the core subjects of their medical training, to a high degree (Pearson 0.82).

Conclusions: Results show that students' attitudes are determinant in their academic performance, and those members of faculty are able to detect these characteristics with precision. Take-home messages: Early assessment tests are valuable in order to reinforce study skills and for positive revision habits to be established in students requiring them.

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Final Year MB,ChB Assessment Mapping: What Value Does This Add?

Christina Tan (Stellenbosch University, Centre for Health Professions Education, Faculty of Medicine & Health Sciences, Tygerberg Campus, Stellenbosch University, Tygerberg 7505, South Africa)

Susan Van Schalkwyk (Stellenbosch University, Centre for Health Professions Education, Faculty of Medicine & Health Sciences, Tygerberg, South Africa) Francois Cilliers (University of Cape Town, Educational Development Unit, Faculty of Health Sciences, Cape Town, South Africa)

ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015

Juanita Bezuidenhout (Stellenbosch University, Centre for Health Professions Education, Faculty of Medicine & Health Sciences, Tygerberg, South Africa)

Background: In high stakes examinations, tests of clinical competence, which allow decisions to be made about medical qualifications and fitness to practise, need to provide reliable and valid measurements of student performance. There are widely accepted criteria for sound assessment. At Stellenbosch University, there is also an assessment policy to provide a framework and to bring the assessment practices of the University in line with current, research-based views and standards regarding assessment. Summary of work: An investigation was undertaken to determine what current assessment methods are being used at exit level in the Bachelor of Medicine, Bachelor of Surgery (MB,ChB) programme at Stellenbosch University and how these assessment methods are described in official module documents. Document analysis of study guides for exit level modules was done for information relating to methods of assessment and their use. Assessment methods, divided into written and non-written formats, were mapped on an Excel spreadsheet against modules to provide an overall view of assessment for all final year modules. Summary of results: Assessment practice varied across modules based on 1) the approaches and number of assessments, 2) weighting of individual components, and 3) the use of assessment tools. Conclusions: Mapping the assessments can provide a useful reference overview for module and programme coordinators.

Take-home messages: The next step in this research would be to determine if there is sound assessment taking place and would provide some indication of the degree of alignment with the Stellenbosch University Assessment Policy as well as with international criteria.

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Population aging, chronic diseases and final exams: are we asking the students the right questions?

Thiago O. Monaco (Universidade Nove de Julho, Medical Department, Av Juruce 873, Ap. 81, Sao Paulo (SP) 04080-013, Brazil)

Iolanda F. L. C. Tiberio (Universidade Nove de Julho,

Medical Department, Sao Paulo (SP), Brazil)

Renata Daud-Gallotti (Universidade Nove de Julho,

Medical Department, Sao Paulo (SP), Brazil)

Richard H. Cabral (Universidade Nove de Julho, Medical

Department, Sao Paulo (SP), Brazil)

Cinthya C.G. Duran (Universidade Nove de Julho, Medical

Department, Sao Paulo (SP), Brazil)

Background: Brazil is one of the world's fastest-aging countries; death and morbidity will be determined more than ever by chronic diseases, which medical students should be able to prevent and treat. Summary of work: To assess if official examinations are balanced for gender, age and acute/chronic health

issues, we tested the last available three editions of both our Ministry of Education's and State Medical Council's examinations for last-year medical students. Both are multiple-choice examinations based on patient cases, which were classified according to gender, age and acuity. We excluded questions of pediatrics and obstetrics-gynecology.

Summary of results: From 117 identified patients in the questions, 57.26% were men, 35.04% were women (unspecified gender: 7.69%); 29.20% were 65+ years old and only 1.71% were aged 75. Acute problems were described in 75.21% of the questions; only 9.40% had a history of more than a year or were clearly chronic. Conclusions: Examinations were biased towards younger men with acute problems. Chronic diseases frequently appeared as risk factors only; their prevention and management was seldom the case in point. Since the results of these examinations are widely used to assess the quality of medical education in our State, the imbalance we found may contribute to students' negative attitudes towards the study of geriatrics and chronic diseases. Take-home messages: Inasmuch as undergraduate students need to be frequently exposed to elderly patients with chronic diseases, official examinations of final-year medical students in Brazil must emphasize the management of older people and chronic diseases.

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Differences of learning strategies in passing the national medical licensing test (NT) step 1 of the 3rd year medical students in Thammasat university

Paskorn Sritipsukho (Faculty of Medicine, Thammasat University, Pediatrics, 95 Moo8 Paholyothin Road, Pathum Thani 12120, Thailand) Panadda Rojpibulsit (Faculty of Medicine, Thammasat University, Preclinical sciences, Pathum Thani, Thailand) Nuchanart Suealek (Faculty of Medicine, Thammasat University, Preclinical sciences, Pathum Thani, Thailand) Aree Taylor (Faculty of Medicine, Thammasat University, Preclinical sciences, Pathum Thani, Thailand) Nuthapol Sukprasert (Faculty of Medicine, Thammasat University, Preclinical sciences, Pathum Thani, Thailand) Siripen Tor-udom (Faculty of Medicine, Thammasat University, Preclinical sciences, Pathum Thani, Thailand)

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