Автор неизвестен - Mededworld and amee 2013 conference connect - страница 18

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Background: Face-to-face learning is becoming less accessible for spine care specialists due to cost, time, and geographic location, therefore, live webinars were delivered in an attempt to make education more available. This study evaluated if this educational format

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

is effective in improving surgeon performance and patient care.

Summary of work: Between 2011 and 2012 five webinars were delivered on topics aligned to an overall curriculum in spinal pathologies. After each webinar participants received an eight-question online survey asking how relevant was the content presented in the webinar to their daily practice and , how likely is it that they would make one or more changes in their clinical practice as a result of participating in this educational event. Participant demographics were also recorded as well as their overall satisfaction with the experience. Summary of results: 403 practicing surgeons and surgical trainees attended the five webinars and a total of 212 participants completed the postwebinar survey. 82% reported the webinar content to be either 'quite' or 'highly' relevant., 36% of the respondents reported they were 'likely' and 15% reported they were 'very likely' to make one or more changes in their clinical practice as a result of participating in the educational event. Conclusions: The results show a high percentage of self-reported intention to change in all of the webinars. Combined with high satisfaction and participation rates, these data suggest that surgeon behavior and performance can be changed using this educational format. Future work could add methods to measure if participants made their intended changes in their practice.

Take-home messages: Live and archived webinars are a valuable educational format to include in the overall portfolio for delivering a curriculum. Participation in a webinar can cause intention to change practice in qualified and trainee surgeons.

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SimPhys: A pilot study using simulation to teach basic cardiovascular physiology

Elizabeth Good (Royal Free Hospital, Acute Medicine, 8 Albert Street, St Albans AL11RU, United Kingdom) Charles Butcher (Harefield Hospital, Cardiology, London, United Kingdom)

Background: Simulation is not often used to teach medical students in the early stages of training but Gordon et al (2010) argue that emotional activation when dealing with a dynamic clinical case improves learning. The practical involvement with the case ties in with Kolb's (1984) notion of experience within a learning cycle. Flexner (1910) said "There is no cement like interest, no stimulus like the hint of a coming practical application." Had 'sim-man' existed in the early 1900s, Flexner might have encouraged its use with early years medical students.

Summary of work: Twelve first year medical students volunteered for a session using high-fidelity simulation to teach physiology underlying hypovolaemia and heart failure. Focus groups explored experiences of the session and opinions on potential for Simulated Physiology within the curriculum. Summary of results: Students identified five ways that simulation impacted on learning; motivation, context,

understanding, memorability and increased self-awareness. The importance of interactivity, "learning by doing", was recognised. Students also proposed Simulated Physiology as useful revision and integration of systems, noting that it mapped better to current examination questions that traditional teaching. Conclusions: There is a drive to integrate 'pre-clinical' and clinical medicine, yet many emphasise the importance of basic sciences (Jonas et al. (1989)). This small pilot study suggests that simulation is a useful and safe environment to provide clinical context to basic sciences, which may enhance learning. Take-home messages: Simulation can be useful for undergraduate as well as postgraduate learners. A more extensive project is underway to further explore the potential for Simulated Physiology.

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A Systematic Review of Mobile Applications for Mental Health Education

David Wilier (Centre for Addiction and Mental Health, Education Services, Rm. 2063A, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada) Andrew Johnson (Centre for Addiction and Mental Health, Education Services, Toronto, Canada) Michelle Hamilton-Page (Centre for Addiction and Mental Health, Education Services, Toronto, Canada) Jackie Bender (Princess Margaret Hospital, ELLICSR: Health, Wellness and Cancer Survivorship Centre, Toronto, Canada)

Michael-Jane Levitan (Centre for Addiction and Mental Health, Education Services, Toronto, Canada) Nelson Shen (Centre for Addiction and Mental Health, Education Services, Toronto, Canada)

Background: Studies suggest mHealth technologies may be powerful educational tools for addressing stigmatized mental health issues. Because formal evaluations of the usefulness of mental health apps are limited; there is a need to assess available apps and to create a conceptual framework to understand their role in mental health education.

Summary of work: A systematic review is being performed on educational mobile devices and tools for depression. The search term "depression" was entered on five leading platforms (Apple, Google, Nokia, Blackberry and Windows). Search results were classified as "relevant," "partially relevant," or "not relevant". Data are being extracted from eligible apps on a set of pre-determined indicators.

Summary of results: Preliminary Results: A pilot search generated 1,020 existing apps (Google: 479, Apple: 421, Windows: 69, Nokia: 36, Blackberry: 15). Of 599 apps reviewed to date, 220 were identified as relevant. A preliminary thematic content analysis was performed to guide the comparative analysis and to inform a representative coding scheme based on function, resulting in five categories: psycho-education (81), diagnostic assessment (33); symptom management (40); therapeutic treatment (58); and supportive resources (8). Features of apps include online books, mood and

activity diaries, support resources and forums, interactive games and news aggregators; evidence-based information is largely absent. Conclusions: The categorization of apps will inform the comparative thematic analysis and assessment and the development of a conceptual framework for mobile

apps.

Take-home messages: This review is identifying education gaps and informing the development of a conceptual framework to assess mobile tools and applications in depression. This conceptual framework will be tested for generalizability by repeating searches in other mental health domains.

2GG ePosters: International Dimensions

Location: North Hall, PCC

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Erasmus Week at the LernKlinik Leipzig, Germany: a peer-teaching course program for international students

Daisy Rotzoll (University of Leipzig Medical Faculty, Dept. of Medical Education, LernKlinik Leipzig, Liebigstrasse 27, Leipzig 04103, Germany) Franziska Lindner (University of Leipzig Medical Faculty, Dept. of Medical Education, LernKlinik Leipzig, Leipzig, Germany)

Pia Kuerz (University of Leipzig Medical Faculty, Dept. of Medical Education, LernKlinik Leipzig, Leipzig, Germany) Stefanie Wiemer (University of Leipzig Medical Faculty, Dept. of Medical Education, LernKlinik Leipzig, Leipzig, Germany)

Background: During the past 10 years, the number of international students applying for an Erasmus stay at the University of Leipzig Medical Faculty has risen constantly. For the academic year 2012/13, n=35 students from 10 nations were enrolled. So far, no clinical preparatory courses were offered to master the challenges of international students, such as the communication barriers to patients and fellow national students or the integration into a foreign medical education system.

Summary of work: A peer-student training week for international students was implemented. The 13 courses offered were selected according to the clinical rotations most frequently chosen by Erasmus students. The course structures were adapted to the international students, i.e. by decreasing the load of learning objectives and creating medical terminology lists with frequently used German terms. Computer-based, anonymous questionnaires for course evaluation were distributed prior to and after the course week. Another post-course questionnaire is to be distributed to the international students before leaving Leipzig. Summary of results: Preliminary questionnaire evaluations show very good evaluation scores for the courses given, not only concerning the amelioration of clinical skills trained, but also concerning the German-speaking ability and use of German medical terminology. Having the opportunity to make first contacts to German medical students in the peer-teaching atmosphere was also considered as extremely valuable. Take-home messages: The combination of clinical skills training, medical terminology usage in the foreign language and contact possibilities to local medical peer-teaching students can be considered an effective measure to promote internationalization in medical education.

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Developing a model for global health medical education: applying learning theories to teaching in resource-poor settings

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

Julie Johnstone (Hospital for Sick Children, University of Toronto, Department of Paediatrics, Toronto, Canada) Helen Batty (University of Toronto, Department of Family and Community Medicine, Toronto, Canada) Shirley Lee (University of Toronto, Department of Family and Community Medicine, Canada)

Background: Global health (GH) partnerships have dramatically increased over the last decade. Many training programs are developing GH streams and partnering with resource poor areas (RPA). Little scholarship, however, is done on the applicability of principles developed in resource rich areas (RRAs) for use in RPAs.

Summary of work: This study reviewed theories of learning in medical education, cross-cultural teaching, and best practice and technology use in GH. Current field concepts were analyzed to develop a novel model to guide education in RPAs.

Summary of results: Instructors from RRAs teaching in RPAs should apply the following process, with reflection-in and on action:

-Preparation: Know local medical milieu; Base recommendations on best practice in GH -Partnership: 'Instructor' brings medical expertise while 'Trainee' provides the reality for application; Interaction creates the lesson's end message -Adult Learning: Partnership; Engage experiences; Goal oriented objectives

-Longitudinal Focus: Telecommunication for sustaining relationships; Focus equally on similarities & differences between medical cultures

-Evaluation: Modify examinations to context; Evaluate teaching for relevance.

Strengths include amalgamation of numerous theories, flexibility for use in multiple settings, and a novel model on which to build. Weaknesses include lack of evaluation and focus on educators from RRAs. Conclusions: This new framework provides a structure for education in GH programs and can be used as a basis for developing further theory and discussion in Global Health Medical Education.

Take-home messages: Theories of education should be modified when applied in GH settings. Using this new model will help frame a process for education in RPAs.

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Development of a glossary for International Medical Graduates undertaking General Practitioner training in the United Kingdom

Jill Choudhury (Bournemouth University, Centre for General Practice, Royal London House (R507), Christchurch Road, Bournemouth BH21 3LT, United Kingdom)

Chris Elfes (Bournemouth University, Centre for General Practice, Bournemouth, United Kingdom) Background: The Membership of the Royal College of General Practitioners (MRCGP) examination is the compulsory assessment of all doctors wishing to become General Practitioners (GPs) in the United Kingdom (UK). One of the three components, the Clinical Skills

Assessment (CSA) is a formal test of clinical and consulting skills. For the academic year 2010-11, 2,820 candidates made a total of 3,590 attempts at the CSA. 1,903 (90.6%) of the attempts resulted in a pass for UK graduates, compared to 548 (36.8%) for international medical graduates (IMGs).

Summary of work: This project aimed to develop a glossary for IMGs containing colloquialisms, slang words and idioms relevant to communicating with patients in the UK. A questionnaire was administered to IMGs at the local GP training centre to ascertain if they felt this would be a useful resource. The content of the glossary was developed by a combination of themed brainstorming sessions with local GP trainees, the authors' own experiences in practice and talking to colleagues and family.

Summary of results: Ten (50%) IMGs completed the questionnaire. Although the numbers were small, the respondents thought the glossary would be useful. This gave us an indication to proceed with the glossary; the IMGs preferred formats were a booklet, online resource

or CD-ROM.

Conclusions: The usefulness of the glossary now needs to be assessed. This project could be extended to other areas of the UK where there are more IMGs and also where regional dialects may impact upon communication with patients.

Take-home messages: Resources need to be developed to improve IMGs success in the CSA.

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Impact of a preparatory English language clinical skills program on the competence and self-efficacy of Japanese Medical Students wishing to study abroad

Kazumi Sakashita (Gifu University, Medical Education

Develoment Center, 1-1, Yanagido, Gifu 5011194, Japan)

Rintaro Imafuku (Gifu University, Medical Education

Develoment Center, Gifu, Japan)

Iyo Kubota (Gifu University, Medical Education

Develoment Center, Gifu, Japan)

Takuya Saiki (Gifu University, Medical Education

Develoment Center, Gifu, Japan)

Yasuyuki Suzuki (Gifu University, Medical Education

Develoment Center, Gifu, Japan)

Farhan Bhanji (McGill University, Pediatrics, Montreal,

Canada)

Background: An international clerkship in English-speaking countries is often educational for international medical students. Previous studies suggest these students face challenges to perform in clinical environments due to suboptimal spoken English language skills and cultural differences. We studied how our educational intervention impacted on students' competence and self-efficacy. Summary of work: In 2012, we had 10 elective applicants who passed a written TOEFL-based English examination. We provided 9-sessions of a preparatory "Medical English" program focusing on basic clinical skills such as history taking, physical examination and

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

presentation skills in the 'Western' context. We assessed learners through a simulated clinical encounter which was scored by a 'blinded' Canadian physician. Students also judged their own competence and self-efficacy before and after the course using the retrospective pre-post format.

Summary of results: Students with an attendance >60% got statistically higher score in the simulated clinical encounter than those with a lower attendance rate. Retrospective pre-post self-assessment revealed all students felt they improved their English communication, history taking and case presentation skills (p<0.05).

Conclusions: In students with similar baseline competence in written English communication skills, our program was able to better prepare students for the type of clinical experience they would encounter and helped them improve their self-efficacy in their communication skills. Further research is needed to determine how the program actually influences students' performance at an international clerkship. Take-home messages: A preparatory Medical English course may improve self-efficacy and abilities of clinical functioning in students planning to undertake international electives.

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Are the PBL cases from a UK-based medical school transferable to an international cohort? The London-Cyprus experience

Stella A. Nicolaou (University of Nicosia, St George's University of London Medical School at the University of Nicosia, 93 Agiou Nikolaou Street, Engomi PO Box 24005, Nicosia 2408, Cyprus)

Shehla Baig (St George's University of London, Centre for Medical and Healthcare Education, London, United Kingdom)

Peter McCrorie (St George's University of London, Centre for Medical and Healthcare Education, London, United Kingdom)

Background: In 2011, the first cohort of students undertaking the franchised MBBS graduate entry programme at St George's University of London (SGUL) started at the University of Nicosia in Cyprus. PBL is the key learning strategy used in years 1 and 2. Summary of work: The PBL cases were designed for a UK-based curriculum so delivery to a much more international cohort (21 countries) was potentially challenging. Further, it was not permitted by Cypriot law to make any significant changes to the PBL cases. Prior to the commencement of the course, all the cases were examined by a team from Cyprus under the guidance of their London colleagues. Supplementary information was provided to students where necessary. Summary of results: The evaluation of the cases highlighted differences relating to (a) nuances of the English language (b) UK-specific cultural issues, and importantly (c) differences in medical care and support services. Other factors considered included running cases simultaneously in two countries in different

timezones and finding appropriate tutors. Evaluations pointed to several differences that were not prohibitive in delivering the curriculum. Indeed the Cyprus cohort of students performed at least as well as their UK counterparts. The additional information provided supported student learning and broadened their understanding of global healthcare issues. Conclusions: A PBL curriculum created for students from the UK can run just as effectively in Cyprus with a group of international students.

Take-home messages: PBL cases are transferable between Cyprus and the UK, provided there is cooperation and support.

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Swansea-Gambia link - A global partnership developing local educational resources

A Ebejer (Swansea College of Medicine, Medicine, Swansea, United Kingdom) P Jones (Swansea College of Medicine, Medicine, Swansea University, Sketty Lane, Swansea SA2 8PP, United Kingdom)

S Hartwell (Swansea College of Medicine, Medicine, Swansea, United Kingdom)

J McKimm (Swansea College of Medicine, Medicine, Swansea, United Kingdom)

Background: Since 2007, the Swansea-Gambia Link has facilitated exchange of medical school staff and students. Recently, it was mutually recognised that clinical skills teaching in the Gambia could benefit from being more structured.

Summary of work: Funded by Welsh Government under the 'Wales-for-Africa' scheme, two experienced clinical skills tutors and one medical student worked with Gambian students in Gambia to film seven standardised clinical examination videos as a learning resource and reference for all Gambian medical students. A checklist for each was finalised involving Gambian teachers to allow for differences in technique. These videos were filmed in the Gambia and brought back to Swansea to be edited and annotated, each comprising a comprehensive examination and short presentation of clinical findings. Four Gambian clinical trainers came to Swansea for training in formalised and standardised clinical skills teaching methods, assessment techniques, feedback and small group teaching. Summary of results: Initial student evaluations demonstrated increased confidence in performing clinical examinations. Students appreciated a reliable learning resource and have asked for further videos to be made, these will be evaluated. The Swansea-Gambia Link facilitated the success of the project in the Gambia and strengthened collaborations. Conclusions: Clinical examination videos relevant to the Gambian environment provide a reliable and structured learning resource for medical students. Training faculty and students ensures sustainability, facilitated by existing partnerships. Clinical examination techniques are universal and can be adapted for each clinical environment and population.

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

Take-home messages: Clinical examination videos relevant to the Gambian environment provide a reliable and structured learning resource for medical students. Training faculty and students ensures sustainability, facilitated by existing partnerships. Clinical examination techniques are universal and can be adapted for each clinical environment and population.

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Identity negotiation in medical students: a comparison between the UK and USA

Gabrielle M Finn (Durham University, School of Medicine, Pharmacy and Health, University Boulevard, Queen's Campus, Thornaby TS17 6BH, United Kingdom) Frederic W Hafferty (Mayo Clinic, Mayo Medical School, Rochester, United States)

Wojciech Pawlina (Mayo Clinic, Mayo Medical School, Rochester, United States) Varun Shahi (Mayo Clinic, Mayo Medical School, Rochester, United States)

Background: Medical students grapple with negotiating their personal and professional identities. Whether this negotiation is cultural and context dependent is unknown. This study explores how medical students in two different educational settings, the NHS in the UK and a private clinic in the USA negotiation their identities.

Summary of work: Focus groups were conducted at the Mayo Clinic in the USA and Durham University in the UK to explore how students negotiate their professional identities. Participants were medical students at each institution. Data collection and analysis was based upon grounded theory.

Summary of results: Results will be presented demonstrating how the similarities and differences in how medical students negotiate their personal and professional identities within the UK and USA. Commonalities such as an increased requirement for professionalism within the social media domain and differences with regard to societal expectations will be demonstrated. Links to the Hidden Curriculum will be highlighted.

Conclusions: There is an ever increasing expectation for medical students to become mini-doctors from day one of medical school. Often, this makes students unable to go through a transitional or developmental period. Subsequently, they struggle to negotiate their personal and professional identities. Despite some cultural differences, medical students in the UK and USA experiences similar scrutiny and thus anxieties. Take-home messages: Despite differing societal expectations, educational settings and cultures, all medical students struggle with identity negotiation and formation. Work needs to be done to aid students in their transition from student to clinician.

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Medical students' perception of their current and career needs for defined global health and health equity competencies

Patricia Mullan (University of Michigan, Medical Education, G1115 Towsley Center, 1515 East Medical Center Drive, Ann Arbor 48109, United States) Joy Williams (University of Michigan, Family Medicine, Ann Arbor, United States)

Preeti Malani (University of Michigan, Internal Medicine, Ann Arbor, United States)

Andrew Haig (University of Michigan, Physical Medicine and Rehabilitation, Ann Arbor, United States) Brent Williams (University of Michigan, Internal Medicine, Ann Arbor, United States)

Background: This study examines the use of an innovative approach to the use of competency expectations related to promoting global health and health equity to promote medical students' reflection and self-assessment, and inform curriculum development.

Summary of work: In 2012, 29 medical students enrolled in a newly developed Global Health and Disparities Path of Excellence (GHD) - a set of mentored co-curricular activities built around 16 competencies related to professional development and leadership skills to ameliorate health disparities in the United States and developing countries. Students reviewed the competencies in terms of: a) their ability to perform the identified competencies as they began GHD and b) the extent to which their future career would require these responsibilities. The ordinal response scale ranged from "Strongly Disagree" to "Strongly Agree." Wilcoxon's paired T-test compared individual students' rating of their current level of ability to the level that they anticipate their career will require, with significance set at p<.01

Summary of results: On most (11) of the 16 competencies, at least 50% of students indicated that the competencies were beyond their present ability level. For each competency, the Wilcoxon paired T-tests results indicate students perceived more need in their careers than they currently possess, at statistically significantly levels.

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