Автор неизвестен - Mededworld and amee 2013 conference connect - страница 26

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Silvana Eloi-Santos (Faculty of Medicine, Universidade Federal de Minas Gerais, Propedeutica Complementar, Belo Horizonte, Brazil)

Edna Regina Pereira (Universidade Federal de Goias, Pediatria, Goiania, Brunei)

Luis Tofoli (UNICAMP, Saude Mental, Campinas, British Sovereign Base Areas) Leonardo Vasconcellos (Faculty of Medicine, Universidade Federal de Minas Gerais, Propedeutica Complementar, Belo Horizonte, Bosnia and Herzegovina)

Background: The practice of teaching represents an opportunity for students to be on the other side of the teacher-student relationship and acquire invaluable skills for their future careers. Summary of work: Since 2006, an annual elective medical discipline organized by selected students (SS) has been offered. Under faculty supervision the students developed the teaching plan: theme selection, audience preparation, topic presentation, and the definition of

students' performance evaluation. Afterwards, the SS took over the managing process, promotion of topic discussions focusing in the clinical-laboratory-pathophysiological-radiological correlation as well as in concepts of cost-effectiveness, statistics and epidemiology, always supported by teachers. Twenty-eight students signed up for the last edition, and at each meeting, a structured questionnaire concerning the perception of the process was offered. Summary of results: The answers indicated that the SS had been successful as teachers. Between 81.3%-100% of audience felt that the methodology contributed to their knowledge acquisition. A positive correlation was observed between the quality of the methodology and the feeling of knowledge acquisition (p<0,01;PC>0,770). Among the SS, all of them fully endorsed the initiative, were satisfied with the activities and the results obtained, and developed higher interest in the academic career/teaching.

Conclusions: Teaching practice for students may be a good strategy to improve the acquisition of specific knowledge as communication skills, planning and organization, important issues for the physician career. Take-home messages: Tasks that put the students in close contact with teacher performance are well received, stimulate academic thinking, and should be promoted in the medical schools.

3N Short Communications: Medical Education Research

Location: Meeting Room 2.1, PCC 3N/1

Determinants of clarification studies in medical education research: a systematic review

WS Lim (Tan Tock Seng Hospital, Geriatric Medicine, 11

Jln Tan Tock Seng Singapore 308433, Singapore)

KM Tham (National University of Singapore, Yong Loo

Lin School of Medicine, Singapore)

HY Neo (Tan Tock Seng Hospital, Palliative Medicine,

Singapore)

WC Wong (Tan Tock Seng Hospital, Geriatric Medicine, Singapore)

C Ringsted (University of Toronto and University Health Network, Anaesthesia, Toronto, Canada)

Background: Medical education research should aspire to illuminate the field by moving beyond descriptive ("What was done?") and justification ("Did it work?") research purposes to clarification studies that address "Why or how did it work?" questions. We aim to ascertain the predictors of clarification studies in medical education research.

Summary of work: We conducted a systematic review of all eligible original research abstracts presented at the 2012 Asia Pacific Medical Education Conference. Abstracts were classified as descriptive, justification or clarification using Cook's framework. We collected data on research approach (Ringsted 2012 framework), Kirkpatrick's learner outcomes, statement of study intent, presentation category, topic of study, professional group, and number of institutions involved. Significant variables from bivariate analysis were included in logistic regression analyses to ascertain the determinants of a clarification study purpose. Summary of results: Our final sample comprised 186 abstracts. Descriptive studies were the most common (65.6%), followed by justification (21.5%) and clarification (12.9%). Clarification studies were more common in non-experimental than experimental studies (18.3% vs 7.5%). In multivariate analyses, the presence of a clear study aim (OR: 5.33, 95% CI 1.17-24.38) and non-descriptive research approach (OR: 4.70, 95% CI 1.50-14.71) but not higher Kirkpatrick's outcome levels predicted a clarification research purpose. Conclusions: Only about one-tenth of studies have a clarification research purpose. A clear study aim and non-descriptive study research approach each confers a five-fold greater likelihood of a clarification purpose. Take-home messages: Study aims and research approach are 2 potentially remediable areas to promote clarification studies in medical education research.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

3N/2

A Systematic Review of Undergraduate Medical Education in UK General Practice

Sophie Park (University College London, Department of Primary Care and Population Health (PCPH), UCL Medical School (Royal Free), Rowland Hill Street, London

NW3 2PF, United Kingdom)

Nada Khan (University College London, Department of Primary Care and Population Health (PCPH), London, United Kingdom)

Background: This study aims to systematically identify, summarise and synthesise empirical research about undergraduate medical education in the UK general practice setting. UK medical schools provide 10-15% of their curricula in primary care, costing approximately £100 million / year.

Summary of work: We systematically searched medical and educational bibliographic databases using terms relating to general practice and medical education. Empirical studies about undergraduate medical education in UK general practice were included. A descriptive synthesis will be produced summarising the data, followed by meta-analysis and meta-synthesis approaches where appropriate. During title and abstract screening, we are piloting 'text-mining', which uses techniques including automatic term recognition to improve reviewing efficiency through early identification of relevant records. The relative sensitivity and specificity of traditional double-screening and text-mining in identifying the final set of included papers will be explored.

Summary of results: Database searches retrieved 12477 records for title and abstract screening. We will report the comparison of text mining with manual, double-screening methods along with a descriptive summary of the selected literature, forming the basis for subsequent meta-synthesis and meta-analysis. Conclusions: This presentation will discuss the utility of text-mining in future systematic reviews, and a descriptive summary of the identified literature. We hope this review will inform future teaching, policy and research through highlighting what knowledge about learning in this context is currently available within the research literature.

Take-home messages: We have conducted a systematic search of the literature on undergraduate medical education in UK general practice and will present a summary of the included literature and discuss the utility of text-mining techniques.

3N/3

Research in Medical Education in Brazil: Strategies to overcome

Izabel C M Meister Coelho (Faculdades Pequeno Principe, Postgraduation in Health Professions - Pro-Ensino na Saude, Av Iguacu, 333, Curitiba 80230020, Brazil)

Marcio Almeida (Faculdades Pequeno Principe, Postgraduation in Health Professions - Pro-Ensino na Saude, Curitiba, Brazil)

Rosiane G Mello (Faculdades Pequeno Principe, Postgraduation in Health Professions - Pro-Ensino na Saude, Curitiba, Brazil)

Evelin Muraguchi (Universidade Estadual de Londrina, Medicina, Londrina, Brazil)

Joao J B Campos (Universidade Estadual de Londrina, Medicina, Londrina, Brazil)

Background: After discussions about difficulties in Medical Education publication in Brazil, the Brazilian Association of Medical Education (ABEM) established in 2006 a group (ABEMPG) for promoting and disseminating debates on this topic formalized by publication of the Brazilian National Curriculum Guidelines for Medicine - 2001. The ABEMPG strategies was defined together the Ministry of Health (MS) and in 2010 a policy to create critical mass in research in the field of Health Education launched the bid proposal to open groups and lines of research inside postgraduate programs recognized by the scientific production in specific areas of health.

Summary of work: Seventy projects competed and 31 were selected that began operations in 2011 with a five year strategic plan and provided financial support for its implementation by MS. Two seminars annual monitoring of the projects were carried out. Summary of results: Benefits are: the large field of research provided by the SUS, the development of new teaching and learning strategies in Universities, the possibility of adding researchers in research groups, prior planning as guiding the actions and the existence of specific resources for the researchers and publications in the area. Problems are, the lack of critical mass in the country, the reality of research associated with teaching and care leading to an overload of tasks, the need to follow standards dictated by foreign scientific journals for publication with impact factor. Strategies to overcome the problems have been the collaborative work between researchers and institutions, the search for experiences in major research centers and inclusion of stakeholders to support new researchers.

Conclusions: There has been a significant increase in the presence of Brazilians in international conferences and published articles in internationally recognized journals in the area.

Take-home messages: A well designed inductive policy can change the research history in developing countries.

3N/4

Strengths and weaknesses in developing a multicentric research network in Medical Education - VERAS Project

Patricia Tempski (School of Medicine of the University of Sao Paulo, Center for Development of Medical Education, Rua Capote Valente, 926 apt 21, Sao Paulo

05409-002, Brazil)

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

Helena Paro (Federal University of Uberlandia, Department of Gynecology and Obstetrics, Sao Paulo, Brazil)

Silvia Enns (School of Medicine of the University of Sao Paulo, Center for Development of Medical Education, Sao Paulo, Brazil)

Paulo SP Silveira (School of Medicine of the University of Sao Paulo, Department of Pathology, Sao Paulo, Brazil) Silmar Gannam (School of Medicine of the University of Sao Paulo, Center for Development of Medical Education, Sao Paulo, Brazil)

Milton A Martins (School of Medicine of the University of Sao Paulo, Department of Medicine and Center for Development of Medical Education, Sao Paulo, Brazil)

Background: Most studies in Medical Education have been performed in single or few institutions and the subjects have not been randomized. There is an urgent need of high quality multicentric randomized studies. Summary of work: Most studies in Medical Education have been performed in single or few institutions and the subjects have not been randomized. There is an urgent need of high quality multicentric randomized studies.

Summary of results: Twenty-three Medical Schools and 1350 randomized medical students participated in the study (81.8% response rate). SWOT analysis (strengths, weaknesses, opportunities and threats) showed that the main strengths were motivation of local researchers, support from local institutions, proximity between local researcher and respondents, electronic database, weekly monitoring of respondent status and customized feedback for respondents. Main weaknesses were small core research team, local researchers' work overload and difficulties in motivating students to answer 290 items.

Conclusions: Our response rates were higher than the average found in most of the reviewed multicentric studies (between 50 and 61%). Surprisingly, our losses due to respondent burden were very small. The highly motivated research team and the closed monitoring of randomized students that accepted to participate in the study are the possible explanations. Building a research network to perform randomized multicentric studies has many challenges but it is very important to perform relevant high-quality studies in Medical Education. Take-home messages: Weaving, keeping and producing a research network in Medical Education is a daily challenge that has been proved possible.

3N/5

When medical education research and web design meet: experiences from a multidisciplinary collaboration

J Shin (The University of Manchester, School of Medicine, Manchester, United Kingdom) E Hill (Maastricht University, School of Health Professions Education, P.O. Box 616, Maastricht 6200 MD, Netherlands)

J Giles (The University of Manchester, School of Medicine, Manchester, United Kingdom)

N Brooks (Independent Web Developer, London, United Kingdom)

S Vaughan (The University of Manchester, School of Medicine, Manchester, United Kingdom)

Background: Survey design, visual layout and social media integration are important considerations in conducting questionnaire research as poorly implemented online surveys may be unlikely to achieve sufficient participant numbers. Online survey services are also often limited in their ability to meet the research objectives of differing studies. Here, we describe our experience of the multidisciplinary design of a large-scale online questionnaire incorporating an interactive careers intervention. Summary of work: The 'Big Training Survey' (www.bigtrainingsurvey.com) focuses on understanding factors that affect medical students' career decisions. The survey utilises a mixed-method approach to data collection combining quantitative data, social networks analysis, and qualitative analysis from free-text answers. We collaborated with web programmers and designers to build a user-friendly survey, whilst giving participants personalised data outputs to encourage reflection. Summary of results: Our multidisciplinary approach, using a number of team design tools, enabled us to construct a bespoke online questionnaire and data management system. Process-based design, conscious development of a shared vocabulary and collaborative wireframing were all included in the research design process.

Conclusions: Close collaboration between the academic and web design teams, facilitated by team and workflow management tools, played an important role in building a survey with seamless user interface. We were also able to address technical issues of the survey early and optimise the system for recruitment, data collection and analysis.

Take-home messages: Active involvement of web programmers and designers during research survey development can be beneficial in maximising the usability and appeal of mixed-methods questionnaire studies.

3N/6

Finding the Evidence on Medical Professionalism

Ruth Sladek (Flinders University, Health Professional Education, School of Medicine, GPO Box 2100, Adelaide 5001, Australia)

Julie Ash (Flinders University, Health Professional Education, School of Medicine, Adelaide, Australia)

Background: Those interested in teaching, assessing and researching medical professionalism need to be able to identify the published literature in databases. Yet this is challenging as it is widely recognised as a complex and multidimensional construct, with different perspectives and terminologies. Using an innovative approach used in other fields, we developed an OvidSP MEDLINE literature search filter to identify this literature.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

Summary of work: Using bibliometrics, frequency analyses and a gold standard comparison approach, we developed and validated a literature search filter using randomised citations identified a priori as relevant from a published critical discourse analysis. The filter's effectiveness was evaluated by calculating how many relevant articles it successfully retrieved. Summary of results: The filter retrieved 379/596 (63.6%) of the relevant literature, and was translated into a PubMed version. A less sensitive version was also iteratively developed for those less concerned with breadth of search coverage. Conclusions: The use of a critical discourse analysis means that multiple perspectives about medical professionalism are likely reflected in the filter, and therefore in the literature it retrieves. This study also provides an example of how medical education can benefit from approaches outside of its own field. Take-home messages: These filters are now available for immediate use by those interested in medical professionalism, and may support further research and practice. This approach may be replicated with other topics of interest such as assessment.

30 Workshop: Training the Trainers to Support Doctors in Difficulty

Location: Meeting Room 3.5, PCC

Liz Spencer (National Association of Clinical Tutors UK (NACT UK))

Alistair Thomson (National Association of Clinical Tutors UK (NACT UK))

Background: Educational supervisors have a key role in identifying and managing doctors in difficulty. With improving assessment and educational supervision a wider, more complex range of issues are being discovered. Supervisors require additional training in knowledge, skills and attitude to enable them to support and remediate these doctors in a structured and timely fashion. NACT UK represents Directors of Medical Education (DMEs) who coordinate Postgraduate Medical Education in UK hospitals. In 2008 NACT UK published a framework for managing these complex situations 1 which has been widely adopted across the UK. This workshop will demonstrate how the NACT UK document can be embedded within a Faculty Development programme to educate those responsible for supervising these doctors.

Intended Outcomes: To enhance the understanding of what causes doctors to run into difficulties and the importance of adopting a structured systematic approach that is connected to the processes of both the educational programme and the employing hospital. To encourage educational leaders to provide additional education and support for clinical trainers. Structure: The key elements of the NACT UK document will be described. A copy will be provided for all participants. Experience of delivering Training the Trainer workshops will be shared. There will be some small group work & sharing of experiences will be encouraged.

Further topics which will be addressed: What factors might affect the performance of a doctor;What "is" and "is not" the role of the educational supervisor; When should the issue be escalated? And to whom?; How to give difficult feedback; What and how to document Who should attend: This is relevant for all educational leaders, medical trainers and those involved in faculty development. The context will be postgraduate but the principles would be relevant to those involved in undergraduate education.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

3P Workshop: Young medical educator workshop: Problematization and Adaptive Action: Authentic learning for a successful career in Medical Education

Location: Meeting Room 4.1, PCC

Regina Helena Petroni Mennin (Universidade Federal do Sao Paulo, Medicine Preventiva, Rua Inhambu 1708, Sao Paulo 04520-015, Brazil)

Stewart Mennin (Mennin Consulting & Associates, Health Professions Education, Sao Paulo, Brazil) Soeren Huwendiek(University Children's Hospital Heidelberg, General Pediatrics, Heidelberg, Germany) Charlotte Ringsted (University of Copenhagen and Capital Region, Medical Education, Copenhagen, Denmark)

Zubair Amin (National University of Singapore, Department of Pediatrics, Singapore) Monica van de Ridder (Albert Schweitzer Hospital, Medical Education, Dordrecht, Netherlands)

Background: The 21st century medial educator has to be capable in many arenas at the same time. Problematization is an approach to learning and problem solving derived from the work of Paulo Freire that is relatively unknown outside of Brazil. Its application is fundamental to learning and living in a constantly changing world in which stability is dynamic and ephemeral.

Intended outcomes: The workshop is focused on participants learning about problematization and adaptive action applied to day-to-day challenges of medical educators. The goal and objective is to introduce this method to address real life problems of the young (new to medical education) medical educators.

Structure of workshop: Following a short introduction to problematization, participants will identify a set of issues/problems and work in groups with shared interests to apply problematization. Groups will share feedback and analysis and synthesis of problematization as adaptive action will summarize the workshop and highlight general principles. Who should attend: Young medical educators interested in exploring a way to solve problems, learn and integrate the multiple roles and challenges they face every day. Level: Intermediate

3Q Workshop: Give us a Cue: On Line Tutor Facilitation

Location: Meeting Room 4.2, PCC

Janet MacDonald (Cardiff University, School of Postgraduate Medical and Dental Education, Cardiff, United Kingdom)

Lesley Pugsley (Cardiff University, School of Postgraduate Medical and Dental Education, Neuadd

Meirionydd, Heath Park, Cardiff CF14 4YS, United

Kingdom

Lynne Allery (Cardiff University, School of Postgraduate Medical and Dental Education, Cardiff, United Kingdom)

Background: The past decade has witnessed a transformation in the provision of on-line learning for medical educators (1). However, tutor emphasis is focused on the interpretation of written material. Little or no attempt is made to compensate for the lack of those all important, non-verbal cues generated between tutors and learners, which can indicate understanding, or the lack thereof, in a face to face environment (2). Intended outcomes: Participants will be able to: Analyse on-line student postings Assess the level of on-line student engagement and understanding

Engage in appropriate on-line educational feedback Structure of workshop: This highly interactive workshop will explore with participants a variety of different approaches to the facilitation of groups in an online environment. Using examples of text from online group discussions, the workshop provides an opportunity for delegates to work together to both craft facilitator responses to educational questions and queries and subsequently analyse and code these responses. Who should attend: This workshop is intended for tutors and supervisors who are currently working, or who intend to work, in an on-line educational environment. It is aimed at an introductory to intermediate audience who wish to engage with others in a highly interactive and theoretically informed fun session.

Level: Introductory

(1) Moore, M. Kearsley, G. (2012)(3rd Edition). Distance Education. Wadsworth:Belmont CA.

(2) Fisker, D. Frey, N. (2007). Assessing for Understanding. Association for Supervision and Curriculum Development:USA.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

3R Workshop: The use of simulation in clinical assessment - are there limitations?

Location: Meeting Room 2.2, PCC

Doris Ostergaard (on behalf of AMEE Simulation Committee)

Background: The reliable assessment of clinical performance at any stage of medical practice is crucial for maintaining professional standards and providing reassurance to patients. The plethora of competency based curricula and related assessment frameworks developed over the past 50 years have assessed an individual's "shows how" level of Miller's pyramid. The competency assessment tools, OSCE, Case-based discussions DOPS and MiniCEX for example provide evidence of competence but are limited in that they don't reliably assess or predict performance in the workplace. There is evidence from high reliability organizations that simulation can be successfully utilized to both prepare and provide diagnostic evidence of performance in an authentic environment which reflects the workplace. Behaviour marker systems and performance assessment tools are increasingly being piloted. The added value of using authentic simulated environment for assessment is that the focus is entirely on the learner. Intended outcomes:

1. Understand the benefits and challenges of the use of simulation in assessment

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