Автор неизвестен - Mededworld and amee 2013 conference connect - страница 62

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Radiology, Hat Yai, Thailand)

Background: Fourth year medical students are taught to interpret chest radiographs in a block titled Health and Diseases of Adults and Elderly. We aimed to determine a suitable teaching method under limited time conditions. Summary of work: Two teaching methods of interpreting chest radiographs were used for 227 students: one-by-one single-disease patterns and mixed-disease patterns. The disease patterns were divided into 6 problem lists: pulmonary infiltration, atelectasis, intra-extrapulmonary mass, mediastinal diseases, pleural diseases and hyperlucent lung. Mixed radiographs of these disease patterns were defined as mixed-disease patterns. Immediate post-test and final semester chest radiograph objective structured clinical examination (OSCE) scores were compared. Summary of results: At a significant difference, the median pre-test scores for the single-disease pattern and mixed-disease pattern groups were 4.0 and 3.5 out

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

of 10, respectively (p=0.01), and the post-test scores were 6.4 and 6.9, respectively (p=0.03), but no significant difference in the final chest radiograph OSCE scores was observed: 8.0 and 8.3, respectively (p=0.19). Conclusions: The teaching methods did not have an impact in the long term. However, the mixed-disease pattern method can help students interpret chest radiographs in the short term. Take-home messages: The mixed disease pattern teaching method is probably more effective than the sequential single-disease pattern method in the short term.

5Z/10

Mapping distributed situation awareness in the operating room

Georges Nassrallah (Schulich School of Medicine & Dentistry, Western University, Centre for Education Research & Innovation, London, Canada) Sayra Cristancho (Schulich School of Medicine & Dentistry, Western University, Centre for Education Research & Innovation, Dept. of Surgery and Dept. of Medical Biophysics, 1151 Richmond St., London N6A 5C1, Canada)

Background: Research regarding surgical decision-making has mainly followed an individualistic approach. However, surgery takes place within a team-based environment. Distributed Situation Awareness (DSA) is used to describe how information is shared and used differently by elements in a system. The purpose of this study was to propose a model of DSA for challenging situations in surgery.

Summary of work: This pilot study included 10 surgical cases. Cases were purposively sampled based on the predicted level of challenge as described by two surgeons. Data included intra-operative observational field notes and post-operative interviews. A preliminary thematic analysis was conducted to identify the types of interactions occurring in the operating room (OR). These themes were used to build diagrammatic representations of those interactions with Propositional Networks (PN) as the modelling tool. Summary of results: Preliminary results suggest that information flow in the OR is dynamic and is not necessarily dominated by the surgeon. This was evident when analyzing the operations from different perspectives. For example, when PNs were created based on surgical stages the patterns of information flow seemed more distributed than those from PNs based on individual roles.

Conclusions: While further research is required to refine and expand these observations, this study has started to show the utility of a systems approach to exploring situation awareness in surgery. This methodology may prove useful in making explicit the kinds of interactions that take place in the OR.

Take-home messages: PNs may constitute a tool to help trainees in better understanding how their role contributes to the functioning of the system.

5Z/11

UVC Skill Practice in 4th Year Medical Students

Busaya Santisant (Vachira Phuket Hospital, Pediatric, 353 Yaowarat Road, Muang, Phuket 83000, Thailand)

Background: The procedure of umbilical caththerizations (UVC) insertion was need in neonatal resuscitation, intravenous fluid or transparental nutrition. This procedure was assigned to 4th Year medical students, to train them in how to carry this out for themselves. The purpose is to determine how many times the medical student should carry out this procedure until they can be described as experienced; utilizing our UVC skill model.

Summary of work: We have used our UVC skill model in this study. Experienced Paediatric staff carried out this procedure 3 times and the mean duration was calculated for reference. Sixteen 4th Year medical students were then assigned to carry out this UVC insertion procedure using the same recognised method. Their individual UVC insertion times were recorded. Each medical student was then instructed to carry out the procedure as many times as it took to achieve the target of a procedure duration of less than 1.5 times the reference time repeatedly. The mean procedure duration for the 16 medical students was calculated to determine how many times the medical student should carry out this procedure until they can be described as experienced.

Summary of results: Paediatric staff were found to need a mean of 179 seconds for UVC insertion. The target time for the medical students was 1.5 times the reference, therefore 269 seconds. The mean count of UVC insertion attempts was 4.88 for this procedure. Conclusions: A 4th Year medical student needs 4.88 times to practice UVC insertion until experienced before they can achieve a procedure duration of less than 1.5 times the reference time.

Take-home messages: At least five consecutive practices of UVC model should be carried out prior to applying to real patients. This UVC model should also be included into the curriculum.

5Z/12

Integrating a longitudinal communication curriculum in a new modular competence-based medical curriculum at the Charite Berlin

P A Arends (Charite Universitaetsmedizin Berlin, Dieter

Scheffner Centre for Medical Teaching and Educational

Research, Chariteplatz 1, Berlin 10117, Germany)

R Kienle (Charite Universitaetsmedizin Berlin, Dieter

Scheffner Centre, Berlin, Germany)

I Muehlinghaus (Charite Universitaetsmedizin Berlin,

Dieter Scheffner Centre, Berlin, Germany)

A Maaz (Charite Universitaetsmedizin Berlin, Dieter

Scheffner Centre, Berlin, Germany)

T Hitzblech (Charite Universitaetsmedizin Berlin, Dieter

Scheffner Centre, Berlin, Germany)

H Peters (Charite Universitaetsmedizin Berlin, Dieter

Scheffner Centre, Berlin, Germany)

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

Background: Inquiries of medical graduates in Germany and corresponding recent needs assessment analysis demonstrate that communication skills are still perceived among the most deficiently conveyed competencies within undergraduate medical education. At Charite Universitaetsmedizin Berlin, communication competencies are being integrated and evaluated in the new local modular curriculum in a structured and interactive process.

Summary of work: Planning and implementing a communication skills programme in the new modular curriculum is a process affiliated to an eight step standardized module planning procedure at Charite. Based on a collection of educational objectives resulting from Delphi surveys and defined outcomes, communication skills thematically are aligned with the contents of each module in which communication skills courses are scheduled. In a structured iterative multi-step procedure the planned objectives and didactics are being discussed and decided, involving module boards, an interdisciplinary group (including students) planning the communication skills training programme, members of the project management team, the academic board and faculty.

Summary of results: The procedure ensures a viable content which thematically and structurally is oriented towards the presettings of the local modular curriculum and at the same time follows national and international criteria on communication skills objectives. In addition it allows involved stakeholders to react flexibly and on short notice to potentially changing requirements arising for example from review or evaluation results. Conclusions: Developing and implementing a longitudinal communication curriculum within a undergraduate medical curriculum is a challenge for all parties involved as well it is for the content itself. Take-home messages: A structured and defined procedure involving stakeholders from all steps of a curriculum planning process is most promising when integrating communication skills programmes.

5Z/13

Integrating Communication Skills Competency into the Medical Education Curriculum at Kazakh National Medical University named after S. Asfendyarov

Marat Assimov (Kazakh National Medical University named after S. Asfendyarov, Center for Communication Skills named after Juliet Draper , Almaty, Kazakhstan) Farida Nurmanbetova (Kazakh National Medical University named after S. Asfendyarov, Department for Medical Education, Almaty, Kazakhstan) (Presenter: Zauresh Issina, Kazakh National Medical University named after S. Asfendyarov, Clinical and Practical Skills Center, 88, Tole Bi street Building 4, Almaty 050012, Kazakhstan)

Background: Communication skills as essential competency for all health professionals were included into new State Medical Education Curriculum in Kazakhstan. The Communication Course has been

developed and adopted within the framework of the KazNMU's Competency-Based Medical Curriculum Model.

Summary of work: The KazNMU's Center for Communication Skills (CCS) named after Juliet Draper established for introduction of the competencies needed for effective clinical encounters and improvement of the physician-patient communication in practice in collaboration with the University of Cambridge, UK.

Summary of results: International collaboration allowed the understanding of the principles of best practice in Communication curriculum emphasis on bioethical competencies, development of the Concept and Strategy for implementation Communication key competencies, development of the Guidelines for Communication Skills Teaching and Assessment based on Calgary-Cambridge Guides (2005), provision of the training courses how to teach communication skills in different learning context and using appropriate teaching methods, organization of the feedback process, development of the OSCE marking sheets, and development of a Capacity Building Plan for Faculty Development in Communication Skills teaching. Also involvement of the medical students into activities of the Personal Development Club "Rainbow" at the CCS encourages them to be self-confident, self-motivated, understand and respect diversity and difference including religion and cultural beliefs. Conclusions: Communication is a core clinical skill that should be introduced at all three levels of medical education. The CCS in collaboration with KazNMU's Clinical Skills Center, Curriculum Committees, clinical educators, psychologists, psychotherapists, other health professionals and providers promote effective relationship and partnership between physician and patient.

Take-home messages: It is necessary to evaluate the effectiveness and quality of the introduction the Communication Skills Curriculum.

5Z/14

Organization of Early Patient Contact Program during the Communication Skills Course at University Teaching Hospital in UAE

Venkatramana Manda (Gulf Medical University, General Surgery, PO Box: 4184, Ajman, United Arab Emirates) Pankaj Lamba (Gulf Medical University, Ophthalmology, Ajman, United Arab Emirates) Sherly Ajay (Gulf Medical University, Academic Office, Ajman, United Arab Emirates)

Background: Successful outcome of any course depends partly on the course content and partly on the organizational aspect. The Early Patient Contact (EPC) program was introduced as an elective in the communication skills course during the first month of medical school. The objective of the present study was to know the perceptions of first year medical students regarding organizational aspects of EPC program.

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

Summary of work: The study sample included 50 first-year MBBS students of GMU who consented for EPC posting in AY 2010-11 & 2011-12 at GMC Hospital, Ajman. Students' feedback was obtained at the end of EPC posting based on Likert scales (5-1) (SA Strongly Agree; A: Agree; US: Unsure; D: Disagree; SD: Strongly Disagree).The data was analysed using PASW 18. Summary of results: 74% of students agreed that the program was well organized and same number disagreed that EPC was not relevant to students at this stage and should be introduced later in the curriculum. 76% were satisfied with the 10-hour duration of posting and 64% with evening posting. 88% felt that the demands of EPC program were reasonable; 76% recommended this program to be part of regular curriculum; 90% were satisfied with the quality of the program and opined that the objectives of the program have been met. 94% enjoyed the clinical posting. Conclusions: Majority of students had positive perceptions regarding organization of EPC program and recommended it to be a part of regular curriculum. Take-home messages: Good organization is critical element in success of EPC Program especially when organized in first month of medical school.

5Z/15

Learning Through Telephone Consultation

Sithtichok Laohawilai (Khon Kaen Hospital, Surgery, Srichan Road, Khon Kaen 40000, Thailand)

Background: Telephone consultation is necessary in medical service especially after working hours. This study aimed to explore how medical students learn through telephone consultation. Summary of work: The learning process during telephone consultation was explored using the self-reported questionnaire among recently graduated medical students. A pilot study was done to test the validity and reliability of the questionnaires. Summary of results: Forty six students were firstly recruited. Nine of them were excluded because of delayed graduation and felt uncomfortable to complete questionnaire. Finally, all data based on 24 responders were analyzed. The average number of telephone consultation made by medical students was 70 times/year; most of these occurred at the emergency room. Seventy percent of the students reflected that they gained knowledge in disease managements during telephone consultation. The consultants should tell them about diseases, clinical manifestations, plan of management and also re-examination. However, they pointed that they had difficulties to describe some clinical manifestations while consultation. The efficiency of consultation could be increased with new applications such as whatsapp, line and facetime. Conclusions: Telephone consultation could provide clinical manifestation and plan of management to medical students.

Take-home messages: Using higher technology applications such as whatsapp, line and facetime could improve the telephone consultations.

5Z/16

Student perceptions of mobile learning for clinical skills training

Kyong-Jee Kim (Sungkyunkwan University School of Medicine, Medical Education, Seoul 135-710, Korea, Republic of (South Korea))

Hye Won Jang (Sungkyunkwan University School of

Medicine, Social and Preventive Medicine, Suwon, Korea,

Republic of (South Korea))

Yon Ho Choe (Sungkyunkwan University School of

Medicine, Pediatrics, Seoul, Korea, Republic of (South

Korea))

Chang Dae Bae (Sungkyunkwan University School of Medicine, Molecular Cell Biology, Suwon, Korea, Republic of (South Korea))

Background: The consortium of Korean medical schools for e-learning has offered over 300 streaming videos on basic clinical skills, which are also accessible on mobile devices. The present study reports a study of the student experience of mobile learning in preparing for OSCE (Objective Structured Clinical Examination). Summary of work: A 30-items questionnaire was administered to students in 34 Korean medical schools registered in the e-learning portal. The students' frequency of access and their perceived effectiveness of the OSCE videos were compared between those who used mobiles devices and those who used computers to access the videos.

Summary of results: 114 students returned the questionnaires, 34% of whom used mobile devices to access the videos. 37% of the total hits on the video clips were also from mobile devices; both mobile and computer users perceived positively on the effectiveness of the OSCE videos (p = .43). The number of OSCE videos viewed was also comparable between the groups (p = .80). Mobile users agreed more with the statement that the access to the videos was convenient (p < .05) and they accessed the videos at home more frequently (p < .05) than their peers; yet, several students pointed out the lower connection speed in mobile devices.

Conclusions: Mobile users felt more positively about the convenience of accessing streaming videos. Optimizing streaming videos for mobile devices is suggested to minimize problems in connection speed. Take-home messages: Students perceived positively of the convenient access to OSCE videos in the mobile learning environment.

5Z/17

Improving Theatre Experiences and Learning for Medical Students in Surgery

Thomas Hardy (Cheltenham General Hospital, Urology, Sandford Road, Cheltenham GL53 7AN, United Kingdom) Ling Wong (University Hospital Coventry and Warwickshire, Colorectal Surgery, Coventry, United Kingdom)

Background: Little research has looked at improving learning from theatres. This study was undertaken to look at ways to enhance medical students' experience and learning in theatres. This was to be achieved by focusing them on the patient journey from admission for elective procedures through to post-operative management of patients.

Summary of work: 32 Warwick Medical School 3rd year students on surgical placement at University Hospital Coventry and Warwickshire (UHCW) were asked to complete a voluntary, anonymous questionnaire. This was completed prior to and following a lecture on approaches to maximise use of theatres. Questions related to subjective views on learning and preparation for theatre. These scores were then tallied and an unpaired t-test was used to analyse the data. There were 2 further questions relating to whether the changes improved their experience of theatres. Summary of results: Students experiences improved with the changes. Students reported that the changes improved their learning. They found that this approach showed a statistically significant improvement in enjoyment and how useful theatre was to their learning. They were also prepared better for upcoming cases. Conclusions: By focusing students on seeing patients prior to and post-operatively and by preparing for theatre, their self-reported experience of theatres improves. They also reported that their learning improved and they took more from theatres with changes.

Take-home messages: Following the patient journey leads to a better learning experience and increased enjoyment and learning from theatres and surgical patients.

5AA Posters: Career Choice

Location: Terrace 2, PCC

5AA/1

How medical students' career choices differ according to their personality types

Yera Hur (Konyang University College of Medicine, Department of Medical Education, Daejeon, Korea, Republic of (South Korea))

Keum-ho Lee (Konyang University College of Medicine, Department of Medical Education, Daejeon, Korea, Republic of (South Korea))

Sun Kim (The Catholic University of Korea School of Medicine, Department of Medical Education, 505 Banpodong, Seochogu, Seoul 137-701, Korea, Republic of (South Korea))

Background: This study examined three overarching topics: 1) What are medical students' preferences with regard to career choices according to their MBTI (Myer-Briggs Type Indicator)? 2) Is there any difference in career choice between MBTI type? and 3) Do the MBTI types in this study coincide with the MBTI types that are related to medical careers?

Summary of work: MBTI types were determined for 237 students of 2 medical colleges in the first semester of 2009, 2011, and 2012. Their planned careers, which were categorized as physician, surgeon, and others, were also recorded. Frequency analysis and chi square test were performed.

Summary of results: 1) Among those who chose physician, ISTJ was the dominant type (20.3%), followed by ESTJ—the opposite pattern developed among those who chose surgery. 2) There were no significant differences between planned careers according to preference type. But, 'introverted' types preferred to choose internal medicine (53.6%), and 'extroverted' types wished to become surgeons (54.4%). 3) Generally, 2 dominant types were observed in doctors, and a preference type was also noted (ISTJ 17.7%, ESTJ 16.0%, Sensing-Thinking type 46.4%).

Conclusions: Choosing specific fields is influenced by the characteristics of extroverted and introverted types, for whom a tailored instructional method or career mentoring program needs to be considered. Take-home messages: Students' personality types affect their career choices and should be taken into account with regard to career mentoring and instructional method.

5AA/2

What is behind students' choice for becoming a doctor? An analysis of 10,640 descriptions written by lst-year medical students in a newly developed exercise

Seiichi Ishii (Tohoku University Graduate School of Medicine, Office of Medical Education, 2-1 Seiryocho, Aobaku, Sendai 980-8575, Japan)

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

Fumie Takahashi (Tohoku University Graduate School of Medicine, Office of Medical Education, Sendai, Japan) Yutaro Arata (Tohoku University Graduate School of Medicine, Office of Medical Education, Sendai, Japan) Junichi Kameoka (Tohoku University Graduate School of Medicine, Office of Medical Education, Sendai, Japan) Hiroshi Kanatsuka (Tohoku University Graduate School of Medicine, Office of Medical Education, Sendai, Japan)

Background: Medical students' perceptions of becoming a doctor were analyzed qualitatively as well as quantitatively.

Summary of work: To promote medical students' awareness of becoming a doctor, we have introduced a new exercise in 2010 to the 1st-year curriculum in which each student was given the task of writing "30 reasons of learning medicine" down on a work sheet. Students read the descriptions one another in a group of six peers and discussed the reasons and purposes of becoming a doctor. Natural language processing technology (NLPT) was used to analyze the students' descriptions. Summary of results: A total of 375 1st-year students participated in this exercise during 2010, 2011 and 2012. Of the 375 students, 367 agreed with utilization of their descriptions in this study. The 367 students had written a total of 10,642 reasons of learning medicine, which were analyzed by NLP software. The five most frequently used nouns in students' descriptions excluding Doctor, Medicine or I were, #1. People (1,985 times), #2. Patients (617 times), #3. Diseases (503

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