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Background: The literature shows the rate of adverse events increases when interns commence employment. In Australia most interns commence employment in January.
Summary of work: In October/November 2012 at Sydney Medical School, Royal Prince Alfred Hospital, we ran a troubleshooting procedural skills course to prepare pre interns (PRINTS) for safe practice in a hospital environment as interns. During this time PRINTS were presented with advanced procedural skills scenarios and encountered common problems that occur on the wards. This is a cohort study N=60. This study will use qualitative and quantitative data to evaluate PRINTS perceived and practical effectiveness of this course. PRINTS commence work as interns in January 2013 and will be followed up by survey and focus groups 2 months into their internship to gauge the impact that the course has had on their transition into internship. Summary of results: Students were surveyed following the course. The outcomes were positive with some students remarking that they could have and more time or that they would have benefited if this to be done earlier in their course. Data results are pending in April
Conclusions: We hypothesise that this course will enhance the existing knowledge that our PRINT students had through simulated models to pure trouble shooting real life problems on the wards. This will enhance their awareness of safety issues in hospitals, and help to prevent adverse events from occurring in our hospitals.
Take-home messages: The benefits of a troubleshooting procedural skills course can help with enhancing safety awareness issues for interns.
7K Short Communications: International Medical Education 2
Location: Club B, PCC
Creating a sustainable training of trainers approach in developing countries
Laura Skippen (The Brooke, Animal Welfare and Research, 41-45 Blackfriars Road, London SE1 8NZ, United Kingdom)
Josep Subirana (The Brooke, Veterinary Team, London, United Kingdom)
Tamsin Fussey (The Brooke, Veterinary Team, London, United Kingdom)
Klara Saville (The Brooke, Veterinary Team, London, United Kingdom)
Kate Exley (Higher Education Assessment and Development Ltd, Wakefield, United Kingdom)
Background: Much Brooke work centres around improving equine healthcare by training local veterinary professionals, many of whom speak little English, making it impossible for the UK veterinary team to deliver training. A programme to train others to train (training and facilitating adult learners - TFAL) was established to develop an international senior training team (STT) who deliver training in their own countries. The aim of this approach is to blend international expertise with local 'know-how' to enhance animal welfare.
Summary of work: A course was developed for the STT, enabling them to deliver TFAL in their local language; thus enlarging the group of people able to train others effectively. The course included one week of training by the UK team, followed by a week in which the initial participants delivered TFAL training to a new group of international participants. The UK team provided support, assessed the new trainers and evaluated the training. An external evaluator advised on programme design, attended and evaluated the course during week one.
Summary of results: Interviews prior to week two indicated all participants felt well-prepared to deliver TFAL and that the training had exceeded their expectations. Those trained in week two gave 100% positive feedback on their experience. The evaluator provided excellent evidence on the success of the training from observations and interviews. Conclusions: Take-home messages: Interviews, questionnaires and consultant evaluation indicate this method of training is effective and appreciated. Evaluation is needed as the STT deliver this training in country to ensure training quality remains consistently high.
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
Middle East Experience of North-American Medicine clerkship
Mai A. Mahmoud (Weill Cornell Medical College in Qatar, Medical Education, PO Box 24144, Doha, Qatar Dora Stadler (Weill Cornell Medical College in Qatar, Medical Education, Doha, Qatar)
Background: Weill Cornell Medical College in Qatar (WCMC-Q), is a direct branch of Weill Cornell Medical College in New York City (WCMC-NY) and is the first medical school in Qatar. The sixth class will graduate this year, with all of them having completed their medicine clerkships at a government affiliated hospital. The medicine clerkship is a 12-week rotation in the third year. The curriculum was adopted from WCMC-NY and consists of 3 blocks, two in General Medicine (GM) and one block Critical Care. During these blocks students also participate in case-based tutorials, write a reflective ethics narrative and several traditional write-ups. Summary of work: We will describe challenges and successes for implementing the curriculum of a North American Medicine Clerkship in an educational culture not totally familiar with the system. We will discuss the improved integration of medical students into the medical teams. We will highlight innovations used to broaden the students' exposure in addition to address specific cultural and ethical issues in our unique setting. Differences in pathology, hospital experiences, clinical teaching and clinical assessment will be addressed. Summary of results: Our successes to overcome boundaries and maintain the similarities between the two campuses include the shared seminars and use of SIMPLE cases to supplement the ambulatory component. Remaining challenges include enhancing our students' exposure to outpatient medicine and continued improvement of meaningful clinical assessment of our students.
Conclusions: This innovation to curricular adaptation is the first in the region and can benefit the growing number of U.S Medical schools establishing branches/affiliations worldwide.
Emotional intelligence development in allied health professional students: An international perspective
SJ Mackay (University of Liverpool, Directorate of Medical Imaging and Radiotherapy, Room 2.04, Johnston Building, School of Health Sciences, Liverpool
L69 3GB, United Kingdom)
Background: Emotional intelligence (EI) is an important and valuable trait for healthcare practitioners. Few studies analyse the development of EI from student to qualified practitioner. This abstract presents results from the first stage of a five year longitudinal international study investigating the development of EI in BSc degree programmes for allied health professional students.
Summary of work: 319 1st year radiography and radiotherapy students from BSc (Hons) degree programmes at three universities (Ireland, UK and Hong Kong) were invited to complete an online EI questionnaire and their scores compared to published norms for qualified radiographers using independent sample t-tests with Bonferoni correction for multiple testing and analysis of covariance to correct for the effects of age and gender.
Summary of results: There were 230 (72% response rate) participants comprising 118 (51.3%) females, 112 (48.7%) males, mean age 19.40yrs. Statistically significant differences were found between the UK/Ireland student group and the norm data for qualified UK radiographers on Global EI (p<0.01) and factors of Well Being and Self-control, both p<0.01. In all cases the mean score for qualified staff was higher than the students [Global EI score (Student = 5.04, Qualified =
5.28); Well Being, (S=5.41, Q=5.75); Self-control,
Conclusions: There are differences between the EI profiles of new students and qualified radiographers and radiotherapists. Qualified staff scored higher on Global EI and two of the four factors which comprise the EI measure.
Take-home messages: Emotional Intelligence of new students in radiography and radiotherapy is less well developed than that of their qualified colleagues.
ASEAN Economic Community (AEC) and Medical Qualification
Jathurong Kittrakulrat (Faculty of Medicine, Chulalongkorn University, Medical Students for Health Systems and Services (MS-HSS), Thailand Research Center for Health Services System, 1873 Rama IV Rd., Patumwan, Bangkok 10330, Thailand) Ravipol Jurjai (Faculty of Medicine, Chulalongkorn University, Medical Students for Health Systems and Services (MS-HSS), Thailand Research Center for Health Services System, Bangkok, Thailand) Witthawin Jongjatuporn (Faculty of Medicine, Chulalongkorn University, Medical Students for Health Systems and Services (MS-HSS), Thailand Research Center for Health Services System, Bangkok, Thailand) Nicha Jarupanich (Faculty of Medicine, Chulalongkorn University, Medical Students for Health Systems and Services (MS-HSS), Thailand Research Center for Health Services System, Bangkok, Thailand) Krit Pongpirul (Faculty of Medicine, Chulalongkorn University, Department of Preventive and Social Medicine, Bangkok, Thailand)
Background: In the regional movement toward ASEAN Economic Community (AEC), medical professions including physician will be free to work across member countries. Ensuring comparable medical qualification systems is therefore crucial but good synthesis of relevant information has been lacking. This study was aimed (1) to comparatively analyze information on Medical Licensing Examination (MLE) across ASEAN
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
countries and (2) to assess stakeholders' view on potential consequences of AEC on medical profession. Summary of work: To search for relevant information on MLE, we started with country's national body (primary data source). In case of data unavailability, secondary data sources such as official websites of medical universities, colleagues in international and national medical student organizations, as well as some other internet sources were approached as appropriate. Feasibility and psychometric properties of these sources were assessed using focus group discussion. For the second objective, in-depth interviews were conducted with stakeholders, purposively selected based on maximum variation sampling technique to represent medical licensing authority, medical profession, as well as economic viewpoints.
Summary of results: MLE systems vary across ASEAN countries. All countries but Brunei offered MLE. While majority use central MLE system, Singapore, Indonesia, and Vietnam decentralized their MLE system. Stakeholders reflected that, for example, common license is unlikely whereas using native language in the examination is fair.
Conclusions: MLE systems differ across ASEAN countries in some important aspects, that should be addressed in the movement toward AEC. Take-home messages: MLE systems differs across ASEAN countries in some important aspects, that should be addressed in the movement toward AEC.
The Health Care Team Challenge: An Innovative International Interprofessional Education Model
Christie Newton (University of British Columbia,
Department of Family Practice, 320-5950 University
Boulevard, Vancouver V6T 1Z3, Canada)
Lesley Bainbridge (University of British Columbia, College
of Health Disciplines, Vancouver, Canada)
Valerie Ball (University of British Columbia, College of
Health Disciplines, Vancouver, Canada)
Background: Academic institutions worldwide have been tasked with embedding interprofessional education (IPE) into the curricula of the health professions, yet few descriptions of interprofessional learning activities that have been successfully implemented internationally are reported in the literature. This paper describes one such IPE model, the Health Care Team Challenge (HCTC), its key and unique features, international variations, implementation and evaluation strategies.
Summary of work: In 2011, the Canadian Institute of Health Research (CIHR) provided the University of British Columbia College of health Disciplines with a Meetings, Planning and Dissemination Grant to bring together a group of Faculty who had experience with the HCTC IPE model from universities in Canada, the United States, Australia, and Japan. Participants formed an International Network of Health Care Team Challenges (INHCTC) with the aim of advancing this IPE model.
Summary of results: This presentation will share the workshop findings of the INHCTC including: an overview of the key features of the educational model, unique aspects of the model as compared to other IPE opportunities, the international variations of the model, implementation and evaluation strategies, and a proposed research agenda for the INHCTC. Conclusions: The HCTC is an innovative IPE model that can be integrated with ease into health profession curricula internationally. Continued research is underway to demonstrate its impact on interprofessional learning and collaborative practice. Take-home messages: Curricular change within the health professions towards IPE is occurring at both the pre and post-licensure levels internationally. IPE models like the Health Care Team Challenge can assist academic institutions in meeting these new curricular demands.
Exploration of PGME curricula on an EU level: Do residents attain an equivalent postgraduate medical education within the EU?
Abe Meininger (University of Groningen, UMC Groningen Postgraduate School of Medicine, University Medical Center Groningen, Groningen, Netherlands) Ulla Al-Saad (University of Groningen, Department of Health Sciences, University Medical Center Groningen, Hanzeplein 1, Groningen 9700RB, Netherlands Johan Groothof (University of Groningen, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands)
Jan Borleffs (University of Groningen, Postgraduate School of Medicine, University Medical Center Groningen, Groningen, Netherlands)
Background: Postgraduate medical education (PGME) is currently the independent responsibility of each European Union member state. The European Union of medical specialties (UEMS) has a longstanding history of attempting to pursue EU standards for PGME in order to ensure quality of care throughout Europe. PGME policies within the EU were compared to uncover variances in curricula, in order to see how far the EU currently is from a shared PGME policy vision. Summary of work: The so-called "CIA-project", was conducted with the use of a semi-structured questionnaire and stakeholder interviews in order to analyze three main aspects at the macro-system level: 1. Current situation and trends; 2. Importance of developments and desired innovations; 3. Attainability of desired innovations. The interviews were held among policymakers in eight selected EU-countries. Selected indicators essential to PGME structure and duration were contrasted.
Summary of results: Consistencies amongst the selected countries included the use of competency-based medical education in six out of the eight selected countries and mandatory Continuing Professional Development in five out of the eight selected countries. The indicator "PGME duration" displayed the most
inconsistencies, mainly relating to diverse transition structures from basic medical education to PGME. Conclusions: Although shared policies appear to be absent at the present time, our overview displayed significant consistencies. This indicates that unified standards may be attainable in the EU through cooperation between policy makers and the continued support from European medical organizations. Take-home messages: Current trends in policy seem to indicate that a shared vision concerning some aspects of PGME may be possible in the future and could assist in making the EU one of the leading PGME experts in the world.
7L Short Communications: Approaches
Location: Club C, PCC
How consistent are results of admission tests?
Hans Georg Kraft (Medical University of Innsbruck, Medical Genetics and Molecular and Clinical Pharmacology, Peter Mayr Str. 1, Innsbruck 6020, Austria)
Background: In 2006 a cognitive aptitude test (EMS -Eignungstest Medizin Schweiz) was introduced as the exclusive criterion for admission of medical students at the Medical University of Innsbruck. In addition a quota system was established which guaranteed 75 % of the vacant places for Austrian applicants. 20 % of the places were reserved for candidates from other EU countries and 5 % for students from non-EU countries. This system was considered necessary to provide sufficient physicians for the Austrian health care system. Candidates who did not reach the necessary limit in the EMS were given the opportunity to repeat the test in another year.
Summary of work: Here we show and analyze the test results of candidates who repeatedly participated in the EMS test in Innsbruck, Austria from 2006 until 2009. It is analyzed whether the retake leads to changes in the test result, whether it leads to an admission to study as a function of gender and quota.
Summary of results: 6478 candidates took part in the EMS in Innsbruck. 516 applicants tried twice, 42 applicants participated three times and 5 took part in all 4 tests. Male applicants were found with higher frequency within the repeaters than females. Two thirds of the candidates reached a higher test result upon repetition, 21 % the same result and 13 % had less points after 1, 2 or 3 years hence the chance to be admitted increased with the number of repeats. Conclusions: The result in the EMS aptitude test is not consistent but can be improved upon repetition.
The Biomedical Admissions Test (BMAT) for medical student selection: overview of research evidence
Joanne Emery (Cambridge Assessment, Research and Validation, 1 Hills Rd, Cambridge CB2 1EU, United Kingdom)
Sarah McElwee (Cambridge Assessment, Research and Validation, Cambridge, United Kingdom)
Background: The BMAT has been in use since 2003 and forms a part of the selection processes of a number of UK institutions. The test consists of three sections measuring scientific aptitude, scientific understanding and written communication. It is designed to assess readiness for demanding, science-based study and not fitness to practice. Institutions use BMAT scores in
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
conjunction with other selection criteria such as national examination results and interview performance, although some institutions use the test as a hurdle to the interview stage. This presentation gives a brief overview of the validation work carried out for the
Summary of work: Early validation work focussed mainly on the predictive validity of the test. The relationship between BMAT scores and test preparation has also been investigated. Group differences in BMAT scores continue to be an important research focus. Summary of results: The BMAT predicts early medicine course performance, with the scientific understanding section generally showing the strongest relationship with both examination success and examination failure. The effect of candidate preparation on test scores is difficult to establish with correlational designs but no relationship has been found between BMAT scores and the preparation help that candidates receive from their schools. Small gender differences in BMAT performance are evident but these do not appear to be a result of test bias.
Conclusions: Research evidence supports the predictive validity and fairness of the test for student selection. Take-home messages: The BMAT appears to be a useful and valid addition to the medical student selection process.
Social networks, identity, and widening access to medicine
Bhamini Vadhwana (West Middlesex University Hospital, Medicine, Twickenham Road, Isleworth, London, United Kingdom)
Suzanne Vaughan (University of Manchester, School of Medicine, Atr4 ERC, University South Hospital Manchester, Manchester M23 9LT, United Kingdom)
Background: Widening participation to recruit students to represent our diverse population is a key policy initiative in the UK. Medical schools have failed to engage students from lower socioeconomic status (SES) backgrounds. Young people from these backgrounds lack many educational and cultural resources, may hold negative perceptions of the medical profession and can struggle to imagine themselves as successful medical students.
Summary of work: We investigated the interaction of social networks, experience and achievement on young people's career decisions with regard to medicine. We collected data from students aged 11-17 (n=107) across ten state schools in Greater Manchester during widening participation sessions facilitated by medical students. The questionnaires were analysed quantitatively and qualitatively.
Summary of results: The attributes students perceived a "good doctor" to have varied according to their SES, gender and ethnicity. The majority of participants could imagine a future as a doctor. Early identifiers (participants deciding to study medicine aged 12 or below), those with professional parents and those with
doctors in their social network were more likely to have work experience and required predicted grades for application to medicine.
Conclusions: There are significant relationships between pupil's social status, social networks, identification and achievement. We consider these in relation to theories of learning and identity. A lack of social and cultural resources prevents many lower SES young people from gaining the experiences and achievement recognised by medical school admissions panels. Take-home messages: With rising tuition fees and falling social mobility it may become harder to recognise individuals with potential who may be disadvantaged by educational or social resources.
Student Admission Quo Vadis?
Guni Kadmon (Medical Faculty, Heidelberg University, HeiCuMed, Ernst Moro Building, Im Neuenheimer Feld 155, Heidelberg D-69120, Germany) Martina Kadmon (Heidelberg University, Klinik for General, Visceral and Trasplantation Surgery, Heidelberg, Germany)
Background: Admission of medical students is often based on instruments, which are disadvantageous if the aim is to increase student diversity without compromising high academic standards. These include admission instruments that strongly correlate with academic performance, admission procedures of insecure validity, and the misleading assumption that we know what me measure by the instruments we use. Summary of work: Our compensatory admission procedure is primarily based on two independent cognitive instruments, baccalaureate GPA and the German Test for Medical Studies. It is monitored by longitudinal quality management. Summary of results: Since its implementation, the students have reached homogeneously high academic grades regardless of their baccalaureate GPAs and diversity. Attrition has been reduced by 60-85%. MMI simulation using categorised OSCEs has shown that the competencies needed for success in the course are different than expected and change in time. Conclusions: (1) The compensatory admission procedure ensures both high diversity and homogeneously high performance. For this, all admission instruments must be offered to ALL applicants. (2) "Cognitive" instruments also reflect non-cognitive traits. (3) The traits that are reflected by admission instruments and those that are needed for success are often obscure. (4) In designing future admission procedures these limitations must be considered. (5) Designing admission instruments that predict both success in the pre-clinical part of the course and future professional success such as EPA competence is an important task for future research. Take-home messages: Admission instruments should be designed to predict high homogeneous performance in different parts of the medical course while accepting procedural limitations and insecurity concerning the relevance of the underlying hypotheses.
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
Identifying attribute domains to blueprint medical student selection tools
Tim Wilkinson (University of Otago, Christchurch, Medical Education Unit, P O Box 4345, Christchurch 8011, New Zealand)
Tom Wilkinson (University of Otago, Medical School, Dunedin, New Zealand)
Background: Determining the ability of admission tools to predict later outcomes is an important component of validating admissions schemes. However, most research focuses on individual assessment tools in isolation, rather than the domains each should aim to measure and their relative importance.
Summary of work: We broke down all measures used for admissions at Otago Medical School into the smallest possible component scores and used linear regression to assess the validity of each score for predicting performance in fifth year examinations. Those found to be useful were re-grouped into domains on the basis of assessed attributes. Regression was repeated to determine the optimum weighting for each domain in an admissions model.
Summary of results: Three measures were found to have no independent predictive value (chemistry, physics, and UMAT section 3). We were able to group the remaining measures into discrete domains of "Biological Science", "Critical Reasoning", "Understanding People", and "Communication Skills", each of which was independently and significantly associated with later success. Conclusions: Medical admissions schemes work best when blueprinted to a range of desirable attributes. However, including components without objectively evaluating their value risks undermining those elements known to be effective.