Автор неизвестен - Mededworld and amee 2013 conference connect - страница 8

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2M/4

How r u going 2 teach me? Perspectives on teaching strategies from a Millennial learner

Vanessa Thoo (Dalhousie University, Department of Psychiatry, Abbie J. Lane Memorial Building, 5909 Veterans' Memorial Lane, 8th Floor, Halifax, NS B3H 2E2, Canada)

Background: While appreciating each individual's particular learning style, there are certain characteristics unique to members of the generation termed the "Millennials". Certainly, their familiarity with technology has revolutionized conventional educational strategies; however, associated with the strengths of Generation Y are the challenges inherent in transmission of knowledge to a group of learners who have been raised in an era of information "overload". With the current shift in medical education from traditional pedagogies to a greater emphasis on the principles of adult learning, new medical curricula being developed must take into consideration the specific learning needs of this forthcoming cohort of students. Summary of work: Current literature on medical education and Millennial learners was reviewed. Additionally, the author provides insights drawn from

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

personal experiences as a member of this generational cohort, with perspectives of being both a student and a teaching facilitator.

Summary of results: Millennial students respond best to active learning strategies, engaging principles of the constructivist theory of social learning via group work and increased peer interactions. Likewise, a reformation in the educational environment to a more informal, relaxed setting further enhances the learning of this group of trainees.

Conclusions: Millennial students learn most effectively in informal educational environments, with emphasis on guided social interactions.

Take-home messages: In order to most effectively meet the educational needs of Millennial medical students, a combination of active learning methods and a modernization of current teaching strategies and attitudes is imperative.

2M/5

Learning styles and Achievement

C.F Smith (University of Southampton, Centre for Learning Anatomical Sciences, Faculty of Medicine, MP845, Level B South Academic Block, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom)

R Hewiston (University of Southampton, Faculty of Medicine, Southampton, United Kingdom) S Walker (University of Durham, School of Medicine, Pharmacy and Health, Durham, United Kingdom) G Finn (University of Durham, School of Medicine, Pharmacy and Health, Durham, United Kingdom)

Background: Junior doctors' knowledge has been deemed unsatisfactory and unsafe for clinical practice by senior clinicians. This is supported by an increasing number of medico-legal litigations related to incompetency. Such cases are avoidable with improved understanding provided by altered training. Knowledge of medical graduates has been criticised, highlighting a potential problem with the way students are taught and emphasising the need to evaluate whether appropriate teaching methods are being used. A learning style is the way in which an individual prepares and learns. Using the experiential learning model (Conceptualize, Apply, Act and Reflect) it is possible to categorize students based on their educational needs. Summary of work: This study set out to explore: the trends in learning styles and academic achievement in medical students' knowledge. Questionnaire packs containing the 80-item Honey & Mumford Learning Styles questionnaire were completed by 1st and 2nd year medical students at two institutions (University of Southampton and University of Durham) n=169. Summary of results: The results revealed that the majority of students portrayed a reflector style (50.3%) followed by Theorist style (14.2%), Pragmatist style (11.2%) and Activist style (9.5%). Learning Style is not significantly correlated to examination success (Activists P=0.064, Reflectors P=.935, Theorists P=.184 and

Pragmatist P=.166) although trend reflect that students using an activist style are more successful. Conclusions: Defining students' learning styles and relating this to academic achievement helps to understand the different types of learners within a curriculum.

Take-home messages: Learning styles are helpful in understanding students. Curricula should offer a multi-modal range of learning opportunities to suit different styles.

2M/6

The perception of candidates to medical school of the roles of the physician

Maria del Carmen Teijeiro (Faculty of Biomedical Sciences, Austral University, Medical Education, Buenos Aires, Argentina)

Malena Sayal (Faculty of Biomedical Sciences, Austral University, Medical Education, Buenos Aires, Argentina) Florencia Moore (Faculty of Biomedical Sciences, Austral University, Medical Education, Buenos Aires, Argentina) Angel Centeno (Faculty of Biomedical Sciences, Austral University, Medical Education, Av Juan Peron 1500, Pilar, Buenos Aires B1625AHJ, Argentina)

Background: Admission procedures throughout the world vary in requirements and many schools include a personal interview to try to identify what students want and how prepared they may be for medical school. Summary of work: In order to understand why applicants select a medical career and how they perceive the role of the physicians, how this decision was influenced, and how they reflect on their personal characteristics to succeed in the medical career, we interviewed 164 candidates to medical school during the admission process.

Summary of results: 76% of our candidates elected medicine to help people, or as a service to the community. Others held a more academic perspective (understanding how the human body works, or interest for biomedical disciplines). Concerning those factors that influenced their election, the most important was the social prestige of the career and its possibility to impact on society, and the encouragement of the family. Regarding their own personality characteristics and skills, most of them recognized the importance of being organized, patient, caring, committed, determined or having good abilities such as curiosity, team-working skills or resilience.

Conclusions: Students entering medical school have a strong commitment to service, and interest for the biomedical sciences, and rely on their perceived personal characteristics to succeed in their studies Take-home messages: Many medical schools still emphasize the academic component of its curriculum, but do not take advantage of this strong motivation to foster service attitude in their students.

2N Short Communications: Communication Skills

Location: Meeting Room 2.1, PCC

2N/1

Handoff Training for Pediatric Medical Students Improves Patient Care Skills

Jennifer Stojan (University of Michigan Medical School, Department of Internal Medicine and Department of Pediatrics, Ann Arbor, United States) Thomas Fitzgerald (University of Michigan Medical School, Department of Medical Education, Ann Arbor,

United States)

Patricia Mullan (University of Michigan Medical School, Department of Medical Education, Ann Arbor, United

States)

Monica Lypson (University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, United

States)

Hilary Haftel (University of Michigan Medical School, Department of Pediatrics, Ann Arbor, United States) Jocelyn Schiller (University of Michigan Medical School, Department of Pediatrics, Ann Arbor, United States)

Background: Failures in communication are the leading root cause of sentinel events. Accreditors worldwide have recognized this and mandated physician handoff education. While graduating medical students assume patient care responsibilities at the onset of their postgraduate training, there is little evidence indicating medical students are taught patient handoff skills. Therefore, a handoff curriculum was developed, implemented, and assessed using direct observation of students' handoffs.

Summary of work: In 2012, students completing a pediatric rotation in their final year at a North American medical school participated in a 2-hour handoff workshop. Over the month long rotation, students where observed three times performing handoffs and received feedback by trained faculty. An assessment instrument was constructed from a previously published "SIGNOUT" mnemonic was used to calculate a performance score. Using a 15-item checklist, the student performance was scored for each item as 0=not done, 1= needs improvement, or 2= done, for a maximum score of 30 (100%). Summary of results: Fifteen students were observed performing 93 handoffs. Performance improved over time: mean score during first observation = 67.7% (SD 13.14), second observation = 94.8% (SD 5.04), third

observation = 96.0% (SD4.67) (MANOVA, p<.0001). Evaluations of the workshop and feedback were overwhelmingly positive, 100% of students agreed they would recommend the workshop to a peer and that teaching was effective.

Conclusions: Student performance on handoffs improved with a curriculum incorporating direct observation and feedback.

Take-home messages: Education, direct observation and feedback of handoffs improve student skills on patient

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

handoffs and can be incorporated into a senior level clinical rotation.

2N/2

Intrinsic clinical knowledge and skills bias and their potential impact on the assessment of communications skills in veterinary medicine

Andrea Vallevand (University of Calgary, Faculty of

Veterinary Medicine, Calgary, Alberta, Canada)

Cindy Adams (University of Calgary, Faculty of Veterinary

Medicine, Calgary, Alberta, Canada)

Elpida Artemiou (Ross University School of Veterinary

Medicine, Clinical Sciences, West Farm, Basseterre 334,

Saint Kitts and Nevi)

Claudio Violato (University of Calgary, Department of Community Health Sciences, Calgary, Alberta, Canada)

Background: Further empirical work is needed in teaching and assessment of communication skills in veterinary education.

Summary of work: Web-based and small group training programs were developed. Two four-station OSCEs were employed to evaluate program efficacy (pre-post design). Twenty-three raters from clinical sciences, basic sciences, communications, and administrative backgrounds attended eight-hours of training on communication skills and the use of the 21-item Calgary-Cambridge Guide.

Summary of results: Semester five veterinary students were randomly assigned to groups: web-based (n = 32), small group (n = 33), and control (n = 30). Statistically significant differences on two post-intervention stations were observed (Canine Behaviour: F[2, 93] = 5.113, p < .008; Equine Lameness: F[2, 93] = 8.004, p < .001). Post-hoc analyses indicated the small group intervention outperformed the other groups (p < .05). Results indicated that students were equally distributed among groups and rater backgrounds (Pearson X2 range: .217 to .793, p = ns). Differences in scores between rater backgrounds were found in all

stations (F range: 3.826 to 21.972, p < .05). NVivo

analysis indicated clinical sciences raters frequently commented about student history taking and clinical knowledge deficiencies.

Conclusions: Small group training was the most effective learning intervention. Basic sciences raters had the highest mean scores; communications raters the lowest. Confounding clinical performance with communication skills might have influenced clinical sciences rater scoring.

Take-home messages: Raters may have intrinsic biases related to their professional training. Clinical expectations that might influence communication skills assessment should be taken into account in rater training.

2N/3

Fostering informed empathy to improve attitudes toward and advocacy for persons with disabilities

Sonya Miller (University of Michigan, Physical Medicine & Rehabilitation and Medical Education, 325 E. Eisenhower Parkway, 2nd Floor, Ann Arbor 48108,

United States)

Background: Having a disability can negatively affect provider-patient communication. Persons with disabilities report the need for better communication with their health care providers and argue that education regarding disabilities is lacking for health care professionals.

Summary of work: An educational module to enhance health care students' capacity for informed empathy was developed. Pre- and post-assessment measures included the Attitude Toward Disabled Persons scale (ATDP), the Attitudes Toward Patient Advocacy Microsocial scale (AMIA) and the Interpersonal Reactivity Index (IRI). A pilot study assessed the development of informed empathy through the qualitative analysis of the post-module question, "How has your understanding, awareness or perception of individuals with disabilities changed?" Summary of results: Themes of the qualitative analysis were a) becoming familiar with the daily life of individuals with disabilities, b) changing notions of normalcy, c) seeing discrimination against individuals with disabilities as issues that impacted them, d) recognition that disability is not only an issue of the

physical body. ATDP (t(126) = -5.324, p = .000) and AMIA (t(123) = -5.499, p = .000) scores increased significantly post-module. Correlations between the pre- or post-module ATDP or AMIA scores and the IRI scores were not significant.

Conclusions: A patient-centered curriculum that utilizes persons with disabilities as the educators is an effective teaching tool for improving attitudes toward and advocacy for individuals with disabilities through the development of informed empathy. Take-home messages: Patient-centered education can foster the development of informed empathy. Patient-centered education is an effective teaching method. Informed empathy can be tailored towards specific groups. Attitudes toward and advocacy for individuals with disabilities can be enhanced through informed empathy.

2N/4

Enhancing medical students' skills in handling awkward communications

Carmella Law (University of Notre Dame, School of Medicine, 160 Oxford Street, Darlinghurst 2010, Australia)

Background: Communication skills are covered in the first and second years of the four-year medical program at the University of Notre Dame, Sydney, Australia, in a

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

series of workshops. Each workshop comprises small groups of up to 15 students.

Summary of work: Many factors contribute towards difficult patient encounters (Breen and Greenberg, 2010). To address the area of awkwardness e.g. sexual history-taking, the following approaches were taken in one workshop in second year: (1) using stories about real patient encounters (Miley, 2009); (2) incremental steps of taking a sexual history with student peers, followed by one-on-one in class with the facilitator as patient, using a "goldfish bowl" technique (Miller &

Benz, 2008).

Summary of results: Feedback in student reflections and evaluations emphasise how this approach engaged them, enhanced their learning and helped them overcome their individual anxieties. "I particularly like how the tutor demonstrates how task should be done and allows the student to practice directly with the tutor. The immediate feedback and opportunity to retry the skill afterwards is also very helpful in the learning process."

Conclusions: The horizontal integration of this workshop in second year with other sexuality related topics has had a synergistic result on the students' performance overall. To minimise facilitator effect, a program for sharing this approach with facilitators from Helsinki University has been trialled to explore the impact of cultural and language.

Take-home messages: Taking a sexual history provides an excellent example of a challenging area of communication skills which focuses medical students' awareness of the interplay between self, patient and environment factors which include professional/ethical standards (French 2007 BASHH guidelines).

2N/5

Predicting Communication Risks in the Emergency Department using Artificial Neural Networks

Annamaria Bagnasco (University of Genoa, Health Science Department, Via A. Pastore 1, Genoa 16132,

Italy)

Anna Siri (University of Genoa, Italy)

Gennaro Rocco (Centro di Eccellenza per la cultura e la

ricerca infermieristica Rome, Italy)

Carlo Turci (Centro di Eccellenza per la cultura e la

ricerca infermieristica Rome, Italy)

Loredana Sasso (University of Genoa, Health Science

Department, Genoa, Italy)

Background: In healthcare, effective communication involves arriving at a shared understanding of a situation and in some instances a shared course of action. This requires a wide range of generic communication skills, from negotiation and listening, to goal setting and assertiveness, and being able to apply these generic skills in a variety of contexts and situations. This study explores if and how Artificial Neural Network can be applied to predict the risk of communication failures in emergency departments.

Summary of work: Data were collected by observing communication interactions in 840 nurses while they

carried out the routine activities in their Emergency Department. The tools used for the observation were a questionnaire to collect personal and descriptive data and their level of training and experience and a grid that applied the Situation-Background-Assessment-Recommendation (SBAR) technique to communication in the Emergency Department. The variables we identified were: terminology, listening, attention, and clarity.

Summary of results: A total of 840 observations were made on the nurses working in the Emergency Department, with a good distribution between males and females (M=40,6%; F=59,4%). Various factors that may likely influence the risk of failure were identified and then used as input variables for the ANN model. A model based on the Multilayer Perceptron Topology was developed and trained. Test data evaluation shows that the ANN model is able to correctly predict the performance of more than 75% of communication failures.

Conclusions: Its application can offer a valid tool to focus educational interventions in the communication area priority to people with a very high risk score.

2N/6

Who should teach medical students in communication skills: Experts in communication, psychiatrists, or someone else? Case study performed at the University of Zagreb School of Medicine

Nada Cikes (University of Zagreb, School of Medicine, Salata 3b, Zagreb 10000, Croatia Gordana Pavlekovic (University of Zagreb, School of Medicine, Department for Social Medicine and Organization of Health Care, Zagreb, Croatia) Marijana Bras (University of Zagreb, School of Medicine, Department for Psychiatry, Zagreb, Croatia) Veljko Djordjevic (University of Zagreb, School of Medicine, Department for Psychiatry, Zagreb, Croatia) Ratko Matijevic (University of Zagreb, School of Medicine, Department for Gynecology, Zagreb, Croatia)

Background: Teaching communication skills is an important part of medical school curricula. However, a question remains: who (professional profile) is responsible to teach medical students how to communicate? According to internationally presented experience, the answer is controversial. Two years ago, at the University of Zagreb School of Medicine, we introduced a longitudinal 6 years course in communication skills. The key question was who should be the teachers.

Summary of work: We present the original model of training teachers (regular staff from clinical, public health and primary health care fields) in communication skills and sharing experience in its implementation and evaluation. Forty younger teachers with various educational backgrounds are trained for teaching. Besides their personal and professional characteristics, the training programme, learning outcomes, materials and process evaluation results are presented.

Summary of results: Teaching communication skills is not exclusively the task of communication skills experts. The model developed and applied at the Zagreb School of Medicine showed that medical teachers could be educated to teach medical students in this field. Take-home messages: Training medical teachers for teaching communication skills for medical students had an additional impact: They became (personally) competent in communication with patients, colleagues and others; a communication oriented atmosphere is generated.

2O Workshop: Using Situational Judgment Tests for Selection into Medical Education and Training

Location: Meeting Room 3.5, PCC

Alison Carr (Health Education England, Department of Health, Caradon, Golf Links Road, Yelverton, Plymouth PL20 6BN, United Kingdom) Fiona Patterson (Work Psychology Group, United Kingdom)

Maire Kerrin (Work Psychology Group, United Kingdom) Bill Burr (Joint Royal College of Physicians Training Board, London, United Kingdom)

Background: Situational Judgment Tests (SJTs) are becoming a popular method of selection for evaluating non-cognitive skills across many high stakes settings. SJTs have been used across a range of occupational groups ranging from the civil service through to the military. Meta-analytic validation studies have shown SJTs to have predictive validity over cognitive ability and personality tests. This workshop explores the research evidence underpinning the reliability and validity of SJTs in selection in medicine and how best to develop SJT items for selection purposes. Intended outcomes: By the end of the session, participants will: (1) Understand the features important in developing a SJT (eg, designing items and response formats); (2) Recognise the advantages and limitations of using an SJT for selection into medical education and training; Understand the research evidence on the reliability and validity of SJTs for medical selection. Structure of workshop: Presenters will share their experience of developing and evaluating SJTs for undergraduate and postgraduate medical selection. Participants will be invited to practice item development and the opportunity of reviewing SJT items. The session will consist of several short presentations on aspects of using the SJT, with a taster session on item writing with lively discussion and some interactive small group work. Who should attend: All those interested in selection into medical training, undergraduate or postgraduate. Level: Introductory

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

2P Workshop: Assessment of teachers' competence

Location: Meeting Room 4.1, PCC

Linda Barman (Karolinska Institutet, Centre for Medical Education/ LIME, Tomtebodavagen 18A, Stockholm 17177, Sweden)

Klara Bolander Laksov (Karolinska Institutet, Centre for Medical Education/ LIME, Stockholm, Sweden) Charlotte Silen (Karolinska Institutet, Centre for Medical Education/ LIME, Stockholm, Sweden) Maria Weurlander (Karolinska Institutet, Centre for Medical Education/ LIME, Stockholm, Sweden)

Background: To ensure high quality in health professions education, universities need to recruit teachers with high educational competence and set incitements for teachers' involvement in the development of teaching-learning. For this purpose, teaching portfolios have been introduced as part of the assessment for tenure track positions, and as a way to encourage teachers scholarly approach to teaching-learning. However, qualitative assessment of educational competence can be difficult. We developed a framework for the assessment of qualitative aspects of educational competence, based on research of what facilitates learning and focus group interviews with teachers. The framework was tested and implemented to reward and recruit teachers with high competence.

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