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Conclusions: Working closely with other healthcare professionals promotes interdisciplinary learning, with effective use of each specialist's knowledge and skills. This in turn ensures accurate advice is conveyed to patients, and adopted by trainee doctors for future practice. Communication skills also improved as doctors needed to adapt to patients' needs and abilities. Health promotion clinics allow foundation doctors to develop important skills in managing long-term conditions through interdisciplinary teaching and greater opportunities to apply knowledge. This also provides opportunities to develop teamwork and communication skills, and leads to doctors with greater experience in preventative medicine. Take-home messages: Health promotion clinics help trainees become better doctors and should be developed across more institutions.
Community mental health promotion project enhances mental health awareness
Varuna Kolkijkovin (Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Psychiatry, Samsen Road, Dusit, Bangkok 10300, Thailand)
Background: Community mental health promotion (CMHP) Project is a part of learning experience in clinical psychiatry rotation of fourth-year medical students at Faculty of Medicine, Vajira Hospital. It provides real experience in mental health promotion as well as treatment in the community setting. The objective of the study is to evaluate the outcomes in terms of satisfaction and test scores.
Summary of work: Two-day activity was provided. In day 1, students with medical teachers, who were from departments of psychiatry, public health and community volunteers, explored community mental health problems, summarized and planned the activities in urban communities. In day 2, they administrated planned activities and concluded the program. The program was evaluated in terms of participation satisfaction and post-test.
Summary of results: The mean satisfactory rate of people was 91.66% and post-test improved in every group. From medical students' perspective, they thought it was useful (86.93%), easily able to make use of experience in the future (96.63%), more aware of the mental health promotion (93.63%). Their overall satisfaction was 90.10%.
Conclusions: The students learned experiences of mental health promotion in real settings. People gained knowledge, attitude and practice about promotion of mental health.
Take-home messages: The institution can provide academic services and teach students of mental health promotion concurrently by using activities designed by students in community.
Improving a Brazilian internship in Primary Care through collaborative practice
Silmar Gannam (University City of Sao Paulo, Public Health, Sao Paulo, Brazil)
Elaine Q Assis (University City of Sao Paulo, Public Health, Rua Capote Valente, 926, apt 21, Sao Paulo 05409-002, Brazil)
Debora Bertussi (University City of Sao Paulo, Public Health, Sao Paulo, Brazil)
Denise Ballester (University City of Sao Paulo, Public Health, Sao Paulo, Brazil)
Eliana Amaral (University of Campinas, Department of Gynecology and Obstetrics, Sao Paulo, Brazil) Jose Lucio M Machado (University City of Sao Paulo, Dean, Sao Paulo, Brazil)
Background: The internship in Primary Care from a private PBL based Medical School in Sao Paulo, Brazil, occurs at primary health centers (PHC). General perception was that the course mainly focused on clinical skills and students felt it was not correlated with future practice, while PHC staff felt responsible for students' training.
Summary of work: A curriculum reform was done based on international literature, document analysis and experts' opinions. Changes implemented: planning of the internship program by the students in partnership with faculty and PHC staff; monitoring of the students by a University faculty coupled with a PHC physicians; weekly seminars based on real life experiences; use of a workplace-based 360o assessment and portfolios. Three focus groups with 10-12 students, portfolios' analysis, and categorization of activities performed by the interns were used to evaluate.
Summary of results: The whole process was a time of great reflection serving as teacher development and culminating with a framework of expected Public Health competencies. The planning of activities and the seminars served as milestones for the course, shifting its focus from medical care to management and leadership skills. Preliminary analysis showed that students seemed to acquire the expected competencies. Conclusions: Both the joint planning of activities and 360oassessment contributed to PHC staff becoming more involved and committed to students' training. Students became active stakeholders of their learning and appreciated the coherence of curriculum, integrating theory and practice.
Take-home messages: A recommendation for internship in Public Heath is to involve all stakeholders in its elaboration and promote collaborative practices among staff, students and teachers.
Evaluation of health promotion teaching in 5th year medical students
Phonphan Phadungcharoen (Department of Social Medicine, Medical Education Center, Maharat Nakhon
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
Ratchasima Hospital, 49 Chang Pueak Rd. Muang District, Thailand Nakhon Ratchasima 30000, Thailand) Nuanla-or Wiwatworaphan (Department of Social Medicine, Medical Education Center, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand) Pipope Chitnumsab (Department of Social Medicine, Medical Education Center, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand)
Background: To evaluate the achievement of Health promotion which consist of: 1) to identify common problem in family practice at PCU. 2.) to propose strategic plan for health promotion regarding the program in target groups. 3.) to implement intervention to target groups. 4.) to reflect what students learn from experiential learning classroom-based session. We have integrated this curriculum into family practice at Primary Care Unit (PCU) setting for 3 years. Summary of work: This descriptive study evaluated 123 5th year medical students from 2010 to 2012. All students had 4 weeks' experience in this curriculum as follows: 1.) 2 hour lecture and groups discussion at the beginning of the course. 2.) during the course students practicing family medicine at PCU, reviewed the common problem, completed a strategic plan for health promotion in target groups and approved the plan by an adviser at the end of the 2nd week. 3.) implemented the intervention to target group in PCU at the end of the 3rd week under the adviser's supervision. 4.) presented their results of experiential learning at the end of the 4th week.
Summary of results: Of 123 medical students, 84.2% can identify the problem in PCU, 74.6% can propose proper health promotion strategic plan in target groups, 82.8% can implement the intervention comprehensively to the target group successfully and 87.5% of them can present their result of learning experience. Conclusions: Most of the 5th year medical students can achieve the objectives of the health promotion course. Take-home messages: Through experiential learning in PCU, students can achieve the objectives better than learning in a classroom-based session.
Public health units as learning scenario for medical students
Fabio Antonio Perecim Volpe (Paulo Prata Faculty of Health Sciences - FACISB, Medical Education Unit, Avenida Loja Maconica Renovadora 68, N° 100. Barretos 14785-002, Brazil
Andrea Serissa Doretto (Paulo Prata Faculty of Health Sciences - FACISB, Education and Community Health Service - IESCS, Barretos, Brazil) Fabiana Faria Rezende (Paulo Prata Faculty of Health Sciences - FACISB, Education and Community Health Service - IESCS, Barretos, Brazil)
Jose Alves Freitas (Paulo Prata Faculty of Health Sciences - FACISB, Medical Course Director, Barretos, Brazil) Eduardo Anselmo Garcia (Paulo Prata Faculty of Health Sciences - FACISB, Medical Education Unit, Barretos, Brazil)
Background: The Brazil Unified Health System (UHS) has established health as a right of all and a state duty. With restricted financial resources there were serious problems. Over the years, new financial incomes have been available, new hospitals were built, and new experts were engaged. Twenty-five years after its creation, important changes have been made in the national epidemiological reality giving assistance to needy people. Many citizens still carry prejudices about the UHS. Our aim was to assess medical students' perceptions about UHS.
Summary of work: Fifty-three medical students of the first year participated in 3 activities in public health units and after that their perceptions about how the UHS works was assessed through questionnaires. Summary of results: In general, students consider the UHS disorganized with fragile infrastructure and low payments for professionals. However, most students felt that working on UHS might be a good opportunity to give assistance to people in need. The main problems in their opinion are: infrastructure (38%), time waiting for assistance (71%) and lack of physicians (38%). Students pointed out as positive aspects: free (75%) and universal (73%) assistance. To resolve these problems, 94% of the students propose actions to improve the infrastructure and humanize care practices. Only 17% suggest better payments.
Conclusions: Students recognize more negative than positive aspects in Brazil UHS but they consider UHS as an opportunity to deliver assistance to the most needy population range.
Take-home messages: Activities in the local public health units can be a powerful tool for helping medical students understand the UHS and can be used as a trigger for important related discussions.
Population Health Intensive: Engaging senior medical students in public health
Chris Bullen (The University of Auckland, National Institute for Health Innovation, Morrin Rd, Glen Innes, Auckland 1150, New Zealand)
Background: Engaging medical students in public health is typically very challenging in New Zealand as elsewhere. Over six years we have developed and implemented a program for final year students that evaluations show succeeds in engagement and high ratings of relevance. This paper outlines the rationale, format and structure of the program and the results of study and faculty evaluations.
Summary of work: We developed a week-long program combining team-based small group learning and work using public health strategies to tackle a public health issue within resource-constraints, supported by trained facilitators; as well as exposure to a range of community-based organizations and clinical and public health role models.
Summary of results: Ratings by students of interest and in the relevance of public health to their future medical careers and usefulness of public health frameworks in
medical practice have been sustained at high levels over six successive years. Key success factors include setting high expectations of professionalism, use of clinician role models who use public health approaches in their work, collaborative small group work with community group exposures to deliver outputs and formal assessment of these outputs.
Conclusions: Engaging students with public health ideas and models is achievable but requires creative approaches to learning with regular adjustment to maintain currency and relevance of topics and tasks. Take-home messages: Despite the challenges of interesting students in a non-clinical area such as public health, sustained high levels of engagement and ratings of relevance of public health are attainable with appropriate learning models, preparation and planning.
7BB Posters: Assessment: The OSCE
Location: South Hall, PCC
Reliability of OSCE (Objective Structured Clinical Examination) assessment comparing between face-to-face and video rating
Nonlawan Chueamuangphan (Medical Education Center, Medicine, 1039 Chiangrai Prachanukroh Hospital, T. Viang A. Muang, Chiang Rai 57000, Thailand)
Samroeng Seekaew (Medical Education Center, Chiangrai Prachanukroh Hospital, Medicine, Chiang Rai, Thailand)
Yaowalak Jariyapongpaiboon (Medical Education Center, Chiangrai Prachanukroh Hospital, Pediatrics, Chiang Rai, Thailand)
Chaiwetch Thanapaisal (Medical Education Center, Chiangrai Prachanukroh Hospital, Surgery, Chiang Rai)
Background: The objective structured clinical examinations (OSCEs) have been used globally in evaluating clinical competencies. In a process, two examiners are needed to reduce examiner bias. In many settings, using two assessors simultaneously is impractical due to shortage of personnel. VDO rating may be possible to be applied for OSCE assessment. This study was aimed to evaluate video rating compare to face-to-face of OSCE assessment using the inter-rater reliability.
Summary of work: 29 fourth year medical students who took the formative OSCEs from April to October 2012 were enrolled. The five OSCEs (anemia, headache, influenza, COPD and UGIH) comprised of five-minute history-taking or patient education stations and each with one simulated patient. The students were assessed and scored by two examiners using the standardized checklists. Real time face-to-face assessment by first examiner appeared in the same room with the student was conducted first, and then the video clips were used afterward for an assessment by a second examiner. The consent forms were attained from all subjects. Correlation analysis using Spearman's rank correlation was applied by setting p-value < 0.05 as statistically significant.
Summary of results: The inter-rater reliabilities between face-to-face and video rating for all stations were considerably high as follows; anemia(r=0.87, p=0.001), headache(r=0.92, p<0.001), influenza(r=0.88,p=0.001),
COPD(r=0.92,p=0.001), and UGIH stations(r=0.80,p=0.005).
Conclusions: There were high positive correlations of OSCEs assessment between face-to-face and video rating.
Take-home messages: The face-to-face ratings having positive correlations with video ratings. Consequently, it can be efficiently applied to assess medical students' clinical competencies.
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
Impact of Mock Objective Structured Clinical Encounter (OSCE) Exams on Anxiety levels during Final OSCE of Third Year Medical students of Ross University
Rhonda Mclntyre-Francis (Ross University School of Medicine, Advanced Introduction to Clinical Medicine, PO Box 266, Picard, Dominica
Carlista Tavernier (Ross University School of Medicine, Advanced Introduction to Clinical Medicine, Picard, Dominica)
Paul Ricketts (Ross University School of Medicine, Advanced Introduction to Clinical Medicine, Picard, Dominica)
Davendra Sharma (Ross University School of Medicine, Advanced Introduction to Clinical Medicine, Picard, Dominica)
Background: The Advanced Introduction to Clinical Medicine department offers 8 weeks of clinical exposure and clinical skills training with the use of standardized patients, to third year medical students. At the end of the semester, their clinical competency is evaluated with the use of an Objective Structured Clinical Examinations (OSCE). This study was undertaken to determine the usefulness of mock OSCE exams as it relates to its effect on anxiety levels and performance on the final OSCE. The Beck's anxiety scale was administered prior to both the Mock and Final OSCE in an attempt to document the students' level of anxiety. Summary of work: Each student in the Advanced Introduction to Clinical Medicine semester at Princess Margaret Hospital participates in a MOCK OSCE prior to their Final OSCE. Students were given an informational sheet explaining the purpose and procedure of gathering information. The anxiety scale responses were tabulated and compared using Wilcoxon rank test for paired data. OSCE performance scores on both mock and final were also compared using a t-test. Summary of results: When compared to Mock OSCE performance, student performance scores were increased on the final exam. In comparison, anxiety levels appeared to remain relatively constant prior to both exams (p =0.69).
Conclusions: Though anxiety levels prior to exams did not show a statistically significant change, OSCE performance increased on the final exam. Maintenance of anxiety therefore does not seem to negatively impact student performance.
Take-home messages: The Mock OSCE appears to help improve student performance on the final exam, irrespective of anxiety level.
Reliability study of OSCE in a Woman's Health station at Public Health of the clerkship students' examination in a Medical University at Universidade Federal de Uberlandia (FAMED-
Marcia Aires Rodrigues de Freitas (Federal University of Uberlandia, Gynecology and Obstetrics, Rua Professor Pedro Bernardo, 40 apto-702, Uberlandia 38400172, Brazil)
Helena Borges Martins da Silva Paro (Federal University of Uberlandia, Gynecology and Obstetrics, Uberlandia, Brazil)
Angelica Lemos Debs Diniz (Federal University of Uberlandia, Gynecology and Obstetrics, Uberlandia, Brazil)
Gizeli Dos Santos Anjos (Federal University of Uberlandia, Gynecology and Obstetrics, Uberlandia, Brazil)
Leila Bitar Moukachar Ramos (Federal University of Uberlandia, Public Health, Uberlandia, Brazil)
Background: Traditionally, the clerkship students' assessment in Public Health FAMED-UFU has been performed by multiple choice questions and subjective global evaluation. Since 2010, the OSCE was added as a new tool for assessing these students. The aim was to check the reliability of the OSCE in students' assessments in a Woman's Health station, at a boarding in Public Health FAMED_UFU.
Summary of work: Cross-sectional study analyzing the checklist final grade of the clerkship students in Public Health in a simulated scenario of Women's Health of the OSCE in October 2012 in FAMED-UFU. Each one was assessed by two examiners simultaneously. The grades of each student were compared by pairs of observers using the Wilcoxon test, considering p <0.05 to establish statistical significance.
Summary of results: Forty one students were included, randomly divided into two groups. Group 1 = with 20 students assessed by examiners A and B, and group II = with 21 students assessed by examiners C and D. There were no statistically significant differences in student assessment between examiners A and B (p = 0.129) and between examiners C and D (p = 0.279). Conclusions: The OSCE is a reliable tool for assessing students at the Women's Health station in a Public Health boarding of FAMED-UFU. Take-home messages: The OSCE test can be used for selection of clerkship students' graduation exams (high-stakes tests)
Clinical skills assessment revised: correlating OSCE performance scores and knowledge grades
Bogdan Zdravkovic (University of Maribor, Faculty of Medicine, Center for Medical Education, Maribor, Slovenia)
ABSTRACT BOOK: SESSION 7 TUESDAY 27 AUGUST: 1045-1230
Tamara Todorovic (University of Maribor, Faculty of Medicine, Center for Medical Education, Slomskov trg 15, Maribor 2000, Slovenia)
Marko Zdravkovic (University of Maribor, Faculty of Medicine, Center for Medical Education, Maribor, Slovenia)
Background: In 2011/2012 our Year-3 medical students could take peer-taught student selected component (SSC) on internal medicine clinical skills training, assessed by objective structured clinical examination (OSCE). Due to different testing domains, OSCE performance was not supposed to correlate with knowledge grades. We decided to determine whether this holds in our situation. Research question: Is there correlation between OSCE scores, students' average grade and students' final internal medicine grade in 2011/2012?
Summary of work: We delivered a non-anonymous questionnaire (piloted a year before) via emails; email, SMS and Facebook reminders were used. Disclosure on protection of individual response confidentiality was included. Students gave consent for using their OSCE results. The collected quantitative data was analysed in
Summary of results: The overall response rate was 90% in a sample size of 40. Students' mean average grade was 8.7 (SD=0.33), mean internal medicine grade was 8.0 (SD=0.15) and mean perception of deserved internal medicine grade was 8.4 (SD=0.13). Average grade was positively correlated with practical procedures points on OSCE by having Pearson correlation coefficient of +0.47 (p=0.006). When analysing data set split by gender, the significant correlation remained only for females. Interestingly, OSCE overall points have been found to negatively correlate with OSCE overall time: -0.64
Conclusions: We found correlation between OSCE subscale of practical procedures scores and female students' average grade.
Take-home messages: Average grades might be positive predictors of practical procedure OSCE performance in females.
A new look at OSCE as an educational method (OSCEd): Interns' CPR competency
Fakhrossadat Mirhosseini (Tehran University of Medical Sciences - Kashan University of Medical Sciences, Medical Education in Faculty of Medicine (Tehran) -Anesthesia Dep. in Allied Medicine (Kashan), Kashan University of Medical Sciences, Ghotb-e Ravandi Blv., Kashan, Isfahan, Iran)
Fariba Raygan (Kashan University of Medical Sciences, Cardiovascular Dep., Kashan, Iran) Reza Rezaee (Tehran Payam-e Nour University and Kashan University of Medical Sciences, Management Dep., Kashan, Iran)
Shoaleh Bigdeli (Iran University of Medical Sciences(IUMS), Department of Medical Education,
Center for Educational Research in Medical Sciences
(CERMS), Tehran, Iran)
Farzaneh Alipour (Jahrom University of Medical Sciences and Student Research Center, Student Research Center, Jahrom, Iran)
Parastoo Pournaghshband (Kashan University of Medical Sciences, Student Research Center, Kashan, Iran)
Background: According to the AHA guideline, the physician as manager of CPR teams needs effective theoretical and practical education that must be updated every 6 months and 2 years, respectively. CPR training is an inseparable part of general medical curricula; although the look out through CPR is nonspecific and unplanned. In regard to CPR, focusing on training is essential. Competency, located near the top of Miller's pyramid, can be assessed by methods such as OSCE. In this study, OSCE was used as pre-post Examination and also as an Educational intervention
Summary of work: In this experimental pre-post test design study, the intervention, Objective Structured Clinical Education (OSCEd), consisted of a booklet and station training, including 8 stations. In each, students spend 20 minutes. Pre-and post-test interval took 3 months. Manpower training, equipment preparation, designing stations, writing expected scenarios, programmable mannequins, trainers, and checklists were prepared. Paired t-test was used for comparing pre- post results through SPSS v.16. Summary of results: Pre, post-test mean of knowledge and skill were 7.14±2.38, 7.38±2.29 and 17.34±1.38, 14.63±2.37 (from 20, p<0.05), respectively. Conclusions: This study indicated that, OSCEd as an Educational Method was effective although the mean score of skill in post test was relatively low (14.63±2.37). Take-home messages: OSCE is an effective method of education (OSCEd) in CPR training.
The effectiveness of video-assisted assessment for Objective Structured Clinical Examination
Srila Samphao (Prince of Songkla University, Department of Surgery, Faculty of Medicine, Hatyai 90110, Thailand)