Автор неизвестен - Mededworld and amee 2013 conference connect - страница 96

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Davinder Sandhu (Severn Deanery, Postgraduate Medical Education, Deanery House, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol BS16 1GW, United Kingdom)

Alan Cook (Severn Deanery, Postgraduate Medical Education, Bristol, United Kingdom)

Background: The biggest challenge for Medical Trainers/Educators is how to deal with performance issues. About 5% of trainees struggle to complete their training and require additional targeted time or an extension of training. Some leave the profession. Many others have periods when they really struggle and need extra support with their training or managing life pressures. This is a traumatic experience and can be a huge drain of resources for faculty who often feel underprepared to deal with such occurrences. Failure to address them can lead to bitterness, huge remedial costs and legal challenges to educational institutions and employers. Intended outcomes:

To gain an understanding of why trainees struggle and/or fail

To be able to analyse the causes of poor performance To know how to pick up these issues early and raise them with a trainee

To know how to deal effectively with this and get good outcomes

Structure of workshop: An initial presentation and discussion led by Prof Sandhu, will focus on why trainees struggle or fail. This will be followed by group work reviewing written and filmed case studies and challenging situations. The workshop will conclude with advice based on researched best practice and guidance on how to develop focused action plans with struggling trainees.

Who should attend: This workshop is open to all involved with education; undergraduate, postgraduate and interdisciplinary nursing and allied health professionals Level: Intermediate

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

8T Workshop: Flipped classrooms - the educators big stage for promoting learning

Location: Meeting Room 3.2, PCC

Vishna Devi Nadarajah (International Medical University, Human Biology, no 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia)

Background: Flipped classrooms are widely used at schools and are gaining momentum with adult learning. Health professions educators have also been enticed with the concept of flipped classrooms to replace traditional lectures. Simply put, with flipped classrooms students access and go through learning materials (prepared or selected by the educator) at their own time and prior to the classroom sessions. During the classroom sessions, educators will instead engage and promote learning through opportunities for clarifications, assessment of student learning, collaborative and self-directed learning. Intended outcomes: Participants are able to: Plan and deliver a flipped classroom session based on student learning outcomes.

Use various interactive learning tools to engage and assess students during the classroom sessions Structure of workshop: We discuss how health professions educators can use this method to deliver learning outcomes on topics related to basic medical sciences to clinical and pharmaceutical sciences. Our experience in introducing flipped classrooms at the International Medical University will provide (i) a case study of how flipped classrooms are supported by e-learning methods and (ii) add context to teacher and student perceptions/acceptance of this method. The workshop will also engage participants by introducing simple and easily accessible interactive tools for flipped classrooms in large and small group teaching. Participants will also be asked to reflect on implementing flipped classrooms with other student learning activities within the curriculum including experiential learning.

Who should attend: Health Professions Educators who want to promote student learning and would like to use the classroom as the big stage to do this. 8U Workshop: An interactive workshop

to understand and design Entrustable

Professional Activities Location: Meeting Room 3.3, PCC

Karen Schultz (Queen's University, Family Medicine, 115 Clarence St., Suite 101, Kingston, Ontario K7L 3N6, Canada)

Jane Griffiths (Queen's University, Family Medicine, Kingston, Ontario, Canada)

Jonathan Kerr (Queen's University, Family Medicine, Kingston, Ontario, Canada) Laura McEwen (Queen's University, Post Graduate Medical Education, Kingston, Ontario, Canada) Miriam Lacasse (Universite Laval, Family Medicine, Laval, Quebec, Canada)

Wayne Weston (Western University, Family Medicine, London, Ontario, Canada)

Background: There is a pressing need for competency assessment tool(s) and processes in medical education that support deliberate assessment across contexts, over time and by different people, incorporating the benchmarks that define core competencies. Entrustable professional activities (EPAs) meet these criteria. EPAs are "...those professional activities that constitute the mass of critical elements that operationally define a profession. They should only be entrusted upon a competent enough professional "(ten Cate & Scheele, 2007). In effect, EPAs are an agreed upon list of core activities a medical specialist would be expected to do and are the expression of multiple integrated competencies (e.g., multiple Can MEDs roles) as they apply in a practice setting. Ultimately, they act to bridge the formal curriculum with ''real world'' and ''real time'' practice (Carraccio & Burke, 2010) and so, are relevant for workplace-based assessment. Doing work solidly grounded in the literature, a collaborative of 5 Canadian Universities have developed EPAs for Family Medicine. By outlining the generic steps to do this, this workshop will enable colleagues from any specialty to start building their own EPAs.

Intended outcomes:

Understand what EPAs add to competency-based assessment

Understand the steps to develop EPAs

Begin developing EPAs for their own setting

Structure of workshop: An interactive and participatory

workshop with brief didactic introductory sessions, small

to large group discussion and individual and table work.

Who should attend: Program, Assessment and

Curriculum directors; educational researchers; anyone

interested in innovative curriculum and assessment

initiatives.

Level: Intermediate

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

8V Workshop: Evidence-based facilitated feedback: A model to enhance feedback acceptance and use

Location: Room A, Holiday Inn

Joan Sargeant (Dalhousie University, Division of Medical Education, 5849 University Ave, Rm C-106, Halifax B3H 4R2, Canada)

Eric Holmboe (American Board of Internal Medicine,, Philadelphia, United States)

Karen Mann (Dalhousie University, Division of Medical Education, Halifax, Canada) Jocelyn Lockyer (University of Calgary, Faculty of Medicine, Calgary, Canada)

Ivan Silver (Center for Addiction and Mental Health, Education, Toronto, Canada)

Erik Driessen (University of Maastricht, Research and Development, Maastricht, Netherlands)

Background: Recent studies demonstrate that learners and physicians do not always readily accept performance feedback or use it for improvement. This occurs for various reasons including inconsistency of the feedback with self-assessment, concerns regarding data credibility, and perceived barriers to feedback use and change. We now understand feedback as a complex interaction in which the recipient plays an active role. Building on earlier work, this has led to the development of a theory and evidence based 4-stage model for facilitating acceptance and use of formal feedback. Intended outcomes: The purpose of this workshop is to explore the proposed feedback model and its four stages, the theory informing it, and its potential application across the continuum of education. Participants will be able to:

Briefly discuss the theory and evidence informing the feedback model, including recent work by the authors. Critique and discuss the model, drawing on their own experiences in giving, receiving and/or studying feedback.

Explore potential application of the model for undergraduate (medical school), postgraduate, and continuing education, and factors that might influence its usefulness.

Begin to identify ways to evaluate effectiveness of the feedback model.

Structure of workshop: This is an interactive workshop using multiple activities: interactive presentation of theories and evidence; small group examination of the model and sample feedback reports, and model critique; small and large group exploration of its potential application across the education continuum and its evaluation; large group and individual summary. Who should attend: Educators, clinicians, students, residents, researchers Level: Intermediate

8W Workshop: Use of an electronic portfolio for undergraduate medical students: Lessons learnt from three UK medical schools

Location: Room B, Holiday Inn

Julia Montgomery (Brighton & Sussex Medical School, Division of Medical Education, Mayfield House Room 344a, University of Brighton, Falmer Campus, Falmer

BN1 9PH, United Kingdom)

Inam Haq (Brighton & Sussex Medical School, Division of Medical Education, Brighton, United Kingdom) Tim Vincent (Brighton & Sussex Medical School, Division of Medical Education, Brighton, United Kingdom) Laura-Jane Smith (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

Deborah Gill (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

Nigel Rawlinson (Bristol Medical School, Student Affairs, Bristol, United Kingdom)

Background: The UK introduced an electronic portfolio for all Foundation Doctors about 6 years ago. We will be discussing a collaborative project, between several UK medical schools and NES Scotland, into the introduction of the Foundation portfolio to medical undergraduates. The GMC (General Medical Council) has stated that all newly qualified doctors must have a portfolio which shows evidence of reflective writing, learning needs analysis and serves as a record of their achievements. The authors feel that the use of the Foundation portfolio rather than a bespoke portfolio lends authenticity for the students. This workshop will discuss implementation issues, use of student advocates and research data about student experiences. Intended outcomes: Participants attending this workshop will understand the importance of the early introduction of authentic portfolios for undergraduates. They will be informed by original research of the challenges that arose from the introduction of a postgraduate portfolio to undergraduates. Each medical school has used the same portfolio in different ways and these will be presented.

Structure of workshop: Most of the workshop will be student led. Students will present original data from questionnaires and focus groups. Each medical school will present data on use and innovations within the portfolio. There will be live presentations of the electronic portfolio.

Who should attend: This workshop would be of use to any UK medical school interested in the introduction of the Foundation portfolio early in undergraduate life. It will be also be of use to anyone with a research interest in portfolio use. Level: Introductory

8X Workshop: Creating PBL Cases: Challenges and Innovations

Location: Room D, Holiday Inn

Samy A Azer (King Saud University, College of Medicine, Medical Education, P O Box 2925, Riyadh 11461, Saudi Arabia)

Gudrun Edgren (Lund University, Faculty of Medicine, Center for Teaching & Learning, Lund, Sweden)

Background: The workshop will provide participants with key elements of creating a PBL template, and educational principles for developing authentic and integrated cases.

Intended outcomes: Participants will have a greater understanding of key elements of successful cases; and learn how to design new cases that address the intended learning objectives, including design of triggers.

Structure of workshop: Participants' previous experience in PBL will be briefly explored. Then there will be a short presentation with interaction with participants on principles for constructing educationally effective cases. Participants will then be divided into small groups and asked to use the principles learnt in beginning the development of the educational objectives, a trigger and an outline of a case. Time will be given to participants to complete their task. Outcomes will be brought together in a plenary session at the end.

Who should attend: Medical and health educators, directors of medical and/or health units, and those involved in writing PBL cases. Level: Intermediate

8Z Posters: Clinical Teaching 2 Location: South Hall, PCC

8Z/1

Competency based curriculum students' self directed learning readiness in entering clerkship phase in Faculty of Medicine Pelita Harapan University

Rhendy Wijayanto (Faculty of Medicine, Pelita Harapan University, Medical Education, Tangerang, Indonesia) Septiani Tjitasura (Faculty of Medicine, Pelita Harapan University, Medical Education, Tangerang, Indonesia) Bertha Bertha (Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia)

Background: Self directed learning readiness is an essential feature that should be possessed by medical students. Competency Based Curriculum that bachelor students undergo emphasizes self directed learning. This background will support learning in clerkship phase which is more self directed learning. Student readiness for self directed learning will also influences preceptor's approach in conducting clinical preceptorship. Summary of work: From 83 respondents of seventh semester of Faculty of Medicine Universitas Pelita Harapan who will enter clerkship, data on readiness to do self directed learning was gathered by using Self Directed Learning Readiness Scale. Summary of results: A good self directed leaning readiness was found in 91,57% of sample. The percentage increases compared to semester one which was 91,18%. A good self management was also found in 90, 36% respondents; willingness to conduct self directed learning was found in 96.39% respondents; and good self control in learning in 96.39%. Conclusions: Respondents are ready to apply self directed learning in clinical clerkship phase, supported by delegative type of perceptorship. Take-home messages: A customized preceptorship style is essential in accommodating student based on their self-directed-readiness.

8Z/2

Coping with Your Supervisor - What Students Really Learn in Clinical Placements

Matilda Liljedahl (Karolinska Institutet, Centre for Medical Education, LIME, Stockholm 171 77, Sweden) Lena Engqvist Boman (Karolinska Institutet, Centre for Medical Education, LIME, Stockholm, Sweden) Charlotte Falt Porthen (Karolinska Institutet, Centre for Medical Education, LIME, Stockholm, Sweden) Klara Bolander Laksov (Karolinska Institutet, Centre for Medical Education, LIME, Stockholm, Sweden)

Background: The view of learning in workplace learning has during the last decades changed from a cognitive view to a cultural approach. Only a few previous studies have explored the impact of the environment on student learning culture. Learning culture is here

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

defined as "the values and norms of teaching and learning that exists within a group". Summary of work: The aim was to explore medical and nursing students' experiences of clinical placements to be able to describe their learning culture. A phenomenological research approach was chosen. Semi structured interviews were conducted with seven medical students and eight nursing students. The interviews were analysed with qualitative content analysis.

Summary of results: Student understanding of learning in clinical placements could be described on three levels; formal, manifest and latent. The formal level includes their approach to clinical placements, the manifest level includes their perception of clinical placements and the latent level involves the influences clinical placements had on their professional development. For instance, the difficulties they experienced, e.g. the relationship to their supervisor, made them develop useful skills for their future profession. Through the mirroring process between the two groups of students it was possible to discover aspects of their learning that would otherwise not have been discovered in the analysis. Conclusions: Apart from learning the explicit skills and attitudes in clinical placements, students also learn latent qualities useful in their future professional work. However, medical and nursing students learning cultures differ which have to be taken into consideration in the design of interprofessional education. Take-home messages: The context and the social environment in clinical placements affect the students and influence their professional development.

8Z/3

Students' feedback on hypertension clinical teaching - a comparison between two teaching models

Ricardo Tjeng (University of Beira Interior, Faculty of Health Science, Av. Infante D. Henrique, Covilha 6200­506, Portugal)

Luis Patrao (University of Beira Interior, Faculty of Health Science, Covilha, Portugal)

Edmundo Dias (University of Beira Interior, Faculty of Health Science, Covilha, Portugal) Pedro Lito (University of Beira Interior, Faculty of Health Science, Covilha, Portugal)

Miguel Castelo-Branco (University of Beira Interior, Faculty of Health Science, Covilha, Portugal)

Background: Outpatient teaching is a good opportunity for students to learn in a clinical context. Different teaching models are described, having their own advantages and disadvantages. Summary of work: All 4th year medical students from the Faculty of Health Science, University of Beira Interior (Covilha - Portugal) participate in the Hypertension Clinic, during the Cardiovascular Module. In academic year 2011/2012, a "sitting-in" model (observational) was used for the learning experience; and in 2012/2013 a "team-member" model (active) was chosen. The aim of this study is to compare medical students' feedback

between these two different approaches to hypertension clinical teaching, including clinical feedback, individualization, relevance of the experience, activity, preparation, motivation, expectations, positive and negative aspects of the outpatient teaching. On-line evaluation form was sent to all those students, with rating and open questions. Summary of results: Students' feedback and data analysis are scheduled for April, 2013. Conclusions: Different approaches to outpatient teaching can be used with pros and cons. Students' feedback of the learning experience is important for the development and/or choice of the model used for clinical teaching. Models where the students have a more active role, and other characteristics (e.g. feedback) may encourage them to make deeper reflection and learning.

Take-home messages: A move towards FAIR teaching model in clinical setting can be set even on already ongoing activities.

8Z/4

Improving Confidence and Competence in Electrocardiogram Interpretation for Undergraduate and Postgraduate Medical Trainees in a UK District General Hospital

HM Leach (Worcester Royal Hospital, Medicine, Charles Hastings Way, Worcester WR5 1DD, United Kingdom)) CJ McAloon (Worcester Royal Hospital, Cardiology, Worcester, United Kingdom)

S Gill (Worcester Royal Hospital, Medicine, Worcester, United Kingdom)

J Trevelyan (Worcester Royal Hospital, Cardiology, Worcester, United Kingdom)

Background: ECG interpretation is central to clinical training, however postgraduates do not interpret common ECGs to the desired level. This lack of competence may impact patient care. Our study compares the effectiveness of two learning strategies to improve competence and confidence in ECG interpretation.

Summary of work: A prospective randomized study was performed comparing learning strategies in two cohorts: undergraduate 3rd year medical students and foundation year one (FY1) doctors. Both cohorts had blinded randomization to either the focused teaching program (FTP) or self-directed learning (SDL). Volunteers completed a questionnaire on confidence and competence in ECG interpretation before and after intervention, and completed an ECG multiple choice question (MCQ) paper after intervention. Summary of results: 21 FY1s and 25 3rd year students participated. Following intervention, 100% (10) FY1s and 92% (12) 3rd year students in the FTP groups felt more confident interpreting ECGs compared to 23% (3) and 25% (3) respectively in the SDL groups. Specific ECG interpretation confidence improved for both learning strategies; the FTP groups showed greater improvement. The 'Hyperkalaemia' ECG demonstrated the greatest improvement for 3rd year students with

ABSTRACT BOOK: SESSION 8 TUESDAY 27 AUGUST: 1400-1530

none being confident before; following intervention 69% (9) FTP group were confident compared to none in the SDL group. The 3rd year FTP group demonstrated a significant difference in successfully interpreting 'Ventricular Tachycardia' (p= 0.0469) and 'Narrow Complex Tachycardia' (p= 0.0094) compared to the SDL group.

Conclusions: Our study demonstrates improvement in confidence and objective skill levels of ECG interpretation especially at the undergraduate level. Take-home messages: A focused teaching program shows greater improvement than self-directed learning alone.

8Z/5

Electrocardiography clinical teaching - Hands on it

Pedro Lito (University of Beira Interior, Faculty of Health Science, LAC - Clinical Skills Lab., Av. Infante D. Henrique, Covilha 6200, Portugal)

Ricardo Tjeng (University of Beira Interior, Faculty of Health Science, LAC - Clinical Skills Lab., Covilha, Portugal)

Bruno Valentim (University of Beira Interior, Faculty of Health Science, LAC - Clinical Skills Lab., Covilha, Portugal)

Filipe Patricio (University of Beira Interior, Faculty of Health Science, LAC - Clinical Skills Lab., Covilha, Portugal)

Background: There is no better place or model to teach. However, there is a better place or model to learn for each student. Allowing students different styles, methods, and opportunities increases their engagement and motivation.

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