AMEE Berlin 2002 Programme

AMEE 

Association for Medical Education in Europe 

Medical Education 

and Standards at a 

Time of Change 

AMEE 

Programme 

and 

2001 

Abstracts 

2-5 September 2001 

Charité, Humboldt University 

BERLIN, GERMANY 

Humbolt University 

Zu Berlin 

Gesellschaft für Medizinische 

Ausbildung (GMA) 

President: 

Professor M Barón-Maldonado 

General Secretary: 

Professor R M Harden 

Administrator: 

Mrs Pat Lilley 

AMEE Office 

University of Dundee 

Tay Park House 

484 Perth Road 

Dundee DD2 1LR 

Scotland, UK 

Tel: +44 (0)1382 631953 

Fax: +44 (0)1382 645748 

E-mail: amee@dundee.ac.uk

Contents 

Welcome from the Berlin students to visiting students .. iii 

Local Organising Committee .. .. .. iii 

Welcome from Professor Margarita Barón-Maldonado, 

President of AMEE .. .. .. .. iv 

AMEE Executive Committee .. .. .. v 

List of sponsors .. .. .. .. v 

Section 1: General Information about Berlin 

and the Conference Venue 

General information about Berlin 

Berlin and how to get there .. .. .. .. 1.1 

Some local information .. .. .. 1.1 

General information about the Conference 

How to get to Campus Virchow Klinikum .. .. 1.4 

Some general information .. .. .. 1.4 

Registration information .. .. .. 1.8 

Information about the Academic Programme 

Plenary presentations .. .. .. 1.9 

Large group sessions .. .. .. 1.9 

Short communications .. .. .. 1.9 

Information for presenters .. .. .. 1.9 

Audio-visuals .. .. .. .. 1.9 

Information for the chairperson .. .. 1.10 

Information for the opening discussant .. .. 1.10 

Poster presentations.. .. .. .. 1.11 

Information for presenters .. .. .. 1.11 

Information for the chairperson .. .. 1.12 

Medical Teacher Poster Prize .. .. .. 1.12 

Workshops .. .. .. .. 1.12 

Pre-Conference .. .. .. .. 1.12 

Conference .. .. .. .. 1.12 

Programme Overview .. .. .. 1.13 

Personal Diary .. .. .. .. 1.15 

List of Exhibitors .. .. .. .. 1.16 

- i -

Section 2: The Academic Programme 

Saturday 1 September .. .. .. 2.1 

Sunday 2 September .. .. .. 2.2 

Monday 3 September .. .. .. 2.4 

Tuesday 4 September .. .. .. 2.15 

Wednesday 5 September .. .. .. 2.28 

Section 3: Conference Social Programme, Tours 

and Accommodation 

Section 4: Abstracts 

- ii -

Welcome from Students 

We, the students of the Charité, Medical Faculty of the Humboldt-University in Berlin, 

look forward to welcoming you to the AMEE Conference. We want you to enjoy your 

stay in Berlin and will do all we can to help. 

We invite you to join us for a free dinner on Monday night in our beautiful ‘lecture-hall 

ruin’. This is the old pathology lecture-hall that was partly destroyed during WW II, 

has been rebuilt and is now being used for social events. This is intended as an alternative 

to the River Cruise in the official social programme and we hope that it will be a good 

opportunity to get to know each other and to make new friends. Places are limited, and 

we need to know in advance who is interested in joining in (students only, please!). 

We are also planning to organize a pub-crawl on Saturday night for all the people who 

arrive early. Please contact us if you’re interested in a guided tour of the Berlin nightlife. 

We are trying hard to find inexpensive accommodation with local students or - if there 

are not enough places available - in youth hostels. At the moment we are searching for 

local students, who are able to accommodate you and offer you a breakfast during the 

conference for a small contribution of 50 DM (about 15£). However we cannot guarantee 

that we will be able to place everybody. Therefore, if you decide to attend the conference 

and want to be placed in private accommodation, please let us know as early as possible 

(email: below), so that we can add you to the accommodation list. Please tell us your 

name, sex, email, address, the day of arrival and departure and if you want to attend the 

dinner on Monday (free of charge!)!! Please send your e-mail to: 

student.amee@charite.de and note: “AMEE Accommodation application” in the reference. 

We look forward to meeting you. 

Local Organising Committee 

Professor Joachim Dudenhausen Professor Gerhard Gaedicke 

Professor Ingrid Reisinger Professor Ulrich Schwantes 

Professor Walter Burger Dr Bernd-Dieter Bohne 

Professor Dieter Scheffner Professor Florian Eitel (Munich) 

Local Administration: 

Dipl. phil. Burkhard Danz 

Charité 

Referat Studienangelegenheiten 

KW: AMEE 

Schumannstraße 20/21 Tel.: 49 30 450 57 60 91 (42) 

10098 Berlin Fax: 49 30 450 57 69 21 

Germany Email: burkhard.danz@charite.de 

- iii -

Welcome from President of AMEE 

Dear AMEE Members and Conference Participants: 

On behalf of AMEE I should like to welcome you to the Berlin 2001 Conference. The 

AMEE annual conference is a focal point of the year, where members and non-members 

alike can meet to share ideas and to discuss problems and challenges facing them in 

their efforts to develop and improve medical and health care professions education in 

their institution. This year we have over 650 participants from 45 countries, more than 

ever before. Many are regular AMEE conference attendees, but every year we are 

pleased to see so many new faces who are keen to participate in what has become a 

major meeting in the medical education calendar. 

The main topic of this Conference “Medical Education and Standards at a Time of 

Change” fits very much in time and space. The international community devoted to 

improving medical education is looking for standards that could guarantee the training 

of professionals to meet health and social needs across country boundaries; therefore to 

find ways of overviewing those standards from a transnational standpoint, without 

losing sight of local needs, is more than timely at the beginning of the third millennium. 

The city of Berlin has undergone spectacular changes in just a few short years and is 

still adapting to new times, new roles and new circumstances. Berlin offers a suitable 

context in which to present views and experiences on medical educational changes and 

reminds us of the ever-adapting attitude that we all should demonstrate in order to 

advance and progress in the field. 

The Charité Campus Virchow-Klinikum of the prestigious Humboldt University of 

Berlin Medical School will be our meeting point and our inspiration to continue the 

work of the many important scientists on which the foundations of Medicine have been 

built. On behalf of us all I want to express my gratitude to the University for hosting 

the Conference. 

The Berlin Conference programme holds exciting plenary sessions; workshops for 

innovation and learning how to think about strategies to achieve our goals; all led by 

well-known and respected educators in Medicine and health care. Large group sessions 

will focus on specific issues and challenges. Short communications and posters, close 

to 400 in total, will give us the opportunity to present our views and work, to discuss 

them and finally to interact. 

Your attendance at the AMEE 2001 Berlin Conference is your own success and I wish 

you, AMEE friends, a most productive and enjoyable meeting. 

Margarita Barón-Maldonado 

President of AMEE 

- iv -

Executive Committee 

List of Sponsors 

President: Professor Margarita Barón-Maldonado (Spain) 

Secretary/Treasurer: Professor Ronald Harden (UK) 

Committee Members: Professor Ralph Bloch (Switzerland) 

Professor Ioan Bocsan (Romania) 

Professor Florian Eitel (Germany) 

Dr Madalena Patrício (Portugal) 

Professor Dominique Perrotin (France) 

Professor Herman van Rossum (Netherlands) 

Ex-officio Members: Professor Hans Karle 

(World Federation for Medical Education) 

Dr Jørgen Nystrup (Past President of AMEE) 

AMEE Administrator: Mrs Pat Lilley 

p.m.lilley@dundee.ac.uk 

AMEE Secretary: Miss Tracey Martin 

t.r.martin@dundee.ac.uk 


University of Dundee, 484 Perth Road, Dundee DD2 1LR, UK 

Tel: +44 (0)1382 631953; Fax: +44 (0)1382 645748; 

AMEE@dundee.ac.uk; http://www.amee.org 

AMEE and the Local Organising Committee are most grateful to the Municipality of 

Berlin for their generosity in hosting the reception at the Opening Ceremony. We would 

also like to acknowledge the generous support of the Founder Sponsors: 

Siemens AG – Medical Solutions 

Schering AG 

Freunde und Förderer der Charité 

Medical Faculty of Humboldt University 

- v -

SECTION 1 

Information about Berlin 

and the Conference Venue

Conference Venue 

General Information 

Berlin 

How to reach Berlin 

Weather 

Banks and Post Offices 

Currency Exchange 

A simplified map of Berlin and a plan of the campus showing the conference buildings 

and rooms appear on pages 1.5 and 1.6. A detailed map will be included in your 

registration pack. 

Berlin has a wide range of attractions. Annual highlights include theatre weeks, 

international concert performances and film festivals. Multiple theatres offer a range 

of performances from classic to modern drama, opera, ballet and light comedy. Berlin´s 

artistic treasures and museums, palaces, galleries and archives have earned high reputation 

all over the world. A great number of monuments bear witness to the history of Berlin 

and Prussian culture. Leisure time may be used for shopping downtown around the 

‘Kurfürstendamm’ and the ‘Friedrichstraße’. There are opportunities for every taste 

and purse. Shopping hours are from 9.00-20.00 hrs Monday to Friday and from 0900 

hrs to 1600 hrs on Saturday. All shops are closed on Sunday. 

Berlin can be reached easily by all means of transportation. Most airlines offer direct 

flights to Berlin Tegel airport, some also fly to Berlin Tempelhof or Berlin Schönefeld. 

A taxi from Berlin Tegel to the city centre (main hotel district) costs approx. DEM 

30,00. There is also a bus service (line no. 109) between Berlin Tegel airport and the 

city centre. The fare is DEM 4,00. Main railway stations are Berlin Bahnhof Zoo, 

Berlin-Ostbahnhof, Bahnhof Berlin Lichtenberg. As the main airports are quite close 

to the city centre, no special arrangements have been made to transfer participants to 

the Conference hotels. 

The congress takes place during the late summer/beginning of autumn where the 

temperatures are around 19°C (66°F) during the day and 10°C (50°F) at night. It may 

be useful to bring a sweater and raincoat. 

Banks are open Monday-Friday between 0800-1800. Post Offices are open Monday- 

Friday between 0800-1800, and on Saturday between 0800-1200. 

The unit of currency is the DeutscheMark (DEM). 1 DEM comprises 100 Pfennig .The 

rate of exchange at the time of going to press is £1 = DM 3.2; US$1 = DM 2.3; 

Euro 1 = DM 2. Major credit cards are widely accepted in hotels, restaurants and shops. 

- 1.1 -

Restaurants/Bars 

Berlin is famous for its wide variety of 7,000 restaurants serving international or German 

cuisine and for its countless pubs called “Kneipen“ with their unique atmosphere. Some 

suggestions are: 

First-class gourmet restaurants 

Borchardt District/address: (Mitte) Französische Str. 47 

Subway station: Französische Str. 

Telephone: 20 38 71 10 

Open: daily 1100 to 2400 hrs 

Cards: Amex, Visa 

Café Einstein District/address: (Tiergarten) Kurfürstenstr. 58 

Subway station: Nollendorfplatz 

Telephone: 2 61 50 96 

Open: Daily 1000 to 0200 hrs 

Cards: Amex, Visa, Euro 

Paris Bar District/address: (Charlottenburg) Kantstr. 152 

Subway station: Zoo 


Open: Daily 1200-0200 hrs 

Cards: Amex 

Luther und Wegner District/address: (Mitte) Charlottenstr. 56 

Subway station: Französische Str. 


Open: Daily 0900-0200 hrs 


German cooking 

Vau District/address: (Mitte) Jägerstr. 54-55 

Subway station: Hausvogteiplatz 


Open: Monday-Saturday from 1200 hrs 

Cards: Amex, Visa, Diners, Euro 

Altes Zollhaus District/address: (Kreuzberg) Carl-Hertz-Ufer 30 

Subway station Prinzenstrasse 


Open: Tuesday-Saturday 1800-0100 hrs 

Cards: All credit cards 

Italian cooking 

Trattoria Lappeggi District/address: (Prenzlauer Berg) Kollwitzstr. 56 

Subway station: Senefelder Platz 


Open: Daily from 12 noon 


XII Apostel District/address: (Charlottenburg) Bleibtreustr. 49 

S-Bahn-station: Savignyplatz 


Open: Daily 24 hours 

Cards: No credit cards 

- 1.2 -

Greek cooking 

Ypsilon District/address: (Schöneberg) Hauptstr. 163 

Subway station: Kleistpark 


Open: Daily from 1700 hrs 


Hip, for young people 

Anita Wronski District/address: (Prenzlauer Berg) Knaackstr. 26-28 

Subway station: Eberswalder Str. 




Ali Baba District/address: (Charlottenburg) Bleibtreustr. 45 

S-Bahn-station: Savignyplatz 



Live music scene 

Kalkscheune District/address: (Mitte) Johannisstr. 2 

Subway station Oranienburger Straße 

Telephone: 28 39 00 65 


Kulturbrauerei District/address: (Prenzlauer Berg) Knaackstr. 97 

Subway station Eberswalder Str. 



Schlot District/address: (Prenzlauer Berg) Kastanienallee 29 





Beer garden 

Prater Garten District/address: (Prenzlauer Berg) Kastanienallee 7-9 





Café am Neuen See (District/address: Tiergarten) in the middle of Tiergarten 



Cards: All credit cards 

- 1.3 -

Information about the Conference Venue 

Transport in Berlin 

Parking Facilities on Campus 

Dress Code 

Smoking Policy for Conference 

Charité is the Medical Faculty of Humboldt-University Berlin. There are three separate 

campuses (Campus Virchow-Klinikum, Campus Mitte and Campus Berlin-Buch). Please 

note that our Conference, including the Pre-conference Workshops, will take place at: 

Campus Virchow-Klinikum 

Charité, Medical Faculty of Humboldt-University 

Berlin-Wedding 

Augustenburger Platz 1 

Berlin D-13353 

Germany 

The Charité web page (German only) can be accessed as follows: http://www.charite.de/ 

index/allginfo.html 

Registration and most of the Conference sessions take place in the Teaching Building 

(Lehrgebaude), marked on the plan on page 1.5. 

Berlin is well served by a wide bus, tram, underground (U-Bahn) and city train 

(S-Bahn) network, operating from 0400 until midnight. On the reverse of your 

Conference name-badge in your registration pack is stamped the Berlin Transport Service 

logo and this badge also serves as a 4-day travel pass which can be used for local buses 

and trains. 

The Campus Virchow-Klinikum is in the north west of the city, about 15 minutes by 

U-bahn from the city centre and can be reached by the following transport: 

Underground (U-Bahn): line U9: Station: ‘Amrumer Straße’ (or line U6 to 

‘Leopoldplatz’ and change to line U9) 

Bus lines: X26, 126 stop: ‘Virchow-Klinikum’ 

221, 248 stop: ‘Amrumer Straße’ 

Tram: line 23 or 24, stop: ‘Virchow-Klinikum’ 

If travelling by U-Bahn, exit to the right. You will see signs to the AMEE Conference. 

It is about 5 minutes’ walk from the station to the Teaching Building. 

Parking Spaces in the vicinity of the Virchow-Klinikum campus are hard to find. Oncampus 

parking is possible (DEM 3 per hour), but spaces are very limited. There is a 

parking garage at the entrance Seestraße, where AMEE participants can park for a 

special fee of 15 DEM per day. Tickets are available at the conference desk. 

Access to the campus for loading and unloading is free of charge for up to one hour. 

Dress is informal for both day and evening sessions. 

Smoking is not permitted in the University buildings, and you are asked to smoke 

outside only. 

- 1.4 -

Map - Charité Virchow-Klinikum 

- 1.5 -

Map of Berlin 

- 1.6 -

Campus Virchow-Klinikum – Teaching Building 

- 1.7 -

Conference Noticeboard and Messages 

Email Contact 

The Noticeboard is located by the Registration Desk. Messages and conference updates 

will be posted on the board and an adjacent board will be provided for messages for 

individuals. Phone and fax messages can be sent to you at the Registration Desk. Numbers 

will be available on the AMEE website from 27 August, or by contacting the AMEE 

Office. 

Please note that the AMEE Office will be closed from 1800 hrs on Thursday 30 August 

until 0900 hrs on Friday 7 September. Whilst in Berlin we can be contacted at the 

Registration Desk. 

Participants are welcome to use the Computer Room (Teaching Building, 2 nd floor, 

room 2.0103) for email contact at all times except during scheduled workshops: Saturday 

1345-1700; Sunday 0915-1230; Monday 1345-1600; Tuesday 1345-1700). 

CME Accreditation and Certificates of Attendance 

Abstracts 

Conference Evaluation 

Registration 

The Conference has been approved by the Royal College of Physicians of London for 

21 CME credits for attending the full Conference. Certificates of attendance, conforming 

to the guidelines provided by the Royal College of Physicians, will be available on 

Wednesday 5 September from 1200 hrs and a register will be available for signature at 

the same time. 

Abstracts will appear on the Conference web site soon after the conference. If there are 

any changes to be made to your abstract as it appears in the programme/abstract book, 

please contact the Registration Desk or the AMEE Secretariat in Dundee. 

We welcome feedback on which aspects of the Conference you have enjoyed, and the 

things you have found less satisfactory. Suggestions for speakers and workshop organisers 

for future conferences are also much appreciated. Please complete the evaluation form 

in your conference pack and either leave it in the box on the registration desk or send 

it to the AMEE Office. 

The registration desk is open in the Teaching Building (Lehrgebaude), Campus Virchow- 

Klinikum, (see plan of Campus on page 1.5) at the following times: 

Saturday 1 September: 1200-1730 

Sunday 2 September: 0800-1700 

Monday 3 September: 0745-1730 

Tuesday 4 September: 0800-1715 

Wednesday 5 September: 0800-1630 

Please use the appropriate registration point: 

Point A: Registered participants with family names beginning with A-F 

Point B: Registered participants with family names beginning with G-N 

Point C: Registered participants with family names beginning with O-Z 

Point D: Unregistered participants, late registrants who have not paid, and 

those requiring further assistance 

- 1.8 -

Tours/Accommodation Registration 

DER-CONGRESS will have a representative available at the Registration Desk at the 

following times: 

Saturday 1 September: 1200-1730 

Sunday 2 September: 0800-1700 

Monday 3 September: 1200-1400 

Tuesday 4 September: 1200-1400 

Wednesday 5 September: 1200-1400 

If you have reserved hotel accommodation, tours or social events through DER you 

should collect vouchers from them. All participants making hotel reservations through 

DER will need a voucher to present to the hotel on departure so that the pre-paid 

deposit may be deducted from the final hotel bill. 

Information on the Academic Programme 

Plenary Presentations 

Large Group Sessions 

Short Communications 

An overview of the programme is shown on pages 1.13 and 1,14. On page 1.15 is a 

personal diary form on which you may like to note the presentations you particularly 

want to attend. 

These are scheduled for Sessions 1 and 9 and will take place in Hörsaal 1 and 2. 

Hörsaal 3 is linked by video to provide additional seating if necessary. 

Three simultaneous large groups are scheduled in Session 4. After the presentations the 

chairperson will open up an interactive discussion between presenters and audience. 

These are scheduled for Sessions 2, 5, and 8. In Sessions 2 and 5 there are 13 simultaneous 

groups of short communications each with a theme and in Session 8 there are 12 

simultaneous groups. The room in which each group will take place is indicated in the 

grid on page X. This year we have tried very carefully to group relevant presentations 

together and encourage you to stay for a whole session and take part in the discussion 

at the end. Please feel free, however, to move between sessions. We have asked the 

Chairpersons to ensure that all sessions follow the time scheduled in the programme. If 

you do choose to move between sessions, please do so as quietly as possible. Each 

presenter has been allocated a ten minute presentation followed by five minutes for 

discussion. A 15 minute period has been allocated at the end of most sessions for a 

general discussion, led by an opening discussant. Each session will also have a 

chairperson. 

Information for Presenters of Short Communications 

Slide viewing area: The Mediothekraum (Teaching Building, first floor) may be used 

for testing audio-visuals and spare carousels will be available for slides. Please do not 

take these earlier than during the session prior to yours and return them as soon as 

possible afterwards. PowerPoint presentations can also be tried out in advance (see 

below). 

- 1.9 -

OHP and slides: An OHP and a 35 mm slide projector are available in every room. 

Computer projection: A data projector/beamer is available on request. If you are 

planning to use a computer presentation it is essential we know this in advance, either 

on the form supplied when your presentation was accepted or by email. This year we 

ask that you bring your presentation on a CD-ROM or zip disk clearly marked with 

your name and session number, as your own laptop may not be suitable for use with 

the in-house system. Laptop computers will be supplied in every room. Presentations 

made using the PC version of PowerPoint 1997 and 2000 are compatible with the inhouse 

system. Mac users should ensure that their presentations are saved on PC formatted 

disks. Please see the technician in the Mediothekraum preferably on Sunday, or at least 

one day before your session in order that your presentation may be loaded up on the 

appropriate computer. If you are a Mac user and wish to have more specific information, 

or if there is a video incorporated into your presentation please contact Pat Lilley 

(p.m.lilley@dundee.ac.uk) 

Technical assistance during the sessions: A technician will be available in each of the 

large lecture theatres, and students familiar with use of the equipment will be available 

in each of the smaller rooms. Each room is equipped with a telephone by which help 

may be requested if necessary. 

Your presentation: The following guidelines will help ensure the smooth-running of 

sessions. 

• Please arrive at least ten minutes before the scheduled start of the session and 

introduce yourself to the chairperson. 

• Keep strictly to the time allotted for your presentation. This is essential. The 

Chairperson will remind you when your time limit has expired and will then 

ask the audience for questions. 

• Please speak slowly and clearly. 

• Ensure your overheads and slides are clear, that there is not too much text to 

read in the limited time available and that the type is large enough to be 

legible for those sitting at the back of the room. 

• Whilst not obligatory, a single page hand-out, giving the key messages from 

your presentation, is always appreciated. As a rough indication you could 

expect between 40-60 participants in the audience. 

Role of the Chairperson in the Short Communications Sessions 

1 Before the session starts, check that the speakers and opening discussant are present; 

2 Introduce each speaker according to the programme. Tell him/her when the allotted 

10 minute presentation period is over (a timer will be provided) and ask the speaker 

to stop his/her presentation; 

3 Allow 5 minutes for discussion between presentations; 

4 If a speaker is not present, arrange for the 15 minute period to be used for further 

discussion; the next presentation should not start until the scheduled time; 

5 Ask the opening discussant to lead off the discussion at the end of the session; 

6 Draw the session to a close and thank participants; 

7 Follow strictly the time schedule in the programme to allow participants to move 

between sessions. 

Role of the Opening Discussant in the Short Communications Sessions 

Introduce the topic in the context of the papers presented and highlight the key points 

for discussion arising from the papers. This should take no more than 5 minutes. 

- 1.10 -

Posters 

There will be twelve themed groups of posters on show throughout the Conference in 

the areas listed below. Please see pages 2.27 to 2.37 for details of presentations in each 

session and see below for the locations of the posters which are all in the Teaching 

Building on either floor 1 or floor 2: 

Session No Title Location 

7A New Learning Technologies Floor 2 

7B Problem-Based Learning Floor 2 

7C Curriculum Planning and Change Floor 2 

7D Curriculum Evaluation/Staff Development Floor 1 

7E Postgraduate Education Floor 2 

7F Assessment Floor 1 

7G Teaching & Learning 1 Floor 2 

7H Teaching & Learning 2 Floor 2 

7I Continuing Professional Development 1 Floor 1 

7J Continuing Professional Development 2 Floor 1 

7K International Medical Education Floor 1 

7L Special Subjects Floor 1 

Poster presentations will take place on Wednesday 5 September from 0830-1000 hrs. 

The sessions will start in the room designated for the presentations (see page 1.13), 

where each presenter will have two minutes to highlight the key points to look out for 

in the poster. Two overheads or slides are allowed for the presentation. Computer 

projection is not available. A chairperson will introduce each presenter. Following the 

short presentations the group will move to the relevant poster area for a group discussion. 

Information for Presenters of Posters 

Posters may be mounted at the following times: 

Saturday 1 September between1200-1730 hrs 

Sunday 2 September between 0830-1700 hrs 

Monday 3 September between 0745-1730 hrs 

Posters will be grouped in themes, and the identification number, name(s) of the author(s) 

and title of the poster will be clearly labelled on each poster board. Poster boards are 

120 cm wide and 150 cm high, fixed with pins. A supply of pins will be available but 

you may find it useful to bring your own. 

To Help the Poster Sessions run Smoothly 

1 Poster presenters should meet in the room allocated to the session at 0820 hrs on 

Wednesday 5 September, and make themselves known to the chairperson. 

2 Presenters must keep strictly to the 2 minutes allowed for initial presentation of the 

poster, and may used one or two overheads or slides (no data projection). No time is 

allowed for discussion at this stage. This time should be used to highlight key points 

to look for in the poster, not to summarise the poster 

3 After all the short presentations have been made, the group will go to the poster 

area allocated. 

4 Presenters should stand by their posters, and be prepared to answer questions. It is 

useful to have some photocopied handouts (approximately 40-80) for distribution, 

with the key messages of the poster. 

5 It is helpful if the presenter can indicate on his/her poster board an alternative time 

when he/she will be available (eg a lunch or coffee break) in case anyone who 

cannot attend the session would like to discuss the poster. 

- 1.11 -

Role of the Chairperson in the Poster Sessions 

Medical Teacher Poster Prize 

Workshops 

1 Before the sessions starts, check that the presenters have arrived; 

2 Introduce each presenter and allow two minutes for the presentations. Do not allow 

any time for discussion between presentations, which should take up to 30 minutes, 

depending on the number in the group. 

3 At the end of the presentations lead the group to the poster area; 

4 Allow the group to look at all the posters (it is suggested that between 15-30 minutes 

is allowed for this activity); 

5 Invite questions for discussion. 

Taylor and Francis Ltd, the publisher of Medical Teacher, has generously agreed once 

again to sponsor a prize of £150 to be awarded for the best poster at the Conference. 

Posters will be judged, by a Committee, on the following criteria: 

• How well are the key messages communicated through the poster? 

• Does the poster arouse the interest of the viewer? 

• Is the poster attractive? 

The winner will be announced at the end of the final plenary session on Wednesday 5 

September. In addition to the prize money, the winner will receive one year’s individual 

membership of AMEE, which includes a personal copy of Medical Teacher. 

Pre-Conference Workshops: Pre-booking of Pre-Conference Workshops via the 

AMEE Secretariat is essential, and a charge is made. At the time of going to press 

almost all the pre-conference workshops are full. 

Conference Workshops: Workshops in Session 3 are listed on pages 2.13 to 2.14 

and those in Session 6 on pages 2.25 to 2.27. A full description of the workshop content 

is given in the Abstracts section (pages 4.23 and 4.51). 

Enclosed with this programme is a Selection Form. One of the items relates to workshop 

choice. Pre-booking of conference workshops offers a better chance of attending your 

first choice of workshops in Sessions 3 and 6. Please complete the information requested 

and either return the form to the AMEE Office or email your choices to 

AMEE@dundee.ac.uk There is no charge for attending conference workshops. A list 

of workshops and attendees will appear on the notice board adjacent to the Registration 

area with an indication of the number of places remaining. Depending on the format, 

some organisers wish to limit participation in their workshops, and we regret that you 

might not be able to attend your first choice on each occasion. 

- 1.12 -

Programme Overview - Short communications, 

Poster, Large Group Sessions 

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Plenary Hall 

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Achieving standards 

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Student Support/ 

Psychiatry and 

the Curriculum 

Multiprofessional 

Education 

Student and 

Curriculum 

Evaluation 

Simulation and 

Clinical Skills 

Training 

Educating the 

Educators 1 

Selection 

Continuing 

Professional 

Development 

Peer 

Assessment 

Postgraduate 

Education - 

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OSCE/ 

Standardised 

Patients in 

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Curriculum 

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Standards and 

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International 

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Standards & 

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- 1.13 - 

Teaching about 

EBM, Critical 

Thinking and 

Research 

Evaluation of 

Multiprofessional 

Education 

Contexts 

for Learning 

Education and 

Cultural 

Diversity 

Educating the 

Educators 2 

Educational 

Strategies/ 

Curriculum 

Planning 

Outcome-based 

Education 

Assessment 

Postgraduate 

Education for Gen 

Practice/Family 

Medicine 

Assessing 

Communication 

Skills/Patients 

as Examiners 

Curriculum 

Evaluation 

Evaluation of 

Problem-based 

Learning 

Learning and 

the Internet 

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Special 

Subjects 

International 

Medical 

Education 

Continuing 

Professional 

Development 2 

Continuing 

Professional 

Development 1 

Teaching and 

Learning 2 

Teaching and 

Learning 1 

Assessment 

Postgraduate 

Education 

Curriculum 

Evaluation/Staff 

Development 

Curriculum 

Planning and 

Change 

Problem-based 

Learning 

New Learning 

Technologies 

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Special 

Subjects 

International 

Aspects of 

Medical Education 

Clinical 

Teaching 

Communication 

Skills Training 

Curriculum 

Change 

Assessment in 

Postgraduate and 

Continuing 

Education 

Teaching and 

Learning 

Postgraduate 

Education/ 

Career Choice 

The Final 

Examination 

Curriculum 

Planning 

Implementation of 

Problem-based 

Learning 

Computer 

Mediated 

Learning and 

Assessment 

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Plenary Hall 

PLENARY 

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What can a general 

medical journal do 

for education in 

medicine? 

The assessment of 

poorly performing 

doctors 

A bachelor master 

structure of medical 

education in Europe 

Effective student 

assessment: 

something old, 

something new 

Concept 

mapping 

Making feedback 

during clerkships 

meaningful and 

effective 

East European 

Task Force 

Best Evidence 

Medical Education: 

Progress Report 

Feedback and 

evaluation: essential 

activities in the 

learning process 

From MD to 

academic 

teacher 

The quality of 


and teaching - thema 

can variatione 

The roles of 

the teacher 

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Bedside Cardiology 

An Introduction Nordic Federation 

Risk management 

Developing 

Learning needs 

Skills Training, 

Professional and Students teaching 

AMEE/ 

to Clinical for Medical 

in medical 

professional attitudes: 

Problem-based Portfolio 

featuring ‘Harvey’ 

organisational culture communication 

Ibero-American 

assessment in A European 

Judgement Analysis Education 

education 

theory, practice and 

Learning Assessment 

& UMedic 

of medical eduaction skills 

Network Workshop 

u/grad and p/grad core curriculum? 

evaluation 


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Basic Skills 

Faculty Development 

Workshop 

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Personal Diary 

TIME MONDAY TUESDAY WEDNESDAY TIME 

0830 Plenary 1 Large Group Sessions Posters 

0830 

0845 0845 

0900 0900 

0915 0915 

0930 0930 

0945 0945 

1000 

1015 

Coffee 

1000 

1015 

1030 

1045 

Coffee Coffee 

Short Communications 3 1030 

1045 

1100 Short Communications 1 Short Communications 2 

1100 

1115 1115 

1130 1130 

1145 1145 

1200 1200 

1215 1215 

1230 1230 

1245 

1300 

Lunch 

1245 

1300 

1315 

1330 

Lunch Lunch 

Plenary 2 

1315 

1330 

1345 Posters 

1345 

1400 Workshop Session 1 Workshop Session 2 

1400 

1415 1415 

1430 1430 

1445 Break 

1445 

1500 Special Presentation 1500 

1515 1515 

1530 1530 

1545 

Coffee 

1545 

1600 Coffee 

Workshops Continued 

Close of Meeting 1600 

1615 General Assembly 

1615 

1630 1630 

1645 1645 

1700 1700 

Note: While you are free to move between short communication and poster sessions, we hope you 

will stay in one session and join in the discussion. 

- 1.15 -

List of Exhibitors 


Association for the Study of Medical Education, UK 

Centre for Medical Education, University of Dundee, UK 

Croatian Association for Medical Education 

Faculty of Medicine, University of Lisbon, Portugal 

Humboldt-University Berlin, Germany 

IAMSE 

Kaplan Medical, USA 

Medical Teacher 

National Association of Clinical Tutors (NACT), UK 

Netherlands Association for Medical Education 

Nordic Federation for Medical Education - NFME 

Open University Centre for Education in Medicine, UK 

Ottawa Conference 

Spanish Association for Medical Education - SEDEM 

Taylor & Francis Ltd, UK 

Teaching & Learning Support Network, UK 

- 1.16 -

SECTION 2 

The Academic Programme

Saturday 1 September 


Pre-conference tours – see page 3.4 for details 

1200-1730 Registration Desk open at Campus Virchow-Klinikum and setting up of Posters 

and Exhibits. 

1400-1700 Pre-conference workshop PCW1: Web-based learning (Part 1). 

Room: Teaching Building, Computer Room 2.0103 (2 nd floor) 

Coffee for workshop participants in Studentencafé at 1530. 

1400-1700 AMEE Executive Committee Meeting 

Teaching Building Room 2.0214 (2 nd floor) (closed meeting) 

- 2.1 -

Sunday 2 September 


0800-1700 Registration Desk open at Campus Virchow-Klinikum and setting up of Posters and 

Exhibits. 

0930-1230 Pre-conference workshops 

Please note: it is essential to reserve a place on these workshops, for which a charge is 

made. Coffee for workshop participants in Studentencafé at 1100. Lunch is not 

provided. 

PCW1 Web-based learning (Part 2). (Part 1 on Saturday afternoon) 

Dr Martin Fischer, University of Munich, Germany, and Dr Raphael Bonvin, 

University of Basel, Switzerland 


PCW2 Faculty rewards and incentives in medical education: the challenges 

and the promise 

Dr Sharon Krackov, New York University School of Medicine, USA 

Room: Teaching Building, 2.0101 (2 nd floor) 

PCW3 Strategies for sustaining change in medical education 

Dr Stewart Mennin, and Dr Scott Obenshain, University of New Mexico School of 

Medicine, Albuquerque, USA 


PCW4 Assessing the reliability of mastery-level decisions in OSCE and 

Standardized Patient examinations: an overview of common 

methods and practical applications 

Dr André De Champlain, National Board of Medical Examiners, Philadelphia, 

USA, and Dr John Boulet, Educational Commission for Foreign Medical 

Graduates, Philadelphia, USA 


PCW5 Consultant appraisal 

Dr Steven Wilkinson, Centre for Organisational Research, Anglia Polytechnic 

University, UK, and Dr Kwee Matheson, West Suffolk Hospital, UK 

Room: Research Building, 2.0026 (2 nd floor) 

PCW6 Developing competence in lifelong learning 

Hajo Schmidt-Traub and colleagues: Medical Students from Charité, Medical 

Faculty of the Humboldt-University, Berlin 

Room: Teaching Building, 1.0105 (1 st floor) 

PCW7 Curriculum change in a traditional medical school 

Professor Herman van Rossum and Dr Janke Cohen-Schotanus, Groningen 

University, Netherlands 

Room: Teaching Building, 1.0107 (1st floor) 

- 2.2 -


0930-1100 BEME Steering Group Meeting 

Teaching Building, Room 2.0214 (2nd floor) (closed meeting) 

1115-1245 Medical Teacher Editorial Board Meeting 

Teaching Building, Room 2.0214 (2nd floor) (closed meeting) 

1400-1700 City coach tour 

Included in registration fee for registered participants and registered accompanying 

persons - see page 3.1 for details. 

1930-2130 Opening Ceremony and Reception at Red Town Hall (Rotes Rathaus) 

Included in registration fee for registered participants and registered accompanying 

persons - see page 3.1 for details. 

- 2.3 -

Monday 3 September 

0745-1730 Registration desk open at Campus Virchow-Klinikum 

0830-1030 Session 1: Plenary 

1 

Achieving standards in the curriculum 

Room: Teaching Building, Hörsaal 1 and 2 

(Note: there will be a video link to Hörsaal 3 to provide additional seating) 

Chairperson: Professor Margarita Barón-Maldonado, Spain 

0830-0855 1/1 Towards global standards for medical education 

Dr Jordan Cohen – President, Association of American Medical Colleges, 

Washington DC, USA 

0900-0925 1/2 New times, new standards: the social accountability of health 

systems and medical schools 

Dr Charles Boelen – Coordinator, Human Resources for Health Program, 

World Health Organization, Geneva, Switzerland 

0930-0955 1/3 Death of the course 

Professor Ronald Harden – Director, Centre for Medical Education, University 

of Dundee, and Director – Education Development Unit, Scottish Council for 

Postgraduate Medical and Dental Education, UK 

1000-1030 Discussion 

1030-1100 Coffee served in the foyers of the Teaching and the Research Buildings 

1100-1300 Session 2: Short Communications 

2A 


13 simultaneous themed sessions on a range of topics: 

A Virtual Learning Environment 

Chairperson: Professor Rein Zwierstra 

Room: Teaching Building, Hörsaal 1 (Ground Floor) 

1100-1115 1 Virtual learning environments - a learner centred review 

Megan Quentin-Baxter* and Suzanne Hardy; Learning and Teaching Support 

Network, University of Newcastle-upon-Tyne, UK 

1115-1130 2 Impact of a digital learning environment on the efficiency of teachers 

Peter G M de Jong* and Hermiette E Idenburg; Leiden University Medical Center, 

The Netherlands 

- 2.4 -

1130-1145 3 Building blocks in a new curriculum: the role of the library in 

educational innovation 

Magriet Lee and Maureen Brassel*; University of Pretoria, South Africa 

1145-1200 4 IT learning environment: more structure or more room for 

manoeuvre? Centrally guided norm path or absolute freedom? 

J Degryse*, A Roex and W Renier; K U Leuven, Belgium 

1200-1215 5 Innovation in self-directed learning (SDL) in CME: Virtual Internet 

Patient Simulation 

M A Raetzo*, R L Thivierge, R J Gagnon, V Loroch and A Bonneau; University 

of Montreal, Canada 

1215-1230 6 Real learning through virtual presentation: an Internet based work 

environment course for medical students at Uppsala University 

Klas Berlin*, Kerstin Graffman and Anna Rask-Andersen; University Hospital, 

Uppsala, Sweden 

1230-1300 Discussion [Opening Discussant: Professor Ian Hart] 

2B 


PBL and the Curriculum 

Chairperson: Dr Michael Schmidts 


1100-1115 1 The birth of a new species - squirrums: towards equal collaboration 

in innovation in medical education 

Peter McCrorie* and David Prideaux*; St George’s Hospital Medical School, 

London, UK 

1115-1130 2 Broadening learning with PBL in a Pathophysiology course 

Antonio Rendas* and Bernardo Correia; Faculdade de Ciencias Medicas, Portugal 

1130-1145 3 The implementation of problem-based learning (PBL) into a 

traditional Radiology Clerkship 

U Keske, U K M Teichgräber, R Schröder, J Berger, S Venz and R Felix; Humboldt 

University, Germany 

1145-1200 4 Medical education innovations in Dresden, Germany: Reformed 

Medical Faculty Carl Gustav Carus, Dresden University of 

Technology 

Peter Dieter; Carl Gustav Carus, Dresden, Germany 

1200-1215 5 Problem-Based Learning in Immunology and Infectious Disease 

(IMID). The Dresden Experience 

S Weber*, G Baretton, S Bergmann, J Graeszler, E Jacobs, H Kunath, I Nitsche, 

U Ravens, A Rethwilm and P Rieber; Dresden Medical School, Germany 

1215-1230 6 From case-based reasoning to problem-based learning 

Haim Eshach* and Haim Bitterman; Technion-Israel Institute of Technology, 

Haifa, ISRAEL 

1230-1245 7 A new approach to PBL in CME; using script concordance tests (SCT) 

M Labelle*, C Maille, R L Thivierge and B Charlin; University of Montreal, 

Canada 

- 2.5 -

1245-1300 8 Discovering versus covering: a new PBL in Behavioural Sciences 

Ala’Aldin Al-Hussaini and Harith Ghassany; Sultan Qaboos University, 

Al-Khod, Sultanate of Oman 

2C 

Curriculum Database 

Chairperson: Dr Ed Peile 

Room: Teaching Building, Hörsaal 3 (Ground Floor). 

1100-1115 1 Aiding the reform - development of a curriculum information 

system 

Patrick Merl*, Paolo Petta and Richard Marz University of Vienna Medical School, 

Austria 

1115-1130 2 How effective is project management software in implementing a 

new course? 

Katharine Grundy; St George’s Hospital Medical School, London, UK 

1130-1145 3 MESMIS – Medical School Staff/Student Management Information 

System: Towards the electronic curriculum 

D A Levison and W M Williamson; University of Dundee Medical School, 

Dundee, UK 

1145-1200 4 SIMON - Student Information and Management Online Network 

P Wagner*, D Zeiss*, S König*, P M Markus and H Becker: University of 

Gottingen, Germany 

1200-1215 5 Portfolio-based Dermatology internship - one year’s experience 

A Boer*, R Kaufmann and F Ochsendorf; Universitats-Hautklinik, Germany 

1215-1230 6 Profile of the consultations made by fifth year medical students in 

the integrated program of Pediatrics and Public Health 

Claudia Astudillo, Roció Arenas, Mariá Bustamante*, Mariá De La Fuente and 

Gladys Yentzen; Universidad de Chile, Santiago, Chile 

1230-1300 Discussion [Opening Discussant: Dr David Davies] 

2D 


OSCE/Standardised Patients in Assessment 

Chairperson: Dr Gerald Whelan 

Room: Research Building, Hörsaal 4 (Ground Floor) 

1100-1115 1 “Check it, rate it, palm it or leave it” - handheld computers replace 

checklists in OSCEs and provide automated feedback 

Michael Schmidts*, Markus Kemmerling, Ruth Willnauer and Martin Lischka; 

Institute für med. Aus-und Weiterbildung, Vienna, Austria 

1115-1130 2 Evaluation of the undergraduate surgery course: effect of OSCE 

Marco Bustamante Z*, Carlos Carvajal H, Fernando Quevedo R, María 

Bustamante C and Claudia Astudillo M; Universidad de Chile, Santiago, Chile 

1130-1145 3 OSCE: are many different stations necessary for each evaluation? 

Carlos Carvajal*, Marco Bustamante and Ilse López; Universidad de Chile, 

Santiago, Chile 

- 2.6 -

1145-1200 4 Assessing ‘attitude awareness’ as part of an OSCE 

Nicholas P Fenlon*, Maureen Kelly, Andrew W Murphy and Gerard Loftus; 

National University of Ireland, Galway, Ireland 

1200-1215 5 Is the assessment of clinical skills affected by the choice and 

characteristics of the standardized patients? 

T Errichetti*, J Boulet, G Whelan and D McKinley; ECFMG, Philadelphia, USA 

1215-1230 6 Use of standardized patients to assess medical response to a 

natural disaster 

Graceanne Adamo*, Marguerite Hawkins, Heidi Worth-Dickstein, Eric Marks, 

Ralph Jones, Gilbert Muniz and Richard E Hawkins; Uniformed Services 

University of the Health Sciences, Bethesda, USA 

1230-1245 7 The weakest link? Performance factors and degrees of influence in 

an interactive long-station general practice examination (VOICEs) 

C M Wiskin*, T Allan and J Skelton, University of Birmingham, UK 

1245-1300 Discussion [Opening Discussant: Professor Stewart Petersen] 

2E 


Postgraduate Education – the Early Years 

Chairperson: Dr John Nicholls 

Room: Building 10, Hörsaal 6 (Ground Floor) 

1100-1115 1 New PRHO: “I am not sure what I am supposed to do”. Can we 

improve on PRHO induction? An evaluation of a new induction 

process 

Dason Evans*, Mike Roberts and Diana Wood; St Bartholomew’s and the 

Royal London Medical and Dental School, London, UK 

1115-1130 2 A comparison of Pre-registration House Officers’ (PRHOs) and 

Senior House Officers’ (SHOs) experience in general practice 

Jan Illing*, Tim van Zwanenberg, Bill Cunningham, George Taylor, Richard 

Prescott and Cath O’Halloran; University of Newcastle, UK 

1130-1145 3 Pre-registration experience in general practice: results of a national 

evaluation 

Janet Grant*, Lesley Southgate, Rodney Gale, George Freeman, Alison Hill, 

Neil Johnson, Frank Smith, Mairead Beirne and Heather Owen; Open University 

Centre for Education in Medicine, Milton Keynes, UK 

1145-1200 4 Family Medicine Month: a human life cycle approach for first year 

residents 

Linda Z Nieman, Rebecca Gladu, Thelma Jean Goodrich, Janet Groff and 

Mary M Velasquez; UT Houston Health Science Center, Houston, USA 

1200-1215 5 Making and sharing decisions about management with patients: the 

views and experiences of Pre-Registration House Officers 

Jill Thistlethwaite; University of Leeds, UK 

1215-1230 6 Teaching the forgotten tribe: tutor views on a generic curriculum for 

SHOs 

Lesley Pugsley* and Janet MacDonald; University of Wales College of Medicine, 

Cardiff, UK 

- 2.7 -

1230-1245 7 General professional training (GPT) for dental graduates in the UK 

Alison Bullock*, Vickie Firmstone and John Frame; University of Birmingham, UK 

1245-1300 Discussion [Opening Discussant: Dr Jon Dowell] 

2F 

Peer Assessment 

Chairperson: Waltraud Georg 

Room: Teaching Building, Mikroscopierraum (First Floor) 

1100-1115 1 Peer- and co-assessment leads to shared responsibility for test results 

Caro Brumsen and Peter G M de Jong*; Leiden University Medical Center, 

The Netherlands 

1115-1130 2 Student self-marking as an assessment approach to developing 

professionalism 

G J Mires* and M Friedman Ben-David; University of Dundee, UK 

1130-1145 3 Comprehensive Assessment: value for learning 

Elaine F Dannefer; University of Rochester Medical Center, USA 

1145-1200 4 Attributes of the excellent physician: a third year student survey 

A V Carneiro*, M F Patrício and J Fernandes e Fernandes; University of Lisbon 

School of Medicine, Portugal 

1200-1215 5 The Medical Student Peer Evaluation Initiative: assessment of 

performance in small group settings 

Steven L Kanter*, Kathleen Ryan, John Mahoney and Joan Harvey; University 

of Pittsburgh, Pittsburgh, USA 

1215-1230 6 Reliability of a multidimensional questionnaire to assess attitudes 

of medical students towards their future profession: the UNI Project 

G L Werneck*, E C O Ribeiro, A C Aguiar and V M B Ribeiro; Nucleo de 

Estudos de Saude Coletiva, Ala Sul, Brazil 

1230-1245 7 Narrowing the gap in the assessment process 

Nicolas Karlsson, University of Goteborg, Sweden 

1245-1300 Discussion [Opening Discussant: Professor Ara Tekian] 

2G 


Continuing Professional Development 

Chairperson: Dr Peder Charles 

Room: Teaching Building, Room 2.0102 (Second Floor) 

1100-1115 1 Learning and partnering: bringing pharmaceutical representatives 

into the educational loop 

Jane Tipping*, Craig Campbell, Jean Claude Dairon, Paul Davis, Francois Goulet, 

Gilles Lachance, Celine Monette, Joan Sargeant, Linda Snell and Robert Thivierge, 

Canada 

- 2.8 -

1115-1130 2 CME with a combination of standardised patients and a CBT 

programme 

S Schewe*, A Schewe and J Loohs; Medizinische Poliklinik, Munich, Germany 

1130-1145 3 The impact of continuing professional development (CPD): 30 case 

studies of dentists 

Vickie Firmstone*, Alison Bullock and John Frame; University of Birmingham, UK 

1145-1200 4 Global trends in continuing medical education 

Lewis A Miller; Global Alliance for Medical Education, Darien, USA 

1200-1215 5 Do we need consultant appraisal? 

K H Matheson; West Suffolk Hospital, Bury St Edmunds, UK 

1215-1230 6 When should clinicians be trained in management? 

J Clark*, R Palmer and P Spurgeon; University of Birmingham, UK 

1230-1245 7 Evaluation of ‘Distance Interactive Learning in Obstetrics and 

Gynaecology (DIALOG)’ 

Vikram Jha*, Sean McAleer and Sean Duffy; St James’s University Hospital, 

Leeds and University of Dundee, UK 

1245-1300 Discussion [Opening Discussant: Dr Brendan Hicks] 

2H 

Selection 


Chairperson: Professor David Wiegman 


1100-1115 1 Selecting aboriginal students to health professional courses 

I E Rolfe and G Garvey*; University of Newcastle, Australia 

1115-1130 2 Demographic and scholastic correlates of scores in the Australian 

Undergraduate Medical and Health Sciences Admission Test (UMAT) 

Peter Tutton*, Chris Browne, Margot Story and Michael Lewenberg; Monash 

University, Australia 

1130-1145 3 Can we make the interview add something new? 

P Hughes, S Miller*, P McCrorie and A Kent; St George’s Hospital Medical 

School, London, UK 

1145-1200 4 Relative effects of learning style, MCAT and prior academic record 

on performance in medical school 

Stephen Aaron* and Ernest Skakun; University of Alberta, Canada 

1200-1215 5 The selection of GP trainees in the West Midlands: audit of 

assessment centre scores by ethnic background and country of 

qualification 

Celia Brown*, Sarah Wakefield and Alison Bullock; University of Birmingham, UK 

1215-1230 6 The selection of GP trainees: perceptions of the new regional 

system 

Sarah Wakefield*, Celia Brown and Alison Bullock; University of Birmingham, 

UK 

- 2.9 -

1230-1245 7 “I want to become a doctor.” Analysis of first year students’ 

motivations 

M F Patrício* and J Gomes-Pedro; University of Lisbon, Portugal 

1245-1300 Discussion [Opening Discussant: Miss Gill Clack] 

2I 

Educating the Educators (1) 

Chairperson: Professor Olle ten Cate 


1100-1115 1 Evaluation of a Train the Trainers program in quality improvement 

and cost-effectiveness 

Antoinette S Peters*, Maryjoan Ladden and Robert Fletcher; Harvard Medical 

School, Boston, USA 

1115-1130 2 Teaching the medical teachers - Beyond ‘TIPS’ 

Jane Richardson* and Jonathan D Cartledge; University College London, UK 

1130-1145 3 Formal courses in further training of medical teachers 

M Vrcic-Keglevic*, Z Jaksic, G Pavlekovic, N Pokrajac, A Smalcelj and B Vrhovac; 

“A.Stampar” School of Public Health, Zagreb, Croatia 

1145-1200 4 Supporting Clinicians on Training in Scotland 

Rose Martin, on behalf of Supporting Clinicians on Training in Scotland Working 

Group; Scottish Council for Postgraduate Medical and Dental Education, 

Dundee, UK 

1200-1215 5 Improving own teaching skills identified as a top priority by 

Registrars 

Iwona Stolarek; Hutt Hospital, Wellington, New Zealand 

1215-1230 6 Dissemination of teaching of medical interviewing and physical 

examination in Japan 

N Ban*, M Hatao, J Ohtaki, M Fujisaki, C Nakamura, T Tsuda, T Matsumura 

and M Shimo; Nagoya University School of Medicine, Japan 

1230-1245 7 Transformational learning in a peer teaching programme 

Angel M Centeno*, Alexandra Blanco and Soledad Campos; Austral University, 

Buenos Aires, Argentina 

1245-1300 Discussion [Opening Discussant: Dr Clair DuBoulay] 

2J 


Simulation and Clinical Skills Training 

Chairperson: Professor Andrzej Wojtczak 

Room: Building 10, Room 1.0107 (Lower Ground Floor) 

1100-1115 1 Teaching clinical skills to medical students using the clinical skills 

laboratory with a new simulator and new tools 

I Yoshida*, T Ueno, M Hotta, H Abe, I Kubara, S Kono, Y Ogo, S Watanabe, 

A Hayashi, T Akagi, S Okuda and M Sata (Working Group on Teaching Basic 

Clinical Skills); Kurume University, Japan 

- 2.10 -

1115-1130 2 Training in vaginal examination technique using the ‘epelvis’ 

C M Pugh* and M S Marsh; GKT Medical School, London, UK 

1130-1145 3 Training medical students to perform vaginal examination using the 

‘epelvis’ 

M S Marsh* and C M Pugh; GKT Medical School, London, UK 

1145-1200 4 Procedural failures - when is enough enough? 

Michael Harrison; Auckland Hospital, New Zealand 

1200-1215 5 Approaches and advancements; Integrating simulation center 

activities into 3rd year medical school clerkship curricula 

Aileen E Zanoni*, Graceanne Adamo, Christoph R Kaufmann and Richard E 

Hawkins; Uniformed Services University, Bethesda, USA 

1215-1230 6 Using scenario based teaching to deliver feedback on technical and 

communication skills 

R L Kneebone*, J Kidd, D Nestel, B Paraskeva, S Asvall and A Darzi; College 

School of Medicine, Imperial London, UK 

1230-1300 Discussion [Opening Discussant: Professor Paul Bradley] 

2K 


Students and Curriculum Evaluation 

Chairperson: Professor Juan Perez-Gonzalez 


1100-1115 1 Teaching quality questionnaire: students’ evaluations of standard 

learning activities in an integrated curriculum 

Øyvind Ellingsen*, Kristin Wigen and Are Holen; Norwegian University of Science 

& Technology, Trondheim, Norway 

1115-1130 2 The retrospective view - formative programme evaluation of 

preclinical courses by final year medical students 

C Schirlo*, W Vetter and P Groscurth; Studiendekanat der Medizinischen Fakultat, 

Zurich, Switzerland 

1130-1145 3 Students’ attitudes towards evaluation of teaching programmes - do 

they fib? 

Richard Phillips* and Alison Hooper; GKT School of Medicine, London, UK 

1145-1200 4 Student evaluation of educational quality: the construction of a 

multidimensional questionnaire 

Volkhard Fischer; Hannover Medical School, Germany 

1200-1215 5 Evaluation of lectures in medical teaching based on focal groups 

and a survey of opinion to formulate a guide of practical 

recommendations 

Juan Cristóbal Maass*, Lorena Tapia, Marcela Jacard, and Teresa Millán; 

University of Chile, Santiago, Chile 

1215-1230 6 Use of a Continuous Quality Improvement (CQI) model to enhance 

curriculum evaluation and integration 

Nehad El-Sawi; University of Health Sciences, Kansas City, USA 

- 2.11 -

1230-1245 7 New faculty-level self-evaluation instruments 

K Lonka*, N Paganus, T Hätönen, A Heikkilä, J Vainio and J Nieminen; 

University of Helsinki, Finland 

1245-1300 8 The doctors’ opinion - a national evaluation of Swedish medical 

education 

Anders Bengtsson, Kerstin Johansson and Sara Engström*; Swedish Medical 

Association, Stockholm, Sweden 

2L 

Multiprofessional Education 

Chairperson: Dr Anna Bukovinszky 

Room: Teaching Building, Room 1.0107 (First Floor) 

1100-1115 1 Interprofessional learning: the New Generation Project 

Debra Humphris* and Chris Stephens*; University of Southampton, UK 

1115-1130 2 “Walking in the moccasins of others”: reflections on a new initiative 

to bring the real world of the patient into the medical curriculum 

Lyn Brown; University of Liverpool, UK 

1130-1145 3 Multiprofessional education in health care ethics in Germany 

Jochen Vollmann; Freie Universitat Berlin, Germany 

1145-1200 4 Dilemmas in resuscitation: nursing and medical students’ 

responses to ethical professional issues related to resuscitation of 

patients 

C Edward*, J Crosby and P E Preece*; University of Dundee, UK 

1200-1215 5 Promoting the use of clinical guidelines in Scotland 

Bernice West* and Peter Wimpenny*; Robert Gordon University, Aberdeen, UK 

1215-1230 6 Can Neuropsychiatry training be successfully delivered in a multiprofessional 

setting? 

Andrew Parkin* and Nisha Dogra; University of Leicester, UK 

1230-1245 7 The CURATA Partnership: linking CHE to patient care 

R L Thivierge*, M Labelle, M Beaulieu and L Bessette; University of Montreal, 

Canada 

1245-1300 Discussion [Opening Discussant: Dr Janke Cohen-Schotanus] 

2M 


Student Support/Psychiatry and the Curriculum 

Chairperson: Dr Jadwiga Mirecka 


1100-1115 1 An evaluation of student support systems at the Medical School at 

Queen’s University Belfast 

Nicola Wilson, David McCluskey and Mairead Boohan*; Queen’s University of 

Belfast, Northern Ireland, UK 

- 2.12 -

1115-1130 2 Is student abuse a problem in our medical school? 

Ana Maida*, Alicia Vasquez, José Calderon, Viviana Herskovic, Marcela Jacard, 

Ana Pereira and Lars Widdel; University of Chile, Santiago, Chile 

1130-1145 3 First year medical nursing and pharmacy students’ approaches to study 

R J Lamdin* and I Martin; University of Auckland, New Zealand 

1145-1200 4 Changing medical students’ attitudes towards homosexuality 

Itzchak Levi* and Tsvi Fischel; Sackler Medical School, Tel Aviv, Israel 

1200-1215 5 The attitudes to Psychiatry of first year medical students 

R K Day; University of Dundee, UK 

1215-1230 6 Psychology basic and applied knowledge 

Agnete Langagergaard* and Berit Eika; University of Aarhus, Denmark 

1230-1300 Discussion [Opening Discussant: Dr Jorgen Nystrup and Ms Mei-Ling Ball] 

1300-1400 Lunch – self-service buffet in the Marquee 

1400-1600 Session 3: Workshops 

3 


Please see the Abstracts section pages 4.23 to 4.26 for details of these workshops. 

Attendance at Conference workshops is free of charge but you are asked to preregister 

on the form included with the programme. Lists of participants who have preregistered 

and places available will be posted by the registration desk. 

3/1 The roles of the teacher 

Organisers: Jennifer Laidlaw and Anne Hesketh, SCPMDE Education 

Development Unit, Dundee, UK 


3/2 The quality of medical education and teaching – thema con 

variatione 

Organiser: Professor Peter Nippert, University of Muenster, Germany 


3/3 From MD to academic teacher 

Organiser: Professor Reinhard Putz, University of Munich, Germany 

Room: Building 10, Kursraum 5 (lower ground floor) 

3/4 Feedback and evaluation: essential activities in the learning process 

Organiser: Dr Charles D Puglia, MCP Hahnemann School of Medicine, 

Philadelphia, USA 


3/5 Best Evidence Medical Education: progress report 

Chairperson: Professor Ian Hart, BEME Collaboration. Contributions from 

representatives of BEME Topic Review Groups 

Room: Teaching Building, Hörsaal 1 (ground floor) 

- 2.13 -


3/6 East European Task Force 

Chairperson: Professor Ioan Bocsan, Iuliu Hatieganu University of Medicine & 

Pharmacy, Romania 

Room: Research Building, Besprechungsraum 2.0026 (2 nd floor) 

3/7 Making feedback during clerkships meaningful and effective: a 

workshop for students and teachers 

Organiser: Dr Paul Hemmer, Uniformed Services University of the Health Sciences, 

Bethesda, USA 


3/8 Concept mapping 

Organiser: Dr Gonul Peker, Ege University School of Medicine, Bornova-Izmir, 

Turkey 


3/9 Effective student assessment: something old, something new 

Organiser: Dr Geoff Norman, McMaster University Medical School, Hamilton, 

Canada 

Room: Teaching Building 2.0102 (2 nd floor) 

3/10 A bachelor-master structure of medical education in Europe? 

Organisers: Professor Olle ten Cate, University Medical Centre Utrecht and 

Professor Herman van Rossum, University of Groningen, Netherlands 

Room: Teaching Building, Horsaal 2 (ground floor) 

3/11 The assessment of poorly performing doctors: experiences from the 

first three years of the Performance Procedures within the UK 

General Medical Council 

Organisers: Professor Lesley Southgate, University College London Medical School, 

and Dr Peter McCrorie, St George’s Hospital Medical School, London UK 


3/12 What can a general medical journal do for education in medicine? 

Sandy Goldbeck-Wood and Dr Ed Peile, University of Oxford, UK 


1600-1615 Coffee served in the foyers of the Teaching and Research Buildings 

1615-1715 AMEE General Assembly 

(Non-members of AMEE are also welcome to attend this business meeting of the Association) 

Room: Teaching Building, Horsaal1 (ground floor) 

1930-2300 River Cruise with buffet and entertainment 

(Optional – not included in Conference registration fee – please see page 3.2 for details) 

1930 til late Alternative evening for students only! 

Dinner and entertainment in the “Lecture Hall Ruin” (see page 3.2 for details) 

- 2.14 -

Tuesday 4 September 

0800-1715 Registration Desk open 

0830-1030 Session 4: Large Group Sessions 

4A 

Standards and professionalism in medical education 

Chairperson: Professor Ian Hart, Canada 


0830 4A/1 Attempto! Instilling mindful teaching 

Dr Maria Lammerding-Köppel, University of Tubingen, Germany 

0855 4A/2 Who is afraid of the didactic wolf? A plea for professionalism in 

medical education and specialist training 

Professor Rein Zwierstra, University of Groningen, Netherlands 

0920 4A/3 What’s good about ‘Best Evidence Medical Education’ (BEME) 

Professor Ralph Bloch, Institute for Medical Education, University of Bern, 

Switzerland 

0945 Discussion 

4B 

International aspects of standards 

Chairperson: Professor Ronald Harden, UK 


0830 4B/1 The challenge of developing international standards in medical 

education 

Dr Andrzej Wojtczak, Institute for International Medical Education, New York, 

USA, and Dr M Roy Schwarz, China Medical Board of New York 

0855 4B/2 Globalisation of medical education: the concept of international 

standards 

Dr Hans Karle, World Federation for Medical Education, Copenhagen, Denmark 



- 2.15 -

4C 

Standards and the curriculum 

Chairperson: Professor Herman van Rossum, Netherlands 


0830 4C/1 Learning can be fun! The student’s experience of standards in a new 

curriculum 

Anke Neuwirth and Johannes Meier, 2 nd year students in the Reformed Medical 

Curriculum, Charité, Medical Faculty of the Humboldt-University, Berlin, Germany 

0855 4C/2 The advantages of longitudinal evaluation of the medical 

curriculum 

Professor Reinhard Pabst, Medical School of Hannover, Germany 

0920 4C/3 Standards and assessment 

Professor Miriam Friedman Ben-David, University of Dundee, UK 


1030-1100 Coffee served in the foyers of the Teaching and Research Buildings 


5A 


13 simultaneous themed sessions on a range of topics: 

Learning and the Internet 

Chairperson: Professor Dieter Scheffner 


1100-1115 1 The “dos and don’ts” of e-learning in medicine: experiences of a 

CD-ROM production 

P Langkafel*, A Oehlsen, U Arnold and J W Dudenhausen; Humboldt University 

Berlin, Germany 

1115-1130 2 Online guide to basic surgical skills: http://olc.chirurgiegoettingen.de 

S Koenig*, P Wagner, D Zeiss, P M Markus and H Becker; Georg-August- 

University Goettingen, Germany 

1130-1145 3 Standards for an international distributed online case repository 

Chris Candler*, Colin Melville and Dave Collins; University of Oklahoma, 

Oklahoma City, USA 

1145-1200 4 Digital study of medicine 

U Arnold*, P Langkafel, L Peppel, I Reisinger and J W Dudenhausen; Humboldt 

University Berlin, Germany 

1200-1215 5 Electronic learning objects and resource discovery 

David A Davies; University of Birmingham, UK 

- 2.16 -

1215-1230 6 Filling a curriculum map with Reusable Learning Objects 

N K McManus *, R M Harden, D Davidson, S Khogali and J M Laidlaw; 

SCPMDE Education Development Unit, Dundee, UK 

1230-1300 Discussion [Opening Discussant: Professor Ralph Bloch] 

5B 


Evaluation of Problem-based Learning 

Chairperson: Professor Reinhard Pabst 


1100-1115 1 Changing to PBL: does it have an effect on junior doctors’ 

conceptualisation of communication skills? 

P A O’Neill*, S C Willis and A Jones; University of Manchester, UK 

1115-1130 2 How do medical students characterize good problem-based 

learning (PBL) tutoring after a year’s experience? 

Gillian Maudsley; University of Liverpool, UK 

1130-1145 3 Predicting outcome by behaviour in PBL groups? 

Kristin Wigen*, Are Holen, Øyvind Ellingsen and Hansjørg Hohr; Norwegian 

University of Technology and Science, Trondheim, Norway 

1145-1200 4 Student evaluation of a problem-based learning module into an 

occupational therapy course 

Deirdre Connolly* and Morag Donovan; Trinity College Dublin, Dun Laoghaire, 

Ireland 

1200-1215 5 Evaluation of student performance in the problem based learning 

(PBL) group 

David C M Taylor, The Physiological Laboratory, University of Liverpool, Crown 

Street, Liverpool L69 3BX, UK 

1215-1230 6 Influence of tutor qualification on test achievement and student 

evaluation in a problem-based course of basic pharmacology 

J Matthes*, B Marxen, R-M Linke, W Antepohl, W Lehmacher and S Herzig; 

University of Cologne, Germany 

1230-1245 7 Individual perceptions of group learning and functioning in a 

problem-based learning programme 

Janet MacDonald; University of Wales College of Medicine, Cardiff, UK 

1245-1300 Discussion [Opening Discussant: Dr Jacques Des Marchais] 

- 2.17 -

5C 

Curriculum Evaluation 

Chairperson: Dr Kirsti Lonka 


1100-1115 1 A course programme evaluation: contribution of students’ selfevaluation 

Carlota Saldanha*, Jorge Lima and Joao Martins-Silva; Institute of Biochemistry, 

University of Lisbon, PORTUGAL 

1115-1130 2 A national evaluation of the reforms to higher specialist training in 

the UK: methodological issues 

Janet Grant*, Rodney Gale, Mairead Beirne and Heather Owen; Open University 

Centre for Education in Medicine, Milton Keynes, UK 

1130-1145 3 Evaluation of PME courses in General Practice in Germany 

S Wilm*, R Jahromi, S Krause and B Hemming; Heinrich-Heine University, 

Duesseldorf, Germany 

1145-1200 4 The Matrix: a visual presentation of registrar term evaluation 

Richard Tarala and Alistair Vickery; Royal Perth Hospital, Australia 

1200-1215 5 Site visits as a method to assess the educational quality of 

clerkships 

Janke Cohen-Schotanus* and Rein P Zwierstra; University of Groningen, Netherlands 

1215-1230 6 Impact of a new curriculum on the clinical competence of medical 

students at the University of Barcelona Medical School (UBMS) 

Ramon Pujol*, Frederic Manresa, Francesc Gudial, Eduard Kranfly, Josep Ma 

Martinez Carsetera; University of Barcelona, Spain 

1230-1245 7 Lessons learnt in designing and implementing a curriculum 

evaluation 

Helen Graham* and Mary Seabrook; GKT School of Medicine, London, UK 

1245-1300 Discussion [Opening Discussant: Professor Geoff Norman and Ms Susanne Pruskil] 

5D 


Assessing Communication Skills/Patients as Examiners 

Chairperson: Dr Andre de Champlain 


1100-1115 1 Detecting rater bias on a measure of spoken English proficiency 

Marta van Zanten*, Danette McKinley, John Boulet and Gerald Whelan; 

ECFMG, Philadelphia, USA 

1115-1130 2 Comparison of communication skills in residency with performance 

on ECFMG Clinical Skills Assessment 

W Burdick*, J Boulet, S Peitzman, G Whelan and D Brody; ECFMG, Philadelphia, 

USA 

1130-1145 3 ACT: a new computer-assisted assessment (CAA) method for 

communication-skills of medical students 

R L Hulsman* and J D Donnison-Speijer; Academic Medical Centre, Amsterdam, 

Netherlands 

- 2.18 -

1145-1200 4 How accurate is lay person assessment of clinical competence of 

student doctors? Comparison of the assessment of medical 

students by Faculty and Standardized Patients during the Objective 

Structured Clinical Examination 

P Heasman*, K Pitkala and N Paganus; University of Helsinki, Finland 

1200-1215 5 Do Simulated Patients grade inter-personal skills as well as 

Faculty? 

A S Arora*, N Natt, S Kluck and R Tiegs; Mayo Foundation, Rochester, USA 

1215-1230 6 The contribution of non medical assessors to the assessment of 

poorly performing doctors 

Lesley Southgate* and Peter McCrorie; University College London Medical School, 

London, UK 

1230-1245 7 Assessment in the elective clinical rotation: centrally reviewed case 

reports 

W M Molenaar*, S A Koopmans, M D Talsma and L H van Essen: University of 

Groningen, Netherlands 

1245-1300 Discussion [Opening Discussant: Dr Wolfram Antepohl] 

5E 


Postgraduate Education for General Practice/ 

Family Medicine 

Chairperson: Dr Kwee Matheson 


1100-1115 1 An educational approach to significant event auditing in primary care 

J McKay* and P Bowie; University of Glasgow, UK 

1115-1130 2 Postgraduate education for generalist physicians 

J F Perez Gonzalez* and M Requena; Universidad Central de Venezuela, Caracas, 

Venezuela 

1130-1145 3 Barriers to change in postgraduate medical education in General 

Practice 

B W McGuinness; Queen Elizabeth Hospital, Swaffham, UK 

1145-1200 4 The use of video in General Practice Registrar training and assessment 

C M Wiskin, Stephen Field* and John Skelton; West Midland GP Unit, 

Birmingham, UK 

1200-1215 5 The consultation styles of female GP Registrars with male and 

female patients 

Sarah Hillman* and John Skelton; University of Birmingham, UK 

1215-1230 6 The development, implementation and evaluation of a ‘concordance’ 

training course 

Jon Dowell*, Claudia Pagliari and Sean McAleer; University of Dundee, UK 

1230-1245 7 A linguistic study of information-giving in 30 doctor-patient 

consultations 

Andy Shanks* and John Skelton; University of Birmingham, UK 

1245-1300 Discussion [Opening Discussant: Professor Graham Buckley] 

- 2.19 -

5F 

Assessment 

Chairperson: Dr Robert Galbraith 


1100-1115 1 Objective Structured Preclinical Exams (OSPE): a new test format of 

summative student assessment in the Problem-Based Learning (PBL) 

curriculum at the Faculty of Medicine of the University of Bern 

Barbara Stadelmann*, R Hofer, Urs Brodbeck and Ara Tekian; University of 

Bern, Switzerland 

1115-1130 2 The quality of an extended-matching multiple choice examination 

J Beullens*, B Van Damme, H Jaspaert, E Struyf and P J Janssen; K.U.Leuven, 

Belgium 

1130-1145 3 Evaluation of a five-dimensional assessment strategy within a 

problem-based learning medical curriculum 

Paul Julian*, Scott Reeves* and Alistair Lumb*; Barts & The London School of 

Medicine & Dentistry, London, UK 

1145-1200 4 A preclinical exam to assess the networked structure of knowledge 

on basic science in the Universidad Nacional de Cuyo (Argentina) 

Ana Maria Reta*, Maria del Carmen Montbrun and Maria José Lopez; 

Universidad Nacional de Cuyo, Mendoza, Argentina 

1200-1215 5 Predictive value for academic performance of two assessment 

devices applied to medical students 

Ma Eugenia Ponce de León C*, Armando Ortiz and M del Carmen Ruiz Alcocer; 

National Autonomous University of Mexico, Mexico 

1215-1230 6 Self-assessed clinical skills levels of newly graduated physicians in 

relation to an intended curriculum 

A M Moercke* and B Eika; University of Aarhus, Denmark 

1230-1245 7 The dynamics of knowledge structure of graduating medical 

students based on results of the Medical Licensing Examination 

M Mrouga*, Y Bogachkov and L Artemchuk; Testing Board, Kyiv, UKRAINE 

1245-1300 Discussion [Opening Discussant: Professor John Cookson] 

5G 


Outcome-based Education 

Chairperson: Dr Jordan Cohen 


1100-1115 1 The Scottish Learning Outcomes Project Phase II - Assessment: 

“the proof of the pudding” 

Jacqueline Furnace* and John Simpson*, on behalf of Scottish Deans’ Medical 

Curriculum Group; University of Aberdeen, UK 

1115-1130 2 Recent developments in an outcome-led curriculum 

Nick Ross; University of Birmingham, UK 

- 2.20 -

1130-1145 3 A New Instrument of curriculum development: Curriculum as a 

function of professional outcomes 

I Bulakh*, Y Voronenko and I Filonchuk; Testing Board and National Medical 

University, Kyiv, Ukraine 

1145-1200 4 Focusing on learning outcomes for the Preregistration House 

Officer (PRHO) year 

E A Hesketh* and M S Allan; Education Development Unit, Dundee, UK 

1200-1215 5 The ACGME Outcome Project: a model resident assessment system 

Susan Swing; ACGME, Chicago, USA 

1215-1230 6 Development of an outcome-based clinical curriculum at 

International Medical University (IMU), Malaysia 

J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, K H Ong, C M K 

Patrick and Q Akhtar; International Medical University, Selangor, Malaysia 

1230-1245 7 An evaluation of the internal validity of specific learning outcomes 

in phase II of a revised undergraduate medical curriculum 

F J Cilliers* and E M Bitzer; University of Stellenbosch, Tygerberg, South Africa 

1245-1300 Discussion [Opening Discussant: Professor Miriam Friedman] 

5H 


Educational Strategies/Curriculum Planning 

Chairperson: Professor G Gaedicke 


1100-1115 1 Structural changes approaching medical education in The 

Netherlands 

Olle Th.J. ten Cate*, Herman J M van Rossum and Albert J J A Scherpbier; 

Utrecht University, Netherlands 

1115-1130 2 Implementation of PBL-Based Curriculum 

Maria Montbrun* and Enrique Guntsche; Universidad Nacional de Cuyo, 

Mendoza, Argentina 

1130-1145 3 An overview of the implementation of curriculum 2001 at Nelson R 

Mandela School of Medicine, University of Natal 

Veena Singaram*, Jacqueline van Wyk, Michelle McLean and Peter Olmesdahl; 

University of Natal, South Africa 

1145-1200 4 Self-directed, self-organized case-based-learning in final year 

students 

Jana Junger, Christiane Roth, Stephan Zipfel, Wolfgang Eich and Wolfgang Herzog; 

University of Heidelberg, Germany 

1200-1215 5 Changing to ‘self-induced learning’ in a speech therapy department 

Martin Peleman; Arteveldehogeschool, Gent, Belgium 

1215-1230 6 Student participation in the organization of education at a medical 

school - a comparison of two South African cases 

B G Lindeque and Pierre L Bredenkamp*; Stellenbosch University, Tygerberg, 

South Africa 

- 2.21 -

1230-1245 7 Preparing the way: encouraging clinical tutors to be co-producers in 

the learning process 

Peter Barton* and Jillian Morrison; University of Glasgow, UK 

1245-1300 Discussion [Opening Discussant: Dr Peter McCrorie] 

5I 

Educating the Educators 

Chairperson: Professor Hywel Thomas 


1100-1115 1 How to help clinical and multimedia staff develop joint programs 

Eleanor Flynn; University of Melbourne, Australia 

1115-1130 2 “Getting Started in Clinical Teaching” - a staff development initiative 

J A Dent* and P E Preece; University of Dundee, UK 

1130-1145 3 Governance in medical teaching: pilot study 

Iain Robbé; University of Wales College of Medicine, Cardiff, UK 

1145-1200 4 The role of an education unit in health professional education: 

proactive or responsive 

Margaret Horsburgh* and Rain Lamdin; University of Auckland, New Zealand 

1200-1215 5 Beyond teacher training; the construction of a faculty development 

strategy 

Patricia Rosado Pinto* and Ramiro Avila; Faculty of Medical Sciences, Lisbon, 

Portugal 

1215-1230 6 The profile of the perfect teaching professor 

F Scheele*, J Th M van der Schoot and A J Goverde; St Lucas Andreas Hospital, 

Amsterdam, Netherlands 

1230-1245 7 Evidence retrieval in medical education: obstructions and 

opportunities 

Alex Haig; SCPMDE Education Development Unit, Dundee, UK 

1245-1300 Discussion [Opening Discussant: Dr John Nicholls] 

5J 


Education and Cultural Diversity 

Chairperson: Dr Brigitte Grether 


1100-1115 1 The development and evaluation of a programme to teach cultural 

diversity to medical undergraduate students 

Nisha Dogra; University of Leicester, UK 

1115-1130 2 Aboriginal health: a tool in the process of reconciliation? 

G Garvey* and I E Rolfe*; University of Newcastle, Callaghan, Australia 

- 2.22 -

1130-1145 3 Valuing diversity: The effectiveness of a roleplay workshop as part 

of a newly introduced community based diversity module 

Sue Conning*, Alison Hooper, Margot Turner and Val Wass; GKT School of 

Medicine, London, UK 

1145-1200 4 Using negative role models positively 

S E Gull* and K H Matheson; Bury St Edmunds, UK 

1200-1215 5 What factors influence underrepresented minority (URM) students in 

their choice of medical schools? 

Ara Tekian*, Laura Hruska and Mark Urosev; University of Illinois at Chicago, 

Chicago IL 60612, USA 

1215-1230 6 Education for professionalism in medicine 

Geoffrey Westwood* and Barbara Westwood; Bankstown Health Service, Australia 

1230-1245 7 Characteristics of students admitted for the medical course at 

Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, 

Brazil 

A R L Cianflone*, M F A Colares, J F C Figueiredo, M L V Rodrigues and L E de 

A Troncon; Faculty of Medicine of Ribeirao Preto, Brazil 

1245-1300 Discussion [Opening Discussant: Dr Angel Centeno] 

5K 


Contexts for Learning 

Chairperson: Dr Abdulwahab Telmesani 


1100-1115 1 Clinical education in the health care professions: a critical analysis 

of the literature 

Alison Rushton; Coventry University, UK 

1115-1130 2 “Contracts for Learning”: project to improve the quality of 

attachments at a District General Hospital 

Richard Ayres*, Henry Averns and Lin Sanders; Northern Devon Healthcare 

Trust, Barnstaple, UK 

1130-1145 3 Does the dedicated teaching environment in ambulatory care 

improve acquisition of learning outcomes? 

Clare I L Stewart*, Paul E Preece and John A Dent; University of Dundee, UK 

1145-1200 4 Could we improve on what patients our pediatrics students saw in 

outpatient clinics? 

Pedro Herskovic*, Alicia Vasquez, Cristian Breinbauer, Patricia Gomez, Viviana 

Herskovic, Marcela Jacard, Claudio Missarelli and Erika Troncoso; University of 

Chile, Santiago, Chile 

1200-1215 5 Using the ward round for teaching and learning: how do junior 

doctors learn from consultants through ward-based teaching? 

Alan Bleakley; Cornwall Postgraduate Education Centre, Truro, UK 

1215-1230 6 Clinical skills training needs of final year medical students and 

PRHOs - A comparison 

D MacLeod*, E Gill, J Gate and J Rees; University Hospital Aintree, Liverpool, UK 

- 2.23 -

1230-1245 7 The impact of a precepted diabetic foot care program 

Linda Z Nieman, Lewis E Foxhall*, Frank Sifuentes and Lee Cheng; University of 

Texas Houston Health Science Center, USA 

1245-1300 Discussion [Opening Discussant: Professor Amanda Howe] 

5L 

Evaluation of Multiprofessional Education 

Chairperson: Dr Pia Forsberg 


1100-1115 1 The benefits of a multiprofessional education programme can be 

sustained 

G J Mires*, F L R Williams, R M Harden and P W Howie; University of Dundee, UK 

1115-1130 2 Self-directed multiprofessional continuing medical education with 

facilitators: an experiment in four European countries. The Belgian 

story 

J Goedhuys*, C Geens, N Mathers, K Billingham, G Maso and O Solas-Gaspar; 

Catholic University Leuven, Belgium 

1130-1145 3 Interprofessional education in a clinical and non-clinical 

environment: Teachers’ and learners’ perspectives 

John Jenkins and Sue Morison*; Queen’s University Belfast, UK 

1145-1200 4 Interprofessional education: experiences of students 

J Agsteribbe*, R M H Schaub and J Cohen-Schotanus; University of Groningen, 

Netherlands 

1200-1215 5 “Capturing the learning”: the development of interprofessional 

education in the Faculty of Medicine, Health and Biological 

Sciences, University of Southampton 

D Humphris* and S Colly; University of Southampton, UK 

1215-1230 6 Learning interprofessionally: a review of experiences 

A Le May*, F Kitsell, I Giles and C Stephens; University of Southampton, UK 

1230-1245 Discussion [Opening Discussant: Dr Gary Mires] 

5M 


Teaching about EBM, Critical Thinking and Research 

Chairperson: Professor Florian Eitel 


1100-1115 1 Questions as the key to knowledge: teaching medical students in 

Evidence-Based Medicine 

Jonna Skov Madsen*, Birgitta Wallstedt, Carl Joakim Brandt and Mogens Horder; 

Odense University Hospital, Denmark 

1115-1130 2 Teaching Evidence-Based Medicine to healthcare professionals: 

implementing and evaluating the programme 

C Osonnaya*, K Osonnaya and E Burke; University of London, UK 

- 2.24 -

1130-1145 3 Impact of a short interactive curriculum on medical students’ 

appreciation of EBM and CAM 

Samuel N Forjuoh*, Robert A Henry, Terry G Rascoe, Barb Symm and Janine C 

Edwards; Texas A & M University, Temple, USA 

1145-1200 4 Annual Students-Congress of Medicine (SCM): a tool for scientific 

education in the medical curriculum 

E J M van Gils*, M H J Maathuis, G J Navis and R H Henning; University of 


1200-1215 5 What do medical graduates think about their earlier research 

projects now? 

Saeed Asefzadeh; Qazvin University of Medical Sciences, Iran 

1215-1230 6 Research and the use of computers in the new curriculum of the 

University of Vienna Medical School 

Richard Marz* and Robert Trappl; University of Vienna, Austria 

1230-1245 7 Experimental courses in Biochemistry - initiation to scientific 

research in undergraduate medicine 

Carlota Saldanha*, Rui Mesquita and J Martins-Silva; University of Lisbon, Portugal 

1245-1300 Discussion [Opening Discussant: Dr Sharon Krackov] 

1300-1400 Lunch in the Marquee 

1400-1700 Session 6: Workshops 

6 


Please see the Abstracts section pages 4.51 to 4.55 for details of these workshops. 

Attendance at Conference workshops is free of charge but you are asked to preregister 

on the form included with the programme. Lists of participants who have preregistered 

and places available will be posted by the registration desk. 

Note: coffee will be available between 1530-1600 hrs in the foyers of the Teaching 

and Research Buildings 

6/1 Basic Skills Faculty Development Workshop 

Dr Anita Duhl Glicken, University of Colorado School of Medicine, Denver, USA 


6/2 An Introduction to Clinical Judgment Analysis 

Dr Anthony LaDuca, National Board of Medical Examiners, Philadelphia, USA 

Room: Teaching Building, Computer Room, 2.0103 (2 nd floor) 

6/3 Nordic Federation for Medical Education 

Chairperson: Dr Eivind Drange 

Room: Teaching Building, Horsaal 1 

- 2.25 -


Note: all participants welcome at the Plenary and the Workshop 

Plenary (1400-1445 ): Reform in a Medical School – needed, wanted, 

possible? 

Dr Kirsti Lonka, Director, Development and Research Unit, Faculty of Medicine, 

University of Helsinki/ Professor in Medical Education Karolinska Institutet, Sweden 

Workshop (1500-1545): NFME and AMEE – do we need them both? 

A discussion of the future role of NFME and possible co-operation with AMEE. The 

workshop will start with a closed debate among the panel followed by an open discussion. 

Panel: Dr Jørgen Nystrup, Dr Dagfinn Øgreid (chair NFME), Dr Kirsti Lonka, 

Professor Jörgen Nordenström 

Moderator: Eivind Drange 

Closed meeting (1600-1700): Extraordinary General Assembly, NFME 

6/4 Bedside Cardiology Skills Training, featuring “Harvey”, The 

Cardiology Patient Simulator and the UMedic Computer System 

Organisers: Dr Michael S. Gordon, University of Miami School of Medicine, and 

Dr Joel M Felner, Emory University School of Medicine, USA 


6/5 Risk management in medical education 

Directors of Research in Postgraduate Medical Education Group 

Organisers: Dr Kwee Matheson, West Suffolk Hospital, UK, Dr Alistair Thomson 

and Dr Andrew Long 


6/6 The professional and organisational culture of medical education – 

an exploratory workshop in the context of an interactive exhibition 

Organisers: Dr Elizabeth Krajic Kachur, Medical Education Development, New 

York, USA, Dr Nobaturo Ban and Hannah Kedar 

Room: Research Building Horsaal 4 (ground floor) 

The exhibition linked to this workshop will be set up in Research Building, 1.0020 1st floor 

6/7 Students teaching communication skills 

Organisers: Students from Charité, Humboldt-University of Berlin, Germany 

Room: Building 8, Seminarraum 2 (1 st floor) 

6/8 Developing professional attitudes: theory, practice and evaluation 

Organiser: Professor Amanda Howe, University of East Anglia, UK 


6/9 AMEE/IberoAmerican Network 

Chairperson: Professor Margarita Barón-Maldonado, AMEE 


6/10 Problem-based Learning 

Organisers: Dr Stewart Mennin and Dr Scott Obenshain, University of New 

Mexico, Albuquerque, USA 


- 2.26 -


6/11 Portfolio as a Method of Student Assessment 

Organiser: Dr Miriam Friedman Ben-David, University of Dundee, UK 


6/12 Learning Needs Assessment in undergraduate and postgraduate 


Organiser: Professor Janet Grant, Open University, UK 


6/13 A European core curriculum? 

Organiser: Professor Lennart Bouman, Netherlands 


1930-2230 Gala Dinner at the Aquarium (Zoologischer Garten Aquarium) 

(Not included in the registration fee – see page X for details) 

- 2.27 -

Wednesday 5 September 

0830-1000 Session 7: Poster presentations 

7A 


12 simultaneous themed sessions. Please meet in the rooms listed below. Participants 

each have two minutes to introduce themselves and their posters. The groups will 

then move to the poster location where a discussion will take place. 

New Learning Technologies 

Chairperson: DrNick Ross 

Meet in: Teaching Building, Hörsaal 1 (ground floor) 

Poster location: Teaching Building, 2 nd floor 

7A1 An International web-based Master’s degree in Primary Care 

Peter Toon* and Trish Greenhalgh; University College London, UK 

7A2 Can practical courses on interpreting blood smears be substituted 

by an interactive, web-based learning programme? 

U Woermann*, A Tobler and M Montandon; University of Bern, 

SWITZERLAND 

7A3 The management of student feedback using the World Wide Web 

Stephanie Cobb* and Helen Graham; Guy’s, King’s and St Thomas’ School of 


7A4 Web-based student feedback on large group teaching: how does it 

compare with traditional paper methods? 

Helen Graham* and Stephanie Cobb; Guy’s, King’s and St Thomas’ School of 


7A5 Reflection on experiences by using trigger movies 

Marianne G Nijnuis*, Caro Brumsen, Jan H Bolk and Peter G M de Jong; 

Leiden University Medical Center, Leiden, NETHERLANDS 

7A6 Provision of IT learning facilities for healthcare education 


7A7 Development and evaluation of an interactive Computer Assisted 

Learning (CAL) programme on vaginal hysterectomy 

Vikram Jha*, Shelley Widdowson, Sean Duffy and Keith Allenby; St James’s 

University Hospital, Leeds, UK 

7A8 Links from ultrasound to anatomy - how is a multimedia teacher 

accepted? 

Dietmar Borchert*, Gunnar Schley, Edda Klotz, Peter Rauh, Clemens Reisinger 

and Thomas Medveczky; Humboldt-University of Berlin, GERMANY 

7A9 Development of a Computer-Based Simulation; the Dynamic 

Patient Simulator 

S Eggermont*, P M Bloemendaal, J M van Baalen, E M Schoonderwaldt; 

Leiden University Medical Center, NETHERLANDS 

- 2.28 -

7B 


7A10 Introduction of laptop computers in Leiden Medical School 

Peter G M de Jong*, Hermiette E Idenburg and Henk L Hendrix; Leiden University 

Medical Center LUMC, Leiden, NETHERLANDS 

Problem-based Learning 

Chairperson: Dr Stewart Mennin 



7B1 Measuring success: partnership in evaluation (work in progress 

report) 

P O’Neill, D Graham, A Garden, S. Watmough*, J Brown; Universities of 

Liverpool, Manchester and Mersey Deanery, UK 

7B2 A new PBL course with an examination with standardised patients 

at the end 

S Schewe*, C Mueller and R Putz; Ludwig-Maximilians-Universitat, Munich, 

GERMANY 

7B3 Training the Problem-Based Learning tutor: implementation issues 


7B4 PBL in Psychiatry - the Holocaust. A unique experience 

T Fischel*, T Weizman and G Zalsman; Geha Psychiatric Center, Ramat Gan, 

ISRAEL 

7B5 Clinical skills of medical students participating in lecture-based 

versus problem-oriented training 

W Rimpau; Park-Klinik Weissensee, Berlin, GERMANY 

7B6 Systematic observations of problem-based study groups - what do 

they reveal? 

K Lonka*, P Sauri and N Paganus; University of Helsinki, FINLAND 

7B7 “Pathomechanisms” - a 9-week integrative and problem-based 

learning oriented course within the 3rd year of the curriculum at the 

Medical Faculty Carl Gustav Carus, Technical University Dresden 

Oliver Tiebel*, Ines Nitsche and Andreas Deussen for the Core Planning Group; 

Medical Faculty, Carl Gustav Carus, Technical University, Dresden, GERMANY 

7B8 Characteristics of tutors’ assessment by students when PBL is 

being implemented 

Yolanda Marin-Campos* and Marcela Lopez-Cabrera; National Autonomous 

University of Mexico, MEXICO 

7B9 From traditional teachers to PBL tutors: how to start the change? 

Yolanda Marin-Campos* and Lizbeth Mendoza-Morales; National Autonomous 

University of Mexico, MEXICO 

7B10 Development of a problem-based curriculum leads to enhancement 

in faculty development - The Dresden experience 

N Lorenz*, T Aretz, E Armstrong and the Harvard-Dresden Medical Education 

Alliance; Technical University, Dresden, GERMANY 

- 2.29 -

7C 


7B11 An orientation programme for 1st year students in a problemorientated 

MBChB curriculum - the Pretoria experience 

Pierre L Bredenkamp; Stellenbosch University, Tygerberg, SOUTH AFRICA 

Curriculum Planning and Change 

Chairperson: Dr Reg Dennick 



7C1 A model of curriculum management in an integrated medical 

curriculum 

Gregory J S Tan* and B E Mustaffa; International Medical University, Kuala 

Lumpur, MALAYSIA 

7C2 The University of Rochester’s Double Helix Curriculum 

Elaine F Dannefer; University of Rochester Medical Center, Rochester, USA 

7C3 Academic administration and mixed programmes 

S Sharma Khanal* and S Koirala; B P Koirala Institute, Dharan, NEPAL 

7C4 Learning responsibly - implementing written guidelines for medical 

students 

Richard Phillips*, Ann Wylie and Anne Stephenson; Guy’s, King’s & St Thomas’ 

Medical School, London, UK 

7C5 HEICUMED - a novel approach to student medical education at the 

Medical Faculty of the University of Heidelberg, Germany 

Hubert J Bardenheuer* on behalf of the HEICUMED Group; University of 

Heidelberg, GERMANY 

7C6 Enhancing curriculum renewal through a “clinical presentation” 

approach to undergraduate medical education 

Nehad El-Sawi; University of Health Sciences, Kansas City, USA 

7C7 Continuous training in General Practice as an integral part of an 

undergraduate medical curriculum - the Witten/Herdecke Model 

(Germany) 

W Kunstmann*, Dieter Wollgarten, René Vollenbroich and Markus Gschwind; 

University of Witten/Herdecke, Witten, GERMANY 

7C8 Developing sense of ownership for curriculum changes within all 

teaching faculty of an Asian medical school 

C B Hazlett*, T F Fok, S S C Chung and J C Y Cheng; Chinese University of 

Hong Kong, Shatin, HONG KONG 

7C9 Sci45: Framework for the implementation of a career guidance 

instrument 

Janet Grant*, Rodney Gale, Mairead Beirne and Heather Owen; Open University 

Centre for Education in Medicine, MILTON KEYNES, UK 

7C10 The facilitation process in a problem-based curriculum at the 

Nelson R. Mandela School of Medicine 

Jacqueline van Wyk, Peter Olmesdahl, Veena Singaram* and Michelle McLean; 

University of Natal, Durban, SOUTH AFRICA 

- 2.30 -

7D 

7E 


Curriculum Evaluation/Staff Development 

Chairperson: Professor Miriam Friedman 

Meet in: Research Building, Hörsaal 4 (ground floor) 

Poster location: Teaching Building, 1st floor 

7D1 Students’ feedback: a Public Health course in medical education 

Eva Rasky*, Wolfgang Freidl; Willibald-Julius Stronegger; Karl-Franzens- 

University, Graz, AUSTRIA 

7D2 Action Research Methodology: a possible framework for course 

evaluations 

Alison Rushton* and Gill James; Coventry University, Coventry, UK 

7D3 The opinion of the graduates of the Faculty of Medicine of the 

University of Barcelona on the new medical curriculum 

J Palés*, A Gual, A Vallés, Ma T Estrach, F Climent, X Gasull, R Gilabert, A Llobet, 

Y Compta, L Peri and J A Bombi; Universitat de Barcelona, Barcelona, SPAIN 

7D4 Comenius University Quality Assurance System (CUQAS) and 

students’ participation in graduate medical education evaluation 

L Plank*, J Danko, E Rozborilova, P Galajda and K Dokus; Jessenius Faculty of 

Medicine, Martin, SLOVAK REPUBLIC 

7D5 Research in medical education: constructing an ethical framework 

E B Peile* and A Slowther; Dept of Primary Healthcare, University of Oxford, UK 

7D6 Students’ perceptions of the Physiology course in a traditional 

medical school 

F Riggione*, J Perez-Ojeda and J F Perez-Gonzalez; Centro de Investigacion y 

Desarrollo de la Educacion Medica, El Hatillo 1083A, VENEZUELA 

7D7 Students’ perceptions of a traditional undergraduate course in 

Microbiology 

Z Uzcategui*, J Perez-Ojeda and J F Perez-Gonzalez; Universidad Central de 

Venezuela, Caracas, VENEZUELA 

7D8 Faculty development in General Practice - the German experience 

M Ehrhardt, P Engeser, M Herrmann, T Lichte, N Donner-Banzhoff and S 

Wilm*, on behalf of the participants; Heinrich-Heine University, Duesseldorf, 

GERMANY 

7D9 Medicine and ethnic issues; do our tutors reflect their community? 

D Reeves, R Loudon and J Parle*; University of Birmingham, UK 

Postgraduate Education 

Chairperson: Dr Charlotte Ringsted 

Meet in: Building 10, Hörsaal 6 (ground floor) 


7E1 Exploring the views of basic surgical trainees on their training 

programme and their future in Surgery 

Jeremy Brown*, Linda de Cossart and Charmian Wiltshire; Mersey Deanery, 

Liverpool, UK 

- 2.31 -

7F 

7E2 An assessment of the skills base and attainments of Senior House 

Officer on a regional Basic Surgical Training Programme 

Linda de Cossart, Charmian Wiltshire and Jeremy Brown*; Mersey Deanery, 

Liverpool, UK 

7E3 Personal and professional development groups for Junior Hospital 

Doctors 

Alan Naftalin and Peter Bruggen; Newham General Hospital, London, UK 

7E4 The educational needs of doctors with English as a second language 

when consulting in General Practice in the United Kingdom 

Sylvia Chudley and John Skelton; West Midlands Dept of Postgraduate Education 

for General Practice, Birmingham, UK 

7E5 “No such thing as a free lunch”: how free are bleep-free sessions? 

Jane Ross* and Rose Martin; Ninewells Hospital and Medical School, Dundee 

DD1 9SY, UK 

7E6 The SHO RITA and portfolio 

Rose Martin* and R W Newton; Ninewells Hospital & Medical School, Dundee, UK 

7E7 General Practice Registrar audit and implementation of change 

J McKay*, J R M Lough and T S Murray; University of Glasgow, UK 

7E8 The Senior Registrar - a new development in higher professional 

training in General Practice 

C T O’ Dubhghaill; NUI Galway, Co Galway, IRELAND 

7E9 Psychosocial training in the Family Residency in Spain: 

present situation and proposals for the future 

José Ramón Loayssa Lara; Servicio Navarro de Salud, Noaín, SPAIN 

7E10 Step by step to methodological exam; report on first year 

experiences with the new introduced GP Licence Examination 

in Austria 

R Willnauer*, M Schmidts, M Lischka; University of Vienna, Wien, AUSTRIA 

7E11 Development of professional doctorates in healthcare disciplines 

Alan Castle*, Graham A Mills and Valda Bunker; University of Portsmouth, 

Portsmouth, UK 

7E12 The appointment process for Anaesthetic Registrars in 

South Thames 

J Clarke* and J Pateman; St George’s Hospital London, UK 

Assessment 


Chairperson: Dr William Burdick 

Meet in: Teaching Building, Mikroscopierraum (1 st floor) 


7F1 Validity of assessment techniques: students’ views differ from 

observed outcomes 

W Colin Duncan; University of Edinburgh, Edinburgh, UK 

- 2.32 -

7G 


7F2 Assessment reliability in an MSc programme in Diabetes 

J Huber*, N Munro, A Felton, C Parker, P Delaney and C McIntosh; University 

of Surrey Roehampton and Chelsea & Westminster Hospital, London, UK 

7F3 Two years of progress-testing at the Charité 

A Mertens*, J Hoffmann, S Kölbel, R Raschke, K Duske, J Berger and U 

Hennewig; HU Berlin Medical Faculty, Berlin, GERMANY 

7F4 OSCE for Paediatric trainee internship examination multicentric 

experience 

M Aldunate, A Lopez, A Mena, M Varas, X Trivino, A Vasquez*, R Lillo, T 

Miranda and E Mandiola; University of Chile, Santiago, CHILE 

7F5 Third year medical student written history and physicals: how many 

is enough? 

Paul A Hemmer*, Thomas Jamieson, Kim Gibson, Lisa Moores, Andy Donato, 

Margaret Gaglione, Steven Durning, Alan Wimmer, Bonnie Cary-Freitas and 

Louis Pangaro; Uniformed Services University, Bethesda, USA 

7F6 Student fitness to practise procedures 

Chris Stephens; University of Southampton, UK 

7F7 Deriving the assessment framework for the Three Royal Colleges 

Diploma in Prison Medicine 

Lesley J Southgate*, Jon H Fuller and Jaz Bihku; University College Medical School 

London, London, UK 

7F8 Assessment in an outcome-based curriculum at the International 

Medical University (IMU), Malaysia 

J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, K H Ong, C M K 

Patrick and AKH Wong; International Medical University, Selangor, MALAYSIA 

7F9 Psychosocial profile of medical students as a predictor of the 

academic success in medical school in Mexico 

Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-R, Victoria Bermudez, 

Juan Montes-V, Santos Guzman, A-Enrique Alcorta-G and Marcos Vinicio; 

Autonomous University of Nuevo Leon, Monterrey, MEXICO 

7F10 Psychometric data for Jefferson Medical College’s non-cognitive 

questionnaire in Mexican medical students 

Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-R, Victoria Bermudez, 

Juan Montes-V, Santos Guzman, A-Enrique Alcorta-G and Marcos Vinicio; 

Autonomous University of Nuevo Leon, Monterrey, MEXICO 

7F11 Portfolio based assessment of students during their internship 

Angel M Centeno*, Soledad Campos, Isabel Fernández and Alfredo Olivieri; 

Universidad Austral, Buenos Aires, ARGENTINA 

Teaching & Learning 1 

Chairperson: Mr John Dent 

Meet in: Teaching Building, Room 2.0102 (2 nd floor) 


7G1 What do first year medical students value in a learning situation? 

Angel M Centeno*, Alejandra Blanco, Soledad Campos and Amelia Cabrera; 

Universidad Austral, Buenos Aires, ARGENTINA 

- 2.33 -

7H 


7G2 Application of Schon’s model for small-group teaching 

Francine Borduas* and Réjean Laprise; Association des médecins omnipraticiens de 

Québec, Québec, CANADA 

7G3 Teaching and learning about case presentations; the need for early 

intervention 

D Nestel* and J Kidd; Imperial College School of Medicine, London, UK 

7G4 Master teacher, master learner 

M P Oosthuizen; University of Pretoria, Pretoria, SOUTH AFRICA 

7G5 Hemisphericity in medical students 

N E Fernandez-Garza*, I A Benitez-Trejo, C Salinas-Guerra, A Davila-Flores 

and J A Castellanos-Lopez; Autonomous University of Nuevo Leon, Monterrey, 

MEXICO 

7G6 Medical student preferences for an “ideal textbook” of Obstetrics 

and Gynaecology 

M S Marsh* and D Katopi; GKT Medical School, London, UK 

7G7 What can be learnt from medical atlases? Expert and novice visual 

schemata in breast sonography 

R Pauli* and J Huber; University of Surrey Roehampton, London, UK 

7G8 Community-based Public Health Education in Healthy City Project 

Yosuke Yamane*, Kuninori Shiwaku, Keiko Kitashima and Anuurad Erdembileg; 

Shimane Medical University, Izumo, JAPAN 

7G9 Two different types of professor authority, results in a traditional 

faculty of medicine 

Carlos E. de la Garza-Gonzalez*, Norberto Lopez-Serna and Ma Esthela Morales- 

Perez; Autonomous University of Nuevo Leon, Monterrey, MEXICO 

7G10 The “excellent teacher” seen by mid-course students 

M Patrício, A V Carneiro and J Fernandes e Fernandes; University of Lisbon, 

Lisbon, PORTUGAL 

7G11 Underrepresented minority (URM) students’ perception of 

mentoring, advising and role modelling in medical school 

Ara Tekian*, Laura Hruska and Jorge Girotti; University of Illinois at Chicago, 

Chicago, USA 

Teaching & Learning 2 

Chairperson: Dr Richard Ayres 

Meet in: Teaching Building, Room 2.0101 (2 nd floor) 


7H1 “Project Carrapato (*tick)”: a psychological focus in medical training 

I R P Scavariello, M S V M Silveira, E H V Celeri*, S L Brenelli and R S Cassorla; 

UNICAMP, Sao Paulo, BRAZIL 

7H2 Evaluating of videotape sessions for learning communication skills 

A Nogueras*, M Bernaus, X Claries and J de Nadal; Universitari Parc Tauli, 

Barcelona, SPAIN 

- 2.34 -

7I 


7H3 Acting up? The recruitment and maintenance of a professional role 

play team for undergraduate and postgraduate medical training and 

assessment 

C M Wiskin* and P Croft; The University of Birmingham, Birmingham, UK 

7H4 Analysis of clinical competence at pre-graduate level 

Gitte Wichmann-Hansen* and Berit Eika; Aarhus University, Aarhus, 

DENMARK 

7H5 Use of paper-cases in undergraduate clinical Dermatology 

education in Germany 

A Boer*, R Kaufmann, W H Boehnke and F Ochsendorf; Universitats-Hautklinik 

Frankfurt/M, Frankfurt am Main, GERMANY 

7H6 Development of a Learning Resource Centre for healthcare 

professionals: an example of an innovative enterprise 

C Osonnaya*, K Osonnaya and E Burke; University of London, London, UK 

7H7 Legal theories of recourse for failed medical students in the United 

States 

Thomas Jamieson; Uniformed Services University of the Health Sciences, Bethesda, 

USA 

7H8 An evaluation of organising student participation in curriculum 

reform using a mentoring programme at the Nelson R Mandela 

School of Medicine, University of Natal, Durban, South Africa 

Dorothy Appalasamy, Michelle McLean* and Jacqueline van Wyk; University of 

Natal, Durban, South Africa 

7H9 Medical education – more than learning? 

Thomas Eichholz and Catharina Crolow; Charité, Humboldt University Berlin, 

Germany 

Continuing Professional Development 1 

Chairperson: Dr Richard Smith 

Meet in: Teaching Building, 2.0104 (2 nd floor) 


7I1 The roles of hospital consultants: more than just patients and students 

Patsy Stark; University of Leeds, Leeds, UK 

7I2 Continuing medical education X indexation? Authors’ opinions 

about editorial policies of a Brazilian academic journal 

Maria de Lourdes Veronese Rodrigues*, Valderes Aparecida Coelho Falaschi and 

Julio Cesar Voltarelli; Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, 

BRAZIL 

7I3 Learning HSR by doing: forming parallel learning groups 

Saeed Asefzadeh; Qazvin University of Medical Science & Health Services, Qazvin, 

IRAN 

7I4 Towards a flexible workforce - a basis for change 

F French*, M Awramenko, A Scott, C Ubach, L Leighton-Beck, G Needham, J 

Mollison and H Coutts; SCPMDE, Aberdeen, UK 

- 2.35 -

7J 


7I5 Ensuring cost-effective CPD: perspectives, problems and policy 

Clive Belfield and Celia Brown*; University of Birmingham, Birmingham, UK 

7I6 Improving your skills in preventive medicine: this CME workshop 

works! 

François Goulet*, André Jacques* and Danielle Saucier; Collège des Médecins du 

Québec, Montréal, CANADA 

7I7 CME program in Kuwait 

K Al-Jarallah and I G Premadasa*; Kuwait Institute for Medical Specialization, 

Safat, KUWAIT 

7I8 The theory of perspective transformation and its applicability to 

CME 

Jill Donahue*, Stephen Hotz and Réjean Laprise*; Aventis Pharma, Laval, 

Québec, CANADA 

7I9 The Transtheoretical Model of behaviour change: does it apply to 

clinical practices? 

Réjean Laprise*, Jill Donahue and Stephen Hotz; Aventis Pharma, Laval, Québec, 

CANADA 

Continuing Professional Development 2 

Chairperson: Dr Alistair Thomson 

Meet in: Building 10, Room Kursraum 5 (Lower ground floor) 


7J1 Sharing visions: working with CPD coordinators in General Practice 

Simon Smail* and Paul Hocking; University of Wales College of Medicine, Cardiff, 

UK 

7J2 The “Advanced Training Practice”: a questionnaire and interviewbased 

study of their role 

John Skelton and Steve Field*; West Midlands GP Unit, Birmingham, UK 

7J3 Does gender make a difference? CME for the female physician 

Jane Tipping* and Jill Donahue; Markham, Ontario, CANADA 

7J4 Strategic planning for effective partnerships 

Jane Tipping* and Danielle Deslauriers; Markham, Ontario, CANADA 

7J5 Integrating practice reflection and practice adjustment planning into 

the design of a CME meeting 

R L Thivierge*, L Samson and J V Patenaude; University of Montreal, Montreal, 

CANADA 

7J6 The Catalan Council of Physicians’ Colleges Accreditation Diploma 

in Continuing Medical Education 

A Ramos*, J Aliaga, A Gual and H Pardell; College of Physicians of Barcelona, 


7J7 Breaking bad news: how to learn in a CME workshop 

Francois Goulet*, André Jacques* and Robert Carrier; Collège des Médecins du 

Québec, Montréal, CANADA 

- 2.36 -

7K 

7L 

International Medical Education 

Chairperson: Professor Lennart Bouman 

Meet in: Building10 , Kursraum 6 (lower ground floor) 

Poster location: Teaching Building, 1 st floor 

7K1 Differences in learning style and satisfaction with Residency 

training for United States and internationally trained students 

Steven R Daugherty; Kaplan Medical, Chicago, USA 

7K2 Crossing borders - The Berlin Biomedical Exchange Office 

U Arnold* and J W Dudenhausen; Charité, Humboldt-University Berlin, 

GERMANY 

7K3 Academic medical education in developing countries: an analysis of 

papers presented at medical education conferences in Argentina 

Angel M Centeno*, Gustavo Amestoy and Amelia Cabrera; Universidad Austral, 

Buenos Aires, ARGENTINA 

7K4 Communication skills training in Germany - results of a survey 

Jan Schildmann* and Ulrich Schwantes; Charité, Humboldt University Berlin, 

GERMANY 

7K5 Reform of the medical educational system in Georgia 

R Khetsuriani, B Kilasonia and A Telia*; Tbilisi State Medical University, Tbilisi, 

GEORGIA 

7K6 Results and main objectives of the first stage of education reform at 

the TSMU 

R Khetsuriani, B Kilassonia and N Pruidze*; Tbilisi State Medical University, 

Tbilisi, GEORGIA 

7K7 First international Integrated Surgery course at the Charité, Berlin 

Hajo Schmidt-Traub; Charité, Humboldt University Berlin, GERMANY 

7K8 Counting the uncounted: estimating the number of overseas doctors 

in training grades in the UK currently not employed in the NHS 

Janet Grant, Mairead Beirne* and Heather Owen; Open University Centre for 

Education in Medicine, MILTON KEYNES, UK 

Special Subjects 


Chairperson: Professor John Simpson 

Meet in: Teaching Building, Room 1.0107 (1st floor) 


7L1 Illegible notes - do tomorrow’s doctors need teaching on how to 

write more clearly? 

E Westcott, A Kontoyannis*, N Murch, T Reid and K Sixsmith; University of 

Wales College of Medicine, Cardiff, UK 

7L2 An active method to prepare students to lead medical interviews: an 

experience at Xavier Bichat Medical School 

Corinne Pieters; Dominique Maillard*, Françoise Blanchet-Benque; Hôpital Louis 

Mourier, Colombes, FRANCE 

- 2.37 -

7L3 Teaching medical students patient advocacy skills; an 

interdisciplinary intervention using Standardized Patients/Families 

Graceanne Adamo*, Virginia Randall, Janice Hanson, William Sykora, Aileen E 

Zanoni, Elizabeth Jeppson and Richard E Hawkins; Uniformed Services University 

of the Health Sciences, Bethesda, USA 

7L4 The parameters affecting attitudes to death among students in a 

Medical College in Taiwan 

Ming-Liang Lai; National Cheng Kung University Hospital, Tainan, TAIWAN 

7L5 Evaluation of practical sessions in Clinical Anatomy: a strategy for 

educational improvement 

M A F Tavares* and M C Silva; Medical School of Porto, Porto, PORTUGAL 

7L6 Towards a more effective teaching of Gross Anatomy: introducing 

new integrated clinical concepts and improving peer presentations/ 

evaluation techniques 

Ameed Raoof*, Thomas Gest, William Burkel and Tamara Stein; University of 

Michigan Medical School, Ann Arbor, USA 

7L7 Putting the salutogenic orientation into practice: the life cycle 

course at the Technion 

H Eshach*, R Van-Raalte, L Dolev, H Bitterman and D Hermoni; Technion, Haifa, 

ISRAEL 

7L8 ASAMANS (Ask Students About Medicine And National Socialism) 

T Drewes*, P Langkafel* and S Muller*; Charité, Humboldt University Berlin, 

GERMANY 

7L9 Stress among medical doctors 

J Agsteribbe* and J Cohen-Schotanus; University of Groningen, Groningen, 

NETHERLANDS 

7L10 Introducing changes in medical education: the “strategy” of Clinical 

Anatomy at the Medical School of Porto 

M A F Tavares; Medical School of Porto, Porto, PORTUGAL 

1000-1030 Coffee in foyers of Teaching and Research Buildings 


8A 


Computer Mediated Learning and Assessment 

Chairperson: Dr Joel Feiner 


1030-1045 1 Preparing clinical small group sessions by using digital video in CBE 

Marianne G Nijnuis*, Caro Brumsen, Jan A Gevers Leuven and Peter G M de 

Jong; Leiden University Medical Center, Netherlands 

1045-1100 2 Inter-physician communication training through computer-based 

patient simulations 

S Eggermont*, P M Bloemendaal, E Schoonderwaldt and J D Donnison-Speyer; 

Leiden University Medical Center, Netherlands 

- 2.38 -

1100-1115 3 Computer Assisted Learning: using and doing research in primary 

care 

Linda Leighton-Beck*, Philip Hannaford, Neil Hamilton, Sara Shaw and Yvonne 

Carter; Scottish Council for Postgraduate Medical & Dental Education, Aberdeen, 

UK 

1115-1130 4 Extracting core competencies “bottom up” from case histories by 

an online consensus seeking process in family medicine 

Peter Schlaeppi* and Ralph Bloch; University of Bern, Switzerland 

1130-1145 5 A new era of teaching. An innovative resource for continuing 

medical education and evidence based management 

K El-Hayes, B McElhinney, B Adams, E Boyd and K McKinney; Co Down, 

Northern Ireland 

1145-1200 6 Evaluating medical student and resident education: a CME software 

program 

J C Edwards*, P Ogden and A A Stricker; Texas A & M University, USA 

1200-1215 7 Metabolic challenges on CD-ROMs 

Marie-Paule Van Damme*, Jonathan Gould, Bruce Livett, Janet Macaulay, Ron 

Maxwell and Graham Parslow; Monash University, Clayton, Australia 

1215-1230 Discussion [Opening Discussant: Dr Megan Quentin-Baxter] 

8B 


Implementation of Problem-based Learning 

Chairperson: Professor Arcadi Gual 


1030-1045 1 Problem-based learning for trainees in Anaesthesiology 

Sigrid Adam* and Jan Klein; Erasmus University, Rotterdam, Netherlands 

1045-1100 2 Communicating with students in a problem-based curriculum: 

experiences with WebCT 

Michelle McLean and Kathy Murrell; Nelson R Mandela School of Medicine, 

Congella, South Africa 

1100-1115 3 Faculty members and senior students as facilitators in PBL-groups 

- similarities and differences 

Are Holen*, Kristin Wigen and Øyvind Ellingsen; Norwegian University of Science 

and Technology, Trondheim, Norway 

1115-1130 4 Tutors’ perspectives of problem-based learning 

Diana Kelly; Guy’s, King’s and St Thomas’ School of Medicine, London, UK 

1130-1145 5 The E.D.I.T. project in Linköping: using web-based scenarios for PBL 

Wolfram Antepohl*, Anne-Christine Persson, Margareta Bachrach-Lindström and 

Björn Bergdahl; Division of Medical Education, Linköping University, SWEDEN 

1145-1200 6 How to promote success in a PBL tutorial session 

N Paganus*, K Lonka and T Hätönen; University of Helsinki, FINLAND 

1200-1215 7 Evaluation of the student staff in the experience of PBL in the 

- 2.39 -

Federal University of Roraima - Brasil 

Álvaro Tulio Fortes*, César Ferreira Penna de Faria, Ruy Guilherme de Souza and 

Fernado Menezes da Silva; University of Roraima, Brazil 

1215-1230 Discussion [Opening Discussant: Anne Garden] 

8C 

Curriculum Planning 

Chairperson: Dr Frank Smith 


1030-1045 1 Priorities in the content of the curriculum from the standpoint of the 

academic staff 

E Nagle*, R Velins and V Pirags; Latvian Medical Academy, Riga, Latvia 

1045-1100 2 Reforming the core curriculum of the Reformstudiengang in Berlin - 

a Delphi study 

B Huenges*, W Burger, J W Dudenhausen, U Frei, C Frömmel, H-P Lemmens, U 

Schwantes and D Scheffner; Arbeitsgruppe Reformstudiengang Medizin, Berlin, 

Germany 

1100-1115 3 Early clinical clerkship - does it make a difference? 

Berit Eika* and Ole Sonne; University of Aarhus, Denmark 

1115-1130 4 ECTS (European Credit Transfer System) as a tool in curriculum 

development 

B Grether; University of Zurich, Switzerland 

1130-1145 5 The continuum of professional development 

H M R Meier; University of Toronto, Canada 

1145-1200 6 Evaluating ethics seminars 

Gerald Neitzke; Hannover Medical School, Germany 

1200-1215 7 A tool to evaluate medical ethics seminars 

Mareike Moeller* and Gerald Neitzke; Hannover Medical School, Germany 

1215-1230 Discussion [Opening Discussant: Professor Ala’aldin Al Hussaini] 

8D 


The Final Examination 

Chairperson: Dr Jack Boulet 


1030-1045 1 Consistency of examination marks 

T Vik*, K H Karlsen and S Westin; Norwegian University of Science & Technology, 

Trondheim, Norway 

1045-1100 2 Identifying threshold competence in an undergraduate qualifying 

clinical examination 

John Cookson* and Stewart Petersen; Leicester Warwick Medical School, Leicester, 

UK 

- 2.40 -

1100-1115 3 The validity of performance standards on a certification examination 

for occupational therapists 

Ernest N Skakun; University of Alberta, Canada 

1115-1130 4 Reliability of a sequential clinical examination 

Stewart Petersen* and John Cookson; Leicester Warwick Medical School, Leicester, 

UK 

1130-1145 5 Consideration of legal, ethical and organizational aspects of clinical 

competence in a National Licensing Examination: evaluation at the 

Medical Council of Canada 

Jacques E. Des Marchais*, Dale W. Dauphinée and David Blackmore; Medical 

Council of Canada, Montreal, Canada 

1145-1200 6 Combining different components of an assessment procedure 

J Degryse*, J Goedhuys, A Roex and A Dermine; K U Leuven, Belgium 

1200-1230 Discussion [Opening Discussant: Dr Diana Wood] 

8E 


Postgraduate Education/Career Choice 

Chairperson: Professor Ope Adekunle 


1030-1045 1 Teaching with patients: moving beyond ‘learning by osmosis’ 

Kath Green; South Thames Department of Postgraduate Medical and Dental 

Education, London, UK 

1045-1100 2 The effect of an interactive postgraduate education programme on 

parenteral treatment in Macedonia 

M Ivanovski, P D Toon*, K Zafirovska, F Tozija and B Gomes; University College 

London, UK 

1100-1115 3 Promoting innovation in postgraduate education through the 

accreditation process 

Judith Armbruster; Accreditation Council for Graduate Medical Education, 

Chicago, USA 

1115-1130 4 A new development in postgraduate surgical education: the 

Intermediate Breast Course - a distance learning course 

H M Sweetland*, E Hoadley-Maidment and M Galea; University of Wales College 

of Medicine, Cardiff, UK 

1130-1145 5 Attitude change in neonatologists-in-training by participation in the 

neuropediatric follow-up of former premature infants 

J B Hentschel; Universitaets – frauenklinik des Inselspitals, Bern, Switzerland 

1145-1200 6 Factors that influence the career choice of medical specialization 

M B M Soethout* and G van der Wal; Vrije Universiteit Medical Centre, 

Amsterdam, Netherlands 

1200-1215 7 Personality differences in doctors affect the factors associated with 

their medical specialty choice 

Gillian B Clack*, Derek Cooper and John O Head; Kings College London, UK 

1215-1230 Discussion [Opening Discussant: Professor Janet Grant] 

- 2.41 -

8F 

Teaching and Learning 

Chairperson: Professor Clarke Hazlett 


1030-1045 1 Impact of peer tutoring on the patient-centered interviewing skills of 

first-year medical students 

D Nestel* and J Kidd; Imperial College School of Medicine, London, UK 

1045-1100 2 Peer assisted learning - a teaching strategy for the new millennium? 

Joy R Crosby and H Mei-Ling Ball*; University of Dundee, UK 

1100-1115 3 An insight into how students learn about a cardiovascular problem 

using study guides 

Shihab E O Khogali*, Jennifer M Laidlaw, Stuart D Pringle and R M Harden; 

University of Dundee, UK 

1115-1130 4 Study guides in an outcome-based medical curriculum at the 

International Medical University (IMU), Malaysia 

M I Nurjahan*, J C Ramesh, S Raman, A Radhakrishnan, C L Teng, K H Ong, C M 

K Patrick and Q Akhtar; International Medical University, Negri Sembilan, Malaysia 

1130-1145 5 How authors of an extensive distance learning programme for 

surgical trainees differed in their use of the specified template 

Jennifer M Laidlaw*, Ronald M Harden, Lorraine J Robertson and E Anne 

Hesketh; SCPMDE Education Development Unit, Dundee, UK 

1145-1200 6 Context-dependent memory in a meaningful environment: in the 

classroom and at the bedside 

Franciska Koens*, Olle Th.J. ten Cate and Eugène J F M Custers; Universitair 

Medisch Centrum, Utrecht, Netherlands 

1200-1215 7 Continuous Interactive Class (C.I.C) 

J Medrano*, R Calpena, A Compañ, M T Pérez Vázquez, J Lacueva and M Díez; 

Miguel Hernandez University, Alicante, Spain 

1215-1230 Discussion [Opening Discussant: Professor David Prideaux] 

8G 


Assessment in Postgraduate and Continuing Education 

Chairperson: Dr Michael Tunbridge 


1030-1045 1 A computerized adaptive test as an element of the final assessment of 

general practitioners in Flanders. Possibilities, difficulties, dilemmas… 

A Roex* and J Degryse; K.U. Leuven, Belgium 

1045-1100 2 Insight 360: a tool for looking at doctors’ performance 

E B Peile* and R Conradt; University of Oxford, UK 

1100-1115 3 Impact on non-principals in General Practice of the summative 

assessment audit project 

P Bowie, A Garvie and J Oliver; University of Glasgow, UK 

- 2.42 -

1115-1130 4 The difference between the ability to apply consultation guidelines 

and the routine of application: A relevant distinction? 

Myrra Vernooij-Dassen*, Ben Bottema and Cees van der Vleuten; University of 

Nijmegen, Netherlands 

1130-1145 5 What do SHO Educational Supervisors REALLY think of appraisal? 

Ann Cadzow*, Helen Coutts, Fiona French, Linda Leighton-Beck and Ken 

McHardy; SCPMDE, Aberdeen, UK 

1145-1200 6 Visual-spatial ability and the objective assessment of technical 

skills 

K R Wanzel*, S J Hamstra, D J Anastakis, E D Matsumoto and M D Cusimano; 

Centre for Research in Education, Toronto, Canada 

1200-1215 7 Validity of MIST-VR in the assessment of laparoscopic skill 

A M Paisley*, P Baldwin and S Paterson Brown; University of Edinburgh, UK 

1215-1230 Discussion [Opening Discussant: Dr John Pitts] 

8H 

Curriculum Change 


Chairperson: Dr Johan Ponten 


1030-1045 1 Innovation and reform of medical education: evaluating the UNI 

Program in Latin America 

E C Ribeiro*, G Werneck, A Aguiar and V Brant; Universidade Federal do Rio de 

Janeiro, Brazil 

1045-1100 2 Promoting responsive curriculum change within the 21st Century 

Cam Enarson; Wake Forest University School of Medicine, Winston-Salem, USA 

1100-1115 3 Improving the University and NHS Teaching Hospital Trust 

Partnership to identify SIFT spending 

Andrea J Bolshaw; University of Birmingham, UK 

1115-1130 4 Assessment of medical student attitudes toward relevant aspects of 

medical practice 

M L V Rodrigues*, L E de A Troncon, M F A Colares, J F C Figueiredo, A R L 

Cianflone, C E Piccinato, L C Peres and J A Dela-Coleta; Faculty of Medicine of 

Ribeirao Preto, Brazil 

1130-1145 5 Effect of a curriculum reform on graduating student performance 

M L V Rodrigues*, J F C Figueiredo, L E A Troncon, C E Piccinato, L C Peres, A R 

L Cianflone and M F A Colares; Faculdade de Medicina de Ribeirao Preto, Brazil 

1145-1200 6 A developmental approach to reduce the long term risk of rejection 

of curricular changes 

Jamsheer Talati* and Camer Vellani; The Aga Khan University, Karachi, Pakistan 

1200-1215 7 The final year in undergraduate medical education: key position 

between theory and daily routine 

K Muller; University of Bonn, Germany 

1215-1230 Discussion [Opening Discussant: Ms Brownell Anderson] 

- 2.43 -

8I 

Communication Skills Training 

Chairperson: Professor Knut Aspegren 


1030-1045 1 Which interviewing skills must be actively taught at medical 

school? 

K Aspegren*, P Henriksen, P Lønberg-Madsen and M Strømming; Copenhagen 

University Hospital, Denmark 

1045-1100 2 Implementing communication skills training at the Charité - a 

project by students and doctors 

Jan Schildmann*, Carsten Schwarz, Eva Herrmann, Heiderose Ortwein, Amelie 

Klambeck, Andreas Brunklaus and Ulrich Schwantes; Humboldt University Berlin 

(Charite), Horn, Germany 

1100-1115 3 Teaching sexual history-taking to health care professionals in 

primary care 

J R Skelton* and P M Matthews; University of Birmingham, UK 

1115-1130 4 SEX SEX SEX, oh yes, and how’s your knee? 

Annie Cushing* and Dason Evans; St. Bartholomews & The Royal London Queen 

Mary’s, London, UK 

1130-1145 5 Training of the systemic approach in doctor patient communication 

I: history taking from a third party 

K P M van Spaendonck* and E M van Weel-Baumgarten; University of Nijmegen, 

Netherlands 

1145-1200 6 Training of the systemic approach in doctor patient communication 

II: history taking with a patient and a third party 

E M van Weel-Baumgarten* and K P M van Spaendonck; University of Nijmegen, 

Netherlands 

1200-1215 7 Breaking bad news - evaluation of courses run by students and 

young doctors 

H Ortwein*, E Herrmann, A Brunklaus, A Kreutz, C Schwarz and J Schildmann; 

Humboldt University Berlin, Germany 

1215-1230 Discussion [Opening Discussant: Dr Amindra Arora] 

8J 

Clinical Teaching 


Chairperson: Dr Ioan Bocsan 

Room: Building 10, Kursraum 5 (Lower Ground Floor) 

1030-1045 1 Increasing student awareness of strengths and weaknesses using a 

Standardized Patient case 

Devra Cohen*, Jerry Colliver, Mark Swartz and Randal Robbs; Mt Sinai School of 

Medicine, New York, USA 

1045-1100 2 Clinical dermatology: prospective randomized comparison of a 

traditional, a personal bed-side teaching (PBST) and a problemoriented-practical 

(POP) course 

F R Ochsendorf*, H Boehncke, R Hovelmann, A Boer and R Kaufmann; Klinikum 

der J.W. Goethe-Universität, Frankfurt/M, Germany 

- 2.44 -

1100-1115 3 Clinical skills training - a new curriculum between BEME and reality 

Peter Frey; University of Bern, Department of Instructional Media (AUM), 

Inselspital 38, CH - 3010 Bern, SWITZERLAND 

1115-1130 4 The effects of student gender on patients’ willingness to be 

examined by medical students 

William P Metheny*, Roxanne Jamshidi and Kara Pitt; Brown University School of 

Medicine/Women and Infants Hospital, Providence, USA 

1130-1145 5 Reality shock among medical students attending first clinical rotation 

I Levi* and T Fischel; Sackler Medical School, Ramat Gan, Israel 

1145-1200 6 Experiential clinical learning in a horizontally-integrated, problembased 

curriculum 

Tim Dornan*, Arno Muijtjens and Henny Boshuizen; Universities of Manchester 

and Maastricht, UK and Netherlands. 

1200-1230 Discussion [Opening Discussant: Dr Paul Hemmer] 

8K 


International Aspects of Medical Education 

Chairperson: Dr M Roy Schwarz 

Room: Building 10, Kursraum 6 (Lower Ground Floor) 

1030-1045 1 Influence of Studying on Students’ Health (ISSH) 

T Schweickert*, P Hodzic, V Jurkovic, J Seitz*, O Onur* and T Shiozawa*; 

German Medical Students’ Association, Aachen, Germany 

1045-1100 2 A comparison of undergraduate medical curricula in various countries 

J Mirecka*, Paola Binetti, Jan Heijlman, Roy Remmen and K Lipinski; Department 

of Medical Education, Krakow, Poland 

1100-1115 3 International differences in medical content preparation 

Steven R Daugherty* and Rochelle Rothstein; Kaplan Medical, Chicago, USA 

1115-1130 4 New trends at TSMU: elaboration of medical education conception 

R Khetsuriani, B Kilassonia, Z Avaliani* and G Simonia; Tbilisi State Medical 

University, Georgia 

1130-1145 5 Learning needs assessments for refugee doctors; establishing 

baseline data about medical knowledge and experience 

Lesley J Southgate* and Joan F Fuller; University College London, UK 

1145-1200 6 Helping refugee doctors back to work 

M J Bannon*, E Paice, G MacFadden, G Cowan, S Cheeroth and Y H Carter; 

London Deanery, Harrow, UK 

1200-1215 7 New York University Master Scholars Program 

Sharon K Krackov; New York University School of Medicine, New York, USA 

1215-1230 Discussion [Opening Discussant: Dr Charles Boelen] 

- 2.45 -

8L 

Special Subjects 

Chairperson: Professor Ester Mateluna 


1030-1045 1 And now for something completely different … reflective style 

learning of the Arts in medicine 

Paul Lazarus; University of Leicester, UK 

1045-1100 2 Seamless humanities: on integrating medical humanities into 

medical education: the Witten project 

C Hick*, B Matzke, B Strahwald, A Weymann and W Vermaasen; Universität 

Witten/Herdecke, Germany 

1100-1115 3 Improving clinical reasoning in novice clinicians: a diagnostic 

training aid to support clinical reasoning in student 

physiotherapists 

Gill James; Coventry University, UK 

1115-1130 4 The culture of criticism and argument in health education 

Barbara Westwood* and Geoffrey Westwood; University of Western Sydney, 

Australia 

1130-1145 5 Development and interim evaluation of a new postgraduate course 

in community gynaecology and reproductive health care 

A Parsons, B Olowokure* and M Walzman; University of Warwick, Coventry, UK 

1145-1200 6 Palliative medicine education for Internal Medicine Resident 

Physicians 

Marcos Montagnini*, Edmund Duthie and Basil Varkey; Medical College of 

Wisconsin, Milwaukee, USA 

1200-1215 7 Teaching stress management and empathic communication to 

medical students 

Ray Melmed and Hannah Kedar*; The Hebrew University, Jerusalem, Israel 

1215-1230 Discussion [Opening Discussant: Professor Paul O’Neill] 

1230-1330 Lunch in Marquee 

1330-1600 Session 9: Plenary 

9 


Different views of medical education 

Room: Teaching Building, Hörsaal 1 and 2 

(Note: there will be a video link to Hörsaal 3 to provide additional seating) 

Chairperson: Dr Madalena Patrício, Portugal 

1330-1355 9/1 The role of clinical experience in the acquisition of clinical 

reasoning: Implications for education 

Professor Geoff Norman, McMaster University, Canada 

- 2.46 -

1355-1420 9/2 Keeping standards up to date 

Ms Susanne Pruskil, Medical Student from Charité, Medical Faculty of the 

Humboldt-University, Berlin 

1420-1445 Discussion 

1445-1500 Short break 


1500-1550 Special presentation: 

Humour in medical education is like a box of chocolates … 

Dr Ron Berk, The Johns Hopkins University, Baltimore, USA 

1550-1610 Close of Conference, and presentation of Medical Teacher Poster Prize 

Please remember to hand in your Conference Evaluation Form at the Registration 

Desk. (Spare copies are available if required). We value your feedback, together with 

your suggestions for future speakers and workshop organisers. 

- 2.47 -

SECTION 3 

Conference Social Programme, 

Tours and Accommodation

Tours, Optional Conference Social Events 

and Accommodation 

Please address all bookings and queries relating to the above to DER-CONGRESS: 

DER-CONGRESS 

Bundesallee 56 Tel: +49 30 857 9030 

D-10715 Berlin Fax: +49 30 85 79 03 26 

Germany Email: der@der-congress.de 

Bookings for accommodation/tours/optional social programme should be submitted on 

Form C, included in the provisional conference programme or available from the AMEE 

Office. Please return Form C direct to DER-CONGRESS and not to the AMEE Office. 

Conference Social Programme 

The following two social events are included in the registration fee: 

Sunday 2 September 1400-1700 hrs 

Sightseeing tour of Berlin by coach, starting at The Forum Hotel, 

Alexanderplatz, Berlin (see map on page 1.6) 

Please make your own way to the Forum Hotel to meet your coach. On the tour you 

will see the most attractive and historic sights of Berlin: Kaiser Wilhelm Memorial 

Church; Europa Center; Bauhaus Archives; New National Gallery; the Philharmonic 

Concert Hall; the “Anhalter” railway station; the “Alexanderplatz”; the 

“Gendarmenmarkt” with its twin French and German cathedrals; Nikolai District; 

Television Tower; Red City Hall (which houses the Berlin Senate, and is the location 

for the Opening Ceremony on Sunday evening); “Zeughaus”; German State Opera; 

the magnificent boulevard “Unter den Linden”; Brandenburgh Gate; the “Reichstag”; 

Congress Hall; the “Tiergarten”; “Schloss Bellevue”; Victory Column; German Opera 

House, and Charlottenburg Palace. The tour will terminate at the Forum Hotel. 

Sunday 2 September 1930-2130 hrs 

Welcome Reception in the “Red Town Hall” (Rotes Rathaus), Rathausstraße 

(see map on page 1.6) 

You are invited by the Senate of Berlin to the Red Town Hall, which is the 

headquarters of Berlin City Council built in neo-Renaissance style between 1861 

and 1870. The evening is the opportunity to meet colleagues and friends; musical 

entertainment by Musici Medici Quartet who will play some pieces by Schubert; 

drinks and snacks provided. Please note that you should make your own way to and 

from the Red Town Hall. 

- 3.1 -

Optional Social Events 

Student Social Events 

The following Conference Social Events are not included in the registration fee and 

can be booked through DER-CONGRESS, using Form C available from DER or from 

the AMEE Office. 

Monday 3 September 1930-2300 hrs 

River Cruise, starting at Jannowitzbrücke 

- 3.2 - 

Price: DM 100 per person 

This river cruise on the Spree presents the historic centre of the city with its most 

important sights from a completely different angle. You will pass such buildings as 

the Reichstag, the Berlin Cathedral, the castle Charlottenburg etc. from the waterfront. 

The tour will be guided in English and will start from the landing stage 

Jannowitzbrücke. It will end at Berlin Cathedral (see map on page X). Buffet dinner 

and two drinks are included. Tickets may be collected from DER on registration and 

please remember to take these with you to the event as they entitle you to two free 

drinks! 

Tuesday 4 September 1930-2230 hrs 

Gala-Dinner at the Aquarium, Budapester Straße 32, 

10787 Berlin (see map on page 1.6) Price: DM 130.00 per person 

The location for our Conference Dinner is the Aquarium, situated in the western 

city centre and part of the famous Zoological Gardens. The Aquarium houses the 

greatest variety of species in the world and you are free to look around. A dinner 

buffet and drinks are provided, with musical entertainment from the Brass Brothers 

– from Bach to the Beatles and, by popular request, Foetus ex Ore, the Norwegian 

medical students’ choir that has amused and amazed us in previous years. We must 

vacate the building by 2300 hrs which is bedtime for the fish – they suffer distress 

and higher mortality rates if deprived of their rest! Please make your own way to 

and from the Aquarium. 


If there is sufficient demand, there will be a pub crawl for all the students who 

arrive early (they may not object to a few non-students tagging along if anyone else 

is interested!). Please contact them if you would like a guided tour of the Berlin 

nightlife: student.amee@charite.de 

Monday 3 September 1930 hrs until late 

An alternative to the River Cruise, for students only! The local students invite visiting 

students to a free dinner in the ‘Lecture-hall Ruin’. This is the old pathology lecturehall 

that was partly destroyed during WW II, has been rebuilt and is now being used 

for social events. All students registering for the Conference will be contacted by 

the Berlin students and asked if they would like to attend the dinner. As numbers are 

limited they can’t promise that places will be available for everyone. Please contact 

student.amee@charite.de for further information.

Accompanying Persons Programme 

Tours leave from and return to the Forum Hotel, Alexanderplatz (see map on page 1.6). 

All tours are guided in English. Lunches do not include drinks. 

Monday 3 September 0830-1630 hrs 

Impressions of the Spreewald Price: DM 150.00 per person 

This day-tour to the Spreewald offers an unparalleled experience of nature. The 

area, which was originally settled by the Sorbs, is traversed by numerous tributaries 

of the River Spree, these often being the only links between houses and fields. The 

tour will take you to Burg and Leipe, two small idyllic towns in a romantic setting. 

Spreewald specialities will be served at lunch. Enjoy a trip along the network of 

waterways on one of the traditional Spreewald punts. 

Tuesday 4 September 0830-1630 hrs 

Neuruppin & Rheinsberg Palace Price: DM 150,00 per person 

This is a Coach trip to the little town of Neuruppin, which is situated on the lake 

”Ruppiner See”. During a sightseeing tour you will get to know the home town of 

Theodor Fontane and Karl Friedrich Schinkel. After lunch the trip continues to 

Rheinsberg, ”picture book for lovers” as Tucholsky called it. The town, which is 

situated on the east bank of the ”Griebericksee”, is famous in particular for its 

palace, Schloß Rheinsberg. It was built in 1566 as a moated castle and in 1737/40 

Knobelsdorff reconstructed it into a major architectural work during Friedrich the 

Great’s reign. The Rheinsberg Palace houses a museum, which is open to the public. 

The tour also includes a walk through the palace gardens, which were originally 

designed in Baroque-style and changed into English-style gardens at the end of the 

18th century. 

Wednesday 5 September 1000-1400 hrs 

Potsdam/Sanssouci Price: DM 70,00 per person 

This tour shows old and modern Potsdam. You will visit the well-preserved, worldfamous 

Rococo Palace Sanssouci with its art treasures and beautiful park. A city 

tour through Potsdam will follow. 

- 3.3 -

Pre-Conference Tours 

All tours are guided in English. Tours leave from and return to the Forum Hotel, 

Alexanderplatz (see map on page 1.6). Programme is subject to change. Lunches do 

not include drinks. 

Saturday 1 and Sunday 2 September (1.5 days) 

Dresden 

Depart Berlin 0900 hrs on 1 September, return to Berlin 1200 hrs on 2 September 

(one overnight stay) 

1 September: Start of the tour in Berlin. On the way to Dresden you will pass by 

the lake “Teupitzer See”, some distant parts of the Spreewald and the coal mining 

area of Niederlausitz. Dresden is one of the most beautiful baroque towns in Europe. 

During a sightseeing tour through the city you will visit the most important sights 

such as the Zwinger, Taschenberg-Palace, the famous Semper Opera House, picture 

gallery ”Old Masters” with the famous painting ”Sixtinische Madonna” or the 

dazzling jewellery exhibition in the ”Green Vault”. 

2 September: At 0900 hrs your return journey to Berlin will start. The tour ends 

also at the Forum-Hotel, Alexanderplatz. 

Rate per person in a double room: DM 305,00 

Rate per person in a single room: DM 375,00 

Rates include following services: de luxe coach, 1 overnight stay including breakfast 

in a Hotel of 4-Stars category, all entrance fees. 

Saturday 1 September 0900-2000 hrs (one day) 

Mecklenburg countryside 

The excursion will take you to Schwerin, an old town “up North”. In this “City of 

Seven Lakes” you can admire the magnificent palace, situated on a charming island, 

which no lesser than Tsar Alexander enthused over. After lunch you will be driven 

past the lake “Schwerin” towards Wismar, the first record of which dates back to 

1229. The buildings still testify to its former glory as a hanseatic city. The historic 

centre has been restored and the whole area is now protected by a conservation 

order. 

Rate per person: DM 175,00 (including transportation in de luxe coach, lunch 

and entrance fees) 

- 3.4 -

Post-Conference Tour 

Cancellation Policy 

Accommodation 

All tours are guided in English. Tours leave from and return to the Forum Hotel, 

Alexanderplatz (see map on page X). Programme is subject to change. Lunches do not 

include drinks. 

Thursday 6 September 0830-1800 hrs (one day) 

Potsdam’s Parks and Palaces 

A visit of the palaces and gardens of Sanssouci will be followed by a guided tour to 

the Cecilienhof, the place where the Potsdam Agreement was signed in 1945. After 

lunch a city tour through the former garrison town with its Dutch Quarters and 

Russian Colony will follow. 

Rate per person: DM 150,00 (including transportation in de luxe coach, lunch 

and entrance fees) 

In case of cancellation of the accompanying persons’ tours and one-day pre- and postconference 

tours after 15 June 2001 the full fee is payable. There will be no refunds. 

After 15 June 2001 the following cancellation fees will be charged for the overnight 

tour: 

Dresden cancellation fee per person (single room) DM 330,00 

cancellation fee per person (double room) DM 260,00 

Rooms are now subject to availability. Please book using Form C, available from DER 

or the AMEE office. All the hotels of categories A, B, C have fitness-centres; category 

A hotels also have swimming-pools. Some of the hotels in categories C and D also have 

fitness-centres and swimming-pools. All the rooms are equipped with telephone, TV, 

shower and WC. In price categories B and C breakfast buffet, service and VAT are 

included. The rates in price category A do not include breakfast. A deposit of DM 

500,00 per room will be charged and will be deducted from the final bill on checking 

out of the hotel on presentation of the voucher which will be given to you at the 

Conference registration desk. Hotel reservations can only be processed if this payment 

and the booking form have been received Requests by telephone cannot be considered. 

Should the requested category be booked out, DER-CONGRESS will make reservations 

in another category. We ask for your understanding that only written changes in 

reservations can be accepted. 

Reserved rooms will be kept until 18.00 hrs on the scheduled day of arrival, unless late 

arrival has been marked on the booking form. 

In case you have to cancel your room reservation the cancellation fee charged by DER- 

CONGRESS is DM 50,00 per single room and DM 100,00 per double room. Should 

the cancellation be received after June 1, 2001 you may be charged with the relevant 

cancellation or no-show-fee by the hotel, in addition to the corresponding cancellation 

fee payable to DER-CONGRESS. A handling fee of DM 20,00 will be charged for 

changes in registration. Administration costs cannot be reimbursed in any case. 

- 3.5 -

Student Accommodation 

DER-CONGRESS does not deal with allocation of student accommodation. 

Local students have a few rooms available in their own homes for visiting students. 

Please contact student.amee@charite.de for information. 

The hostels listed below may also have rooms available: 

Jugendgästehaus Nordufer Phone: +49-30-451 70 30 

Nordufer 28 Fax: +49-30-452 41 00 

D-13351 Berlin e-mail: Nordufer@t-online.de 

BDP-Gäste-Etage Phone: +49-30-493 10 70 

Osloer Str. 12 Fax: +49-30-493 60 01 

D-13359 Berlin e-mail: gaeste-etage@snafu.de 

Hostel „Die Etage“ Phone: +49-30-89 09 08 20 

Katharinenstraße 14 Fax: +49-30-89 09 08 27 

D-10117 Berlin e-mail: dieetage@aol.com 

Globetrotter Hostel “Odyssee” Phone: +49-30-29 00 00 81 

Grünberger Straße 23 Fax: +49-30-29 00 00 81 

D-10243 Berlin e-mail: odyssee@hostel-berlin.de 

The rates are between DM 24,00 and DM 65,00 per night. 

- 3.6 -

SECTION 4 

Abstracts

Contents 


Session 1 – Plenary 1:Achieving standards in the curriculum 4.1 

Session 2 – Short Communications 1 

2A A virtual learning environment .. .. 4.2 

2B PBL and the curriculum .. .. .. 4.3 

2C Curriculum database .. .. .. 4.5 

2D OSCE/Standardised patients in assessment .. 4.7 

2E Postgraduate education – the early years .. 4.8 

2F Peer assessment .. .. .. 4.10 

2G Continuing Professional Development .. .. 4.12 

2H Selection .. .. .. .. 4.13 

2I Educating the educators (1) .. .. .. 4.15 

2J Simulation and clinical skills training .. .. 4.17 

2K Students and curriculum evaluation .. .. 4.18 

2L Multiprofessional education .. .. .. 4.20 

2M Student support/Psychiatry and the curriculum .. 4.21 

Session 3 – Workshops 1 .. .. .. 4.23 


Session 4 – Large Group Sessions 

4A Standards and professionalism in medical education 4.27 

4B The challenge of developing international standards 

in medical education .. .. .. 4.27 

4C Standards and the curriculum .. .. 4.28 


5A Learning and the Internet .. .. .. 4.29 

5B Evaluation of PBL .. .. .. 4.30 

5C Curriculum evaluation .. .. .. 4.32 

5D Assessing communication skills/Patients as examiners 4.33 

5E Postgraduate education for General Practice/Family Medicine 4.35 

5F Assessment .. .. .. .. 4.37 

5G Outcome-based education .. .. .. 4.38 

5H Educational strategies/curriculum planning .. 4.40 

5I Educating the educators (2) .. .. .. 4.42 

5J Education and cultural diversity .. .. 4.43 

5K Contexts for learning .. .. .. 4.45 

5L Evaluation of multiprofessional education .. 4.47 

5M Teaching about EBM, critical thinking and research .. 4.48 

Session 6 – Workshops 2 .. .. .. 4.51 

- i - 

Page


Session 7 – Posters 

7A New learning technologies .. .. .. 4.56 

7B Problem-based learning .. .. .. 4.58 

7C Curriculum planning and change .. .. 4.60 

7D Curriculum evaluation/staff development .. 4.63 

7E Postgraduate education .. .. .. 4.65 

7F Assessment .. .. .. .. 4.68 

7G Teaching and learning (1) .. .. .. 4.70 

7H Teaching and learning (2) .. .. .. 4.73 

7I Continuing Professional Development (1) .. 4.75 

7J Continuing Professional Development (2) .. 4.77 

7K International medical education .. .. 4.78 

7L Special subjects .. .. .. .. 4.80 


8A Computer mediated learning and assessment .. 4.83 

8B Implementation of PBL .. .. .. 4.84 

8C Curriculum planning .. .. .. 4.86 

8D The final examination .. .. .. 4.87 

8E Postgraduate education/Career choice .. .. 4.89 

8F Teaching and learning .. .. .. 4.90 

8G Assessment in postgraduate and continuing education 4.92 

8H Curriculum change .. .. .. 4.94 

8I Communication skills training .. .. 4.96 

8J Clinical teaching .. .. .. .. 4.97 

8K International aspects of medical education .. 4.99 

8L Special subjects .. .. .. .. 4.100 

Session 9 – Plenary 2: Different views of medical education 4.103 

- ii -

Session 1 Plenary 

1/1 Towards global standards for 


Jordan J Cohen 

President, Association of American Medical Colleges, 2450 N 

Street N.W., Washington DC 20037-1126, USA 

Jordan Cohen has had a longstanding interest in 

standards in medical education from the perspective 

of a Dean of a medical school and Professor of 

Medicine, a Chair of the American Board of Internal 

Medicine and the Accreditation Council for Graduate 

Medical Education, and President and Chief Executive 

Officer of AAMC. In this session he will share his views 

about standards in medical education. Why are 

standards important? To what extent should we aim for 

global standards? How might this be achieved? 

1/2 New times, new standards: the 

social accountability of health 

systems and medical schools 

Charles Boelen 

Coordinator, Human Resources for Health Program, World 

Health Organization, CH-1211 Geneva 27, Switzerland 

Health systems worldwide face the challenge of 

providing evidence to various stakeholders, including 

the public, of their capacity to meet priority health needs 

and expectations of individuals and society at large. 

Medical schools alike, to ensure continuous support, 

will increasingly be expected to demonstrate how their 

educational, research and service delivery activities best 

contribute to meet requirements for improved quality, 

equity, relevance and cost-effectiveness in health care. 

These requirements and conformity to new standards 

should not just be seen as constraints but as 

opportunities for expansion and renewed leadership in 

the health sector. 


- 4.1 - 

1/3 Death of the course 

R M Harden 

Centre for Medical Education and SCPMDE Education 

Development Unit, University of Dundee, Tay Park House, 484 

Perth Road, Dundee DD2 1LR, UK 

Traditionally, curricula were made up of a series of 

courses based on disciplines such as anatomy, 

pathology, surgery or medicine. These have evolved to 

courses based on body systems or other topics. Such 

courses are usually described in terms of a timetable 

or syllabus with the number and topics of lectures, small 

group, practical, or clinical sessions specified. This 

paper argues that we will see a revolution in curriculum 

and instructional design in response to real needs such 

as the need for more flexible training programmes, 

more multiprofessional learning opportunities and 

greater cooperation between education providers. These 

changes will be achieved through the application of 

new technologies and a fresh approach to educational 

thinking. Contributing to this fundamental change will 

be: 

1 The move to outcome-based education; 

2 The development of electronic curriculum maps 

accompanied by appropriate study guides; 

3 A dynamic adaptive approach to learning based on 

reusable learning objects with an appropriate 

learning management system. 

The course as we know it today may not be already 

dead, but it is dying.

Session 2A A virtual learning environment 

2A1 Virtual learning environments – 

a learner centred review 

Megan Quentin-Baxter* and Suzanne Hardy 

Learning and Teaching Support Network, Medicine, Dentistry 

and Veterinary Medicine (LTSN-01), Faculty of Medicine, 

University of Newcastle, Newcastle-upon-Tyne NE2 4HH, UK 

The findings of a study to investigate approaches to 

Virtual (Managed) Learning Environments which the 

United Kingdom’s National Health Service might take 

in implementing a ‘virtual classroom’ are reported. The 

brief was to assess current strategies in Internet-based 

learning and teaching via a review of current known 

VMLE products/projects in relation to NHS needs; to 

consider the suitability for transfer to a UK-wide 

learner centred continuing professional development 

environment (the NHS) based on an adult learning 

model, incorporating sophisticated portable reflection/ 

recording tools; to examine the conceptual models of 

‘teacher’ and ‘learner’, and how these definitions might 

affect the assessment/construction of a VMLE based 

on the required model and applied to the NHS 

workforce. The methodologies employed, a brief 

analysis of some of the representative VMLEs 

identified, and the need for new or integration of 

existing technologies to support a learner centred 

approach will be discussed. 

2A2 Impact of a digital learning 

environment on the efficiency 

of teachers 

Peter G M de Jong* and Hermiette E Idenburg 

Leiden University Medical Center LUMC, Onderwijscentrum 

IG, Kamer C5-54, PO Box 9600, 2300 RC Leiden, 

NETHERLANDS 

In September 1999 a digital learning environment for 

students was introduced at the Leiden University 

Medical Center. The environment supplies students 

with additional organizational information as well as 

course-related content. In May 2000, the influence of 

this environment was evaluated by means of a 

questionnaire among all students and teachers in the 

first year of study. Teachers use the environment mostly 

for schedules (66%) and changes in schedule (56%), 

formative questions (56%) and publication of the right 

answers on the final examination (44%). Images, 

pictures and articles are hardly published due to 

possible violation of copyrights. However, almost 

unanimously teachers declare that from their point of 

view, students now have more rapid access to much 

more information and that for themselves, publishing 

information is much more time-efficient than before. 

In May 2001 the same questionnaire will be conducted 

and the results will be compared with the 2000 

questionnaire. 


- 4.2 - 

2A3 Building blocks in a new 

curriculum: the role of the library in 

educational innovation 

Margriet Lee and Maureen Brassel* 

University of Pretoria, Medical Library, P O Box 667, Pretoria 

0001, SOUTH AFRICA 

In support of the University of Pretoria’s aim of 

providing a virtual campus by means of telematic 

teaching and web-based training, the Medical Library 

began a virtual information service on the Internet. This 

service is integrated into the curriculum of the Faculty 

of Medicine by the information specialists by creating 

webpages to support the study programmes. Using 

block books of specific courses, a spectrum of 

information sources is put together on webpages. These 

sources include fulltext articles, CD-ROM, videos, 

websites, etc. Students work interactively by doing their 

searches on various databases, access the library 

catalogue and fulltext journals. Webpages differ in 

content according to individual courses. Students are 

exposed to a wider variety of information, enabling 

them to make informed decisions, to make more use 

of the library material, to work from home - not bound 

geographically, and also to prepare themselves for the 

virtual information world of the future. 

2A4 IT learning environment: more 

structure or more room for 

manoeuvre? Centrally guided norm 

path or absolute freedom? 

J Degryse*, A Roex and W Renier 

ACHG K U Leuven, Department of General Practice, 

Kapucijnenvoer 33 Blok J, B3000 Leuven, BELGIUM 

Various typologies and taxonomies for IT learning 

environments are already described in literature. A 

central element is the principle of navigation. Is there 

an imposed “norm path” or, on the contrary, can an 

absolute freedom of movement be provided for, that 

will allow the student to study flexibly according to 

his own style of learning? ICHO is in the process of 

developing a new electronic learning environment. 

Since 1 September 1999, every student has access to 

his or her own ‘workplace’ on the website. With the 

introduction of the Internet-based iTOL further 

progress has been made. More than just the latest 

software package, iTOL is a new approach to teaching. 

The model that forms the basis of the iTOL is essentially 

a hybrid. Individual study and self-guided learning are 

central features. Within the discussion forum group 

learning is of uppermost importance. The focus of the 

case studies is problem-oriented thinking and problemsolving 

learning. The iTOL project closely follows the 

constructivist vision of learning and teaching 

(Grabinger 1996, White 1992, Dufy & Cunningham 

1996, Harel & Papert 1991). Strictly speaking, no norm 

path is imposed in an iTOL. However, the aim is to

exploit the role of periodic and modularly organised 

tests and navigation, which is directed by explicitly 

formulated learning goals. 

2A5 Innovation in self-directed learning 

(SDL) in CME: Virtual Internet 

Patient Simulation 

M A Raetzo*, R L Thivierge, R J Gagnon, V Loroch and 

A Bonneau 

721 Hartland, Montreal H2V 2X5, CANADA 

SDL in CME has been mainly driven by the use of 

published written material and also now the growing 

use of the Internet. Unfortunately, reading material is 

still a rather passive activity. We have developed a 

computer software built with clinical vignettes in which 

each participant will simulate real encounters with 

virtual patients. To do so, the user will have to follow 

each step of the basic clinical approach: 1 – finding 

the problem: open-questions system; 2 – fixing the 

problem; 3 – at each step: each question or decision 

has to be justified (exploring the clinical reasoning); 

4 – an ongoing feedback can be given upon request at 

each level (EBM content already included); 5 - a final 

feedback and report is given at the end of each case. 

This paper will present the main features of VIPS and 

will cover a qualitative evaluation conducted with a 

group of 20 family practitioners. 

Session 2B PBL and the curriculum 

2B1 The birth of a new species – 

squirrums: towards equal 

collaboration in innovation in 


Peter McCrorie* and David Prideaux* 

St George’s Hospital Medical School, Department of Medical & 

Health Care Education, Cranmer Terrace, Tooting, London 

SW17 ORE, UK 

In September 2000, St George’s Hospital Medical 

School in London began a new problem-based medical 

course for graduates. Initially St George’s purchased 

problem-based cases and tutor training expertise from 

Flinders University in Adelaide, Australia, where a 

similar course had been introduced in 1996. The 

resulting collaboration began as a predominantly onesided 

affair with a net information flow from Adelaide 

to London. But it did not remain that way for long. 

There is now an active exchange of existing, new and 

revised cases, sharing of web-based resources, regular 

staff visits, student bulletin boards, joint workshops 

through video-conferencing and collaborations on 

evaluation and research. We liken the resultant curricula 

to a new species – squirrums – a cross between squirrels 

and possums. This paper will outline and analyse the 

essential features of the collaboration and draw out 

issues and ideas that could be applied to other such 

partnerships. 


- 4.3 - 

2A6 Real learning through virtual 

presentation: an Internet based 

work environment course for 

medical students at Uppsala 

University 

Klas Berlin*, Kerstin Graffman and Anna Rask-Andersen 

Department of Medical Sciences, Occupational and 

Environmental Medicine, University Hospital, Entrance 91, SE 

751 85 Uppsala, SWEDEN 

Internet based learning in occupational and 

environmental medicine in Uppsala Medical School 

was introduced during the spring term 1999. A 

homepage was constructed which contained schedule, 

handouts, message area and quality assessed links. The 

written exam was omitted for Internet assignments. The 

project was evaluated by a questionnaire. Sixty-six 

percent of the 113 students answered the questionnaire. 

The teaching stimulated students to reflect about 

possible relationships between the patients’ symptoms 

and their occupations as well as the environment. The 

students also knew where to find information about 

such relationships. The Internet project had made it 

easier for the students to control their time. The course 

had a positive effect upon student interest in the field 

and encouraged integrating earlier knowledge. 

Occupational and environmental medicine may be 

especially suitable for Internet based learning but it is 

likely that this kind of teaching would be useful even 

in other classes. 

2B2 Broadening learning with PBL in a 

pathophysiology course 

Antonio Rendas* and Bernardo Correia 

Faculdade de Ciencias Medicas, Campo dos Martires da Patria 

130, 1200 Lisboa, PORTUGAL 

Based on our experience of PBL in a pathophysiology 

course from a traditional curriculum, we developed a 

computer simulation to register the tasks performed 

by the students. These records allowed us to identify, 

in three consecutive years, the following elements; 

learning needs (ln) – expressed in PBL sessions; 

learning resources (lr) – used during the self-learning 

periods. Six cases were analysed every year covering 

different body systems (digestive, circulatory, blood, 

respiratory, kidney and endocrine). Each case, based 

on a complete patient history, was analysed by a small 

group of students (an average of 10), in five tutorial 

sessions, lasting for two hours and occurring twice a 

week. Despite the single discipline nature of the course 

we found a wide range of ln and lr, from basic sciences, 

especially physiology and histopathology, to clinical 

medicine, especially internal medicine. In our 

experience PBL proved to be a useful method to 

broaden learning beyond the boundaries of 

pathophysiology.

2B3 The implementation of problembased 

learning (PBL) into a 

traditional Radiology clerkship 

U Keske, U K M Teichgraber, R Schroder, J Berger, S Venz 

and R Felix 

Humboldt University, Gr. Hamburger Str. 36, 10115 Berlin, 

GERMANY 

The aim of the study was to demonstrate the 

implementation of problem-based learning (PBL) into 

a traditional Radiology clerkship. In addition to the 

reformed medical curriculum which is running as a 

parallel track, PBL is also applied as a teaching method 

in the traditional curriculum. The core radiology 

clerkship was taught as a two week block course with 

PBL sessions every morning followed by clinical 

rotations in radiology. Continuous end of block 

evaluation was performed applying a questionnaire. 

Based on students’ feedback, changes in the course 

structure were made. After four years it is obvious that 

radiology is suitable for the use of PBL, because of its 

interdisciplinary character. Based on both student and 

faculty feedback the group dynamics, student and 

faculty satisfaction, course effectiveness and role of 

the tutor were rated positively. A set of standard cases 

was adapted according to comments from a mandatory 

review session at the end of the clerkship. It is 

concluded that the introduction of problem-based 

learning in radiology had a positive impact on faculty 

development. Five faculty members were educated in 

becoming PBL tutors and tutored later students of the 

reformed medical curriculum of the Charité. 

2B4 Medical education innovations in 

Dresden, Germany: Reformed 

Medical Faculty Carl Gustav Carus, 

Dresden University of Technology 

Peter Dieter 

Medical Faculty, Carl Gustav Carus, Office of the Dean of 

Student Affairs, Fetscherstrasse 74, D-01307 Dresden, 

GERMANY 

The new curriculum in Dresden is based on the 

principle of Problem-Based Learning (PBL). The 

curriculum is developed in collaboration with Harvard 

Medical School. All teachers are professionally trained 

in specific courses. The PBL program will integrate 

elements of medical ethics, quality management, health 

economics and evidence-based medicine. At present, 

five multidisciplinary courses have been introduced 

into Year 3 and 4. The focal point of each course is a 

tutorial with eight participating students and one PBLtrained 

tutor. Students and tutors discuss a particular 

patient´s case, related to the theme of the course. 

Lectures, laboratory courses and “bed-side learning” 

complete the curriculum. The Dresden program plans 

the integration of further PBL courses into Years 4 to 

6. Multidisciplinary courses in basic sciences in Years 

1 and 2 will complete the program. Every aspect of the 

PBL program is regularly evaluated by an external 

institution. 


- 4.4 - 

2B5 Problem-based Learning in 

Immunology and Infectious 

Disease (IMID): the Dresden 

experience 

S T Weber*, G Baretton, S Bergmann, J Graeszlear, E Jacobs, 

H Kunath, I Nitsche, U Ravens, A Rethwilm and P Rieber 

Institute of Medical Microbiology and Hygiene, Dresden Medical 

School, Fiedlerstr. 42, 01307 Dresden, GERMANY 

IMID are underrepresented in the curriculum of 

German medical students. In the final exam, less than 

ten out of more than 500 questions are related to 

immunology. IMID are scheduled early in the medical 

curriculum when most students have not seen patients 

regularly. This situation does not reflect the medical 

development where immunology and infectious 

diseases are becoming increasingly important. Based 

on the principles of problem-oriented learning, we 

conducted an eleven-week-multi-disciplinary course in 

IMID. The schedule included morning-lectures, two 

laboratory sessions and three tutorials (8-10 students) 

per week. Eleven cases were presented covering major 

issues in the field. Due to the clinical background of 

the cases the students were able to learn the principles 

in infectious diseases from a “real life story”. Lectures, 

tutorials and lab sessions were evaluated permanently 

by a questionnaire. Students reported a higher 

motivation to learn and to self-study. We think that a 

more profound insight into IMID will be a benefit for 

their professional careers. 

2B6 From case-based reasoning to 

problem-based learning 

Haim Eshach* and Haim Bitterman 

Technion, Israel Institute of Technology, PO Box 9649, Bat 

Galim, Haifa 31096, ISRAEL 

Many medical schools question whether they should 

implement a problem-based learning (PBL) 

curriculum. Educators raise some serious questions 

regarding the efficiency of PBL and therefore 

recommend learning more about the cognitive 

processes developed by PBL before broadly 

implementing it. In addition, it is important to 

determine whether PBL best matches the human 

reasoning processes. In this theoretical article we 

examine the relationships between the case-based 

reasoning (CBR) model and PBL. CBR indicates that 

the source of knowledge one uses while solving a new 

problem is not only generalized rules or general cases, 

but often a memory of stored cases recording specific 

prior episodes. CBR allows the reasoner to propose 

solutions to problems quickly and to propose solutions 

in domains that are not completely understood, such 

as medicine. Our analysis reveals strong association 

between CBR and PBL. We conclude that PBL is a 

successful teaching method that should be encouraged 

by medical schools.

2B7 A new approach to PBL in CME; 

using script concordance tests (SCT) 

M Labelle*, C Maille, R L Thivierge and B Charlin 

University of Montreal, CME Office, Faculty of Medicine, P O 

Box 6128, Centre-Ville Station, Montreal, CANADA H3C 3J7 

Traditionally the PBL material for CME is prepared 

with the help of clinical cases to be discussed between 

peers while answering specific questions. A prior needs 

assessment is done to ensure that the material and its 

content will respond to the learning needs of the 

participants. In order to be more tied to the learners’ 

needs, we have designed a new model (SCT) for 

building each case where the answer to each question 

can be displayed and compared to the responses of a 

group of expert physicians (previously obtained) on 

the same topic. Similarities and discrepancies between 

the responses (participants vs experts) become overtly 

obvious when revealed on the overhead screen during 

the running of the workshop. This PBL model using 

SCT has a primary effect of obtaining an ongoing needs 

assessment of the learners while the workshop is 

actually being delivered. 

Session 2C Curriculum database 

2C1 Aiding the reform – development of 

a curriculum information system 

Patrick Merl*, Paolo Petta and Richard Marz 

Institute of Medical Chemistry, University of Vienna Medical 

School, Wahringerstr. 10, A-1090 Vienna, AUSTRIA 

Curriculum information systems have been discussed 

in the literature since the early 1970s. Most systems in 

existence deliver structural information, and little is 

known about systems that have been designed to 

successfully serve as planning tools. We explore 

possible reasons for this phenomenon. The University 

of Vienna Medical School is currently reforming its 

curriculum from strictly subject based to one with an 

integrative approach. Such a process generates large 

amounts of data and a great need for information and 

coordination. At the same time the systemic shift 

stimulates a climate of uncertainty for individuals and 

departments. Our school has therefore funded the 

design of an information system to fill the needs of 

exchange and coordination in the reform process. The 

presentation will discuss how this information system 

supports the planning process: it represents information 

in several structured formats, aids in decision making, 

and provides orientation for stakeholders. 

2C2 How effective is project 

management software in 

implementing a new course? 

Katharine Grundy 

St George’s Hospital Medical School, Cranmer Terrace, Tooting, 

London SW17 0RE, UK 


- 4.5 - 

2B8 Discovering versus covering: a 

new PBL in Behavioural Sciences 

Ala’Aldin Al-Hussaini and Harith Ghassany 

College of Medicine, Sultan Qaboos University, Post Box: 35, 

Postal Code: 123, Al-Khod, Sultanate of Oman 

During the initial decade since its establishment in 

1986, the Department of Behavioural Medicine at 

Sultan Qaboos University had placed more weight on 

teaching at the expense of learning. As with most 

teacher-centred learning, the implicit assumption has 

always been that a good teacher must necessarily 

produce good students regardless of the fact that student 

learning is active or passive. Over the last 5 years the 

Department has initiated student-centered learning 

teams while reducing the lecture format to the 

minimum. The shift is essentially a move away from a 

culture of rote teaching and learning to a more 

interactive culture of critical reading, thinking, and 

reading material, which can be made relevant to the 

culture of the students and the common problems of 

their communities. Following initial problems of 

adjustment and reluctance by both teachers and 

students, it has been found that there is more value in 

the balance between the discovery approach to learning 

and the covering of material approach to teaching. 

Planning and implementing a new graduate entry 

programme in medicine presented many challenges. A 

management system was required to assist in the 

administration of the project and to generate 

communications tailored to the needs of the individual 

teachers and administrators. We decided to use 

Microsoft Project, the most widely used project 

management software. It assists in the organisation of 

administrative tasks such as identifying key milestones, 

scheduling activities, assigning resources and tracking 

progress. An invaluable feature of the software is its 

ability to publish reports e.g. filtering information to 

ensure individuals only receive details relevant to 

themselves. This information can be distributed either 

on paper, by email or published on the Intranet. For a 

project to succeed, however, it requires more than good 

software. Critical factors for successful project 

administration include rigorous planning, realistic timescales, 

effective communication, clearly defined 

responsibilities, commitment from senior management 

and regular monitoring. 

2C3 MESMIS – Medical School Staff/ 

Student Management Information 

System: Towards the electronic 

curriculum 

D A Levison and W M Williamson 

University of Dundee Medical School, Dundee DD1 9SY, UK 

MESMIS is a comprehensive web-based management 

information system developed at Dundee Medical 

School to provide communication; resource

management; staff and student support mechanisms; 

course information inclusive of personal (staff and 

student) timetables; e-learning and now outcome based 

enquiries for each learning opportunity. Access to the 

system is secure and only accessible by registered 

medical students and staff, including internal and 

external honorary clinical staff involved with the 

delivery of the medical course. Registration is achieved 

on-line and permits access to information by students 

and staff from anywhere in the world. It provides a 

comprehensive Managed Learning Environment 

(MLE) with a number of active links providing the basis 

of a Virtual Learning Environment (VLE). This is 

complemented by an outcome-based assessment 

process that is enhanced by the components of 

“outcome-mapping”, significantly strengthening its 

already generic application. 

2C4 SIMON – Student Information and 

Management Online Network 

P Wagner*, D Zeiss*, S Konig*, P M Markus and H Becker 

Klinik fur Allgemeinchirurgie, Universitat Goettingen, Robert 

Koch Str. 40, D-37075 Gottingen, GERMANY 

We have developed a web-based administration and 

information system to improve both student and faculty 

facilities through enhancement of the online 

experience. SIMON offers a central starting point for 

students and teachers alike and allows direct interaction 

between them. Registration for courses may take place 

online. Lists and information are generated 

automatically and are always up to date. Curriculum 

evaluation may occur via a web interface. SIMON 

provide teachers the opportunity to contact students 

prior to the start of a course and distribute instructions, 

help or hints. Furthermore, SIMON is an ideal forum 

for discussion, problems and reflection on case studies 

outside the classroom environment. Integration of 

additional teaching modules has been allowed for, such 

as online guides for specific courses. Individual 

departments may employ variable programming 

structures, allowing this project to be extended and 

adjusted accordingly and as their future needs arise. 

2C5 Portfolio-based Dermatology 

internship – one year’s experience 

A Boer*, R Kaufmann and F Ochsendorf 

Universitats-Hautklinik Frankfurt/M, Theodor Stern Kai-7, 

60590 Frankfurt am Main, GERMANY 


- 4.6 - 

The last year (practical year) of medical education in 

Germany is not very systematized. In order to improve 

student learning during the dermatology internship we 

introduced a portfolio to clarify which components are 

considered important within dermatology: 25 

qualifications divided into “general basics”, 

“dermatology-basics” and “special-dermatology” were 

listed in a student’s portfolio with a theory, supervision 

and clinical practice part. The individual achievements 

were documented in the portfolio by the educating 

residents. Since May 1999 15 students participated in 

the portfolio-program, they completed in the mean 70% 

of the listed activities; general basics were fully 

completed by all the students, 75% of dermatology 

basics and 46% of special dermatology were completed. 

The students welcomed the portfolio as it provided a 

useful overview of learning opportunities and 

achievements. This is the first use of portfolio-based 

medical education in a dermatology internship in 

Germany. Students strongly requested implementation 

of portfolio-based learning in other faculties. 

2C6 Profile of the consultations made 

by fifth year medical students in the 

integrated program of pediatrics 

and public health 

Claudia Astudillo, Rocio Arenas, Maria Bustamante*, 

Maria De La Fuente and Gladys Yentzen 

Universidad de Chile, Walter Scott 1115, Vitacura, Santiago, 

CHILE 

During the 5th year of medical school, the students 

participate in an integrated program of pediatrics and 

public health, which includes a visit to a primary care 

clinic where the students are able to apply the 

knowledge acquired in the theoretical course of 

pediatrics and learn the abilities that will help them 

participate in actions of promotion, protection and 

recovery of health. The objective of this study is to 

know which were the most common diagnoses they 

made and verify if they are the same they will see in 

the future. We analyzed 609 consultations, with a total 

of 795 diagnoses, which were classified according to 

the ICD 10. The three most frequently found diagnoses 

were respiratory, infectious and cutaneous diseases, 

which are the same found in the literature. It is 

concluded that to prepare medical students to recognise 

and treat the most common diseases, the primary care 

clinics are a necessary instrument that can easily be 

inserted in the curriculum.

Session 2D OSCE/Standardised patients in assessment 

2D1 “Check it, rate it, palm it or leave it” 

– handheld computers replace 

checklists in OSCEs and provide 

automated feedback 

Michael Schmidts*, Markus Kemmerling, Ruth Willnauer 

and Martin Lischka 

Studienzentrum - AKH, P O B 10, A-1097 Vienna, AUSTRIA 

We recently developed software that enables PalmOS 

powered handheld computers to replace checklists in 

an OSCE. Each observer is now provided with a mobile 

handheld device to record mistakes, incomplete or 

missing actions by striking with a pen on a touchscreen. 

Additionally, the examiner can enter new items during 

the test, which serve as suggestions when the item 

database is updated. At the end of the examination the 

data of all participating candidates are synchronised 

(by “beaming”) and transferred to a desktop computer 

for further processing (like statistical item analysis or 

immediate candidate feedback printouts). Based on 18 

months’ experience with our new assessment system 

we see clear advantages in the speed of data gathering, 

the ease of data evaluation and the quick and highly 

elaborated feedback. Observers familiarised well with 

the device, which also turned out to be less intrusive 

than checklists. So far the program worked failsafe. 

2D2 Evaluation of the undergraduate 

surgery course: effect of OSCE 

Marco Bustamante Z*, Carlos Carvajal H, Fernando 

Quevedo R, María Bustamante C and Claudia Astudillo M 

Universidad de Chile, Depto de Cirugía, Avenida Salvador 368, 

Providencia, Santiago, CHILE 

Two different methods, a guideline of evaluation 

applied by different teachers and OSCE, have been used 

to estimate knowledge, attitudes and dexterities in 

undergraduate medical students of the 4th year in the 

subject of surgery. The objective of this communication 

is to compare the results on the final grades of the class 

before and after the introduction of OSCE. In the year 

1997-1998, the final grade was composed of theoretical 

exams 40%, evaluation guidelines 60%. In the 1999- 

2000 period, this grade was composed of theoretical 

exams 40%, OSCE 40%, evaluation guidelines 20%. 

The final grades averages, standard deviation and 

variation coefficients were compared during the two 

periods. Period 1997-1998 final grades average was 

6.15, st dev 0.23, var coeff 3.7. Period 1999-2000 final 

grades average was 5.62, st dev 0.66, var coeff 11.7. It 

is concluded that establishing a type of examination 

that measures skills objectively increases the dispersion 

of the grades threefold. This allows us to conclude that, 

with OSCE, a more valid document is obtained, 

assuring better discrimination amongst students. 

2D3 OSCE: are many different stations 

necessary for each evaluation? 

Carlos Carvajal*, Marco Bustamante and Ilse López 

Universidad de Chile, Facultad de Medicina, Camino De La 

Laguna 13452, Lo Barneclen, Santiago, CHILE 


- 4.7 - 

One of the objections about the Objective Standardised 

Clinical Examination (OSCE) is the need for many 

different stations for each evaluation. The supposition 

is that early consciousness of OSCE stations may 

increase the OSCE score. At the Medical School of 

Chile University, we used OSCE evaluation 

consecutively in 4 groups of medical students, all of 

these with the same stations; groups 1 and 2 in 1999; 

groups 3 and 4 in 2000. There were no statistically 

significant differences among the mean score between 

groups 1 and 2. The mean score in group 1 was greater 

than group 3 (p values

ecoming more common. Here, it is imperative that 

scores are reliable and valid. To accomplish this task, 

great care must be taken in the training and monitoring 

of SPs. For the Clinical Skills Assessment (CSA), 

administered by the Educational Commission for 

Foreign Medical Graduates (ECFMG), SP performance 

is continually scrutinized. In addition, surveys are 

administered to collect data on SP demographics and 

opinions regarding exam logistics and training. The 

purpose of this paper is to explore the relationship 

between SP-related variables (e.g., work history, 

training, conditions portrayed) and the adequacy of 

candidate scores. Initial results suggest that some, albeit 

small, variation in candidate scores can be attributed 

to some characteristics of the SP. Fortunately, 

continuous quality control, combined with periodic 

training and re-training of SPs, ensures that decisions 

regarding candidate competence are accurate, fair, and 

unbiased. 

2D6 Use of standardized patients to 

assess medical response to a 

natural disaster 

Graceanne Adamo*, Marguerite Hawkins, Heidi Worth- 

Dickstein, Eric Marks, Ralph Jones, Gilbert Muniz and 

Richard E Hawkins 

Uniformed Services University of the Health Sciences, National 

Capital Area Medical Simulation Center, 4301 Jones Bridge 

Road, Bethesda MD 20814, USA 

We describe the feasibility and advantages of utilizing 

Standardized Patients (SPs) to train and assess the 

ability of military medical teams to provide 

international health care following natural disasters. 

The real-time simulation took place aboard ship after 

a hurricane in Belize. Cases were based upon 

geographic and natural disaster-related epidemiology. 

Moulage, radiographs, computerized laboratory and 

imaging reports were provided. Analytic methods 

included surveys, structured medical record review, SP 

- 4.8 - 

checklists, and direct observation. Crew rated the 

exercise as more realistic and significantly better than 

a previous exercise without SPs in assessing and 

preparing them to triage and care for casualties. Medical 

record audits and SP checklists were complementary 

in evaluating quality of care for individuals. Observers 

yielded important data regarding patient flow, 

communication, equipment function, supply use, and 

ancillary support. The simulation and inclusion of a 

variety of assessment measures allowed for high quality 

evaluation of complex care delivery. 

2D7 The weakest link? Performance 

factors and degrees of influence in 

an interactive long-station general 

practice examination (VOICEs) 

C M Wiskin*, T Allan and J Skelton 

The Medical School, University of Birmingham, Edgbaston, 

Birmingham B15 2TT, UK 

Passing a six-station Primary Care OSCE examination 

is compulsory. In 2 tasks students improvise 

consultations with ‘patients’ portrayed by our role-play 

team. Clinical performance is marked by a clinical 

examiner. Communication scores (professionalism, 

competence, attitude) are awarded by negotiation 

between examiner and role-player. This paper is part 

of a study evaluating reliability and bias across 

examination variables. Data about role-players, students 

and examiners; the dynamics and score-awards, 

demographics and the logistics of exam days were 

collected. Results from over 1,000 assessed 

consultations were collated on SPSSv.10. Preliminary 

data suggest variables such as question selection, order 

in which students are seen, age/experience of examiners 

and relationship between role-player and examiner 

assessment are not significant. Despite the apparent 

subjectivity of the format, interactive examinations are 

an appropriate means of testing the communication 

skills of medical students. 

Session 2E Postgraduate education – the early years 

2E1 New PRHO: “I am not sure what I 

am supposed to do”. Can we 

improve on PRHO induction? An 

evaluation of a new induction 

process 

Dason Evans*, Mike Roberts and Diana Wood 

St Bartholomew’s and the Royal London, Department of Medical 

Educational Research & Innovation, Robin Brook Centre, School 

of Medicine & Dentistry, West Smithfield, London EC1A 7BE, 

UK 

We conducted a controlled study involving 48 PRHOs. 

We compared a traditional, one-day induction with a 

newer process principally involving five days of 

shadowing before the commencement of the PRHO 

post. Clinical responsibility was taken in a safe 

environment with full support from the outgoing teams. 


We assessed feelings of anxiety, preparedness and 

confidence in clinical skills via questionnaire, and 

ability in clinical skills via an OSCE, before and after 

induction and at one month. We audited prescribing 

errors, radiology request errors, note keeping and 

adverse events in both groups. Pre-induction levels of 

anxiety and uncertainty were high, with almost half 

having biological symptoms of anxiety. Clinical skills 

improved during the longer induction, and 21/22 of 

intervention PRHOs felt more prepared for their post 

(cf 13/22 controls with 7/22 controls feeling less 

prepared after a traditional induction). We will discuss 

the induction process and statistical analysis of results 

in depth.

2E2 A comparison of Pre-registration 

House Officers’ (PRHOs) and 

Senior House Officers’ (SHOs) 

experience in general practice 

Jan Illing*, Tim van Zwanenberg, Bill Cunningham, 

George Taylor, Richard Prescott and Cath O’Halloran 

University of Newcastle, Postgraduate Institute for Medicine & 

Dentistry, 10-12 Framlington Place, Newcastle upon Tyne NE2 

4AB, UK 

The aim was to compare the experiences of SHOs and 

PRHOs spending four months training in general 

practice. While government funding has been provided 

for PRHOs, similar schemes for SHOs remain rare and 

experimental. A case study approach was used 

employing various sources of data. The study involved 

nine SHOs, twelve PRHOs, nine GP trainers and sixteen 

hospital consultants. Data were collected from PRHOs, 

SHOs, GP trainers and hospital consultants. Interview 

data were tape-recorded and analysed using thematic 

analysis and grounded theory to identify important 

themes and patterns in the data. SHOs and PRHOs were 

unanimous about the value of the experience in general 

practice. They reported learning skills not covered in 

hospital posts. GP trainers and hospital consultants 

valued the rotations for all doctors irrespective of final 

career destination. SHOs were considered better 

equipped for general practice and required less 

supervision. However, PRHOs felt able to cope with 

the demands of general practice. 

2E3 Pre-registration experience in 

general practice: results of a 

national evaluation 

Janet Grant*, Lesley Southgate, Rodney Gale, George 

Freeman, Alison Hill, Neil Johnson, Frank Smith, Mairead 

Beirne and Heather Owen 

Open University Centre for Education in Medicine, The Open 

University, Walton Hall, Milton Keynes MK7 6AA, UK 

A national pilot project to give pre-registration house 

officers experience in primary care [with 4 months in 

each of medicine, surgery and primary care] was 

conducted from August 1998 – August 1999. A national 

evaluation was commissioned involving all 96 PRHOs 

and their supervisors, and a reference group from the 

traditional scheme [6 months medicine, 6 months 

surgery]. Tailored survey questionnaires were 

completed by trainees and supervisors at the end of 

each 4- or 6-month post. The areas evaluated included 

costs, governance, content and process of learning, 

outcomes of learning, and assessment, quality 

assurance and monitoring. 

Main findings were: 

• the three posts make a balanced, coherent package. 

• the scheme produced no detriment for the PRHOs. 

• there were no detrimental effects on hospital 

supervisors’ time commitment 

• the time impact on the general practices was 

significant 

• the new scheme has some effect on PRHOs’ career 

plans. 


- 4.9 - 

2E4 Family Medicine Month: a human 

life cycle approach for first year 

residents 

Linda Z Nieman, Rebecca Gladu, Thelma Jean Goodrich, 

Janet Groff and Mary M Velasquez 

UT Houston Health Science Center, Family Practice and 

Community Medicine, 6431 Fannin, Suite JJL324, Houston, TX 

77030, USA 

We designed “Family Medicine Month,” a rotation for 

first year residents, to provide a contextual, lifecycle 

approach to medical care and related family practice 

skills. Individual daily sessions related to a particular 

stage of the lifecycle (e.g., adolescence) and related 

behavioural and technical skills (e.g., interviewing the 

adolescent patient and casting skills for common sport 

injuries). We intended that our residents would integrate 

this inclusive approach into their professional 

behaviour. Twenty residents who participated in the 

rotation in 1999 and 2000 were satisfied with the 

rotation’s usefulness. They also reported greater selfefficacy 

in performing family practice skills after the 

rotation (8.1 ± 0.7) as compared to before the rotation 

(6.2 ± 1.4) (p

2E6 Teaching the forgotten tribe: tutor 

views on a generic curriculum 

for SHOs 

Lesley Pugsley* and Janet MacDonald 

School of Postgraduate Medical and Dental Education, Academic 

Department of Postgraduate Medical and Dental Education, 

University of Wales College of Medicine, Heath Park, Cardiff, 

CF4 4XN, UK 

A consortium of postgraduate centres has developed 

as a pilot, a generic programme for the SHOs in South 

East Wales. It is designed to run for an initial eight 

week period commencing in the Spring of this year, 

with an evaluation in July and a report on the 

programme in August 2001. The core curriculum has 

been resource led, its design predicated on the various 

skills and topics which individual consortium members 

felt able to contribute. This paper complements the 

initial phase of a research study which focused on the 

perceived needs of SHOs and VTS and takes as its focus 

the core tutor team. It seeks to identify emergent themes 

of congruence and dissonance between the groups of 

learners and teachers in order to assist in the 

identification of a compatible curriculum addressing 

the perceived needs of the SHO grade within the 

limitations of resources and service commitments. 

Session 2F Peer assessment 

2F1 Peer- and co-assessment leads to 

shared responsibility for test results 

Caro Brumsen and Peter G M de Jong* 


IG, Kamer C5-54, P O Box 9600, 2300 RC Leiden, 

NETHERLANDS 

During the clerkship in Internal Medicine, an 

introductory test is taken every 3 weeks by a group of 

10 students. A pool of correctors corrects the test. 

Usually there is a lot of discussion concerning the test 

results. Therefore a new correction procedure was 

introduced. In duos, students do the first correction on 

copied versions of the test, with the aid of a standard 

answer sheet. Discussion is encouraged and students 

can put down their comment in writing, preferably with 

references added. This comment is sent to the second 

corrector together with the original version of the test 

answers. On evaluation, most of the students 

commented positively, especially on the possibility to 

gain insight into the correct answers. The method of 

peer- and co-assessment appears to have led to an 

improved acceptance of test results, reflected by a 

dramatic decrease in complaints. 

2F2 Student self-marking as an 

assessment approach to 

developing professionalism 

G J Mires* and M Friedman Ben-David 

University of Dundee, Department of Obstetrics and 

Gynaecology, Ninewells Hospital & Medical School, Dundee 

DD1 9SY, UK 


- 4.10 - 

2E7 General professional training (GPT) 

for dental graduates in the UK 

Alison Bullock*, Vickie Firmstone and John Frame 

Centre for Research in Medical & Dental Education, School of 

Education, University of Birmingham, Edgbaston, Birmingham 

B15 2TT, UK 

This presentation reports on GPT in UK dentistry. 

Comparison is made with senior house officer training 

for medical graduates which is currently under review 

in the UK. The study gained information on the GPT 

undertaken by recent graduates in dentistry and their 

views on it. A questionnaire was sent to those registered 

(since 1997) for Membership of the Faculty of Dental 

Surgery (MFDS) Distance Learning Course (Royal 

College of Surgeons of England). A 55% (n=342) 

response rate was achieved. Widespread support was 

found amongst trainees for a period of GPT. However 

there was consensus that this period should be 

voluntary. There was support for both formal, integrated 

2-year programmes and self-constructed versions that 

can offer greater flexibility. A qualification marking 

the successful completion of GPT was favoured. GPT 

that provides experience of primary and secondary care 

forms a broad basis for future careers. 

Dundee University Medical School has adopted an 

outcome-based curriculum in which personal 

development is one of the defined outcomes. Selflearning 

and self-awareness are important attributes of 

this outcome. A study was undertaken to evaluate the 

feasibility and reliability and to survey student opinion 

regarding the value of undergraduate medical student 

self-marking of written examinations as a means of 

developing these attributes. The correlation between 

student and staff marks, and the reliability of marking 

was high. The majority of students considered there 

was value in the exercise as a learning and feedback 

opportunity, but found it stressful. We believe that this 

approach, as well as being reliable, provides a powerful 

feedback and self-learning opportunity. It also provides 

a mechanism to identify individuals who over or under 

mark or who feel threatened by feedback or are unable 

to receive negative feedback, with whom Faculty can 

work. 

2F3 Comprehensive assessment: value 

for learning 

Elaine F Dannefer 

University of Rochester Medical Center, 601 Elmwood Avenue, 

Box 601, Rochester NY 14642, USA 

The University of Rochester School of Medicine and 

Dentistry has implemented a two-week long 

comprehensive assessment of second year medical 

students for purposes of providing formative feedback. 

Multiple assessment techniques, including standardized 

clinical encounters and peer assessments, provide

feedback that identifies specific learning needs as well 

as problematic patterns of behaviour. Students work 

with their advisory deans to interpret the feedback and 

construct individualized learning plans. An overview 

of the various components will be presented as well as 

examples of different types of feedback and learning 

plans. The value of this comprehensive assessment for 

student learning and for curricular planning will be 

discussed with attention given to the resources required 

for implementation. 

2F4 Attributes of the excellent physician: 

a third year student survey 

A V Carneiro*, M F Patrício and J Fernandes e Fernandes 

University of Lisbon School of Medicine, Rua Sousa Lopes, Lote 

KL - 8 E, 1600-207 Lisbon, PORTUGAL 

Role-modeling is a basic part of medical education. 

Sixty-six third year medical students were asked – using 

questionnaires with open and closed (Likert scale type) 

questions – to indicate their opinions on the attributes 

of a good doctor. The students favoured good 

humanistic qualities in the relationship with patients 

and families (96% good or very good), ability to look 

for help when needed in clinical practice (97%), 

diagnostic abilities (97%) and honesty and ethical 

behaviour (94%). The least important attributes 

included leadership (68% little or no importance), 

research abilities (71%) and a good general culture 

(67%). It is concluded that third year medical students 

can define a set of attributes of what they consider to 

be a good doctor: these include professional behaviour, 

ethics, knowledge and leadership. We will recheck these 

results at graduation time (within 3 years). 

2F5 The Medical Student Peer 

Evaluation Initiative: assessment 

of performance in small group 

settings 

Steven L Kanter*, Kathleen Ryan, John Mahoney and 

Joan Harvey 

University of Pittsburgh, School of Medicine, M-240 Scaife Hall, 

3550 Terrace Street, Pittsburgh PA 15261, USA 

Experience with student assessment at the University 

of Pittsburgh School of Medicine led to the observation 

that, although a faculty facilitator was not identifying 

early a student experiencing difficulty in small group, 

the student’s peers were generally aware of the problem. 

This led to the development of the Medical Student 

Peer Evaluation Initiative (PEI), which aims to provide 

feedback to students on performance in small group 

sessions; recognize students who demonstrate 

excellence; identify poorly functioning students and 

offer counseling. Each student rates each other group 

member on the member’s ability to help the student 

learn. If a score pattern indicates a problem, a faculty 

overseer meets with the student. Results of the PEI 

reveal excellent participation, early identification of 


- 4.11 - 

students with a range of difficulties, and rapid 

remediation of most problems. In conclusion, peer 

evaluation is a feasible and useful measure of student 

small group performance. 

2F6 Reliability of a multidimensional 

questionnaire to assess attitudes of 

medical students towards their 

future profession: the UNI Project 

G L Werneck*, E C O Ribeiro, A C Aguiar and V M B Ribeiro 

Nucleo de Estudos de Saude Coletiva, NESC/UFRJ, Av. Brig. 

Trompovsky s/n - HUCFF, 5o andar - Ala Sul, BRAZIL 

The objective of this study was to assess the reliability 

of answers to questions concerning attitudes of medical 

students towards their future profession. We developed 

a self-administered questionnaire including 52 

questions covering attitudes expected to be developed 

by students during medical school. A test-retest design 

was used as a preliminary evaluation of the 

questionnaire. The questionnaire was completed twice 

within a one-week interval by students of the major 

university of Rio de Janeiro, Brazil. The test-retest 

reliability was estimated by kappa statistics (K). 

Twenty-four questions (46%) had K greater than 0.6 

(substantial agreement); 13 questions (25%) had K 

between 0.4 and 0.6 (moderate agreement); and 15 

questions (29%) had K below 0.4 (fair agreement). 

Considering the complexity of assessing attitudes, we 

judge these preliminary results as satisfactory. The next 

step will be to revise and test those questions showing 

low agreement. 

2F7 Narrowing the gap in the 

assessment process 

Nicolas Karlsson 

Villa Medici, Hogasplatsen 6, 412 56 Goteborg, SWEDEN 

The problem with assessment processes in the past has 

been to motivate the participants to take an active and 

creative part in the process. This requires a narrowing 

of the gap between different groups and that the process 

stimulates each individual participating. On the 

initiative of the student organisation, the Faculty of 

Medicine in Göteborg implemented the Course 

Committee in year 2000 after three succesful pilot 

projects. The Course Committee is the motor in the 

assessment process, creating a suitable environment for 

communication in close connection to the reality of 

each participant. As a meeting point between the 

different parts in the educational process it improves 

not only the democracy of the organisation necessary 

for continuous improvement, but the course committee 

also facilitates the translation from the student’s 

descriptional language into the defined language of the 

manager of the course. A protocol published on the 

www preserves the productive dialogue and the 

suggestions made.

Session 2G Continuing professional development 

2G1 Learning and partnering: bringing 

pharmaceutical representatives 

into the educational loop 

Jane Tipping*, Craig Campbell, Jean Claude Dairon, Paul 

Davis, Francois Goulet, Gilles Lachance, Celine Monette, 

Joan Sargeant, Linda Snell and Robert Thivierge 

10987 Warden Avenue, Markham, Ontario L6C 1M9, 

CANADA 

Pharmaceutical representatives play a key role in 

upholding high standards for CME in Canada. 

Representatives receive many opportunities to upgrade 

knowledge of disease states and management; however 

very little is offered for the practice of CME. A group 

of dedicated professionals from across Canada 

representing academia, industry and the Council for 

Continuing Pharmaceutical Education has created a 

training module specifically for pharmaceutical 

representatives. The outcome has been a quality 

program that includes a method of training and 

evaluation unique in format and congruent with the 

philosophy of adult education. The coalition of three 

stakeholder groups represents an example of 

partnership that promises to offer a means of raising 

and maintaining standards of CME across the country. 

A method of education and evaluation is presented that 

will evoke critical discussion in the issues of industry 

CME and the meaning of partnership. Methods of 

conducting research on efficacy will also be discussed. 

2G2 CME with a combination of 

standardised patients and a CBT 

programme 

S Schewe*, A Schewe and J Loohs 

Medizinische Poliklinik, Klinikum der Universitat, Ludwig- 

Maximilians-Universitat, Pettenkoferstr 8a, D-80336 Munich, 

GERMANY 

A new approach to continuous medical education CME 

concerns teaching and knowledge assessing of general 

practitioners in musculoskeletal diseases sponsored by 

Aventis Pharma. The three elements of the CMEseminar 

were an interactive tutorial with a CBTprogramme, 

the assessment and discussion of problem 

solving strategies including three standardized patients 

with frequent musculoskeletal diseases and finally a 

lecture on innovative therapeutic possibilities. The new 

form of CME was welcomed by nearly all of the 26 

physicians (with the exception of 1); their opinion about 

this kind of training was very positive. Individual 

deficits in problem solving were obvious to each of 

the physicians so that immediate improvement was 

possible. The three educational elements of the CME 

were judged almost equally with a slight advantage for 

the part with the standardised patients. The CBT 

programme was considered an integral and important 

part of the rheumatology seminar. 


- 4.12 - 

2G3 The impact of continuing 

professional development (CPD): 

30 case studies of dentists 

Vickie Firmstone*, Alison Bullock and John Frame 



B15 2TT, UK 

This presentation reports on a key part of a Department 

of Health funded study whose principal aim was to 

explore the impact of CPD on the practice of GDPs. 

Thirty dentists were interviewed before and after 

undertaking a self-chosen educational activity. 

Discussion focussed on the specific activity and on their 

experience of CPD more generally. Factors affecting 

the impact of CPD on practice include: 

1 the process by which CPD is selected. Much is 

undertaken on an ad hoc/ opportunistic basis rather 

than an analysis of learning needs. This can lead to 

CPD which ‘confirms’ current practice rather than 

introduces new learning; 

2 barriers to undertaking CPD (access, time, 

financial); and 

3 constraints to implementing change. 

There was broad support for the importance of CPD 

for personal and professional development, but there 

are significant factors which affect the impact of CPD 

in general dental practice. 

2G4 Global trends in continuing medical 

education 

Lewis A Miller 

Global Alliance for Medical Education, 90 Goodwives River 

Road, Darien, CT 06820-5921, USA 

Patterns of Continuing Medical Education (CME) are 

changing rapidly worldwide. Accreditation systems are 

being adopted rapidly in Europe and Latin America, 

but are not yet well recognized. At the same time some 

countries and medical specialties are changing from 

CME to CPD (Continuous Professional Development) 

despite failure of earlier CPD experiments. Methods 

of delivering CME are also changing. Lectures are 

regarded as less useful than newer forms of interactive 

learning. The use of the Internet and CD-ROMs is 

increasing. CME of the future will take place at the 

point of care. Two new and critical issues are emerging 

as CME becomes mandatory for many physicians: 

1 Who regulates CME? Government or the 

profession? 

2 Who pays for CME? Government? Physicians? 

Health insurance? Pharmaceutical Industry? 

Medical educators in Europe have a major opportunity 

to take a leadership role.

2G5 Do we need consultant appraisal? 

K H Matheson 

West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ, 

UK 

There are societal and political demands for 

accountability by the medical profession in a world of 

rapid technological advances, and with better-educated 

and sophisticated consumers. No longer does “doctor 

know best”. In the UK the profession has been suffering 

from some high profile cases and a hostile media. As a 

result the government has now made consultant (senior 

medical staff) appraisal compulsory from 2001 and the 

General Medical Council will make revalidation 

compulsory for all doctors to allay public fears about 

poorly performing doctors. 

This paper will explore what is meant by “appraisal”, 

whether it is the correct mechanism to support 

revalidation, and whether it is possible to prove that 

appraisal will support doctors in improving their 

professional development and performance. There is 

tension between the formative and summative 

processes, and between a demanding public and a 

sceptical profession. 

2G6 When should clinicians be trained 

in management? 

J Clark*, R Palmer and P Spurgeon 

Health Services Management Centre, University of Birmingham, 

Park House, 40 Edgbaston Park Road, Birmingham, B15 2RT, 

UK 

The involvement of clinicians in management is an 

objective pursued increasingly by most health systems. 

In part this reflects a concern to control costs but also 

a need to provide a proper integration of clinical and 

managerial perspectives. Many senior clinicians arrive 

in managerial roles with relatively little managerial 

Session 2H Selection 

2H1 Selecting aboriginal students to 

health professional courses 

I E Rolfe* and G Garvey 

University of Newcastle, Discipline of Aboriginal Health, Level 

1 MSB, Faculty of Medicine & Health Sciences, University Drive, 

Callaghan 2308, AUSTRALIA 

Aboriginal students are greatly under-represented in 

health professional courses in Australia. The reasons 

for this are a complex interplay of historical, social, 

cultural, economic and political factors resulting in the 

inequity of access to higher education. There is an 

imperative to develop culturally appropriate methods 

which will increase the numbers of applicants to health 

professional courses and then the candidates most likely 

to succeed at these University courses. The Faculty of 

Medicine & Health Sciences has a long and successful 


- 4.13 - 

training. Subsequent provision can often feel urgent 

and remedial. In a more planned sense, there is a need 

to address the clinical educational curriculum to 

examine how best the ‘what’ and ‘when’ of managerial 

teaching might be incorporated. This paper reports the 

findings of a survey of a range of clinical staff 

(undergraduates, junior doctors and consultants) and 

health service managers about the key content areas of 

management training and their varying perceptions of 

where within the educational spectrum the most 

appropriate and relevant time for training might be. It 

also explores how such training could be provided. 

2G7 Evaluation of ‘Distance Interactive 

Learning in Obstetrics and 

Gynaecology (DIALOG)’ 

Vikram Jha*, Sean McAleer and Sean Duffy 

St James’s University Hospital, Academic Department of 

Obstetrics & Gynaecology, Level 9, Gledhow Wing, St James’s 

Hospital, Leeds LS9 7TF, UK 

In recent years, there has been an increase in the 

production of computer assisted learning programmes. 

‘DIALOG’ is a distance learning programme, available 

on CD-ROM, developed by the Royal College of 

Obstetricians and Gynaecologists for continuing 

professional development. The aim of the study was to 

determine if DIALOG was achieving its educational 

objective and to receive feedback from its users. A 

literature review was carried out to select a suitable 

model for evaluation. The CIPP model (Context, Input, 

Process and Product) was used to design a 

questionnaire. This was posted out to 150 users selected 

by systematic randomisation. A response rate of 60% 

was achieved. There has been a positive response from 

users in terms of content, design, presentation, 

interactivity and outcome. The educational objectives 

of DIALOG are being achieved. 

history of admitting Aboriginal medical students. The 

medical school has graduated approximately 60% of 

the nations’ Aboriginal doctors. Given the Faculty 

incorporates now a range of other health professional 

courses, we revised our selection method to meet four 

broad aims: 

1 Suitability for selecting students to all health 

professional courses, 

2 Incorporation of best evidence literature, 

3 Determination in large part by Aboriginal peoples 

and, 

4 Cultural appropriateness of the selection process.

2H2 Demographic and scholastic 

correlates of scores in the 

Australian Undergraduate Medical 

and Health Sciences Admission 

Test (UMAT) 

Peter Tutton*, Chris Browne, Margot Story and Michael 

Lewenberg 

Monash University, Department of Anatomy and Cell Biology, 

Post Office Box 13C, Victoria 3800, AUSTRALIA 

The UMAT is an aptitude test used for selection of 

medical students. It is an MCQ with three components 

– Book 1, logical reasoning & problem solving – Book 

2, human interaction skills and Book 3, non-verbal 

reasoning (a group embedded figure test measuring 

field independent cognitive style). Despite its wide use, 

little is known about the demographic or scholastic 

attributes of candidates scoring well on the UMAT. In 

this study correlations between UMAT scores and both 

family demographic variables and concurrent scholastic 

achievements are analysed. UMAT Book 1 scores were 

weakly associated with duration of family residence in 

Australia and with managerial and professional parental 

occupation: they were more strongly associated with 

concurrent scholastic achievement, particularly in 

biology. UMAT Book 2 scores had no conspicuous 

association with any of our demographic or scholastic 

variables, nor with selection interview scores. UMAT 

Book 3 scores most strongly associated with scholastic 

achievement in physics. 

2H3 Can we make the interview add 

something new? 

P Hughes, S Miller*, P McCrorie and A Kent 

Department of Psychiatry, St George’s Hospital Medical School, 

Hunter Wing, Cranmer Terrace, London SW17 0RE, UK 

There is evidence that in selecting for complex task 

performance the best predictor is some measure of IQ. 

A structured interview may add a useful degree of 

prediction. It is important, however, to ensure that the 

interview does not simply re-assess intelligence. We 

used a two-stage process to select for our Graduate 

Entry Programme. The GAMSAT assesses reasoning 

in sciences and humanities and writing ability. Highest 

scoring applicants were invited for interview. We 

devised an interview with high face-validity and 

reduced opportunity for bias by blinding interviewers 

to social and academic variables, and by introducing 

structured objective criteria. The interview appeared 

acceptable to interviewers and candidates. We 

demonstrated that performance at interview did not 

correlate with recent or previous academic performance 

so was adding something to academic assessment. 

Follow up of successful candidates will address the 

important question of the predictive validity of this 

selection process. 

2H4 Relative effects of learning style, 

MCAT and prior academic record 

on performance in medical school 

Stephen Aaron* and Ernest Skakun 

Department of Rheumatology, 562 Heritage Medical Research 

Centre, Faculty of Medicine and Dentistry, University of Alberta, 

Edmonton, Alberta T6G 2S2, CANADA 


- 4.14 - 

Several studies have demonstrated that previous 

academic record does not fully predict success in 

medical school. We hypothesized that student learning 

styles would also correlate with medical school grades, 

independently of MCAT or prior academic record. We 

correlated learning style to marks in our largest and 

most integrated first year course (in Cardiology, 

Pulmonology and Nephrology, CPN), using the ASSIST 

instrument. Negative correlation was found between 

CPN and surface learning style (SL) assessed after the 

course was completed (r = -.247, p = .038). Significant 

correlation was also found between CPN and student 

MCAT results (r = .263, p = .027), but not to grades 

prior to medical school admission (GPA). There was 

no correlation between SL and MCAT (r = .053). 

Correlation between SL and CPN was independent of 

MCAT or GPA. We conclude that learning style is 

predictive of medical school grades independently of 

prior academic record. 

2H5 The selection of GP trainees in 

the West Midlands: audit of 

assessment centre scores by 

ethnic background and country 

of qualification 

Celia Brown*, Sarah Wakefield and Alison Bullock 



B15 2TT, UK 

The new centralised system of selecting GP trainees in 

the West Midlands aims to be fair and nondiscriminatory 

in the processes of recruiting the most 

suitable candidates, and allocating the successful 

candidates to their preferred posts. This paper provides 

an audit of the achievements of all the candidates in 

the October 2000 selection round. The data are 

examined with respect to candidates’ ethnic 

background and their country of qualification. Two 

levels of analysis are possible, based on average 

‘success’ or placement rates, and average scores 

achieved at each stage of the selection process. The 

analysis suggests that white candidates, and those 

qualifying in the UK, are more likely to succeed in the 

selection process. Possible explanations are offered 

from a more detailed interrogation of the selection 

criteria. Finally, the implications for the next selection 

round are discussed in the light of these findings. 

2H6 The selection of GP trainees: 

perceptions of the new regional 

system 

Sarah Wakefield*, Celia Brown and Alison Bullock 



B15 2TT, UK 

A new regional system of selecting GP trainees has 

been introduced in the West Midlands, replacing 

selection by individual GP practices. Perceptions of the 

regional system amongst key stakeholders were 

explored as part of a larger study evaluating the West 

Midlands selection procedures in October 2000. Data 

were collected by interview (with organisers, GP 

trainers, assessors and candidates) and questionnaire

(to candidates: 46% response rate). The analysis 

revealed that the new process was viewed positively, 

with particular praise for the role-play assessment and 

the inclusion of a lay-person on the interview panels. 

Many thought that the new system was fairer than the 

old. Concerns were expressed that the process was 

impersonal, and that candidates had less control over 

their choice of practice location. The implications for 

future selection rounds, and for other regions 

considering regional selection systems, will be explored 

in the presentation. 

2H7 “I want to become a doctor.” 

Analysis of first year students’ 

motivations 

M F Patrício* and J Gomes-Pedro 

Faculdade de Medicina de Lisboa, University of Lisbon, Av Prof 

Egas Moniz, Piso 1, 1649-028 Lisboa Codex, PORTUGAL 

The psychological and cultural basis for career choice 

is a poorly researched subject. The objectives of the 

present study were to identify, after 6 months in Medical 

School, the reasons why students decided to be a doctor 

and whether they would make the same choice again 

Session 2I Educating the educators (1) 

2I1 Evaluation of a Train the Trainers 

program in quality improvement 

and cost-effectiveness 

Antoinette S Peters*, Maryjoan Ladden and Robert 

Fletcher 

Department of Ambulatory Care & Prevention, Harvard Medical 

School and Harvard Pilgrim Health Care, 126 Brookline Avenue, 

Boston, MA 02215, USA 

A 4-month program was developed to teach community 

and academic physicians how to teach “managing care” 

competencies, especially quality improvement and 

cost-effectiveness. Interactive and didactic methods 

were used to teach the competencies, learning theory, 

and evaluation; different pedagogical methods were 

also modeled. Participants submitted a project plan, 

attended two 2-day workshops with a partner, revised 

their plans, and practised new methods at their home 

institutions. Ratings of their own knowledge of quality 

improvement and cost-effectiveness increased 

significantly. Knowledge of traditionally taught 

content, such as prevention and patient-doctor 

communication, was not affected. Participants’ ratings 

of their skill in teaching using different methods and 

in developing and evaluating teaching innovations 

increased significantly. There was smaller change in 

self-ratings of skill in giving a lecture, precepting in 

the office, and teaching at the bedside than in leading 

interactive large groups, giving feedback, or tutoring 

small groups. 


- 4.15 - 

given a second opportunity. First year students (n=153) 

were asked to complete an open-ended questionnaire. 

Protocols were treated through content analysis 

technique. The study found that students made their 

professional choice mainly for: 

• altruistic motivation or social desirability: help 

people 75% / useful to society 24%; 

• self motivations: loving medicine 29%, safe career 

22%, personal achievement 17%, lack of routine 

8%, prestige/status 7%, child dream 4%, family 

tradition 3%. 

After 6 months when asked if they confirm their initial 

choice: 

• 39% confirm it enthusiastically 

• 51% just confirm 

• 8% hesitate 

• 2% do not confirm. 

Correlations between the reasons underlying the 

professional option and the degree of enthusiasm will 

be explored. Implications for the student selection 

process will be presented. 

2I2 Teaching the Medical Teachers 

Beyond ‘TIPS’ 

Jane Richardson* and Jonathan D Cartledge 

University College London, 4th Floor, Holburn Union Building, 

The Archway Campus, Highgate Hill, London N19 3UA, UK 

Since 1999, 30 ‘TIPS’ courses have been run at 

RF&UCMS. The results of post course questionnaires 

obtained from 256 (70%) of 366 participants informed 

the development of further courses. Participant 

identified areas for further training were: Clinical and 

bedside teaching; One to one teaching; Teaching larger 

groups; Presentation skills; Group dynamics and small 

groups. As a result of this feedback three follow up 

courses have been designed and piloted. The “TIPS” 

name was maintained because of the positive 

association. “TIPS 2” focuses on clinical/bedside 

teaching and student and course factors affecting 

learning. “TIPS 3” focuses on large group teaching and 

presentation skills. “TIPS 4” focuses on small group 

teaching and facilitation skills. “Microteaching”, voted 

the most helpful aspect of TIPS 1, has been retained as 

an opportunity for individualised feedback and putting 

theory into practice. Full details of objectives, content, 

teaching plans and feedback for these courses will be 

presented.

2I3 Formal courses in further training 

of medical teachers 

M Vrcic-Keglevic*, Z Jaksic, G Pavlekovic, N Pokrajac, A 

Smalcelj and B Vrhovac 

“A.Stampar” School of Public Health, Medical School, University 

of Zagreb, Rockefellerova 4, 10000 Zagreb, CROATIA 

The Croatian Association of Medical Education has 

been organising two types of attitudes aimed at further 

training of medical teachers; interactive workshops for 

experienced and formal courses for less experienced 

teachers of one week duration. The main aim of the 

formal courses is to help young teachers acquire basic 

pedagogical knowledge, skills and attitudes. Therefore, 

the following items have been covered: a psychology 

of learning; the principles of adult learning; curriculum 

development; giving a lecture, clinical teaching and 

tutorials; working in a small group; use of educational 

tools; and current developments in medical education. 

Special interest is paid on development of education 

methods, planning a timetable, defining the methods 

of evaluation and assessment. Since active learning is 

the most important, work in a small group, on individual 

projects and at plenary discussions occupy most of the 

time. Assessment consists of three parts: pre-course, 

written essay and MCQ, post-course MCQ, and 

preparation and presentation of an educational module. 

The participants are provided with a CME diploma in 

medical education - an important prerequisite for a 

teacher’s advancement. 

2I4 Supporting Clinicians on Training 

in Scotland 

Rose Martin, on behalf of Supporting Clinicians on 

Training in Scotland Working Group 

SCPMDE, Postgraduate Office, Level 7, Ninewells Hospital and 

Medical School, Dundee, DD1 9SY, UK 

A successful collaboration between Scottish Council 

for Postgraduate Medical & Dental Education 

(SCPMDE) and the Scottish Royal Colleges has 

resulted in the development of a Scottish based course 

to support clinical trainers. The SCOTS Course 

(Supporting Clinicians on Training in Scotland) is 

unique in its content, providing instruction on 

assessment and appraisal, skills training, teaching and 

training method, reflective practice, objective setting 

and a strategy to manage poor performance, delivered 

using many teaching styles. This two-day intensive 

course is aimed primarily at Consultant Educational 

Supervisors, and it is hoped that it will be delivered to 

Specialist Registrars in early 2001 in a modular format. 

It is designed to enable trainers to provide an effective 

educational experience for their trainees. The positive 

evaluations of the course and the plan to run ten SCOTS 

Courses in Scotland in 2001 will ensure its position in 

the innovative field of Medical Education. The initiative 

and its evaluation will be presented in depth and its 

effectiveness in relation to practice will be discussed. 

2I5 Improving own teaching skills 

identified as a top priority by 

Registrars 

Iwona Stolarek 

Hutt Hospital, Private Bag, Wellington, NEW ZEALAND 


- 4.16 - 

In order to ascertain the educational needs of Medical 

Registrars, a questionnaire study was carried out at Hutt 

Hospital. This was to allow the development of an 

educational programme to address these specifically. 

The 12 registrars were sent a 7-point questionnaire. 11/ 

12 (92%) responded with the non-responder being a 

locum UK doctor. Ninety percent of the respondents 

were aiming at a hospital consultant career and 82% 

were currently sitting higher exams. None had 

educational supervisors though 82% felt these would 

be useful and were keen to develop log-books or 

learning diaries. In terms of learning need priorities, 

help with teaching skills was ranked the number one 

priority along with both exam practice and presentation 

skills by 82% of the registrars. This small pilot study 

has shown that junior doctors rate help in improving 

their teaching skills as highly as exam passes. 

2I6 Dissemination of teaching of 

medical interviewing and physical 

examination in Japan 

N Ban*, M Hatao, J Ohtaki, M Fujisaki, C Nakamura, T 

Tsuda, T Matsumura and M Shimo 

Nagoya University School of Medicine, Department of General 

Medicine, Place 65, Tsurumai-cho, Showa-ku, Nagoya 466- 

8560, JAPAN 

The objective of the study was to evaluate the effects 

of the nationwide faculty development workshop, 

sponsored by the Japan Society of Medical Education, 

on the teaching of medical interviewing and physical 

examination in Japanese medical schools. A 

questionnaire was sent to all 94 medical educators from 

54 of the 80 Japanese medical schools that participated 

in the workshop in 1996, 1997 and 1998. The response 

rate was 77.8%. Thirty schools (71.4%) reported 

substantial curriculum changes in interviewing and 29 

schools (69.1%) in physical examination courses. Out 

of 25 Japanese medical schools where standardized 

patients (SP) are currently used, 16 (64%) started to 

use SP as a result of the workshop. Among 24 schools 

that currently use Objective Structured Clinical 

Examination (OSCE), 18 (75%) initiated OSCE after 

the workshop. The faculty development workshop on 

teaching medical interviewing and physical 

examination is helping to change undergraduate 

medical education in Japan. 

2I7 Transformational learning in a peer 

teaching programme 

Angel M Centeno*, Alexandra Blanco and Soledad Campos 

Faculty of Biomedical Sciences, Universidad Austral-Medicina, 

Av J Peron 1500, B1629AHJ Derqui, Pilar, Pov Buenos Aires, 

ARGENTINA 

Students’ personal attitudes towards learning after their 

participation in a programme of teaching skills for 21 

medical students acting as peer teachers are described. 

After completing the program we analysed data from 

four different areas: identification of teaching 

difficulties, perceived personal changes, change in 

studying approaches and the ability to understand 

faculty’s actions. The difficulty in facing their peer 

students, and to adapt to the role of a teacher with their

peers; the increased ability to work successfully in a 

team, and to become self confident, and improve their 

own learning skills (which led to better grades in their 

exams); and an increased understanding of their own 

faculty’s actions were the more important changes they 

- 4.17 - 

mentioned. These data, despite the small number of 

students, show that our students have not only acquired 

pedagogical skills, but they have gone through a 

personal transformational learning experience. 

Session 2J Simulation and clinical skills training 

2J1 Teaching clinical skills to medical 

students using the clinical skills 

laboratory with a new simulator and 

new tools 

I Yoshida*, T Ueno, M Hotta, H Abe, I Kubara, S Kono, Y 

Ogo, S Watanabe, A Hayashi, T Akagi, S Okuda and M 

Sata (Working Group on teaching basic clinical skills) 

Office of Medical Education, Kurume University, School of 

Medicine, 67 Asahi-Machi, Kurume 830 0011, JAPAN 

The objective of the study was to evaluate the usefulness 

of the clinical skills laboratory (CSL) to learn basic 

clinical skills. The CSL was introduced to medical 

students to learn the medical interview, physical 

examination, resuscitation and X-ray film reading. A 

questionnaire was sent to the students. The results 

showed that the CSL was useful to 61% of the students; 

especially the new cardiology patient simulator “Ichiro” 

was appreciated by 90% of the medical students. 

2J2 Training in vaginal examination 

technique using the ‘epelvis’ 

C M Pugh* and M S Marsh 

GKT Medical School, Academic Department of Obstetrics & 

Gynaecology, 9th Floor, Ruskin Wing, King’s College Hospital, 

Bessemer Road, London SE5 9PJ, UK 

Undergraduate medical students find it increasingly 

difficult to learn the technique of vaginal examination 

(VE) using real patients. A pelvic mannequin has been 

developed which incorporates pressure sensors over 

important points within the pelvis, eg. the uterine 

fundus, cervix and ovaries. These sensors enable the 

duration and magnitude of pressure applied to parts of 

the pelvic organs during a pelvic examination to be 

measured and stored electronically. The data can be 

represented visually and may be seen by the student 

during the examination as an aid to teaching. A large 

database of “epelvis” examinations from vaginal 

examinations by undergraduates and postgraduates has 

been collected. The epelvis has considerable potential 

for the training and assessment of vaginal examination. 

2J3 Training medical students to 

perform vaginal examination using 

the ‘epelvis’ 

M S Marsh* and C M Pugh 

GKT Medical School, Academic Department of Obstetrics & 



We have examined medical student training in vaginal 

examination (VE) using a pelvic mannequin (“epelvis”) 

incorporating pressure transducers, enabling online 


visual feedback of the pelvic areas examined. 74 

students underwent a test of VE using three pelvic 

models, followed by epelvis training, followed by 

testing using two other pelvic models. Before testing 

33% had performed >5 VEs on subjects and 55% had 

used a pelvic mannequin. The number of previous VEs 

or mannequin training was unrelated to the ability to 

estimate the size of the uterus correctly in pre-training 

tests. There was no improvement in ability to determine 

the size of the uterus after training in the whole group. 

However, in those students that had performed >5 VEs 

prior to testing, those able to judge uterine size correctly 

rose from 66% to 92% (P

programmatic evaluations. More innovative approaches 

such as incorporating both technological and human 

simulation in a multi-modal learning experience, and 

implementing an OSCE that serves both a needs and 

outcome assessment purpose (measuring consistency 

in learning across multiple clerkship sites in order to 

direct specific educational interventions) will be 

described. 

2J6 Using scenario based teaching to 

deliver feedback on technical and 

communication skills 

R L Kneebone*, J Kidd, D Nestel, B Paraskeva, S Asvall 

and A Darzi 

Academic Surgical Unit and, Department of Cognitive 

Neuroscience & Behaviour, Imperial College School of Medicine, 

10th Floor QEQM, Praed Street, London W2 1NY, UK 

- 4.18 - 

Technical skills and communication skills are 

inseparable in clinical practice but are often taught in 

isolation. Skills labs commonly use benchtop models 

for teaching core skills, but often away from their 

clinical context. Our solution bridges this gap by linking 

standardised patients (SPs) and inanimate models 

within a structured learning framework. Students work 

within a ‘safe zone’ to practise technical skills without 

jeopardising patient safety. They talk and listen to their 

‘patient’ (the SP) while carrying out procedures (e.g. 

wound closure, urinary catheterisation) in realistic 

clinical scenarios. Procedures are observed by tutors 

and simultaneously videotaped. After each procedure, 

the student writes down personal reflections, then tutors 

and SPs provide verbal feedback on salient points. Each 

student reviews their videotape, using formative rating 

scales to assess technical and communication skills. 

Qualitative data from 35 undergraduate medical 

students will be presented to outline the development 

of this approach to giving feedback. 

Session 2K Students and curriculum evaluation 

2K1 Teaching quality questionnaire: 

students’ evaluations of standard 

learning activities in an integrated 

curriculum 

Øyvind Ellingsen*, Kristin Wigen and Are Holen 

Norwegian University of Science & Technology, Department of 

Physiology and Biomedical Engineering, Medical Technical 

Center, NO-7489 Trondheim, NORWAY 

Sound evaluation routines are important to improve the 

standard of medical education. In an integrated 

curriculum it is often useful to evaluate individual 

clinics, seminars or lectures rather than large blocks of 

learning activities. We therefore developed a 

questionnaire to assess the quality of standard learning 

activities such as clinics, lectures, seminars and 

workshops. The students rated all presentations on five 

items, including structure and illustrations, oral 

presentation, dialog with students, relevance according 

to stage of study and future profession and inspiration 

for further studying, using a 1-5-9 scale. In evaluations 

of 125 learning activities by 43 first year medical 

students the five items clustered into one single factor, 

representing overall teaching quality. The teaching 

quality score identified 6 learning activities that 

required revision (mean score

placement. 13% of students are concerned that their 

evaluation will affect their grades. We will discuss the 

implication of these findings on the procedures for 

collecting attributable evaluation material. 

2K4 Student evaluation of educational 

quality: the construction of a 

multidimensional questionnaire 

Volkhard Fischer 

Hannover Medical School, OE 9103, Rectors Office, 30623 

Hannover, GERMANY 

Educational quality is a complex construct. Marsh has 

developed a differentiated questionnaire for student 

evaluations of educational quality which is widely 

accepted. Our 37-item questionnaire is a localized 

version of this general questionnaire (SEEQ) adapted 

for the evaluation of medical courses in Germany. The 

items concerning the factor work load were formulated 

as bipolar questions on seven-point scales. The 

midpoint was labeled “appropriate”. The other items 

had a unipolar format with six grades from “not true” 

to “true” and an extra checkbox “does not apply”. The 

global rating of the course had to be made on a 16point 

Likert scale. The theoretical model was tested in 

a confirmatory factor analysis for the whole sample 

and several evaluative factor analyses for selected 

courses. Discrepancies between the theoretical model 

and the empirical results were discussed and integrated 

into an exploratory model. 

2K5 Evaluation of lectures in medical 

teaching based on focal groups 

and a survey of opinion to 

formulate a guide of practical 

recommendations 

Juan Cristóbal Maass, Lorena Tapia, Marcela Jacard, and 

Teresa Millán 

Depto. de Pediatría y Cirugía Infantil, Facultad de Medicina, 

Universidad de Chile 

In spite of new tendencies, in Chile lectures are mainly 

used in medical teaching. Our objective was to find 

out students’ opinions about aspects that influence 

quality of lectures, with the purpose of formulating a 

guide of practical recommendations (GPR). A survey 

was designed based on focal groups and applied to 181 

5th year students. We evaluated different aspects of 

lectures (teacher; content, dynamics and structure; 

support material; and atmosphere). Of 113 students 

interviewed, 96.4% think that it would be useful to have 

a GPR for lecturers. Positive practical aspects of lectures 

highlighted were: delivery of lecture notes (93.8%); to 

give practical details (98.2%); and to give a summary 

(94.5%). Among negatives: that lectures were carried 

out in the afternoon (94.6%); lasted longer than 

foreseen (94.7%); and small fonts were used in 

projection (92.9%). We intend to discuss this guide 

based on the opinions obtained, showing aspects not 

traditionally considered. 


- 4.19 - 

2K6 Use of a Continuous Quality 

Improvement (CQI) model to 

enhance curriculum evaluation and 

integration 

Nehad El-Sawi 

University of Health Sciences, 1750 Independence Avenue, 

Kansas City, MO 64106, USA 

Course evaluation is one of the corner stones for the 

documentation of the educational process quality. CQI 

is a process of constructive self study that encourages 

participation of all students and faculty in order to 

maximize the benefit of the evaluation process. Eight 

essential activities involved in course delivery are 

identified. A written survey is designed to evaluate 

these activities. The survey is administered at the end 

of each course and the entire class results are tabulated 

as the comprehensive evaluation. Students are assigned 

to CQI teams before each course begins and are 

responsible for reviewing the comprehensive 

evaluation, drafting a one-page consensus report, 

prioritizing improvements that could enhance student 

learning and presenting the report to faculty and 

curriculum committee. The CQI evaluation model 

produced a more effective, meaningful and constructive 

evaluation while building interdisciplinary team skills 

and professional behavior among medical students. 

2K7 New faculty-level self-evaluation 

instruments 

K Lonka*, N Paganus, T Hatonen, A Heikkila, J Vainio 

and J Nieminen 

University of Helsinki, Leiviskatie 2 E 64, Fin-00440 Helsinki, 

FINLAND 

The Faculty of Medicine at the University of Helsinki 

began to evaluate and reform its curriculum of medical 

studies in 1994. This process resulted in Helsinki 2000, 

a hybrid-PBL curriculum, which was introduced in 

1998. A systematic programme was also integrated to 

support students’ personal growth and to advance their 

communication and thinking skills, called Professional 

Growth of Medical Students. 

In order to see how well these reforms have been 

implemented, we developed a set of evaluation 

instruments. Questionnaires and observation methods 

were applied for both students and teachers. The data 

are extensive, and some examples are presented here. 

The final goal is to finish a self-evaluation report for 

the international evaluation of all studies and 

programmes of the University of Helsinki, which will 

take place in the years 2001-2002. 

2K8 The doctors’ opinion - a national 

evaluation of Swedish medical 

education 

Anders Bengtsson, Kerstin Johansson and Sara Engstrom* 

Swedish Medical Association, Sveriges Lakarforbund, PO Box 

5610, S-11486 STOCKHOLM, SWEDEN 

In autumn 2000, the Swedish Medical Association sent 

out a questionnaire in order to evaluate Swedish medical 

education. Junior doctors were asked to assess medical 

education in relation to the declared objectives. They

were also asked whether they thought the objectives 

were relevant. The questionnaire was sent to all 743 

members who had been registered in 1999 (they had 

been working for approximately 3-4 years). More than 

90% replied to the questionnaire. This is the first time 

a survey including all doctors from all six universities 

Session 2L Multiprofessional education 

2L1 Interprofessional learning: the New 

Generation Project 

Debra Humphris* and Chris Stephens* 

The Department of Medical Education, Office of School of 

Medicine, University of Southampton, MP 801 Level C, South 

Academic Block, Southampton General Hospital, Southampton, 

SO16 6DY, UK 

At the University of Southampton the undergraduate 

BM course takes place within a multiprofessional 

Faculty of Medicine, Health and Biological Sciences, 

which includes the School of Nursing and Midwifery, 

the School of Health Professions and Rehabilitation 

Sciences and the School of Biological Sciences. The 

rich mix of professional programmes within the Faculty 

has led over the past decade to numerous developments 

in interprofessional learning and practice. The Faculty’s 

commitment to building on its experience of 

interprofessional learning is reflected in its strategic 

plan, and the establishment of the New Generation 

Project. This bold project will enable the Faculty to 

demonstrate its contribution to the modernisation of 

education and training for the health and social care 

workforce. The process of these changes within a large 

educational organisation will be explored and 

discussed. 

2L2 “Walking in the moccasins of 

others”: reflections on a new 

initiative to bring the real world of the 

patient into the medical curriculum 

Lyn Brown 

University of Liverpool, Community Studies Unit, Department 

of Primary Care, Whelan Building, Quadrangle, Brownlow Hill, 

Liverpool L59 3GB, UK 

Community Placements are an essential feature of the 

Liverpool University Undergraduate Medical 

Curriculum. They are designed to give students contact 

with all aspects of health and medicine outside the 

immediate confines of hospital and general practice. 

During second year, placement in community health 

services, statutory and voluntary social work agencies, 

and supervised University based groups, provide 

excellent learning opportunities that complement other 

aspects of the students’ learning. Without diminishing 

the bio-medical approach to health-care, placements 

enhance the students’ learning by developing a broader 

view of health and disease that includes psychological 

and socio-economic factors. This would seem to offer 

students wider options in management of ill-health and 

disability; effecting involvement with, and better long 

term care of, their patients. This paper describes the 

methods, evaluations and outcomes set in place to 

achieve the above. 


- 4.20 - 

has been carried out. The survey is intended to be 

carried out annually, thus providing a series of results 

at national level, as well as an impact assessment of 

the new curricula which are being implemented in 

Swedish medical schools. The results will be presented 

at the conference. 

2L3 Multiprofessional education in 

health care ethics in Germany 

Jochen Vollmann 

Freie Universitat Berlin, Arbeitsgruppe Ethik in der Medizin, 

Institut fur Geschichte der Medizin, Klingsorstr. 119, D-12203 

Berlin, GERMANY 

In Germany only very limited practical experience and 

knowledge in teaching of medical ethics and ethics of 

health care is available. German medical schools do 

not offer regular ethics teaching, whereas the 

“Reformstudiengang Medizin” at the Charité in Berlin 

provides some teaching blocks in medical ethics. 

Graduate ethics training in nursing sciences, public 

health and social work varies widely. Since 1995 the 

author teaches ethics to medical students as well as 

students in public health, nursing and social work at 

various universities in Berlin and the U.S. In this short 

communication preliminary data from a 5 year pilot 

study are presented. Different demands, approaches and 

evaluation results of ethics teaching in the different 

professional graduate courses are presented. Pro and 

cons of ethics teaching in the various professional 

programs are compared with the multiprofessional 

approaches in the Berlin program of public health and 

at the Evangelische Fachhochschule Berlin. 

2L4 Dilemmas in resuscitation: nursing 

and medical students’ responses to 

ethical professional issues related 

to resuscitation of patients 

C Edward*, J Crosby and P E Preece* 

University of Dundee, School of Nursing & Midwifery, Tayside 

Campus, Ninewells Hospital & Medical School, Dundee 

DD1 9SY, UK 

At the University of Dundee a three hour teaching 

session involving 280+ nursing and medical students 

took place in 1999. The aim was to enable the students 

to explore and debate, together, the ethical/professional 

issues inherent within resuscitation. An automated 

audience response test containing 5 set questions was 

given to the students immediately pre/post the session. 

Two significantly different responses were related to: 

• Who should have the major say in advanced 

decisions of resuscitation? (Doctor, Nurse, Patient, 

Relatives, Team). Team-Pre: Nursing 66% Medical 

78%. Post: Nursing 97% Medical 89%. 

• Should close relatives be permitted to witness 

resuscitation? Permit-Pre: Nursing 63% Medical 

12%; Post: Nursing 55% (still permit) Medical 29% 

(now in favour).

Analyses were by Wilcoxon and Mann-U-Whitney 

tests. Written comments from students were 

encouraging and in 2000 the topic of resuscitation was 

established as part of each student programme for third 

year nursing/medical students. 

2L5 Promoting the use of clinical 

guidelines in Scotland 

Bernice West* and Peter Wimpenny* 

Robert Gordon University, Centre for Nurse Practice Research 

and Development, School of Nursing and Midwifery, Northern 

College, E Block, Hilton Drive, Aberdeen AB24 4FP, UK 

The initiative was funded by the National Board for 

Nursing, Midwifery and Health Visiting for Scotland 

and jointly managed by the Centre for Nurse Practice 

Research and Development at the Robert Gordon 

University, Aberdeen and The Royal College of Nursing 

Institute. The initiative’s aims were to increase nurses’ 

knowledge and skills in using clinical guidelines. The 

initiative clearly demonstrated the need for 

multiprofessional involvement in all aspects of clinical 

guidelines. The educational approach comprised: 

• Identifying a Local Facilitator; 

• Introducing key skills for multiprofessional 

guideline implementation through five Open/ 

Distance Learning modules covering guideline 

choice, appraisal, implementation strategies and 

evaluation; 

• Supporting Local Facilitators by: (1) regular contact 

with education providers, (2) problem solving group 

work at workshops, (3) provision of a buddy who 

has clinical and/or change management expertise. 

Implementing clinical guidelines is a complex activity 

that demands multiprofessional education and 

intervention. Recommendations for such provision will 

be presented. 

2L6 Can Neuropsychiatry training be 

successfully delivered in a multiprofessional 

setting? 

Andrew Parkin* and Nisha Dogra 

University of Leicester, Greenwood Institute of Child Health, 

Westcotes House, Westcotes Drive, Leicester LE2 1SF, UK 

Session 2M Student support/psychiatry and the curriculum 

2M1 An evaluation of student support 

systems at the Medical School at 

Queen’s University Belfast 

Nicola Wilson, David McCluskey and Mairead Boohan* 

Queen’s University of Belfast, Medical Education Unit, Room 

145 Whitla Medical Building, 97 Lisburn Road, Belfast BT9 

7DL, UK 

The Faculty Tutorial Scheme at the Medical School at 

Queen’s University Belfast was established in 1984 to 

provide pastoral support for students. During 1999 

qualitative and quantitative research techniques were 

used to evaluate this support mechanism. Questionnaire 


- 4.21 - 

A half-day training course on epilepsy in child mental 

health was devised for a multi-professional audience. 

Evaluation included delegates’ self-reported 

knowledge, attitudes, and perception of the course. 83 

professionals attended, representing related disciplines. 

81 completed a pre-, 73 a feedback, 65 a post-, and 18 

an eight-month follow-up questionnaire. Most reported 

the learning objectives to be clear (85%) and met (80%), 

the course was structured to facilitate learning (78%), 

links were made with clinical practice (78%), and they 

had questioned their own practice as a result (72%). 

Correct responses to knowledge questions rose (56% 

to 91%), incorrect (7% to

suggest that while this scheme was seen as innovative 

it still has limitations. 

2M2 Is student abuse a problem in our 

medical school? 

Ana Maida*, Alicia Vasquez, José Calderon, Viviana 

Herskovic, Marcela Jacard, Ana Pereira and Lars Widdel 

University of Chile, Facultad de Medicina, Universidad de Chile, 

Departamento de Pediatría, Campus Oriente, Casilla 16117, 

Correo 9, Providencia, Santiago, CHILE 

The purpose of this study was to determine the 

incidence, and the consequences, of abusive situations 

as perceived by students during the course of their 

Medical training. A descriptive study was made 

surveying the entire 2000 fifth year class in the Medical 

School of the University of Chile. The questionnaire 

was answered by 144 students. Results showed that 

91.7% of the students had suffered at least one episode 

of abuse while enrolled in Medical School. Main 

offenders were teachers and peers. Verbal abuse was 

the most common (85.4%), followed by psychological 

(79.9%), sexual (26.4%) and physical (23.6%) abuse. 

Students reported that abuse had effects on their mental 

health, social life and the image they had of physicians; 

17% considered dropping out of school as a 

consequence of this experience. The high proportion 

of teachers involved in situations perceived as abusive 

by students should prompt educators to reflect on their 

role. 

2M3 First year medical, nursing and 

pharmacy students’ approaches to 

study 

R J Lamdin* and I Martin 

9A Sentinel Road, Herne Bay, Auckland, NEW ZEALAND 

The Approaches to Study Inventory (ASI) was 

administered to first year health sciences students prior 

to course commencement at the University of 

Auckland.This was to aid understanding of approaches 

to study in a large multi-professional first year 

programme. Prior to 1999 medical students in the 

Faculty of Medical and Health Sciences were taught a 

unique course but as of 2000, nursing and pharmacy 

students were admitted to new nursing and pharmacy 

programmes. In the first year, medical, nursing, 

pharmacy and general health science students share 

common courses. Each group of students is admitted 

via different admission systems and goes on to complete 

different programmes of study. This project describes 

the learning styles of the first year students using the 

ASI and considers the importance of this knowledge 

in teaching. Consideration of gender and age 

differences and the possible effect of different 

admission systems will be undertaken. 

2M4 Changing medical students’ 

attitudes towards homosexuality 

Itzchak Levi* and Tsvi Fischel 

Sackler Medical School, 13/2 Tsel Hagivaa, Ramat Gan, ISRAEL 

In many surveys it is found that many physicians hold 

negative attitudes towards homosexuality. In addition, 

due to negative experience many gay people feel 


- 4.22 - 

uncomfortable to report to their physician about their 

sexual orientation. As well as the fact that gays have 

unique health conditions, they do not tend to share with 

their physician even their general health problems, and 

not even problems concerning preventive medicine. In 

view of the above, it is interesting that most medical 

schools do not include in their curriculum a place to 

teach “homosexuality”. Attitudes towards 

homosexuality can be changed through workshops and 

active learning. Two case studies were discussed and 

processed by medical students in their pre clinical 

studies as part of the behavioral sciences course. The 

students showed a high level of satisfaction. Case 

studies could be a useful tool to teach and experience 

attitudes towards gays and homosexuality in medical 

schools. 

2M5 The attitudes to Psychiatry of first 

year medical students 

R K Day 

University of Dundee, Department of Psychiatry, Level 5, 

Ninewells Hospital, Dundee DD1 9SY, UK 

For over thirty years there has been evidence that 

psychiatry is viewed negatively by medical students. 

A number of self-report questionnaires of attitudes to 

psychiatry have been constructed, of which the most 

widely used is the ATP-30. The ATP-30 was 

administered to first year medical students on their first 

day of medical school to assess their initial attitudes. It 

was also administered to a first year science class. The 

ATP-30 was also modified to inquire about attitudes 

to gynaecology and this was completed by the new 

medical students. The attitudes of new medical students 

to psychiatry do not differ from those of science 

students. However, medical students view gynaecology 

more positively than they do psychiatry. Further studies 

are required to determine how this initially negative 

view of psychiatry is affected by the medical 

curriculum. 

2M6 Psychology basic and applied 

knowledge 

Agnete Langagergaard* and Berit Eika 

Unit of Medical Education, University of Aarhus, Vennelyst 

Boulevard 9, DK 8000 Aarhus, DENMARK 

In a new medical curriculum an innovative course of 

psychology was introduced, consisting of: (1) a short 

(20 hour) 3rd term course giving a factual knowledge 

base within the domain of psychology, and (2) a longer 

(4 weeks) 7th term course where the application of 

knowledge previously acquired is trained. The short 

course is lecture based and within the framework of 

developmental psychology. Each double lecture covers 

an age span thereby making sure that students become 

aware of general as well as of age specific psychological 

issues. In the latter course a case based teaching format 

helps students develop a systematic approach to 

psychological themes relevant to the medical 

profession. Clinical psychologists introduce students 

to themes such as anxiety, minority problems, and 

psychosomatic problems. Finally, in conjunction with 

the Department of Philosophy, a topic (eg. the dying 

patient) is chosen as a returning theme covered from 

different angles.

Session 3 Workshops 1 

3/1 The roles of the teacher 

Jennifer Laidlaw and E Anne Hesketh 

SCPMDE Education Development Unit, Tay Park House, 484 


Background 

All doctors are teachers. It is a role that is constantly 

changing and is often a challenge for today’s doctors - 

especially with the many other tasks they have to carry 

out. This workshop gives the opportunity to explore 

the teaching roles and tasks that doctors might have to 

adopt whether they are doctors at the start of their 

postgraduate training or fully trained with a formal 

teaching responsibility. 

Aims 

The workshop aims to give insight into: 

the roles that today’s doctors, as clinical educators, 

have to adopt 

the associated tasks that they have to carry out 

the approaches to these tasks and the 

professionalism required of today’s educator . 

Who should attend 

Those involved in teaching in any capacity eg 

having to look after juniors, being a contributor to 

a course or a departmental teaching session, having 

formal supervision responsibilities, being a course 

organiser 

Those involved in identifying generic skills for the 

postgraduate training of doctors 

Note: This workshop is very similar to last year’s workshop 

‘12 roles of the teacher’ which was oversubscribed. Due to 

interest expressed it is being repeated in an extended format. 

Those attending last year would not gain further significant 

benefit from attending. 

Content and structure 

1 Introduction to roles (25 min): Ice breaker activity 

and short plenary with hand out; 

2 Tasks associated with roles (35 min): Group activity 

with feedback; 

3 A framework for identifying the competencies 

required by the clinical educator (15 min): Short 

plenary with time to study grid and make link to 

findings of previous group activity; 

4 Using the grid (35 min):Group activity with 

feedback; 

5 Courses in teaching from Dundee(10 min): Display 

of material from a ‘taster’ course through to a 

Diploma/Masters in Medical Education. 

3/2 The quality of medical education and 

teaching – thema con variatione 

Professor Peter Nippert 

University of Muenster, Germany 


- 4.23 - 

3/3 From MD to academic teacher 

Professor Reinhard Putz 

University of Munich, Germany 

Background 

Medical education focusses on knowledge and abilities. 

Students are faced with a lot of information including 

general understanding of processes, differential 

diagnosis and therapeutic consequences. In most 

European universities, lectures, courses and practical 

exercises on patients are the preferred teaching 

elements. Some medical schools have changed to 

problem based learning (PBL). The effectiveness of the 

teaching depends on many aspects. One is the student/ 

teacher ratio; another is the structure of the program. 

However, the education of the teacher is the last in this 

list. On the other hand, many studies show that the 

performance and personality of the teacher has the 

highest impact on the learning effect. This is especially 

true for lectures and teacher-guided courses, but also 

in PBL the tutor plays a crucial role in the learning 

process. In light of this it is surprising that academic 

teachers are not forced to undergo any kind of didactic 

training. Only few institutions offer a structured training 

program for young assistants. 

Aim 

One of the goals of the workshop is the preparation of 

participants for the role of academic teacher. The 

participants should leave the workshop with the insight 

that academic teaching can become an attractive 

challenge especially for scientific educated people. 


The report of good and bad experiences should 

contribute to a picture of the present personal situation 

of teaching staff in many schools. Next, the needs for 

improvement will be addressed. Then a period of 

discussion in small groups is planned. In this part a 

particular teaching situation will be designed and 

structured: lecture for a large class (more than 100), 

lecture for a small class (ca. 40–80), seminar (10–20), 

course, PBL group. Back in the plenary, the results of 

the sections will be presented and discussed. The 

preparation for the requirements of an academic teacher 

should be the goal of this part followed by some 

suggestions for the structure of a training course for 

academic teachers. 

1 Plenary (ca. 20‘): Reflection on the personal state 

of teaching ability (advantages and shortcomings) 

2 Plenary (ca. 20‘): Description of necessary teaching 

abilities 

3 Groups (ca. 20‘): Structure of particular teaching 

situations (large lecture, small lecture, course, 

practical exercise, POL-group) 

4 Plenary (ca. 20‘): How to prepare an M.D. for 

education as an academic teacher 

5 Plenary (ca. 30‘): Elements of a training course for 

academic teachers .

3/4 Feedback and evaluation: essential 

activities in the learning process 

(helping students learn to seek 

continuing improvement - as 

students and career professionals) 

Dr Charles D Puglia, 

MCP Hahnemann School of Medicine, 2900 Queen Lane, 

Philadelphia PA 19129, USA 

Background 

Fear, anxiety, and panic are common reactions to the 

suggestion that an individual is to receive feedback or 

evaluation of their work. Often, the perception that selfesteem 

is about to be threatened elicits a defensive 

barrier that interferes with communication of 

information which is intended to improve performance. 

This view of feedback, perceived as a painful process, 

has developed because of injurious methods of delivery 

of evaluative information beginning in childhood and 

in many cases continuing throughout a student’s formal 

educative experience. Feedback and evaluative 

information must be recognized as essential for an 

individual to succeed at self-directed learning. The 

learner must be encouraged to seek evaluative comment 

as a means of continuing intellectual growth and 

thereby enhancing self-esteem. 

Achievement of the objectives of all learning systems 

such as medical school curricula is dependent upon 

formative evaluation and feedback as well as summative 

evaluation. Evaluative methods are especially important 

in times when curricular change is introduced. 

Feedback and evaluation is necessary to aid faculty as 

well as students to clearly define the objectives of the 

change in terms of the ultimate goal of the curriculum. 

Aim of workshop 

This workshop will identify attitudes and techniques 

which faculty can adopt to enable feedback and 

evaluation to be delivered in a constructive, esteembuilding 

manner. Students will begin to actively seek 

feedback as an opportunity to continually improve and 

grow. 

3/5 Best Evidence Medical Education 

(BEME): progress report 

Chairperson: Professor Ian Hart 

BEME Collaboration (www.bemecollaboration.org) 

Background 

BEME is defined as: “The implementation by teachers 

and educational bodies in their practice, of methods 

and approaches to education based on the best evidence 

available.” In the three years since the AMEE Prague 

Conference, when the topic of BEME was raised, there 

has been much activity, leading to the formation of the 

BEME Collaboration in 1999. The Collaboration aims 

to promote a culture of the use of best evidence in 

medical and healthcare professions education, to carry 

out systematic reviews of the evidence and to 

dissemination information on best practice. A 

systematic review is defined as “A review of the 

evidence on a clearly formulated question that uses 

systematic and explicit methods to identify, select and 


- 4.24 - 

critically appraise relevant primary research, and to 

extract and analyse data from the studies that are 

included in the review. “ (NHS Centre for Reviews and 

Dissemination 2001). 

Several international Topic Review Groups have 

recently been formed to carry out pilot studies, prior 

to the commencement of systematic reviews of the 

evidence, in the following areas: 

1 The use of feedback in assessment; 

2 The use of high fidelity simulators as an aid to 

student learning 

3 Faculty development 

4 The use of computers in clinical education. 


The workshop will be conducted in plenary. First there 

will be a short introduction to familiarise participants 

with the issues. Presentations from each of the Topic 

Review Groups will follow, reporting on issues raised 

in the early stages of the pilot studies. These involve 

setting up the review groups, deciding on the research 

question to be examined, finding and judging the 

evidence and the format in which the evidence is to be 

presented. Where appropriate, an insight will be given 

by the group into the impressions of the data collected 

to date in each of the areas. The session will finish 

with an interactive discussion with the audience and it 

is envisaged that methodological issues will form a 

major part of the discussions. 

Prospective participants might like to refer to the BEME 

website to gain some insight into the project: 

www.bemecollaboration.org 

3/6 East European Task Force 

Chairperson: Professor Ioan Bocsan 

Iuliu Hatieganu University of Medicine & Pharmacy, 13 Emil 

Isac St , RO-3400 Cluj-Napoca, Romania 

A review of some of the issues facing medical education 

in East and Central Europe, with contributions from 

participants. 

3/7 Making feedback during clerkships 

meaningful and effective: a workshop 

for students and teachers 

Dr Paul Hemmer 

Uniformed Services University of the Health Sciences, 4301 Jones 

Bridge Road, Bethesda MD 20814, USA 

Background 

Medical students have concerns that the feedback they 

receive during clinical clerkships is sporadic, and that 

it varies in quality. Teachers are not always comfortable 

providing feedback, and may be uncertain of clerkship 

goals and expectations. 

Aims 

Participants will a) gain familiarity with the RIME 

descriptors, b) improve their ability to solicit and 

provide feedback, and c) discuss the potential for 

educational research.


In this workshop, we will seek input from students and 

teachers about feedback during a clinical clerkship. 

From this discussion, we will present a framework of 

goals and expectations for medical students on clinical 

clerkships, known as RIME for Reporter-Interpreter- 

Manager/Educator. Using this framework, we will 

explore how students can self-assess their performance, 

and to use this as a means to solicit feedback from 

teachers. Teachers will be introduced to using RIME 

for evaluating students and subsequently providing 

feedback. We will use interactive discussion, role-play, 

and teaching cases. 

3/8 Concept mapping 

Dr Gonul Peker 

Ege University School of Medicine, Bornova 35100 Izmir, Turkey 

3/9 Effective student assessment: 

something old, something new 

Dr Geoff Norman 

McMaster University Medical School, Health Sciences Centre, 

1200 Main Street West, Hamilton ON L8N 3Z5, Canada 

Aims 

• To familiarise participants with reliability/validity 

of various tools; 

• To introduce some new promising approaches to 

assessment : Reasoning Exercise; 

• Key features; Clinical Work Sampling. 


This workshop will be of interest to both clinical and 

pre-clinical teachers. 

Content and structure: 

1 Plenary session (1 hour): Ground rules; Review of 

various traditional methods; Introduction of new 

approaches 

2 Practice designing new approaches (1/2 hour) 

3 Discussion and conclusions (1/2 hour) 

Handouts will be provided. 

3/10 A bachelor-master structure of 

medical education in Europe? 

Professor Olle ten Cate 

University Medical Centre Utrecht and Professor Herman van 

Rossum, University of Groningen, Netherlands 

University Medical Centre Utrecht, P O Box 85060, 3508 AB 

Utrecht, Netherlands 

Background 

In 1999 the Ministers of Education of the European 

Union countries agreed upon the so-called Bologna 

Declaration. This agreement concerns the 

harmonization of higher education. One element is the 

restructuring education into two phases: a bachelor 

(undergraduate) phase of three years and a master 

(graduate) phase of one or two years. Major reasons to 


- 4.25 - 

harmonize higher education include international 

comparability and enhancing exchange possibilities. 

In the Netherlands, several universities and vocational 

schools have started curricular changes to implement 

the new structure, preferably in 2003. Medical schools 

have been hesitant to adapt their curricula. A national 

project on The Continuum of Medical Training has been 

asked to first investigate the possibilities and 

desirability of this new structure. It may be contrary to 

current medical curriculum developments, as in 

innovative schools clinical education is gradually 

moving to early years of education and being integrated 

with basic sciences. The BaMa-structure may throw 

medical education back to a separation of basic and 

clinical sciences. However, medical education could 

become too isolated within the universities and and too 

little harmonized internationally, if is does not 

implement the structure. 


In this workshop participants from different countries 

will be invited to (a) briefly discuss the current structure 

of medical training in their country in a structured 

format and (b) generate arguments pro and/or contra 

harmonization of medical education in Europe 

according to the Bologna Declaration. 

3/11 The assessment of poorly 

performing doctors: experiences 

from the first three years of the 

Performance Procedures within the 

UK General Medical Council 

Professor Lesley Southgate, CHIME, London 

Dr Peter McCrorie, St George’s Hospital Medical School 

CHIME, University College London Medical School, Archway 

Campus, Highgate Hill, London N19 3UA, UK 

The assessment of poorly performing doctors: 

experiences from the first three years of the 

Performance Procedures within the UK General 

Medical Council. 

Aim 

This workshop will inform participants about the UK 

programme to assess doctors whose competence to hold 

a medical licence has been questioned. This is carried 

out in two phases: peer review of performance in the 

workplace and tests of knowledge and skills in a clinical 

skills lab. 


The workshop will be divided into three sections, each 

of one hour. The first section will describe the 

programme and the assessment principles on which it 

is based. The second section will examine the methods 

of assessment used in both phases and will also include 

presentation of data from actual assessments. The third 

section will describe the recruitment, training and 

assessment of the performance assessors. Each section 

will be introduced by an interactive lecture for 20 

minutes, followed by group work for 20 minutes and 

plenary discussion for 20 minutes. Throughout the three 

hours examples from surgery, anaesthetics, ob&gyn, 

general practice and psychiatry will be used.

No preparation is needed in advance and handouts will 

be available. 

3/12 What can a general medical journal 

do for education in medicine? 

Sandy Goldbeck-Wood, Assistant Editor BMJ and Dr Ed 

Peile, Research Fellow in Medical Education, University of 

Oxford and Editorial Advisor, BMJ 

Dept of Primary Healthcare, University of Oxford, Chiltern 

Waters, 1 Stablebridge Road, Aston Clinton, Bucks HP22 5ND, 

UK 


- 4.26 - 

Background 

The BMJ is considering new ventures in medical 

education and we will put forward some ideas for future 

ventures in publication. We would like participants’ 

reactions and ideas for how medical education themes 

may be developed in a general medical journal. 


Anyone with an interest in medical education; graduates 

or undergraduates, particularly those who read general 

medical journals.

Session 4 Large Group Sessions 

4A Standards and professionalism in 


1 Attempto! Instilling mindful teaching 

Dr Maria Lammerding-Köppel 

Faculty of Medicine, University of Tübingen, Geissweg 5/1, D- 

72076 Tübingen, Germany 

The need for staff development programmes and the 

training of medical teachers in education have been 

recognized. The areas to be covered in such 

programmes and the specific teacher competencies and 

attitudes are often a matter of debate. Intended 

outcomes and standards of quality must relate to the 

professional roles of the medical teacher and to the 

culture of good teaching practice based on consensus. 

The task for the future is to ensure that we address 

outcomes that expand the scope of the medical teacher 

and that are deeply relevant to an optimal professional 

development. 

2 Who is afraid of the didactic wolf? A plea for 

professionalism in medical education and 

specialist training 

Professor Rein Zwierstra 

Institute for Medical Education, Faculty of Medical Sciences, 

University of Groningen, Ant. Deusinglaan 1, 9713 AV 


In the present era there is no longer a need for expert 

doctors who can talk enthusiastically about their subject 

in a teaching setting. Changes in health care 

organisation and curriculum design call for effective 

teaching by teachers who operate in a team. Whilst in 

the world of research peer review is accepted as a 

standard, it is remarkable that in medical education 

practice peer opinions about each other’s teaching is 

regarded as patronising or even threatening. The quality 

of teaching and of curricula will improve significantly 

if teachers, trained in didactic principles, were to 

prepare their contribution as a team and reflect with 

mutual respect upon each other’s participation. Why 

are medical teachers and trainers afraid of the didactic 

wolf? 

3 What’s good about “Best Evidence Medical 

Education (BEME)”? 

Professor Ralph Bloch 

Institute for Medical Education, Inselspital 37a, University of 

Bern, H-3010 Bern, Switzerland 

BEME, like its older cousin “Evidence Based Medicine 

(EBM)” is likely to meet supporters and detractors. 

EBM and BEME are often depicted as new religions. 

The simile is quite apt. Both movements encompass a 

core philosophy, a set of prescribed rituals and a 

supporting, hierarchical organization. The central 

dogmata of both activities derive from logical 

positivism with the utilitarian goal of doing more good 

than harm - one in the practice of medicine, the other 

in the training of medical practitioners. The rituals 

pertain to the efficient extraction of valid (both internal 


- 4.27 - 

and external) evidence from the published literature. 

The hierarchical organizations, finally, serve the 

purpose of optimizing economies of scale and fostering 

consensus on standards of quality within the academic 

community. Not unlike established religions, EBM and 

BEME run the risk of blind adherence and of assuming 

the cloak of infallibility. The way we develop and 

implement BEME will ultimately determine whether 

it will do more good than harm. 

4B International aspects of standards 

1 International standards in medical education: 

what are they and do we really need them? 

Dr Andrzej Wojtcjak and Dr M Roy Schwarz 

Institute for International Medical Education, 106 Corporate 

Park Drive, Suite 100, White Plains, New York NY 10604-3817, 

USA 

Physicians are now members of the global community. 

Created by interlocking economies, a global language, 

informatics networks and rapid travel, globalization has 

penetrated science, public health, the environment, law 

and religion, as well as medicine. Hence, minimal 

physician competencies must be defined and 

mechanisms developed to ensure that all medical school 

graduates possess these essential requirements. 

Established by a grant from the China Medical Board 

of New York, the Institute for International Medical 

Education (IIME) has undertaken the responsibility of 

defining “global minimum essential requirements” 

(GMER) for undergraduate medical programs. 

Developed by international medical experts, GMER 

consist of knowledge, clinical skills, professional 

attitudes, behaviour and ethical values. Since GMER 

alone are not likely to change graduates’ competencies 

unless they are linked to assessment, evaluation tools 

for educational outcomes are also being developed. The 

lessons learned from the pilot implementation of 

GMER in selected medical schools will be available to 

the global medical education community. 

2 Globalisation of Medical Education: The 

concept of international standards 

Dr. Hans Karle 

President, World Federation for Medical Education, Faculty of 

Health Sciences, University of Copenhagen, Panum Institute, 

Blegdamsvej 3, 2200 Copenhagen N, DENMARK 

The increasing internationalisation of the medical 

profession raises the question of safeguarding the 

practice of medicine and medical manpower utilisation 

through well-defined international standards in medical 

education. Evaluation of educational institutions and 

programmes based on internationally adopted standards 

is an important incentive for institutional improvements 

and for generally raising the quality of medical 

education. Furthermore, such standards can serve as 

guidelines for national or regional agencies dealing 

with recognition and accreditation of medical schools

and postgraduate training institutions and educational 

programmes. In 1998, the World Federation for Medical 

Education (WFME) launched its project on 

”International standards in medical education” 

(Medical Education 1998;32,549-558). A WFME 

Working Party defined a set of international standards 

in basic medical education dealing with the structure, 

process, conditions and outcome, and specified at two 

levels of attainment: (a) basic standards (or minimal 

requirements), and (b) standards for quality 

development (Medical Education 2000;34,665-675). 

In the light of comments received from an international 

panel of advisors and from a number of conferences 

around the world, the standard document has now been 

refined and further developed, including guidelines for 

the implementation of the standards at the institutional, 

national and regional levels. The concept, and the 

purpose and rationale for the WFME Standards in Basic 

Medical Education will be presented. Pilot studies on 

the value of these standards are now being prepared in 

the six WFME Regions. WFME is now planning a 

similar process concerning international standards in 

postgraduate medical education covering both 

specialist training and continuing medical education/ 

personal development. 

4C Standards and the curriculum 

1 Learning can be fun! The student’s 

experience in a new curriculum 

Anke Neuwirth and Johannes Meier 

Second year students in the Reformed Medical Curriculum, 

Charité, Humboldt-University Berlin, Germany 

Two years ago 63 students at the Humboldt-University 

began studying medicine in a reformed parallel track. 

This is the first attempt in Germany at changing a 

traditional curriculum. Basic sciences are combined 

with clinical practice right from the beginning: PBL as 

the main learning format plus one day per week with a 


- 4.28 - 

general practitioner, practical and communication skills 

training and theoretical seminars. Students from the 

first class will share their personal experiences of new 

standards in learning, teaching and assessment. A large 

part of the presentation will be reserved for discussion 

with the audience. 

2 The advantages of longitudinal evaluation of 

the medical curriculum 

Prof. Dr. Reinhard Pabst 

Medical School of Hannover, Centre of Anatomy – 4120, Care 

Neuberg Strasse 1, D30625 Hannover, GERMANY 

After implementing modifications in the undergraduate 

medical curriculum, the outcome should be evaluated. 

Questionnaires answered by medical students at the end 

of a term are helpful, but of even greater relevance are 

evaluations at different times during and after the 

undergraduate phase. Some examples will be presented 

to show why and for whom these data are relevant, as 

well as how the questionnaire should be designed. It 

will be proposed to perform similar evaluations in 

different European countries, and also to ask in 

particular those doctors who have studied medicine in 

different countries to evaluate their medical curriculum 

retrospectively. 

3 Standards and assessment 

Professor Miriam Friedman Ben-David 

Centre for Medical Education, University of Dundee, Tay Park 

House, 484 Perth Road, Dundee DD2 1LR, UK 

The important effect of assessment on students’ 

behaviour and pattern of learning is well documented. 

The assessment process has a key effect on establishing 

standards within the medical school. This presentation 

looks at the relationship between standards and 

assessment. It explores the links between the two and 

looks at issues relating to standard setting procedures 

as part of the assessment process.

Session 5A Learning and the internet 

5A1 The “dos and don’ts” of e-learning 

in medicine: experiences of a CD- 

ROM production 

P Langkafel*, A Oehlsen, U Arnold and J W Dudenhausen 

Charité, Department of Obstetrics, Faculty of Medicine, 

Humboldt-University of Berlin, Augustenburger Platz 1, 13353 


In November 2000 the Department of Obstetrics 

published the CD-ROM “Digital Obstetrics”. After 

almost 2 years of work we were glad to publish this 

piece of software with a well known editor in Medicine. 

We will focus in our presentation on the process of 

conception and the production of this CD-ROM and 

other Internet-based courses. What are our experiences? 

What are - in our opinion - the “musts” of a good 

production, what are the “nevers”? What did we learn 

from this process? What are our “golden rules” from 

this experience to be learnt for different topics of elearning 

in medicine? There will be the possibility for 

a continuous virtual discussion via the 

Internet:(www.golden-rules.de) The audience and 

interested people will have the opportunity to add their 

opinions and to share in the discussion with others 

digitally. 

5A2 Online guide to basic surgical 

skills: http://olc.chirurgiegoettingen.de 

S Koenig*, P Wagner, D Zeiss, P M Markus and H Becker 

Georg-August-University Goettingen, Department of General 

Surgery, Faculty of Medicine and University Hospital, Robert- 

Koch-Str. 40, 37075 Goettingen, GERMANY 

The emphasis of medical education in Germany lies in 

the imparting of theoretical knowledge. During their 

clinical studies, medical students increasingly have to 

deal with the major problem of how to gain experience 

in clinical practice and learn the relevant skills. With 

this in mind, an online guide is being developed as a 

teaching aid demonstrating basic skills in surgery to 

accompany the existing curriculum. The guide is 

presented as a website, centred around a series of 

digitised video sequences, photographs and illustrations 

highlighting the basic clinical skills required in the field 

of surgery. Examples include blood sampling, IV line 

management, suture techniques, wound management 

and general practice in theatre such as scrubbing up, 

aseptic procedures and use of specific instruments. 

Student feedback to date is exceptionally encouraging 

for the further development of the platform, including 

integration of other fields in medical education. 

5A3 Standards for an international 

distributed online case repository 

Chris Candler*, Colin Melville and Dave Collins 

University of Oklahoma, Science Centre, 941 Stanton L. Young 

Blvd, BSEB 115A, Oklahoma City, OK 73104, USA 

Teaching cases have been used by medical schools for 

years as a means to simulate the patient encounter, 


- 4.29 - 

provide early exposure to clinical problems, and to 

ensure a consistent educational experience. Recently, 

many schools have developed online cases to 

supplement existing coursework. Through the use of 

emerging technologies, cases may display high-quality 

multimedia, track student reasoning, facilitate facultystudent 

collaboration, and even adapt to the student’s 

educational needs. While schools have created online 

cases for a variety of purposes, development costs are 

rarely trivial. Unfortunately, medical schools have not 

employed the same technologies to share and reuse 

these costly resources. New technologies could be used 

to develop case banks that house cases independent of 

purpose or pedagogy. The authors propose the 

development of an international case repository and 

suggest a technical implementation based on distributed 

systems and open standards such as the eXtensible 

Markup Language. 

5A4 Digital study of medicine 

U Arnold*, P Langkafel, L Peppel, I Reisinger and 

J W Dudenhausen 

Charité, Humboldt-University Berlin, Berlin Biomedical 

Exchange Office, Campus Virchow-Klinikum, Augustenburger 

Platz 1, D-13353 Berlin, GERMANY 

Digital media becomes more and more a major force 

in medicine and medical education. This representative 

study among students of medicine demonstrates the 

big differences between varying student samples 

concerning the use of and the expectations on new 

media and e-learning. In a sample survey (n=282) using 

machine readable questionnaires students of the first 

pre-clinic and the first clinic semester were questioned 

about their current and future computer and internet 

use as well as their attitude as regards these subjects. 

57.8 % of the beginners use a PC and the internet more 

than once a week while 12.6% do not use computers at 

all. More than half of the beginners (55%) do not know 

internet based learning at all. While only 0.6% of the 

beginners claim to use CD-ROM for learning purposes 

this number increases to 23.9% among the students 

from the first clinic semester. Nearly half of the students 

wish to see an amount of 16 to 30% for new media 

based learning in the curriculum of the future. The 

detailed results will be discussed focussing on their 

consequences for e-learning in the field of medical 

education. 

5A5 Electronic learning objects and 

resource discovery 

David A Davies 

University of Birmingham, Medical Education Unit, School of 

Medicine, Edgbaston, Birmingham B15 2TT, UK 

A challenge facing many institutions engaged in 

teaching is to find electronic learning resources to meet 

the requirements of the curriculum. Electronic learning 

resources may be clinical images, digital video clips, 

case scenarios, MCQs, etc. These ‘learning objects’ may 

be viewed as the building blocks for new web-based

teaching packages. There are opportunities for the 

development of new learning objects both within an 

institution but also by sharing existing resources with 

other institutions. A central issue therefore becomes 

how does any individual know what resources are 

available either locally or remotely? We have developed 

an internet-based system that greatly facilitates 

resources discovery. Our system uses open standards 

and does not rely upon any specific hardware or 

software platform. By using our Electronic Curriculum 

as an example, which we first demonstrated to AMEE 

two years ago, we will show, using real examples, how 

institutions can collaboratively share learning objects. 

5A6 Filling a curriculum map with 

Reusable Learning Objects 

N K McManus*, R M Harden, D Davidson, S Khogali and 

J M Laidlaw 

SCPMDE, Education Development Unit, Tay Park House, 484 


Session 5B Evaluation of PBL 

5B1 Changing to PBL: does it have 

an effect on junior doctors’ 

conceptualisation of 

communication skills? 

P A O’Neill*, S C Willis and A Jones 

University of Manchester, Research and Teaching Building, South 

Manchester University Hospitals Trust, Nell Lane, Manchester 

M2O 2LR, UK 

In 1994 Manchester Medical School introduced a 

learner-centred, problem based learning course, which 

involves more emphasis on acquisition of effective 

communication skills. This study explored how 

Manchester graduates conceptualise communication 

skills. Twenty-four traditional course graduates and 23 

new course graduates were interviewed 3 months into 

their first job. Graduates were asked to reflect on how 

well the course had prepared them for being an effective 

communicator. Interviews were tape-recorded, 

transcribed, coded and analysed. Traditional course 

graduates conceptualised communication as ‘talking 

to people’. Being an effective communicator was 

described as ‘a personal thing’ rather than something 

which could be taught or learned. New course graduates 

conceptualised communication skills as being 

important for patient outcomes; and as something 

which could be both taught and learned. A comparison 

between traditional and PBL course graduates suggests 

that there are some differences in their 

conceptualisation of communication skills. 


- 4.30 - 

For a computer-based learning system to be widely 

usable, it must be possible to tailor the information 

presented to the learner to match the level of study and 

topic of interest. To achieve this, it is necessary to 

describe the content in a way that makes it reusable in 

a variety of contexts. By applying a standard template 

to describe structure within topics, specifying 

associations between concepts, and describing the 

content using a standard coding scheme, it is possible 

to produce standalone ‘Reusable Learning Objects’. 

These can then be filtered by the system to match the 

learner’s requirements. In an experimental 

implementation to investigate methods for creating 

these electronic curriculum maps, a prototype system 

is being produced covering three areas in neurology, 

cardiology and dermatology. A web interface allows 

these sections to be developed concurrently, then 

delivered to a wide audience. 

5B2 How do medical students 

characterize good problem-based 

learning (PBL) tutoring after a 

year’s experience? 

Gillian Maudsley 

University of Liverpool, Department of Public Health, Whelan 

Building, Quadrangle, Liverpool L69 3GB, UK 

In 1996, Liverpool’s 5-year undergraduate medical 

(MBChB) curriculum became problem-based. 

Students’ initial experiences of problem-based learning 

(PBL) and PBL tutors could influence subsequent 

progress. Empirical evidence on students’ perceptions 

of PBL tutors’ role is developing. The aim was to 

explore how medical students conceptualize good PBL 

tutors (and learning) in a problem-based curriculum. 

The subjects were 224 medical students at end of Year 

1. A cross-sectional (self-completed questionnaire) 

survey of mostly open-ended questions explored, e.g.: 

main advantage/disadvantage of PBL; characteristics 

of a good PBL tutor. Qualitative data-themes 

formulated inductively and iteratively. 137/224 (61.2%) 

responded. Despite diverse views, students mostly 

highlighted that, e.g.: good tutors should be 

approachable, ‘knowledgeable’ (without imposing 

knowledge), encourage participation; and PBL is good 

for acquiring, retaining, and applying knowledge (yet 

lack of ‘structure’ can cause concern). The implications 

of the results will be related to previous literature.

5B3 Predicting outcome by behaviour in 

PBL groups? 

Kristin Wigen*, Are Holen, Øyvind Ellingsen and 

Hansjørg Hohr 

Norwegian University of Technology and Science, Department 

of Community Medicine & General Practice, MTFS, N-7489 

Trondheim, NORWAY 

In the fall of 1999 and 2000, new medical students at 

the Norwegian University of Science and Technology 

were asked to complete these questionnaires: (1) 

Entwistle’s Learning Style Inventory - 30 items, (2) 

Braithwaite’s shortened neuroticism scale - 15 items, 

and (3) Craig’s Locus of Control of Behaviour Scale - 

17 items. Additionally, variables included the admission 

scores and gender of the students. Behaviour in PBL 

groups was assessed by peers on Holen’s Group Process 

Evaluation Scale once each term for each student. The 

aim was to study the correlations between these 

variables and the academic achievements of the students 

at their first exams by the end of the first year in June 

2000 and 2001. Preliminary findings will be presented 

and briefly discussed. 

5B4 Student evaluation of a problembased 

learning module into an 

occupational therapy course 

Deirdre Connolly* and Morag Donovan 

Trinity College Dublin, School of Occupational Therapy, 

Rochestown Avenue, Dun Laoghaire, Co Dublin, IRELAND 

“ I’m very satisfied with this course. The method of 

continuous assessment was very helpful and beneficial. 

I wonder how this volume of material could be covered 

in any other way”. 

“Tiring, inflexible and inconsistent marking”. 

These are contrasting opinions of two third year 

occupational therapy students on their experience of 

Problem Based Learning (PBL). As PBL encourages 

open-minded, reflective and active learning 

(Margetson, 1991), qualities that are highly valued from 

a university education, it was decided to introduce a 

PBL module into the four-year honours degree course 

in occupational therapy. Students were then asked to 

evaluate the first semester of using the PBL approach. 

This paper presents the process involved in setting up 

the module and the quantitative and qualitative results 

of the initial evaluation. 

5B5 Evaluation of student performance 

in the problem based learning 

(PBL) group 

David C M Taylor 

The Physiological Laboratory, University of Liverpool, Crown 

Street, Liverpool L69 3BX, UK 

During the course of each semester, students in years 

one and two of the medical course at Liverpool 

University complete a self assessment form which 

relates to their performance in the PBL Group. A form 

is also completed independently for students by their 

PBL tutor, and the two forms are compared. If there 

are differences between the perceptions of student and 

tutor, then an informal conversation takes place to 

identify possible explanations. We originally used a 


- 4.31 - 

form similar to that developed in Hong Kong, where 

there are five descriptors for each of five domains; 

participation, communication, preparation, critical 

thinking and group skills. It rapidly became apparent 

that we needed to add two other domains – “Evaluation 

Skills” and “Cross Curricular Links”. This change 

means that students and staff are required to reflect on 

what we believe to be the key skills for problem-based 

learning. 

5B6 Influence of tutor qualification on 

test achievement and student 

evaluation in a problem-based 

course of basic pharmacology 

J Matthes*, B Marxen, R-M Linke, W Antepohl, 

W Lehmacher and S Herzig 

Gleueler Str.24, 50931 Koln, GERMANY 

Increased demand on staff when using problem-based 

learning (PBL) necessitates involvement of tutors at 

different stages of medical or non-medical (under-, 

post-,) graduate education. To address whether such 

differences in qualification affect evaluation of PBL 

by participants or their outcome (test results), we 

analysed data of a 3½ year longitudinal study 

performed with 3rd year medical students taking a PBLcourse 

in basic pharmacology. We compared student 

tutors (undergraduate, >3rd year; n=30), nonspecialized 

professional tutors (physicians, pharmacists 

or natural scientists during postgraduate education; 

n=38) and specialized professional tutors (completed 

postgraduate education; n=26). While evaluation and 

outcome of student-led groups did not differ from staffled 

groups, tutor experience with PBL inproved 

evaluation scores. Interestingly, student tutors as well 

as non-specialized professional tutors came off badly 

in some evaluation parameters, however their groups´ 

test achievement equalled that of specialized 

professional tutors. 

5B7 Individual perceptions of group 

learning and functioning in a 

problem-based learning programme 

Janet MacDonald 

Academic Departmentt, Postgraduate Medical & Dental 

Education, University of Wales College of Medicine, Heath Park, 

Cardiff CF14 4XN, UK 

Drawing on data from a cohort of BSc Occupational 

Therapy students on a PBL programme, this paper 

reports on students’ individual perceptions of their own 

and others’ participation and performance within small 

group learning. Students were asked to rate the 

contributions and performance of themselves, other 

group members and the group as a whole with factors 

influencing functioning being considered. 

Questionnaires were completed by students who were 

then involved in group discussion and subsequently 

completed individual action plans with the intention 

of enhancing future group involvement and personal 

development. Initial findings explore issues such as 

group development and cohesion, use of ground rules, 

contextual learning and the role of the group in personal 

development. Difficulties involved in conducting this 

type of inquiry will also be briefly discussed.

Session 5C Curriculum evaluation 

5C1 A course programme evaluation: 

contribution of students’ selfevaluation 

Carlota Saldanha*, Jorge Lima and Joao Martins-Silva 

Institute of Biochemistry, Faculty of Medicine of Lisbon, Av Prof 

Egas Moniz, 1649-028 Lisbon, PORTUGAL 

A course programme evaluation (CPE) is useful to 

highlight issues for introducing further changes. The 

aim of this work was to compare the results of the CPE 

performed in the discipline of Cellular Biochemistry 

in three consecutive years. The first year students in 

1999 (n=199), in 2000 (n=189) and in 2001 (n=173) 

of the Faculty of Medicine of Lisbon were required to 

answer a questionnaire anonymously with 19 closed 

questions. Phi and Cramer’s VC statistical analysis were 

used. The answers profile for the majority of the 

questions was similar in the three consecutive years. 

The main differences were those related to the influence 

of the teaching process in the assessment methods and 

in students’ self-confidence. The majority of students 

were not motivated with their self-evaluation. It is 

concluded that the course programme evaluation 

depends on the student population and not exclusively 

on the changes introduced by the teaching staff. 

5C2 A national evaluation of the reforms 

to higher specialist training in the 

UK: methodological issues 

Janet Grant*, Rodney Gale, Mairead Beirne and 

Heather Owen 


University, Walton Hall, Milton Keynes MK7 6AA, UK 

Over the past 5 years, wholesale reform of higher 

specialist training in the UK has occurred with changes 

in training structure, processes, infrastructure, 

assessment, records, post types, endpoint qualification, 

curricula, selection, standard setting, and monitoring. 

The Department of Health commissioned a national 

evaluation, conducted over three years. The evaluation 

was designed and conducted as policy research, 

involving 15 researchers with expertise in postgraduate 

medical education, qualitative and quantitative research 

methods, management, selection, public sector 

economics, assessment, and pedagogy. Data collection 

methods included surveys, consultative groups, 

interviews, site visits, case studies, documentary 

analysis and in-depth reference studies. Seven focal 

specialties were studied. Data for the 20 separate reports 

of the evaluation were gathered from upwards of 5,000 

participants. The evaluation covered costs, organisation, 

management, funding, change management, 

assessment, appraisal, educational processes and 

outcomes, new roles and responsibilities, selection, and 

effects on service and workload. Methodological issues 

will be discussed. 


- 4.32 - 

5C3 Evaluation of PME courses in 

General Practice in Germany 

S Wilm*, R Jahromi, S Krause and B Hemming 

Heinrich-Heine University, Department of General Practice, 

PO Box 10 10 07, D-40001 Duesseldorf, GERMANY 

Vocational training in general practice in Germany 

requires 240 hours of accompanying courses, aiming 

at reinforcing professional knowledge, problem solving 

abilities and at training in interdisciplinary teamwork 

and audit. For the participants it has the character of an 

expensive obligation, with possibly negative effects on 

intrinsic motivation and demands. The continuous builtin 

evaluation of courses in Duesseldorf/North-Rhine 

covers written interviews with participants and teachers, 

participatory observation, oral interviews and focus 

groups. In 1999 and 2000 71 seminars were evaluated. 

935 questionnaires of participants (response rate 70%), 

46 data sheets for participatory observation, 33 

questionnaires of 29 teachers and 10 focus groups show 

that the educational quality increased, while the overall 

satisfaction of the trainees decreased. Possible reasons 

for this complex phenomenon are discussed. 

Organizational aspects influence participants’ 

satisfaction much more than content of seminars. 

5C4 The Matrix: a visual presentation of 

registrar term evaluation 

Richard Tarala and Alistair Vickery 

Department of Postgraduate Medical Education, Royal Perth 

Hospital, GPO Box X2213, Perth, Western Australia 6847, 

AUSTRALIA 

Evaluation of junior medical officer posts can be 

hindered by the need to distribute questionnaires, the 

time required for their completion and by low response 

rates. Collation and assessment can be time-consuming 

and the resultant evaluation difficult to interpret. We 

used a simple evaluation tool for the assessment of 

registrar terms. Trainees were asked to assess on a fivepoint 

scale the workload and the training/teaching value 

of each rotation they had experienced over the previous 

two years. We have undertaken a pilot to provide a 

‘snapshot’ or audit of the trainees’ perception of the 

rotations. The evaluation can be performed quickly and 

the collated results when plotted in a graphical 

(“matrix”) form provide a powerful visual assessment 

of the trainee’s perspective of each post. This evaluation 

can be used to assess the workload of each position to 

assist in reallocation of workload and to optimise 

training in each post. 

5C5 Site visits as a method to assess the 

educational quality of clerkships 

Janke Cohen-Schotanus* and Rein P Zwierstra 

Institute for Medical Education (OWI-OK), Faculty of Medical 

Sciences, University of Groningen, Ant.Deusinglaan 1, 9713 

AV Groningen, NETHERLANDS 

Clerkships, as part of the training of medical students, 

are organized in several hospitals. In general, students 

are content with this training. However, what do we

know about the educational quality of the clerkships? 

To answer this question we developed a procedure for 

structured site visits. The visits were conducted by a 

Visitation Committee on the basis of an assignment of 

the director of the Institute for Medical Education. 

Before the actual visit, the committee sent out 

questionnaires and gathered written information about 

the clerkships. During the site visit, the committee 

discussed the educational topics with the groups 

involved in the programme. 

After the procedure the committee concluded that in 

general the students were trained satisfactorily. 

However, in the clerkships more educational structure 

is necessary. Students need to receive feedback on the 

way they practise their skills and on attitudinal aspects 

much more frequently and on a structured basis. 

5C6 Impact of a new curriculum on the 

clinical competence of medical 

students at the University of 

Barcelona Medical School (UBMS) 

Ramon Pujol*, Frederic Manresa, Francesc Gudial, 

Eduard Kranfly, Josep Ma Martinez Carsetera 

Bellvitge Unit, University of Barcelona, Bellvitge Hospital, Dept 

of Internal Medicine, c/Feixa Llarga s/n, 08907 Hospitalet de 

Llibregat, SPAIN 

UBMS has recently modified its undergraduate 

curriculum. A group (A) of 44 students belonging to 

the first cohort (1999-2000) of the new curriculum was 

compared with another group (B) of 51 students 

belonging to the last cohort (1998-1999) of the 

traditional curriculum. The assessment was performed 

at the end of licensure by means of a multistation OSCE 

of 17 cases with 22 stations including 10 common cases 

for both cohorts. Statistical analysis included Cronbach 

Alpha test to analyse reliability and the result was 0.79, 

- 4.33 - 

and for comparability t-student test was used. Group A 

showed better scores, particularly in interprofessional 

relationships (mean values A vs B: 59.5 vs. 48.6; 

p=0.001); attitudes (59.7 vs. 41.6; p=0.001); technical 

skills (70 vs 61.6; p=0.01); clinical knowledge (62.9 

vs. 56.6; p=0.001), and clinical judgement (47.2 vs. 

42; p=0.001). The new curriculum has improved the 

clinical competence of last year’s students assessed by 

a multistation OSCE examination. 

5C7 Lessons learnt in designing and 

implementing a curriculum 

evaluation 

Helen Graham* and Mary Seabrook 

Department of Medical and Dental Education, Guys, Kings & 

St Thomas’ School of Medicine, Kings College London, Sherman 

Education Centre, 4th floor, Thomas Guy House, London SE1 

9RT, UK 

Evaluation is particularly important when a new course 

is established. The new year 4 medical curriculum at 

Kings College, London was introduced in 1999. It 

teaches reproductive and sexual health; child health, 

development and ageing; and trauma, locomotion and 

rehabilitation to 360 students across 4 main campuses. 

Since inception, an evaluation strategy has gradually 

been developed by the year head and the course 

management committee. Feedback was collected from 

students and teachers within the teaching hierarchy 

during the year using a range of methods. These 

included meetings, facilitated discussions, written and 

computer-based questionnaires, teacher reports and email. 

In this presentation we will discuss how the 

various methods worked, the advantages and 

disadvantages of each and the problems encountered. 

We shall also describe the mechanisms used to ensure 

teacher participation in the evaluation and course 

development process. 

Session 5D Assessing communication skills/patients as examiners 

5D1 Detecting rater bias on a measure 

of spoken English proficiency 

Marta van Zanten*, Danette McKinley, John Boulet and 

Gerald Whelan 

ECFMG, Test Development and Research/CSA, 4th floor, 3624 

Market Street, Philadelphia, PA 19104, USA 

Rater severity can affect the validity of scores and 

introduce bias that will impact the measurement of 

examinee ability. Few studies, especially in the area of 

clinical skills assessment, have examined the effect of 

rater demographics on rater severity. In this study, 

standardized patient (SP) ratings of spoken English 

proficiency were contrasted by SP and examinee 

characteristics. Two analyses were conducted. In the 

first analysis, least square mean scores were calculated 

based on whether English was the native language of 

the examinee and the SP. Examinees whose native 

language was not English received significantly lower 

ratings from the SPs, regardless of the SP’s native 

language. In the second analysis, data were analyzed 


based on SP and examinee gender. Female examinees 

received higher ratings than male examinees from SPs 

of both genders. The results suggest that the SP 

characteristics studied had no effect on ratings of 

spoken English proficiency. 

5D2 Comparison of communication 

skills in residency with 

performance on ECFMG Clinical 

Skills Assessment 

W Burdick*, J Boulet, S Peitzman, G Whelan and D Brody 

ECFMG, 3624 Market Street, 3rd Floor, Philadelphia, 

Pennsylvania 19104-2685, USA 

The Education Commission for Foreign Medical 

Graduates assesses graduates of foreign medical 

schools for readiness to enter US residencies using a 

ten station standardized patient examination. The 

Clinical Skills Assessment (CSA) tests data gathering,

clinical reasoning, written communication, and oral 

communication skills, including spoken English. We 

assessed the communication skills of first year internal 

medicine residents using trained observers and postencounter 

patient surveys in an outpatient clinic setting 

and compared these results with performance on CSA. 

Over 250 encounters from about 60 residents who had 

graduated from foreign medical schools were scored 

by observers and patients. Moderate correlation with 

communication skills as assessed by CSA was found. 

This evidence suggests that CSA is a valid predictor of 

performance in the first year of residency. 

5D3 ACT: a new computer-assisted 

assessment (CAA) method for 

communication-skills of medical 

students 

R L Hulsman* and J D Donnison-Speijer 

Academic Medical Centre, Department of Medical Psychology, 

J4, PO Box 22660, 1100 DD Amsterdam, NETHERLANDS 

CAA of communication skills is innovative and has 

several advantages: a broad range of communication 

problems can be covered in one assessment; both the 

testing and judgement procedures are highly 

standardised; students can be assessed in large groups 

without a complex organisation. ACT, developed in our 

medical school, was used for the first time in April and 

May 2001. More than 200 third year students were 

assessed. ACT presents three short movies of doctorpatient 

encounters. Topics are: history taking, breaking 

bad news, shared decision making. Each topic is 

covered by 5 to 10 questions; 20 questions in total. 

The assessment model of ACT is based on Miller’s 

pyramid (Acad Med 1990; 65:S63-67) yielding four 

types of essay questions: 1. knowledge, 2. 

understanding, 3. skill phrasing, 4. integration of skills. 

Presented will be: the adapted assessment model, 

examples of questions, the program design, and results 

about the feasibility and reliability of ACT. 

5D4 How accurate is lay person 

assessment of clinical competence 

of student doctors? The 

comparison of the assessment of 

medical students by faculty and 

standardized patients during the 

Objective Structured Clinical 

Examination 

P Heasman*, K Pitkala and N Paganus 

University of Helsinki, Faculty of Medicine, P O Box 63, 00014 

Helsinki, FINLAND 

This paper discusses the results of two types of 

assessment of the students carried out during the OSCE, 

a performance-based assessment of clinical 

competence. For the first time in the history of the 

Medical School in Helsinki a comprehensive OSCE 

was arranged in December 2000. All participants (n= 

80) were sixth year undergraduate medical students. 

The exam consisted of ten stations where simulated 

consultations with standardized patients (SPs) took 

place. Professional actors were used as patients to 

guarantee a similar experience to all students. During 


- 4.34 - 

the consultation a faculty member assessed the clinical 

performance of the student and the doctor-patient 

interaction using a checklist for the assessment of the 

clinical skills and a communication skills questionnaire. 

The students were also evaluated by the actors with an 

assessment form. While some students with low ratings 

in clinical skills by the faculty scored high on the actors 

evaluations, none of the students to whom the SPs gave 

the maximum scores, failed. Inter-station reliability of 

the SP ratings was considerably higher than clinician 

rating of communication skills. Also there was a poor 

correlation between SP and clinician ratings, equaling 

0.22. The scores of a single student varied depending 

on the clinical situation he or she was confronted with. 

Results and their implications for the future 

development of the medical students’ integrated 

competence assessment will be discussed. 

5D5 Do simulated patients grade interpersonal 

skills as well as Faculty? 

A S Arora*, N Natt, S Kluck and R Tiegs 

Mayo Foundation, Department of GIH, 200 First Street SW, 

Rochester MN 55905, USA 

Simulated patients (SPs) are being used to assess a 

number of skills in medical students. The SP may grade 

students with regard to history taking, physical exam 

and inter-personal skills (IPS) according to a checklist. 

Using SPs to grade student performance has been 

shown to be reliable though it is difficult to assess 

validity of this method. The aim of this study was to 

determine the validity of SPs’ scoring of student IPS at 

Mayo Medical School. Third year medical students 

undertaking a Clinical Skill Assessment had IPS 

evaluated by SPs and faculty observers. Identical 5section 

IPS checklists were completed following each 

student encounter by the SP and the faculty. There were 

8 clinical encounters for each student. The agreement 

between faculty and SP was very high in most of the 

sections in the IPS checklist. In conclusion, SPs are 

able to evaluate students' interpersonal skills as 

effectively as faculty. 

5D6 The contribution of non-medical 

assessors to the assessment of 

poorly performing doctors 

Lesley Southgate* and Peter McCrorie 

Centre for Health Informatics & Multiprofessional Education, 

University College London Medical School, Archway Campus, 

Highgate Hill, London N19 3UA, UK 

The UK Medical (Professional Performance) Act 1995 

gives the General Medical Council powers to assess 

any doctor on the register whose performance in 

practice may be seriously deficient, and below the 

standard for fitness to practise. The Council has stated 

its commitment to involve members of the public 

equally in all stages of the development and 

implementation of the assessment programmes, which 

comprise peer review of performance in the workplace 

by a team of three assessors, followed by tests of 

competence. More than 35 doctors from several 

disciplines have now been assessed within the 

procedures. The non-medical assessors contribute 

equally to the database assembled during the

assessments. We will present the background to their 

participation; data from actual assessments in general 

practice, surgery and psychiatry, and conclude with a 

discussion of the implications for partnership within 

professional regulation between the profession and 

members of the public. 

5D7 Assessment in the elective clinical 

rotation: centrally reviewed case 

reports 

W M Molenaar*, S A Koopmans, M D Talsma and 

L H van Essen 

Institute of Medical Education, University of Groningen, Ant. 

Deusinglaan 1, 9713 AV Groningen, NETHERLANDS 

The performance of medical students in clinical 

rotations is usually assessed by supervising clinicians. 

- 4.35 - 

Students at the University of Groningen in addition have 

to write a case report during their elective clinical 

rotation. Since students are widely scattered for their 

elective rotations individual clinicians supervise only 

a few of them, which tends to bias their judgements. 

Accordingly, the assessments of the students’ clinical 

performances by the supervising clinicians were 

skewed towards ‘excellent’. To overcome this problem 

all case reports are centrally graded by one of three 

medical specialists using criteria known to the students 

and their supervisors. The major criterion is the 

relevance of the ‘lesson’ to be learned from the patient’s 

history. This study analyzes the scores over the years 

1998 through 2000 (714 reports). The distributions of 

given grades were relatively balanced and very similar 

in each year and the reviewers showed comparable 

patterns. 

Session 5E Postgraduate education for general practice/ 

family medicine 

5E1 An educational approach to 

significant event auditing in 

primary care 

J McKay* and P Bowie 

Department of Postgraduate Medical Education, University of 

Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK 

Little is known about the content and educational value 

of significant event audits (SEA) in primary care. 

General practitioners (GPs) in the west of Scotland are 

encouraged to submit a SEA as part of their 

postgraduate education. Two trained assessors 

independently mark SEAs and educational feedback 

is offered to the GP. Of 132 SEAs submitted, 47% 

involved primarily clinical issues, 29% practice 

administration and 17% involved both. Main areas of 

analysis were in disease management (36%), drug 

prescribing (20%) and communication (32%). 

Complaints (14%) are not a major factor in prompting 

SEAs. 68% of SEAs were judged educationally 

satisfactory by both assessors; 24% satisfactory by one 

assessor only; and 9% unsatisfactory by both assessors. 

SEAs judged satisfactory by both assessors were more 

likely to have involved the implementation of change 

(P

5E4 The use of video in General Practice 

Registrar training and assessment 

C M Wiskin, Stephen Field* and John Skelton 

West Midland GP Unit, 27 Highfield Road, Edgbaston, 

Birmingham B15 3DP, UK 

In 1994 a questionnaire-based evaluation was 

conducted among training practices in the West 

Midlands. A 2000 comparative study identified changes 

in the use of and attitude towards video as a training 

and assessment tool in General Practice. Areas of 

interest are future application to GP trainer reaccreditation 

and the MRCGP examination, and issues 

of informed consent. Questionnaires combined Likert 

scales, evaluation scales for levels of statement 

agreement/disagreement, demographic information 

and free text comments. Greater frequency of use across 

most targeted areas was reported, in particular obtaining 

appropriate consent. Relationships between the general 

practice trainers’ personal and practice uses of video 

with their registrars and their opinions about other postgraduate 

uses of videos are positively correlated. Rank 

order lists of perceived vulnerable patient groups 

remained identical over the six-year period. Video for 

teaching, testing and developing self-awareness is 

increasingly acceptable to GP Trainers. 

5E5 The consultation styles of female 

GP Registrars with male and female 

patients 

Sarah Hillman* and John Skelton 

Dept of Primary Care & General Practice, Medical School, 

University of Birmingham, Edgbaston, Birmingham B15 2TT, 

UK 

It is acknowledged that there are differences between 

men and women in conversation – it is often argued 

for example that men communicate competitively and 

women co-operatively. Yet male and female registrars, 

with patients of both sexes, are trained similarly, and 

assessed with the same criteria for their Summative 

Assessment examination. Ten western-dressing female 

GP Registrars in the South Birmingham area (UK) were 

videod with male and female patients, and data analysed 

using language concordancing software and discourse 

analysis techniques. Preliminary results suggest that 

the sex of the patient may be one factor which 

constrains consultation style, and that the speech-style 

of participating Registrars is both characteristically 

“feminine” and co-operative.The fact that key 

characteristics of co-operative language are both valued 

in the patient-centred methodology and regarded as 

typical of female speech has implications for the 

training and assessment of registrars of both sexes. 


- 4.36 - 

5E6 The development, implementation 

and evaluation of a ‘concordance’ 

training course 

Jon Dowell*, Claudia Pagliari and Sean McAleer 

University of Dundee, Tayside Centre for General Practice, Kirsty 

Semple Way, Dundee DD2 4AD, UK 

We report the development and assessment of a 

‘concordance’ course. The four day course included 

building relationships, assessing beliefs, identifying 

barriers, considering these with patients, formal 

decision sharing process and agreeing treatment goals. 

Change in knowledge, attitude and skills was assessed 

using a written exam and double marked simulated 

surgeries. The eight General Practitioners attending 

rated the course highly (30/35 Range 27-33). 

Knowledge improved with True/False scores increasing 

from 13 to 17 out of 22 (P=0.005), Short Essay from 

20.4 to 25.1 out of 45 (P=0.062). Patients’ rating 

increased from 26.5 to 28.1 out of 35 (ns). Blinded 

scoring of 48 consultations rose from 14.3 to 16.1 out 

of 26 (p=0.04 Inter-rater reliability: rho = 0.59 p < 

0.001, Internal consistency: a = 83). This work shows 

that concordance skills can be taught and measured. 

5E7 A linguistic study of informationgiving 

in 30 doctor-patient 

consultations 

Andy Shanks* and John Skelton 

Department of Primary Care & General Practice, Medical 

School, University of Birmingham, Edgbaston, Birmingham 

B15 2TT, UK 

The need for patient-centred consultations is wellestablished. 

However few linguistic studies have 

analysed what kind of communication makes patients 

more proactive. This paper employs a type of discourse 

analysis developed at Birmingham University for 

educational settings, now widely used for analysis of 

organisational language. 30 consultations were 

analysed according to the IRF (initiation, follow-up, 

response) model. Eight different types of exchange 

were identified including the ‘doctor-inform’ exchange, 

which is used when the doctor passes on facts, opinions 

and ideas about treatment to the patient. Patient 

interruptions of doctor-inform exchanges are often met 

with short answers and little response. However, when 

doctors responded at length to patients’ questions and 

checked understanding, patients initiated questions 

more frequently. The evidence suggests that patients 

are more likely to initiate exchanges if the doctor checks 

frequently for understanding and concordance. 

Secondly, a more informative style of consultation 

creates more proactive patients.

Session 5F Assessment 

5F1 Objective Structured Preclinical 

Exams (OSPE): a new test format of 

summative student assessment in 

the Problem-Based Learning (PBL) 

curriculum at the Faculty of 

Medicine of the University of Bern 

Barbara Stadelmann*, R Hofer, Urs Brodbeck and Ara Tekian 

Institute of Biochemistry and Molecular Biology, University of 

Bern, Buehlstrasse 28, CH-3012 Bern, SWITZERLAND 

In October 1999, the Faculty of Medicine of the 

University of Bern implemented a new system of 

summative student assessment in the preclinical PBL 

curriculum of medical education. It is interdisciplinary 

or at least multi-disciplinary, and allows assessment of 

knowledge, skills and attitudes. About half of the exam 

consists of traditional multiple choice questions 

(MCQ). The other half has been replaced by the OSPE, 

a new test format allowing assessment of how well 

students understand, apply and integrate their 

knowledge, and how well their data interpretation and 

communication skills are developed. It is analogous to 

the clinical counterpart, the OSCE. During 2 – 2 1/2 

hours students rotate through a series of stations 

consisting of interdisciplinary oral, structured oral and 

written exams. Evaluation of the first cycle of 

assessment revealed high reliability for both the 

traditional MCQ-exam and the new OSPE (Cronbachalpha 

> 0.8). 

5F2 The quality of an extendedmatching 

multiple choice 

examination 

J Beullens*, B Van Damme, H Jaspaert, E Struyf and 

P J Janssen 

Department of Medical Education, Faculty of Medicine K.U. 

Leuven, Minderbroedersstraat 17, B-3000 Leuven, BELGIUM 

Last year we reported the development of an extendedmatching 

multiple choice test for final year medical 

students at K.U. Leuven. Extended-matching questions 

(EMQs) start from a case and have one correct answer 

within a list of 7 to 26 alternatives. Indications were 

given for the reliability and validity of the test. This 

year two parallel exams of 200 EMQs were constructed 

and solved on separate occasions by respectively 168 

and 178 students. In contrast with the test, which lasted 

half a day, the exam took a whole day and the students 

were prepared for question format and content. 

Feasibility, reliability and validity seemed to be 

indicated and will be reported. In the discussion of 

feasibility attention will be paid to the possible 

influence of fatigue and growing familiarity with the 

question format on the scores. Face, content and 

criterion validity will be evaluated. 


- 4.37 - 

5F3 Evaluation of a five-dimensional 

assessment strategy within a 

problem-based learning medical 

curriculum 

Paul Julian*, Scott Reeves* and Alistair Lumb* 

Barts & The London School of Medicine & Dentistry, Dept of 

General Practice, Queen Mary, University of London, Mile End 

Road, London E1, UK 

This paper reports findings from an evaluation of a 

problem-based learning (PBL) assessment strategy 

within a new medical curriculum. As there is little 

published material on PBL assessment for medical 

students, it was decided to develop a new strategy. As a 

result, a five dimensional assessment strategy was 

developed. The five areas used to assess learning were: 

student attendance; the production of learning 

objectives; input into group work; an individual written 

assignment and a verbal assessment of progress. To 

obtain a comprehensive understanding of issues linked 

to this assessment strategy a multi-method evaluation 

was undertaken. Questionnaire and interview data were 

collected with students and tutors to explore their views 

and experiences of this assessment strategy. Findings 

from this work indicate that, although students and 

tutors consider this assessment strategy to be of value, 

problems around assessment inconsistency and the 

weighing of these different dimensions need further 

development. 

5F4 A preclinical exam to assess the 

networked structure of knowledge 

of basic science in the Universidad 

Nacional de Cuyo (Argentina) 

Ana Maria Reta*, Maria del Carmen Montbrun and 

Maria Jose Lopez 

Asesoria Pedagogica, Facultad de Ciencias Medicas, Universidad 

Nacional de Cuyo, Centro Universitario, Parque General San 

Martin, 5500 Mendoza, ARGENTINA 

The new curriculum promotes the acquisition of a 

networked structure of knowledge. Students must pass 

a Preclinical Exam in Basic Sciences before going into 

clerkships. This exam has been administered twice 

already. Its format was as follows: Four complex clinical 

cases in 2000 and eight cases in 2001 were followed 

by a number of questions dealing with the basic science 

subjects. Results showed that: 97.1% (2000) and 94.5% 

(2001) of the students passed. Reliability, measured 

by the Cronbach alpha coefficient: 0.867 and 0.830; 

mean scores: 73.27% and 70.20%; standard deviations: 

8.77 and 8.08. The results allow the following 

conclusions: 1) The format of the exam seems adequate 

to assess the acquisition of a networked structure of 

knowledge. 2) The new curriculum promotes this kind 

of knowledge. 3) Further research must be done, 

including a control group educated in a traditional 

curriculum.

5F5 Predictive value for academic 

performance of two assessment 

devices applied to medical 

students 

Ma Eugenia Ponce de León C*, Armando Ortiz and 

M del Carmen Ruiz Alcocer, Camino Santa Teresa 

277 Casa 15, Bosques del Pedregal, Delegación Tlalpán, CP 

14010, MEXICO D F 

872 students admitted in 1998 to the National 

Autonomous University of México Medical School 

answered a learning strategies and study habits 

questionnaire, as well as a diagnostic exam testing for 

background knowledge on Physics, Chemistry, 

Mathematics, Biology, Spanish, English, and General 

Knowledge. Our aim was to follow up their academic 

performance during their first two years (basic 

sciences) at Medical School, and to compare their 

average grade score with the results obtained on the 

questionnaire and the diagnostic exam (predictive 

value). Results showed a weak but positive association 

with three of the ten areas of the questionnaire: learning 

strategies, preparation for the exams and problemsolving 

skills. A statistical significance and a positive 

correlation were found in the diagnostic exam with 

General Knowledge, Spanish, Biology and Chemistry. 

5F6 Self-assessed clinical skills levels 

of newly graduated physicians in 

relation to an intended curriculum 

A M Moercke* and B Eika 

University of Aarhus, Enhed for Medicinsk Uddannelse, Det 

Sundhedsvidenskabelige Fakultet, Universitetsparken, Bygning 

611, 8000 Aarhus, DENMARK 

We have explored the degree of overlap between an 

intended curriculum and the learned curriculum 

concerning clinical skills. In 1999 we conducted a 

Delphi-study in which 52 experts reached consensus 

Session 5G Outcome-based education 

5G1 The Scottish Learning Outcomes 

Project Phase II - Assessment: “the 

proof of the pudding” 

Jacqueline Furnace* and John Simpson*, on behalf of 

Scottish Deans’ Medical Curriculum Group 

Cottar House, Meddens, Newmachar, Aberdeenshire AB21 0QJ, 

UK 

Following the successful completion of Phase I of the 

Learning Outcomes Project the Scottish Deans’ 

Medical Curriculum Group (SDMCG) sought to 

maintain the momentum created by this collaborative 

work and in addition, we considered it essential to 

demonstrate our assertion that the Learning Outcomes 

are a useful and practical tool in undergraduate 

medicine rather than purely theoretical. With this in 

mind we decided to test the robustness of the outcomes 

by looking at their assessment. We established several 

working groups - each assigned different outcomes - 


- 4.38 - 

on skills levels for 210 practical clinical skills to be 

attained during undergraduate medical education. In 

summer 2000 we mailed a questionnaire listing these 

210 skills to the 226 just graduated Danish physicians. 

They were asked if they could meet the minimum skills 

level for each of the skills listed. None of the responders 

met the minimum of all the 210 skills. On average the 

responders met the minimum of 74% (155) of the skills. 

We concluded that newly graduated Danish physicians 

have gaps in their clinical skills. Making checklists and 

stating learning objectives is recommended as a 

necessary but not sufficient step. Therefore we are 

trying to develop a bottom up strategy for the 

curriculum design process. 

5F7 The dynamics of knowledge 

structure of graduating medical 

students based on results of the 

Medical Licensing Examination 

M Mrouga*, Y Bogachkov and L Artemchuk 

Testing Board, 5 Estonska St, Apt. 85, Kyiv 03190, UKRAINE 

The licensing examination for medical doctors (MLE) 

in Ukraine is undergoing its last year of piloting. 

However, MLE results are already taken into 

consideration during final exams, thus providing a 

certain motivation for the students. They are also used 

as part of medical schools’ rating, providing motivation 

for schools as well. For better preparation and selfassessment 

of students, the pretest is administered prior 

to MLE using the actual test MLE materials from 

previous years. Based upon pretest results students can 

build their intensive training to MLE in 1-2 weeks. 

Current research investigates the difference in 

knowledge structure between pretest and actual test 

results and possible sources of influence on such 

difference and dynamics of knowledge structure 

between the two parts of the licensing examination. 

to consider the overall implications for assessment, 

identify assessment tools, develop guidelines and 

establish the cost of required resources. The groups 

began work at the beginning of October 2000 and have 

until the end of May 2001 to complete their task. 

Already there has been an unprecedented exchange of 

knowledge and ideas and some useful and practical 

suggestions have emerged. 

5G2 Recent developments in an 

outcome-led curriculum 

Nick Ross 


Birmingham B17 8HN, UK 

This paper reports on current developments in the 

MBChB at the University of Birmingham and discusses

the relationship between the outcome structure of the 

course and current change drivers, which include 

preparation of a programme specification for QAA. 

The nested outcomes that have been a feature of the 

current curriculum since its inception in 1996 are 

currently being reviewed. In addition to revalidation 

of outcome content at course and module level, this 

will involve fundamental restructuring of the outcome 

set. The current ‘tree’ structure (in which a number of 

detailed module outcomes contribute to a single year 

outcome and thence to a single endpoint outcome) is 

to be replaced by a ‘net’ structure, enabling crosscontribution 

and emphasising horizontal as well as 

vertical integration. Links between formal teaching and 

outcomes will be supplemented by links from learning 

opportunities. The benefits and potential pitfalls for 

learning and assessment will be discussed. 

5G3 A new instrument of curriculum 

development: curriculum as a 

function of professional outcomes 

I Bulakh*, Y Voronenko and I Filonchuk 

Testing Board and National Medical University, 22 Pushkinska 

St, Suite 304, Kyiv, 01004, UKRAINE 

Under a national program of development of new 

standards for higher education, medical educators face 

the need to work out the new professional descriptions, 

new curriculum and new diagnostic tools for Ukrainian 

medical schools. In the first phase an expert team has 

developed the professional description of a doctor 

expressed in terms of outcome skills that should be 

possessed by the medical graduate and in terms of 

relevant lists of pathologies, emergencies and 

laboratory investigations. Also, earlier there was 

developed the test blueprint for the medical licensing 

examination that describes the medical professional in 

terms of knowledge which was structured by 

pathologies, by subject and by medical tasks 

(prevention, diagnostic, treatment, etc). In the second 

phase, the curriculum is being constructed as a function 

of professional description and test blueprint, 

demonstrating the misfit between the scope of desirable 

final outcomes and regulated time for their mastering. 

5G4 Focusing on learning outcomes for 

the Preregistration House Officer 

(PRHO) year 

E A Hesketh* and M S Allan 

Education Development Unit, Tay Park House, 484 Perth Road, 

Dundee DD2 1LR, UK 

The General Medical Council’s document ‘ The New 

Doctor’ outlines areas in which new medical graduates 

can expect to develop during PRHO training. The 

document not only emphasises the development of 

clinical skills and knowledge, but also the wider aspects 

of communication, disease prevention and the role of 

the doctor within the health service. Are PRHOs being 

given the opportunity to develop in all these areas? This 

paper describes the perceptions on this issue from those 

closely associated with the delivery of PRHO training. 

The study is part of a larger project which aims to 

specify the expected outcomes for the PRHO year. This 


- 4.39 - 

paper focuses on a questionnaire which was used to 

explore the views of doctors in training, consultants 

and nurses on the importance given in reality and ‘best 

practice’ PRHO training to key learning outcomes. 

Findings showed that there was a desire for more 

emphasis on all the outcomes in PRHO training, 

although some need to be given more prominence if 

‘The New Doctor’ is to be properly implemented. 

5G5 The ACGME Outcome Project: a 

model resident assessment system 

Susan Swing 

ACGME, 515 N State St, Ste 2000, Chicago, IL 60610, USA 

As a part of its Outcome Project, the Accreditation 

Council for Graduate Medical Education is developing 

conceptual models of dependable assessment systems 

for residency programs. The models are intended as 

guidelines to assist programs in meeting new 

accreditation standards for evaluating residents’ 

attainment of the ACGME’s general competencies. This 

presentation will describe the development process for 

the models and an example model. Development steps 

include Outcome Project Advisory Group work and 

feedback from experts and residency program directors. 

The model consists of general principles and features, 

assessment approaches for each competency, and 

example assessment methods. The recommended 

assessment approaches include: (a) tracking of learning 

objectives attainment; (b) focused assessment of patient 

care by supervisors; (c) ratings of professionalism and 

communication skills by patients and professional 

associates; (d) standardized test assessment of medical 

knowledge; and (e) portfolio assessment of practicebased 

learning and improvement and systems-based 

practice. 

5G6 Development of an outcome-based 

clinical curriculum at International 


J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, 

K H Ong, C M K Patrick and Q Akhtar 

International Medical University, 33 A Jalan 17/1, Block A-4, 

Condo 3A, Astana Damansara, 46400 Petaling Jaya, Selangor, 

MALAYSIA 

Eight major outcomes were identified for our new 

clinical School. The outcomes form the basis to reflect 

the competencies expected of the IMU graduate. This 

paper evaluates how our undergraduate curriculum was 

developed with the aim of achieving these objectives. 

One hundred and thirteen study-guides, the community 

and family case study (CFCS) and the learning portfolio 

formed our core curriculum. The “selectives” 

complimented the core. The IMU curriculum has 

adopted task-based learning, which is a continuum of 

PBL undertaken in the earlier phase. The study-guides 

based on various tasks identify how the 8 outcomes 

can be achieved and the outcome measures. The CFCS 

consists of students adopting and visiting a family in 

the community for two years. Specific objectives 

guided by “themes” have been identified for each visit. 

The students are required to develop a portfolio 

consisting of case summaries, case reports, projects and 

maintain a logbook.

5G7 An evaluation of the internal 

validity of specific learning 

outcomes in phase II of a revised 

undergraduate medical curriculum 

F J Cilliers* and E M Bitzer 

University of Stellenbosch, Division for University Education, 

P O Box 19063, Tygerberg 7505, SOUTH AFRICA 

The objective was to undertake a formative evaluation 

of part of a revised undergraduate medical curriculum 

by determining the degree of congruence between 

specific and exit outcomes. A cross sectional case-study 

utilising document analysis was carried out. 1510 

specific outcomes from 13 modules were compared 

- 4.40 - 

for congruence with each of 32 exit outcomes. 1495 

specific outcomes were considered congruent with exit 

outcomes. Between 0-68.9% of all specific outcomes 

were considered congruent with any given exit 

outcome. Three exit outcomes were addressed by 

>=15% of specific outcomes: two addressed lower 

order cognitive outcomes. 27 exit outcomes were 

addressed by

5H4 Self-directed, self-organized casebased-learning 

in final year 

students 

Jana Junger, Christiane Roth, Stephan Zipfel, 

Wolfgang Eich and Wolfgang Herzog 

Department of Internal Medicine, University of Heidelberg, 

Bergheimerstr. 58, 69115 Heidelberg, GERMANY 

The objective is to promote self-directed learning and 

to train interdisciplinary teamwork in final year 

students. Final year students from different medical 

departments meet to discuss a self-selected case on their 

ward with a modified case based method.The roles of 

tutor and presenter are played by students of the same 

peer-group. New tutors are trained by their 

predecessors. One teacher supervises the process. 

Because of the different background of students, 

everybody contributes his own experience of the 

respective internistic department. The close relationship 

to everyday work and active involvement of students 

increases the motivation to learn. The students realize 

the advantages of well-prepared and presented cases 

for the whole learning group. Evaluation of the tutorials 

showed good results concerning engagement of tutors 

and learning-atmosphere. It is concluded that selforganized 

peer group learning might be an additional 

model of case-based learning in advanced students. 

5H5 Changing to ‘self-induced learning’ 

in a speech therapy department 

Martin Peleman 

Arteveldehogeschool, Campus Sint-Lievenspoortstraat, Sint- 

Lievenspoortstraat 143, 9000 Gent, BELGIUM 

The Speech Department of the Arteveldehogeschool 

changed its curriculum from a traditional teachercentered 

towards a more student-centered educational 

system. Because of the apparent differences with PBL, 

we prefer to define our new system as ‘self-induced 

learning’. One third of the content of the original 

theoretical courses was transformed into different types 

of tasks which are dealt with by the students in group 

sessions and under the supervision of a teacher. This 

supervision is mainly focused on the process of working 

and studying together in an efficient way. The project 

is gradually implemented over the three years of the 

curriculum. Students themselves as well as staff 

members and external professionals and organisations 

were consulted during the whole process of this 

curricular change. All of them also took part in the 

continuous evaluation of the project during the first 

year. 


- 4.41 - 

5H6 Student participation in the 

organization of education at a 

medical school - a comparison of 

two South African cases 

B G Lindeque and Pierre L Bredenkamp* 

Faculty of Health Sciences, Stellenbosch University, P O Box 

19063, Tygerberg 7505, SOUTH AFRICA 

The political democratization of South Africa caused 

the international community to open up - trends and 

innovations in education worldwide had therefore a 

significant impact on training in South Africa, resulting 

in curricular reform. Pretoria and Stellenbosch were 

the first medical schools to change - student 

participation became a key element to drive this change. 

The Pretoria medical school implemented a problemorientated 

integrated model and Stellenbosch 

emphasized a core curriculum with certain key 

elements (integration, clinical relevance, stated 

outcomes). At both schools, students were utilized as 

important participants in all committee structures. Both 

schools went along the route of implementing the early 

years while developing the later years at the same time. 

Thus students played a major role in the continuous 

improving of the standards of training, as well as the 

effectiveness of the changes. This led to students 

becoming an integral part of the management of the 

faculty as a whole. 

5H7 Preparing the way: encouraging 

clinical tutors to be co-producers in 

the learning process 

Peter Barton* and Jillian Morrison 

Department of General Practice, University of Glasgow, 

4 Lancaster Crescent, Glasgow G12 0RR, UK 

In year 3 of Glasgow University’s new student-centred 

problem-based curriculum, students receive 20 days, 

one day per week, of structured “Clinical Practice”. 

GPs and hospital tutors provide this on alternate weeks. 

Clinical Practice in the Community (CPC), an 

innovative course of community based education, 

comprises: 

1 Student Consultation Surgery: supervised personal 

consulting; 

2 Signs and Symptoms Surgery: history taking and 

examination practice; 

3 Longitudinal Care Project (LCP): students 

undertake detailed assessments of patients with 

chronic illness. The LCP contributes 20% to 

summative assessment. 

From CPC’s earliest iterations, 80 GP tutors have been 

involved as co-producers. Using small group 

workshops, questionnaire surveys, telephone 

discussions, and a 2-day staff development programme, 

academic staff and tutors have worked together to 

design and develop the course. The course and its 

clinical tutors are highly evaluated by students and 

external examiners alike. We believe co-production is 

an essential part of curriculum design.

Session 5I Educating the educators (2) 

5I1 How to help clinical and multimedia 

staff develop joint programs 

Eleanor Flynn 

Faculty Education Unit, Faculty of Medicine, Dentisty and Health 

Sciences, Level 7, Medical Building, University of Melbourne, 

Victoria 3010, AUSTRALIA 

As medical education courses use multimedia based 

modes of delivery more, it becomes vital that clinical 

and multimedia staff understand each other’s frames 

of reference. They need to work effectively together to 

produce programs which meet the needs of students in 

a timely manner by recognising, defining and 

overcoming the problems that occur. The project being 

used as an illustration of how to manage these problems 

is the development of a web based program to teach 

Rational Test Ordering to postgraduate year 1 & 2 

doctors for the Postgraduate Medical Council of New 

South Wales. The particularly useful techniques were 

the development of a detailed storyboard preceded by 

an exhaustive needs analysis, especially to the project 

manager who was a clinician moving into multimedia 

education. The presentation will give examples of the 

problems and their solutions especially those relating 

to improving communication between clinicians and 

multimedia staff. 

5I2 “Getting Started in Clinical 

Teaching” - a staff development 

initiative 

J A Dent* and P E Preece 

Clinical Skills Centre, University of Dundee, Ninewells Hospital 

& Medical School, Dundee DD1 9SY, UK 

Enabling clinicians to fulfil their clinical teaching role 

necessitates support mechanisms which facilitate 

linking enthusiasm for student-teaching to the 

requirements of a structured curriculum. ”Getting 

Started in Clinical Teaching” comprises instructional 

booklets supplemented by a two-day course providing 

a combination of educational theory and practical 

instruction. It aims to support clinical teachers in wards, 

out-patient clinics and the Clinical Skills Centre. 

Information on curriculum construction, adult learning 

and curriculum outcomes is provided, together with 

practical experience of learning resources available in 

these venues. The course includes content-preparation, 

delivery mechanisms, models for organising student/ 

patient interactions and the role of constructive 

feedback. Workshops are used to construct clinical 

teaching sessions using the approaches described 

including simulation, role-play and self-video. Selfcritique 

and peer review are encouraged. Areas of 

potential resistance to change are discussed. The 

“Getting Started” booklets summarising keypoints are 

suitable for wider dissemination. 


- 4.42 - 

5I3 Governance in medical teaching: 

pilot study 

Iain Robbé 

University of Wales College of Medicine, Temple of Peace & 

Health, Cathays Park, Cardiff CF10 3NW, UK 

Quality in tertiary teaching is increasingly important 

(McLean, 2001) and it can be linked to the government 

policy of improving medical practices through 

governance (Scally & Donaldson, 1998). A checklist 

for governance was developed to investigate its 

theoretical validity (Cohen & Manion, 1989) for 

medical educators. Random sample [20%, n=12] of 

postgraduate educators in a medical college completed 

the checklist using a five point Likert scale and 

discussed its validity compared to the literature, their 

experiences and governance issues. Respondents 

judged the checklist to assess governance had high 

construct and content validity. They easily identified 

tasks they aimed to achieve to provide quality teaching. 

Checklist issues of infrastructure, coherence, culture, 

appropriateness of tasks, and systems to assess 

performance were evaluated positively. There was high 

theoretical validity in this setting. Further research is 

needed to test the validity and reliability of these results. 

5I4 The role of an education unit in 

health professional education: 

proactive or responsive 

Margaret Horsburgh* and Rain Lamdin 

Faulty of Medicine and Health Sciences, University of Auckland, 

Private Bag 92019, Auckland, New Zealand 

The teaching of health professions at The University 

of Auckland has undergone significant change in the 

last few years. The transformation has been from a 

medical school to a multi-professional Faculty of 

Medical and Health Sciences. At an undergraduate level 

medical, nursing, medical science and health science 

students now share learning opportunities. In order to 

support learning and teaching across the Faculty and 

establish best practice for curriculum, learning, 

teaching and assessment a multi-professional unit has 

been established. This presentation describes the goals 

of the Unit and identifies the tension between being 

responsive to individuals and groups and being 

proactive through setting an agenda for educational 

development within the Faculty. Potential conflict 

between the roles of curriculum management, 

monitoring and appraisal, leadership for change and 

research are discussed. Conclusions are drawn about 

the purpose and value of such centres in a multiprofessional 

environment.

5I5 Beyond teacher training; the 

construction of a faculty 

development strategy 

Patricia Rosado Pinto* and Ramiro Avila 

Department of Medical Education, Faculdade de Ciencias 

Medicas, Campo de Santana, 130, 1169-056 Lisboa, 

PORTUGAL 

In Portuguese medical schools the pedagogical 

preparation of faculty members has been a neglected 

enterprise. Furthermore faculty are constantly being 

asked to assume new educational roles for which they 

have received no specific training. Thus formal faculty 

development programmes are becoming more and more 

vital. The aim of this presentation is to describe the 

institutional strategy of our Medical Education 

Department, established in 1996, concerning: teacher 

training workshops for junior and for senior lecturers; 

Journal clubs and sharing good practice sessions; 

Working sessions with the teachers - rethinking the 

teachers’ assumptions about teaching and learning; 

discussing curricular issues; designing and developing 

specific educational and evaluation materials, providing 

educational feedback. More than isolated courses on 

“teaching how to teach” we aim at a real, 

comprehensive and structured staff development 

strategy in which subject matter and educational experts 

can work together avoiding isolated discipline 

knowledge and contributing to a systematic 

improvement of teaching. 

5I6 The profile of the perfect teaching 

professor 

F Scheele*, J Th M van der Schoot and A J Goverde 

St Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE 

Amsterdam, NETHERLANDS 

The aim of the study was to assess the characteristics 

of the perfect teaching professor from the perspective 

of postgraduate trainees in obstetrics and gynaecology. 

A written interview was sent to 120 trainees. The 

interview contained 3 questions such as: ‘What is your 

Session 5J Education and cultural diversity 

5J1 The development and evaluation of 

a programme to teach cultural 

diversity to medical undergraduate 

students 

Nisha Dogra 

University of Leicester, Greenwood Institute of Child Health, 

Westcotes House, Westcotes Drive, Leicester LE3 3TP, UK 

The study aimed to assess any attitudinal change in 

students following teaching on cultural/racial diversity 

using a previously developed questionnaire and whether 

the teaching enabled the learning objectives to be met 

in a measurable way. Students completed a 

questionnaire designed in a previous study at two 

stages; the first before the component on cultural 

diversity was delivered and the second after the sessions 


- 4.43 - 

advice to improve your teaching professor?’ The 

answers were subsequently divided in three categories: 

knowledge (the head), practical skills (the hands) and 

attitude (the heart). 74 trainees responded. 74% of the 

answers given fell in the heart category, 23% in the 

head category and 3% in the hand category. From the 

perspective of trainees in obstetrics and gynaecology 

the perfect teaching professor is the king of positive 

feedback and has personal interest in the trainee. The 

perfect teacher has good knowledge and average skills. 

It is recommended that the teaching professor should 

appoint a stimulating tutor with interest in the social 

aspects surrounding the trainee. 

5I7 Evidence retrieval in medical 

education: obstructions and 

opportunities 

Alex Haig 

SCPMDE, Education Development Unit, Tay Park House, 484 


With the ever-increasing emphasis on best evidence in 

medical education it is imperative that researchers and 

practitioners have full access to the evidence in order 

to reduce bias. The various factors impeding evidence 

retrieval in medical education will be outlined, and the 

problems inherent with database indexing will be 

highlighted with the results of a study of comparative 

search strategies. By examining the search strategies’ 

rates of precision, sensitivity, and specificity it can be 

shown that the major databases containing relevant 

peer-reviewed studies (Medline, Embase, ERIC) are 

not indexed for effective searches in medical education. 

Presently there is no existing database or search tool 

that provides the conceptual context required for 

evidence retrieval for medical education. Alternative 

approaches to compensate for current inadequate 

indexing will be outlined, as will possible future models 

that could resolve existing problems and provide 

analytical tools for the evidence-based research and 

decision-making of tomorrow. 

on cultural diversity. The time interval between stage 

one and two was one week. The cultural diversity 

component was developed using a range of sources. 

140 out of 181 (77.3%) students completed the 

questionnaire at both stages. The findings include 

statistically significant changes that reflect more 

“positive” attitudes about cultures coming together and 

about specific cultures. The study indicates that 

attitudes changed over the period of teaching. There 

is, however, scope for further development of measures 

to enable attitudinal shifts to be measured.

5J2 Aboriginal health: a tool in the 

process of reconciliation? 

G Garvey* and I E Rolfe* 

University of Newcastle, Faculty of Medicine and Health 

Sciences, University Drive, Callaghan 2308, AUSTRALIA 

The inclusion of culturally appropriate, relevant and 

academically sound content and practical experience 

in Aboriginal Health is an important tool in the process 

of reconciliation in Australia. The inclusion of 

Aboriginal Health content also serves several other 

purposes. It recognises the importance of Aboriginal 

Health in Australian society and also provides 

Aboriginal students with a sense of belonging. It can 

also assist in attracting and retaining health 

professionals to work in Aboriginal communities and 

provides all students with an understanding of cultural 

practices and beliefs of patients from other cultures. 

We aim to outline the Aboriginal Health content for 

health professional students at the Faculty of Medicine 

and Health Sciences, Newcastle, Australia. We will 

present an innovative, specifically designed multimedia 

resource that is used to orientate students to 

Aboriginal History, Cultural Awareness, Aboriginal 

Health and working with Aboriginal organisations. 

5J3 Valuing diversity: the effectiveness 

of a roleplay workshop as part of a 

newly introduced communitybased 

diversity module 

Sue Conning*, Alison Hooper, Margot Turner and Val Wass 

Guy's, King's and St Thomas' School of Medicine, Department 

of General Practice, Weston Education Centre, 10 Cutcombe 

Road, London SE5 3PJ 

Learning about the diverse needs of people with 

disabilities, deprivation, homosexuality or minority 

ethnicity is challenging. We run a “diversity” course 

where students interview individuals, visit community 

organisations and explore issues raised in seminars. 

Evaluation showed that some viewed these issues as 

common sense. A workshop using trained, standardised 

patients was introduced into the module. Specific 

diversity scenarios were enacted and students then 

reflected on their personal reactions to these in small 

groups. Students completed a questionnaire evaluating 

the impact of this workshop. A cultural discourse 

analyst observed the scenarios and group interaction. 

197 (60%) students completed the questionnaire (20% 

non-attendance). Students rated the workshop very 

positively. It proved an innovative experience, which 

challenged their own prejudices and added further 

personal reality to their community experiences. 

Reasons for this will be discussed. This interactive 

learning model proved most effective in encouraging 

students to explore their personal approaches to 

diversity issues. 

5J4 Using negative role models 

positively 

S E Gull* and K H Matheson 

Cambridge, 42 Southgate Street, Bury St Edmunds IP33 2AZ, 

Suffolk, UK 


- 4.44 - 

The influence of the negative role model will be 

presented. The main aim of the study was to consider 

the issue of gender and role models for women in 

medical education. One investigator (SEG) carried out 

semi-structured interviews with 8 undergraduate 

students and 10 female doctors. A question asked was 

“what characteristics of role models influenced you 

during your medical education?”. The importance of 

role models was acknowledged. The positive and 

negative attributes of role models will be discussed with 

particular reference to the positive effect of negative 

role models. Role models appear to be related to the 

self-identity of the student, and negative attributes may 

be influential in a positive as well as a negative way. 

5J5 What factors influence 

underrepresented minority (URM) 

students in their choice of medical 

schools? 

Ara Tekian*, Laura Hruska and Mark Urosev 

University of Illinois at Chicago, Department of Medical 

Education (m/c 591), 808 S. Wood St, CME 986, Chicago IL 

60612, USA 

This study investigates specific factors influencing 

underrepresented minority students’ (URMs) choice 

among medical schools. Quantitative and qualitative 

pre-matriculate data were gathered from all applicants 

to the University of Illinois at Chicago College of 

Medicine (1999/2000-2000/2001). Applicants were 

classified both by ethnicity and student groups listed 

as follows: interviewed and denied (ID); interviewed, 

accepted and matriculated (AM); and interviewed, 

accepted but declined the offer (AD). A series of Chisquare 

tests of independence and t-test were performed. 

MCAT scores were significantly higher for the AD 

group, whereas GPA was statistically different only 

between the ID and AD students. Particular choices 

such as the prestige and affiliation of undergraduate 

institutions and medical schools, multiple acceptances, 

and choices among multiple acceptances were also 

statistically dependent on student groups and ethnicity. 

Distinguishable trends exist regarding the selection of 

a medical school that follow either student ethnicity, 

or entrance categorization. 

5J6 Education for professionalism in 

medicine 

Geoffrey Westwood* and Barbara Westwood 

Bankstown Health Service, Locked Mail Bag 1600, Bankstown 

NSW 2200, AUSTRALIA 

One of the themes for this conference is professionalism 

in medical education. The concept of professionalism 

in medical practice as distinct from medical education 

is discussed along with what constitutes 

professionalism in current medical practice in Australia. 

The question is proposed that unless medical education 

addresses the issues of professionalism then it is 

unrealistic to expect young doctors to exhibit so-called 

professional behaviour in their practice of medicine. 

The authors draw on their long experience in health 

administration and health education.

5J7 Characteristics of students admitted 

for the medical course at the Faculty 

of Medicine of Ribeirao Preto, 

University of Sao Paulo, Brazil 

A R L Cianflone*, M F A Colares, J F C Figueiredo, 

M L V Rodrigues and L E de A Troncon 

Faculty of Medicine or Ribeirao Preto, Rua Dom Luiz Amaral 

Mousinho, 1662-ap.2, 14090-180 Ribeirao Preto SP, BRAZIL 

In order to determine some characteristics of the 

medical students, a standardized questionnaire was 

applied to 96 students admitted in 1994 and to 98 

students admitted in 2000. The results were: age at 

admission: 18 years or less (62.8%); number of 

Session 5K Contexts for learning 

5K1 Clinical education in the health care 

professions: a critical analysis of 

the literature 

Alison Rushton 

Coventry University, School of Health & Social Sciences, Priory 

Street, Coventry CV1 5FB, UK 

Clinical education is an integral component of medical 

education, providing an essential bridge between the 

academic and clinical environments. A soft systems 

methodology provided a conceptual framework for 

structuring an analysis of clinical education. The search 

encompassed all major databases and manual searching 

of key journals for healthcare professions. Content 

analysis identified emerging themes, and informed the 

sub-divisions of the analysis. Key themes included: 

balance between theoretical and clinical course 

components, timing of placements, assessment, models 

of placement, supervisory process, and roles of the 

clinical educator and the university tutor. The analysis 

identified a paucity of good quality research, with both 

theory-practice and literature-practice gaps in 

existence. The literature also highlighted the necessity 

for change and the need to develop theory and research. 

The findings reflect that a structured approach to 

address the issues raised by clinical education at 

individual profession and interdisciplinary levels is 

perhaps required. 

5K2 “Contracts for Learning”: project to 

improve the quality of attachments 

at a District General Hospital 

Richard Ayres*, Henry Averns and Lin Sanders 

Northern Devon Healthcare Trust, Medical Education Centre, 

North Devon District Hospital, Barnstaple, Devon EX31 4JB, 

UK 

Our District Hospital serves a mainly rural population 

of 160,000 and has good links with local GPs and 

community hospitals. Undergraduate medical students 

come for various attachments, mostly from Bristol 

University. Often they have no clear idea what they 

want from the attachment, and sometimes we have no 


- 4.45 - 

previous applications: 1(64.9%) and >1 (13.4%); 

previous experience in other university courses: 5.1%; 

father with university degree: 76.8%; mother with 

university degree: 53.1%; students who have parent 

physicians: 19.5% (other relatives physicians: 39.5%). 

38.5% of the students decided to apply for medicine 

between the ages of 14 and 16 years and 30.5% decided 

between 10 and 13 years. The disciplines of better 

performance during the high school were Biology 

(91.5%), Chemistry (78.2%), Physics (77.5%) and 

Mathematics (77.5%). The reasons given for 

application to Medicine were: liking Biology (45%); 

personal achievement (30%); to help people (23%). 

clear idea what to teach them. “Contracts for Learning” 

is a new project based on a model already used here 

for nursing students. We email students four weeks 

before their attachment. We provide detailed profiles 

of teaching staff in the hospital and primary care; also 

particular departments, GP surgeries and community 

hospitals. This amounts to an extensive menu of choices 

(including multidisciplinary modules offered to 

healthcare students). Students then submit a form 

detailing their learning requirements. We then produce 

a “Learning Contract” specifying what learning 

experiences we will provide. We will be presenting our 

early experience of this project. 

5K3 Does the dedicated teaching 

environment in ambulatory care 

improve acquisition of learning 

outcomes? 

Clare I L Stewart*, Paul E Preece and John A Dent 

Dundee University, Clinical Skills Centre, Ninewells Hospital 

and Medical School, Dundee DD1 9SY, UK 

Current trends in undergraduate medical education are 

away from traditional ward-based learning to 

ambulatory care teaching. We wanted to know whether 

students gain more learning outcomes from a dedicated 

ambulatory teaching environment than a conventional 

outpatient clinic. A comparative evaluation study using 

a semi-structured student questionnaire and a structured 

patient questionnaire was performed. Surprisingly, 

results indicated the learning environment and 

organisation of the teaching were rated equally. 

However, more learning outcomes were achieved 

utilising the Ambulatory Care Teaching Centre 

(ACTC), but each venue demonstrated particular 

strengths with regard to individual outcomes. The level 

of patient satisfaction in the ACTC was high, implying 

patient care was not adversely affected utilising this 

setting. This information will inform practice for the 

content of future teaching sessions.

5K4 Could we improve on what patients 

our pediatrics students saw in 

outpatient clinics? 

Pedro Herskovic*, Alicia Vasquez, Cristian Breinbauer, 

Patricia Gomez, Viviana Herskovic, Marcela Jacard, 

Claudio Missarelli and Erika Troncoso 

Pediatrics Department, University of Chile, Faculty of Medicine, 

Campus Oriente, Casilla 16117, Correo 9, Providencia, 

Santiago, CHILE 

For the last two years we have registered every contact 

of fifth year medical students with pediatric outpatients. 

In 1999 we found that exposure to pathologies included 

in the contents for the rotation ranged from 43.5% to 

71.7%. In year 2000 an intervention was made with 

the students’ tutors to increase their awareness about 

the need of contact with more pathologies. Our 

objective was to check if such intervention would 

improve on the deficiencies detected in 1999. In year 

2000 six student groups attended 50 sessions in 

outpatient clinics. Patients were registered with up to 

three diagnoses, which were compared with the 46 

pathologies included in our learning objectives. Patient 

encounters ranged from 38 to 127 per group. Exposure 

to pathologies ranged from 43.0% to 80.4%, which was 

similar to what was observed in 1999. Correlation was 

found between the number of patients seen and contact 

with more pathologies. A briefing session for tutors 

did not improve the completion of the rotation 

objectives. We have to keep assessing what is going on 

in clinical rotations. 

5K5 Using the ward round for teaching 

and learning: how do junior 

doctors learn from consultants 

through ward-based teaching? 

Alan Bleakley 

Cornwall Postgraduate Education Centre, Royal Cornwall 

Hospital, Truro Cornwall TR1 3LJ, UK 

Traditional psychological models of knowledge and 

skills transmission fail to tell the entire story of how 

junior doctors are effectively taught on ward rounds, 

moving from novice to expert status through 

‘professional adhesion’. This paper presentation reports 

an ongoing combined qualitative methods research 

project with a mixed speciality group of twenty-five 

consultants in a large rural hospital in Britain. Data 

analysis of semi-structured interviews responding to 

examples of videotaped ward practice, has led to a more 

anthropological, rather than the conventional 

psychological, exploration of the working modes of 

specific communities of practice in a complex teaching 

and learning context. Contemporary models of 

constructed, distributed and situated learning, of 

cognitive apprenticeship, of adaptation to a ‘habitus’ 

(informal rules and regulations of a community of 

practice) and of the construction of practitioner 

identities, are used as an exploratory, and in some cases 

explanatory, framework for the data collected from the 

study. 


- 4.46 - 

5K6 Clinical skills training needs of final 

year medical students and PRHOs - 

a comparison 

D MacLeod*, E Gill, J Gate and J Rees 

NHS, University Hospital Aintree, Longmoor Lane, Liverpool 

L9 4EL, UK 

We compared the clinical skills training needs of final 

year medical students and PRHOs. We surveyed 257 

final year medical students undergoing clinical skills 

training, including a ‘Harvey’ cardiac patient simulator 

and communication training. Then, 22 PRHOs 

completed a questionnaire assessing training needs to 

plan clinical skills teaching. The most frequent student 

revision requests were all commonly encountered 

OSCE stations; catheterization, suturing, 

ophthalmoscopy, IV fluid management and breast 

examination (100%, 95%, 79% and 58% of student 

sessions respectively). By contrast, PRHOs requested 

training on infrequently performed skills (joint 

aspiration, pneumothorax aspiration, central vein 

cannulation) or common but complex skills. Selfassessed 

training needs of final year medical students 

reflect impending OSCE assessment, whilst degree of 

exposure and skill complexity drive training needs for 

the PRHOs. This suggests some adjustment in student 

skills training and the need for further skills training 

sessions for PRHOs. 

5K7 The impact of a precepted diabetic 

foot care program 

Linda Z Nieman, Lewis E Foxhall*, Frank Sifuentes and 

Lee Cheng 

UT Houston Health Science Center, Family Practice and 

Community Medicine, 6431 Fannin, Suite JJL324, Houston TX 

77030, USA 

Diabetes is a growing international health problem that 

too often leads to foot amputation. Over a two summer 

period, 156 preclinical students in the Texas Statewide 

Family Practice Preceptors hip Program screened the 

feet of more than 300 diabetics, 30% of whom had 

loss of pedal sensation. Screening was accomplished 

with the Semmes Weinstein 5.07/10g, monofilament. 

Students also taught these patients diabetic foot care. 

From the analysis of the copies of the patient 

evaluations submitted to us, we found that patients 

whose age was greater than 60 years and patients who 

received their care in rural settings were more likely to 

have a greater number of foot problems than those 

patients who were younger and those who received care 

in metropolitan areas. The students’ participation in 

diabetic screening and patient education has saved 

preceptors time and is considered helpful by patients. 

This program is transferable to other settings.

Session 5L Evaluation of multiprofessional education 

5L1 The benefits of a multiprofessional 

education programme can be 

sustained 

G J Mires*, F L R Williams, R M Harden and P W Howie 

University of Dundee, Department of Obstetrics and 

Gynaecology, Ninewells Hospital & Medical School, Dundee, 

DD1 9SY, UK 

Improved understanding by third year medical students 

about the professional roles of doctors and midwives 

in the care of labouring women following a 

multiprofessional education programme have 

previously been reported (Mires et al, 1999). Following 

a clinical attachment in the fourth year, the previously 

observed changes in awareness of professional 

responsibilty were maintained in the same group of 

students and in some areas enhanced. We believe that 

a short multiprofessional course early in the medical 

curriculum can change awareness of professional 

responsibility. Further, we have evidence that these 

attitude changes were maintained and enhanced 

following a clinical attachment later in the educational 

programme. This reinforcement of multiprofessional 

experiences may enhance working practice after 

graduation. 

(Mires GJ, Williams FLR, Harden RM, Howie PW, McCarey M, 

Robertson A. Multiprofessional education in undergraduate 

curricula can work. Medical Teacher 1999;21:281-285) 

5L2 Self-directed multiprofessional 

continuing medical education with 

facilitators: an experiment in four 

European countries. The Belgian 

story 

J Goedhuys*, C Geens, N Mathers, K Billingham, G Maso 

and O Solas-Gaspar 

Catholic University Leuven, Kapucijnenvoer 33 J, 

Minderbroedersstraat 17, 3000 Leuven, BELGIUM 

In order to further implement fundamental options like 

self-directed learning, multiprofessional education and 

case-based learning, Continuing Medical Education has 

to provide a model that integrates the values of these 

options into daily practice. The aim of our project was 

to try out such a model in UK, Belgium, Italy and Spain. 

In this paper the Belgian experience is reported. Six 

general practice/family medicine group practices were 

selected, with at least two GPs and at least one extra 

discipline attached to the practice. Two facilitators 

(young GPs) were appointed to three practices each. 

They facilitated the group in constructing a common 

learning agenda and made sure the group found the 

methods to realise it. All processes and outcomes were 

registered and all participants were interviewed 

afterwards. Results show a high satisfaction, perceived 

relevance and enhanced teamspirit. The balance 

between task-oriented and group-oriented facilitation 



- 4.47 - 

5L3 Interprofessional education in a 

clinical and non-clinical 

environment: teachers’ and 

learners’ perspectives 

John Jenkins and Sue Morison* 

Queen’s University Belfast, School of Nursing & Midwifery, 

Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, 

UK 

This paper presents the results of the evaluation of an 

interprofessional education (IPE) pilot programme for 

undergraduate medical and nursing students. The pilot 

involved 136 students in the specialist areas of 

paediatrics and Children’s Nursing. Three groups, with 

a maximum of 44 students per group undertook the 

project during 2000-01. Experts from both professions, 

University and Health Service, delivered the 

programme and assessed student learning. Qualitative 

and quantitative evaluation techniques were employed 

to compare the success of classroom-based (lectures, 

problem-based learning (PBL), case discussion) and 

clinical placement (tutorials, ward rounds, teamwork) 

teaching and learning. The views of both teachers and 

learners will be presented. Initial results suggest that 

both students and teachers identify PBL as the most 

successful classroom-based teaching and learning 

strategy but that clinical placement learning was 

preferred overall. That teaching staff demonstrated a 

positive attitude to IPE was also important. 

5L4 Interprofessional education: 

experiences of students 

J Agsteribbe*, R M H Schaub and J Cohen-Schotanus 

University of Groningen, Department of Education, Faculty of 

Medical Sciences, A. Deusinglaan 1, 9713 AV Groningen, 

NETHERLANDS 

The courses of the undergraduate dental and dental 

hygienist training at Groningen University are partially 

shared. The concept of this educational programme is 

that dentists and dental hygienists join forces within 

their workfield. The students therefore should get 

acquainted with the concept of working together. The 

research question is: how do students experience this 

concept? In order to answer this question we used the 

critical incidents method. We asked the students 

(n=300) to answer the following question: “ During 

which event in the course did you personally experience 

the team concept and did it work out well for you, or 

did it not work out at all?” 85 forms were returned to 

us. The students’ opinions towards their professional 

colleagues became increasingly critical. In particular 

the dental hygienist students did not have the feeling 

they were taken seriously by the teachers and the dental 

students.

5L5 “Capturing the learning”: the 

development of interprofessional 

education in the Faculty of Medicine, 

Health and Biological Sciences, 

University of Southampton 

D Humphris* and S Colly 

New Generation Project, Building 67, University of 

Southampton, Highfield, Southampton, Hants SO17 1BJ, UK 

The Faculty of Medicine, Health & Biological Sciences, 

University of Southampton have a track record of 

developing a number of successful small 

interprofessional teaching and learning projects. This 

paper reports the findings of a study designed to 

‘Capture the Learning’ emerging from the experience 

of the last decade of inter-professional education 

activity in the Faculty. This small-scale qualitative study 

involved interviews with 16 key informants from a 

range of professional backgrounds, from across the 

Faculty and service. This paper reports the key emergent 

themes from the analysis of data. This includes a 

reflection on the conditions necessary for the 

development of interprofessional education and 

learning in the Faculty. The outcomes of this study will 

be related to the development of the Faculty’s 

commitment to the establishment of the New 

Generation Project. 

- 4.48 - 

5L6 Learning interprofessionally: a 

review of experiences 

A Le May*, F Kitsell, I Giles and C Stephens 

School of Nursing & Midwifery, Building 67, University of 

Southampton, Southampton, Hants SO17 1BJ, UK 

This paper details the educational approaches used in 

a programme of interprofessional education within the 

Faculty of Medicine, Health and Biological Sciences 

at the University of Southampton. This initiative 

focussed on 1,000 first year undergraduate students 

undertaking courses in medicine, midwifery, nursing, 

occupational therapy, physiotherapy and podiatry. 

Students were split into 100 facilitated learning groups 

and asked to construct a scenario, from a selection of 

clinical topics, against which they answered 3 clinically 

focussed questions and critically appraised their 

experiences of team working. Assessment was through 

an oral presentation of their work to peers and 

facilitators. The entire experience has been evaluated 

from both the students’ and the facilitators’ view points 

– salient issues raised in this evaluation will be 

presented and discussed in the light of planned future 

interprofessional exercises during the second and third 

years of these students’ programmes. Conclusions 

surrounding the opportunities and barriers to 

interprofessional education will be drawn. 

Session 5M Teaching about EBM, critical thinking and research 

5M1 Questions as the key to knowledge: 

teaching medical students in 

Evidence-Based Medicine 

Jonna Skov Madsen*, Birgitta Wallstedt, Carl Joakim 

Brandt and Mogens Horder 

Odense University Hospital, Department of Clinical 

Biochemistry, DK-5000 Odense C, DENMARK 

There is a focus on teaching Evidence-Based Medicine 

(EBM) but until recently EBM training was not 

incorporated in our undergraduate curriculum. We 

introduced an EBM course in the 9th semester (out of 

13) in the subject matter ‘clinical biochemistry’. The 

course consisted of seven (1-hour) lectures during three 

weeks. First an introduction to the EBM method was 

given after which students in small groups chose and 

focused their own question, undertook a structured 

search and selected one article. The process and results 

were subsequently presented to and discussed within 

the entire group of students. The course was evaluated 

using a questionnaire. Students improved in the 

evaluation of scientific articles and in seeking 

information and reported that they had been stimulated 

to understand concepts instead of memorising details. 

In our opinion medical students should be introduced 

to EBM at an early stage to be able to practice EBM 

throughout their education. 


5M2 Teaching Evidence-Based Medicine 

to healthcare professionals: 

implementing and evaluating the 

programme 

C Osonnaya*, K Osonnaya and E Burke 

Department of General Practice and Primary Care, Queen Mary 

College, University of London, Mile End Road, London E1 4NS, 

UK 

Many papers have described the importance of 

exposing healthcare professionals to the ‘new 

paradigm’ of evidence-based medicine (EBM) as one 

of the best ways to improve patient care. To this end, 

we developed and evaluated short courses in EBM for 

health professionals from 1998 to 2000 at the United 

Medical Education Consortium, London. Each of the 

courses lasts for four weeks. The aims of the course 

are to enable participants to learn how to go through 

logical laid questions, search on-line databases, review 

articles critically and apply information from the 

literature to specific clinical questions. All the 

participants were surveyed immediately before and 

after the short course to assess changes in reading, 

critical evaluation and literature search in medical 

decision making. The results showed that on-line 

database search and critical appraisal skills increased 

significantly in the participants, as did their tendency 

to use MEDLINE, BIDS and original research articles 

to solve clinical problems.

5M3 Impact of a short interactive 

curriculum on medical students’ 

appreciation of EBM and CAM 

Samuel N Forjuoh*, Robert A Henry, Terry G Rascoe, 

Barb Symm and Janine C Edwards 

Department of Family & Community Medicine, Scott & White 

Memorial Hospital, Texas A & M University, System Health 

Science Center, College of Medicine, Scott & White Santa Fe 

Center, Temple, TX 76504, USA 

To evaluate the impact of a short, interactive curriculum 

on students’ appreciation of evidence-based medicine 

(EBM) and complementary/alternative medicine 

(CAM), a one-page anonymous questionnaire was 

distributed to all third-year students during their sixweek 

family medicine clerkship before/after a new 

curriculum, comprising interactive sessions on 

principles of epidemiology, biostatistics, EBM/CAM. 

The majority reported that the new instruction in 

epidemiology (83%), biostatistics (88%), EBM (95%), 

and CAM (100%) would help their future work. Even 

though the increase in their mean response on 

appropriateness of integrating EBM/CAM from 3.79 

to 4.05 on a 5-point Likert scale was not statistically 

significant (p=.095), significant changes were reported 

in the areas of “critiquing the medical literature” 

(p=.030) and “appraising a clinical trial” (p

5M7 Experimental courses in 

Biochemistry - initiation to 

scientific research in 

undergraduate medicine 

Carlota Saldanha*, Rui Mesquita and J Martins-Silva 

Institute of Biochemistry, Faculty of Medicine of Lisbon, Av Prof 

Egas Moniz, 1649-028 Lisbon, PORTUGAL 

Experimental courses in biochemistry have been 

carried out in order to develop critical thinking, 

autonomy and decision-making capacity in first year 

students. To determine the students’ outcomes in terms 

of learning success and satisfaction, an anonymous 


- 4.50 - 

questionnaire with 15 questions based on a Likert scale 

(bad, insufficient, sufficient, good, very good) was 

applied to the 14 students that attended the course in 

1998/1999, at the beginning and the end of the course. 

At the end of the course there was an increase in the 

number of students who responded ‘very good’ to: the 

stay in the lab, to using bibliographic search, to what is 

the quality control, to doing statistical analysis and to 

making oral results presentations. There was an increase 

in the students’ interest in research, practical skills in 

the lab and their knowledge in different areas of 

biomedical research.

Session 6 Workshops 2 

6/1 Basic Skills Faculty Development 

Workshop 

Dr Anita Duhl Glicken 

University of Colorado School of Medicine, Box C219, 4200 E 

9th Avenue Denver, Colorado 60262, USA 

Background 

Medical faculty are often recruited directly from 

clinical practice and while clinical expertise is 

invaluable to an applied educational process, these 

individuals may feel unprepared for the expectations 

and demands of academic teaching. 

Aims 

The purpose of this workshop is to provide new faculty 

with participatory learning experiences designed to 

enhance basic skills that contribute to success in the 

academic environment. The workshop will also benefit 

senior faculty who wish to improve their skills or 

mentor new faculty in their program. Materials will be 

provided to enable participants to replicate this 

workshop at their own institution. 


Faculty interested in improving their own teaching skills 

or mentoring new faculty 


Two faculty development modules, designed to increase 

awareness of active teaching strategies, will engage 

participants in an interactive exploration of ways to 

enhance didactic teaching through the creation of a 

complete course syllabus that serves as a contract for 

partnership in learning. In addition, participants will 

explore strategies to improve student-faculty 

communication and feedback. These model workshops 

illustrate two components of an existing integrated 

program for faculty development. As a final exercise, 

time permitting, participants will review an existing 

integrated framework for faculty development and 

generate a strategic plan for developing a framework 

within their program. This plan will address issues of 

needs assessment, identification of educational 

components, models and strategies for course delivery, 

and assessment. 

This workshop will include several interactive 

exercises. Participants will work together to apply 

principles presented in class and to generate new 

information to share with the larger group. Brief 

computer-generated presentations will be used to share 

information and guide discussions in the larger group. 

Handouts will be distributed. 

6/2 An Introduction to Clinical 

Judgment Analysis 

Dr Anthony LaDuca 

National Board of Medical Examiners, 3750 Market Street, 

Philadelphia, PA 19104, USA 


- 4.51 - 

Background 

Medical school faculty and practising physicians place 

great importance on clinical judgment. Frequently, it 

is cited as a crucial element of a clinician’s proficiency. 

For some, judgment encompasses the “art” of medicine 

and the prospect of teaching it is seen as daunting if 

not impossible. But expert judgment has been studied 

for decades and clinical judgment has been the object 

of many investigations in Europe and North America 

for more than 30 years. Despite this lengthy history, 

few clinician educators are familiar with the concepts 

underlying judgment theory and judgment analysis. 

This workshop is intended to address that need. 

Aims 

• To introduce participants to the theory and practice 

of judgment analysis in clinical applications; 

• To engage participants in a systematic judgment 

analysis exercise; 

• To encourage participants to locate places for CJA 

in their instructional program; 

• To familiarize participants with the principal 

features of judgment theory as formulated by 

Brunswik and Hammond. 


Post-graduate clinical education teaching faculty and 

administrators; clerkship directors; members of student 

progress committees; medical education support 

professionals; other medical school faculty and 

administrators. 


The presenter will lead participants in a CJA exercise, 

such as diagnosing pneumonia. This exercise will use 

a Web-based CJA system developed by the NBME. The 

CJA system produces a graphical representation of the 

participant’s judgment “policy” and statistical feedback 

comparing that policy with a criterion policy. The 

participant is permitted to complete a second block of 

“cases” after which further feedback is provided. This 

latter feature illustrates the powerful instructional 

potential for CJA technology. 

1 [20 m] Participants engage a Web-based CJA 

Tutorial on chest pain. Presenter leads discussion 

of the meaning of graphical and statistical feedback 

2 [20 m] Participants complete exercise on diagnosis 

of pneumonia in 30 patients presenting in an 

emergency department. Feedback is discussed. 

3 [20 m] Participants complete the second block of 

30 pneumonia cases and discuss the feedback. 

4 [45 m] Presenter leads discussion of theoretical 

foundations of judgment analysis. 

5 [45 m] Working in small groups, participants begin 

to construct an original CJA problem as a means of 

addressing the potential utility of a computer-based 

CJA system in their instructional programs. 

6 [30 m] Small groups report on their products.

6/3 Norwegian Federation for Medical 

Education 

Chairperson: Dr Eivind Drange 

The workshop consists of three parts. All participants 

are welcome to attend parts 1 and 2. Part 3 is an 

Extraordinary General Assembly of the NFME. 

Part 1: 14.00-14.45 

Plenary: Reform in a medical school – 

needed, wanted, possible? 

Kirsti Lonka, Ph.D. Director, Development and Research 

Unit, Faculty of Medicine, 

University of Helsinki, Finland/Professor in Medical Education, 

Karolinska Institutet, Sweden 

Medical education is in the constant process of change, 

which makes it a dynamic field of study. Typical 

proposals for the improvement of undergraduate 

medical education have involved teaching the practical 

skills needed in general practice and closer integration 

of theoretical and clinical studies. Movement towards 

problem-based curricula is taking place all over the 

world. Also communication studies and professional 

growth are emphasized. In Finland, curriculum reforms 

have been frequent. Probably the most radical one took 

place in the Faculty of Medicine at the University of 

Tampere in 1994, when a pure PBL (problem-based 

learning) curriculum was started. Faculty of Medicine 

at the University of Helsinki began to evaluate and 

reform its curriculum of medical studies in 1994. This 

process resulted in Helsinki 2000, a hybrid-PBL 

curriculum, which was introduced in 1998. In this 

program, a systematic programme was also integrated 

to support students’ personal growth and to advance 

their communication and thinking skills. The main 

challenges for such a change process are not economic 

or technical, but rather, social and psychological. Most 

teachers lack educational training, and their 

understanding of the learning process is rather modest. 

A new approach to teaching requires medical teachers 

to view students as active constructors of knowledge. 

However, even though reforms may look good on paper, 

their implementation is the main challenge of medical 

education. Successful reforms are not possible without 

serious scientific research on medical education. 

Part 2: 1500-1545 

Workshop: NFME and AMEE – do we need 

them both? 

A discussion on the future role of NFME and possible 

co-operation with AMEE 

The workshop will start with a closed debate among 

the panel followed by an open discussion. 

NFME and AMEE pursue similar objectives, and in 

many ways they fulfil them using the same means. 

Because of this, some Nordic institutions have claimed 

that there no longer is a need for NFME. At the 

workshop we want to challenge this claim and discuss 

if and how the two organisations can work side by side 

and together. 


- 4.52 - 

6/4 Bedside Cardiology Skills Training, 

featuring “Harvey”, the Cardiology 

Patient 

Simulator and the UMedic Computer System 

Dr Michael S. Gordon, University of Miami School of 

Medicine, USA 

Dr Joel M Felner, Emory University School of Medicine, USA 

Center for Research in Medical Education, P O Box 01690 (D- 

41), Miami, FL 33101, USA 

Background 

As changes in medical care reduce the faculty time and 

patients available for teaching, simulation and 

multimedia systems are becoming a required 

component of medical curricula. The requirement for 

the faculty is leadership and a willingness to accept 

and implement change. 

Aim 

The objective of this workshop is to demonstrate the 

effective use of simulation to teach and assess bedside 

cardiology skills. 


The presentation will be interactive, with full audience 

participation in the “patient” evaluation through video 

projection and audio for impulses, heart sounds and 

murmurs. Examples will be presented using the 

UMedic multimedia computer system. UMedic features 

“Harvey”, a life-sized manikin capable of simulating 

the bedside findings of 27 cardiac diseases, including 

blood pressure, venous, arterial and precordial impulses 

and auscultation. The UMedic system provides a 

comprehensive standardized multimedia curriculum in 

cardiology that includes the history, bedside findings, 

laboratory evaluation and therapy, and measures learner 

performance. 

6/5 Risk Management in Medical 

Education 

Directors of Research in Postgraduate Medical 

Education Group 

Presenters: Dr Kwee Matheson, Dr Alistair Thomson and 

Dr Andrew Long 

West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ, 

UK 

Background 

There is worldwide interest in risk management. Studies 

in the USA and Australia quote that up to 16% of 

hospital admissions suffer adverse events. Costs are 

estimated at £2 billion in the UK alone and are 

escalating. Postgraduate Medical Education (PGME) 

may help doctors prepare to manage and minimise risk, 

but medical education itself may need risk 

management. 

Aims 

This workshop aims to identify the issues and to 

develop a model for good practice to guide Directors 

of PGME (DPGME).


Plenary 30 mins., Group work 1 hour, Report back and 

discussion 1 hour. 

Participants will explore the relevance of risk 

management to PGME by discussing the following 

subjects through plenary and small group work, under 

the guidance of experienced facilitators: 

Why errors occur; How we can learn from mistakes; 

Risk management and the learning cycle; Clinical/ 

critical incident reporting and links with audit; How 

can PGME contribute to a safer environment; Trainers 

and trainees: both angels and devils; Educational 

governance: Standards, Assessment and Poor 

Performers; Validity and reliability of current 

assessment methods; Culture versus curriculum; The 

risks to DPGME; What can the DPGME do to 

encourage a pro-active approach to risk management? 

Conclusions from this workshop should be a template 

to help medical educators fulfill their key role in risk 

management. 

6/6 The professional and 

organisational culture of medical 

education – an exploratory 

workshop in the context of an 

interactive exhibition* 

Dr Elizabeth Krajic Kachur, Dr Nobaturo Ban and Hannah 

Kedar 

Medical Education Development, 201 East 21st Street, Suite 

2E, New York, New York 10010, USA 

(There will be an exhibition linked to this workshop in 

Research Building Seminar Room 1.0020 1st floor 

throughout the Conference) 

Aims 

This session will provide an opportunity to explore and 

reflect upon the professional and organizational 

environment of medical education as it currently exists 

and as it might develop in the future. This increased 

awareness should help participants better understand 

their current study/work situation and empower them 

to move the field into a direction that will assure 

progress. 


Education professionals, teachers, administrators, 

trainees involved in medical education. 


• 15min Welcome and introductions 

• 15min Exhibition background and orientation 

• 30min Individual exploration of exhibition areas 

with the help of a worksheet that asks for the 

completion of specific questions (e.g., identify what 

exhibition area/item makes you feel most “at home,” 

list what objects/images you would have expected 

to see) 

• 30min Discussion of individual experience (first 

in pairs and then in a large group format, a list of 

adjectives that describe the current cultural climate 


- 4.53 - 

will be generated) 30min Medical education in the 

future (participants work alone or in pairs, they pick 

an exhibition area and draw on a flip chart sheet 

what this area would look like in 20 years) 

• 30min Presentation and discussion of individual 

drawings that get posted on the wall and 

incorporated in future exhibitions (at the end of this 

discussion a list of adjectives describing the 

predicted future culture of medical education is 

generated by the group and the two lists are 

juxtaposed for an additional debate) 

• 15min Strategies for strengthening or changing 

culture - What can you do to be an active participant 

in your culture? (a list will be generated and a tips 

sheet based on the literature will be disseminated) 

• 15 min Generation of Take-Home-Points from the 

session. 

6/7 Students teaching communication 

skills 

Organisers: Diana Mitter, Heiderose Ortwein, Jan 

Schildmann & Gunda Siemssen 

Students from Charité, Humboldt-University of Berlin, Germany 

Aims 

At German medical schools there is a long tradition of 

students teaching communication skills in peer groups. 

We therefore would like to invite you to experience 

different methods we use at the Charité, Medical 

Faculty at the Humboldt University Berlin. Two options 

are available to participants: one session will 

demonstrate the work of history taking groups 

(Anamnesegruppe) led by student tutors. In parallel 

there will be a training for future student tutors of 

breaking bad news courses. 


Invited are persons interested in teaching 

communication skills (professors, students and 

administration professionals). 


The workshop will be divided in two sessions - a 

practical part with experimental methods and a second 

part including discussion of the following topics: 

advantages and disadvantages of student tutors (from 

our experience students can learn a lot as tutors of 

communication skills courses), quality management 

(e.g. training and supervision of future tutors), 

comparison of student recruitment in different 

countries. A summary of results will be sent to all 

participants after the conference. 

6/8 Developing professional attitudes 

in medical training: theory, practice 

and evaluation 

Professor Amanda Howe 

Dept of Primary Care, University of East Anglia Medical School, 

Norwich NR4 7TJ, UK

Aims 

To examine the evidence base for effective learning of 

professional attitudes in medicine, and to evaluate the 

methods through which this aspect of learning can best 

be evaluated. 


Any educators or researchers interested, particularly 

those involved in creating or evaluating the ways in 

which professional attitudes can be influenced through 

education & training. 


Each participant should come prepared to join in by 

providing a single overhead, outlining their contribution 

to this field (what they do), its evidence base or 

theoretical framework (why they do it), and how they 

evaluate the impact on professional attitudes. These will 

be shared at introduction, and followed by a keynote 

of about 20 minutes. We will then work in small groups 

to consider a) the level of consensus b) the strengths of 

different approaches c) key questions which remain and 

how these might be addressed. These will be shared in 

plenary at the end. 

6/9 AMEE-IberoAmerican Network 

Workshop 

Organiser: Professor Margarita Barón-Maldonado, AMEE 

Background 

Over the past few years, participation by teachers and 

students from Latin American countries at AMEE 

Conferences has been growing steadily. A discussion 

forum has been set up to allow them to discuss areas of 

particular relevance and interest to them. Because of 

the close links that exist between universities in Spain 

and Latin America, a new group has been set up, 

facilitated by AMEE, which will be known as the 

AMEE-IberoAmerican Network for Medical 

Education, chaired by Professor Margarita Barón- 

Maldonado, President of AMEE. 


The workshop is open to anyone who wishes to attend. 

Comments and suggestions for further topics for 

discussion can be Emailed to: amee@dundee.ac.uk 


The following topics have been suggested by 

participants for initial discussions: 

1 What are AMEE expectations from the group 

function? What are IberoAmerican group 

expectations from AMEE? 

2 Presentations from each country relating to the 

current state of medical education, new 

developments and challenges; 

3 Accreditation of Medical Schools, particularly in 

relation to Mercosur; 

4 Potential collaboration both within the Network and 

with other organisations. 


- 4.54 - 

6/10 Problem-based Learning 

Dr Stewart Mennin, and Dr Scott Obenshain 

Department of Cell Biology and Physiology, BMSB, Box 507, 

School of Medicine, University of New Mexico, Albuquerque, 

New Mexico 87131-5134, USA 

6/11 Portfolios as a method of student 

assessment 

Dr Miriam Friedman Ben-David 

Centre for Medical Education, University of Dundee, Tay Park 

House, 484 Perth Road, Dundee, DD2 1LR UK 

Aim 

This workshop aims at informing medical educators 

about portfolios. 


Medical educators who are interested in innovative 

methods of assessing professional behaviours will 

benefit from this workshop. 


It will contain a review of the use of portfolios, 

psychometric aspects unique to portfolio assessment, 

selection of portfolio material and guidelines for 

implementation. Participants will work in small groups 

to design, implement and evaluate administration of 

portfolios. Half of the time will be devoted to plenary 

presentation and discussions and the other half to small 

group work. 

6/12 Learning Needs Assessment in 

undergraduate and postgraduate 


Professor Janet Grant 

Open University Centre for Education in Medicine, Walton Hall, 

Milton Keynes MK7 6AA, UK 

Aims 

• To consider the role of needs assessment in 

undergraduate and postgraduate medical education 

• To consider and evaluate methods of needs 

assessment 

• To identify how needs assessment is and can be done 

efficiently and effectively 

• To consider and evaluate the consequences of needs 

assessment for educational planning and review 


The workshop concerns only undergraduate and 

postgraduate medical education, but participants from 

other health care disciplines will be welcome. 

Objectives 

By the end of the meeting, participants should be able 

to: 

• State the roles of needs assessment in undergraduate 

and postgraduate medical education

• Describe and evaluate the available methods of 

educational needs assessment 

• Advise about practical needs assessment methods 

• Plan the stages that follow on from educational 

needs assessment in undergraduate and 

postgraduate medical education. 

• Offer a critical appreciation of needs assessment in 

education. 


The workshop will consist of a series of short 

presentations, with comprehensive handouts. Integrated 

with this will be participative group exercises which 

will enable participants to review each of the objectives 

stated above and make practical plans for their own 

situations. 

6/13 A European core curriculum? 

Prof. dr. Lennart N. Bouman 

MedEducad Consultancy, In de Korenmolen 17, 1115 GN 

Duivendrecht , The Netherlands 

Aim 

The aim of the workshop is to produce a set of global 

aims and objectives that could act as a common 

framework for the medical schools in the European 

Community. This framework must fit into the directives 

of the European Council on the mutual recognition of 


- 4.55 - 

formal qualifications. Secondly it must be adapted to 

the profound changes that the professional roles of the 

doctor will undergo in the near future. 


The workshop will help participants to become familiar 

with European legislation on the requirements for 

primary medical education and its continuation into 

residency and continuing education afterwards. This 

may be beneficially to those who will be involved in 

future curriculum planning on a local or national scale. 


The workshop will be based on two key papers: 

1 European Council Directive 93/16/EEC, from 

Internet available as: 

http://www.europa.eu.int/eur-lex/en/lif/dat/1993/ 

en_393L0016.html 

2 Learning Objectives for Medical Student Education 

from the American Association of Medical Colleges 

(AAMC), available as: 

http://www.aamc.org/meded/msop/report1.htm 

In the first hour we will discuss content and significance 

of these two papers (participants are requested to 

download these papers and read them prior to the 

workshop). In the second hour elements for a core 

curriculum will be selected in small group discussions. 

The outcomes will be discussed in plenary in the last 

hour.

Session 7A New learning technologies 

7A1 An international web-based 

Master’s degree in Primary Care 

Peter Toon* and Trish Greenhalgh 

University College London, 137 Roding Road, London E5 0DR, 

UK 

Worldwide, the academic basis of primary care needs 

strengthening. In the UK, Masters’ degrees, usually 

part-time over three years, have become important in 

this process. Since 1999 University College London 

(UCL) has offered a multidisciplinary MSc in Primary 

Care, largely through web-based distance learning. 

Students, mostly UK based, follow a structured 

programme of reading, with exercises to help them 

relate their study to previous learning and their 

professional life, and work together in virtual group 

discussions and seminars using computer conferencing. 

As a pilot for the proposed UK “e-university”, we are 

now developing a similar course for an international 

audience. The scope, methods and content of the 

existing course and our qualitative evaluations will be 

described, and the issues involved in devising a course 

for an international audience in a discipline which has 

strong culturally and organisationally specific elements 

will be considered. 

7A2 Can practical courses on 

interpreting blood smears be 

substituted by an interactive, webbased 

learning programme? 

U Woermann*, A Tobler and M Montandon 

Division for Instructional Media, Institute of Medical Education, 

University of Bern, Inselspital 38, CH-3010 Bern, 

SWITZERLAND 

In Bern, medical students learn to interpret blood 

smears in two practical courses. Because students felt 

very unsure in this skill, the web-based programme 

HemoSurf was developed. Some students suggested 

replacing the course by HemoSurf. How much of their 

sureness in interpreting blood smears would students 

attribute to HemoSurf? In a questionnaire students 

indicated that 61% used HemoSurf, 72% printed 

materials, and 11% did not prepare. Students using 

HemoSurf invested on average less than an hour, but 

attributed 49% of their sureness to HemoSurf and only 

30% to the practical courses (six hours). The students 

using printed materials spent on average more than an 

hour, but attributed only 19% of their sureness to these 

materials. We conclude that HemoSurf is an efficient 

tool to learn interpretation of blood smears. We will 

replace the practical courses by a small group format 

discussing the impact of haematological investigations 

on clinical medicine. 

7A3 The management of student 

feedback using the World Wide Web 

Stephanie Cobb* and Helen Graham 

King’s College, Room 4.14 Henriette Raphael House, Guy’s 

Campus, London SE1 9RT, UK 


- 4.56 - 

This poster will outline the introduction of web-based 

student feedback for large group clinical teaching to 

undergraduate medical students. In a pilot study at the 

GKT School of Medicine, London, a system for 

implementing web-based feedback to replace 

traditional paper-based methods was set-up, and the 

potential for this method explored. The steps taken in 

this process will be illustrated and explained. These 

include: 

1 The recruitment of teachers and students to an 

electronic method of student feedback. 

2 The briefing of teachers and students in use of the 

system. 

3 The implementation of the pilot study. 

4 The evaluation of the method. 

7A4 Web-based student feedback on 

large group teaching: how does it 

compare with traditional paper 

methods? 

Helen Graham* and Stephanie Cobb 

Department of Medical and Dental Education, Guys, Kings & 

St Thomas’ School of Medicine, Kings College London, Sherman 

Education Centre, 4th floor, Thomas Guy House, London SE1 

9RT, UK 

Quality assurance is integral to good teaching. It 

requires a commitment from students to provide regular 

feedback, and from teachers to analyze and act on 

information received. The organisation and analysis of 

student feedback is time-consuming and difficult to 

co-ordinate for a complex clinical course. Web-based 

feedback using a dedicated school web-site offers the 

advantage of ease of collation of student assessment 

ratings and comments. In Year 4 of the undergraduate 

course at Guys, Kings and St Thomas’ School of 

Medicine, Kings College London, web-based student 

feedback of large group teaching was compared with 

traditional paper based methods using response rates 

and quality of assessments. The preference of teachers 

for both methods was assessed and their comments 

sought. The advantages and disadvantages of both 

methods will be presented. 

7A5 Reflection on experiences by using 

trigger movies 

Marianne G Nijnuis*, Caro Brumsen, Jan H Bolk and 

Peter G M de Jong 

Leiden University Medical Center, Onderwijscentrum IG, kamer 

C5-54, PO Box 9600, 2300 RC Leiden, NETHERLANDS 

During clerkships, students encounter a lot of new 

impressive, and sometimes frightening or sad 

experiences. At the Leiden University Medical Center, 

an obvious need for reflection on this subject becomes 

apparent during small group sessions in which case 

histories are discussed. Unfortunately no structural 

attention is paid to these experiences during the first 

few months of clinical education. From the small group

sessions, difficult situations encountered by students 

during practice were collected. Situations occurring the 

most frequently were translated into script and recorded 

on video using actors. Subsequently, these materials 

are used as a trigger for discussion in small group 

settings under supervision of an experienced physician. 

The use of the trigger movies improved the capability 

of students to cope with emotions and helped them to 

handle difficult situations better during practical work. 

7A6 Provision of IT learning facilities for 

healthcare education 




UK 

In recent years there has been an increase in the use of 

information technology in medical education. This is 

in response to a growing recognition of the need to 

promote computer literacy among healthcare 

professionals. Our main objective was to design and 

implement Computer Aided Learning (CAL) 

applications, which can be integrated into the healthcare 

education curriculum. Hence a logical approach to CAL 

was developed by building a team of professionals 

which forms a CAL Unit, using existing expertise and 

by implementing a process to ensure that the CAL had 

a maximum impact upon healthcare education. The 

CAL resources include: multimedia learning facilities, 

learning guides, computer aided assessment, model 

patients, anatomical models, statistical models, IT 

interactive learning facilities, teaching and learning 

facilities via the Internet, diagnostic and treatment 

models. We have now implemented over 27 IT based 

learning resources and course evaluations have showed 

that these have been well received by users. 

7A7 Development and evaluation of an 

interactive Computer Assisted 

Learning (CAL) programme on 

vaginal hysterectomy 

Vikram Jha*, Shelley Widdowson, Sean Duffy and 

Keith Allenby 

St James’s University Hospital, Academic Department of 

Obstetrics & Gynaecology, Level 9, Gledhow Wing, St James’s 

Hospital, Leeds LS9 7TF, UK 

In Gynaecology,understanding of anatomy and surgical 

principles involved in vaginal surgery such as vaginal 

hysterectomy is often confusing to students and junior 

trainees. The aim was to develop a CAL programme in 

CD-ROM form combining video, illustrations and 

three-dimensional images for better understanding of 

vaginal hysterectomy. We used Macromedia’s ‘Director’ 

to develop the CD-ROM. This allows text, graphics, 

video and sound to be combined to create interactive 

material. The video was filmed and edited at the 

Hospital. The illustrations were resized and exported 

as quick time. The three-dimensional images were 

created using anatomical models and True Space 

programme. The CD-ROM has been piloted amongst 

fourth year students. It has received a positive response. 

It is intended to demonstrate the CD-ROM and present 

the evaluation results at the meeting. 


- 4.57 - 

7A8 Links from ultrasound to anatomy - 

how is a multimedia teacher 

accepted? 

Dietmar Borchert*, Gunnar Schley, Edda Klotz, 

Peter Rauh, Clemens Reisinger and Thomas Medveczky 

Humboldt - University of Berlin, Medical Faculty, Department 

of Study Organisation, Schumanstrasse 20-21, 10117 Berlin, 

GERMANY 

Since Spring 1998 a group of students has tried to 

establish a multimedia teacher existing of ultrasound 

machines, computer, specialized monitors and 

additional mulitmedia tools. Students from the first 

course were educated in ultrasound in parallel with the 

normal anatomy curriculum. In small groups of 4 

students they learned to handle ultrasound machines 

and to integrate their knowledge of anatomy with 

practical experience. The multimedia teacher was 

equipped with ultrasound software, videos and weblinks. 

The computer can be driven via wireless, handheld 

mouse menus. Pictures of special interest with 

hyperlink-explanation can be loaded and structures on 

the ultrasound images can be compared and identified. 

Students are able to save and edit their own images. 

We tried to estimate how web-based and multimedia 

learning is accepted by students and if early handling 

of ultrasound machines improves knowledge in 

anatomy. 

7A9 Development of a computer-based 

simulation: the Dynamic Patient 

Simulator 

S Eggermont*, P M Bloemendaal, J M van Baalen, 

E M Schoonderwaldt 

Leiden University Medical Center, Heelkunde Onderwijs K6-R, 

Postbus 9600, 2300 RC Leiden, NETHERLANDS 

For obvious ethical and legal reasons it is not allowed 

for students to practise medicine on patients without 

supervision. At Leiden University Medical Center a 

computer-based simulation program, the Dynamic 

Patient Simulator (DPS), was developed to overcome 

this restriction. DPS provides medical students with 

the opportunity to practise medicine on a virtual patient, 

offering all the possible diagnostic and therapeutic 

actions as in real life. Students can practise making 

decisions autonomously, considering the state of the 

patient and accepting responsibility for the 

consequences. Students therefore acquire clinical 

experience in an early stage of their studies and are 

encouraged to fill gaps in their knowledge. DPS can 

be used in the absence of a teacher because a built-in 

assistance system attempts to help students on request, 

depending on the student’s preceding actions. The 

system provides feedback, gives a final score and can 

therefore be used as a self-test. 

7A10 Introduction of laptop computers in 

Leiden Medical School 

Peter G M de Jong*, Hermiette E Idenburg and 

Henk L Hendrix 


IG, Kamer C5-54, P O Box 9600, 2300 RC Leiden, 

NETHERLANDS

In 1998, the board of the Leiden University Medical 

Center decided to introduce information and 

communication technology (ICT) in the medical 

curriculum to prepare students for their professional 

life as a medical doctor. To attain this goal, special 

facilities for students have been created in 2000 to buy 

a laptop computer. For students, participation in the 

laptop-project is voluntary and only first-year students 

are allowed to join. Participants pay only one-third of 

Session 7B Problem-based learning 

7B1 Measuring success: partnership in 

evaluation (work in progress report) 

P O’Neill, D Graham, A Garden, S. Watmough*, J Brown 

University of Liverpool, Curricular Development Unit, 

Department of Primary Care, 2nd Floor Thornley Building, 

Brownlow Street, Liverpool L69 3GP, UK 

An innovative collaborative evaluation project is taking 

place between the Universities of Liverpool and 

Manchester and the Mersey Deanery. The goal is to 

assess whether the new problem-based learning 

curricula at Liverpool and Manchester are producing 

Pre-registration House Officers who are capable of 

meeting the competencies expected by the General 

Medical Council and the National Health Service. 

Preliminary work at Liverpool has involved 

questionnaire surveys of Educational Supervisors and 

Pre-registration House Officers. Mersey Deanery has 

delivered questionnaires to Pre-registration House 

Officers in the area. University of Manchester has 

compiled data on cohorts from the old curriculum 

whilst continuing to work with Pre-registration House 

Officers who have graduated from the new curriculum. 

Further questionnaires, focus groups and interviews 

will be held to gauge differences between old and new 

curricula cohorts and assess the educational aspects of 

the PRHO year. 

7B2 A new PBL course with an 

examination with standardised 

patients at the end 

S Schewe*, C Mueller and R Putz 

Medizinische Poliklinik, Klinikum der Universitat, Ludwig- 

Maximilians-Universitat, Pettenkoferstr 8a, D-80336 Munich, 

GERMANY 

A new problem-based learning (PBL) course dealing 

with disorders of the musculoskeletal system (MuSkel) 

was introduced at Ludwig-Maximilians University 

(LMU) Medical School lasting 4 weeks. All 234 4th year students were enrolled in the summer term 2000. 

For the first time at the LMU an examination with 

standardised patients has been carried out at the end of 

this course. MuSkel followed 3 other PBL-courses 

successively implemented at the LMU. With the new 

form of this examination other insights into correctable 

deficits of medical education could be found, e.g. the 

demand of teaching a more structured clinical 

examination, of teaching problem-solving strategies, 


- 4.58 - 

the total costs, the Medical Center pays for all other 

costs. Insurance of the laptop is included, as well as 

access to a specially designed wireless network. Effects 

of introducing laptops have been evaluated by a 

questionnaire performed in January 2001 among all 

first-year students. This questionnaire shows that the 

use of Internet and Microsoft Office has increased 

enormously, but teachers do not take advantage of the 

possibilities presented. 

considering cost-effectiveness and time constraints of 

ambulatory medicine. The opinion of the students about 

this type of examination was very positive. Focussing 

on practical skills assessment gave further insights in 

deficits which could be partially corrected in the second 

MuSkel course in the winter term 2000/2001. 

7B3 Training the problem-based 

learning tutor: implementation 

issues 




UK 

Problem-based learning (PBL) is widely regarded as a 

useful strategy to improve students’ learning in Medical 

School and to prepare graduates for the informational 

challenges of the years to come. This has led to many 

medical schools adopting this educational approach, 

which increases the need to train tutors to facilitate PBL 

groups. Therefore, we developed a PBL training 

programme for medical teachers. The training 

programme, which lasts for four weeks, is devoted to 

acquainting teachers with the key elements of PBL. 

The principles, the seven steps, the tutorial sessions, 

group interaction, information management, critical 

analysis skills, assessment and evaluation of PBL group 

sessions were also dealt with during this period. The 

role of the group tutor to facilitate and not to lecture 

was emphasised, as well as the goals of PBL. The tutors 

practised acting as PBL tutor, scribe and group member. 

Evaluation of the course showed that it has wide appeal 

and has been well received by the teachers. The 

strongest influence for any modifications made have 

come from the teachers who have participated in the 

course and they had recommended for the programme 

to continue. We therefore recommend it as a realistic 

way of training teachers as PBL facilitators. 

7B4 PBL in Psychiatry - the Holocaust: 

a unique experience 

T Fischel*, T Weizman and G Zalsman 

Geha Psychiatric Center, 13 Tsel Hagiva, Ramat Gan 52374, 

ISRAEL 

Planning a rotation in psychiatry meets a major 

problem: whether and how to incorporate an inner touch

in the student’s soul. Group dynamic and projective 

“games” are some of the possible methods. Teaching 

and learning about the holocaust and its emotional 

implications, is another challenging problem. We aim 

not to be reductive by teaching psychiatric diagnoses. 

In order to meet those two difficulties we constructed 

a PBL session. The goal was to produce a learning 

experience, which involved a controlled emotional 

touch. The case was about a “child survivor”, who 

organized his life and personality as a stiff and 

demanding character, and appeared in the emergency 

room with somatic complains. Besides theoretical 

subjects such as PTSD, somatization disorders and 

obsessive-compulsive personality, the students learned 

about “child survivor” “survivors` guilt” “second 

generation”. The presentation includes the case, the 

emotional response and the students’ feedback to this 

unique experience. 

7B5 Clinical skills of medical students 

participating in lecture-based 

versus problem-oriented training 

W Rimpau 

Park-Klinik Weissensee, Abteilung fur Neurologie, Schonstrasse 

80, 13086 Berlin, GERMANY 

Medical education in Germany is theory-oriented. New 

methods to improve and evaluate skills are needed.The 

study was designed to determine whether students with 

lecture-based versus problem oriented training in 

neurology have different clinical skills. A prospective 

cohort study was carried out. The outcomes of a 

modified version of the objective structured long 

examination record (OSLER) were compared between 

two groups of students. Group I (n=20): Students of 

the Humboldt University Berlin, with a 4-month 

reform-elective in their final (sixth) year of medical 

training. Their previous training has been lecture-based. 

Group II (n=25): Students with a 6 week neurology 

training in their fourth year at the University Witten- 

Herdecke, who have a problem oriented curriculum 

throughout their entire training. Students of the lecturebased 

group showed satisfying but significantly worse 

outcomes. 

7B6 Systematic observations of 

problem-based study groups - what 

do they reveal? 

K Lonka*, P Sauri and N Paganus 

University of Helsinki, Leiviskatie 2 E 64, Fin-00440 Helsinki, 

FINLAND 

The curriculum of the Faculty of Medicine at the 

University of Helsinki was changed towards PBL in 

1998. The aims of the present study are: 1) To see how 

the new approach to teaching and learning works, and 

whether something should be done to improve it, and 

2) to see whether group functioning is related to 

students’ study success. A systematic observation of 

tutorial groups was carried out during Spring term 

2001. A closing session of all 14 first-year tutorial 

groups (10-12 students in each) was observed once. 

All students and their tutors were given questionnaires 

which were filled in after a tutorial session. A specific 


- 4.59 - 

observation sheet was also developed and an external 

observer was hired. The observer also gave feedback 

to the group. Data are presented that consist of the 

questionnaire data, a summary of observation forms, 

and study success of each group. 

7B7 “Pathomechanisms” - a 9-week 

integrative and problem-based 

learning oriented course within the 

3rd year of the curriculum at the 

Medical Faculty Carl Gustav Carus, 

Technical University Dresden 

Oliver Tiebel*, Ines Nitsche and Andreas Deussen for the 

Core Planning Group 

Institute of Clinical Chemistry & Laboratory Medicine, Medical 

Faculty Carl Gustav Carus, TU Dresden, Fetscherstr 74, 01307 

Dresden, GERMANY 

To prepare physicians for the changing demands of 

future developments in medicine the Dresden Medical 

Faculty is restructuring its curriculum implementing 

problem-based learning elements. The changes start 

from the 3rd year of the curriculum. This year - 

equivalent to the first clinical year - consists of 4 PBLcourses: 

“Pathomechanisms” (9 weeks), “Basics of 

Pharmacotherapy” (6 weeks), “Infectiology” (11 

weeks) and “Emergency Medicine” (3 weeks). In this 

presentation we will focus on the structure and 

organization of the “Pathomechanisms” course which 

has been organized as an interdisciplinary enterprise 

including pathology, laboratory medicine, 

pathophysiology and pathobiochemistry. Cases 

discussed in small groups of students and tutored by 

experienced mentors are supplemented by lectures 

specifically related to the case topic and course 

objectives. Additionally students have two practical 

classes each week focussing on pathology and clinical 

pathology. A clinical examination class which extends 

over the entire study year supplements the course. 

7B8 Characteristics of tutors’ 

assessment by students when PBL 

is being implemented 

Yolanda Marin-Campos* and Marcela Lopez-Cabrera 

National Autonomous University of Mexico, Porto Alegre 259, 

“A-402”. Col. San Andres Tetepilco, Delegacion Iztapalapa, DF 

09440, MEXICO 

The students’ perception regarding the performance of 

the tutor has particular characteristics when PBL is 

being implemented, since they are going through a 

transitional process from a traditional to a studentcentered 

approach. Thus, the tutor’s performance must 

be adequately monitored, given that the students are 

adapting to the teacher´s new role. In order to assess 

the tutor’s performance, we selected the functions that 

are most significant of the change in their new role, 

and that are directly related to the tasks of the students, 

that is, those functions the students might have an 

opinion about whether they are being adequately 

accomplished, and if the tutor’s performance is 

facilitating their learning. The elements of the tutor’s 

performance that were selected to be evaluated are: 

support in knowledge elaboration; directing the

learning process; promoting knowledge integration; 

stimulating group member interaction; respect for the 

students; warmth and accountability. 

7B9 From traditional teachers to PBL 

tutors: how to start the change? 

Yolanda Marin-Campos* and Lizbeth Mendoza-Morales 

National Autonomous University of Mexico, Porto Alegre 259, 

“A-402”. Col. San Andres Tetepilco, Delegacion Iztapalapa, DF 

09440, MEXICO 

One of the most difficult elements to change for 

achieving successful implementation of PBL, in 

traditional curriculum schools, is the acceptance of the 

teachers’ new role as tutors. In this project a program 

is presented, whose main challenge has been to 

demonstrate the advantages of PBL over the traditional 

teaching system. To do so, a 60-hour workshop was 

designed in which sceptical teachers are presented with 

the theoretical and methodological basis of PBL, so 

that they themselves can find the answers to their many 

questions.This workshop has been developed 

throughout 6 years, working with teachers from the 

basic and clinical sciences. Included are the educational 

theories that are the basis of PBL components, the 

“How to” apply it to the students’ learning process, 

evaluation methods and some of the methodological 

approaches important for educational research 

development. 

7B10 Development of a problem-based 

curriculum leads to enhancement 

in faculty development - the 

Dresden experience 

N Lorenz*, T Aretz, E Armstrong and the Harvard- 

Dresden Medical Education Alliance 

Technical University, Dresden Carl Gustav Carus, Children’s 

Hospital, TU Dresden, Fetscher Str. 74, 01307 Dresden, 

GERMANY 

Session 7C Curriculum planning and change 

7C1 A model of curriculum management 

in an integrated medical curriculum 

Gregory J S Tan* and B E Mustaffa 

International Medical University, Sesama Centre, Plaza 

Komanwel, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA 

Curriculum management is an integral component of 

any curriculum. The success of curriculum 

development and implementation to a certain extent 

depends on how well the curriculum is being managed. 

Creation of tiers of responsibilities to provide the 

management structure and a well-defined line of 

communication and standing operating procedures 

allow “checks and balances” to be instituted to the 


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Medical education in Germany needs innovative 

approaches to face the challenges of medicine in the 

21st century. Therefore, an educational alliance 

between Harvard Medical International and the 

Technical University of Dresden (TUD) is restructuring 

TUD’s undergraduate medical curriculum by using an 

interdisciplinary approach since 1999. Problem-based 

learning is incorporated in integrated classes consisting 

of lectures, tutorials and practical training. To foster 

the new curriculum, to establish a high quality of 

education, and to train faculty members in PBLmethods 

a faculty training program was developed 

simultaneously. A tutor-training group educated 120 

faculty members in an 18-month period. When the 

development of the curriculum after the 2nd state 

examination led to a demand for new and more complex 

teaching and assessment methods a transition of the 

“tutor-training group” to a working group for faculty 

development was made. The process and methods will 

be described in detail. 

7B11 An orientation programme for 1st 

year students in a problemorientated 

MBChB curriculum - the 

Pretoria experience 

Pierre L Bredenkamp 

Faculty of Health Sciences, Stellenbosch University, P O Box 

19063, Tygerberg 7505, SOUTH AFRICA 

Because the Pretoria medical school changed its model 

of teaching and training from a traditional to a problemorientated 

integrated one, an orientation programme 

(which lasts two weeks) was introduced before the first 

block. Five aims were set for the programme, focusing 

on information, support, motivation, opportunity and 

exposure. Detail regarding these objectives, as well as 

the outline of the programme as a whole, will be given. 

Every student received a block book, and the 35 

learning sessions, as well as the 10 visits, were 

evaluated. The method of this evaluation and the results 

will be made available. The recommendations which 

had been made, will also be shown. 

management of the curriculum. This paper describes 

how the International Medical University (IMU) utilises 

the above principles to manage its medical curriculum 

in a 3-tier management structure. The structure is 

dynamic and it allows an exposition of the curriculum 

philosophy and monitoring of the curriculum (an 

internal audit) through its structural linkage. Its 

dynamism is further reflected in the coherent 

participation and ownership of the curriculum by all 

Faculty members as one would expect in the 

management of a modern medical curriculum.

7C2 The University of Rochester’s 

Double Helix Curriculum 

Elaine F Dannefer 

University of Rochester Medical Center, 601 Elmwood Avenue, 

Box 601, Rochester NY 14642, USA 

Beginning in 1999, a fourth-year, interdisciplinary 

curriculum has been phased in at the University of 

Rochester. Called the Double Helix Curriculum, this 

curriculum integrates basic science and clinical 

medicine throughout the four years of undergraduate 

education with the clinical strand comprising 

approximately 30 of curricular time in years one and 

two and 70% in years three and four, with the basic 

science strand representing the converse. An 18-month 

ambulatory clerkship in years 1 and 2 is followed by 

inpatient clerkships and electives. Students begin their 

education with a course that provides the foundation 

for the practice of evidence based medicine and 

includes biostatistics, epidemiology and skills related 

to searching and evaluating the scientific literature. 

Two-week long comprehensive assessments at the end 

of years 2 and 3 provide feedback for students as well 

as a means of assessing the curriculum. 

7C3 Academic administration and 

mixed programmes 

S Sharma Khanal* and S Koirala 

B P Koirala Institute, Dharan, NEPAL 

The B.P. Koirala Institute is a Health Sciences 

University in Nepal with undergraduate courses in 

medicine, nursing, dentistry and allied health sciences 

plus postgraduate courses to PhD level. This poses an 

overwhelming challenge for maintaining harmonious 

and positive administrative approaches. It becomes 

further intensified as trained manpower is scarce in 

Nepal and the potential danger of manpower leaving 

the Institute has led to new approaches to retain 

teachers. These will be presented in the poster. 

7C4 Learning responsibly - 

implementing written guidelines for 


Richard Phillips*, Ann Wylie and Anne Stephenson 

Department of General Practice and Primary Care, Guy’s King’s 

and St Thomas’ Medical School, King’s College London, Weston 

Education Centre, Cutcombe Road, London SE5 9RJ, UK 

Contemporary medical undergraduate curricula include 

early patient contact in community settings. Whilst 

there may be concurrent teaching in ethics, the focus 

of this may be on the behaviour of a qualified doctor; 

what of the students’ responsibilities to patients and 

each other? As a department, we have 1,800 students 

placed in hundreds of community settings during the 

year, and we are concerned about student awareness of 

their current ethical responsibilities. We prepared 

written guidelines for students about responsible 

learning. Questionnaire follow-up in 1999-2000 

showed only 121 of 263 students definitely had read 

the booklet (of these 121, the majority found it helpful), 

and 20% said they had lost it altogether. For 2000-2001 

modifications were made in delivery and highlighting 


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the material, and the questionnaire repeated. This 

presentation reports on more detailed results of both 

questionnaires and will discuss the modifications and 

the implications. 

7C5 HEICUMED - a novel approach to 

student medical education at the 

Medical Faculty of the University of 

Heidelberg, Germany 

Hubert J Bardenheuer* on behalf of the HEICUMED 

Group 

Medical Faculty, University of Heidelberg, Im Neuenheimer Feld 

346, 69120 Heidelberg, GERMANY 

Heidelberg Medical Faculty developed “HEICUMED“, 

in which the clinical years are completely reorganized 

into organ-related block courses (“modules”). Modules 

are taught multiple times during the year in small 

student groups. A multidisciplinary planning group 

redesigned the original plan and combined the modules 

into interdisciplinary “clusters”, such as surgery and 

medicine. Strong connections between the various 

disciplines are guaranteed by lectures and cases related 

to leading symptoms. Subjects like pathology, 

radiology, clinical laboratory, etc are all integrated into 

the topics of the week and taught alongside. This novel 

approach of student education is directed to 

significantly improve: 

• students’ clinical and practical instructions and 

keeping training of medical facts at a high level; 

• the personal interactions with faculty members; 

• case-related problems in which all pieces of 

knowledge in clinical medicine have to be 

connected; and 

• teamwork by encouraging studying in groups and 

establishing PBL group learning. 

7C6 Enhancing curriculum renewal 

through a “clinical presentation” 

approach to undergraduate medical 

education 

Nehad El-Sawi 

University of Health Sciences, 1750 Independence Avenue, 

Kansas City, MO 64106, USA 

UHSCOM has revised its ‘discipline based’ curriculum 

and adopted the ‘integrative clinical presentation 

curriculum’ modelled, in part, after the Calgary 

curriculum. The discipline-based curriculum 

emphasized traditional basic sciences but lacked 

integration throughout disciplines, and across the four 

years. The integrative Clinical Presentation curriculum 

combined a strong knowledge base of basic and clinical 

sciences where clinical instruction guides basic science 

learning. Each clinical presentation began with a 

decision tree review, demonstration of its use, and a 

series of lectures covering the related basic and clinical 

sciences, ending with opportunities to practice 

diagnostic reasoning. The integration of subject matter 

created a coherent foundation for students` subsequent 

efforts at organizing the relationships between various 

basic and clinical science concepts.

7C7 Continuous training in General 

Practice as an integral part of an 

undergraduate medical curriculum 

- the Witten/Herdecke Model 

(Germany) 

W Kunstmann*, Dieter Wollgarten, René Vollenbroich 

and Markus Gschwind 

University of Witten/Herdecke, 58448 Witten, GERMANY 

Changes in the demographic composition of our 

population as well as changes in health care delivery 

will strengthen the role of general practitioners in the 

future. However, undergraduate medical education has 

not yet appropriately responded to the outlined secular 

trends, and training for students in respective settings 

is broadly missing. At the University of Witten/ 

Herdecke (Germany) a course for continuous training 

in general practice has been established as a mandatory 

part of its undergraduate medical curriculum. 

Beginning in year 1 and ending in year 5, students will 

perform 6 training units in general practice, each of 14 

days’ length. Each unit is structured by a training 

manual, containing specific tasks to be performed by 

students under supervision of their doctors. Tasks cover 

areas such as communication, history taking, physical 

examination, long-term patient care, prevention as well 

as economic and management aspects of health care 

delivery. The course design and its learning objectives 

will be presented. 

7C8 Developing sense of ownership for 

curriculum changes within all 

teaching faculty of an Asian 


C B Hazlett*, T F Fok, S S C Chung and J C Y Cheng 

Office of Educational Services, Faculty of Medicine, Chinese 

University of Hong Kong, Prince of Wales Hospital, Shatin, New 

Territories, HONG KONG 

Major curriculum changes are difficult, and prove to 

be eventually ineffective if there is no wide 

endorsement among the teaching staff. At the Chinese 

University of Hong Kong a curriculum change designed 

to enhanced skills (clinical, communication, and life 

long learning), as well as for enhancing integration of 

basic, social and clinical skills throughout the entire 

five years of its medical undergraduate programme 

were proposed by the Faculty’s leaders. Initially, many 

teaching staff regarded such a change to be of dubious 

need and of low priority, particularly in comparison to 

other work obligations in clinical service and/or in their 

basic or clinical research. The steps taken and methods 

used to effect changes in attitude towards, to build 

support for and to develop a sense of ownership of the 

changes within the entire teaching staff are given in 

this presentation. The process of introducing the 

curriculum change is still ongoing, but the approaches 

used to date have successfully co-opted a reasonably 

high level of willingness and cooperation in at least 

designing and beginning the implementation of change. 

Mechanisms for securing this cooperation within an 

Asian medical school context are compared and 

contrasted with methods frequently proposed and used 

in medical schools operating in Western societies. 


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7C9 Sci45: Framework for the 

implementation of a career 

guidance instrument 

Janet Grant*, Rodney Gale, Mairead Beirne and 

Heather Owen 


University, Walton Hall, MILTON KEYNES MK7 6AA, UK 

The rigorous psychometric development of the 

Specialty Choice Inventory [Sci45] was reported at the 

1999 AMEE meeting. This 130-item instrument 

matches respondents to 45 specialties. The successful 

implementation of Sci45 depends on its flexibility to 

respond to many different needs. To date, six potential 

uses for Sci45 are being developed: 

• Availability on CD-ROM for individual use; 

• Use for final year medical students to assist them 

in their career choice: about 20% of career choices 

are made at this stage; 

• For hospital clinical tutors to offer to all doctors in 

training; 

• Development of Sci45 to include subspecialty 

profiles so that selection panels can ensure a wide 

range of trainees for a range of subspecialty posts; 

• For research into variables that might impinge on 

successful progress through the training grades; 

• To provide independent feedback to selection panels 

to help them reflect on their decisions. 

7C10 The facilitation process in a 

problem-based curriculum at the 

Nelson R. Mandela School of 

Medicine 

Jacqueline van Wyk, Peter Olmesdahl, Veena Singaram* 

and Michelle McLean 

University of Natal, Faculty of Medicine, Medical Education 

Development, Private Bag 7, PBX Congella, 4013, SOUTH 

AFRICA 

The Nelson R. Mandela School of Medicine’s studentcentred, 

5-year, problem-based curriculum greatly 

emphasizes the role of students as self-directed learners. 

Large group resource sessions are scheduled with the 

objective of introducing students to concepts and 

principles. Students are expected to use a variety of 

resources to solve their cases/problems, hopefully 

engendering deep learning strategies. Groups of 

students from diverse cultural and social backgrounds 

meet twice weekly (2 x 2h sessions) for small group 

sessions. Problem identification and resolution are two 

phases monitored by facilitators in order to guide and 

check whether learning outcomes (as identified by 

module designers) are achieved by students. This report 

describes various aspects of facilitation within the 

Faculty, including selection of facilitators, training, their 

role, perceptions of facilitators prior to and after a 

module and their experiences during the module. 

Student perceptions of the role of facilitators are also 

discussed.

Session 7D Curriculum evaluation/staff development 

7D1 Students’ feedback: a public health 

course in medical education 

Eva Rasky*, Wolfgang Freidl; Willibald-Julius Stronegger 

Institute of Social Medicine and Epidemiology, Karl-Franzens- 

University Graz, Universitaetsstrasse 6/I, A-8010 Graz, 

AUSTRIA 

Since 1999 Austrian universities have been required 

by law to evaluate the teaching competence of their 

faculty. The Institute of Social Medicine and 

Epidemiology, Karl-Franzens-University Graz, started 

evaluating its courses in 1998. Public health is a 

required one-week course within the medical school 

curriculum. We used a standardized questionnaire 

developed by an expert committee of this university 

including five sections with ratings on 5-point scales. 

The students answered the questionnaire at the end of 

the module, therefore the response rate was nearly 

100%. The performance of three teachers in the time 

period from 1998 to 2000 was analysed by descriptive 

analysis of 240 questionnaires. Around 60% of the 

students were female and 40% were male. The results 

and the relevance of evaluating public health courses 


7D2 Action Research Methodology: a 

possible framework for course 

evaluations 

Alison Rushton* and Gill James 

Coventry University, School of Health & Social Sciences, Priory 


The process of curriculum design incorporates 

evaluation of existing courses. This paper describes a 

possible methodology for such evaluations. A 

conceptual framework, based upon action research 

methodology, was developed; combining diagnosis 

with reflection. This framework was used in the 

evaluation of a physiotherapy undergraduate course in 

the UK. The course was structured around a thematic 

approach, whereby the core areas of physiotherapy 

practice informed the course design. The diagnostic 

phase identified all aspects impinging upon the success 

of the programme. All stakeholders (including students, 

tutors and funding bodies) were targeted for the data 

collection phase. Reflection is seen as an important 

component of the action research cycle, facilitating 

prescription of data collection methods (which included 

focus groups, questionnaires, module evaluations and 

analysis of existing documentation). These data were 

analysed and triangulated and the results provided a 

reasoned justification for maintaining and 

strengthening the thematic approach of this course. 


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7D3 The opinion of graduates of the 

Faculty of Medicine of the 

University of Barcelona on the new 

medical curriculum 

J Palés*, A Gual, A Vallés, Ma T Estrach, F Climent, 

X Gasull, R Gilabert, A Llobet, Y Compta, L Peri and 

J A Bombi 

Universitat de Barcelona, Facultat de Medicina, Departmento 

de Ciencias Fisiologicas I., Casanova 143, 08036 Barcelona, 

SPAIN 

Our Faculty introduced in 1994 a new curriculum that 

has represented a significant change from the old one. 

To evaluate the results of this curriculum in order to 

facilitate appropriate future development, a 

questionnaire was administered to the graduates, asking 

about their opinion on the following aspects: 

accomplishment of the curriculum objectives, the 

quality of medical education offered by the Faculty, 

the influence of the national board examination on the 

development of the curriculum, the effort that the new 

curriculum requires of the students and the strong and 

weak points of the program. 120 students (80% of total 

students) answered the questionnaire. In general, the 

acceptance of the new curriculum by the students was 

high although some deficiencies have been detected. 

The information furnished by the graduates will be 

useful in introducing the necessary modifications to 

improve our educational program in the coming years. 

7D4 Comenius University Quality 

Assurance System (CUQAS) and 

students’ participation in graduate 

medical education evaluation 

L Plank*, J Danko, E Rozborilova, P Galajda and K Dokus 

Jessenius Faculty of Medicine, Dean’s Office, Comenius 

University, Zaborskeho 2, SVK 036 45 MARTIN, SLOVAK 

REPUBLIC 

We believe that students should take an active part in 

the process of education evaluation applied at the 

Jessenius Medical Faculty. Students in the 11th and 12th 

semester were asked to answer an anonymous 

questionnaire on education quality in four basic clinical 

subjects (four-grade-quality-system). Questions related 

to the structure and content of lectures, teachers´ 

approach towards students, contacts with patients and 

others. In contrast to prevailing positive evaluations 

within the scale of “fully”, “partially satisfied” and 

“more satisfied than unsatisfied”, less than 1/5 of 

students were “not satisfied” with at least one of the 

evaluated education components. The education quality 

evaluation system helps the faculty management to 

improve educational standards and to identify its weak 

and strong components. In the future, this is planned 

to be applied annually for the whole graduate education 

within the uniform CUQAS system and database.

7D5 Research in medical education: 

constructing an ethical framework 

E B Peile* and A Slowther 

Department of Primary Healthcare, University of Oxford, 

Chiltern Waters, 1 Stablebridge Road, Aston Clinton, Bucks 

HP22 5ND, UK 

Proposals for research in medical education are 

frequently submitted to UK medical research ethics 

committees, which are more accustomed to considering 

the implications of research on patients than research 

on learners. After reviewing relevant codes for 

educational research, we propose an adaptation to a 

framework of medical research ethics for use in medical 

education research. Key issues in our suggested 

framework include: 

• Scientific validity of the research on medical 

education 

• Safety aspects, including 

- risk to the students’ psychological well-being 

- risk to patients from exposure to learners 

• Consent procedure: 

- are students fully informed about the study and 

the implications for their education? 

- is consent voluntary and without coercion? 

• Confidentiality issues, including whether examiners 

or assessors will have access to research 

information. 

We discuss some ethics considerations, which may help 

to inform the critical appraisal of research projects in 

medical education and thereby encourage good 

practice. 

7D6 Students’ perceptions of the 

Physiology course in a traditional 


F Riggione*, J Perez-Ojeda and J F Perez-Gonzalez 

Centro de Investigacion y Desarrollo de la Educacion Medica, 

Escuela de Medicina “Luis Razetti”, Facultad de Medicina, 

Universidad Central de Venezuela, Caracas, Apartado de 

Correos No 90.350, El Hatillo 1083A, VENEZUELA 

Students’ perceptions of learning experiences 

contribute to a better understanding of the need for 

curricular reform. We explored the opinion of 2nd year 

medical students after their 36 week Physiology course 

of lectures and laboratory sessions. 166 students 

received a 25 item survey and 146 responses (88%) 

were evaluated. 76% of the respondents attended 50% 

or less of the lectures. 64% considered the course to be 

detailed and 57% to be complex. 34% considered it 

relevant and 34% difficult. Teachers were considered 

competent by 56%, accessible by 51% and rigid by 

48%. On a 5 point Likert scale (0 = not at all, 5 = very 

much) their experience of the course was defined as 

significant (mean score = 3.65), pleasurable (2.51) and 

stressing (2.28), while it lacked “feeling of discovery” 

(0.55) and motivation (0.37). 41% of respondents 

indicated to have learnt 50% or less of the course 

contents, and only 9% indicated learning >70%. 


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7D7 Students’ perceptions of a 

traditional undergraduate course in 

Microbiology 

Z Uzcategui*, J Perez-Ojeda and J F Perez-Gonzalez 

Centro de Investigacion y Desarrollo de la Educacion Medica, 

Escuela de Medicina “Luis Razetti”, Facultad de Medicina, 

Universidad Central de Venezuela, Caracas, Apartado de 

Correos No 90.350, El Hatillo 1083A, VENEZUELA 

Microbiology can be an abstruse subject for medical 

students. We explored the opinion of our students after 

their 36 week traditional Microbiology course of 

lectures and laboratory sessions in the 2nd year. 187 

students completed a 25 item survey of their 

experiences in the course. 71% of respondents attended 

50% or less of the lectures and 100% attended >85% 

of the compulsory laboratory sessions. 68% thought 

the course was relevant, 41% found it detailed and 24% 

excessive. Teachers were considered competent (79%), 

accessible (69%), interested (66%) and stimulating 

(41%). The students defined their learning experience 

by grading items on a 5 point Likert scale (0 = not at 

all, 5 = very much), as significant (mean score = 4.15), 

creating a “feeling of discovery” (4.08), leading to new 

questions (3.88), pleasurable (3.7) and stimulating 

(3.63). 88% of respondents indicated to have learnt 

>50% of the course’s contents. 

7D8 Faculty development in General 

Practice - the German experience 

M Ehrhardt, P Engeser, M Herrmann, T Lichte, N Donner- 

Banzhoff and S Wilm*, on behalf of the participants 

Heinrich-Heine University, Department of General Practice, PO 

Box 10 10 07, D-40001 Duesseldorf, GERMANY 

Since 1978 General Practice has been a required subject 

of the undergraduate curriculum in Germany. However, 

only about one third of all 33 medical schools have 

established academic departments. At the remaining 

schools, GP teachers are often working in isolation and 

without adequate support. In 1999 the National Society 

of General Practice started a programme to help GP 

teachers develop their academic skills. Six weekends 

spanning 1 1/2 years are being offered covering 

teaching, clinical work, quality issues, research and 

academic survival skills. Participants are expected to 

work together in small groups on projects during 

intervals and to complete an international practicum 

of at least one week duration. There is also an intranet 

platform to facilitate the exchange of ideas and 

materials. 

While in the beginning the learner-centered philosophy 

created tension and uncertainty, the group has now 

found a working identity that participants find 

enjoyable and productive. 

7D9 Medicine and ethnic issues; do our 

tutors reflect their community? 

D Reeves, R Loudon and J Parle* 


School, University of Birmingham, Birmingham, B15 3QR, UK 

We conducted an audit of primary care teaching 

practices in order to determine the characteristics of

doctors providing different elements of the extensive 

Birmingham community based curriculum. 185 

questionnaires (concerning gender, ethnicity, languages 

spoken) were distributed. 540 doctors from 163 

practices responded (practice response rate 88%). 

Ethnic and gender differences were clear across 

different practice types. The 2001 Amendment to the 

1976 UK Race Relations Act will mean for the first 

time that providers of services to the public will have 

Session 7E Postgraduate education 

7E1 Exploring the views of Basic 

Surgical Trainees on their training 

programme and their future in 

Surgery 

Jeremy Brown*, Linda de Cossart and Charmian Wiltshire 

Mersey Deanery, 1st Floor, Hamilton House, 24 Pall Mall, 

Liverpool L3 6AL, UK 

The aim of the study was to explore views of Basic 

Surgical Trainees (Senior House Officers) on a training 

scheme for Basic Surgical Training that complies with 

college requirements. A quantitative study postal 

questionnaire devised in liaison with UK Medical 

Careers Research Group was distributed to 115 Mersey 

Basic Surgical Trainees. Qualitative data were collected 

from free-text responses. Questions focused on career 

choices, views on the scheme, and assessment. 93 

(81%) questionnaires were returned. 51 (54%) were 

graduates from local university, 49 (52.7%) came 

directly onto the Mersey BST scheme from PRHO 

posts, 4 (4.3 %) had more than 1 year’s UK SHO 

experience. 26 (27.9%) changed their surgical specialty 

intention since medical school; factors influencing 

change were: - PRHO/SHO experience; teachers; 

departments. A young, parochial and inexperienced 

cohort of trainees who have strong convictions were 

identified. Many issues raised have one common 

denominator: the strong influence of teachers on 

trainees. 

7E2 An assessment of the skills base 

and attainments of Senior House 

Officers on a regional Basic 

Surgical Training Programme 

Linda de Cossart, Charmian Wiltshire and Jeremy Brown* 

Mersey Deanery, 1st Floor, Hamilton House, 24 Pall Mall, 

Liverpool L3 6AL, UK 

The aim of the study was to assess the skills base and 

achievements of trainees on a Basic Surgical Training 

Programme. All trainees on the 3-year Basic Surgical 

Training Programme insituted in 1996/7 were given a 

questionnaire designed to find out their aspirations and 

opinions about the programme and design. The findings 

related to the trainees’ logbook for the general surgical 

operations of abscess drainage, appendisectomy, 

inguinal hernia repair, upper and lower GI endoscopy, 

varicose vein surgery and small bowel anastomosis. The 

results were analysed by year of training and whether 


- 4.65 - 

to demonstrate they are working for equality rather than 

merely avoiding discrimination. This audit, experience 

with attempts to collaborate with secondary care 

teachers plus our larger curriculum development project 

stimulate a wider debate about whether, when 

commissioning teaching practices, we should assess 

other aspects of quality of service provision; and 

whether, in the absence of an appropriate environment, 

learning outcomes are achievable. 

performed independently or supervised. 84 (73%) of 

trainees returned analysable forms. Abscess drainage 

and appendisectomy are acquired most often as the 

three years progress but a few still do not achieve 

independence by year three. The Profession should 

insist on ‘Protected Operative Teaching’ for surgical 

trainees. 

7E3 Personal and Professional 

Development Groups for Junior 

Hospital Doctors 

Alan Naftalin and Peter Bruggen 

Newham General Hospital, 22 Mackeson Road, London NW3 

2LT, UK 

You were a junior doctor. In personal and professional 

development groups at Newham General Hospital in 

East London, UK, the valued experience was often 

discovering that each was not alone. Others had 

‘strange’ thoughts and feelings. The figure of a junior 

doctor will be surrounded by radiating lines labelled: 

blushing, feeling faint, losing 3D thought, frozen 

memory, challenged by consultants, dreaming of 

patients, psychosomatic symptoms, unable to stop eye 

contact, erections, impulse to touch too much, being 

told off, feeling embarrassed, needing to rescue the 

deprived, fostering special relationships, scoring PR 

and PV examinations, enjoying power, etc. Pens or 

labels will be provided for participants to add ideas or 

experiences. In the corners will be background to the 

group, and references; details and email addresses of 

both authors; invitation to mailing list or web site; and 

invitation for suggestions. 

7E4 The educational needs of doctors 

with English as a second language 

when consulting in General 

Practice in the United Kingdom 

Sylvia Chudley and John Skelton 

West Midlands Dept of Postgraduate Education for General 

Practice, 16 Ashmore Road, Cotteridge, Birmingham, B30 2HA, 

UK 

Results of the consulting skills component of the 

national summative assessment procedure in the United 

Kingdom, (assessment of videotaped consultations), 

indicate that the failure rate is significantly higher in 

those doctors who have had undergraduate medical

training abroad. Preliminary observations suggest that 

these doctors have specific difficulties that relate not 

only to linguistic problems, but to cultural differences 

in 1) communication in general, 2) communication 

within the medical consultation, and 3) the nature of 

the teacher/pupil relationship. This research explores 

these 3 issues through in-depth interviews with such 

doctors who are currently training in general practice. 

A better understanding of the educational needs of 

doctors from abroad should enable educators to provide 

appropriate training and preparation for work in general 

practice in the United Kingdom. 

7E5 “No such thing as a free lunch” - 

how free are bleep-free sessions? 

Jane Ross* and Rose Martin 

Postgraduate Office, Level 7, Ninewells Hospital and Medical 

School, Dundee DD1 9SY, UK 

Bleep-free weekly educational sessions have been 

identified as an essential requirement in the clinical 

training of PRHOs. A GMC review supported by 

anecdotal evidence identified this issue as a concern. 

A three phase prospective audit to evaluate the effect 

of implementing a trust-wide bleeping policy in the 

provision of bleep-free weekly educational sessions for 

PRHOs was evaluated. 

Phase 1: 6 weeks: a researcher intercepted all bleep 

interruptions during weekly PRHO teaching. 

Bleeping reasons were logged into a coding 

grid. 

Phase 2: Implementation of Trust Bleeping Policy. 

Phase 3: 6 weeks (repeat of phase 1). 

Bleeping incidents were logged and coded pre and post 

policy implementation. Results showed improved 

negotiated bleep responsibility to colleague, a decrease 

in bleeping incidents during teaching sessions and 

decrease in non-essential bleep interruptions. 

Implementation of a bleeping policy improved bleepfree 

sessions for PRHOs. 

7E6 The SHO Record of In-Service 

Training and Achievement (RITA) 

and Portfolio 

Rose Martin* and R W Newton 

SCPMDE, Postgraduate Office, Level 7, Ninewells Hospital and 

Medical School, Dundee, DD1 9SY, UK 

Documentation will be required to support the new 

SHO RITA process; models are currently being 

developed and tested. The SHO Portfolio and Record 

of In–Service Training and Achievement has been 

developed in the East Region and is currently being 

piloted in Tayside and Edinburgh amongst all SHOs 

within medicine and its sub-specialties. The SHO 

Portfolio aims to promote a more structured approach 

to SHO training, appraisal and assessment. It is based 

on the concept of a partnership between SHO and 

Educational Supervisor; the documentation includes a 

training agreement which emphasises the 

responsibilities on both sides in ensuring that learning 

opportunities are maximised. It enables a continuum 

of training, incorporating a strategy for the management 


- 4.66 - 

of poor performance which can be passed from the 

initial Educational Supervisor to the next, if the training 

plan is not completed. Split between five sections and 

based on the GMC’s Good Medical Practice booklet, 

the final section is designed to enhance the CV and 

detail critical incident analysis, audit projects, record 

interesting cases and provide a platform for promoting 

clinical and educational achievement at interview. 

Specific Royal College documentation can be inserted 

and the portfolio itself should be used to inform the 

Revalidation process. 

7E7 General Practice Registrar audit 

and implementation of change 

J McKay*, J R M Lough and T S Murray 



General practice registrars (GPRs), submit an audit 

project as part of the summative assessment process. 

Assessment of these projects does not require the 

registrar to implement change nor collect a second data 

set. From 1988 west of Scotland GPRs were required 

to submit a completed audit cycle (CAC), which 

included implementing change and a second data 

collection. Audit submissions in the 3 years before and 

after the introduction of CAC were compared. Projects 

submitted after the introduction of CAC were 

significantly more likely to have 3 or less criteria 

(p

7E9 Psychosocial training in the Family 

Residency in Spain: present 

situation and proposals for the 

future 

José Ramón Loayssa Lara 

Servicio Navarro de Salud, Centro de Salud de Noaín, 31110 

Noaín, SPAIN 

The psychosocial training in the family practice 

residency in Spain, despite the increasing interest and 

the growing number of educational activities, is not 

obtaining the desired results. In order to formulate a 

proposal for curriculum development, a study of the 

programme in the different teaching units was 

undertaken. Based on the suggestions of the faculty 

and on the analysis of experiences in different countries, 

a series of recommendations and possible lines of 

development are discussed. 

7E10 Step by step to methodological 

exam: report on first year 

experiences with the new 

introduced GP Licence 

Examination in Austria 

R Willnauer*, M Schmidts, M Lischka 

Institute for Medical Education, University of Vienna, Wahringer 

Gurtel 18-20, Postfach 10, A-1097 Wien, AUSTRIA 

There are three prerequisites for being granted a licence 

as a GP: 3-year-inhouse rotational training, 

accompanied by a certification process (longitudinal 

evaluation) and a summative examination at the end of 

the training period. This exam was introduced in 

November 1999 and is held three times a year. The 

exam is made up of 20-25 case vignettes followed by 

1-5 questions in SAQ format. The cases are developed 

by GPs and are thoroughly reviewed. Required answers 

are predetermined by GP experts. Answers are 

corrected by specialists on machine readable sheets, 

providing PC-based item analysis and scoring. We will 

report on: 

• our attempts to meet quality criteria (objectivity, 

reliability, validity) 

• results of four examinations (total of 372 

candidates) 

• institutional and organisational experience with the 

instruction of examination methodology. 


- 4.67 - 

7E11 Development of professional 

doctorates in healthcare disciplines 

Alan Castle*, Graham A Mills and Valda Bunker 

University of Portsmouth, Centre for Radiography Education, 

St George’s Building, Portsmouth, Hampshire PO1 2HY, UK 

Originally, the PhD was a qualification for an academic 

career. Recently the appropriateness of this 

qualification has been questioned as it is not necessarily 

relevant to industry or professional interests. 

Consequently universities are re-shaping Doctoral level 

learning by providing flexible, part-time, work-based 

‘Professional Doctorates’ (PD). These are “equal in 

rigour but different in substance” to a PhD. The 

University of Portsmouth has recently developed an 

innovative PD programme supporting multidisciplinary 

learning in biomedical sciences, 

chiropractic, medical imaging, nursing and pharmacy. 

Entry to the programme is at Master’s level, with 

Doctoral level learning in two parts. A ‘taught’ Part 1 

(1-2 years) includes advanced research techniques, 

professional review and publication and dissemination 

units. Part 2 (2-3 years) comprises the work-based 

professional research and development project 

submitted as a portfolio. This curriculum model, 

facilitating continuing professional development, is 

appropriate for all healthcare disciplines and suitable 

for adoption by other higher education institutions. 

7E12 The appointment process for 

Anaesthetic Registrars in South 

Thames 

J Clarke* and J Pateman 

St George’s Hospital London, Department of Anaesthesia, 

Blackshaw Road, London SW17 0QT, UK 

Each 6 months we appoint approximately 25 registrars 

to our training scheme from about 100 applicants. 

Historically we used the classical large panel, roundtable, 

15 minute interview technique. For the last 18 

months we have employed an OSCE style interview 

process using 4 ‘tables’. Candidates rotate through all 

tables, where they undergo targeted questioning on 

different aspects of the person specification that cannot 

be obtained from their paper application. The 

advantages are that each candidate is now interviewed 

for 32 minutes and we are able to explore in greater 

detail desirable attributes. Furthermore because we are 

now able to interview up to 50 candidates in one day, 

the short listing has become a less important part of 

the process and we can interview a more diverse group. 

Audits carried out have shown a marked preference 

for this technique amongst both interviewers and 

interviewees.

Session 7F Assessment 

7F1 Validity of assessment techniques: 

students’ views differ from 

observed outcomes 

W Colin Duncan 

University of Edinburgh, Obstetrics and Gynaecology, Centre 

for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 

9ET, UK 

We assess medical students in Obstetrics and 

Gynaecology using a combination of four assessment 

techniques: continuous assessment (CA), multiple 

essay questions (MEQ), OSCE exam and clinical exam. 

This study aimed to compare the students’ perception 

(n=75) of validity of these assessment techniques with 

actual validity. Validity of each component was assessed 

by correlation with the final mark. Students’ perception 

was obtained by asking students what they felt they 

deserved and what they felt they got in each assessment. 

In predicting final mark, CA performed worst 

(r=0.667), followed by MEQ (r=0.791), Clinical 

(r=0.861) and finally OSCE (r=0.877). In the students’ 

perception, CA performed best (-3.8% difference), 

followed by MEQ (-4.9%), Clinical (-5.4%) and finally 

OSCE (-11%). There is a clear inverse relationship 

(r=0.705) between the students’ perception of 

assessment validity and the actual validity in this 

assessment scenario. 

7F2 Assessment reliability in an MSc 

programme in Diabetes 

J Huber*, N Munro, A Felton, C Parker, P Delaney and 

C McIntosh 

School of Life Sciences, University of Surrey Roehampton, West 

Hill, London SW15 3SN, UK 

Reliability within examinations is a precondition to 

validity. In order to confirm internal reliability in 

assessment instruments, a range of measures can be 

employed. This study aimed to establish the reliability 

of assessments used in a Diabetes Masters programme. 

Percentage scores from the attendance cohort (1999/ 

00) for the four assessments in a ‘management of 

diabetes’ module were analysed, resulting in an alpha 

coefficient of .75. Correlations between individual 

assessments and the total assessment scores (corrected 

for the individual assessment) were .58, .41, .64 and 

.57. Both the alpha and item-total correlations indicate 

a satisfactory level of internal reliability. The figures 

indicate that all assessments evaluate a common skills 

range. Alphas greater than .8 are recognised as 

achievable in professional examinations. In order to 

attain this it will be necessary to evaluate assessment 

two further to understand why this essay has a lower 

correlation with the overall grade achieved. 

7F3 Two years of progress-testing at 

the Charité 

A Mertens*, J Hoffmann, S Kölbel, R Raschke, K Duske, J 

Berger and U Hennewig 

HU Berlin Medical Faculty, Charité, AG Reformstudiengang, 

Medizinische Fakultat, Schumannstr 20-21, 10117 Berlin, 

GERMANY 


- 4.68 - 

The Humboldt-University Progress-Test is based on the 

principles for Progress-Testing developed in the 

Netherlands. It will be shown that the format works 

also within a traditional German medical faculty. The 

results of the four tests organized in Berlin so far will 

be presented, including a summary of our subsequently 

performed test-evaluation programme. Special 

attention will be payed to the comparison of the students 

in the reformed curriculum vs. the students in the 

traditional curriculum in all respects. 

7F4 OSCE for a Paediatric Trainee 

Internship examination: 

multicentric experience 

M Aldunate, A Lopez, A Mena, M Varas, X Trivino, 

A Vasquez*, R Lillo, T Miranda and E Mandiola 

ESC Medicina - Officina de Educacion Medica, Fac Medicina, 

Universidad de Chile, La Siembra 8952 Vitacura Santiago, 

CHILE 

The University of Chile and the Catholic University, 

the main Chilean Universities, started in 2000 a joint 

program in order to consolidate and improve the 

assessment system for the paediatric training period 

(internship 6th year). The objective of the program was 

to improve the quality of the final assessment of clinical 

competences of the Paediatric trainee (internship) in 

two Chilean Universities. Members of both Schools of 

Medicine have developed, organized, implemented and 

run an identical, simultaneous, multicentric and interuniversity 

20 station OSCE in order to assess 124 

students; to analyze the results and statistically compare 

them to other traditional assessment methods. 

Questionnaires were used for considering the results 

and opinions as well as academic opinions before and 

after the OSCE. The OSCE allowed the measurement 

of main objectives in all domains and the components 

of predetermined clinical competences. Statistical 

analysis of results showed the advantages of this method 

in relation to the traditional exam. The results of the 

questionnaire analysis are presented and discussed. 

Results permit the recommendation of the OSCE as a 

clinical examination of the Paediatric trainee at the end 

of the internship period in both Schools of Medicine. 

7F5 Third year medical student written 

history and physicals: how many is 

enough? 

Paul A Hemmer*, Thomas Jamieson, Kim Gibson, Lisa 

Moores, Andy Donato, Margaret Gaglione, Steven Durning, 

Alan Wimmer, Bonnie Cary-Freitas and Louis Pangaro 

USUHS - EDP, 4301 Jones Bridge Road, Bethesda MD 20814, 

USA 

The aim was to determine when students can reliably 

write a history and physical. In 1998-99, faculty ranked 

20 specific aspects of 10 student write-ups, using a 

validated, 4-point Likert scale rating form. We assessed 

intra-write up reliability/correlation and inter-write up 

reliability (Cronbach’s alpha). Data were available for 

240 students (1998-1999). The table summarizes the

number of write-ups necessary to achieve a specific 

level of agreement for seven of the 20 rated categories. 

Write-up Variable a � 0.7 a � 0.8 

Chief Complaint 

HPI (degree that history 

Never Never 

differentiates possible etiologies) 9 10 

PE (precision) 

Problem List (specificity of 

Never Never 

problem) 4 Never 

Analysis (level/depth) 8 9 

Scholarship (level/depth) 3 9 

Overall 2 10 

Items most correlated with the overall score: 

Assessment and Plan (.83), Level of Analysis (.7), HPI 

(.64), and Level of Scholarship (.6). It is concluded 

that fostering a student’s transition from “Reporter” to 

“Interpreter” requires 8-10 written H&Ps. 

7F6 Student fitness to practise 

procedures 

Chris Stephens 

The Department of Medical Education, Office of School of 

Medicine, University of Southampton, MP 801 Level C, South 

Academic Block, Southampton General Hospital, Southampton, 

SO16 6DY, UK 

Students can be suspended from their course for a 

number of reasons such as health, conduct and 

academic progress. These three do not cover specific 

professional areas related to medicine and so the School 

of Medicine University of Southampton developed 

student fitness to practise procedures. These procedures 

are based on a number of GMC documents and link 

into the University’s regulations and have been used 

on a number of occasions. The presentation will explore 

a number of case scenarios to illustrate that there is 

often overlap between the different areas, how the 

fitness to practise procedures need to reflect current 

GMC professional conduct guidance and why the 

system needs to be fair, transparent and open. 

7F7 Deriving the assessment 

framework for the Three Royal 

Colleges Diploma in Prison 

Medicine 

Lesley J Southgate*, Jon H Fuller and Jaz Bihku 




Prisoners suffer from high levels of mental health 

problems, substance misuse, communicable diseases 

and chronic physical illness. But health services for 

UK prisoners have been isolated from the wider health 

community in the NHS. Improving the health and health 

care of prisoners has not been a priority for either the 

Prison Service or the NHS. As a result, despite patches 

of good practice, services overall have fallen short of 

collective aspirations. As a contribution to CPD for 

prison medical officers, three UK Royal Colleges 

(General Practice, Physicians, Psychiatry) have 


- 4.69 - 

established a Diploma in Prison Medicine. The Diploma 

is delivered by the University of Nottingham, but the 

assessment and quality assurance framework was 

developed and is implemented by the Examination 

Board from the Royal Colleges. We describe here the 

derivation of the assessment framework, both content 

and methods, and present data from the first three years 

of the Diploma. 

7F8 Assessment in an outcome-based 

curriculum at the International 


J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, 

K H Ong, C M K Patrick and A K H Wong 

International Medical University, 33 A Jalan 17/1, Block A-4, 

Condo 3A, Astana Damansara, 46400 Petaling Jaya, Selangor, 

MALAYSIA 

Eight major outcomes were identified for the clinical 

programme of the International Medical University 

(IMU). The outcomes form the basis to reflect the 

competencies expected of our graduates. Task-based 

study-guides, a community and family case study 

(CFCS) and the learning portfolio form our core 

curriculum. We employ a variety of assessment tools 

to assess the competencies achieved in the eight IMU 

outcomes. These include end of posting examinations 

as well as the portfolio. Both OSPE and OSCE are used 

in the professional examinations to assess the various 

outcomes. An OSCE grid has been developed to 

evaluate the effectiveness of our assessment in 

measuring all the IMU outcomes. Issues related to 

community and health are assessed in the CFCS. The 

final semester is for senior clerkship and a structured 

exit viva at the end will be used to assess the 

competency in the outcomes before the students 

graduate. 

7F9 Psychosocial profile of medical 

students as a predictor of the 

academic success in medical 

school in Mexico 

Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer- 

R, Victoria Bermudez, Juan Montes-V, Santos Guzman, A- 

Enrique Alcorta-G and Marcos Vinicio 

Autonomous University of Nuevo Leon, 1815 JFK Blvd. Apt # 

1606, Philadelphia PA 19103, USA 

We examined the contribution of psychosocial 

measures in predicting academic success among 

Mexican medical students. Participants were 694 

medical students at the Autonomous University of 

Nuevo Leon, in Mexico. A set of psychosocial scales, 

including Jefferson Medical College’s noncognitive 

questionnaire, was administered. Data supported the 

psychometrics of the instruments. Participants were 

divided into 3 groups. Group 1 consisted of those who 

succeeded in the first and second years of medical 

school (n=277). Group 2 included those students who 

were put on probation (n=339). Group 3 comprised 

those who were dismissed (n=78). We compared these 

3 groups on a number of psychosocial measures, and 

found significant differences among the groups on the 

following scales: Depression, Stress Life Events, 

Terman Merrill IQ, Self-esteem, Cognitive Process or

Thinking Problems, Family Structure and Function. 

Findings have implications in admission decisions and 

in academic and professional counselling. 

7F10 Psychometric data for Jefferson 

Medical College’s Non Cognitive 

Questionnaire in Mexican medical 

students 

Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer- 

R, Victoria Bermudez, Juan Montes-V, Santos Guzman, A- 

Enrique Alcorta-G and Marcos Vinicio 

Autonomous University of Nuevo Leon, 1815 JFK Blvd. Apt # 

1606, Philadelphia PA 19103, USA 

A Spanish version of the Jefferson Medical College’s 

Noncognitive Questionnaire was administered to 700 

first year medical students at the Autonomous 

University of Nuevo Leon, in Mexico. Factor analysis 

resulted in a factor matrix that was comparable to that 

obtained between noncognitive scale scores and 

external criterion measures. Results of this study 

support the construct validity, criterion-related validity, 

and internal consistency aspect of reliability 

(Cronbach’s alpha) of the noncognitive measures 

(general anxiety, test anxiety, loneliness, self-esteem, 

extroversion, stressful life events, neuroticism and locus 

of control) in Mexican medical students. We concluded 

that the noncognitive questionnaire, in general, is a valid 

and reliable instrument for Mexican medical students 

to investigate the contribution of personal qualities, 

Session 7G Teaching and learning (1) 

7G1 What do first year medical students 

value in a learning situation? 

Angel M Centeno*, Alejandra Blanco, Soledad Campos 

and Amelia Cabrera 



ARGENTINA 

Lack of appropriate learning skills when entering 

medical school is one the major obstacles our students 

face during their first year at medical school. We used 

the critical incident technique to determine which 

elements in a learning episode during high school were 

highly valued as most effective by students admitted 

to medical school. Incidents were coded for learning 

characteristics, and for disciplines mentioned. Seventyone 

medical students recently admitted were included 

in the study. Faculty personal aptitudes was the most 

frequently cited element (34%), followed by practical 

teaching (22%), students’ personal growth or 

transformation (13%), influence of the evaluation 

(12%), team working (8%), and good teaching 

resources (8%). Sciences related to medicine were the 

most influential (65%), while humanistic disciplines 

(23%), and exact sciences (9%) were mentioned too. 

These data permit the design of educational activities 

using those elements in order to improve their efficacy. 


- 4.70 - 

personality factors and psychosocial characteristics in 

predicting academic success in medical school, and 

professional success in medical practice, which is the 

broader goal of this project. 

7F11 Portfolio based assessment of 

students during their internship 

Angel M Centeno*, Soledad Campos, Isabel Fernández 

and Alfredo Olivieri 



ARGENTINA 

Portfolio is an assessment tool that allows students to 

record and reflect on key events of their daily activities. 

Our sixth year (internship) students record their daily 

activities, their reactions to their real life work, they 

identify their learning needs, and their studying 

strategies, including self evaluation. The faculty gives 

student feedback, helps her/him to apply her/his 

learning in a practical context, and challenges and 

motivates the intern to advance in their learning. 

Thirteen students and four faculties were involved in 

this project. Despite the lack of previous experience 

with the instrument, students and faculties found it 

useful. Faculty development activities directed towards 

improving the use of the portfolio, and protecting time 

(minimum 2 hours/week) to meet with the students are 

changes we are planning to perfect its use. Portfolio is 

not used for promotion but for developing and 

consolidating adult and life-long learning strategies. 

7G2 Application of Schon’s model for 

small-group teaching 

Francine Borduas* and Réjean Laprise 

Association des médecins omnipraticiens de Québec, Clinique 

médicale de Neufchatel, 2350 boul Bastien #2, Québec G2B 

1B5, CANADA 

Schon proposed that physicians acquire expertise 

through a process of reflection in and on action. This 

process is triggered by abnormal cases seen in the 

clinic, which cause ‘surprises’. These surprises lead to 

the investigation of the new phenomena and 

experimentation of new course of actions, which are, 

ultimately, integrated into practice. We present an 

application of Schon’s model for small-group teaching. 

An interactive workshop, based on the study of a real 

patient followed by her doctor for 15 years, was 

designed to cause ‘surprises’ among participants and 

make them go through the process described by Schon. 

This method was assessed during a CME event. Results 

from the administration of a multiple choice 

questionnaire pre- and post-intervention showed a 

significant improvement in knowledge following the 

event (p

7G3 Teaching and learning about case 

presentations: the need for early 

intervention 

D Nestel* and J Kidd 

Imperial College School of Medicine, Connaught House, 

Apartment 17, Davies Street, London W1K 3DA, UK 

At Imperial College School of Medicine, students are 

introduced to case presentations during their second 

year. During a three-hour session, the content and 

context of case presentations are discussed and students 

participate in a brainstorming activity to identify 

characteristics of effective presentations. Students then 

work in small groups to prepare and deliver a case 

presentation based on a videotaped interview. 

Approximately five presentations are made in each 

session. In addition to the content of the presentation, 

students receive feedback on their presentation skills. 

Data will be presented from an assessment conducted 

three-months after the session and a clinical attachment. 

The assessment examines students’ knowledge in 

relation to the content and context of presentations and 

the features of effective presentations. Students are also 

asked about their experiences of case presentations 

during their clinical attachments and if there is anything 

else they would like to have addressed in the session. 

7G4 Master teacher, master learner 

M P Oosthuizen 

University of Pretoria, P O Box 1266, Tand en Mond Hospital, 

Pretoria 0001, SOUTH AFRICA 

The aim of this study was to make use of a whole brain 

teaching and learning model for the study-unit of toothmorphology 

in a 3rd year dental curriculum to 

accommodate and develop students’ knowledge, skills 

and attitudes.The Herrmann Whole Brain Model on 

teaching and learning was used to stimulate a learningcentred 

approach. His instrument was used to determine 

thinking style preferences of the individual students 

and the group as a whole. Whole brain teaching 

interventions were designed to accommodate and 

develop diverse thinking style preferences during 

learning activities. The results of this study indicated a 

significant improvement of students’ retention, 

participation and attitudes toward the content and 

learning as well as group interaction and problem 

solving. The impact of this pre-clinical intervention in 

the third year is still evident and contributing to the 

students’ performances in their clinical work during 

the fourth year. This success had a major impact on the 

decision of the faculty to incorporate whole brain 

teaching and learning in the new outcomes-based 

learning-centred curriculum for dentistry. 

7G5 Hemisphericity in medical students 

N E Fernandez-Garza*, I A Benitez-Trejo, C Salinas- 

Guerra, A Davila-Flores and J A Castellanos-Lopez 

Facultad de Medicina, Universidad Autonoma de Nuevo Leon, 

Nuno de Guzman 309, Col. Cumbres, 3er Sector, Monterrey, 

N.L., c.p. 64610, MEXICO 

From Sperry studies, attention has been focused on 

brain dominance or hemisphericity. Left hemisphere 

(LH) is considered better for verbal tasks and right (RH) 


- 4.71 - 

for visual. For the teaching-learning process, it is 

important to consider which learning style (verbal or 

visual) is more used by students. In this project, nine 

medicine students were tested in five cognitive 

paradigms; reaction time was measured. Paradigms 

were: (1) simple reaction time (SRT) to familiarize with 

the procedure; (2) memory using letters (LS); (3) 

memory using patterns (PM); (4) patterns recognition 

using letters (LTM); and (5) patterns recognition using 

patterns (PC). All subjects had the lowest reaction time 

in the SRT, in second were LS and PM, third LTM and 

fourth PC. These suggest that the cognitive process in 

which memory is involved are well developed (LH), 

but the same is not true for the cognitive processes 

involved in pattern recognition (RH). 

7G6 Medical student preferences for an 

“ideal textbook” of Obstetrics and 

Gynaecology 

M S Marsh* and D Katopi 

GKT Medical School, Academic Dept of Obstetrics & 



Although medical students increasingly use CAL and 

the internet for their medical education, and much effort 

is put into the presentation of this information, the 

textbook still remains the chief tool for self directed 

learning. There is surprisingly little data concerning 

student opinion of the form and content of textbooks. 

We surveyed 88 (of approximately 100) 4th year 

medical students undergoing a course in Obstetrics and 

Gynaecology (O & G) about their “ideal textbook” for 

O & G. 46% of students wanted a book of A5 size, 

80% wanted some coloured content, 83% wanted the 

type in a medium size, 75% wished it to be made up of 

lists and short notes and 67% with one topic per page 

or double page. 79% of students wanted space for notes 

within the text pages. It appears there is consensus 

amongst medical students about the content and form 

of textbooks of O & G. 

7G7 What can be learnt from medical 

atlases? Expert and novice visual 

schemata in breast sonography 

R Pauli* and J Huber 

School of Life Sciences, University of Surrey Roehampton, West 

Hill, London SW15 3SN, UK 

Medical education in the visual domain focuses on 

teaching diagnostic processes verbally, usually by 

discussion between expert and trainee. A problem with 

this approach is that visual medical information may 

not be easily or efficiently transmitted in this mode. 

Our research aims to address the degree to which 

observers are able to extract visual features of breast 

sonograms, which are diagnostically significant. The 

first study compared expert and novice interpretations 

of breast sonograms taken from medical atlases. It was 

found that novices do not trail far behind experts in 

accuracy. The second study aimed to investigate the 

overlap between diagnostic categories and visual 

characteristics in breast sonograms by examining 

novices’ image categorisation strategies. This further 

confirmed that readily available visual information

lends itself to making diagnostic classifications. The 

evidence shows that medical atlases aimed at illustrating 

typical appearances are useful, but should perhaps cover 

less typical appearances. 

7G8 Community-based Public Health 

Education in Healthy City Project 

Yosuke Yamane*, Kuninori Shiwaku, Keiko Kitashima and 

Anuurad Erdembileg 

Department of Environmental Medicine, Shimane Medical 

University, Enya 89, Izumo 693-8501, JAPAN 

The drastic changes in the field of public health require 

educational innovation in the university. The 

development of a new learning strategy should be 

problem-solving; student autonomy; holistic approach 

to the complicated physical-mental-social 

phenomenon. We have performed community-based 

public health education integrating family health, 

school health, occupational health and community 

health since 1979. The persistent exposure of the 

student into the community dynamics is useful to 

understand the health promotion strategy. The 

education in the healthy city model is especially 

effective to recognize community empowerment, 

collaboration with the inhabitants, care workers, 

researchers and policy makers, the partnership between 

the community and the academic, social support 

networking and policy making for amenity community. 

7G9 Two different types of professorial 

authority: results in a traditional 

faculty of medicine 

Carlos E. de la Garza-Gonzalez*, Norberto Lopez-Serna 

and Ma Esthela Morales-Perez 

Facultad de Medicina, Universidad Autonoma de Nuevo Leon, 

Administracion de Correos no 3, Apartado postal no 712, 64460 

Monterrey N.L., MEXICO 

We compare the results of the final examination of four 

groups of students. Two of them had the Embryology 

course on an annual, and the other on a semi-annual 

basis. All groups had the same professor during the 

entire course. In one of the groups in each term, the 

examination was performed on a highly authoritarian 

basis, for example: seat assignment in alphabetical 

order; once the professor was in the lecture hall, the 

students have to use only one of the access doors; five 

minutes after the scheduled start time re-entry was 

forbidden, students were not allowed to talk to each 

other, among others. In the other groups none of the 

above conditions was demanded. A z test on the final 

exam results at a level of confidence of 95% was done. 

We did not find a significant difference. 

7G10 The “excellent teacher” seen by 

mid-course students 

M Patrício, A V Carneiro and J Fernandes e Fernandes 

Faculdade de Medicina de Lisboa, University of Lisbon, Av Prof 

Egas Moniz, Piso 1, 1649-028 Lisboa Codex, PORTUGAL 


- 4.72 - 

The importance of a role model in the teaching-learning 

process is well accepted. The objective of the study 

was to identify perceptions of mid-course students on 

the characteristics of an “excellent teacher”. Third year 

students (n=66) completed a semi-structured 

questionnaire on the profile of an excellent teacher 

(open questions followed by 32 specific characteristics 

- Likert scale). Quantitative analysis reveals a teacher 

is perceived as: 

• information provider (selection of topics to be 

taught 99%; transmission of clear information 97%; 

distinguishing essential from non-essential 

knowledge 97%). 

• facilitator (creating the opportunities for practical 

training 95%; available to students 90%) 

• assessor (fair when assessing 94%) 

• nice person (agreeable when dealing with students 

94%), and 

• planner (organizing the program 90%; integration 

of the discipline in other course areas 83%) 

Qualitative analysis confirms, in general, these results. 

Curiously enough, 21% of the students state as nonimportant 

qualities: being a role model, having a broad 

culture, good leadership and good research abilities. 

A discussion will take place on the implications for 

the teaching-learning process. 

7G11 Underrepresented minority (URM) 

students’ perception of mentoring, 

advising and role modelling in 


Ara Tekian*, Laura Hruska and Jorge Girotti 

University of Illinois at Chicago, Department of Medical 

Education (m/c 591), 808 S. Wood St, CME 986, Chicago IL 

60612, USA 

This study investigates the underrepresented minority 

(URM) students’ perception of particular characteristics 

and functions associated with their mentor, adviser, or 

role models. A two-part brief questionnaire was given 

to 56 URM and non-URM first and second year 

medical students studying at the University of Illinois 

at Chicago College of Medicine. Paired t-test revealed 

significant results among all levels of comparisons that 

include opinion differences between URM and non- 

URMs, mentor, role model and advisor functions and 

characteristics like empathy, maturity, resourcefulness, 

providing resources, and availability. The results show 

a clear differentiation among the perceived 

characteristics and expected functions of mentors, 

advisors and role models between URMs and non- 

URMs. Results from the first part of the questionnaire 

are reinforced by an evaluation of the second part that 

includes open responses from students emphasizing 

particular qualities and responsibilities for each role.

Session 7H Teaching and learning (2) 

7H1 “Project Carrapato (*Tick)”: a 

psychological focus in medical 

training 

I R P Scavariello, M S V M Silveira, E H V Celeri*, 

S L Brenelli and R S Cassorla 

Group for Psychopedagogic Assistance to Medical/Nursing 

Students and Resident Doctors - UNICAMP, Faculty of Medical 

Sciences, Tessalia Vieira de Camargo St 126/6111, Barao 

Geraldo District, Campinas, Sao Paulo 13083-970, BRAZIL 

The separation of the basic course from the clinical 

course can be a cause of anguish and conflict in medical 

students. With the aim of reducing this conflict, the 

teaching body at the medical school developed the 

“Project Carrapato(*Tick)” during the reception for the 

year 2000 freshmen. This project familiarised the 

freshmen with the medical reality. The students 

accompanied the hospital activities of the medical staff 

for a week. After this, they were divided into 5 reflection 

groups which were coordinated by the GRAPEME 

professionals and FCM docents. The project was seen 

as a possible preventive action because it helped 

students to: reflect and expose their expectations, 

anguish and fears; question their fantasies; experience 

limitations. This can help to avoid or reduce the 

development of inadequate defence mechanisms that 

hinder personal and professional growth. 

* next to (jargon) 

7H2 Evaluating of videotape sessions 

for learning communication skills 

A Nogueras*, M Bernaus, X Claries and J de Nadal 

I. Universitari Parc Tauli, Parc Tauli s/n,0820 Sabadell, 


Evaluating training systems to develop and assess 

communication skills is not easy. We report an 

extension of our experience. Since 1997, we have 

carried out a short training program in doctor-patient 

communication for first year residents; it incorporates 

simulated patients, role-play techniques and each 

participant is videotaped. 81 residents have taken part. 

Before and after the course, a validated video showing 

a questionable doctor-patient interview is presented to 

the students for evaluation of the doctor’s 

communication skills, scored on a scale from 0 to 10. 

The first day 25-percentile of the video interview score 

varied every year and sometimes did not show a normal 

distribution, nevertheless, the number of students that 

scored high the first day always fell down notoriously 

on the last day’s evaluation: in 1997 from 27% to 14%; 

in 1998 from 39% to 6%; in 1999 from 50% to 37% 

and in 2000 from 24% to 6%. It is concluded that videos 

of validated simulations of clinical interviews can help 

to evaluate the usefulness of courses such as the one 

reported. 


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7H3 Acting up? The recruitment and 

maintenance of a professional role 

play team for undergraduate and 

postgraduate medical training and 

assessment 

C M Wiskin* and P Croft 


Birmingham B15 2TT, UK 

Role play is widely used in medical education. 

Professional role players provide constructive teaching 

for participant development. The recruitment of 

individuals with the aptitude for professional role play 

is key. Theatrical sourcing may have its uses, but other 

attributes need consideration. Our role play team has 

10 years’ experience. Its role players are consistently 

involved in undergraduate and specialist postgraduate 

training. Demographics, educational/vocational 

qualifications, professional experience and educational 

interests of role players were collected. Supporting 

evaluation comes from postgraduate delegates (all 

specialties), facilitators and students. Not all actors can 

role play, not all role players can act. Personal skills, 

articulacy, intellectual involvement, improvisation and 

teaching skills are crucial. Results, skills lists, 

recruitment criteria and recommendations are 

presented. Training role players is less of an issue than 

the initial recruitment of individuals capable of 

developing as medical educators. 

7H4 Analysis of clinical competence at 

pre-graduate level 

Gitte Wichmann-Hansen* and Berit Eika 

Enhed for Medicinsk Uddannelse, SVF, Universitetsparken, 

Bygning 611, 8000 Aarhus C, DENMARK 

The overall objective of this study is to explore what 

opportunities the clinical clerkship offers medical 

students to develop their clinical competence, and how 

these opportunities can be maximized. The study takes 

its theoretical starting point in a semantic analysis of 

the term ‘clinical competence’, showing that it means 

both the ability and right to act adequately in clinical 

situations. A general aim of clinical clerkships is to 

train medical students in acting adequately in a clinical 

situation. Data from our pilot field observations 

indicate that it is difficult to reach this aim, since the 

students are only rarely given the right to act. Often 

they are passive observers or performing isolated 

repetitive tasks without feedback from trainers. 

Therefore, our working hypothesis is that learning 

clinical competence requires that students participate 

as legitimate members of the community. This 

hypothesis is described in a set of ideal criteria.

7H5 Use of paper-cases in 

undergraduate clinical 

Dermatology education in Germany 

A Boer*, R Kaufmann, W H Boehnke and F Ochsendorf 

Universitats-Hautklinik Frankfurt/M, Theodor Stern Kai-7, 

60590 Frankfurt am Main, GERMANY 

In Germany practical dermatology teaching is primarily 

performed as a bedside course. Large numbers of 

students made it increasingly difficult to find 

appropriate patients for demonstration. In recent years 

we developed paper-cases (short story and photo 

material), which were tried over 2.5 years in PBLseminars 

with voluntary and randomly assigned 

students. In each group the students matched the 

intended teaching goals in 75% (mean). After a tutortraining 

our residents were allowed to use the papercases 

individually to substitute patients when necessary. 

Last semester 14% of the patients needed were replaced 

by paper cases. A third of the residents used this 

opportunity and evaluated it as a good alternative. 80% 

of the students received paper-case teaching, 77% of 

them evaluated this type of education either good (55%) 

or very good (22%). We conclude that paper-cases are 

a useful alternative if there are not enough patients. 

7H6 Development of a Learning 

Resource Centre for healthcare 

professionals: an example of an 

innovative enterprise 


Dept of General Practice and Primary Care, Queen Mary 


UK 

In 1998, the need to develop a learning skill centre 

arose at United Medical Education Consortium 

(UMEC) in London with resources for multiprofessional 

teaching and learning in healthcare 

educational approaches, administration, research, 

clinical and computer skills. Logs of all the users of 

the centre between 25 February 1998 and 28 February 

2001 were kept. All the courses run by the centre were 

monitored and evaluated using standardised evaluation 

forms. Data about activities were analysed to compare 

the usage of the centre’s resources by different groups 

in different years (25 February 1998 and 27th February 

2001) and their needs for skill facilities. The evaluation 

results show that availability of flexible skills training 

facilities for UMEC members and visitors have created 

an effective teaching and learning environment. Our 

future plan involves investigating how to provide more 

informed multidisciplinary teaching using new 

technology and extending the services to a wider 

audience. 

7H7 Legal theories of recourse for failed 

medical students in the United 

States 

Thomas Jamieson 

Uniformed Services University of the Health Sciences, 4301 Jones 

Bridge Road, Bethesda, MD 20814-4712, USA 

Medical students aggrieved by a failing grade(s) or 

disenrollment sometimes consider legal action. In the 


- 4.74 - 

United States students typically cite an institutional 

breach of the constitutional right to procedural 

propriety (“procedural due process”) and/or arbitrary 

motivation (“substantive due process”). Caselaw has 

established that constitutional protections are owed 

medical students, but courts have consistently offered 

a presumption of legitimacy to institutions’ decisions 

and students have seldom prevailed when alleging 

inadequate due process. Although minimally exercised 

to date, prospective medical student plaintiffs may 

begin to consider alternative premise(s) for a legal 

challenge. Increasingly, courts view students as 

consumers with expectations for acceptable 

institutional performance of services based on “implied 

contract.” Medical schools should be cognizant of the 

concept of “contract” and of stipulations in their own 

handbooks. If these documents can be read as “implied 

contracts” institutions must ensure they are actually 

doing what they say they are doing. 

7H8 An evaluation of organising student 

participation in curriculum reform 

using a mentoring programme at the 

Nelson R Mandela School of 

Medicine, University of Natal, 

Durban, South Africa 

Dorothy Appalasamy, Michelle McLean* and 

Jacqueline van Wyk 

Department of Physiology, Faculty of Medicine, Private Bag X7, 

Congella 4013, South Africa 

In implementing (January 2001) a student-centred 

curriculum at the Nelson R Mandela School of 

Medicine, an already successful (re: addressing student 

needs) mentoring programme involving 4th and 5th 

year students, was modified to assist 1st year students 

cope with the new learning paradigm. First year 

students enrolled for Curriculum 2001 were organised 

into twenty tutorial groups (n = ± 200) for Module 1, 

each group being allocated a trained facilitator. Twenty 

senior students underwent training to work with these 

tutorial groups, with the aim to provide peer support 

for group members. Mentors meet regularly with their 

groups and with the year co-ordinator for input, 

clarification and for evaluation of student progress and 

needs. Preliminary results indicate that 1st year students 

have embraced the concept of PBL. Issues, for example, 

relating to the small group process and timetabling, 

have been addressed by the mentors and the year coordinator. 

7H9 Medical education – more than 

learning? 

Thomas Eichholz and Catharina Crolow 

Charité, Zeppelinplatz 6, 13353 Berlin, GERMANY 

For most medical students, medical education is mainly 

an instrument to acquire the knowledge to treat the 

patients. In our poster we want to discuss chances 

existing in medical education in Germany. Does 

medical education offer alternatives an an extra 

qualification, as a field of research and as a basis for a 

career?

Session 7I Continuing professional development (1) 

7I1 The roles of hospital consultants: 

more than just patients and 

students 

Patsy Stark 

University of Leeds, Clinical Skills Learning Centre, The General 

Infirmary at Leeds, A Floor Gilbert Scott Building, Leeds LS1 

3EX, UK 

Hospital consultants undertake roles extending beyond 

clinical medicine and undergraduate teaching. In most 

healthcare systems they are increasingly required to 

do more. How do they identify and prioritise roles and 

cope with increasing pressures? A study carried out at 

University of Leeds School of Medicine and the Leeds 

Teaching Hospitals Trust aimed to discover the range 

of consultants’ roles, how they prioritise activities and 

their perceptions of change. Semi-structured interviews 

with hospital consultants were conducted. Analysis of 

the data was performed using qualitative methods. The 

participants revealed wide-ranging roles inside and 

outside the employing organisation, strong allegiances 

to aspects of their work and frustrations about 

increasing demands. In general this was not reflected 

in job plans or contracts. It was concluded that 

consultant contracts and job plans must recognise not 

only the obvious clinical and undergraduate teaching 

roles but also those which have impact on professional 

organisations multiprofessional groups and other 

institutions. 

7I2 Continuing medical education X 

indexation? Authors’ opinions 

about editorial policies of a 

Brazilian academic journal 

Maria de Lourdes Veronese Rodrigues*, Valderes 

Aparecida Coelho Falaschi and Julio Cesar Voltarelli 

Hospital das Clínicas - Oftalmologia, Faculdade de Medicina de 

Ribeirao Preto, 12 andar - Campus Universitario, 14048-900 

Ribeirao Preto SP, BRAZIL 

The main objective of this investigation was to find 

out authors’ opinions about some aspects of editorial 

policies of an academic journal, published by a 

Brazilian Medical School/University Hospital. This 

journal emphasizes Continuing Medical Education, 

publishing mainly review papers and topic symposia, 

and it is not indexed in MEDLINE. The instrument used 

was a self-administered, non-identified questionnaire 

answered by 28 members of the scientific community, 

authors of some papers published by the journal, in the 

last three years. On a three points scale (3 - definitely 

agree, or high level of adequacy; 1 - definitely disagree, 

or inadequate), participants rated the quality of different 

aspects of editorial policies adopted by Revista 

Medicina-Ribeirão Preto (Brazil). Most authors agreed 

with the policy “emphasis in continuing medical 

education” (mean = 2.39, s = 1.22) even if it prevents 

indexation in MEDLINE. 


- 4.75 - 

7I3 Learning HSR by doing: forming 

parallel learning groups 

Saeed Asefzadeh 

Qazvin University of Medical Science & Health Services, Qazvin, 

IRAN 

Health Systems Research (HSR) is a necessary 

approach for resolving health problems. We assessed 

the educational needs of the health workers for HSR 

through focused group discussions in order to develop 

a module that can enable them to participate actively 

in HSR. A module for the health workers has been 

designed in 10 steps as a practical guide for problem 

solving – from finding problems to evaluating the 

solution. The focus of our work is a change from 

traditional workshops to continuous in-the-field 

training workshops using learning by doing method. 

At least two hours a week, the health workers as a 

learning group come together and one step of the 

module is taught and practised on the real identified 

problems. The participants track and work on the step 

during the week. In this way the learning group makes 

up a parallel learning group which works continuously 

and learns autonomously to develop the health 

organisation. 

7I4 Towards a flexible workforce - a 

basis for change 

F French*, M Awramenko, A Scott, C Ubach, L Leighton- 

Beck, G Needham, J Mollison and H Coutts 

SCPMDE, Dept of Postgraduate Medicine, Room 25, Westburn 

Centre, Foresterhill, Aberdeen AB25 2XG, UK 

The Scottish Executive seeks increased flexiblity 

among healthcare professionals. The Scottish Council 

for Postgraduate Medical and Dental Education has 

commissioned a study of perceptions of flexible 

working among non-training grade doctors and 

dentists. Hospital consultants have been selected as the 

first group for study and this will be the first 

comprehensive study of hospital consultants in 

Scotland. The aims of the study are: 

• to elicit the views of non-training grade doctors and 

dentists regarding flexible working; 

• to assess the implications of increased flexibility 

on continuing professional development; 

• to ascertain levels of job satisfaction and 

occupational stress. 

Focus groups and/or interviews will be used to inform 

the design of a questionnaire. Follow-up interviews will 

be conducted to clarify/expand on issues arising from 

the survey. Selected results from the survey of hospital 

consultants will be presented.

7I5 Ensuring cost-effective CPD: 

perspectives, problems and policy 

Clive Belfield and Celia Brown* 



B15 2TT, UK 

CPD must be cost-effective if the optimal quantity is 

to be funded within health care systems burdened by 

resource constraints. This paper details the 

requirements for ensuring effective and cost-effective 

CPD established as part of an investigation into CPD 

funding, provision and participation in the UK NHS. 

The perspectives for ensuring cost-effective CPD are 

framed within a taxonomy that describes an educational 

intervention (Bullock and Thomas, 1997). Thus issues 

pertinent to both provider and participant: access, 

management and planning, curriculum and pedagogy, 

setting, assessment and evaluation are addressed. There 

are however a number of constraints that hinder the 

adoption of cost-effective CPD strategies. Empirical 

and primary evidence that suggests current practice 

fails to meet the requirements is presented and the 

implications for CPD policy in the UK are discussed. 

7I6 Improving your skills in preventive 

medicine: this CME workshop works! 

François Goulet*, André Jacques* and Danielle Saucier 

College des Médecins du Québec, 2170 René-Levesque Ouest, 

Montréal QC H3H 2T8, CANADA 

A 90-minute workshop offered to small groups has been 

developed to help family physicians to include 

evidence-based intervention to their periodic health 

examination (PHE). After the workshop, participants 

completed a questionnaire with opened and closed 

questions. Between September 1996 and December 

1997, 40 workshops were held reaching 667 

participants (16.7 participants/workshop) in all regions 

of the province of Quebec. The evaluations (98.5% 

response rate) showed that participants have reached 

the workshop objectives (2.05 on the Likert scale –3 to 

+3). The most important messages retained were a 

better choice of tests (34.9%) and physician’s self 

involvement (27.2%). Changes anticipated in their 

practice were: better screening of tests (38.9%), 

enhancement of knowledge (18.9%) and to insist on 

counselling (12.8%). Role playing and discussion with 

peers were effective methods used to produce 

anticipated changes in the practice of family physicians. 

7I7 CME program in Kuwait 

K Al-Jarallah and I G Premadasa* 

Kuwait Institute for Medical Specialization, Behbehani Bldg, 10th 

Floor, PO Box 1793, Al-Sharq, Safat 13018, KUWAIT 

The Kuwait Institute for Medical Specialization is the 

designated authority for implementing a unified 

continuing medical education scheme. The CME 

Center administers the scheme, which commenced in 

September 2000. The current phase covers medical and 

dental practitioners. Participation in CME activities is 

optional, but includes reinforcement policies. The 

program operates in 5-year cycles, with practitioners 

expected to acquire a minimum of 250 credit points 


- 4.76 - 

within the cycle. CME activities fall into one of two 

categories. The web site of the CME Center at 

www.kims.org.kw/cme provides details of the scheme, 

and an online facility for participants to register, and 

for CME providers to apply for accreditation of 

activities. Program implementation is monitored by 

reviewing random samples of organizers and 

participants. Peer review by an external evaluator has 

led to quality assurance. International recognition has 

been received via accreditation by Royal Colleges in 

North America and Europe. 

7I8 The theory of perspective 

transformation and its applicability 

to CME 

Jill Donahue*, Stephen Hotz and Réjean Laprise* 

Aventis Pharma, 49 Fallingbrook Street, Whitby, Ontario L1R 

1M4, CANADA 

In the field of adult education, Jack Mezirow published 

his theory of Perspective Transformation which has 

become one of the most important contributions to the 

recent adult education literature. He identified 10 

phases a learner goes through before he/she 

incorporates a new perspective. There are many lessons 

from this theory that we can apply to our work in CME. 

After interacting with the poster, the participant will 

be able to: 

1 identify parallels between issues faced by 

practitioners in CME and contributions of the theory 

of Perspective Transformation; 

2 assess the application of key concepts of the theory 

to needs assessment, design and evaluation 

The key point of the presentation is that when designing 

CME one should consider that in order to incorporate 

a new perspective, a learner may go through ten phases 

that begin with a disorienting dilemma. 

7I9 The transtheoretical model of 

behaviour change: does it apply to 

clinical practices? 

Réjean Laprise*, Jill Donahue and Stephen Hotz 

Aventis Pharma, Department of Professional Education, 2150 

St Elzear Boulevard West, Laval, Quebec H7L 4A8, CANADA 

The transtheoretical model (TTM) proposes that people 

go through a series of 5 different stages of readiness 

when adopting new behaviours. Stage-specific 

educational interventions based on this model were 

shown to facilitate adoption of healthy behaviours in 

patients. In this presentation, we show evidence that 

the TTM may also be useful with physicians. A study 

was carried out on a convenient sample of 195 general 

practioners attending continuing medical education in 

cardiology. Physicians were asked to stage themselves 

according to their readiness to prescribe an ACE 

inhibitor to a high risk cardiac patient, to rate the 

importance they put on this medical practice and to 

indicate their degree of confidence in overcoming 

barriers associated with the performance of this clinical 

behaviour. The relationship between readiness to 

change behaviour on one hand, and self-confidence and 

importance on the other hand, were consistent with 

predictions made from the TTM.

Session 7J Continuing professional development (2) 

7J1 Sharing visions: working with CPD 

coordinators in General Practice 

Simon Smail* and Paul Hocking 

Dept of Postgraduate Education for General Practice, School of 

Postgraduate Studies, University of Wales College of Medicine, 

Heath Park, Cardiff CF14 4XN, UK 

During 2000, twenty general practitioners were 

recruited to work part-time with the Dept of 

Postgraduate Education for General Practice in Wales 

as ‘CPD co-ordinators’. Each general practitioner was 

employed to work one day a week to develop a managed 

programme of CPD in the locality for which they were 

responsible, drawing on local resources and supported 

with an operational budget. Since all these staff were 

facing new challenges in working as educational 

managers, a two-day workshop was held to assist them 

in developing a vision for their future work. This 

workshop used a variety of methods, including an 

‘imaginisation’ exercise in which the participants were 

asked to draw graphical representations of the ideals 

they wished to pursue in their work. The concepts were 

then discussed and developed into themes. This 

presentation describes the methods used in the 

workshop and presents the outcome in summary form. 

7J2 The “Advanced Training Practice”: 

a questionnaire and interviewbased 

study of their role 

John Skelton and Steve Field* 

West Midland GP Unit, 27 Highfield Road, Edgbaston, 

Birmingham B15 3DP, UK 

In the West Midlands Region, UK, 6 practices have 

been designated “Advanced Training Practices” (ATPs). 

They offer specialised, often remedial, training to GP 

Registrars who, for example, have failed summative 

assessment. Registrars, trainers and other stakeholders 

have previously been studied to assess support offered 

for communication skills: this study extends this work 

by questionnaire and interview with trainers, to assess 

the perceived value of ATPs. Many Registrars at ATPs 

are overseas graduates. Major issues are poor English 

language and communication, (eg from doctors 

accustomed to a doctor-centred environment), poor 

cross-cultural understanding, poor study skills and 

defective knowledge. For trainers, a major issue is the 

extent to which Registrars are “trainable”: however, 

they have confidence in their ability to train and assess. 

The specialised needs of Registrars are adequately met, 

but the level of additional support, particularly through 

commercially available materials, requires expansion. 

7J3 Does gender make a difference? 

CME for the female physician 

Jane Tipping* and Jill Donahue 


CANADA 

The population of female physicians in Canada is 

growing such that the percentage of female primary 

care physicians in practice is equal to males. CME is 


- 4.77 - 

still designed and conducted based on the learning 

needs of a population that has been predominantly 

male. This research questions the assumption that the 

two genders are the same in their approaches to 

learning. The research identifies ways in which learning 

differs for female physicians in terms of preferred 

activity, motivation and participation. In addition, the 

particular challenges female physicians encounter in 

CME will be discussed along with strategies that may 

better meet the needs of this group. 

7J4 Strategic planning for effective 

partnerships 

Jane Tipping* and Danielle Deslauriers 


CANADA 

We have reached a point in the evolution of CME 

whereby the creation of true partnerships between 

stakeholders and the effective pooling of resources is 

becoming a necessity. Within the past several years, 

the role of the pharmaceutical industry in Canada as a 

credible partner and provider of CME has become 

evident. Without dialogue between the stakeholder, 

duplication of efforts, territorial issues and 

miscommunication can arise resulting in less value for 

the learner. Ways to align mutual goals are sorely 

needed. This presentation will discuss the directions in 

which CME is growing and describe attempts of Merck 

Frosst Canada to align itself with the developing needs 

of the field. The presentation will critique a needs 

assessment technique used with 36 Canadian CME 

leaders; discuss results; the implications of 

pharmaceutical involvement in CME; and help 

determine ways in which partnership between 

academia, industry and others responsible for CME can 

grow. 

7J5 Integrating practice reflection and 

practice adjustment planning into 

the design of a CME meeting 

R L Thivierge*, L Samson and J V Patenaude 

721 Hartland, Montreal H2V 2X5, CANADA 

The new context of Continuing Professional 

Development (CPD) and of the Maintenance of 

Certification (MOC) of the Royal College of Physicians 

in Canada, brings an important pathway to ensure one’s 

CPD: the development of Personal Learning Projects 

(PLP). At the end of each half-day of a scientific 

meeting, periods of “reflection on my practice” (called 

CPD modules) are conducted by a facilitator as an 

integrated part of the program. Module 1 serves as an 

introduction to CPD, PLP and practice reflection 

generalities. Module 2 will help the participants to 

select specific key-messages derived from educational 

sessions to be applied to their practice environment 

(selecting own PLP). Module 3 helps to plan the 

validation and the implementation of their PLP once 

they are back to work. This model of intervention in 

CME meetings facilitates the linking between theory 

and practice.

7J6 The Catalan Council of Physicians’ 

Colleges Accreditation Diploma in 

Continuing Medical Education 

A Ramos*, J Aliaga, A Gual and H Pardell 

College of Physicians of Barcelona, Centre of Studies, P Bonanova 

47, 08017 Barcelona, SPAIN 

The Catalan Council of Physicians’ Colleges has 

initiated an individual accreditation system, based on 

accredited Continuing Medical Education (CME). The 

system is voluntary and physicians can opt to obtain 

the Diploma of College Accreditation if the following 

prerequisites are achieved: a minimum of 10 credits 

obtained from the CME, accumulated to a minimum 

of 3 training activities carried out within the two 

previous years. The system includes a Technical 

Accreditation Office which deals with technical and 

administrative aspects and the Accreditation 

Commission which determines the accreditation system 

and grants the credits to be endorsed by the Governing 

Boards of the 4 Physicians’ Colleges in Catalonia 

(Barcelona, Girona, and Tarragona). This paper 

contains the first 100 accreditation requests, the 

percentages of concessions and denials, as well as the 

average of credits obtained, the activities presented, and 

a description of age and gender among other parameters 

of interest. 

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7J7 Breaking bad news: how to learn in 

a CME workshop 

François Goulet*, André Jacques* and Robert Carrier 

College des Médecins du Québec, 2170 René-Levesque Ouest, 

Montréal QC H3H 2T8, CANADA 

A 90-minute workshop offered to small groups was 

developed to help physicians to break bad news to their 

clientele. After the workshop and six months later, 

participants were asked to complete opened-question 

questionnaires. Between September 1997 and June 

1998, 50 workshops were held, reaching 706 

participants. From this number, 520 participants could 

be reached six months later. 207 participants (40%) 

completed the second questionnaire and 74% of them 

were identified from the first questionnaire to estimate 

the correlation. After six months, the key-messages 

retained were: never be overwhelmed, always have hope 

to offer, be prepared, find the right moment. The 

barriers still existing are: bad news is bad news, 

discomfort, and difficulty in taking the time. The 

participants found the workshop extremely helpful. 

Role playing and discussions with peers were effective 

methods used to produce changes in the practice. 

Session 7K International medical education 

7K1 Differences in learning style and 

satisfaction with Residency training 

for United States and 

internationally trained students 

Steven R Daugherty 

Kaplan Medical, 820 West Jackson, Suite 550, Chicago IL 60612, 

USA 

A national sample of medical residents training in the 

United States was surveyed about their residency 

experience. 3,604 returned usable surveys for a 64% 

response rate. Analyses examined ratings of satisfaction 

and what contributed most to learning experience for 

US trained students compared with the respondents 

who completed undergraduate medical education 

outside the US (IMGs). Results show that IMGs 

reported less time with attending physicians (5.61 vs. 

4.94, 7-point scale) and were overall less satisfied with 

their residency experience (5.14 vs. 4.78). US trained 

students rated contact with attending physicians and 

other residents as contributing most to their learning 

experience, while IMGs rated reading, patient rounds 

and lectures as the most important elements. These 

results suggest important differences both as to how 

IMGs learn and the structure of their residency training 

programs. Results are discussed with an eye towards 

students’ expectations and specialty selection. 


7K2 Crossing borders - The Berlin 

Biomedical Exchange Office 

U Arnold* and J W Dudenhausen 

Charité, Humboldt-University Berlin, Berlin Biomedical 

Exchange Office, Campus Virchow-Klinikum, Augustenburger 

Platz 1, D-13353 Berlin, GERMANY 

“To promote international education and qualification 

of medical students” is the mission of the Berlin 

Biomedical Exchange Office (BBEO), which was 

initially founded in 1996 as a cooperation project 

between the medical faculties of Humboldt-Universität 

(Charité) and Freie Universität Berlin (University 

Hospital Benjamin Franklin). The activities of the 

BBEO are: 

International Exchange 

• ERASMUS/SOKRATES 

• Biomedical Sciences Exchange Program between 

North America and Europe (BMEP) 

• Bilateral Cooperation 

• International Courses in English 

New Technologies in Education 

• Medic@l Deutsch 

• MedVoice 

• IMIPPP 

• Other projects

Service for Students. The BBEO 

• provides extensive personal consulting; 

• writes letters of recommendation for applications 

at foreign medical schools; 

• hands out various information regarding study 

abroad, and provides up-to-date information on the 

website; 

• shows poster exhibitions, extended by lectures and 

discussions, on the subject; 

• offers special medical language courses for 

incoming and outgoing students. 

7K3 Academic medical education in 

developing countries: an analysis 

of papers presented at medical 

education conferences in Argentina 

Angel M Centeno*, Gustavo Amestoy and 

Amelia Cabrera 



ARGENTINA 

Globalization of medical education, including some 

agencies’ proposals of defining a universal curriculum, 

make it necessary to define what kind of activities are 

conducted in different regions. In order to determine 

what aspects of medical education were of interest in 

our country, what kind of methods were used and which 

disciplines were the most active in medical education, 

228 papers presented at two consecutive medical 

education conferences in Argentina were analyzed. 

Curriculum design (11%), problem based learning 

(10%), faculty development (10%), program evaluation 

(8%), teaching methods (8%), disciplines integration 

(7%), informatics and multimedia (5%), community 

service (5%), evaluation methods (5%), continuing 

medical education (5%), and admissions (5%), were 

the most frequently cited. 

Thirty percent of the papers were research based, and 

70% were narrative descriptions of programs in 

progress. Basic and clinical sciences were equally 

represented, the latter mainly in postgraduate education. 

These results are similar to those reported in developed 

countries. 

7K4 Communication skills training in 

Germany - results of a survey 

Jan Schildmann* and Ulrich Schwantes 

Humboldt University Berlin (Charite), Department of General 

Practice, Vogelsang 16, 78343 Horn, GERMANY 

The training of communication skills has become an 

important part of the curricula at many medical schools 

in Europe. In Germany however a lot of universities 

do not offer regular communication skills courses. To 

find out more about the actual situation regarding 

education in this field of medical education we 

conducted a survey among medical students who took 

part in seminars and lectures organised by the 

department of General Practice at different Medical 

Schools in Germany. The aim of our survey was to 

explore the existing learning opportunities offered by 


- 4.79 - 

the medical faculties. Furthermore we asked the 

students about their needs regarding this aspect of 

medical training. In our presentation we will show the 

data of the survey and our conclusions for the future 

development of communication skills training as part 

of the training at German Medical Schools. 

7K5 Reform of the medical educational 

system in Georgia 

R Khetsuriani, B Kilasonia and A Telia* 

Tbilisi State Medical University, 33 Vazha-Pshavela Ave, Tbilisi 

380077, GEORGIA 

Tbilisi Medical State University prepares annually 500 

specialists in medicine and pharmacy. Ten years ago 

our country moved to a new economic formation under 

difficult social and economical conditions and faced 

the necessity for reforms in the medical educational 

system. Following the Soviet era, and without central 

financing, medical education tries to fill the vacuum 

with “European air”. At the Medical University reform 

has been partially implemented. The learning process 

consists of three stages: 

1 Two years – basic course – examination 

2 Three years – clinical course – examination 

3 Two years – specialization – state examination 

certification (specialty – medical affairs, 

qualification – physician). 

A net of University clinics has been created as well as 

a rectorial post. The second step of the reform involved 

the establishment of outcome-based education, 

development and optimization of the learning process, 

translation of standard educational programs and 

textbooks, and acquaintance with the European 

educational system and standards. Realization of this 

goal is fairly difficult without support from the 

international community. 

7K6 Results and main objectives of the 

first stage of education reform at 

the TSMU 

R Khetsuriani, B Kilassonia and N Pruidze* 

Tbilisi State Medical University, 33 Vazha-Pshavela Ave, Tbilisi 

380077, GEORGIA 

Based on the tradition of European medical education, 

a high medical school was founded in Georgia in 1918; 

its successor is Tbilisi State Medical University. A new 

period of this high school started in 1992, when total 

autonomy was given to the high schools in independent 

Georgia. Since this time it has become possible to 

implement the cardinal changes in medical education 

and to engage highly qualified pedagogical and medical 

staff, which was quite difficult during the period of 

transition from one politico-economic system to 

another. In that period, well-known medical schools in 

the USA, Austria, Germany, France, Spain, Turkey, 

Egypt, etc. became our partners. At Tbilisi State 

Medical University there are departments of General 

Practice, Pediatrics, Preventive Medicine and 

Healthcare Management, Stomatology, Military 

Medicine, Medical Biology, Psychosomatic Medicine,

Psychotherapy and Pharmacy. Studies in the faculty of 

General Practice consist of 14 semesters, in total 8800 

academic hours. In our opinion, the curriculum is 

overloaded and a revision of the teaching methodology 

is needed. We aim to have close integration with 

European medical schools, which will give us an 

opportunity of reciprocal recognition of qualifications. 

7K7 First international integrated 

surgery course at the Charité, 

Berlin, Germany 

Hajo Schmidt-Traub 

Charité, Humboldt University Berlin, Isländische Str. 11, Berlin, 

GERMANY 

In cooperation with the Karolinska Institutet, 

Stockholm, Sweden, a 16 week surgery course took 

place in Berlin. It included surgery, orthopaedics, 

anaesthesia, radiology and urology. The course was 

mainly planned and organised by students who had 

taken part in the Stockholm international surgery 

course. The aim of the course was to mediate both 

practical and theoretical skills. The students were 

integrated into the daily routine of a general hospital 

and participated in practical and problem based 

seminars. Half of the students came from foreign 

countries. Language of instruction was English. The 

students’ learning experiences in seminars and hospital 

departments were evaluated. Feedback from both 

students and teachers was very positive. This project 

proved to be a good example of a different way of 

teaching. Therefore it may have a positive impact on 

the future structure of the medical curriculum at the 

Charité. 

Session 7L Special subjects 

7L1 Illegible notes - do tomorrow’s 

doctors need teaching on how to 

write more clearly? 

E Westcott, A Kontoyannis*, N Murch, T Reid and 

K Sixsmith 

University of Wales College of Medicine, 9 Connaught Road, 

Roath, Cardiff CF24 3PT, UK 

Hand-written entries by doctors in patient notes aim to 

communicate information to other team members. It 

is important that these entries can be easily read and 

understood. 205 patient clerkings were read by medical 

students (fourth year) to asses the percentage of illegible 

words and unrecognisable abbreviations, and the 

absence of date, time, patient details and doctor’s 

identification. Whereas the recording of patient 

identification was good (due to the use of patient 

‘addressograph’ stickers), the recording of the doctor’s 

identification (name, position, bleep number), was 

incomplete in over half the entries. This poster discusses 

the implications of poorly written patient notes and 

suggests methods for improvement. These results call 

for improved teaching on handwriting legibility, the 

appropriate use of abbreviations and the recording of 

doctor identification. The use of doctor ‘identograph’ 

stickers is suggested. 


- 4.80 - 

7K8 Counting the uncounted: 

estimating the number of overseas 

doctors in training grades in the UK 

currently not employed in the NHS 

Janet Grant, Mairead Beirne* and Heather Owen 


University, Walton Hall, MILTON KEYNES MK7 6AA, UK 

The main aims of this project were to: 

• Estimate the size of the pool of unemployed 

overseas doctors in the UK and to indicate its 

distribution across specialties and subspecialties; 

• Determine the career and job-seeking strategies of 

these doctors; 

• Describe the scope for improving these doctors’ 

prospects of employment; 

• Estimate the background availability of posts. 

Because of their unemployment, there are no records 

of unemployed overseas doctors in the UK. This project 

therefore addressed the challenge of counting the 

uncounted. An approach to estimation was therefore 

selected which involved adopting a variety of methods 

and triangulating these to reach an overall view of the 

magnitude of the pool, its distribution and the reasons 

behind it. The methods adopted included: 

• Survey of Senior House Officer applicants 

• Documentary analysis 

• Secondary analysis of GMC and DoH statistics 

• Survey of competition for posts. 

7L2 An active method to prepare 

students to lead medical 

interviews: an experience at Xavier 

Bichat Medical School 

Corinne Pieters; Dominique Maillard*, Françoise 

Blanchet-Benqué 

Hopital Louis Mourier, Explorations Fonctionnelles, 178, rue 

des Renouillers, 92700 Colombes, FRANCE 

This study describes a series of two active trainings, 

teaching basic communication skills in the pre-clinical 

curriculum. In the first intervention, of a one-day 

duration, students had to reformulate in a popular radiostyle, 

different messages from a scientific paper, in front 

of 20 students. In the second intervention of a threehour 

duration, students working in small groups of 10, 

had to (from a video extract): observe behaviours of a 

patient meeting several doctors, analyse the styles of 

verbal and non-verbal communication and expose to 

other students the communication gap between the 

patient and the doctors he/she met. Each presentation 

is followed by a group discussion and a synthesis done 

by the teacher. Formative assessment will allow the 

students to master their own abilities to conduct medical 

interviews.

7L3 Teaching medical students patient 

advocacy skills; An 

interdisciplinary intervention using 

Standardized Patients/Families 

Graceanne Adamo*, Virginia Randall, Janice Hanson, 

William Sykora, Aileen E Zanoni, Elizabeth Jeppson and 

Richard E Hawkins 

Uniformed Services University of the Health Sciences, National 

Capital Area Medical Simulation Center, 4301 Jones Bridge 

Road, Bethesda MD 20814, USA 

We describe an innovative medical education 

intervention, designed by interdisciplinary faculty 

collaborators, to teach and evaluate patient advocacy 

skills. The intervention is integrated into the required 

Family Medicine Clerkship within a comprehensive 

clinical experience in a simulation center. The goals of 

this educational intervention are to instill in medical 

students the appropriate knowledge, skills and attitudes 

to advocate effectively for their patients in a managed 

care environment. Intervention activities evolve around 

encounters with standardized patients/families. The 

specific clinical challenges focus on discharge planning 

for patients with significant home-health care needs. 

Related instructional activities include: individual 

feedback from standardized patients and faculty, an 

interactive teaching session featuring an advocacy 

contact workbook, interviews with real patients, and 

an opportunity to practice advocating to a standardized 

attending physician on behalf of a patient or family. 

Outcome measures include participant satisfaction and 

performance on the final clinical examination. 

7L4 The parameters affecting attitudes 

to death among students in a 

Medical College in Taiwan 

Ming-Liang Lai 

Department of Neurology, National Cheng Kung University 

Hospital, 138 Sheng-Li Road, Tainan, TAIWAN 

The parameters affecting the attitude to death and dying 

(anxiety, avoiding, philosophical thinking, and reality 

facing) were evaluated through a questionnaire to 

students at the Medical College of National Cheng 

Kung University. The anxiety response was more 

frequently noted in the female gender, in more 

pessimistic students, in those who consider religion to 

be important in their life, particularly Daoism and 

Buddhism, and in students not in the Department of 

Medicine. The avoiding response was noted more in 

the male, with AB blood type, and in students in the 

Department of Medicine. Interesting enough, the 

sophomore and higher-grade medical students seemed 

more avoiding than freshman. The pessimists, and those 

who had considered their own death, who had read 

books on thalantology, seen movies or read novels with 

death or dying as the main theme, presented a 

significantly stronger tendency towards philosophical 

thinking. Finally the reality facing response was more 

frequently noted in those who had read books on 

thalantology. 


- 4.81 - 

7L5 Evaluation of practical sessions in 

Clinical Anatomy: a strategy for 

educational improvement 

M A F Tavares* and M C Silva 

Institute of Anatomy, Medical School of Porto, Alameda Hernani 

Monteiro, 4200-319- Porto, PORTUGAL 

We have evaluated the students’ response to practical 

teaching sessions in Clinical Anatomy in our Medical 

School using action-research. The aim was to identify 

problems and to introduce changes which might 

improve the program and the performance of the 

teaching staff. At the end of each section of the program, 

each student completed a “target type” questionnaire 

with eight different components. As each quarter of 

the whole class had its own teacher, an analysis of 

variance was used to evaluate the target questions in 

the various sections of the program, and the 

performance of the four teachers. This research method 

gave us feedback on the students’ responses while the 

program was in progress. The results emphasize the 

importance of action-research in assessing and 

improving a developing program in a basic discipline 

of the medical curriculum. 

(Supported by Project PRAXIS XXI PCSH/C/CED/157/96) 

7L6 Towards a more effective teaching 

of Gross Anatomy: introducing new 

integrated clinical concepts and 

improving peer presentations/ 

evaluation techniques 

Ameed Raoof*, Thomas Gest, William Burkel and 

Tamara Stein 

University of Michigan Medical School, Department. of 

Anatomical Sciences, Office of Medical Education, 3808 Med 

Sci Bldg II, Ann Arbor MI 48109-0608, USA 

Relevance and teaching methods of gross anatomy 

remains one of the most frequently assessed subjects 

among basic medical sciences. The medical gross 

anatomy course is taught at the University of Michigan 

to an average of 170 students. Measures to enhance 

effectiveness and promote relevance and learning 

opportunities included the introduction of new 

integrated clinical teaching concepts. These included 

clinical tutorials, clinical vignettes and modified 

practical exam questions. Students’ opinions about 

these techniques were assessed at the end of the 

semester. An interesting array of responses was 

obtained. Also, plans were laid down on providing 

students with clinical data related to the cadavers they 

dissect during the next semester. In addition, the peer 

presentation/evaluation technique that has been applied 

for a few years witnessed some further improvements. 

Students’ opinion about the new measures showed a 

significant improvement in the effectiveness of the 

technique in promoting the relevance of anatomical 

knowledge.

7L7 Putting the salutogenic orientation 

into practice: the life cycle course 

at the Technion 

H Eshach*, R Van-Raalte, L Dolev, H Bitterman and 

D Hermoni 

Technion, Israel Institute of Technology, PO Box 9649, Bat 

Galim, Haifa 31096, ISRAEL 

The salutogenic orientation, which focuses on origins 

of health, poses that we study the location of each 

person, at any time, in the ‘health ease/disease’ 

continuum rather than dichotomize between healthy 

and sick people. The Life Cycle course at the Technion 

presents human social development from birth to death. 

Students, equipped with the salutogenic and 

biopsychosocial model, learn that patients’ “stories” 

reveal etiologically significant data that is often missed 

by clinicians. The aim is to identify a shift in students’ 

perspectives regarding data about psychosocial aspects 

of the “patient story”. Before and after the Life Cycle 

course, students were provided with cases that required 

knowledge of the psychosocial aspects surrounding 

patients’ lives in order to treat them. Students were 

asked to rank contributing factors, including 

psychosocial and pathological factors, according to 

their relevance to the intended treatments. Results are 

pending and will be presented at the conference. 

7L8 ASAMANS (Ask Students About 

Medicine And National Socialism) 

T Drewes*, P Langkafel* and S Muller* 

Charité, Department of Obstetrics, Faculty of Medicine, 

Humboldt-University of Berlin, Augustenburger Platz 1, 13353 


Medicine during National Socialism (1933-1945) in 

Germany and the consequences for medical practice 

nowadays are the topic of this presentation. Focus of 

the study is the knowledge, assessment and attitudes 

of medical students towards medicine and National 

Socialism. We asked in which way medical education 

at the Charité/Berlin promotes the discussion of this 

subject among students. We asked about general basic 

topics such as euthanasia, medical experiments in 

concentration camps and the role of German doctors 

during National Socialism. A sample of 300 students 

at the start, middle and end of the studies (first, fifth, 

tenth semester) answered a questionnaire of 35 

questions between April and May 2001. The team 

consisted of one physician and two medical students. 

The results will be discussed and presented at the 

conference. Further information will be posted at 

www.asamans.de 


- 4.82 - 

7L9 Stress among medical doctors 

J Agsteribbe* and J Cohen-Schotanus 

University of Groningen, Department of Education, Faculty of 

Medical Sciences, A. Deusinglaan 1, 9713 AV Groningen, 

NETHERLANDS 

While interviewing medical doctors we noticed quite 

a number of complaints concerning job load and lack 

of leisure time. The overwhelming amount of 

complaints surprised us since one of the objectives for 

medical training is to learn to deal with stress and to 

become aware of the mutual influences of work and 

private life. Our research question is therefore: are 

workers in the medical profession more susceptible to 

stress than those in other occupations? 235 medical 

doctors were interviewed by phone and asked to fill 

out the General Health questionnaire (GQH-12); 150 

responded. The results indicated that: i) medical doctors 

were more stressed than their age group with the same 

educational level; ii) female doctors were much more 

stressed than their male colleagues; iii) female doctors 

are at a greater risk of experiencing stress than male 

doctors. It therefore seems necessary to pay more 

attention to this phenomenon during medical training. 

7L10 Introducing changes in medical 

education: the “Strategy” of 

Clinical Anatomy at the Medical 

School of Porto 

M A F Tavares 

Institute of Anatomy, Medical School of Porto, Alameda Hernani 

Monteiro, 4200-319- Porto, PORTUGAL 

The discipline of Clinical Anatomy, as introduced in 

the Medical School of Porto in academic year 1995/ 

1996, involved big changes in the way we teach 

anatomy to medical students, by adopting a clinically 

oriented approach. The teaching/learning program has 

been developed over the last 5 years through an actionresearch 

project: (1) organisation of a new approach in 

Sections (regional approach) divided into different 

Units (physical examination, sectional and imaging 

anatomy sessions, malformations and anatomical 

variations, case-studies); (2) development of 

instructional materials (study guides, handouts, casestudies) 

and (3) introduction of interactive audiovisuals. 

This program involved all the staff and students as 

active researchers in this project. Its full implementation 

is providing medical students with a solid anatomical 

competence through the acquisition of an “anatomical 

reasoning” that aims to provide skilled clinical 

performance. 

(Supported by Project PRAXIS XXI PCSH/C/CED/157/96)

Session 8A Computer mediated learning and assessment 

8A1 Preparing clinical small group 

sessions by using digital video in 

CBE 

Marianne G Nijnuis*, Caro Brumsen, Jan A Gevers 

Leuven and Peter G M de Jong 

Leiden University Medical Center, Onderwijscentrum IG, Kamer 

C5-54, PO Box 9600, 2300 RC Leiden, NETHERLANDS 

Small-group patient demonstrations form an important 

part of the Internal Medicine clerkship in Leiden. The 

purpose of these meetings is to discuss symptoms, signs 

and management of common health problems and 

diseases. In practice it is often difficult to get a patient 

with the required diagnosis at the right time and place. 

As a result, most cases have to be presented in written 

text. In order to make better use of the available patient 

material several patients were recorded on digital video 

at a time that was more convenient for them. The images 

were used in a computer based educational program. 

Students are requested to study this program on the 

evening before the small-group discussion takes place. 

During the session the students can discuss the case 

under supervision of a clinician. The use of this new 

teaching method has improved the educational value 

of the already highly appreciated patient 

demonstrations. 

8A2 Inter-physician communication 

training through computer-based 

patient simulations 

S Eggermont*, P M Bloemendaal, E Schoonderwaldt and 

J D Donnison-Speyer 

Leiden University Medical Center, Heelkunde Onderwijs K6-R, 

Postbus 9600, 2300 RC Leiden, NETHERLANDS 

Communication between physicians is essential in 

modern medicine; therefore communication training 

should be integrated in medical curricula. A joint 

project of the Leiden University Medical Center and 

the Amsterdam Medical Center, will result in twenty 

computer-based cases, developed in the Dynamic 

Patient Simulator (DPS). DPS is a computer program 

for creating and running patient simulations. In such a 

simulation several students treat one virtual patient 

asynchronously, enabling them to practise clear and 

adequate communication by training the transfer of the 

patient’s medical record. For this purpose we created a 

model of the inter-physician communication. With this 

model we can differentiate between multiple types of 

communication with different modalities, such as 

transfer of collected evidence, consultancy and 

strategies for further evidence collection, assessment 

and intervention. In our presentation we will explain 

the communication model and demonstrate its 

implementation in DPS. 


- 4.83 - 

8A3 Computer Assisted Learning: using 

and doing research in primary care 

Linda Leighton-Beck*, Philip Hannaford, Neil Hamilton, 

Sara Shaw and Yvonne Carter 

Scottish Council for Postgraduate Medical & Dental Education, 

Postgraduate Medical Department, University of Aberdeen, 

Foresterhill, Aberdeen AB25 2ZD, UK 

Development of CAL for research in primary care 

resulted from practitioners’ expressed needs, and the 

policy agenda. National collaboration achieved funding 

for a demonstration model. The project will: 

• design an innovative educational intervention to 

support staff in health settings, nationally and 

internationally; 

• develop a comprehensive course on research - 

Understanding Research and, Learning to do 

Research - utilising, initially, CD-ROM; 

• develop applications facilitating web access; 

• evaluate the concept through a pilot CD-ROM. 

The CD-ROM has been developed as a demonstration 

model through a collaboration of researchers and Medi- 

CAL technologists. Evaluation of its educational value 

and technological robustness will utilise questionnaire 

and interview of a defined sample of General 

Practitioners and healthcare professionals. Evidence of 

usefulness, effectiveness and accessibility will inform 

development. Successful outcomes will facilitate 

progress from demonstration model to platform support 

tools, customised to the needs of specialities. 

8A4 Extracting core competencies 

“bottom up” from case histories by 

an online consensus seeking 

process in family medicine 

Peter Schlaeppi* and Ralph Bloch 

Institute of Medical Education IAWF, University of Bern, 

Inselspital 37A, CH-3010 Bern, SWITZERLAND 

This project responds to the need for a clear and detailed 

definition of the required competencies for future 

family physicians in Switzerland. The aim of the project 

is to demonstrate that a web-based platform is a feasible 

and comfortable means to define relevant core 

competencies based on case histories. The practitioners 

of an expert panel had to write case histories based on 

their daily work. The panel outlined core problems and 

core criteria to solve core problems. Thus, a core 

competence is defined as a bundle of the criteria 

necessary to solve a core problem. In a first step 82 

core competencies consisting of 348 criteria could be 

identified. Online work was well accepted by the panel. 

Working together online seems to be a feasible means 

to seek relevant consensus in the continuing process 

of developing and updating core competencies in 

family medicine.

8A5 A new era of teaching: an 

innovative resource for continuing 

medical education and evidencebased 

management 

K El-Hayes, B McElhinney, B Adams, E Boyd and 

K McKinney 

1 Oakridge, Castlewellan Road, Banbridge, Co Down BT32 

4RT, NORTHERN IRELAND 

The aim of the project was to use and develop the skills 

of existing personnel to create a unique educational 

resource suitable for use by the multiprofessional team 

and adaptable to any setting. Using standard Microsoft 

Office software, resources from established Obstetric 

and Gynaecology texts and RCOG publications were 

used as references and incorporated with commercially 

available CD ROMs and pre-existing protocols and 

procedures into an interactive format. The result is an 

educational, multimedia computerised shell adaptable 

to any speciality. It forms a huge, informative teaching 

source that includes: 

• Case Based Learning 

• Evidence Based Protocols 

• All-encompassing hospital directory 

• Animated presentations of common procedures 

• Enormous database for self-assessment including 

MCQs, essay questions etc. 

• User-friendly site. 

There is no doubt that the result is an unfolding journey 

of extreme magnitude. We believe that the 

incorporation of this concept is essential for personal 

development in Obstetrics and Gynaecology in the new 

Millennium. Forget the WWW: meet the Obs and 

Gynae Wide Web. 

8A6 Evaluating medical student and 

resident education: a CME software 

J C Edwards*, P Ogden and A A Stricker 

Department of Family & Community Medicine, Texas A & M 

University, 810 Southern Hills, College Station, Texas 77843- 

1114, USA 

The software CME program titled “Evaluating Medical 

Student and Resident Education” delivers an interactive 

multimedia application on CD-ROM. Designed as an 

interactive tutorial, it requires only 30 to 45 minutes 


Session 8B Implementation of PBL 

8B1 Problem-based learning for 

trainees in Anaesthesiology 

Sigrid Adam* and Jan Klein 

University Hospital Rotterdam, Department of Anaesthesiology, 

Erasmus University Rotterdam, Dr. Molewaterplein 40, 3015 

GD Rotterdam, NETHERLANDS 

In order to increase the efficiency of learning during 

postgraduate training we educate our residents in a 

programme which is problem-based. Weekly tutorials 

- 4.84 - 

for a busy doctor to complete. Objectives are: (1) 

understand and apply the concept of judge/ 

diagnostician in evaluating student/resident 

performance; (2) understand and apply defined 

standards to evaluate reliably. The content, new in 

medical education, addresses the physician tendency 

to nurture trainees. The outcome - ability to change 

roles from teacher to judge/diagnostician. Brief 

instruction and four videotaped interactions between 

attending physicians and trainees provide self-diagnosis 

and practice. The program incorporates two published 

examples of defined standards. Print materials can be 

downloaded from the CD-ROM. MPEG-1 compressed 

videos provide exceptional quality, closely matching 

movie industry standards at 30 frames/second. This 

high quality video prevents use of the internet, which 

would lessen quality. 

8A7 Metabolic challenges on CD-ROMs 

Marie-Paule Van Damme*, Jonathan Gould, Bruce Livett, 

Janet Macaulay, Ron Maxwell and Graham Parslow 

Monash University, Department of Biochemistry & Molecular 

Biology, Faculty of Medicine, Clayton 3800, Victoria, 

AUSTRALIA 

As a way of engaging students more actively in their 

learning process, we have created multimedia 

presentations that offer: 

• “Self-Directed Learning” using interactive tutorials 

on various aspects of metabolism, nutrition and 

diabetes; 

• “Problem-solving exercises” requiring students to 

think logically and integrate information drawn 

from a variety of sources; 

• “Case studies” to teach students to apply their 

knowledge to specific clinical cases, such as “The 

Effects of Alcohol on Metabolism” and “Dietary 

Therapy for Type 2 Diabetes”. 

These programs have been compiled as two CD-ROMs: 

“Biochemistry-A Metabolic Challenge” and 

“Nutritional and Hormonal Aspects of Diabetes”. They 

challenge students to acquire a wide understanding of 

the interdependence of metabolic processes occurring 

in the major tissues of the body under different 

nutritional and hormonal states. Surveys have shown 

that the use of these teaching tools improves student 

understanding and enjoyment of the subject compared 

to conventional teaching methods. 

involve 9 trainees per group. Since active learning is 

known to improve knowledge and recall, the specific 

learning objectives of a fictive patient case are worked 

out by the group and discussed with the support of a 

tutor. Self-studies are an integral part of the programme 

which also involves questions and instructions 

distributed by the tutor via internet. According to the 

concept of iterative integration the learning issues of 

the cases gradually get more difficult and are

longitudinally related to what has already been learned. 

Residents find this form of learning very encouraging 

and stimulating. Besides improvement of knowledge, 

problem-based learning also improves the quality of 

teamwork and communicative skills. 

8B2 Communicating with students in a 

problem-based curriculum: 

experiences with WebCT 

Michelle McLean and Kathy Murrell 

University of Natal, Department of Physiology, Faculty of 

Medicine, Private Bag X7, Congella 4013, SOUTH AFRICA 

A problem-based curriculum was introduced at the 

Nelson R. Mandela School of Medicine (University of 

Natal, Durban, South Africa) in January 2001. Several 

factors required that the year co-ordinator be able to 

communicate with students on a daily basis. After 

evaluating several packages, WebCT (Web Course 

Tools) was chosen as the front-end product for the 

delivery of Internet material because of e-mail and 

bulletin board facilities, its ability to handle high quality 

graphics and streaming video, as well as the integration 

of student records and student tracking. Accessing 

WebCT from sites outside the campus was considered 

important, in the light of the community work senior 

students would be undertaking. Results from the 

preliminary evaluation of WebCT by first year students 

(after Module 1) are encouraging. This presentation 

will discuss the development of module course material 

in WebCT, as well as how students of differing 

educational background have embraced the technology. 

8B3 Faculty members and senior 

students as facilitators in PBLgroups 

- similarities and differences 

Are Holen*, Kristin Wigen and Oyvind Ellingsen 

Institute of Community Medicine and General Practice, 

Medisinsk teknisk forskningssenter, Norwegian University of 

Science and Technology, N-7489 Trondheim, NORWAY 

Both faculty members and senior students may serve 

as facilitators (tutors) in PBL-groups at the Faculty of 

Medicine, Norwegian University of Science and 

Technology. Each group has two alternating facilitators; 

one only may be a senior student. A scale has been 

developed to assess central dimensions of the 

facilitators’ group behaviour. Once each term, the 

students complete the scale. Along with general 

feedback, the results are given to the facilitators. The 

aim is to improve facilitators’ contributions to group 

interaction and learning processes in PBL-groups. 

Findings about similarities and differences between 

faculty members and senior students as facilitators will 

be presented and discussed. Also, some reflections on 

senior students as facilitators in PBL-groups will be 

discussed. 

8B4 Tutors’ perspectives of problembased 

learning 

Diana Kelly 

Department of Education for Medicine & Dentistry, 4th Floor, 

Henrietta Raphael House, Guy’s Campus, St Thomas Street, 

London SE1 9RT, UK 


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While PBL has been widely written about, there is 

limited research concerning PBL tutors’ perspectives. 

This study set out to explore teachers’ viewpoints in a 

context where PBL was introduced part way through 

the undergraduate curriculum, and as one of several 

teaching methods. The aim was to investigate the 

question: how do teachers perceive and experience their 

role as PBL tutors? Research was conducted during 

1999/2000 at King’s campus of Guy’s, King’s and St. 

Thomas’ School of Medicine. Qualitative methods of 

data collection and analysis were used, with interviews 

being conducted with tutors from the newly established 

PBL programme. From the findings it emerged that 

tutors faced challenges as they grappled with the 

complexities of their role. These challenges were 

located within personal understandings and external 

perceptions of PBL, as well as tutors’ own experiences. 

Discussion of the findings will be the focus of this 

presentation. 

8B5 The E.D.I.T. project in Linköping: 

using web-based scenarios for PBL 

Wolfram Antepohl*, Anne-Christine Persson, Margareta 

Bachrach-Lindström and Björn Bergdahl 

Division of Medical Education, Linköping University, University 

Hospital, S-581 85 Linköping, SWEDEN 

In the spring term of 2001, the Faculty of Health 

Sciences, inspired by the Graduate Medical Programme 

at the University of Sydney, started to implement its 

E.D.I.T. (Educational Development using Information 

and Communication Technology)-project. The idea 

behind the project is to increase the reality aspects of 

scenarios (cases or problems) used to facilitate learning 

in a problem-based curriculum. Apart from text 

documents, web-based scenarios may contain video 

clips, digital images of high quality (plain photographs, 

x-ray, microscopy, etc.), sound, graphics and other 

media formats. In the fifth semester of the medical 

curriculum, EDIT was implemented as a pilot project. 

Twenty-five patient scenarios were designed and put 

on an intranet-server using the media formats 

mentioned above. PBL groups worked in rooms 

equipped with a computer connected to the intranet, a 

projector and an interactive whiteboard. Students’ and 

tutors’ experiences with the new scenario format were 

evaluated using qualitative and quantitative approaches. 

Group sessions were observed and analysed concerning 

potential effects on the PBL-process. The project and 

results of the evaluation will be presented during the 

conference. 

8B6 How to promote success in a PBL 

tutorial session 

N Paganus*, K Lonka and T Hatonen 

Faculty of Medicine, Learning Centre/Development & Resource 

Unit, University of Helsinki, P.O. Box 63, 00014 Helsinki, 

FINLAND 

The present study examines the effects of students’ 

attitudes towards PBL on study behaviour and learning 

outcomes. The quality and functioning of the tutorials 

in relation to learning outcomes were looked at. The 

participants were 17 second-year medical students. Six 

PBL-tutorial sessions were videotaped. Of the total of

540 minutes of videotape, “brainstorming”, “setting 

learning goals”, and “evaluation” were analysed. The 

participants filled in Likert-type questionnaires. After 

the last session, the students also answered open-ended 

questions. The relations among students’ attitudes, time 

spent on individual study, student behaviour in tutorials, 

and their academic achievement were analysed. It was 

found that students with a positive attitude used more 

time for individual study and concentrated more on 

medical knowledge than on irrelevant comments during 

tutorials. It appeared that the positive attitude, study 

time spent, and an active role in tutorial sessions were 

all related to good exam grades. 

8B7 Evaluation of the student staff in the 

experience of PBL in the Federal 

University of Roraima - Brasil 


Session 8C Curriculum planning 

8C1 Priorities in the content of the 

curriculum from the standpoint of 

the academic staff 

E Nagle*, R Velins and V Pirags 

Latvian Medical Academy, Department of Medical Biology, Riga 

Stradina University, Dzirciema Str. 16, Riga LV-1007, LATVIA 

A questionnaire of academic staff has been conducted 

to ascertain opinion about the most important aims and 

essential elements of the curriculum highlighted in the 

National Concept “Tomorrow`s Doctors in Latvia”. 

Teachers were asked to arrange the aims of a curriculum 

in order of relevance. The sequence was as follows: 

knowledge as a basis for medical practice, health 

promotion and prevention, independent learning and 

life long learning. This questionnaire highlights also 

that the most essential elements of the curriculum are 

the compulsory amount of theoretical knowledge 

defined for each study term, mastering of appropriate 

practical skills and introduction of optional study 

modules. Analysis of these results could be used for 

further curriculum planning at the Faculty of General 

Medicine. 

8C2 Reforming the core curriculum of 

the Reformstudiengang in Berlin - a 

Delphi study 

B Huenges*, W Burger, J W Dudenhausen, U Frei, 

C Frommel, H-P Lemmens, U Schwantes and D Scheffner 

Arbeitsgruppe Reformstudiengang Medizin, Charité, Campus 

Virchow-Klinikum, Lehrgebaude, 2 Stock, Augustenburger Platz 

1, 13353 Berlin, GERMANY 

After experiences with three semesters in the new 

reformed curriculum we realised the necessity to 

reconstruct our core content. To do this, about 1400 

topics, derived by different health and disease surveys, 

were reviewed. Out of these our interdisciplinary core 

group identified 376 ‘health problems’ (123 patients’ 

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Alvaro Tulio Fortes*, Cesar Ferreira Penna de Faria, 

Ruy Guilherme de Souza and Fernado Menezes da Silva 

UFRR Brasil, Rua Irineu Lucena 50, Mecejana, Boa Vista 

Roraima, 6930-4210, BRAZIL 

From the history of Medicine, and particularly in the 

area of Medical Education, can be observed prominent 

aspects in its secular evolution. The first one, classical 

medicine, comes from Ancient Greece and the other, 

clinical medicine, originates in Occidental Europe, 

which today constitutes the basis of modern scientific 

medicine. This work intends, through an evaluation on 

the part of the student staff, to demonstrate the 

developed activities, the experiences and the results of 

the introduction of a model of problem-based medical 

education in the Medicine course of the Federal 

University of Roraima. A total of 128 evaluations 

relating to the organization and content of the program, 

the system of evaluation, the physical structure and the 

human factors, have been carried out on the learning 

of 1st and 4th years. 

symptoms and signs, 205 diseases and diagnoses, and 

48 general aspects of medicine) which appeared crucial 

for modern medical education. Topics were selected 

according to their frequency, urgency and exemplarity. 

This corpus represents the basis for a faculty wide 

Delphi survey, started in April 2001. In the first round, 

463 faculty members from 63 different departments 

were contacted and asked to review our proposal from 

the point of view of their area of practice. This 

procedure was chosen to promote faculties’ 

involvement and feeling of ownership of the 

‘Reformstudiengang Medizin’. 

8C3 Early clinical clerkship - does it 

make a difference? 

Berit Eika* and Ole Sonne 

Enhed for Medicinsk Uddannelse, SVF, Universitetsparken, 

Bygning 611, DK 8000 Aarhus C, DENMARK 

The effects of an early (2nd year) 8 week long clinical 

clerkship were investigated. Students with clinical 

exposure were compared to students without clinical 

experience on: 1) attitudes towards medical education, 

and 2) performance on a short essay examination in 

physiology. More students with clinical exposure felt 

they had insight into the medical profession. When 

compared to students with no clinical experience, the 

early clinical exposure induced a more favourable 

attitude towards the significance of early patient 

contact. No differences were found in the two groups’ 

study motivation, feelings for having chosen the right 

study, or sense of belonging to the profession. The 

students with clinical exposure performed slightly 

better on the physiology examination, but other 

differences in study population could account for this. 

In conclusion, despite very positive evaluations of early 

clinical clerkships it is difficult to document that the 

clerkship changes students’ attitudes or performance.

8C4 ECTS (European Credit Transfer 

System) as a tool in curriculum 

development 

B Grether 

Veterinarmedizinische Fakultat der, Universitat Zurich, 

Winterthurerstr. 252, CH 8057 Zurich, SWITZERLAND 

The European credit transfer system is based on the 

total study workload of an average student. The “lecture 

per week” is no longer the measure for study workload; 

credits also allow the reflection of student time devoted 

to other learning activities such as e-learning, group 

work, directed self-study and time spent in skills labs. 

Whereas transferring an already existing curriculum 

into credits may be very difficult, ECTS can be a helpful 

tool when planning a new curriculum. The total amount 

of study workload will be defined for each course, 

including contact hours, pre- and post- course 

assignment, preparation for examinations and time 

necessary for various learning activities other than 

lectures. By attributing credits for this a balance of 

study workload over the whole course of study can be 

found. A credit system may also create an environment 

adequate for introducing new self-directed learning 

methods. 

8C5 The continuum of professional 

development 

H M R Meier 

University of Toronto, Mount Sinai Hospital, 600 University 

Avenue, Department of Psychiatry, Room 929, Toronto ON 

M5G 1X5, CANADA 

The first Elective provides the first step on the lifelong 

journey of professional development. This 

teaching-learning relationship offers additional 

dimensions for student and Tutor. Appropriate support 

for the Tutor’s professional contribution, including 

educational credits, enhances the spirit of the Electives 

programme and encourages experience in areas underrepresented 

or not yet represented in the core 

curriculum. Collaboration with CME and rural medical 

education includes conceptualisation of faculty 

development applicable beyond the Electives 

programme, as changes in core curriculum increasingly 

involve off-campus Tutors. 


Session 8D The final examination 

8D1 Consistency of examination marks 

T Vik*, K H Karlsen and S Westin 

Norwegian University of Science & Technology, Department of 

Community Medicine, Medical Faculty, Olav Kyrres gt 3, N- 

7489 Trondheim, NORWAY 

To assess the consistency of examination marks, four 

examiners marked two cases given to 69 graduating 

medical students as part of the final board examination. 

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8C6 Evaluating ethics seminars 

Gerald Neitzke 

Department of History, Ethics & Theory of Medicine, Hannover 

Medical School (MHH), Carl-Neuberg - Str 1, D30623 

Hannover, GERMANY 

Teaching medical ethics involves teaching aims and 

objectives on different levels. On a cognitive level facts 

are taught to extend students’ knowledge. On an 

affective level emotions and conscience are dealt with 

to foster students’ attitudes and conduct. On the 

practical level skills are exercised to achieve sound 

moral judgement and decision-making, teamqualifications, 

and communication skills. If the 

effectiveness of ethics seminars is to be evaluated, all 

levels of teaching objectives have to be considered. 

Changes of attitudes and behaviour are key qualities 

of successful moral education. How can they be 

measured and what are fundamental conditions of such 

tests? Results should not be biased by students’ moral 

convictions. Behavioural changes should be 

distinguished from changes of attitudes only. A control 

group in a strict statistical sense has to be found. This 

presentation scrutinises the prerequisites of a standard 

of best evidence in ethics education. 

8C7 A tool to evaluate medical ethics 

seminars 

Mareike Moeller* and Gerald Neitzke 

Geibelplatz 4, 30173 Hannover, GERMANY 

The development and testing-phase of a survey to 

evaluate ethics seminars are presented. At Hannover 

Medical School one third of first year medical students 

get the chance to attend ethics classes. This offers the 

opportunity of an ideal study design with a randomised 

control group. The questionnaire is designed to test 

affective and practical components related to specific 

teaching aims. Attitudes like moral conscientiousness 

and empathy, and abilities like argumentation skills and 

decision-making are detected. The rationale is to 

measure students’ development in the handling of moral 

dilemmas before and after attending ethics classes. 

Students are confronted with two case histories which 

pose moral problems. A total of 16 statements (4 on 

each teaching objective) are to be approved/disapproved 

on a ratio scale. The pre-test took place already; the 

post-test will be carried out in July 2001. The 

questionnaire and preliminary results are presented. 

The marks were scored from 5 (failed) to 12 (excellent) 

and grouped in four categories: Failed, acceptable, 

good, and excellent. No student failed. Mean score 

given by one examiner (7.9; SD: 1.6) was significantly 

lower than that given by the other three (9.4; SD: 1.2). 

Correlation coefficients between examiners’ scores 

varied from 0.61 to 0.72 (p < 0.001). Agreement in 

classifying a student’s knowledge as acceptable, good 

or excellent varied from no (kappa: 0.04; 95% CI: -

0.05 - 0.13) to moderate (kappa: 0.51; 95% CI: 0.32 - 

0.70) between various pairs of examiners. Agreement 

between two endocrinologists assessing a case in 

endocrinology was only fair (kappa: 0.21; 95% CI: 

0.02-0.40). The results suggest unreliable (inter-rater) 

grading in written clinical case examinations. 

8D2 Identifying threshold competence 

in an undergraduate qualifying 

clinical examination 

John Cookson* and Stewart Petersen 

Leicester Warwick Medical School, Division of Medical 

Education, Faculty of Medicine, P O Box 138, Leicester LE1 

9HN, UK 

Undergraduate qualifying examinations seek to identify 

those who are competent to proceed to house officer 

training. This requires definition of the standard of 

competence required of the new graduate, and its 

conversion to a threshold within an examination. We 

have attempted to define the concept of the ‘minimally 

competent’ practitioner – one who is just able to 

proceed. The final professional clinical examination 

at LWMS is graded in terms of five ‘categories of 

competence’, with precise grade descriptors. We asked 

consultants who train house officers to define the 

minimally competent new graduate in terms of the 

proportions of patients where they would not perform 

satisfactorily in each category of competence. 

Proportions ranged from 0% to 50%. There was a clear 

tendency for history and examination skills to be 

considered more important. The findings have 

implications for setting examination thresholds. 

8D3 The validity of performance 

standards on a certification 

examination for occupational 

therapists 

Ernest Skakun 

Division of Studies in Medical Education, 2 J3000 WMC, Faculty 

of Medicine and Oral Health Sciences, University of Alberta, 

EDMONTON, Alberta, T6G 2R7, CANADA 

This study investigated the validity of passing scores 

set by the Nedelsky and Angoff methods for an 

occupational therapy national certification exam. Eight 

judges rendered Nedelsky and Angoff judgments for 

302 multiple choice items. Judges used a five-point 

scale to rate the competence of examinees selecting 

each alternative as an answer. Judges’ decisions were 

correlated with scores of examinees near the passing 

scores. Item difficulties were computed for examinees 

with scores just above (higher) and just below (lower) 

the passing scores for each method. The number of 

alternatives rated as “significant concerns about 

competence” and selected as possible answers was 

compared for higher and lower scoring examinees. The 

correlation between judges’ decisions and examinee 

scores around the passing score was 0.34 and 0.23 for 

the Angoff and Nedelsky methods respectively. 

Comparisons of proportion correct for higher and lower 

candidates showed more consistency for the Angoff 

method. 


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8D4 Reliability of a sequential clinical 

examination 

Stewart Petersen* and John Cookson 

Leicester Warwick Medical School, Division of Medical 

Education, Faculty of Medicine, P O Box 138, Leicester LE1 

9HN, UK 

Clinical competence of students at Leicester Warwick 

Medical School is assessed by direct observation of 

consultations with a series of patients. Summative 

assessments are sequential. All students are observed 

with 2 or 4 patients, (depending on stage in the course), 

and those whose competence remains in doubt are 

observed with a further 3 or 4. In each consultation, a 

different pair of examiners observes students 

continuously. Examiners grade independently 

performance in five categories of competence defined 

by precise descriptors. There are precise grade 

descriptors. All examiners are trained. In a full, final 

examination, therefore, each student has 16 grades for 

each of five categories of competence. Analysis of data 

from three full cycles of assessment demonstrates that: 

(i) there is a high degree of inter-examiner reliability; 

(ii) eight cases are sufficient to mitigate case specificity; 

(iii) students vary in the relationship between 

performance in different categories of competence. 

8D5 Considerations of Legal, Ethical, 

Organizational Aspect of Clinical 

Competence in a National 

Licencing Examination, Evaluation 

at the Medical Council of Canada 

Jacques E. Des Marchais*, Dale W. Dauphinee and 

David Blackmore 

12420 rue Joseph-Edouard-Samson, Montreal Quebec H4K 

2N9, CANADA 

Organizations responsible for development and 

administration of national licensing examinations are 

becoming major partners in responding to evolution 

of emerging new social needs, such as Considerations 

of Legal, Ethical and Organizational aspects of medical 

practice(CLEO).The Medical Council of Canada 

(MCC) has been responsible for developing an 

examination process which leads to licensure to practise 

in the Canadian provinces. The study presents the 

decision-making process which has resulted in the 

development of the CLEO content of the Medical 

Council of Canada Qualifying Examination. The 

validation process of this new content is demonstrated 

as well as specific objectives in each of the three CLEO 

components. Results are presented from the first 

mandatory implementation, in May 2000, for about 

2000 candidates. Comparison with the MCQ scientific 

component is presented and discussed. Integration of 

CLEO disciplines into the second component (OSCE) 

of the MCC Qualifying examinations is also 

demonstrated. 

8D6 Combining different components of 

an assessment procedure 

J Degryse*, J Goedhuys, A Roex and A Dermine 

ACHG K U Leuven, Department of General Practice, 

Kapucijnenvoer 33 Blok J, B3000 Leuven, BELGIUM

In Flanders the Departments of General Practice in 

different universities worked together to organise a 

common final assessment procedure. This takes place 

at the end of the vocational training period in General 

Practice and takes the form of a certification exam. 

This assessment procedure is built out of four different 

components: a well-designed written knowledge test, 

a structured oral exam, a large scale OSCE type exam 

and a structured report from the trainers. A pass-fail 

standard is defined for each separate module using 

appropriate procedures. A final pass-fail decision is 

based on a combination of the scores obtained from 

the different modules. This presentation discusses the 


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different approaches that can be used to combine the 

different component scores. From a pure reliability 

perspective the reliability analysis of composite scores 

can be computed using a multivariate reliability 

analysis. The discussion is illustrated with data collected 

from the final assessment procedure in 1996-2000. The 

impact of using different approaches and computation 

methods is simulated and discussed. The choice for a 

specific combination method should be inspired by the 

psychometric characteristics of the assessment tools 

but the final decision is made on an empirical basis. 

Session 8E Postgraduate education/career choice 

8E1 Teaching with patients: moving 

beyond ‘learning by osmosis’ 

Kath Green 

South Thames Department of Postgraduate Medical and Dental 

Education, 33 Millman Street, London WC1N 3EJ, UK 

Teaching with patients in everyday workplace contexts 

(such as ward rounds, clinics, theatre etc.) provides a 

unique opportunity for postgraduate doctors to gain 

insight into the complex thinking that lies at the heart 

of professional practice in medical education. It is easy 

to assume, however, that these inexperienced doctors 

will ‘pick up’ a range of important generic skills (e.g. 

communicating with patients, working in multiprofessional 

teams, understanding patient anxiety etc.) 

merely by accompanying a more experienced clinician 

in one of the above contexts. Could it be that some of 

the excellent role models of good practice being 

provided by experienced colleagues are going largely 

unnoticed by postgraduate doctors whose personal 

agendas may be narrowly focused on exam preparation? 

Some ideas for raising the status of this kind of 

‘teaching by example’ will be outlined and opened up 

for further discussion. 

8E2 The effect of an interactive 

postgraduate education 

programme on parenteral treatment 

in Macedonia 

M Ivanovski, P D Toon*, K Zafirovska, F Tozija and B Gomes 

University College London, 137 Roding Road, London E5 0DR, 

UK 

Macedonia has no formal system of postgraduate or 

continuing education for doctors working in primary 

care. These doctors are poorly equipped and have little 

access to current medical information. Treatment is 

therefore often inappropriate; overuse of antibiotics and 

injected drugs, and high referral rates are particular 

problems. To improve matters the Chamber of 

Physicians encouraged the Ministry of Health to 

support a programme of continuing education using 

World Bank funds and foreign technical assistance. 

Evidence-based guidelines were customised and 

translated, and an 18 day course based around these 

was developed. This was piloted in the Prilep region in 

1999. It was well received by participants, and is now 

being extended throughout the country. We will present 

details of the course and data demonstrating a fall in 

the cost of injectable drugs in the Prilep region by 26% 

in the four months following the course, compared with 

the previous year. 

8E3 Promoting innovation in 

postgraduate education through 

the accreditation process 

Judith Armbruster 

ACGME, 5555 N Sheridan, Apt 601, Chicago IL 60640, USA 

U.S. residency programs and their institutions are 

subject to many destabilizing influences, eg, economic 

pressures for clinical productivity, shortened 

hospitalizations, decentralization of patient care, all of 

which may negatively impact teaching. The ACGME, 

the U.S. accrediting agency for postgraduate medical 

education, has initiated a project to help programs meet 

these challenges. An invitation was issued to programs 

and institutions to submit proposals for innovative 

approaches to teaching and evaluation. The proposals, 

which must also ensure the training quality is not 

compromised, should result in initiatives that may be 

adopted by other institutions. Principal benefits of the 

RFP (request for proposals) approach are that it will 

stimulate creativity and flexibility in teaching 

institutions, recognize and reward viable innovation, 

and promote the sharing of information among 

programs. Over 100 proposals were received. This 

presentation will explain future plans for the project 

and describe some of the most promising proposals. 

8E4 A new development in 

postgraduate surgical education: 

the Intermediate Breast Course - a 

distance learning course 

H M Sweetland*, E Hoadley-Maidment and M Galea 

Raven Dept of Education, Royal College of Surgeons of England 

(RCS), University of Wales College of Medicine, University 

Department of Surgery, Heath Park, Cardiff CF4 4XN, UK

In the UK there have recently been significant changes 

in Postgraduate Surgical training. The RCS has been 

instrumental in developing new courses for surgical 

trainees. In 1999 a Committee of breast surgeons set 

out to plan and develop a Distance Learning course 

for breast trainees. The aims of the course were to 

present breast disease as an interesting specialty area, 

provide basic knowledge but stimulate learning ‘on the 

job’, and ultimately to encourage more trainees into 

breast surgery. The curriculum was planned together 

with a distance learning study guide and 3 study days 

to teach practical skills and to discuss what has been 

learnt from the study guide and the clinical situation. 

The course has run from October 2000 to April 2001, 

and it is currently being evaluated from participant 

feedback. The rationale, curriculum and evaluation of 

the course will be presented. It is proposed that this 

course will be a model for further courses to be 

organised by the RCS. 

8E5 Attitude change in neonatologistsin-training 

by participation in the 

neuropediatric follow-up of former 

premature infants 

J B Hentschel 

Department of Neonatology, Universitaets-Frauenklinik des 

Inselspitals, Schanzeneckstr 1, CH 3012 Bern, SWITZERLAND 

Attitudes among neonatologists towards resuscitation 

of premature infants at the limit of viability (range 22- 

26 weeks gestation) differ. Many families of immature 

infants are burdened by varying degrees of disability 

of their child. Participation in neuropediatric followup 

of premature infants is part of neonatology training, 

but not every neonatologist-in-training is exposed to 

such a program. It is unknown whether changes in 

attitude occur in neonatologists exposed to outcomes 

of prematures; the hypothesis is that active participation 

in a follow-up program is likely to influence attitudes 

indicated by an opinion change regarding resuscitation 

of infants at the limits of viability. A research design is 

proposed containing a pre- and post-training 

questionnaire administered to pediatric residents in 

neonatology training before and after participation in 

a neuropediatric follow-up program of prematures, 

compared to questionnaire results in residents who do 

not participate in such a follow-up. 


Session 8F Teaching and learning 

8F1 Impact of peer tutoring on the 

patient-centered interviewing skills 

of first-year medical students 

D Nestel* and J Kidd 

Imperial College School of Medicine, Connaught House, 

Apartment 17, Davies Street, London W1K 3DA, UK 

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8E6 Factors that influence the career 

choice of medical specialization 

M B M Soethout* and G van der Wal 

Vrije Universiteit Medical Centre, Department of Social 

Medicine, EMGO-Institute, Van der Boechorststraat 7, 1081 

BT. Amsterdam, NETHERLANDS 

To identify factors that influence the career choice for 

medical specialization, a review of the literature was 

carried out, based on a qualitative and quantitative study 

design. Altogether 24 studies were analyzed. The results 

showed that most studies were of good quality. A 

quantitative assessment showed that many factors, like 

‘hours and working conditions’, ‘domestic 

circumstances’ and ‘enthusiasm for specialty’ played a 

role in the medical career choice. Nowadays more 

women than men study medicine. The majority of 

doctors with a first choice of general practice at the 

time of qualification achieved this. Women, who 

wanted a clinical specialization, could not accomplish 

or continue this career sufficiently. Social Medicine 

was not very popular for qualified doctors, but some 

years after qualification a substantial amount of doctors, 

especially women, worked in this field. The method of 

this review and the results will be presented. 

8E7 Personality differences in doctors 

affect the factors associated with 

their medical specialty choice 

Gillian B Clack*, Derek Cooper and John O Head 

51 Burbage Road, Herne Hill, London SE24 9HB, UK 

Attention has been drawn in the literature to the change 

in focus over the years on factors associated with 

medical specialty choice, ranging from personality, 

attitudes and values, socio-economic factors, the effect 

of medical education, to the influence of debt, expected 

earning and anticipated working conditions. 313 out 

of 464 doctors surveyed (68% response rate) completed 

a questionnaire, the Myers-Briggs Type Indicator 

(MBTI), which measures normal personality 

differences. They also gave details of factors which 

most influenced them in their choice of medical 

specialty from 30 options, e.g. experience on the course, 

opportunities for research, need for security, etc. 

Analysis of this data resulted in significant differences 

being found between the factors which were most 

important to the different personality types. These 

results will be presented which will be of interest to 

those involved in recruitment to the different 

specialities. 

In medical education, peer tutoring is most frequently 

used for knowledge-based subjects. There are no 

published accounts of peer tutoring in relation to the 

acquisition of patient-centred interviewing skills. At 

Imperial College, 23 third-year medical students 

participated in a project in which they facilitated 

sessions for their first-year colleagues in the skills of

patient-centred interviewing. In each session, two thirdyear 

students co-facilitated a group of six first-year 

students as they practised the skills of patient-centred 

interviewing. Each first-year student interviewed a 

simulated patient and then received feedback from the 

actor, facilitators and fellow students on their 

interviewing skills. Two months after the sessions, the 

patient-centred interviewing skills of the first-year 

students were assessed. In this presentation, the 

interviewing skills of first-year students are compared 

with those of students who worked in groups facilitated 

by medical teachers. 

8F2 Peer Assisted Learning - a teaching 

strategy for the new millennium? 

Joy R Crosby and H Mei-Ling Ball* 

Curriculum Office, Ninewells Hospital and Medical School, 

Dundee DD1 9SY, UK 

Peer Assisted Learning (PAL) is a key learning tool 

and increasingly being used in medical education. For 

2 years, a voluntary PAL system has been run in Dundee 

Medical School using 4th and 5th year students to tutor 

2nd and 3rd years. Tutee evaluation of each session 

was performed using a brief questionnaire of tutee 

satisfaction and motivation for attendance. 626 

responses were returned and analysed showing a highly 

favourable response to PAL, with 95% rating sessions 

as useful / very useful and 93% as a good / very good 

learning aid. Particular focus on why students attended 

PAL sessions showed a diverse range of motivation, 

with an emphasis on enhancing exam performance. The 

effect of attending PAL reflected in exam performance 

was also examined. These data have been used to devise 

a tutee profile which will be used to make the scheme 

more accessible and beneficial to all students. 

8F3 An insight into how students learn 

about a cardiovascular problem 

using study guides 

Shihab E O Khogali*, Jennifer M Laidlaw, Stuart D 

Pringle and R M Harden 

Dept of Cardiology, University of Dundee, Ninewells Hospital 

& Medical School, Dundee, DD1 9SY, UK 

A study guide is a useful tool to help students manage 

their learning more effectively, but to what extent does 

the format of these guides play a part in the learning 

process? One hundred and fifty-one second year 

medical students were given three different formats of 

guides covering the topic of hypertension. The guides 

were timetable-based; problem-based; outcome-based. 

Although the content for all three types was the same, 

the weighting on the different components of the guides 

differed. Students were asked to select the guide of their 

choice to learn about the topic. From our study, we 

concluded that: 

1 In general students find study guides helpful in 

managing their learning; 

2 The guide which adopted a timetable approach to 

learning was the preferred choice; 


- 4.91 - 

3 The guide which adopted an outcome-based 

approach was the least preferred choice; 

4 Of all the components of guides, the incorporation 

of a clinical problem was deemed the most helpful. 

8F4 Study guides in an outcome-based 

medical curriculum at the 

International Medical University 

(IMU), Malaysia 

M I Nurjahan*, J C Ramesh, S Raman, R Ammu, 

K H Ong, C M K Patrick and Q Akhtar 

International Medical University, Clinical School, Jalan Rasah, 

70300 Seremban, Negri Sembilan, MALAYSIA 

An outcome-based undergraduate curriculum with 

eight major outcomes was developed for our clinical 

school. The core curriculum consists of 113 studyguides 

among others. This paper describes how the 

study guides were developed with the aim of facilitating 

task-based and independent learning. These guides 

were prepared and reviewed utilizing a “study guide 

matrix” by a multidisciplinary faculty; and these form 

a key learning resource throughout the clinical years. 

A study guide was prepared for each key clinical 

problem. They identified learning issues in the 8 

outcomes including basic medical sciences in each of 

the problems and specific themes like ethics, which 

run through the curriculum. The IMU adopts a spiral 

curriculum and revisiting basic sciences in solving 

clinical problems is one of our outcomes. The guides 

help the students manage their own learning and obtain 

the maximum from each clinical attachment in 

accordance with the major outcomes. 

8F5 How authors of an extensive 

distance learning programme for 

surgical trainees differed in their 

use of the specified template 

Jennifer M Laidlaw*, Ronald M Harden, Lorraine J 

Robertson and E Anne Hesketh 

SCPMDE, Education Development Unit, Tay Park House, 

484 Perth Road, Dundee DD2 1LR, UK 

The development of new technologies has resulted in 

an increased use of and interest in distance learning. 

The production of effective distance learning materials 

is time consuming and requires the skills of content, 

educational, and technical experts. A wide range of 

content experts may contribute to a programme, but 

often they are based at a distance from each other, and 

frequently with no previous educational expertise in 

producing distance learning materials. This was the 

situation encountered by the Centre for Medical 

Education Dundee when commissioned by The Royal 

College of Surgeons of Edinburgh to produce 42 

distance learning modules to prepare Basic Surgical 

Trainees for the AFRC examination. To tackle this 

initiative, a template was developed which defined the 

educational strategies to be adopted in the programme, 

and to help authors to structure their content. This paper 

examines the use made of the template by the authors, 

and in particular, the extent to which they utilised the 

various educational strategies which were built in to 

the programme’s design.

8F6 Context-dependent memory in a 

meaningful environment: in the 

classroom and at the bedside 

Franciska Koens*, Olle Th.J. ten Cate and Eugene J F M 

Custers 

School of Medical Sciences, University of Utrecht, Universitair 

Medisch Centrum, Stratenum 0.303, Onderwijsinstituut, Postbus 

85060, 3508 AB Utrecht, NETHERLANDS 

Godden and Baddeley (1975) showed that divers who 

learned words under water or on land, recalled these 

words better when the recall condition matched the 

original learning environment, a finding often cited in 

the medical education literature. Because the ecological 

validity of this experiment for medical education can 

be questioned, we replicated the Godden and Baddeley 

study, but now contrasting a clinical with an educational 

environment. Besides that, we added medically 

meaningful subject matter (clinical case description and 

biomedical words) to the non-medical type of common 

words used in the G&B study. Preliminary results 

indicate no significant differences. However, there does 

appear to be a slight tendency towards better recall of 

the case description if the encoding took place in the 

clinical environment. 

Godden D, Baddeley A. Context-dependent memory in two natural 

environments: on land and underwater. British Journal of Psychology 

66[3], 325-331. 1975 


Session 8G Assessment in postgraduate and 

continuing education 

8G1 A computerized adaptive test as an 

element of the final assessment of 

general practitioners in Flanders. 

Possibilities, difficulties, dilemmas… 

A Roex* and J Degryse 

K.U. Leuven, ACHG - Department of General Practice, 

Kapucijnenvoer 33 Blok j, B3000 Leuven, BELGIUM 

The many advantages of CAT make it very attractive 

for use in the final assessment procedure for general 

practitioners in Flanders. The actual written test is based 

on a 3 dimensional blueprint. The item response theory, 

which is essential for the development of a CAT, is 

based upon the assumption that the test scores reflect 

the amount of one latent trait possessed by the 

individual. Is the general practitioner’s competency 

unidimensional and how can our blueprint be adapted 

to take account of this assumption? Subdividing the 

test in different modules and working with testlets are 

some of the solutions we will discuss in order to solve 

the problem of case-specificity as described by Elstein 

et al. (1978), Norman and Newble (1985) and van der 

Vleuten (1988). Several mathematical constructs (1, 2 

and 3 parameter models) can be used to make a CAT. 

Each of these has implications on the size of the item 

database software choice. 

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8F7 Continuous Interactive Class (C.I.C) 

J Medrano*, R Calpena, A Compan, M T Pérez Vázquez, 

J Lacueva and M Díez 

Miguel Hernandez University, Facultad de Medicina, Carretera 

Alicante-Valencia, km 87, 03550 San Juan, Alicante, SPAIN 

In 1999 we initiated a pedagogical project in teaching 

called Continuous Interactive Class. Consisting of a 

technical card comprising objectives and contents of a 

theme to learn, 6 students with a tutor, after consulting 

the bibliography, discuss a theme that is outlined on 

the web. An electronic mailbox is opened so that any 

student may consult his/her tutor. Finally, an interactive 

“seminary” takes place to discuss the mail received and 

the problems that have arisen, elaborating a new 

version. Educational contents are better explained and 

brought up to date and the active participation of the 

group increases student motivation. There was low 

participation by the students through e-mail and lack 

of interest in the change of pedagogical methodology. 

The reasons for this were considered to be too many 

exams and classes, fear of change and possibly low 

availability of personal computers. 

8G2 Insight 360: a tool for looking at 

doctors’ performance 

E B Peile* and R Conradt 

Department of Primary Healthcare, University of Oxford, 

Chiltern Waters, 1 Stablebridge Road, Aston Clinton, Bucks 

HP22 5ND, UK 

Researching effectiveness of GP registrar education, 

we needed to develop proxy measures of performance 

in trained doctors in order to look at the outcome of 

training. We adapted a tool which is used in 

developmental work with general practices. Insight 360 

contrasts the perceptions of a doctor’s patients and 

colleagues with self perception in relevant areas of 

performance. We encourage groups of trained 

practitioners to take part in this exercise. Each 

respondent is asked to rate both the importance of a 

particular item of performance, and how well the doctor 

performs on this item. Individual reports are prepared 

for each doctor taking part, and we also prepare group 

reports, if requested. This feedback material can be very 

useful towards the doctor’s personal development. The 

database provides us with valuable indicators of a 

doctor’s perceived performance, enabling us to look 

for influences of education and training.

8G3 Impact on non-principals in 

General Practice of the summative 

assessment audit project 

P Bowie, A Garvie and J Oliver 



General practice registrars (trainees) must pass an audit 

project as part of summative assessment (SA). Its 

impact after training on audit knowledge, ability to 

recognise audit criteria and standards, and attitudes 

towards audit is unknown. 200 GP non-principals in 

the west of Scotland were surveyed (79% response rate) 

to assess these factors. 67 respondents (42%) underwent 

SA and 91 (58%) had not. Respondents rated their 

knowledge of different areas of audit method. 

Significantly higher mean scores were recorded for the 

SA group in every area (P

complex four-flap Z-plasty, suggesting a lesser ability 

to transfer learned principles to a novel and more 

complex task. The ability to mentally manipulate threedimensional 

objects is related to initial performance 

on a spatially complex surgical procedure. Subjects 

with lesser visual-spatial abilities achieve satisfactory 

levels of performance following practice and feedback. 

8G7 Validity of MIST-VR in the 

assessment of laparoscopic skill 

A M Paisley*, P Baldwin and S Paterson Brown 

University of Edinburgh, University Department of Surgery, Royal 

Infirmary, Lauriston Place, Edinburgh EH3 9YW, UK 

The aim of the study was to determine whether MIST- 

VR laparoscopic simulation correlates with 

performance in theatre. Error, economy and time taken 

for 36 surgical trainees, 37 surgically naïve students 


Session 8H Curriculum change 

8H1 Innovation and reform of medical 

education: evaluating the UNI 

program in Latin America 

E C Ribeiro*, G Werneck, A Aguiar and V Brant 

Universidade Federal do Rio de Janeiro, Nucleo de Tecnologia 

Educacional para a Saude, Centro de Ciencias da Saude 

SubsoloBloco A Sala 33, Cidade Universitaria - Ilha do Fundao, 

Rio de Janeiro CEP 21941-590, BRAZIL 

The UNI program is a Kellogg Foundation initiative in 

the field of human health resources development in 

Latin America, based on the idea that partnership 

between university, local health services and 

community should be the cornerstone for innovation 

of professional training and health practices. The study 

evaluates the achievement of UNI schools students of 

a set of expected and consistent professional attitudes 

according to principles guiding the UNI Program. The 

study includes comparison with non-UNI schools of 

the eight countries involved so that inference of 

program results can be performed. The design includes 

a categorization of schools according to variables 

referenced to the concepts of innovation and reform 

defined in a theoretical model in which the medical 

school is considered as a space of transformation and 

reproduction of social practices. The methodological 

pathway is discussed, particularly the study design and 

instrument construction, its limits and possibilities. 

8H2 Promoting responsive curriculum 

change within the 21st century 

Cam Enarson 

Wake Forest University School of Medicine, Medical Center 

Boulevard, Winston-Salem, NC 27157, USA 

The process of curriculum change is complex, political 

and dynamic. The curriculum reform process includes: 

1) identification of the rationale for curricular change; 

2) managing the change process; 3) development of 

- 4.94 - 

and 16 surgical consultants to complete 2 tasks on 

MIST-VR were recorded. 26 trainees and 36 students 

underwent repeat assessment after 6 months. A 

validated in-theatre technical assessment form was 

completed by each trainee’s consultant. Trainee MIST- 

VR performance did not correlate significantly with 

consultant assessment and was not significantly 

different from that of consultants or students. A 

significant but weak correlation was found between 

MIST VR time score and duration of surgical 

experience (p=0.036, rho=-0.242 Spearman). Trainees 

showed significant improvement in time and economy 

after 6 months (median (IQR) time 0 to time 6 months: 

time (seconds): 217(176-291) to 184(157-215) 

p=0.003; economy score: 26(19-32) to 21(16-25) 

p=0.002 Wilcoxon); however, similar improvement was 

also seen in the student group. Further work into this 

area is needed. 

the new curriculum model/plan; 4) curricular 

implementation. The curriculum renewal process at the 

Wake Forest University School of Medicine will be 

used to illustrate the curriculum planning process noted 

above. Wake Forest University embarked on a 3 year 

curriculum planning process in 1995. During the first 

year of planning, ten principles were identified to serve 

as the foundation for the new curriculum. A curriculum 

model was developed during the second- and thirdyears 

which showed the 46 month educational program 

as a continuum. Implementation of the new Prescription 

for Excellence: A Physician’s Pathway to Lifelong 

Learning curriculum is occurring over a 4 year period. 

A program evaluation plan has been developed linked 

specifically to curricular goals and objectives. 

8H3 Improving the University and NHS 

Teaching Hospital Trust 

Partnership to identify SIFT 

spending 

Andrea J Bolshaw 

University of Birmingham, Medical School, Medical Education 

Unit, Edgbaston, Birmingham B15 2TT, UK 

The perceived underspend of SIFT on Undergraduate 

teaching is widely acknowledged throughout UK 

medical schools and NHS teaching hospitals. In order 

to monitor the provision of services under the SIFT 

contracts, the University of Birmingham Medical 

School has developed a vehicle in the form of a 

Framework Agreement to strengthen links with the 

NHS and ensure the highest quality clinical care, 

teaching and research. In collaboration, a system has 

been developed to monitor compliance with the 

Agreement in the form of Undergraduate Clinical 

Education Monitoring Visits. This paper sets out how 

such a mechanism has been developed, and as a result, 

offers guidelines for the design and implementation of 

a framework for quality monitoring of undergraduate

teaching activities within NHS hospital trusts. A 

thorough insight will be given into how this practical 

strategy works in real terms to effectively meet high 

standards in university medical education. 

8H4 Assessment of medical student 

attitudes toward relevant aspects of 

medical practice 

Maria de Lourdes Veronese Rodrigues*, L E de A Troncon, 

M F A Colares, J F C Figueiredo, ARL Cianflone, 

CE Piccinato, LC Peres and JA Dela-Coleta 

Faculty of Medicine of Ribeirao Preto, Department of Clinical 

Medicine, Hospital das Clinicas, Campus Universitário, 14048- 

900 Ribeirao Preto SP, BRAZIL 

At the Faculty of Medicine of Ribeirão Preto 

(University of São Paulo, Brazil), a 5-point Likert scale 

containing 52 items was developed for measurement 

of medical student attitudes toward 6 relevant aspects 

of medical practice. Preliminary tests determined the 

scale’s apparent and content validity and showed high 

internal consistency (Cronbach’s alpha = 0.86). 

Attitudes of graduating classes of medical students were 

measured for 4 consecutive years. Pooled results from 

317 students showed predominantly positive attitudes 

toward: 1) psychological issues in organic diseases; 2) 

primary care; 3) aspects of medical work in the 

community; and either conflicting or undefined 

attitudes were detected toward the following aspects: 

4) mental diseases; 5) physician roles in medical 

research and 6) death-related situations. Data obtained 

are likely to represent deeper medical school values 

and have to be taken into consideration for further 

improvements in medical student education. 

8H5 Effect of a curriculum reform of 

graduating student performance 

M L V Rodrigues*, J F C Figueiredo, L E A Troncon, 

C E Piccinato, L C Peres, A R L Cianflone and M F A Colares 

Hospital das Clínicas - Oftalmologia, Faculdade de Medicina de 

Ribeirao Preto, 12 andar - Campus Universitario, 14048-900 

Ribeirao Preto SP, BRAZIL 

Aiming at evaluating the efficacy of a new curriculum 

implemented at the Faculty of Medicine of Ribeirão 

Preto, a yearly objective assessment of graduating (6th 

year) students was performed. Shortly before 

graduation, all students underwent sets of multiplechoice 

questions (MCQs) and groups of 18-20 students/ 

year were randomly assigned to OSCEs for either 

clinical (real and standardised patients) or procedure 

(mannequins) skills. The average MCQs score for the 

new curriculum (63.1, SD=8.9, n=261) was 

significantly higher (p

Session 8I Communication skills training 

8I1 Which interviewing skills must be 

actively taught at medical school? 

K Aspegren*, P Henriksen, P Lonberg-Madsen and 

M Stromming 

Laboratorium for Kliniske Faerdigheder, Rigshospitalet, Afsnit 

5404, Blegdamsvej 9, 2100 Kobenhavn O, DENMARK 

The study looked at which interviewing skills must be 

actively taught at medical school. 29 and 60 students 

from the last semester in their studies, and from two 

different years, were randomly selected in a medical 

school where there is little systematic training of 

interviewing skills. They were videotaped as they 

performed an interview with a standardised patient. The 

interviews were rated using the Arizona Clinical 

Medical Interview Rating Scale. Interrater reliability 

was controlled. The students rated high on 6 of the 14 

items of the scale, low on 2 and very low on 6. The 

strengths were such as characterize civil conversation. 

The weaknesses were important interviewing skills 

such as summarizing, using open ended questions, etc. 

There was good agreement between years, indicating 

a systematic trait in strengths and weaknesses. We 

believe our results can be used for planning 

interviewing skills courses in medical schools. 

8I2 Implementing communication skills 

training at the Charité - a project by 

students and doctors 

Jan Schildmann*, Carsten Schwarz, Eva Herrmann, 

Heiderose Ortwein, Amelie Klambeck, Andreas Brunklaus 

and Ulrich Schwantes 

Humboldt University Berlin (Charite), Department of General 

Practice, Vogelsang 16, 78343 Horn, GERMANY 

A lack of formal training in communication skills 

during the time as medical students combined with the 

impression that the ability to talk with patients is 

essential for our practical work was the motivation for 

us (3 doctors and 3 students) to organise optional 

courses in this field at the medical faculty of the 

Humboldt University in Berlin. Within the last 1½ years 

courses about how to break bad news, a communication 

skills course for students during their first clinical year 

and a role play session as part of a course in paediatrics 

for fifth year students have been the preliminary results 

of our work which is supported by the medical faculty. 

In this short communication we will describe our 

experiences so far and discuss our plans to implement 

the training of communication skills as part of the 

curriculum at our faculty within the next few years. 

8I3 Teaching sexual history-taking to 

health care professionals in 

primary care 

J R Skelton* and P M Matthews 


School, University of Birmingham, Egbaston, BIRMINGHAM 

B15 2TT, UK 

History-taking is essential to diagnosis, yet little work 

has been done on the development of sexual history- 


- 4.96 - 

taking, nor on how to train people to undertake it 

adequately. Courses designed to assist healthprofessionals 

in sexual history-taking were delivered 

in a variety of formats, and evaluations collected from 

participants. 114 participants took part in 9 teaching 

interventions. All courses were very positively 

evaluated (89.95% for quality: 91% for relevance). 

Role-play, which was a feature of all courses, was 

particularly valued as a methodology. Free text 

comments centred on the power of such courses as 

consciousness-raisers, and as helping to overcome 

embarrassment, and the need to develop and change 

communication strategies. Good sexual history-taking 

should be part of the health professional’s armoury. It 

can be taught, and courses designed to teach it are 

highly acceptable to participants. 

8I4 SEX SEX SEX, oh yes, and how’s 

your knee? 

Annie Cushing* and Dason Evans 

St. Bartholomews & The Royal London Queen Mary’s, School 

of Medicine and Dentistry, Department of Human Science & 

Medical Ethics, Turner Street, London E1 2AD, UK 

Our study shows that, with the exception of the 

specialities of O&G and sexual health, medical students 

rarely ask patients questions about sex, even when they 

think this might be an issue. A workshop using roleplay 

was introduced to address this shortfall in general 

medical history taking. One hundred and ninety two 

students completed pre- and post- workshop 

questionnaires comprising 12 attitudinal statements. 

Subsequent cohorts completed a questionnaire to assess 

future intentions to ask patients about sexual health 

issues. Results showed a statistically significant 

improvement in all the attitudinal statements. After the 

workshop 84% of students stated they were now likely 

to ask patients about sex when they thought it was 

relevant. Moreover one-third intended to include such 

questions as part of their review of systems. There 

remains a group who do not think they will be asking 

patients questions about sexual health. 

8I5 Training of the systemic approach 

in doctor patient communication I: 

history taking from a third party 

K P M van Spaendonck* and E M van Weel-Baumgarten 

University of Nijmegen, 300 Med Psych Neuro, PO Box 9101, 

6500 HB Nijmegen, NETHERLANDS 

The format of the usual training of communication 

skills is derived from the conversation of the doctor 

with an individual patient. However, when a patient 

does or cannot speak for himself (for instance because 

the patient is too young or too ill), the patient is 

represented by somebody else. This is generally a 

parent, a partner or an adult child, who in turn speaks 

on behalf of the family to which the patient belongs. 

Moreover, doctors have to deal increasingly with 

patients who are accompanied by a third person. In 

both cases, doctors have to face so-called systemic

dynamics, a term derived from family therapy, and 

which focuses on relations, coalitions, behavioural 

codes etc within the core family. Systemic dynamics 

may have a strong impact on diagnosis and treatment. 

In the first part of this double presentation, we will 

show a video of a training, which involves the major 

sources of information distortion, which might result 

from history taking from a third party. 

8I6 Training of the systemic approach 

in doctor patient communication II: 

history taking with a patient and a 

third party 

E M van Weel-Baumgarten* and K P M van Spaendonck 

University of Nijmegen, Hermelynstraat 50, 6531 JZ Nijmegen, 

NETHERLANDS 

The next part of this double presentation focuses on a 

training of a consultation with a patient and a third party. 

In such cases the doctor is confronted with two people 

who usually have a long history of intimate life in 

common, which has resulted in a specific pattern of 

interaction and behavioural codes. Any remark of the 

doctor addressed to one of them, also has implications 

for the other, and may disrupt the mentioned pattern of 

interaction and behavioural codes. This type of 

consultation involves a number of skills: to be in control 

of the consultation, to negotiate, to give both parties 

equal attention. Training also focuses on how to avoid 

pitfalls, such as choosing sides, arbitrating, allowing 

Session 8J Clinical teaching 

8J1 Increasing student awareness of 

strengths and weaknesses using a 

standardized patient case 

Devra Cohen*, Jerry Colliver, Mark Swartz and Randal Robbs 

The Morchand Center, Mount Sinai School of Medicine, One 

Gustave L. Levy Place, Box 1127, New York NY 10029, USA 

Two classes of seond-year medical students (n=105, 

class of 1999; n=107, class of 2000) rated awareness 

of their strengths and weaknesses in performing a 

physical examination, taking a history, and 

communicating with a patient before and after an 

interaction and feedback session with an SP. The ratings 

were on a 5-point scale; 1-not at all; 2-a little; 3moderately; 

4-very; 5-extremely. The results showed 

that students were “moderately” aware of their strengths 

and weaknesses before the encounter and “very” aware 

following the encounter. The ratings increased from 

pre to post on average 1.0 standard deviation (ranging 

from .69 to 1.21 DSs) showing increased awareness of 

strengths and weaknesses as a result of the whole 

interactive session. Changes in awareness of strengths 

and weaknesses for each of the three outcomes 

separately as well as relationships between changes in 

awareness and performance on the SP case will be 

discussed. 


- 4.97 - 

the dominant party to overrule the other etc. A tripartite 

consultation requires different communication skills 

than a patient-centred interview. In our presentation 

we will also show a video of how students can be trained 

in this type of consultation. 

8I7 Breaking bad news - evaluation of 

courses run by students and young 

doctors 

H Ortwein*, E Herrmann, A Brunklaus, A Kreutz, 

C Schwarz and J Schildmann 

Department of Anaesthesiology, Charité, Humboldt University 

of Berlin, Lychener Str 60, 10437 Berlin, GERMANY 

Breaking bad news is one of the most challenging tasks 

in medical communication. At German medical schools 

communication skills training is usually not part of the 

curriculum. A group of experienced students and young 

doctors started a breaking bad news course for medical 

students in their fourth year of medical training. During 

a weekend course, participants receive excessive 

training of the subject in role-plays in small groups. 

Every student is able to play the role of the doctor as 

well as the patient’s part in different situations which 

are handed out as paper cases. We evaluated these 

course with questionnaires, one before and one after 

the course. The values of self-rating regarding the 

capability to break bad news improved. Teaching 

methods like peer group learning and role-plays were 

judged positive for the subject. 

8J2 Clinical dermatology: prospective 

randomized comparison of a 

traditional, a personal bed-side 

teaching (PBST) and a problemoriented-practical 

(POP) course 

F R Ochsendorf*, H Boehncke, R Hovelmann, A Boer and 

R Kaufmann 

Zentrum Dermatologie und Venerologie, Klinikum der J W 

Goethe-Universitat, Theodor-Stern-Kai 7, D-60590 Frankfurt/ 

M, GERMANY 

To assess satisfaction, practicability and knowledge 

gain, students were randomly allocated to a traditional 

course (lectures and bed-side teaching; evaluable 

n=137), bed-side teaching groups always with the same 

teacher (PBST, n=37) and POP groups only using 

“paper-cases” (n=36) over two terms. For evaluation, 

a questionnaire and multiple-choice tests, written 

anonymously at start and end of the course, were used. 

The PBST-course (1.7 ± 0.7; mean ± SD) and the POPcourse 

(1.6 ± 0.8) were rated significantly better 

(p

8J3 Clinical skills training - a new 

curriculum between BEME and 

reality 

Peter Frey 

University of Bern, Department of Instructional Media (AUM), 

Inselspital 38, CH - 3010 Bern, SWITZERLAND 

Clinical skills like history taking and physical 

examination are basic skills for clinical reasoning and 

the right decisions in patient management. How should 

a curriculum be planned and implemented to get the 

best evidence medical education? At the Medical 

School of Berne Switzerland fundamental changes in 

the third year curriculum (first clinical year) allows 

the establishment of a new state-of-the art curriculum. 

The presentation describes the needs and the change 

management, how the goals and objectives were 

formulated, the instructional strategies (small group 

work, standardization of the training, instruction of 

tutors, use of guidelines), the credit system, the use of 

information technologies and the barriers of the new 

curriculum. Homepage: http://studmed.unibe.ch 

8J4 The effects of student gender on 

patients’ willingness to be 

examined by medical students 

William P Metheny*, Roxanne Jamshidi and Kara Pitt 

Brown University School of Medicine/Women and Infants 

Hospital, 101 Dudley Street, Providence, RI 02905, USA 

Gender discrimination by patients can affect the clinical 

experiences medical students get. Excluding male 

medical students from the gynecologic exam or the 

prenatal visit may directly affect their clinical 

performance. We hypothesized that patients who were 

told the student’s gender (males in particular) prior to 

the examination were more likely to reject the student 

than patients who were not told the student’s gender in 

advance. Our experiment tested this hypothesis by 

assigning students to one of two female residents in an 

ob/gyn clinic who in asking permission of the patient 

would either refer to the student as a medical student 

(gender neutral) or identify the student’s gender. 

Patients (n=66) did not differ (p> .05) in responding to 

the two conditions; however they rejected only males 

in the gender specific situation. The way students are 

presented to patients can affect patient receptivity to 

them. 


- 4.98 - 

8J5 Reality shock among medical 

students attending first clinical 

rotation 

I Levi* and T Fischel 

Sackler Medical School, 13/2 Tsel Hagivaa, Ramat Gan, ISRAEL 

Discrepancy between fantasy that is perceived during 

preclinical studies, and reality as met during clinical 

rotation may cause difficulties and frustration, a state 

that can be defined as “reality shock”. An open 

interview was conducted with 40 students attending 

their first clinical rotation in an internal medicine 

department. Main difficulties described by the students 

were their position within the department staff, and their 

right to disturb patients while taking their history and 

making a physical examination. Significant gaps in 

“doctor–patient relationship” as met in real life opposed 

to what was learned at school, and gaps in “success 

rates” in medical treatment between real life and fantasy 

contributed also to “reality shock”. Reality shock is 

common in medical students attending their first 

clinical experience and can contribute to students’ 

frustration and burnout. Medical schools should take 

this into consideration in planning the preclinical and 

clinical curriculum. 

8J6 Experiential clinical learning in a 

horizontally-integrated, problembased 

curriculum 

Tim Dornan*, Arno Muijtjens and Henny Boshuizen 

Universities of Manchester and Maastricht, 10 Raynham Avenue, 

Didsbury, Manchester M20 6BW, UK 

The aim of the study was to test whether better 

horizontal integration was achievable in the clerkship 

phase of a problem-based curriculum. Eight first 

clerkship students using a learning portfolio and 

attending weekly group tutorials to support selfdirected 

reflective clinical learning were compared with 

16 historical and 16 contemporary controls. Results 

revealed mean agreement with: ‘I was able to see the 

types of patients I needed to see’ rose from 3.5 ± 1.1 to 

4.4 ± 0.7; 0.1>p>0.05. Historical controls commented 

on the inappropriateness of casemix whereas 

experimental subjects commented positively about 

casemix, and outpatient learning. Mean rating of 

outpatient learning rose: 3.6 ± 0.8 to 4.6 ± 0.5 (p= 

0.001). Mean rating for inpatient learning was 

unchanged. Despite those improvements, learning 

remained strongly influenced by the clerkship’s 

specialty interest. It was concluded that some measures 

of experiential clinical learning improved; other 

interventions are needed to help students cross specialty 

boundaries.

Session 8K International aspects of medical education 

8K1 Influence of Studying on Students’ 

Health (ISSH) 

T Schweickert*, P Hodzic, V Jurkovic, J Seitz*, O Onur* 

and T Shiozawa* 

German Medical Students’ Association, Gringelsbach 61, 52080 

Aachen, GERMANY 

The aim of the project is to find out if there is a 

correlation between studying and students´ health, 

especially if there is a significant correlation between 

the students´ health and the various medical education 

systems. This study is part of an international project 

organized by the IFMSA (international student 

organization). Croatian Students developed a 

questionnaire for students, which consists of 27 

questions divided into four sections – General 

information, General health information, Studying, 

Health and Lifestyle. In our analysis we focus on three 

aspects: 1) education system 2) educational level 3) 

medical/non medical students. The first steps of the 

study have shown that students’ health has deteriorated 

since the beginning of their studies. They consider their 

health to be worse compared to the peer population. 

About one third suffer from vision deterioration, 

headaches and digestion problems and they sleep less, 

drink much more coffee and take less care of 

themselves. 

8K2 A comparison of curricula – a cross 

country approach 

J Mirecka*, Paola Binetti, Jan Hijlman, Roy Remmen, 

K Lipinski 

Department of Medical Education, Medical College of 

Jagiellonian University, Str. Kopernika 19E/1, 31-501 Krakow, 

POLAND 

Comparison of undergraduate medical curricula in 

various countries was undertaken within the JEP- 

Tempus project and involved four medical schools . It 

was found that: 

• The total number of hours varied from 3500 to 

6500; 

• The lists of courses were not compatible because 

of their different names and content; 

• The content of courses could be compared after 

identifying the topics according to the traditional 

disciplines; 

• When viewed from this perspective the essential 

content of four curricula appeared quite similar; 

• The accents underlying importance of particular 

subjects were distributed differently; 

• The structure of curricula reflected by percentage 

of lectures, small group sessions, laboratories, 

varied considerably; 

• Other components of the curricula such as 

clerkship, electives, bed-side teaching, research, 

revealed also school specificity. 


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8K3 International differences in medical 

content preparation 

Steven R Daugherty* and Rochelle Rothstein 

Kaplan Medical, 820 West Jackson, Suite 550, Chicago IL 60612, 

USA 

Scores of medical students from eight regions of the 

world were compared by means of a standardized, 

content-focused exam targeted to the United States 

Medical Licensing Exam (USMLE, Step 1). The 

diagnostic exam was offered in English to participants 

studying at Kaplan Medical Centers in the United 

States. Analyses examined differences in scores in 

traditional medical subject area and by organ system 

knowledge. Results show that students trained outside 

the US averaged significantly lower scores in most 

areas, with the largest differences found in 

Biochemistry, Behavioral Sciences, and General 

Principles. Scores on Microbiology were most similar 

to US students across all groups. Students trained in 

South America had the lowest scores, while students 

from Asia show the most similarity to US trained 

students. Results are discussed with reference to the 

role of language fluency in determining test scores and 

international differences in medical education. 

8K4 New trends at TSMU: elaboration of 

medical education conception 

R Khetsuriani, B Kilassonia, Z Avaliani* and G Simonia 

Tbilisi State Medical University, 33 Vazha-Pshavela Avenue, 

Tbilisi 380077, GEORGIA 

In Georgia, as in other post-Soviet countries, a 

necessary condition for success of the current reform 

in healthcare is a basic reorganization of the medical 

education system, which first of all means introduction 

of the optimal model of teaching. The Outcome-based 

Model of medical education has been considered as 

the most acceptable method of teaching at TSME. This 

means the introduction of a flexible, integrated teaching 

frame-plan and appropriate study programs, that enable 

us to align professional activity of the graduates with 

the knowledge accepted at the University. The aims of 

the teaching process and main criteria, which should 

correspond to each grade of the study process, will be 

defined according to the last outcome. For optimization 

of the teaching process at TSMU some problems must 

be solved. First of all it is necessary to take part in the 

important process of inter-recognition and interacknowledgement 

of recognised medical schools, 

which, through international experiences and with 

support from AMEE and the other educational 

organizations and international programs, will give us 

the opportunity to improve the qualifications of our 

university professors at other medical schools through 

visits and training courses. In addition, it is very 

important to extend the existing practice of student 

exchanges with leading university clinics (more than 

100 students are being trained abroad annually).

8K5 Learning Needs Assessments for 

Refugee Doctors; establishing 

baseline data about medical 

knowledge and experience 

Lesley J Southgate* and Joan F Fuller 




The profound and all embracing sense of loss 

experienced by refugees may be compounded for 

professionals, many of whom feel their special skills 

and knowledge are unused. Dependence on welfare and 

charity, loss of pride and socio-economic standing 

contribute further to low self-esteem and lack of 

confidence. We organised a learning needs assessment 

workshop for refugee doctors as part of a wider 

programme. Participants took a knowledge test in the 

same format as the new GMC PLAB test. Next, doctors 

working in the NHS interviewed refugee doctors to 

ascertain their experiences and expectations. Feedback 

from the interviewers and the refugee doctors was 

systematically recorded. We present here the outline 

of the wider programme, the themes from the 

interviews, the results of the knowledge test and plans 

for future work. 

8K6 Helping refugee doctors back to work 

M J Bannon*, E Paice, G MacFadden, G Cowan, 

S Cheeroth and Y H Carter 

London Deanery, Medical Education Department, Level 6V, 

Northwick Park Hospital, Watford Road, Harrow, Middlesex 

HA1 3UJ, UK 

It is estimated that there may be as many as 2,000 

refugee doctors living in the UK. They face a variety 

of hurdles (including loss of professional 

documentation and status, separation from family/ 

friends, financial hardship and language difficulties). 

To date, a minority has succeeded in gaining clinical 

employment in the NHS. In November 2000, a project 

was initiated by London Deanery with the following 

aims: 

• To offer refugee doctors support, career advice and 

help with obtaining clinical attachments; 

• To directly place them as appropriate in specially 

arranged supervised senior house officer posts. 

Session 8L Special subjects 

8L1 And now for something completely 

different… reflective style learning 

of the Arts in medicine 

Paul Lazarus 

University of Leicester, Department of General Practice and 

Primary Health Care, Leicester General Hospital, Gwendolen 

Road, Leicester LE5 4PW, UK 

There is an increasing trend towards including a study 

of the Arts in undergraduate medical curricula, and the 


- 4.100 - 

To date 20 doctors have been seen; 6 have been directly 

placed in clinical posts; 4 have clinical attachments that 

will lead to clinical posts. As a result of these efforts a 

network of support has begun for refugee doctors in 

West London. By listening to their stories, we have 

gained an enhanced appreciation of the difficulties 

faced by them. 

8K7 New York University School of 

Medicine Master Scholars Program 

Sharon K. Krackov 

Master Scholars Program, Dean’s Office, New York University 

School of Medicine, 550 First Ave, New York, NY 10016, USA 

New York University School of Medicine’s new and 

unique Master Scholars 

Program was launched in June 2000. The overall 

mission is the creation of a fabric of learning that 

promotes the principles of humanism and 

professionalism throughout all aspects of the education 

of physicians. A second mission is that the Master 

Scholars Program serves as a center for the 

development of ideas on contemporary social and 

ethical issues. It achieves these missions in a variety of 

ways through: 

1 The medical student curriculum where humanism 

and professionalism are interwoven with the study 

of science; 

2 Student mentoring activities; 

3 Seminars where students and faculty discuss topics 

of relevance; 

4 Development of joint degree programs with the 

other schools of New York University; 

5 Monthly colloquia on topics of public interest; 

6 Scholarly publications; 

7 A planned international symposium in London in 

Spring 2002. 

This broad program is implemented through five 

theme-based Societies (biomedical and health sciences; 

medical informatics and technology; health policy and 

public health; bioethics and human rights; and arts and 

humanities in medicine in which both students and 

faculty participate. [www.MasterScholars.med.nyu.edu] 

Leicester-Warwick Medical School has set up a module 

using the study of literature, drama, music and visual 

art to enhance students’ understanding of the human 

experience in health and sickness. As well as marking 

a departure from the study of more traditional scientific 

and clinical subjects, new ground is broken in using 

multi-disciplinary tutoring and in introducing students 

to a more reflective style of learning in the form of 

personal learning journals. This presentation describes 

why and how the module was set up and how reflective

learning practice is useful to students and doctors. An 

evaluation of the module’s success so far will also be 

given. 

8L2 Seamless humanities: on integrating 

medical humanities into medical 

education: the Witten project 

C Hick*, B Matzke, B Strahwald, A Weymann and 

W Vermaasen 

Universitat Witten/Herdecke, Alfred-Herrhausen-Str.50, 58448 

Witten, GERMANY 

We report on the curricular development and first year 

experience with the “seamless” integration of medical 

humanities into a medical reform curriculum at Witten 

/ Herdecke University, Germany, aiming at enhancing 

the communicative and ethical competences of medical 

students. Specifically addressed will be the strategies 

employed for opening up problem-based learning and 

simulated patients to topics in medical ethics, 

philosophy of medicine and medical history. We will 

stress the importance of overcoming traditional 

disciplinary orientations in the medical humanities and 

argue for a topical, hands-on approach seeking to 

develop the “humanistic skills” of medical students in 

clinical contexts. 

8L3 Improving clinical reasoning in 

novice clinicians: a diagnostic 

training aid to support clinical 

reasoning in student 

physiotherapists 

Gill James 

Coventry University, School of Health and Social Sciences, Priory 


Medicine and physiotherapy (PT) are two health care 

professions to identify difficulties in Clinical Reasoning 

(CR). CR comprises cognition, knowledge and metareasoning, 

with research suggesting that knowledge is 

the key to expertise. This paper describes the testing of 

a diagnostic training aid, designed to support 

knowledge. Two groups of PT students (halfway 

through their clinical education hours) were recruited. 

Using a standardised case study, they verbally reasoned 

about the diagnosis and treatment plan. One group used 

the training aid. Content analysis and the Mann- 

Whitney test were used to analyse these data. Subjects 

using the diagnostic training aid (n=8) recruited 

significantly more knowledge (p

symptom control (nausea, vomiting, anorexia, 

constipation, bowel obstruction, dyspnea, cough, 

delirium, depression, anxiety). Residents complete a 

pre-post knowledge assessment questionnaire at the end 

of their rotation. Statistical analysis (n=28 

questionnaires) demonstrated a significant increase in 

knowledge for each educational domain taught during 

this experience. This teaching format can be considered 

when implementing Palliative Care education into 

Internal Medicine residency programs. 

8L7 Teaching stress management and 

empathic communication to 


Ray Melmed and Hannah Kedar* 

The Hebrew University, Hadassah Faculty of Medicine, Centre 

for Medical Education, PO Box 12272, Jerusalem 91120, 

ISRAEL 


- 4.102 - 

A workshop based on principles of neuro-psychoimmunology 

combined with skills of empathic 

communication was designed as a 2-week elective for 

6 th year medical students. The workshop included topics 

such as the psycho-neuro-physiological basis of stressinduced 

syndromes (e.g., panic disorder, chronic pain) 

and of behavioural interventions in these situations; 

the use of relaxation, meditation and guided imagery 

in medical practice; principles of empathic 

communication and their application to difficult 

interpersonal situations (e.g., angry, depressed, or 

anxious patients); breaking bad news; truth telling; and 

difficulties around sex-related issues in medical 

practice. Teaching methods were mostly experiential, 

including role-plays, videotapes, exercises of 

relaxation, and encounters with patients. Feedback data 

presented reflect high appreciation of this workshop 

and emphasise the need to include these topics in the 

curriculum.

Session 9 Plenary 

1 The role of clinical experience in 

the acquisition of clinical 

reasoning: Implications for 

education 

Geoff Norman 

McMaster University Medical School, Dept of Clinical 

Epidemiology, 1200 Main Street West, Hamilton, ON L8N 3Z5, 

CANADA 

An extensive body of research in psychology and 

medicine indicates that many diagnostic problems aRe 

solved by recognizing their similiarity to a previously 

encountered specific example. This “exemplar-based” 

reasoning is both efficient and effective. However, if 

this is a critical component of expertise, we must give 

serious consideration to how students can obtain 

sufficient clinical exposure. The talk will review some 

of the research evidence in support of exemplar-based 

reasoning, and describe experimental tests of alternate 

instructional strategies. 

2 Keeping standards up to date 

Susanne Pruskil 

Medical Student, Charité, Medical Faculty of Humboldt- 

University, Berlin, GERMANY 


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Medical knowledge is expanding and changing rapidly. 

Consequently standards in medical education should 

be adapted continuously. However our learning 

objectives are largely overstuffed, reflect specialty/ 

departmental interests and their relevance is often 

unclear. The aim of a modern medical school should 

be to include a manageable, ever-adapting, 

interdisciplinary core curriculum. Relevant standards 

are of crucial importance for the self-directed 

undergraduate learner as well as for the lifelong 

postgraduate learner. 

3 Humour in medical education is 

like a box of chocolates … 

Ron Berk 

The Johns Hopkins University, 525 North Wolfe Street, Baltimore 

MD 21205-2110, USA 

This session will present research-based teaching 

techniques for integrating humour into your course 

handouts, examples, case studies, discussion questions, 

problems, tests, wedding invitations and parking tickets. 

Examples include quotations, cartoons, multiple-choice 

items, top 10 lists, anecdotes and skits/dramatizations 

with music. This presentation “boldly goes where no 

medical educator has gone before,” maybe!

AMEE Berlin 2002 Programme

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