AMEE Berlin 2002 Programme
AMEE Berlin 2002 Programme
AMEE Berlin 2002 Programme
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<strong>AMEE</strong><br />
Association for Medical Education in Europe<br />
Medical Education<br />
and Standards at a<br />
Time of Change<br />
<strong>AMEE</strong><br />
<strong>Programme</strong><br />
and<br />
2001<br />
Abstracts<br />
2-5 September 2001<br />
Charité, Humboldt University<br />
BERLIN, GERMANY<br />
Humbolt University<br />
Zu <strong>Berlin</strong><br />
Gesellschaft für Medizinische<br />
Ausbildung (GMA)<br />
President:<br />
Professor M Barón-Maldonado<br />
General Secretary:<br />
Professor R M Harden<br />
Administrator:<br />
Mrs Pat Lilley<br />
<strong>AMEE</strong> Office<br />
University of Dundee<br />
Tay Park House<br />
484 Perth Road<br />
Dundee DD2 1LR<br />
Scotland, UK<br />
Tel: +44 (0)1382 631953<br />
Fax: +44 (0)1382 645748<br />
E-mail: amee@dundee.ac.uk
Contents<br />
Welcome from the <strong>Berlin</strong> students to visiting students .. iii<br />
Local Organising Committee .. .. .. iii<br />
Welcome from Professor Margarita Barón-Maldonado,<br />
President of <strong>AMEE</strong> .. .. .. .. iv<br />
<strong>AMEE</strong> Executive Committee .. .. .. v<br />
List of sponsors .. .. .. .. v<br />
Section 1: General Information about <strong>Berlin</strong><br />
and the Conference Venue<br />
General information about <strong>Berlin</strong><br />
<strong>Berlin</strong> and how to get there .. .. .. .. 1.1<br />
Some local information .. .. .. 1.1<br />
General information about the Conference<br />
How to get to Campus Virchow Klinikum .. .. 1.4<br />
Some general information .. .. .. 1.4<br />
Registration information .. .. .. 1.8<br />
Information about the Academic <strong>Programme</strong><br />
Plenary presentations .. .. .. 1.9<br />
Large group sessions .. .. .. 1.9<br />
Short communications .. .. .. 1.9<br />
Information for presenters .. .. .. 1.9<br />
Audio-visuals .. .. .. .. 1.9<br />
Information for the chairperson .. .. 1.10<br />
Information for the opening discussant .. .. 1.10<br />
Poster presentations.. .. .. .. 1.11<br />
Information for presenters .. .. .. 1.11<br />
Information for the chairperson .. .. 1.12<br />
Medical Teacher Poster Prize .. .. .. 1.12<br />
Workshops .. .. .. .. 1.12<br />
Pre-Conference .. .. .. .. 1.12<br />
Conference .. .. .. .. 1.12<br />
<strong>Programme</strong> Overview .. .. .. 1.13<br />
Personal Diary .. .. .. .. 1.15<br />
List of Exhibitors .. .. .. .. 1.16<br />
- i -
Section 2: The Academic <strong>Programme</strong><br />
Saturday 1 September .. .. .. 2.1<br />
Sunday 2 September .. .. .. 2.2<br />
Monday 3 September .. .. .. 2.4<br />
Tuesday 4 September .. .. .. 2.15<br />
Wednesday 5 September .. .. .. 2.28<br />
Section 3: Conference Social <strong>Programme</strong>, Tours<br />
and Accommodation<br />
Section 4: Abstracts<br />
- ii -
Welcome from Students<br />
We, the students of the Charité, Medical Faculty of the Humboldt-University in <strong>Berlin</strong>,<br />
look forward to welcoming you to the <strong>AMEE</strong> Conference. We want you to enjoy your<br />
stay in <strong>Berlin</strong> and will do all we can to help.<br />
We invite you to join us for a free dinner on Monday night in our beautiful ‘lecture-hall<br />
ruin’. This is the old pathology lecture-hall that was partly destroyed during WW II,<br />
has been rebuilt and is now being used for social events. This is intended as an alternative<br />
to the River Cruise in the official social programme and we hope that it will be a good<br />
opportunity to get to know each other and to make new friends. Places are limited, and<br />
we need to know in advance who is interested in joining in (students only, please!).<br />
We are also planning to organize a pub-crawl on Saturday night for all the people who<br />
arrive early. Please contact us if you’re interested in a guided tour of the <strong>Berlin</strong> nightlife.<br />
We are trying hard to find inexpensive accommodation with local students or - if there<br />
are not enough places available - in youth hostels. At the moment we are searching for<br />
local students, who are able to accommodate you and offer you a breakfast during the<br />
conference for a small contribution of 50 DM (about 15£). However we cannot guarantee<br />
that we will be able to place everybody. Therefore, if you decide to attend the conference<br />
and want to be placed in private accommodation, please let us know as early as possible<br />
(email: below), so that we can add you to the accommodation list. Please tell us your<br />
name, sex, email, address, the day of arrival and departure and if you want to attend the<br />
dinner on Monday (free of charge!)!! Please send your e-mail to:<br />
student.amee@charite.de and note: “<strong>AMEE</strong> Accommodation application” in the reference.<br />
We look forward to meeting you.<br />
Local Organising Committee<br />
Professor Joachim Dudenhausen Professor Gerhard Gaedicke<br />
Professor Ingrid Reisinger Professor Ulrich Schwantes<br />
Professor Walter Burger Dr Bernd-Dieter Bohne<br />
Professor Dieter Scheffner Professor Florian Eitel (Munich)<br />
Local Administration:<br />
Dipl. phil. Burkhard Danz<br />
Charité<br />
Referat Studienangelegenheiten<br />
KW: <strong>AMEE</strong><br />
Schumannstraße 20/21 Tel.: 49 30 450 57 60 91 (42)<br />
10098 <strong>Berlin</strong> Fax: 49 30 450 57 69 21<br />
Germany Email: burkhard.danz@charite.de<br />
- iii -
Welcome from President of <strong>AMEE</strong><br />
Dear <strong>AMEE</strong> Members and Conference Participants:<br />
On behalf of <strong>AMEE</strong> I should like to welcome you to the <strong>Berlin</strong> 2001 Conference. The<br />
<strong>AMEE</strong> annual conference is a focal point of the year, where members and non-members<br />
alike can meet to share ideas and to discuss problems and challenges facing them in<br />
their efforts to develop and improve medical and health care professions education in<br />
their institution. This year we have over 650 participants from 45 countries, more than<br />
ever before. Many are regular <strong>AMEE</strong> conference attendees, but every year we are<br />
pleased to see so many new faces who are keen to participate in what has become a<br />
major meeting in the medical education calendar.<br />
The main topic of this Conference “Medical Education and Standards at a Time of<br />
Change” fits very much in time and space. The international community devoted to<br />
improving medical education is looking for standards that could guarantee the training<br />
of professionals to meet health and social needs across country boundaries; therefore to<br />
find ways of overviewing those standards from a transnational standpoint, without<br />
losing sight of local needs, is more than timely at the beginning of the third millennium.<br />
The city of <strong>Berlin</strong> has undergone spectacular changes in just a few short years and is<br />
still adapting to new times, new roles and new circumstances. <strong>Berlin</strong> offers a suitable<br />
context in which to present views and experiences on medical educational changes and<br />
reminds us of the ever-adapting attitude that we all should demonstrate in order to<br />
advance and progress in the field.<br />
The Charité Campus Virchow-Klinikum of the prestigious Humboldt University of<br />
<strong>Berlin</strong> Medical School will be our meeting point and our inspiration to continue the<br />
work of the many important scientists on which the foundations of Medicine have been<br />
built. On behalf of us all I want to express my gratitude to the University for hosting<br />
the Conference.<br />
The <strong>Berlin</strong> Conference programme holds exciting plenary sessions; workshops for<br />
innovation and learning how to think about strategies to achieve our goals; all led by<br />
well-known and respected educators in Medicine and health care. Large group sessions<br />
will focus on specific issues and challenges. Short communications and posters, close<br />
to 400 in total, will give us the opportunity to present our views and work, to discuss<br />
them and finally to interact.<br />
Your attendance at the <strong>AMEE</strong> 2001 <strong>Berlin</strong> Conference is your own success and I wish<br />
you, <strong>AMEE</strong> friends, a most productive and enjoyable meeting.<br />
Margarita Barón-Maldonado<br />
President of <strong>AMEE</strong><br />
- iv -
Executive Committee<br />
List of Sponsors<br />
President: Professor Margarita Barón-Maldonado (Spain)<br />
Secretary/Treasurer: Professor Ronald Harden (UK)<br />
Committee Members: Professor Ralph Bloch (Switzerland)<br />
Professor Ioan Bocsan (Romania)<br />
Professor Florian Eitel (Germany)<br />
Dr Madalena Patrício (Portugal)<br />
Professor Dominique Perrotin (France)<br />
Professor Herman van Rossum (Netherlands)<br />
Ex-officio Members: Professor Hans Karle<br />
(World Federation for Medical Education)<br />
Dr Jørgen Nystrup (Past President of <strong>AMEE</strong>)<br />
<strong>AMEE</strong> Administrator: Mrs Pat Lilley<br />
p.m.lilley@dundee.ac.uk<br />
<strong>AMEE</strong> Secretary: Miss Tracey Martin<br />
t.r.martin@dundee.ac.uk<br />
Association for Medical Education in Europe<br />
University of Dundee, 484 Perth Road, Dundee DD2 1LR, UK<br />
Tel: +44 (0)1382 631953; Fax: +44 (0)1382 645748;<br />
<strong>AMEE</strong>@dundee.ac.uk; http://www.amee.org<br />
<strong>AMEE</strong> and the Local Organising Committee are most grateful to the Municipality of<br />
<strong>Berlin</strong> for their generosity in hosting the reception at the Opening Ceremony. We would<br />
also like to acknowledge the generous support of the Founder Sponsors:<br />
Siemens AG – Medical Solutions<br />
Schering AG<br />
Freunde und Förderer der Charité<br />
Medical Faculty of Humboldt University<br />
- v -
SECTION 1<br />
Information about <strong>Berlin</strong><br />
and the Conference Venue
Conference Venue<br />
General Information<br />
<strong>Berlin</strong><br />
How to reach <strong>Berlin</strong><br />
Weather<br />
Banks and Post Offices<br />
Currency Exchange<br />
A simplified map of <strong>Berlin</strong> and a plan of the campus showing the conference buildings<br />
and rooms appear on pages 1.5 and 1.6. A detailed map will be included in your<br />
registration pack.<br />
<strong>Berlin</strong> has a wide range of attractions. Annual highlights include theatre weeks,<br />
international concert performances and film festivals. Multiple theatres offer a range<br />
of performances from classic to modern drama, opera, ballet and light comedy. <strong>Berlin</strong>´s<br />
artistic treasures and museums, palaces, galleries and archives have earned high reputation<br />
all over the world. A great number of monuments bear witness to the history of <strong>Berlin</strong><br />
and Prussian culture. Leisure time may be used for shopping downtown around the<br />
‘Kurfürstendamm’ and the ‘Friedrichstraße’. There are opportunities for every taste<br />
and purse. Shopping hours are from 9.00-20.00 hrs Monday to Friday and from 0900<br />
hrs to 1600 hrs on Saturday. All shops are closed on Sunday.<br />
<strong>Berlin</strong> can be reached easily by all means of transportation. Most airlines offer direct<br />
flights to <strong>Berlin</strong> Tegel airport, some also fly to <strong>Berlin</strong> Tempelhof or <strong>Berlin</strong> Schönefeld.<br />
A taxi from <strong>Berlin</strong> Tegel to the city centre (main hotel district) costs approx. DEM<br />
30,00. There is also a bus service (line no. 109) between <strong>Berlin</strong> Tegel airport and the<br />
city centre. The fare is DEM 4,00. Main railway stations are <strong>Berlin</strong> Bahnhof Zoo,<br />
<strong>Berlin</strong>-Ostbahnhof, Bahnhof <strong>Berlin</strong> Lichtenberg. As the main airports are quite close<br />
to the city centre, no special arrangements have been made to transfer participants to<br />
the Conference hotels.<br />
The congress takes place during the late summer/beginning of autumn where the<br />
temperatures are around 19°C (66°F) during the day and 10°C (50°F) at night. It may<br />
be useful to bring a sweater and raincoat.<br />
Banks are open Monday-Friday between 0800-1800. Post Offices are open Monday-<br />
Friday between 0800-1800, and on Saturday between 0800-1200.<br />
The unit of currency is the DeutscheMark (DEM). 1 DEM comprises 100 Pfennig .The<br />
rate of exchange at the time of going to press is £1 = DM 3.2; US$1 = DM 2.3;<br />
Euro 1 = DM 2. Major credit cards are widely accepted in hotels, restaurants and shops.<br />
- 1.1 -
Restaurants/Bars<br />
<strong>Berlin</strong> is famous for its wide variety of 7,000 restaurants serving international or German<br />
cuisine and for its countless pubs called “Kneipen“ with their unique atmosphere. Some<br />
suggestions are:<br />
First-class gourmet restaurants<br />
Borchardt District/address: (Mitte) Französische Str. 47<br />
Subway station: Französische Str.<br />
Telephone: 20 38 71 10<br />
Open: daily 1100 to 2400 hrs<br />
Cards: Amex, Visa<br />
Café Einstein District/address: (Tiergarten) Kurfürstenstr. 58<br />
Subway station: Nollendorfplatz<br />
Telephone: 2 61 50 96<br />
Open: Daily 1000 to 0200 hrs<br />
Cards: Amex, Visa, Euro<br />
Paris Bar District/address: (Charlottenburg) Kantstr. 152<br />
Subway station: Zoo<br />
Telephone: 3 13 80 52<br />
Open: Daily 1200-0200 hrs<br />
Cards: Amex<br />
Luther und Wegner District/address: (Mitte) Charlottenstr. 56<br />
Subway station: Französische Str.<br />
Telephone: 2 02 95 40<br />
Open: Daily 0900-0200 hrs<br />
Cards: Amex, Visa, Euro<br />
German cooking<br />
Vau District/address: (Mitte) Jägerstr. 54-55<br />
Subway station: Hausvogteiplatz<br />
Telephone: 2 02 97 30<br />
Open: Monday-Saturday from 1200 hrs<br />
Cards: Amex, Visa, Diners, Euro<br />
Altes Zollhaus District/address: (Kreuzberg) Carl-Hertz-Ufer 30<br />
Subway station Prinzenstrasse<br />
Telephone: 6 92 33 00<br />
Open: Tuesday-Saturday 1800-0100 hrs<br />
Cards: All credit cards<br />
Italian cooking<br />
Trattoria Lappeggi District/address: (Prenzlauer Berg) Kollwitzstr. 56<br />
Subway station: Senefelder Platz<br />
Telephone: 4 42 63 47<br />
Open: Daily from 12 noon<br />
Cards: Amex, Visa, Euro<br />
XII Apostel District/address: (Charlottenburg) Bleibtreustr. 49<br />
S-Bahn-station: Savignyplatz<br />
Telephone: 3 12 14 33<br />
Open: Daily 24 hours<br />
Cards: No credit cards<br />
- 1.2 -
Greek cooking<br />
Ypsilon District/address: (Schöneberg) Hauptstr. 163<br />
Subway station: Kleistpark<br />
Telephone: 7 82 45 39<br />
Open: Daily from 1700 hrs<br />
Cards: No credit cards<br />
Hip, for young people<br />
Anita Wronski District/address: (Prenzlauer Berg) Knaackstr. 26-28<br />
Subway station: Eberswalder Str.<br />
Telephone: 4 42 84 83<br />
Open: Daily 1000 to 0200 hrs<br />
Cards: No credit cards<br />
Ali Baba District/address: (Charlottenburg) Bleibtreustr. 45<br />
S-Bahn-station: Savignyplatz<br />
Telephone: 8 81 13 50<br />
Open: Daily 1130 to 0300 hrs<br />
Live music scene<br />
Kalkscheune District/address: (Mitte) Johannisstr. 2<br />
Subway station Oranienburger Straße<br />
Telephone: 28 39 00 65<br />
Cards: No credit cards<br />
Kulturbrauerei District/address: (Prenzlauer Berg) Knaackstr. 97<br />
Subway station Eberswalder Str.<br />
Telephone: 4 41 92 69<br />
Cards: No credit cards<br />
Schlot District/address: (Prenzlauer Berg) Kastanienallee 29<br />
Subway station Eberswalder Str.<br />
Telephone: 4 48 21 60<br />
Open: Daily from 1930 hrs<br />
Cards: No credit cards<br />
Beer garden<br />
Prater Garten District/address: (Prenzlauer Berg) Kastanienallee 7-9<br />
Subway station Eberswalder Str.<br />
Telephone: 4 48 56 88<br />
Open: Daily from 1400 hrs<br />
Cards: No credit cards<br />
Café am Neuen See (District/address: Tiergarten) in the middle of Tiergarten<br />
Telephone: 2 54 49 30<br />
Open: Daily 1000 to 2300 hrs<br />
Cards: All credit cards<br />
- 1.3 -
Information about the Conference Venue<br />
Transport in <strong>Berlin</strong><br />
Parking Facilities on Campus<br />
Dress Code<br />
Smoking Policy for Conference<br />
Charité is the Medical Faculty of Humboldt-University <strong>Berlin</strong>. There are three separate<br />
campuses (Campus Virchow-Klinikum, Campus Mitte and Campus <strong>Berlin</strong>-Buch). Please<br />
note that our Conference, including the Pre-conference Workshops, will take place at:<br />
Campus Virchow-Klinikum<br />
Charité, Medical Faculty of Humboldt-University<br />
<strong>Berlin</strong>-Wedding<br />
Augustenburger Platz 1<br />
<strong>Berlin</strong> D-13353<br />
Germany<br />
The Charité web page (German only) can be accessed as follows: http://www.charite.de/<br />
index/allginfo.html<br />
Registration and most of the Conference sessions take place in the Teaching Building<br />
(Lehrgebaude), marked on the plan on page 1.5.<br />
<strong>Berlin</strong> is well served by a wide bus, tram, underground (U-Bahn) and city train<br />
(S-Bahn) network, operating from 0400 until midnight. On the reverse of your<br />
Conference name-badge in your registration pack is stamped the <strong>Berlin</strong> Transport Service<br />
logo and this badge also serves as a 4-day travel pass which can be used for local buses<br />
and trains.<br />
The Campus Virchow-Klinikum is in the north west of the city, about 15 minutes by<br />
U-bahn from the city centre and can be reached by the following transport:<br />
Underground (U-Bahn): line U9: Station: ‘Amrumer Straße’ (or line U6 to<br />
‘Leopoldplatz’ and change to line U9)<br />
Bus lines: X26, 126 stop: ‘Virchow-Klinikum’<br />
221, 248 stop: ‘Amrumer Straße’<br />
Tram: line 23 or 24, stop: ‘Virchow-Klinikum’<br />
If travelling by U-Bahn, exit to the right. You will see signs to the <strong>AMEE</strong> Conference.<br />
It is about 5 minutes’ walk from the station to the Teaching Building.<br />
Parking Spaces in the vicinity of the Virchow-Klinikum campus are hard to find. Oncampus<br />
parking is possible (DEM 3 per hour), but spaces are very limited. There is a<br />
parking garage at the entrance Seestraße, where <strong>AMEE</strong> participants can park for a<br />
special fee of 15 DEM per day. Tickets are available at the conference desk.<br />
Access to the campus for loading and unloading is free of charge for up to one hour.<br />
Dress is informal for both day and evening sessions.<br />
Smoking is not permitted in the University buildings, and you are asked to smoke<br />
outside only.<br />
- 1.4 -
Map - Charité Virchow-Klinikum<br />
- 1.5 -
Map of <strong>Berlin</strong><br />
- 1.6 -
Campus Virchow-Klinikum – Teaching Building<br />
- 1.7 -
Conference Noticeboard and Messages<br />
Email Contact<br />
The Noticeboard is located by the Registration Desk. Messages and conference updates<br />
will be posted on the board and an adjacent board will be provided for messages for<br />
individuals. Phone and fax messages can be sent to you at the Registration Desk. Numbers<br />
will be available on the <strong>AMEE</strong> website from 27 August, or by contacting the <strong>AMEE</strong><br />
Office.<br />
Please note that the <strong>AMEE</strong> Office will be closed from 1800 hrs on Thursday 30 August<br />
until 0900 hrs on Friday 7 September. Whilst in <strong>Berlin</strong> we can be contacted at the<br />
Registration Desk.<br />
Participants are welcome to use the Computer Room (Teaching Building, 2 nd floor,<br />
room 2.0103) for email contact at all times except during scheduled workshops: Saturday<br />
1345-1700; Sunday 0915-1230; Monday 1345-1600; Tuesday 1345-1700).<br />
CME Accreditation and Certificates of Attendance<br />
Abstracts<br />
Conference Evaluation<br />
Registration<br />
The Conference has been approved by the Royal College of Physicians of London for<br />
21 CME credits for attending the full Conference. Certificates of attendance, conforming<br />
to the guidelines provided by the Royal College of Physicians, will be available on<br />
Wednesday 5 September from 1200 hrs and a register will be available for signature at<br />
the same time.<br />
Abstracts will appear on the Conference web site soon after the conference. If there are<br />
any changes to be made to your abstract as it appears in the programme/abstract book,<br />
please contact the Registration Desk or the <strong>AMEE</strong> Secretariat in Dundee.<br />
We welcome feedback on which aspects of the Conference you have enjoyed, and the<br />
things you have found less satisfactory. Suggestions for speakers and workshop organisers<br />
for future conferences are also much appreciated. Please complete the evaluation form<br />
in your conference pack and either leave it in the box on the registration desk or send<br />
it to the <strong>AMEE</strong> Office.<br />
The registration desk is open in the Teaching Building (Lehrgebaude), Campus Virchow-<br />
Klinikum, (see plan of Campus on page 1.5) at the following times:<br />
Saturday 1 September: 1200-1730<br />
Sunday 2 September: 0800-1700<br />
Monday 3 September: 0745-1730<br />
Tuesday 4 September: 0800-1715<br />
Wednesday 5 September: 0800-1630<br />
Please use the appropriate registration point:<br />
Point A: Registered participants with family names beginning with A-F<br />
Point B: Registered participants with family names beginning with G-N<br />
Point C: Registered participants with family names beginning with O-Z<br />
Point D: Unregistered participants, late registrants who have not paid, and<br />
those requiring further assistance<br />
- 1.8 -
Tours/Accommodation Registration<br />
DER-CONGRESS will have a representative available at the Registration Desk at the<br />
following times:<br />
Saturday 1 September: 1200-1730<br />
Sunday 2 September: 0800-1700<br />
Monday 3 September: 1200-1400<br />
Tuesday 4 September: 1200-1400<br />
Wednesday 5 September: 1200-1400<br />
If you have reserved hotel accommodation, tours or social events through DER you<br />
should collect vouchers from them. All participants making hotel reservations through<br />
DER will need a voucher to present to the hotel on departure so that the pre-paid<br />
deposit may be deducted from the final hotel bill.<br />
Information on the Academic <strong>Programme</strong><br />
Plenary Presentations<br />
Large Group Sessions<br />
Short Communications<br />
An overview of the programme is shown on pages 1.13 and 1,14. On page 1.15 is a<br />
personal diary form on which you may like to note the presentations you particularly<br />
want to attend.<br />
These are scheduled for Sessions 1 and 9 and will take place in Hörsaal 1 and 2.<br />
Hörsaal 3 is linked by video to provide additional seating if necessary.<br />
Three simultaneous large groups are scheduled in Session 4. After the presentations the<br />
chairperson will open up an interactive discussion between presenters and audience.<br />
These are scheduled for Sessions 2, 5, and 8. In Sessions 2 and 5 there are 13 simultaneous<br />
groups of short communications each with a theme and in Session 8 there are 12<br />
simultaneous groups. The room in which each group will take place is indicated in the<br />
grid on page X. This year we have tried very carefully to group relevant presentations<br />
together and encourage you to stay for a whole session and take part in the discussion<br />
at the end. Please feel free, however, to move between sessions. We have asked the<br />
Chairpersons to ensure that all sessions follow the time scheduled in the programme. If<br />
you do choose to move between sessions, please do so as quietly as possible. Each<br />
presenter has been allocated a ten minute presentation followed by five minutes for<br />
discussion. A 15 minute period has been allocated at the end of most sessions for a<br />
general discussion, led by an opening discussant. Each session will also have a<br />
chairperson.<br />
Information for Presenters of Short Communications<br />
Slide viewing area: The Mediothekraum (Teaching Building, first floor) may be used<br />
for testing audio-visuals and spare carousels will be available for slides. Please do not<br />
take these earlier than during the session prior to yours and return them as soon as<br />
possible afterwards. PowerPoint presentations can also be tried out in advance (see<br />
below).<br />
- 1.9 -
OHP and slides: An OHP and a 35 mm slide projector are available in every room.<br />
Computer projection: A data projector/beamer is available on request. If you are<br />
planning to use a computer presentation it is essential we know this in advance, either<br />
on the form supplied when your presentation was accepted or by email. This year we<br />
ask that you bring your presentation on a CD-ROM or zip disk clearly marked with<br />
your name and session number, as your own laptop may not be suitable for use with<br />
the in-house system. Laptop computers will be supplied in every room. Presentations<br />
made using the PC version of PowerPoint 1997 and 2000 are compatible with the inhouse<br />
system. Mac users should ensure that their presentations are saved on PC formatted<br />
disks. Please see the technician in the Mediothekraum preferably on Sunday, or at least<br />
one day before your session in order that your presentation may be loaded up on the<br />
appropriate computer. If you are a Mac user and wish to have more specific information,<br />
or if there is a video incorporated into your presentation please contact Pat Lilley<br />
(p.m.lilley@dundee.ac.uk)<br />
Technical assistance during the sessions: A technician will be available in each of the<br />
large lecture theatres, and students familiar with use of the equipment will be available<br />
in each of the smaller rooms. Each room is equipped with a telephone by which help<br />
may be requested if necessary.<br />
Your presentation: The following guidelines will help ensure the smooth-running of<br />
sessions.<br />
• Please arrive at least ten minutes before the scheduled start of the session and<br />
introduce yourself to the chairperson.<br />
• Keep strictly to the time allotted for your presentation. This is essential. The<br />
Chairperson will remind you when your time limit has expired and will then<br />
ask the audience for questions.<br />
• Please speak slowly and clearly.<br />
• Ensure your overheads and slides are clear, that there is not too much text to<br />
read in the limited time available and that the type is large enough to be<br />
legible for those sitting at the back of the room.<br />
• Whilst not obligatory, a single page hand-out, giving the key messages from<br />
your presentation, is always appreciated. As a rough indication you could<br />
expect between 40-60 participants in the audience.<br />
Role of the Chairperson in the Short Communications Sessions<br />
1 Before the session starts, check that the speakers and opening discussant are present;<br />
2 Introduce each speaker according to the programme. Tell him/her when the allotted<br />
10 minute presentation period is over (a timer will be provided) and ask the speaker<br />
to stop his/her presentation;<br />
3 Allow 5 minutes for discussion between presentations;<br />
4 If a speaker is not present, arrange for the 15 minute period to be used for further<br />
discussion; the next presentation should not start until the scheduled time;<br />
5 Ask the opening discussant to lead off the discussion at the end of the session;<br />
6 Draw the session to a close and thank participants;<br />
7 Follow strictly the time schedule in the programme to allow participants to move<br />
between sessions.<br />
Role of the Opening Discussant in the Short Communications Sessions<br />
Introduce the topic in the context of the papers presented and highlight the key points<br />
for discussion arising from the papers. This should take no more than 5 minutes.<br />
- 1.10 -
Posters<br />
There will be twelve themed groups of posters on show throughout the Conference in<br />
the areas listed below. Please see pages 2.27 to 2.37 for details of presentations in each<br />
session and see below for the locations of the posters which are all in the Teaching<br />
Building on either floor 1 or floor 2:<br />
Session No Title Location<br />
7A New Learning Technologies Floor 2<br />
7B Problem-Based Learning Floor 2<br />
7C Curriculum Planning and Change Floor 2<br />
7D Curriculum Evaluation/Staff Development Floor 1<br />
7E Postgraduate Education Floor 2<br />
7F Assessment Floor 1<br />
7G Teaching & Learning 1 Floor 2<br />
7H Teaching & Learning 2 Floor 2<br />
7I Continuing Professional Development 1 Floor 1<br />
7J Continuing Professional Development 2 Floor 1<br />
7K International Medical Education Floor 1<br />
7L Special Subjects Floor 1<br />
Poster presentations will take place on Wednesday 5 September from 0830-1000 hrs.<br />
The sessions will start in the room designated for the presentations (see page 1.13),<br />
where each presenter will have two minutes to highlight the key points to look out for<br />
in the poster. Two overheads or slides are allowed for the presentation. Computer<br />
projection is not available. A chairperson will introduce each presenter. Following the<br />
short presentations the group will move to the relevant poster area for a group discussion.<br />
Information for Presenters of Posters<br />
Posters may be mounted at the following times:<br />
Saturday 1 September between1200-1730 hrs<br />
Sunday 2 September between 0830-1700 hrs<br />
Monday 3 September between 0745-1730 hrs<br />
Posters will be grouped in themes, and the identification number, name(s) of the author(s)<br />
and title of the poster will be clearly labelled on each poster board. Poster boards are<br />
120 cm wide and 150 cm high, fixed with pins. A supply of pins will be available but<br />
you may find it useful to bring your own.<br />
To Help the Poster Sessions run Smoothly<br />
1 Poster presenters should meet in the room allocated to the session at 0820 hrs on<br />
Wednesday 5 September, and make themselves known to the chairperson.<br />
2 Presenters must keep strictly to the 2 minutes allowed for initial presentation of the<br />
poster, and may used one or two overheads or slides (no data projection). No time is<br />
allowed for discussion at this stage. This time should be used to highlight key points<br />
to look for in the poster, not to summarise the poster<br />
3 After all the short presentations have been made, the group will go to the poster<br />
area allocated.<br />
4 Presenters should stand by their posters, and be prepared to answer questions. It is<br />
useful to have some photocopied handouts (approximately 40-80) for distribution,<br />
with the key messages of the poster.<br />
5 It is helpful if the presenter can indicate on his/her poster board an alternative time<br />
when he/she will be available (eg a lunch or coffee break) in case anyone who<br />
cannot attend the session would like to discuss the poster.<br />
- 1.11 -
Role of the Chairperson in the Poster Sessions<br />
Medical Teacher Poster Prize<br />
Workshops<br />
1 Before the sessions starts, check that the presenters have arrived;<br />
2 Introduce each presenter and allow two minutes for the presentations. Do not allow<br />
any time for discussion between presentations, which should take up to 30 minutes,<br />
depending on the number in the group.<br />
3 At the end of the presentations lead the group to the poster area;<br />
4 Allow the group to look at all the posters (it is suggested that between 15-30 minutes<br />
is allowed for this activity);<br />
5 Invite questions for discussion.<br />
Taylor and Francis Ltd, the publisher of Medical Teacher, has generously agreed once<br />
again to sponsor a prize of £150 to be awarded for the best poster at the Conference.<br />
Posters will be judged, by a Committee, on the following criteria:<br />
• How well are the key messages communicated through the poster?<br />
• Does the poster arouse the interest of the viewer?<br />
• Is the poster attractive?<br />
The winner will be announced at the end of the final plenary session on Wednesday 5<br />
September. In addition to the prize money, the winner will receive one year’s individual<br />
membership of <strong>AMEE</strong>, which includes a personal copy of Medical Teacher.<br />
Pre-Conference Workshops: Pre-booking of Pre-Conference Workshops via the<br />
<strong>AMEE</strong> Secretariat is essential, and a charge is made. At the time of going to press<br />
almost all the pre-conference workshops are full.<br />
Conference Workshops: Workshops in Session 3 are listed on pages 2.13 to 2.14<br />
and those in Session 6 on pages 2.25 to 2.27. A full description of the workshop content<br />
is given in the Abstracts section (pages 4.23 and 4.51).<br />
Enclosed with this programme is a Selection Form. One of the items relates to workshop<br />
choice. Pre-booking of conference workshops offers a better chance of attending your<br />
first choice of workshops in Sessions 3 and 6. Please complete the information requested<br />
and either return the form to the <strong>AMEE</strong> Office or email your choices to<br />
<strong>AMEE</strong>@dundee.ac.uk There is no charge for attending conference workshops. A list<br />
of workshops and attendees will appear on the notice board adjacent to the Registration<br />
area with an indication of the number of places remaining. Depending on the format,<br />
some organisers wish to limit participation in their workshops, and we regret that you<br />
might not be able to attend your first choice on each occasion.<br />
- 1.12 -
<strong>Programme</strong> Overview - Short communications,<br />
Poster, Large Group Sessions<br />
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Achieving standards<br />
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Student and<br />
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Simulation and<br />
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Training<br />
Educating the<br />
Educators 1<br />
Selection<br />
Continuing<br />
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Peer<br />
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Postgraduate<br />
Education -<br />
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OSCE/<br />
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Patients in<br />
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A Virtual<br />
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Standards and<br />
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- 1.13 -<br />
Teaching about<br />
EBM, Critical<br />
Thinking and<br />
Research<br />
Evaluation of<br />
Multiprofessional<br />
Education<br />
Contexts<br />
for Learning<br />
Education and<br />
Cultural<br />
Diversity<br />
Educating the<br />
Educators 2<br />
Educational<br />
Strategies/<br />
Curriculum<br />
Planning<br />
Outcome-based<br />
Education<br />
Assessment<br />
Postgraduate<br />
Education for Gen<br />
Practice/Family<br />
Medicine<br />
Assessing<br />
Communication<br />
Skills/Patients<br />
as Examiners<br />
Curriculum<br />
Evaluation<br />
Evaluation of<br />
Problem-based<br />
Learning<br />
Learning and<br />
the Internet<br />
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Special<br />
Subjects<br />
International<br />
Medical<br />
Education<br />
Continuing<br />
Professional<br />
Development 2<br />
Continuing<br />
Professional<br />
Development 1<br />
Teaching and<br />
Learning 2<br />
Teaching and<br />
Learning 1<br />
Assessment<br />
Postgraduate<br />
Education<br />
Curriculum<br />
Evaluation/Staff<br />
Development<br />
Curriculum<br />
Planning and<br />
Change<br />
Problem-based<br />
Learning<br />
New Learning<br />
Technologies<br />
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Clinical<br />
Teaching<br />
Communication<br />
Skills Training<br />
Curriculum<br />
Change<br />
Assessment in<br />
Postgraduate and<br />
Continuing<br />
Education<br />
Teaching and<br />
Learning<br />
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Career Choice<br />
The Final<br />
Examination<br />
Curriculum<br />
Planning<br />
Implementation of<br />
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Computer<br />
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Learning and<br />
Assessment<br />
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medical journal do<br />
for education in<br />
medicine?<br />
The assessment of<br />
poorly performing<br />
doctors<br />
A bachelor master<br />
structure of medical<br />
education in Europe<br />
Effective student<br />
assessment:<br />
something old,<br />
something new<br />
Concept<br />
mapping<br />
Making feedback<br />
during clerkships<br />
meaningful and<br />
effective<br />
East European<br />
Task Force<br />
Best Evidence<br />
Medical Education:<br />
Progress Report<br />
Feedback and<br />
evaluation: essential<br />
activities in the<br />
learning process<br />
From MD to<br />
academic<br />
teacher<br />
The quality of<br />
medical education<br />
and teaching - thema<br />
can variatione<br />
The roles of<br />
the teacher<br />
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- 1.14 -<br />
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Bedside Cardiology<br />
An Introduction Nordic Federation<br />
Risk management<br />
Developing<br />
Learning needs<br />
Skills Training,<br />
Professional and Students teaching<br />
<strong>AMEE</strong>/<br />
to Clinical for Medical<br />
in medical<br />
professional attitudes:<br />
Problem-based Portfolio<br />
featuring ‘Harvey’<br />
organisational culture communication<br />
Ibero-American<br />
assessment in A European<br />
Judgement Analysis Education<br />
education<br />
theory, practice and<br />
Learning Assessment<br />
& UMedic<br />
of medical eduaction skills<br />
Network Workshop<br />
u/grad and p/grad core curriculum?<br />
evaluation<br />
medical education<br />
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Workshop<br />
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Personal Diary<br />
TIME MONDAY TUESDAY WEDNESDAY TIME<br />
0830 Plenary 1 Large Group Sessions Posters<br />
0830<br />
0845 0845<br />
0900 0900<br />
0915 0915<br />
0930 0930<br />
0945 0945<br />
1000<br />
1015<br />
Coffee<br />
1000<br />
1015<br />
1030<br />
1045<br />
Coffee Coffee<br />
Short Communications 3 1030<br />
1045<br />
1100 Short Communications 1 Short Communications 2<br />
1100<br />
1115 1115<br />
1130 1130<br />
1145 1145<br />
1200 1200<br />
1215 1215<br />
1230 1230<br />
1245<br />
1300<br />
Lunch<br />
1245<br />
1300<br />
1315<br />
1330<br />
Lunch Lunch<br />
Plenary 2<br />
1315<br />
1330<br />
1345 Posters<br />
1345<br />
1400 Workshop Session 1 Workshop Session 2<br />
1400<br />
1415 1415<br />
1430 1430<br />
1445 Break<br />
1445<br />
1500 Special Presentation 1500<br />
1515 1515<br />
1530 1530<br />
1545<br />
Coffee<br />
1545<br />
1600 Coffee<br />
Workshops Continued<br />
Close of Meeting 1600<br />
1615 General Assembly<br />
1615<br />
1630 1630<br />
1645 1645<br />
1700 1700<br />
Note: While you are free to move between short communication and poster sessions, we hope you<br />
will stay in one session and join in the discussion.<br />
- 1.15 -
List of Exhibitors<br />
Association for Medical Education in Europe<br />
Association for the Study of Medical Education, UK<br />
Centre for Medical Education, University of Dundee, UK<br />
Croatian Association for Medical Education<br />
Faculty of Medicine, University of Lisbon, Portugal<br />
Humboldt-University <strong>Berlin</strong>, Germany<br />
IAMSE<br />
Kaplan Medical, USA<br />
Medical Teacher<br />
National Association of Clinical Tutors (NACT), UK<br />
Netherlands Association for Medical Education<br />
Nordic Federation for Medical Education - NFME<br />
Open University Centre for Education in Medicine, UK<br />
Ottawa Conference<br />
Spanish Association for Medical Education - SEDEM<br />
Taylor & Francis Ltd, UK<br />
Teaching & Learning Support Network, UK<br />
- 1.16 -
SECTION 2<br />
The Academic <strong>Programme</strong>
Saturday 1 September<br />
Saturday 1 September<br />
Pre-conference tours – see page 3.4 for details<br />
1200-1730 Registration Desk open at Campus Virchow-Klinikum and setting up of Posters<br />
and Exhibits.<br />
1400-1700 Pre-conference workshop PCW1: Web-based learning (Part 1).<br />
Room: Teaching Building, Computer Room 2.0103 (2 nd floor)<br />
Coffee for workshop participants in Studentencafé at 1530.<br />
1400-1700 <strong>AMEE</strong> Executive Committee Meeting<br />
Teaching Building Room 2.0214 (2 nd floor) (closed meeting)<br />
- 2.1 -
Sunday 2 September<br />
Sunday 2 September<br />
0800-1700 Registration Desk open at Campus Virchow-Klinikum and setting up of Posters and<br />
Exhibits.<br />
0930-1230 Pre-conference workshops<br />
Please note: it is essential to reserve a place on these workshops, for which a charge is<br />
made. Coffee for workshop participants in Studentencafé at 1100. Lunch is not<br />
provided.<br />
PCW1 Web-based learning (Part 2). (Part 1 on Saturday afternoon)<br />
Dr Martin Fischer, University of Munich, Germany, and Dr Raphael Bonvin,<br />
University of Basel, Switzerland<br />
Room: Teaching Building, Computer Room 2.0103 (2 nd floor)<br />
PCW2 Faculty rewards and incentives in medical education: the challenges<br />
and the promise<br />
Dr Sharon Krackov, New York University School of Medicine, USA<br />
Room: Teaching Building, 2.0101 (2 nd floor)<br />
PCW3 Strategies for sustaining change in medical education<br />
Dr Stewart Mennin, and Dr Scott Obenshain, University of New Mexico School of<br />
Medicine, Albuquerque, USA<br />
Room: Teaching Building, 2.0102 (2 nd floor)<br />
PCW4 Assessing the reliability of mastery-level decisions in OSCE and<br />
Standardized Patient examinations: an overview of common<br />
methods and practical applications<br />
Dr André De Champlain, National Board of Medical Examiners, Philadelphia,<br />
USA, and Dr John Boulet, Educational Commission for Foreign Medical<br />
Graduates, Philadelphia, USA<br />
Room: Teaching Building, 2.0104 (2 nd floor)<br />
PCW5 Consultant appraisal<br />
Dr Steven Wilkinson, Centre for Organisational Research, Anglia Polytechnic<br />
University, UK, and Dr Kwee Matheson, West Suffolk Hospital, UK<br />
Room: Research Building, 2.0026 (2 nd floor)<br />
PCW6 Developing competence in lifelong learning<br />
Hajo Schmidt-Traub and colleagues: Medical Students from Charité, Medical<br />
Faculty of the Humboldt-University, <strong>Berlin</strong><br />
Room: Teaching Building, 1.0105 (1 st floor)<br />
PCW7 Curriculum change in a traditional medical school<br />
Professor Herman van Rossum and Dr Janke Cohen-Schotanus, Groningen<br />
University, Netherlands<br />
Room: Teaching Building, 1.0107 (1st floor)<br />
- 2.2 -
Sunday 2 September<br />
0930-1100 BEME Steering Group Meeting<br />
Teaching Building, Room 2.0214 (2nd floor) (closed meeting)<br />
1115-1245 Medical Teacher Editorial Board Meeting<br />
Teaching Building, Room 2.0214 (2nd floor) (closed meeting)<br />
1400-1700 City coach tour<br />
Included in registration fee for registered participants and registered accompanying<br />
persons - see page 3.1 for details.<br />
1930-2130 Opening Ceremony and Reception at Red Town Hall (Rotes Rathaus)<br />
Included in registration fee for registered participants and registered accompanying<br />
persons - see page 3.1 for details.<br />
- 2.3 -
Monday 3 September<br />
0745-1730 Registration desk open at Campus Virchow-Klinikum<br />
0830-1030 Session 1: Plenary<br />
1<br />
Achieving standards in the curriculum<br />
Room: Teaching Building, Hörsaal 1 and 2<br />
(Note: there will be a video link to Hörsaal 3 to provide additional seating)<br />
Chairperson: Professor Margarita Barón-Maldonado, Spain<br />
0830-0855 1/1 Towards global standards for medical education<br />
Dr Jordan Cohen – President, Association of American Medical Colleges,<br />
Washington DC, USA<br />
0900-0925 1/2 New times, new standards: the social accountability of health<br />
systems and medical schools<br />
Dr Charles Boelen – Coordinator, Human Resources for Health Program,<br />
World Health Organization, Geneva, Switzerland<br />
0930-0955 1/3 Death of the course<br />
Professor Ronald Harden – Director, Centre for Medical Education, University<br />
of Dundee, and Director – Education Development Unit, Scottish Council for<br />
Postgraduate Medical and Dental Education, UK<br />
1000-1030 Discussion<br />
1030-1100 Coffee served in the foyers of the Teaching and the Research Buildings<br />
1100-1300 Session 2: Short Communications<br />
2A<br />
Monday 3 September<br />
13 simultaneous themed sessions on a range of topics:<br />
A Virtual Learning Environment<br />
Chairperson: Professor Rein Zwierstra<br />
Room: Teaching Building, Hörsaal 1 (Ground Floor)<br />
1100-1115 1 Virtual learning environments - a learner centred review<br />
Megan Quentin-Baxter* and Suzanne Hardy; Learning and Teaching Support<br />
Network, University of Newcastle-upon-Tyne, UK<br />
1115-1130 2 Impact of a digital learning environment on the efficiency of teachers<br />
Peter G M de Jong* and Hermiette E Idenburg; Leiden University Medical Center,<br />
The Netherlands<br />
- 2.4 -
1130-1145 3 Building blocks in a new curriculum: the role of the library in<br />
educational innovation<br />
Magriet Lee and Maureen Brassel*; University of Pretoria, South Africa<br />
1145-1200 4 IT learning environment: more structure or more room for<br />
manoeuvre? Centrally guided norm path or absolute freedom?<br />
J Degryse*, A Roex and W Renier; K U Leuven, Belgium<br />
1200-1215 5 Innovation in self-directed learning (SDL) in CME: Virtual Internet<br />
Patient Simulation<br />
M A Raetzo*, R L Thivierge, R J Gagnon, V Loroch and A Bonneau; University<br />
of Montreal, Canada<br />
1215-1230 6 Real learning through virtual presentation: an Internet based work<br />
environment course for medical students at Uppsala University<br />
Klas <strong>Berlin</strong>*, Kerstin Graffman and Anna Rask-Andersen; University Hospital,<br />
Uppsala, Sweden<br />
1230-1300 Discussion [Opening Discussant: Professor Ian Hart]<br />
2B<br />
Monday 3 September<br />
PBL and the Curriculum<br />
Chairperson: Dr Michael Schmidts<br />
Room: Teaching Building, Hörsaal 2 (Ground Floor)<br />
1100-1115 1 The birth of a new species - squirrums: towards equal collaboration<br />
in innovation in medical education<br />
Peter McCrorie* and David Prideaux*; St George’s Hospital Medical School,<br />
London, UK<br />
1115-1130 2 Broadening learning with PBL in a Pathophysiology course<br />
Antonio Rendas* and Bernardo Correia; Faculdade de Ciencias Medicas, Portugal<br />
1130-1145 3 The implementation of problem-based learning (PBL) into a<br />
traditional Radiology Clerkship<br />
U Keske, U K M Teichgräber, R Schröder, J Berger, S Venz and R Felix; Humboldt<br />
University, Germany<br />
1145-1200 4 Medical education innovations in Dresden, Germany: Reformed<br />
Medical Faculty Carl Gustav Carus, Dresden University of<br />
Technology<br />
Peter Dieter; Carl Gustav Carus, Dresden, Germany<br />
1200-1215 5 Problem-Based Learning in Immunology and Infectious Disease<br />
(IMID). The Dresden Experience<br />
S Weber*, G Baretton, S Bergmann, J Graeszler, E Jacobs, H Kunath, I Nitsche,<br />
U Ravens, A Rethwilm and P Rieber; Dresden Medical School, Germany<br />
1215-1230 6 From case-based reasoning to problem-based learning<br />
Haim Eshach* and Haim Bitterman; Technion-Israel Institute of Technology,<br />
Haifa, ISRAEL<br />
1230-1245 7 A new approach to PBL in CME; using script concordance tests (SCT)<br />
M Labelle*, C Maille, R L Thivierge and B Charlin; University of Montreal,<br />
Canada<br />
- 2.5 -
1245-1300 8 Discovering versus covering: a new PBL in Behavioural Sciences<br />
Ala’Aldin Al-Hussaini and Harith Ghassany; Sultan Qaboos University,<br />
Al-Khod, Sultanate of Oman<br />
2C<br />
Curriculum Database<br />
Chairperson: Dr Ed Peile<br />
Room: Teaching Building, Hörsaal 3 (Ground Floor).<br />
1100-1115 1 Aiding the reform - development of a curriculum information<br />
system<br />
Patrick Merl*, Paolo Petta and Richard Marz University of Vienna Medical School,<br />
Austria<br />
1115-1130 2 How effective is project management software in implementing a<br />
new course?<br />
Katharine Grundy; St George’s Hospital Medical School, London, UK<br />
1130-1145 3 MESMIS – Medical School Staff/Student Management Information<br />
System: Towards the electronic curriculum<br />
D A Levison and W M Williamson; University of Dundee Medical School,<br />
Dundee, UK<br />
1145-1200 4 SIMON - Student Information and Management Online Network<br />
P Wagner*, D Zeiss*, S König*, P M Markus and H Becker: University of<br />
Gottingen, Germany<br />
1200-1215 5 Portfolio-based Dermatology internship - one year’s experience<br />
A Boer*, R Kaufmann and F Ochsendorf; Universitats-Hautklinik, Germany<br />
1215-1230 6 Profile of the consultations made by fifth year medical students in<br />
the integrated program of Pediatrics and Public Health<br />
Claudia Astudillo, Roció Arenas, Mariá Bustamante*, Mariá De La Fuente and<br />
Gladys Yentzen; Universidad de Chile, Santiago, Chile<br />
1230-1300 Discussion [Opening Discussant: Dr David Davies]<br />
2D<br />
Monday 3 September<br />
OSCE/Standardised Patients in Assessment<br />
Chairperson: Dr Gerald Whelan<br />
Room: Research Building, Hörsaal 4 (Ground Floor)<br />
1100-1115 1 “Check it, rate it, palm it or leave it” - handheld computers replace<br />
checklists in OSCEs and provide automated feedback<br />
Michael Schmidts*, Markus Kemmerling, Ruth Willnauer and Martin Lischka;<br />
Institute für med. Aus-und Weiterbildung, Vienna, Austria<br />
1115-1130 2 Evaluation of the undergraduate surgery course: effect of OSCE<br />
Marco Bustamante Z*, Carlos Carvajal H, Fernando Quevedo R, María<br />
Bustamante C and Claudia Astudillo M; Universidad de Chile, Santiago, Chile<br />
1130-1145 3 OSCE: are many different stations necessary for each evaluation?<br />
Carlos Carvajal*, Marco Bustamante and Ilse López; Universidad de Chile,<br />
Santiago, Chile<br />
- 2.6 -
1145-1200 4 Assessing ‘attitude awareness’ as part of an OSCE<br />
Nicholas P Fenlon*, Maureen Kelly, Andrew W Murphy and Gerard Loftus;<br />
National University of Ireland, Galway, Ireland<br />
1200-1215 5 Is the assessment of clinical skills affected by the choice and<br />
characteristics of the standardized patients?<br />
T Errichetti*, J Boulet, G Whelan and D McKinley; ECFMG, Philadelphia, USA<br />
1215-1230 6 Use of standardized patients to assess medical response to a<br />
natural disaster<br />
Graceanne Adamo*, Marguerite Hawkins, Heidi Worth-Dickstein, Eric Marks,<br />
Ralph Jones, Gilbert Muniz and Richard E Hawkins; Uniformed Services<br />
University of the Health Sciences, Bethesda, USA<br />
1230-1245 7 The weakest link? Performance factors and degrees of influence in<br />
an interactive long-station general practice examination (VOICEs)<br />
C M Wiskin*, T Allan and J Skelton, University of Birmingham, UK<br />
1245-1300 Discussion [Opening Discussant: Professor Stewart Petersen]<br />
2E<br />
Monday 3 September<br />
Postgraduate Education – the Early Years<br />
Chairperson: Dr John Nicholls<br />
Room: Building 10, Hörsaal 6 (Ground Floor)<br />
1100-1115 1 New PRHO: “I am not sure what I am supposed to do”. Can we<br />
improve on PRHO induction? An evaluation of a new induction<br />
process<br />
Dason Evans*, Mike Roberts and Diana Wood; St Bartholomew’s and the<br />
Royal London Medical and Dental School, London, UK<br />
1115-1130 2 A comparison of Pre-registration House Officers’ (PRHOs) and<br />
Senior House Officers’ (SHOs) experience in general practice<br />
Jan Illing*, Tim van Zwanenberg, Bill Cunningham, George Taylor, Richard<br />
Prescott and Cath O’Halloran; University of Newcastle, UK<br />
1130-1145 3 Pre-registration experience in general practice: results of a national<br />
evaluation<br />
Janet Grant*, Lesley Southgate, Rodney Gale, George Freeman, Alison Hill,<br />
Neil Johnson, Frank Smith, Mairead Beirne and Heather Owen; Open University<br />
Centre for Education in Medicine, Milton Keynes, UK<br />
1145-1200 4 Family Medicine Month: a human life cycle approach for first year<br />
residents<br />
Linda Z Nieman, Rebecca Gladu, Thelma Jean Goodrich, Janet Groff and<br />
Mary M Velasquez; UT Houston Health Science Center, Houston, USA<br />
1200-1215 5 Making and sharing decisions about management with patients: the<br />
views and experiences of Pre-Registration House Officers<br />
Jill Thistlethwaite; University of Leeds, UK<br />
1215-1230 6 Teaching the forgotten tribe: tutor views on a generic curriculum for<br />
SHOs<br />
Lesley Pugsley* and Janet MacDonald; University of Wales College of Medicine,<br />
Cardiff, UK<br />
- 2.7 -
1230-1245 7 General professional training (GPT) for dental graduates in the UK<br />
Alison Bullock*, Vickie Firmstone and John Frame; University of Birmingham, UK<br />
1245-1300 Discussion [Opening Discussant: Dr Jon Dowell]<br />
2F<br />
Peer Assessment<br />
Chairperson: Waltraud Georg<br />
Room: Teaching Building, Mikroscopierraum (First Floor)<br />
1100-1115 1 Peer- and co-assessment leads to shared responsibility for test results<br />
Caro Brumsen and Peter G M de Jong*; Leiden University Medical Center,<br />
The Netherlands<br />
1115-1130 2 Student self-marking as an assessment approach to developing<br />
professionalism<br />
G J Mires* and M Friedman Ben-David; University of Dundee, UK<br />
1130-1145 3 Comprehensive Assessment: value for learning<br />
Elaine F Dannefer; University of Rochester Medical Center, USA<br />
1145-1200 4 Attributes of the excellent physician: a third year student survey<br />
A V Carneiro*, M F Patrício and J Fernandes e Fernandes; University of Lisbon<br />
School of Medicine, Portugal<br />
1200-1215 5 The Medical Student Peer Evaluation Initiative: assessment of<br />
performance in small group settings<br />
Steven L Kanter*, Kathleen Ryan, John Mahoney and Joan Harvey; University<br />
of Pittsburgh, Pittsburgh, USA<br />
1215-1230 6 Reliability of a multidimensional questionnaire to assess attitudes<br />
of medical students towards their future profession: the UNI Project<br />
G L Werneck*, E C O Ribeiro, A C Aguiar and V M B Ribeiro; Nucleo de<br />
Estudos de Saude Coletiva, Ala Sul, Brazil<br />
1230-1245 7 Narrowing the gap in the assessment process<br />
Nicolas Karlsson, University of Goteborg, Sweden<br />
1245-1300 Discussion [Opening Discussant: Professor Ara Tekian]<br />
2G<br />
Monday 3 September<br />
Continuing Professional Development<br />
Chairperson: Dr Peder Charles<br />
Room: Teaching Building, Room 2.0102 (Second Floor)<br />
1100-1115 1 Learning and partnering: bringing pharmaceutical representatives<br />
into the educational loop<br />
Jane Tipping*, Craig Campbell, Jean Claude Dairon, Paul Davis, Francois Goulet,<br />
Gilles Lachance, Celine Monette, Joan Sargeant, Linda Snell and Robert Thivierge,<br />
Canada<br />
- 2.8 -
1115-1130 2 CME with a combination of standardised patients and a CBT<br />
programme<br />
S Schewe*, A Schewe and J Loohs; Medizinische Poliklinik, Munich, Germany<br />
1130-1145 3 The impact of continuing professional development (CPD): 30 case<br />
studies of dentists<br />
Vickie Firmstone*, Alison Bullock and John Frame; University of Birmingham, UK<br />
1145-1200 4 Global trends in continuing medical education<br />
Lewis A Miller; Global Alliance for Medical Education, Darien, USA<br />
1200-1215 5 Do we need consultant appraisal?<br />
K H Matheson; West Suffolk Hospital, Bury St Edmunds, UK<br />
1215-1230 6 When should clinicians be trained in management?<br />
J Clark*, R Palmer and P Spurgeon; University of Birmingham, UK<br />
1230-1245 7 Evaluation of ‘Distance Interactive Learning in Obstetrics and<br />
Gynaecology (DIALOG)’<br />
Vikram Jha*, Sean McAleer and Sean Duffy; St James’s University Hospital,<br />
Leeds and University of Dundee, UK<br />
1245-1300 Discussion [Opening Discussant: Dr Brendan Hicks]<br />
2H<br />
Selection<br />
Monday 3 September<br />
Chairperson: Professor David Wiegman<br />
Room: Teaching Building, Room 2.0101 (Second Floor)<br />
1100-1115 1 Selecting aboriginal students to health professional courses<br />
I E Rolfe and G Garvey*; University of Newcastle, Australia<br />
1115-1130 2 Demographic and scholastic correlates of scores in the Australian<br />
Undergraduate Medical and Health Sciences Admission Test (UMAT)<br />
Peter Tutton*, Chris Browne, Margot Story and Michael Lewenberg; Monash<br />
University, Australia<br />
1130-1145 3 Can we make the interview add something new?<br />
P Hughes, S Miller*, P McCrorie and A Kent; St George’s Hospital Medical<br />
School, London, UK<br />
1145-1200 4 Relative effects of learning style, MCAT and prior academic record<br />
on performance in medical school<br />
Stephen Aaron* and Ernest Skakun; University of Alberta, Canada<br />
1200-1215 5 The selection of GP trainees in the West Midlands: audit of<br />
assessment centre scores by ethnic background and country of<br />
qualification<br />
Celia Brown*, Sarah Wakefield and Alison Bullock; University of Birmingham, UK<br />
1215-1230 6 The selection of GP trainees: perceptions of the new regional<br />
system<br />
Sarah Wakefield*, Celia Brown and Alison Bullock; University of Birmingham,<br />
UK<br />
- 2.9 -
1230-1245 7 “I want to become a doctor.” Analysis of first year students’<br />
motivations<br />
M F Patrício* and J Gomes-Pedro; University of Lisbon, Portugal<br />
1245-1300 Discussion [Opening Discussant: Miss Gill Clack]<br />
2I<br />
Educating the Educators (1)<br />
Chairperson: Professor Olle ten Cate<br />
Room: Teaching Building, Room 2.0104 (Second Floor)<br />
1100-1115 1 Evaluation of a Train the Trainers program in quality improvement<br />
and cost-effectiveness<br />
Antoinette S Peters*, Maryjoan Ladden and Robert Fletcher; Harvard Medical<br />
School, Boston, USA<br />
1115-1130 2 Teaching the medical teachers - Beyond ‘TIPS’<br />
Jane Richardson* and Jonathan D Cartledge; University College London, UK<br />
1130-1145 3 Formal courses in further training of medical teachers<br />
M Vrcic-Keglevic*, Z Jaksic, G Pavlekovic, N Pokrajac, A Smalcelj and B Vrhovac;<br />
“A.Stampar” School of Public Health, Zagreb, Croatia<br />
1145-1200 4 Supporting Clinicians on Training in Scotland<br />
Rose Martin, on behalf of Supporting Clinicians on Training in Scotland Working<br />
Group; Scottish Council for Postgraduate Medical and Dental Education,<br />
Dundee, UK<br />
1200-1215 5 Improving own teaching skills identified as a top priority by<br />
Registrars<br />
Iwona Stolarek; Hutt Hospital, Wellington, New Zealand<br />
1215-1230 6 Dissemination of teaching of medical interviewing and physical<br />
examination in Japan<br />
N Ban*, M Hatao, J Ohtaki, M Fujisaki, C Nakamura, T Tsuda, T Matsumura<br />
and M Shimo; Nagoya University School of Medicine, Japan<br />
1230-1245 7 Transformational learning in a peer teaching programme<br />
Angel M Centeno*, Alexandra Blanco and Soledad Campos; Austral University,<br />
Buenos Aires, Argentina<br />
1245-1300 Discussion [Opening Discussant: Dr Clair DuBoulay]<br />
2J<br />
Monday 3 September<br />
Simulation and Clinical Skills Training<br />
Chairperson: Professor Andrzej Wojtczak<br />
Room: Building 10, Room 1.0107 (Lower Ground Floor)<br />
1100-1115 1 Teaching clinical skills to medical students using the clinical skills<br />
laboratory with a new simulator and new tools<br />
I Yoshida*, T Ueno, M Hotta, H Abe, I Kubara, S Kono, Y Ogo, S Watanabe,<br />
A Hayashi, T Akagi, S Okuda and M Sata (Working Group on Teaching Basic<br />
Clinical Skills); Kurume University, Japan<br />
- 2.10 -
1115-1130 2 Training in vaginal examination technique using the ‘epelvis’<br />
C M Pugh* and M S Marsh; GKT Medical School, London, UK<br />
1130-1145 3 Training medical students to perform vaginal examination using the<br />
‘epelvis’<br />
M S Marsh* and C M Pugh; GKT Medical School, London, UK<br />
1145-1200 4 Procedural failures - when is enough enough?<br />
Michael Harrison; Auckland Hospital, New Zealand<br />
1200-1215 5 Approaches and advancements; Integrating simulation center<br />
activities into 3rd year medical school clerkship curricula<br />
Aileen E Zanoni*, Graceanne Adamo, Christoph R Kaufmann and Richard E<br />
Hawkins; Uniformed Services University, Bethesda, USA<br />
1215-1230 6 Using scenario based teaching to deliver feedback on technical and<br />
communication skills<br />
R L Kneebone*, J Kidd, D Nestel, B Paraskeva, S Asvall and A Darzi; College<br />
School of Medicine, Imperial London, UK<br />
1230-1300 Discussion [Opening Discussant: Professor Paul Bradley]<br />
2K<br />
Monday 3 September<br />
Students and Curriculum Evaluation<br />
Chairperson: Professor Juan Perez-Gonzalez<br />
Room: Building 10, Room 1.0105 (Lower Ground Floor)<br />
1100-1115 1 Teaching quality questionnaire: students’ evaluations of standard<br />
learning activities in an integrated curriculum<br />
Øyvind Ellingsen*, Kristin Wigen and Are Holen; Norwegian University of Science<br />
& Technology, Trondheim, Norway<br />
1115-1130 2 The retrospective view - formative programme evaluation of<br />
preclinical courses by final year medical students<br />
C Schirlo*, W Vetter and P Groscurth; Studiendekanat der Medizinischen Fakultat,<br />
Zurich, Switzerland<br />
1130-1145 3 Students’ attitudes towards evaluation of teaching programmes - do<br />
they fib?<br />
Richard Phillips* and Alison Hooper; GKT School of Medicine, London, UK<br />
1145-1200 4 Student evaluation of educational quality: the construction of a<br />
multidimensional questionnaire<br />
Volkhard Fischer; Hannover Medical School, Germany<br />
1200-1215 5 Evaluation of lectures in medical teaching based on focal groups<br />
and a survey of opinion to formulate a guide of practical<br />
recommendations<br />
Juan Cristóbal Maass*, Lorena Tapia, Marcela Jacard, and Teresa Millán;<br />
University of Chile, Santiago, Chile<br />
1215-1230 6 Use of a Continuous Quality Improvement (CQI) model to enhance<br />
curriculum evaluation and integration<br />
Nehad El-Sawi; University of Health Sciences, Kansas City, USA<br />
- 2.11 -
1230-1245 7 New faculty-level self-evaluation instruments<br />
K Lonka*, N Paganus, T Hätönen, A Heikkilä, J Vainio and J Nieminen;<br />
University of Helsinki, Finland<br />
1245-1300 8 The doctors’ opinion - a national evaluation of Swedish medical<br />
education<br />
Anders Bengtsson, Kerstin Johansson and Sara Engström*; Swedish Medical<br />
Association, Stockholm, Sweden<br />
2L<br />
Multiprofessional Education<br />
Chairperson: Dr Anna Bukovinszky<br />
Room: Teaching Building, Room 1.0107 (First Floor)<br />
1100-1115 1 Interprofessional learning: the New Generation Project<br />
Debra Humphris* and Chris Stephens*; University of Southampton, UK<br />
1115-1130 2 “Walking in the moccasins of others”: reflections on a new initiative<br />
to bring the real world of the patient into the medical curriculum<br />
Lyn Brown; University of Liverpool, UK<br />
1130-1145 3 Multiprofessional education in health care ethics in Germany<br />
Jochen Vollmann; Freie Universitat <strong>Berlin</strong>, Germany<br />
1145-1200 4 Dilemmas in resuscitation: nursing and medical students’<br />
responses to ethical professional issues related to resuscitation of<br />
patients<br />
C Edward*, J Crosby and P E Preece*; University of Dundee, UK<br />
1200-1215 5 Promoting the use of clinical guidelines in Scotland<br />
Bernice West* and Peter Wimpenny*; Robert Gordon University, Aberdeen, UK<br />
1215-1230 6 Can Neuropsychiatry training be successfully delivered in a multiprofessional<br />
setting?<br />
Andrew Parkin* and Nisha Dogra; University of Leicester, UK<br />
1230-1245 7 The CURATA Partnership: linking CHE to patient care<br />
R L Thivierge*, M Labelle, M Beaulieu and L Bessette; University of Montreal,<br />
Canada<br />
1245-1300 Discussion [Opening Discussant: Dr Janke Cohen-Schotanus]<br />
2M<br />
Monday 3 September<br />
Student Support/Psychiatry and the Curriculum<br />
Chairperson: Dr Jadwiga Mirecka<br />
Room: Teaching Building, Room 1.0105 (First Floor)<br />
1100-1115 1 An evaluation of student support systems at the Medical School at<br />
Queen’s University Belfast<br />
Nicola Wilson, David McCluskey and Mairead Boohan*; Queen’s University of<br />
Belfast, Northern Ireland, UK<br />
- 2.12 -
1115-1130 2 Is student abuse a problem in our medical school?<br />
Ana Maida*, Alicia Vasquez, José Calderon, Viviana Herskovic, Marcela Jacard,<br />
Ana Pereira and Lars Widdel; University of Chile, Santiago, Chile<br />
1130-1145 3 First year medical nursing and pharmacy students’ approaches to study<br />
R J Lamdin* and I Martin; University of Auckland, New Zealand<br />
1145-1200 4 Changing medical students’ attitudes towards homosexuality<br />
Itzchak Levi* and Tsvi Fischel; Sackler Medical School, Tel Aviv, Israel<br />
1200-1215 5 The attitudes to Psychiatry of first year medical students<br />
R K Day; University of Dundee, UK<br />
1215-1230 6 Psychology basic and applied knowledge<br />
Agnete Langagergaard* and Berit Eika; University of Aarhus, Denmark<br />
1230-1300 Discussion [Opening Discussant: Dr Jorgen Nystrup and Ms Mei-Ling Ball]<br />
1300-1400 Lunch – self-service buffet in the Marquee<br />
1400-1600 Session 3: Workshops<br />
3<br />
Monday 3 September<br />
Please see the Abstracts section pages 4.23 to 4.26 for details of these workshops.<br />
Attendance at Conference workshops is free of charge but you are asked to preregister<br />
on the form included with the programme. Lists of participants who have preregistered<br />
and places available will be posted by the registration desk.<br />
3/1 The roles of the teacher<br />
Organisers: Jennifer Laidlaw and Anne Hesketh, SCPMDE Education<br />
Development Unit, Dundee, UK<br />
Room: Teaching Building, 1.0105 (1 st floor)<br />
3/2 The quality of medical education and teaching – thema con<br />
variatione<br />
Organiser: Professor Peter Nippert, University of Muenster, Germany<br />
Room: Teaching Building, 1.0107 (1 st floor)<br />
3/3 From MD to academic teacher<br />
Organiser: Professor Reinhard Putz, University of Munich, Germany<br />
Room: Building 10, Kursraum 5 (lower ground floor)<br />
3/4 Feedback and evaluation: essential activities in the learning process<br />
Organiser: Dr Charles D Puglia, MCP Hahnemann School of Medicine,<br />
Philadelphia, USA<br />
Room: Teaching Building, 2.0101 (2 nd floor)<br />
3/5 Best Evidence Medical Education: progress report<br />
Chairperson: Professor Ian Hart, BEME Collaboration. Contributions from<br />
representatives of BEME Topic Review Groups<br />
Room: Teaching Building, Hörsaal 1 (ground floor)<br />
- 2.13 -
Monday 3 September<br />
3/6 East European Task Force<br />
Chairperson: Professor Ioan Bocsan, Iuliu Hatieganu University of Medicine &<br />
Pharmacy, Romania<br />
Room: Research Building, Besprechungsraum 2.0026 (2 nd floor)<br />
3/7 Making feedback during clerkships meaningful and effective: a<br />
workshop for students and teachers<br />
Organiser: Dr Paul Hemmer, Uniformed Services University of the Health Sciences,<br />
Bethesda, USA<br />
Room: Teaching Building, 2.0104 (2 nd floor)<br />
3/8 Concept mapping<br />
Organiser: Dr Gonul Peker, Ege University School of Medicine, Bornova-Izmir,<br />
Turkey<br />
Room: Teaching Building, Computer Room 2.0103 (2 nd floor)<br />
3/9 Effective student assessment: something old, something new<br />
Organiser: Dr Geoff Norman, McMaster University Medical School, Hamilton,<br />
Canada<br />
Room: Teaching Building 2.0102 (2 nd floor)<br />
3/10 A bachelor-master structure of medical education in Europe?<br />
Organisers: Professor Olle ten Cate, University Medical Centre Utrecht and<br />
Professor Herman van Rossum, University of Groningen, Netherlands<br />
Room: Teaching Building, Horsaal 2 (ground floor)<br />
3/11 The assessment of poorly performing doctors: experiences from the<br />
first three years of the Performance Procedures within the UK<br />
General Medical Council<br />
Organisers: Professor Lesley Southgate, University College London Medical School,<br />
and Dr Peter McCrorie, St George’s Hospital Medical School, London UK<br />
Room: Building 10, Kursraum 6 (lower ground floor)<br />
3/12 What can a general medical journal do for education in medicine?<br />
Sandy Goldbeck-Wood and Dr Ed Peile, University of Oxford, UK<br />
Room: Teaching Building, Horsaal 3 (ground floor)<br />
1600-1615 Coffee served in the foyers of the Teaching and Research Buildings<br />
1615-1715 <strong>AMEE</strong> General Assembly<br />
(Non-members of <strong>AMEE</strong> are also welcome to attend this business meeting of the Association)<br />
Room: Teaching Building, Horsaal1 (ground floor)<br />
1930-2300 River Cruise with buffet and entertainment<br />
(Optional – not included in Conference registration fee – please see page 3.2 for details)<br />
1930 til late Alternative evening for students only!<br />
Dinner and entertainment in the “Lecture Hall Ruin” (see page 3.2 for details)<br />
- 2.14 -
Tuesday 4 September<br />
0800-1715 Registration Desk open<br />
0830-1030 Session 4: Large Group Sessions<br />
4A<br />
Standards and professionalism in medical education<br />
Chairperson: Professor Ian Hart, Canada<br />
Room: Teaching Building, Hörsaal 1 (ground floor)<br />
0830 4A/1 Attempto! Instilling mindful teaching<br />
Dr Maria Lammerding-Köppel, University of Tubingen, Germany<br />
0855 4A/2 Who is afraid of the didactic wolf? A plea for professionalism in<br />
medical education and specialist training<br />
Professor Rein Zwierstra, University of Groningen, Netherlands<br />
0920 4A/3 What’s good about ‘Best Evidence Medical Education’ (BEME)<br />
Professor Ralph Bloch, Institute for Medical Education, University of Bern,<br />
Switzerland<br />
0945 Discussion<br />
4B<br />
International aspects of standards<br />
Chairperson: Professor Ronald Harden, UK<br />
Room: Teaching Building, Horsaal 2 (ground floor)<br />
0830 4B/1 The challenge of developing international standards in medical<br />
education<br />
Dr Andrzej Wojtczak, Institute for International Medical Education, New York,<br />
USA, and Dr M Roy Schwarz, China Medical Board of New York<br />
0855 4B/2 Globalisation of medical education: the concept of international<br />
standards<br />
Dr Hans Karle, World Federation for Medical Education, Copenhagen, Denmark<br />
0920 Discussion<br />
Tuesday 4 September<br />
- 2.15 -
4C<br />
Standards and the curriculum<br />
Chairperson: Professor Herman van Rossum, Netherlands<br />
Room: Teaching Building, Hörsaal 3 (ground floor)<br />
0830 4C/1 Learning can be fun! The student’s experience of standards in a new<br />
curriculum<br />
Anke Neuwirth and Johannes Meier, 2 nd year students in the Reformed Medical<br />
Curriculum, Charité, Medical Faculty of the Humboldt-University, <strong>Berlin</strong>, Germany<br />
0855 4C/2 The advantages of longitudinal evaluation of the medical<br />
curriculum<br />
Professor Reinhard Pabst, Medical School of Hannover, Germany<br />
0920 4C/3 Standards and assessment<br />
Professor Miriam Friedman Ben-David, University of Dundee, UK<br />
0945 Discussion<br />
1030-1100 Coffee served in the foyers of the Teaching and Research Buildings<br />
1100-1300 Session 5: Short Communications<br />
5A<br />
Tuesday 4 September<br />
13 simultaneous themed sessions on a range of topics:<br />
Learning and the Internet<br />
Chairperson: Professor Dieter Scheffner<br />
Room: Teaching Building, Hörsaal 1 (Ground Floor)<br />
1100-1115 1 The “dos and don’ts” of e-learning in medicine: experiences of a<br />
CD-ROM production<br />
P Langkafel*, A Oehlsen, U Arnold and J W Dudenhausen; Humboldt University<br />
<strong>Berlin</strong>, Germany<br />
1115-1130 2 Online guide to basic surgical skills: http://olc.chirurgiegoettingen.de<br />
S Koenig*, P Wagner, D Zeiss, P M Markus and H Becker; Georg-August-<br />
University Goettingen, Germany<br />
1130-1145 3 Standards for an international distributed online case repository<br />
Chris Candler*, Colin Melville and Dave Collins; University of Oklahoma,<br />
Oklahoma City, USA<br />
1145-1200 4 Digital study of medicine<br />
U Arnold*, P Langkafel, L Peppel, I Reisinger and J W Dudenhausen; Humboldt<br />
University <strong>Berlin</strong>, Germany<br />
1200-1215 5 Electronic learning objects and resource discovery<br />
David A Davies; University of Birmingham, UK<br />
- 2.16 -
1215-1230 6 Filling a curriculum map with Reusable Learning Objects<br />
N K McManus *, R M Harden, D Davidson, S Khogali and J M Laidlaw;<br />
SCPMDE Education Development Unit, Dundee, UK<br />
1230-1300 Discussion [Opening Discussant: Professor Ralph Bloch]<br />
5B<br />
Tuesday 4 September<br />
Evaluation of Problem-based Learning<br />
Chairperson: Professor Reinhard Pabst<br />
Room: Teaching Building, Hörsaal 2 (Ground Floor)<br />
1100-1115 1 Changing to PBL: does it have an effect on junior doctors’<br />
conceptualisation of communication skills?<br />
P A O’Neill*, S C Willis and A Jones; University of Manchester, UK<br />
1115-1130 2 How do medical students characterize good problem-based<br />
learning (PBL) tutoring after a year’s experience?<br />
Gillian Maudsley; University of Liverpool, UK<br />
1130-1145 3 Predicting outcome by behaviour in PBL groups?<br />
Kristin Wigen*, Are Holen, Øyvind Ellingsen and Hansjørg Hohr; Norwegian<br />
University of Technology and Science, Trondheim, Norway<br />
1145-1200 4 Student evaluation of a problem-based learning module into an<br />
occupational therapy course<br />
Deirdre Connolly* and Morag Donovan; Trinity College Dublin, Dun Laoghaire,<br />
Ireland<br />
1200-1215 5 Evaluation of student performance in the problem based learning<br />
(PBL) group<br />
David C M Taylor, The Physiological Laboratory, University of Liverpool, Crown<br />
Street, Liverpool L69 3BX, UK<br />
1215-1230 6 Influence of tutor qualification on test achievement and student<br />
evaluation in a problem-based course of basic pharmacology<br />
J Matthes*, B Marxen, R-M Linke, W Antepohl, W Lehmacher and S Herzig;<br />
University of Cologne, Germany<br />
1230-1245 7 Individual perceptions of group learning and functioning in a<br />
problem-based learning programme<br />
Janet MacDonald; University of Wales College of Medicine, Cardiff, UK<br />
1245-1300 Discussion [Opening Discussant: Dr Jacques Des Marchais]<br />
- 2.17 -
5C<br />
Curriculum Evaluation<br />
Chairperson: Dr Kirsti Lonka<br />
Room: Teaching Building, Hörsaal 3 (Ground Floor)<br />
1100-1115 1 A course programme evaluation: contribution of students’ selfevaluation<br />
Carlota Saldanha*, Jorge Lima and Joao Martins-Silva; Institute of Biochemistry,<br />
University of Lisbon, PORTUGAL<br />
1115-1130 2 A national evaluation of the reforms to higher specialist training in<br />
the UK: methodological issues<br />
Janet Grant*, Rodney Gale, Mairead Beirne and Heather Owen; Open University<br />
Centre for Education in Medicine, Milton Keynes, UK<br />
1130-1145 3 Evaluation of PME courses in General Practice in Germany<br />
S Wilm*, R Jahromi, S Krause and B Hemming; Heinrich-Heine University,<br />
Duesseldorf, Germany<br />
1145-1200 4 The Matrix: a visual presentation of registrar term evaluation<br />
Richard Tarala and Alistair Vickery; Royal Perth Hospital, Australia<br />
1200-1215 5 Site visits as a method to assess the educational quality of<br />
clerkships<br />
Janke Cohen-Schotanus* and Rein P Zwierstra; University of Groningen, Netherlands<br />
1215-1230 6 Impact of a new curriculum on the clinical competence of medical<br />
students at the University of Barcelona Medical School (UBMS)<br />
Ramon Pujol*, Frederic Manresa, Francesc Gudial, Eduard Kranfly, Josep Ma<br />
Martinez Carsetera; University of Barcelona, Spain<br />
1230-1245 7 Lessons learnt in designing and implementing a curriculum<br />
evaluation<br />
Helen Graham* and Mary Seabrook; GKT School of Medicine, London, UK<br />
1245-1300 Discussion [Opening Discussant: Professor Geoff Norman and Ms Susanne Pruskil]<br />
5D<br />
Tuesday 4 September<br />
Assessing Communication Skills/Patients as Examiners<br />
Chairperson: Dr Andre de Champlain<br />
Room: Research Building, Hörsaal 4 (Ground Floor)<br />
1100-1115 1 Detecting rater bias on a measure of spoken English proficiency<br />
Marta van Zanten*, Danette McKinley, John Boulet and Gerald Whelan;<br />
ECFMG, Philadelphia, USA<br />
1115-1130 2 Comparison of communication skills in residency with performance<br />
on ECFMG Clinical Skills Assessment<br />
W Burdick*, J Boulet, S Peitzman, G Whelan and D Brody; ECFMG, Philadelphia,<br />
USA<br />
1130-1145 3 ACT: a new computer-assisted assessment (CAA) method for<br />
communication-skills of medical students<br />
R L Hulsman* and J D Donnison-Speijer; Academic Medical Centre, Amsterdam,<br />
Netherlands<br />
- 2.18 -
1145-1200 4 How accurate is lay person assessment of clinical competence of<br />
student doctors? Comparison of the assessment of medical<br />
students by Faculty and Standardized Patients during the Objective<br />
Structured Clinical Examination<br />
P Heasman*, K Pitkala and N Paganus; University of Helsinki, Finland<br />
1200-1215 5 Do Simulated Patients grade inter-personal skills as well as<br />
Faculty?<br />
A S Arora*, N Natt, S Kluck and R Tiegs; Mayo Foundation, Rochester, USA<br />
1215-1230 6 The contribution of non medical assessors to the assessment of<br />
poorly performing doctors<br />
Lesley Southgate* and Peter McCrorie; University College London Medical School,<br />
London, UK<br />
1230-1245 7 Assessment in the elective clinical rotation: centrally reviewed case<br />
reports<br />
W M Molenaar*, S A Koopmans, M D Talsma and L H van Essen: University of<br />
Groningen, Netherlands<br />
1245-1300 Discussion [Opening Discussant: Dr Wolfram Antepohl]<br />
5E<br />
Tuesday 4 September<br />
Postgraduate Education for General Practice/<br />
Family Medicine<br />
Chairperson: Dr Kwee Matheson<br />
Room: Building 10, Hörsaal 6 (Ground Floor)<br />
1100-1115 1 An educational approach to significant event auditing in primary care<br />
J McKay* and P Bowie; University of Glasgow, UK<br />
1115-1130 2 Postgraduate education for generalist physicians<br />
J F Perez Gonzalez* and M Requena; Universidad Central de Venezuela, Caracas,<br />
Venezuela<br />
1130-1145 3 Barriers to change in postgraduate medical education in General<br />
Practice<br />
B W McGuinness; Queen Elizabeth Hospital, Swaffham, UK<br />
1145-1200 4 The use of video in General Practice Registrar training and assessment<br />
C M Wiskin, Stephen Field* and John Skelton; West Midland GP Unit,<br />
Birmingham, UK<br />
1200-1215 5 The consultation styles of female GP Registrars with male and<br />
female patients<br />
Sarah Hillman* and John Skelton; University of Birmingham, UK<br />
1215-1230 6 The development, implementation and evaluation of a ‘concordance’<br />
training course<br />
Jon Dowell*, Claudia Pagliari and Sean McAleer; University of Dundee, UK<br />
1230-1245 7 A linguistic study of information-giving in 30 doctor-patient<br />
consultations<br />
Andy Shanks* and John Skelton; University of Birmingham, UK<br />
1245-1300 Discussion [Opening Discussant: Professor Graham Buckley]<br />
- 2.19 -
5F<br />
Assessment<br />
Chairperson: Dr Robert Galbraith<br />
Room: Teaching Building, Mikroscopierraum (First Floor)<br />
1100-1115 1 Objective Structured Preclinical Exams (OSPE): a new test format of<br />
summative student assessment in the Problem-Based Learning (PBL)<br />
curriculum at the Faculty of Medicine of the University of Bern<br />
Barbara Stadelmann*, R Hofer, Urs Brodbeck and Ara Tekian; University of<br />
Bern, Switzerland<br />
1115-1130 2 The quality of an extended-matching multiple choice examination<br />
J Beullens*, B Van Damme, H Jaspaert, E Struyf and P J Janssen; K.U.Leuven,<br />
Belgium<br />
1130-1145 3 Evaluation of a five-dimensional assessment strategy within a<br />
problem-based learning medical curriculum<br />
Paul Julian*, Scott Reeves* and Alistair Lumb*; Barts & The London School of<br />
Medicine & Dentistry, London, UK<br />
1145-1200 4 A preclinical exam to assess the networked structure of knowledge<br />
on basic science in the Universidad Nacional de Cuyo (Argentina)<br />
Ana Maria Reta*, Maria del Carmen Montbrun and Maria José Lopez;<br />
Universidad Nacional de Cuyo, Mendoza, Argentina<br />
1200-1215 5 Predictive value for academic performance of two assessment<br />
devices applied to medical students<br />
Ma Eugenia Ponce de León C*, Armando Ortiz and M del Carmen Ruiz Alcocer;<br />
National Autonomous University of Mexico, Mexico<br />
1215-1230 6 Self-assessed clinical skills levels of newly graduated physicians in<br />
relation to an intended curriculum<br />
A M Moercke* and B Eika; University of Aarhus, Denmark<br />
1230-1245 7 The dynamics of knowledge structure of graduating medical<br />
students based on results of the Medical Licensing Examination<br />
M Mrouga*, Y Bogachkov and L Artemchuk; Testing Board, Kyiv, UKRAINE<br />
1245-1300 Discussion [Opening Discussant: Professor John Cookson]<br />
5G<br />
Tuesday 4 September<br />
Outcome-based Education<br />
Chairperson: Dr Jordan Cohen<br />
Room: Teaching Building, Room 2.0102 (Second Floor)<br />
1100-1115 1 The Scottish Learning Outcomes Project Phase II - Assessment:<br />
“the proof of the pudding”<br />
Jacqueline Furnace* and John Simpson*, on behalf of Scottish Deans’ Medical<br />
Curriculum Group; University of Aberdeen, UK<br />
1115-1130 2 Recent developments in an outcome-led curriculum<br />
Nick Ross; University of Birmingham, UK<br />
- 2.20 -
1130-1145 3 A New Instrument of curriculum development: Curriculum as a<br />
function of professional outcomes<br />
I Bulakh*, Y Voronenko and I Filonchuk; Testing Board and National Medical<br />
University, Kyiv, Ukraine<br />
1145-1200 4 Focusing on learning outcomes for the Preregistration House<br />
Officer (PRHO) year<br />
E A Hesketh* and M S Allan; Education Development Unit, Dundee, UK<br />
1200-1215 5 The ACGME Outcome Project: a model resident assessment system<br />
Susan Swing; ACGME, Chicago, USA<br />
1215-1230 6 Development of an outcome-based clinical curriculum at<br />
International Medical University (IMU), Malaysia<br />
J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, K H Ong, C M K<br />
Patrick and Q Akhtar; International Medical University, Selangor, Malaysia<br />
1230-1245 7 An evaluation of the internal validity of specific learning outcomes<br />
in phase II of a revised undergraduate medical curriculum<br />
F J Cilliers* and E M Bitzer; University of Stellenbosch, Tygerberg, South Africa<br />
1245-1300 Discussion [Opening Discussant: Professor Miriam Friedman]<br />
5H<br />
Tuesday 4 September<br />
Educational Strategies/Curriculum Planning<br />
Chairperson: Professor G Gaedicke<br />
Room: Teaching Building, Room 2.0101 (Second Floor)<br />
1100-1115 1 Structural changes approaching medical education in The<br />
Netherlands<br />
Olle Th.J. ten Cate*, Herman J M van Rossum and Albert J J A Scherpbier;<br />
Utrecht University, Netherlands<br />
1115-1130 2 Implementation of PBL-Based Curriculum<br />
Maria Montbrun* and Enrique Guntsche; Universidad Nacional de Cuyo,<br />
Mendoza, Argentina<br />
1130-1145 3 An overview of the implementation of curriculum 2001 at Nelson R<br />
Mandela School of Medicine, University of Natal<br />
Veena Singaram*, Jacqueline van Wyk, Michelle McLean and Peter Olmesdahl;<br />
University of Natal, South Africa<br />
1145-1200 4 Self-directed, self-organized case-based-learning in final year<br />
students<br />
Jana Junger, Christiane Roth, Stephan Zipfel, Wolfgang Eich and Wolfgang Herzog;<br />
University of Heidelberg, Germany<br />
1200-1215 5 Changing to ‘self-induced learning’ in a speech therapy department<br />
Martin Peleman; Arteveldehogeschool, Gent, Belgium<br />
1215-1230 6 Student participation in the organization of education at a medical<br />
school - a comparison of two South African cases<br />
B G Lindeque and Pierre L Bredenkamp*; Stellenbosch University, Tygerberg,<br />
South Africa<br />
- 2.21 -
1230-1245 7 Preparing the way: encouraging clinical tutors to be co-producers in<br />
the learning process<br />
Peter Barton* and Jillian Morrison; University of Glasgow, UK<br />
1245-1300 Discussion [Opening Discussant: Dr Peter McCrorie]<br />
5I<br />
Educating the Educators<br />
Chairperson: Professor Hywel Thomas<br />
Room: Teaching Building, Room 2.0104 (Second Floor)<br />
1100-1115 1 How to help clinical and multimedia staff develop joint programs<br />
Eleanor Flynn; University of Melbourne, Australia<br />
1115-1130 2 “Getting Started in Clinical Teaching” - a staff development initiative<br />
J A Dent* and P E Preece; University of Dundee, UK<br />
1130-1145 3 Governance in medical teaching: pilot study<br />
Iain Robbé; University of Wales College of Medicine, Cardiff, UK<br />
1145-1200 4 The role of an education unit in health professional education:<br />
proactive or responsive<br />
Margaret Horsburgh* and Rain Lamdin; University of Auckland, New Zealand<br />
1200-1215 5 Beyond teacher training; the construction of a faculty development<br />
strategy<br />
Patricia Rosado Pinto* and Ramiro Avila; Faculty of Medical Sciences, Lisbon,<br />
Portugal<br />
1215-1230 6 The profile of the perfect teaching professor<br />
F Scheele*, J Th M van der Schoot and A J Goverde; St Lucas Andreas Hospital,<br />
Amsterdam, Netherlands<br />
1230-1245 7 Evidence retrieval in medical education: obstructions and<br />
opportunities<br />
Alex Haig; SCPMDE Education Development Unit, Dundee, UK<br />
1245-1300 Discussion [Opening Discussant: Dr John Nicholls]<br />
5J<br />
Tuesday 4 September<br />
Education and Cultural Diversity<br />
Chairperson: Dr Brigitte Grether<br />
Room: Building 10, Room 1.0107 (Lower Ground Floor)<br />
1100-1115 1 The development and evaluation of a programme to teach cultural<br />
diversity to medical undergraduate students<br />
Nisha Dogra; University of Leicester, UK<br />
1115-1130 2 Aboriginal health: a tool in the process of reconciliation?<br />
G Garvey* and I E Rolfe*; University of Newcastle, Callaghan, Australia<br />
- 2.22 -
1130-1145 3 Valuing diversity: The effectiveness of a roleplay workshop as part<br />
of a newly introduced community based diversity module<br />
Sue Conning*, Alison Hooper, Margot Turner and Val Wass; GKT School of<br />
Medicine, London, UK<br />
1145-1200 4 Using negative role models positively<br />
S E Gull* and K H Matheson; Bury St Edmunds, UK<br />
1200-1215 5 What factors influence underrepresented minority (URM) students in<br />
their choice of medical schools?<br />
Ara Tekian*, Laura Hruska and Mark Urosev; University of Illinois at Chicago,<br />
Chicago IL 60612, USA<br />
1215-1230 6 Education for professionalism in medicine<br />
Geoffrey Westwood* and Barbara Westwood; Bankstown Health Service, Australia<br />
1230-1245 7 Characteristics of students admitted for the medical course at<br />
Faculty of Medicine of Ribeirao Preto, University of Sao Paulo,<br />
Brazil<br />
A R L Cianflone*, M F A Colares, J F C Figueiredo, M L V Rodrigues and L E de<br />
A Troncon; Faculty of Medicine of Ribeirao Preto, Brazil<br />
1245-1300 Discussion [Opening Discussant: Dr Angel Centeno]<br />
5K<br />
Tuesday 4 September<br />
Contexts for Learning<br />
Chairperson: Dr Abdulwahab Telmesani<br />
Room: Building 10, Room 1.0105 (Lower Ground Floor)<br />
1100-1115 1 Clinical education in the health care professions: a critical analysis<br />
of the literature<br />
Alison Rushton; Coventry University, UK<br />
1115-1130 2 “Contracts for Learning”: project to improve the quality of<br />
attachments at a District General Hospital<br />
Richard Ayres*, Henry Averns and Lin Sanders; Northern Devon Healthcare<br />
Trust, Barnstaple, UK<br />
1130-1145 3 Does the dedicated teaching environment in ambulatory care<br />
improve acquisition of learning outcomes?<br />
Clare I L Stewart*, Paul E Preece and John A Dent; University of Dundee, UK<br />
1145-1200 4 Could we improve on what patients our pediatrics students saw in<br />
outpatient clinics?<br />
Pedro Herskovic*, Alicia Vasquez, Cristian Breinbauer, Patricia Gomez, Viviana<br />
Herskovic, Marcela Jacard, Claudio Missarelli and Erika Troncoso; University of<br />
Chile, Santiago, Chile<br />
1200-1215 5 Using the ward round for teaching and learning: how do junior<br />
doctors learn from consultants through ward-based teaching?<br />
Alan Bleakley; Cornwall Postgraduate Education Centre, Truro, UK<br />
1215-1230 6 Clinical skills training needs of final year medical students and<br />
PRHOs - A comparison<br />
D MacLeod*, E Gill, J Gate and J Rees; University Hospital Aintree, Liverpool, UK<br />
- 2.23 -
1230-1245 7 The impact of a precepted diabetic foot care program<br />
Linda Z Nieman, Lewis E Foxhall*, Frank Sifuentes and Lee Cheng; University of<br />
Texas Houston Health Science Center, USA<br />
1245-1300 Discussion [Opening Discussant: Professor Amanda Howe]<br />
5L<br />
Evaluation of Multiprofessional Education<br />
Chairperson: Dr Pia Forsberg<br />
Room: Teaching Building, Room 1.0107 (First Floor)<br />
1100-1115 1 The benefits of a multiprofessional education programme can be<br />
sustained<br />
G J Mires*, F L R Williams, R M Harden and P W Howie; University of Dundee, UK<br />
1115-1130 2 Self-directed multiprofessional continuing medical education with<br />
facilitators: an experiment in four European countries. The Belgian<br />
story<br />
J Goedhuys*, C Geens, N Mathers, K Billingham, G Maso and O Solas-Gaspar;<br />
Catholic University Leuven, Belgium<br />
1130-1145 3 Interprofessional education in a clinical and non-clinical<br />
environment: Teachers’ and learners’ perspectives<br />
John Jenkins and Sue Morison*; Queen’s University Belfast, UK<br />
1145-1200 4 Interprofessional education: experiences of students<br />
J Agsteribbe*, R M H Schaub and J Cohen-Schotanus; University of Groningen,<br />
Netherlands<br />
1200-1215 5 “Capturing the learning”: the development of interprofessional<br />
education in the Faculty of Medicine, Health and Biological<br />
Sciences, University of Southampton<br />
D Humphris* and S Colly; University of Southampton, UK<br />
1215-1230 6 Learning interprofessionally: a review of experiences<br />
A Le May*, F Kitsell, I Giles and C Stephens; University of Southampton, UK<br />
1230-1245 Discussion [Opening Discussant: Dr Gary Mires]<br />
5M<br />
Tuesday 4 September<br />
Teaching about EBM, Critical Thinking and Research<br />
Chairperson: Professor Florian Eitel<br />
Room: Teaching Building, Room 1.0105 (First Floor)<br />
1100-1115 1 Questions as the key to knowledge: teaching medical students in<br />
Evidence-Based Medicine<br />
Jonna Skov Madsen*, Birgitta Wallstedt, Carl Joakim Brandt and Mogens Horder;<br />
Odense University Hospital, Denmark<br />
1115-1130 2 Teaching Evidence-Based Medicine to healthcare professionals:<br />
implementing and evaluating the programme<br />
C Osonnaya*, K Osonnaya and E Burke; University of London, UK<br />
- 2.24 -
1130-1145 3 Impact of a short interactive curriculum on medical students’<br />
appreciation of EBM and CAM<br />
Samuel N Forjuoh*, Robert A Henry, Terry G Rascoe, Barb Symm and Janine C<br />
Edwards; Texas A & M University, Temple, USA<br />
1145-1200 4 Annual Students-Congress of Medicine (SCM): a tool for scientific<br />
education in the medical curriculum<br />
E J M van Gils*, M H J Maathuis, G J Navis and R H Henning; University of<br />
Groningen, Netherlands<br />
1200-1215 5 What do medical graduates think about their earlier research<br />
projects now?<br />
Saeed Asefzadeh; Qazvin University of Medical Sciences, Iran<br />
1215-1230 6 Research and the use of computers in the new curriculum of the<br />
University of Vienna Medical School<br />
Richard Marz* and Robert Trappl; University of Vienna, Austria<br />
1230-1245 7 Experimental courses in Biochemistry - initiation to scientific<br />
research in undergraduate medicine<br />
Carlota Saldanha*, Rui Mesquita and J Martins-Silva; University of Lisbon, Portugal<br />
1245-1300 Discussion [Opening Discussant: Dr Sharon Krackov]<br />
1300-1400 Lunch in the Marquee<br />
1400-1700 Session 6: Workshops<br />
6<br />
Tuesday 4 September<br />
Please see the Abstracts section pages 4.51 to 4.55 for details of these workshops.<br />
Attendance at Conference workshops is free of charge but you are asked to preregister<br />
on the form included with the programme. Lists of participants who have preregistered<br />
and places available will be posted by the registration desk.<br />
Note: coffee will be available between 1530-1600 hrs in the foyers of the Teaching<br />
and Research Buildings<br />
6/1 Basic Skills Faculty Development Workshop<br />
Dr Anita Duhl Glicken, University of Colorado School of Medicine, Denver, USA<br />
Room: Building 10, Kursraum 6 (lower ground floor)<br />
6/2 An Introduction to Clinical Judgment Analysis<br />
Dr Anthony LaDuca, National Board of Medical Examiners, Philadelphia, USA<br />
Room: Teaching Building, Computer Room, 2.0103 (2 nd floor)<br />
6/3 Nordic Federation for Medical Education<br />
Chairperson: Dr Eivind Drange<br />
Room: Teaching Building, Horsaal 1<br />
- 2.25 -
Tuesday 4 September<br />
Note: all participants welcome at the Plenary and the Workshop<br />
Plenary (1400-1445 ): Reform in a Medical School – needed, wanted,<br />
possible?<br />
Dr Kirsti Lonka, Director, Development and Research Unit, Faculty of Medicine,<br />
University of Helsinki/ Professor in Medical Education Karolinska Institutet, Sweden<br />
Workshop (1500-1545): NFME and <strong>AMEE</strong> – do we need them both?<br />
A discussion of the future role of NFME and possible co-operation with <strong>AMEE</strong>. The<br />
workshop will start with a closed debate among the panel followed by an open discussion.<br />
Panel: Dr Jørgen Nystrup, Dr Dagfinn Øgreid (chair NFME), Dr Kirsti Lonka,<br />
Professor Jörgen Nordenström<br />
Moderator: Eivind Drange<br />
Closed meeting (1600-1700): Extraordinary General Assembly, NFME<br />
6/4 Bedside Cardiology Skills Training, featuring “Harvey”, The<br />
Cardiology Patient Simulator and the UMedic Computer System<br />
Organisers: Dr Michael S. Gordon, University of Miami School of Medicine, and<br />
Dr Joel M Felner, Emory University School of Medicine, USA<br />
Room: Teaching Building, 2.0101 (2 nd floor)<br />
6/5 Risk management in medical education<br />
Directors of Research in Postgraduate Medical Education Group<br />
Organisers: Dr Kwee Matheson, West Suffolk Hospital, UK, Dr Alistair Thomson<br />
and Dr Andrew Long<br />
Room: Teaching Building, 1.0105 (1 st floor)<br />
6/6 The professional and organisational culture of medical education –<br />
an exploratory workshop in the context of an interactive exhibition<br />
Organisers: Dr Elizabeth Krajic Kachur, Medical Education Development, New<br />
York, USA, Dr Nobaturo Ban and Hannah Kedar<br />
Room: Research Building Horsaal 4 (ground floor)<br />
The exhibition linked to this workshop will be set up in Research Building, 1.0020 1st floor<br />
6/7 Students teaching communication skills<br />
Organisers: Students from Charité, Humboldt-University of <strong>Berlin</strong>, Germany<br />
Room: Building 8, Seminarraum 2 (1 st floor)<br />
6/8 Developing professional attitudes: theory, practice and evaluation<br />
Organiser: Professor Amanda Howe, University of East Anglia, UK<br />
Room: Teaching Building, 1.0107 (1 st floor)<br />
6/9 <strong>AMEE</strong>/IberoAmerican Network<br />
Chairperson: Professor Margarita Barón-Maldonado, <strong>AMEE</strong><br />
Room: Teaching Building, Hörsaal 3 (ground floor)<br />
6/10 Problem-based Learning<br />
Organisers: Dr Stewart Mennin and Dr Scott Obenshain, University of New<br />
Mexico, Albuquerque, USA<br />
Room: Teaching Building, 2.0102 (2 nd floor)<br />
- 2.26 -
Tuesday 4 September<br />
6/11 Portfolio as a Method of Student Assessment<br />
Organiser: Dr Miriam Friedman Ben-David, University of Dundee, UK<br />
Room: Teaching Building, 2.0104 (2 nd floor)<br />
6/12 Learning Needs Assessment in undergraduate and postgraduate<br />
medical education<br />
Organiser: Professor Janet Grant, Open University, UK<br />
Room: Building 10, Kursraum 5 (lower ground floor)<br />
6/13 A European core curriculum?<br />
Organiser: Professor Lennart Bouman, Netherlands<br />
Room: Teaching Building, Hörsaal 2 (ground floor)<br />
1930-2230 Gala Dinner at the Aquarium (Zoologischer Garten Aquarium)<br />
(Not included in the registration fee – see page X for details)<br />
- 2.27 -
Wednesday 5 September<br />
0830-1000 Session 7: Poster presentations<br />
7A<br />
Wednesday 5 September<br />
12 simultaneous themed sessions. Please meet in the rooms listed below. Participants<br />
each have two minutes to introduce themselves and their posters. The groups will<br />
then move to the poster location where a discussion will take place.<br />
New Learning Technologies<br />
Chairperson: DrNick Ross<br />
Meet in: Teaching Building, Hörsaal 1 (ground floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7A1 An International web-based Master’s degree in Primary Care<br />
Peter Toon* and Trish Greenhalgh; University College London, UK<br />
7A2 Can practical courses on interpreting blood smears be substituted<br />
by an interactive, web-based learning programme?<br />
U Woermann*, A Tobler and M Montandon; University of Bern,<br />
SWITZERLAND<br />
7A3 The management of student feedback using the World Wide Web<br />
Stephanie Cobb* and Helen Graham; Guy’s, King’s and St Thomas’ School of<br />
Medicine, London, UK<br />
7A4 Web-based student feedback on large group teaching: how does it<br />
compare with traditional paper methods?<br />
Helen Graham* and Stephanie Cobb; Guy’s, King’s and St Thomas’ School of<br />
Medicine, London, UK<br />
7A5 Reflection on experiences by using trigger movies<br />
Marianne G Nijnuis*, Caro Brumsen, Jan H Bolk and Peter G M de Jong;<br />
Leiden University Medical Center, Leiden, NETHERLANDS<br />
7A6 Provision of IT learning facilities for healthcare education<br />
C Osonnaya*, K Osonnaya and E Burke; University of London, UK<br />
7A7 Development and evaluation of an interactive Computer Assisted<br />
Learning (CAL) programme on vaginal hysterectomy<br />
Vikram Jha*, Shelley Widdowson, Sean Duffy and Keith Allenby; St James’s<br />
University Hospital, Leeds, UK<br />
7A8 Links from ultrasound to anatomy - how is a multimedia teacher<br />
accepted?<br />
Dietmar Borchert*, Gunnar Schley, Edda Klotz, Peter Rauh, Clemens Reisinger<br />
and Thomas Medveczky; Humboldt-University of <strong>Berlin</strong>, GERMANY<br />
7A9 Development of a Computer-Based Simulation; the Dynamic<br />
Patient Simulator<br />
S Eggermont*, P M Bloemendaal, J M van Baalen, E M Schoonderwaldt;<br />
Leiden University Medical Center, NETHERLANDS<br />
- 2.28 -
7B<br />
Wednesday 5 September<br />
7A10 Introduction of laptop computers in Leiden Medical School<br />
Peter G M de Jong*, Hermiette E Idenburg and Henk L Hendrix; Leiden University<br />
Medical Center LUMC, Leiden, NETHERLANDS<br />
Problem-based Learning<br />
Chairperson: Dr Stewart Mennin<br />
Meet in: Teaching Building, Hörsaal 2 (ground floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7B1 Measuring success: partnership in evaluation (work in progress<br />
report)<br />
P O’Neill, D Graham, A Garden, S. Watmough*, J Brown; Universities of<br />
Liverpool, Manchester and Mersey Deanery, UK<br />
7B2 A new PBL course with an examination with standardised patients<br />
at the end<br />
S Schewe*, C Mueller and R Putz; Ludwig-Maximilians-Universitat, Munich,<br />
GERMANY<br />
7B3 Training the Problem-Based Learning tutor: implementation issues<br />
C Osonnaya*, K Osonnaya and E Burke; University of London, UK<br />
7B4 PBL in Psychiatry - the Holocaust. A unique experience<br />
T Fischel*, T Weizman and G Zalsman; Geha Psychiatric Center, Ramat Gan,<br />
ISRAEL<br />
7B5 Clinical skills of medical students participating in lecture-based<br />
versus problem-oriented training<br />
W Rimpau; Park-Klinik Weissensee, <strong>Berlin</strong>, GERMANY<br />
7B6 Systematic observations of problem-based study groups - what do<br />
they reveal?<br />
K Lonka*, P Sauri and N Paganus; University of Helsinki, FINLAND<br />
7B7 “Pathomechanisms” - a 9-week integrative and problem-based<br />
learning oriented course within the 3rd year of the curriculum at the<br />
Medical Faculty Carl Gustav Carus, Technical University Dresden<br />
Oliver Tiebel*, Ines Nitsche and Andreas Deussen for the Core Planning Group;<br />
Medical Faculty, Carl Gustav Carus, Technical University, Dresden, GERMANY<br />
7B8 Characteristics of tutors’ assessment by students when PBL is<br />
being implemented<br />
Yolanda Marin-Campos* and Marcela Lopez-Cabrera; National Autonomous<br />
University of Mexico, MEXICO<br />
7B9 From traditional teachers to PBL tutors: how to start the change?<br />
Yolanda Marin-Campos* and Lizbeth Mendoza-Morales; National Autonomous<br />
University of Mexico, MEXICO<br />
7B10 Development of a problem-based curriculum leads to enhancement<br />
in faculty development - The Dresden experience<br />
N Lorenz*, T Aretz, E Armstrong and the Harvard-Dresden Medical Education<br />
Alliance; Technical University, Dresden, GERMANY<br />
- 2.29 -
7C<br />
Wednesday 5 September<br />
7B11 An orientation programme for 1st year students in a problemorientated<br />
MBChB curriculum - the Pretoria experience<br />
Pierre L Bredenkamp; Stellenbosch University, Tygerberg, SOUTH AFRICA<br />
Curriculum Planning and Change<br />
Chairperson: Dr Reg Dennick<br />
Meet in: Teaching Building, Hörsaal 3 (ground floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7C1 A model of curriculum management in an integrated medical<br />
curriculum<br />
Gregory J S Tan* and B E Mustaffa; International Medical University, Kuala<br />
Lumpur, MALAYSIA<br />
7C2 The University of Rochester’s Double Helix Curriculum<br />
Elaine F Dannefer; University of Rochester Medical Center, Rochester, USA<br />
7C3 Academic administration and mixed programmes<br />
S Sharma Khanal* and S Koirala; B P Koirala Institute, Dharan, NEPAL<br />
7C4 Learning responsibly - implementing written guidelines for medical<br />
students<br />
Richard Phillips*, Ann Wylie and Anne Stephenson; Guy’s, King’s & St Thomas’<br />
Medical School, London, UK<br />
7C5 HEICUMED - a novel approach to student medical education at the<br />
Medical Faculty of the University of Heidelberg, Germany<br />
Hubert J Bardenheuer* on behalf of the HEICUMED Group; University of<br />
Heidelberg, GERMANY<br />
7C6 Enhancing curriculum renewal through a “clinical presentation”<br />
approach to undergraduate medical education<br />
Nehad El-Sawi; University of Health Sciences, Kansas City, USA<br />
7C7 Continuous training in General Practice as an integral part of an<br />
undergraduate medical curriculum - the Witten/Herdecke Model<br />
(Germany)<br />
W Kunstmann*, Dieter Wollgarten, René Vollenbroich and Markus Gschwind;<br />
University of Witten/Herdecke, Witten, GERMANY<br />
7C8 Developing sense of ownership for curriculum changes within all<br />
teaching faculty of an Asian medical school<br />
C B Hazlett*, T F Fok, S S C Chung and J C Y Cheng; Chinese University of<br />
Hong Kong, Shatin, HONG KONG<br />
7C9 Sci45: Framework for the implementation of a career guidance<br />
instrument<br />
Janet Grant*, Rodney Gale, Mairead Beirne and Heather Owen; Open University<br />
Centre for Education in Medicine, MILTON KEYNES, UK<br />
7C10 The facilitation process in a problem-based curriculum at the<br />
Nelson R. Mandela School of Medicine<br />
Jacqueline van Wyk, Peter Olmesdahl, Veena Singaram* and Michelle McLean;<br />
University of Natal, Durban, SOUTH AFRICA<br />
- 2.30 -
7D<br />
7E<br />
Wednesday 5 September<br />
Curriculum Evaluation/Staff Development<br />
Chairperson: Professor Miriam Friedman<br />
Meet in: Research Building, Hörsaal 4 (ground floor)<br />
Poster location: Teaching Building, 1st floor<br />
7D1 Students’ feedback: a Public Health course in medical education<br />
Eva Rasky*, Wolfgang Freidl; Willibald-Julius Stronegger; Karl-Franzens-<br />
University, Graz, AUSTRIA<br />
7D2 Action Research Methodology: a possible framework for course<br />
evaluations<br />
Alison Rushton* and Gill James; Coventry University, Coventry, UK<br />
7D3 The opinion of the graduates of the Faculty of Medicine of the<br />
University of Barcelona on the new medical curriculum<br />
J Palés*, A Gual, A Vallés, Ma T Estrach, F Climent, X Gasull, R Gilabert, A Llobet,<br />
Y Compta, L Peri and J A Bombi; Universitat de Barcelona, Barcelona, SPAIN<br />
7D4 Comenius University Quality Assurance System (CUQAS) and<br />
students’ participation in graduate medical education evaluation<br />
L Plank*, J Danko, E Rozborilova, P Galajda and K Dokus; Jessenius Faculty of<br />
Medicine, Martin, SLOVAK REPUBLIC<br />
7D5 Research in medical education: constructing an ethical framework<br />
E B Peile* and A Slowther; Dept of Primary Healthcare, University of Oxford, UK<br />
7D6 Students’ perceptions of the Physiology course in a traditional<br />
medical school<br />
F Riggione*, J Perez-Ojeda and J F Perez-Gonzalez; Centro de Investigacion y<br />
Desarrollo de la Educacion Medica, El Hatillo 1083A, VENEZUELA<br />
7D7 Students’ perceptions of a traditional undergraduate course in<br />
Microbiology<br />
Z Uzcategui*, J Perez-Ojeda and J F Perez-Gonzalez; Universidad Central de<br />
Venezuela, Caracas, VENEZUELA<br />
7D8 Faculty development in General Practice - the German experience<br />
M Ehrhardt, P Engeser, M Herrmann, T Lichte, N Donner-Banzhoff and S<br />
Wilm*, on behalf of the participants; Heinrich-Heine University, Duesseldorf,<br />
GERMANY<br />
7D9 Medicine and ethnic issues; do our tutors reflect their community?<br />
D Reeves, R Loudon and J Parle*; University of Birmingham, UK<br />
Postgraduate Education<br />
Chairperson: Dr Charlotte Ringsted<br />
Meet in: Building 10, Hörsaal 6 (ground floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7E1 Exploring the views of basic surgical trainees on their training<br />
programme and their future in Surgery<br />
Jeremy Brown*, Linda de Cossart and Charmian Wiltshire; Mersey Deanery,<br />
Liverpool, UK<br />
- 2.31 -
7F<br />
7E2 An assessment of the skills base and attainments of Senior House<br />
Officer on a regional Basic Surgical Training <strong>Programme</strong><br />
Linda de Cossart, Charmian Wiltshire and Jeremy Brown*; Mersey Deanery,<br />
Liverpool, UK<br />
7E3 Personal and professional development groups for Junior Hospital<br />
Doctors<br />
Alan Naftalin and Peter Bruggen; Newham General Hospital, London, UK<br />
7E4 The educational needs of doctors with English as a second language<br />
when consulting in General Practice in the United Kingdom<br />
Sylvia Chudley and John Skelton; West Midlands Dept of Postgraduate Education<br />
for General Practice, Birmingham, UK<br />
7E5 “No such thing as a free lunch”: how free are bleep-free sessions?<br />
Jane Ross* and Rose Martin; Ninewells Hospital and Medical School, Dundee<br />
DD1 9SY, UK<br />
7E6 The SHO RITA and portfolio<br />
Rose Martin* and R W Newton; Ninewells Hospital & Medical School, Dundee, UK<br />
7E7 General Practice Registrar audit and implementation of change<br />
J McKay*, J R M Lough and T S Murray; University of Glasgow, UK<br />
7E8 The Senior Registrar - a new development in higher professional<br />
training in General Practice<br />
C T O’ Dubhghaill; NUI Galway, Co Galway, IRELAND<br />
7E9 Psychosocial training in the Family Residency in Spain:<br />
present situation and proposals for the future<br />
José Ramón Loayssa Lara; Servicio Navarro de Salud, Noaín, SPAIN<br />
7E10 Step by step to methodological exam; report on first year<br />
experiences with the new introduced GP Licence Examination<br />
in Austria<br />
R Willnauer*, M Schmidts, M Lischka; University of Vienna, Wien, AUSTRIA<br />
7E11 Development of professional doctorates in healthcare disciplines<br />
Alan Castle*, Graham A Mills and Valda Bunker; University of Portsmouth,<br />
Portsmouth, UK<br />
7E12 The appointment process for Anaesthetic Registrars in<br />
South Thames<br />
J Clarke* and J Pateman; St George’s Hospital London, UK<br />
Assessment<br />
Wednesday 5 September<br />
Chairperson: Dr William Burdick<br />
Meet in: Teaching Building, Mikroscopierraum (1 st floor)<br />
Poster location: Teaching Building, 1st floor<br />
7F1 Validity of assessment techniques: students’ views differ from<br />
observed outcomes<br />
W Colin Duncan; University of Edinburgh, Edinburgh, UK<br />
- 2.32 -
7G<br />
Wednesday 5 September<br />
7F2 Assessment reliability in an MSc programme in Diabetes<br />
J Huber*, N Munro, A Felton, C Parker, P Delaney and C McIntosh; University<br />
of Surrey Roehampton and Chelsea & Westminster Hospital, London, UK<br />
7F3 Two years of progress-testing at the Charité<br />
A Mertens*, J Hoffmann, S Kölbel, R Raschke, K Duske, J Berger and U<br />
Hennewig; HU <strong>Berlin</strong> Medical Faculty, <strong>Berlin</strong>, GERMANY<br />
7F4 OSCE for Paediatric trainee internship examination multicentric<br />
experience<br />
M Aldunate, A Lopez, A Mena, M Varas, X Trivino, A Vasquez*, R Lillo, T<br />
Miranda and E Mandiola; University of Chile, Santiago, CHILE<br />
7F5 Third year medical student written history and physicals: how many<br />
is enough?<br />
Paul A Hemmer*, Thomas Jamieson, Kim Gibson, Lisa Moores, Andy Donato,<br />
Margaret Gaglione, Steven Durning, Alan Wimmer, Bonnie Cary-Freitas and<br />
Louis Pangaro; Uniformed Services University, Bethesda, USA<br />
7F6 Student fitness to practise procedures<br />
Chris Stephens; University of Southampton, UK<br />
7F7 Deriving the assessment framework for the Three Royal Colleges<br />
Diploma in Prison Medicine<br />
Lesley J Southgate*, Jon H Fuller and Jaz Bihku; University College Medical School<br />
London, London, UK<br />
7F8 Assessment in an outcome-based curriculum at the International<br />
Medical University (IMU), Malaysia<br />
J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan, K H Ong, C M K<br />
Patrick and AKH Wong; International Medical University, Selangor, MALAYSIA<br />
7F9 Psychosocial profile of medical students as a predictor of the<br />
academic success in medical school in Mexico<br />
Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-R, Victoria Bermudez,<br />
Juan Montes-V, Santos Guzman, A-Enrique Alcorta-G and Marcos Vinicio;<br />
Autonomous University of Nuevo Leon, Monterrey, MEXICO<br />
7F10 Psychometric data for Jefferson Medical College’s non-cognitive<br />
questionnaire in Mexican medical students<br />
Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-R, Victoria Bermudez,<br />
Juan Montes-V, Santos Guzman, A-Enrique Alcorta-G and Marcos Vinicio;<br />
Autonomous University of Nuevo Leon, Monterrey, MEXICO<br />
7F11 Portfolio based assessment of students during their internship<br />
Angel M Centeno*, Soledad Campos, Isabel Fernández and Alfredo Olivieri;<br />
Universidad Austral, Buenos Aires, ARGENTINA<br />
Teaching & Learning 1<br />
Chairperson: Mr John Dent<br />
Meet in: Teaching Building, Room 2.0102 (2 nd floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7G1 What do first year medical students value in a learning situation?<br />
Angel M Centeno*, Alejandra Blanco, Soledad Campos and Amelia Cabrera;<br />
Universidad Austral, Buenos Aires, ARGENTINA<br />
- 2.33 -
7H<br />
Wednesday 5 September<br />
7G2 Application of Schon’s model for small-group teaching<br />
Francine Borduas* and Réjean Laprise; Association des médecins omnipraticiens de<br />
Québec, Québec, CANADA<br />
7G3 Teaching and learning about case presentations; the need for early<br />
intervention<br />
D Nestel* and J Kidd; Imperial College School of Medicine, London, UK<br />
7G4 Master teacher, master learner<br />
M P Oosthuizen; University of Pretoria, Pretoria, SOUTH AFRICA<br />
7G5 Hemisphericity in medical students<br />
N E Fernandez-Garza*, I A Benitez-Trejo, C Salinas-Guerra, A Davila-Flores<br />
and J A Castellanos-Lopez; Autonomous University of Nuevo Leon, Monterrey,<br />
MEXICO<br />
7G6 Medical student preferences for an “ideal textbook” of Obstetrics<br />
and Gynaecology<br />
M S Marsh* and D Katopi; GKT Medical School, London, UK<br />
7G7 What can be learnt from medical atlases? Expert and novice visual<br />
schemata in breast sonography<br />
R Pauli* and J Huber; University of Surrey Roehampton, London, UK<br />
7G8 Community-based Public Health Education in Healthy City Project<br />
Yosuke Yamane*, Kuninori Shiwaku, Keiko Kitashima and Anuurad Erdembileg;<br />
Shimane Medical University, Izumo, JAPAN<br />
7G9 Two different types of professor authority, results in a traditional<br />
faculty of medicine<br />
Carlos E. de la Garza-Gonzalez*, Norberto Lopez-Serna and Ma Esthela Morales-<br />
Perez; Autonomous University of Nuevo Leon, Monterrey, MEXICO<br />
7G10 The “excellent teacher” seen by mid-course students<br />
M Patrício, A V Carneiro and J Fernandes e Fernandes; University of Lisbon,<br />
Lisbon, PORTUGAL<br />
7G11 Underrepresented minority (URM) students’ perception of<br />
mentoring, advising and role modelling in medical school<br />
Ara Tekian*, Laura Hruska and Jorge Girotti; University of Illinois at Chicago,<br />
Chicago, USA<br />
Teaching & Learning 2<br />
Chairperson: Dr Richard Ayres<br />
Meet in: Teaching Building, Room 2.0101 (2 nd floor)<br />
Poster location: Teaching Building, 2 nd floor<br />
7H1 “Project Carrapato (*tick)”: a psychological focus in medical training<br />
I R P Scavariello, M S V M Silveira, E H V Celeri*, S L Brenelli and R S Cassorla;<br />
UNICAMP, Sao Paulo, BRAZIL<br />
7H2 Evaluating of videotape sessions for learning communication skills<br />
A Nogueras*, M Bernaus, X Claries and J de Nadal; Universitari Parc Tauli,<br />
Barcelona, SPAIN<br />
- 2.34 -
7I<br />
Wednesday 5 September<br />
7H3 Acting up? The recruitment and maintenance of a professional role<br />
play team for undergraduate and postgraduate medical training and<br />
assessment<br />
C M Wiskin* and P Croft; The University of Birmingham, Birmingham, UK<br />
7H4 Analysis of clinical competence at pre-graduate level<br />
Gitte Wichmann-Hansen* and Berit Eika; Aarhus University, Aarhus,<br />
DENMARK<br />
7H5 Use of paper-cases in undergraduate clinical Dermatology<br />
education in Germany<br />
A Boer*, R Kaufmann, W H Boehnke and F Ochsendorf; Universitats-Hautklinik<br />
Frankfurt/M, Frankfurt am Main, GERMANY<br />
7H6 Development of a Learning Resource Centre for healthcare<br />
professionals: an example of an innovative enterprise<br />
C Osonnaya*, K Osonnaya and E Burke; University of London, London, UK<br />
7H7 Legal theories of recourse for failed medical students in the United<br />
States<br />
Thomas Jamieson; Uniformed Services University of the Health Sciences, Bethesda,<br />
USA<br />
7H8 An evaluation of organising student participation in curriculum<br />
reform using a mentoring programme at the Nelson R Mandela<br />
School of Medicine, University of Natal, Durban, South Africa<br />
Dorothy Appalasamy, Michelle McLean* and Jacqueline van Wyk; University of<br />
Natal, Durban, South Africa<br />
7H9 Medical education – more than learning?<br />
Thomas Eichholz and Catharina Crolow; Charité, Humboldt University <strong>Berlin</strong>,<br />
Germany<br />
Continuing Professional Development 1<br />
Chairperson: Dr Richard Smith<br />
Meet in: Teaching Building, 2.0104 (2 nd floor)<br />
Poster location: Teaching Building, 1st floor<br />
7I1 The roles of hospital consultants: more than just patients and students<br />
Patsy Stark; University of Leeds, Leeds, UK<br />
7I2 Continuing medical education X indexation? Authors’ opinions<br />
about editorial policies of a Brazilian academic journal<br />
Maria de Lourdes Veronese Rodrigues*, Valderes Aparecida Coelho Falaschi and<br />
Julio Cesar Voltarelli; Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto,<br />
BRAZIL<br />
7I3 Learning HSR by doing: forming parallel learning groups<br />
Saeed Asefzadeh; Qazvin University of Medical Science & Health Services, Qazvin,<br />
IRAN<br />
7I4 Towards a flexible workforce - a basis for change<br />
F French*, M Awramenko, A Scott, C Ubach, L Leighton-Beck, G Needham, J<br />
Mollison and H Coutts; SCPMDE, Aberdeen, UK<br />
- 2.35 -
7J<br />
Wednesday 5 September<br />
7I5 Ensuring cost-effective CPD: perspectives, problems and policy<br />
Clive Belfield and Celia Brown*; University of Birmingham, Birmingham, UK<br />
7I6 Improving your skills in preventive medicine: this CME workshop<br />
works!<br />
François Goulet*, André Jacques* and Danielle Saucier; Collège des Médecins du<br />
Québec, Montréal, CANADA<br />
7I7 CME program in Kuwait<br />
K Al-Jarallah and I G Premadasa*; Kuwait Institute for Medical Specialization,<br />
Safat, KUWAIT<br />
7I8 The theory of perspective transformation and its applicability to<br />
CME<br />
Jill Donahue*, Stephen Hotz and Réjean Laprise*; Aventis Pharma, Laval,<br />
Québec, CANADA<br />
7I9 The Transtheoretical Model of behaviour change: does it apply to<br />
clinical practices?<br />
Réjean Laprise*, Jill Donahue and Stephen Hotz; Aventis Pharma, Laval, Québec,<br />
CANADA<br />
Continuing Professional Development 2<br />
Chairperson: Dr Alistair Thomson<br />
Meet in: Building 10, Room Kursraum 5 (Lower ground floor)<br />
Poster location: Teaching Building, 1st floor<br />
7J1 Sharing visions: working with CPD coordinators in General Practice<br />
Simon Smail* and Paul Hocking; University of Wales College of Medicine, Cardiff,<br />
UK<br />
7J2 The “Advanced Training Practice”: a questionnaire and interviewbased<br />
study of their role<br />
John Skelton and Steve Field*; West Midlands GP Unit, Birmingham, UK<br />
7J3 Does gender make a difference? CME for the female physician<br />
Jane Tipping* and Jill Donahue; Markham, Ontario, CANADA<br />
7J4 Strategic planning for effective partnerships<br />
Jane Tipping* and Danielle Deslauriers; Markham, Ontario, CANADA<br />
7J5 Integrating practice reflection and practice adjustment planning into<br />
the design of a CME meeting<br />
R L Thivierge*, L Samson and J V Patenaude; University of Montreal, Montreal,<br />
CANADA<br />
7J6 The Catalan Council of Physicians’ Colleges Accreditation Diploma<br />
in Continuing Medical Education<br />
A Ramos*, J Aliaga, A Gual and H Pardell; College of Physicians of Barcelona,<br />
Barcelona, SPAIN<br />
7J7 Breaking bad news: how to learn in a CME workshop<br />
Francois Goulet*, André Jacques* and Robert Carrier; Collège des Médecins du<br />
Québec, Montréal, CANADA<br />
- 2.36 -
7K<br />
7L<br />
International Medical Education<br />
Chairperson: Professor Lennart Bouman<br />
Meet in: Building10 , Kursraum 6 (lower ground floor)<br />
Poster location: Teaching Building, 1 st floor<br />
7K1 Differences in learning style and satisfaction with Residency<br />
training for United States and internationally trained students<br />
Steven R Daugherty; Kaplan Medical, Chicago, USA<br />
7K2 Crossing borders - The <strong>Berlin</strong> Biomedical Exchange Office<br />
U Arnold* and J W Dudenhausen; Charité, Humboldt-University <strong>Berlin</strong>,<br />
GERMANY<br />
7K3 Academic medical education in developing countries: an analysis of<br />
papers presented at medical education conferences in Argentina<br />
Angel M Centeno*, Gustavo Amestoy and Amelia Cabrera; Universidad Austral,<br />
Buenos Aires, ARGENTINA<br />
7K4 Communication skills training in Germany - results of a survey<br />
Jan Schildmann* and Ulrich Schwantes; Charité, Humboldt University <strong>Berlin</strong>,<br />
GERMANY<br />
7K5 Reform of the medical educational system in Georgia<br />
R Khetsuriani, B Kilasonia and A Telia*; Tbilisi State Medical University, Tbilisi,<br />
GEORGIA<br />
7K6 Results and main objectives of the first stage of education reform at<br />
the TSMU<br />
R Khetsuriani, B Kilassonia and N Pruidze*; Tbilisi State Medical University,<br />
Tbilisi, GEORGIA<br />
7K7 First international Integrated Surgery course at the Charité, <strong>Berlin</strong><br />
Hajo Schmidt-Traub; Charité, Humboldt University <strong>Berlin</strong>, GERMANY<br />
7K8 Counting the uncounted: estimating the number of overseas doctors<br />
in training grades in the UK currently not employed in the NHS<br />
Janet Grant, Mairead Beirne* and Heather Owen; Open University Centre for<br />
Education in Medicine, MILTON KEYNES, UK<br />
Special Subjects<br />
Wednesday 5 September<br />
Chairperson: Professor John Simpson<br />
Meet in: Teaching Building, Room 1.0107 (1st floor)<br />
Poster location: Teaching Building, 1st floor<br />
7L1 Illegible notes - do tomorrow’s doctors need teaching on how to<br />
write more clearly?<br />
E Westcott, A Kontoyannis*, N Murch, T Reid and K Sixsmith; University of<br />
Wales College of Medicine, Cardiff, UK<br />
7L2 An active method to prepare students to lead medical interviews: an<br />
experience at Xavier Bichat Medical School<br />
Corinne Pieters; Dominique Maillard*, Françoise Blanchet-Benque; Hôpital Louis<br />
Mourier, Colombes, FRANCE<br />
- 2.37 -
7L3 Teaching medical students patient advocacy skills; an<br />
interdisciplinary intervention using Standardized Patients/Families<br />
Graceanne Adamo*, Virginia Randall, Janice Hanson, William Sykora, Aileen E<br />
Zanoni, Elizabeth Jeppson and Richard E Hawkins; Uniformed Services University<br />
of the Health Sciences, Bethesda, USA<br />
7L4 The parameters affecting attitudes to death among students in a<br />
Medical College in Taiwan<br />
Ming-Liang Lai; National Cheng Kung University Hospital, Tainan, TAIWAN<br />
7L5 Evaluation of practical sessions in Clinical Anatomy: a strategy for<br />
educational improvement<br />
M A F Tavares* and M C Silva; Medical School of Porto, Porto, PORTUGAL<br />
7L6 Towards a more effective teaching of Gross Anatomy: introducing<br />
new integrated clinical concepts and improving peer presentations/<br />
evaluation techniques<br />
Ameed Raoof*, Thomas Gest, William Burkel and Tamara Stein; University of<br />
Michigan Medical School, Ann Arbor, USA<br />
7L7 Putting the salutogenic orientation into practice: the life cycle<br />
course at the Technion<br />
H Eshach*, R Van-Raalte, L Dolev, H Bitterman and D Hermoni; Technion, Haifa,<br />
ISRAEL<br />
7L8 ASAMANS (Ask Students About Medicine And National Socialism)<br />
T Drewes*, P Langkafel* and S Muller*; Charité, Humboldt University <strong>Berlin</strong>,<br />
GERMANY<br />
7L9 Stress among medical doctors<br />
J Agsteribbe* and J Cohen-Schotanus; University of Groningen, Groningen,<br />
NETHERLANDS<br />
7L10 Introducing changes in medical education: the “strategy” of Clinical<br />
Anatomy at the Medical School of Porto<br />
M A F Tavares; Medical School of Porto, Porto, PORTUGAL<br />
1000-1030 Coffee in foyers of Teaching and Research Buildings<br />
1030-1230 Session 8: Short Communications<br />
8A<br />
Wednesday 5 September<br />
Computer Mediated Learning and Assessment<br />
Chairperson: Dr Joel Feiner<br />
Room: Teaching Building, Hörsaal 1 (Ground Floor)<br />
1030-1045 1 Preparing clinical small group sessions by using digital video in CBE<br />
Marianne G Nijnuis*, Caro Brumsen, Jan A Gevers Leuven and Peter G M de<br />
Jong; Leiden University Medical Center, Netherlands<br />
1045-1100 2 Inter-physician communication training through computer-based<br />
patient simulations<br />
S Eggermont*, P M Bloemendaal, E Schoonderwaldt and J D Donnison-Speyer;<br />
Leiden University Medical Center, Netherlands<br />
- 2.38 -
1100-1115 3 Computer Assisted Learning: using and doing research in primary<br />
care<br />
Linda Leighton-Beck*, Philip Hannaford, Neil Hamilton, Sara Shaw and Yvonne<br />
Carter; Scottish Council for Postgraduate Medical & Dental Education, Aberdeen,<br />
UK<br />
1115-1130 4 Extracting core competencies “bottom up” from case histories by<br />
an online consensus seeking process in family medicine<br />
Peter Schlaeppi* and Ralph Bloch; University of Bern, Switzerland<br />
1130-1145 5 A new era of teaching. An innovative resource for continuing<br />
medical education and evidence based management<br />
K El-Hayes, B McElhinney, B Adams, E Boyd and K McKinney; Co Down,<br />
Northern Ireland<br />
1145-1200 6 Evaluating medical student and resident education: a CME software<br />
program<br />
J C Edwards*, P Ogden and A A Stricker; Texas A & M University, USA<br />
1200-1215 7 Metabolic challenges on CD-ROMs<br />
Marie-Paule Van Damme*, Jonathan Gould, Bruce Livett, Janet Macaulay, Ron<br />
Maxwell and Graham Parslow; Monash University, Clayton, Australia<br />
1215-1230 Discussion [Opening Discussant: Dr Megan Quentin-Baxter]<br />
8B<br />
Wednesday 5 September<br />
Implementation of Problem-based Learning<br />
Chairperson: Professor Arcadi Gual<br />
Room: Teaching Building, Hörsaal 2 (Ground Floor)<br />
1030-1045 1 Problem-based learning for trainees in Anaesthesiology<br />
Sigrid Adam* and Jan Klein; Erasmus University, Rotterdam, Netherlands<br />
1045-1100 2 Communicating with students in a problem-based curriculum:<br />
experiences with WebCT<br />
Michelle McLean and Kathy Murrell; Nelson R Mandela School of Medicine,<br />
Congella, South Africa<br />
1100-1115 3 Faculty members and senior students as facilitators in PBL-groups<br />
- similarities and differences<br />
Are Holen*, Kristin Wigen and Øyvind Ellingsen; Norwegian University of Science<br />
and Technology, Trondheim, Norway<br />
1115-1130 4 Tutors’ perspectives of problem-based learning<br />
Diana Kelly; Guy’s, King’s and St Thomas’ School of Medicine, London, UK<br />
1130-1145 5 The E.D.I.T. project in Linköping: using web-based scenarios for PBL<br />
Wolfram Antepohl*, Anne-Christine Persson, Margareta Bachrach-Lindström and<br />
Björn Bergdahl; Division of Medical Education, Linköping University, SWEDEN<br />
1145-1200 6 How to promote success in a PBL tutorial session<br />
N Paganus*, K Lonka and T Hätönen; University of Helsinki, FINLAND<br />
1200-1215 7 Evaluation of the student staff in the experience of PBL in the<br />
- 2.39 -
Federal University of Roraima - Brasil<br />
Álvaro Tulio Fortes*, César Ferreira Penna de Faria, Ruy Guilherme de Souza and<br />
Fernado Menezes da Silva; University of Roraima, Brazil<br />
1215-1230 Discussion [Opening Discussant: Anne Garden]<br />
8C<br />
Curriculum Planning<br />
Chairperson: Dr Frank Smith<br />
Room: Teaching Building, Hörsaal 3 (Ground Floor)<br />
1030-1045 1 Priorities in the content of the curriculum from the standpoint of the<br />
academic staff<br />
E Nagle*, R Velins and V Pirags; Latvian Medical Academy, Riga, Latvia<br />
1045-1100 2 Reforming the core curriculum of the Reformstudiengang in <strong>Berlin</strong> -<br />
a Delphi study<br />
B Huenges*, W Burger, J W Dudenhausen, U Frei, C Frömmel, H-P Lemmens, U<br />
Schwantes and D Scheffner; Arbeitsgruppe Reformstudiengang Medizin, <strong>Berlin</strong>,<br />
Germany<br />
1100-1115 3 Early clinical clerkship - does it make a difference?<br />
Berit Eika* and Ole Sonne; University of Aarhus, Denmark<br />
1115-1130 4 ECTS (European Credit Transfer System) as a tool in curriculum<br />
development<br />
B Grether; University of Zurich, Switzerland<br />
1130-1145 5 The continuum of professional development<br />
H M R Meier; University of Toronto, Canada<br />
1145-1200 6 Evaluating ethics seminars<br />
Gerald Neitzke; Hannover Medical School, Germany<br />
1200-1215 7 A tool to evaluate medical ethics seminars<br />
Mareike Moeller* and Gerald Neitzke; Hannover Medical School, Germany<br />
1215-1230 Discussion [Opening Discussant: Professor Ala’aldin Al Hussaini]<br />
8D<br />
Wednesday 5 September<br />
The Final Examination<br />
Chairperson: Dr Jack Boulet<br />
Room: Research Building, Hörsaal 4 (Ground Floor)<br />
1030-1045 1 Consistency of examination marks<br />
T Vik*, K H Karlsen and S Westin; Norwegian University of Science & Technology,<br />
Trondheim, Norway<br />
1045-1100 2 Identifying threshold competence in an undergraduate qualifying<br />
clinical examination<br />
John Cookson* and Stewart Petersen; Leicester Warwick Medical School, Leicester,<br />
UK<br />
- 2.40 -
1100-1115 3 The validity of performance standards on a certification examination<br />
for occupational therapists<br />
Ernest N Skakun; University of Alberta, Canada<br />
1115-1130 4 Reliability of a sequential clinical examination<br />
Stewart Petersen* and John Cookson; Leicester Warwick Medical School, Leicester,<br />
UK<br />
1130-1145 5 Consideration of legal, ethical and organizational aspects of clinical<br />
competence in a National Licensing Examination: evaluation at the<br />
Medical Council of Canada<br />
Jacques E. Des Marchais*, Dale W. Dauphinée and David Blackmore; Medical<br />
Council of Canada, Montreal, Canada<br />
1145-1200 6 Combining different components of an assessment procedure<br />
J Degryse*, J Goedhuys, A Roex and A Dermine; K U Leuven, Belgium<br />
1200-1230 Discussion [Opening Discussant: Dr Diana Wood]<br />
8E<br />
Wednesday 5 September<br />
Postgraduate Education/Career Choice<br />
Chairperson: Professor Ope Adekunle<br />
Room: Building 10, Hörsaal 6 (Ground Floor)<br />
1030-1045 1 Teaching with patients: moving beyond ‘learning by osmosis’<br />
Kath Green; South Thames Department of Postgraduate Medical and Dental<br />
Education, London, UK<br />
1045-1100 2 The effect of an interactive postgraduate education programme on<br />
parenteral treatment in Macedonia<br />
M Ivanovski, P D Toon*, K Zafirovska, F Tozija and B Gomes; University College<br />
London, UK<br />
1100-1115 3 Promoting innovation in postgraduate education through the<br />
accreditation process<br />
Judith Armbruster; Accreditation Council for Graduate Medical Education,<br />
Chicago, USA<br />
1115-1130 4 A new development in postgraduate surgical education: the<br />
Intermediate Breast Course - a distance learning course<br />
H M Sweetland*, E Hoadley-Maidment and M Galea; University of Wales College<br />
of Medicine, Cardiff, UK<br />
1130-1145 5 Attitude change in neonatologists-in-training by participation in the<br />
neuropediatric follow-up of former premature infants<br />
J B Hentschel; Universitaets – frauenklinik des Inselspitals, Bern, Switzerland<br />
1145-1200 6 Factors that influence the career choice of medical specialization<br />
M B M Soethout* and G van der Wal; Vrije Universiteit Medical Centre,<br />
Amsterdam, Netherlands<br />
1200-1215 7 Personality differences in doctors affect the factors associated with<br />
their medical specialty choice<br />
Gillian B Clack*, Derek Cooper and John O Head; Kings College London, UK<br />
1215-1230 Discussion [Opening Discussant: Professor Janet Grant]<br />
- 2.41 -
8F<br />
Teaching and Learning<br />
Chairperson: Professor Clarke Hazlett<br />
Room: Teaching Building, Mikroscopierraum (First Floor)<br />
1030-1045 1 Impact of peer tutoring on the patient-centered interviewing skills of<br />
first-year medical students<br />
D Nestel* and J Kidd; Imperial College School of Medicine, London, UK<br />
1045-1100 2 Peer assisted learning - a teaching strategy for the new millennium?<br />
Joy R Crosby and H Mei-Ling Ball*; University of Dundee, UK<br />
1100-1115 3 An insight into how students learn about a cardiovascular problem<br />
using study guides<br />
Shihab E O Khogali*, Jennifer M Laidlaw, Stuart D Pringle and R M Harden;<br />
University of Dundee, UK<br />
1115-1130 4 Study guides in an outcome-based medical curriculum at the<br />
International Medical University (IMU), Malaysia<br />
M I Nurjahan*, J C Ramesh, S Raman, A Radhakrishnan, C L Teng, K H Ong, C M<br />
K Patrick and Q Akhtar; International Medical University, Negri Sembilan, Malaysia<br />
1130-1145 5 How authors of an extensive distance learning programme for<br />
surgical trainees differed in their use of the specified template<br />
Jennifer M Laidlaw*, Ronald M Harden, Lorraine J Robertson and E Anne<br />
Hesketh; SCPMDE Education Development Unit, Dundee, UK<br />
1145-1200 6 Context-dependent memory in a meaningful environment: in the<br />
classroom and at the bedside<br />
Franciska Koens*, Olle Th.J. ten Cate and Eugène J F M Custers; Universitair<br />
Medisch Centrum, Utrecht, Netherlands<br />
1200-1215 7 Continuous Interactive Class (C.I.C)<br />
J Medrano*, R Calpena, A Compañ, M T Pérez Vázquez, J Lacueva and M Díez;<br />
Miguel Hernandez University, Alicante, Spain<br />
1215-1230 Discussion [Opening Discussant: Professor David Prideaux]<br />
8G<br />
Wednesday 5 September<br />
Assessment in Postgraduate and Continuing Education<br />
Chairperson: Dr Michael Tunbridge<br />
Room: Teaching Building, Room 2.0102 (Second Floor)<br />
1030-1045 1 A computerized adaptive test as an element of the final assessment of<br />
general practitioners in Flanders. Possibilities, difficulties, dilemmas…<br />
A Roex* and J Degryse; K.U. Leuven, Belgium<br />
1045-1100 2 Insight 360: a tool for looking at doctors’ performance<br />
E B Peile* and R Conradt; University of Oxford, UK<br />
1100-1115 3 Impact on non-principals in General Practice of the summative<br />
assessment audit project<br />
P Bowie, A Garvie and J Oliver; University of Glasgow, UK<br />
- 2.42 -
1115-1130 4 The difference between the ability to apply consultation guidelines<br />
and the routine of application: A relevant distinction?<br />
Myrra Vernooij-Dassen*, Ben Bottema and Cees van der Vleuten; University of<br />
Nijmegen, Netherlands<br />
1130-1145 5 What do SHO Educational Supervisors REALLY think of appraisal?<br />
Ann Cadzow*, Helen Coutts, Fiona French, Linda Leighton-Beck and Ken<br />
McHardy; SCPMDE, Aberdeen, UK<br />
1145-1200 6 Visual-spatial ability and the objective assessment of technical<br />
skills<br />
K R Wanzel*, S J Hamstra, D J Anastakis, E D Matsumoto and M D Cusimano;<br />
Centre for Research in Education, Toronto, Canada<br />
1200-1215 7 Validity of MIST-VR in the assessment of laparoscopic skill<br />
A M Paisley*, P Baldwin and S Paterson Brown; University of Edinburgh, UK<br />
1215-1230 Discussion [Opening Discussant: Dr John Pitts]<br />
8H<br />
Curriculum Change<br />
Wednesday 5 September<br />
Chairperson: Dr Johan Ponten<br />
Room: Teaching Building, Room 2.0101 (Second Floor)<br />
1030-1045 1 Innovation and reform of medical education: evaluating the UNI<br />
Program in Latin America<br />
E C Ribeiro*, G Werneck, A Aguiar and V Brant; Universidade Federal do Rio de<br />
Janeiro, Brazil<br />
1045-1100 2 Promoting responsive curriculum change within the 21st Century<br />
Cam Enarson; Wake Forest University School of Medicine, Winston-Salem, USA<br />
1100-1115 3 Improving the University and NHS Teaching Hospital Trust<br />
Partnership to identify SIFT spending<br />
Andrea J Bolshaw; University of Birmingham, UK<br />
1115-1130 4 Assessment of medical student attitudes toward relevant aspects of<br />
medical practice<br />
M L V Rodrigues*, L E de A Troncon, M F A Colares, J F C Figueiredo, A R L<br />
Cianflone, C E Piccinato, L C Peres and J A Dela-Coleta; Faculty of Medicine of<br />
Ribeirao Preto, Brazil<br />
1130-1145 5 Effect of a curriculum reform on graduating student performance<br />
M L V Rodrigues*, J F C Figueiredo, L E A Troncon, C E Piccinato, L C Peres, A R<br />
L Cianflone and M F A Colares; Faculdade de Medicina de Ribeirao Preto, Brazil<br />
1145-1200 6 A developmental approach to reduce the long term risk of rejection<br />
of curricular changes<br />
Jamsheer Talati* and Camer Vellani; The Aga Khan University, Karachi, Pakistan<br />
1200-1215 7 The final year in undergraduate medical education: key position<br />
between theory and daily routine<br />
K Muller; University of Bonn, Germany<br />
1215-1230 Discussion [Opening Discussant: Ms Brownell Anderson]<br />
- 2.43 -
8I<br />
Communication Skills Training<br />
Chairperson: Professor Knut Aspegren<br />
Room: Teaching Building, Room 2.0104 (Second Floor)<br />
1030-1045 1 Which interviewing skills must be actively taught at medical<br />
school?<br />
K Aspegren*, P Henriksen, P Lønberg-Madsen and M Strømming; Copenhagen<br />
University Hospital, Denmark<br />
1045-1100 2 Implementing communication skills training at the Charité - a<br />
project by students and doctors<br />
Jan Schildmann*, Carsten Schwarz, Eva Herrmann, Heiderose Ortwein, Amelie<br />
Klambeck, Andreas Brunklaus and Ulrich Schwantes; Humboldt University <strong>Berlin</strong><br />
(Charite), Horn, Germany<br />
1100-1115 3 Teaching sexual history-taking to health care professionals in<br />
primary care<br />
J R Skelton* and P M Matthews; University of Birmingham, UK<br />
1115-1130 4 SEX SEX SEX, oh yes, and how’s your knee?<br />
Annie Cushing* and Dason Evans; St. Bartholomews & The Royal London Queen<br />
Mary’s, London, UK<br />
1130-1145 5 Training of the systemic approach in doctor patient communication<br />
I: history taking from a third party<br />
K P M van Spaendonck* and E M van Weel-Baumgarten; University of Nijmegen,<br />
Netherlands<br />
1145-1200 6 Training of the systemic approach in doctor patient communication<br />
II: history taking with a patient and a third party<br />
E M van Weel-Baumgarten* and K P M van Spaendonck; University of Nijmegen,<br />
Netherlands<br />
1200-1215 7 Breaking bad news - evaluation of courses run by students and<br />
young doctors<br />
H Ortwein*, E Herrmann, A Brunklaus, A Kreutz, C Schwarz and J Schildmann;<br />
Humboldt University <strong>Berlin</strong>, Germany<br />
1215-1230 Discussion [Opening Discussant: Dr Amindra Arora]<br />
8J<br />
Clinical Teaching<br />
Wednesday 5 September<br />
Chairperson: Dr Ioan Bocsan<br />
Room: Building 10, Kursraum 5 (Lower Ground Floor)<br />
1030-1045 1 Increasing student awareness of strengths and weaknesses using a<br />
Standardized Patient case<br />
Devra Cohen*, Jerry Colliver, Mark Swartz and Randal Robbs; Mt Sinai School of<br />
Medicine, New York, USA<br />
1045-1100 2 Clinical dermatology: prospective randomized comparison of a<br />
traditional, a personal bed-side teaching (PBST) and a problemoriented-practical<br />
(POP) course<br />
F R Ochsendorf*, H Boehncke, R Hovelmann, A Boer and R Kaufmann; Klinikum<br />
der J.W. Goethe-Universität, Frankfurt/M, Germany<br />
- 2.44 -
1100-1115 3 Clinical skills training - a new curriculum between BEME and reality<br />
Peter Frey; University of Bern, Department of Instructional Media (AUM),<br />
Inselspital 38, CH - 3010 Bern, SWITZERLAND<br />
1115-1130 4 The effects of student gender on patients’ willingness to be<br />
examined by medical students<br />
William P Metheny*, Roxanne Jamshidi and Kara Pitt; Brown University School of<br />
Medicine/Women and Infants Hospital, Providence, USA<br />
1130-1145 5 Reality shock among medical students attending first clinical rotation<br />
I Levi* and T Fischel; Sackler Medical School, Ramat Gan, Israel<br />
1145-1200 6 Experiential clinical learning in a horizontally-integrated, problembased<br />
curriculum<br />
Tim Dornan*, Arno Muijtjens and Henny Boshuizen; Universities of Manchester<br />
and Maastricht, UK and Netherlands.<br />
1200-1230 Discussion [Opening Discussant: Dr Paul Hemmer]<br />
8K<br />
Wednesday 5 September<br />
International Aspects of Medical Education<br />
Chairperson: Dr M Roy Schwarz<br />
Room: Building 10, Kursraum 6 (Lower Ground Floor)<br />
1030-1045 1 Influence of Studying on Students’ Health (ISSH)<br />
T Schweickert*, P Hodzic, V Jurkovic, J Seitz*, O Onur* and T Shiozawa*;<br />
German Medical Students’ Association, Aachen, Germany<br />
1045-1100 2 A comparison of undergraduate medical curricula in various countries<br />
J Mirecka*, Paola Binetti, Jan Heijlman, Roy Remmen and K Lipinski; Department<br />
of Medical Education, Krakow, Poland<br />
1100-1115 3 International differences in medical content preparation<br />
Steven R Daugherty* and Rochelle Rothstein; Kaplan Medical, Chicago, USA<br />
1115-1130 4 New trends at TSMU: elaboration of medical education conception<br />
R Khetsuriani, B Kilassonia, Z Avaliani* and G Simonia; Tbilisi State Medical<br />
University, Georgia<br />
1130-1145 5 Learning needs assessments for refugee doctors; establishing<br />
baseline data about medical knowledge and experience<br />
Lesley J Southgate* and Joan F Fuller; University College London, UK<br />
1145-1200 6 Helping refugee doctors back to work<br />
M J Bannon*, E Paice, G MacFadden, G Cowan, S Cheeroth and Y H Carter;<br />
London Deanery, Harrow, UK<br />
1200-1215 7 New York University Master Scholars Program<br />
Sharon K Krackov; New York University School of Medicine, New York, USA<br />
1215-1230 Discussion [Opening Discussant: Dr Charles Boelen]<br />
- 2.45 -
8L<br />
Special Subjects<br />
Chairperson: Professor Ester Mateluna<br />
Room: Teaching Building, Room 1.0107 (First Floor)<br />
1030-1045 1 And now for something completely different … reflective style<br />
learning of the Arts in medicine<br />
Paul Lazarus; University of Leicester, UK<br />
1045-1100 2 Seamless humanities: on integrating medical humanities into<br />
medical education: the Witten project<br />
C Hick*, B Matzke, B Strahwald, A Weymann and W Vermaasen; Universität<br />
Witten/Herdecke, Germany<br />
1100-1115 3 Improving clinical reasoning in novice clinicians: a diagnostic<br />
training aid to support clinical reasoning in student<br />
physiotherapists<br />
Gill James; Coventry University, UK<br />
1115-1130 4 The culture of criticism and argument in health education<br />
Barbara Westwood* and Geoffrey Westwood; University of Western Sydney,<br />
Australia<br />
1130-1145 5 Development and interim evaluation of a new postgraduate course<br />
in community gynaecology and reproductive health care<br />
A Parsons, B Olowokure* and M Walzman; University of Warwick, Coventry, UK<br />
1145-1200 6 Palliative medicine education for Internal Medicine Resident<br />
Physicians<br />
Marcos Montagnini*, Edmund Duthie and Basil Varkey; Medical College of<br />
Wisconsin, Milwaukee, USA<br />
1200-1215 7 Teaching stress management and empathic communication to<br />
medical students<br />
Ray Melmed and Hannah Kedar*; The Hebrew University, Jerusalem, Israel<br />
1215-1230 Discussion [Opening Discussant: Professor Paul O’Neill]<br />
1230-1330 Lunch in Marquee<br />
1330-1600 Session 9: Plenary<br />
9<br />
Wednesday 5 September<br />
Different views of medical education<br />
Room: Teaching Building, Hörsaal 1 and 2<br />
(Note: there will be a video link to Hörsaal 3 to provide additional seating)<br />
Chairperson: Dr Madalena Patrício, Portugal<br />
1330-1355 9/1 The role of clinical experience in the acquisition of clinical<br />
reasoning: Implications for education<br />
Professor Geoff Norman, McMaster University, Canada<br />
- 2.46 -
1355-1420 9/2 Keeping standards up to date<br />
Ms Susanne Pruskil, Medical Student from Charité, Medical Faculty of the<br />
Humboldt-University, <strong>Berlin</strong><br />
1420-1445 Discussion<br />
1445-1500 Short break<br />
Wednesday 5 September<br />
1500-1550 Special presentation:<br />
Humour in medical education is like a box of chocolates …<br />
Dr Ron Berk, The Johns Hopkins University, Baltimore, USA<br />
1550-1610 Close of Conference, and presentation of Medical Teacher Poster Prize<br />
Please remember to hand in your Conference Evaluation Form at the Registration<br />
Desk. (Spare copies are available if required). We value your feedback, together with<br />
your suggestions for future speakers and workshop organisers.<br />
- 2.47 -
SECTION 3<br />
Conference Social <strong>Programme</strong>,<br />
Tours and Accommodation
Tours, Optional Conference Social Events<br />
and Accommodation<br />
Please address all bookings and queries relating to the above to DER-CONGRESS:<br />
DER-CONGRESS<br />
Bundesallee 56 Tel: +49 30 857 9030<br />
D-10715 <strong>Berlin</strong> Fax: +49 30 85 79 03 26<br />
Germany Email: der@der-congress.de<br />
Bookings for accommodation/tours/optional social programme should be submitted on<br />
Form C, included in the provisional conference programme or available from the <strong>AMEE</strong><br />
Office. Please return Form C direct to DER-CONGRESS and not to the <strong>AMEE</strong> Office.<br />
Conference Social <strong>Programme</strong><br />
The following two social events are included in the registration fee:<br />
Sunday 2 September 1400-1700 hrs<br />
Sightseeing tour of <strong>Berlin</strong> by coach, starting at The Forum Hotel,<br />
Alexanderplatz, <strong>Berlin</strong> (see map on page 1.6)<br />
Please make your own way to the Forum Hotel to meet your coach. On the tour you<br />
will see the most attractive and historic sights of <strong>Berlin</strong>: Kaiser Wilhelm Memorial<br />
Church; Europa Center; Bauhaus Archives; New National Gallery; the Philharmonic<br />
Concert Hall; the “Anhalter” railway station; the “Alexanderplatz”; the<br />
“Gendarmenmarkt” with its twin French and German cathedrals; Nikolai District;<br />
Television Tower; Red City Hall (which houses the <strong>Berlin</strong> Senate, and is the location<br />
for the Opening Ceremony on Sunday evening); “Zeughaus”; German State Opera;<br />
the magnificent boulevard “Unter den Linden”; Brandenburgh Gate; the “Reichstag”;<br />
Congress Hall; the “Tiergarten”; “Schloss Bellevue”; Victory Column; German Opera<br />
House, and Charlottenburg Palace. The tour will terminate at the Forum Hotel.<br />
Sunday 2 September 1930-2130 hrs<br />
Welcome Reception in the “Red Town Hall” (Rotes Rathaus), Rathausstraße<br />
(see map on page 1.6)<br />
You are invited by the Senate of <strong>Berlin</strong> to the Red Town Hall, which is the<br />
headquarters of <strong>Berlin</strong> City Council built in neo-Renaissance style between 1861<br />
and 1870. The evening is the opportunity to meet colleagues and friends; musical<br />
entertainment by Musici Medici Quartet who will play some pieces by Schubert;<br />
drinks and snacks provided. Please note that you should make your own way to and<br />
from the Red Town Hall.<br />
- 3.1 -
Optional Social Events<br />
Student Social Events<br />
The following Conference Social Events are not included in the registration fee and<br />
can be booked through DER-CONGRESS, using Form C available from DER or from<br />
the <strong>AMEE</strong> Office.<br />
Monday 3 September 1930-2300 hrs<br />
River Cruise, starting at Jannowitzbrücke<br />
- 3.2 -<br />
Price: DM 100 per person<br />
This river cruise on the Spree presents the historic centre of the city with its most<br />
important sights from a completely different angle. You will pass such buildings as<br />
the Reichstag, the <strong>Berlin</strong> Cathedral, the castle Charlottenburg etc. from the waterfront.<br />
The tour will be guided in English and will start from the landing stage<br />
Jannowitzbrücke. It will end at <strong>Berlin</strong> Cathedral (see map on page X). Buffet dinner<br />
and two drinks are included. Tickets may be collected from DER on registration and<br />
please remember to take these with you to the event as they entitle you to two free<br />
drinks!<br />
Tuesday 4 September 1930-2230 hrs<br />
Gala-Dinner at the Aquarium, Budapester Straße 32,<br />
10787 <strong>Berlin</strong> (see map on page 1.6) Price: DM 130.00 per person<br />
The location for our Conference Dinner is the Aquarium, situated in the western<br />
city centre and part of the famous Zoological Gardens. The Aquarium houses the<br />
greatest variety of species in the world and you are free to look around. A dinner<br />
buffet and drinks are provided, with musical entertainment from the Brass Brothers<br />
– from Bach to the Beatles and, by popular request, Foetus ex Ore, the Norwegian<br />
medical students’ choir that has amused and amazed us in previous years. We must<br />
vacate the building by 2300 hrs which is bedtime for the fish – they suffer distress<br />
and higher mortality rates if deprived of their rest! Please make your own way to<br />
and from the Aquarium.<br />
Saturday 1 September<br />
If there is sufficient demand, there will be a pub crawl for all the students who<br />
arrive early (they may not object to a few non-students tagging along if anyone else<br />
is interested!). Please contact them if you would like a guided tour of the <strong>Berlin</strong><br />
nightlife: student.amee@charite.de<br />
Monday 3 September 1930 hrs until late<br />
An alternative to the River Cruise, for students only! The local students invite visiting<br />
students to a free dinner in the ‘Lecture-hall Ruin’. This is the old pathology lecturehall<br />
that was partly destroyed during WW II, has been rebuilt and is now being used<br />
for social events. All students registering for the Conference will be contacted by<br />
the <strong>Berlin</strong> students and asked if they would like to attend the dinner. As numbers are<br />
limited they can’t promise that places will be available for everyone. Please contact<br />
student.amee@charite.de for further information.
Accompanying Persons <strong>Programme</strong><br />
Tours leave from and return to the Forum Hotel, Alexanderplatz (see map on page 1.6).<br />
All tours are guided in English. Lunches do not include drinks.<br />
Monday 3 September 0830-1630 hrs<br />
Impressions of the Spreewald Price: DM 150.00 per person<br />
This day-tour to the Spreewald offers an unparalleled experience of nature. The<br />
area, which was originally settled by the Sorbs, is traversed by numerous tributaries<br />
of the River Spree, these often being the only links between houses and fields. The<br />
tour will take you to Burg and Leipe, two small idyllic towns in a romantic setting.<br />
Spreewald specialities will be served at lunch. Enjoy a trip along the network of<br />
waterways on one of the traditional Spreewald punts.<br />
Tuesday 4 September 0830-1630 hrs<br />
Neuruppin & Rheinsberg Palace Price: DM 150,00 per person<br />
This is a Coach trip to the little town of Neuruppin, which is situated on the lake<br />
”Ruppiner See”. During a sightseeing tour you will get to know the home town of<br />
Theodor Fontane and Karl Friedrich Schinkel. After lunch the trip continues to<br />
Rheinsberg, ”picture book for lovers” as Tucholsky called it. The town, which is<br />
situated on the east bank of the ”Griebericksee”, is famous in particular for its<br />
palace, Schloß Rheinsberg. It was built in 1566 as a moated castle and in 1737/40<br />
Knobelsdorff reconstructed it into a major architectural work during Friedrich the<br />
Great’s reign. The Rheinsberg Palace houses a museum, which is open to the public.<br />
The tour also includes a walk through the palace gardens, which were originally<br />
designed in Baroque-style and changed into English-style gardens at the end of the<br />
18th century.<br />
Wednesday 5 September 1000-1400 hrs<br />
Potsdam/Sanssouci Price: DM 70,00 per person<br />
This tour shows old and modern Potsdam. You will visit the well-preserved, worldfamous<br />
Rococo Palace Sanssouci with its art treasures and beautiful park. A city<br />
tour through Potsdam will follow.<br />
- 3.3 -
Pre-Conference Tours<br />
All tours are guided in English. Tours leave from and return to the Forum Hotel,<br />
Alexanderplatz (see map on page 1.6). <strong>Programme</strong> is subject to change. Lunches do<br />
not include drinks.<br />
Saturday 1 and Sunday 2 September (1.5 days)<br />
Dresden<br />
Depart <strong>Berlin</strong> 0900 hrs on 1 September, return to <strong>Berlin</strong> 1200 hrs on 2 September<br />
(one overnight stay)<br />
1 September: Start of the tour in <strong>Berlin</strong>. On the way to Dresden you will pass by<br />
the lake “Teupitzer See”, some distant parts of the Spreewald and the coal mining<br />
area of Niederlausitz. Dresden is one of the most beautiful baroque towns in Europe.<br />
During a sightseeing tour through the city you will visit the most important sights<br />
such as the Zwinger, Taschenberg-Palace, the famous Semper Opera House, picture<br />
gallery ”Old Masters” with the famous painting ”Sixtinische Madonna” or the<br />
dazzling jewellery exhibition in the ”Green Vault”.<br />
2 September: At 0900 hrs your return journey to <strong>Berlin</strong> will start. The tour ends<br />
also at the Forum-Hotel, Alexanderplatz.<br />
Rate per person in a double room: DM 305,00<br />
Rate per person in a single room: DM 375,00<br />
Rates include following services: de luxe coach, 1 overnight stay including breakfast<br />
in a Hotel of 4-Stars category, all entrance fees.<br />
Saturday 1 September 0900-2000 hrs (one day)<br />
Mecklenburg countryside<br />
The excursion will take you to Schwerin, an old town “up North”. In this “City of<br />
Seven Lakes” you can admire the magnificent palace, situated on a charming island,<br />
which no lesser than Tsar Alexander enthused over. After lunch you will be driven<br />
past the lake “Schwerin” towards Wismar, the first record of which dates back to<br />
1229. The buildings still testify to its former glory as a hanseatic city. The historic<br />
centre has been restored and the whole area is now protected by a conservation<br />
order.<br />
Rate per person: DM 175,00 (including transportation in de luxe coach, lunch<br />
and entrance fees)<br />
- 3.4 -
Post-Conference Tour<br />
Cancellation Policy<br />
Accommodation<br />
All tours are guided in English. Tours leave from and return to the Forum Hotel,<br />
Alexanderplatz (see map on page X). <strong>Programme</strong> is subject to change. Lunches do not<br />
include drinks.<br />
Thursday 6 September 0830-1800 hrs (one day)<br />
Potsdam’s Parks and Palaces<br />
A visit of the palaces and gardens of Sanssouci will be followed by a guided tour to<br />
the Cecilienhof, the place where the Potsdam Agreement was signed in 1945. After<br />
lunch a city tour through the former garrison town with its Dutch Quarters and<br />
Russian Colony will follow.<br />
Rate per person: DM 150,00 (including transportation in de luxe coach, lunch<br />
and entrance fees)<br />
In case of cancellation of the accompanying persons’ tours and one-day pre- and postconference<br />
tours after 15 June 2001 the full fee is payable. There will be no refunds.<br />
After 15 June 2001 the following cancellation fees will be charged for the overnight<br />
tour:<br />
Dresden cancellation fee per person (single room) DM 330,00<br />
cancellation fee per person (double room) DM 260,00<br />
Rooms are now subject to availability. Please book using Form C, available from DER<br />
or the <strong>AMEE</strong> office. All the hotels of categories A, B, C have fitness-centres; category<br />
A hotels also have swimming-pools. Some of the hotels in categories C and D also have<br />
fitness-centres and swimming-pools. All the rooms are equipped with telephone, TV,<br />
shower and WC. In price categories B and C breakfast buffet, service and VAT are<br />
included. The rates in price category A do not include breakfast. A deposit of DM<br />
500,00 per room will be charged and will be deducted from the final bill on checking<br />
out of the hotel on presentation of the voucher which will be given to you at the<br />
Conference registration desk. Hotel reservations can only be processed if this payment<br />
and the booking form have been received Requests by telephone cannot be considered.<br />
Should the requested category be booked out, DER-CONGRESS will make reservations<br />
in another category. We ask for your understanding that only written changes in<br />
reservations can be accepted.<br />
Reserved rooms will be kept until 18.00 hrs on the scheduled day of arrival, unless late<br />
arrival has been marked on the booking form.<br />
In case you have to cancel your room reservation the cancellation fee charged by DER-<br />
CONGRESS is DM 50,00 per single room and DM 100,00 per double room. Should<br />
the cancellation be received after June 1, 2001 you may be charged with the relevant<br />
cancellation or no-show-fee by the hotel, in addition to the corresponding cancellation<br />
fee payable to DER-CONGRESS. A handling fee of DM 20,00 will be charged for<br />
changes in registration. Administration costs cannot be reimbursed in any case.<br />
- 3.5 -
Student Accommodation<br />
DER-CONGRESS does not deal with allocation of student accommodation.<br />
Local students have a few rooms available in their own homes for visiting students.<br />
Please contact student.amee@charite.de for information.<br />
The hostels listed below may also have rooms available:<br />
Jugendgästehaus Nordufer Phone: +49-30-451 70 30<br />
Nordufer 28 Fax: +49-30-452 41 00<br />
D-13351 <strong>Berlin</strong> e-mail: Nordufer@t-online.de<br />
BDP-Gäste-Etage Phone: +49-30-493 10 70<br />
Osloer Str. 12 Fax: +49-30-493 60 01<br />
D-13359 <strong>Berlin</strong> e-mail: gaeste-etage@snafu.de<br />
Hostel „Die Etage“ Phone: +49-30-89 09 08 20<br />
Katharinenstraße 14 Fax: +49-30-89 09 08 27<br />
D-10117 <strong>Berlin</strong> e-mail: dieetage@aol.com<br />
Globetrotter Hostel “Odyssee” Phone: +49-30-29 00 00 81<br />
Grünberger Straße 23 Fax: +49-30-29 00 00 81<br />
D-10243 <strong>Berlin</strong> e-mail: odyssee@hostel-berlin.de<br />
The rates are between DM 24,00 and DM 65,00 per night.<br />
- 3.6 -
SECTION 4<br />
Abstracts
Contents<br />
Monday 3 September<br />
Session 1 – Plenary 1:Achieving standards in the curriculum 4.1<br />
Session 2 – Short Communications 1<br />
2A A virtual learning environment .. .. 4.2<br />
2B PBL and the curriculum .. .. .. 4.3<br />
2C Curriculum database .. .. .. 4.5<br />
2D OSCE/Standardised patients in assessment .. 4.7<br />
2E Postgraduate education – the early years .. 4.8<br />
2F Peer assessment .. .. .. 4.10<br />
2G Continuing Professional Development .. .. 4.12<br />
2H Selection .. .. .. .. 4.13<br />
2I Educating the educators (1) .. .. .. 4.15<br />
2J Simulation and clinical skills training .. .. 4.17<br />
2K Students and curriculum evaluation .. .. 4.18<br />
2L Multiprofessional education .. .. .. 4.20<br />
2M Student support/Psychiatry and the curriculum .. 4.21<br />
Session 3 – Workshops 1 .. .. .. 4.23<br />
Tuesday 4 September<br />
Session 4 – Large Group Sessions<br />
4A Standards and professionalism in medical education 4.27<br />
4B The challenge of developing international standards<br />
in medical education .. .. .. 4.27<br />
4C Standards and the curriculum .. .. 4.28<br />
Session 5 – Short Communications 2<br />
5A Learning and the Internet .. .. .. 4.29<br />
5B Evaluation of PBL .. .. .. 4.30<br />
5C Curriculum evaluation .. .. .. 4.32<br />
5D Assessing communication skills/Patients as examiners 4.33<br />
5E Postgraduate education for General Practice/Family Medicine 4.35<br />
5F Assessment .. .. .. .. 4.37<br />
5G Outcome-based education .. .. .. 4.38<br />
5H Educational strategies/curriculum planning .. 4.40<br />
5I Educating the educators (2) .. .. .. 4.42<br />
5J Education and cultural diversity .. .. 4.43<br />
5K Contexts for learning .. .. .. 4.45<br />
5L Evaluation of multiprofessional education .. 4.47<br />
5M Teaching about EBM, critical thinking and research .. 4.48<br />
Session 6 – Workshops 2 .. .. .. 4.51<br />
- i -<br />
Page
Wednesday 5 September<br />
Session 7 – Posters<br />
7A New learning technologies .. .. .. 4.56<br />
7B Problem-based learning .. .. .. 4.58<br />
7C Curriculum planning and change .. .. 4.60<br />
7D Curriculum evaluation/staff development .. 4.63<br />
7E Postgraduate education .. .. .. 4.65<br />
7F Assessment .. .. .. .. 4.68<br />
7G Teaching and learning (1) .. .. .. 4.70<br />
7H Teaching and learning (2) .. .. .. 4.73<br />
7I Continuing Professional Development (1) .. 4.75<br />
7J Continuing Professional Development (2) .. 4.77<br />
7K International medical education .. .. 4.78<br />
7L Special subjects .. .. .. .. 4.80<br />
Session 8 – Short Communications 3<br />
8A Computer mediated learning and assessment .. 4.83<br />
8B Implementation of PBL .. .. .. 4.84<br />
8C Curriculum planning .. .. .. 4.86<br />
8D The final examination .. .. .. 4.87<br />
8E Postgraduate education/Career choice .. .. 4.89<br />
8F Teaching and learning .. .. .. 4.90<br />
8G Assessment in postgraduate and continuing education 4.92<br />
8H Curriculum change .. .. .. 4.94<br />
8I Communication skills training .. .. 4.96<br />
8J Clinical teaching .. .. .. .. 4.97<br />
8K International aspects of medical education .. 4.99<br />
8L Special subjects .. .. .. .. 4.100<br />
Session 9 – Plenary 2: Different views of medical education 4.103<br />
- ii -
Session 1 Plenary<br />
1/1 Towards global standards for<br />
medical education<br />
Jordan J Cohen<br />
President, Association of American Medical Colleges, 2450 N<br />
Street N.W., Washington DC 20037-1126, USA<br />
Jordan Cohen has had a longstanding interest in<br />
standards in medical education from the perspective<br />
of a Dean of a medical school and Professor of<br />
Medicine, a Chair of the American Board of Internal<br />
Medicine and the Accreditation Council for Graduate<br />
Medical Education, and President and Chief Executive<br />
Officer of AAMC. In this session he will share his views<br />
about standards in medical education. Why are<br />
standards important? To what extent should we aim for<br />
global standards? How might this be achieved?<br />
1/2 New times, new standards: the<br />
social accountability of health<br />
systems and medical schools<br />
Charles Boelen<br />
Coordinator, Human Resources for Health Program, World<br />
Health Organization, CH-1211 Geneva 27, Switzerland<br />
Health systems worldwide face the challenge of<br />
providing evidence to various stakeholders, including<br />
the public, of their capacity to meet priority health needs<br />
and expectations of individuals and society at large.<br />
Medical schools alike, to ensure continuous support,<br />
will increasingly be expected to demonstrate how their<br />
educational, research and service delivery activities best<br />
contribute to meet requirements for improved quality,<br />
equity, relevance and cost-effectiveness in health care.<br />
These requirements and conformity to new standards<br />
should not just be seen as constraints but as<br />
opportunities for expansion and renewed leadership in<br />
the health sector.<br />
Monday 3 September<br />
- 4.1 -<br />
1/3 Death of the course<br />
R M Harden<br />
Centre for Medical Education and SCPMDE Education<br />
Development Unit, University of Dundee, Tay Park House, 484<br />
Perth Road, Dundee DD2 1LR, UK<br />
Traditionally, curricula were made up of a series of<br />
courses based on disciplines such as anatomy,<br />
pathology, surgery or medicine. These have evolved to<br />
courses based on body systems or other topics. Such<br />
courses are usually described in terms of a timetable<br />
or syllabus with the number and topics of lectures, small<br />
group, practical, or clinical sessions specified. This<br />
paper argues that we will see a revolution in curriculum<br />
and instructional design in response to real needs such<br />
as the need for more flexible training programmes,<br />
more multiprofessional learning opportunities and<br />
greater cooperation between education providers. These<br />
changes will be achieved through the application of<br />
new technologies and a fresh approach to educational<br />
thinking. Contributing to this fundamental change will<br />
be:<br />
1 The move to outcome-based education;<br />
2 The development of electronic curriculum maps<br />
accompanied by appropriate study guides;<br />
3 A dynamic adaptive approach to learning based on<br />
reusable learning objects with an appropriate<br />
learning management system.<br />
The course as we know it today may not be already<br />
dead, but it is dying.
Session 2A A virtual learning environment<br />
2A1 Virtual learning environments –<br />
a learner centred review<br />
Megan Quentin-Baxter* and Suzanne Hardy<br />
Learning and Teaching Support Network, Medicine, Dentistry<br />
and Veterinary Medicine (LTSN-01), Faculty of Medicine,<br />
University of Newcastle, Newcastle-upon-Tyne NE2 4HH, UK<br />
The findings of a study to investigate approaches to<br />
Virtual (Managed) Learning Environments which the<br />
United Kingdom’s National Health Service might take<br />
in implementing a ‘virtual classroom’ are reported. The<br />
brief was to assess current strategies in Internet-based<br />
learning and teaching via a review of current known<br />
VMLE products/projects in relation to NHS needs; to<br />
consider the suitability for transfer to a UK-wide<br />
learner centred continuing professional development<br />
environment (the NHS) based on an adult learning<br />
model, incorporating sophisticated portable reflection/<br />
recording tools; to examine the conceptual models of<br />
‘teacher’ and ‘learner’, and how these definitions might<br />
affect the assessment/construction of a VMLE based<br />
on the required model and applied to the NHS<br />
workforce. The methodologies employed, a brief<br />
analysis of some of the representative VMLEs<br />
identified, and the need for new or integration of<br />
existing technologies to support a learner centred<br />
approach will be discussed.<br />
2A2 Impact of a digital learning<br />
environment on the efficiency<br />
of teachers<br />
Peter G M de Jong* and Hermiette E Idenburg<br />
Leiden University Medical Center LUMC, Onderwijscentrum<br />
IG, Kamer C5-54, PO Box 9600, 2300 RC Leiden,<br />
NETHERLANDS<br />
In September 1999 a digital learning environment for<br />
students was introduced at the Leiden University<br />
Medical Center. The environment supplies students<br />
with additional organizational information as well as<br />
course-related content. In May 2000, the influence of<br />
this environment was evaluated by means of a<br />
questionnaire among all students and teachers in the<br />
first year of study. Teachers use the environment mostly<br />
for schedules (66%) and changes in schedule (56%),<br />
formative questions (56%) and publication of the right<br />
answers on the final examination (44%). Images,<br />
pictures and articles are hardly published due to<br />
possible violation of copyrights. However, almost<br />
unanimously teachers declare that from their point of<br />
view, students now have more rapid access to much<br />
more information and that for themselves, publishing<br />
information is much more time-efficient than before.<br />
In May 2001 the same questionnaire will be conducted<br />
and the results will be compared with the 2000<br />
questionnaire.<br />
Monday 3 September<br />
- 4.2 -<br />
2A3 Building blocks in a new<br />
curriculum: the role of the library in<br />
educational innovation<br />
Margriet Lee and Maureen Brassel*<br />
University of Pretoria, Medical Library, P O Box 667, Pretoria<br />
0001, SOUTH AFRICA<br />
In support of the University of Pretoria’s aim of<br />
providing a virtual campus by means of telematic<br />
teaching and web-based training, the Medical Library<br />
began a virtual information service on the Internet. This<br />
service is integrated into the curriculum of the Faculty<br />
of Medicine by the information specialists by creating<br />
webpages to support the study programmes. Using<br />
block books of specific courses, a spectrum of<br />
information sources is put together on webpages. These<br />
sources include fulltext articles, CD-ROM, videos,<br />
websites, etc. Students work interactively by doing their<br />
searches on various databases, access the library<br />
catalogue and fulltext journals. Webpages differ in<br />
content according to individual courses. Students are<br />
exposed to a wider variety of information, enabling<br />
them to make informed decisions, to make more use<br />
of the library material, to work from home - not bound<br />
geographically, and also to prepare themselves for the<br />
virtual information world of the future.<br />
2A4 IT learning environment: more<br />
structure or more room for<br />
manoeuvre? Centrally guided norm<br />
path or absolute freedom?<br />
J Degryse*, A Roex and W Renier<br />
ACHG K U Leuven, Department of General Practice,<br />
Kapucijnenvoer 33 Blok J, B3000 Leuven, BELGIUM<br />
Various typologies and taxonomies for IT learning<br />
environments are already described in literature. A<br />
central element is the principle of navigation. Is there<br />
an imposed “norm path” or, on the contrary, can an<br />
absolute freedom of movement be provided for, that<br />
will allow the student to study flexibly according to<br />
his own style of learning? ICHO is in the process of<br />
developing a new electronic learning environment.<br />
Since 1 September 1999, every student has access to<br />
his or her own ‘workplace’ on the website. With the<br />
introduction of the Internet-based iTOL further<br />
progress has been made. More than just the latest<br />
software package, iTOL is a new approach to teaching.<br />
The model that forms the basis of the iTOL is essentially<br />
a hybrid. Individual study and self-guided learning are<br />
central features. Within the discussion forum group<br />
learning is of uppermost importance. The focus of the<br />
case studies is problem-oriented thinking and problemsolving<br />
learning. The iTOL project closely follows the<br />
constructivist vision of learning and teaching<br />
(Grabinger 1996, White 1992, Dufy & Cunningham<br />
1996, Harel & Papert 1991). Strictly speaking, no norm<br />
path is imposed in an iTOL. However, the aim is to
exploit the role of periodic and modularly organised<br />
tests and navigation, which is directed by explicitly<br />
formulated learning goals.<br />
2A5 Innovation in self-directed learning<br />
(SDL) in CME: Virtual Internet<br />
Patient Simulation<br />
M A Raetzo*, R L Thivierge, R J Gagnon, V Loroch and<br />
A Bonneau<br />
721 Hartland, Montreal H2V 2X5, CANADA<br />
SDL in CME has been mainly driven by the use of<br />
published written material and also now the growing<br />
use of the Internet. Unfortunately, reading material is<br />
still a rather passive activity. We have developed a<br />
computer software built with clinical vignettes in which<br />
each participant will simulate real encounters with<br />
virtual patients. To do so, the user will have to follow<br />
each step of the basic clinical approach: 1 – finding<br />
the problem: open-questions system; 2 – fixing the<br />
problem; 3 – at each step: each question or decision<br />
has to be justified (exploring the clinical reasoning);<br />
4 – an ongoing feedback can be given upon request at<br />
each level (EBM content already included); 5 - a final<br />
feedback and report is given at the end of each case.<br />
This paper will present the main features of VIPS and<br />
will cover a qualitative evaluation conducted with a<br />
group of 20 family practitioners.<br />
Session 2B PBL and the curriculum<br />
2B1 The birth of a new species –<br />
squirrums: towards equal<br />
collaboration in innovation in<br />
medical education<br />
Peter McCrorie* and David Prideaux*<br />
St George’s Hospital Medical School, Department of Medical &<br />
Health Care Education, Cranmer Terrace, Tooting, London<br />
SW17 ORE, UK<br />
In September 2000, St George’s Hospital Medical<br />
School in London began a new problem-based medical<br />
course for graduates. Initially St George’s purchased<br />
problem-based cases and tutor training expertise from<br />
Flinders University in Adelaide, Australia, where a<br />
similar course had been introduced in 1996. The<br />
resulting collaboration began as a predominantly onesided<br />
affair with a net information flow from Adelaide<br />
to London. But it did not remain that way for long.<br />
There is now an active exchange of existing, new and<br />
revised cases, sharing of web-based resources, regular<br />
staff visits, student bulletin boards, joint workshops<br />
through video-conferencing and collaborations on<br />
evaluation and research. We liken the resultant curricula<br />
to a new species – squirrums – a cross between squirrels<br />
and possums. This paper will outline and analyse the<br />
essential features of the collaboration and draw out<br />
issues and ideas that could be applied to other such<br />
partnerships.<br />
Monday 3 September<br />
- 4.3 -<br />
2A6 Real learning through virtual<br />
presentation: an Internet based<br />
work environment course for<br />
medical students at Uppsala<br />
University<br />
Klas <strong>Berlin</strong>*, Kerstin Graffman and Anna Rask-Andersen<br />
Department of Medical Sciences, Occupational and<br />
Environmental Medicine, University Hospital, Entrance 91, SE<br />
751 85 Uppsala, SWEDEN<br />
Internet based learning in occupational and<br />
environmental medicine in Uppsala Medical School<br />
was introduced during the spring term 1999. A<br />
homepage was constructed which contained schedule,<br />
handouts, message area and quality assessed links. The<br />
written exam was omitted for Internet assignments. The<br />
project was evaluated by a questionnaire. Sixty-six<br />
percent of the 113 students answered the questionnaire.<br />
The teaching stimulated students to reflect about<br />
possible relationships between the patients’ symptoms<br />
and their occupations as well as the environment. The<br />
students also knew where to find information about<br />
such relationships. The Internet project had made it<br />
easier for the students to control their time. The course<br />
had a positive effect upon student interest in the field<br />
and encouraged integrating earlier knowledge.<br />
Occupational and environmental medicine may be<br />
especially suitable for Internet based learning but it is<br />
likely that this kind of teaching would be useful even<br />
in other classes.<br />
2B2 Broadening learning with PBL in a<br />
pathophysiology course<br />
Antonio Rendas* and Bernardo Correia<br />
Faculdade de Ciencias Medicas, Campo dos Martires da Patria<br />
130, 1200 Lisboa, PORTUGAL<br />
Based on our experience of PBL in a pathophysiology<br />
course from a traditional curriculum, we developed a<br />
computer simulation to register the tasks performed<br />
by the students. These records allowed us to identify,<br />
in three consecutive years, the following elements;<br />
learning needs (ln) – expressed in PBL sessions;<br />
learning resources (lr) – used during the self-learning<br />
periods. Six cases were analysed every year covering<br />
different body systems (digestive, circulatory, blood,<br />
respiratory, kidney and endocrine). Each case, based<br />
on a complete patient history, was analysed by a small<br />
group of students (an average of 10), in five tutorial<br />
sessions, lasting for two hours and occurring twice a<br />
week. Despite the single discipline nature of the course<br />
we found a wide range of ln and lr, from basic sciences,<br />
especially physiology and histopathology, to clinical<br />
medicine, especially internal medicine. In our<br />
experience PBL proved to be a useful method to<br />
broaden learning beyond the boundaries of<br />
pathophysiology.
2B3 The implementation of problembased<br />
learning (PBL) into a<br />
traditional Radiology clerkship<br />
U Keske, U K M Teichgraber, R Schroder, J Berger, S Venz<br />
and R Felix<br />
Humboldt University, Gr. Hamburger Str. 36, 10115 <strong>Berlin</strong>,<br />
GERMANY<br />
The aim of the study was to demonstrate the<br />
implementation of problem-based learning (PBL) into<br />
a traditional Radiology clerkship. In addition to the<br />
reformed medical curriculum which is running as a<br />
parallel track, PBL is also applied as a teaching method<br />
in the traditional curriculum. The core radiology<br />
clerkship was taught as a two week block course with<br />
PBL sessions every morning followed by clinical<br />
rotations in radiology. Continuous end of block<br />
evaluation was performed applying a questionnaire.<br />
Based on students’ feedback, changes in the course<br />
structure were made. After four years it is obvious that<br />
radiology is suitable for the use of PBL, because of its<br />
interdisciplinary character. Based on both student and<br />
faculty feedback the group dynamics, student and<br />
faculty satisfaction, course effectiveness and role of<br />
the tutor were rated positively. A set of standard cases<br />
was adapted according to comments from a mandatory<br />
review session at the end of the clerkship. It is<br />
concluded that the introduction of problem-based<br />
learning in radiology had a positive impact on faculty<br />
development. Five faculty members were educated in<br />
becoming PBL tutors and tutored later students of the<br />
reformed medical curriculum of the Charité.<br />
2B4 Medical education innovations in<br />
Dresden, Germany: Reformed<br />
Medical Faculty Carl Gustav Carus,<br />
Dresden University of Technology<br />
Peter Dieter<br />
Medical Faculty, Carl Gustav Carus, Office of the Dean of<br />
Student Affairs, Fetscherstrasse 74, D-01307 Dresden,<br />
GERMANY<br />
The new curriculum in Dresden is based on the<br />
principle of Problem-Based Learning (PBL). The<br />
curriculum is developed in collaboration with Harvard<br />
Medical School. All teachers are professionally trained<br />
in specific courses. The PBL program will integrate<br />
elements of medical ethics, quality management, health<br />
economics and evidence-based medicine. At present,<br />
five multidisciplinary courses have been introduced<br />
into Year 3 and 4. The focal point of each course is a<br />
tutorial with eight participating students and one PBLtrained<br />
tutor. Students and tutors discuss a particular<br />
patient´s case, related to the theme of the course.<br />
Lectures, laboratory courses and “bed-side learning”<br />
complete the curriculum. The Dresden program plans<br />
the integration of further PBL courses into Years 4 to<br />
6. Multidisciplinary courses in basic sciences in Years<br />
1 and 2 will complete the program. Every aspect of the<br />
PBL program is regularly evaluated by an external<br />
institution.<br />
Monday 3 September<br />
- 4.4 -<br />
2B5 Problem-based Learning in<br />
Immunology and Infectious<br />
Disease (IMID): the Dresden<br />
experience<br />
S T Weber*, G Baretton, S Bergmann, J Graeszlear, E Jacobs,<br />
H Kunath, I Nitsche, U Ravens, A Rethwilm and P Rieber<br />
Institute of Medical Microbiology and Hygiene, Dresden Medical<br />
School, Fiedlerstr. 42, 01307 Dresden, GERMANY<br />
IMID are underrepresented in the curriculum of<br />
German medical students. In the final exam, less than<br />
ten out of more than 500 questions are related to<br />
immunology. IMID are scheduled early in the medical<br />
curriculum when most students have not seen patients<br />
regularly. This situation does not reflect the medical<br />
development where immunology and infectious<br />
diseases are becoming increasingly important. Based<br />
on the principles of problem-oriented learning, we<br />
conducted an eleven-week-multi-disciplinary course in<br />
IMID. The schedule included morning-lectures, two<br />
laboratory sessions and three tutorials (8-10 students)<br />
per week. Eleven cases were presented covering major<br />
issues in the field. Due to the clinical background of<br />
the cases the students were able to learn the principles<br />
in infectious diseases from a “real life story”. Lectures,<br />
tutorials and lab sessions were evaluated permanently<br />
by a questionnaire. Students reported a higher<br />
motivation to learn and to self-study. We think that a<br />
more profound insight into IMID will be a benefit for<br />
their professional careers.<br />
2B6 From case-based reasoning to<br />
problem-based learning<br />
Haim Eshach* and Haim Bitterman<br />
Technion, Israel Institute of Technology, PO Box 9649, Bat<br />
Galim, Haifa 31096, ISRAEL<br />
Many medical schools question whether they should<br />
implement a problem-based learning (PBL)<br />
curriculum. Educators raise some serious questions<br />
regarding the efficiency of PBL and therefore<br />
recommend learning more about the cognitive<br />
processes developed by PBL before broadly<br />
implementing it. In addition, it is important to<br />
determine whether PBL best matches the human<br />
reasoning processes. In this theoretical article we<br />
examine the relationships between the case-based<br />
reasoning (CBR) model and PBL. CBR indicates that<br />
the source of knowledge one uses while solving a new<br />
problem is not only generalized rules or general cases,<br />
but often a memory of stored cases recording specific<br />
prior episodes. CBR allows the reasoner to propose<br />
solutions to problems quickly and to propose solutions<br />
in domains that are not completely understood, such<br />
as medicine. Our analysis reveals strong association<br />
between CBR and PBL. We conclude that PBL is a<br />
successful teaching method that should be encouraged<br />
by medical schools.
2B7 A new approach to PBL in CME;<br />
using script concordance tests (SCT)<br />
M Labelle*, C Maille, R L Thivierge and B Charlin<br />
University of Montreal, CME Office, Faculty of Medicine, P O<br />
Box 6128, Centre-Ville Station, Montreal, CANADA H3C 3J7<br />
Traditionally the PBL material for CME is prepared<br />
with the help of clinical cases to be discussed between<br />
peers while answering specific questions. A prior needs<br />
assessment is done to ensure that the material and its<br />
content will respond to the learning needs of the<br />
participants. In order to be more tied to the learners’<br />
needs, we have designed a new model (SCT) for<br />
building each case where the answer to each question<br />
can be displayed and compared to the responses of a<br />
group of expert physicians (previously obtained) on<br />
the same topic. Similarities and discrepancies between<br />
the responses (participants vs experts) become overtly<br />
obvious when revealed on the overhead screen during<br />
the running of the workshop. This PBL model using<br />
SCT has a primary effect of obtaining an ongoing needs<br />
assessment of the learners while the workshop is<br />
actually being delivered.<br />
Session 2C Curriculum database<br />
2C1 Aiding the reform – development of<br />
a curriculum information system<br />
Patrick Merl*, Paolo Petta and Richard Marz<br />
Institute of Medical Chemistry, University of Vienna Medical<br />
School, Wahringerstr. 10, A-1090 Vienna, AUSTRIA<br />
Curriculum information systems have been discussed<br />
in the literature since the early 1970s. Most systems in<br />
existence deliver structural information, and little is<br />
known about systems that have been designed to<br />
successfully serve as planning tools. We explore<br />
possible reasons for this phenomenon. The University<br />
of Vienna Medical School is currently reforming its<br />
curriculum from strictly subject based to one with an<br />
integrative approach. Such a process generates large<br />
amounts of data and a great need for information and<br />
coordination. At the same time the systemic shift<br />
stimulates a climate of uncertainty for individuals and<br />
departments. Our school has therefore funded the<br />
design of an information system to fill the needs of<br />
exchange and coordination in the reform process. The<br />
presentation will discuss how this information system<br />
supports the planning process: it represents information<br />
in several structured formats, aids in decision making,<br />
and provides orientation for stakeholders.<br />
2C2 How effective is project<br />
management software in<br />
implementing a new course?<br />
Katharine Grundy<br />
St George’s Hospital Medical School, Cranmer Terrace, Tooting,<br />
London SW17 0RE, UK<br />
Monday 3 September<br />
- 4.5 -<br />
2B8 Discovering versus covering: a<br />
new PBL in Behavioural Sciences<br />
Ala’Aldin Al-Hussaini and Harith Ghassany<br />
College of Medicine, Sultan Qaboos University, Post Box: 35,<br />
Postal Code: 123, Al-Khod, Sultanate of Oman<br />
During the initial decade since its establishment in<br />
1986, the Department of Behavioural Medicine at<br />
Sultan Qaboos University had placed more weight on<br />
teaching at the expense of learning. As with most<br />
teacher-centred learning, the implicit assumption has<br />
always been that a good teacher must necessarily<br />
produce good students regardless of the fact that student<br />
learning is active or passive. Over the last 5 years the<br />
Department has initiated student-centered learning<br />
teams while reducing the lecture format to the<br />
minimum. The shift is essentially a move away from a<br />
culture of rote teaching and learning to a more<br />
interactive culture of critical reading, thinking, and<br />
reading material, which can be made relevant to the<br />
culture of the students and the common problems of<br />
their communities. Following initial problems of<br />
adjustment and reluctance by both teachers and<br />
students, it has been found that there is more value in<br />
the balance between the discovery approach to learning<br />
and the covering of material approach to teaching.<br />
Planning and implementing a new graduate entry<br />
programme in medicine presented many challenges. A<br />
management system was required to assist in the<br />
administration of the project and to generate<br />
communications tailored to the needs of the individual<br />
teachers and administrators. We decided to use<br />
Microsoft Project, the most widely used project<br />
management software. It assists in the organisation of<br />
administrative tasks such as identifying key milestones,<br />
scheduling activities, assigning resources and tracking<br />
progress. An invaluable feature of the software is its<br />
ability to publish reports e.g. filtering information to<br />
ensure individuals only receive details relevant to<br />
themselves. This information can be distributed either<br />
on paper, by email or published on the Intranet. For a<br />
project to succeed, however, it requires more than good<br />
software. Critical factors for successful project<br />
administration include rigorous planning, realistic timescales,<br />
effective communication, clearly defined<br />
responsibilities, commitment from senior management<br />
and regular monitoring.<br />
2C3 MESMIS – Medical School Staff/<br />
Student Management Information<br />
System: Towards the electronic<br />
curriculum<br />
D A Levison and W M Williamson<br />
University of Dundee Medical School, Dundee DD1 9SY, UK<br />
MESMIS is a comprehensive web-based management<br />
information system developed at Dundee Medical<br />
School to provide communication; resource
management; staff and student support mechanisms;<br />
course information inclusive of personal (staff and<br />
student) timetables; e-learning and now outcome based<br />
enquiries for each learning opportunity. Access to the<br />
system is secure and only accessible by registered<br />
medical students and staff, including internal and<br />
external honorary clinical staff involved with the<br />
delivery of the medical course. Registration is achieved<br />
on-line and permits access to information by students<br />
and staff from anywhere in the world. It provides a<br />
comprehensive Managed Learning Environment<br />
(MLE) with a number of active links providing the basis<br />
of a Virtual Learning Environment (VLE). This is<br />
complemented by an outcome-based assessment<br />
process that is enhanced by the components of<br />
“outcome-mapping”, significantly strengthening its<br />
already generic application.<br />
2C4 SIMON – Student Information and<br />
Management Online Network<br />
P Wagner*, D Zeiss*, S Konig*, P M Markus and H Becker<br />
Klinik fur Allgemeinchirurgie, Universitat Goettingen, Robert<br />
Koch Str. 40, D-37075 Gottingen, GERMANY<br />
We have developed a web-based administration and<br />
information system to improve both student and faculty<br />
facilities through enhancement of the online<br />
experience. SIMON offers a central starting point for<br />
students and teachers alike and allows direct interaction<br />
between them. Registration for courses may take place<br />
online. Lists and information are generated<br />
automatically and are always up to date. Curriculum<br />
evaluation may occur via a web interface. SIMON<br />
provide teachers the opportunity to contact students<br />
prior to the start of a course and distribute instructions,<br />
help or hints. Furthermore, SIMON is an ideal forum<br />
for discussion, problems and reflection on case studies<br />
outside the classroom environment. Integration of<br />
additional teaching modules has been allowed for, such<br />
as online guides for specific courses. Individual<br />
departments may employ variable programming<br />
structures, allowing this project to be extended and<br />
adjusted accordingly and as their future needs arise.<br />
2C5 Portfolio-based Dermatology<br />
internship – one year’s experience<br />
A Boer*, R Kaufmann and F Ochsendorf<br />
Universitats-Hautklinik Frankfurt/M, Theodor Stern Kai-7,<br />
60590 Frankfurt am Main, GERMANY<br />
Monday 3 September<br />
- 4.6 -<br />
The last year (practical year) of medical education in<br />
Germany is not very systematized. In order to improve<br />
student learning during the dermatology internship we<br />
introduced a portfolio to clarify which components are<br />
considered important within dermatology: 25<br />
qualifications divided into “general basics”,<br />
“dermatology-basics” and “special-dermatology” were<br />
listed in a student’s portfolio with a theory, supervision<br />
and clinical practice part. The individual achievements<br />
were documented in the portfolio by the educating<br />
residents. Since May 1999 15 students participated in<br />
the portfolio-program, they completed in the mean 70%<br />
of the listed activities; general basics were fully<br />
completed by all the students, 75% of dermatology<br />
basics and 46% of special dermatology were completed.<br />
The students welcomed the portfolio as it provided a<br />
useful overview of learning opportunities and<br />
achievements. This is the first use of portfolio-based<br />
medical education in a dermatology internship in<br />
Germany. Students strongly requested implementation<br />
of portfolio-based learning in other faculties.<br />
2C6 Profile of the consultations made<br />
by fifth year medical students in the<br />
integrated program of pediatrics<br />
and public health<br />
Claudia Astudillo, Rocio Arenas, Maria Bustamante*,<br />
Maria De La Fuente and Gladys Yentzen<br />
Universidad de Chile, Walter Scott 1115, Vitacura, Santiago,<br />
CHILE<br />
During the 5th year of medical school, the students<br />
participate in an integrated program of pediatrics and<br />
public health, which includes a visit to a primary care<br />
clinic where the students are able to apply the<br />
knowledge acquired in the theoretical course of<br />
pediatrics and learn the abilities that will help them<br />
participate in actions of promotion, protection and<br />
recovery of health. The objective of this study is to<br />
know which were the most common diagnoses they<br />
made and verify if they are the same they will see in<br />
the future. We analyzed 609 consultations, with a total<br />
of 795 diagnoses, which were classified according to<br />
the ICD 10. The three most frequently found diagnoses<br />
were respiratory, infectious and cutaneous diseases,<br />
which are the same found in the literature. It is<br />
concluded that to prepare medical students to recognise<br />
and treat the most common diseases, the primary care<br />
clinics are a necessary instrument that can easily be<br />
inserted in the curriculum.
Session 2D OSCE/Standardised patients in assessment<br />
2D1 “Check it, rate it, palm it or leave it”<br />
– handheld computers replace<br />
checklists in OSCEs and provide<br />
automated feedback<br />
Michael Schmidts*, Markus Kemmerling, Ruth Willnauer<br />
and Martin Lischka<br />
Studienzentrum - AKH, P O B 10, A-1097 Vienna, AUSTRIA<br />
We recently developed software that enables PalmOS<br />
powered handheld computers to replace checklists in<br />
an OSCE. Each observer is now provided with a mobile<br />
handheld device to record mistakes, incomplete or<br />
missing actions by striking with a pen on a touchscreen.<br />
Additionally, the examiner can enter new items during<br />
the test, which serve as suggestions when the item<br />
database is updated. At the end of the examination the<br />
data of all participating candidates are synchronised<br />
(by “beaming”) and transferred to a desktop computer<br />
for further processing (like statistical item analysis or<br />
immediate candidate feedback printouts). Based on 18<br />
months’ experience with our new assessment system<br />
we see clear advantages in the speed of data gathering,<br />
the ease of data evaluation and the quick and highly<br />
elaborated feedback. Observers familiarised well with<br />
the device, which also turned out to be less intrusive<br />
than checklists. So far the program worked failsafe.<br />
2D2 Evaluation of the undergraduate<br />
surgery course: effect of OSCE<br />
Marco Bustamante Z*, Carlos Carvajal H, Fernando<br />
Quevedo R, María Bustamante C and Claudia Astudillo M<br />
Universidad de Chile, Depto de Cirugía, Avenida Salvador 368,<br />
Providencia, Santiago, CHILE<br />
Two different methods, a guideline of evaluation<br />
applied by different teachers and OSCE, have been used<br />
to estimate knowledge, attitudes and dexterities in<br />
undergraduate medical students of the 4th year in the<br />
subject of surgery. The objective of this communication<br />
is to compare the results on the final grades of the class<br />
before and after the introduction of OSCE. In the year<br />
1997-1998, the final grade was composed of theoretical<br />
exams 40%, evaluation guidelines 60%. In the 1999-<br />
2000 period, this grade was composed of theoretical<br />
exams 40%, OSCE 40%, evaluation guidelines 20%.<br />
The final grades averages, standard deviation and<br />
variation coefficients were compared during the two<br />
periods. Period 1997-1998 final grades average was<br />
6.15, st dev 0.23, var coeff 3.7. Period 1999-2000 final<br />
grades average was 5.62, st dev 0.66, var coeff 11.7. It<br />
is concluded that establishing a type of examination<br />
that measures skills objectively increases the dispersion<br />
of the grades threefold. This allows us to conclude that,<br />
with OSCE, a more valid document is obtained,<br />
assuring better discrimination amongst students.<br />
2D3 OSCE: are many different stations<br />
necessary for each evaluation?<br />
Carlos Carvajal*, Marco Bustamante and Ilse López<br />
Universidad de Chile, Facultad de Medicina, Camino De La<br />
Laguna 13452, Lo Barneclen, Santiago, CHILE<br />
Monday 3 September<br />
- 4.7 -<br />
One of the objections about the Objective Standardised<br />
Clinical Examination (OSCE) is the need for many<br />
different stations for each evaluation. The supposition<br />
is that early consciousness of OSCE stations may<br />
increase the OSCE score. At the Medical School of<br />
Chile University, we used OSCE evaluation<br />
consecutively in 4 groups of medical students, all of<br />
these with the same stations; groups 1 and 2 in 1999;<br />
groups 3 and 4 in 2000. There were no statistically<br />
significant differences among the mean score between<br />
groups 1 and 2. The mean score in group 1 was greater<br />
than group 3 (p values
ecoming more common. Here, it is imperative that<br />
scores are reliable and valid. To accomplish this task,<br />
great care must be taken in the training and monitoring<br />
of SPs. For the Clinical Skills Assessment (CSA),<br />
administered by the Educational Commission for<br />
Foreign Medical Graduates (ECFMG), SP performance<br />
is continually scrutinized. In addition, surveys are<br />
administered to collect data on SP demographics and<br />
opinions regarding exam logistics and training. The<br />
purpose of this paper is to explore the relationship<br />
between SP-related variables (e.g., work history,<br />
training, conditions portrayed) and the adequacy of<br />
candidate scores. Initial results suggest that some, albeit<br />
small, variation in candidate scores can be attributed<br />
to some characteristics of the SP. Fortunately,<br />
continuous quality control, combined with periodic<br />
training and re-training of SPs, ensures that decisions<br />
regarding candidate competence are accurate, fair, and<br />
unbiased.<br />
2D6 Use of standardized patients to<br />
assess medical response to a<br />
natural disaster<br />
Graceanne Adamo*, Marguerite Hawkins, Heidi Worth-<br />
Dickstein, Eric Marks, Ralph Jones, Gilbert Muniz and<br />
Richard E Hawkins<br />
Uniformed Services University of the Health Sciences, National<br />
Capital Area Medical Simulation Center, 4301 Jones Bridge<br />
Road, Bethesda MD 20814, USA<br />
We describe the feasibility and advantages of utilizing<br />
Standardized Patients (SPs) to train and assess the<br />
ability of military medical teams to provide<br />
international health care following natural disasters.<br />
The real-time simulation took place aboard ship after<br />
a hurricane in Belize. Cases were based upon<br />
geographic and natural disaster-related epidemiology.<br />
Moulage, radiographs, computerized laboratory and<br />
imaging reports were provided. Analytic methods<br />
included surveys, structured medical record review, SP<br />
- 4.8 -<br />
checklists, and direct observation. Crew rated the<br />
exercise as more realistic and significantly better than<br />
a previous exercise without SPs in assessing and<br />
preparing them to triage and care for casualties. Medical<br />
record audits and SP checklists were complementary<br />
in evaluating quality of care for individuals. Observers<br />
yielded important data regarding patient flow,<br />
communication, equipment function, supply use, and<br />
ancillary support. The simulation and inclusion of a<br />
variety of assessment measures allowed for high quality<br />
evaluation of complex care delivery.<br />
2D7 The weakest link? Performance<br />
factors and degrees of influence in<br />
an interactive long-station general<br />
practice examination (VOICEs)<br />
C M Wiskin*, T Allan and J Skelton<br />
The Medical School, University of Birmingham, Edgbaston,<br />
Birmingham B15 2TT, UK<br />
Passing a six-station Primary Care OSCE examination<br />
is compulsory. In 2 tasks students improvise<br />
consultations with ‘patients’ portrayed by our role-play<br />
team. Clinical performance is marked by a clinical<br />
examiner. Communication scores (professionalism,<br />
competence, attitude) are awarded by negotiation<br />
between examiner and role-player. This paper is part<br />
of a study evaluating reliability and bias across<br />
examination variables. Data about role-players, students<br />
and examiners; the dynamics and score-awards,<br />
demographics and the logistics of exam days were<br />
collected. Results from over 1,000 assessed<br />
consultations were collated on SPSSv.10. Preliminary<br />
data suggest variables such as question selection, order<br />
in which students are seen, age/experience of examiners<br />
and relationship between role-player and examiner<br />
assessment are not significant. Despite the apparent<br />
subjectivity of the format, interactive examinations are<br />
an appropriate means of testing the communication<br />
skills of medical students.<br />
Session 2E Postgraduate education – the early years<br />
2E1 New PRHO: “I am not sure what I<br />
am supposed to do”. Can we<br />
improve on PRHO induction? An<br />
evaluation of a new induction<br />
process<br />
Dason Evans*, Mike Roberts and Diana Wood<br />
St Bartholomew’s and the Royal London, Department of Medical<br />
Educational Research & Innovation, Robin Brook Centre, School<br />
of Medicine & Dentistry, West Smithfield, London EC1A 7BE,<br />
UK<br />
We conducted a controlled study involving 48 PRHOs.<br />
We compared a traditional, one-day induction with a<br />
newer process principally involving five days of<br />
shadowing before the commencement of the PRHO<br />
post. Clinical responsibility was taken in a safe<br />
environment with full support from the outgoing teams.<br />
Monday 3 September<br />
We assessed feelings of anxiety, preparedness and<br />
confidence in clinical skills via questionnaire, and<br />
ability in clinical skills via an OSCE, before and after<br />
induction and at one month. We audited prescribing<br />
errors, radiology request errors, note keeping and<br />
adverse events in both groups. Pre-induction levels of<br />
anxiety and uncertainty were high, with almost half<br />
having biological symptoms of anxiety. Clinical skills<br />
improved during the longer induction, and 21/22 of<br />
intervention PRHOs felt more prepared for their post<br />
(cf 13/22 controls with 7/22 controls feeling less<br />
prepared after a traditional induction). We will discuss<br />
the induction process and statistical analysis of results<br />
in depth.
2E2 A comparison of Pre-registration<br />
House Officers’ (PRHOs) and<br />
Senior House Officers’ (SHOs)<br />
experience in general practice<br />
Jan Illing*, Tim van Zwanenberg, Bill Cunningham,<br />
George Taylor, Richard Prescott and Cath O’Halloran<br />
University of Newcastle, Postgraduate Institute for Medicine &<br />
Dentistry, 10-12 Framlington Place, Newcastle upon Tyne NE2<br />
4AB, UK<br />
The aim was to compare the experiences of SHOs and<br />
PRHOs spending four months training in general<br />
practice. While government funding has been provided<br />
for PRHOs, similar schemes for SHOs remain rare and<br />
experimental. A case study approach was used<br />
employing various sources of data. The study involved<br />
nine SHOs, twelve PRHOs, nine GP trainers and sixteen<br />
hospital consultants. Data were collected from PRHOs,<br />
SHOs, GP trainers and hospital consultants. Interview<br />
data were tape-recorded and analysed using thematic<br />
analysis and grounded theory to identify important<br />
themes and patterns in the data. SHOs and PRHOs were<br />
unanimous about the value of the experience in general<br />
practice. They reported learning skills not covered in<br />
hospital posts. GP trainers and hospital consultants<br />
valued the rotations for all doctors irrespective of final<br />
career destination. SHOs were considered better<br />
equipped for general practice and required less<br />
supervision. However, PRHOs felt able to cope with<br />
the demands of general practice.<br />
2E3 Pre-registration experience in<br />
general practice: results of a<br />
national evaluation<br />
Janet Grant*, Lesley Southgate, Rodney Gale, George<br />
Freeman, Alison Hill, Neil Johnson, Frank Smith, Mairead<br />
Beirne and Heather Owen<br />
Open University Centre for Education in Medicine, The Open<br />
University, Walton Hall, Milton Keynes MK7 6AA, UK<br />
A national pilot project to give pre-registration house<br />
officers experience in primary care [with 4 months in<br />
each of medicine, surgery and primary care] was<br />
conducted from August 1998 – August 1999. A national<br />
evaluation was commissioned involving all 96 PRHOs<br />
and their supervisors, and a reference group from the<br />
traditional scheme [6 months medicine, 6 months<br />
surgery]. Tailored survey questionnaires were<br />
completed by trainees and supervisors at the end of<br />
each 4- or 6-month post. The areas evaluated included<br />
costs, governance, content and process of learning,<br />
outcomes of learning, and assessment, quality<br />
assurance and monitoring.<br />
Main findings were:<br />
• the three posts make a balanced, coherent package.<br />
• the scheme produced no detriment for the PRHOs.<br />
• there were no detrimental effects on hospital<br />
supervisors’ time commitment<br />
• the time impact on the general practices was<br />
significant<br />
• the new scheme has some effect on PRHOs’ career<br />
plans.<br />
Monday 3 September<br />
- 4.9 -<br />
2E4 Family Medicine Month: a human<br />
life cycle approach for first year<br />
residents<br />
Linda Z Nieman, Rebecca Gladu, Thelma Jean Goodrich,<br />
Janet Groff and Mary M Velasquez<br />
UT Houston Health Science Center, Family Practice and<br />
Community Medicine, 6431 Fannin, Suite JJL324, Houston, TX<br />
77030, USA<br />
We designed “Family Medicine Month,” a rotation for<br />
first year residents, to provide a contextual, lifecycle<br />
approach to medical care and related family practice<br />
skills. Individual daily sessions related to a particular<br />
stage of the lifecycle (e.g., adolescence) and related<br />
behavioural and technical skills (e.g., interviewing the<br />
adolescent patient and casting skills for common sport<br />
injuries). We intended that our residents would integrate<br />
this inclusive approach into their professional<br />
behaviour. Twenty residents who participated in the<br />
rotation in 1999 and 2000 were satisfied with the<br />
rotation’s usefulness. They also reported greater selfefficacy<br />
in performing family practice skills after the<br />
rotation (8.1 ± 0.7) as compared to before the rotation<br />
(6.2 ± 1.4) (p
2E6 Teaching the forgotten tribe: tutor<br />
views on a generic curriculum<br />
for SHOs<br />
Lesley Pugsley* and Janet MacDonald<br />
School of Postgraduate Medical and Dental Education, Academic<br />
Department of Postgraduate Medical and Dental Education,<br />
University of Wales College of Medicine, Heath Park, Cardiff,<br />
CF4 4XN, UK<br />
A consortium of postgraduate centres has developed<br />
as a pilot, a generic programme for the SHOs in South<br />
East Wales. It is designed to run for an initial eight<br />
week period commencing in the Spring of this year,<br />
with an evaluation in July and a report on the<br />
programme in August 2001. The core curriculum has<br />
been resource led, its design predicated on the various<br />
skills and topics which individual consortium members<br />
felt able to contribute. This paper complements the<br />
initial phase of a research study which focused on the<br />
perceived needs of SHOs and VTS and takes as its focus<br />
the core tutor team. It seeks to identify emergent themes<br />
of congruence and dissonance between the groups of<br />
learners and teachers in order to assist in the<br />
identification of a compatible curriculum addressing<br />
the perceived needs of the SHO grade within the<br />
limitations of resources and service commitments.<br />
Session 2F Peer assessment<br />
2F1 Peer- and co-assessment leads to<br />
shared responsibility for test results<br />
Caro Brumsen and Peter G M de Jong*<br />
Leiden University Medical Center LUMC, Onderwijscentrum<br />
IG, Kamer C5-54, P O Box 9600, 2300 RC Leiden,<br />
NETHERLANDS<br />
During the clerkship in Internal Medicine, an<br />
introductory test is taken every 3 weeks by a group of<br />
10 students. A pool of correctors corrects the test.<br />
Usually there is a lot of discussion concerning the test<br />
results. Therefore a new correction procedure was<br />
introduced. In duos, students do the first correction on<br />
copied versions of the test, with the aid of a standard<br />
answer sheet. Discussion is encouraged and students<br />
can put down their comment in writing, preferably with<br />
references added. This comment is sent to the second<br />
corrector together with the original version of the test<br />
answers. On evaluation, most of the students<br />
commented positively, especially on the possibility to<br />
gain insight into the correct answers. The method of<br />
peer- and co-assessment appears to have led to an<br />
improved acceptance of test results, reflected by a<br />
dramatic decrease in complaints.<br />
2F2 Student self-marking as an<br />
assessment approach to<br />
developing professionalism<br />
G J Mires* and M Friedman Ben-David<br />
University of Dundee, Department of Obstetrics and<br />
Gynaecology, Ninewells Hospital & Medical School, Dundee<br />
DD1 9SY, UK<br />
Monday 3 September<br />
- 4.10 -<br />
2E7 General professional training (GPT)<br />
for dental graduates in the UK<br />
Alison Bullock*, Vickie Firmstone and John Frame<br />
Centre for Research in Medical & Dental Education, School of<br />
Education, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
This presentation reports on GPT in UK dentistry.<br />
Comparison is made with senior house officer training<br />
for medical graduates which is currently under review<br />
in the UK. The study gained information on the GPT<br />
undertaken by recent graduates in dentistry and their<br />
views on it. A questionnaire was sent to those registered<br />
(since 1997) for Membership of the Faculty of Dental<br />
Surgery (MFDS) Distance Learning Course (Royal<br />
College of Surgeons of England). A 55% (n=342)<br />
response rate was achieved. Widespread support was<br />
found amongst trainees for a period of GPT. However<br />
there was consensus that this period should be<br />
voluntary. There was support for both formal, integrated<br />
2-year programmes and self-constructed versions that<br />
can offer greater flexibility. A qualification marking<br />
the successful completion of GPT was favoured. GPT<br />
that provides experience of primary and secondary care<br />
forms a broad basis for future careers.<br />
Dundee University Medical School has adopted an<br />
outcome-based curriculum in which personal<br />
development is one of the defined outcomes. Selflearning<br />
and self-awareness are important attributes of<br />
this outcome. A study was undertaken to evaluate the<br />
feasibility and reliability and to survey student opinion<br />
regarding the value of undergraduate medical student<br />
self-marking of written examinations as a means of<br />
developing these attributes. The correlation between<br />
student and staff marks, and the reliability of marking<br />
was high. The majority of students considered there<br />
was value in the exercise as a learning and feedback<br />
opportunity, but found it stressful. We believe that this<br />
approach, as well as being reliable, provides a powerful<br />
feedback and self-learning opportunity. It also provides<br />
a mechanism to identify individuals who over or under<br />
mark or who feel threatened by feedback or are unable<br />
to receive negative feedback, with whom Faculty can<br />
work.<br />
2F3 Comprehensive assessment: value<br />
for learning<br />
Elaine F Dannefer<br />
University of Rochester Medical Center, 601 Elmwood Avenue,<br />
Box 601, Rochester NY 14642, USA<br />
The University of Rochester School of Medicine and<br />
Dentistry has implemented a two-week long<br />
comprehensive assessment of second year medical<br />
students for purposes of providing formative feedback.<br />
Multiple assessment techniques, including standardized<br />
clinical encounters and peer assessments, provide
feedback that identifies specific learning needs as well<br />
as problematic patterns of behaviour. Students work<br />
with their advisory deans to interpret the feedback and<br />
construct individualized learning plans. An overview<br />
of the various components will be presented as well as<br />
examples of different types of feedback and learning<br />
plans. The value of this comprehensive assessment for<br />
student learning and for curricular planning will be<br />
discussed with attention given to the resources required<br />
for implementation.<br />
2F4 Attributes of the excellent physician:<br />
a third year student survey<br />
A V Carneiro*, M F Patrício and J Fernandes e Fernandes<br />
University of Lisbon School of Medicine, Rua Sousa Lopes, Lote<br />
KL - 8 E, 1600-207 Lisbon, PORTUGAL<br />
Role-modeling is a basic part of medical education.<br />
Sixty-six third year medical students were asked – using<br />
questionnaires with open and closed (Likert scale type)<br />
questions – to indicate their opinions on the attributes<br />
of a good doctor. The students favoured good<br />
humanistic qualities in the relationship with patients<br />
and families (96% good or very good), ability to look<br />
for help when needed in clinical practice (97%),<br />
diagnostic abilities (97%) and honesty and ethical<br />
behaviour (94%). The least important attributes<br />
included leadership (68% little or no importance),<br />
research abilities (71%) and a good general culture<br />
(67%). It is concluded that third year medical students<br />
can define a set of attributes of what they consider to<br />
be a good doctor: these include professional behaviour,<br />
ethics, knowledge and leadership. We will recheck these<br />
results at graduation time (within 3 years).<br />
2F5 The Medical Student Peer<br />
Evaluation Initiative: assessment<br />
of performance in small group<br />
settings<br />
Steven L Kanter*, Kathleen Ryan, John Mahoney and<br />
Joan Harvey<br />
University of Pittsburgh, School of Medicine, M-240 Scaife Hall,<br />
3550 Terrace Street, Pittsburgh PA 15261, USA<br />
Experience with student assessment at the University<br />
of Pittsburgh School of Medicine led to the observation<br />
that, although a faculty facilitator was not identifying<br />
early a student experiencing difficulty in small group,<br />
the student’s peers were generally aware of the problem.<br />
This led to the development of the Medical Student<br />
Peer Evaluation Initiative (PEI), which aims to provide<br />
feedback to students on performance in small group<br />
sessions; recognize students who demonstrate<br />
excellence; identify poorly functioning students and<br />
offer counseling. Each student rates each other group<br />
member on the member’s ability to help the student<br />
learn. If a score pattern indicates a problem, a faculty<br />
overseer meets with the student. Results of the PEI<br />
reveal excellent participation, early identification of<br />
Monday 3 September<br />
- 4.11 -<br />
students with a range of difficulties, and rapid<br />
remediation of most problems. In conclusion, peer<br />
evaluation is a feasible and useful measure of student<br />
small group performance.<br />
2F6 Reliability of a multidimensional<br />
questionnaire to assess attitudes of<br />
medical students towards their<br />
future profession: the UNI Project<br />
G L Werneck*, E C O Ribeiro, A C Aguiar and V M B Ribeiro<br />
Nucleo de Estudos de Saude Coletiva, NESC/UFRJ, Av. Brig.<br />
Trompovsky s/n - HUCFF, 5o andar - Ala Sul, BRAZIL<br />
The objective of this study was to assess the reliability<br />
of answers to questions concerning attitudes of medical<br />
students towards their future profession. We developed<br />
a self-administered questionnaire including 52<br />
questions covering attitudes expected to be developed<br />
by students during medical school. A test-retest design<br />
was used as a preliminary evaluation of the<br />
questionnaire. The questionnaire was completed twice<br />
within a one-week interval by students of the major<br />
university of Rio de Janeiro, Brazil. The test-retest<br />
reliability was estimated by kappa statistics (K).<br />
Twenty-four questions (46%) had K greater than 0.6<br />
(substantial agreement); 13 questions (25%) had K<br />
between 0.4 and 0.6 (moderate agreement); and 15<br />
questions (29%) had K below 0.4 (fair agreement).<br />
Considering the complexity of assessing attitudes, we<br />
judge these preliminary results as satisfactory. The next<br />
step will be to revise and test those questions showing<br />
low agreement.<br />
2F7 Narrowing the gap in the<br />
assessment process<br />
Nicolas Karlsson<br />
Villa Medici, Hogasplatsen 6, 412 56 Goteborg, SWEDEN<br />
The problem with assessment processes in the past has<br />
been to motivate the participants to take an active and<br />
creative part in the process. This requires a narrowing<br />
of the gap between different groups and that the process<br />
stimulates each individual participating. On the<br />
initiative of the student organisation, the Faculty of<br />
Medicine in Göteborg implemented the Course<br />
Committee in year 2000 after three succesful pilot<br />
projects. The Course Committee is the motor in the<br />
assessment process, creating a suitable environment for<br />
communication in close connection to the reality of<br />
each participant. As a meeting point between the<br />
different parts in the educational process it improves<br />
not only the democracy of the organisation necessary<br />
for continuous improvement, but the course committee<br />
also facilitates the translation from the student’s<br />
descriptional language into the defined language of the<br />
manager of the course. A protocol published on the<br />
www preserves the productive dialogue and the<br />
suggestions made.
Session 2G Continuing professional development<br />
2G1 Learning and partnering: bringing<br />
pharmaceutical representatives<br />
into the educational loop<br />
Jane Tipping*, Craig Campbell, Jean Claude Dairon, Paul<br />
Davis, Francois Goulet, Gilles Lachance, Celine Monette,<br />
Joan Sargeant, Linda Snell and Robert Thivierge<br />
10987 Warden Avenue, Markham, Ontario L6C 1M9,<br />
CANADA<br />
Pharmaceutical representatives play a key role in<br />
upholding high standards for CME in Canada.<br />
Representatives receive many opportunities to upgrade<br />
knowledge of disease states and management; however<br />
very little is offered for the practice of CME. A group<br />
of dedicated professionals from across Canada<br />
representing academia, industry and the Council for<br />
Continuing Pharmaceutical Education has created a<br />
training module specifically for pharmaceutical<br />
representatives. The outcome has been a quality<br />
program that includes a method of training and<br />
evaluation unique in format and congruent with the<br />
philosophy of adult education. The coalition of three<br />
stakeholder groups represents an example of<br />
partnership that promises to offer a means of raising<br />
and maintaining standards of CME across the country.<br />
A method of education and evaluation is presented that<br />
will evoke critical discussion in the issues of industry<br />
CME and the meaning of partnership. Methods of<br />
conducting research on efficacy will also be discussed.<br />
2G2 CME with a combination of<br />
standardised patients and a CBT<br />
programme<br />
S Schewe*, A Schewe and J Loohs<br />
Medizinische Poliklinik, Klinikum der Universitat, Ludwig-<br />
Maximilians-Universitat, Pettenkoferstr 8a, D-80336 Munich,<br />
GERMANY<br />
A new approach to continuous medical education CME<br />
concerns teaching and knowledge assessing of general<br />
practitioners in musculoskeletal diseases sponsored by<br />
Aventis Pharma. The three elements of the CMEseminar<br />
were an interactive tutorial with a CBTprogramme,<br />
the assessment and discussion of problem<br />
solving strategies including three standardized patients<br />
with frequent musculoskeletal diseases and finally a<br />
lecture on innovative therapeutic possibilities. The new<br />
form of CME was welcomed by nearly all of the 26<br />
physicians (with the exception of 1); their opinion about<br />
this kind of training was very positive. Individual<br />
deficits in problem solving were obvious to each of<br />
the physicians so that immediate improvement was<br />
possible. The three educational elements of the CME<br />
were judged almost equally with a slight advantage for<br />
the part with the standardised patients. The CBT<br />
programme was considered an integral and important<br />
part of the rheumatology seminar.<br />
Monday 3 September<br />
- 4.12 -<br />
2G3 The impact of continuing<br />
professional development (CPD):<br />
30 case studies of dentists<br />
Vickie Firmstone*, Alison Bullock and John Frame<br />
Centre for Research in Medical & Dental Education, School of<br />
Education, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
This presentation reports on a key part of a Department<br />
of Health funded study whose principal aim was to<br />
explore the impact of CPD on the practice of GDPs.<br />
Thirty dentists were interviewed before and after<br />
undertaking a self-chosen educational activity.<br />
Discussion focussed on the specific activity and on their<br />
experience of CPD more generally. Factors affecting<br />
the impact of CPD on practice include:<br />
1 the process by which CPD is selected. Much is<br />
undertaken on an ad hoc/ opportunistic basis rather<br />
than an analysis of learning needs. This can lead to<br />
CPD which ‘confirms’ current practice rather than<br />
introduces new learning;<br />
2 barriers to undertaking CPD (access, time,<br />
financial); and<br />
3 constraints to implementing change.<br />
There was broad support for the importance of CPD<br />
for personal and professional development, but there<br />
are significant factors which affect the impact of CPD<br />
in general dental practice.<br />
2G4 Global trends in continuing medical<br />
education<br />
Lewis A Miller<br />
Global Alliance for Medical Education, 90 Goodwives River<br />
Road, Darien, CT 06820-5921, USA<br />
Patterns of Continuing Medical Education (CME) are<br />
changing rapidly worldwide. Accreditation systems are<br />
being adopted rapidly in Europe and Latin America,<br />
but are not yet well recognized. At the same time some<br />
countries and medical specialties are changing from<br />
CME to CPD (Continuous Professional Development)<br />
despite failure of earlier CPD experiments. Methods<br />
of delivering CME are also changing. Lectures are<br />
regarded as less useful than newer forms of interactive<br />
learning. The use of the Internet and CD-ROMs is<br />
increasing. CME of the future will take place at the<br />
point of care. Two new and critical issues are emerging<br />
as CME becomes mandatory for many physicians:<br />
1 Who regulates CME? Government or the<br />
profession?<br />
2 Who pays for CME? Government? Physicians?<br />
Health insurance? Pharmaceutical Industry?<br />
Medical educators in Europe have a major opportunity<br />
to take a leadership role.
2G5 Do we need consultant appraisal?<br />
K H Matheson<br />
West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ,<br />
UK<br />
There are societal and political demands for<br />
accountability by the medical profession in a world of<br />
rapid technological advances, and with better-educated<br />
and sophisticated consumers. No longer does “doctor<br />
know best”. In the UK the profession has been suffering<br />
from some high profile cases and a hostile media. As a<br />
result the government has now made consultant (senior<br />
medical staff) appraisal compulsory from 2001 and the<br />
General Medical Council will make revalidation<br />
compulsory for all doctors to allay public fears about<br />
poorly performing doctors.<br />
This paper will explore what is meant by “appraisal”,<br />
whether it is the correct mechanism to support<br />
revalidation, and whether it is possible to prove that<br />
appraisal will support doctors in improving their<br />
professional development and performance. There is<br />
tension between the formative and summative<br />
processes, and between a demanding public and a<br />
sceptical profession.<br />
2G6 When should clinicians be trained<br />
in management?<br />
J Clark*, R Palmer and P Spurgeon<br />
Health Services Management Centre, University of Birmingham,<br />
Park House, 40 Edgbaston Park Road, Birmingham, B15 2RT,<br />
UK<br />
The involvement of clinicians in management is an<br />
objective pursued increasingly by most health systems.<br />
In part this reflects a concern to control costs but also<br />
a need to provide a proper integration of clinical and<br />
managerial perspectives. Many senior clinicians arrive<br />
in managerial roles with relatively little managerial<br />
Session 2H Selection<br />
2H1 Selecting aboriginal students to<br />
health professional courses<br />
I E Rolfe* and G Garvey<br />
University of Newcastle, Discipline of Aboriginal Health, Level<br />
1 MSB, Faculty of Medicine & Health Sciences, University Drive,<br />
Callaghan 2308, AUSTRALIA<br />
Aboriginal students are greatly under-represented in<br />
health professional courses in Australia. The reasons<br />
for this are a complex interplay of historical, social,<br />
cultural, economic and political factors resulting in the<br />
inequity of access to higher education. There is an<br />
imperative to develop culturally appropriate methods<br />
which will increase the numbers of applicants to health<br />
professional courses and then the candidates most likely<br />
to succeed at these University courses. The Faculty of<br />
Medicine & Health Sciences has a long and successful<br />
Monday 3 September<br />
- 4.13 -<br />
training. Subsequent provision can often feel urgent<br />
and remedial. In a more planned sense, there is a need<br />
to address the clinical educational curriculum to<br />
examine how best the ‘what’ and ‘when’ of managerial<br />
teaching might be incorporated. This paper reports the<br />
findings of a survey of a range of clinical staff<br />
(undergraduates, junior doctors and consultants) and<br />
health service managers about the key content areas of<br />
management training and their varying perceptions of<br />
where within the educational spectrum the most<br />
appropriate and relevant time for training might be. It<br />
also explores how such training could be provided.<br />
2G7 Evaluation of ‘Distance Interactive<br />
Learning in Obstetrics and<br />
Gynaecology (DIALOG)’<br />
Vikram Jha*, Sean McAleer and Sean Duffy<br />
St James’s University Hospital, Academic Department of<br />
Obstetrics & Gynaecology, Level 9, Gledhow Wing, St James’s<br />
Hospital, Leeds LS9 7TF, UK<br />
In recent years, there has been an increase in the<br />
production of computer assisted learning programmes.<br />
‘DIALOG’ is a distance learning programme, available<br />
on CD-ROM, developed by the Royal College of<br />
Obstetricians and Gynaecologists for continuing<br />
professional development. The aim of the study was to<br />
determine if DIALOG was achieving its educational<br />
objective and to receive feedback from its users. A<br />
literature review was carried out to select a suitable<br />
model for evaluation. The CIPP model (Context, Input,<br />
Process and Product) was used to design a<br />
questionnaire. This was posted out to 150 users selected<br />
by systematic randomisation. A response rate of 60%<br />
was achieved. There has been a positive response from<br />
users in terms of content, design, presentation,<br />
interactivity and outcome. The educational objectives<br />
of DIALOG are being achieved.<br />
history of admitting Aboriginal medical students. The<br />
medical school has graduated approximately 60% of<br />
the nations’ Aboriginal doctors. Given the Faculty<br />
incorporates now a range of other health professional<br />
courses, we revised our selection method to meet four<br />
broad aims:<br />
1 Suitability for selecting students to all health<br />
professional courses,<br />
2 Incorporation of best evidence literature,<br />
3 Determination in large part by Aboriginal peoples<br />
and,<br />
4 Cultural appropriateness of the selection process.
2H2 Demographic and scholastic<br />
correlates of scores in the<br />
Australian Undergraduate Medical<br />
and Health Sciences Admission<br />
Test (UMAT)<br />
Peter Tutton*, Chris Browne, Margot Story and Michael<br />
Lewenberg<br />
Monash University, Department of Anatomy and Cell Biology,<br />
Post Office Box 13C, Victoria 3800, AUSTRALIA<br />
The UMAT is an aptitude test used for selection of<br />
medical students. It is an MCQ with three components<br />
– Book 1, logical reasoning & problem solving – Book<br />
2, human interaction skills and Book 3, non-verbal<br />
reasoning (a group embedded figure test measuring<br />
field independent cognitive style). Despite its wide use,<br />
little is known about the demographic or scholastic<br />
attributes of candidates scoring well on the UMAT. In<br />
this study correlations between UMAT scores and both<br />
family demographic variables and concurrent scholastic<br />
achievements are analysed. UMAT Book 1 scores were<br />
weakly associated with duration of family residence in<br />
Australia and with managerial and professional parental<br />
occupation: they were more strongly associated with<br />
concurrent scholastic achievement, particularly in<br />
biology. UMAT Book 2 scores had no conspicuous<br />
association with any of our demographic or scholastic<br />
variables, nor with selection interview scores. UMAT<br />
Book 3 scores most strongly associated with scholastic<br />
achievement in physics.<br />
2H3 Can we make the interview add<br />
something new?<br />
P Hughes, S Miller*, P McCrorie and A Kent<br />
Department of Psychiatry, St George’s Hospital Medical School,<br />
Hunter Wing, Cranmer Terrace, London SW17 0RE, UK<br />
There is evidence that in selecting for complex task<br />
performance the best predictor is some measure of IQ.<br />
A structured interview may add a useful degree of<br />
prediction. It is important, however, to ensure that the<br />
interview does not simply re-assess intelligence. We<br />
used a two-stage process to select for our Graduate<br />
Entry <strong>Programme</strong>. The GAMSAT assesses reasoning<br />
in sciences and humanities and writing ability. Highest<br />
scoring applicants were invited for interview. We<br />
devised an interview with high face-validity and<br />
reduced opportunity for bias by blinding interviewers<br />
to social and academic variables, and by introducing<br />
structured objective criteria. The interview appeared<br />
acceptable to interviewers and candidates. We<br />
demonstrated that performance at interview did not<br />
correlate with recent or previous academic performance<br />
so was adding something to academic assessment.<br />
Follow up of successful candidates will address the<br />
important question of the predictive validity of this<br />
selection process.<br />
2H4 Relative effects of learning style,<br />
MCAT and prior academic record<br />
on performance in medical school<br />
Stephen Aaron* and Ernest Skakun<br />
Department of Rheumatology, 562 Heritage Medical Research<br />
Centre, Faculty of Medicine and Dentistry, University of Alberta,<br />
Edmonton, Alberta T6G 2S2, CANADA<br />
Monday 3 September<br />
- 4.14 -<br />
Several studies have demonstrated that previous<br />
academic record does not fully predict success in<br />
medical school. We hypothesized that student learning<br />
styles would also correlate with medical school grades,<br />
independently of MCAT or prior academic record. We<br />
correlated learning style to marks in our largest and<br />
most integrated first year course (in Cardiology,<br />
Pulmonology and Nephrology, CPN), using the ASSIST<br />
instrument. Negative correlation was found between<br />
CPN and surface learning style (SL) assessed after the<br />
course was completed (r = -.247, p = .038). Significant<br />
correlation was also found between CPN and student<br />
MCAT results (r = .263, p = .027), but not to grades<br />
prior to medical school admission (GPA). There was<br />
no correlation between SL and MCAT (r = .053).<br />
Correlation between SL and CPN was independent of<br />
MCAT or GPA. We conclude that learning style is<br />
predictive of medical school grades independently of<br />
prior academic record.<br />
2H5 The selection of GP trainees in<br />
the West Midlands: audit of<br />
assessment centre scores by<br />
ethnic background and country<br />
of qualification<br />
Celia Brown*, Sarah Wakefield and Alison Bullock<br />
Centre for Research in Medical & Dental Education, School of<br />
Education, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
The new centralised system of selecting GP trainees in<br />
the West Midlands aims to be fair and nondiscriminatory<br />
in the processes of recruiting the most<br />
suitable candidates, and allocating the successful<br />
candidates to their preferred posts. This paper provides<br />
an audit of the achievements of all the candidates in<br />
the October 2000 selection round. The data are<br />
examined with respect to candidates’ ethnic<br />
background and their country of qualification. Two<br />
levels of analysis are possible, based on average<br />
‘success’ or placement rates, and average scores<br />
achieved at each stage of the selection process. The<br />
analysis suggests that white candidates, and those<br />
qualifying in the UK, are more likely to succeed in the<br />
selection process. Possible explanations are offered<br />
from a more detailed interrogation of the selection<br />
criteria. Finally, the implications for the next selection<br />
round are discussed in the light of these findings.<br />
2H6 The selection of GP trainees:<br />
perceptions of the new regional<br />
system<br />
Sarah Wakefield*, Celia Brown and Alison Bullock<br />
Centre for Research in Medical & Dental Education, School of<br />
Education, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
A new regional system of selecting GP trainees has<br />
been introduced in the West Midlands, replacing<br />
selection by individual GP practices. Perceptions of the<br />
regional system amongst key stakeholders were<br />
explored as part of a larger study evaluating the West<br />
Midlands selection procedures in October 2000. Data<br />
were collected by interview (with organisers, GP<br />
trainers, assessors and candidates) and questionnaire
(to candidates: 46% response rate). The analysis<br />
revealed that the new process was viewed positively,<br />
with particular praise for the role-play assessment and<br />
the inclusion of a lay-person on the interview panels.<br />
Many thought that the new system was fairer than the<br />
old. Concerns were expressed that the process was<br />
impersonal, and that candidates had less control over<br />
their choice of practice location. The implications for<br />
future selection rounds, and for other regions<br />
considering regional selection systems, will be explored<br />
in the presentation.<br />
2H7 “I want to become a doctor.”<br />
Analysis of first year students’<br />
motivations<br />
M F Patrício* and J Gomes-Pedro<br />
Faculdade de Medicina de Lisboa, University of Lisbon, Av Prof<br />
Egas Moniz, Piso 1, 1649-028 Lisboa Codex, PORTUGAL<br />
The psychological and cultural basis for career choice<br />
is a poorly researched subject. The objectives of the<br />
present study were to identify, after 6 months in Medical<br />
School, the reasons why students decided to be a doctor<br />
and whether they would make the same choice again<br />
Session 2I Educating the educators (1)<br />
2I1 Evaluation of a Train the Trainers<br />
program in quality improvement<br />
and cost-effectiveness<br />
Antoinette S Peters*, Maryjoan Ladden and Robert<br />
Fletcher<br />
Department of Ambulatory Care & Prevention, Harvard Medical<br />
School and Harvard Pilgrim Health Care, 126 Brookline Avenue,<br />
Boston, MA 02215, USA<br />
A 4-month program was developed to teach community<br />
and academic physicians how to teach “managing care”<br />
competencies, especially quality improvement and<br />
cost-effectiveness. Interactive and didactic methods<br />
were used to teach the competencies, learning theory,<br />
and evaluation; different pedagogical methods were<br />
also modeled. Participants submitted a project plan,<br />
attended two 2-day workshops with a partner, revised<br />
their plans, and practised new methods at their home<br />
institutions. Ratings of their own knowledge of quality<br />
improvement and cost-effectiveness increased<br />
significantly. Knowledge of traditionally taught<br />
content, such as prevention and patient-doctor<br />
communication, was not affected. Participants’ ratings<br />
of their skill in teaching using different methods and<br />
in developing and evaluating teaching innovations<br />
increased significantly. There was smaller change in<br />
self-ratings of skill in giving a lecture, precepting in<br />
the office, and teaching at the bedside than in leading<br />
interactive large groups, giving feedback, or tutoring<br />
small groups.<br />
Monday 3 September<br />
- 4.15 -<br />
given a second opportunity. First year students (n=153)<br />
were asked to complete an open-ended questionnaire.<br />
Protocols were treated through content analysis<br />
technique. The study found that students made their<br />
professional choice mainly for:<br />
• altruistic motivation or social desirability: help<br />
people 75% / useful to society 24%;<br />
• self motivations: loving medicine 29%, safe career<br />
22%, personal achievement 17%, lack of routine<br />
8%, prestige/status 7%, child dream 4%, family<br />
tradition 3%.<br />
After 6 months when asked if they confirm their initial<br />
choice:<br />
• 39% confirm it enthusiastically<br />
• 51% just confirm<br />
• 8% hesitate<br />
• 2% do not confirm.<br />
Correlations between the reasons underlying the<br />
professional option and the degree of enthusiasm will<br />
be explored. Implications for the student selection<br />
process will be presented.<br />
2I2 Teaching the Medical Teachers<br />
Beyond ‘TIPS’<br />
Jane Richardson* and Jonathan D Cartledge<br />
University College London, 4th Floor, Holburn Union Building,<br />
The Archway Campus, Highgate Hill, London N19 3UA, UK<br />
Since 1999, 30 ‘TIPS’ courses have been run at<br />
RF&UCMS. The results of post course questionnaires<br />
obtained from 256 (70%) of 366 participants informed<br />
the development of further courses. Participant<br />
identified areas for further training were: Clinical and<br />
bedside teaching; One to one teaching; Teaching larger<br />
groups; Presentation skills; Group dynamics and small<br />
groups. As a result of this feedback three follow up<br />
courses have been designed and piloted. The “TIPS”<br />
name was maintained because of the positive<br />
association. “TIPS 2” focuses on clinical/bedside<br />
teaching and student and course factors affecting<br />
learning. “TIPS 3” focuses on large group teaching and<br />
presentation skills. “TIPS 4” focuses on small group<br />
teaching and facilitation skills. “Microteaching”, voted<br />
the most helpful aspect of TIPS 1, has been retained as<br />
an opportunity for individualised feedback and putting<br />
theory into practice. Full details of objectives, content,<br />
teaching plans and feedback for these courses will be<br />
presented.
2I3 Formal courses in further training<br />
of medical teachers<br />
M Vrcic-Keglevic*, Z Jaksic, G Pavlekovic, N Pokrajac, A<br />
Smalcelj and B Vrhovac<br />
“A.Stampar” School of Public Health, Medical School, University<br />
of Zagreb, Rockefellerova 4, 10000 Zagreb, CROATIA<br />
The Croatian Association of Medical Education has<br />
been organising two types of attitudes aimed at further<br />
training of medical teachers; interactive workshops for<br />
experienced and formal courses for less experienced<br />
teachers of one week duration. The main aim of the<br />
formal courses is to help young teachers acquire basic<br />
pedagogical knowledge, skills and attitudes. Therefore,<br />
the following items have been covered: a psychology<br />
of learning; the principles of adult learning; curriculum<br />
development; giving a lecture, clinical teaching and<br />
tutorials; working in a small group; use of educational<br />
tools; and current developments in medical education.<br />
Special interest is paid on development of education<br />
methods, planning a timetable, defining the methods<br />
of evaluation and assessment. Since active learning is<br />
the most important, work in a small group, on individual<br />
projects and at plenary discussions occupy most of the<br />
time. Assessment consists of three parts: pre-course,<br />
written essay and MCQ, post-course MCQ, and<br />
preparation and presentation of an educational module.<br />
The participants are provided with a CME diploma in<br />
medical education - an important prerequisite for a<br />
teacher’s advancement.<br />
2I4 Supporting Clinicians on Training<br />
in Scotland<br />
Rose Martin, on behalf of Supporting Clinicians on<br />
Training in Scotland Working Group<br />
SCPMDE, Postgraduate Office, Level 7, Ninewells Hospital and<br />
Medical School, Dundee, DD1 9SY, UK<br />
A successful collaboration between Scottish Council<br />
for Postgraduate Medical & Dental Education<br />
(SCPMDE) and the Scottish Royal Colleges has<br />
resulted in the development of a Scottish based course<br />
to support clinical trainers. The SCOTS Course<br />
(Supporting Clinicians on Training in Scotland) is<br />
unique in its content, providing instruction on<br />
assessment and appraisal, skills training, teaching and<br />
training method, reflective practice, objective setting<br />
and a strategy to manage poor performance, delivered<br />
using many teaching styles. This two-day intensive<br />
course is aimed primarily at Consultant Educational<br />
Supervisors, and it is hoped that it will be delivered to<br />
Specialist Registrars in early 2001 in a modular format.<br />
It is designed to enable trainers to provide an effective<br />
educational experience for their trainees. The positive<br />
evaluations of the course and the plan to run ten SCOTS<br />
Courses in Scotland in 2001 will ensure its position in<br />
the innovative field of Medical Education. The initiative<br />
and its evaluation will be presented in depth and its<br />
effectiveness in relation to practice will be discussed.<br />
2I5 Improving own teaching skills<br />
identified as a top priority by<br />
Registrars<br />
Iwona Stolarek<br />
Hutt Hospital, Private Bag, Wellington, NEW ZEALAND<br />
Monday 3 September<br />
- 4.16 -<br />
In order to ascertain the educational needs of Medical<br />
Registrars, a questionnaire study was carried out at Hutt<br />
Hospital. This was to allow the development of an<br />
educational programme to address these specifically.<br />
The 12 registrars were sent a 7-point questionnaire. 11/<br />
12 (92%) responded with the non-responder being a<br />
locum UK doctor. Ninety percent of the respondents<br />
were aiming at a hospital consultant career and 82%<br />
were currently sitting higher exams. None had<br />
educational supervisors though 82% felt these would<br />
be useful and were keen to develop log-books or<br />
learning diaries. In terms of learning need priorities,<br />
help with teaching skills was ranked the number one<br />
priority along with both exam practice and presentation<br />
skills by 82% of the registrars. This small pilot study<br />
has shown that junior doctors rate help in improving<br />
their teaching skills as highly as exam passes.<br />
2I6 Dissemination of teaching of<br />
medical interviewing and physical<br />
examination in Japan<br />
N Ban*, M Hatao, J Ohtaki, M Fujisaki, C Nakamura, T<br />
Tsuda, T Matsumura and M Shimo<br />
Nagoya University School of Medicine, Department of General<br />
Medicine, Place 65, Tsurumai-cho, Showa-ku, Nagoya 466-<br />
8560, JAPAN<br />
The objective of the study was to evaluate the effects<br />
of the nationwide faculty development workshop,<br />
sponsored by the Japan Society of Medical Education,<br />
on the teaching of medical interviewing and physical<br />
examination in Japanese medical schools. A<br />
questionnaire was sent to all 94 medical educators from<br />
54 of the 80 Japanese medical schools that participated<br />
in the workshop in 1996, 1997 and 1998. The response<br />
rate was 77.8%. Thirty schools (71.4%) reported<br />
substantial curriculum changes in interviewing and 29<br />
schools (69.1%) in physical examination courses. Out<br />
of 25 Japanese medical schools where standardized<br />
patients (SP) are currently used, 16 (64%) started to<br />
use SP as a result of the workshop. Among 24 schools<br />
that currently use Objective Structured Clinical<br />
Examination (OSCE), 18 (75%) initiated OSCE after<br />
the workshop. The faculty development workshop on<br />
teaching medical interviewing and physical<br />
examination is helping to change undergraduate<br />
medical education in Japan.<br />
2I7 Transformational learning in a peer<br />
teaching programme<br />
Angel M Centeno*, Alexandra Blanco and Soledad Campos<br />
Faculty of Biomedical Sciences, Universidad Austral-Medicina,<br />
Av J Peron 1500, B1629AHJ Derqui, Pilar, Pov Buenos Aires,<br />
ARGENTINA<br />
Students’ personal attitudes towards learning after their<br />
participation in a programme of teaching skills for 21<br />
medical students acting as peer teachers are described.<br />
After completing the program we analysed data from<br />
four different areas: identification of teaching<br />
difficulties, perceived personal changes, change in<br />
studying approaches and the ability to understand<br />
faculty’s actions. The difficulty in facing their peer<br />
students, and to adapt to the role of a teacher with their
peers; the increased ability to work successfully in a<br />
team, and to become self confident, and improve their<br />
own learning skills (which led to better grades in their<br />
exams); and an increased understanding of their own<br />
faculty’s actions were the more important changes they<br />
- 4.17 -<br />
mentioned. These data, despite the small number of<br />
students, show that our students have not only acquired<br />
pedagogical skills, but they have gone through a<br />
personal transformational learning experience.<br />
Session 2J Simulation and clinical skills training<br />
2J1 Teaching clinical skills to medical<br />
students using the clinical skills<br />
laboratory with a new simulator and<br />
new tools<br />
I Yoshida*, T Ueno, M Hotta, H Abe, I Kubara, S Kono, Y<br />
Ogo, S Watanabe, A Hayashi, T Akagi, S Okuda and M<br />
Sata (Working Group on teaching basic clinical skills)<br />
Office of Medical Education, Kurume University, School of<br />
Medicine, 67 Asahi-Machi, Kurume 830 0011, JAPAN<br />
The objective of the study was to evaluate the usefulness<br />
of the clinical skills laboratory (CSL) to learn basic<br />
clinical skills. The CSL was introduced to medical<br />
students to learn the medical interview, physical<br />
examination, resuscitation and X-ray film reading. A<br />
questionnaire was sent to the students. The results<br />
showed that the CSL was useful to 61% of the students;<br />
especially the new cardiology patient simulator “Ichiro”<br />
was appreciated by 90% of the medical students.<br />
2J2 Training in vaginal examination<br />
technique using the ‘epelvis’<br />
C M Pugh* and M S Marsh<br />
GKT Medical School, Academic Department of Obstetrics &<br />
Gynaecology, 9th Floor, Ruskin Wing, King’s College Hospital,<br />
Bessemer Road, London SE5 9PJ, UK<br />
Undergraduate medical students find it increasingly<br />
difficult to learn the technique of vaginal examination<br />
(VE) using real patients. A pelvic mannequin has been<br />
developed which incorporates pressure sensors over<br />
important points within the pelvis, eg. the uterine<br />
fundus, cervix and ovaries. These sensors enable the<br />
duration and magnitude of pressure applied to parts of<br />
the pelvic organs during a pelvic examination to be<br />
measured and stored electronically. The data can be<br />
represented visually and may be seen by the student<br />
during the examination as an aid to teaching. A large<br />
database of “epelvis” examinations from vaginal<br />
examinations by undergraduates and postgraduates has<br />
been collected. The epelvis has considerable potential<br />
for the training and assessment of vaginal examination.<br />
2J3 Training medical students to<br />
perform vaginal examination using<br />
the ‘epelvis’<br />
M S Marsh* and C M Pugh<br />
GKT Medical School, Academic Department of Obstetrics &<br />
Gynaecology, 9th Floor, Ruskin Wing, King’s College Hospital,<br />
Bessemer Road, London SE5 9PJ, UK<br />
We have examined medical student training in vaginal<br />
examination (VE) using a pelvic mannequin (“epelvis”)<br />
incorporating pressure transducers, enabling online<br />
Monday 3 September<br />
visual feedback of the pelvic areas examined. 74<br />
students underwent a test of VE using three pelvic<br />
models, followed by epelvis training, followed by<br />
testing using two other pelvic models. Before testing<br />
33% had performed >5 VEs on subjects and 55% had<br />
used a pelvic mannequin. The number of previous VEs<br />
or mannequin training was unrelated to the ability to<br />
estimate the size of the uterus correctly in pre-training<br />
tests. There was no improvement in ability to determine<br />
the size of the uterus after training in the whole group.<br />
However, in those students that had performed >5 VEs<br />
prior to testing, those able to judge uterine size correctly<br />
rose from 66% to 92% (P
programmatic evaluations. More innovative approaches<br />
such as incorporating both technological and human<br />
simulation in a multi-modal learning experience, and<br />
implementing an OSCE that serves both a needs and<br />
outcome assessment purpose (measuring consistency<br />
in learning across multiple clerkship sites in order to<br />
direct specific educational interventions) will be<br />
described.<br />
2J6 Using scenario based teaching to<br />
deliver feedback on technical and<br />
communication skills<br />
R L Kneebone*, J Kidd, D Nestel, B Paraskeva, S Asvall<br />
and A Darzi<br />
Academic Surgical Unit and, Department of Cognitive<br />
Neuroscience & Behaviour, Imperial College School of Medicine,<br />
10th Floor QEQM, Praed Street, London W2 1NY, UK<br />
- 4.18 -<br />
Technical skills and communication skills are<br />
inseparable in clinical practice but are often taught in<br />
isolation. Skills labs commonly use benchtop models<br />
for teaching core skills, but often away from their<br />
clinical context. Our solution bridges this gap by linking<br />
standardised patients (SPs) and inanimate models<br />
within a structured learning framework. Students work<br />
within a ‘safe zone’ to practise technical skills without<br />
jeopardising patient safety. They talk and listen to their<br />
‘patient’ (the SP) while carrying out procedures (e.g.<br />
wound closure, urinary catheterisation) in realistic<br />
clinical scenarios. Procedures are observed by tutors<br />
and simultaneously videotaped. After each procedure,<br />
the student writes down personal reflections, then tutors<br />
and SPs provide verbal feedback on salient points. Each<br />
student reviews their videotape, using formative rating<br />
scales to assess technical and communication skills.<br />
Qualitative data from 35 undergraduate medical<br />
students will be presented to outline the development<br />
of this approach to giving feedback.<br />
Session 2K Students and curriculum evaluation<br />
2K1 Teaching quality questionnaire:<br />
students’ evaluations of standard<br />
learning activities in an integrated<br />
curriculum<br />
Øyvind Ellingsen*, Kristin Wigen and Are Holen<br />
Norwegian University of Science & Technology, Department of<br />
Physiology and Biomedical Engineering, Medical Technical<br />
Center, NO-7489 Trondheim, NORWAY<br />
Sound evaluation routines are important to improve the<br />
standard of medical education. In an integrated<br />
curriculum it is often useful to evaluate individual<br />
clinics, seminars or lectures rather than large blocks of<br />
learning activities. We therefore developed a<br />
questionnaire to assess the quality of standard learning<br />
activities such as clinics, lectures, seminars and<br />
workshops. The students rated all presentations on five<br />
items, including structure and illustrations, oral<br />
presentation, dialog with students, relevance according<br />
to stage of study and future profession and inspiration<br />
for further studying, using a 1-5-9 scale. In evaluations<br />
of 125 learning activities by 43 first year medical<br />
students the five items clustered into one single factor,<br />
representing overall teaching quality. The teaching<br />
quality score identified 6 learning activities that<br />
required revision (mean score
placement. 13% of students are concerned that their<br />
evaluation will affect their grades. We will discuss the<br />
implication of these findings on the procedures for<br />
collecting attributable evaluation material.<br />
2K4 Student evaluation of educational<br />
quality: the construction of a<br />
multidimensional questionnaire<br />
Volkhard Fischer<br />
Hannover Medical School, OE 9103, Rectors Office, 30623<br />
Hannover, GERMANY<br />
Educational quality is a complex construct. Marsh has<br />
developed a differentiated questionnaire for student<br />
evaluations of educational quality which is widely<br />
accepted. Our 37-item questionnaire is a localized<br />
version of this general questionnaire (SEEQ) adapted<br />
for the evaluation of medical courses in Germany. The<br />
items concerning the factor work load were formulated<br />
as bipolar questions on seven-point scales. The<br />
midpoint was labeled “appropriate”. The other items<br />
had a unipolar format with six grades from “not true”<br />
to “true” and an extra checkbox “does not apply”. The<br />
global rating of the course had to be made on a 16point<br />
Likert scale. The theoretical model was tested in<br />
a confirmatory factor analysis for the whole sample<br />
and several evaluative factor analyses for selected<br />
courses. Discrepancies between the theoretical model<br />
and the empirical results were discussed and integrated<br />
into an exploratory model.<br />
2K5 Evaluation of lectures in medical<br />
teaching based on focal groups<br />
and a survey of opinion to<br />
formulate a guide of practical<br />
recommendations<br />
Juan Cristóbal Maass, Lorena Tapia, Marcela Jacard, and<br />
Teresa Millán<br />
Depto. de Pediatría y Cirugía Infantil, Facultad de Medicina,<br />
Universidad de Chile<br />
In spite of new tendencies, in Chile lectures are mainly<br />
used in medical teaching. Our objective was to find<br />
out students’ opinions about aspects that influence<br />
quality of lectures, with the purpose of formulating a<br />
guide of practical recommendations (GPR). A survey<br />
was designed based on focal groups and applied to 181<br />
5th year students. We evaluated different aspects of<br />
lectures (teacher; content, dynamics and structure;<br />
support material; and atmosphere). Of 113 students<br />
interviewed, 96.4% think that it would be useful to have<br />
a GPR for lecturers. Positive practical aspects of lectures<br />
highlighted were: delivery of lecture notes (93.8%); to<br />
give practical details (98.2%); and to give a summary<br />
(94.5%). Among negatives: that lectures were carried<br />
out in the afternoon (94.6%); lasted longer than<br />
foreseen (94.7%); and small fonts were used in<br />
projection (92.9%). We intend to discuss this guide<br />
based on the opinions obtained, showing aspects not<br />
traditionally considered.<br />
Monday 3 September<br />
- 4.19 -<br />
2K6 Use of a Continuous Quality<br />
Improvement (CQI) model to<br />
enhance curriculum evaluation and<br />
integration<br />
Nehad El-Sawi<br />
University of Health Sciences, 1750 Independence Avenue,<br />
Kansas City, MO 64106, USA<br />
Course evaluation is one of the corner stones for the<br />
documentation of the educational process quality. CQI<br />
is a process of constructive self study that encourages<br />
participation of all students and faculty in order to<br />
maximize the benefit of the evaluation process. Eight<br />
essential activities involved in course delivery are<br />
identified. A written survey is designed to evaluate<br />
these activities. The survey is administered at the end<br />
of each course and the entire class results are tabulated<br />
as the comprehensive evaluation. Students are assigned<br />
to CQI teams before each course begins and are<br />
responsible for reviewing the comprehensive<br />
evaluation, drafting a one-page consensus report,<br />
prioritizing improvements that could enhance student<br />
learning and presenting the report to faculty and<br />
curriculum committee. The CQI evaluation model<br />
produced a more effective, meaningful and constructive<br />
evaluation while building interdisciplinary team skills<br />
and professional behavior among medical students.<br />
2K7 New faculty-level self-evaluation<br />
instruments<br />
K Lonka*, N Paganus, T Hatonen, A Heikkila, J Vainio<br />
and J Nieminen<br />
University of Helsinki, Leiviskatie 2 E 64, Fin-00440 Helsinki,<br />
FINLAND<br />
The Faculty of Medicine at the University of Helsinki<br />
began to evaluate and reform its curriculum of medical<br />
studies in 1994. This process resulted in Helsinki 2000,<br />
a hybrid-PBL curriculum, which was introduced in<br />
1998. A systematic programme was also integrated to<br />
support students’ personal growth and to advance their<br />
communication and thinking skills, called Professional<br />
Growth of Medical Students.<br />
In order to see how well these reforms have been<br />
implemented, we developed a set of evaluation<br />
instruments. Questionnaires and observation methods<br />
were applied for both students and teachers. The data<br />
are extensive, and some examples are presented here.<br />
The final goal is to finish a self-evaluation report for<br />
the international evaluation of all studies and<br />
programmes of the University of Helsinki, which will<br />
take place in the years 2001-<strong>2002</strong>.<br />
2K8 The doctors’ opinion - a national<br />
evaluation of Swedish medical<br />
education<br />
Anders Bengtsson, Kerstin Johansson and Sara Engstrom*<br />
Swedish Medical Association, Sveriges Lakarforbund, PO Box<br />
5610, S-11486 STOCKHOLM, SWEDEN<br />
In autumn 2000, the Swedish Medical Association sent<br />
out a questionnaire in order to evaluate Swedish medical<br />
education. Junior doctors were asked to assess medical<br />
education in relation to the declared objectives. They
were also asked whether they thought the objectives<br />
were relevant. The questionnaire was sent to all 743<br />
members who had been registered in 1999 (they had<br />
been working for approximately 3-4 years). More than<br />
90% replied to the questionnaire. This is the first time<br />
a survey including all doctors from all six universities<br />
Session 2L Multiprofessional education<br />
2L1 Interprofessional learning: the New<br />
Generation Project<br />
Debra Humphris* and Chris Stephens*<br />
The Department of Medical Education, Office of School of<br />
Medicine, University of Southampton, MP 801 Level C, South<br />
Academic Block, Southampton General Hospital, Southampton,<br />
SO16 6DY, UK<br />
At the University of Southampton the undergraduate<br />
BM course takes place within a multiprofessional<br />
Faculty of Medicine, Health and Biological Sciences,<br />
which includes the School of Nursing and Midwifery,<br />
the School of Health Professions and Rehabilitation<br />
Sciences and the School of Biological Sciences. The<br />
rich mix of professional programmes within the Faculty<br />
has led over the past decade to numerous developments<br />
in interprofessional learning and practice. The Faculty’s<br />
commitment to building on its experience of<br />
interprofessional learning is reflected in its strategic<br />
plan, and the establishment of the New Generation<br />
Project. This bold project will enable the Faculty to<br />
demonstrate its contribution to the modernisation of<br />
education and training for the health and social care<br />
workforce. The process of these changes within a large<br />
educational organisation will be explored and<br />
discussed.<br />
2L2 “Walking in the moccasins of<br />
others”: reflections on a new<br />
initiative to bring the real world of the<br />
patient into the medical curriculum<br />
Lyn Brown<br />
University of Liverpool, Community Studies Unit, Department<br />
of Primary Care, Whelan Building, Quadrangle, Brownlow Hill,<br />
Liverpool L59 3GB, UK<br />
Community Placements are an essential feature of the<br />
Liverpool University Undergraduate Medical<br />
Curriculum. They are designed to give students contact<br />
with all aspects of health and medicine outside the<br />
immediate confines of hospital and general practice.<br />
During second year, placement in community health<br />
services, statutory and voluntary social work agencies,<br />
and supervised University based groups, provide<br />
excellent learning opportunities that complement other<br />
aspects of the students’ learning. Without diminishing<br />
the bio-medical approach to health-care, placements<br />
enhance the students’ learning by developing a broader<br />
view of health and disease that includes psychological<br />
and socio-economic factors. This would seem to offer<br />
students wider options in management of ill-health and<br />
disability; effecting involvement with, and better long<br />
term care of, their patients. This paper describes the<br />
methods, evaluations and outcomes set in place to<br />
achieve the above.<br />
Monday 3 September<br />
- 4.20 -<br />
has been carried out. The survey is intended to be<br />
carried out annually, thus providing a series of results<br />
at national level, as well as an impact assessment of<br />
the new curricula which are being implemented in<br />
Swedish medical schools. The results will be presented<br />
at the conference.<br />
2L3 Multiprofessional education in<br />
health care ethics in Germany<br />
Jochen Vollmann<br />
Freie Universitat <strong>Berlin</strong>, Arbeitsgruppe Ethik in der Medizin,<br />
Institut fur Geschichte der Medizin, Klingsorstr. 119, D-12203<br />
<strong>Berlin</strong>, GERMANY<br />
In Germany only very limited practical experience and<br />
knowledge in teaching of medical ethics and ethics of<br />
health care is available. German medical schools do<br />
not offer regular ethics teaching, whereas the<br />
“Reformstudiengang Medizin” at the Charité in <strong>Berlin</strong><br />
provides some teaching blocks in medical ethics.<br />
Graduate ethics training in nursing sciences, public<br />
health and social work varies widely. Since 1995 the<br />
author teaches ethics to medical students as well as<br />
students in public health, nursing and social work at<br />
various universities in <strong>Berlin</strong> and the U.S. In this short<br />
communication preliminary data from a 5 year pilot<br />
study are presented. Different demands, approaches and<br />
evaluation results of ethics teaching in the different<br />
professional graduate courses are presented. Pro and<br />
cons of ethics teaching in the various professional<br />
programs are compared with the multiprofessional<br />
approaches in the <strong>Berlin</strong> program of public health and<br />
at the Evangelische Fachhochschule <strong>Berlin</strong>.<br />
2L4 Dilemmas in resuscitation: nursing<br />
and medical students’ responses to<br />
ethical professional issues related<br />
to resuscitation of patients<br />
C Edward*, J Crosby and P E Preece*<br />
University of Dundee, School of Nursing & Midwifery, Tayside<br />
Campus, Ninewells Hospital & Medical School, Dundee<br />
DD1 9SY, UK<br />
At the University of Dundee a three hour teaching<br />
session involving 280+ nursing and medical students<br />
took place in 1999. The aim was to enable the students<br />
to explore and debate, together, the ethical/professional<br />
issues inherent within resuscitation. An automated<br />
audience response test containing 5 set questions was<br />
given to the students immediately pre/post the session.<br />
Two significantly different responses were related to:<br />
• Who should have the major say in advanced<br />
decisions of resuscitation? (Doctor, Nurse, Patient,<br />
Relatives, Team). Team-Pre: Nursing 66% Medical<br />
78%. Post: Nursing 97% Medical 89%.<br />
• Should close relatives be permitted to witness<br />
resuscitation? Permit-Pre: Nursing 63% Medical<br />
12%; Post: Nursing 55% (still permit) Medical 29%<br />
(now in favour).
Analyses were by Wilcoxon and Mann-U-Whitney<br />
tests. Written comments from students were<br />
encouraging and in 2000 the topic of resuscitation was<br />
established as part of each student programme for third<br />
year nursing/medical students.<br />
2L5 Promoting the use of clinical<br />
guidelines in Scotland<br />
Bernice West* and Peter Wimpenny*<br />
Robert Gordon University, Centre for Nurse Practice Research<br />
and Development, School of Nursing and Midwifery, Northern<br />
College, E Block, Hilton Drive, Aberdeen AB24 4FP, UK<br />
The initiative was funded by the National Board for<br />
Nursing, Midwifery and Health Visiting for Scotland<br />
and jointly managed by the Centre for Nurse Practice<br />
Research and Development at the Robert Gordon<br />
University, Aberdeen and The Royal College of Nursing<br />
Institute. The initiative’s aims were to increase nurses’<br />
knowledge and skills in using clinical guidelines. The<br />
initiative clearly demonstrated the need for<br />
multiprofessional involvement in all aspects of clinical<br />
guidelines. The educational approach comprised:<br />
• Identifying a Local Facilitator;<br />
• Introducing key skills for multiprofessional<br />
guideline implementation through five Open/<br />
Distance Learning modules covering guideline<br />
choice, appraisal, implementation strategies and<br />
evaluation;<br />
• Supporting Local Facilitators by: (1) regular contact<br />
with education providers, (2) problem solving group<br />
work at workshops, (3) provision of a buddy who<br />
has clinical and/or change management expertise.<br />
Implementing clinical guidelines is a complex activity<br />
that demands multiprofessional education and<br />
intervention. Recommendations for such provision will<br />
be presented.<br />
2L6 Can Neuropsychiatry training be<br />
successfully delivered in a multiprofessional<br />
setting?<br />
Andrew Parkin* and Nisha Dogra<br />
University of Leicester, Greenwood Institute of Child Health,<br />
Westcotes House, Westcotes Drive, Leicester LE2 1SF, UK<br />
Session 2M Student support/psychiatry and the curriculum<br />
2M1 An evaluation of student support<br />
systems at the Medical School at<br />
Queen’s University Belfast<br />
Nicola Wilson, David McCluskey and Mairead Boohan*<br />
Queen’s University of Belfast, Medical Education Unit, Room<br />
145 Whitla Medical Building, 97 Lisburn Road, Belfast BT9<br />
7DL, UK<br />
The Faculty Tutorial Scheme at the Medical School at<br />
Queen’s University Belfast was established in 1984 to<br />
provide pastoral support for students. During 1999<br />
qualitative and quantitative research techniques were<br />
used to evaluate this support mechanism. Questionnaire<br />
Monday 3 September<br />
- 4.21 -<br />
A half-day training course on epilepsy in child mental<br />
health was devised for a multi-professional audience.<br />
Evaluation included delegates’ self-reported<br />
knowledge, attitudes, and perception of the course. 83<br />
professionals attended, representing related disciplines.<br />
81 completed a pre-, 73 a feedback, 65 a post-, and 18<br />
an eight-month follow-up questionnaire. Most reported<br />
the learning objectives to be clear (85%) and met (80%),<br />
the course was structured to facilitate learning (78%),<br />
links were made with clinical practice (78%), and they<br />
had questioned their own practice as a result (72%).<br />
Correct responses to knowledge questions rose (56%<br />
to 91%), incorrect (7% to
suggest that while this scheme was seen as innovative<br />
it still has limitations.<br />
2M2 Is student abuse a problem in our<br />
medical school?<br />
Ana Maida*, Alicia Vasquez, José Calderon, Viviana<br />
Herskovic, Marcela Jacard, Ana Pereira and Lars Widdel<br />
University of Chile, Facultad de Medicina, Universidad de Chile,<br />
Departamento de Pediatría, Campus Oriente, Casilla 16117,<br />
Correo 9, Providencia, Santiago, CHILE<br />
The purpose of this study was to determine the<br />
incidence, and the consequences, of abusive situations<br />
as perceived by students during the course of their<br />
Medical training. A descriptive study was made<br />
surveying the entire 2000 fifth year class in the Medical<br />
School of the University of Chile. The questionnaire<br />
was answered by 144 students. Results showed that<br />
91.7% of the students had suffered at least one episode<br />
of abuse while enrolled in Medical School. Main<br />
offenders were teachers and peers. Verbal abuse was<br />
the most common (85.4%), followed by psychological<br />
(79.9%), sexual (26.4%) and physical (23.6%) abuse.<br />
Students reported that abuse had effects on their mental<br />
health, social life and the image they had of physicians;<br />
17% considered dropping out of school as a<br />
consequence of this experience. The high proportion<br />
of teachers involved in situations perceived as abusive<br />
by students should prompt educators to reflect on their<br />
role.<br />
2M3 First year medical, nursing and<br />
pharmacy students’ approaches to<br />
study<br />
R J Lamdin* and I Martin<br />
9A Sentinel Road, Herne Bay, Auckland, NEW ZEALAND<br />
The Approaches to Study Inventory (ASI) was<br />
administered to first year health sciences students prior<br />
to course commencement at the University of<br />
Auckland.This was to aid understanding of approaches<br />
to study in a large multi-professional first year<br />
programme. Prior to 1999 medical students in the<br />
Faculty of Medical and Health Sciences were taught a<br />
unique course but as of 2000, nursing and pharmacy<br />
students were admitted to new nursing and pharmacy<br />
programmes. In the first year, medical, nursing,<br />
pharmacy and general health science students share<br />
common courses. Each group of students is admitted<br />
via different admission systems and goes on to complete<br />
different programmes of study. This project describes<br />
the learning styles of the first year students using the<br />
ASI and considers the importance of this knowledge<br />
in teaching. Consideration of gender and age<br />
differences and the possible effect of different<br />
admission systems will be undertaken.<br />
2M4 Changing medical students’<br />
attitudes towards homosexuality<br />
Itzchak Levi* and Tsvi Fischel<br />
Sackler Medical School, 13/2 Tsel Hagivaa, Ramat Gan, ISRAEL<br />
In many surveys it is found that many physicians hold<br />
negative attitudes towards homosexuality. In addition,<br />
due to negative experience many gay people feel<br />
Monday 3 September<br />
- 4.22 -<br />
uncomfortable to report to their physician about their<br />
sexual orientation. As well as the fact that gays have<br />
unique health conditions, they do not tend to share with<br />
their physician even their general health problems, and<br />
not even problems concerning preventive medicine. In<br />
view of the above, it is interesting that most medical<br />
schools do not include in their curriculum a place to<br />
teach “homosexuality”. Attitudes towards<br />
homosexuality can be changed through workshops and<br />
active learning. Two case studies were discussed and<br />
processed by medical students in their pre clinical<br />
studies as part of the behavioral sciences course. The<br />
students showed a high level of satisfaction. Case<br />
studies could be a useful tool to teach and experience<br />
attitudes towards gays and homosexuality in medical<br />
schools.<br />
2M5 The attitudes to Psychiatry of first<br />
year medical students<br />
R K Day<br />
University of Dundee, Department of Psychiatry, Level 5,<br />
Ninewells Hospital, Dundee DD1 9SY, UK<br />
For over thirty years there has been evidence that<br />
psychiatry is viewed negatively by medical students.<br />
A number of self-report questionnaires of attitudes to<br />
psychiatry have been constructed, of which the most<br />
widely used is the ATP-30. The ATP-30 was<br />
administered to first year medical students on their first<br />
day of medical school to assess their initial attitudes. It<br />
was also administered to a first year science class. The<br />
ATP-30 was also modified to inquire about attitudes<br />
to gynaecology and this was completed by the new<br />
medical students. The attitudes of new medical students<br />
to psychiatry do not differ from those of science<br />
students. However, medical students view gynaecology<br />
more positively than they do psychiatry. Further studies<br />
are required to determine how this initially negative<br />
view of psychiatry is affected by the medical<br />
curriculum.<br />
2M6 Psychology basic and applied<br />
knowledge<br />
Agnete Langagergaard* and Berit Eika<br />
Unit of Medical Education, University of Aarhus, Vennelyst<br />
Boulevard 9, DK 8000 Aarhus, DENMARK<br />
In a new medical curriculum an innovative course of<br />
psychology was introduced, consisting of: (1) a short<br />
(20 hour) 3rd term course giving a factual knowledge<br />
base within the domain of psychology, and (2) a longer<br />
(4 weeks) 7th term course where the application of<br />
knowledge previously acquired is trained. The short<br />
course is lecture based and within the framework of<br />
developmental psychology. Each double lecture covers<br />
an age span thereby making sure that students become<br />
aware of general as well as of age specific psychological<br />
issues. In the latter course a case based teaching format<br />
helps students develop a systematic approach to<br />
psychological themes relevant to the medical<br />
profession. Clinical psychologists introduce students<br />
to themes such as anxiety, minority problems, and<br />
psychosomatic problems. Finally, in conjunction with<br />
the Department of Philosophy, a topic (eg. the dying<br />
patient) is chosen as a returning theme covered from<br />
different angles.
Session 3 Workshops 1<br />
3/1 The roles of the teacher<br />
Jennifer Laidlaw and E Anne Hesketh<br />
SCPMDE Education Development Unit, Tay Park House, 484<br />
Perth Road, Dundee DD2 1LR, UK<br />
Background<br />
All doctors are teachers. It is a role that is constantly<br />
changing and is often a challenge for today’s doctors -<br />
especially with the many other tasks they have to carry<br />
out. This workshop gives the opportunity to explore<br />
the teaching roles and tasks that doctors might have to<br />
adopt whether they are doctors at the start of their<br />
postgraduate training or fully trained with a formal<br />
teaching responsibility.<br />
Aims<br />
The workshop aims to give insight into:<br />
the roles that today’s doctors, as clinical educators,<br />
have to adopt<br />
the associated tasks that they have to carry out<br />
the approaches to these tasks and the<br />
professionalism required of today’s educator .<br />
Who should attend<br />
Those involved in teaching in any capacity eg<br />
having to look after juniors, being a contributor to<br />
a course or a departmental teaching session, having<br />
formal supervision responsibilities, being a course<br />
organiser<br />
Those involved in identifying generic skills for the<br />
postgraduate training of doctors<br />
Note: This workshop is very similar to last year’s workshop<br />
‘12 roles of the teacher’ which was oversubscribed. Due to<br />
interest expressed it is being repeated in an extended format.<br />
Those attending last year would not gain further significant<br />
benefit from attending.<br />
Content and structure<br />
1 Introduction to roles (25 min): Ice breaker activity<br />
and short plenary with hand out;<br />
2 Tasks associated with roles (35 min): Group activity<br />
with feedback;<br />
3 A framework for identifying the competencies<br />
required by the clinical educator (15 min): Short<br />
plenary with time to study grid and make link to<br />
findings of previous group activity;<br />
4 Using the grid (35 min):Group activity with<br />
feedback;<br />
5 Courses in teaching from Dundee(10 min): Display<br />
of material from a ‘taster’ course through to a<br />
Diploma/Masters in Medical Education.<br />
3/2 The quality of medical education and<br />
teaching – thema con variatione<br />
Professor Peter Nippert<br />
University of Muenster, Germany<br />
Monday 3 September<br />
- 4.23 -<br />
3/3 From MD to academic teacher<br />
Professor Reinhard Putz<br />
University of Munich, Germany<br />
Background<br />
Medical education focusses on knowledge and abilities.<br />
Students are faced with a lot of information including<br />
general understanding of processes, differential<br />
diagnosis and therapeutic consequences. In most<br />
European universities, lectures, courses and practical<br />
exercises on patients are the preferred teaching<br />
elements. Some medical schools have changed to<br />
problem based learning (PBL). The effectiveness of the<br />
teaching depends on many aspects. One is the student/<br />
teacher ratio; another is the structure of the program.<br />
However, the education of the teacher is the last in this<br />
list. On the other hand, many studies show that the<br />
performance and personality of the teacher has the<br />
highest impact on the learning effect. This is especially<br />
true for lectures and teacher-guided courses, but also<br />
in PBL the tutor plays a crucial role in the learning<br />
process. In light of this it is surprising that academic<br />
teachers are not forced to undergo any kind of didactic<br />
training. Only few institutions offer a structured training<br />
program for young assistants.<br />
Aim<br />
One of the goals of the workshop is the preparation of<br />
participants for the role of academic teacher. The<br />
participants should leave the workshop with the insight<br />
that academic teaching can become an attractive<br />
challenge especially for scientific educated people.<br />
Content and structure<br />
The report of good and bad experiences should<br />
contribute to a picture of the present personal situation<br />
of teaching staff in many schools. Next, the needs for<br />
improvement will be addressed. Then a period of<br />
discussion in small groups is planned. In this part a<br />
particular teaching situation will be designed and<br />
structured: lecture for a large class (more than 100),<br />
lecture for a small class (ca. 40–80), seminar (10–20),<br />
course, PBL group. Back in the plenary, the results of<br />
the sections will be presented and discussed. The<br />
preparation for the requirements of an academic teacher<br />
should be the goal of this part followed by some<br />
suggestions for the structure of a training course for<br />
academic teachers.<br />
1 Plenary (ca. 20‘): Reflection on the personal state<br />
of teaching ability (advantages and shortcomings)<br />
2 Plenary (ca. 20‘): Description of necessary teaching<br />
abilities<br />
3 Groups (ca. 20‘): Structure of particular teaching<br />
situations (large lecture, small lecture, course,<br />
practical exercise, POL-group)<br />
4 Plenary (ca. 20‘): How to prepare an M.D. for<br />
education as an academic teacher<br />
5 Plenary (ca. 30‘): Elements of a training course for<br />
academic teachers .
3/4 Feedback and evaluation: essential<br />
activities in the learning process<br />
(helping students learn to seek<br />
continuing improvement - as<br />
students and career professionals)<br />
Dr Charles D Puglia,<br />
MCP Hahnemann School of Medicine, 2900 Queen Lane,<br />
Philadelphia PA 19129, USA<br />
Background<br />
Fear, anxiety, and panic are common reactions to the<br />
suggestion that an individual is to receive feedback or<br />
evaluation of their work. Often, the perception that selfesteem<br />
is about to be threatened elicits a defensive<br />
barrier that interferes with communication of<br />
information which is intended to improve performance.<br />
This view of feedback, perceived as a painful process,<br />
has developed because of injurious methods of delivery<br />
of evaluative information beginning in childhood and<br />
in many cases continuing throughout a student’s formal<br />
educative experience. Feedback and evaluative<br />
information must be recognized as essential for an<br />
individual to succeed at self-directed learning. The<br />
learner must be encouraged to seek evaluative comment<br />
as a means of continuing intellectual growth and<br />
thereby enhancing self-esteem.<br />
Achievement of the objectives of all learning systems<br />
such as medical school curricula is dependent upon<br />
formative evaluation and feedback as well as summative<br />
evaluation. Evaluative methods are especially important<br />
in times when curricular change is introduced.<br />
Feedback and evaluation is necessary to aid faculty as<br />
well as students to clearly define the objectives of the<br />
change in terms of the ultimate goal of the curriculum.<br />
Aim of workshop<br />
This workshop will identify attitudes and techniques<br />
which faculty can adopt to enable feedback and<br />
evaluation to be delivered in a constructive, esteembuilding<br />
manner. Students will begin to actively seek<br />
feedback as an opportunity to continually improve and<br />
grow.<br />
3/5 Best Evidence Medical Education<br />
(BEME): progress report<br />
Chairperson: Professor Ian Hart<br />
BEME Collaboration (www.bemecollaboration.org)<br />
Background<br />
BEME is defined as: “The implementation by teachers<br />
and educational bodies in their practice, of methods<br />
and approaches to education based on the best evidence<br />
available.” In the three years since the <strong>AMEE</strong> Prague<br />
Conference, when the topic of BEME was raised, there<br />
has been much activity, leading to the formation of the<br />
BEME Collaboration in 1999. The Collaboration aims<br />
to promote a culture of the use of best evidence in<br />
medical and healthcare professions education, to carry<br />
out systematic reviews of the evidence and to<br />
dissemination information on best practice. A<br />
systematic review is defined as “A review of the<br />
evidence on a clearly formulated question that uses<br />
systematic and explicit methods to identify, select and<br />
Monday 3 September<br />
- 4.24 -<br />
critically appraise relevant primary research, and to<br />
extract and analyse data from the studies that are<br />
included in the review. “ (NHS Centre for Reviews and<br />
Dissemination 2001).<br />
Several international Topic Review Groups have<br />
recently been formed to carry out pilot studies, prior<br />
to the commencement of systematic reviews of the<br />
evidence, in the following areas:<br />
1 The use of feedback in assessment;<br />
2 The use of high fidelity simulators as an aid to<br />
student learning<br />
3 Faculty development<br />
4 The use of computers in clinical education.<br />
Content and structure<br />
The workshop will be conducted in plenary. First there<br />
will be a short introduction to familiarise participants<br />
with the issues. Presentations from each of the Topic<br />
Review Groups will follow, reporting on issues raised<br />
in the early stages of the pilot studies. These involve<br />
setting up the review groups, deciding on the research<br />
question to be examined, finding and judging the<br />
evidence and the format in which the evidence is to be<br />
presented. Where appropriate, an insight will be given<br />
by the group into the impressions of the data collected<br />
to date in each of the areas. The session will finish<br />
with an interactive discussion with the audience and it<br />
is envisaged that methodological issues will form a<br />
major part of the discussions.<br />
Prospective participants might like to refer to the BEME<br />
website to gain some insight into the project:<br />
www.bemecollaboration.org<br />
3/6 East European Task Force<br />
Chairperson: Professor Ioan Bocsan<br />
Iuliu Hatieganu University of Medicine & Pharmacy, 13 Emil<br />
Isac St , RO-3400 Cluj-Napoca, Romania<br />
A review of some of the issues facing medical education<br />
in East and Central Europe, with contributions from<br />
participants.<br />
3/7 Making feedback during clerkships<br />
meaningful and effective: a workshop<br />
for students and teachers<br />
Dr Paul Hemmer<br />
Uniformed Services University of the Health Sciences, 4301 Jones<br />
Bridge Road, Bethesda MD 20814, USA<br />
Background<br />
Medical students have concerns that the feedback they<br />
receive during clinical clerkships is sporadic, and that<br />
it varies in quality. Teachers are not always comfortable<br />
providing feedback, and may be uncertain of clerkship<br />
goals and expectations.<br />
Aims<br />
Participants will a) gain familiarity with the RIME<br />
descriptors, b) improve their ability to solicit and<br />
provide feedback, and c) discuss the potential for<br />
educational research.
Content and structure<br />
In this workshop, we will seek input from students and<br />
teachers about feedback during a clinical clerkship.<br />
From this discussion, we will present a framework of<br />
goals and expectations for medical students on clinical<br />
clerkships, known as RIME for Reporter-Interpreter-<br />
Manager/Educator. Using this framework, we will<br />
explore how students can self-assess their performance,<br />
and to use this as a means to solicit feedback from<br />
teachers. Teachers will be introduced to using RIME<br />
for evaluating students and subsequently providing<br />
feedback. We will use interactive discussion, role-play,<br />
and teaching cases.<br />
3/8 Concept mapping<br />
Dr Gonul Peker<br />
Ege University School of Medicine, Bornova 35100 Izmir, Turkey<br />
3/9 Effective student assessment:<br />
something old, something new<br />
Dr Geoff Norman<br />
McMaster University Medical School, Health Sciences Centre,<br />
1200 Main Street West, Hamilton ON L8N 3Z5, Canada<br />
Aims<br />
• To familiarise participants with reliability/validity<br />
of various tools;<br />
• To introduce some new promising approaches to<br />
assessment : Reasoning Exercise;<br />
• Key features; Clinical Work Sampling.<br />
Who should attend<br />
This workshop will be of interest to both clinical and<br />
pre-clinical teachers.<br />
Content and structure:<br />
1 Plenary session (1 hour): Ground rules; Review of<br />
various traditional methods; Introduction of new<br />
approaches<br />
2 Practice designing new approaches (1/2 hour)<br />
3 Discussion and conclusions (1/2 hour)<br />
Handouts will be provided.<br />
3/10 A bachelor-master structure of<br />
medical education in Europe?<br />
Professor Olle ten Cate<br />
University Medical Centre Utrecht and Professor Herman van<br />
Rossum, University of Groningen, Netherlands<br />
University Medical Centre Utrecht, P O Box 85060, 3508 AB<br />
Utrecht, Netherlands<br />
Background<br />
In 1999 the Ministers of Education of the European<br />
Union countries agreed upon the so-called Bologna<br />
Declaration. This agreement concerns the<br />
harmonization of higher education. One element is the<br />
restructuring education into two phases: a bachelor<br />
(undergraduate) phase of three years and a master<br />
(graduate) phase of one or two years. Major reasons to<br />
Monday 3 September<br />
- 4.25 -<br />
harmonize higher education include international<br />
comparability and enhancing exchange possibilities.<br />
In the Netherlands, several universities and vocational<br />
schools have started curricular changes to implement<br />
the new structure, preferably in 2003. Medical schools<br />
have been hesitant to adapt their curricula. A national<br />
project on The Continuum of Medical Training has been<br />
asked to first investigate the possibilities and<br />
desirability of this new structure. It may be contrary to<br />
current medical curriculum developments, as in<br />
innovative schools clinical education is gradually<br />
moving to early years of education and being integrated<br />
with basic sciences. The BaMa-structure may throw<br />
medical education back to a separation of basic and<br />
clinical sciences. However, medical education could<br />
become too isolated within the universities and and too<br />
little harmonized internationally, if is does not<br />
implement the structure.<br />
Content and structure<br />
In this workshop participants from different countries<br />
will be invited to (a) briefly discuss the current structure<br />
of medical training in their country in a structured<br />
format and (b) generate arguments pro and/or contra<br />
harmonization of medical education in Europe<br />
according to the Bologna Declaration.<br />
3/11 The assessment of poorly<br />
performing doctors: experiences<br />
from the first three years of the<br />
Performance Procedures within the<br />
UK General Medical Council<br />
Professor Lesley Southgate, CHIME, London<br />
Dr Peter McCrorie, St George’s Hospital Medical School<br />
CHIME, University College London Medical School, Archway<br />
Campus, Highgate Hill, London N19 3UA, UK<br />
The assessment of poorly performing doctors:<br />
experiences from the first three years of the<br />
Performance Procedures within the UK General<br />
Medical Council.<br />
Aim<br />
This workshop will inform participants about the UK<br />
programme to assess doctors whose competence to hold<br />
a medical licence has been questioned. This is carried<br />
out in two phases: peer review of performance in the<br />
workplace and tests of knowledge and skills in a clinical<br />
skills lab.<br />
Content and structure<br />
The workshop will be divided into three sections, each<br />
of one hour. The first section will describe the<br />
programme and the assessment principles on which it<br />
is based. The second section will examine the methods<br />
of assessment used in both phases and will also include<br />
presentation of data from actual assessments. The third<br />
section will describe the recruitment, training and<br />
assessment of the performance assessors. Each section<br />
will be introduced by an interactive lecture for 20<br />
minutes, followed by group work for 20 minutes and<br />
plenary discussion for 20 minutes. Throughout the three<br />
hours examples from surgery, anaesthetics, ob&gyn,<br />
general practice and psychiatry will be used.
No preparation is needed in advance and handouts will<br />
be available.<br />
3/12 What can a general medical journal<br />
do for education in medicine?<br />
Sandy Goldbeck-Wood, Assistant Editor BMJ and Dr Ed<br />
Peile, Research Fellow in Medical Education, University of<br />
Oxford and Editorial Advisor, BMJ<br />
Dept of Primary Healthcare, University of Oxford, Chiltern<br />
Waters, 1 Stablebridge Road, Aston Clinton, Bucks HP22 5ND,<br />
UK<br />
Monday 3 September<br />
- 4.26 -<br />
Background<br />
The BMJ is considering new ventures in medical<br />
education and we will put forward some ideas for future<br />
ventures in publication. We would like participants’<br />
reactions and ideas for how medical education themes<br />
may be developed in a general medical journal.<br />
Who should attend<br />
Anyone with an interest in medical education; graduates<br />
or undergraduates, particularly those who read general<br />
medical journals.
Session 4 Large Group Sessions<br />
4A Standards and professionalism in<br />
medical education<br />
1 Attempto! Instilling mindful teaching<br />
Dr Maria Lammerding-Köppel<br />
Faculty of Medicine, University of Tübingen, Geissweg 5/1, D-<br />
72076 Tübingen, Germany<br />
The need for staff development programmes and the<br />
training of medical teachers in education have been<br />
recognized. The areas to be covered in such<br />
programmes and the specific teacher competencies and<br />
attitudes are often a matter of debate. Intended<br />
outcomes and standards of quality must relate to the<br />
professional roles of the medical teacher and to the<br />
culture of good teaching practice based on consensus.<br />
The task for the future is to ensure that we address<br />
outcomes that expand the scope of the medical teacher<br />
and that are deeply relevant to an optimal professional<br />
development.<br />
2 Who is afraid of the didactic wolf? A plea for<br />
professionalism in medical education and<br />
specialist training<br />
Professor Rein Zwierstra<br />
Institute for Medical Education, Faculty of Medical Sciences,<br />
University of Groningen, Ant. Deusinglaan 1, 9713 AV<br />
Groningen, Netherlands<br />
In the present era there is no longer a need for expert<br />
doctors who can talk enthusiastically about their subject<br />
in a teaching setting. Changes in health care<br />
organisation and curriculum design call for effective<br />
teaching by teachers who operate in a team. Whilst in<br />
the world of research peer review is accepted as a<br />
standard, it is remarkable that in medical education<br />
practice peer opinions about each other’s teaching is<br />
regarded as patronising or even threatening. The quality<br />
of teaching and of curricula will improve significantly<br />
if teachers, trained in didactic principles, were to<br />
prepare their contribution as a team and reflect with<br />
mutual respect upon each other’s participation. Why<br />
are medical teachers and trainers afraid of the didactic<br />
wolf?<br />
3 What’s good about “Best Evidence Medical<br />
Education (BEME)”?<br />
Professor Ralph Bloch<br />
Institute for Medical Education, Inselspital 37a, University of<br />
Bern, H-3010 Bern, Switzerland<br />
BEME, like its older cousin “Evidence Based Medicine<br />
(EBM)” is likely to meet supporters and detractors.<br />
EBM and BEME are often depicted as new religions.<br />
The simile is quite apt. Both movements encompass a<br />
core philosophy, a set of prescribed rituals and a<br />
supporting, hierarchical organization. The central<br />
dogmata of both activities derive from logical<br />
positivism with the utilitarian goal of doing more good<br />
than harm - one in the practice of medicine, the other<br />
in the training of medical practitioners. The rituals<br />
pertain to the efficient extraction of valid (both internal<br />
Tuesday 4 September<br />
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and external) evidence from the published literature.<br />
The hierarchical organizations, finally, serve the<br />
purpose of optimizing economies of scale and fostering<br />
consensus on standards of quality within the academic<br />
community. Not unlike established religions, EBM and<br />
BEME run the risk of blind adherence and of assuming<br />
the cloak of infallibility. The way we develop and<br />
implement BEME will ultimately determine whether<br />
it will do more good than harm.<br />
4B International aspects of standards<br />
1 International standards in medical education:<br />
what are they and do we really need them?<br />
Dr Andrzej Wojtcjak and Dr M Roy Schwarz<br />
Institute for International Medical Education, 106 Corporate<br />
Park Drive, Suite 100, White Plains, New York NY 10604-3817,<br />
USA<br />
Physicians are now members of the global community.<br />
Created by interlocking economies, a global language,<br />
informatics networks and rapid travel, globalization has<br />
penetrated science, public health, the environment, law<br />
and religion, as well as medicine. Hence, minimal<br />
physician competencies must be defined and<br />
mechanisms developed to ensure that all medical school<br />
graduates possess these essential requirements.<br />
Established by a grant from the China Medical Board<br />
of New York, the Institute for International Medical<br />
Education (IIME) has undertaken the responsibility of<br />
defining “global minimum essential requirements”<br />
(GMER) for undergraduate medical programs.<br />
Developed by international medical experts, GMER<br />
consist of knowledge, clinical skills, professional<br />
attitudes, behaviour and ethical values. Since GMER<br />
alone are not likely to change graduates’ competencies<br />
unless they are linked to assessment, evaluation tools<br />
for educational outcomes are also being developed. The<br />
lessons learned from the pilot implementation of<br />
GMER in selected medical schools will be available to<br />
the global medical education community.<br />
2 Globalisation of Medical Education: The<br />
concept of international standards<br />
Dr. Hans Karle<br />
President, World Federation for Medical Education, Faculty of<br />
Health Sciences, University of Copenhagen, Panum Institute,<br />
Blegdamsvej 3, 2200 Copenhagen N, DENMARK<br />
The increasing internationalisation of the medical<br />
profession raises the question of safeguarding the<br />
practice of medicine and medical manpower utilisation<br />
through well-defined international standards in medical<br />
education. Evaluation of educational institutions and<br />
programmes based on internationally adopted standards<br />
is an important incentive for institutional improvements<br />
and for generally raising the quality of medical<br />
education. Furthermore, such standards can serve as<br />
guidelines for national or regional agencies dealing<br />
with recognition and accreditation of medical schools
and postgraduate training institutions and educational<br />
programmes. In 1998, the World Federation for Medical<br />
Education (WFME) launched its project on<br />
”International standards in medical education”<br />
(Medical Education 1998;32,549-558). A WFME<br />
Working Party defined a set of international standards<br />
in basic medical education dealing with the structure,<br />
process, conditions and outcome, and specified at two<br />
levels of attainment: (a) basic standards (or minimal<br />
requirements), and (b) standards for quality<br />
development (Medical Education 2000;34,665-675).<br />
In the light of comments received from an international<br />
panel of advisors and from a number of conferences<br />
around the world, the standard document has now been<br />
refined and further developed, including guidelines for<br />
the implementation of the standards at the institutional,<br />
national and regional levels. The concept, and the<br />
purpose and rationale for the WFME Standards in Basic<br />
Medical Education will be presented. Pilot studies on<br />
the value of these standards are now being prepared in<br />
the six WFME Regions. WFME is now planning a<br />
similar process concerning international standards in<br />
postgraduate medical education covering both<br />
specialist training and continuing medical education/<br />
personal development.<br />
4C Standards and the curriculum<br />
1 Learning can be fun! The student’s<br />
experience in a new curriculum<br />
Anke Neuwirth and Johannes Meier<br />
Second year students in the Reformed Medical Curriculum,<br />
Charité, Humboldt-University <strong>Berlin</strong>, Germany<br />
Two years ago 63 students at the Humboldt-University<br />
began studying medicine in a reformed parallel track.<br />
This is the first attempt in Germany at changing a<br />
traditional curriculum. Basic sciences are combined<br />
with clinical practice right from the beginning: PBL as<br />
the main learning format plus one day per week with a<br />
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general practitioner, practical and communication skills<br />
training and theoretical seminars. Students from the<br />
first class will share their personal experiences of new<br />
standards in learning, teaching and assessment. A large<br />
part of the presentation will be reserved for discussion<br />
with the audience.<br />
2 The advantages of longitudinal evaluation of<br />
the medical curriculum<br />
Prof. Dr. Reinhard Pabst<br />
Medical School of Hannover, Centre of Anatomy – 4120, Care<br />
Neuberg Strasse 1, D30625 Hannover, GERMANY<br />
After implementing modifications in the undergraduate<br />
medical curriculum, the outcome should be evaluated.<br />
Questionnaires answered by medical students at the end<br />
of a term are helpful, but of even greater relevance are<br />
evaluations at different times during and after the<br />
undergraduate phase. Some examples will be presented<br />
to show why and for whom these data are relevant, as<br />
well as how the questionnaire should be designed. It<br />
will be proposed to perform similar evaluations in<br />
different European countries, and also to ask in<br />
particular those doctors who have studied medicine in<br />
different countries to evaluate their medical curriculum<br />
retrospectively.<br />
3 Standards and assessment<br />
Professor Miriam Friedman Ben-David<br />
Centre for Medical Education, University of Dundee, Tay Park<br />
House, 484 Perth Road, Dundee DD2 1LR, UK<br />
The important effect of assessment on students’<br />
behaviour and pattern of learning is well documented.<br />
The assessment process has a key effect on establishing<br />
standards within the medical school. This presentation<br />
looks at the relationship between standards and<br />
assessment. It explores the links between the two and<br />
looks at issues relating to standard setting procedures<br />
as part of the assessment process.
Session 5A Learning and the internet<br />
5A1 The “dos and don’ts” of e-learning<br />
in medicine: experiences of a CD-<br />
ROM production<br />
P Langkafel*, A Oehlsen, U Arnold and J W Dudenhausen<br />
Charité, Department of Obstetrics, Faculty of Medicine,<br />
Humboldt-University of <strong>Berlin</strong>, Augustenburger Platz 1, 13353<br />
<strong>Berlin</strong>, GERMANY<br />
In November 2000 the Department of Obstetrics<br />
published the CD-ROM “Digital Obstetrics”. After<br />
almost 2 years of work we were glad to publish this<br />
piece of software with a well known editor in Medicine.<br />
We will focus in our presentation on the process of<br />
conception and the production of this CD-ROM and<br />
other Internet-based courses. What are our experiences?<br />
What are - in our opinion - the “musts” of a good<br />
production, what are the “nevers”? What did we learn<br />
from this process? What are our “golden rules” from<br />
this experience to be learnt for different topics of elearning<br />
in medicine? There will be the possibility for<br />
a continuous virtual discussion via the<br />
Internet:(www.golden-rules.de) The audience and<br />
interested people will have the opportunity to add their<br />
opinions and to share in the discussion with others<br />
digitally.<br />
5A2 Online guide to basic surgical<br />
skills: http://olc.chirurgiegoettingen.de<br />
S Koenig*, P Wagner, D Zeiss, P M Markus and H Becker<br />
Georg-August-University Goettingen, Department of General<br />
Surgery, Faculty of Medicine and University Hospital, Robert-<br />
Koch-Str. 40, 37075 Goettingen, GERMANY<br />
The emphasis of medical education in Germany lies in<br />
the imparting of theoretical knowledge. During their<br />
clinical studies, medical students increasingly have to<br />
deal with the major problem of how to gain experience<br />
in clinical practice and learn the relevant skills. With<br />
this in mind, an online guide is being developed as a<br />
teaching aid demonstrating basic skills in surgery to<br />
accompany the existing curriculum. The guide is<br />
presented as a website, centred around a series of<br />
digitised video sequences, photographs and illustrations<br />
highlighting the basic clinical skills required in the field<br />
of surgery. Examples include blood sampling, IV line<br />
management, suture techniques, wound management<br />
and general practice in theatre such as scrubbing up,<br />
aseptic procedures and use of specific instruments.<br />
Student feedback to date is exceptionally encouraging<br />
for the further development of the platform, including<br />
integration of other fields in medical education.<br />
5A3 Standards for an international<br />
distributed online case repository<br />
Chris Candler*, Colin Melville and Dave Collins<br />
University of Oklahoma, Science Centre, 941 Stanton L. Young<br />
Blvd, BSEB 115A, Oklahoma City, OK 73104, USA<br />
Teaching cases have been used by medical schools for<br />
years as a means to simulate the patient encounter,<br />
Tuesday 4 September<br />
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provide early exposure to clinical problems, and to<br />
ensure a consistent educational experience. Recently,<br />
many schools have developed online cases to<br />
supplement existing coursework. Through the use of<br />
emerging technologies, cases may display high-quality<br />
multimedia, track student reasoning, facilitate facultystudent<br />
collaboration, and even adapt to the student’s<br />
educational needs. While schools have created online<br />
cases for a variety of purposes, development costs are<br />
rarely trivial. Unfortunately, medical schools have not<br />
employed the same technologies to share and reuse<br />
these costly resources. New technologies could be used<br />
to develop case banks that house cases independent of<br />
purpose or pedagogy. The authors propose the<br />
development of an international case repository and<br />
suggest a technical implementation based on distributed<br />
systems and open standards such as the eXtensible<br />
Markup Language.<br />
5A4 Digital study of medicine<br />
U Arnold*, P Langkafel, L Peppel, I Reisinger and<br />
J W Dudenhausen<br />
Charité, Humboldt-University <strong>Berlin</strong>, <strong>Berlin</strong> Biomedical<br />
Exchange Office, Campus Virchow-Klinikum, Augustenburger<br />
Platz 1, D-13353 <strong>Berlin</strong>, GERMANY<br />
Digital media becomes more and more a major force<br />
in medicine and medical education. This representative<br />
study among students of medicine demonstrates the<br />
big differences between varying student samples<br />
concerning the use of and the expectations on new<br />
media and e-learning. In a sample survey (n=282) using<br />
machine readable questionnaires students of the first<br />
pre-clinic and the first clinic semester were questioned<br />
about their current and future computer and internet<br />
use as well as their attitude as regards these subjects.<br />
57.8 % of the beginners use a PC and the internet more<br />
than once a week while 12.6% do not use computers at<br />
all. More than half of the beginners (55%) do not know<br />
internet based learning at all. While only 0.6% of the<br />
beginners claim to use CD-ROM for learning purposes<br />
this number increases to 23.9% among the students<br />
from the first clinic semester. Nearly half of the students<br />
wish to see an amount of 16 to 30% for new media<br />
based learning in the curriculum of the future. The<br />
detailed results will be discussed focussing on their<br />
consequences for e-learning in the field of medical<br />
education.<br />
5A5 Electronic learning objects and<br />
resource discovery<br />
David A Davies<br />
University of Birmingham, Medical Education Unit, School of<br />
Medicine, Edgbaston, Birmingham B15 2TT, UK<br />
A challenge facing many institutions engaged in<br />
teaching is to find electronic learning resources to meet<br />
the requirements of the curriculum. Electronic learning<br />
resources may be clinical images, digital video clips,<br />
case scenarios, MCQs, etc. These ‘learning objects’ may<br />
be viewed as the building blocks for new web-based
teaching packages. There are opportunities for the<br />
development of new learning objects both within an<br />
institution but also by sharing existing resources with<br />
other institutions. A central issue therefore becomes<br />
how does any individual know what resources are<br />
available either locally or remotely? We have developed<br />
an internet-based system that greatly facilitates<br />
resources discovery. Our system uses open standards<br />
and does not rely upon any specific hardware or<br />
software platform. By using our Electronic Curriculum<br />
as an example, which we first demonstrated to <strong>AMEE</strong><br />
two years ago, we will show, using real examples, how<br />
institutions can collaboratively share learning objects.<br />
5A6 Filling a curriculum map with<br />
Reusable Learning Objects<br />
N K McManus*, R M Harden, D Davidson, S Khogali and<br />
J M Laidlaw<br />
SCPMDE, Education Development Unit, Tay Park House, 484<br />
Perth Road, Dundee DD2 1LR, UK<br />
Session 5B Evaluation of PBL<br />
5B1 Changing to PBL: does it have<br />
an effect on junior doctors’<br />
conceptualisation of<br />
communication skills?<br />
P A O’Neill*, S C Willis and A Jones<br />
University of Manchester, Research and Teaching Building, South<br />
Manchester University Hospitals Trust, Nell Lane, Manchester<br />
M2O 2LR, UK<br />
In 1994 Manchester Medical School introduced a<br />
learner-centred, problem based learning course, which<br />
involves more emphasis on acquisition of effective<br />
communication skills. This study explored how<br />
Manchester graduates conceptualise communication<br />
skills. Twenty-four traditional course graduates and 23<br />
new course graduates were interviewed 3 months into<br />
their first job. Graduates were asked to reflect on how<br />
well the course had prepared them for being an effective<br />
communicator. Interviews were tape-recorded,<br />
transcribed, coded and analysed. Traditional course<br />
graduates conceptualised communication as ‘talking<br />
to people’. Being an effective communicator was<br />
described as ‘a personal thing’ rather than something<br />
which could be taught or learned. New course graduates<br />
conceptualised communication skills as being<br />
important for patient outcomes; and as something<br />
which could be both taught and learned. A comparison<br />
between traditional and PBL course graduates suggests<br />
that there are some differences in their<br />
conceptualisation of communication skills.<br />
Tuesday 4 September<br />
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For a computer-based learning system to be widely<br />
usable, it must be possible to tailor the information<br />
presented to the learner to match the level of study and<br />
topic of interest. To achieve this, it is necessary to<br />
describe the content in a way that makes it reusable in<br />
a variety of contexts. By applying a standard template<br />
to describe structure within topics, specifying<br />
associations between concepts, and describing the<br />
content using a standard coding scheme, it is possible<br />
to produce standalone ‘Reusable Learning Objects’.<br />
These can then be filtered by the system to match the<br />
learner’s requirements. In an experimental<br />
implementation to investigate methods for creating<br />
these electronic curriculum maps, a prototype system<br />
is being produced covering three areas in neurology,<br />
cardiology and dermatology. A web interface allows<br />
these sections to be developed concurrently, then<br />
delivered to a wide audience.<br />
5B2 How do medical students<br />
characterize good problem-based<br />
learning (PBL) tutoring after a<br />
year’s experience?<br />
Gillian Maudsley<br />
University of Liverpool, Department of Public Health, Whelan<br />
Building, Quadrangle, Liverpool L69 3GB, UK<br />
In 1996, Liverpool’s 5-year undergraduate medical<br />
(MBChB) curriculum became problem-based.<br />
Students’ initial experiences of problem-based learning<br />
(PBL) and PBL tutors could influence subsequent<br />
progress. Empirical evidence on students’ perceptions<br />
of PBL tutors’ role is developing. The aim was to<br />
explore how medical students conceptualize good PBL<br />
tutors (and learning) in a problem-based curriculum.<br />
The subjects were 224 medical students at end of Year<br />
1. A cross-sectional (self-completed questionnaire)<br />
survey of mostly open-ended questions explored, e.g.:<br />
main advantage/disadvantage of PBL; characteristics<br />
of a good PBL tutor. Qualitative data-themes<br />
formulated inductively and iteratively. 137/224 (61.2%)<br />
responded. Despite diverse views, students mostly<br />
highlighted that, e.g.: good tutors should be<br />
approachable, ‘knowledgeable’ (without imposing<br />
knowledge), encourage participation; and PBL is good<br />
for acquiring, retaining, and applying knowledge (yet<br />
lack of ‘structure’ can cause concern). The implications<br />
of the results will be related to previous literature.
5B3 Predicting outcome by behaviour in<br />
PBL groups?<br />
Kristin Wigen*, Are Holen, Øyvind Ellingsen and<br />
Hansjørg Hohr<br />
Norwegian University of Technology and Science, Department<br />
of Community Medicine & General Practice, MTFS, N-7489<br />
Trondheim, NORWAY<br />
In the fall of 1999 and 2000, new medical students at<br />
the Norwegian University of Science and Technology<br />
were asked to complete these questionnaires: (1)<br />
Entwistle’s Learning Style Inventory - 30 items, (2)<br />
Braithwaite’s shortened neuroticism scale - 15 items,<br />
and (3) Craig’s Locus of Control of Behaviour Scale -<br />
17 items. Additionally, variables included the admission<br />
scores and gender of the students. Behaviour in PBL<br />
groups was assessed by peers on Holen’s Group Process<br />
Evaluation Scale once each term for each student. The<br />
aim was to study the correlations between these<br />
variables and the academic achievements of the students<br />
at their first exams by the end of the first year in June<br />
2000 and 2001. Preliminary findings will be presented<br />
and briefly discussed.<br />
5B4 Student evaluation of a problembased<br />
learning module into an<br />
occupational therapy course<br />
Deirdre Connolly* and Morag Donovan<br />
Trinity College Dublin, School of Occupational Therapy,<br />
Rochestown Avenue, Dun Laoghaire, Co Dublin, IRELAND<br />
“ I’m very satisfied with this course. The method of<br />
continuous assessment was very helpful and beneficial.<br />
I wonder how this volume of material could be covered<br />
in any other way”.<br />
“Tiring, inflexible and inconsistent marking”.<br />
These are contrasting opinions of two third year<br />
occupational therapy students on their experience of<br />
Problem Based Learning (PBL). As PBL encourages<br />
open-minded, reflective and active learning<br />
(Margetson, 1991), qualities that are highly valued from<br />
a university education, it was decided to introduce a<br />
PBL module into the four-year honours degree course<br />
in occupational therapy. Students were then asked to<br />
evaluate the first semester of using the PBL approach.<br />
This paper presents the process involved in setting up<br />
the module and the quantitative and qualitative results<br />
of the initial evaluation.<br />
5B5 Evaluation of student performance<br />
in the problem based learning<br />
(PBL) group<br />
David C M Taylor<br />
The Physiological Laboratory, University of Liverpool, Crown<br />
Street, Liverpool L69 3BX, UK<br />
During the course of each semester, students in years<br />
one and two of the medical course at Liverpool<br />
University complete a self assessment form which<br />
relates to their performance in the PBL Group. A form<br />
is also completed independently for students by their<br />
PBL tutor, and the two forms are compared. If there<br />
are differences between the perceptions of student and<br />
tutor, then an informal conversation takes place to<br />
identify possible explanations. We originally used a<br />
Tuesday 4 September<br />
- 4.31 -<br />
form similar to that developed in Hong Kong, where<br />
there are five descriptors for each of five domains;<br />
participation, communication, preparation, critical<br />
thinking and group skills. It rapidly became apparent<br />
that we needed to add two other domains – “Evaluation<br />
Skills” and “Cross Curricular Links”. This change<br />
means that students and staff are required to reflect on<br />
what we believe to be the key skills for problem-based<br />
learning.<br />
5B6 Influence of tutor qualification on<br />
test achievement and student<br />
evaluation in a problem-based<br />
course of basic pharmacology<br />
J Matthes*, B Marxen, R-M Linke, W Antepohl,<br />
W Lehmacher and S Herzig<br />
Gleueler Str.24, 50931 Koln, GERMANY<br />
Increased demand on staff when using problem-based<br />
learning (PBL) necessitates involvement of tutors at<br />
different stages of medical or non-medical (under-,<br />
post-,) graduate education. To address whether such<br />
differences in qualification affect evaluation of PBL<br />
by participants or their outcome (test results), we<br />
analysed data of a 3½ year longitudinal study<br />
performed with 3rd year medical students taking a PBLcourse<br />
in basic pharmacology. We compared student<br />
tutors (undergraduate, >3rd year; n=30), nonspecialized<br />
professional tutors (physicians, pharmacists<br />
or natural scientists during postgraduate education;<br />
n=38) and specialized professional tutors (completed<br />
postgraduate education; n=26). While evaluation and<br />
outcome of student-led groups did not differ from staffled<br />
groups, tutor experience with PBL inproved<br />
evaluation scores. Interestingly, student tutors as well<br />
as non-specialized professional tutors came off badly<br />
in some evaluation parameters, however their groups´<br />
test achievement equalled that of specialized<br />
professional tutors.<br />
5B7 Individual perceptions of group<br />
learning and functioning in a<br />
problem-based learning programme<br />
Janet MacDonald<br />
Academic Departmentt, Postgraduate Medical & Dental<br />
Education, University of Wales College of Medicine, Heath Park,<br />
Cardiff CF14 4XN, UK<br />
Drawing on data from a cohort of BSc Occupational<br />
Therapy students on a PBL programme, this paper<br />
reports on students’ individual perceptions of their own<br />
and others’ participation and performance within small<br />
group learning. Students were asked to rate the<br />
contributions and performance of themselves, other<br />
group members and the group as a whole with factors<br />
influencing functioning being considered.<br />
Questionnaires were completed by students who were<br />
then involved in group discussion and subsequently<br />
completed individual action plans with the intention<br />
of enhancing future group involvement and personal<br />
development. Initial findings explore issues such as<br />
group development and cohesion, use of ground rules,<br />
contextual learning and the role of the group in personal<br />
development. Difficulties involved in conducting this<br />
type of inquiry will also be briefly discussed.
Session 5C Curriculum evaluation<br />
5C1 A course programme evaluation:<br />
contribution of students’ selfevaluation<br />
Carlota Saldanha*, Jorge Lima and Joao Martins-Silva<br />
Institute of Biochemistry, Faculty of Medicine of Lisbon, Av Prof<br />
Egas Moniz, 1649-028 Lisbon, PORTUGAL<br />
A course programme evaluation (CPE) is useful to<br />
highlight issues for introducing further changes. The<br />
aim of this work was to compare the results of the CPE<br />
performed in the discipline of Cellular Biochemistry<br />
in three consecutive years. The first year students in<br />
1999 (n=199), in 2000 (n=189) and in 2001 (n=173)<br />
of the Faculty of Medicine of Lisbon were required to<br />
answer a questionnaire anonymously with 19 closed<br />
questions. Phi and Cramer’s VC statistical analysis were<br />
used. The answers profile for the majority of the<br />
questions was similar in the three consecutive years.<br />
The main differences were those related to the influence<br />
of the teaching process in the assessment methods and<br />
in students’ self-confidence. The majority of students<br />
were not motivated with their self-evaluation. It is<br />
concluded that the course programme evaluation<br />
depends on the student population and not exclusively<br />
on the changes introduced by the teaching staff.<br />
5C2 A national evaluation of the reforms<br />
to higher specialist training in the<br />
UK: methodological issues<br />
Janet Grant*, Rodney Gale, Mairead Beirne and<br />
Heather Owen<br />
Open University Centre for Education in Medicine, The Open<br />
University, Walton Hall, Milton Keynes MK7 6AA, UK<br />
Over the past 5 years, wholesale reform of higher<br />
specialist training in the UK has occurred with changes<br />
in training structure, processes, infrastructure,<br />
assessment, records, post types, endpoint qualification,<br />
curricula, selection, standard setting, and monitoring.<br />
The Department of Health commissioned a national<br />
evaluation, conducted over three years. The evaluation<br />
was designed and conducted as policy research,<br />
involving 15 researchers with expertise in postgraduate<br />
medical education, qualitative and quantitative research<br />
methods, management, selection, public sector<br />
economics, assessment, and pedagogy. Data collection<br />
methods included surveys, consultative groups,<br />
interviews, site visits, case studies, documentary<br />
analysis and in-depth reference studies. Seven focal<br />
specialties were studied. Data for the 20 separate reports<br />
of the evaluation were gathered from upwards of 5,000<br />
participants. The evaluation covered costs, organisation,<br />
management, funding, change management,<br />
assessment, appraisal, educational processes and<br />
outcomes, new roles and responsibilities, selection, and<br />
effects on service and workload. Methodological issues<br />
will be discussed.<br />
Tuesday 4 September<br />
- 4.32 -<br />
5C3 Evaluation of PME courses in<br />
General Practice in Germany<br />
S Wilm*, R Jahromi, S Krause and B Hemming<br />
Heinrich-Heine University, Department of General Practice,<br />
PO Box 10 10 07, D-40001 Duesseldorf, GERMANY<br />
Vocational training in general practice in Germany<br />
requires 240 hours of accompanying courses, aiming<br />
at reinforcing professional knowledge, problem solving<br />
abilities and at training in interdisciplinary teamwork<br />
and audit. For the participants it has the character of an<br />
expensive obligation, with possibly negative effects on<br />
intrinsic motivation and demands. The continuous builtin<br />
evaluation of courses in Duesseldorf/North-Rhine<br />
covers written interviews with participants and teachers,<br />
participatory observation, oral interviews and focus<br />
groups. In 1999 and 2000 71 seminars were evaluated.<br />
935 questionnaires of participants (response rate 70%),<br />
46 data sheets for participatory observation, 33<br />
questionnaires of 29 teachers and 10 focus groups show<br />
that the educational quality increased, while the overall<br />
satisfaction of the trainees decreased. Possible reasons<br />
for this complex phenomenon are discussed.<br />
Organizational aspects influence participants’<br />
satisfaction much more than content of seminars.<br />
5C4 The Matrix: a visual presentation of<br />
registrar term evaluation<br />
Richard Tarala and Alistair Vickery<br />
Department of Postgraduate Medical Education, Royal Perth<br />
Hospital, GPO Box X2213, Perth, Western Australia 6847,<br />
AUSTRALIA<br />
Evaluation of junior medical officer posts can be<br />
hindered by the need to distribute questionnaires, the<br />
time required for their completion and by low response<br />
rates. Collation and assessment can be time-consuming<br />
and the resultant evaluation difficult to interpret. We<br />
used a simple evaluation tool for the assessment of<br />
registrar terms. Trainees were asked to assess on a fivepoint<br />
scale the workload and the training/teaching value<br />
of each rotation they had experienced over the previous<br />
two years. We have undertaken a pilot to provide a<br />
‘snapshot’ or audit of the trainees’ perception of the<br />
rotations. The evaluation can be performed quickly and<br />
the collated results when plotted in a graphical<br />
(“matrix”) form provide a powerful visual assessment<br />
of the trainee’s perspective of each post. This evaluation<br />
can be used to assess the workload of each position to<br />
assist in reallocation of workload and to optimise<br />
training in each post.<br />
5C5 Site visits as a method to assess the<br />
educational quality of clerkships<br />
Janke Cohen-Schotanus* and Rein P Zwierstra<br />
Institute for Medical Education (OWI-OK), Faculty of Medical<br />
Sciences, University of Groningen, Ant.Deusinglaan 1, 9713<br />
AV Groningen, NETHERLANDS<br />
Clerkships, as part of the training of medical students,<br />
are organized in several hospitals. In general, students<br />
are content with this training. However, what do we
know about the educational quality of the clerkships?<br />
To answer this question we developed a procedure for<br />
structured site visits. The visits were conducted by a<br />
Visitation Committee on the basis of an assignment of<br />
the director of the Institute for Medical Education.<br />
Before the actual visit, the committee sent out<br />
questionnaires and gathered written information about<br />
the clerkships. During the site visit, the committee<br />
discussed the educational topics with the groups<br />
involved in the programme.<br />
After the procedure the committee concluded that in<br />
general the students were trained satisfactorily.<br />
However, in the clerkships more educational structure<br />
is necessary. Students need to receive feedback on the<br />
way they practise their skills and on attitudinal aspects<br />
much more frequently and on a structured basis.<br />
5C6 Impact of a new curriculum on the<br />
clinical competence of medical<br />
students at the University of<br />
Barcelona Medical School (UBMS)<br />
Ramon Pujol*, Frederic Manresa, Francesc Gudial,<br />
Eduard Kranfly, Josep Ma Martinez Carsetera<br />
Bellvitge Unit, University of Barcelona, Bellvitge Hospital, Dept<br />
of Internal Medicine, c/Feixa Llarga s/n, 08907 Hospitalet de<br />
Llibregat, SPAIN<br />
UBMS has recently modified its undergraduate<br />
curriculum. A group (A) of 44 students belonging to<br />
the first cohort (1999-2000) of the new curriculum was<br />
compared with another group (B) of 51 students<br />
belonging to the last cohort (1998-1999) of the<br />
traditional curriculum. The assessment was performed<br />
at the end of licensure by means of a multistation OSCE<br />
of 17 cases with 22 stations including 10 common cases<br />
for both cohorts. Statistical analysis included Cronbach<br />
Alpha test to analyse reliability and the result was 0.79,<br />
- 4.33 -<br />
and for comparability t-student test was used. Group A<br />
showed better scores, particularly in interprofessional<br />
relationships (mean values A vs B: 59.5 vs. 48.6;<br />
p=0.001); attitudes (59.7 vs. 41.6; p=0.001); technical<br />
skills (70 vs 61.6; p=0.01); clinical knowledge (62.9<br />
vs. 56.6; p=0.001), and clinical judgement (47.2 vs.<br />
42; p=0.001). The new curriculum has improved the<br />
clinical competence of last year’s students assessed by<br />
a multistation OSCE examination.<br />
5C7 Lessons learnt in designing and<br />
implementing a curriculum<br />
evaluation<br />
Helen Graham* and Mary Seabrook<br />
Department of Medical and Dental Education, Guys, Kings &<br />
St Thomas’ School of Medicine, Kings College London, Sherman<br />
Education Centre, 4th floor, Thomas Guy House, London SE1<br />
9RT, UK<br />
Evaluation is particularly important when a new course<br />
is established. The new year 4 medical curriculum at<br />
Kings College, London was introduced in 1999. It<br />
teaches reproductive and sexual health; child health,<br />
development and ageing; and trauma, locomotion and<br />
rehabilitation to 360 students across 4 main campuses.<br />
Since inception, an evaluation strategy has gradually<br />
been developed by the year head and the course<br />
management committee. Feedback was collected from<br />
students and teachers within the teaching hierarchy<br />
during the year using a range of methods. These<br />
included meetings, facilitated discussions, written and<br />
computer-based questionnaires, teacher reports and email.<br />
In this presentation we will discuss how the<br />
various methods worked, the advantages and<br />
disadvantages of each and the problems encountered.<br />
We shall also describe the mechanisms used to ensure<br />
teacher participation in the evaluation and course<br />
development process.<br />
Session 5D Assessing communication skills/patients as examiners<br />
5D1 Detecting rater bias on a measure<br />
of spoken English proficiency<br />
Marta van Zanten*, Danette McKinley, John Boulet and<br />
Gerald Whelan<br />
ECFMG, Test Development and Research/CSA, 4th floor, 3624<br />
Market Street, Philadelphia, PA 19104, USA<br />
Rater severity can affect the validity of scores and<br />
introduce bias that will impact the measurement of<br />
examinee ability. Few studies, especially in the area of<br />
clinical skills assessment, have examined the effect of<br />
rater demographics on rater severity. In this study,<br />
standardized patient (SP) ratings of spoken English<br />
proficiency were contrasted by SP and examinee<br />
characteristics. Two analyses were conducted. In the<br />
first analysis, least square mean scores were calculated<br />
based on whether English was the native language of<br />
the examinee and the SP. Examinees whose native<br />
language was not English received significantly lower<br />
ratings from the SPs, regardless of the SP’s native<br />
language. In the second analysis, data were analyzed<br />
Tuesday 4 September<br />
based on SP and examinee gender. Female examinees<br />
received higher ratings than male examinees from SPs<br />
of both genders. The results suggest that the SP<br />
characteristics studied had no effect on ratings of<br />
spoken English proficiency.<br />
5D2 Comparison of communication<br />
skills in residency with<br />
performance on ECFMG Clinical<br />
Skills Assessment<br />
W Burdick*, J Boulet, S Peitzman, G Whelan and D Brody<br />
ECFMG, 3624 Market Street, 3rd Floor, Philadelphia,<br />
Pennsylvania 19104-2685, USA<br />
The Education Commission for Foreign Medical<br />
Graduates assesses graduates of foreign medical<br />
schools for readiness to enter US residencies using a<br />
ten station standardized patient examination. The<br />
Clinical Skills Assessment (CSA) tests data gathering,
clinical reasoning, written communication, and oral<br />
communication skills, including spoken English. We<br />
assessed the communication skills of first year internal<br />
medicine residents using trained observers and postencounter<br />
patient surveys in an outpatient clinic setting<br />
and compared these results with performance on CSA.<br />
Over 250 encounters from about 60 residents who had<br />
graduated from foreign medical schools were scored<br />
by observers and patients. Moderate correlation with<br />
communication skills as assessed by CSA was found.<br />
This evidence suggests that CSA is a valid predictor of<br />
performance in the first year of residency.<br />
5D3 ACT: a new computer-assisted<br />
assessment (CAA) method for<br />
communication-skills of medical<br />
students<br />
R L Hulsman* and J D Donnison-Speijer<br />
Academic Medical Centre, Department of Medical Psychology,<br />
J4, PO Box 22660, 1100 DD Amsterdam, NETHERLANDS<br />
CAA of communication skills is innovative and has<br />
several advantages: a broad range of communication<br />
problems can be covered in one assessment; both the<br />
testing and judgement procedures are highly<br />
standardised; students can be assessed in large groups<br />
without a complex organisation. ACT, developed in our<br />
medical school, was used for the first time in April and<br />
May 2001. More than 200 third year students were<br />
assessed. ACT presents three short movies of doctorpatient<br />
encounters. Topics are: history taking, breaking<br />
bad news, shared decision making. Each topic is<br />
covered by 5 to 10 questions; 20 questions in total.<br />
The assessment model of ACT is based on Miller’s<br />
pyramid (Acad Med 1990; 65:S63-67) yielding four<br />
types of essay questions: 1. knowledge, 2.<br />
understanding, 3. skill phrasing, 4. integration of skills.<br />
Presented will be: the adapted assessment model,<br />
examples of questions, the program design, and results<br />
about the feasibility and reliability of ACT.<br />
5D4 How accurate is lay person<br />
assessment of clinical competence<br />
of student doctors? The<br />
comparison of the assessment of<br />
medical students by faculty and<br />
standardized patients during the<br />
Objective Structured Clinical<br />
Examination<br />
P Heasman*, K Pitkala and N Paganus<br />
University of Helsinki, Faculty of Medicine, P O Box 63, 00014<br />
Helsinki, FINLAND<br />
This paper discusses the results of two types of<br />
assessment of the students carried out during the OSCE,<br />
a performance-based assessment of clinical<br />
competence. For the first time in the history of the<br />
Medical School in Helsinki a comprehensive OSCE<br />
was arranged in December 2000. All participants (n=<br />
80) were sixth year undergraduate medical students.<br />
The exam consisted of ten stations where simulated<br />
consultations with standardized patients (SPs) took<br />
place. Professional actors were used as patients to<br />
guarantee a similar experience to all students. During<br />
Tuesday 4 September<br />
- 4.34 -<br />
the consultation a faculty member assessed the clinical<br />
performance of the student and the doctor-patient<br />
interaction using a checklist for the assessment of the<br />
clinical skills and a communication skills questionnaire.<br />
The students were also evaluated by the actors with an<br />
assessment form. While some students with low ratings<br />
in clinical skills by the faculty scored high on the actors<br />
evaluations, none of the students to whom the SPs gave<br />
the maximum scores, failed. Inter-station reliability of<br />
the SP ratings was considerably higher than clinician<br />
rating of communication skills. Also there was a poor<br />
correlation between SP and clinician ratings, equaling<br />
0.22. The scores of a single student varied depending<br />
on the clinical situation he or she was confronted with.<br />
Results and their implications for the future<br />
development of the medical students’ integrated<br />
competence assessment will be discussed.<br />
5D5 Do simulated patients grade interpersonal<br />
skills as well as Faculty?<br />
A S Arora*, N Natt, S Kluck and R Tiegs<br />
Mayo Foundation, Department of GIH, 200 First Street SW,<br />
Rochester MN 55905, USA<br />
Simulated patients (SPs) are being used to assess a<br />
number of skills in medical students. The SP may grade<br />
students with regard to history taking, physical exam<br />
and inter-personal skills (IPS) according to a checklist.<br />
Using SPs to grade student performance has been<br />
shown to be reliable though it is difficult to assess<br />
validity of this method. The aim of this study was to<br />
determine the validity of SPs’ scoring of student IPS at<br />
Mayo Medical School. Third year medical students<br />
undertaking a Clinical Skill Assessment had IPS<br />
evaluated by SPs and faculty observers. Identical 5section<br />
IPS checklists were completed following each<br />
student encounter by the SP and the faculty. There were<br />
8 clinical encounters for each student. The agreement<br />
between faculty and SP was very high in most of the<br />
sections in the IPS checklist. In conclusion, SPs are<br />
able to evaluate students' interpersonal skills as<br />
effectively as faculty.<br />
5D6 The contribution of non-medical<br />
assessors to the assessment of<br />
poorly performing doctors<br />
Lesley Southgate* and Peter McCrorie<br />
Centre for Health Informatics & Multiprofessional Education,<br />
University College London Medical School, Archway Campus,<br />
Highgate Hill, London N19 3UA, UK<br />
The UK Medical (Professional Performance) Act 1995<br />
gives the General Medical Council powers to assess<br />
any doctor on the register whose performance in<br />
practice may be seriously deficient, and below the<br />
standard for fitness to practise. The Council has stated<br />
its commitment to involve members of the public<br />
equally in all stages of the development and<br />
implementation of the assessment programmes, which<br />
comprise peer review of performance in the workplace<br />
by a team of three assessors, followed by tests of<br />
competence. More than 35 doctors from several<br />
disciplines have now been assessed within the<br />
procedures. The non-medical assessors contribute<br />
equally to the database assembled during the
assessments. We will present the background to their<br />
participation; data from actual assessments in general<br />
practice, surgery and psychiatry, and conclude with a<br />
discussion of the implications for partnership within<br />
professional regulation between the profession and<br />
members of the public.<br />
5D7 Assessment in the elective clinical<br />
rotation: centrally reviewed case<br />
reports<br />
W M Molenaar*, S A Koopmans, M D Talsma and<br />
L H van Essen<br />
Institute of Medical Education, University of Groningen, Ant.<br />
Deusinglaan 1, 9713 AV Groningen, NETHERLANDS<br />
The performance of medical students in clinical<br />
rotations is usually assessed by supervising clinicians.<br />
- 4.35 -<br />
Students at the University of Groningen in addition have<br />
to write a case report during their elective clinical<br />
rotation. Since students are widely scattered for their<br />
elective rotations individual clinicians supervise only<br />
a few of them, which tends to bias their judgements.<br />
Accordingly, the assessments of the students’ clinical<br />
performances by the supervising clinicians were<br />
skewed towards ‘excellent’. To overcome this problem<br />
all case reports are centrally graded by one of three<br />
medical specialists using criteria known to the students<br />
and their supervisors. The major criterion is the<br />
relevance of the ‘lesson’ to be learned from the patient’s<br />
history. This study analyzes the scores over the years<br />
1998 through 2000 (714 reports). The distributions of<br />
given grades were relatively balanced and very similar<br />
in each year and the reviewers showed comparable<br />
patterns.<br />
Session 5E Postgraduate education for general practice/<br />
family medicine<br />
5E1 An educational approach to<br />
significant event auditing in<br />
primary care<br />
J McKay* and P Bowie<br />
Department of Postgraduate Medical Education, University of<br />
Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK<br />
Little is known about the content and educational value<br />
of significant event audits (SEA) in primary care.<br />
General practitioners (GPs) in the west of Scotland are<br />
encouraged to submit a SEA as part of their<br />
postgraduate education. Two trained assessors<br />
independently mark SEAs and educational feedback<br />
is offered to the GP. Of 132 SEAs submitted, 47%<br />
involved primarily clinical issues, 29% practice<br />
administration and 17% involved both. Main areas of<br />
analysis were in disease management (36%), drug<br />
prescribing (20%) and communication (32%).<br />
Complaints (14%) are not a major factor in prompting<br />
SEAs. 68% of SEAs were judged educationally<br />
satisfactory by both assessors; 24% satisfactory by one<br />
assessor only; and 9% unsatisfactory by both assessors.<br />
SEAs judged satisfactory by both assessors were more<br />
likely to have involved the implementation of change<br />
(P
5E4 The use of video in General Practice<br />
Registrar training and assessment<br />
C M Wiskin, Stephen Field* and John Skelton<br />
West Midland GP Unit, 27 Highfield Road, Edgbaston,<br />
Birmingham B15 3DP, UK<br />
In 1994 a questionnaire-based evaluation was<br />
conducted among training practices in the West<br />
Midlands. A 2000 comparative study identified changes<br />
in the use of and attitude towards video as a training<br />
and assessment tool in General Practice. Areas of<br />
interest are future application to GP trainer reaccreditation<br />
and the MRCGP examination, and issues<br />
of informed consent. Questionnaires combined Likert<br />
scales, evaluation scales for levels of statement<br />
agreement/disagreement, demographic information<br />
and free text comments. Greater frequency of use across<br />
most targeted areas was reported, in particular obtaining<br />
appropriate consent. Relationships between the general<br />
practice trainers’ personal and practice uses of video<br />
with their registrars and their opinions about other postgraduate<br />
uses of videos are positively correlated. Rank<br />
order lists of perceived vulnerable patient groups<br />
remained identical over the six-year period. Video for<br />
teaching, testing and developing self-awareness is<br />
increasingly acceptable to GP Trainers.<br />
5E5 The consultation styles of female<br />
GP Registrars with male and female<br />
patients<br />
Sarah Hillman* and John Skelton<br />
Dept of Primary Care & General Practice, Medical School,<br />
University of Birmingham, Edgbaston, Birmingham B15 2TT,<br />
UK<br />
It is acknowledged that there are differences between<br />
men and women in conversation – it is often argued<br />
for example that men communicate competitively and<br />
women co-operatively. Yet male and female registrars,<br />
with patients of both sexes, are trained similarly, and<br />
assessed with the same criteria for their Summative<br />
Assessment examination. Ten western-dressing female<br />
GP Registrars in the South Birmingham area (UK) were<br />
videod with male and female patients, and data analysed<br />
using language concordancing software and discourse<br />
analysis techniques. Preliminary results suggest that<br />
the sex of the patient may be one factor which<br />
constrains consultation style, and that the speech-style<br />
of participating Registrars is both characteristically<br />
“feminine” and co-operative.The fact that key<br />
characteristics of co-operative language are both valued<br />
in the patient-centred methodology and regarded as<br />
typical of female speech has implications for the<br />
training and assessment of registrars of both sexes.<br />
Tuesday 4 September<br />
- 4.36 -<br />
5E6 The development, implementation<br />
and evaluation of a ‘concordance’<br />
training course<br />
Jon Dowell*, Claudia Pagliari and Sean McAleer<br />
University of Dundee, Tayside Centre for General Practice, Kirsty<br />
Semple Way, Dundee DD2 4AD, UK<br />
We report the development and assessment of a<br />
‘concordance’ course. The four day course included<br />
building relationships, assessing beliefs, identifying<br />
barriers, considering these with patients, formal<br />
decision sharing process and agreeing treatment goals.<br />
Change in knowledge, attitude and skills was assessed<br />
using a written exam and double marked simulated<br />
surgeries. The eight General Practitioners attending<br />
rated the course highly (30/35 Range 27-33).<br />
Knowledge improved with True/False scores increasing<br />
from 13 to 17 out of 22 (P=0.005), Short Essay from<br />
20.4 to 25.1 out of 45 (P=0.062). Patients’ rating<br />
increased from 26.5 to 28.1 out of 35 (ns). Blinded<br />
scoring of 48 consultations rose from 14.3 to 16.1 out<br />
of 26 (p=0.04 Inter-rater reliability: rho = 0.59 p <<br />
0.001, Internal consistency: a = 83). This work shows<br />
that concordance skills can be taught and measured.<br />
5E7 A linguistic study of informationgiving<br />
in 30 doctor-patient<br />
consultations<br />
Andy Shanks* and John Skelton<br />
Department of Primary Care & General Practice, Medical<br />
School, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
The need for patient-centred consultations is wellestablished.<br />
However few linguistic studies have<br />
analysed what kind of communication makes patients<br />
more proactive. This paper employs a type of discourse<br />
analysis developed at Birmingham University for<br />
educational settings, now widely used for analysis of<br />
organisational language. 30 consultations were<br />
analysed according to the IRF (initiation, follow-up,<br />
response) model. Eight different types of exchange<br />
were identified including the ‘doctor-inform’ exchange,<br />
which is used when the doctor passes on facts, opinions<br />
and ideas about treatment to the patient. Patient<br />
interruptions of doctor-inform exchanges are often met<br />
with short answers and little response. However, when<br />
doctors responded at length to patients’ questions and<br />
checked understanding, patients initiated questions<br />
more frequently. The evidence suggests that patients<br />
are more likely to initiate exchanges if the doctor checks<br />
frequently for understanding and concordance.<br />
Secondly, a more informative style of consultation<br />
creates more proactive patients.
Session 5F Assessment<br />
5F1 Objective Structured Preclinical<br />
Exams (OSPE): a new test format of<br />
summative student assessment in<br />
the Problem-Based Learning (PBL)<br />
curriculum at the Faculty of<br />
Medicine of the University of Bern<br />
Barbara Stadelmann*, R Hofer, Urs Brodbeck and Ara Tekian<br />
Institute of Biochemistry and Molecular Biology, University of<br />
Bern, Buehlstrasse 28, CH-3012 Bern, SWITZERLAND<br />
In October 1999, the Faculty of Medicine of the<br />
University of Bern implemented a new system of<br />
summative student assessment in the preclinical PBL<br />
curriculum of medical education. It is interdisciplinary<br />
or at least multi-disciplinary, and allows assessment of<br />
knowledge, skills and attitudes. About half of the exam<br />
consists of traditional multiple choice questions<br />
(MCQ). The other half has been replaced by the OSPE,<br />
a new test format allowing assessment of how well<br />
students understand, apply and integrate their<br />
knowledge, and how well their data interpretation and<br />
communication skills are developed. It is analogous to<br />
the clinical counterpart, the OSCE. During 2 – 2 1/2<br />
hours students rotate through a series of stations<br />
consisting of interdisciplinary oral, structured oral and<br />
written exams. Evaluation of the first cycle of<br />
assessment revealed high reliability for both the<br />
traditional MCQ-exam and the new OSPE (Cronbachalpha<br />
> 0.8).<br />
5F2 The quality of an extendedmatching<br />
multiple choice<br />
examination<br />
J Beullens*, B Van Damme, H Jaspaert, E Struyf and<br />
P J Janssen<br />
Department of Medical Education, Faculty of Medicine K.U.<br />
Leuven, Minderbroedersstraat 17, B-3000 Leuven, BELGIUM<br />
Last year we reported the development of an extendedmatching<br />
multiple choice test for final year medical<br />
students at K.U. Leuven. Extended-matching questions<br />
(EMQs) start from a case and have one correct answer<br />
within a list of 7 to 26 alternatives. Indications were<br />
given for the reliability and validity of the test. This<br />
year two parallel exams of 200 EMQs were constructed<br />
and solved on separate occasions by respectively 168<br />
and 178 students. In contrast with the test, which lasted<br />
half a day, the exam took a whole day and the students<br />
were prepared for question format and content.<br />
Feasibility, reliability and validity seemed to be<br />
indicated and will be reported. In the discussion of<br />
feasibility attention will be paid to the possible<br />
influence of fatigue and growing familiarity with the<br />
question format on the scores. Face, content and<br />
criterion validity will be evaluated.<br />
Tuesday 4 September<br />
- 4.37 -<br />
5F3 Evaluation of a five-dimensional<br />
assessment strategy within a<br />
problem-based learning medical<br />
curriculum<br />
Paul Julian*, Scott Reeves* and Alistair Lumb*<br />
Barts & The London School of Medicine & Dentistry, Dept of<br />
General Practice, Queen Mary, University of London, Mile End<br />
Road, London E1, UK<br />
This paper reports findings from an evaluation of a<br />
problem-based learning (PBL) assessment strategy<br />
within a new medical curriculum. As there is little<br />
published material on PBL assessment for medical<br />
students, it was decided to develop a new strategy. As a<br />
result, a five dimensional assessment strategy was<br />
developed. The five areas used to assess learning were:<br />
student attendance; the production of learning<br />
objectives; input into group work; an individual written<br />
assignment and a verbal assessment of progress. To<br />
obtain a comprehensive understanding of issues linked<br />
to this assessment strategy a multi-method evaluation<br />
was undertaken. Questionnaire and interview data were<br />
collected with students and tutors to explore their views<br />
and experiences of this assessment strategy. Findings<br />
from this work indicate that, although students and<br />
tutors consider this assessment strategy to be of value,<br />
problems around assessment inconsistency and the<br />
weighing of these different dimensions need further<br />
development.<br />
5F4 A preclinical exam to assess the<br />
networked structure of knowledge<br />
of basic science in the Universidad<br />
Nacional de Cuyo (Argentina)<br />
Ana Maria Reta*, Maria del Carmen Montbrun and<br />
Maria Jose Lopez<br />
Asesoria Pedagogica, Facultad de Ciencias Medicas, Universidad<br />
Nacional de Cuyo, Centro Universitario, Parque General San<br />
Martin, 5500 Mendoza, ARGENTINA<br />
The new curriculum promotes the acquisition of a<br />
networked structure of knowledge. Students must pass<br />
a Preclinical Exam in Basic Sciences before going into<br />
clerkships. This exam has been administered twice<br />
already. Its format was as follows: Four complex clinical<br />
cases in 2000 and eight cases in 2001 were followed<br />
by a number of questions dealing with the basic science<br />
subjects. Results showed that: 97.1% (2000) and 94.5%<br />
(2001) of the students passed. Reliability, measured<br />
by the Cronbach alpha coefficient: 0.867 and 0.830;<br />
mean scores: 73.27% and 70.20%; standard deviations:<br />
8.77 and 8.08. The results allow the following<br />
conclusions: 1) The format of the exam seems adequate<br />
to assess the acquisition of a networked structure of<br />
knowledge. 2) The new curriculum promotes this kind<br />
of knowledge. 3) Further research must be done,<br />
including a control group educated in a traditional<br />
curriculum.
5F5 Predictive value for academic<br />
performance of two assessment<br />
devices applied to medical<br />
students<br />
Ma Eugenia Ponce de León C*, Armando Ortiz and<br />
M del Carmen Ruiz Alcocer, Camino Santa Teresa<br />
277 Casa 15, Bosques del Pedregal, Delegación Tlalpán, CP<br />
14010, MEXICO D F<br />
872 students admitted in 1998 to the National<br />
Autonomous University of México Medical School<br />
answered a learning strategies and study habits<br />
questionnaire, as well as a diagnostic exam testing for<br />
background knowledge on Physics, Chemistry,<br />
Mathematics, Biology, Spanish, English, and General<br />
Knowledge. Our aim was to follow up their academic<br />
performance during their first two years (basic<br />
sciences) at Medical School, and to compare their<br />
average grade score with the results obtained on the<br />
questionnaire and the diagnostic exam (predictive<br />
value). Results showed a weak but positive association<br />
with three of the ten areas of the questionnaire: learning<br />
strategies, preparation for the exams and problemsolving<br />
skills. A statistical significance and a positive<br />
correlation were found in the diagnostic exam with<br />
General Knowledge, Spanish, Biology and Chemistry.<br />
5F6 Self-assessed clinical skills levels<br />
of newly graduated physicians in<br />
relation to an intended curriculum<br />
A M Moercke* and B Eika<br />
University of Aarhus, Enhed for Medicinsk Uddannelse, Det<br />
Sundhedsvidenskabelige Fakultet, Universitetsparken, Bygning<br />
611, 8000 Aarhus, DENMARK<br />
We have explored the degree of overlap between an<br />
intended curriculum and the learned curriculum<br />
concerning clinical skills. In 1999 we conducted a<br />
Delphi-study in which 52 experts reached consensus<br />
Session 5G Outcome-based education<br />
5G1 The Scottish Learning Outcomes<br />
Project Phase II - Assessment: “the<br />
proof of the pudding”<br />
Jacqueline Furnace* and John Simpson*, on behalf of<br />
Scottish Deans’ Medical Curriculum Group<br />
Cottar House, Meddens, Newmachar, Aberdeenshire AB21 0QJ,<br />
UK<br />
Following the successful completion of Phase I of the<br />
Learning Outcomes Project the Scottish Deans’<br />
Medical Curriculum Group (SDMCG) sought to<br />
maintain the momentum created by this collaborative<br />
work and in addition, we considered it essential to<br />
demonstrate our assertion that the Learning Outcomes<br />
are a useful and practical tool in undergraduate<br />
medicine rather than purely theoretical. With this in<br />
mind we decided to test the robustness of the outcomes<br />
by looking at their assessment. We established several<br />
working groups - each assigned different outcomes -<br />
Tuesday 4 September<br />
- 4.38 -<br />
on skills levels for 210 practical clinical skills to be<br />
attained during undergraduate medical education. In<br />
summer 2000 we mailed a questionnaire listing these<br />
210 skills to the 226 just graduated Danish physicians.<br />
They were asked if they could meet the minimum skills<br />
level for each of the skills listed. None of the responders<br />
met the minimum of all the 210 skills. On average the<br />
responders met the minimum of 74% (155) of the skills.<br />
We concluded that newly graduated Danish physicians<br />
have gaps in their clinical skills. Making checklists and<br />
stating learning objectives is recommended as a<br />
necessary but not sufficient step. Therefore we are<br />
trying to develop a bottom up strategy for the<br />
curriculum design process.<br />
5F7 The dynamics of knowledge<br />
structure of graduating medical<br />
students based on results of the<br />
Medical Licensing Examination<br />
M Mrouga*, Y Bogachkov and L Artemchuk<br />
Testing Board, 5 Estonska St, Apt. 85, Kyiv 03190, UKRAINE<br />
The licensing examination for medical doctors (MLE)<br />
in Ukraine is undergoing its last year of piloting.<br />
However, MLE results are already taken into<br />
consideration during final exams, thus providing a<br />
certain motivation for the students. They are also used<br />
as part of medical schools’ rating, providing motivation<br />
for schools as well. For better preparation and selfassessment<br />
of students, the pretest is administered prior<br />
to MLE using the actual test MLE materials from<br />
previous years. Based upon pretest results students can<br />
build their intensive training to MLE in 1-2 weeks.<br />
Current research investigates the difference in<br />
knowledge structure between pretest and actual test<br />
results and possible sources of influence on such<br />
difference and dynamics of knowledge structure<br />
between the two parts of the licensing examination.<br />
to consider the overall implications for assessment,<br />
identify assessment tools, develop guidelines and<br />
establish the cost of required resources. The groups<br />
began work at the beginning of October 2000 and have<br />
until the end of May 2001 to complete their task.<br />
Already there has been an unprecedented exchange of<br />
knowledge and ideas and some useful and practical<br />
suggestions have emerged.<br />
5G2 Recent developments in an<br />
outcome-led curriculum<br />
Nick Ross<br />
The Medical School, University of Birmingham, Edgbaston,<br />
Birmingham B17 8HN, UK<br />
This paper reports on current developments in the<br />
MBChB at the University of Birmingham and discusses
the relationship between the outcome structure of the<br />
course and current change drivers, which include<br />
preparation of a programme specification for QAA.<br />
The nested outcomes that have been a feature of the<br />
current curriculum since its inception in 1996 are<br />
currently being reviewed. In addition to revalidation<br />
of outcome content at course and module level, this<br />
will involve fundamental restructuring of the outcome<br />
set. The current ‘tree’ structure (in which a number of<br />
detailed module outcomes contribute to a single year<br />
outcome and thence to a single endpoint outcome) is<br />
to be replaced by a ‘net’ structure, enabling crosscontribution<br />
and emphasising horizontal as well as<br />
vertical integration. Links between formal teaching and<br />
outcomes will be supplemented by links from learning<br />
opportunities. The benefits and potential pitfalls for<br />
learning and assessment will be discussed.<br />
5G3 A new instrument of curriculum<br />
development: curriculum as a<br />
function of professional outcomes<br />
I Bulakh*, Y Voronenko and I Filonchuk<br />
Testing Board and National Medical University, 22 Pushkinska<br />
St, Suite 304, Kyiv, 01004, UKRAINE<br />
Under a national program of development of new<br />
standards for higher education, medical educators face<br />
the need to work out the new professional descriptions,<br />
new curriculum and new diagnostic tools for Ukrainian<br />
medical schools. In the first phase an expert team has<br />
developed the professional description of a doctor<br />
expressed in terms of outcome skills that should be<br />
possessed by the medical graduate and in terms of<br />
relevant lists of pathologies, emergencies and<br />
laboratory investigations. Also, earlier there was<br />
developed the test blueprint for the medical licensing<br />
examination that describes the medical professional in<br />
terms of knowledge which was structured by<br />
pathologies, by subject and by medical tasks<br />
(prevention, diagnostic, treatment, etc). In the second<br />
phase, the curriculum is being constructed as a function<br />
of professional description and test blueprint,<br />
demonstrating the misfit between the scope of desirable<br />
final outcomes and regulated time for their mastering.<br />
5G4 Focusing on learning outcomes for<br />
the Preregistration House Officer<br />
(PRHO) year<br />
E A Hesketh* and M S Allan<br />
Education Development Unit, Tay Park House, 484 Perth Road,<br />
Dundee DD2 1LR, UK<br />
The General Medical Council’s document ‘ The New<br />
Doctor’ outlines areas in which new medical graduates<br />
can expect to develop during PRHO training. The<br />
document not only emphasises the development of<br />
clinical skills and knowledge, but also the wider aspects<br />
of communication, disease prevention and the role of<br />
the doctor within the health service. Are PRHOs being<br />
given the opportunity to develop in all these areas? This<br />
paper describes the perceptions on this issue from those<br />
closely associated with the delivery of PRHO training.<br />
The study is part of a larger project which aims to<br />
specify the expected outcomes for the PRHO year. This<br />
Tuesday 4 September<br />
- 4.39 -<br />
paper focuses on a questionnaire which was used to<br />
explore the views of doctors in training, consultants<br />
and nurses on the importance given in reality and ‘best<br />
practice’ PRHO training to key learning outcomes.<br />
Findings showed that there was a desire for more<br />
emphasis on all the outcomes in PRHO training,<br />
although some need to be given more prominence if<br />
‘The New Doctor’ is to be properly implemented.<br />
5G5 The ACGME Outcome Project: a<br />
model resident assessment system<br />
Susan Swing<br />
ACGME, 515 N State St, Ste 2000, Chicago, IL 60610, USA<br />
As a part of its Outcome Project, the Accreditation<br />
Council for Graduate Medical Education is developing<br />
conceptual models of dependable assessment systems<br />
for residency programs. The models are intended as<br />
guidelines to assist programs in meeting new<br />
accreditation standards for evaluating residents’<br />
attainment of the ACGME’s general competencies. This<br />
presentation will describe the development process for<br />
the models and an example model. Development steps<br />
include Outcome Project Advisory Group work and<br />
feedback from experts and residency program directors.<br />
The model consists of general principles and features,<br />
assessment approaches for each competency, and<br />
example assessment methods. The recommended<br />
assessment approaches include: (a) tracking of learning<br />
objectives attainment; (b) focused assessment of patient<br />
care by supervisors; (c) ratings of professionalism and<br />
communication skills by patients and professional<br />
associates; (d) standardized test assessment of medical<br />
knowledge; and (e) portfolio assessment of practicebased<br />
learning and improvement and systems-based<br />
practice.<br />
5G6 Development of an outcome-based<br />
clinical curriculum at International<br />
Medical University (IMU), Malaysia<br />
J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan,<br />
K H Ong, C M K Patrick and Q Akhtar<br />
International Medical University, 33 A Jalan 17/1, Block A-4,<br />
Condo 3A, Astana Damansara, 46400 Petaling Jaya, Selangor,<br />
MALAYSIA<br />
Eight major outcomes were identified for our new<br />
clinical School. The outcomes form the basis to reflect<br />
the competencies expected of the IMU graduate. This<br />
paper evaluates how our undergraduate curriculum was<br />
developed with the aim of achieving these objectives.<br />
One hundred and thirteen study-guides, the community<br />
and family case study (CFCS) and the learning portfolio<br />
formed our core curriculum. The “selectives”<br />
complimented the core. The IMU curriculum has<br />
adopted task-based learning, which is a continuum of<br />
PBL undertaken in the earlier phase. The study-guides<br />
based on various tasks identify how the 8 outcomes<br />
can be achieved and the outcome measures. The CFCS<br />
consists of students adopting and visiting a family in<br />
the community for two years. Specific objectives<br />
guided by “themes” have been identified for each visit.<br />
The students are required to develop a portfolio<br />
consisting of case summaries, case reports, projects and<br />
maintain a logbook.
5G7 An evaluation of the internal<br />
validity of specific learning<br />
outcomes in phase II of a revised<br />
undergraduate medical curriculum<br />
F J Cilliers* and E M Bitzer<br />
University of Stellenbosch, Division for University Education,<br />
P O Box 19063, Tygerberg 7505, SOUTH AFRICA<br />
The objective was to undertake a formative evaluation<br />
of part of a revised undergraduate medical curriculum<br />
by determining the degree of congruence between<br />
specific and exit outcomes. A cross sectional case-study<br />
utilising document analysis was carried out. 1510<br />
specific outcomes from 13 modules were compared<br />
- 4.40 -<br />
for congruence with each of 32 exit outcomes. 1495<br />
specific outcomes were considered congruent with exit<br />
outcomes. Between 0-68.9% of all specific outcomes<br />
were considered congruent with any given exit<br />
outcome. Three exit outcomes were addressed by<br />
>=15% of specific outcomes: two addressed lower<br />
order cognitive outcomes. 27 exit outcomes were<br />
addressed by
5H4 Self-directed, self-organized casebased-learning<br />
in final year<br />
students<br />
Jana Junger, Christiane Roth, Stephan Zipfel,<br />
Wolfgang Eich and Wolfgang Herzog<br />
Department of Internal Medicine, University of Heidelberg,<br />
Bergheimerstr. 58, 69115 Heidelberg, GERMANY<br />
The objective is to promote self-directed learning and<br />
to train interdisciplinary teamwork in final year<br />
students. Final year students from different medical<br />
departments meet to discuss a self-selected case on their<br />
ward with a modified case based method.The roles of<br />
tutor and presenter are played by students of the same<br />
peer-group. New tutors are trained by their<br />
predecessors. One teacher supervises the process.<br />
Because of the different background of students,<br />
everybody contributes his own experience of the<br />
respective internistic department. The close relationship<br />
to everyday work and active involvement of students<br />
increases the motivation to learn. The students realize<br />
the advantages of well-prepared and presented cases<br />
for the whole learning group. Evaluation of the tutorials<br />
showed good results concerning engagement of tutors<br />
and learning-atmosphere. It is concluded that selforganized<br />
peer group learning might be an additional<br />
model of case-based learning in advanced students.<br />
5H5 Changing to ‘self-induced learning’<br />
in a speech therapy department<br />
Martin Peleman<br />
Arteveldehogeschool, Campus Sint-Lievenspoortstraat, Sint-<br />
Lievenspoortstraat 143, 9000 Gent, BELGIUM<br />
The Speech Department of the Arteveldehogeschool<br />
changed its curriculum from a traditional teachercentered<br />
towards a more student-centered educational<br />
system. Because of the apparent differences with PBL,<br />
we prefer to define our new system as ‘self-induced<br />
learning’. One third of the content of the original<br />
theoretical courses was transformed into different types<br />
of tasks which are dealt with by the students in group<br />
sessions and under the supervision of a teacher. This<br />
supervision is mainly focused on the process of working<br />
and studying together in an efficient way. The project<br />
is gradually implemented over the three years of the<br />
curriculum. Students themselves as well as staff<br />
members and external professionals and organisations<br />
were consulted during the whole process of this<br />
curricular change. All of them also took part in the<br />
continuous evaluation of the project during the first<br />
year.<br />
Tuesday 4 September<br />
- 4.41 -<br />
5H6 Student participation in the<br />
organization of education at a<br />
medical school - a comparison of<br />
two South African cases<br />
B G Lindeque and Pierre L Bredenkamp*<br />
Faculty of Health Sciences, Stellenbosch University, P O Box<br />
19063, Tygerberg 7505, SOUTH AFRICA<br />
The political democratization of South Africa caused<br />
the international community to open up - trends and<br />
innovations in education worldwide had therefore a<br />
significant impact on training in South Africa, resulting<br />
in curricular reform. Pretoria and Stellenbosch were<br />
the first medical schools to change - student<br />
participation became a key element to drive this change.<br />
The Pretoria medical school implemented a problemorientated<br />
integrated model and Stellenbosch<br />
emphasized a core curriculum with certain key<br />
elements (integration, clinical relevance, stated<br />
outcomes). At both schools, students were utilized as<br />
important participants in all committee structures. Both<br />
schools went along the route of implementing the early<br />
years while developing the later years at the same time.<br />
Thus students played a major role in the continuous<br />
improving of the standards of training, as well as the<br />
effectiveness of the changes. This led to students<br />
becoming an integral part of the management of the<br />
faculty as a whole.<br />
5H7 Preparing the way: encouraging<br />
clinical tutors to be co-producers in<br />
the learning process<br />
Peter Barton* and Jillian Morrison<br />
Department of General Practice, University of Glasgow,<br />
4 Lancaster Crescent, Glasgow G12 0RR, UK<br />
In year 3 of Glasgow University’s new student-centred<br />
problem-based curriculum, students receive 20 days,<br />
one day per week, of structured “Clinical Practice”.<br />
GPs and hospital tutors provide this on alternate weeks.<br />
Clinical Practice in the Community (CPC), an<br />
innovative course of community based education,<br />
comprises:<br />
1 Student Consultation Surgery: supervised personal<br />
consulting;<br />
2 Signs and Symptoms Surgery: history taking and<br />
examination practice;<br />
3 Longitudinal Care Project (LCP): students<br />
undertake detailed assessments of patients with<br />
chronic illness. The LCP contributes 20% to<br />
summative assessment.<br />
From CPC’s earliest iterations, 80 GP tutors have been<br />
involved as co-producers. Using small group<br />
workshops, questionnaire surveys, telephone<br />
discussions, and a 2-day staff development programme,<br />
academic staff and tutors have worked together to<br />
design and develop the course. The course and its<br />
clinical tutors are highly evaluated by students and<br />
external examiners alike. We believe co-production is<br />
an essential part of curriculum design.
Session 5I Educating the educators (2)<br />
5I1 How to help clinical and multimedia<br />
staff develop joint programs<br />
Eleanor Flynn<br />
Faculty Education Unit, Faculty of Medicine, Dentisty and Health<br />
Sciences, Level 7, Medical Building, University of Melbourne,<br />
Victoria 3010, AUSTRALIA<br />
As medical education courses use multimedia based<br />
modes of delivery more, it becomes vital that clinical<br />
and multimedia staff understand each other’s frames<br />
of reference. They need to work effectively together to<br />
produce programs which meet the needs of students in<br />
a timely manner by recognising, defining and<br />
overcoming the problems that occur. The project being<br />
used as an illustration of how to manage these problems<br />
is the development of a web based program to teach<br />
Rational Test Ordering to postgraduate year 1 & 2<br />
doctors for the Postgraduate Medical Council of New<br />
South Wales. The particularly useful techniques were<br />
the development of a detailed storyboard preceded by<br />
an exhaustive needs analysis, especially to the project<br />
manager who was a clinician moving into multimedia<br />
education. The presentation will give examples of the<br />
problems and their solutions especially those relating<br />
to improving communication between clinicians and<br />
multimedia staff.<br />
5I2 “Getting Started in Clinical<br />
Teaching” - a staff development<br />
initiative<br />
J A Dent* and P E Preece<br />
Clinical Skills Centre, University of Dundee, Ninewells Hospital<br />
& Medical School, Dundee DD1 9SY, UK<br />
Enabling clinicians to fulfil their clinical teaching role<br />
necessitates support mechanisms which facilitate<br />
linking enthusiasm for student-teaching to the<br />
requirements of a structured curriculum. ”Getting<br />
Started in Clinical Teaching” comprises instructional<br />
booklets supplemented by a two-day course providing<br />
a combination of educational theory and practical<br />
instruction. It aims to support clinical teachers in wards,<br />
out-patient clinics and the Clinical Skills Centre.<br />
Information on curriculum construction, adult learning<br />
and curriculum outcomes is provided, together with<br />
practical experience of learning resources available in<br />
these venues. The course includes content-preparation,<br />
delivery mechanisms, models for organising student/<br />
patient interactions and the role of constructive<br />
feedback. Workshops are used to construct clinical<br />
teaching sessions using the approaches described<br />
including simulation, role-play and self-video. Selfcritique<br />
and peer review are encouraged. Areas of<br />
potential resistance to change are discussed. The<br />
“Getting Started” booklets summarising keypoints are<br />
suitable for wider dissemination.<br />
Tuesday 4 September<br />
- 4.42 -<br />
5I3 Governance in medical teaching:<br />
pilot study<br />
Iain Robbé<br />
University of Wales College of Medicine, Temple of Peace &<br />
Health, Cathays Park, Cardiff CF10 3NW, UK<br />
Quality in tertiary teaching is increasingly important<br />
(McLean, 2001) and it can be linked to the government<br />
policy of improving medical practices through<br />
governance (Scally & Donaldson, 1998). A checklist<br />
for governance was developed to investigate its<br />
theoretical validity (Cohen & Manion, 1989) for<br />
medical educators. Random sample [20%, n=12] of<br />
postgraduate educators in a medical college completed<br />
the checklist using a five point Likert scale and<br />
discussed its validity compared to the literature, their<br />
experiences and governance issues. Respondents<br />
judged the checklist to assess governance had high<br />
construct and content validity. They easily identified<br />
tasks they aimed to achieve to provide quality teaching.<br />
Checklist issues of infrastructure, coherence, culture,<br />
appropriateness of tasks, and systems to assess<br />
performance were evaluated positively. There was high<br />
theoretical validity in this setting. Further research is<br />
needed to test the validity and reliability of these results.<br />
5I4 The role of an education unit in<br />
health professional education:<br />
proactive or responsive<br />
Margaret Horsburgh* and Rain Lamdin<br />
Faulty of Medicine and Health Sciences, University of Auckland,<br />
Private Bag 92019, Auckland, New Zealand<br />
The teaching of health professions at The University<br />
of Auckland has undergone significant change in the<br />
last few years. The transformation has been from a<br />
medical school to a multi-professional Faculty of<br />
Medical and Health Sciences. At an undergraduate level<br />
medical, nursing, medical science and health science<br />
students now share learning opportunities. In order to<br />
support learning and teaching across the Faculty and<br />
establish best practice for curriculum, learning,<br />
teaching and assessment a multi-professional unit has<br />
been established. This presentation describes the goals<br />
of the Unit and identifies the tension between being<br />
responsive to individuals and groups and being<br />
proactive through setting an agenda for educational<br />
development within the Faculty. Potential conflict<br />
between the roles of curriculum management,<br />
monitoring and appraisal, leadership for change and<br />
research are discussed. Conclusions are drawn about<br />
the purpose and value of such centres in a multiprofessional<br />
environment.
5I5 Beyond teacher training; the<br />
construction of a faculty<br />
development strategy<br />
Patricia Rosado Pinto* and Ramiro Avila<br />
Department of Medical Education, Faculdade de Ciencias<br />
Medicas, Campo de Santana, 130, 1169-056 Lisboa,<br />
PORTUGAL<br />
In Portuguese medical schools the pedagogical<br />
preparation of faculty members has been a neglected<br />
enterprise. Furthermore faculty are constantly being<br />
asked to assume new educational roles for which they<br />
have received no specific training. Thus formal faculty<br />
development programmes are becoming more and more<br />
vital. The aim of this presentation is to describe the<br />
institutional strategy of our Medical Education<br />
Department, established in 1996, concerning: teacher<br />
training workshops for junior and for senior lecturers;<br />
Journal clubs and sharing good practice sessions;<br />
Working sessions with the teachers - rethinking the<br />
teachers’ assumptions about teaching and learning;<br />
discussing curricular issues; designing and developing<br />
specific educational and evaluation materials, providing<br />
educational feedback. More than isolated courses on<br />
“teaching how to teach” we aim at a real,<br />
comprehensive and structured staff development<br />
strategy in which subject matter and educational experts<br />
can work together avoiding isolated discipline<br />
knowledge and contributing to a systematic<br />
improvement of teaching.<br />
5I6 The profile of the perfect teaching<br />
professor<br />
F Scheele*, J Th M van der Schoot and A J Goverde<br />
St Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE<br />
Amsterdam, NETHERLANDS<br />
The aim of the study was to assess the characteristics<br />
of the perfect teaching professor from the perspective<br />
of postgraduate trainees in obstetrics and gynaecology.<br />
A written interview was sent to 120 trainees. The<br />
interview contained 3 questions such as: ‘What is your<br />
Session 5J Education and cultural diversity<br />
5J1 The development and evaluation of<br />
a programme to teach cultural<br />
diversity to medical undergraduate<br />
students<br />
Nisha Dogra<br />
University of Leicester, Greenwood Institute of Child Health,<br />
Westcotes House, Westcotes Drive, Leicester LE3 3TP, UK<br />
The study aimed to assess any attitudinal change in<br />
students following teaching on cultural/racial diversity<br />
using a previously developed questionnaire and whether<br />
the teaching enabled the learning objectives to be met<br />
in a measurable way. Students completed a<br />
questionnaire designed in a previous study at two<br />
stages; the first before the component on cultural<br />
diversity was delivered and the second after the sessions<br />
Tuesday 4 September<br />
- 4.43 -<br />
advice to improve your teaching professor?’ The<br />
answers were subsequently divided in three categories:<br />
knowledge (the head), practical skills (the hands) and<br />
attitude (the heart). 74 trainees responded. 74% of the<br />
answers given fell in the heart category, 23% in the<br />
head category and 3% in the hand category. From the<br />
perspective of trainees in obstetrics and gynaecology<br />
the perfect teaching professor is the king of positive<br />
feedback and has personal interest in the trainee. The<br />
perfect teacher has good knowledge and average skills.<br />
It is recommended that the teaching professor should<br />
appoint a stimulating tutor with interest in the social<br />
aspects surrounding the trainee.<br />
5I7 Evidence retrieval in medical<br />
education: obstructions and<br />
opportunities<br />
Alex Haig<br />
SCPMDE, Education Development Unit, Tay Park House, 484<br />
Perth Road, Dundee DD2 1LR, UK<br />
With the ever-increasing emphasis on best evidence in<br />
medical education it is imperative that researchers and<br />
practitioners have full access to the evidence in order<br />
to reduce bias. The various factors impeding evidence<br />
retrieval in medical education will be outlined, and the<br />
problems inherent with database indexing will be<br />
highlighted with the results of a study of comparative<br />
search strategies. By examining the search strategies’<br />
rates of precision, sensitivity, and specificity it can be<br />
shown that the major databases containing relevant<br />
peer-reviewed studies (Medline, Embase, ERIC) are<br />
not indexed for effective searches in medical education.<br />
Presently there is no existing database or search tool<br />
that provides the conceptual context required for<br />
evidence retrieval for medical education. Alternative<br />
approaches to compensate for current inadequate<br />
indexing will be outlined, as will possible future models<br />
that could resolve existing problems and provide<br />
analytical tools for the evidence-based research and<br />
decision-making of tomorrow.<br />
on cultural diversity. The time interval between stage<br />
one and two was one week. The cultural diversity<br />
component was developed using a range of sources.<br />
140 out of 181 (77.3%) students completed the<br />
questionnaire at both stages. The findings include<br />
statistically significant changes that reflect more<br />
“positive” attitudes about cultures coming together and<br />
about specific cultures. The study indicates that<br />
attitudes changed over the period of teaching. There<br />
is, however, scope for further development of measures<br />
to enable attitudinal shifts to be measured.
5J2 Aboriginal health: a tool in the<br />
process of reconciliation?<br />
G Garvey* and I E Rolfe*<br />
University of Newcastle, Faculty of Medicine and Health<br />
Sciences, University Drive, Callaghan 2308, AUSTRALIA<br />
The inclusion of culturally appropriate, relevant and<br />
academically sound content and practical experience<br />
in Aboriginal Health is an important tool in the process<br />
of reconciliation in Australia. The inclusion of<br />
Aboriginal Health content also serves several other<br />
purposes. It recognises the importance of Aboriginal<br />
Health in Australian society and also provides<br />
Aboriginal students with a sense of belonging. It can<br />
also assist in attracting and retaining health<br />
professionals to work in Aboriginal communities and<br />
provides all students with an understanding of cultural<br />
practices and beliefs of patients from other cultures.<br />
We aim to outline the Aboriginal Health content for<br />
health professional students at the Faculty of Medicine<br />
and Health Sciences, Newcastle, Australia. We will<br />
present an innovative, specifically designed multimedia<br />
resource that is used to orientate students to<br />
Aboriginal History, Cultural Awareness, Aboriginal<br />
Health and working with Aboriginal organisations.<br />
5J3 Valuing diversity: the effectiveness<br />
of a roleplay workshop as part of a<br />
newly introduced communitybased<br />
diversity module<br />
Sue Conning*, Alison Hooper, Margot Turner and Val Wass<br />
Guy's, King's and St Thomas' School of Medicine, Department<br />
of General Practice, Weston Education Centre, 10 Cutcombe<br />
Road, London SE5 3PJ<br />
Learning about the diverse needs of people with<br />
disabilities, deprivation, homosexuality or minority<br />
ethnicity is challenging. We run a “diversity” course<br />
where students interview individuals, visit community<br />
organisations and explore issues raised in seminars.<br />
Evaluation showed that some viewed these issues as<br />
common sense. A workshop using trained, standardised<br />
patients was introduced into the module. Specific<br />
diversity scenarios were enacted and students then<br />
reflected on their personal reactions to these in small<br />
groups. Students completed a questionnaire evaluating<br />
the impact of this workshop. A cultural discourse<br />
analyst observed the scenarios and group interaction.<br />
197 (60%) students completed the questionnaire (20%<br />
non-attendance). Students rated the workshop very<br />
positively. It proved an innovative experience, which<br />
challenged their own prejudices and added further<br />
personal reality to their community experiences.<br />
Reasons for this will be discussed. This interactive<br />
learning model proved most effective in encouraging<br />
students to explore their personal approaches to<br />
diversity issues.<br />
5J4 Using negative role models<br />
positively<br />
S E Gull* and K H Matheson<br />
Cambridge, 42 Southgate Street, Bury St Edmunds IP33 2AZ,<br />
Suffolk, UK<br />
Tuesday 4 September<br />
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The influence of the negative role model will be<br />
presented. The main aim of the study was to consider<br />
the issue of gender and role models for women in<br />
medical education. One investigator (SEG) carried out<br />
semi-structured interviews with 8 undergraduate<br />
students and 10 female doctors. A question asked was<br />
“what characteristics of role models influenced you<br />
during your medical education?”. The importance of<br />
role models was acknowledged. The positive and<br />
negative attributes of role models will be discussed with<br />
particular reference to the positive effect of negative<br />
role models. Role models appear to be related to the<br />
self-identity of the student, and negative attributes may<br />
be influential in a positive as well as a negative way.<br />
5J5 What factors influence<br />
underrepresented minority (URM)<br />
students in their choice of medical<br />
schools?<br />
Ara Tekian*, Laura Hruska and Mark Urosev<br />
University of Illinois at Chicago, Department of Medical<br />
Education (m/c 591), 808 S. Wood St, CME 986, Chicago IL<br />
60612, USA<br />
This study investigates specific factors influencing<br />
underrepresented minority students’ (URMs) choice<br />
among medical schools. Quantitative and qualitative<br />
pre-matriculate data were gathered from all applicants<br />
to the University of Illinois at Chicago College of<br />
Medicine (1999/2000-2000/2001). Applicants were<br />
classified both by ethnicity and student groups listed<br />
as follows: interviewed and denied (ID); interviewed,<br />
accepted and matriculated (AM); and interviewed,<br />
accepted but declined the offer (AD). A series of Chisquare<br />
tests of independence and t-test were performed.<br />
MCAT scores were significantly higher for the AD<br />
group, whereas GPA was statistically different only<br />
between the ID and AD students. Particular choices<br />
such as the prestige and affiliation of undergraduate<br />
institutions and medical schools, multiple acceptances,<br />
and choices among multiple acceptances were also<br />
statistically dependent on student groups and ethnicity.<br />
Distinguishable trends exist regarding the selection of<br />
a medical school that follow either student ethnicity,<br />
or entrance categorization.<br />
5J6 Education for professionalism in<br />
medicine<br />
Geoffrey Westwood* and Barbara Westwood<br />
Bankstown Health Service, Locked Mail Bag 1600, Bankstown<br />
NSW 2200, AUSTRALIA<br />
One of the themes for this conference is professionalism<br />
in medical education. The concept of professionalism<br />
in medical practice as distinct from medical education<br />
is discussed along with what constitutes<br />
professionalism in current medical practice in Australia.<br />
The question is proposed that unless medical education<br />
addresses the issues of professionalism then it is<br />
unrealistic to expect young doctors to exhibit so-called<br />
professional behaviour in their practice of medicine.<br />
The authors draw on their long experience in health<br />
administration and health education.
5J7 Characteristics of students admitted<br />
for the medical course at the Faculty<br />
of Medicine of Ribeirao Preto,<br />
University of Sao Paulo, Brazil<br />
A R L Cianflone*, M F A Colares, J F C Figueiredo,<br />
M L V Rodrigues and L E de A Troncon<br />
Faculty of Medicine or Ribeirao Preto, Rua Dom Luiz Amaral<br />
Mousinho, 1662-ap.2, 14090-180 Ribeirao Preto SP, BRAZIL<br />
In order to determine some characteristics of the<br />
medical students, a standardized questionnaire was<br />
applied to 96 students admitted in 1994 and to 98<br />
students admitted in 2000. The results were: age at<br />
admission: 18 years or less (62.8%); number of<br />
Session 5K Contexts for learning<br />
5K1 Clinical education in the health care<br />
professions: a critical analysis of<br />
the literature<br />
Alison Rushton<br />
Coventry University, School of Health & Social Sciences, Priory<br />
Street, Coventry CV1 5FB, UK<br />
Clinical education is an integral component of medical<br />
education, providing an essential bridge between the<br />
academic and clinical environments. A soft systems<br />
methodology provided a conceptual framework for<br />
structuring an analysis of clinical education. The search<br />
encompassed all major databases and manual searching<br />
of key journals for healthcare professions. Content<br />
analysis identified emerging themes, and informed the<br />
sub-divisions of the analysis. Key themes included:<br />
balance between theoretical and clinical course<br />
components, timing of placements, assessment, models<br />
of placement, supervisory process, and roles of the<br />
clinical educator and the university tutor. The analysis<br />
identified a paucity of good quality research, with both<br />
theory-practice and literature-practice gaps in<br />
existence. The literature also highlighted the necessity<br />
for change and the need to develop theory and research.<br />
The findings reflect that a structured approach to<br />
address the issues raised by clinical education at<br />
individual profession and interdisciplinary levels is<br />
perhaps required.<br />
5K2 “Contracts for Learning”: project to<br />
improve the quality of attachments<br />
at a District General Hospital<br />
Richard Ayres*, Henry Averns and Lin Sanders<br />
Northern Devon Healthcare Trust, Medical Education Centre,<br />
North Devon District Hospital, Barnstaple, Devon EX31 4JB,<br />
UK<br />
Our District Hospital serves a mainly rural population<br />
of 160,000 and has good links with local GPs and<br />
community hospitals. Undergraduate medical students<br />
come for various attachments, mostly from Bristol<br />
University. Often they have no clear idea what they<br />
want from the attachment, and sometimes we have no<br />
Tuesday 4 September<br />
- 4.45 -<br />
previous applications: 1(64.9%) and >1 (13.4%);<br />
previous experience in other university courses: 5.1%;<br />
father with university degree: 76.8%; mother with<br />
university degree: 53.1%; students who have parent<br />
physicians: 19.5% (other relatives physicians: 39.5%).<br />
38.5% of the students decided to apply for medicine<br />
between the ages of 14 and 16 years and 30.5% decided<br />
between 10 and 13 years. The disciplines of better<br />
performance during the high school were Biology<br />
(91.5%), Chemistry (78.2%), Physics (77.5%) and<br />
Mathematics (77.5%). The reasons given for<br />
application to Medicine were: liking Biology (45%);<br />
personal achievement (30%); to help people (23%).<br />
clear idea what to teach them. “Contracts for Learning”<br />
is a new project based on a model already used here<br />
for nursing students. We email students four weeks<br />
before their attachment. We provide detailed profiles<br />
of teaching staff in the hospital and primary care; also<br />
particular departments, GP surgeries and community<br />
hospitals. This amounts to an extensive menu of choices<br />
(including multidisciplinary modules offered to<br />
healthcare students). Students then submit a form<br />
detailing their learning requirements. We then produce<br />
a “Learning Contract” specifying what learning<br />
experiences we will provide. We will be presenting our<br />
early experience of this project.<br />
5K3 Does the dedicated teaching<br />
environment in ambulatory care<br />
improve acquisition of learning<br />
outcomes?<br />
Clare I L Stewart*, Paul E Preece and John A Dent<br />
Dundee University, Clinical Skills Centre, Ninewells Hospital<br />
and Medical School, Dundee DD1 9SY, UK<br />
Current trends in undergraduate medical education are<br />
away from traditional ward-based learning to<br />
ambulatory care teaching. We wanted to know whether<br />
students gain more learning outcomes from a dedicated<br />
ambulatory teaching environment than a conventional<br />
outpatient clinic. A comparative evaluation study using<br />
a semi-structured student questionnaire and a structured<br />
patient questionnaire was performed. Surprisingly,<br />
results indicated the learning environment and<br />
organisation of the teaching were rated equally.<br />
However, more learning outcomes were achieved<br />
utilising the Ambulatory Care Teaching Centre<br />
(ACTC), but each venue demonstrated particular<br />
strengths with regard to individual outcomes. The level<br />
of patient satisfaction in the ACTC was high, implying<br />
patient care was not adversely affected utilising this<br />
setting. This information will inform practice for the<br />
content of future teaching sessions.
5K4 Could we improve on what patients<br />
our pediatrics students saw in<br />
outpatient clinics?<br />
Pedro Herskovic*, Alicia Vasquez, Cristian Breinbauer,<br />
Patricia Gomez, Viviana Herskovic, Marcela Jacard,<br />
Claudio Missarelli and Erika Troncoso<br />
Pediatrics Department, University of Chile, Faculty of Medicine,<br />
Campus Oriente, Casilla 16117, Correo 9, Providencia,<br />
Santiago, CHILE<br />
For the last two years we have registered every contact<br />
of fifth year medical students with pediatric outpatients.<br />
In 1999 we found that exposure to pathologies included<br />
in the contents for the rotation ranged from 43.5% to<br />
71.7%. In year 2000 an intervention was made with<br />
the students’ tutors to increase their awareness about<br />
the need of contact with more pathologies. Our<br />
objective was to check if such intervention would<br />
improve on the deficiencies detected in 1999. In year<br />
2000 six student groups attended 50 sessions in<br />
outpatient clinics. Patients were registered with up to<br />
three diagnoses, which were compared with the 46<br />
pathologies included in our learning objectives. Patient<br />
encounters ranged from 38 to 127 per group. Exposure<br />
to pathologies ranged from 43.0% to 80.4%, which was<br />
similar to what was observed in 1999. Correlation was<br />
found between the number of patients seen and contact<br />
with more pathologies. A briefing session for tutors<br />
did not improve the completion of the rotation<br />
objectives. We have to keep assessing what is going on<br />
in clinical rotations.<br />
5K5 Using the ward round for teaching<br />
and learning: how do junior<br />
doctors learn from consultants<br />
through ward-based teaching?<br />
Alan Bleakley<br />
Cornwall Postgraduate Education Centre, Royal Cornwall<br />
Hospital, Truro Cornwall TR1 3LJ, UK<br />
Traditional psychological models of knowledge and<br />
skills transmission fail to tell the entire story of how<br />
junior doctors are effectively taught on ward rounds,<br />
moving from novice to expert status through<br />
‘professional adhesion’. This paper presentation reports<br />
an ongoing combined qualitative methods research<br />
project with a mixed speciality group of twenty-five<br />
consultants in a large rural hospital in Britain. Data<br />
analysis of semi-structured interviews responding to<br />
examples of videotaped ward practice, has led to a more<br />
anthropological, rather than the conventional<br />
psychological, exploration of the working modes of<br />
specific communities of practice in a complex teaching<br />
and learning context. Contemporary models of<br />
constructed, distributed and situated learning, of<br />
cognitive apprenticeship, of adaptation to a ‘habitus’<br />
(informal rules and regulations of a community of<br />
practice) and of the construction of practitioner<br />
identities, are used as an exploratory, and in some cases<br />
explanatory, framework for the data collected from the<br />
study.<br />
Tuesday 4 September<br />
- 4.46 -<br />
5K6 Clinical skills training needs of final<br />
year medical students and PRHOs -<br />
a comparison<br />
D MacLeod*, E Gill, J Gate and J Rees<br />
NHS, University Hospital Aintree, Longmoor Lane, Liverpool<br />
L9 4EL, UK<br />
We compared the clinical skills training needs of final<br />
year medical students and PRHOs. We surveyed 257<br />
final year medical students undergoing clinical skills<br />
training, including a ‘Harvey’ cardiac patient simulator<br />
and communication training. Then, 22 PRHOs<br />
completed a questionnaire assessing training needs to<br />
plan clinical skills teaching. The most frequent student<br />
revision requests were all commonly encountered<br />
OSCE stations; catheterization, suturing,<br />
ophthalmoscopy, IV fluid management and breast<br />
examination (100%, 95%, 79% and 58% of student<br />
sessions respectively). By contrast, PRHOs requested<br />
training on infrequently performed skills (joint<br />
aspiration, pneumothorax aspiration, central vein<br />
cannulation) or common but complex skills. Selfassessed<br />
training needs of final year medical students<br />
reflect impending OSCE assessment, whilst degree of<br />
exposure and skill complexity drive training needs for<br />
the PRHOs. This suggests some adjustment in student<br />
skills training and the need for further skills training<br />
sessions for PRHOs.<br />
5K7 The impact of a precepted diabetic<br />
foot care program<br />
Linda Z Nieman, Lewis E Foxhall*, Frank Sifuentes and<br />
Lee Cheng<br />
UT Houston Health Science Center, Family Practice and<br />
Community Medicine, 6431 Fannin, Suite JJL324, Houston TX<br />
77030, USA<br />
Diabetes is a growing international health problem that<br />
too often leads to foot amputation. Over a two summer<br />
period, 156 preclinical students in the Texas Statewide<br />
Family Practice Preceptors hip Program screened the<br />
feet of more than 300 diabetics, 30% of whom had<br />
loss of pedal sensation. Screening was accomplished<br />
with the Semmes Weinstein 5.07/10g, monofilament.<br />
Students also taught these patients diabetic foot care.<br />
From the analysis of the copies of the patient<br />
evaluations submitted to us, we found that patients<br />
whose age was greater than 60 years and patients who<br />
received their care in rural settings were more likely to<br />
have a greater number of foot problems than those<br />
patients who were younger and those who received care<br />
in metropolitan areas. The students’ participation in<br />
diabetic screening and patient education has saved<br />
preceptors time and is considered helpful by patients.<br />
This program is transferable to other settings.
Session 5L Evaluation of multiprofessional education<br />
5L1 The benefits of a multiprofessional<br />
education programme can be<br />
sustained<br />
G J Mires*, F L R Williams, R M Harden and P W Howie<br />
University of Dundee, Department of Obstetrics and<br />
Gynaecology, Ninewells Hospital & Medical School, Dundee,<br />
DD1 9SY, UK<br />
Improved understanding by third year medical students<br />
about the professional roles of doctors and midwives<br />
in the care of labouring women following a<br />
multiprofessional education programme have<br />
previously been reported (Mires et al, 1999). Following<br />
a clinical attachment in the fourth year, the previously<br />
observed changes in awareness of professional<br />
responsibilty were maintained in the same group of<br />
students and in some areas enhanced. We believe that<br />
a short multiprofessional course early in the medical<br />
curriculum can change awareness of professional<br />
responsibility. Further, we have evidence that these<br />
attitude changes were maintained and enhanced<br />
following a clinical attachment later in the educational<br />
programme. This reinforcement of multiprofessional<br />
experiences may enhance working practice after<br />
graduation.<br />
(Mires GJ, Williams FLR, Harden RM, Howie PW, McCarey M,<br />
Robertson A. Multiprofessional education in undergraduate<br />
curricula can work. Medical Teacher 1999;21:281-285)<br />
5L2 Self-directed multiprofessional<br />
continuing medical education with<br />
facilitators: an experiment in four<br />
European countries. The Belgian<br />
story<br />
J Goedhuys*, C Geens, N Mathers, K Billingham, G Maso<br />
and O Solas-Gaspar<br />
Catholic University Leuven, Kapucijnenvoer 33 J,<br />
Minderbroedersstraat 17, 3000 Leuven, BELGIUM<br />
In order to further implement fundamental options like<br />
self-directed learning, multiprofessional education and<br />
case-based learning, Continuing Medical Education has<br />
to provide a model that integrates the values of these<br />
options into daily practice. The aim of our project was<br />
to try out such a model in UK, Belgium, Italy and Spain.<br />
In this paper the Belgian experience is reported. Six<br />
general practice/family medicine group practices were<br />
selected, with at least two GPs and at least one extra<br />
discipline attached to the practice. Two facilitators<br />
(young GPs) were appointed to three practices each.<br />
They facilitated the group in constructing a common<br />
learning agenda and made sure the group found the<br />
methods to realise it. All processes and outcomes were<br />
registered and all participants were interviewed<br />
afterwards. Results show a high satisfaction, perceived<br />
relevance and enhanced teamspirit. The balance<br />
between task-oriented and group-oriented facilitation<br />
will be discussed.<br />
Tuesday 4 September<br />
- 4.47 -<br />
5L3 Interprofessional education in a<br />
clinical and non-clinical<br />
environment: teachers’ and<br />
learners’ perspectives<br />
John Jenkins and Sue Morison*<br />
Queen’s University Belfast, School of Nursing & Midwifery,<br />
Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL,<br />
UK<br />
This paper presents the results of the evaluation of an<br />
interprofessional education (IPE) pilot programme for<br />
undergraduate medical and nursing students. The pilot<br />
involved 136 students in the specialist areas of<br />
paediatrics and Children’s Nursing. Three groups, with<br />
a maximum of 44 students per group undertook the<br />
project during 2000-01. Experts from both professions,<br />
University and Health Service, delivered the<br />
programme and assessed student learning. Qualitative<br />
and quantitative evaluation techniques were employed<br />
to compare the success of classroom-based (lectures,<br />
problem-based learning (PBL), case discussion) and<br />
clinical placement (tutorials, ward rounds, teamwork)<br />
teaching and learning. The views of both teachers and<br />
learners will be presented. Initial results suggest that<br />
both students and teachers identify PBL as the most<br />
successful classroom-based teaching and learning<br />
strategy but that clinical placement learning was<br />
preferred overall. That teaching staff demonstrated a<br />
positive attitude to IPE was also important.<br />
5L4 Interprofessional education:<br />
experiences of students<br />
J Agsteribbe*, R M H Schaub and J Cohen-Schotanus<br />
University of Groningen, Department of Education, Faculty of<br />
Medical Sciences, A. Deusinglaan 1, 9713 AV Groningen,<br />
NETHERLANDS<br />
The courses of the undergraduate dental and dental<br />
hygienist training at Groningen University are partially<br />
shared. The concept of this educational programme is<br />
that dentists and dental hygienists join forces within<br />
their workfield. The students therefore should get<br />
acquainted with the concept of working together. The<br />
research question is: how do students experience this<br />
concept? In order to answer this question we used the<br />
critical incidents method. We asked the students<br />
(n=300) to answer the following question: “ During<br />
which event in the course did you personally experience<br />
the team concept and did it work out well for you, or<br />
did it not work out at all?” 85 forms were returned to<br />
us. The students’ opinions towards their professional<br />
colleagues became increasingly critical. In particular<br />
the dental hygienist students did not have the feeling<br />
they were taken seriously by the teachers and the dental<br />
students.
5L5 “Capturing the learning”: the<br />
development of interprofessional<br />
education in the Faculty of Medicine,<br />
Health and Biological Sciences,<br />
University of Southampton<br />
D Humphris* and S Colly<br />
New Generation Project, Building 67, University of<br />
Southampton, Highfield, Southampton, Hants SO17 1BJ, UK<br />
The Faculty of Medicine, Health & Biological Sciences,<br />
University of Southampton have a track record of<br />
developing a number of successful small<br />
interprofessional teaching and learning projects. This<br />
paper reports the findings of a study designed to<br />
‘Capture the Learning’ emerging from the experience<br />
of the last decade of inter-professional education<br />
activity in the Faculty. This small-scale qualitative study<br />
involved interviews with 16 key informants from a<br />
range of professional backgrounds, from across the<br />
Faculty and service. This paper reports the key emergent<br />
themes from the analysis of data. This includes a<br />
reflection on the conditions necessary for the<br />
development of interprofessional education and<br />
learning in the Faculty. The outcomes of this study will<br />
be related to the development of the Faculty’s<br />
commitment to the establishment of the New<br />
Generation Project.<br />
- 4.48 -<br />
5L6 Learning interprofessionally: a<br />
review of experiences<br />
A Le May*, F Kitsell, I Giles and C Stephens<br />
School of Nursing & Midwifery, Building 67, University of<br />
Southampton, Southampton, Hants SO17 1BJ, UK<br />
This paper details the educational approaches used in<br />
a programme of interprofessional education within the<br />
Faculty of Medicine, Health and Biological Sciences<br />
at the University of Southampton. This initiative<br />
focussed on 1,000 first year undergraduate students<br />
undertaking courses in medicine, midwifery, nursing,<br />
occupational therapy, physiotherapy and podiatry.<br />
Students were split into 100 facilitated learning groups<br />
and asked to construct a scenario, from a selection of<br />
clinical topics, against which they answered 3 clinically<br />
focussed questions and critically appraised their<br />
experiences of team working. Assessment was through<br />
an oral presentation of their work to peers and<br />
facilitators. The entire experience has been evaluated<br />
from both the students’ and the facilitators’ view points<br />
– salient issues raised in this evaluation will be<br />
presented and discussed in the light of planned future<br />
interprofessional exercises during the second and third<br />
years of these students’ programmes. Conclusions<br />
surrounding the opportunities and barriers to<br />
interprofessional education will be drawn.<br />
Session 5M Teaching about EBM, critical thinking and research<br />
5M1 Questions as the key to knowledge:<br />
teaching medical students in<br />
Evidence-Based Medicine<br />
Jonna Skov Madsen*, Birgitta Wallstedt, Carl Joakim<br />
Brandt and Mogens Horder<br />
Odense University Hospital, Department of Clinical<br />
Biochemistry, DK-5000 Odense C, DENMARK<br />
There is a focus on teaching Evidence-Based Medicine<br />
(EBM) but until recently EBM training was not<br />
incorporated in our undergraduate curriculum. We<br />
introduced an EBM course in the 9th semester (out of<br />
13) in the subject matter ‘clinical biochemistry’. The<br />
course consisted of seven (1-hour) lectures during three<br />
weeks. First an introduction to the EBM method was<br />
given after which students in small groups chose and<br />
focused their own question, undertook a structured<br />
search and selected one article. The process and results<br />
were subsequently presented to and discussed within<br />
the entire group of students. The course was evaluated<br />
using a questionnaire. Students improved in the<br />
evaluation of scientific articles and in seeking<br />
information and reported that they had been stimulated<br />
to understand concepts instead of memorising details.<br />
In our opinion medical students should be introduced<br />
to EBM at an early stage to be able to practice EBM<br />
throughout their education.<br />
Tuesday 4 September<br />
5M2 Teaching Evidence-Based Medicine<br />
to healthcare professionals:<br />
implementing and evaluating the<br />
programme<br />
C Osonnaya*, K Osonnaya and E Burke<br />
Department of General Practice and Primary Care, Queen Mary<br />
College, University of London, Mile End Road, London E1 4NS,<br />
UK<br />
Many papers have described the importance of<br />
exposing healthcare professionals to the ‘new<br />
paradigm’ of evidence-based medicine (EBM) as one<br />
of the best ways to improve patient care. To this end,<br />
we developed and evaluated short courses in EBM for<br />
health professionals from 1998 to 2000 at the United<br />
Medical Education Consortium, London. Each of the<br />
courses lasts for four weeks. The aims of the course<br />
are to enable participants to learn how to go through<br />
logical laid questions, search on-line databases, review<br />
articles critically and apply information from the<br />
literature to specific clinical questions. All the<br />
participants were surveyed immediately before and<br />
after the short course to assess changes in reading,<br />
critical evaluation and literature search in medical<br />
decision making. The results showed that on-line<br />
database search and critical appraisal skills increased<br />
significantly in the participants, as did their tendency<br />
to use MEDLINE, BIDS and original research articles<br />
to solve clinical problems.
5M3 Impact of a short interactive<br />
curriculum on medical students’<br />
appreciation of EBM and CAM<br />
Samuel N Forjuoh*, Robert A Henry, Terry G Rascoe,<br />
Barb Symm and Janine C Edwards<br />
Department of Family & Community Medicine, Scott & White<br />
Memorial Hospital, Texas A & M University, System Health<br />
Science Center, College of Medicine, Scott & White Santa Fe<br />
Center, Temple, TX 76504, USA<br />
To evaluate the impact of a short, interactive curriculum<br />
on students’ appreciation of evidence-based medicine<br />
(EBM) and complementary/alternative medicine<br />
(CAM), a one-page anonymous questionnaire was<br />
distributed to all third-year students during their sixweek<br />
family medicine clerkship before/after a new<br />
curriculum, comprising interactive sessions on<br />
principles of epidemiology, biostatistics, EBM/CAM.<br />
The majority reported that the new instruction in<br />
epidemiology (83%), biostatistics (88%), EBM (95%),<br />
and CAM (100%) would help their future work. Even<br />
though the increase in their mean response on<br />
appropriateness of integrating EBM/CAM from 3.79<br />
to 4.05 on a 5-point Likert scale was not statistically<br />
significant (p=.095), significant changes were reported<br />
in the areas of “critiquing the medical literature”<br />
(p=.030) and “appraising a clinical trial” (p
5M7 Experimental courses in<br />
Biochemistry - initiation to<br />
scientific research in<br />
undergraduate medicine<br />
Carlota Saldanha*, Rui Mesquita and J Martins-Silva<br />
Institute of Biochemistry, Faculty of Medicine of Lisbon, Av Prof<br />
Egas Moniz, 1649-028 Lisbon, PORTUGAL<br />
Experimental courses in biochemistry have been<br />
carried out in order to develop critical thinking,<br />
autonomy and decision-making capacity in first year<br />
students. To determine the students’ outcomes in terms<br />
of learning success and satisfaction, an anonymous<br />
Tuesday 4 September<br />
- 4.50 -<br />
questionnaire with 15 questions based on a Likert scale<br />
(bad, insufficient, sufficient, good, very good) was<br />
applied to the 14 students that attended the course in<br />
1998/1999, at the beginning and the end of the course.<br />
At the end of the course there was an increase in the<br />
number of students who responded ‘very good’ to: the<br />
stay in the lab, to using bibliographic search, to what is<br />
the quality control, to doing statistical analysis and to<br />
making oral results presentations. There was an increase<br />
in the students’ interest in research, practical skills in<br />
the lab and their knowledge in different areas of<br />
biomedical research.
Session 6 Workshops 2<br />
6/1 Basic Skills Faculty Development<br />
Workshop<br />
Dr Anita Duhl Glicken<br />
University of Colorado School of Medicine, Box C219, 4200 E<br />
9th Avenue Denver, Colorado 60262, USA<br />
Background<br />
Medical faculty are often recruited directly from<br />
clinical practice and while clinical expertise is<br />
invaluable to an applied educational process, these<br />
individuals may feel unprepared for the expectations<br />
and demands of academic teaching.<br />
Aims<br />
The purpose of this workshop is to provide new faculty<br />
with participatory learning experiences designed to<br />
enhance basic skills that contribute to success in the<br />
academic environment. The workshop will also benefit<br />
senior faculty who wish to improve their skills or<br />
mentor new faculty in their program. Materials will be<br />
provided to enable participants to replicate this<br />
workshop at their own institution.<br />
Who should attend<br />
Faculty interested in improving their own teaching skills<br />
or mentoring new faculty<br />
Content and structure<br />
Two faculty development modules, designed to increase<br />
awareness of active teaching strategies, will engage<br />
participants in an interactive exploration of ways to<br />
enhance didactic teaching through the creation of a<br />
complete course syllabus that serves as a contract for<br />
partnership in learning. In addition, participants will<br />
explore strategies to improve student-faculty<br />
communication and feedback. These model workshops<br />
illustrate two components of an existing integrated<br />
program for faculty development. As a final exercise,<br />
time permitting, participants will review an existing<br />
integrated framework for faculty development and<br />
generate a strategic plan for developing a framework<br />
within their program. This plan will address issues of<br />
needs assessment, identification of educational<br />
components, models and strategies for course delivery,<br />
and assessment.<br />
This workshop will include several interactive<br />
exercises. Participants will work together to apply<br />
principles presented in class and to generate new<br />
information to share with the larger group. Brief<br />
computer-generated presentations will be used to share<br />
information and guide discussions in the larger group.<br />
Handouts will be distributed.<br />
6/2 An Introduction to Clinical<br />
Judgment Analysis<br />
Dr Anthony LaDuca<br />
National Board of Medical Examiners, 3750 Market Street,<br />
Philadelphia, PA 19104, USA<br />
Tuesday 4 September<br />
- 4.51 -<br />
Background<br />
Medical school faculty and practising physicians place<br />
great importance on clinical judgment. Frequently, it<br />
is cited as a crucial element of a clinician’s proficiency.<br />
For some, judgment encompasses the “art” of medicine<br />
and the prospect of teaching it is seen as daunting if<br />
not impossible. But expert judgment has been studied<br />
for decades and clinical judgment has been the object<br />
of many investigations in Europe and North America<br />
for more than 30 years. Despite this lengthy history,<br />
few clinician educators are familiar with the concepts<br />
underlying judgment theory and judgment analysis.<br />
This workshop is intended to address that need.<br />
Aims<br />
• To introduce participants to the theory and practice<br />
of judgment analysis in clinical applications;<br />
• To engage participants in a systematic judgment<br />
analysis exercise;<br />
• To encourage participants to locate places for CJA<br />
in their instructional program;<br />
• To familiarize participants with the principal<br />
features of judgment theory as formulated by<br />
Brunswik and Hammond.<br />
Who should attend<br />
Post-graduate clinical education teaching faculty and<br />
administrators; clerkship directors; members of student<br />
progress committees; medical education support<br />
professionals; other medical school faculty and<br />
administrators.<br />
Content and structure<br />
The presenter will lead participants in a CJA exercise,<br />
such as diagnosing pneumonia. This exercise will use<br />
a Web-based CJA system developed by the NBME. The<br />
CJA system produces a graphical representation of the<br />
participant’s judgment “policy” and statistical feedback<br />
comparing that policy with a criterion policy. The<br />
participant is permitted to complete a second block of<br />
“cases” after which further feedback is provided. This<br />
latter feature illustrates the powerful instructional<br />
potential for CJA technology.<br />
1 [20 m] Participants engage a Web-based CJA<br />
Tutorial on chest pain. Presenter leads discussion<br />
of the meaning of graphical and statistical feedback<br />
2 [20 m] Participants complete exercise on diagnosis<br />
of pneumonia in 30 patients presenting in an<br />
emergency department. Feedback is discussed.<br />
3 [20 m] Participants complete the second block of<br />
30 pneumonia cases and discuss the feedback.<br />
4 [45 m] Presenter leads discussion of theoretical<br />
foundations of judgment analysis.<br />
5 [45 m] Working in small groups, participants begin<br />
to construct an original CJA problem as a means of<br />
addressing the potential utility of a computer-based<br />
CJA system in their instructional programs.<br />
6 [30 m] Small groups report on their products.
6/3 Norwegian Federation for Medical<br />
Education<br />
Chairperson: Dr Eivind Drange<br />
The workshop consists of three parts. All participants<br />
are welcome to attend parts 1 and 2. Part 3 is an<br />
Extraordinary General Assembly of the NFME.<br />
Part 1: 14.00-14.45<br />
Plenary: Reform in a medical school –<br />
needed, wanted, possible?<br />
Kirsti Lonka, Ph.D. Director, Development and Research<br />
Unit, Faculty of Medicine,<br />
University of Helsinki, Finland/Professor in Medical Education,<br />
Karolinska Institutet, Sweden<br />
Medical education is in the constant process of change,<br />
which makes it a dynamic field of study. Typical<br />
proposals for the improvement of undergraduate<br />
medical education have involved teaching the practical<br />
skills needed in general practice and closer integration<br />
of theoretical and clinical studies. Movement towards<br />
problem-based curricula is taking place all over the<br />
world. Also communication studies and professional<br />
growth are emphasized. In Finland, curriculum reforms<br />
have been frequent. Probably the most radical one took<br />
place in the Faculty of Medicine at the University of<br />
Tampere in 1994, when a pure PBL (problem-based<br />
learning) curriculum was started. Faculty of Medicine<br />
at the University of Helsinki began to evaluate and<br />
reform its curriculum of medical studies in 1994. This<br />
process resulted in Helsinki 2000, a hybrid-PBL<br />
curriculum, which was introduced in 1998. In this<br />
program, a systematic programme was also integrated<br />
to support students’ personal growth and to advance<br />
their communication and thinking skills. The main<br />
challenges for such a change process are not economic<br />
or technical, but rather, social and psychological. Most<br />
teachers lack educational training, and their<br />
understanding of the learning process is rather modest.<br />
A new approach to teaching requires medical teachers<br />
to view students as active constructors of knowledge.<br />
However, even though reforms may look good on paper,<br />
their implementation is the main challenge of medical<br />
education. Successful reforms are not possible without<br />
serious scientific research on medical education.<br />
Part 2: 1500-1545<br />
Workshop: NFME and <strong>AMEE</strong> – do we need<br />
them both?<br />
A discussion on the future role of NFME and possible<br />
co-operation with <strong>AMEE</strong><br />
The workshop will start with a closed debate among<br />
the panel followed by an open discussion.<br />
NFME and <strong>AMEE</strong> pursue similar objectives, and in<br />
many ways they fulfil them using the same means.<br />
Because of this, some Nordic institutions have claimed<br />
that there no longer is a need for NFME. At the<br />
workshop we want to challenge this claim and discuss<br />
if and how the two organisations can work side by side<br />
and together.<br />
Tuesday 4 September<br />
- 4.52 -<br />
6/4 Bedside Cardiology Skills Training,<br />
featuring “Harvey”, the Cardiology<br />
Patient<br />
Simulator and the UMedic Computer System<br />
Dr Michael S. Gordon, University of Miami School of<br />
Medicine, USA<br />
Dr Joel M Felner, Emory University School of Medicine, USA<br />
Center for Research in Medical Education, P O Box 01690 (D-<br />
41), Miami, FL 33101, USA<br />
Background<br />
As changes in medical care reduce the faculty time and<br />
patients available for teaching, simulation and<br />
multimedia systems are becoming a required<br />
component of medical curricula. The requirement for<br />
the faculty is leadership and a willingness to accept<br />
and implement change.<br />
Aim<br />
The objective of this workshop is to demonstrate the<br />
effective use of simulation to teach and assess bedside<br />
cardiology skills.<br />
Content and structure<br />
The presentation will be interactive, with full audience<br />
participation in the “patient” evaluation through video<br />
projection and audio for impulses, heart sounds and<br />
murmurs. Examples will be presented using the<br />
UMedic multimedia computer system. UMedic features<br />
“Harvey”, a life-sized manikin capable of simulating<br />
the bedside findings of 27 cardiac diseases, including<br />
blood pressure, venous, arterial and precordial impulses<br />
and auscultation. The UMedic system provides a<br />
comprehensive standardized multimedia curriculum in<br />
cardiology that includes the history, bedside findings,<br />
laboratory evaluation and therapy, and measures learner<br />
performance.<br />
6/5 Risk Management in Medical<br />
Education<br />
Directors of Research in Postgraduate Medical<br />
Education Group<br />
Presenters: Dr Kwee Matheson, Dr Alistair Thomson and<br />
Dr Andrew Long<br />
West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ,<br />
UK<br />
Background<br />
There is worldwide interest in risk management. Studies<br />
in the USA and Australia quote that up to 16% of<br />
hospital admissions suffer adverse events. Costs are<br />
estimated at £2 billion in the UK alone and are<br />
escalating. Postgraduate Medical Education (PGME)<br />
may help doctors prepare to manage and minimise risk,<br />
but medical education itself may need risk<br />
management.<br />
Aims<br />
This workshop aims to identify the issues and to<br />
develop a model for good practice to guide Directors<br />
of PGME (DPGME).
Content and structure<br />
Plenary 30 mins., Group work 1 hour, Report back and<br />
discussion 1 hour.<br />
Participants will explore the relevance of risk<br />
management to PGME by discussing the following<br />
subjects through plenary and small group work, under<br />
the guidance of experienced facilitators:<br />
Why errors occur; How we can learn from mistakes;<br />
Risk management and the learning cycle; Clinical/<br />
critical incident reporting and links with audit; How<br />
can PGME contribute to a safer environment; Trainers<br />
and trainees: both angels and devils; Educational<br />
governance: Standards, Assessment and Poor<br />
Performers; Validity and reliability of current<br />
assessment methods; Culture versus curriculum; The<br />
risks to DPGME; What can the DPGME do to<br />
encourage a pro-active approach to risk management?<br />
Conclusions from this workshop should be a template<br />
to help medical educators fulfill their key role in risk<br />
management.<br />
6/6 The professional and<br />
organisational culture of medical<br />
education – an exploratory<br />
workshop in the context of an<br />
interactive exhibition*<br />
Dr Elizabeth Krajic Kachur, Dr Nobaturo Ban and Hannah<br />
Kedar<br />
Medical Education Development, 201 East 21st Street, Suite<br />
2E, New York, New York 10010, USA<br />
(There will be an exhibition linked to this workshop in<br />
Research Building Seminar Room 1.0020 1st floor<br />
throughout the Conference)<br />
Aims<br />
This session will provide an opportunity to explore and<br />
reflect upon the professional and organizational<br />
environment of medical education as it currently exists<br />
and as it might develop in the future. This increased<br />
awareness should help participants better understand<br />
their current study/work situation and empower them<br />
to move the field into a direction that will assure<br />
progress.<br />
Who should attend<br />
Education professionals, teachers, administrators,<br />
trainees involved in medical education.<br />
Content and structure<br />
• 15min Welcome and introductions<br />
• 15min Exhibition background and orientation<br />
• 30min Individual exploration of exhibition areas<br />
with the help of a worksheet that asks for the<br />
completion of specific questions (e.g., identify what<br />
exhibition area/item makes you feel most “at home,”<br />
list what objects/images you would have expected<br />
to see)<br />
• 30min Discussion of individual experience (first<br />
in pairs and then in a large group format, a list of<br />
adjectives that describe the current cultural climate<br />
Tuesday 4 September<br />
- 4.53 -<br />
will be generated) 30min Medical education in the<br />
future (participants work alone or in pairs, they pick<br />
an exhibition area and draw on a flip chart sheet<br />
what this area would look like in 20 years)<br />
• 30min Presentation and discussion of individual<br />
drawings that get posted on the wall and<br />
incorporated in future exhibitions (at the end of this<br />
discussion a list of adjectives describing the<br />
predicted future culture of medical education is<br />
generated by the group and the two lists are<br />
juxtaposed for an additional debate)<br />
• 15min Strategies for strengthening or changing<br />
culture - What can you do to be an active participant<br />
in your culture? (a list will be generated and a tips<br />
sheet based on the literature will be disseminated)<br />
• 15 min Generation of Take-Home-Points from the<br />
session.<br />
6/7 Students teaching communication<br />
skills<br />
Organisers: Diana Mitter, Heiderose Ortwein, Jan<br />
Schildmann & Gunda Siemssen<br />
Students from Charité, Humboldt-University of <strong>Berlin</strong>, Germany<br />
Aims<br />
At German medical schools there is a long tradition of<br />
students teaching communication skills in peer groups.<br />
We therefore would like to invite you to experience<br />
different methods we use at the Charité, Medical<br />
Faculty at the Humboldt University <strong>Berlin</strong>. Two options<br />
are available to participants: one session will<br />
demonstrate the work of history taking groups<br />
(Anamnesegruppe) led by student tutors. In parallel<br />
there will be a training for future student tutors of<br />
breaking bad news courses.<br />
Who should attend<br />
Invited are persons interested in teaching<br />
communication skills (professors, students and<br />
administration professionals).<br />
Content and structure<br />
The workshop will be divided in two sessions - a<br />
practical part with experimental methods and a second<br />
part including discussion of the following topics:<br />
advantages and disadvantages of student tutors (from<br />
our experience students can learn a lot as tutors of<br />
communication skills courses), quality management<br />
(e.g. training and supervision of future tutors),<br />
comparison of student recruitment in different<br />
countries. A summary of results will be sent to all<br />
participants after the conference.<br />
6/8 Developing professional attitudes<br />
in medical training: theory, practice<br />
and evaluation<br />
Professor Amanda Howe<br />
Dept of Primary Care, University of East Anglia Medical School,<br />
Norwich NR4 7TJ, UK
Aims<br />
To examine the evidence base for effective learning of<br />
professional attitudes in medicine, and to evaluate the<br />
methods through which this aspect of learning can best<br />
be evaluated.<br />
Who should attend<br />
Any educators or researchers interested, particularly<br />
those involved in creating or evaluating the ways in<br />
which professional attitudes can be influenced through<br />
education & training.<br />
Content and structure<br />
Each participant should come prepared to join in by<br />
providing a single overhead, outlining their contribution<br />
to this field (what they do), its evidence base or<br />
theoretical framework (why they do it), and how they<br />
evaluate the impact on professional attitudes. These will<br />
be shared at introduction, and followed by a keynote<br />
of about 20 minutes. We will then work in small groups<br />
to consider a) the level of consensus b) the strengths of<br />
different approaches c) key questions which remain and<br />
how these might be addressed. These will be shared in<br />
plenary at the end.<br />
6/9 <strong>AMEE</strong>-IberoAmerican Network<br />
Workshop<br />
Organiser: Professor Margarita Barón-Maldonado, <strong>AMEE</strong><br />
Background<br />
Over the past few years, participation by teachers and<br />
students from Latin American countries at <strong>AMEE</strong><br />
Conferences has been growing steadily. A discussion<br />
forum has been set up to allow them to discuss areas of<br />
particular relevance and interest to them. Because of<br />
the close links that exist between universities in Spain<br />
and Latin America, a new group has been set up,<br />
facilitated by <strong>AMEE</strong>, which will be known as the<br />
<strong>AMEE</strong>-IberoAmerican Network for Medical<br />
Education, chaired by Professor Margarita Barón-<br />
Maldonado, President of <strong>AMEE</strong>.<br />
Who should attend<br />
The workshop is open to anyone who wishes to attend.<br />
Comments and suggestions for further topics for<br />
discussion can be Emailed to: amee@dundee.ac.uk<br />
Content and structure<br />
The following topics have been suggested by<br />
participants for initial discussions:<br />
1 What are <strong>AMEE</strong> expectations from the group<br />
function? What are IberoAmerican group<br />
expectations from <strong>AMEE</strong>?<br />
2 Presentations from each country relating to the<br />
current state of medical education, new<br />
developments and challenges;<br />
3 Accreditation of Medical Schools, particularly in<br />
relation to Mercosur;<br />
4 Potential collaboration both within the Network and<br />
with other organisations.<br />
Tuesday 4 September<br />
- 4.54 -<br />
6/10 Problem-based Learning<br />
Dr Stewart Mennin, and Dr Scott Obenshain<br />
Department of Cell Biology and Physiology, BMSB, Box 507,<br />
School of Medicine, University of New Mexico, Albuquerque,<br />
New Mexico 87131-5134, USA<br />
6/11 Portfolios as a method of student<br />
assessment<br />
Dr Miriam Friedman Ben-David<br />
Centre for Medical Education, University of Dundee, Tay Park<br />
House, 484 Perth Road, Dundee, DD2 1LR UK<br />
Aim<br />
This workshop aims at informing medical educators<br />
about portfolios.<br />
Who should attend<br />
Medical educators who are interested in innovative<br />
methods of assessing professional behaviours will<br />
benefit from this workshop.<br />
Content and structure<br />
It will contain a review of the use of portfolios,<br />
psychometric aspects unique to portfolio assessment,<br />
selection of portfolio material and guidelines for<br />
implementation. Participants will work in small groups<br />
to design, implement and evaluate administration of<br />
portfolios. Half of the time will be devoted to plenary<br />
presentation and discussions and the other half to small<br />
group work.<br />
6/12 Learning Needs Assessment in<br />
undergraduate and postgraduate<br />
medical education<br />
Professor Janet Grant<br />
Open University Centre for Education in Medicine, Walton Hall,<br />
Milton Keynes MK7 6AA, UK<br />
Aims<br />
• To consider the role of needs assessment in<br />
undergraduate and postgraduate medical education<br />
• To consider and evaluate methods of needs<br />
assessment<br />
• To identify how needs assessment is and can be done<br />
efficiently and effectively<br />
• To consider and evaluate the consequences of needs<br />
assessment for educational planning and review<br />
Who should attend<br />
The workshop concerns only undergraduate and<br />
postgraduate medical education, but participants from<br />
other health care disciplines will be welcome.<br />
Objectives<br />
By the end of the meeting, participants should be able<br />
to:<br />
• State the roles of needs assessment in undergraduate<br />
and postgraduate medical education
• Describe and evaluate the available methods of<br />
educational needs assessment<br />
• Advise about practical needs assessment methods<br />
• Plan the stages that follow on from educational<br />
needs assessment in undergraduate and<br />
postgraduate medical education.<br />
• Offer a critical appreciation of needs assessment in<br />
education.<br />
Content and structure<br />
The workshop will consist of a series of short<br />
presentations, with comprehensive handouts. Integrated<br />
with this will be participative group exercises which<br />
will enable participants to review each of the objectives<br />
stated above and make practical plans for their own<br />
situations.<br />
6/13 A European core curriculum?<br />
Prof. dr. Lennart N. Bouman<br />
MedEducad Consultancy, In de Korenmolen 17, 1115 GN<br />
Duivendrecht , The Netherlands<br />
Aim<br />
The aim of the workshop is to produce a set of global<br />
aims and objectives that could act as a common<br />
framework for the medical schools in the European<br />
Community. This framework must fit into the directives<br />
of the European Council on the mutual recognition of<br />
Tuesday 4 September<br />
- 4.55 -<br />
formal qualifications. Secondly it must be adapted to<br />
the profound changes that the professional roles of the<br />
doctor will undergo in the near future.<br />
Who should attend<br />
The workshop will help participants to become familiar<br />
with European legislation on the requirements for<br />
primary medical education and its continuation into<br />
residency and continuing education afterwards. This<br />
may be beneficially to those who will be involved in<br />
future curriculum planning on a local or national scale.<br />
Content and structure<br />
The workshop will be based on two key papers:<br />
1 European Council Directive 93/16/EEC, from<br />
Internet available as:<br />
http://www.europa.eu.int/eur-lex/en/lif/dat/1993/<br />
en_393L0016.html<br />
2 Learning Objectives for Medical Student Education<br />
from the American Association of Medical Colleges<br />
(AAMC), available as:<br />
http://www.aamc.org/meded/msop/report1.htm<br />
In the first hour we will discuss content and significance<br />
of these two papers (participants are requested to<br />
download these papers and read them prior to the<br />
workshop). In the second hour elements for a core<br />
curriculum will be selected in small group discussions.<br />
The outcomes will be discussed in plenary in the last<br />
hour.
Session 7A New learning technologies<br />
7A1 An international web-based<br />
Master’s degree in Primary Care<br />
Peter Toon* and Trish Greenhalgh<br />
University College London, 137 Roding Road, London E5 0DR,<br />
UK<br />
Worldwide, the academic basis of primary care needs<br />
strengthening. In the UK, Masters’ degrees, usually<br />
part-time over three years, have become important in<br />
this process. Since 1999 University College London<br />
(UCL) has offered a multidisciplinary MSc in Primary<br />
Care, largely through web-based distance learning.<br />
Students, mostly UK based, follow a structured<br />
programme of reading, with exercises to help them<br />
relate their study to previous learning and their<br />
professional life, and work together in virtual group<br />
discussions and seminars using computer conferencing.<br />
As a pilot for the proposed UK “e-university”, we are<br />
now developing a similar course for an international<br />
audience. The scope, methods and content of the<br />
existing course and our qualitative evaluations will be<br />
described, and the issues involved in devising a course<br />
for an international audience in a discipline which has<br />
strong culturally and organisationally specific elements<br />
will be considered.<br />
7A2 Can practical courses on<br />
interpreting blood smears be<br />
substituted by an interactive, webbased<br />
learning programme?<br />
U Woermann*, A Tobler and M Montandon<br />
Division for Instructional Media, Institute of Medical Education,<br />
University of Bern, Inselspital 38, CH-3010 Bern,<br />
SWITZERLAND<br />
In Bern, medical students learn to interpret blood<br />
smears in two practical courses. Because students felt<br />
very unsure in this skill, the web-based programme<br />
HemoSurf was developed. Some students suggested<br />
replacing the course by HemoSurf. How much of their<br />
sureness in interpreting blood smears would students<br />
attribute to HemoSurf? In a questionnaire students<br />
indicated that 61% used HemoSurf, 72% printed<br />
materials, and 11% did not prepare. Students using<br />
HemoSurf invested on average less than an hour, but<br />
attributed 49% of their sureness to HemoSurf and only<br />
30% to the practical courses (six hours). The students<br />
using printed materials spent on average more than an<br />
hour, but attributed only 19% of their sureness to these<br />
materials. We conclude that HemoSurf is an efficient<br />
tool to learn interpretation of blood smears. We will<br />
replace the practical courses by a small group format<br />
discussing the impact of haematological investigations<br />
on clinical medicine.<br />
7A3 The management of student<br />
feedback using the World Wide Web<br />
Stephanie Cobb* and Helen Graham<br />
King’s College, Room 4.14 Henriette Raphael House, Guy’s<br />
Campus, London SE1 9RT, UK<br />
Wednesday 5 September<br />
- 4.56 -<br />
This poster will outline the introduction of web-based<br />
student feedback for large group clinical teaching to<br />
undergraduate medical students. In a pilot study at the<br />
GKT School of Medicine, London, a system for<br />
implementing web-based feedback to replace<br />
traditional paper-based methods was set-up, and the<br />
potential for this method explored. The steps taken in<br />
this process will be illustrated and explained. These<br />
include:<br />
1 The recruitment of teachers and students to an<br />
electronic method of student feedback.<br />
2 The briefing of teachers and students in use of the<br />
system.<br />
3 The implementation of the pilot study.<br />
4 The evaluation of the method.<br />
7A4 Web-based student feedback on<br />
large group teaching: how does it<br />
compare with traditional paper<br />
methods?<br />
Helen Graham* and Stephanie Cobb<br />
Department of Medical and Dental Education, Guys, Kings &<br />
St Thomas’ School of Medicine, Kings College London, Sherman<br />
Education Centre, 4th floor, Thomas Guy House, London SE1<br />
9RT, UK<br />
Quality assurance is integral to good teaching. It<br />
requires a commitment from students to provide regular<br />
feedback, and from teachers to analyze and act on<br />
information received. The organisation and analysis of<br />
student feedback is time-consuming and difficult to<br />
co-ordinate for a complex clinical course. Web-based<br />
feedback using a dedicated school web-site offers the<br />
advantage of ease of collation of student assessment<br />
ratings and comments. In Year 4 of the undergraduate<br />
course at Guys, Kings and St Thomas’ School of<br />
Medicine, Kings College London, web-based student<br />
feedback of large group teaching was compared with<br />
traditional paper based methods using response rates<br />
and quality of assessments. The preference of teachers<br />
for both methods was assessed and their comments<br />
sought. The advantages and disadvantages of both<br />
methods will be presented.<br />
7A5 Reflection on experiences by using<br />
trigger movies<br />
Marianne G Nijnuis*, Caro Brumsen, Jan H Bolk and<br />
Peter G M de Jong<br />
Leiden University Medical Center, Onderwijscentrum IG, kamer<br />
C5-54, PO Box 9600, 2300 RC Leiden, NETHERLANDS<br />
During clerkships, students encounter a lot of new<br />
impressive, and sometimes frightening or sad<br />
experiences. At the Leiden University Medical Center,<br />
an obvious need for reflection on this subject becomes<br />
apparent during small group sessions in which case<br />
histories are discussed. Unfortunately no structural<br />
attention is paid to these experiences during the first<br />
few months of clinical education. From the small group
sessions, difficult situations encountered by students<br />
during practice were collected. Situations occurring the<br />
most frequently were translated into script and recorded<br />
on video using actors. Subsequently, these materials<br />
are used as a trigger for discussion in small group<br />
settings under supervision of an experienced physician.<br />
The use of the trigger movies improved the capability<br />
of students to cope with emotions and helped them to<br />
handle difficult situations better during practical work.<br />
7A6 Provision of IT learning facilities for<br />
healthcare education<br />
C Osonnaya*, K Osonnaya and E Burke<br />
Department of General Practice and Primary Care, Queen Mary<br />
College, University of London, Mile End Road, London E1 4NS,<br />
UK<br />
In recent years there has been an increase in the use of<br />
information technology in medical education. This is<br />
in response to a growing recognition of the need to<br />
promote computer literacy among healthcare<br />
professionals. Our main objective was to design and<br />
implement Computer Aided Learning (CAL)<br />
applications, which can be integrated into the healthcare<br />
education curriculum. Hence a logical approach to CAL<br />
was developed by building a team of professionals<br />
which forms a CAL Unit, using existing expertise and<br />
by implementing a process to ensure that the CAL had<br />
a maximum impact upon healthcare education. The<br />
CAL resources include: multimedia learning facilities,<br />
learning guides, computer aided assessment, model<br />
patients, anatomical models, statistical models, IT<br />
interactive learning facilities, teaching and learning<br />
facilities via the Internet, diagnostic and treatment<br />
models. We have now implemented over 27 IT based<br />
learning resources and course evaluations have showed<br />
that these have been well received by users.<br />
7A7 Development and evaluation of an<br />
interactive Computer Assisted<br />
Learning (CAL) programme on<br />
vaginal hysterectomy<br />
Vikram Jha*, Shelley Widdowson, Sean Duffy and<br />
Keith Allenby<br />
St James’s University Hospital, Academic Department of<br />
Obstetrics & Gynaecology, Level 9, Gledhow Wing, St James’s<br />
Hospital, Leeds LS9 7TF, UK<br />
In Gynaecology,understanding of anatomy and surgical<br />
principles involved in vaginal surgery such as vaginal<br />
hysterectomy is often confusing to students and junior<br />
trainees. The aim was to develop a CAL programme in<br />
CD-ROM form combining video, illustrations and<br />
three-dimensional images for better understanding of<br />
vaginal hysterectomy. We used Macromedia’s ‘Director’<br />
to develop the CD-ROM. This allows text, graphics,<br />
video and sound to be combined to create interactive<br />
material. The video was filmed and edited at the<br />
Hospital. The illustrations were resized and exported<br />
as quick time. The three-dimensional images were<br />
created using anatomical models and True Space<br />
programme. The CD-ROM has been piloted amongst<br />
fourth year students. It has received a positive response.<br />
It is intended to demonstrate the CD-ROM and present<br />
the evaluation results at the meeting.<br />
Wednesday 5 September<br />
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7A8 Links from ultrasound to anatomy -<br />
how is a multimedia teacher<br />
accepted?<br />
Dietmar Borchert*, Gunnar Schley, Edda Klotz,<br />
Peter Rauh, Clemens Reisinger and Thomas Medveczky<br />
Humboldt - University of <strong>Berlin</strong>, Medical Faculty, Department<br />
of Study Organisation, Schumanstrasse 20-21, 10117 <strong>Berlin</strong>,<br />
GERMANY<br />
Since Spring 1998 a group of students has tried to<br />
establish a multimedia teacher existing of ultrasound<br />
machines, computer, specialized monitors and<br />
additional mulitmedia tools. Students from the first<br />
course were educated in ultrasound in parallel with the<br />
normal anatomy curriculum. In small groups of 4<br />
students they learned to handle ultrasound machines<br />
and to integrate their knowledge of anatomy with<br />
practical experience. The multimedia teacher was<br />
equipped with ultrasound software, videos and weblinks.<br />
The computer can be driven via wireless, handheld<br />
mouse menus. Pictures of special interest with<br />
hyperlink-explanation can be loaded and structures on<br />
the ultrasound images can be compared and identified.<br />
Students are able to save and edit their own images.<br />
We tried to estimate how web-based and multimedia<br />
learning is accepted by students and if early handling<br />
of ultrasound machines improves knowledge in<br />
anatomy.<br />
7A9 Development of a computer-based<br />
simulation: the Dynamic Patient<br />
Simulator<br />
S Eggermont*, P M Bloemendaal, J M van Baalen,<br />
E M Schoonderwaldt<br />
Leiden University Medical Center, Heelkunde Onderwijs K6-R,<br />
Postbus 9600, 2300 RC Leiden, NETHERLANDS<br />
For obvious ethical and legal reasons it is not allowed<br />
for students to practise medicine on patients without<br />
supervision. At Leiden University Medical Center a<br />
computer-based simulation program, the Dynamic<br />
Patient Simulator (DPS), was developed to overcome<br />
this restriction. DPS provides medical students with<br />
the opportunity to practise medicine on a virtual patient,<br />
offering all the possible diagnostic and therapeutic<br />
actions as in real life. Students can practise making<br />
decisions autonomously, considering the state of the<br />
patient and accepting responsibility for the<br />
consequences. Students therefore acquire clinical<br />
experience in an early stage of their studies and are<br />
encouraged to fill gaps in their knowledge. DPS can<br />
be used in the absence of a teacher because a built-in<br />
assistance system attempts to help students on request,<br />
depending on the student’s preceding actions. The<br />
system provides feedback, gives a final score and can<br />
therefore be used as a self-test.<br />
7A10 Introduction of laptop computers in<br />
Leiden Medical School<br />
Peter G M de Jong*, Hermiette E Idenburg and<br />
Henk L Hendrix<br />
Leiden University Medical Center LUMC, Onderwijscentrum<br />
IG, Kamer C5-54, P O Box 9600, 2300 RC Leiden,<br />
NETHERLANDS
In 1998, the board of the Leiden University Medical<br />
Center decided to introduce information and<br />
communication technology (ICT) in the medical<br />
curriculum to prepare students for their professional<br />
life as a medical doctor. To attain this goal, special<br />
facilities for students have been created in 2000 to buy<br />
a laptop computer. For students, participation in the<br />
laptop-project is voluntary and only first-year students<br />
are allowed to join. Participants pay only one-third of<br />
Session 7B Problem-based learning<br />
7B1 Measuring success: partnership in<br />
evaluation (work in progress report)<br />
P O’Neill, D Graham, A Garden, S. Watmough*, J Brown<br />
University of Liverpool, Curricular Development Unit,<br />
Department of Primary Care, 2nd Floor Thornley Building,<br />
Brownlow Street, Liverpool L69 3GP, UK<br />
An innovative collaborative evaluation project is taking<br />
place between the Universities of Liverpool and<br />
Manchester and the Mersey Deanery. The goal is to<br />
assess whether the new problem-based learning<br />
curricula at Liverpool and Manchester are producing<br />
Pre-registration House Officers who are capable of<br />
meeting the competencies expected by the General<br />
Medical Council and the National Health Service.<br />
Preliminary work at Liverpool has involved<br />
questionnaire surveys of Educational Supervisors and<br />
Pre-registration House Officers. Mersey Deanery has<br />
delivered questionnaires to Pre-registration House<br />
Officers in the area. University of Manchester has<br />
compiled data on cohorts from the old curriculum<br />
whilst continuing to work with Pre-registration House<br />
Officers who have graduated from the new curriculum.<br />
Further questionnaires, focus groups and interviews<br />
will be held to gauge differences between old and new<br />
curricula cohorts and assess the educational aspects of<br />
the PRHO year.<br />
7B2 A new PBL course with an<br />
examination with standardised<br />
patients at the end<br />
S Schewe*, C Mueller and R Putz<br />
Medizinische Poliklinik, Klinikum der Universitat, Ludwig-<br />
Maximilians-Universitat, Pettenkoferstr 8a, D-80336 Munich,<br />
GERMANY<br />
A new problem-based learning (PBL) course dealing<br />
with disorders of the musculoskeletal system (MuSkel)<br />
was introduced at Ludwig-Maximilians University<br />
(LMU) Medical School lasting 4 weeks. All 234 4th year students were enrolled in the summer term 2000.<br />
For the first time at the LMU an examination with<br />
standardised patients has been carried out at the end of<br />
this course. MuSkel followed 3 other PBL-courses<br />
successively implemented at the LMU. With the new<br />
form of this examination other insights into correctable<br />
deficits of medical education could be found, e.g. the<br />
demand of teaching a more structured clinical<br />
examination, of teaching problem-solving strategies,<br />
Wednesday 5 September<br />
- 4.58 -<br />
the total costs, the Medical Center pays for all other<br />
costs. Insurance of the laptop is included, as well as<br />
access to a specially designed wireless network. Effects<br />
of introducing laptops have been evaluated by a<br />
questionnaire performed in January 2001 among all<br />
first-year students. This questionnaire shows that the<br />
use of Internet and Microsoft Office has increased<br />
enormously, but teachers do not take advantage of the<br />
possibilities presented.<br />
considering cost-effectiveness and time constraints of<br />
ambulatory medicine. The opinion of the students about<br />
this type of examination was very positive. Focussing<br />
on practical skills assessment gave further insights in<br />
deficits which could be partially corrected in the second<br />
MuSkel course in the winter term 2000/2001.<br />
7B3 Training the problem-based<br />
learning tutor: implementation<br />
issues<br />
C Osonnaya*, K Osonnaya and E Burke<br />
Department of General Practice and Primary Care, Queen Mary<br />
College, University of London, Mile End Road, London E1 4NS,<br />
UK<br />
Problem-based learning (PBL) is widely regarded as a<br />
useful strategy to improve students’ learning in Medical<br />
School and to prepare graduates for the informational<br />
challenges of the years to come. This has led to many<br />
medical schools adopting this educational approach,<br />
which increases the need to train tutors to facilitate PBL<br />
groups. Therefore, we developed a PBL training<br />
programme for medical teachers. The training<br />
programme, which lasts for four weeks, is devoted to<br />
acquainting teachers with the key elements of PBL.<br />
The principles, the seven steps, the tutorial sessions,<br />
group interaction, information management, critical<br />
analysis skills, assessment and evaluation of PBL group<br />
sessions were also dealt with during this period. The<br />
role of the group tutor to facilitate and not to lecture<br />
was emphasised, as well as the goals of PBL. The tutors<br />
practised acting as PBL tutor, scribe and group member.<br />
Evaluation of the course showed that it has wide appeal<br />
and has been well received by the teachers. The<br />
strongest influence for any modifications made have<br />
come from the teachers who have participated in the<br />
course and they had recommended for the programme<br />
to continue. We therefore recommend it as a realistic<br />
way of training teachers as PBL facilitators.<br />
7B4 PBL in Psychiatry - the Holocaust:<br />
a unique experience<br />
T Fischel*, T Weizman and G Zalsman<br />
Geha Psychiatric Center, 13 Tsel Hagiva, Ramat Gan 52374,<br />
ISRAEL<br />
Planning a rotation in psychiatry meets a major<br />
problem: whether and how to incorporate an inner touch
in the student’s soul. Group dynamic and projective<br />
“games” are some of the possible methods. Teaching<br />
and learning about the holocaust and its emotional<br />
implications, is another challenging problem. We aim<br />
not to be reductive by teaching psychiatric diagnoses.<br />
In order to meet those two difficulties we constructed<br />
a PBL session. The goal was to produce a learning<br />
experience, which involved a controlled emotional<br />
touch. The case was about a “child survivor”, who<br />
organized his life and personality as a stiff and<br />
demanding character, and appeared in the emergency<br />
room with somatic complains. Besides theoretical<br />
subjects such as PTSD, somatization disorders and<br />
obsessive-compulsive personality, the students learned<br />
about “child survivor” “survivors` guilt” “second<br />
generation”. The presentation includes the case, the<br />
emotional response and the students’ feedback to this<br />
unique experience.<br />
7B5 Clinical skills of medical students<br />
participating in lecture-based<br />
versus problem-oriented training<br />
W Rimpau<br />
Park-Klinik Weissensee, Abteilung fur Neurologie, Schonstrasse<br />
80, 13086 <strong>Berlin</strong>, GERMANY<br />
Medical education in Germany is theory-oriented. New<br />
methods to improve and evaluate skills are needed.The<br />
study was designed to determine whether students with<br />
lecture-based versus problem oriented training in<br />
neurology have different clinical skills. A prospective<br />
cohort study was carried out. The outcomes of a<br />
modified version of the objective structured long<br />
examination record (OSLER) were compared between<br />
two groups of students. Group I (n=20): Students of<br />
the Humboldt University <strong>Berlin</strong>, with a 4-month<br />
reform-elective in their final (sixth) year of medical<br />
training. Their previous training has been lecture-based.<br />
Group II (n=25): Students with a 6 week neurology<br />
training in their fourth year at the University Witten-<br />
Herdecke, who have a problem oriented curriculum<br />
throughout their entire training. Students of the lecturebased<br />
group showed satisfying but significantly worse<br />
outcomes.<br />
7B6 Systematic observations of<br />
problem-based study groups - what<br />
do they reveal?<br />
K Lonka*, P Sauri and N Paganus<br />
University of Helsinki, Leiviskatie 2 E 64, Fin-00440 Helsinki,<br />
FINLAND<br />
The curriculum of the Faculty of Medicine at the<br />
University of Helsinki was changed towards PBL in<br />
1998. The aims of the present study are: 1) To see how<br />
the new approach to teaching and learning works, and<br />
whether something should be done to improve it, and<br />
2) to see whether group functioning is related to<br />
students’ study success. A systematic observation of<br />
tutorial groups was carried out during Spring term<br />
2001. A closing session of all 14 first-year tutorial<br />
groups (10-12 students in each) was observed once.<br />
All students and their tutors were given questionnaires<br />
which were filled in after a tutorial session. A specific<br />
Wednesday 5 September<br />
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observation sheet was also developed and an external<br />
observer was hired. The observer also gave feedback<br />
to the group. Data are presented that consist of the<br />
questionnaire data, a summary of observation forms,<br />
and study success of each group.<br />
7B7 “Pathomechanisms” - a 9-week<br />
integrative and problem-based<br />
learning oriented course within the<br />
3rd year of the curriculum at the<br />
Medical Faculty Carl Gustav Carus,<br />
Technical University Dresden<br />
Oliver Tiebel*, Ines Nitsche and Andreas Deussen for the<br />
Core Planning Group<br />
Institute of Clinical Chemistry & Laboratory Medicine, Medical<br />
Faculty Carl Gustav Carus, TU Dresden, Fetscherstr 74, 01307<br />
Dresden, GERMANY<br />
To prepare physicians for the changing demands of<br />
future developments in medicine the Dresden Medical<br />
Faculty is restructuring its curriculum implementing<br />
problem-based learning elements. The changes start<br />
from the 3rd year of the curriculum. This year -<br />
equivalent to the first clinical year - consists of 4 PBLcourses:<br />
“Pathomechanisms” (9 weeks), “Basics of<br />
Pharmacotherapy” (6 weeks), “Infectiology” (11<br />
weeks) and “Emergency Medicine” (3 weeks). In this<br />
presentation we will focus on the structure and<br />
organization of the “Pathomechanisms” course which<br />
has been organized as an interdisciplinary enterprise<br />
including pathology, laboratory medicine,<br />
pathophysiology and pathobiochemistry. Cases<br />
discussed in small groups of students and tutored by<br />
experienced mentors are supplemented by lectures<br />
specifically related to the case topic and course<br />
objectives. Additionally students have two practical<br />
classes each week focussing on pathology and clinical<br />
pathology. A clinical examination class which extends<br />
over the entire study year supplements the course.<br />
7B8 Characteristics of tutors’<br />
assessment by students when PBL<br />
is being implemented<br />
Yolanda Marin-Campos* and Marcela Lopez-Cabrera<br />
National Autonomous University of Mexico, Porto Alegre 259,<br />
“A-402”. Col. San Andres Tetepilco, Delegacion Iztapalapa, DF<br />
09440, MEXICO<br />
The students’ perception regarding the performance of<br />
the tutor has particular characteristics when PBL is<br />
being implemented, since they are going through a<br />
transitional process from a traditional to a studentcentered<br />
approach. Thus, the tutor’s performance must<br />
be adequately monitored, given that the students are<br />
adapting to the teacher´s new role. In order to assess<br />
the tutor’s performance, we selected the functions that<br />
are most significant of the change in their new role,<br />
and that are directly related to the tasks of the students,<br />
that is, those functions the students might have an<br />
opinion about whether they are being adequately<br />
accomplished, and if the tutor’s performance is<br />
facilitating their learning. The elements of the tutor’s<br />
performance that were selected to be evaluated are:<br />
support in knowledge elaboration; directing the
learning process; promoting knowledge integration;<br />
stimulating group member interaction; respect for the<br />
students; warmth and accountability.<br />
7B9 From traditional teachers to PBL<br />
tutors: how to start the change?<br />
Yolanda Marin-Campos* and Lizbeth Mendoza-Morales<br />
National Autonomous University of Mexico, Porto Alegre 259,<br />
“A-402”. Col. San Andres Tetepilco, Delegacion Iztapalapa, DF<br />
09440, MEXICO<br />
One of the most difficult elements to change for<br />
achieving successful implementation of PBL, in<br />
traditional curriculum schools, is the acceptance of the<br />
teachers’ new role as tutors. In this project a program<br />
is presented, whose main challenge has been to<br />
demonstrate the advantages of PBL over the traditional<br />
teaching system. To do so, a 60-hour workshop was<br />
designed in which sceptical teachers are presented with<br />
the theoretical and methodological basis of PBL, so<br />
that they themselves can find the answers to their many<br />
questions.This workshop has been developed<br />
throughout 6 years, working with teachers from the<br />
basic and clinical sciences. Included are the educational<br />
theories that are the basis of PBL components, the<br />
“How to” apply it to the students’ learning process,<br />
evaluation methods and some of the methodological<br />
approaches important for educational research<br />
development.<br />
7B10 Development of a problem-based<br />
curriculum leads to enhancement<br />
in faculty development - the<br />
Dresden experience<br />
N Lorenz*, T Aretz, E Armstrong and the Harvard-<br />
Dresden Medical Education Alliance<br />
Technical University, Dresden Carl Gustav Carus, Children’s<br />
Hospital, TU Dresden, Fetscher Str. 74, 01307 Dresden,<br />
GERMANY<br />
Session 7C Curriculum planning and change<br />
7C1 A model of curriculum management<br />
in an integrated medical curriculum<br />
Gregory J S Tan* and B E Mustaffa<br />
International Medical University, Sesama Centre, Plaza<br />
Komanwel, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA<br />
Curriculum management is an integral component of<br />
any curriculum. The success of curriculum<br />
development and implementation to a certain extent<br />
depends on how well the curriculum is being managed.<br />
Creation of tiers of responsibilities to provide the<br />
management structure and a well-defined line of<br />
communication and standing operating procedures<br />
allow “checks and balances” to be instituted to the<br />
Wednesday 5 September<br />
- 4.60 -<br />
Medical education in Germany needs innovative<br />
approaches to face the challenges of medicine in the<br />
21st century. Therefore, an educational alliance<br />
between Harvard Medical International and the<br />
Technical University of Dresden (TUD) is restructuring<br />
TUD’s undergraduate medical curriculum by using an<br />
interdisciplinary approach since 1999. Problem-based<br />
learning is incorporated in integrated classes consisting<br />
of lectures, tutorials and practical training. To foster<br />
the new curriculum, to establish a high quality of<br />
education, and to train faculty members in PBLmethods<br />
a faculty training program was developed<br />
simultaneously. A tutor-training group educated 120<br />
faculty members in an 18-month period. When the<br />
development of the curriculum after the 2nd state<br />
examination led to a demand for new and more complex<br />
teaching and assessment methods a transition of the<br />
“tutor-training group” to a working group for faculty<br />
development was made. The process and methods will<br />
be described in detail.<br />
7B11 An orientation programme for 1st<br />
year students in a problemorientated<br />
MBChB curriculum - the<br />
Pretoria experience<br />
Pierre L Bredenkamp<br />
Faculty of Health Sciences, Stellenbosch University, P O Box<br />
19063, Tygerberg 7505, SOUTH AFRICA<br />
Because the Pretoria medical school changed its model<br />
of teaching and training from a traditional to a problemorientated<br />
integrated one, an orientation programme<br />
(which lasts two weeks) was introduced before the first<br />
block. Five aims were set for the programme, focusing<br />
on information, support, motivation, opportunity and<br />
exposure. Detail regarding these objectives, as well as<br />
the outline of the programme as a whole, will be given.<br />
Every student received a block book, and the 35<br />
learning sessions, as well as the 10 visits, were<br />
evaluated. The method of this evaluation and the results<br />
will be made available. The recommendations which<br />
had been made, will also be shown.<br />
management of the curriculum. This paper describes<br />
how the International Medical University (IMU) utilises<br />
the above principles to manage its medical curriculum<br />
in a 3-tier management structure. The structure is<br />
dynamic and it allows an exposition of the curriculum<br />
philosophy and monitoring of the curriculum (an<br />
internal audit) through its structural linkage. Its<br />
dynamism is further reflected in the coherent<br />
participation and ownership of the curriculum by all<br />
Faculty members as one would expect in the<br />
management of a modern medical curriculum.
7C2 The University of Rochester’s<br />
Double Helix Curriculum<br />
Elaine F Dannefer<br />
University of Rochester Medical Center, 601 Elmwood Avenue,<br />
Box 601, Rochester NY 14642, USA<br />
Beginning in 1999, a fourth-year, interdisciplinary<br />
curriculum has been phased in at the University of<br />
Rochester. Called the Double Helix Curriculum, this<br />
curriculum integrates basic science and clinical<br />
medicine throughout the four years of undergraduate<br />
education with the clinical strand comprising<br />
approximately 30 of curricular time in years one and<br />
two and 70% in years three and four, with the basic<br />
science strand representing the converse. An 18-month<br />
ambulatory clerkship in years 1 and 2 is followed by<br />
inpatient clerkships and electives. Students begin their<br />
education with a course that provides the foundation<br />
for the practice of evidence based medicine and<br />
includes biostatistics, epidemiology and skills related<br />
to searching and evaluating the scientific literature.<br />
Two-week long comprehensive assessments at the end<br />
of years 2 and 3 provide feedback for students as well<br />
as a means of assessing the curriculum.<br />
7C3 Academic administration and<br />
mixed programmes<br />
S Sharma Khanal* and S Koirala<br />
B P Koirala Institute, Dharan, NEPAL<br />
The B.P. Koirala Institute is a Health Sciences<br />
University in Nepal with undergraduate courses in<br />
medicine, nursing, dentistry and allied health sciences<br />
plus postgraduate courses to PhD level. This poses an<br />
overwhelming challenge for maintaining harmonious<br />
and positive administrative approaches. It becomes<br />
further intensified as trained manpower is scarce in<br />
Nepal and the potential danger of manpower leaving<br />
the Institute has led to new approaches to retain<br />
teachers. These will be presented in the poster.<br />
7C4 Learning responsibly -<br />
implementing written guidelines for<br />
medical students<br />
Richard Phillips*, Ann Wylie and Anne Stephenson<br />
Department of General Practice and Primary Care, Guy’s King’s<br />
and St Thomas’ Medical School, King’s College London, Weston<br />
Education Centre, Cutcombe Road, London SE5 9RJ, UK<br />
Contemporary medical undergraduate curricula include<br />
early patient contact in community settings. Whilst<br />
there may be concurrent teaching in ethics, the focus<br />
of this may be on the behaviour of a qualified doctor;<br />
what of the students’ responsibilities to patients and<br />
each other? As a department, we have 1,800 students<br />
placed in hundreds of community settings during the<br />
year, and we are concerned about student awareness of<br />
their current ethical responsibilities. We prepared<br />
written guidelines for students about responsible<br />
learning. Questionnaire follow-up in 1999-2000<br />
showed only 121 of 263 students definitely had read<br />
the booklet (of these 121, the majority found it helpful),<br />
and 20% said they had lost it altogether. For 2000-2001<br />
modifications were made in delivery and highlighting<br />
Wednesday 5 September<br />
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the material, and the questionnaire repeated. This<br />
presentation reports on more detailed results of both<br />
questionnaires and will discuss the modifications and<br />
the implications.<br />
7C5 HEICUMED - a novel approach to<br />
student medical education at the<br />
Medical Faculty of the University of<br />
Heidelberg, Germany<br />
Hubert J Bardenheuer* on behalf of the HEICUMED<br />
Group<br />
Medical Faculty, University of Heidelberg, Im Neuenheimer Feld<br />
346, 69120 Heidelberg, GERMANY<br />
Heidelberg Medical Faculty developed “HEICUMED“,<br />
in which the clinical years are completely reorganized<br />
into organ-related block courses (“modules”). Modules<br />
are taught multiple times during the year in small<br />
student groups. A multidisciplinary planning group<br />
redesigned the original plan and combined the modules<br />
into interdisciplinary “clusters”, such as surgery and<br />
medicine. Strong connections between the various<br />
disciplines are guaranteed by lectures and cases related<br />
to leading symptoms. Subjects like pathology,<br />
radiology, clinical laboratory, etc are all integrated into<br />
the topics of the week and taught alongside. This novel<br />
approach of student education is directed to<br />
significantly improve:<br />
• students’ clinical and practical instructions and<br />
keeping training of medical facts at a high level;<br />
• the personal interactions with faculty members;<br />
• case-related problems in which all pieces of<br />
knowledge in clinical medicine have to be<br />
connected; and<br />
• teamwork by encouraging studying in groups and<br />
establishing PBL group learning.<br />
7C6 Enhancing curriculum renewal<br />
through a “clinical presentation”<br />
approach to undergraduate medical<br />
education<br />
Nehad El-Sawi<br />
University of Health Sciences, 1750 Independence Avenue,<br />
Kansas City, MO 64106, USA<br />
UHSCOM has revised its ‘discipline based’ curriculum<br />
and adopted the ‘integrative clinical presentation<br />
curriculum’ modelled, in part, after the Calgary<br />
curriculum. The discipline-based curriculum<br />
emphasized traditional basic sciences but lacked<br />
integration throughout disciplines, and across the four<br />
years. The integrative Clinical Presentation curriculum<br />
combined a strong knowledge base of basic and clinical<br />
sciences where clinical instruction guides basic science<br />
learning. Each clinical presentation began with a<br />
decision tree review, demonstration of its use, and a<br />
series of lectures covering the related basic and clinical<br />
sciences, ending with opportunities to practice<br />
diagnostic reasoning. The integration of subject matter<br />
created a coherent foundation for students` subsequent<br />
efforts at organizing the relationships between various<br />
basic and clinical science concepts.
7C7 Continuous training in General<br />
Practice as an integral part of an<br />
undergraduate medical curriculum<br />
- the Witten/Herdecke Model<br />
(Germany)<br />
W Kunstmann*, Dieter Wollgarten, René Vollenbroich<br />
and Markus Gschwind<br />
University of Witten/Herdecke, 58448 Witten, GERMANY<br />
Changes in the demographic composition of our<br />
population as well as changes in health care delivery<br />
will strengthen the role of general practitioners in the<br />
future. However, undergraduate medical education has<br />
not yet appropriately responded to the outlined secular<br />
trends, and training for students in respective settings<br />
is broadly missing. At the University of Witten/<br />
Herdecke (Germany) a course for continuous training<br />
in general practice has been established as a mandatory<br />
part of its undergraduate medical curriculum.<br />
Beginning in year 1 and ending in year 5, students will<br />
perform 6 training units in general practice, each of 14<br />
days’ length. Each unit is structured by a training<br />
manual, containing specific tasks to be performed by<br />
students under supervision of their doctors. Tasks cover<br />
areas such as communication, history taking, physical<br />
examination, long-term patient care, prevention as well<br />
as economic and management aspects of health care<br />
delivery. The course design and its learning objectives<br />
will be presented.<br />
7C8 Developing sense of ownership for<br />
curriculum changes within all<br />
teaching faculty of an Asian<br />
medical school<br />
C B Hazlett*, T F Fok, S S C Chung and J C Y Cheng<br />
Office of Educational Services, Faculty of Medicine, Chinese<br />
University of Hong Kong, Prince of Wales Hospital, Shatin, New<br />
Territories, HONG KONG<br />
Major curriculum changes are difficult, and prove to<br />
be eventually ineffective if there is no wide<br />
endorsement among the teaching staff. At the Chinese<br />
University of Hong Kong a curriculum change designed<br />
to enhanced skills (clinical, communication, and life<br />
long learning), as well as for enhancing integration of<br />
basic, social and clinical skills throughout the entire<br />
five years of its medical undergraduate programme<br />
were proposed by the Faculty’s leaders. Initially, many<br />
teaching staff regarded such a change to be of dubious<br />
need and of low priority, particularly in comparison to<br />
other work obligations in clinical service and/or in their<br />
basic or clinical research. The steps taken and methods<br />
used to effect changes in attitude towards, to build<br />
support for and to develop a sense of ownership of the<br />
changes within the entire teaching staff are given in<br />
this presentation. The process of introducing the<br />
curriculum change is still ongoing, but the approaches<br />
used to date have successfully co-opted a reasonably<br />
high level of willingness and cooperation in at least<br />
designing and beginning the implementation of change.<br />
Mechanisms for securing this cooperation within an<br />
Asian medical school context are compared and<br />
contrasted with methods frequently proposed and used<br />
in medical schools operating in Western societies.<br />
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7C9 Sci45: Framework for the<br />
implementation of a career<br />
guidance instrument<br />
Janet Grant*, Rodney Gale, Mairead Beirne and<br />
Heather Owen<br />
Open University Centre for Education in Medicine, The Open<br />
University, Walton Hall, MILTON KEYNES MK7 6AA, UK<br />
The rigorous psychometric development of the<br />
Specialty Choice Inventory [Sci45] was reported at the<br />
1999 <strong>AMEE</strong> meeting. This 130-item instrument<br />
matches respondents to 45 specialties. The successful<br />
implementation of Sci45 depends on its flexibility to<br />
respond to many different needs. To date, six potential<br />
uses for Sci45 are being developed:<br />
• Availability on CD-ROM for individual use;<br />
• Use for final year medical students to assist them<br />
in their career choice: about 20% of career choices<br />
are made at this stage;<br />
• For hospital clinical tutors to offer to all doctors in<br />
training;<br />
• Development of Sci45 to include subspecialty<br />
profiles so that selection panels can ensure a wide<br />
range of trainees for a range of subspecialty posts;<br />
• For research into variables that might impinge on<br />
successful progress through the training grades;<br />
• To provide independent feedback to selection panels<br />
to help them reflect on their decisions.<br />
7C10 The facilitation process in a<br />
problem-based curriculum at the<br />
Nelson R. Mandela School of<br />
Medicine<br />
Jacqueline van Wyk, Peter Olmesdahl, Veena Singaram*<br />
and Michelle McLean<br />
University of Natal, Faculty of Medicine, Medical Education<br />
Development, Private Bag 7, PBX Congella, 4013, SOUTH<br />
AFRICA<br />
The Nelson R. Mandela School of Medicine’s studentcentred,<br />
5-year, problem-based curriculum greatly<br />
emphasizes the role of students as self-directed learners.<br />
Large group resource sessions are scheduled with the<br />
objective of introducing students to concepts and<br />
principles. Students are expected to use a variety of<br />
resources to solve their cases/problems, hopefully<br />
engendering deep learning strategies. Groups of<br />
students from diverse cultural and social backgrounds<br />
meet twice weekly (2 x 2h sessions) for small group<br />
sessions. Problem identification and resolution are two<br />
phases monitored by facilitators in order to guide and<br />
check whether learning outcomes (as identified by<br />
module designers) are achieved by students. This report<br />
describes various aspects of facilitation within the<br />
Faculty, including selection of facilitators, training, their<br />
role, perceptions of facilitators prior to and after a<br />
module and their experiences during the module.<br />
Student perceptions of the role of facilitators are also<br />
discussed.
Session 7D Curriculum evaluation/staff development<br />
7D1 Students’ feedback: a public health<br />
course in medical education<br />
Eva Rasky*, Wolfgang Freidl; Willibald-Julius Stronegger<br />
Institute of Social Medicine and Epidemiology, Karl-Franzens-<br />
University Graz, Universitaetsstrasse 6/I, A-8010 Graz,<br />
AUSTRIA<br />
Since 1999 Austrian universities have been required<br />
by law to evaluate the teaching competence of their<br />
faculty. The Institute of Social Medicine and<br />
Epidemiology, Karl-Franzens-University Graz, started<br />
evaluating its courses in 1998. Public health is a<br />
required one-week course within the medical school<br />
curriculum. We used a standardized questionnaire<br />
developed by an expert committee of this university<br />
including five sections with ratings on 5-point scales.<br />
The students answered the questionnaire at the end of<br />
the module, therefore the response rate was nearly<br />
100%. The performance of three teachers in the time<br />
period from 1998 to 2000 was analysed by descriptive<br />
analysis of 240 questionnaires. Around 60% of the<br />
students were female and 40% were male. The results<br />
and the relevance of evaluating public health courses<br />
will be discussed.<br />
7D2 Action Research Methodology: a<br />
possible framework for course<br />
evaluations<br />
Alison Rushton* and Gill James<br />
Coventry University, School of Health & Social Sciences, Priory<br />
Street, Coventry CV1 5FB, UK<br />
The process of curriculum design incorporates<br />
evaluation of existing courses. This paper describes a<br />
possible methodology for such evaluations. A<br />
conceptual framework, based upon action research<br />
methodology, was developed; combining diagnosis<br />
with reflection. This framework was used in the<br />
evaluation of a physiotherapy undergraduate course in<br />
the UK. The course was structured around a thematic<br />
approach, whereby the core areas of physiotherapy<br />
practice informed the course design. The diagnostic<br />
phase identified all aspects impinging upon the success<br />
of the programme. All stakeholders (including students,<br />
tutors and funding bodies) were targeted for the data<br />
collection phase. Reflection is seen as an important<br />
component of the action research cycle, facilitating<br />
prescription of data collection methods (which included<br />
focus groups, questionnaires, module evaluations and<br />
analysis of existing documentation). These data were<br />
analysed and triangulated and the results provided a<br />
reasoned justification for maintaining and<br />
strengthening the thematic approach of this course.<br />
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7D3 The opinion of graduates of the<br />
Faculty of Medicine of the<br />
University of Barcelona on the new<br />
medical curriculum<br />
J Palés*, A Gual, A Vallés, Ma T Estrach, F Climent,<br />
X Gasull, R Gilabert, A Llobet, Y Compta, L Peri and<br />
J A Bombi<br />
Universitat de Barcelona, Facultat de Medicina, Departmento<br />
de Ciencias Fisiologicas I., Casanova 143, 08036 Barcelona,<br />
SPAIN<br />
Our Faculty introduced in 1994 a new curriculum that<br />
has represented a significant change from the old one.<br />
To evaluate the results of this curriculum in order to<br />
facilitate appropriate future development, a<br />
questionnaire was administered to the graduates, asking<br />
about their opinion on the following aspects:<br />
accomplishment of the curriculum objectives, the<br />
quality of medical education offered by the Faculty,<br />
the influence of the national board examination on the<br />
development of the curriculum, the effort that the new<br />
curriculum requires of the students and the strong and<br />
weak points of the program. 120 students (80% of total<br />
students) answered the questionnaire. In general, the<br />
acceptance of the new curriculum by the students was<br />
high although some deficiencies have been detected.<br />
The information furnished by the graduates will be<br />
useful in introducing the necessary modifications to<br />
improve our educational program in the coming years.<br />
7D4 Comenius University Quality<br />
Assurance System (CUQAS) and<br />
students’ participation in graduate<br />
medical education evaluation<br />
L Plank*, J Danko, E Rozborilova, P Galajda and K Dokus<br />
Jessenius Faculty of Medicine, Dean’s Office, Comenius<br />
University, Zaborskeho 2, SVK 036 45 MARTIN, SLOVAK<br />
REPUBLIC<br />
We believe that students should take an active part in<br />
the process of education evaluation applied at the<br />
Jessenius Medical Faculty. Students in the 11th and 12th<br />
semester were asked to answer an anonymous<br />
questionnaire on education quality in four basic clinical<br />
subjects (four-grade-quality-system). Questions related<br />
to the structure and content of lectures, teachers´<br />
approach towards students, contacts with patients and<br />
others. In contrast to prevailing positive evaluations<br />
within the scale of “fully”, “partially satisfied” and<br />
“more satisfied than unsatisfied”, less than 1/5 of<br />
students were “not satisfied” with at least one of the<br />
evaluated education components. The education quality<br />
evaluation system helps the faculty management to<br />
improve educational standards and to identify its weak<br />
and strong components. In the future, this is planned<br />
to be applied annually for the whole graduate education<br />
within the uniform CUQAS system and database.
7D5 Research in medical education:<br />
constructing an ethical framework<br />
E B Peile* and A Slowther<br />
Department of Primary Healthcare, University of Oxford,<br />
Chiltern Waters, 1 Stablebridge Road, Aston Clinton, Bucks<br />
HP22 5ND, UK<br />
Proposals for research in medical education are<br />
frequently submitted to UK medical research ethics<br />
committees, which are more accustomed to considering<br />
the implications of research on patients than research<br />
on learners. After reviewing relevant codes for<br />
educational research, we propose an adaptation to a<br />
framework of medical research ethics for use in medical<br />
education research. Key issues in our suggested<br />
framework include:<br />
• Scientific validity of the research on medical<br />
education<br />
• Safety aspects, including<br />
- risk to the students’ psychological well-being<br />
- risk to patients from exposure to learners<br />
• Consent procedure:<br />
- are students fully informed about the study and<br />
the implications for their education?<br />
- is consent voluntary and without coercion?<br />
• Confidentiality issues, including whether examiners<br />
or assessors will have access to research<br />
information.<br />
We discuss some ethics considerations, which may help<br />
to inform the critical appraisal of research projects in<br />
medical education and thereby encourage good<br />
practice.<br />
7D6 Students’ perceptions of the<br />
Physiology course in a traditional<br />
medical school<br />
F Riggione*, J Perez-Ojeda and J F Perez-Gonzalez<br />
Centro de Investigacion y Desarrollo de la Educacion Medica,<br />
Escuela de Medicina “Luis Razetti”, Facultad de Medicina,<br />
Universidad Central de Venezuela, Caracas, Apartado de<br />
Correos No 90.350, El Hatillo 1083A, VENEZUELA<br />
Students’ perceptions of learning experiences<br />
contribute to a better understanding of the need for<br />
curricular reform. We explored the opinion of 2nd year<br />
medical students after their 36 week Physiology course<br />
of lectures and laboratory sessions. 166 students<br />
received a 25 item survey and 146 responses (88%)<br />
were evaluated. 76% of the respondents attended 50%<br />
or less of the lectures. 64% considered the course to be<br />
detailed and 57% to be complex. 34% considered it<br />
relevant and 34% difficult. Teachers were considered<br />
competent by 56%, accessible by 51% and rigid by<br />
48%. On a 5 point Likert scale (0 = not at all, 5 = very<br />
much) their experience of the course was defined as<br />
significant (mean score = 3.65), pleasurable (2.51) and<br />
stressing (2.28), while it lacked “feeling of discovery”<br />
(0.55) and motivation (0.37). 41% of respondents<br />
indicated to have learnt 50% or less of the course<br />
contents, and only 9% indicated learning >70%.<br />
Wednesday 5 September<br />
- 4.64 -<br />
7D7 Students’ perceptions of a<br />
traditional undergraduate course in<br />
Microbiology<br />
Z Uzcategui*, J Perez-Ojeda and J F Perez-Gonzalez<br />
Centro de Investigacion y Desarrollo de la Educacion Medica,<br />
Escuela de Medicina “Luis Razetti”, Facultad de Medicina,<br />
Universidad Central de Venezuela, Caracas, Apartado de<br />
Correos No 90.350, El Hatillo 1083A, VENEZUELA<br />
Microbiology can be an abstruse subject for medical<br />
students. We explored the opinion of our students after<br />
their 36 week traditional Microbiology course of<br />
lectures and laboratory sessions in the 2nd year. 187<br />
students completed a 25 item survey of their<br />
experiences in the course. 71% of respondents attended<br />
50% or less of the lectures and 100% attended >85%<br />
of the compulsory laboratory sessions. 68% thought<br />
the course was relevant, 41% found it detailed and 24%<br />
excessive. Teachers were considered competent (79%),<br />
accessible (69%), interested (66%) and stimulating<br />
(41%). The students defined their learning experience<br />
by grading items on a 5 point Likert scale (0 = not at<br />
all, 5 = very much), as significant (mean score = 4.15),<br />
creating a “feeling of discovery” (4.08), leading to new<br />
questions (3.88), pleasurable (3.7) and stimulating<br />
(3.63). 88% of respondents indicated to have learnt<br />
>50% of the course’s contents.<br />
7D8 Faculty development in General<br />
Practice - the German experience<br />
M Ehrhardt, P Engeser, M Herrmann, T Lichte, N Donner-<br />
Banzhoff and S Wilm*, on behalf of the participants<br />
Heinrich-Heine University, Department of General Practice, PO<br />
Box 10 10 07, D-40001 Duesseldorf, GERMANY<br />
Since 1978 General Practice has been a required subject<br />
of the undergraduate curriculum in Germany. However,<br />
only about one third of all 33 medical schools have<br />
established academic departments. At the remaining<br />
schools, GP teachers are often working in isolation and<br />
without adequate support. In 1999 the National Society<br />
of General Practice started a programme to help GP<br />
teachers develop their academic skills. Six weekends<br />
spanning 1 1/2 years are being offered covering<br />
teaching, clinical work, quality issues, research and<br />
academic survival skills. Participants are expected to<br />
work together in small groups on projects during<br />
intervals and to complete an international practicum<br />
of at least one week duration. There is also an intranet<br />
platform to facilitate the exchange of ideas and<br />
materials.<br />
While in the beginning the learner-centered philosophy<br />
created tension and uncertainty, the group has now<br />
found a working identity that participants find<br />
enjoyable and productive.<br />
7D9 Medicine and ethnic issues; do our<br />
tutors reflect their community?<br />
D Reeves, R Loudon and J Parle*<br />
Department of Primary Care & General Practice, Medical<br />
School, University of Birmingham, Birmingham, B15 3QR, UK<br />
We conducted an audit of primary care teaching<br />
practices in order to determine the characteristics of
doctors providing different elements of the extensive<br />
Birmingham community based curriculum. 185<br />
questionnaires (concerning gender, ethnicity, languages<br />
spoken) were distributed. 540 doctors from 163<br />
practices responded (practice response rate 88%).<br />
Ethnic and gender differences were clear across<br />
different practice types. The 2001 Amendment to the<br />
1976 UK Race Relations Act will mean for the first<br />
time that providers of services to the public will have<br />
Session 7E Postgraduate education<br />
7E1 Exploring the views of Basic<br />
Surgical Trainees on their training<br />
programme and their future in<br />
Surgery<br />
Jeremy Brown*, Linda de Cossart and Charmian Wiltshire<br />
Mersey Deanery, 1st Floor, Hamilton House, 24 Pall Mall,<br />
Liverpool L3 6AL, UK<br />
The aim of the study was to explore views of Basic<br />
Surgical Trainees (Senior House Officers) on a training<br />
scheme for Basic Surgical Training that complies with<br />
college requirements. A quantitative study postal<br />
questionnaire devised in liaison with UK Medical<br />
Careers Research Group was distributed to 115 Mersey<br />
Basic Surgical Trainees. Qualitative data were collected<br />
from free-text responses. Questions focused on career<br />
choices, views on the scheme, and assessment. 93<br />
(81%) questionnaires were returned. 51 (54%) were<br />
graduates from local university, 49 (52.7%) came<br />
directly onto the Mersey BST scheme from PRHO<br />
posts, 4 (4.3 %) had more than 1 year’s UK SHO<br />
experience. 26 (27.9%) changed their surgical specialty<br />
intention since medical school; factors influencing<br />
change were: - PRHO/SHO experience; teachers;<br />
departments. A young, parochial and inexperienced<br />
cohort of trainees who have strong convictions were<br />
identified. Many issues raised have one common<br />
denominator: the strong influence of teachers on<br />
trainees.<br />
7E2 An assessment of the skills base<br />
and attainments of Senior House<br />
Officers on a regional Basic<br />
Surgical Training <strong>Programme</strong><br />
Linda de Cossart, Charmian Wiltshire and Jeremy Brown*<br />
Mersey Deanery, 1st Floor, Hamilton House, 24 Pall Mall,<br />
Liverpool L3 6AL, UK<br />
The aim of the study was to assess the skills base and<br />
achievements of trainees on a Basic Surgical Training<br />
<strong>Programme</strong>. All trainees on the 3-year Basic Surgical<br />
Training <strong>Programme</strong> insituted in 1996/7 were given a<br />
questionnaire designed to find out their aspirations and<br />
opinions about the programme and design. The findings<br />
related to the trainees’ logbook for the general surgical<br />
operations of abscess drainage, appendisectomy,<br />
inguinal hernia repair, upper and lower GI endoscopy,<br />
varicose vein surgery and small bowel anastomosis. The<br />
results were analysed by year of training and whether<br />
Wednesday 5 September<br />
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to demonstrate they are working for equality rather than<br />
merely avoiding discrimination. This audit, experience<br />
with attempts to collaborate with secondary care<br />
teachers plus our larger curriculum development project<br />
stimulate a wider debate about whether, when<br />
commissioning teaching practices, we should assess<br />
other aspects of quality of service provision; and<br />
whether, in the absence of an appropriate environment,<br />
learning outcomes are achievable.<br />
performed independently or supervised. 84 (73%) of<br />
trainees returned analysable forms. Abscess drainage<br />
and appendisectomy are acquired most often as the<br />
three years progress but a few still do not achieve<br />
independence by year three. The Profession should<br />
insist on ‘Protected Operative Teaching’ for surgical<br />
trainees.<br />
7E3 Personal and Professional<br />
Development Groups for Junior<br />
Hospital Doctors<br />
Alan Naftalin and Peter Bruggen<br />
Newham General Hospital, 22 Mackeson Road, London NW3<br />
2LT, UK<br />
You were a junior doctor. In personal and professional<br />
development groups at Newham General Hospital in<br />
East London, UK, the valued experience was often<br />
discovering that each was not alone. Others had<br />
‘strange’ thoughts and feelings. The figure of a junior<br />
doctor will be surrounded by radiating lines labelled:<br />
blushing, feeling faint, losing 3D thought, frozen<br />
memory, challenged by consultants, dreaming of<br />
patients, psychosomatic symptoms, unable to stop eye<br />
contact, erections, impulse to touch too much, being<br />
told off, feeling embarrassed, needing to rescue the<br />
deprived, fostering special relationships, scoring PR<br />
and PV examinations, enjoying power, etc. Pens or<br />
labels will be provided for participants to add ideas or<br />
experiences. In the corners will be background to the<br />
group, and references; details and email addresses of<br />
both authors; invitation to mailing list or web site; and<br />
invitation for suggestions.<br />
7E4 The educational needs of doctors<br />
with English as a second language<br />
when consulting in General<br />
Practice in the United Kingdom<br />
Sylvia Chudley and John Skelton<br />
West Midlands Dept of Postgraduate Education for General<br />
Practice, 16 Ashmore Road, Cotteridge, Birmingham, B30 2HA,<br />
UK<br />
Results of the consulting skills component of the<br />
national summative assessment procedure in the United<br />
Kingdom, (assessment of videotaped consultations),<br />
indicate that the failure rate is significantly higher in<br />
those doctors who have had undergraduate medical
training abroad. Preliminary observations suggest that<br />
these doctors have specific difficulties that relate not<br />
only to linguistic problems, but to cultural differences<br />
in 1) communication in general, 2) communication<br />
within the medical consultation, and 3) the nature of<br />
the teacher/pupil relationship. This research explores<br />
these 3 issues through in-depth interviews with such<br />
doctors who are currently training in general practice.<br />
A better understanding of the educational needs of<br />
doctors from abroad should enable educators to provide<br />
appropriate training and preparation for work in general<br />
practice in the United Kingdom.<br />
7E5 “No such thing as a free lunch” -<br />
how free are bleep-free sessions?<br />
Jane Ross* and Rose Martin<br />
Postgraduate Office, Level 7, Ninewells Hospital and Medical<br />
School, Dundee DD1 9SY, UK<br />
Bleep-free weekly educational sessions have been<br />
identified as an essential requirement in the clinical<br />
training of PRHOs. A GMC review supported by<br />
anecdotal evidence identified this issue as a concern.<br />
A three phase prospective audit to evaluate the effect<br />
of implementing a trust-wide bleeping policy in the<br />
provision of bleep-free weekly educational sessions for<br />
PRHOs was evaluated.<br />
Phase 1: 6 weeks: a researcher intercepted all bleep<br />
interruptions during weekly PRHO teaching.<br />
Bleeping reasons were logged into a coding<br />
grid.<br />
Phase 2: Implementation of Trust Bleeping Policy.<br />
Phase 3: 6 weeks (repeat of phase 1).<br />
Bleeping incidents were logged and coded pre and post<br />
policy implementation. Results showed improved<br />
negotiated bleep responsibility to colleague, a decrease<br />
in bleeping incidents during teaching sessions and<br />
decrease in non-essential bleep interruptions.<br />
Implementation of a bleeping policy improved bleepfree<br />
sessions for PRHOs.<br />
7E6 The SHO Record of In-Service<br />
Training and Achievement (RITA)<br />
and Portfolio<br />
Rose Martin* and R W Newton<br />
SCPMDE, Postgraduate Office, Level 7, Ninewells Hospital and<br />
Medical School, Dundee, DD1 9SY, UK<br />
Documentation will be required to support the new<br />
SHO RITA process; models are currently being<br />
developed and tested. The SHO Portfolio and Record<br />
of In–Service Training and Achievement has been<br />
developed in the East Region and is currently being<br />
piloted in Tayside and Edinburgh amongst all SHOs<br />
within medicine and its sub-specialties. The SHO<br />
Portfolio aims to promote a more structured approach<br />
to SHO training, appraisal and assessment. It is based<br />
on the concept of a partnership between SHO and<br />
Educational Supervisor; the documentation includes a<br />
training agreement which emphasises the<br />
responsibilities on both sides in ensuring that learning<br />
opportunities are maximised. It enables a continuum<br />
of training, incorporating a strategy for the management<br />
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of poor performance which can be passed from the<br />
initial Educational Supervisor to the next, if the training<br />
plan is not completed. Split between five sections and<br />
based on the GMC’s Good Medical Practice booklet,<br />
the final section is designed to enhance the CV and<br />
detail critical incident analysis, audit projects, record<br />
interesting cases and provide a platform for promoting<br />
clinical and educational achievement at interview.<br />
Specific Royal College documentation can be inserted<br />
and the portfolio itself should be used to inform the<br />
Revalidation process.<br />
7E7 General Practice Registrar audit<br />
and implementation of change<br />
J McKay*, J R M Lough and T S Murray<br />
Department of Postgraduate Medical Education, University of<br />
Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK<br />
General practice registrars (GPRs), submit an audit<br />
project as part of the summative assessment process.<br />
Assessment of these projects does not require the<br />
registrar to implement change nor collect a second data<br />
set. From 1988 west of Scotland GPRs were required<br />
to submit a completed audit cycle (CAC), which<br />
included implementing change and a second data<br />
collection. Audit submissions in the 3 years before and<br />
after the introduction of CAC were compared. Projects<br />
submitted after the introduction of CAC were<br />
significantly more likely to have 3 or less criteria<br />
(p
7E9 Psychosocial training in the Family<br />
Residency in Spain: present<br />
situation and proposals for the<br />
future<br />
José Ramón Loayssa Lara<br />
Servicio Navarro de Salud, Centro de Salud de Noaín, 31110<br />
Noaín, SPAIN<br />
The psychosocial training in the family practice<br />
residency in Spain, despite the increasing interest and<br />
the growing number of educational activities, is not<br />
obtaining the desired results. In order to formulate a<br />
proposal for curriculum development, a study of the<br />
programme in the different teaching units was<br />
undertaken. Based on the suggestions of the faculty<br />
and on the analysis of experiences in different countries,<br />
a series of recommendations and possible lines of<br />
development are discussed.<br />
7E10 Step by step to methodological<br />
exam: report on first year<br />
experiences with the new<br />
introduced GP Licence<br />
Examination in Austria<br />
R Willnauer*, M Schmidts, M Lischka<br />
Institute for Medical Education, University of Vienna, Wahringer<br />
Gurtel 18-20, Postfach 10, A-1097 Wien, AUSTRIA<br />
There are three prerequisites for being granted a licence<br />
as a GP: 3-year-inhouse rotational training,<br />
accompanied by a certification process (longitudinal<br />
evaluation) and a summative examination at the end of<br />
the training period. This exam was introduced in<br />
November 1999 and is held three times a year. The<br />
exam is made up of 20-25 case vignettes followed by<br />
1-5 questions in SAQ format. The cases are developed<br />
by GPs and are thoroughly reviewed. Required answers<br />
are predetermined by GP experts. Answers are<br />
corrected by specialists on machine readable sheets,<br />
providing PC-based item analysis and scoring. We will<br />
report on:<br />
• our attempts to meet quality criteria (objectivity,<br />
reliability, validity)<br />
• results of four examinations (total of 372<br />
candidates)<br />
• institutional and organisational experience with the<br />
instruction of examination methodology.<br />
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7E11 Development of professional<br />
doctorates in healthcare disciplines<br />
Alan Castle*, Graham A Mills and Valda Bunker<br />
University of Portsmouth, Centre for Radiography Education,<br />
St George’s Building, Portsmouth, Hampshire PO1 2HY, UK<br />
Originally, the PhD was a qualification for an academic<br />
career. Recently the appropriateness of this<br />
qualification has been questioned as it is not necessarily<br />
relevant to industry or professional interests.<br />
Consequently universities are re-shaping Doctoral level<br />
learning by providing flexible, part-time, work-based<br />
‘Professional Doctorates’ (PD). These are “equal in<br />
rigour but different in substance” to a PhD. The<br />
University of Portsmouth has recently developed an<br />
innovative PD programme supporting multidisciplinary<br />
learning in biomedical sciences,<br />
chiropractic, medical imaging, nursing and pharmacy.<br />
Entry to the programme is at Master’s level, with<br />
Doctoral level learning in two parts. A ‘taught’ Part 1<br />
(1-2 years) includes advanced research techniques,<br />
professional review and publication and dissemination<br />
units. Part 2 (2-3 years) comprises the work-based<br />
professional research and development project<br />
submitted as a portfolio. This curriculum model,<br />
facilitating continuing professional development, is<br />
appropriate for all healthcare disciplines and suitable<br />
for adoption by other higher education institutions.<br />
7E12 The appointment process for<br />
Anaesthetic Registrars in South<br />
Thames<br />
J Clarke* and J Pateman<br />
St George’s Hospital London, Department of Anaesthesia,<br />
Blackshaw Road, London SW17 0QT, UK<br />
Each 6 months we appoint approximately 25 registrars<br />
to our training scheme from about 100 applicants.<br />
Historically we used the classical large panel, roundtable,<br />
15 minute interview technique. For the last 18<br />
months we have employed an OSCE style interview<br />
process using 4 ‘tables’. Candidates rotate through all<br />
tables, where they undergo targeted questioning on<br />
different aspects of the person specification that cannot<br />
be obtained from their paper application. The<br />
advantages are that each candidate is now interviewed<br />
for 32 minutes and we are able to explore in greater<br />
detail desirable attributes. Furthermore because we are<br />
now able to interview up to 50 candidates in one day,<br />
the short listing has become a less important part of<br />
the process and we can interview a more diverse group.<br />
Audits carried out have shown a marked preference<br />
for this technique amongst both interviewers and<br />
interviewees.
Session 7F Assessment<br />
7F1 Validity of assessment techniques:<br />
students’ views differ from<br />
observed outcomes<br />
W Colin Duncan<br />
University of Edinburgh, Obstetrics and Gynaecology, Centre<br />
for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3<br />
9ET, UK<br />
We assess medical students in Obstetrics and<br />
Gynaecology using a combination of four assessment<br />
techniques: continuous assessment (CA), multiple<br />
essay questions (MEQ), OSCE exam and clinical exam.<br />
This study aimed to compare the students’ perception<br />
(n=75) of validity of these assessment techniques with<br />
actual validity. Validity of each component was assessed<br />
by correlation with the final mark. Students’ perception<br />
was obtained by asking students what they felt they<br />
deserved and what they felt they got in each assessment.<br />
In predicting final mark, CA performed worst<br />
(r=0.667), followed by MEQ (r=0.791), Clinical<br />
(r=0.861) and finally OSCE (r=0.877). In the students’<br />
perception, CA performed best (-3.8% difference),<br />
followed by MEQ (-4.9%), Clinical (-5.4%) and finally<br />
OSCE (-11%). There is a clear inverse relationship<br />
(r=0.705) between the students’ perception of<br />
assessment validity and the actual validity in this<br />
assessment scenario.<br />
7F2 Assessment reliability in an MSc<br />
programme in Diabetes<br />
J Huber*, N Munro, A Felton, C Parker, P Delaney and<br />
C McIntosh<br />
School of Life Sciences, University of Surrey Roehampton, West<br />
Hill, London SW15 3SN, UK<br />
Reliability within examinations is a precondition to<br />
validity. In order to confirm internal reliability in<br />
assessment instruments, a range of measures can be<br />
employed. This study aimed to establish the reliability<br />
of assessments used in a Diabetes Masters programme.<br />
Percentage scores from the attendance cohort (1999/<br />
00) for the four assessments in a ‘management of<br />
diabetes’ module were analysed, resulting in an alpha<br />
coefficient of .75. Correlations between individual<br />
assessments and the total assessment scores (corrected<br />
for the individual assessment) were .58, .41, .64 and<br />
.57. Both the alpha and item-total correlations indicate<br />
a satisfactory level of internal reliability. The figures<br />
indicate that all assessments evaluate a common skills<br />
range. Alphas greater than .8 are recognised as<br />
achievable in professional examinations. In order to<br />
attain this it will be necessary to evaluate assessment<br />
two further to understand why this essay has a lower<br />
correlation with the overall grade achieved.<br />
7F3 Two years of progress-testing at<br />
the Charité<br />
A Mertens*, J Hoffmann, S Kölbel, R Raschke, K Duske, J<br />
Berger and U Hennewig<br />
HU <strong>Berlin</strong> Medical Faculty, Charité, AG Reformstudiengang,<br />
Medizinische Fakultat, Schumannstr 20-21, 10117 <strong>Berlin</strong>,<br />
GERMANY<br />
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The Humboldt-University Progress-Test is based on the<br />
principles for Progress-Testing developed in the<br />
Netherlands. It will be shown that the format works<br />
also within a traditional German medical faculty. The<br />
results of the four tests organized in <strong>Berlin</strong> so far will<br />
be presented, including a summary of our subsequently<br />
performed test-evaluation programme. Special<br />
attention will be payed to the comparison of the students<br />
in the reformed curriculum vs. the students in the<br />
traditional curriculum in all respects.<br />
7F4 OSCE for a Paediatric Trainee<br />
Internship examination:<br />
multicentric experience<br />
M Aldunate, A Lopez, A Mena, M Varas, X Trivino,<br />
A Vasquez*, R Lillo, T Miranda and E Mandiola<br />
ESC Medicina - Officina de Educacion Medica, Fac Medicina,<br />
Universidad de Chile, La Siembra 8952 Vitacura Santiago,<br />
CHILE<br />
The University of Chile and the Catholic University,<br />
the main Chilean Universities, started in 2000 a joint<br />
program in order to consolidate and improve the<br />
assessment system for the paediatric training period<br />
(internship 6th year). The objective of the program was<br />
to improve the quality of the final assessment of clinical<br />
competences of the Paediatric trainee (internship) in<br />
two Chilean Universities. Members of both Schools of<br />
Medicine have developed, organized, implemented and<br />
run an identical, simultaneous, multicentric and interuniversity<br />
20 station OSCE in order to assess 124<br />
students; to analyze the results and statistically compare<br />
them to other traditional assessment methods.<br />
Questionnaires were used for considering the results<br />
and opinions as well as academic opinions before and<br />
after the OSCE. The OSCE allowed the measurement<br />
of main objectives in all domains and the components<br />
of predetermined clinical competences. Statistical<br />
analysis of results showed the advantages of this method<br />
in relation to the traditional exam. The results of the<br />
questionnaire analysis are presented and discussed.<br />
Results permit the recommendation of the OSCE as a<br />
clinical examination of the Paediatric trainee at the end<br />
of the internship period in both Schools of Medicine.<br />
7F5 Third year medical student written<br />
history and physicals: how many is<br />
enough?<br />
Paul A Hemmer*, Thomas Jamieson, Kim Gibson, Lisa<br />
Moores, Andy Donato, Margaret Gaglione, Steven Durning,<br />
Alan Wimmer, Bonnie Cary-Freitas and Louis Pangaro<br />
USUHS - EDP, 4301 Jones Bridge Road, Bethesda MD 20814,<br />
USA<br />
The aim was to determine when students can reliably<br />
write a history and physical. In 1998-99, faculty ranked<br />
20 specific aspects of 10 student write-ups, using a<br />
validated, 4-point Likert scale rating form. We assessed<br />
intra-write up reliability/correlation and inter-write up<br />
reliability (Cronbach’s alpha). Data were available for<br />
240 students (1998-1999). The table summarizes the
number of write-ups necessary to achieve a specific<br />
level of agreement for seven of the 20 rated categories.<br />
Write-up Variable a � 0.7 a � 0.8<br />
Chief Complaint<br />
HPI (degree that history<br />
Never Never<br />
differentiates possible etiologies) 9 10<br />
PE (precision)<br />
Problem List (specificity of<br />
Never Never<br />
problem) 4 Never<br />
Analysis (level/depth) 8 9<br />
Scholarship (level/depth) 3 9<br />
Overall 2 10<br />
Items most correlated with the overall score:<br />
Assessment and Plan (.83), Level of Analysis (.7), HPI<br />
(.64), and Level of Scholarship (.6). It is concluded<br />
that fostering a student’s transition from “Reporter” to<br />
“Interpreter” requires 8-10 written H&Ps.<br />
7F6 Student fitness to practise<br />
procedures<br />
Chris Stephens<br />
The Department of Medical Education, Office of School of<br />
Medicine, University of Southampton, MP 801 Level C, South<br />
Academic Block, Southampton General Hospital, Southampton,<br />
SO16 6DY, UK<br />
Students can be suspended from their course for a<br />
number of reasons such as health, conduct and<br />
academic progress. These three do not cover specific<br />
professional areas related to medicine and so the School<br />
of Medicine University of Southampton developed<br />
student fitness to practise procedures. These procedures<br />
are based on a number of GMC documents and link<br />
into the University’s regulations and have been used<br />
on a number of occasions. The presentation will explore<br />
a number of case scenarios to illustrate that there is<br />
often overlap between the different areas, how the<br />
fitness to practise procedures need to reflect current<br />
GMC professional conduct guidance and why the<br />
system needs to be fair, transparent and open.<br />
7F7 Deriving the assessment<br />
framework for the Three Royal<br />
Colleges Diploma in Prison<br />
Medicine<br />
Lesley J Southgate*, Jon H Fuller and Jaz Bihku<br />
Centre for Health Informatics & Multiprofessional Education,<br />
University College London Medical School, Archway Campus,<br />
Highgate Hill, London N19 3UA, UK<br />
Prisoners suffer from high levels of mental health<br />
problems, substance misuse, communicable diseases<br />
and chronic physical illness. But health services for<br />
UK prisoners have been isolated from the wider health<br />
community in the NHS. Improving the health and health<br />
care of prisoners has not been a priority for either the<br />
Prison Service or the NHS. As a result, despite patches<br />
of good practice, services overall have fallen short of<br />
collective aspirations. As a contribution to CPD for<br />
prison medical officers, three UK Royal Colleges<br />
(General Practice, Physicians, Psychiatry) have<br />
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established a Diploma in Prison Medicine. The Diploma<br />
is delivered by the University of Nottingham, but the<br />
assessment and quality assurance framework was<br />
developed and is implemented by the Examination<br />
Board from the Royal Colleges. We describe here the<br />
derivation of the assessment framework, both content<br />
and methods, and present data from the first three years<br />
of the Diploma.<br />
7F8 Assessment in an outcome-based<br />
curriculum at the International<br />
Medical University (IMU), Malaysia<br />
J C Ramesh*, S Raman, M I Nurjahan, A Radhakrishnan,<br />
K H Ong, C M K Patrick and A K H Wong<br />
International Medical University, 33 A Jalan 17/1, Block A-4,<br />
Condo 3A, Astana Damansara, 46400 Petaling Jaya, Selangor,<br />
MALAYSIA<br />
Eight major outcomes were identified for the clinical<br />
programme of the International Medical University<br />
(IMU). The outcomes form the basis to reflect the<br />
competencies expected of our graduates. Task-based<br />
study-guides, a community and family case study<br />
(CFCS) and the learning portfolio form our core<br />
curriculum. We employ a variety of assessment tools<br />
to assess the competencies achieved in the eight IMU<br />
outcomes. These include end of posting examinations<br />
as well as the portfolio. Both OSPE and OSCE are used<br />
in the professional examinations to assess the various<br />
outcomes. An OSCE grid has been developed to<br />
evaluate the effectiveness of our assessment in<br />
measuring all the IMU outcomes. Issues related to<br />
community and health are assessed in the CFCS. The<br />
final semester is for senior clerkship and a structured<br />
exit viva at the end will be used to assess the<br />
competency in the outcomes before the students<br />
graduate.<br />
7F9 Psychosocial profile of medical<br />
students as a predictor of the<br />
academic success in medical<br />
school in Mexico<br />
Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-<br />
R, Victoria Bermudez, Juan Montes-V, Santos Guzman, A-<br />
Enrique Alcorta-G and Marcos Vinicio<br />
Autonomous University of Nuevo Leon, 1815 JFK Blvd. Apt #<br />
1606, Philadelphia PA 19103, USA<br />
We examined the contribution of psychosocial<br />
measures in predicting academic success among<br />
Mexican medical students. Participants were 694<br />
medical students at the Autonomous University of<br />
Nuevo Leon, in Mexico. A set of psychosocial scales,<br />
including Jefferson Medical College’s noncognitive<br />
questionnaire, was administered. Data supported the<br />
psychometrics of the instruments. Participants were<br />
divided into 3 groups. Group 1 consisted of those who<br />
succeeded in the first and second years of medical<br />
school (n=277). Group 2 included those students who<br />
were put on probation (n=339). Group 3 comprised<br />
those who were dismissed (n=78). We compared these<br />
3 groups on a number of psychosocial measures, and<br />
found significant differences among the groups on the<br />
following scales: Depression, Stress Life Events,<br />
Terman Merrill IQ, Self-esteem, Cognitive Process or
Thinking Problems, Family Structure and Function.<br />
Findings have implications in admission decisions and<br />
in academic and professional counselling.<br />
7F10 Psychometric data for Jefferson<br />
Medical College’s Non Cognitive<br />
Questionnaire in Mexican medical<br />
students<br />
Adelina Alcorta-G*, Mohammadreza Hojat, Jesus Ancer-<br />
R, Victoria Bermudez, Juan Montes-V, Santos Guzman, A-<br />
Enrique Alcorta-G and Marcos Vinicio<br />
Autonomous University of Nuevo Leon, 1815 JFK Blvd. Apt #<br />
1606, Philadelphia PA 19103, USA<br />
A Spanish version of the Jefferson Medical College’s<br />
Noncognitive Questionnaire was administered to 700<br />
first year medical students at the Autonomous<br />
University of Nuevo Leon, in Mexico. Factor analysis<br />
resulted in a factor matrix that was comparable to that<br />
obtained between noncognitive scale scores and<br />
external criterion measures. Results of this study<br />
support the construct validity, criterion-related validity,<br />
and internal consistency aspect of reliability<br />
(Cronbach’s alpha) of the noncognitive measures<br />
(general anxiety, test anxiety, loneliness, self-esteem,<br />
extroversion, stressful life events, neuroticism and locus<br />
of control) in Mexican medical students. We concluded<br />
that the noncognitive questionnaire, in general, is a valid<br />
and reliable instrument for Mexican medical students<br />
to investigate the contribution of personal qualities,<br />
Session 7G Teaching and learning (1)<br />
7G1 What do first year medical students<br />
value in a learning situation?<br />
Angel M Centeno*, Alejandra Blanco, Soledad Campos<br />
and Amelia Cabrera<br />
Faculty of Biomedical Sciences, Universidad Austral-Medicina,<br />
Av J Peron 1500, B1629AHJ Derqui, Pilar, Pov Buenos Aires,<br />
ARGENTINA<br />
Lack of appropriate learning skills when entering<br />
medical school is one the major obstacles our students<br />
face during their first year at medical school. We used<br />
the critical incident technique to determine which<br />
elements in a learning episode during high school were<br />
highly valued as most effective by students admitted<br />
to medical school. Incidents were coded for learning<br />
characteristics, and for disciplines mentioned. Seventyone<br />
medical students recently admitted were included<br />
in the study. Faculty personal aptitudes was the most<br />
frequently cited element (34%), followed by practical<br />
teaching (22%), students’ personal growth or<br />
transformation (13%), influence of the evaluation<br />
(12%), team working (8%), and good teaching<br />
resources (8%). Sciences related to medicine were the<br />
most influential (65%), while humanistic disciplines<br />
(23%), and exact sciences (9%) were mentioned too.<br />
These data permit the design of educational activities<br />
using those elements in order to improve their efficacy.<br />
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personality factors and psychosocial characteristics in<br />
predicting academic success in medical school, and<br />
professional success in medical practice, which is the<br />
broader goal of this project.<br />
7F11 Portfolio based assessment of<br />
students during their internship<br />
Angel M Centeno*, Soledad Campos, Isabel Fernández<br />
and Alfredo Olivieri<br />
Faculty of Biomedical Sciences, Universidad Austral-Medicina,<br />
Av J Peron 1500, B1629AHJ Derqui, Pilar, Pov Buenos Aires,<br />
ARGENTINA<br />
Portfolio is an assessment tool that allows students to<br />
record and reflect on key events of their daily activities.<br />
Our sixth year (internship) students record their daily<br />
activities, their reactions to their real life work, they<br />
identify their learning needs, and their studying<br />
strategies, including self evaluation. The faculty gives<br />
student feedback, helps her/him to apply her/his<br />
learning in a practical context, and challenges and<br />
motivates the intern to advance in their learning.<br />
Thirteen students and four faculties were involved in<br />
this project. Despite the lack of previous experience<br />
with the instrument, students and faculties found it<br />
useful. Faculty development activities directed towards<br />
improving the use of the portfolio, and protecting time<br />
(minimum 2 hours/week) to meet with the students are<br />
changes we are planning to perfect its use. Portfolio is<br />
not used for promotion but for developing and<br />
consolidating adult and life-long learning strategies.<br />
7G2 Application of Schon’s model for<br />
small-group teaching<br />
Francine Borduas* and Réjean Laprise<br />
Association des médecins omnipraticiens de Québec, Clinique<br />
médicale de Neufchatel, 2350 boul Bastien #2, Québec G2B<br />
1B5, CANADA<br />
Schon proposed that physicians acquire expertise<br />
through a process of reflection in and on action. This<br />
process is triggered by abnormal cases seen in the<br />
clinic, which cause ‘surprises’. These surprises lead to<br />
the investigation of the new phenomena and<br />
experimentation of new course of actions, which are,<br />
ultimately, integrated into practice. We present an<br />
application of Schon’s model for small-group teaching.<br />
An interactive workshop, based on the study of a real<br />
patient followed by her doctor for 15 years, was<br />
designed to cause ‘surprises’ among participants and<br />
make them go through the process described by Schon.<br />
This method was assessed during a CME event. Results<br />
from the administration of a multiple choice<br />
questionnaire pre- and post-intervention showed a<br />
significant improvement in knowledge following the<br />
event (p
7G3 Teaching and learning about case<br />
presentations: the need for early<br />
intervention<br />
D Nestel* and J Kidd<br />
Imperial College School of Medicine, Connaught House,<br />
Apartment 17, Davies Street, London W1K 3DA, UK<br />
At Imperial College School of Medicine, students are<br />
introduced to case presentations during their second<br />
year. During a three-hour session, the content and<br />
context of case presentations are discussed and students<br />
participate in a brainstorming activity to identify<br />
characteristics of effective presentations. Students then<br />
work in small groups to prepare and deliver a case<br />
presentation based on a videotaped interview.<br />
Approximately five presentations are made in each<br />
session. In addition to the content of the presentation,<br />
students receive feedback on their presentation skills.<br />
Data will be presented from an assessment conducted<br />
three-months after the session and a clinical attachment.<br />
The assessment examines students’ knowledge in<br />
relation to the content and context of presentations and<br />
the features of effective presentations. Students are also<br />
asked about their experiences of case presentations<br />
during their clinical attachments and if there is anything<br />
else they would like to have addressed in the session.<br />
7G4 Master teacher, master learner<br />
M P Oosthuizen<br />
University of Pretoria, P O Box 1266, Tand en Mond Hospital,<br />
Pretoria 0001, SOUTH AFRICA<br />
The aim of this study was to make use of a whole brain<br />
teaching and learning model for the study-unit of toothmorphology<br />
in a 3rd year dental curriculum to<br />
accommodate and develop students’ knowledge, skills<br />
and attitudes.The Herrmann Whole Brain Model on<br />
teaching and learning was used to stimulate a learningcentred<br />
approach. His instrument was used to determine<br />
thinking style preferences of the individual students<br />
and the group as a whole. Whole brain teaching<br />
interventions were designed to accommodate and<br />
develop diverse thinking style preferences during<br />
learning activities. The results of this study indicated a<br />
significant improvement of students’ retention,<br />
participation and attitudes toward the content and<br />
learning as well as group interaction and problem<br />
solving. The impact of this pre-clinical intervention in<br />
the third year is still evident and contributing to the<br />
students’ performances in their clinical work during<br />
the fourth year. This success had a major impact on the<br />
decision of the faculty to incorporate whole brain<br />
teaching and learning in the new outcomes-based<br />
learning-centred curriculum for dentistry.<br />
7G5 Hemisphericity in medical students<br />
N E Fernandez-Garza*, I A Benitez-Trejo, C Salinas-<br />
Guerra, A Davila-Flores and J A Castellanos-Lopez<br />
Facultad de Medicina, Universidad Autonoma de Nuevo Leon,<br />
Nuno de Guzman 309, Col. Cumbres, 3er Sector, Monterrey,<br />
N.L., c.p. 64610, MEXICO<br />
From Sperry studies, attention has been focused on<br />
brain dominance or hemisphericity. Left hemisphere<br />
(LH) is considered better for verbal tasks and right (RH)<br />
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for visual. For the teaching-learning process, it is<br />
important to consider which learning style (verbal or<br />
visual) is more used by students. In this project, nine<br />
medicine students were tested in five cognitive<br />
paradigms; reaction time was measured. Paradigms<br />
were: (1) simple reaction time (SRT) to familiarize with<br />
the procedure; (2) memory using letters (LS); (3)<br />
memory using patterns (PM); (4) patterns recognition<br />
using letters (LTM); and (5) patterns recognition using<br />
patterns (PC). All subjects had the lowest reaction time<br />
in the SRT, in second were LS and PM, third LTM and<br />
fourth PC. These suggest that the cognitive process in<br />
which memory is involved are well developed (LH),<br />
but the same is not true for the cognitive processes<br />
involved in pattern recognition (RH).<br />
7G6 Medical student preferences for an<br />
“ideal textbook” of Obstetrics and<br />
Gynaecology<br />
M S Marsh* and D Katopi<br />
GKT Medical School, Academic Dept of Obstetrics &<br />
Gynaecology, 9th Floor, Ruskin Wing, King’s College Hospital,<br />
Bessemer Road, London SE5 9PJ, UK<br />
Although medical students increasingly use CAL and<br />
the internet for their medical education, and much effort<br />
is put into the presentation of this information, the<br />
textbook still remains the chief tool for self directed<br />
learning. There is surprisingly little data concerning<br />
student opinion of the form and content of textbooks.<br />
We surveyed 88 (of approximately 100) 4th year<br />
medical students undergoing a course in Obstetrics and<br />
Gynaecology (O & G) about their “ideal textbook” for<br />
O & G. 46% of students wanted a book of A5 size,<br />
80% wanted some coloured content, 83% wanted the<br />
type in a medium size, 75% wished it to be made up of<br />
lists and short notes and 67% with one topic per page<br />
or double page. 79% of students wanted space for notes<br />
within the text pages. It appears there is consensus<br />
amongst medical students about the content and form<br />
of textbooks of O & G.<br />
7G7 What can be learnt from medical<br />
atlases? Expert and novice visual<br />
schemata in breast sonography<br />
R Pauli* and J Huber<br />
School of Life Sciences, University of Surrey Roehampton, West<br />
Hill, London SW15 3SN, UK<br />
Medical education in the visual domain focuses on<br />
teaching diagnostic processes verbally, usually by<br />
discussion between expert and trainee. A problem with<br />
this approach is that visual medical information may<br />
not be easily or efficiently transmitted in this mode.<br />
Our research aims to address the degree to which<br />
observers are able to extract visual features of breast<br />
sonograms, which are diagnostically significant. The<br />
first study compared expert and novice interpretations<br />
of breast sonograms taken from medical atlases. It was<br />
found that novices do not trail far behind experts in<br />
accuracy. The second study aimed to investigate the<br />
overlap between diagnostic categories and visual<br />
characteristics in breast sonograms by examining<br />
novices’ image categorisation strategies. This further<br />
confirmed that readily available visual information
lends itself to making diagnostic classifications. The<br />
evidence shows that medical atlases aimed at illustrating<br />
typical appearances are useful, but should perhaps cover<br />
less typical appearances.<br />
7G8 Community-based Public Health<br />
Education in Healthy City Project<br />
Yosuke Yamane*, Kuninori Shiwaku, Keiko Kitashima and<br />
Anuurad Erdembileg<br />
Department of Environmental Medicine, Shimane Medical<br />
University, Enya 89, Izumo 693-8501, JAPAN<br />
The drastic changes in the field of public health require<br />
educational innovation in the university. The<br />
development of a new learning strategy should be<br />
problem-solving; student autonomy; holistic approach<br />
to the complicated physical-mental-social<br />
phenomenon. We have performed community-based<br />
public health education integrating family health,<br />
school health, occupational health and community<br />
health since 1979. The persistent exposure of the<br />
student into the community dynamics is useful to<br />
understand the health promotion strategy. The<br />
education in the healthy city model is especially<br />
effective to recognize community empowerment,<br />
collaboration with the inhabitants, care workers,<br />
researchers and policy makers, the partnership between<br />
the community and the academic, social support<br />
networking and policy making for amenity community.<br />
7G9 Two different types of professorial<br />
authority: results in a traditional<br />
faculty of medicine<br />
Carlos E. de la Garza-Gonzalez*, Norberto Lopez-Serna<br />
and Ma Esthela Morales-Perez<br />
Facultad de Medicina, Universidad Autonoma de Nuevo Leon,<br />
Administracion de Correos no 3, Apartado postal no 712, 64460<br />
Monterrey N.L., MEXICO<br />
We compare the results of the final examination of four<br />
groups of students. Two of them had the Embryology<br />
course on an annual, and the other on a semi-annual<br />
basis. All groups had the same professor during the<br />
entire course. In one of the groups in each term, the<br />
examination was performed on a highly authoritarian<br />
basis, for example: seat assignment in alphabetical<br />
order; once the professor was in the lecture hall, the<br />
students have to use only one of the access doors; five<br />
minutes after the scheduled start time re-entry was<br />
forbidden, students were not allowed to talk to each<br />
other, among others. In the other groups none of the<br />
above conditions was demanded. A z test on the final<br />
exam results at a level of confidence of 95% was done.<br />
We did not find a significant difference.<br />
7G10 The “excellent teacher” seen by<br />
mid-course students<br />
M Patrício, A V Carneiro and J Fernandes e Fernandes<br />
Faculdade de Medicina de Lisboa, University of Lisbon, Av Prof<br />
Egas Moniz, Piso 1, 1649-028 Lisboa Codex, PORTUGAL<br />
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The importance of a role model in the teaching-learning<br />
process is well accepted. The objective of the study<br />
was to identify perceptions of mid-course students on<br />
the characteristics of an “excellent teacher”. Third year<br />
students (n=66) completed a semi-structured<br />
questionnaire on the profile of an excellent teacher<br />
(open questions followed by 32 specific characteristics<br />
- Likert scale). Quantitative analysis reveals a teacher<br />
is perceived as:<br />
• information provider (selection of topics to be<br />
taught 99%; transmission of clear information 97%;<br />
distinguishing essential from non-essential<br />
knowledge 97%).<br />
• facilitator (creating the opportunities for practical<br />
training 95%; available to students 90%)<br />
• assessor (fair when assessing 94%)<br />
• nice person (agreeable when dealing with students<br />
94%), and<br />
• planner (organizing the program 90%; integration<br />
of the discipline in other course areas 83%)<br />
Qualitative analysis confirms, in general, these results.<br />
Curiously enough, 21% of the students state as nonimportant<br />
qualities: being a role model, having a broad<br />
culture, good leadership and good research abilities.<br />
A discussion will take place on the implications for<br />
the teaching-learning process.<br />
7G11 Underrepresented minority (URM)<br />
students’ perception of mentoring,<br />
advising and role modelling in<br />
medical school<br />
Ara Tekian*, Laura Hruska and Jorge Girotti<br />
University of Illinois at Chicago, Department of Medical<br />
Education (m/c 591), 808 S. Wood St, CME 986, Chicago IL<br />
60612, USA<br />
This study investigates the underrepresented minority<br />
(URM) students’ perception of particular characteristics<br />
and functions associated with their mentor, adviser, or<br />
role models. A two-part brief questionnaire was given<br />
to 56 URM and non-URM first and second year<br />
medical students studying at the University of Illinois<br />
at Chicago College of Medicine. Paired t-test revealed<br />
significant results among all levels of comparisons that<br />
include opinion differences between URM and non-<br />
URMs, mentor, role model and advisor functions and<br />
characteristics like empathy, maturity, resourcefulness,<br />
providing resources, and availability. The results show<br />
a clear differentiation among the perceived<br />
characteristics and expected functions of mentors,<br />
advisors and role models between URMs and non-<br />
URMs. Results from the first part of the questionnaire<br />
are reinforced by an evaluation of the second part that<br />
includes open responses from students emphasizing<br />
particular qualities and responsibilities for each role.
Session 7H Teaching and learning (2)<br />
7H1 “Project Carrapato (*Tick)”: a<br />
psychological focus in medical<br />
training<br />
I R P Scavariello, M S V M Silveira, E H V Celeri*,<br />
S L Brenelli and R S Cassorla<br />
Group for Psychopedagogic Assistance to Medical/Nursing<br />
Students and Resident Doctors - UNICAMP, Faculty of Medical<br />
Sciences, Tessalia Vieira de Camargo St 126/6111, Barao<br />
Geraldo District, Campinas, Sao Paulo 13083-970, BRAZIL<br />
The separation of the basic course from the clinical<br />
course can be a cause of anguish and conflict in medical<br />
students. With the aim of reducing this conflict, the<br />
teaching body at the medical school developed the<br />
“Project Carrapato(*Tick)” during the reception for the<br />
year 2000 freshmen. This project familiarised the<br />
freshmen with the medical reality. The students<br />
accompanied the hospital activities of the medical staff<br />
for a week. After this, they were divided into 5 reflection<br />
groups which were coordinated by the GRAPEME<br />
professionals and FCM docents. The project was seen<br />
as a possible preventive action because it helped<br />
students to: reflect and expose their expectations,<br />
anguish and fears; question their fantasies; experience<br />
limitations. This can help to avoid or reduce the<br />
development of inadequate defence mechanisms that<br />
hinder personal and professional growth.<br />
* next to (jargon)<br />
7H2 Evaluating of videotape sessions<br />
for learning communication skills<br />
A Nogueras*, M Bernaus, X Claries and J de Nadal<br />
I. Universitari Parc Tauli, Parc Tauli s/n,0820 Sabadell,<br />
Barcelona, SPAIN<br />
Evaluating training systems to develop and assess<br />
communication skills is not easy. We report an<br />
extension of our experience. Since 1997, we have<br />
carried out a short training program in doctor-patient<br />
communication for first year residents; it incorporates<br />
simulated patients, role-play techniques and each<br />
participant is videotaped. 81 residents have taken part.<br />
Before and after the course, a validated video showing<br />
a questionable doctor-patient interview is presented to<br />
the students for evaluation of the doctor’s<br />
communication skills, scored on a scale from 0 to 10.<br />
The first day 25-percentile of the video interview score<br />
varied every year and sometimes did not show a normal<br />
distribution, nevertheless, the number of students that<br />
scored high the first day always fell down notoriously<br />
on the last day’s evaluation: in 1997 from 27% to 14%;<br />
in 1998 from 39% to 6%; in 1999 from 50% to 37%<br />
and in 2000 from 24% to 6%. It is concluded that videos<br />
of validated simulations of clinical interviews can help<br />
to evaluate the usefulness of courses such as the one<br />
reported.<br />
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7H3 Acting up? The recruitment and<br />
maintenance of a professional role<br />
play team for undergraduate and<br />
postgraduate medical training and<br />
assessment<br />
C M Wiskin* and P Croft<br />
The Medical School, University of Birmingham, Edgbaston,<br />
Birmingham B15 2TT, UK<br />
Role play is widely used in medical education.<br />
Professional role players provide constructive teaching<br />
for participant development. The recruitment of<br />
individuals with the aptitude for professional role play<br />
is key. Theatrical sourcing may have its uses, but other<br />
attributes need consideration. Our role play team has<br />
10 years’ experience. Its role players are consistently<br />
involved in undergraduate and specialist postgraduate<br />
training. Demographics, educational/vocational<br />
qualifications, professional experience and educational<br />
interests of role players were collected. Supporting<br />
evaluation comes from postgraduate delegates (all<br />
specialties), facilitators and students. Not all actors can<br />
role play, not all role players can act. Personal skills,<br />
articulacy, intellectual involvement, improvisation and<br />
teaching skills are crucial. Results, skills lists,<br />
recruitment criteria and recommendations are<br />
presented. Training role players is less of an issue than<br />
the initial recruitment of individuals capable of<br />
developing as medical educators.<br />
7H4 Analysis of clinical competence at<br />
pre-graduate level<br />
Gitte Wichmann-Hansen* and Berit Eika<br />
Enhed for Medicinsk Uddannelse, SVF, Universitetsparken,<br />
Bygning 611, 8000 Aarhus C, DENMARK<br />
The overall objective of this study is to explore what<br />
opportunities the clinical clerkship offers medical<br />
students to develop their clinical competence, and how<br />
these opportunities can be maximized. The study takes<br />
its theoretical starting point in a semantic analysis of<br />
the term ‘clinical competence’, showing that it means<br />
both the ability and right to act adequately in clinical<br />
situations. A general aim of clinical clerkships is to<br />
train medical students in acting adequately in a clinical<br />
situation. Data from our pilot field observations<br />
indicate that it is difficult to reach this aim, since the<br />
students are only rarely given the right to act. Often<br />
they are passive observers or performing isolated<br />
repetitive tasks without feedback from trainers.<br />
Therefore, our working hypothesis is that learning<br />
clinical competence requires that students participate<br />
as legitimate members of the community. This<br />
hypothesis is described in a set of ideal criteria.
7H5 Use of paper-cases in<br />
undergraduate clinical<br />
Dermatology education in Germany<br />
A Boer*, R Kaufmann, W H Boehnke and F Ochsendorf<br />
Universitats-Hautklinik Frankfurt/M, Theodor Stern Kai-7,<br />
60590 Frankfurt am Main, GERMANY<br />
In Germany practical dermatology teaching is primarily<br />
performed as a bedside course. Large numbers of<br />
students made it increasingly difficult to find<br />
appropriate patients for demonstration. In recent years<br />
we developed paper-cases (short story and photo<br />
material), which were tried over 2.5 years in PBLseminars<br />
with voluntary and randomly assigned<br />
students. In each group the students matched the<br />
intended teaching goals in 75% (mean). After a tutortraining<br />
our residents were allowed to use the papercases<br />
individually to substitute patients when necessary.<br />
Last semester 14% of the patients needed were replaced<br />
by paper cases. A third of the residents used this<br />
opportunity and evaluated it as a good alternative. 80%<br />
of the students received paper-case teaching, 77% of<br />
them evaluated this type of education either good (55%)<br />
or very good (22%). We conclude that paper-cases are<br />
a useful alternative if there are not enough patients.<br />
7H6 Development of a Learning<br />
Resource Centre for healthcare<br />
professionals: an example of an<br />
innovative enterprise<br />
C Osonnaya*, K Osonnaya and E Burke<br />
Dept of General Practice and Primary Care, Queen Mary<br />
College, University of London, Mile End Road, London E1 4NS,<br />
UK<br />
In 1998, the need to develop a learning skill centre<br />
arose at United Medical Education Consortium<br />
(UMEC) in London with resources for multiprofessional<br />
teaching and learning in healthcare<br />
educational approaches, administration, research,<br />
clinical and computer skills. Logs of all the users of<br />
the centre between 25 February 1998 and 28 February<br />
2001 were kept. All the courses run by the centre were<br />
monitored and evaluated using standardised evaluation<br />
forms. Data about activities were analysed to compare<br />
the usage of the centre’s resources by different groups<br />
in different years (25 February 1998 and 27th February<br />
2001) and their needs for skill facilities. The evaluation<br />
results show that availability of flexible skills training<br />
facilities for UMEC members and visitors have created<br />
an effective teaching and learning environment. Our<br />
future plan involves investigating how to provide more<br />
informed multidisciplinary teaching using new<br />
technology and extending the services to a wider<br />
audience.<br />
7H7 Legal theories of recourse for failed<br />
medical students in the United<br />
States<br />
Thomas Jamieson<br />
Uniformed Services University of the Health Sciences, 4301 Jones<br />
Bridge Road, Bethesda, MD 20814-4712, USA<br />
Medical students aggrieved by a failing grade(s) or<br />
disenrollment sometimes consider legal action. In the<br />
Wednesday 5 September<br />
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United States students typically cite an institutional<br />
breach of the constitutional right to procedural<br />
propriety (“procedural due process”) and/or arbitrary<br />
motivation (“substantive due process”). Caselaw has<br />
established that constitutional protections are owed<br />
medical students, but courts have consistently offered<br />
a presumption of legitimacy to institutions’ decisions<br />
and students have seldom prevailed when alleging<br />
inadequate due process. Although minimally exercised<br />
to date, prospective medical student plaintiffs may<br />
begin to consider alternative premise(s) for a legal<br />
challenge. Increasingly, courts view students as<br />
consumers with expectations for acceptable<br />
institutional performance of services based on “implied<br />
contract.” Medical schools should be cognizant of the<br />
concept of “contract” and of stipulations in their own<br />
handbooks. If these documents can be read as “implied<br />
contracts” institutions must ensure they are actually<br />
doing what they say they are doing.<br />
7H8 An evaluation of organising student<br />
participation in curriculum reform<br />
using a mentoring programme at the<br />
Nelson R Mandela School of<br />
Medicine, University of Natal,<br />
Durban, South Africa<br />
Dorothy Appalasamy, Michelle McLean* and<br />
Jacqueline van Wyk<br />
Department of Physiology, Faculty of Medicine, Private Bag X7,<br />
Congella 4013, South Africa<br />
In implementing (January 2001) a student-centred<br />
curriculum at the Nelson R Mandela School of<br />
Medicine, an already successful (re: addressing student<br />
needs) mentoring programme involving 4th and 5th<br />
year students, was modified to assist 1st year students<br />
cope with the new learning paradigm. First year<br />
students enrolled for Curriculum 2001 were organised<br />
into twenty tutorial groups (n = ± 200) for Module 1,<br />
each group being allocated a trained facilitator. Twenty<br />
senior students underwent training to work with these<br />
tutorial groups, with the aim to provide peer support<br />
for group members. Mentors meet regularly with their<br />
groups and with the year co-ordinator for input,<br />
clarification and for evaluation of student progress and<br />
needs. Preliminary results indicate that 1st year students<br />
have embraced the concept of PBL. Issues, for example,<br />
relating to the small group process and timetabling,<br />
have been addressed by the mentors and the year coordinator.<br />
7H9 Medical education – more than<br />
learning?<br />
Thomas Eichholz and Catharina Crolow<br />
Charité, Zeppelinplatz 6, 13353 <strong>Berlin</strong>, GERMANY<br />
For most medical students, medical education is mainly<br />
an instrument to acquire the knowledge to treat the<br />
patients. In our poster we want to discuss chances<br />
existing in medical education in Germany. Does<br />
medical education offer alternatives an an extra<br />
qualification, as a field of research and as a basis for a<br />
career?
Session 7I Continuing professional development (1)<br />
7I1 The roles of hospital consultants:<br />
more than just patients and<br />
students<br />
Patsy Stark<br />
University of Leeds, Clinical Skills Learning Centre, The General<br />
Infirmary at Leeds, A Floor Gilbert Scott Building, Leeds LS1<br />
3EX, UK<br />
Hospital consultants undertake roles extending beyond<br />
clinical medicine and undergraduate teaching. In most<br />
healthcare systems they are increasingly required to<br />
do more. How do they identify and prioritise roles and<br />
cope with increasing pressures? A study carried out at<br />
University of Leeds School of Medicine and the Leeds<br />
Teaching Hospitals Trust aimed to discover the range<br />
of consultants’ roles, how they prioritise activities and<br />
their perceptions of change. Semi-structured interviews<br />
with hospital consultants were conducted. Analysis of<br />
the data was performed using qualitative methods. The<br />
participants revealed wide-ranging roles inside and<br />
outside the employing organisation, strong allegiances<br />
to aspects of their work and frustrations about<br />
increasing demands. In general this was not reflected<br />
in job plans or contracts. It was concluded that<br />
consultant contracts and job plans must recognise not<br />
only the obvious clinical and undergraduate teaching<br />
roles but also those which have impact on professional<br />
organisations multiprofessional groups and other<br />
institutions.<br />
7I2 Continuing medical education X<br />
indexation? Authors’ opinions<br />
about editorial policies of a<br />
Brazilian academic journal<br />
Maria de Lourdes Veronese Rodrigues*, Valderes<br />
Aparecida Coelho Falaschi and Julio Cesar Voltarelli<br />
Hospital das Clínicas - Oftalmologia, Faculdade de Medicina de<br />
Ribeirao Preto, 12 andar - Campus Universitario, 14048-900<br />
Ribeirao Preto SP, BRAZIL<br />
The main objective of this investigation was to find<br />
out authors’ opinions about some aspects of editorial<br />
policies of an academic journal, published by a<br />
Brazilian Medical School/University Hospital. This<br />
journal emphasizes Continuing Medical Education,<br />
publishing mainly review papers and topic symposia,<br />
and it is not indexed in MEDLINE. The instrument used<br />
was a self-administered, non-identified questionnaire<br />
answered by 28 members of the scientific community,<br />
authors of some papers published by the journal, in the<br />
last three years. On a three points scale (3 - definitely<br />
agree, or high level of adequacy; 1 - definitely disagree,<br />
or inadequate), participants rated the quality of different<br />
aspects of editorial policies adopted by Revista<br />
Medicina-Ribeirão Preto (Brazil). Most authors agreed<br />
with the policy “emphasis in continuing medical<br />
education” (mean = 2.39, s = 1.22) even if it prevents<br />
indexation in MEDLINE.<br />
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7I3 Learning HSR by doing: forming<br />
parallel learning groups<br />
Saeed Asefzadeh<br />
Qazvin University of Medical Science & Health Services, Qazvin,<br />
IRAN<br />
Health Systems Research (HSR) is a necessary<br />
approach for resolving health problems. We assessed<br />
the educational needs of the health workers for HSR<br />
through focused group discussions in order to develop<br />
a module that can enable them to participate actively<br />
in HSR. A module for the health workers has been<br />
designed in 10 steps as a practical guide for problem<br />
solving – from finding problems to evaluating the<br />
solution. The focus of our work is a change from<br />
traditional workshops to continuous in-the-field<br />
training workshops using learning by doing method.<br />
At least two hours a week, the health workers as a<br />
learning group come together and one step of the<br />
module is taught and practised on the real identified<br />
problems. The participants track and work on the step<br />
during the week. In this way the learning group makes<br />
up a parallel learning group which works continuously<br />
and learns autonomously to develop the health<br />
organisation.<br />
7I4 Towards a flexible workforce - a<br />
basis for change<br />
F French*, M Awramenko, A Scott, C Ubach, L Leighton-<br />
Beck, G Needham, J Mollison and H Coutts<br />
SCPMDE, Dept of Postgraduate Medicine, Room 25, Westburn<br />
Centre, Foresterhill, Aberdeen AB25 2XG, UK<br />
The Scottish Executive seeks increased flexiblity<br />
among healthcare professionals. The Scottish Council<br />
for Postgraduate Medical and Dental Education has<br />
commissioned a study of perceptions of flexible<br />
working among non-training grade doctors and<br />
dentists. Hospital consultants have been selected as the<br />
first group for study and this will be the first<br />
comprehensive study of hospital consultants in<br />
Scotland. The aims of the study are:<br />
• to elicit the views of non-training grade doctors and<br />
dentists regarding flexible working;<br />
• to assess the implications of increased flexibility<br />
on continuing professional development;<br />
• to ascertain levels of job satisfaction and<br />
occupational stress.<br />
Focus groups and/or interviews will be used to inform<br />
the design of a questionnaire. Follow-up interviews will<br />
be conducted to clarify/expand on issues arising from<br />
the survey. Selected results from the survey of hospital<br />
consultants will be presented.
7I5 Ensuring cost-effective CPD:<br />
perspectives, problems and policy<br />
Clive Belfield and Celia Brown*<br />
Centre for Research in Medical & Dental Education, School of<br />
Education, University of Birmingham, Edgbaston, Birmingham<br />
B15 2TT, UK<br />
CPD must be cost-effective if the optimal quantity is<br />
to be funded within health care systems burdened by<br />
resource constraints. This paper details the<br />
requirements for ensuring effective and cost-effective<br />
CPD established as part of an investigation into CPD<br />
funding, provision and participation in the UK NHS.<br />
The perspectives for ensuring cost-effective CPD are<br />
framed within a taxonomy that describes an educational<br />
intervention (Bullock and Thomas, 1997). Thus issues<br />
pertinent to both provider and participant: access,<br />
management and planning, curriculum and pedagogy,<br />
setting, assessment and evaluation are addressed. There<br />
are however a number of constraints that hinder the<br />
adoption of cost-effective CPD strategies. Empirical<br />
and primary evidence that suggests current practice<br />
fails to meet the requirements is presented and the<br />
implications for CPD policy in the UK are discussed.<br />
7I6 Improving your skills in preventive<br />
medicine: this CME workshop works!<br />
François Goulet*, André Jacques* and Danielle Saucier<br />
College des Médecins du Québec, 2170 René-Levesque Ouest,<br />
Montréal QC H3H 2T8, CANADA<br />
A 90-minute workshop offered to small groups has been<br />
developed to help family physicians to include<br />
evidence-based intervention to their periodic health<br />
examination (PHE). After the workshop, participants<br />
completed a questionnaire with opened and closed<br />
questions. Between September 1996 and December<br />
1997, 40 workshops were held reaching 667<br />
participants (16.7 participants/workshop) in all regions<br />
of the province of Quebec. The evaluations (98.5%<br />
response rate) showed that participants have reached<br />
the workshop objectives (2.05 on the Likert scale –3 to<br />
+3). The most important messages retained were a<br />
better choice of tests (34.9%) and physician’s self<br />
involvement (27.2%). Changes anticipated in their<br />
practice were: better screening of tests (38.9%),<br />
enhancement of knowledge (18.9%) and to insist on<br />
counselling (12.8%). Role playing and discussion with<br />
peers were effective methods used to produce<br />
anticipated changes in the practice of family physicians.<br />
7I7 CME program in Kuwait<br />
K Al-Jarallah and I G Premadasa*<br />
Kuwait Institute for Medical Specialization, Behbehani Bldg, 10th<br />
Floor, PO Box 1793, Al-Sharq, Safat 13018, KUWAIT<br />
The Kuwait Institute for Medical Specialization is the<br />
designated authority for implementing a unified<br />
continuing medical education scheme. The CME<br />
Center administers the scheme, which commenced in<br />
September 2000. The current phase covers medical and<br />
dental practitioners. Participation in CME activities is<br />
optional, but includes reinforcement policies. The<br />
program operates in 5-year cycles, with practitioners<br />
expected to acquire a minimum of 250 credit points<br />
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within the cycle. CME activities fall into one of two<br />
categories. The web site of the CME Center at<br />
www.kims.org.kw/cme provides details of the scheme,<br />
and an online facility for participants to register, and<br />
for CME providers to apply for accreditation of<br />
activities. Program implementation is monitored by<br />
reviewing random samples of organizers and<br />
participants. Peer review by an external evaluator has<br />
led to quality assurance. International recognition has<br />
been received via accreditation by Royal Colleges in<br />
North America and Europe.<br />
7I8 The theory of perspective<br />
transformation and its applicability<br />
to CME<br />
Jill Donahue*, Stephen Hotz and Réjean Laprise*<br />
Aventis Pharma, 49 Fallingbrook Street, Whitby, Ontario L1R<br />
1M4, CANADA<br />
In the field of adult education, Jack Mezirow published<br />
his theory of Perspective Transformation which has<br />
become one of the most important contributions to the<br />
recent adult education literature. He identified 10<br />
phases a learner goes through before he/she<br />
incorporates a new perspective. There are many lessons<br />
from this theory that we can apply to our work in CME.<br />
After interacting with the poster, the participant will<br />
be able to:<br />
1 identify parallels between issues faced by<br />
practitioners in CME and contributions of the theory<br />
of Perspective Transformation;<br />
2 assess the application of key concepts of the theory<br />
to needs assessment, design and evaluation<br />
The key point of the presentation is that when designing<br />
CME one should consider that in order to incorporate<br />
a new perspective, a learner may go through ten phases<br />
that begin with a disorienting dilemma.<br />
7I9 The transtheoretical model of<br />
behaviour change: does it apply to<br />
clinical practices?<br />
Réjean Laprise*, Jill Donahue and Stephen Hotz<br />
Aventis Pharma, Department of Professional Education, 2150<br />
St Elzear Boulevard West, Laval, Quebec H7L 4A8, CANADA<br />
The transtheoretical model (TTM) proposes that people<br />
go through a series of 5 different stages of readiness<br />
when adopting new behaviours. Stage-specific<br />
educational interventions based on this model were<br />
shown to facilitate adoption of healthy behaviours in<br />
patients. In this presentation, we show evidence that<br />
the TTM may also be useful with physicians. A study<br />
was carried out on a convenient sample of 195 general<br />
practioners attending continuing medical education in<br />
cardiology. Physicians were asked to stage themselves<br />
according to their readiness to prescribe an ACE<br />
inhibitor to a high risk cardiac patient, to rate the<br />
importance they put on this medical practice and to<br />
indicate their degree of confidence in overcoming<br />
barriers associated with the performance of this clinical<br />
behaviour. The relationship between readiness to<br />
change behaviour on one hand, and self-confidence and<br />
importance on the other hand, were consistent with<br />
predictions made from the TTM.
Session 7J Continuing professional development (2)<br />
7J1 Sharing visions: working with CPD<br />
coordinators in General Practice<br />
Simon Smail* and Paul Hocking<br />
Dept of Postgraduate Education for General Practice, School of<br />
Postgraduate Studies, University of Wales College of Medicine,<br />
Heath Park, Cardiff CF14 4XN, UK<br />
During 2000, twenty general practitioners were<br />
recruited to work part-time with the Dept of<br />
Postgraduate Education for General Practice in Wales<br />
as ‘CPD co-ordinators’. Each general practitioner was<br />
employed to work one day a week to develop a managed<br />
programme of CPD in the locality for which they were<br />
responsible, drawing on local resources and supported<br />
with an operational budget. Since all these staff were<br />
facing new challenges in working as educational<br />
managers, a two-day workshop was held to assist them<br />
in developing a vision for their future work. This<br />
workshop used a variety of methods, including an<br />
‘imaginisation’ exercise in which the participants were<br />
asked to draw graphical representations of the ideals<br />
they wished to pursue in their work. The concepts were<br />
then discussed and developed into themes. This<br />
presentation describes the methods used in the<br />
workshop and presents the outcome in summary form.<br />
7J2 The “Advanced Training Practice”:<br />
a questionnaire and interviewbased<br />
study of their role<br />
John Skelton and Steve Field*<br />
West Midland GP Unit, 27 Highfield Road, Edgbaston,<br />
Birmingham B15 3DP, UK<br />
In the West Midlands Region, UK, 6 practices have<br />
been designated “Advanced Training Practices” (ATPs).<br />
They offer specialised, often remedial, training to GP<br />
Registrars who, for example, have failed summative<br />
assessment. Registrars, trainers and other stakeholders<br />
have previously been studied to assess support offered<br />
for communication skills: this study extends this work<br />
by questionnaire and interview with trainers, to assess<br />
the perceived value of ATPs. Many Registrars at ATPs<br />
are overseas graduates. Major issues are poor English<br />
language and communication, (eg from doctors<br />
accustomed to a doctor-centred environment), poor<br />
cross-cultural understanding, poor study skills and<br />
defective knowledge. For trainers, a major issue is the<br />
extent to which Registrars are “trainable”: however,<br />
they have confidence in their ability to train and assess.<br />
The specialised needs of Registrars are adequately met,<br />
but the level of additional support, particularly through<br />
commercially available materials, requires expansion.<br />
7J3 Does gender make a difference?<br />
CME for the female physician<br />
Jane Tipping* and Jill Donahue<br />
10987 Warden Avenue, Markham, Ontario L6C 1M9,<br />
CANADA<br />
The population of female physicians in Canada is<br />
growing such that the percentage of female primary<br />
care physicians in practice is equal to males. CME is<br />
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still designed and conducted based on the learning<br />
needs of a population that has been predominantly<br />
male. This research questions the assumption that the<br />
two genders are the same in their approaches to<br />
learning. The research identifies ways in which learning<br />
differs for female physicians in terms of preferred<br />
activity, motivation and participation. In addition, the<br />
particular challenges female physicians encounter in<br />
CME will be discussed along with strategies that may<br />
better meet the needs of this group.<br />
7J4 Strategic planning for effective<br />
partnerships<br />
Jane Tipping* and Danielle Deslauriers<br />
10987 Warden Avenue, Markham, Ontario L6C 1M9,<br />
CANADA<br />
We have reached a point in the evolution of CME<br />
whereby the creation of true partnerships between<br />
stakeholders and the effective pooling of resources is<br />
becoming a necessity. Within the past several years,<br />
the role of the pharmaceutical industry in Canada as a<br />
credible partner and provider of CME has become<br />
evident. Without dialogue between the stakeholder,<br />
duplication of efforts, territorial issues and<br />
miscommunication can arise resulting in less value for<br />
the learner. Ways to align mutual goals are sorely<br />
needed. This presentation will discuss the directions in<br />
which CME is growing and describe attempts of Merck<br />
Frosst Canada to align itself with the developing needs<br />
of the field. The presentation will critique a needs<br />
assessment technique used with 36 Canadian CME<br />
leaders; discuss results; the implications of<br />
pharmaceutical involvement in CME; and help<br />
determine ways in which partnership between<br />
academia, industry and others responsible for CME can<br />
grow.<br />
7J5 Integrating practice reflection and<br />
practice adjustment planning into<br />
the design of a CME meeting<br />
R L Thivierge*, L Samson and J V Patenaude<br />
721 Hartland, Montreal H2V 2X5, CANADA<br />
The new context of Continuing Professional<br />
Development (CPD) and of the Maintenance of<br />
Certification (MOC) of the Royal College of Physicians<br />
in Canada, brings an important pathway to ensure one’s<br />
CPD: the development of Personal Learning Projects<br />
(PLP). At the end of each half-day of a scientific<br />
meeting, periods of “reflection on my practice” (called<br />
CPD modules) are conducted by a facilitator as an<br />
integrated part of the program. Module 1 serves as an<br />
introduction to CPD, PLP and practice reflection<br />
generalities. Module 2 will help the participants to<br />
select specific key-messages derived from educational<br />
sessions to be applied to their practice environment<br />
(selecting own PLP). Module 3 helps to plan the<br />
validation and the implementation of their PLP once<br />
they are back to work. This model of intervention in<br />
CME meetings facilitates the linking between theory<br />
and practice.
7J6 The Catalan Council of Physicians’<br />
Colleges Accreditation Diploma in<br />
Continuing Medical Education<br />
A Ramos*, J Aliaga, A Gual and H Pardell<br />
College of Physicians of Barcelona, Centre of Studies, P Bonanova<br />
47, 08017 Barcelona, SPAIN<br />
The Catalan Council of Physicians’ Colleges has<br />
initiated an individual accreditation system, based on<br />
accredited Continuing Medical Education (CME). The<br />
system is voluntary and physicians can opt to obtain<br />
the Diploma of College Accreditation if the following<br />
prerequisites are achieved: a minimum of 10 credits<br />
obtained from the CME, accumulated to a minimum<br />
of 3 training activities carried out within the two<br />
previous years. The system includes a Technical<br />
Accreditation Office which deals with technical and<br />
administrative aspects and the Accreditation<br />
Commission which determines the accreditation system<br />
and grants the credits to be endorsed by the Governing<br />
Boards of the 4 Physicians’ Colleges in Catalonia<br />
(Barcelona, Girona, and Tarragona). This paper<br />
contains the first 100 accreditation requests, the<br />
percentages of concessions and denials, as well as the<br />
average of credits obtained, the activities presented, and<br />
a description of age and gender among other parameters<br />
of interest.<br />
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7J7 Breaking bad news: how to learn in<br />
a CME workshop<br />
François Goulet*, André Jacques* and Robert Carrier<br />
College des Médecins du Québec, 2170 René-Levesque Ouest,<br />
Montréal QC H3H 2T8, CANADA<br />
A 90-minute workshop offered to small groups was<br />
developed to help physicians to break bad news to their<br />
clientele. After the workshop and six months later,<br />
participants were asked to complete opened-question<br />
questionnaires. Between September 1997 and June<br />
1998, 50 workshops were held, reaching 706<br />
participants. From this number, 520 participants could<br />
be reached six months later. 207 participants (40%)<br />
completed the second questionnaire and 74% of them<br />
were identified from the first questionnaire to estimate<br />
the correlation. After six months, the key-messages<br />
retained were: never be overwhelmed, always have hope<br />
to offer, be prepared, find the right moment. The<br />
barriers still existing are: bad news is bad news,<br />
discomfort, and difficulty in taking the time. The<br />
participants found the workshop extremely helpful.<br />
Role playing and discussions with peers were effective<br />
methods used to produce changes in the practice.<br />
Session 7K International medical education<br />
7K1 Differences in learning style and<br />
satisfaction with Residency training<br />
for United States and<br />
internationally trained students<br />
Steven R Daugherty<br />
Kaplan Medical, 820 West Jackson, Suite 550, Chicago IL 60612,<br />
USA<br />
A national sample of medical residents training in the<br />
United States was surveyed about their residency<br />
experience. 3,604 returned usable surveys for a 64%<br />
response rate. Analyses examined ratings of satisfaction<br />
and what contributed most to learning experience for<br />
US trained students compared with the respondents<br />
who completed undergraduate medical education<br />
outside the US (IMGs). Results show that IMGs<br />
reported less time with attending physicians (5.61 vs.<br />
4.94, 7-point scale) and were overall less satisfied with<br />
their residency experience (5.14 vs. 4.78). US trained<br />
students rated contact with attending physicians and<br />
other residents as contributing most to their learning<br />
experience, while IMGs rated reading, patient rounds<br />
and lectures as the most important elements. These<br />
results suggest important differences both as to how<br />
IMGs learn and the structure of their residency training<br />
programs. Results are discussed with an eye towards<br />
students’ expectations and specialty selection.<br />
Wednesday 5 September<br />
7K2 Crossing borders - The <strong>Berlin</strong><br />
Biomedical Exchange Office<br />
U Arnold* and J W Dudenhausen<br />
Charité, Humboldt-University <strong>Berlin</strong>, <strong>Berlin</strong> Biomedical<br />
Exchange Office, Campus Virchow-Klinikum, Augustenburger<br />
Platz 1, D-13353 <strong>Berlin</strong>, GERMANY<br />
“To promote international education and qualification<br />
of medical students” is the mission of the <strong>Berlin</strong><br />
Biomedical Exchange Office (BBEO), which was<br />
initially founded in 1996 as a cooperation project<br />
between the medical faculties of Humboldt-Universität<br />
(Charité) and Freie Universität <strong>Berlin</strong> (University<br />
Hospital Benjamin Franklin). The activities of the<br />
BBEO are:<br />
International Exchange<br />
• ERASMUS/SOKRATES<br />
• Biomedical Sciences Exchange Program between<br />
North America and Europe (BMEP)<br />
• Bilateral Cooperation<br />
• International Courses in English<br />
New Technologies in Education<br />
• Medic@l Deutsch<br />
• MedVoice<br />
• IMIPPP<br />
• Other projects
Service for Students. The BBEO<br />
• provides extensive personal consulting;<br />
• writes letters of recommendation for applications<br />
at foreign medical schools;<br />
• hands out various information regarding study<br />
abroad, and provides up-to-date information on the<br />
website;<br />
• shows poster exhibitions, extended by lectures and<br />
discussions, on the subject;<br />
• offers special medical language courses for<br />
incoming and outgoing students.<br />
7K3 Academic medical education in<br />
developing countries: an analysis<br />
of papers presented at medical<br />
education conferences in Argentina<br />
Angel M Centeno*, Gustavo Amestoy and<br />
Amelia Cabrera<br />
Faculty of Biomedical Sciences, Universidad Austral-Medicina,<br />
Av J Peron 1500, B1629AHJ Derqui, Pilar, Pov Buenos Aires,<br />
ARGENTINA<br />
Globalization of medical education, including some<br />
agencies’ proposals of defining a universal curriculum,<br />
make it necessary to define what kind of activities are<br />
conducted in different regions. In order to determine<br />
what aspects of medical education were of interest in<br />
our country, what kind of methods were used and which<br />
disciplines were the most active in medical education,<br />
228 papers presented at two consecutive medical<br />
education conferences in Argentina were analyzed.<br />
Curriculum design (11%), problem based learning<br />
(10%), faculty development (10%), program evaluation<br />
(8%), teaching methods (8%), disciplines integration<br />
(7%), informatics and multimedia (5%), community<br />
service (5%), evaluation methods (5%), continuing<br />
medical education (5%), and admissions (5%), were<br />
the most frequently cited.<br />
Thirty percent of the papers were research based, and<br />
70% were narrative descriptions of programs in<br />
progress. Basic and clinical sciences were equally<br />
represented, the latter mainly in postgraduate education.<br />
These results are similar to those reported in developed<br />
countries.<br />
7K4 Communication skills training in<br />
Germany - results of a survey<br />
Jan Schildmann* and Ulrich Schwantes<br />
Humboldt University <strong>Berlin</strong> (Charite), Department of General<br />
Practice, Vogelsang 16, 78343 Horn, GERMANY<br />
The training of communication skills has become an<br />
important part of the curricula at many medical schools<br />
in Europe. In Germany however a lot of universities<br />
do not offer regular communication skills courses. To<br />
find out more about the actual situation regarding<br />
education in this field of medical education we<br />
conducted a survey among medical students who took<br />
part in seminars and lectures organised by the<br />
department of General Practice at different Medical<br />
Schools in Germany. The aim of our survey was to<br />
explore the existing learning opportunities offered by<br />
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- 4.79 -<br />
the medical faculties. Furthermore we asked the<br />
students about their needs regarding this aspect of<br />
medical training. In our presentation we will show the<br />
data of the survey and our conclusions for the future<br />
development of communication skills training as part<br />
of the training at German Medical Schools.<br />
7K5 Reform of the medical educational<br />
system in Georgia<br />
R Khetsuriani, B Kilasonia and A Telia*<br />
Tbilisi State Medical University, 33 Vazha-Pshavela Ave, Tbilisi<br />
380077, GEORGIA<br />
Tbilisi Medical State University prepares annually 500<br />
specialists in medicine and pharmacy. Ten years ago<br />
our country moved to a new economic formation under<br />
difficult social and economical conditions and faced<br />
the necessity for reforms in the medical educational<br />
system. Following the Soviet era, and without central<br />
financing, medical education tries to fill the vacuum<br />
with “European air”. At the Medical University reform<br />
has been partially implemented. The learning process<br />
consists of three stages:<br />
1 Two years – basic course – examination<br />
2 Three years – clinical course – examination<br />
3 Two years – specialization – state examination<br />
certification (specialty – medical affairs,<br />
qualification – physician).<br />
A net of University clinics has been created as well as<br />
a rectorial post. The second step of the reform involved<br />
the establishment of outcome-based education,<br />
development and optimization of the learning process,<br />
translation of standard educational programs and<br />
textbooks, and acquaintance with the European<br />
educational system and standards. Realization of this<br />
goal is fairly difficult without support from the<br />
international community.<br />
7K6 Results and main objectives of the<br />
first stage of education reform at<br />
the TSMU<br />
R Khetsuriani, B Kilassonia and N Pruidze*<br />
Tbilisi State Medical University, 33 Vazha-Pshavela Ave, Tbilisi<br />
380077, GEORGIA<br />
Based on the tradition of European medical education,<br />
a high medical school was founded in Georgia in 1918;<br />
its successor is Tbilisi State Medical University. A new<br />
period of this high school started in 1992, when total<br />
autonomy was given to the high schools in independent<br />
Georgia. Since this time it has become possible to<br />
implement the cardinal changes in medical education<br />
and to engage highly qualified pedagogical and medical<br />
staff, which was quite difficult during the period of<br />
transition from one politico-economic system to<br />
another. In that period, well-known medical schools in<br />
the USA, Austria, Germany, France, Spain, Turkey,<br />
Egypt, etc. became our partners. At Tbilisi State<br />
Medical University there are departments of General<br />
Practice, Pediatrics, Preventive Medicine and<br />
Healthcare Management, Stomatology, Military<br />
Medicine, Medical Biology, Psychosomatic Medicine,
Psychotherapy and Pharmacy. Studies in the faculty of<br />
General Practice consist of 14 semesters, in total 8800<br />
academic hours. In our opinion, the curriculum is<br />
overloaded and a revision of the teaching methodology<br />
is needed. We aim to have close integration with<br />
European medical schools, which will give us an<br />
opportunity of reciprocal recognition of qualifications.<br />
7K7 First international integrated<br />
surgery course at the Charité,<br />
<strong>Berlin</strong>, Germany<br />
Hajo Schmidt-Traub<br />
Charité, Humboldt University <strong>Berlin</strong>, Isländische Str. 11, <strong>Berlin</strong>,<br />
GERMANY<br />
In cooperation with the Karolinska Institutet,<br />
Stockholm, Sweden, a 16 week surgery course took<br />
place in <strong>Berlin</strong>. It included surgery, orthopaedics,<br />
anaesthesia, radiology and urology. The course was<br />
mainly planned and organised by students who had<br />
taken part in the Stockholm international surgery<br />
course. The aim of the course was to mediate both<br />
practical and theoretical skills. The students were<br />
integrated into the daily routine of a general hospital<br />
and participated in practical and problem based<br />
seminars. Half of the students came from foreign<br />
countries. Language of instruction was English. The<br />
students’ learning experiences in seminars and hospital<br />
departments were evaluated. Feedback from both<br />
students and teachers was very positive. This project<br />
proved to be a good example of a different way of<br />
teaching. Therefore it may have a positive impact on<br />
the future structure of the medical curriculum at the<br />
Charité.<br />
Session 7L Special subjects<br />
7L1 Illegible notes - do tomorrow’s<br />
doctors need teaching on how to<br />
write more clearly?<br />
E Westcott, A Kontoyannis*, N Murch, T Reid and<br />
K Sixsmith<br />
University of Wales College of Medicine, 9 Connaught Road,<br />
Roath, Cardiff CF24 3PT, UK<br />
Hand-written entries by doctors in patient notes aim to<br />
communicate information to other team members. It<br />
is important that these entries can be easily read and<br />
understood. 205 patient clerkings were read by medical<br />
students (fourth year) to asses the percentage of illegible<br />
words and unrecognisable abbreviations, and the<br />
absence of date, time, patient details and doctor’s<br />
identification. Whereas the recording of patient<br />
identification was good (due to the use of patient<br />
‘addressograph’ stickers), the recording of the doctor’s<br />
identification (name, position, bleep number), was<br />
incomplete in over half the entries. This poster discusses<br />
the implications of poorly written patient notes and<br />
suggests methods for improvement. These results call<br />
for improved teaching on handwriting legibility, the<br />
appropriate use of abbreviations and the recording of<br />
doctor identification. The use of doctor ‘identograph’<br />
stickers is suggested.<br />
Wednesday 5 September<br />
- 4.80 -<br />
7K8 Counting the uncounted:<br />
estimating the number of overseas<br />
doctors in training grades in the UK<br />
currently not employed in the NHS<br />
Janet Grant, Mairead Beirne* and Heather Owen<br />
Open University Centre for Education in Medicine, The Open<br />
University, Walton Hall, MILTON KEYNES MK7 6AA, UK<br />
The main aims of this project were to:<br />
• Estimate the size of the pool of unemployed<br />
overseas doctors in the UK and to indicate its<br />
distribution across specialties and subspecialties;<br />
• Determine the career and job-seeking strategies of<br />
these doctors;<br />
• Describe the scope for improving these doctors’<br />
prospects of employment;<br />
• Estimate the background availability of posts.<br />
Because of their unemployment, there are no records<br />
of unemployed overseas doctors in the UK. This project<br />
therefore addressed the challenge of counting the<br />
uncounted. An approach to estimation was therefore<br />
selected which involved adopting a variety of methods<br />
and triangulating these to reach an overall view of the<br />
magnitude of the pool, its distribution and the reasons<br />
behind it. The methods adopted included:<br />
• Survey of Senior House Officer applicants<br />
• Documentary analysis<br />
• Secondary analysis of GMC and DoH statistics<br />
• Survey of competition for posts.<br />
7L2 An active method to prepare<br />
students to lead medical<br />
interviews: an experience at Xavier<br />
Bichat Medical School<br />
Corinne Pieters; Dominique Maillard*, Françoise<br />
Blanchet-Benqué<br />
Hopital Louis Mourier, Explorations Fonctionnelles, 178, rue<br />
des Renouillers, 92700 Colombes, FRANCE<br />
This study describes a series of two active trainings,<br />
teaching basic communication skills in the pre-clinical<br />
curriculum. In the first intervention, of a one-day<br />
duration, students had to reformulate in a popular radiostyle,<br />
different messages from a scientific paper, in front<br />
of 20 students. In the second intervention of a threehour<br />
duration, students working in small groups of 10,<br />
had to (from a video extract): observe behaviours of a<br />
patient meeting several doctors, analyse the styles of<br />
verbal and non-verbal communication and expose to<br />
other students the communication gap between the<br />
patient and the doctors he/she met. Each presentation<br />
is followed by a group discussion and a synthesis done<br />
by the teacher. Formative assessment will allow the<br />
students to master their own abilities to conduct medical<br />
interviews.
7L3 Teaching medical students patient<br />
advocacy skills; An<br />
interdisciplinary intervention using<br />
Standardized Patients/Families<br />
Graceanne Adamo*, Virginia Randall, Janice Hanson,<br />
William Sykora, Aileen E Zanoni, Elizabeth Jeppson and<br />
Richard E Hawkins<br />
Uniformed Services University of the Health Sciences, National<br />
Capital Area Medical Simulation Center, 4301 Jones Bridge<br />
Road, Bethesda MD 20814, USA<br />
We describe an innovative medical education<br />
intervention, designed by interdisciplinary faculty<br />
collaborators, to teach and evaluate patient advocacy<br />
skills. The intervention is integrated into the required<br />
Family Medicine Clerkship within a comprehensive<br />
clinical experience in a simulation center. The goals of<br />
this educational intervention are to instill in medical<br />
students the appropriate knowledge, skills and attitudes<br />
to advocate effectively for their patients in a managed<br />
care environment. Intervention activities evolve around<br />
encounters with standardized patients/families. The<br />
specific clinical challenges focus on discharge planning<br />
for patients with significant home-health care needs.<br />
Related instructional activities include: individual<br />
feedback from standardized patients and faculty, an<br />
interactive teaching session featuring an advocacy<br />
contact workbook, interviews with real patients, and<br />
an opportunity to practice advocating to a standardized<br />
attending physician on behalf of a patient or family.<br />
Outcome measures include participant satisfaction and<br />
performance on the final clinical examination.<br />
7L4 The parameters affecting attitudes<br />
to death among students in a<br />
Medical College in Taiwan<br />
Ming-Liang Lai<br />
Department of Neurology, National Cheng Kung University<br />
Hospital, 138 Sheng-Li Road, Tainan, TAIWAN<br />
The parameters affecting the attitude to death and dying<br />
(anxiety, avoiding, philosophical thinking, and reality<br />
facing) were evaluated through a questionnaire to<br />
students at the Medical College of National Cheng<br />
Kung University. The anxiety response was more<br />
frequently noted in the female gender, in more<br />
pessimistic students, in those who consider religion to<br />
be important in their life, particularly Daoism and<br />
Buddhism, and in students not in the Department of<br />
Medicine. The avoiding response was noted more in<br />
the male, with AB blood type, and in students in the<br />
Department of Medicine. Interesting enough, the<br />
sophomore and higher-grade medical students seemed<br />
more avoiding than freshman. The pessimists, and those<br />
who had considered their own death, who had read<br />
books on thalantology, seen movies or read novels with<br />
death or dying as the main theme, presented a<br />
significantly stronger tendency towards philosophical<br />
thinking. Finally the reality facing response was more<br />
frequently noted in those who had read books on<br />
thalantology.<br />
Wednesday 5 September<br />
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7L5 Evaluation of practical sessions in<br />
Clinical Anatomy: a strategy for<br />
educational improvement<br />
M A F Tavares* and M C Silva<br />
Institute of Anatomy, Medical School of Porto, Alameda Hernani<br />
Monteiro, 4200-319- Porto, PORTUGAL<br />
We have evaluated the students’ response to practical<br />
teaching sessions in Clinical Anatomy in our Medical<br />
School using action-research. The aim was to identify<br />
problems and to introduce changes which might<br />
improve the program and the performance of the<br />
teaching staff. At the end of each section of the program,<br />
each student completed a “target type” questionnaire<br />
with eight different components. As each quarter of<br />
the whole class had its own teacher, an analysis of<br />
variance was used to evaluate the target questions in<br />
the various sections of the program, and the<br />
performance of the four teachers. This research method<br />
gave us feedback on the students’ responses while the<br />
program was in progress. The results emphasize the<br />
importance of action-research in assessing and<br />
improving a developing program in a basic discipline<br />
of the medical curriculum.<br />
(Supported by Project PRAXIS XXI PCSH/C/CED/157/96)<br />
7L6 Towards a more effective teaching<br />
of Gross Anatomy: introducing new<br />
integrated clinical concepts and<br />
improving peer presentations/<br />
evaluation techniques<br />
Ameed Raoof*, Thomas Gest, William Burkel and<br />
Tamara Stein<br />
University of Michigan Medical School, Department. of<br />
Anatomical Sciences, Office of Medical Education, 3808 Med<br />
Sci Bldg II, Ann Arbor MI 48109-0608, USA<br />
Relevance and teaching methods of gross anatomy<br />
remains one of the most frequently assessed subjects<br />
among basic medical sciences. The medical gross<br />
anatomy course is taught at the University of Michigan<br />
to an average of 170 students. Measures to enhance<br />
effectiveness and promote relevance and learning<br />
opportunities included the introduction of new<br />
integrated clinical teaching concepts. These included<br />
clinical tutorials, clinical vignettes and modified<br />
practical exam questions. Students’ opinions about<br />
these techniques were assessed at the end of the<br />
semester. An interesting array of responses was<br />
obtained. Also, plans were laid down on providing<br />
students with clinical data related to the cadavers they<br />
dissect during the next semester. In addition, the peer<br />
presentation/evaluation technique that has been applied<br />
for a few years witnessed some further improvements.<br />
Students’ opinion about the new measures showed a<br />
significant improvement in the effectiveness of the<br />
technique in promoting the relevance of anatomical<br />
knowledge.
7L7 Putting the salutogenic orientation<br />
into practice: the life cycle course<br />
at the Technion<br />
H Eshach*, R Van-Raalte, L Dolev, H Bitterman and<br />
D Hermoni<br />
Technion, Israel Institute of Technology, PO Box 9649, Bat<br />
Galim, Haifa 31096, ISRAEL<br />
The salutogenic orientation, which focuses on origins<br />
of health, poses that we study the location of each<br />
person, at any time, in the ‘health ease/disease’<br />
continuum rather than dichotomize between healthy<br />
and sick people. The Life Cycle course at the Technion<br />
presents human social development from birth to death.<br />
Students, equipped with the salutogenic and<br />
biopsychosocial model, learn that patients’ “stories”<br />
reveal etiologically significant data that is often missed<br />
by clinicians. The aim is to identify a shift in students’<br />
perspectives regarding data about psychosocial aspects<br />
of the “patient story”. Before and after the Life Cycle<br />
course, students were provided with cases that required<br />
knowledge of the psychosocial aspects surrounding<br />
patients’ lives in order to treat them. Students were<br />
asked to rank contributing factors, including<br />
psychosocial and pathological factors, according to<br />
their relevance to the intended treatments. Results are<br />
pending and will be presented at the conference.<br />
7L8 ASAMANS (Ask Students About<br />
Medicine And National Socialism)<br />
T Drewes*, P Langkafel* and S Muller*<br />
Charité, Department of Obstetrics, Faculty of Medicine,<br />
Humboldt-University of <strong>Berlin</strong>, Augustenburger Platz 1, 13353<br />
<strong>Berlin</strong>, GERMANY<br />
Medicine during National Socialism (1933-1945) in<br />
Germany and the consequences for medical practice<br />
nowadays are the topic of this presentation. Focus of<br />
the study is the knowledge, assessment and attitudes<br />
of medical students towards medicine and National<br />
Socialism. We asked in which way medical education<br />
at the Charité/<strong>Berlin</strong> promotes the discussion of this<br />
subject among students. We asked about general basic<br />
topics such as euthanasia, medical experiments in<br />
concentration camps and the role of German doctors<br />
during National Socialism. A sample of 300 students<br />
at the start, middle and end of the studies (first, fifth,<br />
tenth semester) answered a questionnaire of 35<br />
questions between April and May 2001. The team<br />
consisted of one physician and two medical students.<br />
The results will be discussed and presented at the<br />
conference. Further information will be posted at<br />
www.asamans.de<br />
Wednesday 5 September<br />
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7L9 Stress among medical doctors<br />
J Agsteribbe* and J Cohen-Schotanus<br />
University of Groningen, Department of Education, Faculty of<br />
Medical Sciences, A. Deusinglaan 1, 9713 AV Groningen,<br />
NETHERLANDS<br />
While interviewing medical doctors we noticed quite<br />
a number of complaints concerning job load and lack<br />
of leisure time. The overwhelming amount of<br />
complaints surprised us since one of the objectives for<br />
medical training is to learn to deal with stress and to<br />
become aware of the mutual influences of work and<br />
private life. Our research question is therefore: are<br />
workers in the medical profession more susceptible to<br />
stress than those in other occupations? 235 medical<br />
doctors were interviewed by phone and asked to fill<br />
out the General Health questionnaire (GQH-12); 150<br />
responded. The results indicated that: i) medical doctors<br />
were more stressed than their age group with the same<br />
educational level; ii) female doctors were much more<br />
stressed than their male colleagues; iii) female doctors<br />
are at a greater risk of experiencing stress than male<br />
doctors. It therefore seems necessary to pay more<br />
attention to this phenomenon during medical training.<br />
7L10 Introducing changes in medical<br />
education: the “Strategy” of<br />
Clinical Anatomy at the Medical<br />
School of Porto<br />
M A F Tavares<br />
Institute of Anatomy, Medical School of Porto, Alameda Hernani<br />
Monteiro, 4200-319- Porto, PORTUGAL<br />
The discipline of Clinical Anatomy, as introduced in<br />
the Medical School of Porto in academic year 1995/<br />
1996, involved big changes in the way we teach<br />
anatomy to medical students, by adopting a clinically<br />
oriented approach. The teaching/learning program has<br />
been developed over the last 5 years through an actionresearch<br />
project: (1) organisation of a new approach in<br />
Sections (regional approach) divided into different<br />
Units (physical examination, sectional and imaging<br />
anatomy sessions, malformations and anatomical<br />
variations, case-studies); (2) development of<br />
instructional materials (study guides, handouts, casestudies)<br />
and (3) introduction of interactive audiovisuals.<br />
This program involved all the staff and students as<br />
active researchers in this project. Its full implementation<br />
is providing medical students with a solid anatomical<br />
competence through the acquisition of an “anatomical<br />
reasoning” that aims to provide skilled clinical<br />
performance.<br />
(Supported by Project PRAXIS XXI PCSH/C/CED/157/96)
Session 8A Computer mediated learning and assessment<br />
8A1 Preparing clinical small group<br />
sessions by using digital video in<br />
CBE<br />
Marianne G Nijnuis*, Caro Brumsen, Jan A Gevers<br />
Leuven and Peter G M de Jong<br />
Leiden University Medical Center, Onderwijscentrum IG, Kamer<br />
C5-54, PO Box 9600, 2300 RC Leiden, NETHERLANDS<br />
Small-group patient demonstrations form an important<br />
part of the Internal Medicine clerkship in Leiden. The<br />
purpose of these meetings is to discuss symptoms, signs<br />
and management of common health problems and<br />
diseases. In practice it is often difficult to get a patient<br />
with the required diagnosis at the right time and place.<br />
As a result, most cases have to be presented in written<br />
text. In order to make better use of the available patient<br />
material several patients were recorded on digital video<br />
at a time that was more convenient for them. The images<br />
were used in a computer based educational program.<br />
Students are requested to study this program on the<br />
evening before the small-group discussion takes place.<br />
During the session the students can discuss the case<br />
under supervision of a clinician. The use of this new<br />
teaching method has improved the educational value<br />
of the already highly appreciated patient<br />
demonstrations.<br />
8A2 Inter-physician communication<br />
training through computer-based<br />
patient simulations<br />
S Eggermont*, P M Bloemendaal, E Schoonderwaldt and<br />
J D Donnison-Speyer<br />
Leiden University Medical Center, Heelkunde Onderwijs K6-R,<br />
Postbus 9600, 2300 RC Leiden, NETHERLANDS<br />
Communication between physicians is essential in<br />
modern medicine; therefore communication training<br />
should be integrated in medical curricula. A joint<br />
project of the Leiden University Medical Center and<br />
the Amsterdam Medical Center, will result in twenty<br />
computer-based cases, developed in the Dynamic<br />
Patient Simulator (DPS). DPS is a computer program<br />
for creating and running patient simulations. In such a<br />
simulation several students treat one virtual patient<br />
asynchronously, enabling them to practise clear and<br />
adequate communication by training the transfer of the<br />
patient’s medical record. For this purpose we created a<br />
model of the inter-physician communication. With this<br />
model we can differentiate between multiple types of<br />
communication with different modalities, such as<br />
transfer of collected evidence, consultancy and<br />
strategies for further evidence collection, assessment<br />
and intervention. In our presentation we will explain<br />
the communication model and demonstrate its<br />
implementation in DPS.<br />
Wednesday 5 September<br />
- 4.83 -<br />
8A3 Computer Assisted Learning: using<br />
and doing research in primary care<br />
Linda Leighton-Beck*, Philip Hannaford, Neil Hamilton,<br />
Sara Shaw and Yvonne Carter<br />
Scottish Council for Postgraduate Medical & Dental Education,<br />
Postgraduate Medical Department, University of Aberdeen,<br />
Foresterhill, Aberdeen AB25 2ZD, UK<br />
Development of CAL for research in primary care<br />
resulted from practitioners’ expressed needs, and the<br />
policy agenda. National collaboration achieved funding<br />
for a demonstration model. The project will:<br />
• design an innovative educational intervention to<br />
support staff in health settings, nationally and<br />
internationally;<br />
• develop a comprehensive course on research -<br />
Understanding Research and, Learning to do<br />
Research - utilising, initially, CD-ROM;<br />
• develop applications facilitating web access;<br />
• evaluate the concept through a pilot CD-ROM.<br />
The CD-ROM has been developed as a demonstration<br />
model through a collaboration of researchers and Medi-<br />
CAL technologists. Evaluation of its educational value<br />
and technological robustness will utilise questionnaire<br />
and interview of a defined sample of General<br />
Practitioners and healthcare professionals. Evidence of<br />
usefulness, effectiveness and accessibility will inform<br />
development. Successful outcomes will facilitate<br />
progress from demonstration model to platform support<br />
tools, customised to the needs of specialities.<br />
8A4 Extracting core competencies<br />
“bottom up” from case histories by<br />
an online consensus seeking<br />
process in family medicine<br />
Peter Schlaeppi* and Ralph Bloch<br />
Institute of Medical Education IAWF, University of Bern,<br />
Inselspital 37A, CH-3010 Bern, SWITZERLAND<br />
This project responds to the need for a clear and detailed<br />
definition of the required competencies for future<br />
family physicians in Switzerland. The aim of the project<br />
is to demonstrate that a web-based platform is a feasible<br />
and comfortable means to define relevant core<br />
competencies based on case histories. The practitioners<br />
of an expert panel had to write case histories based on<br />
their daily work. The panel outlined core problems and<br />
core criteria to solve core problems. Thus, a core<br />
competence is defined as a bundle of the criteria<br />
necessary to solve a core problem. In a first step 82<br />
core competencies consisting of 348 criteria could be<br />
identified. Online work was well accepted by the panel.<br />
Working together online seems to be a feasible means<br />
to seek relevant consensus in the continuing process<br />
of developing and updating core competencies in<br />
family medicine.
8A5 A new era of teaching: an<br />
innovative resource for continuing<br />
medical education and evidencebased<br />
management<br />
K El-Hayes, B McElhinney, B Adams, E Boyd and<br />
K McKinney<br />
1 Oakridge, Castlewellan Road, Banbridge, Co Down BT32<br />
4RT, NORTHERN IRELAND<br />
The aim of the project was to use and develop the skills<br />
of existing personnel to create a unique educational<br />
resource suitable for use by the multiprofessional team<br />
and adaptable to any setting. Using standard Microsoft<br />
Office software, resources from established Obstetric<br />
and Gynaecology texts and RCOG publications were<br />
used as references and incorporated with commercially<br />
available CD ROMs and pre-existing protocols and<br />
procedures into an interactive format. The result is an<br />
educational, multimedia computerised shell adaptable<br />
to any speciality. It forms a huge, informative teaching<br />
source that includes:<br />
• Case Based Learning<br />
• Evidence Based Protocols<br />
• All-encompassing hospital directory<br />
• Animated presentations of common procedures<br />
• Enormous database for self-assessment including<br />
MCQs, essay questions etc.<br />
• User-friendly site.<br />
There is no doubt that the result is an unfolding journey<br />
of extreme magnitude. We believe that the<br />
incorporation of this concept is essential for personal<br />
development in Obstetrics and Gynaecology in the new<br />
Millennium. Forget the WWW: meet the Obs and<br />
Gynae Wide Web.<br />
8A6 Evaluating medical student and<br />
resident education: a CME software<br />
J C Edwards*, P Ogden and A A Stricker<br />
Department of Family & Community Medicine, Texas A & M<br />
University, 810 Southern Hills, College Station, Texas 77843-<br />
1114, USA<br />
The software CME program titled “Evaluating Medical<br />
Student and Resident Education” delivers an interactive<br />
multimedia application on CD-ROM. Designed as an<br />
interactive tutorial, it requires only 30 to 45 minutes<br />
Wednesday 5 September<br />
Session 8B Implementation of PBL<br />
8B1 Problem-based learning for<br />
trainees in Anaesthesiology<br />
Sigrid Adam* and Jan Klein<br />
University Hospital Rotterdam, Department of Anaesthesiology,<br />
Erasmus University Rotterdam, Dr. Molewaterplein 40, 3015<br />
GD Rotterdam, NETHERLANDS<br />
In order to increase the efficiency of learning during<br />
postgraduate training we educate our residents in a<br />
programme which is problem-based. Weekly tutorials<br />
- 4.84 -<br />
for a busy doctor to complete. Objectives are: (1)<br />
understand and apply the concept of judge/<br />
diagnostician in evaluating student/resident<br />
performance; (2) understand and apply defined<br />
standards to evaluate reliably. The content, new in<br />
medical education, addresses the physician tendency<br />
to nurture trainees. The outcome - ability to change<br />
roles from teacher to judge/diagnostician. Brief<br />
instruction and four videotaped interactions between<br />
attending physicians and trainees provide self-diagnosis<br />
and practice. The program incorporates two published<br />
examples of defined standards. Print materials can be<br />
downloaded from the CD-ROM. MPEG-1 compressed<br />
videos provide exceptional quality, closely matching<br />
movie industry standards at 30 frames/second. This<br />
high quality video prevents use of the internet, which<br />
would lessen quality.<br />
8A7 Metabolic challenges on CD-ROMs<br />
Marie-Paule Van Damme*, Jonathan Gould, Bruce Livett,<br />
Janet Macaulay, Ron Maxwell and Graham Parslow<br />
Monash University, Department of Biochemistry & Molecular<br />
Biology, Faculty of Medicine, Clayton 3800, Victoria,<br />
AUSTRALIA<br />
As a way of engaging students more actively in their<br />
learning process, we have created multimedia<br />
presentations that offer:<br />
• “Self-Directed Learning” using interactive tutorials<br />
on various aspects of metabolism, nutrition and<br />
diabetes;<br />
• “Problem-solving exercises” requiring students to<br />
think logically and integrate information drawn<br />
from a variety of sources;<br />
• “Case studies” to teach students to apply their<br />
knowledge to specific clinical cases, such as “The<br />
Effects of Alcohol on Metabolism” and “Dietary<br />
Therapy for Type 2 Diabetes”.<br />
These programs have been compiled as two CD-ROMs:<br />
“Biochemistry-A Metabolic Challenge” and<br />
“Nutritional and Hormonal Aspects of Diabetes”. They<br />
challenge students to acquire a wide understanding of<br />
the interdependence of metabolic processes occurring<br />
in the major tissues of the body under different<br />
nutritional and hormonal states. Surveys have shown<br />
that the use of these teaching tools improves student<br />
understanding and enjoyment of the subject compared<br />
to conventional teaching methods.<br />
involve 9 trainees per group. Since active learning is<br />
known to improve knowledge and recall, the specific<br />
learning objectives of a fictive patient case are worked<br />
out by the group and discussed with the support of a<br />
tutor. Self-studies are an integral part of the programme<br />
which also involves questions and instructions<br />
distributed by the tutor via internet. According to the<br />
concept of iterative integration the learning issues of<br />
the cases gradually get more difficult and are
longitudinally related to what has already been learned.<br />
Residents find this form of learning very encouraging<br />
and stimulating. Besides improvement of knowledge,<br />
problem-based learning also improves the quality of<br />
teamwork and communicative skills.<br />
8B2 Communicating with students in a<br />
problem-based curriculum:<br />
experiences with WebCT<br />
Michelle McLean and Kathy Murrell<br />
University of Natal, Department of Physiology, Faculty of<br />
Medicine, Private Bag X7, Congella 4013, SOUTH AFRICA<br />
A problem-based curriculum was introduced at the<br />
Nelson R. Mandela School of Medicine (University of<br />
Natal, Durban, South Africa) in January 2001. Several<br />
factors required that the year co-ordinator be able to<br />
communicate with students on a daily basis. After<br />
evaluating several packages, WebCT (Web Course<br />
Tools) was chosen as the front-end product for the<br />
delivery of Internet material because of e-mail and<br />
bulletin board facilities, its ability to handle high quality<br />
graphics and streaming video, as well as the integration<br />
of student records and student tracking. Accessing<br />
WebCT from sites outside the campus was considered<br />
important, in the light of the community work senior<br />
students would be undertaking. Results from the<br />
preliminary evaluation of WebCT by first year students<br />
(after Module 1) are encouraging. This presentation<br />
will discuss the development of module course material<br />
in WebCT, as well as how students of differing<br />
educational background have embraced the technology.<br />
8B3 Faculty members and senior<br />
students as facilitators in PBLgroups<br />
- similarities and differences<br />
Are Holen*, Kristin Wigen and Oyvind Ellingsen<br />
Institute of Community Medicine and General Practice,<br />
Medisinsk teknisk forskningssenter, Norwegian University of<br />
Science and Technology, N-7489 Trondheim, NORWAY<br />
Both faculty members and senior students may serve<br />
as facilitators (tutors) in PBL-groups at the Faculty of<br />
Medicine, Norwegian University of Science and<br />
Technology. Each group has two alternating facilitators;<br />
one only may be a senior student. A scale has been<br />
developed to assess central dimensions of the<br />
facilitators’ group behaviour. Once each term, the<br />
students complete the scale. Along with general<br />
feedback, the results are given to the facilitators. The<br />
aim is to improve facilitators’ contributions to group<br />
interaction and learning processes in PBL-groups.<br />
Findings about similarities and differences between<br />
faculty members and senior students as facilitators will<br />
be presented and discussed. Also, some reflections on<br />
senior students as facilitators in PBL-groups will be<br />
discussed.<br />
8B4 Tutors’ perspectives of problembased<br />
learning<br />
Diana Kelly<br />
Department of Education for Medicine & Dentistry, 4th Floor,<br />
Henrietta Raphael House, Guy’s Campus, St Thomas Street,<br />
London SE1 9RT, UK<br />
Wednesday 5 September<br />
- 4.85 -<br />
While PBL has been widely written about, there is<br />
limited research concerning PBL tutors’ perspectives.<br />
This study set out to explore teachers’ viewpoints in a<br />
context where PBL was introduced part way through<br />
the undergraduate curriculum, and as one of several<br />
teaching methods. The aim was to investigate the<br />
question: how do teachers perceive and experience their<br />
role as PBL tutors? Research was conducted during<br />
1999/2000 at King’s campus of Guy’s, King’s and St.<br />
Thomas’ School of Medicine. Qualitative methods of<br />
data collection and analysis were used, with interviews<br />
being conducted with tutors from the newly established<br />
PBL programme. From the findings it emerged that<br />
tutors faced challenges as they grappled with the<br />
complexities of their role. These challenges were<br />
located within personal understandings and external<br />
perceptions of PBL, as well as tutors’ own experiences.<br />
Discussion of the findings will be the focus of this<br />
presentation.<br />
8B5 The E.D.I.T. project in Linköping:<br />
using web-based scenarios for PBL<br />
Wolfram Antepohl*, Anne-Christine Persson, Margareta<br />
Bachrach-Lindström and Björn Bergdahl<br />
Division of Medical Education, Linköping University, University<br />
Hospital, S-581 85 Linköping, SWEDEN<br />
In the spring term of 2001, the Faculty of Health<br />
Sciences, inspired by the Graduate Medical <strong>Programme</strong><br />
at the University of Sydney, started to implement its<br />
E.D.I.T. (Educational Development using Information<br />
and Communication Technology)-project. The idea<br />
behind the project is to increase the reality aspects of<br />
scenarios (cases or problems) used to facilitate learning<br />
in a problem-based curriculum. Apart from text<br />
documents, web-based scenarios may contain video<br />
clips, digital images of high quality (plain photographs,<br />
x-ray, microscopy, etc.), sound, graphics and other<br />
media formats. In the fifth semester of the medical<br />
curriculum, EDIT was implemented as a pilot project.<br />
Twenty-five patient scenarios were designed and put<br />
on an intranet-server using the media formats<br />
mentioned above. PBL groups worked in rooms<br />
equipped with a computer connected to the intranet, a<br />
projector and an interactive whiteboard. Students’ and<br />
tutors’ experiences with the new scenario format were<br />
evaluated using qualitative and quantitative approaches.<br />
Group sessions were observed and analysed concerning<br />
potential effects on the PBL-process. The project and<br />
results of the evaluation will be presented during the<br />
conference.<br />
8B6 How to promote success in a PBL<br />
tutorial session<br />
N Paganus*, K Lonka and T Hatonen<br />
Faculty of Medicine, Learning Centre/Development & Resource<br />
Unit, University of Helsinki, P.O. Box 63, 00014 Helsinki,<br />
FINLAND<br />
The present study examines the effects of students’<br />
attitudes towards PBL on study behaviour and learning<br />
outcomes. The quality and functioning of the tutorials<br />
in relation to learning outcomes were looked at. The<br />
participants were 17 second-year medical students. Six<br />
PBL-tutorial sessions were videotaped. Of the total of
540 minutes of videotape, “brainstorming”, “setting<br />
learning goals”, and “evaluation” were analysed. The<br />
participants filled in Likert-type questionnaires. After<br />
the last session, the students also answered open-ended<br />
questions. The relations among students’ attitudes, time<br />
spent on individual study, student behaviour in tutorials,<br />
and their academic achievement were analysed. It was<br />
found that students with a positive attitude used more<br />
time for individual study and concentrated more on<br />
medical knowledge than on irrelevant comments during<br />
tutorials. It appeared that the positive attitude, study<br />
time spent, and an active role in tutorial sessions were<br />
all related to good exam grades.<br />
8B7 Evaluation of the student staff in the<br />
experience of PBL in the Federal<br />
University of Roraima - Brasil<br />
Wednesday 5 September<br />
Session 8C Curriculum planning<br />
8C1 Priorities in the content of the<br />
curriculum from the standpoint of<br />
the academic staff<br />
E Nagle*, R Velins and V Pirags<br />
Latvian Medical Academy, Department of Medical Biology, Riga<br />
Stradina University, Dzirciema Str. 16, Riga LV-1007, LATVIA<br />
A questionnaire of academic staff has been conducted<br />
to ascertain opinion about the most important aims and<br />
essential elements of the curriculum highlighted in the<br />
National Concept “Tomorrow`s Doctors in Latvia”.<br />
Teachers were asked to arrange the aims of a curriculum<br />
in order of relevance. The sequence was as follows:<br />
knowledge as a basis for medical practice, health<br />
promotion and prevention, independent learning and<br />
life long learning. This questionnaire highlights also<br />
that the most essential elements of the curriculum are<br />
the compulsory amount of theoretical knowledge<br />
defined for each study term, mastering of appropriate<br />
practical skills and introduction of optional study<br />
modules. Analysis of these results could be used for<br />
further curriculum planning at the Faculty of General<br />
Medicine.<br />
8C2 Reforming the core curriculum of<br />
the Reformstudiengang in <strong>Berlin</strong> - a<br />
Delphi study<br />
B Huenges*, W Burger, J W Dudenhausen, U Frei,<br />
C Frommel, H-P Lemmens, U Schwantes and D Scheffner<br />
Arbeitsgruppe Reformstudiengang Medizin, Charité, Campus<br />
Virchow-Klinikum, Lehrgebaude, 2 Stock, Augustenburger Platz<br />
1, 13353 <strong>Berlin</strong>, GERMANY<br />
After experiences with three semesters in the new<br />
reformed curriculum we realised the necessity to<br />
reconstruct our core content. To do this, about 1400<br />
topics, derived by different health and disease surveys,<br />
were reviewed. Out of these our interdisciplinary core<br />
group identified 376 ‘health problems’ (123 patients’<br />
- 4.86 -<br />
Alvaro Tulio Fortes*, Cesar Ferreira Penna de Faria,<br />
Ruy Guilherme de Souza and Fernado Menezes da Silva<br />
UFRR Brasil, Rua Irineu Lucena 50, Mecejana, Boa Vista<br />
Roraima, 6930-4210, BRAZIL<br />
From the history of Medicine, and particularly in the<br />
area of Medical Education, can be observed prominent<br />
aspects in its secular evolution. The first one, classical<br />
medicine, comes from Ancient Greece and the other,<br />
clinical medicine, originates in Occidental Europe,<br />
which today constitutes the basis of modern scientific<br />
medicine. This work intends, through an evaluation on<br />
the part of the student staff, to demonstrate the<br />
developed activities, the experiences and the results of<br />
the introduction of a model of problem-based medical<br />
education in the Medicine course of the Federal<br />
University of Roraima. A total of 128 evaluations<br />
relating to the organization and content of the program,<br />
the system of evaluation, the physical structure and the<br />
human factors, have been carried out on the learning<br />
of 1st and 4th years.<br />
symptoms and signs, 205 diseases and diagnoses, and<br />
48 general aspects of medicine) which appeared crucial<br />
for modern medical education. Topics were selected<br />
according to their frequency, urgency and exemplarity.<br />
This corpus represents the basis for a faculty wide<br />
Delphi survey, started in April 2001. In the first round,<br />
463 faculty members from 63 different departments<br />
were contacted and asked to review our proposal from<br />
the point of view of their area of practice. This<br />
procedure was chosen to promote faculties’<br />
involvement and feeling of ownership of the<br />
‘Reformstudiengang Medizin’.<br />
8C3 Early clinical clerkship - does it<br />
make a difference?<br />
Berit Eika* and Ole Sonne<br />
Enhed for Medicinsk Uddannelse, SVF, Universitetsparken,<br />
Bygning 611, DK 8000 Aarhus C, DENMARK<br />
The effects of an early (2nd year) 8 week long clinical<br />
clerkship were investigated. Students with clinical<br />
exposure were compared to students without clinical<br />
experience on: 1) attitudes towards medical education,<br />
and 2) performance on a short essay examination in<br />
physiology. More students with clinical exposure felt<br />
they had insight into the medical profession. When<br />
compared to students with no clinical experience, the<br />
early clinical exposure induced a more favourable<br />
attitude towards the significance of early patient<br />
contact. No differences were found in the two groups’<br />
study motivation, feelings for having chosen the right<br />
study, or sense of belonging to the profession. The<br />
students with clinical exposure performed slightly<br />
better on the physiology examination, but other<br />
differences in study population could account for this.<br />
In conclusion, despite very positive evaluations of early<br />
clinical clerkships it is difficult to document that the<br />
clerkship changes students’ attitudes or performance.
8C4 ECTS (European Credit Transfer<br />
System) as a tool in curriculum<br />
development<br />
B Grether<br />
Veterinarmedizinische Fakultat der, Universitat Zurich,<br />
Winterthurerstr. 252, CH 8057 Zurich, SWITZERLAND<br />
The European credit transfer system is based on the<br />
total study workload of an average student. The “lecture<br />
per week” is no longer the measure for study workload;<br />
credits also allow the reflection of student time devoted<br />
to other learning activities such as e-learning, group<br />
work, directed self-study and time spent in skills labs.<br />
Whereas transferring an already existing curriculum<br />
into credits may be very difficult, ECTS can be a helpful<br />
tool when planning a new curriculum. The total amount<br />
of study workload will be defined for each course,<br />
including contact hours, pre- and post- course<br />
assignment, preparation for examinations and time<br />
necessary for various learning activities other than<br />
lectures. By attributing credits for this a balance of<br />
study workload over the whole course of study can be<br />
found. A credit system may also create an environment<br />
adequate for introducing new self-directed learning<br />
methods.<br />
8C5 The continuum of professional<br />
development<br />
H M R Meier<br />
University of Toronto, Mount Sinai Hospital, 600 University<br />
Avenue, Department of Psychiatry, Room 929, Toronto ON<br />
M5G 1X5, CANADA<br />
The first Elective provides the first step on the lifelong<br />
journey of professional development. This<br />
teaching-learning relationship offers additional<br />
dimensions for student and Tutor. Appropriate support<br />
for the Tutor’s professional contribution, including<br />
educational credits, enhances the spirit of the Electives<br />
programme and encourages experience in areas underrepresented<br />
or not yet represented in the core<br />
curriculum. Collaboration with CME and rural medical<br />
education includes conceptualisation of faculty<br />
development applicable beyond the Electives<br />
programme, as changes in core curriculum increasingly<br />
involve off-campus Tutors.<br />
Wednesday 5 September<br />
Session 8D The final examination<br />
8D1 Consistency of examination marks<br />
T Vik*, K H Karlsen and S Westin<br />
Norwegian University of Science & Technology, Department of<br />
Community Medicine, Medical Faculty, Olav Kyrres gt 3, N-<br />
7489 Trondheim, NORWAY<br />
To assess the consistency of examination marks, four<br />
examiners marked two cases given to 69 graduating<br />
medical students as part of the final board examination.<br />
- 4.87 -<br />
8C6 Evaluating ethics seminars<br />
Gerald Neitzke<br />
Department of History, Ethics & Theory of Medicine, Hannover<br />
Medical School (MHH), Carl-Neuberg - Str 1, D30623<br />
Hannover, GERMANY<br />
Teaching medical ethics involves teaching aims and<br />
objectives on different levels. On a cognitive level facts<br />
are taught to extend students’ knowledge. On an<br />
affective level emotions and conscience are dealt with<br />
to foster students’ attitudes and conduct. On the<br />
practical level skills are exercised to achieve sound<br />
moral judgement and decision-making, teamqualifications,<br />
and communication skills. If the<br />
effectiveness of ethics seminars is to be evaluated, all<br />
levels of teaching objectives have to be considered.<br />
Changes of attitudes and behaviour are key qualities<br />
of successful moral education. How can they be<br />
measured and what are fundamental conditions of such<br />
tests? Results should not be biased by students’ moral<br />
convictions. Behavioural changes should be<br />
distinguished from changes of attitudes only. A control<br />
group in a strict statistical sense has to be found. This<br />
presentation scrutinises the prerequisites of a standard<br />
of best evidence in ethics education.<br />
8C7 A tool to evaluate medical ethics<br />
seminars<br />
Mareike Moeller* and Gerald Neitzke<br />
Geibelplatz 4, 30173 Hannover, GERMANY<br />
The development and testing-phase of a survey to<br />
evaluate ethics seminars are presented. At Hannover<br />
Medical School one third of first year medical students<br />
get the chance to attend ethics classes. This offers the<br />
opportunity of an ideal study design with a randomised<br />
control group. The questionnaire is designed to test<br />
affective and practical components related to specific<br />
teaching aims. Attitudes like moral conscientiousness<br />
and empathy, and abilities like argumentation skills and<br />
decision-making are detected. The rationale is to<br />
measure students’ development in the handling of moral<br />
dilemmas before and after attending ethics classes.<br />
Students are confronted with two case histories which<br />
pose moral problems. A total of 16 statements (4 on<br />
each teaching objective) are to be approved/disapproved<br />
on a ratio scale. The pre-test took place already; the<br />
post-test will be carried out in July 2001. The<br />
questionnaire and preliminary results are presented.<br />
The marks were scored from 5 (failed) to 12 (excellent)<br />
and grouped in four categories: Failed, acceptable,<br />
good, and excellent. No student failed. Mean score<br />
given by one examiner (7.9; SD: 1.6) was significantly<br />
lower than that given by the other three (9.4; SD: 1.2).<br />
Correlation coefficients between examiners’ scores<br />
varied from 0.61 to 0.72 (p < 0.001). Agreement in<br />
classifying a student’s knowledge as acceptable, good<br />
or excellent varied from no (kappa: 0.04; 95% CI: -
0.05 - 0.13) to moderate (kappa: 0.51; 95% CI: 0.32 -<br />
0.70) between various pairs of examiners. Agreement<br />
between two endocrinologists assessing a case in<br />
endocrinology was only fair (kappa: 0.21; 95% CI:<br />
0.02-0.40). The results suggest unreliable (inter-rater)<br />
grading in written clinical case examinations.<br />
8D2 Identifying threshold competence<br />
in an undergraduate qualifying<br />
clinical examination<br />
John Cookson* and Stewart Petersen<br />
Leicester Warwick Medical School, Division of Medical<br />
Education, Faculty of Medicine, P O Box 138, Leicester LE1<br />
9HN, UK<br />
Undergraduate qualifying examinations seek to identify<br />
those who are competent to proceed to house officer<br />
training. This requires definition of the standard of<br />
competence required of the new graduate, and its<br />
conversion to a threshold within an examination. We<br />
have attempted to define the concept of the ‘minimally<br />
competent’ practitioner – one who is just able to<br />
proceed. The final professional clinical examination<br />
at LWMS is graded in terms of five ‘categories of<br />
competence’, with precise grade descriptors. We asked<br />
consultants who train house officers to define the<br />
minimally competent new graduate in terms of the<br />
proportions of patients where they would not perform<br />
satisfactorily in each category of competence.<br />
Proportions ranged from 0% to 50%. There was a clear<br />
tendency for history and examination skills to be<br />
considered more important. The findings have<br />
implications for setting examination thresholds.<br />
8D3 The validity of performance<br />
standards on a certification<br />
examination for occupational<br />
therapists<br />
Ernest Skakun<br />
Division of Studies in Medical Education, 2 J3000 WMC, Faculty<br />
of Medicine and Oral Health Sciences, University of Alberta,<br />
EDMONTON, Alberta, T6G 2R7, CANADA<br />
This study investigated the validity of passing scores<br />
set by the Nedelsky and Angoff methods for an<br />
occupational therapy national certification exam. Eight<br />
judges rendered Nedelsky and Angoff judgments for<br />
302 multiple choice items. Judges used a five-point<br />
scale to rate the competence of examinees selecting<br />
each alternative as an answer. Judges’ decisions were<br />
correlated with scores of examinees near the passing<br />
scores. Item difficulties were computed for examinees<br />
with scores just above (higher) and just below (lower)<br />
the passing scores for each method. The number of<br />
alternatives rated as “significant concerns about<br />
competence” and selected as possible answers was<br />
compared for higher and lower scoring examinees. The<br />
correlation between judges’ decisions and examinee<br />
scores around the passing score was 0.34 and 0.23 for<br />
the Angoff and Nedelsky methods respectively.<br />
Comparisons of proportion correct for higher and lower<br />
candidates showed more consistency for the Angoff<br />
method.<br />
Wednesday 5 September<br />
- 4.88 -<br />
8D4 Reliability of a sequential clinical<br />
examination<br />
Stewart Petersen* and John Cookson<br />
Leicester Warwick Medical School, Division of Medical<br />
Education, Faculty of Medicine, P O Box 138, Leicester LE1<br />
9HN, UK<br />
Clinical competence of students at Leicester Warwick<br />
Medical School is assessed by direct observation of<br />
consultations with a series of patients. Summative<br />
assessments are sequential. All students are observed<br />
with 2 or 4 patients, (depending on stage in the course),<br />
and those whose competence remains in doubt are<br />
observed with a further 3 or 4. In each consultation, a<br />
different pair of examiners observes students<br />
continuously. Examiners grade independently<br />
performance in five categories of competence defined<br />
by precise descriptors. There are precise grade<br />
descriptors. All examiners are trained. In a full, final<br />
examination, therefore, each student has 16 grades for<br />
each of five categories of competence. Analysis of data<br />
from three full cycles of assessment demonstrates that:<br />
(i) there is a high degree of inter-examiner reliability;<br />
(ii) eight cases are sufficient to mitigate case specificity;<br />
(iii) students vary in the relationship between<br />
performance in different categories of competence.<br />
8D5 Considerations of Legal, Ethical,<br />
Organizational Aspect of Clinical<br />
Competence in a National<br />
Licencing Examination, Evaluation<br />
at the Medical Council of Canada<br />
Jacques E. Des Marchais*, Dale W. Dauphinee and<br />
David Blackmore<br />
12420 rue Joseph-Edouard-Samson, Montreal Quebec H4K<br />
2N9, CANADA<br />
Organizations responsible for development and<br />
administration of national licensing examinations are<br />
becoming major partners in responding to evolution<br />
of emerging new social needs, such as Considerations<br />
of Legal, Ethical and Organizational aspects of medical<br />
practice(CLEO).The Medical Council of Canada<br />
(MCC) has been responsible for developing an<br />
examination process which leads to licensure to practise<br />
in the Canadian provinces. The study presents the<br />
decision-making process which has resulted in the<br />
development of the CLEO content of the Medical<br />
Council of Canada Qualifying Examination. The<br />
validation process of this new content is demonstrated<br />
as well as specific objectives in each of the three CLEO<br />
components. Results are presented from the first<br />
mandatory implementation, in May 2000, for about<br />
2000 candidates. Comparison with the MCQ scientific<br />
component is presented and discussed. Integration of<br />
CLEO disciplines into the second component (OSCE)<br />
of the MCC Qualifying examinations is also<br />
demonstrated.<br />
8D6 Combining different components of<br />
an assessment procedure<br />
J Degryse*, J Goedhuys, A Roex and A Dermine<br />
ACHG K U Leuven, Department of General Practice,<br />
Kapucijnenvoer 33 Blok J, B3000 Leuven, BELGIUM
In Flanders the Departments of General Practice in<br />
different universities worked together to organise a<br />
common final assessment procedure. This takes place<br />
at the end of the vocational training period in General<br />
Practice and takes the form of a certification exam.<br />
This assessment procedure is built out of four different<br />
components: a well-designed written knowledge test,<br />
a structured oral exam, a large scale OSCE type exam<br />
and a structured report from the trainers. A pass-fail<br />
standard is defined for each separate module using<br />
appropriate procedures. A final pass-fail decision is<br />
based on a combination of the scores obtained from<br />
the different modules. This presentation discusses the<br />
Wednesday 5 September<br />
- 4.89 -<br />
different approaches that can be used to combine the<br />
different component scores. From a pure reliability<br />
perspective the reliability analysis of composite scores<br />
can be computed using a multivariate reliability<br />
analysis. The discussion is illustrated with data collected<br />
from the final assessment procedure in 1996-2000. The<br />
impact of using different approaches and computation<br />
methods is simulated and discussed. The choice for a<br />
specific combination method should be inspired by the<br />
psychometric characteristics of the assessment tools<br />
but the final decision is made on an empirical basis.<br />
Session 8E Postgraduate education/career choice<br />
8E1 Teaching with patients: moving<br />
beyond ‘learning by osmosis’<br />
Kath Green<br />
South Thames Department of Postgraduate Medical and Dental<br />
Education, 33 Millman Street, London WC1N 3EJ, UK<br />
Teaching with patients in everyday workplace contexts<br />
(such as ward rounds, clinics, theatre etc.) provides a<br />
unique opportunity for postgraduate doctors to gain<br />
insight into the complex thinking that lies at the heart<br />
of professional practice in medical education. It is easy<br />
to assume, however, that these inexperienced doctors<br />
will ‘pick up’ a range of important generic skills (e.g.<br />
communicating with patients, working in multiprofessional<br />
teams, understanding patient anxiety etc.)<br />
merely by accompanying a more experienced clinician<br />
in one of the above contexts. Could it be that some of<br />
the excellent role models of good practice being<br />
provided by experienced colleagues are going largely<br />
unnoticed by postgraduate doctors whose personal<br />
agendas may be narrowly focused on exam preparation?<br />
Some ideas for raising the status of this kind of<br />
‘teaching by example’ will be outlined and opened up<br />
for further discussion.<br />
8E2 The effect of an interactive<br />
postgraduate education<br />
programme on parenteral treatment<br />
in Macedonia<br />
M Ivanovski, P D Toon*, K Zafirovska, F Tozija and B Gomes<br />
University College London, 137 Roding Road, London E5 0DR,<br />
UK<br />
Macedonia has no formal system of postgraduate or<br />
continuing education for doctors working in primary<br />
care. These doctors are poorly equipped and have little<br />
access to current medical information. Treatment is<br />
therefore often inappropriate; overuse of antibiotics and<br />
injected drugs, and high referral rates are particular<br />
problems. To improve matters the Chamber of<br />
Physicians encouraged the Ministry of Health to<br />
support a programme of continuing education using<br />
World Bank funds and foreign technical assistance.<br />
Evidence-based guidelines were customised and<br />
translated, and an 18 day course based around these<br />
was developed. This was piloted in the Prilep region in<br />
1999. It was well received by participants, and is now<br />
being extended throughout the country. We will present<br />
details of the course and data demonstrating a fall in<br />
the cost of injectable drugs in the Prilep region by 26%<br />
in the four months following the course, compared with<br />
the previous year.<br />
8E3 Promoting innovation in<br />
postgraduate education through<br />
the accreditation process<br />
Judith Armbruster<br />
ACGME, 5555 N Sheridan, Apt 601, Chicago IL 60640, USA<br />
U.S. residency programs and their institutions are<br />
subject to many destabilizing influences, eg, economic<br />
pressures for clinical productivity, shortened<br />
hospitalizations, decentralization of patient care, all of<br />
which may negatively impact teaching. The ACGME,<br />
the U.S. accrediting agency for postgraduate medical<br />
education, has initiated a project to help programs meet<br />
these challenges. An invitation was issued to programs<br />
and institutions to submit proposals for innovative<br />
approaches to teaching and evaluation. The proposals,<br />
which must also ensure the training quality is not<br />
compromised, should result in initiatives that may be<br />
adopted by other institutions. Principal benefits of the<br />
RFP (request for proposals) approach are that it will<br />
stimulate creativity and flexibility in teaching<br />
institutions, recognize and reward viable innovation,<br />
and promote the sharing of information among<br />
programs. Over 100 proposals were received. This<br />
presentation will explain future plans for the project<br />
and describe some of the most promising proposals.<br />
8E4 A new development in<br />
postgraduate surgical education:<br />
the Intermediate Breast Course - a<br />
distance learning course<br />
H M Sweetland*, E Hoadley-Maidment and M Galea<br />
Raven Dept of Education, Royal College of Surgeons of England<br />
(RCS), University of Wales College of Medicine, University<br />
Department of Surgery, Heath Park, Cardiff CF4 4XN, UK
In the UK there have recently been significant changes<br />
in Postgraduate Surgical training. The RCS has been<br />
instrumental in developing new courses for surgical<br />
trainees. In 1999 a Committee of breast surgeons set<br />
out to plan and develop a Distance Learning course<br />
for breast trainees. The aims of the course were to<br />
present breast disease as an interesting specialty area,<br />
provide basic knowledge but stimulate learning ‘on the<br />
job’, and ultimately to encourage more trainees into<br />
breast surgery. The curriculum was planned together<br />
with a distance learning study guide and 3 study days<br />
to teach practical skills and to discuss what has been<br />
learnt from the study guide and the clinical situation.<br />
The course has run from October 2000 to April 2001,<br />
and it is currently being evaluated from participant<br />
feedback. The rationale, curriculum and evaluation of<br />
the course will be presented. It is proposed that this<br />
course will be a model for further courses to be<br />
organised by the RCS.<br />
8E5 Attitude change in neonatologistsin-training<br />
by participation in the<br />
neuropediatric follow-up of former<br />
premature infants<br />
J B Hentschel<br />
Department of Neonatology, Universitaets-Frauenklinik des<br />
Inselspitals, Schanzeneckstr 1, CH 3012 Bern, SWITZERLAND<br />
Attitudes among neonatologists towards resuscitation<br />
of premature infants at the limit of viability (range 22-<br />
26 weeks gestation) differ. Many families of immature<br />
infants are burdened by varying degrees of disability<br />
of their child. Participation in neuropediatric followup<br />
of premature infants is part of neonatology training,<br />
but not every neonatologist-in-training is exposed to<br />
such a program. It is unknown whether changes in<br />
attitude occur in neonatologists exposed to outcomes<br />
of prematures; the hypothesis is that active participation<br />
in a follow-up program is likely to influence attitudes<br />
indicated by an opinion change regarding resuscitation<br />
of infants at the limits of viability. A research design is<br />
proposed containing a pre- and post-training<br />
questionnaire administered to pediatric residents in<br />
neonatology training before and after participation in<br />
a neuropediatric follow-up program of prematures,<br />
compared to questionnaire results in residents who do<br />
not participate in such a follow-up.<br />
Wednesday 5 September<br />
Session 8F Teaching and learning<br />
8F1 Impact of peer tutoring on the<br />
patient-centered interviewing skills<br />
of first-year medical students<br />
D Nestel* and J Kidd<br />
Imperial College School of Medicine, Connaught House,<br />
Apartment 17, Davies Street, London W1K 3DA, UK<br />
- 4.90 -<br />
8E6 Factors that influence the career<br />
choice of medical specialization<br />
M B M Soethout* and G van der Wal<br />
Vrije Universiteit Medical Centre, Department of Social<br />
Medicine, EMGO-Institute, Van der Boechorststraat 7, 1081<br />
BT. Amsterdam, NETHERLANDS<br />
To identify factors that influence the career choice for<br />
medical specialization, a review of the literature was<br />
carried out, based on a qualitative and quantitative study<br />
design. Altogether 24 studies were analyzed. The results<br />
showed that most studies were of good quality. A<br />
quantitative assessment showed that many factors, like<br />
‘hours and working conditions’, ‘domestic<br />
circumstances’ and ‘enthusiasm for specialty’ played a<br />
role in the medical career choice. Nowadays more<br />
women than men study medicine. The majority of<br />
doctors with a first choice of general practice at the<br />
time of qualification achieved this. Women, who<br />
wanted a clinical specialization, could not accomplish<br />
or continue this career sufficiently. Social Medicine<br />
was not very popular for qualified doctors, but some<br />
years after qualification a substantial amount of doctors,<br />
especially women, worked in this field. The method of<br />
this review and the results will be presented.<br />
8E7 Personality differences in doctors<br />
affect the factors associated with<br />
their medical specialty choice<br />
Gillian B Clack*, Derek Cooper and John O Head<br />
51 Burbage Road, Herne Hill, London SE24 9HB, UK<br />
Attention has been drawn in the literature to the change<br />
in focus over the years on factors associated with<br />
medical specialty choice, ranging from personality,<br />
attitudes and values, socio-economic factors, the effect<br />
of medical education, to the influence of debt, expected<br />
earning and anticipated working conditions. 313 out<br />
of 464 doctors surveyed (68% response rate) completed<br />
a questionnaire, the Myers-Briggs Type Indicator<br />
(MBTI), which measures normal personality<br />
differences. They also gave details of factors which<br />
most influenced them in their choice of medical<br />
specialty from 30 options, e.g. experience on the course,<br />
opportunities for research, need for security, etc.<br />
Analysis of this data resulted in significant differences<br />
being found between the factors which were most<br />
important to the different personality types. These<br />
results will be presented which will be of interest to<br />
those involved in recruitment to the different<br />
specialities.<br />
In medical education, peer tutoring is most frequently<br />
used for knowledge-based subjects. There are no<br />
published accounts of peer tutoring in relation to the<br />
acquisition of patient-centred interviewing skills. At<br />
Imperial College, 23 third-year medical students<br />
participated in a project in which they facilitated<br />
sessions for their first-year colleagues in the skills of
patient-centred interviewing. In each session, two thirdyear<br />
students co-facilitated a group of six first-year<br />
students as they practised the skills of patient-centred<br />
interviewing. Each first-year student interviewed a<br />
simulated patient and then received feedback from the<br />
actor, facilitators and fellow students on their<br />
interviewing skills. Two months after the sessions, the<br />
patient-centred interviewing skills of the first-year<br />
students were assessed. In this presentation, the<br />
interviewing skills of first-year students are compared<br />
with those of students who worked in groups facilitated<br />
by medical teachers.<br />
8F2 Peer Assisted Learning - a teaching<br />
strategy for the new millennium?<br />
Joy R Crosby and H Mei-Ling Ball*<br />
Curriculum Office, Ninewells Hospital and Medical School,<br />
Dundee DD1 9SY, UK<br />
Peer Assisted Learning (PAL) is a key learning tool<br />
and increasingly being used in medical education. For<br />
2 years, a voluntary PAL system has been run in Dundee<br />
Medical School using 4th and 5th year students to tutor<br />
2nd and 3rd years. Tutee evaluation of each session<br />
was performed using a brief questionnaire of tutee<br />
satisfaction and motivation for attendance. 626<br />
responses were returned and analysed showing a highly<br />
favourable response to PAL, with 95% rating sessions<br />
as useful / very useful and 93% as a good / very good<br />
learning aid. Particular focus on why students attended<br />
PAL sessions showed a diverse range of motivation,<br />
with an emphasis on enhancing exam performance. The<br />
effect of attending PAL reflected in exam performance<br />
was also examined. These data have been used to devise<br />
a tutee profile which will be used to make the scheme<br />
more accessible and beneficial to all students.<br />
8F3 An insight into how students learn<br />
about a cardiovascular problem<br />
using study guides<br />
Shihab E O Khogali*, Jennifer M Laidlaw, Stuart D<br />
Pringle and R M Harden<br />
Dept of Cardiology, University of Dundee, Ninewells Hospital<br />
& Medical School, Dundee, DD1 9SY, UK<br />
A study guide is a useful tool to help students manage<br />
their learning more effectively, but to what extent does<br />
the format of these guides play a part in the learning<br />
process? One hundred and fifty-one second year<br />
medical students were given three different formats of<br />
guides covering the topic of hypertension. The guides<br />
were timetable-based; problem-based; outcome-based.<br />
Although the content for all three types was the same,<br />
the weighting on the different components of the guides<br />
differed. Students were asked to select the guide of their<br />
choice to learn about the topic. From our study, we<br />
concluded that:<br />
1 In general students find study guides helpful in<br />
managing their learning;<br />
2 The guide which adopted a timetable approach to<br />
learning was the preferred choice;<br />
Wednesday 5 September<br />
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3 The guide which adopted an outcome-based<br />
approach was the least preferred choice;<br />
4 Of all the components of guides, the incorporation<br />
of a clinical problem was deemed the most helpful.<br />
8F4 Study guides in an outcome-based<br />
medical curriculum at the<br />
International Medical University<br />
(IMU), Malaysia<br />
M I Nurjahan*, J C Ramesh, S Raman, R Ammu,<br />
K H Ong, C M K Patrick and Q Akhtar<br />
International Medical University, Clinical School, Jalan Rasah,<br />
70300 Seremban, Negri Sembilan, MALAYSIA<br />
An outcome-based undergraduate curriculum with<br />
eight major outcomes was developed for our clinical<br />
school. The core curriculum consists of 113 studyguides<br />
among others. This paper describes how the<br />
study guides were developed with the aim of facilitating<br />
task-based and independent learning. These guides<br />
were prepared and reviewed utilizing a “study guide<br />
matrix” by a multidisciplinary faculty; and these form<br />
a key learning resource throughout the clinical years.<br />
A study guide was prepared for each key clinical<br />
problem. They identified learning issues in the 8<br />
outcomes including basic medical sciences in each of<br />
the problems and specific themes like ethics, which<br />
run through the curriculum. The IMU adopts a spiral<br />
curriculum and revisiting basic sciences in solving<br />
clinical problems is one of our outcomes. The guides<br />
help the students manage their own learning and obtain<br />
the maximum from each clinical attachment in<br />
accordance with the major outcomes.<br />
8F5 How authors of an extensive<br />
distance learning programme for<br />
surgical trainees differed in their<br />
use of the specified template<br />
Jennifer M Laidlaw*, Ronald M Harden, Lorraine J<br />
Robertson and E Anne Hesketh<br />
SCPMDE, Education Development Unit, Tay Park House,<br />
484 Perth Road, Dundee DD2 1LR, UK<br />
The development of new technologies has resulted in<br />
an increased use of and interest in distance learning.<br />
The production of effective distance learning materials<br />
is time consuming and requires the skills of content,<br />
educational, and technical experts. A wide range of<br />
content experts may contribute to a programme, but<br />
often they are based at a distance from each other, and<br />
frequently with no previous educational expertise in<br />
producing distance learning materials. This was the<br />
situation encountered by the Centre for Medical<br />
Education Dundee when commissioned by The Royal<br />
College of Surgeons of Edinburgh to produce 42<br />
distance learning modules to prepare Basic Surgical<br />
Trainees for the AFRC examination. To tackle this<br />
initiative, a template was developed which defined the<br />
educational strategies to be adopted in the programme,<br />
and to help authors to structure their content. This paper<br />
examines the use made of the template by the authors,<br />
and in particular, the extent to which they utilised the<br />
various educational strategies which were built in to<br />
the programme’s design.
8F6 Context-dependent memory in a<br />
meaningful environment: in the<br />
classroom and at the bedside<br />
Franciska Koens*, Olle Th.J. ten Cate and Eugene J F M<br />
Custers<br />
School of Medical Sciences, University of Utrecht, Universitair<br />
Medisch Centrum, Stratenum 0.303, Onderwijsinstituut, Postbus<br />
85060, 3508 AB Utrecht, NETHERLANDS<br />
Godden and Baddeley (1975) showed that divers who<br />
learned words under water or on land, recalled these<br />
words better when the recall condition matched the<br />
original learning environment, a finding often cited in<br />
the medical education literature. Because the ecological<br />
validity of this experiment for medical education can<br />
be questioned, we replicated the Godden and Baddeley<br />
study, but now contrasting a clinical with an educational<br />
environment. Besides that, we added medically<br />
meaningful subject matter (clinical case description and<br />
biomedical words) to the non-medical type of common<br />
words used in the G&B study. Preliminary results<br />
indicate no significant differences. However, there does<br />
appear to be a slight tendency towards better recall of<br />
the case description if the encoding took place in the<br />
clinical environment.<br />
Godden D, Baddeley A. Context-dependent memory in two natural<br />
environments: on land and underwater. British Journal of Psychology<br />
66[3], 325-331. 1975<br />
Wednesday 5 September<br />
Session 8G Assessment in postgraduate and<br />
continuing education<br />
8G1 A computerized adaptive test as an<br />
element of the final assessment of<br />
general practitioners in Flanders.<br />
Possibilities, difficulties, dilemmas…<br />
A Roex* and J Degryse<br />
K.U. Leuven, ACHG - Department of General Practice,<br />
Kapucijnenvoer 33 Blok j, B3000 Leuven, BELGIUM<br />
The many advantages of CAT make it very attractive<br />
for use in the final assessment procedure for general<br />
practitioners in Flanders. The actual written test is based<br />
on a 3 dimensional blueprint. The item response theory,<br />
which is essential for the development of a CAT, is<br />
based upon the assumption that the test scores reflect<br />
the amount of one latent trait possessed by the<br />
individual. Is the general practitioner’s competency<br />
unidimensional and how can our blueprint be adapted<br />
to take account of this assumption? Subdividing the<br />
test in different modules and working with testlets are<br />
some of the solutions we will discuss in order to solve<br />
the problem of case-specificity as described by Elstein<br />
et al. (1978), Norman and Newble (1985) and van der<br />
Vleuten (1988). Several mathematical constructs (1, 2<br />
and 3 parameter models) can be used to make a CAT.<br />
Each of these has implications on the size of the item<br />
database software choice.<br />
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8F7 Continuous Interactive Class (C.I.C)<br />
J Medrano*, R Calpena, A Compan, M T Pérez Vázquez,<br />
J Lacueva and M Díez<br />
Miguel Hernandez University, Facultad de Medicina, Carretera<br />
Alicante-Valencia, km 87, 03550 San Juan, Alicante, SPAIN<br />
In 1999 we initiated a pedagogical project in teaching<br />
called Continuous Interactive Class. Consisting of a<br />
technical card comprising objectives and contents of a<br />
theme to learn, 6 students with a tutor, after consulting<br />
the bibliography, discuss a theme that is outlined on<br />
the web. An electronic mailbox is opened so that any<br />
student may consult his/her tutor. Finally, an interactive<br />
“seminary” takes place to discuss the mail received and<br />
the problems that have arisen, elaborating a new<br />
version. Educational contents are better explained and<br />
brought up to date and the active participation of the<br />
group increases student motivation. There was low<br />
participation by the students through e-mail and lack<br />
of interest in the change of pedagogical methodology.<br />
The reasons for this were considered to be too many<br />
exams and classes, fear of change and possibly low<br />
availability of personal computers.<br />
8G2 Insight 360: a tool for looking at<br />
doctors’ performance<br />
E B Peile* and R Conradt<br />
Department of Primary Healthcare, University of Oxford,<br />
Chiltern Waters, 1 Stablebridge Road, Aston Clinton, Bucks<br />
HP22 5ND, UK<br />
Researching effectiveness of GP registrar education,<br />
we needed to develop proxy measures of performance<br />
in trained doctors in order to look at the outcome of<br />
training. We adapted a tool which is used in<br />
developmental work with general practices. Insight 360<br />
contrasts the perceptions of a doctor’s patients and<br />
colleagues with self perception in relevant areas of<br />
performance. We encourage groups of trained<br />
practitioners to take part in this exercise. Each<br />
respondent is asked to rate both the importance of a<br />
particular item of performance, and how well the doctor<br />
performs on this item. Individual reports are prepared<br />
for each doctor taking part, and we also prepare group<br />
reports, if requested. This feedback material can be very<br />
useful towards the doctor’s personal development. The<br />
database provides us with valuable indicators of a<br />
doctor’s perceived performance, enabling us to look<br />
for influences of education and training.
8G3 Impact on non-principals in<br />
General Practice of the summative<br />
assessment audit project<br />
P Bowie, A Garvie and J Oliver<br />
Department of Postgraduate Medical Education, University of<br />
Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK<br />
General practice registrars (trainees) must pass an audit<br />
project as part of summative assessment (SA). Its<br />
impact after training on audit knowledge, ability to<br />
recognise audit criteria and standards, and attitudes<br />
towards audit is unknown. 200 GP non-principals in<br />
the west of Scotland were surveyed (79% response rate)<br />
to assess these factors. 67 respondents (42%) underwent<br />
SA and 91 (58%) had not. Respondents rated their<br />
knowledge of different areas of audit method.<br />
Significantly higher mean scores were recorded for the<br />
SA group in every area (P
complex four-flap Z-plasty, suggesting a lesser ability<br />
to transfer learned principles to a novel and more<br />
complex task. The ability to mentally manipulate threedimensional<br />
objects is related to initial performance<br />
on a spatially complex surgical procedure. Subjects<br />
with lesser visual-spatial abilities achieve satisfactory<br />
levels of performance following practice and feedback.<br />
8G7 Validity of MIST-VR in the<br />
assessment of laparoscopic skill<br />
A M Paisley*, P Baldwin and S Paterson Brown<br />
University of Edinburgh, University Department of Surgery, Royal<br />
Infirmary, Lauriston Place, Edinburgh EH3 9YW, UK<br />
The aim of the study was to determine whether MIST-<br />
VR laparoscopic simulation correlates with<br />
performance in theatre. Error, economy and time taken<br />
for 36 surgical trainees, 37 surgically naïve students<br />
Wednesday 5 September<br />
Session 8H Curriculum change<br />
8H1 Innovation and reform of medical<br />
education: evaluating the UNI<br />
program in Latin America<br />
E C Ribeiro*, G Werneck, A Aguiar and V Brant<br />
Universidade Federal do Rio de Janeiro, Nucleo de Tecnologia<br />
Educacional para a Saude, Centro de Ciencias da Saude<br />
SubsoloBloco A Sala 33, Cidade Universitaria - Ilha do Fundao,<br />
Rio de Janeiro CEP 21941-590, BRAZIL<br />
The UNI program is a Kellogg Foundation initiative in<br />
the field of human health resources development in<br />
Latin America, based on the idea that partnership<br />
between university, local health services and<br />
community should be the cornerstone for innovation<br />
of professional training and health practices. The study<br />
evaluates the achievement of UNI schools students of<br />
a set of expected and consistent professional attitudes<br />
according to principles guiding the UNI Program. The<br />
study includes comparison with non-UNI schools of<br />
the eight countries involved so that inference of<br />
program results can be performed. The design includes<br />
a categorization of schools according to variables<br />
referenced to the concepts of innovation and reform<br />
defined in a theoretical model in which the medical<br />
school is considered as a space of transformation and<br />
reproduction of social practices. The methodological<br />
pathway is discussed, particularly the study design and<br />
instrument construction, its limits and possibilities.<br />
8H2 Promoting responsive curriculum<br />
change within the 21st century<br />
Cam Enarson<br />
Wake Forest University School of Medicine, Medical Center<br />
Boulevard, Winston-Salem, NC 27157, USA<br />
The process of curriculum change is complex, political<br />
and dynamic. The curriculum reform process includes:<br />
1) identification of the rationale for curricular change;<br />
2) managing the change process; 3) development of<br />
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and 16 surgical consultants to complete 2 tasks on<br />
MIST-VR were recorded. 26 trainees and 36 students<br />
underwent repeat assessment after 6 months. A<br />
validated in-theatre technical assessment form was<br />
completed by each trainee’s consultant. Trainee MIST-<br />
VR performance did not correlate significantly with<br />
consultant assessment and was not significantly<br />
different from that of consultants or students. A<br />
significant but weak correlation was found between<br />
MIST VR time score and duration of surgical<br />
experience (p=0.036, rho=-0.242 Spearman). Trainees<br />
showed significant improvement in time and economy<br />
after 6 months (median (IQR) time 0 to time 6 months:<br />
time (seconds): 217(176-291) to 184(157-215)<br />
p=0.003; economy score: 26(19-32) to 21(16-25)<br />
p=0.002 Wilcoxon); however, similar improvement was<br />
also seen in the student group. Further work into this<br />
area is needed.<br />
the new curriculum model/plan; 4) curricular<br />
implementation. The curriculum renewal process at the<br />
Wake Forest University School of Medicine will be<br />
used to illustrate the curriculum planning process noted<br />
above. Wake Forest University embarked on a 3 year<br />
curriculum planning process in 1995. During the first<br />
year of planning, ten principles were identified to serve<br />
as the foundation for the new curriculum. A curriculum<br />
model was developed during the second- and thirdyears<br />
which showed the 46 month educational program<br />
as a continuum. Implementation of the new Prescription<br />
for Excellence: A Physician’s Pathway to Lifelong<br />
Learning curriculum is occurring over a 4 year period.<br />
A program evaluation plan has been developed linked<br />
specifically to curricular goals and objectives.<br />
8H3 Improving the University and NHS<br />
Teaching Hospital Trust<br />
Partnership to identify SIFT<br />
spending<br />
Andrea J Bolshaw<br />
University of Birmingham, Medical School, Medical Education<br />
Unit, Edgbaston, Birmingham B15 2TT, UK<br />
The perceived underspend of SIFT on Undergraduate<br />
teaching is widely acknowledged throughout UK<br />
medical schools and NHS teaching hospitals. In order<br />
to monitor the provision of services under the SIFT<br />
contracts, the University of Birmingham Medical<br />
School has developed a vehicle in the form of a<br />
Framework Agreement to strengthen links with the<br />
NHS and ensure the highest quality clinical care,<br />
teaching and research. In collaboration, a system has<br />
been developed to monitor compliance with the<br />
Agreement in the form of Undergraduate Clinical<br />
Education Monitoring Visits. This paper sets out how<br />
such a mechanism has been developed, and as a result,<br />
offers guidelines for the design and implementation of<br />
a framework for quality monitoring of undergraduate
teaching activities within NHS hospital trusts. A<br />
thorough insight will be given into how this practical<br />
strategy works in real terms to effectively meet high<br />
standards in university medical education.<br />
8H4 Assessment of medical student<br />
attitudes toward relevant aspects of<br />
medical practice<br />
Maria de Lourdes Veronese Rodrigues*, L E de A Troncon,<br />
M F A Colares, J F C Figueiredo, ARL Cianflone,<br />
CE Piccinato, LC Peres and JA Dela-Coleta<br />
Faculty of Medicine of Ribeirao Preto, Department of Clinical<br />
Medicine, Hospital das Clinicas, Campus Universitário, 14048-<br />
900 Ribeirao Preto SP, BRAZIL<br />
At the Faculty of Medicine of Ribeirão Preto<br />
(University of São Paulo, Brazil), a 5-point Likert scale<br />
containing 52 items was developed for measurement<br />
of medical student attitudes toward 6 relevant aspects<br />
of medical practice. Preliminary tests determined the<br />
scale’s apparent and content validity and showed high<br />
internal consistency (Cronbach’s alpha = 0.86).<br />
Attitudes of graduating classes of medical students were<br />
measured for 4 consecutive years. Pooled results from<br />
317 students showed predominantly positive attitudes<br />
toward: 1) psychological issues in organic diseases; 2)<br />
primary care; 3) aspects of medical work in the<br />
community; and either conflicting or undefined<br />
attitudes were detected toward the following aspects:<br />
4) mental diseases; 5) physician roles in medical<br />
research and 6) death-related situations. Data obtained<br />
are likely to represent deeper medical school values<br />
and have to be taken into consideration for further<br />
improvements in medical student education.<br />
8H5 Effect of a curriculum reform of<br />
graduating student performance<br />
M L V Rodrigues*, J F C Figueiredo, L E A Troncon,<br />
C E Piccinato, L C Peres, A R L Cianflone and M F A Colares<br />
Hospital das Clínicas - Oftalmologia, Faculdade de Medicina de<br />
Ribeirao Preto, 12 andar - Campus Universitario, 14048-900<br />
Ribeirao Preto SP, BRAZIL<br />
Aiming at evaluating the efficacy of a new curriculum<br />
implemented at the Faculty of Medicine of Ribeirão<br />
Preto, a yearly objective assessment of graduating (6th<br />
year) students was performed. Shortly before<br />
graduation, all students underwent sets of multiplechoice<br />
questions (MCQs) and groups of 18-20 students/<br />
year were randomly assigned to OSCEs for either<br />
clinical (real and standardised patients) or procedure<br />
(mannequins) skills. The average MCQs score for the<br />
new curriculum (63.1, SD=8.9, n=261) was<br />
significantly higher (p
Session 8I Communication skills training<br />
8I1 Which interviewing skills must be<br />
actively taught at medical school?<br />
K Aspegren*, P Henriksen, P Lonberg-Madsen and<br />
M Stromming<br />
Laboratorium for Kliniske Faerdigheder, Rigshospitalet, Afsnit<br />
5404, Blegdamsvej 9, 2100 Kobenhavn O, DENMARK<br />
The study looked at which interviewing skills must be<br />
actively taught at medical school. 29 and 60 students<br />
from the last semester in their studies, and from two<br />
different years, were randomly selected in a medical<br />
school where there is little systematic training of<br />
interviewing skills. They were videotaped as they<br />
performed an interview with a standardised patient. The<br />
interviews were rated using the Arizona Clinical<br />
Medical Interview Rating Scale. Interrater reliability<br />
was controlled. The students rated high on 6 of the 14<br />
items of the scale, low on 2 and very low on 6. The<br />
strengths were such as characterize civil conversation.<br />
The weaknesses were important interviewing skills<br />
such as summarizing, using open ended questions, etc.<br />
There was good agreement between years, indicating<br />
a systematic trait in strengths and weaknesses. We<br />
believe our results can be used for planning<br />
interviewing skills courses in medical schools.<br />
8I2 Implementing communication skills<br />
training at the Charité - a project by<br />
students and doctors<br />
Jan Schildmann*, Carsten Schwarz, Eva Herrmann,<br />
Heiderose Ortwein, Amelie Klambeck, Andreas Brunklaus<br />
and Ulrich Schwantes<br />
Humboldt University <strong>Berlin</strong> (Charite), Department of General<br />
Practice, Vogelsang 16, 78343 Horn, GERMANY<br />
A lack of formal training in communication skills<br />
during the time as medical students combined with the<br />
impression that the ability to talk with patients is<br />
essential for our practical work was the motivation for<br />
us (3 doctors and 3 students) to organise optional<br />
courses in this field at the medical faculty of the<br />
Humboldt University in <strong>Berlin</strong>. Within the last 1½ years<br />
courses about how to break bad news, a communication<br />
skills course for students during their first clinical year<br />
and a role play session as part of a course in paediatrics<br />
for fifth year students have been the preliminary results<br />
of our work which is supported by the medical faculty.<br />
In this short communication we will describe our<br />
experiences so far and discuss our plans to implement<br />
the training of communication skills as part of the<br />
curriculum at our faculty within the next few years.<br />
8I3 Teaching sexual history-taking to<br />
health care professionals in<br />
primary care<br />
J R Skelton* and P M Matthews<br />
Department of Primary Care & General Practice, Medical<br />
School, University of Birmingham, Egbaston, BIRMINGHAM<br />
B15 2TT, UK<br />
History-taking is essential to diagnosis, yet little work<br />
has been done on the development of sexual history-<br />
Wednesday 5 September<br />
- 4.96 -<br />
taking, nor on how to train people to undertake it<br />
adequately. Courses designed to assist healthprofessionals<br />
in sexual history-taking were delivered<br />
in a variety of formats, and evaluations collected from<br />
participants. 114 participants took part in 9 teaching<br />
interventions. All courses were very positively<br />
evaluated (89.95% for quality: 91% for relevance).<br />
Role-play, which was a feature of all courses, was<br />
particularly valued as a methodology. Free text<br />
comments centred on the power of such courses as<br />
consciousness-raisers, and as helping to overcome<br />
embarrassment, and the need to develop and change<br />
communication strategies. Good sexual history-taking<br />
should be part of the health professional’s armoury. It<br />
can be taught, and courses designed to teach it are<br />
highly acceptable to participants.<br />
8I4 SEX SEX SEX, oh yes, and how’s<br />
your knee?<br />
Annie Cushing* and Dason Evans<br />
St. Bartholomews & The Royal London Queen Mary’s, School<br />
of Medicine and Dentistry, Department of Human Science &<br />
Medical Ethics, Turner Street, London E1 2AD, UK<br />
Our study shows that, with the exception of the<br />
specialities of O&G and sexual health, medical students<br />
rarely ask patients questions about sex, even when they<br />
think this might be an issue. A workshop using roleplay<br />
was introduced to address this shortfall in general<br />
medical history taking. One hundred and ninety two<br />
students completed pre- and post- workshop<br />
questionnaires comprising 12 attitudinal statements.<br />
Subsequent cohorts completed a questionnaire to assess<br />
future intentions to ask patients about sexual health<br />
issues. Results showed a statistically significant<br />
improvement in all the attitudinal statements. After the<br />
workshop 84% of students stated they were now likely<br />
to ask patients about sex when they thought it was<br />
relevant. Moreover one-third intended to include such<br />
questions as part of their review of systems. There<br />
remains a group who do not think they will be asking<br />
patients questions about sexual health.<br />
8I5 Training of the systemic approach<br />
in doctor patient communication I:<br />
history taking from a third party<br />
K P M van Spaendonck* and E M van Weel-Baumgarten<br />
University of Nijmegen, 300 Med Psych Neuro, PO Box 9101,<br />
6500 HB Nijmegen, NETHERLANDS<br />
The format of the usual training of communication<br />
skills is derived from the conversation of the doctor<br />
with an individual patient. However, when a patient<br />
does or cannot speak for himself (for instance because<br />
the patient is too young or too ill), the patient is<br />
represented by somebody else. This is generally a<br />
parent, a partner or an adult child, who in turn speaks<br />
on behalf of the family to which the patient belongs.<br />
Moreover, doctors have to deal increasingly with<br />
patients who are accompanied by a third person. In<br />
both cases, doctors have to face so-called systemic
dynamics, a term derived from family therapy, and<br />
which focuses on relations, coalitions, behavioural<br />
codes etc within the core family. Systemic dynamics<br />
may have a strong impact on diagnosis and treatment.<br />
In the first part of this double presentation, we will<br />
show a video of a training, which involves the major<br />
sources of information distortion, which might result<br />
from history taking from a third party.<br />
8I6 Training of the systemic approach<br />
in doctor patient communication II:<br />
history taking with a patient and a<br />
third party<br />
E M van Weel-Baumgarten* and K P M van Spaendonck<br />
University of Nijmegen, Hermelynstraat 50, 6531 JZ Nijmegen,<br />
NETHERLANDS<br />
The next part of this double presentation focuses on a<br />
training of a consultation with a patient and a third party.<br />
In such cases the doctor is confronted with two people<br />
who usually have a long history of intimate life in<br />
common, which has resulted in a specific pattern of<br />
interaction and behavioural codes. Any remark of the<br />
doctor addressed to one of them, also has implications<br />
for the other, and may disrupt the mentioned pattern of<br />
interaction and behavioural codes. This type of<br />
consultation involves a number of skills: to be in control<br />
of the consultation, to negotiate, to give both parties<br />
equal attention. Training also focuses on how to avoid<br />
pitfalls, such as choosing sides, arbitrating, allowing<br />
Session 8J Clinical teaching<br />
8J1 Increasing student awareness of<br />
strengths and weaknesses using a<br />
standardized patient case<br />
Devra Cohen*, Jerry Colliver, Mark Swartz and Randal Robbs<br />
The Morchand Center, Mount Sinai School of Medicine, One<br />
Gustave L. Levy Place, Box 1127, New York NY 10029, USA<br />
Two classes of seond-year medical students (n=105,<br />
class of 1999; n=107, class of 2000) rated awareness<br />
of their strengths and weaknesses in performing a<br />
physical examination, taking a history, and<br />
communicating with a patient before and after an<br />
interaction and feedback session with an SP. The ratings<br />
were on a 5-point scale; 1-not at all; 2-a little; 3moderately;<br />
4-very; 5-extremely. The results showed<br />
that students were “moderately” aware of their strengths<br />
and weaknesses before the encounter and “very” aware<br />
following the encounter. The ratings increased from<br />
pre to post on average 1.0 standard deviation (ranging<br />
from .69 to 1.21 DSs) showing increased awareness of<br />
strengths and weaknesses as a result of the whole<br />
interactive session. Changes in awareness of strengths<br />
and weaknesses for each of the three outcomes<br />
separately as well as relationships between changes in<br />
awareness and performance on the SP case will be<br />
discussed.<br />
Wednesday 5 September<br />
- 4.97 -<br />
the dominant party to overrule the other etc. A tripartite<br />
consultation requires different communication skills<br />
than a patient-centred interview. In our presentation<br />
we will also show a video of how students can be trained<br />
in this type of consultation.<br />
8I7 Breaking bad news - evaluation of<br />
courses run by students and young<br />
doctors<br />
H Ortwein*, E Herrmann, A Brunklaus, A Kreutz,<br />
C Schwarz and J Schildmann<br />
Department of Anaesthesiology, Charité, Humboldt University<br />
of <strong>Berlin</strong>, Lychener Str 60, 10437 <strong>Berlin</strong>, GERMANY<br />
Breaking bad news is one of the most challenging tasks<br />
in medical communication. At German medical schools<br />
communication skills training is usually not part of the<br />
curriculum. A group of experienced students and young<br />
doctors started a breaking bad news course for medical<br />
students in their fourth year of medical training. During<br />
a weekend course, participants receive excessive<br />
training of the subject in role-plays in small groups.<br />
Every student is able to play the role of the doctor as<br />
well as the patient’s part in different situations which<br />
are handed out as paper cases. We evaluated these<br />
course with questionnaires, one before and one after<br />
the course. The values of self-rating regarding the<br />
capability to break bad news improved. Teaching<br />
methods like peer group learning and role-plays were<br />
judged positive for the subject.<br />
8J2 Clinical dermatology: prospective<br />
randomized comparison of a<br />
traditional, a personal bed-side<br />
teaching (PBST) and a problemoriented-practical<br />
(POP) course<br />
F R Ochsendorf*, H Boehncke, R Hovelmann, A Boer and<br />
R Kaufmann<br />
Zentrum Dermatologie und Venerologie, Klinikum der J W<br />
Goethe-Universitat, Theodor-Stern-Kai 7, D-60590 Frankfurt/<br />
M, GERMANY<br />
To assess satisfaction, practicability and knowledge<br />
gain, students were randomly allocated to a traditional<br />
course (lectures and bed-side teaching; evaluable<br />
n=137), bed-side teaching groups always with the same<br />
teacher (PBST, n=37) and POP groups only using<br />
“paper-cases” (n=36) over two terms. For evaluation,<br />
a questionnaire and multiple-choice tests, written<br />
anonymously at start and end of the course, were used.<br />
The PBST-course (1.7 ± 0.7; mean ± SD) and the POPcourse<br />
(1.6 ± 0.8) were rated significantly better<br />
(p
8J3 Clinical skills training - a new<br />
curriculum between BEME and<br />
reality<br />
Peter Frey<br />
University of Bern, Department of Instructional Media (AUM),<br />
Inselspital 38, CH - 3010 Bern, SWITZERLAND<br />
Clinical skills like history taking and physical<br />
examination are basic skills for clinical reasoning and<br />
the right decisions in patient management. How should<br />
a curriculum be planned and implemented to get the<br />
best evidence medical education? At the Medical<br />
School of Berne Switzerland fundamental changes in<br />
the third year curriculum (first clinical year) allows<br />
the establishment of a new state-of-the art curriculum.<br />
The presentation describes the needs and the change<br />
management, how the goals and objectives were<br />
formulated, the instructional strategies (small group<br />
work, standardization of the training, instruction of<br />
tutors, use of guidelines), the credit system, the use of<br />
information technologies and the barriers of the new<br />
curriculum. Homepage: http://studmed.unibe.ch<br />
8J4 The effects of student gender on<br />
patients’ willingness to be<br />
examined by medical students<br />
William P Metheny*, Roxanne Jamshidi and Kara Pitt<br />
Brown University School of Medicine/Women and Infants<br />
Hospital, 101 Dudley Street, Providence, RI 02905, USA<br />
Gender discrimination by patients can affect the clinical<br />
experiences medical students get. Excluding male<br />
medical students from the gynecologic exam or the<br />
prenatal visit may directly affect their clinical<br />
performance. We hypothesized that patients who were<br />
told the student’s gender (males in particular) prior to<br />
the examination were more likely to reject the student<br />
than patients who were not told the student’s gender in<br />
advance. Our experiment tested this hypothesis by<br />
assigning students to one of two female residents in an<br />
ob/gyn clinic who in asking permission of the patient<br />
would either refer to the student as a medical student<br />
(gender neutral) or identify the student’s gender.<br />
Patients (n=66) did not differ (p> .05) in responding to<br />
the two conditions; however they rejected only males<br />
in the gender specific situation. The way students are<br />
presented to patients can affect patient receptivity to<br />
them.<br />
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8J5 Reality shock among medical<br />
students attending first clinical<br />
rotation<br />
I Levi* and T Fischel<br />
Sackler Medical School, 13/2 Tsel Hagivaa, Ramat Gan, ISRAEL<br />
Discrepancy between fantasy that is perceived during<br />
preclinical studies, and reality as met during clinical<br />
rotation may cause difficulties and frustration, a state<br />
that can be defined as “reality shock”. An open<br />
interview was conducted with 40 students attending<br />
their first clinical rotation in an internal medicine<br />
department. Main difficulties described by the students<br />
were their position within the department staff, and their<br />
right to disturb patients while taking their history and<br />
making a physical examination. Significant gaps in<br />
“doctor–patient relationship” as met in real life opposed<br />
to what was learned at school, and gaps in “success<br />
rates” in medical treatment between real life and fantasy<br />
contributed also to “reality shock”. Reality shock is<br />
common in medical students attending their first<br />
clinical experience and can contribute to students’<br />
frustration and burnout. Medical schools should take<br />
this into consideration in planning the preclinical and<br />
clinical curriculum.<br />
8J6 Experiential clinical learning in a<br />
horizontally-integrated, problembased<br />
curriculum<br />
Tim Dornan*, Arno Muijtjens and Henny Boshuizen<br />
Universities of Manchester and Maastricht, 10 Raynham Avenue,<br />
Didsbury, Manchester M20 6BW, UK<br />
The aim of the study was to test whether better<br />
horizontal integration was achievable in the clerkship<br />
phase of a problem-based curriculum. Eight first<br />
clerkship students using a learning portfolio and<br />
attending weekly group tutorials to support selfdirected<br />
reflective clinical learning were compared with<br />
16 historical and 16 contemporary controls. Results<br />
revealed mean agreement with: ‘I was able to see the<br />
types of patients I needed to see’ rose from 3.5 ± 1.1 to<br />
4.4 ± 0.7; 0.1>p>0.05. Historical controls commented<br />
on the inappropriateness of casemix whereas<br />
experimental subjects commented positively about<br />
casemix, and outpatient learning. Mean rating of<br />
outpatient learning rose: 3.6 ± 0.8 to 4.6 ± 0.5 (p=<br />
0.001). Mean rating for inpatient learning was<br />
unchanged. Despite those improvements, learning<br />
remained strongly influenced by the clerkship’s<br />
specialty interest. It was concluded that some measures<br />
of experiential clinical learning improved; other<br />
interventions are needed to help students cross specialty<br />
boundaries.
Session 8K International aspects of medical education<br />
8K1 Influence of Studying on Students’<br />
Health (ISSH)<br />
T Schweickert*, P Hodzic, V Jurkovic, J Seitz*, O Onur*<br />
and T Shiozawa*<br />
German Medical Students’ Association, Gringelsbach 61, 52080<br />
Aachen, GERMANY<br />
The aim of the project is to find out if there is a<br />
correlation between studying and students´ health,<br />
especially if there is a significant correlation between<br />
the students´ health and the various medical education<br />
systems. This study is part of an international project<br />
organized by the IFMSA (international student<br />
organization). Croatian Students developed a<br />
questionnaire for students, which consists of 27<br />
questions divided into four sections – General<br />
information, General health information, Studying,<br />
Health and Lifestyle. In our analysis we focus on three<br />
aspects: 1) education system 2) educational level 3)<br />
medical/non medical students. The first steps of the<br />
study have shown that students’ health has deteriorated<br />
since the beginning of their studies. They consider their<br />
health to be worse compared to the peer population.<br />
About one third suffer from vision deterioration,<br />
headaches and digestion problems and they sleep less,<br />
drink much more coffee and take less care of<br />
themselves.<br />
8K2 A comparison of curricula – a cross<br />
country approach<br />
J Mirecka*, Paola Binetti, Jan Hijlman, Roy Remmen,<br />
K Lipinski<br />
Department of Medical Education, Medical College of<br />
Jagiellonian University, Str. Kopernika 19E/1, 31-501 Krakow,<br />
POLAND<br />
Comparison of undergraduate medical curricula in<br />
various countries was undertaken within the JEP-<br />
Tempus project and involved four medical schools . It<br />
was found that:<br />
• The total number of hours varied from 3500 to<br />
6500;<br />
• The lists of courses were not compatible because<br />
of their different names and content;<br />
• The content of courses could be compared after<br />
identifying the topics according to the traditional<br />
disciplines;<br />
• When viewed from this perspective the essential<br />
content of four curricula appeared quite similar;<br />
• The accents underlying importance of particular<br />
subjects were distributed differently;<br />
• The structure of curricula reflected by percentage<br />
of lectures, small group sessions, laboratories,<br />
varied considerably;<br />
• Other components of the curricula such as<br />
clerkship, electives, bed-side teaching, research,<br />
revealed also school specificity.<br />
Wednesday 5 September<br />
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8K3 International differences in medical<br />
content preparation<br />
Steven R Daugherty* and Rochelle Rothstein<br />
Kaplan Medical, 820 West Jackson, Suite 550, Chicago IL 60612,<br />
USA<br />
Scores of medical students from eight regions of the<br />
world were compared by means of a standardized,<br />
content-focused exam targeted to the United States<br />
Medical Licensing Exam (USMLE, Step 1). The<br />
diagnostic exam was offered in English to participants<br />
studying at Kaplan Medical Centers in the United<br />
States. Analyses examined differences in scores in<br />
traditional medical subject area and by organ system<br />
knowledge. Results show that students trained outside<br />
the US averaged significantly lower scores in most<br />
areas, with the largest differences found in<br />
Biochemistry, Behavioral Sciences, and General<br />
Principles. Scores on Microbiology were most similar<br />
to US students across all groups. Students trained in<br />
South America had the lowest scores, while students<br />
from Asia show the most similarity to US trained<br />
students. Results are discussed with reference to the<br />
role of language fluency in determining test scores and<br />
international differences in medical education.<br />
8K4 New trends at TSMU: elaboration of<br />
medical education conception<br />
R Khetsuriani, B Kilassonia, Z Avaliani* and G Simonia<br />
Tbilisi State Medical University, 33 Vazha-Pshavela Avenue,<br />
Tbilisi 380077, GEORGIA<br />
In Georgia, as in other post-Soviet countries, a<br />
necessary condition for success of the current reform<br />
in healthcare is a basic reorganization of the medical<br />
education system, which first of all means introduction<br />
of the optimal model of teaching. The Outcome-based<br />
Model of medical education has been considered as<br />
the most acceptable method of teaching at TSME. This<br />
means the introduction of a flexible, integrated teaching<br />
frame-plan and appropriate study programs, that enable<br />
us to align professional activity of the graduates with<br />
the knowledge accepted at the University. The aims of<br />
the teaching process and main criteria, which should<br />
correspond to each grade of the study process, will be<br />
defined according to the last outcome. For optimization<br />
of the teaching process at TSMU some problems must<br />
be solved. First of all it is necessary to take part in the<br />
important process of inter-recognition and interacknowledgement<br />
of recognised medical schools,<br />
which, through international experiences and with<br />
support from <strong>AMEE</strong> and the other educational<br />
organizations and international programs, will give us<br />
the opportunity to improve the qualifications of our<br />
university professors at other medical schools through<br />
visits and training courses. In addition, it is very<br />
important to extend the existing practice of student<br />
exchanges with leading university clinics (more than<br />
100 students are being trained abroad annually).
8K5 Learning Needs Assessments for<br />
Refugee Doctors; establishing<br />
baseline data about medical<br />
knowledge and experience<br />
Lesley J Southgate* and Joan F Fuller<br />
Centre for Health Informatics & Multiprofessional Education,<br />
University College London Medical School, Archway Campus,<br />
Highgate Hill, London N19 3UA, UK<br />
The profound and all embracing sense of loss<br />
experienced by refugees may be compounded for<br />
professionals, many of whom feel their special skills<br />
and knowledge are unused. Dependence on welfare and<br />
charity, loss of pride and socio-economic standing<br />
contribute further to low self-esteem and lack of<br />
confidence. We organised a learning needs assessment<br />
workshop for refugee doctors as part of a wider<br />
programme. Participants took a knowledge test in the<br />
same format as the new GMC PLAB test. Next, doctors<br />
working in the NHS interviewed refugee doctors to<br />
ascertain their experiences and expectations. Feedback<br />
from the interviewers and the refugee doctors was<br />
systematically recorded. We present here the outline<br />
of the wider programme, the themes from the<br />
interviews, the results of the knowledge test and plans<br />
for future work.<br />
8K6 Helping refugee doctors back to work<br />
M J Bannon*, E Paice, G MacFadden, G Cowan,<br />
S Cheeroth and Y H Carter<br />
London Deanery, Medical Education Department, Level 6V,<br />
Northwick Park Hospital, Watford Road, Harrow, Middlesex<br />
HA1 3UJ, UK<br />
It is estimated that there may be as many as 2,000<br />
refugee doctors living in the UK. They face a variety<br />
of hurdles (including loss of professional<br />
documentation and status, separation from family/<br />
friends, financial hardship and language difficulties).<br />
To date, a minority has succeeded in gaining clinical<br />
employment in the NHS. In November 2000, a project<br />
was initiated by London Deanery with the following<br />
aims:<br />
• To offer refugee doctors support, career advice and<br />
help with obtaining clinical attachments;<br />
• To directly place them as appropriate in specially<br />
arranged supervised senior house officer posts.<br />
Session 8L Special subjects<br />
8L1 And now for something completely<br />
different… reflective style learning<br />
of the Arts in medicine<br />
Paul Lazarus<br />
University of Leicester, Department of General Practice and<br />
Primary Health Care, Leicester General Hospital, Gwendolen<br />
Road, Leicester LE5 4PW, UK<br />
There is an increasing trend towards including a study<br />
of the Arts in undergraduate medical curricula, and the<br />
Wednesday 5 September<br />
- 4.100 -<br />
To date 20 doctors have been seen; 6 have been directly<br />
placed in clinical posts; 4 have clinical attachments that<br />
will lead to clinical posts. As a result of these efforts a<br />
network of support has begun for refugee doctors in<br />
West London. By listening to their stories, we have<br />
gained an enhanced appreciation of the difficulties<br />
faced by them.<br />
8K7 New York University School of<br />
Medicine Master Scholars Program<br />
Sharon K. Krackov<br />
Master Scholars Program, Dean’s Office, New York University<br />
School of Medicine, 550 First Ave, New York, NY 10016, USA<br />
New York University School of Medicine’s new and<br />
unique Master Scholars<br />
Program was launched in June 2000. The overall<br />
mission is the creation of a fabric of learning that<br />
promotes the principles of humanism and<br />
professionalism throughout all aspects of the education<br />
of physicians. A second mission is that the Master<br />
Scholars Program serves as a center for the<br />
development of ideas on contemporary social and<br />
ethical issues. It achieves these missions in a variety of<br />
ways through:<br />
1 The medical student curriculum where humanism<br />
and professionalism are interwoven with the study<br />
of science;<br />
2 Student mentoring activities;<br />
3 Seminars where students and faculty discuss topics<br />
of relevance;<br />
4 Development of joint degree programs with the<br />
other schools of New York University;<br />
5 Monthly colloquia on topics of public interest;<br />
6 Scholarly publications;<br />
7 A planned international symposium in London in<br />
Spring <strong>2002</strong>.<br />
This broad program is implemented through five<br />
theme-based Societies (biomedical and health sciences;<br />
medical informatics and technology; health policy and<br />
public health; bioethics and human rights; and arts and<br />
humanities in medicine in which both students and<br />
faculty participate. [www.MasterScholars.med.nyu.edu]<br />
Leicester-Warwick Medical School has set up a module<br />
using the study of literature, drama, music and visual<br />
art to enhance students’ understanding of the human<br />
experience in health and sickness. As well as marking<br />
a departure from the study of more traditional scientific<br />
and clinical subjects, new ground is broken in using<br />
multi-disciplinary tutoring and in introducing students<br />
to a more reflective style of learning in the form of<br />
personal learning journals. This presentation describes<br />
why and how the module was set up and how reflective
learning practice is useful to students and doctors. An<br />
evaluation of the module’s success so far will also be<br />
given.<br />
8L2 Seamless humanities: on integrating<br />
medical humanities into medical<br />
education: the Witten project<br />
C Hick*, B Matzke, B Strahwald, A Weymann and<br />
W Vermaasen<br />
Universitat Witten/Herdecke, Alfred-Herrhausen-Str.50, 58448<br />
Witten, GERMANY<br />
We report on the curricular development and first year<br />
experience with the “seamless” integration of medical<br />
humanities into a medical reform curriculum at Witten<br />
/ Herdecke University, Germany, aiming at enhancing<br />
the communicative and ethical competences of medical<br />
students. Specifically addressed will be the strategies<br />
employed for opening up problem-based learning and<br />
simulated patients to topics in medical ethics,<br />
philosophy of medicine and medical history. We will<br />
stress the importance of overcoming traditional<br />
disciplinary orientations in the medical humanities and<br />
argue for a topical, hands-on approach seeking to<br />
develop the “humanistic skills” of medical students in<br />
clinical contexts.<br />
8L3 Improving clinical reasoning in<br />
novice clinicians: a diagnostic<br />
training aid to support clinical<br />
reasoning in student<br />
physiotherapists<br />
Gill James<br />
Coventry University, School of Health and Social Sciences, Priory<br />
Street, Coventry CV1 5FB, UK<br />
Medicine and physiotherapy (PT) are two health care<br />
professions to identify difficulties in Clinical Reasoning<br />
(CR). CR comprises cognition, knowledge and metareasoning,<br />
with research suggesting that knowledge is<br />
the key to expertise. This paper describes the testing of<br />
a diagnostic training aid, designed to support<br />
knowledge. Two groups of PT students (halfway<br />
through their clinical education hours) were recruited.<br />
Using a standardised case study, they verbally reasoned<br />
about the diagnosis and treatment plan. One group used<br />
the training aid. Content analysis and the Mann-<br />
Whitney test were used to analyse these data. Subjects<br />
using the diagnostic training aid (n=8) recruited<br />
significantly more knowledge (p
symptom control (nausea, vomiting, anorexia,<br />
constipation, bowel obstruction, dyspnea, cough,<br />
delirium, depression, anxiety). Residents complete a<br />
pre-post knowledge assessment questionnaire at the end<br />
of their rotation. Statistical analysis (n=28<br />
questionnaires) demonstrated a significant increase in<br />
knowledge for each educational domain taught during<br />
this experience. This teaching format can be considered<br />
when implementing Palliative Care education into<br />
Internal Medicine residency programs.<br />
8L7 Teaching stress management and<br />
empathic communication to<br />
medical students<br />
Ray Melmed and Hannah Kedar*<br />
The Hebrew University, Hadassah Faculty of Medicine, Centre<br />
for Medical Education, PO Box 12272, Jerusalem 91120,<br />
ISRAEL<br />
Wednesday 5 September<br />
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A workshop based on principles of neuro-psychoimmunology<br />
combined with skills of empathic<br />
communication was designed as a 2-week elective for<br />
6 th year medical students. The workshop included topics<br />
such as the psycho-neuro-physiological basis of stressinduced<br />
syndromes (e.g., panic disorder, chronic pain)<br />
and of behavioural interventions in these situations;<br />
the use of relaxation, meditation and guided imagery<br />
in medical practice; principles of empathic<br />
communication and their application to difficult<br />
interpersonal situations (e.g., angry, depressed, or<br />
anxious patients); breaking bad news; truth telling; and<br />
difficulties around sex-related issues in medical<br />
practice. Teaching methods were mostly experiential,<br />
including role-plays, videotapes, exercises of<br />
relaxation, and encounters with patients. Feedback data<br />
presented reflect high appreciation of this workshop<br />
and emphasise the need to include these topics in the<br />
curriculum.
Session 9 Plenary<br />
1 The role of clinical experience in<br />
the acquisition of clinical<br />
reasoning: Implications for<br />
education<br />
Geoff Norman<br />
McMaster University Medical School, Dept of Clinical<br />
Epidemiology, 1200 Main Street West, Hamilton, ON L8N 3Z5,<br />
CANADA<br />
An extensive body of research in psychology and<br />
medicine indicates that many diagnostic problems aRe<br />
solved by recognizing their similiarity to a previously<br />
encountered specific example. This “exemplar-based”<br />
reasoning is both efficient and effective. However, if<br />
this is a critical component of expertise, we must give<br />
serious consideration to how students can obtain<br />
sufficient clinical exposure. The talk will review some<br />
of the research evidence in support of exemplar-based<br />
reasoning, and describe experimental tests of alternate<br />
instructional strategies.<br />
2 Keeping standards up to date<br />
Susanne Pruskil<br />
Medical Student, Charité, Medical Faculty of Humboldt-<br />
University, <strong>Berlin</strong>, GERMANY<br />
Wednesday 5 September<br />
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Medical knowledge is expanding and changing rapidly.<br />
Consequently standards in medical education should<br />
be adapted continuously. However our learning<br />
objectives are largely overstuffed, reflect specialty/<br />
departmental interests and their relevance is often<br />
unclear. The aim of a modern medical school should<br />
be to include a manageable, ever-adapting,<br />
interdisciplinary core curriculum. Relevant standards<br />
are of crucial importance for the self-directed<br />
undergraduate learner as well as for the lifelong<br />
postgraduate learner.<br />
3 Humour in medical education is<br />
like a box of chocolates …<br />
Ron Berk<br />
The Johns Hopkins University, 525 North Wolfe Street, Baltimore<br />
MD 21205-2110, USA<br />
This session will present research-based teaching<br />
techniques for integrating humour into your course<br />
handouts, examples, case studies, discussion questions,<br />
problems, tests, wedding invitations and parking tickets.<br />
Examples include quotations, cartoons, multiple-choice<br />
items, top 10 lists, anecdotes and skits/dramatizations<br />
with music. This presentation “boldly goes where no<br />
medical educator has gone before,” maybe!