Автор неизвестен - Mededworld and amee 2013 conference connect - страница 116

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Summary of results: Selection strategy (grade-based or attribute-based) had no statistically significant effect on the social diversity of medical students. Conclusions: The choice of admission criteria may be less important to widening access and increased social diversity in a medical school. Attracting a sufficiently diverse applicant pool could be a better diversity strategy.

Take-home messages: More studies examining when diversity is most severely restricted (upon application, during selection or in medical school) would be valuable to better understand diversity in medical education.


Introduction of an interview practice program for specialist training admission in obstetrics and gynaecology

T Nippita (University of Sydney, Obstetrics and Gynaecology, Building B52, Royal North Shore Hospital, Pacific Highway, St Leonards, Sydney NSW 2065, Australia)

P Bland (Royal North Shore Hospital, Obstetrics and Gynaecology, Sydney NSW, Australia)

Background: In Australia the selection for specialty training positions is increasingly competitive. Work practices have dictated the need for a fair and transparent process. This involves references, Curriculum Vitae and interview. The last of these has been the least considered but is paradoxically the most discriminative. Following poor performance of local Obstetrics and Gynaecology candidates in this area of assessment in 2011, a program of interview training was instigated at Royal North Shore Hospital in 2012. Summary of work: The interview practice program comprised three formal sessions: presentations on non­verbal communication and how to approach answering questions; brainstorming possible questions which may be asked at the interview; public individual mock interviews, where the trainees were asked several questions by a panel of consultants in front of the other trainees. After conclusion of the selection process, candidates were surveyed regarding the interview training and its impact on them.

Summary of results: Ten trainees attended the program for at least one session; seven responded to the survey. All ten trainees were successful in their specialty selection, including three who were unsuccessful the

previous year. The mock interview session was considered the most useful. Conclusions: All of the trainees were successful in specialty selection. Interview skills are a vital aspect in the acquisition of speciality training positions and employment. Such skills are not a routine part of medical training but can be successfully taught to an interested cohort.

Take-home messages: Interview skills are vital aspect in acquisition of specialty training positions and can be successfully taught.


Development a fair and transparent admissions system for postgraduate level of medical education in Iran

Shima Tabatabai (Shahid Beheshti University of Medical Sciences, Medical Education Department, Velenjak, Tehran 1984813568, Iran)

Background: Although colleges and universities have long cherished their right to choose the students they will teach, the manner in which they make those choices is under intense scrutiny during the first decade of the 21st century. (1) Students, parents, legislators, litigators, and judges have challenged both particular admissions decisions and the process by which those decisions were made by colleges, graduate, and professional schools. (2). A fair and transparent admissions system is essential for all applicants. Summary of work: This preliminary study was conducted to design and implement a fair admission process in postgraduate level of medical education in Iran. The proposed admission system was designed in different stages.

Summary of results: The proposed admission process intended to bring some clarity to the admissions debate, concerned with the following questions: How should postgraduate medical science students have been chosen? In this study the principles and processes that constitute a fair admissions process elucidated in designed model.

Conclusions: Considering the need for comparing different admission process strategies and developing national models, the results would help designers and providers of the postgraduate medical education admission process in decision making. Also, more studies should be performed to determine these programs' learning outcomes.

This study also provides some wider recommendations to produce a high quality admissions process and facilitate holistic assessment while minimizing any increase in the overall cost to the postgraduate medical education sector. Many of these recommendations will involve a range of partners in addition to universities and colleges.



Winning the golden ticket - can we predict successful selection into surgical training?

Charlotte Thomas (University Hospital of Wales, Department of Upper GI Surgery, Heath Park, Cardiff CF14 4XW, United Kingdom)

Alex Karran (University Hospital of Wales, Department of

Upper GI Surgery, Cardiff, United Kingdom)

Paul Blake (University Hospital of Wales, Department of

Upper GI Surgery, Cardiff, United Kingdom)

Awen Iorwerth (Royal Glamorgan Hospital, Department

of Orthopaedic Surgery, Cardiff, United Kingdom)

Wyn Lewis (University Hospital of Wales, Department of

Upper GI Surgery, Cardiff, United Kingdom)

Background: The exact shape of UK core surgical training (CST) remains controversial and in particular whether there should be a third year available (CT3). The aim of this study was to establish whether there are measurable factors that predict successful selection from CST after CT2 to ST3 in surgery in a single UK deanery.

Summary of work: Fifty-eight trainees appointed to CT1 in August 2010 were identified and their on-line portfolios assessed for 2 years with reference to the performance of; operations, workplace based assessments, audits, presentations, and scientific publications. Primary outcome measure was success at ST3 selection.

Summary of results: MRCS examination pass rate was 58.6%. Six trainees (13.3%) successfully progressed to ST3 (3 NTNs and 3 LATs); 16 left surgery (27.5%), 1 is undertaking research, and 36 remain in CST at CT2 or CT2+ level. Progression to ST3 was associated with higher median operative numbers (355 vs. 263, p=0.300), national presentations (median 2.5 vs. 1.0, p=0.01), international presentations (median 1.0 vs. 0, p=0.006), and scientific publications (median 2.5 vs. 0, p=0.009). The number of WBAs and audits did not influence selection. Binary logistic regression revealed the only factor to predict successful selection was trainees' publication record (HR 1.501, 95% CI 0.934 to

2.411, p=0.093).

Conclusions: Successful ST3 selection can in part be predicted and trainers and trainees alike should be aware of this as they progress through training. Arguably an additional experiential year at CT3 level could be beneficial to enhance attainment of such competencies. Take-home messages: The only factor to influence ST3 selection was number of publications.


Comparative study exploring self-evaluation of perceived confidence levels between undergraduate and graduate entry students in 3rd year and 5th year at one London medical school

Rachel Swain (Imperial College, Medical Student, Northwick Park Hospital, Watford Road, London HA1 3UJ, United Kingdom)

Naila Kamal (Lead for CPD London Deanery/ Imperial College/NWLH, Associate Specialist O&G/Honorary Lecturer, London, United Kingdom)

Background: This short study is based upon the hypothesis that graduate students have a lower perceived confidence level compared with their counterpart undergraduates due to the shorter nature of the course.

Summary of work: A questionnaire for self-evaluation of perceived clinical competence was developed using a focus group to generate the tool. Following study outline consent procedures, undergraduate and graduate medical students were engaged in the study. 89 third year and 87 fifth year medical students completed the questionnaire.

Summary of results: Whilst in year 3, overall feeling of confidence starting their first ever clinical attachment was similar in undergraduates and graduates, by 5th year only 56.7% of undergraduates had positive perceptions of self-confidence starting their clinical attachment, compared to 96.3% of graduates. The graduate course is still fairly new and undergoing constant student-lead modification. When reflecting back on starting their first ever clinical attachment two years ago, 48.1% of 5th year graduate entry students remembered not feeling competent in their 3rd year. In comparison, of the current graduates who had just started their first ever clinical attachment, 66.6% did feel confident in starting. This could well reflect a change in teaching practice, since the course has been modified according to student feedback over the years. Conclusions: This study shows that at this London medical school, graduates are not at a disadvantage when it comes to perceived clinical confidence levels. Take-home messages: The graduate medicine course has the capacity to produce students whose perceived confidence is just as high, if not higher than undergraduates. Acting on student feedback is vital to constantly improve the course.


Graduate versus undergraduate medical students: who will be our future surgeons?

David Ferguson (University of Leicester, Medical School, Leicester, United Kingdom)

Abdul Rahman Hassan (University of Leicester, Medical School, 22 Greenhill Road, Leicester LE2 3DJ, United Kingdom)


A Nasim (University Hospitals NHS Trust, Department of Vascular Surgery, Leicester, United Kingdom)

Background: We hypothesize that increased enrolment of graduate students i.e. those with previous degrees alongside a power devolution into general practice reduces the interest in surgical careers amongst medical students

Summary of work: Undergraduate and graduate medical students reading the 4th year of an MBChB programme responded to a 25-item questionnaire delivered via Turning Point Technologies. Participants were asked if they were interested in surgery then ranked 7 items known to influence careers in surgery. Summary of results: 86 (67.0%) fully completed datasets were returned, of those 36 (42.0%) were graduate medical students and 50 (58.0%) were undergraduate medical students. 18 (20.9%) were interested in surgery of which 8 were graduate students and 10 were undergraduate. 68 (79.1%) were not interested in surgery of which 28 were graduate students and 40 were undergraduate. Therefore as a cohort, 22.2% of the graduate students were interested in surgery compared to 20.0% of the undergraduate students. Both groups interested in surgery rated hands on technical skills and job satisfaction as their 1st and 2nd most influential factor. Interestingly, the 3rd most influential factor differed between the 2 groups- financial reward (16.0%) scored the highest for the undergraduates however for the graduates they scored undergraduate surgical exposure (15.0%) as their 3rd most influential factor.

Conclusions: This research demonstrates that there is a greater proportion of graduate students compared to undergraduate students interested in surgery. Furthermore, both groups demonstrated similar primary and secondary influential factors for careers in surgery however the difference observed in the 3rd influential factor could be related to graduate students having greater financial security. This information should be used by the medical community when supporting students considering pursing a surgical career. Take-home messages: There are some fundamental differences between graduate and undergraduate medical students which need to be taken into account for future workplace planning.


A graduate entry programme in medicine and research at the VUmc School of Medical Sciences

Inge van Wijk (VU University Medical Center, Department of Paediatrics, PO BOX 7057, Amsterdam 1007 MB, Netherlands)

Gerda Croiset (VUmc School of Medical Sciences, Institute for Education and Training, Amsterdam, Netherlands)

Marleen Westerhof-Sinke (VUmc School of Medical Sciences, Institute for Education and Training, Amsterdam, Netherlands)

Joke Jansen (VUmc School of Medical Sciences, Institute for Education and Training, Amsterdam, Netherlands)

Rashmi Kusurkar (VUmc School of Medical Sciences, Institute for Education and Training, Amsterdam, Netherlands)

Background: A new graduate entry programme was launched at our institute in 2012 with a mission to educate research-oriented medical practitioners. Summary of work: Students with a bachelor's degree in biomedical sciences were selected through a cognitive test, an assessment of past performance and Multiple Mini Interviews. A four year programme was designed consisting of a transition year dedicated to acquiring basic medical knowledge and skills, followed by a 3-year master programme consisting of clinical rotations, an extended research training period and specialised research courses. The students receive personal supervision by a mentor, work in the form of a student community and are given the opportunity to start a PhD training following their own research project, during their master programme.

Summary of results: Twenty one highly motivated students (out of 128 applicants) entered the programme. They are dedicated to investing the extra effort needed in the programme. At the end of their first year they have formed a tightly knit community, obtained good grades and will enter the master programme being involved in research. Conclusions: The selection procedure enabled us to recruit highly motivated and qualified students. The preliminary results of the students enrolled in this programme are promising. Students perform well, acknowledge the support they feel being part of the student community, and show commitment to perform research.

Take-home messages: Setting up student communities and personal supervision is important in supporting these students in the intense effort they need to invest to become a clinician-researcher.


Is there a relationship between entrance exam and academic results during Italian students' three-year, pre-clinical undergraduate careers?

Giuseppe Familiari (Faculty of Pharmacy and Medicine, Sapienza University of Rome, Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Via Alfonso Borelli 50, Rome 00161, Italy) Rossella Baldini (Faculty of Pharmacy and Medicine, Sapienza University of Rome, Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Rome,


Antonio Lanzone (Faculty of Medicine and Surgery, Catholic University of Sacred Heart, Institute of Obstetrics and Gynaecology, Rome, Italy) Michela Relucenti (Faculty of Pharmacy and Medicine, Sapienza University of Rome, Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Rome,


Andrea Lenzi (Faculty of Medicine and Dentistry, Sapienza University of Rome, Department of Experimental Medicine, Rome, Italy)


Eugenio Gaudio (Faculty of Pharmacy and Medicine, Sapienza University of Rome, Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Rome,


Background: In Italy, entrance exams to state-run medical faculties are national and based on tests involving logic, general knowledge, chemistry, physics and mathematics, with no reference to previous grades. In some non-state medical schools the exam is local and based, besides the above-mentioned subjects, on aptitude tests and previous grades. Summary of work: In 2008, 273 students took the national test at Rome's Sapienza University, the day before that administered by the Rome branch of the private Catholic University of Sacred Heart. 195 students (group A) passed the national exam at the Sapienza while they were rejected by the Catholic institution; 78 students (group B) who passed both exams enrolled at Sapienza. The data for these students, the percentage of prescribed exams taken and average grades for the three pre-clinical years (2008-2009; 2009-2010; 2010­2011) have been analysed.

Summary of results: The A-group took 11,3±1,9 of the prescribed exams (13), the B-group 11,1±2,1. The A-group obtained average grades (max 30/30 - min 18/30) of 27,2±1,8, the B-group 27,9±2,4. The number for exams taken show no significant differences (P=0,446) between the two groups although the B-group obtained slightly better, though statistically non-significant grades


Conclusions: The students who passed both exams obtained statistically non-significant, slightly better grades than those who took the national test only. Differences in results concerning the clinical phase will be examined in the future.

Take-home messages: Entrance exams of different kinds do not seem to impact significantly on the academic results of medical students during their three-year pre-clinical careers.


Improvement in perception of self-competencies of the clinical performance of students after implementation of graduate medical education

Sung Soo Jung (Chungnam National University School of Medicine, Medical Education, Internal Medicine, CNU Hospital, Munwharo 33, Jung-Gu, Daejeon 301-721, Korea, Republic of (South Korea)) Yoba Lee (Chungnam National University School of Medicine, Medical Education, Daejeon, Korea, Republic of (South Korea))

Background: This survey was done to evaluate whether or not students' self-competency on the clinical performance is improved after implementation of graduate medical school (GMS) system from undergraduate medical school (UMS) system. Summary of work: A serial survey of senior medical students (70 students of UMS and 111 students of GMS) at a medical school in Korea was conducted in 2008

(students of UMS) and 2012 (students of GMS). This medical school formerly had UMS system (2 + 4 years, total 6 year) until 2008, then the school system was changed into GMS (4 + 4 years, total 8 year) since 2009. In the GMS system intensified clinical clerkship and clinical performance assessment was newly introduced. The data were gathered using 1-5 point Likert scale questionnaires about self-competencies with regard to clinical performance for 47 clinical presentations. Summary of results: Students of GMS had higher self-assessments of competency on the clinical performance in 45 clinical presentations. Average score of self-competencies were 3.33 points in students of GMS and 2.87 points in students of UMS. The variables that influenced self-competency were intensified clinical clerkship and introduction of clinical performance assessment.

Conclusions: Implementation of the GMS system improved the self-competencies on the clinical performance.

Take-home messages: Intensified clinical clerkship and assessment of clinical performance is essential to improving student's self-competencies.


The UK medical school application: Examining the perceptions of prospective students surrounding work experience in relation to socio-economic background

Lewis Peake (University of Leicester, Medical Sciences, Maurice Shock Building, PO Box 138, University Road, Leicester LE1 9HN, United Kingdom) Dhawal Patel (University of Leicester, Medical Sciences, Leicester, United Kingdom)

Mohamed Mohamed (Walton Hospital, Department of Neurosurgery, Liverpool, United Kingdom) Lopa Patel (Wythenshawe Hospital, Department of Plastic Surgery and Burns, Manchester, United Kingdom)

Background: Work experience is expected from prospective medical students. We examined if students whose parents work within medical professions have an advantage in seeking experience and if this creates a perceived bias towards the higher social classes. Summary of work: The SAMPLE Medicine project allowed students from a variety of socio-economic backgrounds to explain their perceptions of the medical school application. Through questionnaires, we asked participants to comment on their difficulties seeking experience and explore their perceptions regarding bias in the application process.

Summary of results: (1) Regarding family: a. 38% had at least 1 parent who was a Doctor (Group A). b. 24% had at least 1 parent who was a medical professional other than Doctors (Group B) c. 38% did not have parents within medical professions (Group C). (2) 97% stated finding experience was "moderate" or "difficult". (3) 67% of Group A admitted to parental assistance in organising experience, whereas 44% in Group B and 0% in Group C claimed to have received help respectively. (4) 80% of Group C believed the application process is

biased towards higher socio-economic backgrounds, compared to only 7% of Group A. Conclusions: Work experience is difficult to organise but crucial for the application process. The results suggest it is easier to arrange work experience when family members work in medical professions. This could contribute to the perception that the application process is biased towards higher socio-economic backgrounds.

Take-home messages: Medical Schools should encourage fair access to work experience through projects such as SAMPLE medicine.

9BB Posters: The Curriculum/Social Responsibility/Patient Safety

Location: South Hall, PCC


Rethinking the wheel: A clinical presentation-oriented Internal Medicine curriculum for South Africa

J.A. Coetser (University of the Free State, Department of Internal Medicine, G73, P.O.Box 339, Bloemfontein 9300, South Africa)

Background: An increased emphasis on primary health care in South Africa, a political mandate to align medical education with socio-epidemiologic need, and the introduction of community based education (CBE) at the University of the Free State (UFS) has necessitated review of the undergraduate curriculum in Internal Medicine. A clinical presentation-oriented model is being developed.

Summary of work: From March 2012 to January 2013, eleven expert workgroups, each consisting of at least the unit head and one consultant of the UFS Department of Internal Medicine subspecialties, were asked to compile a consensus list of the most common primary clinical presentations for patients presenting to their subspecialty, as well as the most common and important differential diagnoses for these presentations. The general medicine workgroup reviewed these lists for completeness and applicability to the South African primary health care setting.

Summary of results: A total of 111 common clinical presentations were identified. The most frequently listed were tiredness/fatigue (50%), shortness of breath (50%), fever (50%), weight loss (50%) and chest pain (40%). For all presentations a total of 670 differential diagnoses were generated (clinical presentations/differential diagnoses): cardiology (10/48), endocrinology (28/137), gastroenterology (14/78), geriatrics (8/30), haematology (14/38), infectious diseases (19/109), nephrology (11/34), neurology (13/63), pulmonology (16/71) and rheumatology (12/62).

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