Автор неизвестен - Mededworld and amee 2013 conference connect - страница 137

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scores of 22.5%; 95% Confidence Interval (19.66%,

25.19%; P< 0.001). 88.7% of students reported that the lecture was useful and when asked 'would you like more clinical embryology teaching in the curriculum' over 50 % of students said 'yes'.

Conclusions: Major birth defects remain a leading cause of infant mortality accounting for approximately 21% of infant deaths. Our report indicated that students respond well to embryology taught with an emphasis on clinical relevance. Lecture based teaching in clinical embryology has significantly improved knowledge in 1st year medical students and was met with positive reports.

Take-home messages: More educational research needs to be undertaken early in the medical curriculum on embryology teaching and its effectiveness.


The Role of Anatomy Demonstrating: a medical student perspective

Krzys Rakowski (St Georges Hospital, Surgery, London, United Kingdom)

Toby Jennison (West Midlands Deanery, Orthopaedics, St Chads Court, 213 Hagley Road, Birmingham B16 9RG, United Kingdom)

Niroshan Sivathasan (Royal Brisbane and Women's Hospital, Queensland, Australia) Darrell Evans (Brighton and Sussex Medical School, Brighton, United Kingdom)


Background: Anatomy-teaching has changed rapidly over recent years with the development of multimedia tools and computer-based teaching. Cadaveric dissection, one of the oldest methods, is still used by many medical schools and is often delivered by anatomy demonstrators who are often junior clinicians interested in a surgical career. The aim of this study was to gauge medical students' experiences of anatomy- teaching and their opinions about the role of the anatomy demonstrator.

Summary of work: A nine-question survey was constructed and sent to medical students in the second and final years of training, in two medical schools. Summary of results: 215 second year medical students and 70 final year medical students responded. 91% found teaching by anatomy demonstrators to be useful. 71% of respondents stated that dissection was their preferred method of anatomy teaching, with 22% preferring prosection. 59% felt that anatomy-teaching as part of their basic sciences was sufficient. 30% of respondents were interested in becoming an anatomy demonstrator, but only 7% were willing to accept a significant pay cut to do so. 23% of respondents wanted to become either a surgeon or radiologist. Conclusions: This study found that the majority of medical students felt the teaching delivered by anatomy demonstrators to be useful, with the preferred method of teaching being dissection. Cadaveric teaching still has a vital role in medical education and is favoured by the majority of students.

Take-home messages: Medical students find teaching by anatomy demonstrators a vital part of medical education.


Do students use what they ask for? Reflections on anonymous student feedback following the introduction of a novel way of teaching surface anatomy to second year medical students

Sanet H Kotze (Stellenbosch University, Department of Biomedical Sciences, P.O.Box 19063, Faculty of Medicine and Health Sciences, Tygerberg 7505, South Africa) Natasha D Driescher (Stellenbosch University, Department of Biomedical Sciences, Tygerberg, South Africa)

Calvin G Mole (Stellenbosch University, Department of Biomedical Sciences, Tygerberg, South Africa)

Background: Student feedback is a valuable tool in the evaluation and maintenance of a successful medical curriculum. During a recent innovation used in 2011, full body digital X-rays of each cadaver dissected by second year medical students were used to aid student learning of surface anatomy. Subsequently, anonymous, voluntary questionnaires were used to gauge its success. Suggestions made by students during the 2011 feedback were implemented during 2012. The aim of the present study was to determine if students used changes suggested by the previous student cohort. Summary of work: The following suggestions were implemented during 2012: the provision of labelled X-

ray images in the dissection halls, making cadaver and labelled X-rays images available online for after-hours viewing of student's own and colleague's cadaver X-rays, the incorporation of informal oral tests on surface anatomy during dissections and explanations of anatomically visible structures on X-ray images during lectures preceding dissections. After completion of the academic year, the 2012 students completed questionnaires (207/259, 80% response rate). Summary of results: During 2012, labelled X-rays in the dissection halls were used by 49% of students while the on-line electronic versions were used by 34% to view their own cadaver X-rays and 42% to view other cadaver X-rays. The informal orals were useful to 72% of students while the incorporation of explanations on X-rays into gross anatomy lectures benefitted 65% of students.

Conclusions: Changes suggested by the 2011 students were used by the 2012 cohort.

Take-home messages: Student feedback was therefore valuable in the improvement of a new teaching innovation.


Implementation of clinical case modules in combination with surgical dissection tutorial and cross sectional anatomy for problem-based integrated anatomy

Joon Ho Song (Inha Univ. School of Medicine, Medical Education Center, Dept. of Internal Medicine, 7-206 Sinhung-dong 3ga, Jung-gu, Incheon 400-103, Korea, Republic of (South Korea))

Min Jung Kim (Inha Univ. School of Medicine, Medical Education Center, Incheon, Korea, Republic of (South Korea))

In Suh Park (Inha Univ. School of Medicine, Medical Education Center, Dept. of Pathology, Incheon, Korea, Republic of (South Korea))

Seong Bin Hong (Inha Univ. School of Medicine, Dept. of Internal Medicine, Incheon, Korea, Republic of (South Korea))

Ji Ho Choi (Inha Univ. School of Medicine, Medical Education Center, Dept. of Family Medicine, Incheon, Korea, Republic of (South Korea))

Background: The implementation of the problem-based learning has been a great issue in the teaching of anatomy. We have developed a new vertically-integrated anatomy course implementing the clinical case modules in combination with relevant surgical dissection tutorial and cross sectional anatomy. Summary of work: Fourteen clinical case modules according to the body compartments and relevant surgical dissection tutorials were developed by clinicians in corporation with anatomists. Each module was instructed as below sequence: introduction of learning outcomes, basic anatomy lecture, relevant cross sectional anatomy focusing on radiologic image, surgical dissection tutorial, self-directed lab activity, and wrap-up discussion. The course covered six weeks of the 1st year of curriculum.


Summary of results: The questionnaire survey using 5-point Likert scale revealed that the new course was significantly better than the old course in terms of giving motivation and interesting to the students, providing good understanding with the insight to the clinical application. Best part of the course was revealed the surgical dissection tutorial by surgeon. Conclusions: It was motivating, time and efforts-saving way of instructing anatomy. Also it was more relevant to educational goal of Medical School. Further studies are required to compare the long-term efficacy in the achievement of knowledge and skills between new versus traditional learning setting. Take-home messages: Implementing clinical case module and surgical dissection tutorial by clinician was effective method of instructing anatomy.


Teaching tools in Neuroanatomy

Uma Gaur (The University of The West Indies Cave Hill Campus, Faculty of Medical Sciences (Anatomy), 170 Bacarat Drive, Crystal Heights, St James, Bridgetown 100000, Barbados)

David B Pettigrew (University of Cincinnati College of Medicine, Mayfield Clinic and Spine Institute, Department of Medical Education, Cincinnati, OH,

United States)

Mahindra Kumar Anand (SR dental Sciences and Research, Anatomy, Faridabad, India) Deepti Gaur (The University of the West Indies, Department of Social Sciences, Bridgetown, Barbados)

Background: Teaching neuroanatomy to undergraduate student is a challenging task. The traditional method of teaching involves the process of didactic lectures which are followed by cadaveric dissection in a small group setting. Various methods have been employed by teachers to help students gain a better understanding of neurosciences yet, no standard teaching methods have been validated so far. Various teaching tool currently being used are models, cadavers and computers. Summary of work: To establish the best teaching tool for neuroanatomy for undergraduate students. The teaching method included didactic lectures. The various modules used during the practical session included plastic models, drawings, brain mapping, case solving, preparation of MCQs, paper models, construction of tracts, CT scans and MRI. A ten item questionnaire was circulated during the classroom session. Summary of results: The statistical analysis of the data indicated the following results. The majority (95%) of students agreed that the best way to learn neuroanatomy is combination of various teaching methods.

Conclusions: The "best tool" to easily understand neuroanatomy is a combination of various methods. Students also find that case solving is the best way to establish basic knowledge of neuro-anatomy in relation to clinical practices. Similar results were reported from University of Cincinnati College of Medicine, Cincinnati,

Ohio, and SR College of Dental Sciences and Research, Faridabad, India.

Take-home messages: There is no "best way" to make the learning of neuroanatomy easy. To minimize the "neurophobia" among the medical students, the teachers must try combination of various teaching tools.


Experience of using integrated lectures-symposiums in teaching normal function and pathology in medical school

Farida Mindubayeva (Karaganda State Medical University, Department of Physiology, Karaganda, Kazakhstan)

Viktor Riklefs (Karaganda State Medical University, Clinical Skills Center, Gogol st., 40, Karaganda 100008, Kazakhstan)

Irina Riklefs (Karaganda State Medical University, Educational Resource Center, Karaganda, Kazakhstan)

Background: Integrated approach to teaching basic sciences and clinical disciplines is not only the main component of reforms in medical education in Kazakhstan, but the prerequisite to effective development of competencies for the graduates of medical schools.

Summary of work: Karaganda State Medical University adopted the integrated approach to learning basic sciences in context of clinical disciplines and introduced lectures-symposiums which completely replaced the traditional lectures at the second and the third years of its 5-year medical curriculum. During these symposiums, the lecture is delivered together by two or three basic scientists and clinicians, and then students are given the opportunity to ask experts the questions. All symposiums are based on clinical case scenarios and application of medical knowledge in clinical decision-making.

Summary of results: Integrated lectures delivered together by different specialists promoted the better understanding of complex theoretical foundation of the disease, increased motivation of students to learning, and created conditions for better emotional comprehension of subject matter and less fatigue due to continuous switch of attention. Conclusions: Survey of students revealed the higher efficiency and better satisfaction with integrated case-based lectures. The academic performance of students as measured by integrated end-of-year examination in basic sciences and clinical disciplines was also enhanced by this new form of lecture delivery. Take-home messages: The integrated delivery of educational material in lectures-symposiums could be certainly recommended for medical schools, especially at the early phase of training.



The relevance of physics in an undergraduate medical curriculum: student's perspective

Rossanun Shoosanglertwijit (Chulalongkorn University, Faculty of Medicine, 4th year Medical Student, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand) Danai Wangsaturaka (Chulalongkorn University, Faculty of Medicine, Pharmacology and Medical Education Unit, Bangkok, Thailand)

Background: There are six years in the undergraduate medical curriculum in Thailand. General biology, chemistry, calculus and physics are the core disciplines in the first year of most medical schools. However, our recent survey shows that, at the end of the course, most Year 1 students could not see the relevance of learning physics in medical curriculum. We, thus, conducted research to investigate if Year 3 and Year 6 students could demonstrate the usefulness of physics for their pre-clinical study and clinical practice, respectively. Their opinions towards the physics course in the curriculum were also studied.

Summary of work: We conducted structured interviews with twenty of Year 3 students and seventeen of Year 6 students. The sessions were audio-recorded and transcribed verbatim. Data obtained were then analysed.

Summary of results: When asked to provide examples of how physics can be applied in medicine, all Year 6 interviewees could come up with at least one. Only two of Year 3 students could think of nothing. Their most common examples related to orthopaedics (e.g. close reduction, mechanism of fracture), cardiology (e.g., EKG, measuring blood pressure), radiology (e.g. computer tomography, ultrasonography) and pulmonology (e.g. ventilator setting-up). The interviewees' positive/negative attitude towards physics did not correlate with the amount of examples they could provide. Their opinions regarding when physics should be taught were divided.

Conclusions: Knowledge in physics is fundamental for learning medicine. Vertical integration and faculty development are the two crucial factors to helping students recognise the relevance of physics in medical practice.

Take-home messages: Clinical relevance!!!


Innovations in teaching methods of pre-clinical subjects at Jessenius School of Medicine in Martin

Juraj Mokry (Jessenius School of Medicine, Comenius University, Department of Pharmacology, Sklabinska 26, Martin 03601, Slovakia)

Daniela Mokra (Jessenius School of Medicine, Comenius University, Department of Physiology, Martin, Slovakia)

Background: Using lectures, labs and seminars is still very popular at medical schools in Slovakia. Physiology and pharmacology belong to the most important pre­clinical subjects and their successful passing is a key to

"survive" in clinical stage of under-graduate medical study.

Summary of work: In order to improve the retention of knowledge among the students and better preparation for clinical stage, several innovative methods were introduced into the curriculum and their impact on students as well as teachers was observed. Simulations (both software and hardware), case-studies, problem-based learning, and interactive formative assessment were implemented as the most important tools in the curriculum. The opinions of students and teachers were evaluated by a specially designed questionnaire and their retention knowledge was compared with students from previous years before involvement of simulation. Summary of results: The students' and teachers' feedback showed significantly increased interest in learning physiology and pharmacology and increased rate of students' theoretical preparation before respective lessons. Furthermore, slight increase in results of retention knowledge tests was observed. Conclusions: Due to the positive feedback from students, more innovations (i.e. interactive tools) will be introduced, e.g. e-learning courses on selected topics, electronic lectures and several study materials available on specially designed portal. However, more detailed evaluation of these changes is required, in order to determine the real impact on students' retention of knowledge and their ability to use them in clinical settings.

Take-home messages: Innovations in curriculum of pre-clinical subjects are essential for improving the performance of students in clinical stage of undergraduate study.

Supported by projects 'Virtual and Simulation Tuition as a new form of education at JFM CU in Martin', co-financed from EU sources, and by project KEGA 055UK-


10DD Posters: International Medical Education

Location: South Hall, PCC


The Challenges That Overseas Doctors might Face When Taking up Their First Appointment in the


Mustafa Jalal (Durham University, School of Medicine and Health, Durham, United Kingdom) (Presenter: Schaida Schirwani, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom)

Background: Overseas doctors represent about 37.1% of the total number of UK doctors, this group of doctors include graduates from European countries and International Medical Graduates (non-UK, non-Europe graduates).

Summary of work: The main aim of this study is to explore the difficulties that overseas doctors might face when they take up their first job in the UK. The secondary aim is to find out the approaches that could help overseas doctors to overcome any potential difficulties that they may face when starting work in the NHS. Method: Literature search conducted using MEDLINE and EMBASE databases. A total of 45 papers were selected for this study including seven hand-searched papers and reports.

Summary of results: The study identified a number of challenges that are facing overseas doctors and these are: lack of information about the UK health system, visa and job finding issues, financial hardship, social isolation, difficulties in securing a structured clinical attachment, language and communication challenges, working in under-resourced areas and in non-training posts, clinical challenges, ethical challenges, challenges with the UK work culture, specialty exam challenges, IT challenges, bullying and harassment, racial discrimination, revalidation, and referral to the GMC because of performance concerns. Conclusions: Overseas doctors experience difficulties in making a smooth transition into the UK health system. Take-home messages: Improving understanding of these challenges and providing appropriate methods to address them are vital to help this group of doctors to progress in their career and to provide better care for patients.


Secret Plans and Clever Tricks. How to ensure cultural competence when delivering teaching

Caroline Fertleman (University College London, Medical School, London, United Kingdom) Chloe Macaulay (Northwick Park Hospital, Paediatrics, London, United Kingdom)


Background: When delivering training in teaching methodology it is imperative to alter language and behaviour for different cultural settings. This includes real-time translation combined with the need for an opportunistic and flexible approach. Summary of work: We describe the process of adapting a teaching course for delivery in a rural health setting in Bangladesh. Lamb is an integrated health-care project which includes a hospital, 30 satellite medical centers and a training center and provides care for two million people. Lamb has a significant educational role training many different levels of staff. We adapted the Teaching Improvement Project System which has been delivered at UCL for health care professionals who teach undergraduates. We based our adaptations on a cultural competency framework which includes - knowledge of epidemiology, awareness of how culture shapes behaviour and thinking, awareness of the social context in which ethnic groups live, awareness of one's own prejudices, ability to transfer information to aid understanding and ability to adapt to new situations flexibly and creatively.

Summary of results: We shortened the content and a local champion vetted the material to ensure it was culturally sensitive. We wore salwar kameez and spoke slowly. The course was simultaneously translated and when participants were flagging action songs were introduced. We started off with a daily devotional (Lamb is a Mission hospital) and participated in a closing ceremony.

Conclusions: The course was delivered successfully and the skills the participants gained have been effective in supporting the development of essential local healthcare providers.

Take-home messages: Paying heed to cultural competence pays off.


Following Erasmus's footsteps: establishing a historical first curricular exchange program in medicine at the Catholic University of Louvain

Alexander Brezina (Universite Catholique de Louvain,

UCL-Health Sciences, Clos Chapelle aux Champs 27,

Letter Box 161, Brussels 1200, Belgium)

Maelle Serrano (Universite Catholique de Louvain, UCL-

Health Sciences, Brussels, Belgium)

Amandine Donneaux (Universite Catholique de Louvain,

UCL-Health Sciences, Brussels, Belgium)

Claire De Burbure (Universite Catholique de Louvain,

International Relations, UCL-Health Sciences, Brussels,


Background: Five centuries have passed since Erasmus of Rotterdam studied at Louvain, yet UCL's Medical School has yet to sign a first Erasmus Studies Exchange Contract. Encouraged by their new Dean, third year medical students searched for suitable medical curricula that could be seamlessly integrated within UCL's cursus for starting bilateral course exchanges. Summary of work: A Facebook discussion was set up, 26 students joined forces, using internet, analyzing over

150 universities, contacting them via mail or telephone when necessary. Where curricula appeared comparable, Excel tables of the courses' equivalence were drawn up, the universities were contacted personally to seek agreement.

Summary of results: Only three universities (2%) had comparable curricula to UCL, and only one foreign university, the second being in Flanders, accepted Erasmus exchanges.

Conclusions: Students can be the catalysts of developing Erasmus exchanges, leading to a win-win situation for faculty and students: by sharing the workload, the likelihood of finding a suitable exchange partner is largely increased while the direct support of the faculty in monitoring the process helps to assure quality education.

Take-home messages: Creating an Exchange program in medicine demands a great effort, yet it can be done in an efficient way if the faculty and students work together.


Removing Borders: CPD recognition through collaborative international agreements

Jennifer Gordon (Royal College of Physicians and Surgeons of Canada, CPD, Office of Professional Affairs, 774 Echo Drive, Ottawa, Ontario K1S 5N8, Canada) Mya Warken (Royal College of Physicians and Surgeons of Canada, CPD, Office of Professional Affairs, Ottawa, Canada)

Craig Campbell (Royal College of Physicians and Surgeons of Canada, Office of Professional Affairs, Ottawa, Canada)

Background: Over the last decade, there has been a shift in 'how and where' physicians access or participate in continuing professional development (CPD) activities. Increasing use of web-based and other learning strategies has decreased the significance of accreditation policies and practices based on geography. Summary of work: Based on a set of core values and principles, the Royal College of Physicians and Surgeons of Canada (Royal College) has renewed three international substantive equivalency agreements: Accreditation Council for Continuing Medical Education (ACCME); American Medical Association (AMA; European Union of Medical Specialists (UEMS). Summary of results: In 2013, the Royal College renewed substantive equivalency agreements with: (1) ACCME -allowing participants attending live, face-to-face activities held in Canada developed by ACCME-accredited physician organizations to qualify for Maintenance of Certification (MOC) Section 1 -Accredited Group Learning credits. (2) AMA - allowing US physicians participating in live and web-based group learning activities, self-assessment programs, and simulation activities approved by Royal College National Specialty Society and Simulation Program accredited CPD providers to apply for conversion of credits to AMA PRA Category 1 Credit™. (3) UEMS - allowing European Union (EU) physicians participating in accredited live

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