Автор неизвестен - Mededworld and amee 2013 conference connect - страница 36

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Summary of results: URL of the online module available upon request.

Take-home messages: This novel e-learning module is designed to overcome barriers to learning ear and temporal bone anatomy by delivering interactive world-class contents to medical trainees worldwide over the internet.


Wiki use for optimising scarce clinical resources!

Karen Ives-Smith (Derby Hospitals, Breast Surgery, Uttoxeter Road, Derby DE22 3NE, United Kingdom) David Foreman (Derby Hospitals, Surgery, Derby, United Kingdom)

Background: Making the most of clinical attachments can provide poor feedback from medical students competing for the best clinical experience. Responding to feedback, and managing clinical resources (patient contact time) effectively is a role of the clinical educator. This is the report from the initial audit of student staff opinions towards the wiki in use. Summary of work: Students and staff using the wiki were sent specific questionnaires and provided general feedback about the use of the wiki. 40 from 124 responses (32%) were collected. All of the responses were anonymous.

Summary of results: The students' opinions of the wiki had changed from it being a useful source of information where things were easy to find, to an overwhelming, possibly confusing addition to all of the other sources of information/instruction the students receive.

Conclusions: There are many aspects of the wiki which complement the current clinical course. Ability to see what is available in terms of clinical activity in their own, and other sub-specialties allowing students to become more self-directed, providing ownership of their learning opportunities. The results of this survey/audit and the year of experience using it, should allow a more involved feedback, and a second version of a wiki that is more fit for purpose.

Take-home messages: The organic evolution of the wiki over the course of the year has demonstrated that there must be some control over the content and organisation of the wiki in order that it doesn't become too wild and confused. Next year's should be an improved version, however, further audit will continue to provide areas for improvement.


Microbe Invader: Teaching microbiology through a computer role playing game

Li Tao (Case Western Reserve University School of Medicine, MD candidate, 11100 Euclid Ave, Cleveland, Ohio 44106, United States)

Background: Microbiology education during pre-clinical years involves learning many facts relating to pathogens, diagnostic tests, and treatments. In absence of direct experience, students must learn by rote memorization. Computer games can offer a more engaging method to learn abstract material. I have created Microbe Invader, an interactive role-playing game to teach and review microbiology facts and concepts.

Summary of work: Microbe Invader places players in the role of a medical student seeing patients consulted by a fictional hospital's Infectious Diseases service. Students diagnose patients by ordering appropriate lab tests and matching history and symptoms to pathogens that fit the clinical picture. Next, students treat patients using appropriate medications considering potential side effects and mechanisms of antibiotic resistance. As students successfully diagnose and treat diseases, they receive virtual achievement badges. The game covers material for bacteria, fungi, viruses, and parasites at a level relevant to preclinical students. The game is publicly available online and includes a forum to share comments.

Summary of results: The game was received well by users, who were primarily medical students in pre­clinical years. Users praised the enjoyability of the game and the opportunity to apply their knowledge in a virtual setting. Users remained engaged, returning to the web site and attempting to complete achievement badges. Many users actively shared suggestions and corrections to the content of the game during development. Conclusions: Many students found role-playing useful in learning and retaining microbiology facts. Virtual incentives and a narrative story also improved students' enjoyment and engagement. Take-home messages: An interactive role playing simulation supplements pre-clinical students microbiology learning.

3GG ePosters: Curriculum Planning/Community Oriented Medical Education

Location: North Hall, PCC


What challenges will our current students face in 2025?

S Hautz (Charite Berlin, Prodekanat Lehre, intern: Virchowweg 5 CCM, Chariteplatz 1, Berlin 10117, Germany)

KA Dannenberg (Charite Berlin, Lernzentrum, Berlin, Germany)

WE Blaum (Charite Berlin, Lernzentrum, Berlin, Germany)

Background: Lifelong learning is an individual's response to an ever-changing professional surrounding. As a systems response, medical schools should foster their students' development by anticipating future challenges when designing their curricula.

Summary of work: We interviewed 9 experts including doctors, students, nurses and patient representatives about their beliefs in important upcoming trends in medical practice and the health care system. Out of the transcribed interviews we synthesized 10 statements about anticipated future trends. We invited 8000 medical doctors from Germany spanning all medical disciplines and places of work to rate the likelihood of each statement on a scale from 0 (not likely at all) to 5 (very likely) in a two-step Delphi process. In a second round we asked participants of the first round to re-rate those statements with inconclusive results and comment on their rating.

Summary of results: 738 doctors responded to the first round and rated 4 statements as likely or very likely while 3 statements were rated as not likely at all or unlikely. 3 statements were rated inconclusive and therefore subject to a second round in which 315 of the initial 738 doctors participated. Trends likely to affect future medical practice include an increasing need to care for elderly patients including special communication trainings, an increasing use of remote monitoring and potentially treatment, increasing necessity for economic expertise in doctors and more procedures being carried out by non-medical personnel. Conclusions: Using Delphi methods allows us to predict future challenges with increased accuracy compared to an individual's prediction. Whether our predictions hold is to be seen in the future.

Take-home messages: Educators should bear in mind that their students of today need to be fit to practice a long time and thus anticipate future challenges to their graduates.



Longitudinal service learning impacts students' attitudes toward primary care

Lisa Rucker (Albert Einstein College of Medicine/Jacobi

Medical Center, Medicine, 1400 Pelham Parkway South,

Bldg1, Room 4W07, Bronx 10416, United States)

Maria Santos (Albert Einstein College of Medicine,

Family Medicine, Bronx, United States)

Jennifer Purcell (Albert Einstein College of Medicine,

Family Medicine, Bronx, United States)

Elizabeth Conley (Albert Einstein College of Medicine,

Family Medicine, Bronx, United States)

Background: The LCME requires service learning opportunities in medical school. The impact of longitudinal programs on student attitudes toward primary care is unclear. Our project measured the impact of an extracurricular service learning opportunity on attitudes toward primary care, self-efficacy working with the underserved, and career plans. Summary of work: We created longitudinal partnerships for first or second year medical students with community based organizations. Students, surveyed pre- and post-voluntary participation in a 1-2 year service learning program, were compared to peer controls. Generalized linear models compared results between groups, controlling for initial measures. Summary of results: Significant differences existed between intervention and control groups at baseline for attitudes, confidence in their choice to pursue primary care and interest in working with underserved populations, but not self-efficacy. Effect sizes were large. Over time, controlling for baseline, the study group significantly increased its confidence about pursuing a primary care career by .407 vs. the control group - .369 (ANCOVA p=.000) and its attitude toward working with underserved communities (.140) vs. the control group's - .108 (ANCOVA p=.043). No significant differences emerged with respect to attitudes toward primary care and self-efficacy. Conclusions: Students who self-select into extracurricular service learning programs are different from other students. Participation in such programs may support students' intentions to pursue a career in primary care and to work with the underserved, while non-participants' intentions decrease. Take-home messages: Participation in an extracurricular service learning program early in medical school may help stay the erosion away from primary care careers and care of the underserved.


Community-oriented medical curriculum with nurse-teachers supervisors

Patricia Cury (FACERES, Medicine, Rua Celia De Novais Moreira 90 Casa 13, Sao Jose Do Rio Preto 15093138, Brazil)

Fernanda Sanfelice (FACERES, Medicine, Sao Jose Do Rio Preto, Brazil)

Toufic Ambar (FACERES, Medicine, Sao Jose Do Rio Preto, Brazil)

Background: Medical Schools in Brazil are traditionally centered in hospital based schools and very specialized doctors. However, from the last 20 years, our National Health System focused attention in primary care and in a family based health program. In order to make general practitioner or family medicine specialty more attractive for medical students in Brazil, medical schools and the Brazilian Government are stimulating medical students' early exposure in the community based learning Summary of work: Our medical school has a problem-based curriculum. Students spend four hours a week in the primary care base, since the first week of the course, lasting the first four years, in a group of 8 students. They are coordinated by a nurse supervisor, in the first two years, and with medical doctors in the next 2 years. Summary of results: Students learn the theory about the functioning of the Brazilian Heath System and perform systematic interventions in health promotion and primary care. They act in many different activities for the well-being of the population at large, such as attention to health in primary schools, diabetes and infection diseases prevention, hygiene care and others. Conclusions: The early exposure of the medical student to primary care stimulates them to participate and understand the health policy and the importance of family medicine in daily life. The nurse supervisor is a strategy to improve these activities as they are a key point in primary care policy.

Take-home messages: Early exposure of the students to primary care stimulates a better understanding of its importance.


Student clinical learning in under-served, GP community areas

Paul Crampton (Durham University, Centre for Medical

Education Research, Burdon House, Leazes Road,

Durham DH1 1TA, United Kingdom)

John McLachlan (Durham University, Centre for Medical

Education Research, Durham, United Kingdom)

Jan Illing (Durham University, Centre for Medical

Education Research, Durham, United Kingdom)

Background: The recruitment and retention of doctors in under-served areas across the world is a persistent issue in healthcare. An increasingly popular rectifying approach has been to deliver undergraduate clinical education in such areas. However, a collective understanding of these initiatives is lacking. Summary of work: A systematic literature review was conducted to identify the strengths and weaknesses for medical students and supervisors of community placements in under-served areas. Search terms used were combinations and variations of four concepts exploring GP primary care, medical students, placements, and location characteristics. Summary of results: Fifty-four articles were included in the final review. Four main categories were identified:


student performance, student perceptions, career pathways, and supervisor experiences. Internationally, under-served area placements have produced beneficial consequences for students, supervisors, and the community. The placements have stimulated student learning through continuity of learning, provided a holistic appreciation of medicine, and increased the likelihood of students returning to the area. Students' exam scores did not significantly differ after undertaking a placement, however; performance equivalency is a pragmatic objective that may detract focus from the development of the student professional identity. Conclusions: This review reflects the emergent qualitative data, as well as quantitative data used to assess initiatives. The educational value of placements is demonstrated mainly in rural areas as opposed to urban, deprived areas.

Take-home messages: A Durham University pilot programme will allow students to experience the complex issues of primary healthcare in under-served, deprived areas.


Assessing the experience of Child and Family Nurse community paediatric placements for medical students

Natalie Ong (South West Sydney Local Health District,

Community Paediatrics, Locked Bag 7008, Hugh Jardine

Building, Liverpool BC 1871, Australia)

Cassandra Healy (University of Wollongong, Graduate

School of Medicine, Wollongong, Australia)

Carl Mahfouz (University of Wollongong, Graduate

School of Medicine, Wollongong, Australia)

Alison Jones (University of Wollongong, Graduate School

of Medicine, Wollongong, Australia)

Background: The Graduate School of Medicine, University of Wollongong has its focus on training medical practitioners for regional and rural practice. During the 3rd of the 4 year program, students have longitudinal placements in a GP practice but with variable exposure to paediatric learning. Summary of work: In order to enhance their learning of paediatrics in the community setting, 11 students in Phase 3 were placed with Child and Family Nurses. They were involved in clinics and home visits; participating in child health, growth and developmental surveillance. Developing an understanding of common presentations, developmental screening tools, local health referral pathways and services was a secondary outcome. The students were assessed pre and post program and compared to a control group. A focus group was also conducted to obtain qualitative information about the students' experiences.

Summary of results: Participating students scored significantly better than controls but sample size was small. The students found the placements very useful as they were provided with opportunities to practice speaking to families and examining babies and young children. They were also more aware of available community services for children and their families.

Placements in other community settings were also thought to be desirable. Conclusions: Overall, the students felt that the placements were a good way to further enhance knowledge and skills in community paediatrics. A suggestion to condense the placements into week long intensives may increase the intensity, scope and variety of the learning experience.

Take-home messages: Placements with Child and Family nurses is effective in developing knowledge and skills in community paediatrics.


The importance of the health community agent in community-based learning at a large urban area: the experience of Unifenas Medical School, Belo Horizonte, Brazil

Alexandre Moura (Unifenas Medical School, Medical Education, Belo Horizonte, Brazil) Fabiano Guimaraes (Unifenas Medical School, Belo Horizonte, Brazil)

Rosa Malena Faria (Unifenas Medical School, Medical Education, R. Libano 66, Belo Horizonte 31710-030, Brazil)

Background: Despite being recommended in national guidelines, integration between university and community aimed at fostering learning of primary care is difficult to implement, particularly in large urban areas. At Unifenas Medical School, community-based activities begin in the first year and the health community agent (HCA), a member of the family health care team, acts as a link between the school and the community. Summary of work: To assess the first year community-based learning at Unifenas Medical School, Belo Horizonte, using biannual evaluation forms. Summary of results: In the first year, the students are involved in 4-hour weekly supervised visits and workshops. They are attached to HCA that provide support to activities such as identification of social resources and health determinants, home visits, and organization of health promotion groups. The students have evaluated the activities in a positive way, highlighting their good interaction with the HCA and the great opportunity to see how the principles of primary care and the tools of family medicine are used in practice. The HCA have been satisfied with the activities and report feeling valued and supported in their routine activities.

Conclusions: Community-based learning with the participation of the HCA is rewarding for both students and HCA allowing teaching to occur deep inside the community, expanding the students' comprehension of the illness process and avoiding crowding of the health care units.

Take-home messages: When conducting community-based activities we should think outside the traditional clinical setting and use professionals that are key to strengthening the link between the university and the community.



The education of health workers in community-based rehabilitation: methodologies and technologies of community intervention directed to people with disabilities

Regina Celia Fiorati (University of Sao Paulo, Faculty of Medicine of Ribeirao Preto, Av Bandeirantes 3900 CEP 14049-900, Rua Graciliano Ramos 100, ap. 21 CEP 14051-039, Ribeirao Preto 14051039, Brazil) Valeria Meirelles Carril Elui (University of Sao Paulo, Faculty of Medicine of Rbeirao Preto, Ribeirao Preto, Brazil)

Thais Cristina Chaves (University of Sao Paulo, Faculty of Medicine of Ribeirao Preto, Ribeirao Preto, Brazil)

Background: This study's objective was to analyze the inclusion of people with disabilities in society and family and to identify their health needs in order to implement teaching-learning actions. It was conducted in Brazil through the University of Sao Paulo, with funding provided by FAPESP during 2011 and 2012. Summary of work: This is a qualitative study with a methodological approach using the following data collection techniques: life histories and systematic observation. The study's subjects were individuals with congenital or acquired disabilities living in the coverage area of a Family Health Unit in the city of Ribeirao Preto, SP, Brazil.

Summary of results: The results indicate that the individuals are restricted to their homes and are socially isolated; there is social exclusion; physical, geographical and psychosocial barriers in the area; social vulnerability with a lack of economic and human resources for the family to provide care; and a generalized lack of information about the problem involving the condition and care provided to disabled people. Health needs include: psychosocial care; access to Primary Health Care (PHC) services; and rehabilitation, involving the need to create home care programs, develop community-based actions and interventions within the area; provide assistive technology, equipment; instruct/guide families concerning disability and care; promote prevention and early diagnosis; encourage greater cooperation among health teams; and establish coping strategies.

Conclusions: There is a need to create teaching methodologies directed to health workers to enable the use of technologies to be used in communities and community-based rehabilitation together with PHC facilities in order to meet the aforementioned needs. Take-home messages: here is a need for a social approach about disability, because there are many social determinants of health indices in people with disability. Therefore, it is necessary to create teaching-learning methodologies that enable students in the field of health for community-based rehabilitation.


Cumulative disciplinary score in an integrated pre-clinical curriculum: a novel solution for an old problem

Sara Mortaz Hejri (Tehran University of Medical Sciences, Medical Education Department, Center for Educational Research in Medical Sciences, Third Floor, Ghods Street, Keshavarz Boulevard, Tehran 14138­43941, Iran)

Azim Mirzazadeh (Tehran University of Medical Sciences, Educational Development Office, Tehran, Iran) Maryam Shahabi (Tehran University of Medical Sciences, Educational Developmental Office, Tehran, Iran)

Background: In an integrated curriculum, in which discipline-based tests have been replaced with multi-disciplinary examinations, serious challenges may arise when students deliberately leave out the content of those disciplines that have smaller weight in each block exam. While reporting disciplinary scores goes against the grain of integration, by calculating an overall score, some of the students possibly will not study some disciplines. We describe the experience of Tehran University of Medical Sciences, where an organ-based integrated curriculum has been launched since September 2011.

Summary of work: In the first academic year, students passed 4 blocks: Introductory, Respiratory, Cardiovascular, and Musculoskeletal. Each block included anatomy, histology, physiology, and embryology. To perform integrated assessment, questions from different disciplines were presented in single booklet while 10% of questions were truly interdisciplinary. Instead of recording each discipline's score separately, the overall block score was reported. Furthermore, cumulative disciplinary score was calculated at the end of the year. Summary of results: In the end of the year, 54 medical students out of 159 did not achieve the required cumulative disciplinary score. In physiology, anatomy, histology, and embryology the number of failed students were 4, 8, 11, and 24, respectively. They were referred to take a disciplinary examination. Conclusions: Comparing number of students who failed disciplines with low credits (e.g. histology) versus number of failed students in disciplines with high credits (e.g. physiology) suggests that the later ones had systematically been ignored by some students. The calculation of a cumulative disciplinary score reduces concern due to this problem in the integrated assessment.


Educational Quality can be Improved when Competence-Based Learning is Applied In the Medical Career

Mario Secchi (Instituto Universitario Italiano De Rosario -Argentina, Medical School, Rosario, Argentina)


Claire De Burbure (University Catholique De Louvain, Histology, Brussels, Belgium)

Roberto Garcia Turiella (Instituto Universitario Italiano De Rosario - Argentina, Medical School, Rosario, Argentina)

Walter Bordino (Instituto Universitario Italiano De Rosario - Argentina, Medical School, Rosario, Argentina) Nicolas Rodriguez Leon (Instituto Universitario Italiano De Rosario - Argentina, Medical School, Rosario, Argentina)

Background: Teaching encyclopedic results in fragile knowledge and is being abandoned by the Medical Careers. It was decided to evaluate the curriculum based on professional competencies. Argentine ME Resolution

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