Автор неизвестен - Mededworld and amee 2013 conference connect - страница 50

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Summary of results: The findings demonstrated a consistent increase in measured performance across waves. Performance, on average, was significantly improved by the final wave of assessment. Interestingly, although the mean performance did improve significantly, the most striking change was the reduction in very low assessments of performance. Conclusions: It appears that the 360° approach, at least in this form, is capable of assessing change over time. The comments of participants in the CME activity indicated that the activity was effective at remediating performance. The results of the 360° demonstrate that improvement as well.

Take-home messages: A 360 instrument can be used as a form of ongoing feedback and a measure of outcome for a remedial CME activity.


E-Poster and Virtual Classrooms - Are German Vets Willing to use new ways of Continuing Education?

Jan P Ehlers (University of Veterinary Medicine Hannover, Foundation, Competence Centre for e-Learning, Didactics and Educational Research in Veterinary Medicine, Buenteweg 10B, Hannover 30559, Germany)

Elisabeth Schaper (University of Veterinary Medicine

Hannover, Foundation, Competence Centre for e-

Learning, Didactics and Educational Research in

Veterinary Medicine, Hannover, Germany)

Yu-Wei Lin (University of Veterinary Medicine Hannover,

Foundation, Clinic for Small Animal Medicine and

Surgery, Hannover, Germany)

Martin Kaske (University of Veterinary Medicine

Hannover, Foundation, Clinic for Cattle, Hannover,


Marion Tischer (Rinderpraxis.com, Berlin, Germany) Andrea Tipold (University of Veterinary Medicine Hannover, Foundation, Clinic for Small Animal Medicine and Surgery, Hannover, Germany)

Background: Continuing education (CVE) is mandatory for German veterinarians. Web-based-trainings are used in CVE for several years. In the current study the hypothesis was proven that synchronous learning sessions can be supported by electronic media.

Summary of work: E-posters were presented at a neurology conference. For buiatric CVE a social network (NOVICE) was realized and sessions in a virtual classroom were conducted. Acceptance was measured by counting participation and using a survey (6-grade


Summary of results: E-posters in neurology were used by 165/815 (24%) of the participants. The evaluation was very good (1.53) and participants ask for more e-posters at conferences (1.58). The social network is used by 640 German vets. In four virtual classroom-sessions 378 vets participated (40/53/132/153) and gave an excellent feedback. Online-talks should be given more frequently.

Conclusions: Electronic enhanced learning can be used in veterinary continuing education. A need for synchronous communication and interaction exist. New ways of media use helps to keep a social aspect in learning. Due to the described results and the excellent evaluation the use of e-posters and virtual-conferencing will be enhanced.

Take-home messages: With a good didactical concept vets are very willing to use electronic enhanced continuing education.


A new E-learning program about breastfeeding, continuing medical education in paediatrics

Virginie Rigourd (Hopital Necker Enfants Malades, Lactarium Dile De France, 149 Rue De Sevres, Paris 75, France)

Claude Billeaud (Hopital Pellegrin , Lactarium De

Bordeaux, Bordeaux, France)

Brune De Villepin (Reseau Medic-Al, Paris, France)

Background: Women mostly stop breastfeeding (BF) because of a lack of support and information in the post­partum period. In spite of the European recommendations: "improvement the training of all the healthcare professionals involved in perinatal period is the first stage of the recommendations to favour BF", during their medical studies, perinatal professionals spend little time studying BF.

Summary of work: Objectives: an E-learning program on BF has been created for healthcare professionals. Material and method: This online program is the result of work between experts in BF and broadcasting distance training professionals. Summary of results: This "BF e-learning program" can be found within the French Association of Paediatrics website, in the section of the AEEP www.aeep.asso.fr. The healthcare professional will need 3 hours to approach the subject. He will be able to: (1) Discover in the "course" tab, 5 main chapters (epidemiological date-BF benefits-Preparation for BF- BF complications- BF in the everyday life); (2) Use the "navicub system" to reach lexicon or go into tackled issues by a keyword; (3) Use the "documents" tab to download all the documents needed; (4) Strengthen his knowledge by studying clinical cases and get closer to an Evidence Based Medicine method; (5) Validate his training by answering


to the "quiz"; (6) Discuss via the "messaging" tab with the experts authors.

Conclusions: This online program on BF is an educational method which provides continuing medical education and evaluates practices in paediatrics. Take-home messages: By improving knowledge of healthcare professionals on this subject we hope help maintain BF.


Let's make it work

Marijke Boorsma-Meerman (VUmc, GERION,

Amsterdam, Netherlands)

CAM Ritmeijer (VUmc, GERION, Amsterdam,


AJ de Groot (VUmc, GERION, Amsterdam, Netherlands) EA Reynders (VUmc, GERION, Amsterdam, Netherlands) (Presenter: Jos van Berkel, VUmc, GERION, De Boelelaan 1109, Amsterdam 1081 HV, Netherlands)

Background: Between 2010 and 2040 Dutch population in the age of 65 years and older increases from 15,5 to 25,6%. At least 17% of these elderly need special care. Most of them live in their own house. Due to the care for these elderly General practitioners (GP) will meet a 60% increase of workload. However GPs do not regard themselves able enough for management of diseases and disabilities associated with frail health. Specialists of elderly care are available but cooperation with the GP is not well implemented.

Summary of work: During a 5-month multi professional learning program specialists of elderly care learn to cooperate with their local GPs. Main focus is to work close together and get to know each other's ways of working and mutual expertise. Goal is to bring their complex elderly care at a higher level and to stimulate shared decision making. This process is supported during 5 course days at which guest speakers share their experience and knowledge. In between those days the participants work on themes, together with their local


Summary of results: Evaluation (N=27) focused mainly on the course days itself. Satisfaction rates lie between 56-100% of which only one item (use of literature) was rated 56%. Overall courses are rated >75%: "Recognition and recognizing each other's field of work is very worthwhile." "I found connecting factors to work on better contacts in my region." Conclusions: The course needs further research to indicate long term success factors. Take-home messages: Stimulating multi professional work locally can be done by setting up a multi professional course in which participants need to work together closely with local medical professionals.


The role of mentorship in remediating 'struggling' doctors

Rachel Locke (The University of Winchester, Faculty of Education, Health and Social Care, Sparkford Road, Winchester SO22 4NR, United Kingdom) Samantha Scallan (Wessex School of General Practice, Wessex Deanery, UK, GP Education Unit, Southampton, United Kingdom)

Laura Edwards (Wessex Local Medical Committee,

Chandlers Ford, United Kingdom)

Richard Weaver (Wessex Deanery, UK, Wessex School of

General Practice, Winchester, United Kingdom)

Richard Mann (Wessex School of General Practice,

Wessex Deanery, UK, Professional Support Unit,

Winchester, United Kingdom)

Heidi Penrose (The University of Winchester, Primary

Health Care Education, Winchester, United Kingdom)

Background: Medical revalidation is likely to identify a small number of GPs with performance issues in their clinical practice, and a slightly larger number of doctors with less serious but defined areas for improvement. It is this group of 'struggling' doctors which forms the subject of this work.

Summary of work: This work reports an evaluation of a mentoring network, Wessex Insight, which aims to support struggling GPs with educational needs and non­performance related professional issues. Participants refer themselves to the scheme, often on advice, and engage with it voluntarily. The evaluation considered the impact, if any, of mentoring on the remediation of the mentoring service users and the continuing professional development needs of the mentors. It also looked at the system and processes for referral and case management. Data collection was by interview with GP mentors and mentees as well as analysis of anonymised case paperwork pre- and post-mentoring. Summary of results: The mentoring process has been found to be empowering and benefits are reported to patient care. The service is evolving and early findings indicate issues emerged concerning case governance, in particular, over the 'closure' of cases. The work suggests that such services need clear guidance on confidentiality and how information is to be shared, especially where there come to be concerns for patient safety. For the mentors, there are issues about responsibilities and role accountability.

Conclusions: This mentoring service was found to be potentially helpful to meeting needs identified through the appraisal process as it provides a clear formal network of help for doctors who find themselves struggling and are willing to address their educational needs.



Can doctors accurately estimate their performance on the GMC's fitness to practise pilot exams?

L Mehdizadeh (University College London, Academic Centre for Medical Education, Archway Campus, Holborn Union Building, 4th Level, 2-10 Highgate Hill, London N19 5LW, United Kingdom)

A Sturrock (University College London, Academic Centre

for Medical Education, London, United Kingdom)

G Myers (University College London, Academic Centre for

Medical Education, London, United Kingdom)

Y Khatib (Queen Mary, University of London, Centre for

Psychiatry, London, United Kingdom)

J Dacre (University College London, UCL Medical School,

London, United Kingdom)

Background: Doctors are expected to recognise strengths and weaknesses in their own clinical knowledge and practice. Evidence from the behavioural sciences has demonstrated the deficits in the ability to assess one's competencies. We investigated whether doctors could accurately estimate their performance on tests of minimal clinical competence. Summary of work: Data was taken from 524 doctors who volunteered to take the GMC's fitness to practise pilot exams. During one day, volunteers completed a knowledge test and an OSCE. Afterwards, volunteers completed a questionnaire about how well they thought they performed. We compared volunteers' estimates with their actual scores.

Summary of results: Most volunteers significantly underestimated their OSCE performance. Whereas self-estimated knowledge test performance differed between high and lower performers. Those who did particularly well significantly underestimated their knowledge test performance (t (196) = -7.70, p<0.01) and those who did less well significantly overestimated

(t (172) = 6.09, p<0.01).

Conclusions: Volunteer doctors were moderately accurate in predicting their knowledge test performance but less accurate in predicting their OSCE performance. Most volunteers did not appear to have an inflated view of their exam performance. However, roughly half of the sample did overestimate their knowledge test performance. This is potentially problematic as overconfidence in doctors is associated with poor clinical judgement and decision making. Medical educators should be cautious when using self-assessment to monitor doctors' professional development and consider whether formal training in accurate self-assessment is necessary. Take-home messages: High and lower performers self-estimated differently on a test of theoretical knowledge but not on a test of practical and clinical communication


Prescribing errors in general practice (family medicine) - implications for GP training

Richard Knox (University of Nottingham, C39 Division of Primary Care, University of Nottingham Medical School, Queens Medical Centre, Nottingham NG7 2UH, United Kingdom)

Tony Avery (University of Nottingham, Division of

Primary Care, Nottingham, United Kingdom)

Kate Marsden (University of Nottingham, Division of

Primary Care, Nottingham, United Kingdom)

Gill Gookey (NHS Rushcliffe Clinical Commissioning

Group, Pharmacy, Nottingham, United Kingdom)

Ndeshi Salema (University of Nottingham, School of

Pharmacy, Nottingham, United Kingdom)

Bassi Mindy (NHS Nottingham City Clinical

Commissioning Group, Pharmacy, Nottingham, United


Background: Five per cent of prescriptions issued by UK general practitioners (GPs) contain an error. Up to 1 in 550 prescriptions contain a serious error. The PRACtICe study (GMC, 2012) highlighted GPs-in-training as a cohort of prescribers who could benefit from further support. We conducted a follow-up study to investigate strategies to enhance prescribing in light of findings from the PRACtICe study.

Summary of work: Twelve focus groups were convened with various stakeholders including GP trainers, GPs in training, pharmacists and members of the public. Results from the PRACtICe study were presented and strategies to enhance the quality of prescribing training were discussed. Focus groups were recorded, transcribed and analysed for emergent themes using a constant comparison approach.

Summary of results: Preliminary analysis of data has highlighted several strategies to improve the quality of prescribing. These include the need for adequate induction to a practice's prescribing protocols, enhancing the prominence of prescribing in the GP Curriculum, the use of personalised feedback to GPs in training, and the development of user-friendly on-line learning packages.

Conclusions: Prescribing is key to the role of the GP, but as this task becomes ever more complex, strategies must be put in place to minimise prescription error. GPs-in-training are an 'at risk' group for the presence of prescribing errors. Enhancing GP training with respect to prescribing is necessary to equip the GPs of tomorrow to be safe practitioners.

Take-home messages: GPs in training have been highlighted as having specific prescribing educational needs - strategies to address these needs are vital to enhance patient safety.



Strengthening professional identity: the experience of Indonesian general practitioners

Nur Syah (Andalas University, Medical Education, Bagian Anatomi, Fakultas Kedokteran Universitas Andalas, Jl. Perintis Kemerdekaan, Jati, Padang 25128, Indonesia) Chris Roberts (The University of Sydney, General Practice, Sydney, Australia) Alison Jones (South Australian Institute of Medical Education and Training, Medical Education, Adelaide, Australia)

Background: A better understanding of General Practitioner (GP)s' practice experiences could guide the development of meaningful strategies to improve those experiences, and ultimately the care they deliver to their patients. However, there are few studies about the socialization experiences and professional identity development of GP, and this is the first from a developing country. This study aims to generate an explanatory framework that could illustrate the structural, social and psychological process of the GPs' professional socialization and identity development. Summary of work: A qualitative research methodology was applied in this study, in particular the grounded theory methodology. Primary data collected via interviews with 25 GPs in West Sumatra Indonesia. Participants were purposively sampled. Secondary data sought from related government and professional bodies' policy documents and social networks. The data was analysed in an iterative process, including inductive data analysis using constant comparative method, deductive and abductive thinking strategies. Summary of results: Professional marginalisation was one of the main concerns of the GPs related to their professional practice experience. Our theoretical framework illustrates the interplay between contextual factors including health care policy and GP training, interactional and personal factors which contributed to GPs experience of professional marginalisation. Conclusions: Professional marginalisation affected GPs' personal wellbeing and professional identity development by lowering GPs' self-esteem and self-efficacy.

Take-home messages: There needs to be a culture change where GPs can consider themselves as being distinguished, being useful, and being needed. Curriculum orientation in medical school and continuing professional development (CPD) programs needs to consider the professional development of GPs.


Educational Needs Assessment and Development of on the Job Training Program for ICU Nurses in Semnan Hospitals

Seyed Habibollah Kavari (University of Social Welfare & Rehabilitation, Sciences, Rehabilitation Management Department, Tehran, Iran)

Background: Educational needs assessment and implementation of continuous educational programs based on these needs is very important for improvement of knowledge.

Summary of work: This educational planning study was consisted of two dependent phases to identify and prioritize educational needs of ICU nurses. Census considered as sampling method in both steps. Data gathering in the first phase from nurse managers and ICU attending physicians conducted by development of a closed ended questionnaire. In the second phase knowledge of nurses assessed by a multiple -choice exam and their skills and competencies evaluated by a specially developed checklist. Psychometric properties (reliability and validity) of both instruments evaluated and confirmed.

Summary of results: The most important special educational needs of ICU nurses in this study were as follows: A) Cardiac monitoring and ability to identify different dysrhythmias and how to manage life threatening ones (71.11%).B) To set and adjust ventilator parameters according to respiratory status of the patient (70.80%).C) Arterial blood sampling and ABGs interpretations (69/00%) .D) Basic and advanced adult CPR (66.66%).E) Maintenance of a secure airway; adequate ventilation and oxygenation and intubation if necessary (66.66%) . F) Planning, implementation and evaluation of skin integrity procedures (60.01%). G) Pharmacotherapy, safe administration of positive inotropic agents (e.g. Adrenalin, Atropine, Dobutamin,...) (57.90%) . H) Central venous pressure (CVP) monitoring and maintaining I.V fluid balance (52.22%). Conclusions: Based on the results of this study it reveals that assessment of educational needs is the most critical step for any continuous educational program planning, and it is equally important that these identified topics according to their priorities and perceived importance be covered in the developed continuous educational package. Only in this way maintenance of the knowledge, skills and attitudes of the nurses to provide better health services in ICUs will be guaranteed.

4DD Posters: Teaching and Learning/Team-Based Learning

Location: South Hall, PCC 4DD/1

An evaluation between teaching techniques and level of knowledge in obstetrics and gynecology

Nungrutai Saeaib (Prince of Songkla University, Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand) Chitkasaem Suwanrath (Prince of Songkla University, Obstetrics and Gynecology, Hat Yai, Songkhla, Thailand) Siwatchaya Khanuengkitkong (Prince of Songkla University, Obstetrics and Gynecology, Hat Yai, Songkhla, Thailand)

Satit Klangsin (Prince of Songkla University, Obstetrics and Gynecology, Hat Yai, Songkhla, Thailand) Sirirat Thamrongwat (Prince of Songkla University, Obstetrics and Gynecology, Hat Yai, Songkhla, Thailand) Kritima Jantanawan (Prince of Songkla University, Obstetrics and Gynecology, Hat Yai, Songkhla, Thailand)

Background: Various methods of teaching are provided in the Department of Obstetrics and Gynecology including lectures, topic conferences, bedside teaching and operative obstetrics. A lecture is passive learning and has the least amount of knowledge retention. Topic conference is active learning and the student will have more knowledge retention. Bedside teaching is better than a lecture and topic conference because the student does the real thing.

Summary of work: Twenty-one Modified Essay Questions (MEQs) were given for assessment and evaluation in 417 fifth-year medical students at the end of the session. The scores of the MEQs were analyzed in accordance with the teaching techniques: lecture, topic conference and bedside teaching. The MEQs were standardized by teachers in the Department of Obstetrics and Gynecology and had no significant difference in Minimum Power Level (MPL). Summary of results: Mean scores of the MEQs in lecture, topic conference and bedside teaching were 57.03, 58.49 and 61.27, respectively, and the percentage of medical students who passed an exam were 64.13%,

72.73% and 84.72%, respectively.

Conclusions: Bedside teaching is the best method of the teaching techniques because of the active learning and it permits a comparison between practice and theory. Take-home messages: Among lecture, topic conference and bedside teaching, bedside teaching is the best teaching technique.


Beyond Conceptual Maps: Using Images to Assess And Evaluate Tutorial Processes

Francisco Jose Passos Soares (Faculdade de Medicina da Universidade Federal de Alagoas, Pediatrics, Street


Conego Antonio F Vasconcelos, 138, apt.301, Jatiuca, Maceio 57036-470, Brazil)

Background: Concept maps, derived from the theory of meaningful learning in Ausubel have been adopted by many medical schools. Imagery map as language is intellectual technology adapted to current times of higher speed operation and synthesis. For Bachelard, "Science is the aesthetics of intelligence". Summary of work: To report the experience of using imagery maps as a teaching-learning strategy. Students were asked to draw and use images associated to concepts about a weekly clinical case. Summary of results: Initially, only students with a talent for drawing or other visual artistic expression showed varying formats and extremely creative imagery maps, showing themselves more motivated and recognized; later, others felt freer to explore their talents, demonstrating greater motivation to study and for setting concepts and contents. The imagery maps with its power of synthesis have for some greater acceptance. Others have developed maps that are too sentimental, as support for expressing conflicts, troubles and difficulties in the first college moments, allowing themselves to express beyond the learning objectives of the week. For these there is the simultaneity of psychosomatic symptoms and the possibility of speaking and listening in the group in which they are inserted. Conclusions: The imagery map reveals artistic talents, arouses admiration and encourages learning. It also allows sublimation with elaboration of conflicts through art and culture.

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