Автор неизвестен - Mededworld and amee 2013 conference connect - страница 56

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teaching performance, organising residents' feedback for faculty in a systematic way is strongly recommended for continuous improvement of teaching performance, and consequently the quality of residency training. References: (1) Boerebach BC, Arah OA, Busch OR, Lombarts MJ. Reliable and valid tools for measuring surgeons' teaching performance: residents' vs. self evaluation. J Surg Educ 2012;69(4):511-20.

(2) Arah OA, Hoekstra JB, Bos AP, Lombarts KM. New

tools for systematic evaluation of teaching qualities of medical faculty: results of an ongoing multi-center

survey. PLoS One 2011;6(10):e25983.

(3) van der Leeuw R, Lombarts K, Heineman MJ, Arah O. Systematic evaluation of the teaching qualities of Obstetrics and Gynecology faculty: reliability and validity of the SETQ tools. PLoS One 2011;6(5):e19142.

(4) Lombarts KM, Bucx MJ, Arah OA. Development of a system for the evaluation of the teaching qualities of anesthesiology faculty. Anesthesiology 2009


(5) Prochaska JO, Redding CA, Evers KE. The Transtheoretical Model and Stages of Change. In: Glanz K, Rimer BK, Visnawath K, editors. Health Behavior and Health Education: Theory, Research, and Practice. 4th ed. San Francisco: John Wiley & Sons, Inc.; 2008. p. 97­121.

5F Symposium: MEDINE2: Implementation of the Ten Dimensions of the Bologna Process in Undergraduate

Medical Education

Location: Chamber Hall, PCC

Madalena Patricio (University of Lisbon, Portugal, and AMEE) and representatives of the different stakeholders including teachers, students and deans

5G Short Communications: Assessment: Progress Test

Location: Conference Hall, PCC


VGTogether - collaborating in progress testing

Jeroen Donkers (Maastricht University, Educational

Development and Research, FHML, P.O. Box 616,

Maastricht 6200 MD, Netherlands)

Annemarie Camp (Maastricht University, Educational

Development and Research, FHML, Maastricht,


Frank van de Kamp (Maastricht University, Educational Development and Research, FHML, Maastricht, Netherlands)

Background: The interuniversity Progress Test in Medicine (iPTM) is jointly produced and simultaneously administered by five medical faculties in the Netherlands. Such a collaborative effort requires an organizational and ICT infrastructure that supports the tasks and logistic processes that are needed in running the progress test four times a year. Some essential processes were not yet supported by ICT at a desired level of quality. The VGTogether project aimed at improving and extending the ICT infrastructure of the


Summary of work: During the two-year project VGTogether, funded by SURF, we concentrated on four problems: the ICT infrastructure was not centralized enough, item writing was not supported by ICT, we needed a business model to valorize products developed within the iPTM, and we needed to support the exchange of knowledge about progress testing. Summary of results: The project produced four results. First, we setup a centralized and generic technical infrastructure, hosted by an independent partner. Second, using an elaborate requirement assessment and selection process, we selected and piloted an online authoring and item banking system (IMS from Heidelberg University). Third, we developed a business model and finally, a website including web 2.0 functionality was set up (www.ivtg.nl). Conclusions: The centralization of the ICT-infrastructure, a business model, and the website are successfully finalized. A pilot study of the IMS system was organized at Maastricht University and where needed adaptations in the system were made. The evaluation results of the pilot study are currently being analyzed and will be presented at the conference. Take-home messages: Collaboration in (progress) testing between institutions requires a solid ICT-infrastructure.


A Nationwide Progress Test (PT) for all Students in Midwifery Programs in the Netherlands

Noortje Jonker (AVAG, Higher Education Midwifery, Amsterdam, Netherlands)


Marianne Prins (AVAG, Higher Education Midwifery, Amsterdam, Netherlands) Patrick Debats (AVM, Higher Education Midwifery, Maastricht, Netherlands)

Anne Dusseljee (VAR, Higher Education Midwifery, Rotterdam, Netherlands)

Xandra Janssen (AVM, Higher Education Midwifery, Maastricht, Netherlands)

Titia Eijndhoven (VAR, Higher Education Midwifery, Rotterdam, Netherlands)

Background: Each year there are 200 graduates who receive the title of Bachelor in Midwifery in the Netherlands. The programs are carried out by the AVM, VAR and AVAG. Although the learning objectives are by law largely the same for these three programs, curriculum structure and teaching models are different. In the development of the joint test and its systems and procedures we were supported by Maastricht University (UM) which is the coordinating University for a Dutch nationwide PT for medical students for fifteen years. Summary of work: To measure and compare the outcomes of these three programs we worked together to develop one nationwide Progress Test (PT). All students will be subjected to this test four times per year in all phases of their four year program. Also information for comparing the performance of the three programs will be available and can be used. The principle is that all three programs can keep their own structure and teaching model if quality measures do not require changes in them.

Summary of results: The tests consist of 200 MPC items spread over the entire body of knowledge for the midwifery domain. To make each test comparable with the others a test blueprint is developed. The MPC items are written by teachers of all three programs and are gathered in one digital item bank, supported by one online test authoring and review system (IMS2).There is one joint quality procedure. Conclusions: The first Nationwide Dutch PT for midwifery will be held in September 2013. AVM and VAR have their own (non joint) PT for several years. For AVAG this will be the first PT. Take-home messages: The Dutch national PT for midwifery will be the first for midwifery students and one of the first for non-medical students.


Report of The First Multi-institutional Progress Test in Saudi Arabia

Hani Al-Shobaili (Qassim University - College of

Medicine, Dermatology, Dean's Office, PO Box 6655,

Meldia 51452, Saudi Arabia)

Mohammed Nour Eldin Saleh (Qassim University -

College of Medicine, Anatomy, Melida, Saudi Arabia)

Abdulla AlGhasham (Qassim University - College of

Medicine, Pharmacology, Melida)

Mohammed Saqr (Qassim University - College of

Medicine, Medicine, Buraydah, Saudi Arabia)

Background: Progress test is a comprehensive assessment of undergraduate medical knowledge that samples all students of a medical school or a group of medical schools regardless of their level in the medical program or instructional methodology of the curriculum. In Saudi Arabia, Qassim College of Medicine (QCM), after two rounds of pilot progress test of its own students, has conducted the first multi-institutional progress test of 3830 students from twelve colleges in the Kingdom.

Summary of work: The test included 200 type-A MCQs covering all aspects of medical study for the graduate level. The exam blueprint was based on The Saudi Meds, with consideration of body systems, medical disciplines and different processes that graduates are expected to be involved in. Test items principally tackled areas of common clinical problems which graduate are expected to master, or high-risk situations where early intervention makes a difference. 35% of items covered basic biomedical sciences and 65% represented clinical science including behavioral and social sciences. 186 items were specially developed "de Novo" in (QCM), and the remaining items were provided by Maastricht University progress test bank. The test was paper based followed by a feedback survey. Summary of results: Results were declared online to each student as percentage score in each of the processes, body systems and disciplines, as compared to same batch in own college and all over participants. Besides, anonymized results and analysis were sent to every college. The test reliability KR21 was 0.96 and students' feedback was generally encouraging. Conclusions: Progress test provided valuable information to students and colleges. Take-home messages: Progress test should be considered for students' assessment and benchmarking.


Psychometric properties of progress testing: an international multicentric study

Carlos Fernando Collares (Maastricht University, Educational Development and Research, Universiteitssingel 60 - Room N5.12, Maastricht 6229ER, Netherlands)

Jose Lucio Martins Machado (Universidade Cidade de Sao Paulo, Medical Education, Sao Paulo, Brazil) Abdullah Alghasham (College of Medicine, Qassim University, Medical Education, Buraidah, Saudi Arabia) Hani Alshobaili (College of Medicine, Qassim University, Dermatology, Buraidah, Saudi Arabia) Rosa Malena Delbone Faria (Jose do Rosario Vellano University and Federal University of Minas Gerais, Medical Education, Belo Horizonte, Brazil) Arno Muijtjens (Maastricht University, Educational Development and Research, Maastricht, Netherlands)

Background: Benchmarking of medical schools has been a reality in regional progress test consortia worldwide. However, validity of comparisons between schools from different countries has unique challenges due to the impact of local differences, such as scoring, summative


or formative usage and blueprinting. This study aimed to explore the relationship between some contextual factors and the psychometric properties of progress testing.

Summary of work: This retrospective, observational, cross-sectional, multicentric study analyzed data from progress tests of four different institutions. Variables regarding the samples included formative/summative usage, testing in native language, and "question mark/penalty for wrong answers" usage. Item response theory logistic models were applied. Item parameters and reliability coefficients were compared, as well as fit indices, local precision graphs and item-person maps. Differential item functioning was performed whenever applicable.

Summary of results: There were no important differences in reliability estimates across institutions. However, especially when the penalty was present, a negatively skewed distribution of b parameters could be observed. This right-sided peak was accompanied by a mismatch between item ("b") and person ("theta") curves. Increased mismatching was associated with poorer model fit, parameter invariance and unidimensionality.

Conclusions: Substantial evidence support usage "question mark/penalty for mistakes" in progress testing. Nevertheless, when applied in international consortia, it may hinder the appropriateness of benchmarking inferences. Apparently, language proficiency and risk-avoidance behavior act together as construct-irrelevant sources of score variance that could affect the validity of international performance comparisons.

Take-home messages: International progress testing consortia may need to sacrifice the educational utility of "question mark/penalty for mistakes" in favor of more accurate benchmarking.


Blueprint Analysis and Feedback based on the Progress Test

L Coombes (Plymouth University, Peninsula School of Medicine and Dentistry, Drake Circus, Plymouth PL4 8AA, United Kingdom)

J Stratford (Plymouth University, Peninsula School of Medicine and Dentistry, Plymouth, United Kingdom)

Background: The Progress Test is used for testing applied medical knowledge and consists of 125 MCQ items taken four times a year by all students in the medical school. Each item is blueprinted against the curriculum to provide a detailed subject and domain that each item assesses.

Summary of work: By developing a simplified version of our curriculum blueprint we are able to provide detailed analysis of subjects and domains. Each student has access to their own scores compared to their cohort for an individual test, and for each academic year. It also allows us to examine whether all knowledge grows at the same rate or whether there are differences between some of the areas under examination.

Summary of results: This analysis has provided a method for feeding back PT performance information in a meaningful way to students, and helps monitor whether changes in the curriculum are mirrored in our knowledge assessments.

Examples will be presented from student feedback and its usage since introducing the feedback system, longitudinal gains in knowledge in different subject areas, and will examine whether there are differences in the rates of knowledge growth for different genders or ethnicities.

Conclusions: The analysis has proven popular and provides good feedback to students, as well as providing the school with information about the rate of knowledge growth across the curriculum. Take-home messages: The Progress Test is particularly useful at examining longitudinal trends in data and the rates at which we can expect medical students to gain expertise in a number of areas.

5H Short Communications: Curriculum: Humanities

Location: Club H, PCC 5H/1

Teaching about Spirituality in New Zealand Medical Schools

Deborah Lambie (University of Otago, Department of Preventive and Social Medicine, Dunedin, New Zealand) Richard Egan (University of Otago, Department of Preventive and Social Medicine, Dunedin, New Zealand) Simon Walker (University of Otago, Bioethics Centre, Dunedin, New Zealand)

(Presenter: Roderick MacLeod, University of Sydney, Palliative and Supportive Care, Greenwich Hospital, 97­115 River Road, Greenwich, Sydney 2065, Australia)

Background: Addressing spirituality has been shown to positively impact a range of health outcomes and patients have been reported as wanting spirituality addressed in medical contexts. Currently more than 80% of medical schools in the US offer courses in spirituality. This study aims to investigate whether and how spirituality is taught in New Zealand medical schools. Summary of work: This study employed mixed methods; qualitative conversations provide depth; quantitative surveys provide complementary breadth. Overall there were 14 interviews and 73 survey responses (rr 39%) from New Zealand medical schools. Summary of results: Results indicate that spirituality is regarded as an important part of healthcare but there was little consensus as to what the topic was essentially about. However, the majority of respondents (58%) were unsure if spirituality was being taught and 18% said it was not being taught. 82% stated the lack of consensus regarding the nature of the topic as a potential obstacle to it being taught effectively. Conclusions: Spirituality is regarded as an important aspect of medical education and yet is not being understood or taught uniformly. Several interviewees spoke of the potential dangers of exploring spirituality which in itself indicates a lack of understanding. Spirituality does not yet have a clearly defined place in medical education in New Zealand. Clarification is needed if progress is to be made in this area. Take-home messages: Spirituality is an important aspect of medical education which is not yet clearly understood or taught in New Zealand medical schools.


Balancing heart, humanity and science in medical education: competencies for Spirituality and


Benjamin Jim Blatt (George Washington University, Medicine, Clinical Skills, Washington, DC, United States) (Presenter: Christina Puchalski, George Washington University, Medicine, Geriatrics and Palliative Care, 2150 Pennsylvania Avenue NW, Washington, DC 20037,

United States)


Background: Early 20th century technological advances in diagnosis and treatment overshadowed the more human elements of medicine. In response, medical academics and practitioners launched Spirituality and Health as a field to reclaim medicine's spiritual roots, defining spirituality beyond religion and ethics, as each person's search for meaning and purpose in life. As the field continued to grow, the need emerged for a framework for communication, curriculum analysis, and scholarship to bring it cohesiveness. Summary of work: To develop a framework, in 2011 a consensus conference of seven medical schools was organized.

Summary of results: Educators from the 7 schools created a framework around competencies: Knowledge, Patient Care, Professional and Personal Development, Communication, and Compassionate Presence. They populated each competency domain with measurable behavioral objectives that learners would be expected to demonstrate in performance assessments. The competencies' first applications were curricular projects of the above seven medical schools as well as the GWish-Templeton Reflection Rounds initiative (G-TRR). Piloted in eight medical schools, G-TRR provided clerkship students with the opportunity through reflection on their patient encounters, to develop their own inner resources for addressing the suffering of others.

Conclusions: Seven US medical schools developed Spirituality and Health Care competencies to form a common framework for this field, which aspires to restore to medicine the balance between heart and humanity and science. Future directions for the Competencies include application across professions and vertical integration across the medical education continuum.

Take-home messages: The Competencies offer a framework that can be used globally within and across professions for curriculum development, analysis and scholarship.


Medical educators rush in where biomedical teachers fear to tread - developing a medical humanities core curriculum

Li Chong Chan (The University of Hong Kong, Pathology, Hong Kong)

Julie Chen (The University of Hong Kong, Family Medicine and Primary Care / Institute of Medical and Health Sciences Education, 2/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong)

Background: Medical humanities is increasingly being included as part of the medical curriculum with the aim of producing doctors who are not only biomedically qualifed but also humanistic and caring. Two key issues are how to make medical humanities pedagogically sound as well to ensure its sustainability given the competition for curriculum time and teaching workload of the faculty.

Summary of work: With 4 years of planning involving various stakeholders, visits to medical schools overseas where medical humanities are being taught, and advice from experts, we piloted several modules in medical humanities. Based on the success of these modules, a Medical Humanities Planning Group was formed to formally develop a medical humanities core curriculum which will extend throughout 6 years starting in September 2012 with a first year intake of 210 medical students.

Summary of results: The curriculum was planned using an outcome approach to student learning model with alignment of teaching and learning activities and assessment. In year 1, teaching and learning activities took the form of lectures, workshops, discussions and museum visit and exploring five themes - narrative medicine, culture, spirituality and healing, history of medicine, death, dying and bereavement, and humanitarism - and presented through reading and writing, performance, visual arts and film. Assessment was based on participation in workshops (spoken and written), online postings and creative output. We were very encouraged with the very positive response from students. An unique feature is the participation of teachers from diverse disciplines in the curriculum. Conclusions: We have succeeded in delivering a medical humanities core curriculum for year 1 medical students with a positive response.

Take-home messages: A medical humanities curriculum has meaning if it is a core curriculum and is assessed, and can be sustainable with careful planning from various stakeholders, and with teaching support from the wider faculty community.


Knowledge is not enough: the undergraduate humanist performance evaluation

Haydee Parra (UACH School of Medicine, Educational Research, Sierra Cristal # 8126, Calle Escorza # 900, Chihuahua 31000, Mexico)

Jesus Guadalupe Benavides (UACH School of Medicine,

Dean's office, Chihuahua, Mexico)

Julio Cesar Lopez (UACH School of Medicine, Research

and Postgraduate, Chihuahua, Mexico)

Raul Manuel Favela (UACH School of Medicine, Research

and Postgraduate, Chihuahua, Mexico)

Alma Delia Vazquez (UACH School of Medicine,

Educational Research, Chihuahua, Mexico)

Carolina Guevara (UACH School of Medicine, Educational

Research, Chihuahua, Mexico)

Background: The global health problems require competent doctors who promote health in a humanitarian way and with ethical commitment. We have implemented a quality management model (QMM) oriented to the integral formation of physician competencies. The aim is to show the implications of this model evaluated through the objective structured clinical evaluation (OSCE). Summary of work: A descriptive-transverse correlational study with the application of OSCE to 46


undergraduate medical interns (UMI) to assess their competencies with standardized patients (SPs) through four levels of performance: receptive, resolving, autonomous and strategic (Tobon, 2010). A questionnaire was applied to measure the relationship between clinical mentoring and the clinical skills of UMI. The results were analyzed with a significance level of p < 0.01 and with a 1-10 scale in performance. Summary of results: The UMI reached autonomous performance (8.5) in interpersonal communication with SPs, they showed values of respect, honesty and truthfulness when informing them about their health; in interpretation of physiopathology they reached a strategic level (10); however in the clinical evaluation they reached a resolving level (6.5), this showed that they require support from the clinical tutor for a complete and systematic patient examination. We found a significant correlation between tutor preparation and a friendly and respectful attitude towards patients (r =0.28).

Conclusions: The QMM favors the development of communication, socio-cultural and professional ethics competencies.

Take-home messages: The training of medical humanists with ethical commitment demands the implementation of a QMM centered on the training of competences with tutorial assistance.


Teaching Medical humanity at Kerbala Medical College: Phenomenological perspective

Ali Tareq AbdulHasan (Kerbala University, College of Medicine, Kerbala 56001, Iraq)

Background: Medicine is usually defined as an art and science. This is what I had been taught at my medical college when I was medical student. In reality they never discussed humanistic dimension of medical practice, the focus was on the biological aspect. Now as a medical teacher, I decided to give room to this important aspect of medicine of which we are in real need in every stage in our medical life.

Summary of work: I started teaching it to my first and sixth year medical students. I use interactive lectures plus relevant movies. I use the phenomenological method to explore the lived experience of being taught medical humanities and watching movie scenes like 'The doctor' and 'Patch Adams'.

Summary of results: Twenty students from both stages were interviewed about their lived experience of the lectures and movies. Three themes were revealed after using phenomenological analysis: first theme: what it is like to be a patient; second theme: is therapeutic power of words (comfort); the last theme: the difference between listening and hearing. Conclusions: Our experience of teaching medical humanities to our student was a transformative experience which creates great interest in this new subject and opens the door to speak about professionalism and empathy. This encourages us to introduce humanities to all students of our college.

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