Автор неизвестен - Mededworld and amee 2013 conference connect - страница 67

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Conclusions: SPH FM piloted and gathered data on TIPs, an electronic reflective learning tool that had perceived value for participants and had impact on practice.

Take-home messages: It is possible and preferred by participants to utilize electronic reflective learning tool at CME conferences.


Online web based discussion for block teaching modular curriculum in postgraduate health professionals' curriculum. The Ethiopian experience

Bineyam Taye (Addis Ababa University, College of Health Sciences, Clinical Lab Sciences, Addis Ababa, Ethiopia) (Presenter: Asaye Birhanu, Addis Ababa University, College of health sciences, Clinical Lab Sciences, Addis

Ababa 170584, Ethiopia)

Background: Despite an increased number of medical schools and frequent revision of health professional training curriculum in Ethiopia, little attention has been given to an innovative educational research improving the existing teaching and learning practices. Summary of work: Between December 2011 and February 2012 two groups, of regular (N=21) and counting education program (CEP, N=52) postgraduate students, participated in online discussions via a Google group created by the instructor as part of a Biostatistics and Research methods module. In each week of the three-week module, the course instructor initiated the online discussion by posting few discussion questions that allow students to share their idea to the group. Participants' collective learning experience was assessed using content analysis of stored text messages of all e­mails generated during the online web discussions. Summary of results: A total of 702 emails were exchanged during the three weeks block teaching, of which 250 emails (35.6%) were posted by regular students and 452 emails (64.4%) by part time (CEP) students. In terms of message content, 83.3% of regular and 65.5% of part time students' messages were pertaining to the topic of discussion. The majority of students in both groups rated high satisfaction level toward their online experience. Conclusions: Online web based discussion could be a valuable addition to face-to-face class room teaching to improve students' engagement and interaction in an intensive block teaching postgraduate health professionals' curriculum.

Take-home messages: Online web based discussion could be applied in resource limited setting.


Learning with Instructional Video

Rocio Garcia (UNAM, Integration Ciencias Medicas, Av. Universidad 3000, Mexico) Araceli Mendez (UNAM, Integracion de Ciencias Medicas, Mexico)

Sara Morales (UNAM, Integracion de Ciencias Medicas, Mexico)

Rocio Garcia (UNAM, Integracion de Ciencias Medicas, Mexico)


Background: The instructional video is a medium that has a language of its own, whose sequence induces to the vewer to synthesize feelings, ideas, concepts, actions and reactions, as well as capture and reproduce exceptional real situations.

Summary of work: As part of a teaching strategy, the Department of Integration of Medical Sciences of the UNAM, asked students enrolled in subgroups 2207, 2208 and 2221 perform a basic neurological examination video with different materials and strategies. Summary of results: 30 students develop a neurological examination video of a family member or friend to evaluate the central nervous system function. The videos were uploaded in a virtual classroom, were evaluated by means of a checklist considering 30 elements that include the physician-patient relationship, the exploration of the 12 cranial nerves, the muscular limbs, tendon reflexes, sensory system , coordination, balance and gait.

Conclusions: The video experience ease the understanding and retention of content to students, encouraging the development of skills that sets the Curriculum 2010 highlighting that related to effective communication.

Take-home message: The instructional video promotes the development of skills and knowledge retention long term.


Exactly when, what and who? Tracking students' use of a medical reference app

Bethany Davies (Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom)

Tim Vincent (Brighton and Sussex Medical School,

Division of Medical Education, Mayfield House, Village

Way, Falmer, Brighton BN1 9PH, United Kingdom)

Tim Lambert (Brighton and Sussex Medical School,

Technology, Brighton, United Kingdom)

Mark Packer (Brighton and Sussex Medical School,

Technology, Brighton, United Kingdom)

Jil Fairclough (Brighton and Sussex Medical School,

Library services, Brighton, United Kingdom)

Inam Haq (Brighton and Sussex Medical School, Division

of Medical Education, Brighton, United Kingdom)

Background: Brighton and Sussex Medical School delivers a mobile learning initiative in which medical students are given a suite of high-quality electronic textbooks through a bespoke app on their own devices. Monitoring accurate use of the resources provides rich data for evaluation but, due to the 'blackbox' effect of handheld computing devices, it can be difficult to gather this data.

Summary of work: We have co-developed novel data collection that allows us to track the students' use of the mobile app. Earlier iterations required the students to synchronise their handheld devices manually but there was impeding variation in compliance. The latest smartphone app features automatic 'push' synchronisation, increasing the detail and reliability of

this new data collection. The datapoints available include individual student use, time of access, and exact pages accessed. Geographical location is not recorded, although it is possible to map the time data to scheduled activities within the teaching timetable. Summary of results: Data is being collected over the academic year 2012/2013. We will be able to accurately describe patterns of use across the duration of the study period, how pages are accessed at different times of day, and which resources are the most popular. We can also see how individual students differ in their use of the


Take-home messages: Accurately monitoring use of the app allows us to: Get the actual picture of what information is used, when, and by which users; Identify the most popular reference and optimise which texts are made available; Control software licensing and minimize software related expenses.

5DD Posters: The Curriculum Location: South Hall, PCC


Imagining a post-structural curriculum for palliative care: Reflections on healthcare workers' experiences in rural South Africa

Laura Campbell (University of KwaZulu-Natal, Medical Education, Durban, South Africa) (Presenter: Nyna Amin, University of KwaZulu-Natal, Education, Edgewood Campus, Edgewood, Durban 3630, South Africa)

Background: This paper offers an imagined curriculum for palliative care based on the experiences of healthcare workers in rural parts of South Africa and its impact on patient care. Many of the patients receiving palliative care live in impoverished homes and have had minimal access to healthcare. Thus there is uncertainty about whether they will die because of a life-limiting illness, or because sophisticated medical care is not available. An additional anxiety is the tensions between their spiritual beliefs and cultural practices and the palliative care approach.

Summary of work: Six healthcare workers, four qualified and two unqualified volunteers who provided palliative care were interviewed using a photo-elicitation technique. Data was analysed using a bottom-up approach.

Summary of results: The caregivers' experiences of home-based care made apparent the limitations and ineffectiveness of a curriculum that excludes patients' social context, spiritual beliefs and cultural values in respect of healthcare, dying and death. The curriculum does not consider the event of an uncertain diagnosis or prognosis.

Conclusions: A curriculum, reconceptualised through a post-structural lens will not only respond to the needs of patients and caregivers, it is also a more resilient means to capture the simultaneous, yet different realities within the same context or across multiple contexts. Take-home messages: A palliative care curriculum should prepare caregivers for uncertainty in practice and a post-structural lens may provide a tool for reconceptualizing current curriculum.


Medical education must be driven by local population reality, mainly those indigenous ones

Glaucia Oliveira Moreira (Federal University of Roraima, Pediatric, 901 Dom Jose Nepote Street, Sao Francisco, 1645 Guianas Avenue, Treze Setembro, Boa Vista

69305070, Brazil)

Paulo Marcondes Carvalho Junior (Marilia Medical School, Marilia, Brazil)

Background: Medical education must be driven by local population reality, mainly those indigenous ones.


Summary of work: We conducted a cross-sectional study with 14 physicians in a pediatrics residency program at a pediatric hospital in northern Brazil. All of them answered a questionnaire with Likert scale questions regarding his prior training for indigenous patient care.

Summary of results: 14 (34.2% of 41) physicians answered the questionnaire. Ten of the 14 physicians often interviewed Indians during undergraduate education, and 12 are still serving this population. The majority (10) feels comfortable on indigenous patient care. About 50% of participants reported feeling technically prepared for this care, however 21% of them use the vaccination schedule specifically for the indigenous population. The majority (64%) reported often feeling it would take training focused on indigenous health and also suggests that teachers in undergraduate education rarely give attention to indigenous health. Related to colleagues and mentors residency in pediatrics, most (64%) also reports that technical knowledge to health care in this specific population is rarely demonstrated. 64% of respondents believe it to be difficult to deal with interference only in a few moments. Patient dissatisfaction is sometimes perceived by 78.5% of respondents. Conclusions: Even having been trained during undergraduate education for the health care of indigenous populations, it is clear there is a need for greater integration of teaching and service to train professionals in the reality of healthcare of the population they serve.

Take-home messages: Special populations such as indigenous ones needs much more attention in the medical curriculum.


Use of a practical guided study to promote an integrative approach to learning

Peter M Kilgour (University of St. Andrews, School of Medicine, Medical and Biological Sciences Building, North Haugh, St. Andrews KY16 9TF, United Kingdom) Susan Whiten (University of St. Andrews, School of Medicine, St. Andrews, United Kingdom) Peter Driscoll (University of St. Andrews, School of Medicine, St. Andrews, United Kingdom)

Background: Emphasis is increasingly placed on the need for horizontal and vertical integration in medical school curricula; this encourages an understanding of medicine as a function of collated information, rather than as merely a sum of individual disciplines. The traditional didactic, teacher-centred approach to learning does not however address the need to engage students in active study. Although the 'Problem-Based Learning' method attempts to address this, many agree that a 'middle of the road' combination of traditional and innovative methods is the most efficient strategy. Summary of work: At the St Andrews University Medical School, guided studies are an integral component of the curriculum. Guided study aims to encourage independence and "deep" learning whilst ensuring

learning objectives are achieved, predominantly using a reading/writing learning style. We aim to extend this approach by promoting horizontal integration of basic sciences, and vertical integration of clinical reasoning, through the use of a practical guided study. Students are supplied with a study guide relating to a patient, who develops an inguinal hernia and diverticulitis secondary to a long standing history of chronic constipation. The questions cover anatomy (using prosections), physiology, histology and clinical skills over 4 stations each lasting 15 minutes.

Summary of results: The students will complete a questionnaire to evaluate whether this has been both an enjoyable and valuable learning experience. Conclusions: We intend that this pilot paves the way for similar guided studies to complement our spiral curriculum in the future.

Take-home messages: Practical guided studies provide a novel, enjoyable and worthwhile approach to ensuring integration within a medical school curriculum.


Basic clinical integration in medical internship: Psychiatry and Pharmacology

Carlos A Lazarini (Faculty of Medicine of Marilia, Pharmacology, Rua Jose Dias Molina, 16, Marilia 17516­460, Brazil)

Flavia C Goulart (Marilia, Brazil)

Background: Activity methodologies were used as a didactic-pedagogic strategy in the fifth-year medical course at Faculty of Medicine of Marflia-Brazil. An integrative activity between pharmacology end psychiatry occurs in this year. Firstly, in this activity, the students are stimulated to do a literature search about medicines (antidepressant, anxiolytic, antipsychotic...) used in practice (ward and emergency room). Secondly, they discuss the content with the pharmacology teacher. This study quantifies students' knowledge before and after their participation in the activity and analyzes their opinion about the relevance of participation. Summary of work: Qualiquantitative study was performed using pre and post test evaluation (multiple choice questions) and thematic analysis of the Collective Subject Speech (CSS).

Summary of results: 72 students (total=85) registered in the fifth year of the course in 2011, agreed to participate. Significant increase (p<0.001) in the percentage of correct answers in the posttest compared to pretest was observed. The central ideas obtained from the analysis of CSS were: very relevant activity; inclusion of this activity in other stages; difficulty in basic disciplines; and faculty active performance. Conclusions: This form of integration between pharmacology and psychiatry, at the real practical activities in internship, allowed the pharmacology concepts to be expanded, making meaningful learning. Although the students indicated the need for further study of basic disciplines, the level of acceptance of this basic clinical integration is expressed in the suggestion


that this activity can be extended to other stages of the 5th year.

Take-home messages: The basic clinical integration facilitated and motivated the acquiring knowledge.


Renal Module in integrated Curriculum of AJK Medical College: Design, Delivery and Assessment

Mohsin Shakil (AJKMC, Urology, AJK Medical College, Muzaffarabad-AJK 53720, Pakistan) Syed Sajid Shah (AJKMC, Pathology, MZD, Pakistan) Sarmud Latif Awan (AJKMC, Anatomy, MZD, Pakistan) Ziyad Afzal Kayani (AJKMC, Surgery, MZD, Pakistan) Muhammad Iqbal Khan (AJKMC, Surgery, MZD, Pakistan) Muhammad Saeed (AJKMC, Medical Education, MZD, Pakistan)

Background: To address the requirements of the modern health care system, medical education has undergone a paradigm shift from traditional disciplinary teaching to outcome based integrated medical education system. Foreseeing the local demands and needs in specific and global change in general, the leadership of Azad Jammu Kashmir Medical College (AJKMC) decided to develop, implement, assess and evaluate an indigenously designed system based integrated modular curriculum at undergraduate level. Summary of work: A multidisciplinary team of faculty members from relevant disciplines conducted meetings to develop a study guide of "Renal Module" by adopting "Six Step Approach" for curriculum development. A thematic 'Core Content' consisting of four themes was approved after thorough deliberation by module team. Learning outcomes were linked to the themes and appropriate instructional strategies and tools of assessment were defined. "Table of Specifications" (TOS) was designed according to clinical significance of the theme. TOS guided the design of instructional schedule and assessment of the 'Renal Module'. Explicit learning outcome in term of knowledge, skill and attitude were assessed through written & integrated practical assessment (IPA)

Summary of results: Module outcome was assessed through a structural written examination, comprising of SAQs & single best MCQs, whereas clinical skills and attitude outcome were assessed through 17 integrated OSPE stations. The Renal Module was evaluated by students and faculty through a pilot tested structured questionnaire. A significant number of students showed complete satisfaction on delivery and assessment of the module.

Conclusions: Design, delivery and assessment of integrated curriculum is laborious, demanding and challenging; though possible even in resource constrained environment of public sector medical college.

Take-home messages: Integrated curriculum is laborious, demanding and challenging; however, possible if there is a strong political will of the leadership.


Is horizontal integration between basic sciences reflected in the students' learning?

Yolanda Marin-Campos (National Autonomous University of Mexico, Pharmacology, Avenida Division del Norte 833 Colonia del valle centro. Delegacion Benito Juareaz, Mexico 03100, Mexico) Bertha Maria Najera-Tijerina (National Autonomous University of Mexico, Pharmacology, Mexico) Adrian Tellez-Hernandez (National Autonomous University of Mexico, Pharmacology, Mexico) Jimena Y. Ramirez-Marin (Northwestern University, Chicago, Ill, United States)

Background: Research has been made on the role of basic sciences knowledge helping students to learn causal explanations and have a more coherent understanding of the relation between diseases and clinical features. However, it is necessary to study whether students are able to apply basic sciences knowledge to each other. In the medical curriculum Physiology is used as Pharmacology basis for understanding the pharmacological targets. Pharmacology teaching reflects this principle. Research question was: if the level of students' knowledge on the two sciences is related?

Summary of work: At the end of the second-year, 58 medical students voluntarily participated in the study. They were from three different performance levels groups: 13 high, 33 medium and 12 low. They were applied a 41-MCQ test: 18 questions on blood pressure Physiology and 23 on antihypertensive drugs Pharmacology. Questions makers were teachers from both courses who had more than 10 years of teaching experience.

Summary of results: One-way ANOVA showed a significant main effect of group performance level. Differences between groups were found in Physiology. In Pharmacology only high performance group was different, low and medium groups were similar. Conclusions: Apparently, differences in tests scores were due to the group to which students belonged, not to the knowledge they had on Physiology and Pharmacology. The research question was not clearly answered.

Take-home messages: Studies on horizontal integration between basic sciences are needed to help students' understanding of the relation between diseases and clinical features.


How does study behaviour influence the contentment with a medical curriculum? Preliminary results from a core elective semester

Sandra Sudmann (Dean s Office for Study Affairs, Medical Faculty RWTH Aachen University, University Hospital, Pauwelsstrasse 30, Aachen 52074, Germany) Anne Scherer (University Hospital of the RWTH Aachen, Institute of Medical Psychology and Medical Sociology, Aachen, Germany)


Thomas Forkmann (University Hospital of the RWTH Aachen, Institute of Medical Psychology and Medical Sociology, Aachen)

Siegfried Gauggel (University Hospital of the RWTH Aachen, Institute of Medical Psychology and Medical Sociology, Aachen, Germany)

Background: In the 4th or 5th year of the medical curriculum in Aachen, Germany, students have one core elective semester. They can use this semester for everything from research, clerkships, study abroad, vacations, jobs, self-studies, practical training, elective courses or preparation of a doctoral thesis. Summary of work: Eighty-four medical students in their 5th year were asked to indicate their general study behaviour, overall contentment with the medical curriculum and how they have spent their elective semester. The data was analysed with regression and regression tree analyses.

Summary of results: Preliminary results show that students use the elective semester for up to six activities. The regression analysis showed that the inclusion of a vacation, but no elective courses, predicted satisfaction with the curriculum. Furthermore, students who make use of progress testing are more content. The regression tree explains further relationships between these factors. Conclusions: While several combinations of activities are chosen, the predictive value with regard to students' contentment of a vacation but not electives may point to a better time management of students who are more content. Generally, the students evaluated the core elective semester as an important part of the curriculum. Further research is needed to investigate which elective elements and study behaviours are predictors for students' dedication and, eventually, for their success.

Take-home messages: In a free semester, students who manage to include a vacation are most content with the curriculum as a whole, probably due to their ability to structure their time.


Development and initial use of the self-accomplished, self-assessment tool iCAN!-Angio specially designed for medical students studied the selected component «Angiology-Vascular Surgery»

Antigoni Pieta (University of Ioannina Medical School, Department of Surgery, Vascular Surgery Unit and Department of Hygiene and Epidemiology, Medical Education Unit, Zagoriou 10-12, Ioannina 45110, Greece) Ioannis DK Dimoliatis (University of Ioannina Medical School, Department of Hygiene and Epidemiology, Medical Education Unit, Ioannina, Greece) Michalis Peroulis (University Hospital of Ioannina, Department of Surgery, Vascular Surgery Unit, Ioannina, Greece)

Eleni Arnaoutoglou (University of Ioannina Medical School, Department of Anesthesiology, Ioannina, Greece)

Stavros Avgos (University Hospital of Ioannina, Department of Surgery, Vascular Surgery Unit, Ioannina, Greece)

Miltiadis Matsagkas (University of Ioannina Medical School, Department of Surgery, Vascular Surgery Unit, Ioannina, Greece)

Background: As we are currently moving from medical school level outcomes to outcomes of specific courses, we developed a self-accomplished, self-assessment tool for students. Students were asked to use this tool before and after attending the special study module (SSM) 'Angiology-Vascular Surgery'.

Summary of work: First a SSM's guide was prepared, where the outcomes that should be met, the teaching/learning activities, the students' workload, etc. were addressed. Then the SSM's outcomes were transformed into the iCAN!-Angio questionnaire, completed by students during the first and last day of the course, declaring their agreement in several statements like "I can measure the ankle-brachial index" etc. Open comments were also analyzed. Summary of results: A 44 question tool was developed. All 13 students participated. In average, students scored 45% the first day compared to 81% of the last day, while their professors' average final mark was 96%. Their worst first-day competence was "I can determine if the vascular access in nephropathic works properly" (14%), whereas their best "I can suspect pulmonary embolism and ask for appropriate laboratory tests in order to substantiate it" (74%), which improved to 71% and 85%, respectively.

Conclusions: Students were enthusiastic about having clearly understood from the beginning of the course what they should be able to achieve in the end and enjoyed the immediate feedback. They did not overestimate (rather underestimate) their competences. Take-home messages: Specific Angio- learning outcomes and self-assessment tool were both very useful to students and professors in their effort regarding further development of the course.


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