Автор неизвестен - Mededworld and amee 2013 conference connect - страница 72

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An evaluation of Paediatric and Neonatal Life-Support Training on Medical Students' Clinical Confidence and Interest in Paediatics

Olivia Corn (University of Cambridge, Clinical School, Churchill College, Cambridge CB3 0DS, United Kingdom) Natasha Aikman (University of Cambridge, Clinical School, Cambridge, United Kingdom)

Background: Few medical students are exposed to paediatrics before their rotations in fifth year, giving little opportunity to gain an insight into the specialty or take part in experiential learning activities. Summary of work: The annual Paediatric and Neonatal Life-Support Training Day is organised by the student-led Cambridge University Paediatric Society for medical students. Based on last year's feedback we allocated student groups by year of study. The format consists of 3 introductory lectures and 8 scenarios and skills stations facilitated by paediatricians, with each student leading one scenario. 21 students returned retrospective questionnaires evaluating the usefulness of teaching and impact on confidence and interest in paediatrics, using the 5-point Likert scale.

Summary of results: Grouping by year of study was felt to be beneficial (4.52) by all students and all sessions were rated as highly useful. Everyone agreed that leading a scenario was useful (4.52), and that they would feel more confident approaching a 'real life' situation (4.35 neonates; 4.5 paediatrics). This is significantly higher than in 2012, when groups were randomly allocated (3.35; 3.87). Overall, the event increased interest in paediatrics as a career (4.14). Conclusions: Dividing students into year groups helped to make the experience of the scenarios as useful for all. Running practical sessions helps increase confidence in how to approach real life situations. Take-home messages: Student-led training days are a good opportunity for students of all levels to develop an interest in paediatrics. Being in groups of a similar level can help make the experience more worthwhile.



'What I wish I had known': Reducing exam-related anxiety through a peer-delivered lecture

Patrik Bachtiger (UCL, Medical School, London, United Kingdom)

Owain Donnelly (UCL, Medical School, London, United Kingdom)

Background: The different approach to learning required in clinical years at medical school may cause students significant anxiety. We composed a lecture to alleviate this anxiety, in two ways: firstly, to explain the format of assessments from a student's point of view, and secondly, to create an early awareness of useful resources. Entitled 'What I wish I had known: Clinical SBAs and OSCEs', the lecture was targeted at students entering their first clinical year (year 4) at medical school.

Summary of work: The lecture was delivered by two year 5 medical students. Content was drawn from the feedback of medical students who recently sat their Year 4 summative single-best-answer (SBA) paper and observed structures clinical examination (OSCE). The lecture sought to clarify the format of assessments, as well as suggesting resources and methods for time-efficient, high-yield revision. The lecture's impact was assessed by questionnaire, the main outcome measure being influence on exam-related anxiety. Summary of results: 89 students returned completed feedback. Anxiety over revision methods and resources significantly decreased. The lecture was rated as "very useful" overall.

Conclusions: Students with recent assessment experience delivering the lecture offers a more relatable presence than a faculty member. Such peer-lectures stand to offer invaluable insight for medical students about the format of assessments and the resources available, with a potential bearing on exam performance by facilitating a reduction in anxiety, as well as through increasing awareness of quality learning tools. Take-home messages: Peer lectures on exam structure and revision resources are considered very useful by students, and considerably decreased student anxiety.


Medical Students' Use of Peer Assisted Learning on Clinical Placements

Joanna Tai (Monash University, HealthPEER (Health Professions Education and Educational Research), Faculty of Medicine, Nursing & Health Sciences, Building 13C, Clayton Campus, Monash University 3800, Australia)

Elizabeth Molloy (Monash University, HealthPEER (Health Professions Education and Educational Research), Faculty of Medicine, Nursing & Health Sciences, Melbourne, Australia) Ben Canny (Monash University, Faculty of Medicine, Nursing & Health Sciences, Melbourne, Australia)

Terry Haines (Monash University, Southern Physiotherapy Clinical School, Physiotherapy Department, Melbourne, Australia)

Background: Monash University runs a hybrid PBL-lecture curriculum, five-year undergraduate medical program. Peer Assisted Learning (PAL) is incorporated into pre-clinical activities. There are fewer formal PAL structures on clinical placements. PAL may be useful in building graduates' life-long 'non-technical skills', such as communication, teamwork, time-management and self-direction (Lincoln & McAllister 1993; Secomb 2008). Little is known about formal (structured) or informal PAL on medical students' clinical placements. Summary of work: In 2012, Year 3 students at Monash University were surveyed on PAL activities and experiences, aiming to capture all PAL occurrences. This provided a basis for ethnographic observations of PAL on clinical placements.

Summary of results: 54 students responded from metropolitan, rural and international (Malaysia) sites. On average, students reported using PAL 24.3 times/week. 71% indicated PAL was self-initiated rather than educator-initiated. Students identified benefits to PAL, but expressed reluctance to evaluate their peers, primarily because they lacked confidence to judge 'good performance'. Results from the subsequent Observational Phase will also be presented. Conclusions: PAL may improve health professional graduates' learning, communication and team-based skills. This study suggests medical students use PAL on clinical placements. Exposure to formalised, facilitated PAL in pre-clinical years may orientate learners to PAL's purpose and benefits. A significant gap in understanding remains regarding how PAL is enacted (and the impact of this) in the clinical environment. Take-home messages: Students voluntarily use PAL on clinical placements: this occurs mainly in informal settings. PAL benefits could be enhanced through orienting learners to PAL methods and outcomes, and providing learners and educators with frameworks for supporting PAL.


A bespoke training programme for effective student representation

Emma Vaccari (The University of Manchester, Manchester Medical School, Manchester, United Kingdom)

Nathan Huneke (The University of Manchester, Manchester Medical School, Manchester, United Kingdom)

Helen Franklin (The University of Manchester, Manchester Medical School, Manchester, United Kingdom)

Leena Patel (The University of Manchester, Manchester Medical School, Manchester, United Kingdom)

Background: Manchester Medical School (MMS) is among the largest in the UK with over 2300 students. Student Representation was restructured in 2010-11


and it was recognised that a tailored training programme would help representatives to fulfil their roles.

Summary of work: The content of the training was identified from discussions with student representatives, academic staff and senior administrators. The training was jointly delivered by staff and retiring student representatives over four interactive evening sessions. The training aimed to familiarise representatives with their specific roles as well as those of staff, the school and the university. Specific workshops included team working, how to represent students at committees, gathering information from students and dealing with challenging situations.

Summary of results: Feedback after each session was positive and was used to improve the following year's training. Student representatives have demonstrated exceptional team working and leadership skills through a range of innovative projects such as a student led award for the excellent teacher. Their contributions are consistently commended by staff. Conclusions: MMS' new training programme has enabled representatives to contribute effectively from early in their role and to develop as leaders and team workers. In a large medical school, an effective student representation system is necessarily complex. A bespoke training programme is vital for the system to work well, especially considering the annual turnover of student reps.

Take-home messages: Large medical schools should provide specific training to allow their student representatives to achieve their full potential.


Development of a mobile web-based tool for competency-based peer assessment of clinical skills

Ryan Luther (University of Toronto - Toronto Western Hospital, Department of Medicine, 399 Bathurst St, Toronto M5T 2S8, Canada)

Okimi Peters (University of Toronto, Department of Medicine, Toronto, Canada)

Lisa Richardson (University of Toronto, Department of Medicine, Toronto, Canada)

Background: Traditionally, students have learned clinical skills by reading text-based resources describing proper technique. Given the recent shift to competency-based education and push to move education out of the classroom and into clinical environments, we have created a tool to facilitate peer-based teaching and feedback of clinical skills in real time. Summary of work: Our student-led initiative is a mobile, web-based tool to aid in peer-to-peer observation and feedback in clinical settings. It contains assessment forms for specific physical exams enabling students to observe each other performing physical exam maneuvers. The tool then emails the student with immediate, objective feedback. It also contains a multimedia-rich resource for learning physical exam

skills. The tool was piloted with medical students in their preclinical years to assess for uptake and perceptions. Summary of results: The tool was extremely well received by administrators and students and has now been integrated into the preclinical curriculum. Since its introduction, the tool has seen consistent use, increasing prior to examinations. Conclusions: This novel tool addresses the need for competency-based assessment of clinical skills training in medical education, while encouraging students to learn in the clinic instead of the classroom. In the future, this tool could be used to formally track students' competency in clinical skills. Advanced layers of content could also be added to increase yield for senior medical students and residents.

Take-home messages: Our tool provides a new way for students to learn and practice clinical skills by enabling real-time observation and feedback in a user-friendly, easily accessible format.


The 3 'E's - ethics, education, elearning

MaxSchofield (KCL, KCLSOM, London, United Kingdom) Natashja Kasianczuk (KCL, KCLSOM, London, United Kingdom)

Qasim Ali (KCL, KCLSOM, London, United Kingdom) Sabrina Jiwani (KCL, KCLSOM, London, United Kingdom) Samuel Evbuomwan (KCL, KCLSOM, London, United Kingdom)

Elizabeth Chamberlain (KCL, KCLSOM, London, United


Background: The inter-disciplinary Student Clinical Ethics Committee at King's College London School of Medicine welcomes members from all healthcare disciplines. Ethical issues arising in cases referred by clinical year students are discussed at monthly meetings and case summaries are disseminated online. In order that SCEC members are confident in discussing complex ethical and legal issues, and to demonstrate core competencies, an e-learning module has been created in collaboration with Faculty and SCEC members. This enables potential SCEC members to work through key ethical and legal issues frequently arising in clinical cases discussed by the SCEC.

Summary of work: Student members of SCEC identified topics frequently discussed at SCEC meetings and created self-contained 'modules' which students can work through to promote knowledge and understanding. Topics include capacity, best interests, consent/refusal, mental health, autonomy and beneficence in end of life care. The e-learning modules utilise film clips, newspaper stories and podcasts to create a dynamic multi-media format. Previous clinical cases discussed by the SCEC are used to illustrate relevant ethical and legal issues. Summary of results: The e-learning module has been piloted with a student led focus group and positive feedback has been received from the School of Nursing and Midwifery.


Conclusions: The ethics e-learning module is an effective method to provide ethics learning to students wishing to become members of the SCEC. It has the potential to be used by medical and other healthcare students to support ethics learning in an innovative way using clinically relevant case scenarios. Take-home messages: The importance of student involvement in developing learning materials.


Preparing for practice using a self-directed approach to learning from virtual patients: A randomised trial of the effect on clinical performance

Rikke Malene H G Jepsen (Rigshospitalet, University of Copenhagen, Center for Clinical Education (CEKU), Afsnit 5404, Teilumbygningen, Blegdamsvej 9, Copenhagen 2100, Denmark)

Martin Gr0nnebaek Tolsgaard (Rigshospitalet, University of Copenhagen, Center for Clinical Education (CEKU), Copenhagen, Denmark)

Maria Birkvad Rasmussen (Rigshospitalet, University of Copenhagen, Center for Clinical Education (CEKU), Copenhagen, Denmark)

Lars Kayser (University of Copenhagen, Faculty of Health and Medical Science, Copenhagen, Denmark) Uno Fors (Stockholm University, Department of Computer and Systems Sciences, Stockholm, Sweden) Charlotte Ringsted (University of Toronto and University Health Network, The Wilson Centre, Toronto, Canada)

Background: Virtual Patients (VPs) are reported to have effectiveness at least similar to traditional teaching methods and have many advantages. The traditional way of using VPs is by having students work on teacher prepared cases. Yet, recent studies suggest that engaging students in preparing cases are both feasible and valuable. However, learning from preparing VP cases has received little attention. Although training on VPs is considered to prepare for meeting real patients, little is known about transfer of skills to clinical performance. The aim of this study was to compare the effect of engaging students in preparing VP cases compared to solving teacher-prepared cases measured by learning in terms of theory (MCQs) and transfer of skills to clinical performance.

Summary of work: A voluntary sample of 34 medical students, without prior clinical experience, was randomized to either creating or solving four virtual patient cases in Web-SP. Learning outcome was measured by MCQ tests (95 questions) before and after working with VPs and a patient encounter skills-test in terms of obtaining history and performing physical examination on two standardised patients. Students' performances were video-taped and assessed using a previously validated scoring form, structured according to RIME categories (Reporter, Interpreter, Manager, and Educator). Finally, students' reactions to the training formats were compared.

Summary of results: Data-analysis is in progress, will be presented at AMEE 2013.

Conclusions: At AMEE 2013 we present the results of Take-home messages: The use of medical students to

MCQ tests, patient encounter skills-tests, and students' create and devise educational resources should be

reactions for two groups of medical students, working strongly encouraged.

with self- or teacher-prepared VP cases.

Take-home messages: Will be presented at AMEE 2013.


Peer learning - exploring resource creation with videos

DS Furmedge (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

A Samways (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

R Kumaria (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

E Collinson (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

S Clark (University College London Medical School, Academic Centre for Medical Education, London, United Kingdom)

A Sturrock (University College London Medical School, Academic Centre for Medical Education, Holborn Union Building 417, Highgate Hill, London N19, United Kingdom)

Background: Each year UCL Medical School runs an 'introduction to medicine' program of peer-assisted learning for students beginning their 'clinical' years. As part of this program peer facilitators undertake an education based project aimed at improving education for students in more junior years. Summary of work: As a pilot, peer facilitators produced short videos for students beginning hospital placements. The videos were designed, written and filmed by the facilitators and included topics such as 'writing in a patient's clinical record' and 'around the patient bedside'. The videos were uploaded onto the medical school virtual learning environment for student use before clinical placement. Students were surveyed with regard to the value of the videos. Summary of results: Evaluation of the videos was positive. 84% felt that the videos were of high quality, 86% wanted more similar videos to be produced and 86% felt that benefit was gained by the videos having been produced by other students. Numerous suggestions for other desirable videos were made. The use of more senior medical students in developing these videos created resources which were valued and have been incorporated into the medical school teaching. Students felt that value was added by the fact that these had been created by medical students rather than faculty.

Conclusions: The use of senior medical students to create teaching videos has been an overwhelming success. The medical school has been encouraged to enable more similar videos to be produced.


SESSION 6: Plenary 2

Tuesday 27 August: 0830-1015

6A Plenary: Connecting medical education and patient care in the 21st century

Location: Congress Hall, PCC

Victoria Brazil (Bond University, Gold Coast, Australia)

Summary: Impressive advances in medical education have occurred through technology, global collaboration and the involvement of professional educators. These have the potential to make healthcare education more effective, efficient and less costly. However there is a risk that these advances may move medical education (and learners) further from direct patient care, and from other agendas in health - resource stewardship, health service improvement and workforce needs. This presentation will look at two critical roles for medical education in the 21st century - aiming for a different 'end point' in the 21st century doctor, and reforming processes to achieve that aim, including returning patients to the centre of the educational process.

Biography: Victoria Brazil is an emergency physician and medical educator. She is a senior staff specialist at Royal Brisbane and Womens Hospital in Brisbane, Australia, where she has worked in clinical emergency medicine practice, and at the 'coalface' of teaching, since 2002. Dr Brazil is also an Associate Professor within the School of Medicine at Bond University on the Gold Coast, where she is Theme Lead for Doctor as Practitioner. She was previously the inaugural Director of Queensland Medical Education and Training (QMET), within Queensland Health. This role encompassed medical education and workforce policy and strategy, across the continuum of medical learners. She is a previous Fulbright scholar (2002) and received the ACEM Teaching Excellence award in 2008.

6B Plenary: "See One. Taste One. Make One. Teach One." Enhancing Medical Education in an Era of Global Obesity and Diabetes

Location: Congress Hall, PCC

David Eisenberg (Harvard School of Public Health, Boston, United States)

Summary: Recognizing that a healthcare professional's personal behaviors (e.g. exercise, diet, seat belts) are strong predictors of their advising patients about these same behaviors, how best to "teach the teachers" to lead by example? And how shall we "translate" decades of nutrition science, behavioral and addictions medicine, exercise physiology, health coaching and mindfulness training into meaningful educational platforms for healthcare professionals and their patients? How can relevant self-care, behavioral skills be judiciously incorporated into medical education programs which now need to include health promotion as well as disease diagnosis, treatment and management? David Eisenberg will summarize work jointly developed by colleagues from Harvard, The Samueli Institute and The Culinary Institute of America, to showcase new educational approaches which combine didactic elements with "experiential learning" to transform practitioners, so that they, in turn, will be more effective healthcare providers.

Biography: David M. Eisenberg is Associate Professor of Nutrition at the Harvard School of Public Health and Executive Vice President for Health Research and Education at the Samueli Institute. He is a graduate of Harvard College and Harvard Medical School and is Board Certified in Internal Medicine. From 2000-2010 Dr. Eisenberg served as the founding Chief of the Division for Research and Education in Complementary and Integrative Medical Therapies at Harvard Medical School. He currently directs the educational conference, "Healthy Kitchens, Healthy Lives - Caring for Our Patients and Ourselves" which is co-sponsored by Harvard and the Culinary Institute of America. His current educational and research interests include the development and assessment of novel, multi-disciplinary strategies to optimize lifestyle and self-care behaviors (e.g. diet, exercise and stress management) to prevent, treat and manage common medical conditions.

SESSION 7: Simultaneous Sessions

Tuesday 27 August: 1045-1230

7A Symposium: Assessing competencies using milestones along the way

Location: Congress Hall, PCC

Ara Tekian (University of Illinois at Chicago, USA) Brian Hodges (The Wilson Centre, University of Toronto, Canada)

John Norcini (FAIMER, Philadelphia, USA)

Trudie Roberts (Leeds Institute of Medical Education,


Lambert Schuwirth (School of Medicine, Flinders University, Adelaide, Australia)

During the past decade, a great emphasis has been placed on outcome based education. Many programs, both at undergraduate and postgraduate levels, have created "competencies" that summarize the fundamental knowledge, skills, and abilities that are required for the successful completion of a program. Furthermore, "milestones" are articulated to monitor and measure the progress of a person. This symposium will explore the different interpretations and misinterpretations of "competencies" and "milestones", debate their application and usefulness in health professions education, and probe the controversies inherent in measuring them. These concerns will be examined through the European, American, Canadian and Australian perspectives.

7B Symposium: Learning to Lead: Pearls

and Practical Insights for Future Leaders

in Academic Medicine Location: Meeting Hall I, PCC

Emery Wilson (University of Kentucky, USA) Carol Elam (University of Kentucky, USA) Frank Simon (Foundation for the Advancement of International Medical Education and Research, USA) Walter Ricciardi (Catholic University of the Sacred Heart, Institute of Hygiene and Public Health, Italy)

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