AMEE
2003
Relevance in
Medical Education
31st August – 3rd September 2003
Faculty of Medicine,
University of Bern, Bern, Switzerland
President:
Professor M Barón-Maldonado
General Secretary:
Professor R M Harden
Administrator:
Mrs Pat Lilley
AMEE Office
University of Dundee
Tay Park House
484 Perth Road
Dundee DD2 1LR
Scotland, UK
Programme and Abstracts
Tel:
+44 (0)1382 631953
Fax:
+44 (0)1382 645748
E-mail: amee@dundee.ac.uk
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AMEE 2003
Relevance in Medical Education
31st August – 3rd September 2003
University of Bern
Switzerland
Programme & Abstracts
in collaboration with
University of Bern, Switzerland
Association for Medical Education in Europe
Tay Park House, 484 Perth Road, Dundee DD2 1LR, Scotland, UK
Tel: +44 (0)1382 631953 Fax: +44 (0)1382 645748
email: amee@dundee.ac.uk http://www.amee.org
–i–
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– ii –
Contents
Welcome from the Dean of the Faculty of Medicine ..
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Welcome from the University of Bern Medical Students
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Organising Committees
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Conference Sponsor ..
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Bern: travel and accommodation ..
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.. 1.1
General information
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.. 1.2
Information about the Conference venue ..
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Registration
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.. 1.5
Information on the Academic Programme
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Information on short communication sessions
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Information on poster sessions
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Information on conference workshops
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Exhibition ..
Section 1: General Information
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Programme Overview
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Personal diary
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Maps and plans ..
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Section 2: The Conference Programme
Sunday 31 August ..
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.. 2.1
Monday 1 September
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Tuesday 2 September
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Wednesday 3 September ..
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.. 2.66
Section 3: Accommodation, Social Programme and Tours
.. 3.1
Section 4: Abstracts
.. 4.1
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– iii –
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– iv –
Welcome
We look forward to welcoming you to Bern. We have tried to make this programme and abstract
book as comprehensive as possible, and to provide all the information you may need. Please take
some time to read through it. If you have any questions the AMEE Office will be pleased to help.
Welcome by Dr Emilio Bossi, Dean of the Faculty
The Faculty of Medicine at the University of Bern as co-host of the AMEE03 Annual Conference
extends its warmest welcome to the participants. The Faculty is pleased and honoured that you
have chosen Bern as the venue for your Conference.
As you can see from the little brochure in your Conference kit, medical education has a long
tradition in Bern. At the same time we are actively participating in shaping the future of medical
education.
We hope that you feel comfortable in our city and its beautiful surroundings, that you have ample
opportunity to extend your professional network, that you can profit from the rich academic offerings,
and above all that you leave our city with a warm glow.
Welcome by the Medical Students of Bern
grüezi, bienvenuto, bienvenue, welcome, bienvenido, dobro poschalovatj, khosch-amedid...
We warmly welcome you on behalf of the medical students of Bern to the amee03 Conference. As
you will be scientifically satisfied by the official conference, we would like to welcome you to the
entertaining part. That’s why we just say: let us take care of you during the stay!
We know where you can sleep for free, show you Bern’s nightlife, take you to the wonderful Aareriver, invite you to the hottest amee03-party ever seen and know where you can get good and
cheap food. Those who stay till Thursday will experience an unforgettable bicycle-tour through the
surroundings of Bern.
So don’t forget to bring your swim-suit, party mood, aspirin (if needed), camera and lots of energy…!
Do you need anything else? Feel free to contact us (j.scherrer@student.unibe.ch or
thidalgo@student.unibe.ch) and have a look on the students’ site of the amee03 homepage to get
further information (http://amee03.unibe.ch/students.htm)
Our phone number during the conference will be: +41 76 502 90 32
We are looking forward to see you in Bern.
Let’s spend a good time together.
See you
Janine and Teresa
–v–
AMEE 2003 Committees
Organising Committee
Ralph Bloch
Peter Schläppi
Peter Frey
Rainer Hofer
Reinhard Westkämper
Christa Beutler (Local Administrator) christa.beutler@iae.unibe.ch
Student Representatives
Teresa Hidalgo Staub
Janine Scherrer
Carmen Wolf
t.hidalgo@student.unibe.ch
j.scherrer@student.unibe.ch
c.wolf@student.unibe.ch
Executive Committee
President:
Margarita Barón-Maldonado (Spain)
Secretary/Treasurer:
Ronald Harden (UK)
Committee:
Ralph Bloch (Swizerland)
Herman van Rossum (Netherlands)
Florian Eitel (Germany)
Madalena Patrício (Portugal)
Graham Buckley (UK)
Coopted member:
Ioan Bocsan (Romania)
Ex officio:
Hans Karle (WFME)
Jorgen Nystrup, Past President (Denmark)
Administrator:
Pat Lilley
Admin Assistant:
Tracey Martin
Conference Sponsor
AMEE is most grateful to the University of Bern for its support, and in particular for providing free
use of the Conference accommodation and equipment.
– vi –
Section 1
Bern: Travel and Accommodation
Travel
Bern is a compact city and most hotels are within walking distance of the University, the Kultur
Casino (where the opening ceremony and plenary sessions take place), the railway station, shops
and most other facilities that participants are likely to need during their stay.
Bern is served by an excellent road and rail network, the railway station being in the centre of the
city. It also has a small airport about 8 km from the city. Zurich or Geneva airports are within easy
reach of Bern, with a regular train service. There is a railway station at both airports, with many
direct trains to Bern. The journey time from Zurich airport (Flughafen) takes about 90 minutes, with
trains approximately every 30 minutes at peak times. From Geneva Airport the journey time is
approximately 2 hours and direct trains run hourly.
For rail timetables and fares information please see the SBB Swiss Federal Railway site:
http://www.sbb.ch/pv/index_e.htm
Accommodation
Bern Tourismus has reserved accommodation in a wide range of hotels and a youth hostel.
Participants still requiring accommodation should complete Form C (available in the provisional
programme or for download from the AMEE web site www.amee.org) and return it to Bern Tourismus
as soon as possible. No deposit is required although a credit card number is requested to guarantee
the booking. Depending on the hotel, you will be asked either to pay in advance or on check out.
Confirmation of booking will be sent as soon as possible.
Cancellation and changes to accommodation bookings made by Bern Tourismus: All
changes should be notified to Bern Tourismus and not to the hotel. At least 48 hours’ notice of
cancellation is required or one night’s accommodation may be charged. To guarantee rooms for
late arrival (after 1800 hrs) please telephone the hotel direct one or two days before your arrival
date.
A representative of Bern Tourismus will be available by the AMEE registration desk at certain times
throughout the Conference for bookings and advice on tours and accommodation. Participants
who need assistance in advance of the conference should contact:
Bern Tourismus
PO Box
CH-3001
Bern
Switzerland
Tel: +41 31 328 12 28
Fax: +41 31 328 12 99
email: info-res@bernetourism.ch
A map of Bern and the surrounding area showing Conference hotels is available on the University
of Bern AMEE Conference website: http://amee03.unibe.ch/accommodation.htm
– 1.1 –
Section 1
General Information
Please check the AMEE website from time to time (www.amee.org) for Conference updates. The
University of Bern AMEE Conference website contains some useful local information:
http://amee03.unibe.ch
Passports and Visas
A passport valid for the duration of your stay is required for all visitors to Switzerland. Please contact
the Swiss Embassy in your country to determine whether a visa is necessary. The Swiss Embassy
in London has some useful travel information: www.swissembassy.org.uk/ A letter of invitation to
support visa application can be provided by the AMEE Office on request.
Credit Cards and Currency Exchange
The currency in Switzerland is the Swiss Franc (CHF), although some hotels, restaurants and
shops may accept payment in Euros. As a rough guide, the exchange rate at end June is 1 Euro
= 1.5 CHF; £1 sterling = 2.2 CHF; US$1 = 1.3 CHF. Visa, American Express and Mastercard are
widely accepted. Bank opening hours are: Monday-Friday 0800-1800 (eg, Berner Kantonalbank,
Bundesplatz). Currency exchange is available (eg at Railway Station) on Monday-Friday from
0700-2000, Saturday 0700-1900 and Sunday 0900-1900.
Climate
Bern enjoys a Central European continental climate. Likely daytime temperatures at the time of the
Conference are 20-25oC.
Electrical Supply
220 volts.
Smoking Policy
No general regulations apply about smoking in public places in Switzerland. However, the
Conference venues including the lunch tents are strictly non-smoking areas.
Language
All conference sessions will be in English.
Gratuities
Usually already included in the price charged in restaurants, bars, taxis etc. An additional amount
is always welcome for exceptional service.
CME accreditation and certificates of attendance
The UK Royal Colleges have awarded the Conference 20 CME points. A register of attendance will
be available to sign, and certificates of participation will be ready for collection on Wednesday
morning at coffee time.
– 1.2 –
Section 1
Disabled participants
Participants with disabilities are asked please to contact the AMEE Office in advance of the conference
so that appropriate arrangements may be made.
Where to Eat
Information on local bars and restaurants is available at the AMEE registration desk. A wide range
of fast-food outlets can be found in the Railway Station (Bahnhof) concourse, open every day.
From the University main building turn right and take the elevator from Uniterasse to the bottom
level.
– 1.3 –
Section 1
Information about the Conference venue
Where the Conference will take place
All sessions, will take place at the University of Bern (see map of Bern on page 1.19) except
for the opening ceremony and the plenary sessions which will be held at Kultur Casino.
University of Bern
Address: University of Bern
Hochschulstrasse 4
CH-3012 Bern
Phone: +41 (0)31 632 49 56 (Christa Beutler)
Email:
christa.beutler@iae.unibe.ch
Directions:
On foot:
From the Railway Station (Bahnhof) – train subway area track 13 – take the elevator at
the end of the hall to the top level (“Uniterasse”) and turn right. You will arrive in front of
the main building (total time 3 minutes).
By bus:
From the front of the Railway Station take bus no 12, direction “Langgasse”. Walk back
through the little park and arrive at the rear of the main building (total time 5 minutes).
Kultur Casino
The opening ceremony (Sunday evening) and the plenary sessions (Monday morning before
coffee break and Wednesday all morning) will take place at Kultur Casino (map page 1.19):
Address: Kultur Casino
Herrengasse 25
CH-3011 Bern
Directions:
On foot:
From the Railway Station, take Spitalgasse, then Marktgasse. Turn right at Zytglogge
(the old clock tower) into Theaterplatz. You will arrive at the front of the Kultur Casino
(total time 8 minutes).
By tram:
From the Railway Station, take tram no 3 (direction “Saali”) or no 5 (direction “Ostring”),
to “Zytglogge” (total time 4 minutes).
Please note that because Bern is a small and compact city, no coach transport has been arranged
between hotels and the two conference venues. A BernMobil Pass providing free transport on
buses and trams for three days will be provided for participants and registered accompanying
persons.
– 1.4 –
Section 1
Registration
Registered participants should collect their conference packs from the following locations:
Date
Time
Location
Saturday 30 August
1200-1700
University of Bern
Sunday 31 August
0830-1600
1800-2100
University of Bern
Kultur Casino
Monday 1 September
0730-0900
1030-1730
Kultur Casino
University of Bern
Tuesday 2 September
0800-1800
University of Bern
Wednesday 3 September
0800-1330
Kultur Casino
Please note: It is highly unlikely that we will be able to accept onsite registrations as the
conference is fully subscribed.
Conference noticeboard and messages
Please check the noticeboards for personal messages and conference updates.
Email and phone contact
Messages for the AMEE Secretariat and for conference participants may be sent care of Christa
Beutler:
Tel: +41 (0)31 632 49 56
email: christa.beutler@iae.unibe.ch
Participants may log in to their email in the Room -302 Juristische Bibliothek (Library – 3 floors
down) – see location on plan on page 1.20. Please note that a password will be necessary, and this
will be provided in your registration pack. Access will not be available on Sunday between
0830-1230 when the room is being used for a workshop.
Conference evaluation
A general evaluation form as well as individual workshop evaluation forms are in the conference
packs. Please complete and return them either to the Registration Desk or by fax/mail to the AMEE
Office after the Conference.
– 1.5 –
Section 1
Information on the Academic Programme
Please see the programme overview on pages 1.12-1.17. All sessions take place at the University
except for the plenaries.
Pre-conference workshops
Morning, afternoon and full-day workshops will take place on Sunday 31 August. All are fully booked,
and admission is strictly by ticket only. Tickets will be included in the conference packs of those prebooking these workshops. Coffee is provided morning and afternoon, but lunch is not provided. A
range of fast-food outlets can be found at the Railway Station – see directions on page 1.3. Please
see overview on page 1.13 for workshops and rooms.
Plenary sessions
Three plenary sessions are scheduled and will take place at Kultur Casino (map page 1.19) on
Monday 1 September from 0830-1000, and on Wednesday from 0830-1300.
Large group sessions and short communications
Five simultaneous large group sessions are scheduled for Tuesday 2 September from
0830-1000. At the same time three short communications sessions will take place. Please see
page 1.14 for details of sessions and locations.
Short communications
Four short communications sessions are scheduled on Monday and Tuesday, each with multiple
themed groups, and some short communications will also take place at the same time as the large
group session. Please see page 1.14 for details of sessions and locations. Each session will have
a chairperson and an opening discussant. We have tried very carefully to group relevant
presentations together and encourage you to stay for a whole session and take part in the discussion
at the end. Each presenter has been allocated a 10 minute presentation followed by 5 minutes for
discussion. A 15 minute period has been allocated at the end of most sessions for a general
discussion, led by the opening discussant.
Poster sessions
AMEE regards posters as a very important part of the Conference. From the presenter’s point of
view posters give maximum exposure, being available throughout the Conference. For the observer,
posters may be viewed and re-viewed at leisure. Additionally there is the option of discussing the
main features with the presenter during the presentation session or at other times.
Poster sessions will take place by the poster boards on Tuesday 2 September from 1510-1640
hrs and all participants are invited to attend. Posters will be set up in themed groups each consisting
of between 12-18 posters. See the plan on page 1.15 with details of sessions and location of poster
boards. Each poster group will have a chairperson who will lead the group around the posters and
invite discussion. Each presenter should highlight the key points of his/her poster.
– 1.6 –
Section 1
Information on Short Communication Sessions
Information for the presenter
Presentation viewing area: Room 104 may be used for checking OHPs and for consultation with
IT staff on PowerPoint presentations.
Slide projection: Please note that slide projection is not available in any of the rooms.
OHPs: An overhead projector is available in every presentation room.
Computer projection: A data projector/beamer and a computer are available in every presentation
room. In the interests of time and efficiency we request that you use the computer provided rather
than your own laptop. All computers are equipped with Win and Office XP with PowerPoint 2002.
Please follow the following instructions:
• Save your presentation in PowerPoint 2002 (or in an older/lower version);
• Bring it on a CD-ROM clearly marked with your name and session/presentation number, or on
a USB memory stick, for loading onto the computer in the appropriate room. Floppy drives
and Zip drives are not available;
• Arrive in the room where your presentation is scheduled 30 minutes before the start of the
session to have your presentation loaded onto the computer.
• Introduce yourself to the chairperson at least ten minutes before the scheduled start of the
session.
• keep strictly to the time allotted for your presentation. The chairperson will remind you when
your time limit has expired and will then ask the audience for questions;
• Please speak slowly and clearly;
• Ensure your OHPs/screens are clear, that there is not too much text to read in the limited time
available and that the type is large enough to be legible for those sitting at the back of the room;
• Whilst not obligatory, a single page handout, giving the key messages from your presentation,
is always appreciated. As a rough indication you could expect between around 50-100 participants
in the audience.
Information for the chairperson
• Before the session starts, check that the presenters and opening discussant are present;
• Introduce each speaker according to the programme, and tell him/her when the allotted 10
minute presentation period is over (a timer will be provided);
• Allow 5 minutes for discussion between presentations;
• If a speaker is not present, arrange for the 15 minute period to be used for further discussion;
the next presentation should not start until the scheduled time;
• Ask the opening discussant to lead off the discussion at the end of the session;
• Draw the session to a close and thank participants.
Information for the opening discussant
• Following all the presentations, introduce the topic in the context of the papers presented and
highlight some of the key points arising from the papers that might be addressed in the discussion
that follows. This introduction should take no more than 4 minutes.
• Invite comments from participants and lead off a group discussion.
– 1.7 –
Section 1
Information on Poster Sessions
Information for presenter
Mounting your poster: Posters should be maximum height of 120 cm and maximum width of
95 cm (ie portrait). Fixings will be provided. Each board will be marked with the number and title of
the poster, which may be found on pages 2.34-2.57 of this programme. Posters may be mounted
from 1200 hrs on Saturday 30 August and should be removed by 1300 hrs on Wednesday 3
September.
Tips for preparing posters:
• The poster should be eye-catching, attractive and not cluttered with unnecessary information. It
should communicate well the key messages. Colour and different type styles should be used
judiciously in order not to detract from the content.
• Content: The poster should have a logical sequence and be understandable by non-experts
in the field, with any abbreviations initially explained.
• Title: The title should be clear enough to read from 5m, with letters approximately 5cm high.
• Text: The text should be laid out attractively, using a range of font sizes. The smallest type
should be legible from at least 1m. Consider using bullet points as appropriate. Graphical
representation is preferable to large amounts of text.
• Figures and photographs: Should be of good quality and large enough to be visible from
1m. Figures and tables should have legends that give adequate explanation.
Contact details: Full contact details for further information should be included, with an email
address wherever possible.
Handouts: Participants appreciate a handout of the key points of your poster. These could be put
into a folder or envelope attached to the poster board.
Further information: You may wish to attach to your board a note of times throughout the
Conference when you will be available for discussion.
Information for chairperson
• Arrive by the poster boards relating to your session at least 10 minutes before the scheduled
start and check presenters have arrived;
• Lead the group around the posters and ask each presenter to introduce him/herself and the key
messages of his/her poster;
• Invite comments/questions from the group.
• Note: based on an average of 15 posters in each session, 6 minutes per poster has been
allowed.
– 1.8 –
Section 1
Information on Conference Workshops
Two workshop sessions (4 and 6) – each with simultaneous workshops and groups – are scheduled
for Monday and Tuesday. Please see pages 1.16 and 1.17 for workshop details and locations. In
order to reserve a place at the workshops of your choice, please complete and return the enclosed
workshop selection form to the AMEE Office as soon as possible (form also available on our
website). Participation in most workshops is by ticket only, and these will be included in your
conference pack if you pre-book. Any remaining tickets may be obtained from the AMEE registration
desk on site. Workshop organisers have designed their programmes with a specific number of
participants in mind, and rooms have been allocated accordingly. We kindly request you do not try
to attend without a ticket.
Exhibition
Commercial and academic exhibits may be mounted from 1200-1700 hrs on Saturday 30 August
or between 0800-1600 hrs on Sunday 31 August, at the University of Bern. The exhibits will be
open from Sunday 31 August at 0830 until Tuesday 2 September at 1800 hrs. Participants will be
on site at these times, except between 0830-1030 hrs on Monday.
Commercial Exhibitors
AD Instruments GmbH
ADInstruments develops, manufactures and distributes their PowerLab data acquisition and analysis
systems for use in life science research and teaching. PowerLab is an integrated system of hardware
and software, comprising the PowerLab recording unit with Chart and Scope software. Additionally,
we supply an extensive selection of signal conditioners, transducers and accessories for use in a
wide range of scientific applications. Our data acquisition systems are powerful and flexible research
tools used by scientists in universities and research institutes around the world.
Contact: Miss Paula Croft & Mr Ferdi Oberheinrich, ADInstruments GmbH, Unit 56, Monument Business
Park, Chalgrove, Oxfordshire OX44 7RW, UK
Tel:
+44 1865 891623
Fax:
+44 1865 890 800;
Email: p.croft@adi-europe.com Website: http://www.adinstruments.com
Blackwell Publishing Ltd
Contact: Mrs Anne Weston, Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2Q, UK
Email: Anne.Weston@oxon.blackwellpublishing.com
Gold Standard Multimedia
Gold Standard Multimedia is a leading developer of innovative drug information and medical
education software and online services. Our Integrated Medical Curriculum (IMC) offers an electronic
collection of courseware to support medical school subjects, featuring multimedia animations, audio
and video streaming, interactive quizzes, photos, illustrations and problem-based case studies
with text. Our Clinical Pharmacology drug reference program contains extensive data on US
prescription drugs, over-the-counter, herbal and nutritional products, and its unique medication
management tools, vast drug content coverage, cutting-edge technology, and interactive functionality
have universal appeal for teaching and preparing students for the real-world practice setting.
Contact: Mrs Tanya Thomas, Gold Standard Multimedia, 320 W Kennedy Blvd, Suite 400, Tampa
FL 33606-1412, USA
Tel:
800 375 4747
Fax:
813 259 1585
Email: thomas.t@gsm.com
Website: www.gsm.com
– 1.9 –
Section 1
Immersion Medical
Immersion Medical (Gaithersburg/MD, USA) develops, manufactures, and markets medical
simulators and is the leading company in the segment of computer-based task trainers having
sold more than 650 simulator systems worldwide. These simulators allow medical personnel to
practice even complex procedures in a virtual reality environment that poses no risks to patients
and mistakes do not have dire consequences. Simulators for the training of vascular access
(CathSim®), endoscopic (AccuTouch®) and laparascopic surgical procedures (LapSim® software
from Surgical Science AB, Gothenburg/Sweden, and Immersion’s Virtual Laparascopic Interface)
will be demonstrated.
Contact: Dr Friedrich Gauper, Immersion Medical, Central & Northern Europe, Stettiner-Str. 26, D69514 Laudenbach, GERMANY
Email: FPGimmersion@aol.com Website: http://www.immersion.com/medical/
Kaplan Medical
Kaplan Medical is a unit of Kaplan’s Test Preparation division, offering preparation courses for
licensure exams for U.S. Medical students, International Medical Graduates, and Nursing, Dental,
and Pharmaceutical students. With more than 30 years of experience, Kaplan Medical programs
are focused on providing high-yield, exam-relevant review. The classroom-based USMLE courses
utilize U.S. medical school faculty and practitioners who are acclaimed lecturers in their respective
fields. The online courses allow students flexible access and customizable exams. As the world
leader in test preparation, Kaplan Medical also creates review and curriculum tools for Institutional
use.
Contact: Mrs Cheri Julien, Kaplan Medical, 820 West Jackson, Suite 550, Chicago, IL 60612, USA
Tel:
305-361-1103
Email: Cheri_Julien@kaplan.com Website: www.kaplanmedical.com
Kyoto Kagaku Co Ltd
Kyoto Kagaku is a manufacturer of anatomy models and medical training simulators in Japan. Our
products are utilized in nursing schools and medical schools. We exhibit various kinds of simulators
for medical education. Simulator “K”, Cardiology Patient Simulator, offers the practice in auscultation
of cardiac diseases (99 findings) and palpation. LSAT, Lung Sounds Auscultation Trainer, allows
you to improve the skill of auscultation of lung sounds. In addition, we will demonstrate simulators
for injection training and prostate examination, and exhibit phantom that has an image close to
human chest in radiography.
Contact: Mr Toshiyuki Takayama, Mr Tamotsu Katayama, Mr Hiroyuki Yamauchi and Mr Mikinori
Ishioka, Kyoto Kagaku Co. Ltd, 35-1 Shimotoba Watarise-cho, Fushimi-ku
Kyoto 6128393, JAPAN
Tel:
81 75 605 2520;
Fax:
81 75 605 2529
Email: t_takayama@kyotokagaku.co.jp Website: http://www.kyotokagaku.co.jp/english/
Limbs & Things
Limbs & Things supplies training and demonstration materials for healthcare professionals,
incorporating synthetic soft tissue models, multimedia training systems and a design and build
service. Our products and services have been specifically designed for ‘hands-on’ structured and
staged clinical, surgical and medical skills training. They offer variation in anatomy, and provide for
increasing levels of technical and procedural difficulty, meeting the needs of education and trainees.
Contact: Mr Nick Gerolemou and Mr Alex Halliday , Limbs & Things Ltd, Sussex Street, St Phillips,
Bristol BS2 0RA, UK
Tel:
+44 117 311 0500
Fax:
+44 117 311 0501
Email: joanne.spicer@limbsandthings.com
Website:
www.limbsandthings.com
– 1.10 –
Section 1
Academic Exhibitors
Association for Medical Education in Europe (AMEE)
Association for the Study of Medical Education (ASME), UK
Association of Health Care Professionals (AHCP), UK
Best Evidence Medical Education (BEME)
British Heart Foundation Harvey Project, UK
Centre for Medical Education, University of Dundee, UK
Harvard Medical International (HMI), USA
International Association of Medical Science Educators (IAMSE), USA
International Medical University, Malaysia
IVIMEDS – An International Virtual Medical School
Medical Teacher, UK
National Association of Clinical Tutors (NACT), UK
National Board of Medical Examiners (NBME), USA
Ottawa Conference Barcelona 2004
South African Association of Health Educationalists (SAAHE), South Africa
New York University School of Medicine, USA
The Network: Towards Unity for Health, Netherlands
University of Bern, Switzerland
University of Wales College of Medicine, UK
World Federation for Medical Education (WFME), Denmark
– 1.11 –
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Section 1
Programme Overview
Date
Time
Session No
Session type
Location
–
–
Pre-conference workshops
Special Interest Group Session
Opening Ceremony
University
University
Kultur Casino
1
Plenary 1
Coffee
Kultur Casino
University – Tent
2
Short communication 1
Lunch
University
University – Tent
3
Short communication 2
Coffee
University
University – Tent
4
Workshops 1
William Tell evening (optional extra)
University
5
Large Groups
Coffee
University
University – Tent
6
Workshops 2
Lunch
AMEE AGM lunch
University
University – Tent
7
Short communication 3
Coffee
University
University – Tent
8
Poster sessions
University
9
Short communication 4
Conference Dinner (optional extra)
University
Kursaal
10
Plenary 2
Coffee
Kultur Casino
Kultur Casino
11
Plenary 3
Kultur Casino
– 1.12 –
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0930-1700
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0930-1700
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0930-1230
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0930-1230
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0930-1230
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0930-1230
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0930-1230
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0930-1230
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1400-1700
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0930-1230
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0930-1230
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1400-1700
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PCW12a
0930-1230
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PCW13
1400-1700
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PCW14
1400-1700
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PCW15
1400-1700
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PCW16
1400-1700
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PCW17
1400-1700
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PCW18
1400-1700
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Section 1
Pre-Conference Workshops
Workshop
Time
Sunday 31 August: 0930-1700 hours
Title
Room (University)
Finding and appraising evidence in
medical education
am: -302 (Juristische Bibliothek)
pm: 212
Preparing tomorrow’s educators for leadership
roles in the health professions: an interactive,
participatory workshop
105
Basic faculty skills
204
Mobile computing and medical education
115
Why offer early clinical experience in
undergraduate medical education?
331
Evaluation of medical education –
methodological implications of new technologies
215
Setting defensible performance standards on
OSCEs and clinical skills examinations: a user’s
guide from A to Z
304
Designing Study Guides
212
Vertical integration in the medical curriculum
331
Using computers to prepare students for ‘real’
clinical experiences
106
Designing multiple choice questions that serve
a purpose
214
Fostering and assessing medical professionalism:
challenges and strategies
208
Fostering and assessing medical professionalism:
challenges and strategies
208
Clinical evaluation exercises (MINI-CEX): how to
improve oral examinations in medical practice
304
Developing learning objectives catalogues
214
Making small group teaching work
215
Programmatic evaluation – how to evaluate your
course/clerkship
106
Enhanced faculty skills
204
E-learning – what do I need to know about it to
get started?
115
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Section 1
Postgraduate Special
multiprofessional subjects in the
curriculum
education
Is the
graduate
competent?
Note: all of the above are short communications, with the exception of the five large groups in Session 5.
* Please note room change for this session only
Rewarding
teaching
Patient
simulation
Courses for
medical
teachers
Clinical
training –
Leonardo
project
Assessment CPD needs
and delivery of assessment
postgraduate
education
Session 9
Computer
based
teaching
Short
Comm 4
Tuesday
1315-1445
Session 7
Short
Comm 5
Tuesday
1645-1800
Curriculum 2
Computers in Assessing
the curriculum communication
skills
Curriculum 1
Final exam
Large Group :
Cognitive
perspective on
learning:
Implications
for teaching
Large Group :
Standard
Setting
Large Groups
and Short
Comm 3
Tuesday
0830-1000
Session 5
– 1.14 –
Student
support
Student
Different
approaches to diversity
staff
development
(Room 304)*
Assessment
of the
practising
doctor
Postgraduate
training in the
early years
Large Group :
Making
medical
education
relevant to
medical
practice
Large Group :
BEME review
of high fidelity
simulation
Training and
Assessment
for GP/FM
Curriculum
planning 2
Virtual learning Computer
environment based
assessment
Short
Comm 2
Monday
1330-1515
Session 3
Continuing
Professional
Development
Large Group:
Complex
Adaptive
Systems and
Medical
Education
Teaching and International
medical
learning
communication education 2
skills
Short comm:
Postgraduate
Assessment
Assessment
of teaching
Short comm:
Communitybased
education
OSCE2
Short comm:
Student
learning
PBLand
computers
Evaluation of Management
problem based of clinical
training
learning
Clinical
training in
different
settings
Progress Test Clinical
Teaching and
the Patient
Professionalism Outcome
based
2
education
Professionalism The Core
1
Curriculum
Undergraduate Research and Selection
Multiprofessional Critical
education
Thinking
Clinical Skills
Training
Problem based Teaching and
learning
assessing
attitudes
Staff
OSCE1
development –
training needs
International
medical
education 1
Teaching
and learning
Curriculum
evaluation
Curriculum
planning 1
Examiner’s
toolkit
E-learning
Short
Comm 1
Monday
1045-1230
Session 2
Room
Room
210
A
Room
110
B
Room
201
C
Room
220
D
Room
205
E
Room
101
F
Room
120
G
Room
215
H
Room
114
I
Room
106
J
Room
206
K
Room
105
L
Room
115
M
Room
304
N
Short Communications/Large Group Sessions Overview
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8A
Assessment General
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8B
Clinical Assessment
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8C
The Curriculum (1) (including Multiprofessional Education)
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8D
The Curriculum (2)
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8E
Evaluation of the Curriculum
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8F
Teaching Clinical Skills (1)
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8G
Teaching Clinical Skills (2)
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8H
International Medical Education
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8I
Problem Based Learning
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8J
Postgraduate Education
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8K
Staff Development
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8L
Students
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8M
Teaching and Learning (1)
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8N
Teaching and Learning (2)
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8O
E-learning and the Internet
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8P
Computer Assisted Learning
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8Q
Learning Management Systems and Computer Based Assessment
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8R
Continuing Professional Development
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8S
Management and Selection
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8T
Outcomes, Professionalism, and Research and Critical Thinking
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Poster Sessions
Session
Section 1
Tuesday 2 September: 1510-1640 hours
Title
– 1.15 –
Location of Boards
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
Dome/Kuppelsaal, 5th Floor
2nd Floor, East Corridor
2nd Floor, East Corridor
Foyer of Dome, 4th Floor
2nd Floor, West Corridor
2nd Floor, West Corridor
1st Floor, East Corridor
1st Floor, West Corridor
1st Floor, West Corridor
Foyer of Dome, 4th Floor
1st Floor, East Corridor
Foyer of Dome, 4th Floor
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4.1
‘A doctor who knows only Medicine doesn’t even know Medicine’.
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Teaching
ethics and attitudes: a global challenge for medical education
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4.2
Why fix assessment?
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4.3
Learning in the new job: how to maximise educational opportunities in
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shifts and other new patterns of working
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4.4
Depression in clinical practice: educating medical students and primary
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care physicians
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4.5
Trials, tribulations and triumphs: supervising a dissertation in
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medical
education
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4.6
Peer teaching
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4.7
Usability in computer-assisted learning programmes
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4.8
Assessing PBL group activity
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4.9
Scenarios for PBL on the web – triggers for learning
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4.10
Creating cases to promote integration into undergraduate medical education
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4.11
IFMSA Student workshop: Outcome-based education
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4.12
Developing a teaching or examination event using Simulated Patients:
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form
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4.13
Assessment methods – what works, what doesn’t
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4.14
Scenario-based teaching and learning – an innovative and relevant
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concept
in medical education
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4.15
Verbal reflection-on-action as a tool in consultation training
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4.16
Central and East European/Eurasian Taskforce – local issues
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4.17
Professionalism – large group
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4.18
Using a Collaborative Work Space in a rich media educational
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environment
– large group
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Conference Workshops
Section 1
Monday 1 September: 1545-1715 hours
See pages 4.40-4.45 for Abstracts.
Workshop
Title
– 1.16 –
Room
208
215
114
101
304
120
117
206
331
205
106
214
105
115
204
220
110
201
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6.1
The nature of curriculum change: complicated and complex
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6.2
Enhancing student learning in your lectures
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6.3
A new approach to curriculum mapping
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6.4
How to build a Comprehensive Integrated Puzzle as a method of assessment
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6.5
Assessment in PBL medical schools: what are we measuring?
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6.6
Creating, implementing and evaluating the personal and professional
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development
curriculum
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6.7
Bridging the gap between curriculum development and delivery
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6.8
Reach out and “teach” someone: instructional methods in the classroom
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6.9
Medical education – trainer or trainee’s responsibility?
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6.10
Looking towards the future: what’s in store for medical education?
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6.11
Didactics for beginners
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6.12
Enriching curriculum through Standardized Patient-based programs
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6.13
Mastering the scholarly process
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6.14
Ibero-American Group – local needs and institutional accreditation (large group)
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6.15
IVIMEDS: The International Virtual Medical School (large group)
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6.16
Standards in Medical Education (large group)
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Conference Workshops
Section 1
Tuesday 2 September: 1030-1215 hours
See pages 4.51-4.56 for Abstracts.
Workshop
Title
– 1.17 –
Room
105
115
212
205
208
331
206
215
120
304
204
114
214
220
201
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START
MONDAY
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0830
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0845
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Plenary 1
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0900
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0915
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0930
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0945
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Walk to University
1000
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1015
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Coffee
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1030
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1045
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1100
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1115
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1130
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1145
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1200
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Discussion
1215
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1230
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1245
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Lunch
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1300
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1315
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1500
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1515
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Section 1
Personal Diary
Large Group Sessions
& Short Comm 3
TUESDAY
Plenary 2
(Kultur Casino)
Discussion
Coffee
Coffee
Short Comm 1
Workshops and
Groups 2
Plenary 3
(Kultur Casino)
Lunch and
General Assembly
Short Comm 4
Close of meeting
Discussion
Coffee
Posters
(1510-1640)
Short Comm 5
Short Comm 2
WEDNESDAY
Discussion
START
0830
0845
0900
0915
0930
0945
1000
1015
1030
1045
1100
1115
1130
1145
1200
1215
1230
1245
1300
1315
1330
1345
1400
1415
1430
1445
1500
1515
1530
1545
1600
1615
1630
1645
1700
1715
1730
1745
1800
1815
Note: While you are free to move between short communication and poster sessions, we hope
you will stay in one session and join in the discussion.
– 1.18 –
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Section 1
Map of Bern
Plan of University Area (top left in above map)
▼
12
No.
s
u
B
– 1.19 –
Section 1
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Plan of Conference Building
– 1.20 –
Section 2: Sunday
Saturday 30 August
1200-1700
Registration
(University of Bern – see location on pages 1.14 and 1.19)
Setting up of posters and exhibits
Sunday 31 August
0830-1600
Registration
University of Bern
Setting up of posters and exhibits
0930-1700
Pre-conference workshops
Location: University of Bern
(Refreshments will be available in the tents between 1045-1115 and between 1515-1545)
0930-1230
Morning session
PCW1
Part 1 (workshop continues after lunch)
Finding and appraising evidence in medical education
Alex Haig (NHS Education for Scotland) and Marshall Dozier (University of Edinburgh, UK)
Location for morning: Room -302 (Juristische Bibliothek – 3 floors down)
Location for afternoon: Room 212
PCW2
Part 1 (workshop continues after lunch)
Preparing tomorrow’s educators for leadership roles in the health professions: an
interactive, participatory workshop
Miriam Friedman Ben-David (Israel) and Stewart Mennin (University of New Mexico, USA)
Location: Room 105
PCW3
Basic faculty skills
Anita Duhl Glicken (University of Colorado, USA)
Location: Room 204
PCW4
Mobile computing and medical education
Ulrich Woermann (University of Bern, Switzerland) and Michael Schmidts (University of
Vienna, Austria)
Location: Room 115
PCW5
Why offer early clinical experience in undergraduate medical education?
Tim Dornan, Christine Bundy and Lis Cordingley (University of Manchester Medical School, UK)
Location: Room 331
– 2.1 –
Section 2: Sunday
PCW6
Evaluation of medical education – methodological implications of new
technologies
R Peter Nippert and Bernhard Marschall (IfAS, Munster, Germany)
Location: Room 215
PCW7
Setting defensible performance standards on OSCEs and clinical skills
examinations: a user’s guide from A to Z
André de Champlain (National Board of Medical Examiners, USA) and Jack Boulet
(Educational Commission for Foreign Medical Graduates, USA)
Location: Room 304
PCW8
Designing Study Guides
Jennifer M Laidlaw (University of Dundee, UK)
Location: Room 212
PCW10
Using computers to prepare students for ‘real’ clinical experiences
Joe Henderson and Christof Daetwyler (Dartmouth College, USA)
Location: Room 106
PCW11
Designing multiple choice questions that serve a purpose
René Krebs (University of Bern, Switzerland)
Location: Room 214
PCW12A*
Fostering and assessing medical professionalism: challenges and
strategies
Sharon Krackov (New York University School of Medicine, USA)
Location: Room 208
(* additional session – same content as PCW12 to be held in the afternoon session)
1230-1400
Lunch break
Lunch is not provided – see page 1.3 for suggestions for lunch.
1400-1700
Afternoon session
PCW9
Vertical integration in the medical curriculum
Eugene Custers and Olle ten Cate (University Medical Centre, Utrecht, Netherlands)
Location: Room 331
PCW12
Fostering and assessing medical professionalism: challenges and
strategies
Sharon Krackov (New York University School of Medicine, USA)
Location: Room 208
PCW13
Clinical evaluation exercises (MINI-CEX): how to improve oral
examinations in medical practice
John Norcini (FAIMER, USA) and Reinhard Westkämper (University of Bern, Switzerland)
Location: Room 304
PCW14
Developing learning objectives catalogues
Ralph Bloch (University of Bern, Switzerland) and Hans Bürgi (SMIFK, Switzerland)
Location: Room 214
– 2.2 –
Section 2: Sunday
PCW15
Making small group teaching work
Phil Race (York, UK)
Location: Room 215
PCW16
Programmatic evaluation – how to evaluate your course/clerkship
Steven J Durning, Paul A Hemmer and Louis N Pangaro (Uniformed Services University of the
Health Sciences, USA)
Location: Room 106
PCW17
Enhanced faculty skills
Anita Duhl Glicken (University of Colorado, USA)
Location: Room 204
PCW18
E-learning – what do I need to know about it to get started?
Peter Cantillon and Nic Fenlon (National University of Ireland, Republic of Ireland)
Location: Room 115
Special Interest Group Meeting
1400-1700
National Groups of Health Science Educators
Organised by The South African Association of Health Educationalists (SAAHE)
(for details, see abstract on page 4.3)
Athol Kent and Trevor Gibbs (University of Cape Town, South Africa)
Location: Room 114
1800-2100
Registration
Location: Kultur Casino, Bern (see map on page 1.19)
1900-2100
Opening ceremony at Kultur Casino, Bern: A minimum of formality and plenty of opportunity
to meet each other. A mixture of classical and jazz music, followed by cocktail reception.
(Please note: this is intended as a light snack, not a full meal)
– 2.3 –
Section 2: Monday
Monday 1 September
0730-0900
Registration
Kultur Casino, Bern (see map on page 1.19)
1030-1730
Registration
University of Bern (see map on page 1.19)
0830-1000
Session 1
Plenary 1: Social responsibility of medical education
Presentations from various viewpoints in the Swiss context, in a plenary organized by the
University of Bern
Chairperson: Ralph Bloch (University of Bern)
Location: Kultur Casino, Bern
0830-0840
What does society expect from its physicians in general and from their training in
particular?
An anonymous health politician
0841-0851
A view from the trenches: what are the essential elements in the education of future
physicians?
H H Brunner (President, Swiss Medical Association FMH)
0852-0902
What do medical students want out of their six years?
Janine Scherrer and Teresa Hidalgo-Staub (Medical Students, University of Bern)
0903-0913
Education or training? What is the role of the University in medical education?
Ch. Schäublin (President, University of Bern)
0914-0924
Squaring the circle: research, teaching, clinical service and management – what else
should professors do?
P Suter (Dean, Faculty of Medicine, University of Geneva)
0925-1000
Discussion
1000-1045
Walk to University (approximately 900 metres/13 minute walk - see page 1.19. A regular public
bus service connects the two venues). Coffee at University, in tents.
– 2.4 –
Section 2: Monday
1045-1230
Session 2
Short Communications 1: Simultaneous themed sessions
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2A
E-learning
Chair:
Ina Treadwell, South Africa
Discussant: David Dewhurst, UK
Location:
Room 210
1045
2A 1
Virtual patients are go!
N K McManus*, R M Harden & S Smith ( IVIMEDS, Dundee, UK)
1100
2A 2
Lessons learned in developing online curricula: five tips for success
David A Cook* & Denise M Dupras (Mayo Graduate School of Medicine, Department of Internal
Medicine, Rochester MN, USA)
1115
2A 3
The Swedish Net University supports net based medical and healthcare
education
Goran Petersson (Council for Renewal of Higher Education, Swedish Net University Agency,
Harnosand, SWEDEN)
1130
2A 4
Evaluating interactivity in on-line postgraduate education
David N Brigden* & Andrew D Sackville (Mersey Deanery, University of Liverpool, Liverpool, UK)
1145
2A 5
Reusable learning objects, content syndication and resource discovery
David A Davies (University of Birmingham, Medical Education Unit, Birmingham, UK)
1200
2A 6
Semantic web based knowledge management by UMLS
T Schroter*, T Richter & R Schumann (Charité, Medizinische Fakultät der Humboldt Universität,
Berlin, GERMANY)
1215-1230
Discussion
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2B
The Examiner’s Toolkit
Chair:
Hettie Till, South Africa
Discussant: Diana Dolmans, Netherlands
Location:
Room 110
1045
2B 1
Credibility of portfolio assessment as an alternative for reliability evaluation
Erik Driessen*, Cees van der Vleuten & Jan van Tartwijk (Maastricht University, Faculty of Medicine,
Maastricht, NETHERLANDS)
1100
2B 2
Medicine clerkship pre-test: the role of an early clerkship examination to
identify clerkship students at risk of final examination failure
Alan Wimmer, Dodd Denton, Paul A Hemmer* & Louis Pangaro (Uniformed Services University, USUHS
- EDP, Bethesda, USA)
1115
2B 3
Feasibility of portfolio
Kirsten Bested (Vejle Hospital, Department of Anaesthesiology, Vejle, DENMARK)
– 2.5 –
Section 2: Monday
1130
2B 4
The educational utility of the “don’t know” response added to a five-options
item format
Yolanda Marin-Campos*, Lizbeth Mendoza-Morales, Jaime Navarro & Eusebio Contreras-Chaires
(National Autonomous University of Mexico, Departmento de Farmacologia, Mexico City, MEXICO)
1145
2B 5
Creating creative assessments
L A Allery*, J MacDonald & L A Pugsley (University of Wales College of Medicine, School of Postgraduate
Medical and Dental Education, Cardiff, UK)
1200
2B 6
Evaluation of open-book exams in an undergraduate biochemistry course
Nadia Al Wardy*, Syed Rizvi & Sean McAleer (Sultan Qaboos University, Department of Biochemistry,
SULTANATE OF OMAN)
1215-1230
Discussion
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2C
Curriculum Planning 1
Chair:
To be announced
Discussant: To be announced
Location:
Room 201
1045
2C 1
Complementary and alternative medicine in the undergraduate medical
curriculum: a needs analysis
J Skinner & A D Cumming* (University of Edinburgh, Medical Teaching Organisation, Edinburgh, UK)
1100
2C 2
Mapping the surgical curriculum
Anne Ellison (Royal Australian College of Surgeons, Melbourne, AUSTRALIA)
1115
2C 3
An innovative method of delivery of the core curriculum in Obstetrics and
Gynaecology – the Leeds model
Vikram Jha*, Jayne Shillito, Judith Moore, Alison Wright & Sean Duffy (St James’s University
Hospital, Academic Dept of Obstetrics & Gynaecology, Leeds, UK)
1130
2C 4
Developing curricula based on learning needs: genetics education for
specialist registrars in non-genetics specialities
Sarah Wakefield*, Hywel Thomas, Peter Farndon & Julie Bedward (Centre for Research in Medical &
Dental Education, School of Education, Birmingham, UK)
1145
2C5
The current medical program at the American University of Beirut: problems
and solutions
Farid Saleh*, Nadim Cortas & Ibrahim Salti (Department of Human Morphology and Medical Education
Unit, American University of Beirut, LEBANON)
1200
2C 6
A survey of people’s complaints against physicians during a five year period
in Fars province
L Bazrafkan*, Z Tabeie & M Saberfirozi (Shiraz University of Medical Science, Shiraz, IRAN)
1215-1230
Discussion
– 2.6 –
Section 2: Monday
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2D
Curriculum Evaluation
Chair:
Pedro Herskovic, Chile
Discussant: Stewart Mennin, USA
Location:
Room 220
1045
2D 1
Keep the customer satisfied: quality control in a medical curriculum
M Maelstaf*, I Vandenreyt & M Vandersteen (LUC, Limburgs Universitair Centrum, Faculty of
Medicine, Diepenbeek, BELGIUM)
1100
2D 2
Evaluating MOET
Mike Davis (Edge Hill, Ormskirk, UK)
1115
2D 3
A student centred approach to course evaluation using the norminal group
technique
William Murdoch* & John Skelton (University of Birmingham, Interactive Skills Unit, Birmingham,
UK)
1130
2D 4
Teaching about the family in the community: purposeful, coherent, integrated
and well-informed?
P G Cawston*, K Mullen, M Nicholson & R A Robertson (Glasgow University, General Practice and
Primary Care, Glasgow, UK)
1145
2D 5
Correlation between students’ GPA and evaluation score of the teacher
A Malayeri, A Alidadi & P Afshari* (Ahvaz Medical Science University, Nursing and Midwifery School
of Medical Science, Ahvaz, IRAN)
1200
2D 6
Teachers’ points of view about evaluation
S Iranfar*, B Izadi, F Monsori & M Rezaie (E.D.C, Kermanshah, IRAN)
1215-1230
Discussion
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2E
Teaching and Learning
Chair:
Nehad El-Sawi, USA
Discussant: Brownell Anderson, USA
Location:
Room 205
1045
2E 1
Factors influencing final year students’ learning climate in Thai Medical
Schools
Danai Wangsaturaka* & Sean McAleer (The Faculty of Medicine, Chulalongkorn University,
Department of Pharmacology, Bangkok, THAILAND)
1100
2E 2
Evaluation of different lecture types in medical education
S Holler*, N De Cono, A Mehrabi, S Schurer, E Gazyakan, M Kadmon & J Schmidt (Department of Surgery,
University of Heidelberg, Heidelberg, GERMANY)
1115
2E 3
Clinical teachers and the new medical education
Tim Dornan*, Albert Scherpbier, Nigel King & Henny Boshuizen (Hope Hospital, Manchester, UK)
1130
2E 4
Student-teachers are not better learners than their peers
Angel M Centeno*, Cecilia Primogerio and Martin O’ Flaherty (School of Biomedical Sciences,
Universidad Austral-Medicina, Buenos Aires, ARGENTINA)
– 2.7 –
Section 2: Monday
1145
2E 5
Interactive large group teaching is an alternative to small-group teaching in a
dermatology practical course
F R Ochsendorf*, A Boer, W H Boehncke & R Kaufmann (Zentrum Dermatologie und Venerologie,
Klinikum der J W Goethe-Universitat, Frankfurt, GERMANY)
1200
2E 6
Using a game format as a teaching strategy in CME: does it work?
Maja Bujas-Bobanovic (Aventis Pharma Inc, Laval, Quebec, CANADA)
1215-1230
Discussion
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2F
International Medical Education (1)
Chair:
Marina Mrouga, Ukraine
Discussant: Jack Boulet, USA
Location:
Room 101
1045
2F 1
Presentation of European Medical Students’ Association (EMSA)
Filip Stoma*, Anna Michalak & Tomasz Kucmin (EMSA, Lublin, POLAND)
1100
2F 2
Cultural probity in medicine
R C Gupta*, S Lingam, M I Memon & D Brigden (Lancashire Teaching Hospitals NHS Trust, Chorley,
UK)
1115
2F 3
Possibilities for change?
Iskender K Akylbekov, Christian Guksch* & Chinara Mambetova (Modellstudiengang Medizin,
Universitatsklinikum, Hamburg, GERMANY)
1130
2F 4
Increasing the relevance of health professions education and health
services: The Network: Towards Unity for Health
Gerard D Majoor (Faculty of Medicine, Maastricht University, Maastricht, NETHERLANDS)
1145
2F 5
Global survey on geriatrics in the medical curriculum
I Keller, N Borojevic*, A Makipaa, T Kalenscher & A Kalache (International Federation of Medical
Students’ Associations, Zagreb, CROATIA)
1200
2F 6
Not just another changed medical school
Trevor Gibbs* & David Taylor (Faculty of Health Sciences, University of Cape Town, Cape Town, SOUTH
AFRICA)
1215-1230
Discussion
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2G
Staff Development – Training Needs
Chair:
Jørgen Nystrup, Denmark
Discussant: Janet Grant, UK
Location:
Room 120
1045
2G 1
Strategic direction for staff development: ensuring relevance in times of
change
Faith Hill (University of Southampton, Medical Education Development Unit, Southampton, UK)
1100
2G 2
Educational needs of a programme director in Denmark
Bente Malling (Videreuddannelsessekretariatet, Aarhus AMT, Hoejbjerg, DENMARK)
– 2.8 –
Section 2: Monday
1115
2G 3
A new preparation for dental trainers
Alexander Stewart (NHS Education for Scotland, Turriff, UK)
1130
2G 4
The effect of ‘Teaching the Teacher’ courses for doctors
Sune Rubak*, Lene Mortensen, Bente Malling & Charlotte Ringsted (Aarhus Amt, Hojbjerg,
DENMARK)
1145-1230
Discussion
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2H
The OSCE (1)
Chair:
To be announced
Discussant: André de Champlain, USA
Location:
Room 215
1045
2H 1
Are standardized patients able to identify poorly performing medical students
in OSCE?
Pirkko Heasman, Kaisu Pitkala, Taina Hatonen, Niina Paganus and Kirsti Lonka* (University of
Helsinki, Faculty of Medicine, Helsinki, FINLAND)
1100
2H 2
Neonatology OSCE: certification of expertise
J Arnau*, T Esque, A Zuasnabar, A Fina, A Moral, F Raspall, N Barragan & J M Martinez-Carretero
(Institute of Health Studies, Barcelona, SPAIN)
1115
2H 3
A computer-based Medline objective structured clinical examination (OSCE)
for third year medical students: aims, methods and outcomes
M Dozier*, S Yewdall, R Ellaway & H Cameron (University of Edinburgh, Edinburgh, UK)
1130
2H 4
Evaluating physician CanMEDS competencies using Objective Structured
Clinical Examination (OSCE) in neonatal-perinatal medicine
Brian Simmons*, Ann Jefferies, Marc Blayney, Kyong Lee, Henry Roukema, Martin Skidmore, Jodi
McIlroy & Diana Tabak (University of Toronto, Sunnybrook & Women’s College of Health Sciences Centre,
Toronto, CANADA)
1145
2H 5
A comparison of several methods for setting passing scores on an OSCE
Ernest N Skakun*, Stephen Aaron, Fraser Brenneis, Narmin Kassam, Ramona Kearney and Peggy
Sagle (University of Alberta, Division of Studies in Medical Education, Edmonton, CANADA)
1200
2H 6
Catalan Family Medicine OSCE: professional career consequences
J M Martinez-Carretero*, C Blay, R Vilatimo, C Lopez Sanmartin, J Arnau, S Juncosa and J M Vilseca
(Institute of Health Studies, Barcelona, SPAIN)
1215-1230
Discussion
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2I
Problem Based Learning
Chair:
To be announced
Discussant: Geoff Norman, Canada
Location:
Room 114
1045
2I 1
Achieving the best of both worlds by Integration of PBL in PBT (Problem
Based Teaching) during the clinical years
N G Patil*, Mary Ip & J Wong (Faculty of Medicine, University of Hong Kong, HONG KONG)
– 2.9 –
Section 2: Monday
1100
2I 2
Formative assessment of problem-based learning tutorial sessions using a
criterion-referenced system
Leticia Elizondo-Montemayor* & Araceli Hambleton Fuentes (School of Medicine Tecnologico de
Monterrey, Nuevo Leon, MEXICO)
1115
2I 3
How medical students’ satisfaction with a problem-based curriculum relates
to their perceptions about learning and future career (and the relevance of
learning about wider issues)
G Maudsley*, E M I Williams & D C M Taylor (University of Liverpool, Department of Public Health,
Liverpool, UK)
1130
2I 4
Assessment of students in PBL tutorials improves attendance and correlates
with academic performance
Salah Kassab*, Hafiz Shazali & Hossam Hamdy (College of Medicine and Medical Sciences, Arabian
Gulf University, Manama, BAHRAIN)
1145
2I 5
Medical students’ ways of learning
Are Holen (NTNU, Department of Neuroscience, Trondheim, NORWAY)
1200
2I 6
Group process and learning outcome in PBL: a new assessment tool
identifies the crucial role of the tutor
Stefan Herzig, Jan Matthes*, Alexander Look, Amina K Hahne, Kain Afhakama and Ara Tekian
(University of Cologne, Department of Pharmacology, Cologne, GERMANY)
1215-1230
Discussion
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2J
Teaching and Assessing Attitudes
Chair:
To be announced
Discussant: Elizabeth Armstrong, USA
Location:
Room 106
1045
2J 1
Using digital video to teach attitudes: gain or pain?
C Chiado* & A Pereira da Silva (Faculty of Medicine, Laboratorio de Genetica, Lisboa, PORTUGAL)
1100
2J 2
Development and validation of the Beersheva Survey of Attitudes and
Knowledge in international health
A Gaaserud*, A Jotkowitz, Y Gidron, C Baskin, J Urkin, M Alkan & C Margolis (Ben Gurion University
of the Negev, Faculty of Health Sciences, Beer Sheva, ISRAEL)
1115
2J 3
Assessment of attitude and conduct - is it feasible?
Helen Sweetland*, Lorna Tapper-Jones, Ania Korszun, Peter Winterburn & Helen Houston (University
of Wales College of Medicine, University Department of Surgery, Cardiff, UK)
1130
2J 4
“To be a Doctor”: Teaching attitudes using commercial films for raising the
discussion on ethical dilemmas
M F Patricio*, A P Lacerda, P Sa & J Gomes-Pedro (Faculdade de Medicina de Lisboa, University of
Lisbon, Lisboa, PORTUGAL)
1145
2J 5
Evaluation of attitude achievement in “doctor-patient relationship” PBL sessions
Orhan Odabasi, Melih Elcin, Iskender Sayek*, Murat Akova & Nural Kiper (Hacettepe Universitesi,
Ankara, TURKEY)
1200-1230
Discussion
– 2.10 –
Section 2: Monday
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2K
Clinical Skills Training
Chair:
Jean Ker, UK
Discussant: Debra Nestel, Australia
Location:
Room 206
1045
2K 1
Establishment of a British Heart Foundation UK Harvey Resource Centre
Shihab E O Khogali*, Ronald M Harden, Jennifer M Laidlaw, Barbara E Scott & Stewart Pringle
(University of Dundee, Department of Cardiology, Dundee, UK)
1100
2K 2
Simulation-based large scale emergency preparedness training programs –
The national role of the Israel Center for Medical Simulation
Amitai Ziv*, Tali Yohanes, Shuli Banita, Ariel Bentancur, Daphna Barsuk, Amir Vardi, Inbal Levin &
Haim Berkenstdt (The Israel Center for Medical Simulation, Chaim Sheba Medical Center, RamatGan, ISRAEL)
1115
2K 3
Does systematic undergraduate training of resuscitation-skills influence
postgraduate performance of resuscitation-skills?
F O Weisser*, B Dirks & M Georgieff (Sektion Notfallmedizin, Universitätsklinik für Anästhesiologie,
Ulm, GERMANY)
1130
2K 4
Multimedia driven education significantly improves medical students’
understanding of operative procedures in heart surgery
R Friedl, H Hoppler, S Stracke* & A Hannekum (University of Ulm, Dept. Heart Surgery, Ulm,
GERMANY)
1145
2K 5
The educational impact of bench model fidelity on the acquisition of technical
skills
Ethan D Grober, Stanley J Hamstra*, Kyle R Wanzel, Keith A Jarvi, Edward D Matsumoto, Rivindar S
Sidhu & Richard K Reznick (University of Toronto, Centre for Research in Education - University Health
Network, Toronto, CANADA)
1200-1230
Discussion
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2L
Undergraduate Multiprofessional Education
Chair:
Trudie Roberts, UK
Discussant: Steffen Eychmueller, Switzerland
Location:
Room 105
1045
2L 1
Multiprofessional education: would a taxonomy help?
C Segouin & B Hodges* (Assistance Publique - Hopitaux de Paris, Service de la Formation Continue
des Medecins, Paris, FRANCE)
1100
2L 2
JUMP2 shared learning for undergraduates in practice
Fanny Mitchell* & Gill Young* (Faculty of Health and Human Sciences, Thames Valley University,
London, UK)
1115
2L 3
Communication skills in a multiprofessional critical illness course
Alan Thomson*, Rachelle Arnold & Jennifer Cleland (Aberdeen Royal Infirmary, Department of
Anaesthetics, Aberdeen, UK)
1130
2L 4
Inter-professional healthcare ethics programme for undergraduate students
of pharmacy, nursing and medicine: developing and evaluating a model for
learning and teaching
Deirdre McAree*, Mairead Boohan & Sue Morison (Queens University Belfast, School of Pharmacy,
Belfast, IRELAND)
– 2.11 –
Section 2: Monday
1145
2L 5
Medical proteomics – from bench to bedside: an interprofessional course in
molecular medicine at the undergraduate level
Annelie Brauner*, Ewa Ehrenborg*, Marie Henriksson* & Maria Sunnerhagen (Karolinska Institutet,
King Gustaf V Research Institute, Stockholm, SWEDEN)
1200
2L 6
Community-based interprofessional education: do the outcomes justify the
effort?
Ruth McNair*, Nick Stone, Jane Sims & Caroline Curtis (The Department of General Practice, The
University of Melbourne, Carlton, AUSTRALIA)
1215-1230
Discussion
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2M
Research and Critical Thinking
Chair:
Florian Eitel, Germany
Discussant: Georges Bordage, USA
Location:
Room 115
1045
2M 1
Peer education workshop on research during medical studies
E Zimmermann*, E Schoenenberger & M Dewey (Charité, Humboldt University Berlin, Berlin,
GERMANY)
1100
2M 2
An evaluation of scientific comprehension among Swedish medical students
G Edgren*, J Adami, O Akre and G Petersson (Karolinska Institutet, Department of Medical
Epidemiology and Biostatistics, Stockholm, SWEDEN)
1115
2M 3
Can our students think, and do they care?
Lynne C Hvidsten*, James R Hulbert & Warren L Moe (Northwestern Health Sciences University,
Department of Clinical Education, Bloomington, USA)
1130
2M 4
Is self-directed learning an illusion? – an evaluation of a new studentcentered course in EBM
P Frey*, K Huwiler & M Battaglia (University of Bern, IAWF, Bern, SWITZERLAND)
1145
2M 5
A program for medical research integrated in the medical curriculum
A Waage*, R Austgulen, A Brubakk, U Sonnewald, T Lindmo, M Rekvig, O J Iversen & T Vik (Faculty of
Medicine, Norwegian University of Science and Technology, Trondheim, NORWAY)
1200-1230
Discussion
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2N
Selection
Chair:
John Clarkson, USA
Discussant: Shimon Glick, Israel
Location:
Room 304
1045
2N 1
Teaching outcomes vs students’ former experience and background
Jadwiga Mirecka (Department of Medical Education, Medical College of Jagiellonian University,
Krakow, POLAND)
1100
2N 2
Selection and admission to medical schools in Europe and USA
Ara Tekian (University of Illinois at Chicago, Department of Medical Education, Chicago, USA)
– 2.12 –
Section 2: Monday
1115
2N 3
Major side effects of the introduction of entrance selection in a medical
school in Flanders (Belgium)
J Van der Veken*, A Derese, J de Maeseneer & B Morlion (Universitair Ziekenhuis Gent, Gent,
BELGIUM)
1130
2N 4
Involving lay assessors in the selection of GP Registrars: an evaluation from
the West Midlands
Stephen Kelly*, Sarah Wakefield, Celia Brown & Marilyn Hammick (West Midlands Deanery, Institute
of Research & Development, Birmingham, UK)
1145
2N 5
Changing profile of people who want to follow medical studies in Romania
Horatiu D Bolosiu (University of Medicine & Pharmacy “I. Hatieganu”, Centre for Medical Education,
Cluj-Napoca, ROMANIA)
1200
2N 6
Motivation and insight of school students considering a career in medicine
Adrian Blundell*, Rick Harrison & Ben Turney (RAFT, Hazel Grove, Cheshire, UK)
1215-1230
Discussion
1230-1330
Lunch – buffet served in tents (see map on page 1.19)
Note: name badges must be worn to gain admission
1230-1330
Private lunch: Harvard Macy Alumni
Location: Room 028 (Senatszimmer)
1330-1715
Best Evidence Medical Education Workshop (closed session). An opportunity for those
involved in BEME Reviews to discuss progress
Location: Room 212
1330-1515
Session 3
Short Communications 2: Simultaneous themed sessions
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3A
The Virtual Learning Environment
Chair:
Goran Pettersen, Sweden
Discussant: David Davies, UK
Location:
Room 210
1330
3A 1
Sustainable development and integration of ICT-supported learning
Annette Langedijk*, Christian Schirlo & Wolfgang Gerke (Medical Faculty, University Hospital Zurich,
Zurich, SWITZERLAND)
1345
3A 2
E-learning tools on a small campus
I Vandenreyt*, M Vandersteen & M Maelstaf (Limburgs Universitair Centrum, Dept of Physiology,
Diepenbeek, BELGIUM)
1400
3A 3
Managing the learning environment in undergraduate medical education: The
Sheffield approach
Chris Roberts*, Mary Lawson, David Newble & Asley Self (Department of Medical Education,
University of Sheffield, Sheffield, UK)
1415
3A 4
Virtual Learning Environments and Communities of Practice
R Ellaway*, D Dewhurst & A Cumming (The University of Edinburgh, MVM Learning Technology Section,
Edinburgh, UK)
– 2.13 –
Section 2: Monday
1430
3A 5
Electronic learning: premises, skills and preferences of medical students –
results of the Meducase-Charité-E-learning survey on 630 medical students
Stefan Hoehne*, Goetz Bosse & Ralf R Schumann (Charité, Institut für Mikrobiologie & Hygiene, Berlin,
GERMANY)
1445
3A 6
Electronic submission and delivery of student feedback
R Ellaway, A Cumming, H Cameron & K Wylde* (University of Edinburgh, Edinburgh, UK)
1500-1515
Discussion
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3B
Computer Based Assessment
Chair:
To be announced
Discussant: To be announced
Location:
Room 110
1330
3B 1
Response times as a function of examinee ability and item difficulty in the
context of a testlet-based computer-administered adaptive examination
D R Miller, A P Boulais, D E Blackmore* & T J Wood (Medical Council of Canada, Ottawa, CANADA)
1345
3B 2
CASEPORT – an integrative learning platform for case-based learning
M R Fischer for the CASEPORT Consortium (University of Munich, Medizinische Klinik, Munich,
GERMANY)
1400
3B 3
Virtual ethics in a Masters’ course
Bryan Vernon (The Medical School, School of Population and Health Sciences, Newcastle, UK)
1415
3B 4
Electronic MEQ – a computer based assessment tool at the University of
Witten/Herdecke, Germany
Marzellus Hofmann* & Brigitte Strahwald (University of Witten, Faculty of Medicine, Witten,
GERMANY)
1430
3B 5
Use of on-line summative assessment in medical education: experience from
a pilot trial at the University of Melbourne
Samy A Azer (FEU, Faculty of Medicine, Dentistry and Health Sciences, Victoria, AUSTRALIA)
1445
3B 6
Use of web-based cases for teaching and assessment in a medical school
curriculum
Debra A Newell*, L Felipe Amador, Mukaila A Raji, Karen A Rasmussen & Robert E Beach (University
of Texas Medical Branch, Office of Educational Development, Galveston, USA)
1500-1515
Discussion
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3C
Curriculum Planning (2)
Chair:
Gonul Peker, Turkey
Discussant: To be announced
Location:
Room 201
1330
3C 1
Basic sciences learning in an integrated, Primary Care oriented curriculum
Fernando Mora-Carrasco*, Rosalinda Flores-Echavarria & Irina B Lazarevich (Universidad
Autonoma Metropolitana (Xochimilco), MEXICO)
– 2.14 –
Section 2: Monday
1345
3C 2
Postgraduate course – “ Palliative Medicine for doctors” – the ‘Fix-FlexDesign’
S Eychmueller* & H Neuenschwander (Kantonsspital St. Gallen, Palliativstation, St Gallen,
SWITZERLAND)
1400
3C 3
Structuring basic science teaching around clinical cases: experiences at GKT
Mary Seabrook*, Philip Aaronson & John Rees (Department of Medical and Dental Education,
Sherman Education Centre, London, UK)
1415
3C 4
Topsy-turvey teaching: trauma as teaching tool
T E Sommerville (University of Natal, Dept of Anaesthetics, Durban, SOUTH AFRICA)
1430
3C 5
A novel, integrated, practice-based, curricular approach
Hettie Till (Canadian Memorial Chiropractic College, Toronto, CANADA)
1445-1515
Discussion
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3D
Training and Assessment for General Practice/Family Medicine
Chair:
Stephen Field, UK
Discussant: Gellisse Bagnall, UK
Location:
Room 220
1330
3D 1
Formative assessment of family medicine residents in Catalonia: features and
feasibility
J M Fornells*, M Ezquerra, M Bundo, D Fores, F Cordon, J M Cots, A Casasa, J M Martinez & A Martin
(IES/ ACEM, Institute of Health Studies, Barcelona, SPAIN)
1345
3D 2
The new scheme for specialist training of GPs in Denmark – best in Europe??
Roar Maagaard (Aarhus Amt, Hojbjerg, DENMARK)
1400
3D 3
Continuity of care in family practice residency training
Mary Alice Parsons (Accreditation Council for Graduate Medical Education, Chicago, USA)
1415
3D 4
“Looking through students eyes” – Evaluation of the examinees’ comments in
a short-answer examination
Thomas Link* & Michael Schmidts (University of Vienna, Institute for Medical Education, Vienna,
AUSTRIA)
1430
3D 5
Tutorship for family medicine students: care for the inner world
L Debaene*, L Ferrant, R Remmen & J Denekens* (University of Antwerp, Department of General
Practice, Antwerp, BELGIUM)
1445-1515
Discussion
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3E
Teaching and Learning Communication Skills
Chair:
Gill Clack, UK
Discussant: Knut Aspegren, Denmark
Location:
Room 205
1330
3E 1
Undergraduate students’ attitudes towards communication skills teaching
J Cleland* & K N Foster (University of Aberdeen, Department of General Practice and Primary Care,
Aberdeen, UK)
– 2.15 –
Section 2: Monday
1345
3E 2
Veterinary medical communication skills curricula: “What’s up Doc?”
C L Adams & S M Kurtz* (University of Guelph, Ontario Veterinary College, Guelph, CANADA)
1400
3E 3
Designing and implementing communication skills curriculum for medical
students
L Kongkam* & N Wiwutworapan (Maharat Nakhon Ratchasima Hospital, School of Medicine, Nakhon
Ratchasima, THAILAND)
1415
3E 4
Practical experiences and pitfalls in teaching communication skills
Martina Schlunder*, Britta Jonitz, Margareta Kampmann & Ulrich Schwantes (Institut für
Allgemeinmedizin, Charité, Berlin, GERMANY)
1430
3E 5
Early experience of video taping encounters with patients
Paul Bradley*, Charlotte Rees & Pamela Bradley (Peninsula Medical School, Plymouth, UK)
1445
3E 6
A survey of real versus simulated patients’ opinions of 1st year students’
communication skills
Pamela Bradley*, Charlotte Rees & Paul Bradley (Peninsula Medical School, Clinical Skills Resource
Centre, Plymouth, UK)
1500-1515
Discussion
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3F
International Medical Education (2)
Chair:
Ioan Bocsan, Romania
Discussant: Hans Karle, Denmark
Location:
Room 101
1330
3F1
International recruitment of general practitioners into the UK workforce – an
educational approach from West Yorkshire, England
Peter Dickson* & Lynn Stinson (Bradford City Teaching PCT, Bradford, UK)
1345
3F2
Results of a clinical bridging course for overseas trained doctors in Australia
Elma Avdi (University of Melbourne, School of Medicine, Melbourne, AUSTRALIA)
1400
3F3
Listserv analysis as a tool for evaluation of an on-line international medical
education program
W P Burdick*, P S Morahan, L M Johnson & J J Norcini (FAIMER, Philadelphia, USA)
1415
3F4
An overview of the characteristics and performance of candidates who take
the ECFMG clinical skills assessment: 5 years of testing
J Boulet*, G Whelan, W Burdick & J Norcini (Educational Commission for Foreign Medical Graduates,
CSA, Philadelphia, USA)
1430
3F5
The assessment of global physician competence
David T Stern*, Andrzej Wojtczak & M Roy Schwarz (University of Michigan Health System, Ann Arbor,
USA)
1445
3F6
Perceived stress and stress sources for Chilean and American medical
students
Meghan McKeever*, Pedro Herskovic & Daniel Hunt (University of Washington, Seattle, USA)
1500-1515
Discussion
– 2.16 –
Section 2: Monday
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3G
Assessment of Teaching
Chair:
To be announced
Discussant: Lynne Allery, UK
Location:
Room 120
1330
3G 1
Feedback to faculty using the SETOC instrument – student evaluation of
teaching in outpatient clinics
Rukhsana W Zuberi* & Georges Bordage (Department of Family Medicine, The Aga Khan Uni, Karachi,
PAKISTAN)
1345
3G 2
Does ‘expert review’ of teaching practice lead to increased effectiveness of
teachers in the healthcare professions?
Kay Mohanna (Staffordshire University, Stoke on Trent, UK)
1400
3G 3
OSTE: Objective Standardized Teaching Examination for a ‘residents as
teachers’ course
Jesus Ibarra-Jimenez*, Ismael Piedra-Noriega, Monica del Angel-Reyes & Jorge Gonzalez (Instituto
Tecnologico y de Estudios Superiores de Monterrey, School of Medicine, Monterrey, MEXICO)
1415
3G 4
Challenges in implementing a computer-based collaborative platform in staff
development
Klara Bolander* & Kirsti Lonka* (Karolinska Institutet, Stockholm, SWEDEN)
1430
3G 5
Attitudes towards teaching in a newly founded medical school: 2 years later
Araya Khaimook* & Boonyarat Warachit (Hatyai Hospital, Songkla, THAILAND)
1445
3G 6
Feedback for physicians supervising students during patient contacts
D H J M Dolmans*, H A P Wolfhagen, W H Gerver & A J J A Scherpbier (University of Maastricht,
Department of Educational Development and Research, Maastricht, NETHERLANDS)
1500-1515
Discussion
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3H
The OSCE (2)
Chair:
Josep-Mariá Martinez-Carretero, Spain
Discussant: Nivritti Patil, Hong Kong
Location:
Room 215
1330
3H 1
Keeping standardized patients standardized
Tony Errichetti* & John Boulet (Philadelphia College of Osteopathic Medicine/National Board of
Osteopathic Medical Examiners, Philadelphia, USA)
1345
3H 2
Psychometric challenges associated with standardized patient assessments
Danette W McKinley, John R Boulet* & Ronald K Hambleton (Educational Commission for Foreign
Medical Graduates, CSA, Philadelphia, USA)
1400
3H 3
Using a standardized patient assessment to measure professional attributes
Marta van Zanten*, John R Boulet, John J Norcini & Danette McKinley (Educational Commission for
Foreign Medical Graduates, Philadelphia, USA)
1415
3H 4
Evaluating the effectiveness of a two-year curriculum in a surgical skills centre
D J Anastakis*, K R Wanzel, M H Brown, J McIlroy, S J Hamstra, J Ali, C R Hutchison, J Murnaghan,
G Regehr & R Reznick (University of Toronto, Toronto Western Hospital, Toronto, CANADA)
– 2.17 –
Section 2: Monday
1430
3H 5
Weighted OSCE checklists: the practice at the Medical Council of Canada
D E Blackmore*, S M Smee, T J Wood & W D Dauphinee (The Medical Council of Canada, Ottawa, CANADA)
1445
3H 6
Self and peer assessment of history taking skills
Caroline Boggis*, S Cooke, M Holland & H Richardson (South Manchester University Hospitals’ NHS
Trust, Manchester, UK)
1500-1515
Discussion
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3I
Problem Based Learning and Computers
Chair:
Roger Koment, USA
Discussant: To be announced
Location:
Room 114
1330
3I 1
Successful implementation of Blackboard in PBL-tutorials
P Room*, A H J Dierssen & F G M Kroese (FMW RuG, Department for Educational Development and
Quality Assurance, Groningen, NETHERLANDS)
1345
3I 2
CAMPUS-Pediatrics: a flexible, interactive, case-oriented, web-based training
program for multi-purpose use in pediatric medical education
S Huwendiek*, S Koepf, B Hoecker, R Singer, F J Leven, G F Hoffmann & B Toenshoff (University Children’s
Hospital Heidelberg, Heidelberg, GERMANY)
1400
3I 3
DIPOL-Edit – a new system supporting the WWW-based delivery of course
content at Dresden Medical Faculty
Oliver Tiebel*, Katja Liesebach, Annett Mitschick, Michael Balzer, Rene Lange, Matthias Hinz, Ronny
Hesse, Gabriele Mueller & Hildbrand Kunath (Institute of Clinical Chemistry & Laboratory Medicine,
Medical Faculty Carl Gustav Carus, Dresden, GERMANY)
1415
3I 4
Cases in problem based learning (PBL) presented on intranet
Torstein Vik & Andreas Haaland* (Norwegian University of Science & Technology, Department of
Community Medicine, Trondheim, NORWAY)
1430
3I 5
“Don’t disturb my circles” – or the use of the computer in problem-based
small group learning
F Ruderich*, R Faber, C Goggelmann, C Roth, C Nikendei, D Schellberg, R Singer, S Riedel, F J Leven & J
Junger (University of Heidelberg, Medizinische Universitatsklinik und Poliklinik, Heidelberg,
GERMANY)
1445
3I 6
Problem based learning on the Web – an outreach to Norwegian Medical
Students abroad
Roar Johnsen*, Toralf Hasvold, Karin Straume, Zoltan Tot & Geir Jacobsen (Norwegian University of
Science and Technology (NTNU), Department of Community Medicine, Trondheim, NORWAY)
1500-1515
Discussion
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3J
The Progress Test
Chair:
Donald Melnick, USA
Discussant: Miriam Friedman Ben-David, Isreal
Location:
Room 106
– 2.18 –
Section 2: Monday
1330
3J 1
Progress testing of two different medical curricula at one faculty – an
outreach to Norwegian Medical Students abroad preliminary results
K Duske*, S Fuhrmann, S Hanfler, J Hoffmann, S Koelbel, D Mueller, Z Nouns, P Wieland, S Zacharias
& A Mertens (Charité Berlin, Progress Test Medizin, Berlin, GERMANY)
1345
3J 2
Progress testing with short-answer questions
J Rademakers*, Th J ten Cate, P R Bar & J M M van de Ridder (UMC Utrecht, Onderwysinstituut,
Utrecht, NETHERLANDS)
1400
3J 3
Does Maastricht-style progress testing work in the UK? The Manchester
Experience
G K Mahadev*, A C Owen, P A O’Neill & G J Byrne (Manchester University, South Manchester University
Hospitals Trust, Manchester, UK)
1415
3J 4
Towards a joint progress test: more quality for less Euros
J Cohen-Schotanus*, L W T Schuwirth, D J Tinga, A J N M Thoben & C P M van der Vleuten (Institute
for Medical Education (OWI-OK), Department for Development and Quality Assurance, Groningen,
NETHERLANDS)
1430
3J 5
Cross-institution comparison of student achievement using a progress test
A M M Muijtjens*, J Cohen-Schotanus, A Thoben, M M Verheggen & C P M van der Vleuten (University
of Maastricht, Department of Educational Development and Research, Maastricht, NETHERLANDS)
1445-1515
Discussion
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3K
Clinical Teaching and the Patient
Chair:
Laurence Gardner, USA
Discussant: Roger Kneebone, UK
Location:
Room 206
1330
3K 1
The gynecological patient in a teaching session
Mette Haase Moen (Norwegian University of Science and Technology, Faculty of Medicine, Trondheim,
NORWAY)
1345
3K 2
Effectiveness of communication and basic clinical skills’ curriculum in
internal medicine
C Nikendei*, C Roth, A Zeuch, S Schafer, M Benkowitsch, B Auler, D Schellberg, W Herzog & J Junger
(University of Heidelberg, Medizinische Universitatsklinik, Heidelberg, GERMANY)
1400
3K 3
Bachelor degree profession and learning in practice – student nurses’
learning and development of competence in psychiatric practice
Linda Kragelund (The Danish University of Education and The Psychiatric Hospital of the County of
Roskilde, Roskilde, DENMARK)
1415
3K 4
Early student-patient interactions: the views of patients regarding their
experiences
JE Thistlethwaite* & E A Cockayne (Academic Unit of Primary Care, Leeds, UK)
1430
3K 5
Training in intimate physical examinations: a challenge in Antwerp
K Hendrickx*, B De Winter, B Selleslags, L Debaene, F Mast, W Tjalma, P Buytaert & J J Wyndaele
(Skillslab, University of Antwerp, Wilrijk, BELGIUM)
1445
3K 6
Enhancing reflection in communication skills training with simulated patients
Eeva Pyorala* and Anni Peura (University of Helsinki, Research and Development Unit for Medical
Education, Helsinki, FINLAND)
1500-1515
Discussion
– 2.19 –
Section 2: Monday
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3L
Professionalism (1)
Chair:
To be announced
Discussant: Stewart Petersen, UK
Location:
Room 105
1330
3L 1
Experiences of medical students with regard to aspects of ethics, cultural
awareness and legal issues (ECL) during clinical rotations
Netta Notzer*, Roni Dadao-Harari, Henri Abramowitz & Avraham Rudnick (Sackler Faculty of
Medicine, Tel Aviv University, ISRAEL)
1345
3L 2
Laying the foundation for professionalism – case presentations in the first
year of study
Brigitte Grether (Faculty of Veterinary Medicine, University of Zurich, Zurich, SWITZERLAND)
1400
3L 3
Gross anatomy curriculum as a framework to teach professionalism
Wojciech Pawlina*, Thomas R Viggiano & Stephen W Carmichael (Mayo Clinic, Mayo Medical School,
Rochester, USA)
1415
3L 4
How to develop professionalism in medical education: the Faculty
Development approach
Ichiro Yoshida* & Kazuhiko Fujisaki (Office of Medical Education, Kurume University, Kurume, JAPAN)
1430
3L 5
Are our tutors promoting professionalism through their behavior?
Pedro Herskovic*, Eduardo Cosoi, Jocelyn Manfredi, Karen Sepulveda Paola Contreras, Esteban Munoz,
Roberto Verdugo, Veronica Fuentes & Anabella Aguilera (University of Chile, Medical School, Santiago,
CHILE)
1445-1515
Discussion
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3M
The Core Curriculum
Chair:
Borghild Roald, Norway
Discussant: Tim Dornan, UK
Location:
Room 115
1330
3M 1
Physicians’ and basic scientists’ opinions about the required depth of
biomedical knowledge for medical students
Franciska Koens*, Eugene J F M Custers & Olle Th J ten Cate (School of Medical Sciences, University
of Utrecht, Universitair Medisch Centrum, Utrecht, NETHERLANDS)
1345
3M 2
Incorporation of ability-based pharmacology education in an integrated
medical school curriculum
K L Franson*, E A Dubois, J M A van Gerven, J H Bolk & A F Cohen (Centre for Human Drug Research,
Leiden, NETHERLANDS)
1400
3M 3
Effective communication: an essential component of professionalism
Hannah Kedar (The Hebrew University - Hadassah, Faculty of Medicine, Jerusalem, ISRAEL)
1415
3M 4
Health promotion in medical undergraduate curricula: its relevance may
depend on definition
Ann Wylie (Guy’s, Kings and St Thomas’ School of Medicine, Department of General Practice and
Primary Care, London, UK)
– 2.20 –
Section 2: Monday
1430
3M 5
Role definition, task analysis and educational needs assessment of general
practitioners in I.R. Iran
Shirin Niroomanesh, Haboballah Peirovi & Shahram Yazdani* (Educational Development Center,
Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, IRAN)
1445-1515
Discussion
1515-1545
Coffee – served in the tents
1545-1715
Session 4
Workshops 1
A selection of workshops and two large groups. Please note that numbers of participants in the
workshops (indicated with an asterisk *) are strictly limited and admission is by ticket only. See
page 1.9 for information on how to reserve a place.
4.1*
‘A doctor who knows only Medicine doesn’t even know Medicine’. Teaching
ethics and attitudes: a global challenge for medical education
Madalena Patrício (University of Lisbon, Portugal)
Location: Room 208
4.2*
Why fix assessment?
Phil Race (York, UK)
Location: Room 215
4.3*
Learning in the new job: how to maximise educational opportunities in shifts
and other new patterns of working: an ASME Workshop
Frank Smith, Clair du Boulay and Sarah Blacklock (on behalf of the Association for the Study of Medical
Education (ASME), UK)
Location: Room 114
4.4*
Depression in clinical practice: educating medical students and primary care
physicians
Eliot Sorel (School of Medicine and Health Sciences and School of Public Health and Health Services,
George Washington University, USA)
Location: Room 101
4.5*
Trials, tribulations and triumphs: supervising a dissertation in medical education
Lesley Pugsley & Janet MacDonald (University of Wales College of Medicine, UK
Location: Room 304
4.6*
Peer teaching
Athol Kent and Trevor Gibbs (University of Cape Town, South Africa)
Location: Room 120
4.7*
Usability in Computer-Assisted Learning programmes
Brigitte Grether (University of Zurich, Switzerland)
Location: Room 117
4.8*
Assessing PBL activity
Christine Bundy & Lis Cordingley (University of Manchester, UK)
Location: Room 206
4.9*
Scenarios for PBL on the web – triggers for learning
Bjorn Bergdahl, Per Hultman & Elvar Theodorsson (Faculty of Health Sciences, University of Linköping,
Sweden)
Location: Room 331
– 2.21 –
Section 2: Monday
4.10*
Creating cases to promote integration into undergraduate medical education
Nehad El Sawi (University of Health Sciences, Kansas City, USA)
Location: Room 205
4.11*
Outcome Based Education: an International Federation of Medical Students’
Associations Workshop
Ozgur Onur, Nikola Borojevic and colleagues (IFMSA)
Location: Room 106
4.12*
Developing a teaching or examination event using Simulated Patients: form
and case materials development
Graceanne Adamo (Uniformed Services University of the Health Sciences, Bethesda, USA) &
Heiderose Ortwein (Charité, Humboldt University, Berlin, Germany)
Location: Room 214
4.13*
Assessment methods: what works, what doesn’t
Geoff Norman (McMaster University, Canada)
Location: Room 105
4.14*
Scenario-based teaching and learning – an innovative and relevant concept
in medical education
Roger Kneebone (Imperial College London, UK) & Debra Nestel (Centre for Medical and Health Sciences
Education, Monash University, Australia)
Location: Room 115
4.15*
Verbal reflection-on-action as a tool in consultation training
Anders Bärheim and actress Torild Jacobsen Alraek (Institute for Public Health and Primary Health
Care, University of Bergen, Norway)
Location: Room 204
4.16
Central and East European/Eurasian Task Force – local issues
Ioan Bocsan, Romania (on behalf of AMEE) & Stewart Mennin (University of New Mexico, USA)
Location: Room 220
4.17
Professionalism – Large Group
Moderator: John Bligh, (Peninsula Medical School, UK)
Presenters: Hank Slotnick and Marianna Shershneva (University of Wisconsin, USA) and Sean Hilton
(St George’s Hospital Medical School, UK)
Location: Room 110
4.18
Using a collaborative work space in a rich media educational environment –
Large Group
Sharon Krackov (New York University, USA)
Location: Room 201
Evening
Optional evening entertainment
Performance of Schiller’s William Tell in the open air theatre at Interlaken, preceded by dinner
at Gwatt on Lake Thun. Coaches depart at 1800 hrs and will return to Bern Railway Station at
approximately 2330 hrs.
Please see the University of Bern Conference website for further information on this very
attractive excursion (http://amee03.unibe.ch/social_programm.htm)
Tickets still available from AMEE Office. Theatre option without dinner also available
(see page 3.1).
– 2.22 –
Section 2: Tuesday
Tuesday 2 September
0800-1800
Registration
University of Bern
0830-1000
Session 5
Eight simultaneous sessions
Five Large Group Sessions and three Short Communications
Large Group Sessions
5A
Standard Setting
Chair: Ronald Nungester (National Board of Medical Examiners, USA)
Panel: André de Champlain (National Board of Medical Examiners, USA), Miriam Friedman Ben-David
(Israel), Arno Muijtjens (Maastricht University, Netherlands), John Norcini (FAIMER, USA)
Location: Room 210
5B
A cognitive perspective on learning: implications for teaching
Geoff Norman (McMaster University, Canada)
Location: Room 110
5C
A BEME Review of High-fidelity Simulation in Medical Education
Barry Issenberg (University of Miami Centre for Medical Education, USA), Bill McGaghie
(Northwestern University, Feinberg School of Medicine, Chicago, USA)
Location: Room 201
5D
Making medical education relevant to medical practice: medical schools in
the continuum of lifelong learning
Chair: Hans Karle (World Federation for Medical Education, Denmark)
Panel: Lew Miller (Alliance for Continuing Medical Education, USA), Dennis Wentz (American Medical
Association, USA)
Location: Room 220
5E
Complex Adaptive Systems and medical education: a new look at how we do
what we do
Stewart Mennin (University of New Mexico, Albuquerque, USA)
Location: Room 205
Three Short Communications Sessions
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5F
Postgraduate Assessment
Chair:
Amindra Arora, USA
Discussant: David Blackmore, USA
Location:
Room 101
0830
5F 1
Assessment of specialist registrars in obstetrics and gynaecology in the
Netherlands
F Scheele*, M Schutte, B Wolf, J Th M van der Schoot and “Commissie Onderwijs NVOG” (St Lucas
Andreas Hospital, Department of Mother and Child Care, Amsterdam, NETHERLANDS)
– 2.23 –
Section 2: Tuesday
0845
5F 2
Improving the RITA process
Robert Palmer*, Zoe Nuttall & David Wall (West Midlands Deanery, Birmingham, UK)
0900
5F 3
Educational impact of in-training assessment (ITA) in postgraduate education
C Ringsted*, A H Henriksen, A M Skaarup & C van der Vleuten (Copenhagen Hospital Corporation
Postgraduate Medical Institute, Bispebjerg Hospital, Copenhagen, DENMARK)
0915
5F 4
Validity of the Royal College of Ophthalmologists part III Clinical Examination
P A Johnstone (Ninewells Hospital and Medical School, Postgraduate Department, Dundee, UK)
0930
5F 5
Measurement of knowledge, attitudes and practice of medical interns about
common ambulatory pediatric diseases in teaching hospitals of Shiraz
University of Medical Sciences
Mitra Amini*, Ali Sadeghi Hassanabadi & Abdolah Karimi (Jahrom Medical School, Jahrom, IRAN)
0945-1000
Discussion
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5G
Community Based Education
Chair:
Jacques des Marchais, Canada
Discussant: To be announced
Location:
Room 120
0830
5G 1
Partnership teaching in community medical education: a study to investigate
the advantages and disadvantages of partnership teaching as perceived by
tutors
Jo Brown*, Annie Cushing & Dason Evans (Barts and the London, Queen Mary’s School of Medicine
and Dentistry, Clinical Communication and Learning Skills Unit, London, UK)
0845
5G 2
Negative views of general practice: where do they come from and where to do
they go?
Jan Illing*, Tim van Zwanenberg, Bill Cunningham, Richard Prescott, George Taylor & Cath O’Halloran
(University of Newcastle, Postgraduate Institute for Medicine & Dentistry, Newcastle upon Tyne,
UK)
0900
5G 3
Participatory community-based health education: identification of barriers to
family planning
Regina Petroni-Mennin*, Celia Iriart, Saverio Sava, Rebecca Radcliff, Rachel Evans, Leah Steimel &
Dan Derksen (University of New Mexico School of Medicine, Center for Community Partnerships,
Albuquerque, USA)
0915
5G 4
Using student confidence questionnaires to validate placement recruitment
procedures
R J W Phillips (Department of General Practice and Primary Care, GKT School of Medicine, London,
UK)
0930
5G 5
Bringing the “Real World” of the patient into the medical curriculum
Jean Quinn* & Lyn Brown (University of Liverpool, Department of Primary Care, Liverpool, UK)
0945-1000
Discussion
– 2.24 –
Section 2: Tuesday
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5H
Students’ Learning
Chair:
Anne Garden, UK
Discussant: Ozgur Onur, Germany
Location:
Room 215
0830
5H 1
How do students with different learning styles perform in formative and
summative exams in the first year of a new curriculum?
H G Kraft* & M Heidegger (University of Innsbruck, Institute for Med. Biology, Innsbruck, AUSTRIA)
0845
5H 2
Locus of control and companion measures in a longitudinal study of medical
students in a southwestern US Medical School
Thomas Stewart*, Ann Frye, Stephanie D Litwins & Christine A Stroup-Benham (School of Medicine,
University of Texas Medical Branch, Galveston, USA)
0900
5H 3
Impact of continuous clinical on-duty hours in medical students’ academic
performance: a comparative study
Enrique Saldivar* & Antonio Davial (ITESM, Monterrey, MEXICO)
0915
5H 4
The educational programmes developed and offered by medical students
Radim Licenik*, Lenka Doubravska, Vit Gloger, Jarmila Indrakova, Daniela Jelenova, Petr Jindra,
Barbora Krajzlova, Pavel Kurfürst, Marie Pecuchova, Jarmila Potomkova, Jan Strojil, Renata Simkova
& Cestmir Cihalik (Palacky University Faculty of Medicine, Olomouc, CZECH REPUBLIC)
0930
5H 5
Celebrated movie viewing and semi-structured interactive discussions In
neuroscience block highly contribute to reinforcement of instruction
GO Peker*, S Amado, S Sorias, O Akyurekli, SA Caliskan, U Seyfioglu, C Terek, EO Koylu & Ege Medical
Students Movie Club (Ege University, Faculty of Medicine, Izmir, TURKEY)
0945-1000
Discussion
1000-1030
Coffee
1030-1215
Session 6
Workshops 2: A selection of workshops and large group sessions
Please note that numbers of participants in the workshops indicated with an asterisk (*) are
strictly limited and admission is by ticket only. See page 1.9 for information on how to reserve
a place.
6.1*
The nature of curriculum change: complicated and complex
Stewart Mennin (University of New Mexico, Albuquerque, USA)
Location: Room 105
Note: this workshop is linked to large group session 5E above.
6.2*
Enhancing student learning in your lectures
Sally Brown (Institute for Learning and Teaching in Higher Education, UK)
Location: Room 115
6.3*
A new approach to curriculum mapping
Nick Ross (University of Birmingham Medical School, UK)
Location: Room 212
6.4*
How to build a Comprehensive Integrative Puzzle as a method of assessment
Rosalie Ber (B. Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Israel)
Location: Room 205
– 2.25 –
Section 2: Tuesday
6.5*
Assessment in PBL medical schools: what are we measuring?
Ara Tekian (University of Illinois at Chicago, USA) & Mathieu Nendaz (University of Geneva,
Switzerland)
Location: Room 208
6.6*
Creating, implementing and evaluating the personal and professional
development curriculum
Iain Robbé and Kate Drysdale (University of Wales College of Medicine, UK) & Debra Nestel (Centre for
Medical and Health Sciences Education, Monash University, Australia)
Location: Room 331
6.7*
Bridging the gap between curriculum development and delivery
Celia Popovic and Bev Merricks (University of Birmingham Medical School, UK)
Location: Room 206
6.8*
Reach out and “teach” someone: instructional methods in the classroom
Steve Johnson (Carolinas Healthcare System, Charlotte, USA)
Location: Room 215
6.9*
Medical education – trainer or trainee’s responsibility?
Directors of Postgraduate Medical Education Group, led by Alistair Thomson (South Cheshire
Postgraduate Medical Centre, UK)
Location: Room 120
6.10*
Looking towards the future: what’s in store for medical education?
Elizabeth Kachur (Medical Education Development, New York, USA)
Location: Room 304
6.11*
Didactics for beginners
Brigitte Grether (Faculty of Veterinary Medicine, University of Zurich, Switzerland), E Brenner
(Faculty of Medicine, University of Innsbruck, Austria), German Clénin (Sportwissenschaftliches
Institut SWI, Magglingen, Switzerland) & Martina Kadmon (Department of General Surgery,
Heidelberg University, Germany)
Location: Room 204
6.12*
Enriching curriculum through Standardized Patient-based programs
Anja Robb, Nancy McNaughton & Diana Tabak (University of Toronto, Centre for Research in Education,
Toronto, Canada)
Location: Room 114
6.13*
Mastering the scholarly process
William McGaghie (Northwestern University, Feinberg School of Medicine, Chicago, USA)
Location: Room 214
6.14
Ibero-American Group: local needs and institutional accreditation
(large group)
Margarita Barón-Maldonado, Spain (on behalf of AMEE)
Location: Room 220
6.15
IVIMEDS: The International Virtual Medical School (large group)
Ronald Harden (Dundee, UK)
Location: Room 201
– 2.26 –
Section 2: Tuesday
6.16
Standards in Medical Education (large group)
Chair: Hans Karle (World Federation for Medical Education, Denmark)
Presenters: Hans Karle (WFME, Denmark), Jorgen Nystrup (Roskilde, Denmark), Lief Christensen
(WFME, Denmark), Hossam Hamdy (Arabian Gulf University, Bahrain) & Ramaz Khetsuriani (Tbilisi
State Medical University, Georgia)
Location: Room 110
1215-1315
Lunch
Buffet served in tents
Note: name badges must be worn to gain admission
1215-1315
AMEE Members’ lunch and Annual General Meeting
Lunch will be provided in the room – members only please.
Location: Room 101
1315-1445
Session 7
Short Communications (3): Simultaneous themed sessions
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7A
Computer Based Teaching
Chair:
Martin Fischer, Gemany
Discussant: To be announced
Location:
Room 210
1315
7A 1
Attitude of medical students towards computer-based learning – effects of a
randomized, controlled exposure
A K Hahne*, R Benndorf, P Frey & S Herzig (University of Cologne, Department of Pharmacology, Koeln,
GERMANY)
1330
7A 2
Teaching glomerulonephritis using the multimedia online system LaMedica
S Stracke*, R Friedel, C Aymanns, N Kadlec, B Lindemann, S Huettner & F Keller (University of Ulm,
Nephrology, Ulm, GERMANY)
1345
7A 3
Application of an Icon Language for clinical pharmacology education
throughout an integrated curriculum
E A Dubois*, K L Franson, J M A van Gerven, J H Bolk & A F Cohen (LUMC, Onderwijscentrum IG, Leiden,
NETHERLANDS)
1400
7A4
Making the virtual real: the true challenge of digital learning
Michael Begg* & Rachel Ellaway (University of Edinburgh, College of Medicine and Veterinary Medicine,
Edinburgh, UK)
1415
7A 5
Comparing lecture and e-learning as pedagogies for new and experienced
professionals in dentistry
Liz Browne* Shalin Mehra, Raj Rattan & Gary Thomas (Westminster Institute of Education, Oxford
Brookes University, Oxford, UK)
1430-1445
Discussion
– 2.27 –
Section 2: Tuesday
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7B
The Final Exam
Chair:
Hossan Hamdy, Bahrain
Discussant: To be announced
Location:
Room 110
1315
7B 1
CLEO component of the Medical Council of Canada qualifying examination
Part 1: a four-year appraisal of its incorporation
Jacques Etienne Des Marchais*, T J Wood, D E Blackmore & W D Dauphinée (Medical Council of Canada,
Montreal, CANADA)
1330
7B 2
Ideas for assessing educational objectives from different domains within the
anatomical dissection course
Erich Brenner*, Bernhard Moriggl, Axel Pomaroli & Herbert Maurer (Institute for Anatomy, Histology
and Embryology, University of Innsbruck, Innsbruck, AUSTRIA)
1345
7B 3
A comparative study of measures to evaluate medical students’ performances
Samkaew Wanvarie* & Boonmee Sathapatayawongse (Ramathibodi Hospital, Faculty of Medicine,
Bangkok, THAILAND)
1400
7B 4
Manifestation of professional competence: is it context-dependent or skilldependent?
M Mrouga* & Iryna Bulakh (Testing Board, Kyiv, UKRAINE)
1415
7B 5
The first experience of conducting the Joint Clinical Graduation Examination
(JCGE) in a medical higher educational institution of Ukraine
G V Dzyak, T A Pertseva* & G V Gorbunova (Dnipropetrovsk State Medical Academy, Dnipropetrovsk,
UKRAINE)
1430
7B 6
The design and implementation of the professional exam at the Dn. Santiago
Ramony Cajal Medical School, Universidad Westhill
Julio Cesar Gomez*, Pilar Talayero & Todd W Ellwein (Universidad Westhill, Mexico City, MEXICO)
Note: there is no time for discussion in this session
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7C
The Curriculum (1)
Chair:
David Wiegman, USA
Discussant: Olle ten Cate, Netherlands
Location:
Room 201
1315
7C 1
Curricular Quality Assurance (CQA): twenty-five years of curricular evolution
S Scott Obenshain*, Stewart Mennin & Arthur Kaufman (University of New Mexico, School of Medicine,
Albuquerque, USA)
1330
7C 2
What can interns teach their junior year teachers?
Soledad Campos, Cecilia Primogerio & Angel M Centeno* (School of Biomedical Sciences, Universidad
Austral-Medicina, Buenos Aires, ARGENTINA)
1345
7C 3
Evaluation and quality development of clinical clerkships
Jorgen Hedemark Poulsen (University of Copenhagen, Copenhagen, DENMARK)
1400
7C 4
Focus group approach to evaluation – a useful addition to the written format
C Schirlo*, F Wirth, W Vetter and W Gerke (University of Zurich, Office for Educational and Student
Affairs, Zurich, SWITZERLAND)
– 2.28 –
Section 2: Tuesday
1415
7C 5
Changing trends in undergraduate medical education in Turkey
Iskender Sayek* & Bülent Kýlýç (Hacettepe University, Faculty of Medicine, Ankara, TURKEY)
1430-1445
Discussion
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7D
Postgraduate Training in the Early Years
Chair:
Anna Bukovinszky, Hungary
Discussant: To be announced
Location:
Room 220
1315
7D 1
An evaluation ‘of practice, in practice’ of the GPPS curriculum for SHOs (UK)
S J Brigley* & M J Golby (School of Postgraduate Medical & Dental Education, University of Wales
College of Medicine, Cardiff, UK)
1330
7D 2
Learning to work with patients: innovative programme design promotes the
rapid acquisition of mature clinical skills with minimal requirement for staff
resources
Richard Hift* & Rae Nash (University of Cape Town, Faculty of Health Sciences, Cape Town, SOUTH
AFRICA)
1345
7D 3
The relevance of nurse involvement in the proposed Foundation Programme
for new medical graduates (PRHOs) in the UK
Jo Vallis*, E Anne Hesketh, Mica Allen & Stuart Macpherson (NHS Education for Scotland, Edinburgh,
UK)
1400
7D 4
Supporting poorly performing trainees in their first postgraduate year
through ward simulation
F Anderson*, D Snadden, E A Hesketh, J Ker & J Foulis (NHS Education for Scotland, Dundee, UK)
1415
7D 5
Obtaining the informed consent of patients: a study into the educational and
training needs of doctors
Lois Parker & Steve Field* (West Midlands Deanery and CRMDE, Birmingham, UK)
1430-1445
Discussion
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7E
Continuing Professional Development
Chair:
Frank Smith, UK
Discussant: Dennis Wentz, USA
Location:
Room 205
1315
7E 1
Bringing pharmaceutical representatives into the educational loop
Craig Campbell, Jean Claude Dairon, Paul Davis, Francois Goulet, Gilles Lachance, Celine Monette,
Joan Sargeant, Robert Thivierge & Jane Tipping* (Markham, Ontario, CANADA)
1330
7E 2
Implementation of a new education and training of medical management for
consultants
Eva Zeuthen Bentzen, Annette Plesner Steenstrup & Helle Nielsen* (Danish Medical Association,
Copenhagen, DENMARK)
1345
7E 3
Meeting the needs in continuing education of paediatricians in Oltenia
Region, Romania
C Gheonea*, A Cupsa, D Bulucea & S Dinescu (Postgraduate Department, Centre for Medical
Education, Craiova, ROMANIA)
– 2.29 –
Section 2: Tuesday
1400
7E 4
Impact of a new accreditation system on specialists’ learning habits
Linda Snell* & Rejean Laprise (Aventis Pharma, Department of Professional Education, Laval,
CANADA)
1415-1445
Discussion
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7F
Assessing the Practising Doctor
Chair:
James Hallock, USA
Discussant: John Pitts, UK
Location:
Room 304
1315
7F 1
Sheffield Peer Review Assessment Tool (SPRAT) for Consultants: screening
for poorly performing doctors
J C Archer* & H A Davies (University of Sheffield, Postgraduate Medical Education Centre, Sheffield,
UK)
1330
7F 2
Blueprinting case based discussions for the assessment of poorly
performing doctors in the UK General Medical Council’s performance
procedures
L Southgate*, Pauline McAvoy & Jim Cox (Academic Centre for Medical Education, London, UK)
1345
7F 3
Piloting the link between revalidation and appraisal for the UK GMC
Pauline McAvoy*, Lesley Southgate, Jim Crossley & Brian Jolly, Malcolm Campbell and Alan McKay
(University of Newcastle, Northern Postgraduate Deanery, Newcastle upon Tyne, UK)
1400
7F 4
Remedial training for doctors identified as “poorly performing” in
communication skills – an update on the Birmingham experience
Jo Piercy*, John Skelton & David Wall (Department of Primary Care and General Practice, University
of Birmingham, Birmingham, UK)
1415-1445
Discussion
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7G
Different Approaches to Staff Development
Chair:
To be announced
Discussant: Juerg Steiger, Switzerland
Location:
Room 120
1315
7G 1
Professionalising teaching: Scottish Clinical Teaching Fellowships
J Syme-Grant* & P A Johnstone (NHS Education for Scotland, Dundee, UK)
1330
7G 2
The development of medical teachers: interviews with ten experienced
medical teachers
Jane MacDougall* & Mary Jane Drummond (Addenbrooke’s Hospital, Department of Obstetrics
and Gynaecology, Cambridge, UK)
1345
7G 3
Webcast audio seminars as a technique for international faculty
development
Roger W Koment*, Peter G Anderson & Julie K Hewett (International Association of Medical Science
Educators (IAMSE), Springfield, USA)
– 2.30 –
Section 2: Tuesday
1400
7G 4
Hunting for medical education references – search strategies compared
E K Kachur*, M Schwartz, C Gillespie, M Yedidia, P Kinnersley, A Kalet, R Janicik, L Altshuler, K
Mukohara & T Comerci (The ROCAT Topic Review Group) (Medical Education Development, New York,
USA)
1415
7G 5
Anaesthetists as teachers
Michael Clapham* & Alison Bullock (West Midlands Deanery, Postgraduate Medical and Dental
Education, Birmingham, UK)
1430-1445
Discussion
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7H
Student Diversity
Chair:
Danai Wangsaturaka, Thailand
Discussant: Ara Tekian, USA
Location:
Room 215
1315
7H 1
Valuing diversity: working class students and doctors
Barry Ewart* & Jill Thistlethwaite (University of Leeds, Medical Education Unit, Leeds, UK)
1330
7H 2
An educational strategy to develop disadvantaged students into health
professionals
Elmi Badenhorst*, Rachel Alexander & Trevor Gibbs (Department of Public Health and Primary Health
Care, Cape Town, SOUTH AFRICA)
1345
7H 3
What students think are the reasons for their academic failure in our
physiology course
Nancy Fernandez-Garza (Facultad de Medicina, Universidad Autónoma de Nuevo Leon, Monterrey,
MEXICO)
1400
7H 4
Are there personality differences between students who drop out of medical
school and those who remain?
Gillian B Clack*, Derek Cooper & Susan Standring (King’s College London, London, UK)
1415
7H 5
Does the choice of elective clerkship predict specialty training?
Willemina M Molenaar*, Jan Jaap Reinders, Janke Cohen-Schotanus (Institute of Medical Education,
University of Groningen, Groningen, NETHERLANDS)
1430-1445
Discussion
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7I
Evaluation of Problem Based Learning
Chair:
Ibraham Alayed, Saudi Arabia
Discussant: Bjorn Bergdahl, Sweden
Location:
Room 114
1315
7I 1
Pre-Registration House Officers (PRHOs) assess their undergraduate education
Simon Watmough*, Anne Garden & David Graham (University of Liverpool, Department of Primary
Care, Liverpool, UK)
1330
7I 2
Comparison of three instructional methods of teaching for medical students
Eiad Al-Faris (Department of Family and Community Medicine, King Saud University, Riyadh, SAUDI
ARABIA)
– 2.31 –
Section 2: Tuesday
1345
7I 3
Does PBL work? Does Music? Side 2: scenario design
Brian Bailey (Napier University, School of Community Health, Edinburgh, UK)
1400
7I 4
Evaluation of a PBL curriculum in comparison to a parallel conventional
course at the Medical Faculty of the University of Hamburg, Germany
Ralf Wieking, Christian E Guksch, Olaf Kuhnigk & Monika Bullinger* (University of Hamburg,
Modellstudiengang Medizin, Hamburg, GERMANY)
1415-1445
Discussion
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7J
Management of Clinical Training
Chair:
Larry Grupen, USA
Discussant: Stephen Aaron, Canada
Location:
Room 106
1315
7J 1
The county hospital – what can it offer medical students and what does it get
in return?
Berit Eika (University of Aarhus, Unit of Medical Education, Aarhus, DENMARK)
1330
7J 2
An academy model for medical education – the student perspective
Julia Sanday, David Mumford & Clive Roberts* (Bristol University Medical School, Centre for Medical
Education, Bristol, UK)
1345
7J 3
Changing perceptions in medical education: the emergence of rural clinical
schools as levers for change
Judi Walker (University of Tasmania, University Department of Rural Health, Tasmania, AUSTRALIA)
1400
7J 4
Evaluation of a web-based project to improve the quality of clinical
attachments in North Devon
Richard Ayres (North Devon District Hospital, Medical Education Centre, Barnstaple, UK)
1415
7J 5
Development of information system to monitor the long-term achievement of
the collaborative project to increase production of rural doctors
Suwat Lertsukprasert & Waraporn Eoaskoon* (Office of the Collaborative Project to Increase
Production of Rural Doctors, Nonthaburi, THAILAND)
1430-1445
Discussion
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7K
Clinical Training in Different Settings
Chair:
Jack Boulet, USA
Discussant: Paul Bradley, UK
Location:
Room 206
1315
7K 1
Modelling clinical competence in a medical internship: the impact of variation
in actual clinical experiences
P F Wimmers*, T A W Splinter & H G Schmidt (University Medical Centre Rotterdam, Erasmus MC,
Rotterdam, NETHERLANDS)
1330
7K 2
Innovations in the clerkship of internal medicine
JCG Jacobs*, S Bolhuis, JA Bulte & RSG Holdrinet (University Medical Centre Nijmegen, Department
of Medical Education, Nijmegen, NETHERLANDS)
– 2.32 –
Section 2: Tuesday
1345
7K 3
Inter-site consistency as a measurement of programmatic evaluation in a
medicine clerkship with multiple, geographically separated sites
Steven J Durning*, Louis N Pangaro, Gerald D Denton, Paul A Hemmer, Alan Wimmer, Thomas Garu,
Margaret Gaglione & Lisa Moores (Uniformed Services University, Dept of Medicine, Bethesda, USA)
1400
7K 4
A student-organized introduction to the clinical rotation of medical education,
Karolinska Institutet, Stockholm
H Brauner*, P Grenholm, I M Petermann, M Nystrom & J Bjorklund (Medical Students Association,
Stockholm, SWEDEN)
1415
7K 5
Acquiring clinical competence during clerkships
Gitte Wichmann-Hansen* & Berit Eika (Aarhus University, Unit of Medical Education, Aarhus,
DENMARK)
1430-1445
Discussion
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7L
Professionalism (2)
Chair:
Marianna Shershneva, USA
Discussant: Hank Slotnick, USA
Location:
Room 105
1315
7L 1
Advancing professionalism in medical education: a view from the margins
Viv Cook* & Sandra Nicholson (Department of General Practice and Primary Care, Barts and The
London, London, UK)
1330
7L2
What is professionalism? A pilot study of Danish Internal Medicine SHOs’ views
D J Davis, A M Skaarup* & C Ringsted (Copenhagen Hospital Corporation Postgraduate Medical
Institute, Copenhagen, DENMARK)
1345
7L 3
Student perceptions of the strengths and possible improvements of a
personal and professional development (PPD) curriculum
Kate Drysdale* & Iain Robbe (University of Wales College of Medicine, Cardiff, UK)
1400
7L 4
Towards assessment of professional behaviour in vocational GP trainees: the
development of the Professional Behaviour in General Practice instrument
K van de Camp*, M Vernooij-Dassen, R Grol & B Bottema (UMC St Radboud, University Medical Centre
Nijmegen, NETHERLANDS)
1415
7L 5
A systematic approach to assessing professionalism
Patricia M Surdyk* and Susan R Swing (Accreditation Council for Graduate Medical Education,
Chicago, USA)
1430-1445
Discussion
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7M
Outcome-based Education
Chair:
To be announced
Discussant: John Simpson, UK
Location:
Room 115
1315
7M 1
The Tecnológico de Monterrey School of Medicine’s competence-based
curriculum with emphasis in professionalism: design and implementation of
longitudinal and integrative development of professionalism competencies
Claudia Hernández Escobar, Leticia Elizondo Montemayor*, Graciela Medina Aguilar, Antonio Dávila
Rivas & Angel Cid García (Tecnologico de Monterrey School of Medicine, Nuevo Leon, MEXICO)
– 2.33 –
Section 2: Tuesday
1330
7M 2
The Competence-based Curriculum Concept of Cologne (4C) – a curriculum
mapping procedure to integrate discipline, problem, and outcome-based
learning
S Herzig*, C Stosch, S Kruse, M Eikermann & R Mosges (University of Koeln, Department of
Pharmacology, Koeln, GERMANY)
1345
7M 3
Required levels of competence in clinical skills at different stages of the
undergraduate medical curriculum
I Treadwell*, J D Makin, J Blitz-Lindeque & P T Kenny (University of Pretoria, Skills Laboratory, Pretoria,
SOUTH AFRICA)
1400
7M 4
Development of a National Framework of Needs-based Competency
Standards: The CanMEDS project
Jason R Frank*, Nadia Mikhael & Gary Cole (Royal College of Physicians and Surgeons of Canada,
Ottawa, CANADA)
1415
7M 5
Designing the undergraduate medical curriculum to reflect postgraduate
competencies and societal needs
P Niall Byrne, Ian L Johnson, Anita Rachlis, Jay Rosenfield*, Xerxes Punthakee, Katherine MacRury
& Barbara McRobb (University of Toronto, Toronto, CANADA)
1430-1445
Discussion
1445-1510
Coffee
1510-1640
Session 8
Posters: Simultaneous themed sessions
Presenters and participants should assemble by the poster boards of the relevant session (see
summary on page 1.15)
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8A
Assessment General
Chair:
Location of Boards:
8A 1
Ernest Skakun, Canada
Dome/Kuppelsaal, 5th Floor
Quality assurance in developing multiple choice questions
Andreas Stein*, Waltraud Georg, Kira Flemming and Katharina Crolow (Humboldt Universitat,
Reformstudiengang Medizin, Berlin, GERMANY)
8A 2
The first partial test note as an assessment tool of performance in first year
medical students
Carlos E de la Garza-Gonzalez*, Maria Esthela Morales Perez & Norberto Lopez Serna (Facultad de
Medicina, Universidad Autónoma de Nuevo Leon, Monterrey, MEXICO)
8A 3
Knowledge acquisition and forgetfulness in health sciences students
Maria Escriva, David Cid, Eva Bailles, Mireia Valero & Jorge Perez* (Facultat de Ciencias de la Salut i
de la Vida, Universitat Pompeu Fabra, Barcelona, SPAIN)
8A 4
Assessing medical students’ communication skills by using drama students
as simulated patients
Jorgen Urnes*, Hilde Grimstad & Bjorn Rasmussen (NTNU, Faculty of Medicine, Trondheim, NORWAY)
8A 5
What contributes to the variance in NBME subject exam scores and
recommended grades from teachers? A 10-year clerkship analysis
Steven J Durning*, Louis N Pangaro, Paul A Hemmer and Gerald D Denton (Uniformed Services
University, Dept of Medicine, Bethesda, USA)
– 2.34 –
Section 2: Tuesday
8A 6
Are medical students’ examination results affected by their gender and ethnicity?
S Kilminster*, K Boursicot, V Wass & T E Roberts (Medical Education Unit, University of Leeds, Leeds,
UK)
8A 7
Gender differences as observation in the assessment of performance
Regina Conradt* & Ed Peile (University of Oxford, Department of Primary Health Care, Oxford, UK)
8A 8
Matching criterion-based student self-assessment with teacher assessment:
is there coherence?
Araceli Hambleton-Fuentes*, David Cantu & Leticia Elizondo-Montemayor (School of Medicine,
Tecnologico de Monterrey, Nuevo Leon, MEXICO)
8A 9
Developing an in-training examination for gastroenterology fellows
Amindra S Arora (Mayo Clinic, Department of GIH, Rochester, USA)
8A 10
Clerkship preceptor handbook of core students skills
Paul Hemmer (USUHS Educational Programs Division) (Uniformed Services University, Bethesda,
USA)
8A 11
Assessment of postgraduate medical courses: the question of how to
improve their quality
Beatriz Graciela Borenstein (on behalf of Pedagogical Dept) (Sociedad Argentina de Terapia Intensiva
(SATI), Buenos Aires, ARGENTINA)
8A 12
Empathy as a function of gender and levels of undergraduate and graduate
medical education in Mexico
Adelina Alcorta G-Gonzalez*, Mohammadreza Hojat, Juan-F González-G, Jesús Ancer-R, María-V
Bermúdez, Juan Montes-V, Marco-V Gómez-M, A-Enrique Alcorta-G, Silvia Tavitas-H & Sheila-M
Garza (University Hospital, Mexico City, MEXICO)
8A 13
Assessment of basic practical skills in an undergraduate medical curriculum
S Elango*, J C Ramesh, T Motilal, L C Loh, P Kandasami & C L Teng (International Medical University,
Seremban, MALAYSIA)
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8B
Clinical Assessment
Chair:
Location of Boards:
8B 1
Brian Hodges, Canada
Dome/Kuppelsaal, 5th Floor
A new approach to a clinical final examination
C Carvajal*, M Bustamante, R Dalmazzo, J Olivos & J Vukasovic (Universidad de Chile, Facultad de
Medicina, Santiago, CHILE)
8B 2
The relationship of examination candidate performances between the Medical
Council of Canada’s (MCC) computer-based examination and the MCC clinical
skills examination
D E Blackmore*, T J Wood, W D Dauphinee, S M Smee & A P Boulais (The Medical Council of Canada,
Ottawa, CANADA)
8B 3
The role of the observed long case in postgraduate medical training
Nicholas Pavlakis and Rodger Laurent* (Department of Rheumatology, Royal North Shore Hospital,
Sydney, AUSTRALIA)
8B 4
Medical students perceive the OSCE as a fair re-sit assessment tool
Jonathan Syme-Grant* & P A Johnstone (NHS Education for Scotland, Dundee, UK)
– 2.35 –
Section 2: Tuesday
8B 5
Easy as ‘pie’ – improving OSCE instructions
Cynthia Yiu, Martin Mueller* & Michael Marsh (Guy’s, King’s and St Thomas’ Medical School, London,
UK)
8B 6
Re-using an OSCE station and its re-take
Leila Niemi-Murola, Pirkko Heasman*, Markku Kaipainen, Timo Kuusi & Kirsti Lonka (Research and
Development Center for Medical Education, Helsinki University, Helsinki, FINLAND)
8B 7
Assessing nurses’ clinical skills with OSCE
A Molins*, M Sola, A M Pulpon, S Juncosa and J M Martinez-Carretero (Institute of Health Studies,
Barcelona, SPAIN)
8B 8
Introduction of objective structure clinical examination (OSCE) at TashPMI
and subsequent evaluation
Dilbar A Mavlyanova* and Muazam A Ismailova (Tashkent Pediatric Medical Institute, Tashkent,
UZBEKISTAN)
8B 9
Analysis of questionnaire survey of raters, students and standardised
patients on the 12-station OSCE used at the Kurume University School of
Medicine
Takato Ueno*, Ichiro Yoshida, Hiroki Inutsuka & Michio Sata (Research Center for Innovative Cancer
Therapy, Kurume University School of Medicine, Kurume, JAPAN)
8B 10
Clinical skills assessment at medical schools – Catalonia (Spain), 2002
E Kronfly, L Gracia, X Julia, J Majo, J Prat, A Castro, J A Bosch, A Urrutia, J L Gimeno, C Blay & R Pujol*
(Institute of Health Studies, Barcelona, SPAIN)
8B 11
The relationship between performance on a third-year medical student OSCE
and performance on the USMLE step 1 examination
Kelly Kirby Ortega*, Neena Natt, Robert Tiegs & Jay Mandrekar (Mayo Graduate School of Medicine,
Mayo Clinic, Rochester, USA)
8B 12
Professional exam: an integral clinical exam with real patients
Maria Eugenia Ponce de Leon*, Armando Ortiz Montalvo and Maria del Carmen Ruiz (National
Autonomous University of Mexico Medical School, Camino Santa Teresa, MEXICO)
8B 13
Rater disagreement in OSCE
J M M van de Ridder*, V Batenbrug, J Buis, V Eijzenbach, F J M Grosfeld & M M Kuyvenhoven (University
Medical Centre Utrecht, Utrecht, NETHERLANDS)
8B 14
Practical assessments used in preparing students for their clinical year
G Till* & H Till (Canadian Memorial Chiropractic College, Toronto, CANADA)
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8C
The Curriculum (1), including Multiprofessional Education
Chair:
Location of Boards:
8C 1
Nick Ross, UK
Dome/Kuppelsaal, 5th Floor
Oncology – an interdisciplinary course
C Haag*, H Alheit, M Baumann, O Hakenberg, U Wehrmann, M Wirth & G Ehninger (Medical Faculty,
Dresden University of Technology, Dresden, GERMANY)
8C 2
Palliative care in the medical curriculum at Bern, Switzerland: when and how
S Eychmueller (Kantonsspital St. Gallen, Palliativstation, St Gallen, SWITZERLAND)
– 2.36 –
Section 2: Tuesday
8C 3
Survey of clinical epidemiology teaching program need in the Thai medical
curriculum
Pairoj Boonluksiri (Hatyai Hospital, Songkhla, THAILAND)
8C 4
From classic to modern: developing a new teaching strategy in epidemiology
Irina Brumboiu*, Ioan S Bocsan, Amanda Radulescu and Ofelia Suteu (Iuliu Hatieganu University of
Medicine and Pharmacy, Epidemiology Department, Cluj-Napoca, ROMANIA)
8C 5
Community based education: strategies for effective student commitment
R G Souza, F Menezes*, L M Camarotti & J Araujo (Federal University of Roraima, Roraima, BRAZIL)
8C 6
Biologic threats to society: successful integration of a longitudinal theme
into the medical school curriculum
John F Mahoney*, Kathleen D Ryan & Steven L Kanter (University of Pittsburgh School of Medicine,
Office of Medical Education, Pittsburgh, USA)
8C 7
Early professional contact (EPC) for medical students: Gothenburg
experience
Gunilla Hellquist*, Bernhard von Below, Stig Rodjer & Gudny Sveinsdottir (Department of Primary
Care, Goteborg, SWEDEN)
8C 8
Early introduction of family medicine during undergraduate medical training
M I Nurjahan*, CL Teng, K Y Loh, A R Yong Rafidah, S K Kwa, M L Young, L C Lai, KY Ong & P C Y Chen
(International Medical University, Clinical School, Negeri Sembilan, MALAYSIA)
8C 9
Defining the content of a physiotherapy program in Switzerland – a needs
assessment
Markus Schenker (Health Education Centre AZI, School of Physiotherapy, Berne, SWITZERLAND)
8C 10
The team profile – the development of assessment criteria for an
interprofessional ward simulation exercise
J S Ker*, L J Mole, C L Stewart, J Syme-Grant, E Gray, S Benvie & P Johnstone (University of Dundee,
Clinical Skills Centre, Dundee, UK)
8C 11
Interprofessional education of first-year medical and nursing students
Pekka Kaapa*, Jaakko Kytola, Susanna Vierre, Paivi Erkko & Kirsti Ellonen (University of Turku,
Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, FINLAND)
8C 12
Transforming a clinical team in primary care into a community of practice
(COP): the Delta project in CME/CPD
M A Raetzo & R L Thivierge* (University of Montreal, Montreal, CANADA)
8C 13
Integration of the dental students into the Dresden PBL – Curriculum
(DIPOL): highlights of the emergency medicine course
M Muller*, S Weber, I Nitsche, P Dieter & T Koch (Department of Anaethesiology and Intensive Care
Medicine, University Hospital Dresden, Dresden, GERMANY)
8C 14
Not just another multi-professional course
Lorna Olckers, Trevor Gibbs*, Melanie Alperstein, Madeleine Duncan, Licia Karp, Pat Mayers & Ermien
van Pletzen (University of Cape Town, Department of Public Health, Cape Town, SOUTH AFRICA)
8C 15
A pilot exercise in multi-professional learning
H McKenzie* & J Harper (Medical Education Unit, Aberdeen University Medical School, Aberdeen,
UK)
8C 16
Interprofessional Education: making it happen
Hazel Chalmers (NUTS, Newcastle upon Tyne, UK)
– 2.37 –
Section 2: Tuesday
8C 17
Narrowing the gap in health – beyond the NHS?
Linda Leighton-Beck (Aberdeen University, Dept of General Practice and Primary Care, Aberdeen, UK)
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8D
The Curriculum (2)
Chair:
Location of Boards:
8D 1
Torstein Vik, Norway
Dome/Kuppelsaal, 5th Floor
Effectiveness of first batch of graduates at Maharat Nakhon Ratchasima
Hospital School of Medicine
Ritthiya Littirong (Maharat Nakhon Ratchasima Hospital, School of Medicine, Nakhon Ratchasima,
THAILAND)
8D 2
The transition from student to doctor: a small step or a big leap?
K Prince*, A Scherpbier, E Boshuizen & C van der Vleuten (Maastricht University, Skillslab,
Maastricht, NETHERLANDS)
8D 3
New curriculum of the School of Medicine of the University of Concepcion,
Chile: training physicians capable of responding to the demands and
challenges of the new century
Octavio Enriquez* & Mario Munoz (University of Concepcion, Concepcion, CHILE)
8D 4
Using modified Delphi technique to prioritise problems in curriculum
development
N Sirisup, S Limpongsanurak, C Ittipanichpong*, A Srikiatikhachorn, S Patumraj, D Wangsaturaka &
P Kamolratanakul (Department of Pharmacology, The Faculty of Medicine, Bangkok, THAILAND)
8D 5
Structuring the first 3 blocks or semesters in the school of medicine –
Monterrey Tec – Mexico in accordance with objectives of courses and
competencies the student must acquire
Graciela Medina*, Demetrio Arcos, Enrique F J Martinez, Jorge Valdez and Ricardo Trevino (School of
Medicine - Monterrey Tec, ITESM, Monterrey, MEXICO)
8D 6
Restructuring the undergraduate medical curriculum at the Medical Faculty
Skopje, Macedonia: comparison with some other European models
Z Gucev*, J Saveski, M Soljakova and K Boskoski (Medical Faculty Skopje, Skopje, MACEDONIA)
8D 7
Transfer appropriate processing and schema formation in first year students
Mary Kelly*, Aileen Patterson, Bernard McCartan & Diarmuid Shanley (Dublin Dental Hospital, Dublin,
IRELAND)
8D 8
Competencies as teaching and learning goals
Monika Beck*, Hansruedi Kaiser*, Beat Keller* & Stefan Knoth* (BZG Kanton Solothurn,
Bildungszentrum fur Gesundheitsberufe, Olten, SWITZERLAND)
8D 9
A comparison between the instructors’ viewpoints and students’ viewpoints
on the current situation of clinical education in SUMS
L Bazrafkan & M Alizadeh* (Shiraz University of Medical Sciences, Internal Medicine Department,
Shiraz, IRAN)
8D 10
First grade students’ interviews as physicians in the community model
Carlos Rojas Mora*, Robles Garcia Lucia & Cura Garcia Norma (School of Medicine Tecnologico de
Monterrey, Monterrey, MEXICO)
8D 11
Physiotherapists’ “clinical reasoning” as a main educational strategy
Peter Eigenmann* & Helena Luginbuhl (Feusi Physiotherapieschule, Bern, SWITZERLAND)
– 2.38 –
Section 2: Tuesday
8D 12
Evaluation as dialogue between stakeholders – a tool for learning and
content development of medical education
Mona Fjellstrom (Umea University, Centre for Teaching and Learning, Umea, SWEDEN)
8D 13
One year experience with the new curriculum at Heidelberg Medical School
N De Cono*, E Gazyakan, S Holler, J Schmidt & M Kadmon (Heidelberg Medical School, Schriesheim,
GERMANY)
8D 14
Problems and perspectives of the teaching of primary care under the new law
on medical education in Germany
M Ehrhardt, H van den Bussche* & H Kaduskiewicz (Institute of General Practice, Institut fur
Allgemeinmedizin, Hamburg, GERMANY)
8D 15
The social service year in medical education: a Mexican case study
Julio Cesar Gomez, Pilar Talayero & Todd W Ellwein (Universidad Westhill, Mexico City, MEXICO)
8D 16
Evaluation of a new model of senior clerkship in an undergraduate medical
curriculum
J C Ramesh*, A L Mohamed, T Motilal, M I Nurjahan, R Khuzaiah & P Kandasamy (International Medical
University, Selangor, MALAYSIA)
8D 17
Teaching case management for chronic illness care in an undergraduate
general practice course
Jochen Gensichen* & Ferinand Gerlach (Institute for General Practice, University Hospital
Schleswig-Holstein, Kiel, GERMANY)
8D 18
Assessment of student attitudes and knowledge about aging: a longitudinal
comparison of medical student cohorts
Debra A Newell*, Anthony DiNuzzo, L Felipe Amador & Ann W Frye (University of Texas Medical Branch,
Office of Educational Development, Galveston, USA)
8D 19
The survey of medical students’ and graduates’ awareness about concepts
and benefits of community-oriented medical education in Iran
Sedighe Najafipour*, F Azizi & M Saberfiroozi (Mottahri Clinic, Shiraz, IRAN)
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8E
Evaluation of the Curriculum
Chair:
Location of Boards:
8E 1
Peter Nippert, Germany
Dome/Kuppelsaal, 5th Floor
Teaching evaluation as part of interactive quality management at the Medical
Faculty of Freiburg
V Peus*, G Valerius, H D Hofmann & M Berger (Studiendekanat der Medizinischen Fakultat Freiburg,
Freiburg, GERMANY)
8E 2
Faculty attitudes: a straight way to faculty evaluation
Abdolreza Jahanmardi, Morteza Haghirizade Roodani*, Hayat Membeini, Roya Jahanmardi (Ahvaz
Medical Sciences University, Educational Development Center (EDC), Ahvaz, IRAN)
8E 3
Think bigger than “happy sheets”
Jane Ross, Sandy Stewart* and Patrick McKinlay (NHS Education for Scotland, Turriff, UK)
8E 4
Evaluating the quality of a problem-based medical training: experiences at
the University of Hamburg
Monika Bullinger (Institute and Clinic for Medical Psychology, Centre for Psychosocial Medicine,
Hamburg, GERMANY)
– 2.39 –
Section 2: Tuesday
8E 5
Students’ evaluation of the undergraduate curriculum
I Rumba* and U Vikmanis (University of Latvia, Riga, LATVIA)
8E 6
Evaluation strategy for the Hybrid-curriculum at the Faculty of Medicine,
University of Basel
G Voigt*, B Roeers, V Exner and K Pierer (Educational Dean’s Office, Faculty of Medicine, Basel,
SWITZERLAND)
8E 7
Registrars in paediatrics demand more personal interest from their teaching
professors
D G van Vuurden*, F Scheele, J van de Lande and B H M Wolf (St Lucas Andreas Hospital, VU Medical
Centre, Amsterdam, NETHERLANDS)
8E 8
Focus group as tool for quality assurance in communication skills training
and standardized patient contact
Isabel Muehlinghaus*, Heiderose Ortwein and Claudia Kiessling (Universitaetsklinikum Charité
Berlin, HU zu Berlin, Berlin, GERMANY)
8E 9
Evaluation of undergraduate medical education as a part of the European
Union access process – an experience at the Jessenius Medical Faculty of
Comenius University in Martin, Slovakia
Lukas Plank*, Jan Danko, Eva Rozborilova, Peter Galajda & Karol Dokus (Jessenius Faculty of Medicine,
Martin, SLOVAK REPUBLIC)
8E 10
Analysis of educational evaluation at the Faculty of Medicine
Lenka Doubravska*, Radim Licenik, Vit Gloger, Miroslav Herman, Jarmila Indrakova, Daniela Jelenova,
Petr Jindra, Barbora Krajzlova, Pavel Kurfurst, Ivana Oborna, Katherine Ruzicka, Jan Strojil &Cestmir
Cihalik (Medical Faculty of Palacky University, Olomouc, CZECH REPUBLIC)
8E 11
The role of evaluation and accreditation in improving medical education quality
Fereshted Farzianpour and colleagues (Education Development Centre, Tehran, IRAN)
8E 12
A survey about probable factors affecting the academic staff’s evaluation by
the students
R Rezaie*, A Bazargani & M Amini (EDC Center, Shiraz, IRAN)
8E 13
Quality improvement in medical student assessment
Supawadee Prakunhungsit*, Boonmee Sathapatayavongs and Tharntip Malaisirirat (ENT
Department, Ramathibodi Hospital, Bangkok, THAILAND)
8E 14
Students’ evaluation of an undergraduate course in the community
Eva Rasky (Institute of Social Medicine and Epidemiology, Karl-Franzens-University Graz, Graz,
AUSTRIA)
8E 15
The most pleasant and the most unpleasant in the first year in the University
according to students’ opinions of the Faculty of Medicine University of Chile
in 2001
Ilse Lopez, Zulema Vivanco, Manuel Castillo & Enrique Mandiola (presented by Beatriz Saavedra)
(Facultad de Medicina, Universidad de Chile, Santiago, CHILE)
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8F
Teaching Clinical Skills (1)
Chair:
Location of Boards:
To be announced
Dome/Kuppelsaal, 5th Floor
– 2.40 –
Section 2: Tuesday
8F 1
Does the Paediatric Advanced Life Support (PALS) course improve
confidence in knowledge and performance of paediatric resuscitation?
Jos M Th Draaisma* & Nigel McBeth Turner (Dutch Foundation for the Emergency Medical Care of
Children, Nijmegen, NETHERLANDS)
8F 2
“Paper cases” help to organize a dermatology practical course
A Boer & F Ochsendorf* (Universitats-Hautklinik, d.j.w. Goethe-Universitat, Frankfurt am Main,
GERMANY)
8F 3
Skills training in obstetrics
Jette Led Sorensen*, Morten Lebech & Tom Weber (The Clinic of Obstetrics, Rigshospitalet,
Copenhagen, DENMARK)
8F 4
Evaluation of modified case-based-learning-lessons
R Faber*, C Nikendei, D Schellberg, C Roth, A Zeuch, B Auler, W Herzog & J Juenger (Department of
Internal Medicine, University of Heidelberg, Heidelberg, GERMANY)
8F 5
Student perceived benefit from a surgical specialty theatre attendance
Michael S W Lee*, Mary-Louise Montague & S S Musheer Hussain (Ninewells Hospital and Medical
School, Dundee, UK)
8F 6
Experience of first ever batch of senior clerkship in International Medical
University Malaysia
Esha Das Gupta*, Nurjahan Mohd Ibrahim, Dr Motilal and Teng C L (International Medical University,
Seremban, MALAYSIA)
8F 7
Providing artificial experience through integrated, case-based,
multidisciplinary forum presentations
Hettie Till*, Oryst Swyszcz & Peter Cauwenbergs (Canadian Memorial Chiropractic College, Toronto,
CANADA)
8F 8
Peer tutoring success in clinical skills
Clare Stewart*, Joy Crosby & Jean Ker (Dundee University, Clinical Skills Centre, Dundee, UK)
8F 9
The 5W-H reflective approach to patient assessment
Joyce Mothabeng (University of Pretoria, Akasia, SOUTH AFRICA)
8F 10
Learning in the clinical environment of district and university hospitals in the
Netherlands
K B Boor*, F Scheele, C van Aken, J Dronkert, J Th M van der Schoot & Bart Wolf (SLAZ, Department
of Women and Child Health, Amsterdam, NETHERLANDS)
8F 11
Strengths and weaknesses of graduate medical clinical training in Ghent,
according to 2nd year postgraduates
M van Winckel, B Morlion*, S van de Moortele, A Derese & M Valcke (Universitair Ziekenhuis Gent,
Gent, BELGIUM)
8F 12
Integration of learning situations in primary health care: experiences from the
Berlin Reformed Track at the Charité, Germany
Claudia Kiessling*, Margareta Kampmann, Dagmar Rolle & Ulrich Schwantes (Arbeitsgruppe
Reformstudiengang Medizin, Charité, Berlin, GERMANY)
8F 13
Redefining the role of a Learning Resource Centre in a medical school
Bruce Holmes (Learning Resource Centre, Dalhousie University, Faculty of Medicine, Halifax, CANADA)
– 2.41 –
Section 2: Tuesday
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8G
Clinical Skills (2)
Chair:
Location of Boards:
8G 1
To be announced
Dome/Kuppelsaal, 5th Floor
Student satisfaction with standardized patient encounters in an emergency
medicine class at Charité Medical School, Humboldt University, Berlin
Heiderose Ortwein*, Torsten Schroeder & Claudia Kiessling (Charité Medical School, Humboldt
University of Berlin, Berlin, GERMANY)
8G 2
Medical students’ communication abilities prior to training
Nicola Brown*, Kathryn Peace & John Campbell (Department of Psychological Medicine, University of
Otago, Dunedin, NEW ZEALAND)
8G 3
Consultation skills never made easy
A Skott*, M Wahlqvist, C Bjorkelund, I Gause-Nilsson, B Dahlin & B Mattsson (Sahlgrenska Academy
at Goteborg University, Department of Public Health, Goteborg, SWEDEN)
8G 4
Obligatory training of communication skills in the regular curriculum of the
Charité, Berlin
Margareta Kampmann*, Britta Jonitz, Martina Schlunder & Ulrich Schwantes (Charité Berlin,
Institut für Allgemeinmedizin, Berlin, GERMANY)
8G 5
Consultation and communication skills for overseas doctors: culture, training
and reward
Alison Henry*, William Murdoch and Mohammed Arafa (Department of Primary Care and General
Practice, Primary Care Sciences and Learning Centre, Birmingham, UK)
8G 6
Course for breaking bad news
Daniela Jelenova*, Renata Simkova, Lenka Doubravska, Vit Gloger, Jarmila Indrakova, Petr Jindra,
Barbora Krajzlova, Pavel Kurfurst, Radim Licenik, Jarmila Potomkova, Jan Strojil, Iveta Zedkova &
Cestmir Cihalik (Medical Faculty of Palacky University, Olomouc, CZECH REPUBLIC)
8G 7
New High Frequency Oscillatory Ventilator Simulator
Abdulla Al Thari*, C A S Melville, Y Wickramasinghe & A Al Shihri (Keele University, North Staffs
Hospital, Centre for Science and Technology in Medicine, Stoke on Trent, UK)
8G 8
Patient safety and high fidelity simulation in undergraduate medical
education: learning the skills of Crisis Resource Management
Brendan Flanagan, Debra Nestel*, Michele Joseph, Michael Bujor, Julia Harrison & Orla Lacey (Monash
University, Centre for Medical & Health Sciences Education, Victoria, AUSTRALIA)
8G 9
Training of simulated patients: the effect of a self-written scenario on
performance and feedback quality
Kenichi Mitsunami*, Masahiko Terada, Hiroki Tamura, Hidetoshi Matsubara and Tadao Bamba (Shiga
University of Medical Science, Department of General Medicina, Shiga, JAPAN)
8G 10
Incorporating a newly developed heart sound simulator into medical student
education
Katsuya Yoshida, Yoichi Kuwabara, Keiichi Nakagawa, Masahiro Tanabe* and Issei Komuro (Chiba
University Graduate School of Medicine, Chiba, JAPAN)
8G 11
Simulator based course in emergency management for primary care dental
practice teams
S Weber*, M Muller, E Armstrong and T Koch (Department of Anaethesiology and Intensive Care
Medicine, University Hospital Dresden, Dresden, GERMANY)
– 2.42 –
Section 2: Tuesday
8G 12
Attitudes and ability: is there a relationship?
Merilyn Liddell* & Sandra Davidson (Monash University, Department of General Practice, East
Bentleigh, AUSTRALIA)
8G 13
The changes in attitudes to death and dying among medical students
Ming-Liang Lai*, Jung-Jong Chen, Hsing-Hsing Chen & Chantal Co-Shi Chao (Tzu Chi University, Hualien, TAIWAN)
8G 14
Survey of staff attitudes to the daily otolaryngology ward round
Mary-Louise Montague*, Michael S W Lee and SS Musheer Hussain (Ninewells Hospital and Medical
School, Department of Otolaryngology, Dundee, UK)
8G 15
Assessment of quality of morning report
Akbar Derakhshan (Mashhad University of Medical Science, EDC, Mashad, IRAN)
8G 16
Bedside tutorial-based formative assessment promotes learning in clinical
clerkships
V C Burch*, T Gibbs and J L Seggie (University of Cape Town, Department of Medicine, Cape Town,
SOUTH AFRICA)
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8H
International Medical Education
Chair:
Location of Boards:
8H 1
To be announced
Dome/Kuppelsaal, 5th Floor
Implementing a womens’ sexual health curriculum for St Petersburg, Russia
L Southgate*, P Toon, S Pavinski & O Kuzatova (Academic Centre for Medical Education, London, UK)
8H 2
Evaluation of a new program in international health
A Jotkowitz*, A Gaaserud, Y Gidron, J Urkin, Y Henkin & C Z Margolis (Ben-Gurion University, The
Moshe Prywes Center for Medical Education, Beer Sheva, ISRAEL)
8H 3
Programme for integration of third world medical doctors
Mette Valbjoern (Office for Postgraduate Medical Education, Hoejbjerg, DENMARK)
8H 4
Experience of improving the neonatal teaching at the pediatric faculty
M A Ismailova*, D A Mavlyanova & Z G Rachmankulova (Tashkent Pediatric Medical Institute,
Tashkent, Uzbekistan)
8H 5
Expanding the boundaries of medical education: evidence for cross-cultural
exchanges
Ian S Mutchnick, Cheryl A Moyer and David T Stern* (University of Michigan Health System, Ann
Arbor, USA)
8H 6
The effect of international medical rotations on students’ attitudes: a
qualitative study
Cheryl A Moyer & David T Stern* (University of Michigan Health System, Ann Arbor, USA)
8H 7
Assessing global essential competencies in the leading Chinese medical
schools: The IIME Project
Andrzej Wojtczak*, David T Stern & M Roy Schwarz (Institute for International Medical Education,
New York, USA)
8H 8
A Harvard program for German final year students
H Baschnegger*, A S Peters, H T Aretz & F Christ (Ludwig Maximilians University, Klinik fuer
Anaesthesiologie, Munich, GERMANY)
– 2.43 –
Section 2: Tuesday
8H 9
Internationalisation of medical education in the Netherlands
Gerard D Majoor* & Susan Niemantsverdriet (Maastricht University, Faculty of Medicine,
Maastricht, NETHERLANDS
8H 10
English taught semester in medicine at the University of Oslo
Borghild Roald*, Sverre Bjerkeset & Babill Stray-Pedersen (University of Oslo, Department of
Pathology, Oslo, NORWAY)
8H 11
Correlations to attitudes and knowledge about international health
A Gaaserud*, A Jotkowitz, Y Gidron, C Baskin, M Alkan, Y Henkin & C Margolis (Ben Gurion University
of the Negev, Faculty of Health Sciences, Beer Sheva, ISRAEL)
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8I
Problem Based Learning
Chair:
Location of Boards:
8I 1
To be announced
Dome/Kuppelsaal, 5th Floor
The correlation between students’ perceptions of PBL session and their
scores on MCQ exams at the end of the session
Melih Elcin, Orhan Odabasi, Iskender Sayek*, Murat Akova & Nural Kiper (Hacettepe Universitesi,
Ankara, TURKEY)
8I 2
PBL: what do students think about it?
R Davidova, St Jochkova, P Moushatova, N Narlieva & D Dimitrov* (Medical University, Pleven,
BULGARIA)
8I 3
Putting it all together: Medical students’ understanding of the curriculum
Agnes Dodds*,Mosepele Mosepele, Glen Evans, Susan Elliott & Jeanette Lawrence (The University
of Melbourne, Faculty Education Unit, Melbourne, AUSTRALIA)
8I 4
Students show increased confidence in supported PBL
David C M Taylor* & Trevor J Gibbs (University of Liverpool, Faculty of Medicine Office, Liverpool, UK)
8I 5
Plenary session as a tool for standardization of objectives and conclusions in
a diversified environment where heterogeneity of small groups and tutors’
expertise are the rule
Enrique F J Martinez*, Graciela Medina, Demetrio Arcos, Ricardo Trevino & Jorge Valdez (School of
Medicine - Monterrey Tec, ITESM, Monterrey, MEXICO)
8I 6
Improving the quality of PBL cases – experiences with the implementation of
quality criteria
Ragna Raschke*, Walter Burger, Claudia Kiessling, Rita Leidinger, Dagmar Rolle & Kai Schnabel
(Reformstudiengang Medizin, Charité, Berlin, GERMANY)
8I 7
Critical assessment of factors affecting the exam performance and study
motivation of preclinical phase medical and dental students in integrated PBL
teaching
Tiina Immonen*, Kirsi Sainio, Sanna Partanan, Tuula Nurminen, Juha Okkeri & Timo Sorsa (Institute
of Biomedicine, Developmental Biology, University of Helsinki, Helsinki, FINLAND)
8I 8
Problem based learning at Marilia Medical School
Ricardo Shoiti Komatsu (Marilia Medical School/Famema, Marilia, BRAZIL)
8I 9
Is unprofessional behaviour recognised by first year problem-based learning
students?
M McLean & J Botha* (Department of Experimental and Clinical Pharmacology, Nelson R Mandela
School of Medicine, Congella, SOUTH AFRICA)
– 2.44 –
Section 2: Tuesday
8I 10
Teaching and learning for what? Curriculum change and the challenge to
produce doctors better equipped to serve community health needs
M Alperstein & J Grossman (University of Cape Town, Faculty of Health Sciences, Cape Town, SOUTH
AFRICA) (presented by Trevor Gibbs)
8I 11
DIPOL® (Dresden Integrative Problem-Oriented Learning): a problem-based,
interdisciplinary patient and student-oriented curriculum covering Year 1 and
2, Medical Faculty, TU Dresden
A Morgner, M Witt, M Kasper, A Deussen, V Zuerich, T Kriegel, R Scheibe, J Oehler, H E Krinke, S Albrecht,
F Schonhofer, G Tchitchekian & P Dieter* (Medical Faculty TU Dresden, Dresden, GERMANY)
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8J
Postgraduate Education
Chair:
Location of Boards:
8J 1
To be announced
2nd Floor, east corridor
Progress in paradigm shift: the RCPSC CanMEDS implementation survey
J R Frank*, G Cole, C Lee, N Mikhael & M Jabbour (Royal College of Physicians and Surgeons of Canada,
Ottawa, Ontario, CANADA)
8J 2
Specialist registrars’ views on training in non-clinical competencies
Kathryn Gunn*, David Wall & Robert Palmer (West Midlands Deanery, Birmingham, UK)
8J 3
Introduction of an e-learning course of health economy in Hungarian
Postgraduate Medical Education
Anna Bukovinszky*, Gabor Biro, Tibor Ertl & Arpad Gogl (Centre for Postgraduate Education,
University of Pecs, Pecs, HUNGARY)
8J 4
New ways of teaching basic surgical trainees: the experience of the Yorkshire
School of Surgery
Margaret Ward*, Zoe Fleet, Mark Lansdown & Mike Gough (Postgraduate Department, St James’
University Hospital, Leeds, UK)
8J 5
Administration of the postgraduate doctors’ evaluation of educational
functions supplied by clinical wards
Mette Engholm Dremstrup (Aarhus AMT, Hojbjerg, DENMARK)
8J 6
An evaluation of the role of the Pre-registration House Officer tutor
Pramod Luthra* and Catherine Smith (North Western Deanery, The University of Manchester,
Manchester, UK)
8J 7
The tasks of an internist: how well prepared are trainees?
D J Davis*, A M Skaarup and C Ringsted (Copenhagen Hospital Corporation Postgraduate Medical
Institute, Copenhagen, DENMARK)
8J 8
A new and innovative post-graduate programme in clinical pharmacology
J Botha*, A Gray and M McLean (Department of Experimental and Clinical Pharmacology, Nelson R
Mandela School of Medicine, Congella, SOUTH AFRICA)
8J 9
Post-graduate training in dermatovenereology in Belarus: current status and
problems
Uladzimir Adaskevich (Medical University, Department of Dermatovenereology, Vitebsk, BELARUS)
8J 10
Assessment of the medical sign-out in postgraduate training in obstetrics
and gynaecology
Jeroen van Bavel*, Fedde Scheele, Casper Jansen & Bart Wolf (St Lucas Andreas Hospital, Haarlem,
NETHERLANDS)
– 2.45 –
Section 2: Tuesday
8J 11
Assessment of the medical sign-out in postgraduate training in pediatrics
Casper Jansen*, Bart Wolf, Jeroen van Bavel & Fedde Scheele (St Lucas Andreas Hospital,
Department of Pediatrics, Amsterdam, NETHERLANDS)
8J 12
The role of the logbook in the training of gynaecologists in the Netherlands:
time for change?
S Mahesh*, F Scheele & B H M Wolf (St Lucas Andreas Hospital Amsterdam, Department of
Gynaecology and Obstetrics, Amsterdam, NETHERLANDS)
8J 13
Pitfalls in postgraduate mentoring
B Wolf*, F Scheele, J Roord & J van der Schoot (SLAZ, Amsterdam, Department of Mother and Child
Health, St Lucas Andreas Ziekenhuis, Amsterdam, NETHERLANDS)
8J 14
Continuity clinic in gynecology and obstetrics
Antonio Davila* & Claudia Hernandez (Escuela de Medicina-Tecnologico de Monterrey, Monterrey,
MEXICO)
8J 15
A study on prescription-writing of the interns in Bandar Abbas School of
Medicine
O Safa, Sh Zare & R Amini* (Hormozgan University of Medical University, Office of Vice-Chancellor for
Education and Research, Hormozgan, IRAN)
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8K
Staff Development
Chair:
Location of Boards:
8K 1
William McGaghie, USA
2nd floor, east corridor
Training of teachers in general/family practice – 20 years of experience
M Vrcic-Keglevic*, W Betz, P Heyerick, Z Jaksic, P Owens, H Tiljak & I O Virjo (“A.Stampar” School of
Public Health, Medical School, Zagreb, CROATIA)
8K 2
Enhancing learning and teaching in veterinary medicine
Sarah Marshall (LTSN-01, Learning and Teaching Support Network, Subject Centre for Medicine,
Dentistry and Veterinary Medicine, Newcastle, UK). Gill McConnell is presenting
8K 3
Individual and institutional impact of professional development courses for
physicians as educators
F Christ*, O Genzel-Boroviczeny, T Aretz, E Armstrong & R Putz (Ludwig Maximilians University, Dept
of Anesthesiology, Munich, GERMANY)
8K 4
Changing teachers’ roles and responsibilities in a new interdisciplinary
learner-centered curriculum at the Higher Medical Institute – Pleven, Bulgaria
Z Radionova*, T Pencheva, R Gindeva & B Rousseva (University School of Medicine - Pleven,
Department of Physiology, Pleven, BULGARIA)
8K 5
Broadening medical teachers’ pedagogical thinking – an interdisciplinary
challenge
Anni Peura*, Juha Nieminen, Eeva Pyorala & Aija Helander (University of Helsinki, Research and
Development Unit for Medical Education, Helsinki, FINLAND)
8K 6
Challenging the ‘what works’ culture in medical education: what kind of
research might support the development of teaching in clinical contexts?
Kath Green (Postgraduate Medical and Dental Education, The KSS Deanery, London, UK)
8K 7
Competence Centre for University Teaching in Medicine: Tuebingen – Freiburg
– Ulm: concept and experiences with the cooperation project
Maria Lammerding-Koeppel*, U U Haering, Kerstin Mueller, H D Hofmann, Hubert Liebhardt &
T Mertens (University of Tuebingen, Faculty of Medicine, Tuebingen, GERMANY)
– 2.46 –
Section 2: Tuesday
8K 8
To determine faculty members’ information and practice about validity and
reliability in exams
P Abedi* & S H Najar (Ahwaz Medical University, Nursing and Midwifery School, Ahwaz, IRAN)
8K 9
The effect of an educational program based on PRECEDE model on the level
of academic advisors’ ability and the medical students’ satisfaction
S M M Hazavehei (Department of Health Education and Health Promotion, School of Health, Isfahan,
IRAN)
8K 10
Registrars still in favour of teaching professors with sufficient personal
attention
J van de Lande*, F Scheele, B Wolf, D van Vuurden & J Th M van der Schoot (MCVU, Amsterdam,
NETHERLANDS)
8K 11
Identifying the training and development needs of teachers in a medical school
Mairead Boohan (Queen’s University of Belfast, Medical Education Unit, Belfast, UK)
8K 12
The effects of educational workshops held by EDC of Tehran University of
Medical Sciences on the participant faculty
S Soheili* & A A Zeinanaloo (Tehran University of Medical Sciences, Tehran, IRAN)
8K 13
Which faculty teaching skills require improvement? – a comparison of faculty
and student perceptions
Neena Natt*, Charles H Rohren & Jayawant N Madrekar (Mayo Graduate School of Medicine, Mayo
Clinic, Rochester, USA)
8K 14
Assessment of academic staff evaluation program
N Zarghami, B Rahimi* & R Mokari (Tabriz University of Medical Sciences, Medical Education
Development Centre, Tabriz, IRAN)
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8L
Students
Chair:
Location of Boards:
8L 1
Reg Dennick, UK
Foyer of Dome/Kuppelsaal, 4th floor
To cure or not to cure? Career choices of final year medical students in Germany
Goetz Fabry* & Niko Michaelis (Department of Medical Psychology, University of Freiburg, Freiburg,
GERMANY)
8L 2
The motivation of medical students for their university career
M Diez, A F Compan*, J Medrano, R Calpena & M T Perez Vazquez (University Miguel Hernandez,
Departamento de Patologia y Cirugia, San Juan de Alicante, SPAIN)
8L 3
Students’ expectations of medicine, the doctor’s role and training: 1998-2002
Ana Marchandon A (Universidad de Chile, Santiago, CHILE)
8L 4
Ethnic diversity and intercultural medical experience at Erasmus Medical
Centre Rotterdam
V J Selleger*, B Bonke & Y A M Leeman (Department of Educational Sciences, University of
Amsterdam, Baarn, NETHERLANDS)
8L 5
Women with authority, men with empathy – gender equality in medical school
in Uppsala, Sweden
Karin Grave & Christine Werner (Uppsala Medical School, Uppsala, SWEDEN)
– 2.47 –
Section 2: Tuesday
8L 6
Significance of scientific competitions between medical students
M M Jafarov* & J J Ergashev (The Department of International Cooperation, Tashkent Pediatric
Medical Institute, Tashkent, UZBEKISTAN)
8L 7
Academic underachievement of junior medical students
Mohamed B Awad (Faculty of Medicine, Zagazig University, Zagazig, EGYPT)
8L 8
Student Scientific Society – background of clinical education
A Kuimov*, K Popov, A Antonov & I Kuimova (Novosibirsk, RUSSIA)
8L 9
The role of the Office of Medical Education in the Faculty of Medicine of the
University of Porto as the interface between high and secondary education in
the medical course
M A F Tavares* & A Bastos (Office of Medical Education, Faculty of Medicine of the University of Porto,
Porto, PORTUGAL)
8L 10
PROAC – Psychological and Pedagogical Orientation Program for medical
students
Eunice de Freitas, Benedito Carlos Weltson, Decio Lourenco Reimao, Sandra Lopes Mattos e Dinato
& Julio Cesar Massonetto* (Medical School of Santos, Centro Universitario Lusiada, Santos, BRAZIL)
8L 11
Students’ research: learning advantages and benefits achieved by students.
Polish experience
Anna Michalak*, Tomasz Kucmin & Filip Stoma (Medical University of Lublin, Lublin, POLAND)
8L 12
Anxiety and distress experienced by medical students during preclinical training
Beata Tobiasz-Adamczyk* & Agnieszka Penar (Dean’s Office, Medical Faculty, Cracow, POLAND)
8L 13
Promoting reflection and self-evaluation across the first clinical course
Adela Virginia Contreras & Toni Peters* (La Reina, CHILE)
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8M
Teaching and Learning (1)
Chair:
Location of Boards:
8M 1
Fernando Mora-Carrasco, Mexico
2nd floor, west corridor
Tumor prevention program of medical students at Szeged University
Katalin Barabas* & Melinda Lakos (University of Szeged, Szeged, HUNGARY)
8M 2
A novel approach to blood and immunity in undergraduate medical studies in
a new medical school of Beira Interior – Portugal
A Macedo*, A Izarra, P Tavares and L Taborda-Barata (Universidade da Beira Interior, Department of
Medical Sciences, Covilha, PORTUGAL)
8M 3
Anatomical cadaveric hearts – integrated horizontal and vertical study
Samar Al Saggaf*, Fawzia Nayeem, Soad Shaker Ali, Amira A Elhaggagy & Khadra Soliman (King Abdul
Aziz University, Faculty of Medicine and Allied Sciences, Jeddah, SAUDI ARABIA)
8M 4
What kind of theory is needed? Experiences with a course on constructivism
in medicine
Rita Leidinger* & Claudia Kiessling (Arbeitsgruppe Reformstudiengang Medizin, Charité, Berlin,
GERMANY)
8M 5
Coaching in medicine
Sam Lingam*, R C Gupta, D Gormley & D Brigden (Potters Bar, UK)
– 2.48 –
Section 2: Tuesday
8M 6
Reflective learning in undergraduate medical students: what is the evidence?
Andrew Grant*, Elizabeth Metcalf & Paul Kinnersley (University of Wales School of Medicine,
Department of General Practice, Cardiff, UK)
8M 7
A study of public opinion on use of tissue samples from living subjects for
clinical research and medical student teaching
M L Goodson* & B G Vernon (University of Newcastle, Newcastle Upon Tyne, UK)
8M 8
Evaluation of a voluntary lecture where a medical student examines a healthy
infant at the Skills Training Centre
H Storm*, R Bentehaugen, A Lippert & E Hanko (The Skills Training Centre, IKLIN, Oslo, NORWAY)
8M 9
Attitudes towards Psychiatry and Psychotherapy (ATP) of medical students
from different years at the University Medical School in Essen, Germany
during the Summer of 2002
O Kuhnigk*, B Strebel & J Schilauske and M Jueptner (Universitatsklinikum Hamburg-Eppendorf,
Modellstudiengang Medzin, Hamburg, GERMANY)
8M 10
Physician training in child development to meet basic needs of children and
families in medical practice
Wendy Roberts* & Elizabeth Thompson (Hospital for Sick Children, Child Development Centre, Toronto,
CANADA)
8M 11
Innovative module for training of medical students as promoters of
prevention of drug abuse
Regina Komsa-Penkova*, Sonali Vaid, Emil Filipov, Dobromir Dimitrov and Zlatina Georgieva (Higher
Medical Institute - Pleven, International Relations’ Office, Pleven, BULGARIA)
8M 12
The arts in medicine – evaluating a new special study module
P A Lazarus* & F M Rosslyn (University of Leicester, Division of Medical Education, Leicester, UK)
8M 13
Injury epidemiology, prevention and treatment: an integrated curriculum
Peter Barss (United Arab Emirates University, Department of Community Medicine, Al Ain, UNITED
ARAB EMIRATES)
8M 14
Community Empowerment Project – promote smoking cessation
M I Memon*, R C Gupta, D Brigden & M A Memon (Preston PCT & Bolton Institute, Bolton, UK)
8M 15
Team working for a reflective medical education resource
L A Paterson*, J Ker & P Davey (University of Dundee, Clinical Skills Centre, Dundee, UK)
8M 16
The role of the Ghanaian medic in preventive medicine
E Moses Fynn* & I Osei (Kwame Nkrumah University of Science and Technology, School of Medical
Sciences, Kumasi, GHANA)
8M 17
What items should be taught and assessed in a longitudinal curriculum of
emergency medicine?
F O Weisser*, B Dirks & M Georgieff (Sektion Notfallmedizin, Universitätsklinik für Anästhesiologie,
Ulm, GERMANY)
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8N
Teaching and Learning (2)
Chair:
Location of Boards:
Are Holen, Norway
2nd floor, west corridor
– 2.49 –
Section 2: Tuesday
8N 1
The proposed use of ‘participatory video’ techniques in undergraduate
veterinary education
C E Bell (University of Glasgow Veterinary School, Division of Farm Animal Medicine and Production,
Glasgow, UK)
8N 2
Comparison of lecturing with and without lecture notes in learning for
medical student virology teaching
Sohrab Najafipour* & Sedighe Najafipour (Fasa Medical School, Fasa, IRAN)
8N 3
Monitored self-study: how do students use the guidelines?
M Vandersteen*, M Maelstaf & I Vandenreyt (Limburgs Universitair Centrum, Universitair Campus,
Dipenbeek, BELGIUM)
8N 4
Introducing changes in the education of medical students: a course on study
skills in the Faculty of Medicine of the University of Porto
E Loureiro*, M J Martins, D Neves, M A Tavares & A Bastos (Office of Medical Education, Faculty of
Medicine, University of Porto, Porto, PORTUGAL)
8N 5
Working with feedback
Reuben M Gerling (Nihon University School of Medicine, Tokyo, JAPAN)
8N 6
The cognitive challenges of learning from medical text: an intervention for
undergraduates
Iona I-Wesso (Department of Medical Biosciences, University of Western Cape, Bellville, SOUTH
AFRICA)
8N 7
A survey of the perceived impact of study guides designed to support
student learning during intermediate clinical rotations in a revised
undergraduate medical curriculum
F J Cilliers*, B B van Heerden & E Wasserman (University of Stellenbosch, Division for University
Education, Tygerberg, SOUTH AFRICA)
8N 8
Student learning profiles in the health sciences
A Patterson* & M Kelly (Faculty of Health Sciences, Trinity College Dublin, Dublin, IRELAND)
8N 9
Technology in a medical lecture – how relevant?
Ujjal Choudhuri*, Rachelle Arnold & Hamish McKenzie (University of Aberdeen, Medical Faculty Office,
Aberdeen, UK)
8N 10
Comparison of the impact of traditional and multimedia independent teaching
methods on the skills of administration of medication by nursing students
Khadijeh Ranjbar (Shiraz University of Medical Sciences, Faculty of Nursing, Shiraz, IRAN)
8N 11
Building a learning culture in primary care: ideas from a Teaching PCT in
Bradford, England
David Pearson*, Lynn Stinson & Peter Dickson (Bradford City Teaching PCT, Bradford, UK)
8N 12
Characteristics of a good medical teacher: opinions of first year
undergraduate medical students
J F C Figueiredo*, M L V Rodrigues & C E Piccinato (University of Sao Paulo, Faculty of Medicine of
Ribeirao Preto, Ribeirao Preto, BRAZIL)
8N 13
Does formative, in-clerkship counseling of students with marginal knowledge
improve pass-fail performance on an end-of-clerkship examination?
Alan P Wimmer, Paul A Hemmer*, Thomas C Grau & Louis N Pangaro (Uniformed Services University,
USUHS - EDP, Bethesda, USA)
8N 14
Complexity and Educating the Health Professional
Jim Price (CMEC, St Richards Hospital, Chichester, UK)
– 2.50 –
Section 2: Tuesday
8N 15
Extracurricular activities of undergraduate students enrolled in a special
training programme
Maria de L Veronese Rodrigues*, Elizabeth Meloni Viera, Guilherme L Martinez, Luciana de M Vicente,
Nelson F Gava & Priscilla G Lira (Hospital das Clínicas - Oftalmologia, Faculdade de Medicina de
Ribeirao Preto, Ribeirao Preto, BRAZIL)
8N 16
Students’ satisfaction with the improvement of introduction to medicine course.
A Nitiapinyasakul, S Lermanuwararat & R Littirong (Maharat Nakon Ratchasima Hospital, School
of Medicine, Muang, Thailand)
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8O
E-learning and the Internet
Chair:
Location of Boards:
8O 1
Barry Issenberg, USA
1st floor, east corridor
Active learning on the web: seven steps to effective e-learning
David A Cook* & Denise M Dupras (Mayo Graduate School of Medicine, Department of Internal
Medicine, Rochester, USA)
8O 2
Comparison of learning outcomes with a WebCT course and a conventional
web-site learning material
Kalle Romanov* & Anne Nevgi (University of Helsinki, Research and Development Unit for Medical
Education, Helsinki, FINLAND)
8O 3
Quality management in e-learning: the use of standards in medicMED at the
University of Witten/Herdecke
B Strahwald (University of Witten, Project medicMED, Witten, GERMANY)
8O 4
Evaluating a web-based video program for undergraduate clinical skills
instruction
S Aaron*, M Brisbourne, S Varnhagen & D Begg (University of Alberta, Department of Rheumatology,
Alberta, CANADA)
8O 5
Integration of e-learning in the curriculum: concept, realisation and
evaluation of medicMED at the University of Witten/Herdecke
B Strahwald, K Kempe & M Hofmann* (University of Witten, Project medicMED, Witten, GERMANY)
8O 6
A survey of internet using status in academic members of Oromiyeh
University of Medical Sciences
B Rahimi*, A Rashidi & N Zarghami (Educational Development Center, Oormiyeh University of Medical
Sciences, Oormiyeh, IRAN)
8O 7
Patient rights in e-learning environments: a model for informed consent in
medicMED at the University of Witten/Herdecke
K Kempe*, B Strahwald & M Hofmann (University of Witten/Herdecke, Project medicMED, Witten,
GERMANY)
8O 8
WASP – a generic web-based, interactive patient simulation system
Nabil Zary* & Uno G H Fors (LIME, Karolinska Institutet, Stockholm, SWEDEN)
8O 9
Faculty members’ computer and internet technology skill
Hassan Gholami*, Mahmoud Dezhhkam & Nasser Valaee (Mashhad University of Medical Sciences,
Education Development Centre, Mashhad, IRAN)
8O 10
Blended learning in a Health Informatics Course
Jens Dorup (Section for Health Informatics, Department of Biostatistics, Aarhus, DENMARK)
– 2.51 –
Section 2: Tuesday
8O 11
Using handheld computers for mobile experiential learning
R Kneebone*, H Fry, C Sorensen, G Wiredu & J Younger (Imperial College School of Science, Technology
and Medicine, Department of Surgical Oncology and Technology, London, UK)
8O 12
Teaching ALS in remote and rural areas: a case for teleconferencing
J Mardon*, L Hislop, S Wilkie & M Boyd (Glasgow, UK)
8O 13
Implementation of a teaching programme in accident and emergency
medicine via teleconferencing
J Mardon* & L Hislop (Glasgow, UK)
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8P
Computer Assisted Learning
Chair:
Location of Boards:
8P 1
To be announced
1st floor, west corridor
Computer-Assisted Learning in undergraduate psychiatry (CAL-PSYCH):
evaluation of a pilot programme
Allys Guerandel*, Patrick Felle & Kevin Malone (St Vincent University Hospital, Department of
Psychiatry, Dublin, IRELAND)
8P 2
Evaluation of an interactive multimedia training module in surgery
A Mehrabi*, A Gohring, D Leisenberg, J Zumbach, E Gazyakan, S Holler, N De Cono, M Kadmon, J
Schmidt, F Kallinowski & M W Buchler (CBT- Laboratory, Chirurgische Univ, Heidelberg, GERMANY)
8P 3
Students’ response to CBT modules in surgical education
A Gohring*, A Mehrabi, J Zumbach, E Gazyakan, S Holler, N De Cono, M Kadmon, J Schmidt, F Kallinowski
& M W Buchler (CBT - Laboratory, Chirurgische Univ, Heidelberg, GERMANY)
8P 4
The Virtual Practicum – a model for comprehensive technology based
education
Joe Henderson* & Christof Daetwyler (Interactive Media Lab, Dartmouth College, Hanover, USA)
8P 5
Virtual interviews and simulation-based learning
Olivier Courteille*, Uno Fors, Rolf Bergin and Kirsti Lonka (Karolinska Instituet/LIME, Stockholm,
SWEDEN)
8P 6
E-learning in medicine: www.meducase.de
Peter Langkafel, Stefan Hoehne and Ralf F Schumann (Charité, Dept of Obstetrics, Faculty of Medicine,
Berlin, GERMANY)
8P 7
Interactive CPN: evaluation phase: a didactic computer program
Evelyn Palominos and Beatriz Saavedra* (School of Nursing, Faculty of Medicine, Santiago, CHILE)
8P 8
Dynamic patient simulations® for residents in dermatology
S Eggermont*, W Bergman & P M Bloemendaal (Leiden University Medical Center, Leiden,
NETHERLANDS)
8P 9
Flexible multi-level knowledge integration in computer-based medical
teaching cases
R Singer*, I Martsfeld, J Heid, S Kopf, S Huwendiek, B Tonshoff & F J Leven (Hygiene Institut, Labor
“Computergestutzte” Lehr/Lernsysteme in der Medizin, Heidelberg, GERMANY)
8P 10
3D pelvic floor: a tool for understanding topographical anatomy
David Ortoft*, Hanna Reuterborg, Bjorn Meister & Staffan Cullheim (Institution for Learning
Informatics, Management and Ethics, Medicinsk Visualisering, Stockholm, SWEDEN)
– 2.52 –
Section 2: Tuesday
8P 11
The computer literacy profile of incoming 1st year health sciences students
at the University of Cape Town, and the effect of pre-course IT intervention
Gudrun Oberprieler*, Ken Masters & Trevor Gibbs (University of Cape Town, Academic Development
Programme (ADP), Cape Town, SOUTH AFRICA)
8P 12
Prize for implementing the new technologies in the teaching of the health
sciences at the Rovira I Virgili University – from lectures to active learning
A Castro, R Descarrega, MR Fenoll-Brunet*, M Giralt, R Miralles, MR Nogués, V Piera, T Sempere,
R Solà & F Vidal (Universitat Rovira I Virgili, Facultat de Medicina I Ciencies de la Salut, Reus,
Tarragona, SPAIN)
8P 13
Symposiaware for improving information dissemination in visceral surgery
M R Ahmadi*, A Mehrabi, K Gawad, A Gohring, J Schmidt, F Kallinowski & M W Buchler (CBT Laboratory,
Chirurgische Univ, Heidelberg, GERMANY)
8P 14
Stimulating interest in the tutorial – what is it worth?
P G Devitt*, E Palmer & N De Young (University of Adelaide, Department of Surgery, Adelaide,
AUSTRALIA)
8P 15
Using a Computer-aided Learning program in an integrated Problem-based
Learning medical course: role in formative assessment
Samy A Azer (Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville,
AUSTRALIA)
8P 16
PBL with a case-based e-learning program: experiences and developments
Kai Sostmann* & Kai Schnabel (Medical Faculty of the Humboldt University, Reformstudiengang
Medizin, Berlin, GERMANY)
8P 17
Residents as teachers: development of a new course using e-learning and
face-to-face teaching
Jesús Ibarra-Jiménez*, Ismael Piedra-Noriega and Maria de los Ángeles Jiménez-Martinez (ITESM,
Monterrey, MEXICO
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8Q
Learning Management Systems and Computer Based Assessment
Chair:
Location of Boards:
8Q 1
Peter Cantillon, Ireland
1st floor, west corridor
Criteria list of a case-based computer-supported examination system in
medicine
C Goetz*, D Neumann & J Neuser (German Institute for Medical and Pharmaceutical Examination,
Mainz, GERMANY)
8Q 2
Students’ reflections on a web-based evaluation system
Frank Sjoblom* & Vitikka Annu (University of Helsinki, Research and Development Unit for Medical
Education, Helsinki, FINLAND)
8Q 3
Using e-learning cases for learning and assessment in an OSCE
B Koerner*, M R Fischer, M Holzer and S Schewe (Med Klinikum Innenstadt der LMU, Munich,
GERMANY)
8Q 4
Assessment with the case-based e-learning system CASUS: acceptance and
pilot validation
V Kopp and M R Fischer* (University of Munich, Klinikum der Universitat Munchen, Munich,
GERMANY)
– 2.53 –
Section 2: Tuesday
8Q 5
Open source software technologies in medical education
Stefan Hoehne*, Peter Langkafel and Ralf R Schumann (Charité, Institut für Mikrobiologie & Hygiene,
Berlin, GERMANY)
8Q 6
Discussion Board in Blackboard software platform as an additional support
at tutorial session in PBL
Demetrio Arcos*, Enrique F J Martinez, Graciela Medina, Ricardo Trevino and Jorge Valdez (Monterrey
Tech School of Medicine, Monterrey, MEXICO)
8Q 7
The Virtual Medical University (VMU) Project: development of an e-learning
platform at the International Medical University, Malaysia
Kamal Salih*, Gregory J S Tan & Anwar Kamal (International Medical University, Kuala Lumpur,
MALAYSIA)
8Q 8
Virtual curriculum map and navigation in the International Medical University
ILMU Learning System
Anwar Kamal*, Gregory J S Tan & Kamal Salih (International Medical University, Kuala Lumpur,
MALAYSIA)
8Q 9
The Interactive Learning Modular Unit: challenges to students’ learning
Gregory J S Tan*, Anwar Kamal & Kamal Salih (International Medical University, Kuala Lumpur,
MALAYSIA)
8Q 10
Should virtual learning environments be proactive communities?
Michael Begg (University of Edinburgh, College of Medicine and Veterinary Medicine, Edinburgh, UK)
8Q 11
Comprehensive electronic portfolio
I Treadwell (University of Pretoria, Skills Laboratory, Pretoria, SOUTH AFRICA)
8Q 12
A content-management framework application for postgraduate paediatric
education
C Melville*, R Melville & D Collins (City General, Academic Dept of Paediatrics, Stoke-on-Trent, UK)
8Q 13
Integration of IT in the study of medicine at the University of Oslo
Silje M Rosseland (The Faculty of Medicine the University of Oslo, OSLO, NORWAY)
8Q 14
The ACETS Project: putting ‘usable’ into the reusable learning object
R Ellaway*, D Dewhurst & D Leeder (The University of Edinburgh, MVM Learning Technology Section,
Edinburgh, UK)
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8R
Continuing Professional Development
Chair:
Location of Boards:
8R 1
To be announced
Foyer of Dome/Kuppelsaal, 4th floor
An on-line, interactive workshop for small-groups – key success factors
Francine Borduas*, Christine Lamoureux and Michel Rouleau (Laval University, Clinique Medicale de
Meutchatel, Laval, CANADA)
8R 2
Using electronic resources to support CPD
Andrew Sackville and David Brigden* (Mersey Deanery, University of Liverpool, Liverpool, UK)
8R 3
General physician opinions of continuing medical education (CME) programs
in Ahwaz, Iran
Abdolhossain Shakurnia* and Mohammad Smaeel Motlagh (Ahwaz University of Medical Sciences,
Educational Development Center (EDC), Ahwaz, IRAN)
– 2.54 –
Section 2: Tuesday
8R 4
Gender and CME: female specialists’ perceptions of CME practices
Jane Tipping* & Jill Donahue (Markham, Ontario, CANADA)
8R 5
An evaluation of the use of a workbook: ‘A framework for professional
development in primary care (the Wessex way)’ in planning CPD
Anthony Curtis*, Robin While, John Pitts, Rosemary Ramsay, Margareth Attwood & Vicky Wood
(Primary and Community Care, Wiltshire Shared Services NHS Consortium, Devizes, UK)
8R 6
The COP Pilot Project: a project to study information exchange among
specialists and other members of selected clinical communities of practice
R Laprise*, M Hotvedt, J Parboosingh, R L Thivierge, J Toews, R Lemay, C Campbell, L Samson &
T Gondoscz (Aventis Pharma, Department of Professional Education, Laval, CANADA)
8R 7
Self evaluation in continuing medical education (CME): a rheumatological
perspective
Christine Beyeler*, Reinhard Westkämper and André Aeschlimann (University of Bern, Department
of Rheumatology, Bern, SWITZERLAND)
8R 8
Comparing two snapshots over time: UK Medical Royal College CPD Policy
Development
Francesca Johnson*, Stephen Brigley, Tom Hayes, Howard Young, Stephen Hunter and Gladys Tinker
(University of Wales College of Medicine, Cardiff, UK)
8R 9
National Clinical Guidelines: educational programme of rheumatoid arthritis
in Finland 2001-2002
Mari Anttolainen*, Ritva Peltomaa, Liisa-Maria Voipio-Pulkki and Juha Pekka Turunen (The Finnish
Medical Society, Helsinki, FINLAND)
8R 10
Continuing Medical Education introduction in Serbia
Sinisa Gradinac*, Nebojsa Lalic and Djordje Radak (Belgrade University Medical School, Dedinde
Cardiovascular Institute, Belgrade, SERBIA AND MONTENEGRO)
8R 11
Teaching Preventive Pediatric Care (PPC): an innovative approach to
integrate evidence-based medicine across the medical curriculum
Martin Labelle*, Robert L Thivierge, Gilles Brunet, Dominique Cousineau and Daniele Lemieux
(University of Montreal, CME Office, Montreal, CANADA)
8R 12
Using individual practice profiles as a guide in medical training for physicians
involved in the Toward Excellence in Asthma Management (TEAM) Program
Michel Turgeon, Louis-Philippe Boulet, Robert Thivierge*, Eileen Dorval & Peirre Raiche (University of
Montreal, Montreal, CANADA)
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8S
Management, and Selection
Chair:
Location of Boards:
8S 1
To be announced
1st floor, east corridor
Setting research priorities in a medical university: building up a partnership
Saeed Asefzadeh (Qazvin University of Medical Science & Health Services, Qazvin, IRAN)
8S 2
Introducing quality culture in the Tbilisi State Medical University
R Khetsuriani, Z Avaliani*, G Simonia & Z Vadachkoria (Tbilisi State Medical University, Tbilisi,
GEORGIA)
8S 3
Administrative staff opinions on the problems of meeting ISO in medical
education
P Afshari* & P Assadullahi (Ahvaz Medical Science University, Nursing and Midwifery School of Medical
Science, Ahvaz, IRAN)
– 2.55 –
Section 2: Tuesday
8S 4
Longitudinal research in medical education: possibilities and challenges
Ann W Frye*, Christine A Stroup-Benham, Stephanie A Litwins & Steven A Lieberman (University of
Texas Medical Branch, Office of Educational Development, Galveston, USA)
8S 5
In METRO-land: developing a controlled vocabulary for medical education
R Ellaway*, A Haig & M Dozier (The University of Edinburgh, MVM Learning Technology Section,
Edinburgh, UK)
8S 6
Linking the undergraduate medical curriculum with resource utilization and
performance management
Judith Hadfield*, Tim Dornan, Tim Johnson & Daniel Powley (Hope Hospital, Department of
Undergraduate Education, Salford, UK)
8S 7
A system to support medical students’ experiential clinical learning
Tim Dornan*, Dan Powley, Judy Hadfield, Stephen Brown & Martin Brown (Hope Hospital, Manchester,
UK)
8S 8
Highlands Schools Medical Mentoring Scheme: Improving applicants’ chance
of selection to medical school
Mandy Hunter & Malcolm Laing* (University of Aberdeen, Undergraduate Teaching Centre, Inverness,
UK)
8S 9
Impact of writing a personal statement on residency candidates
Angel M Centeno*, Cecilia Primogerio & Alejandra Blanco (School of Biomedical Sciences, Universidad
Austral-Medicina, Buenos Aires, ARGENTINA)
8S 10
Gender difference in training for medical specialise of Thai physicians
Chusak Uewichitrapochana (Buddhachinaraj Hospital Medical Centre, Department of Surgery,
Phitsanulok, THAILAND)
8S 11
The collaborative project to increase production of rural doctors: equity of
student selection
Suwat Lertsukprasert (Office of the Collaborative Project to Increase Production of Rural Doctors,
Nonthaburi, THAILAND)
8S 12
The medical admissions interview: comparison of individual unstructured
interviews and semi-structured panel interview
C A Courneya*, K Wright, V Finton & G Pachev (University of British Columbia, Department of
Physiology, Vancouver, CANADA)
8S 13
A preferential access program to a Faculty of Medicine for outstanding
socially disadvantaged students: lessons learned in two years
Verónica Gaete*, Gloria Riquelme, Jorge Las Heras, Cristina Zuñiga, Carolina López & Fabio Sáenz
(University of Chile, Santiago, CHILE)
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8T
Outcomes, Professionalism, and Research and Critical Thinking
Chair:
Location of Boards:
8T 1
To be announced
Foyer of Dome/Kuppelsaal, 4th floor
Good characteristics of doctors according to a perception and self-assessment
of the 6th year medical student practising in Khon Kaen Hospital, Thailand
Surachai Saranrittichai*, Sirijitt Vasanawathana & Mungkon Noimay (Medical Education Center,
Khon Kaen Regional Hospital, Khon Kaen Province, THAILAND)
– 2.56 –
Section 2: Tuesday
8T 2
Effective multidisciplinary education and training in child abuse and neglect
M J Bannon* & Y H Carter* (London Deanery, Medical Education Dept, Harrow, UK)
8T 3
Students’ perception of the medical profession at different stages of medical
training
M G H Nieuwhof*, M M Kuyvenhoven, M B M Soethout & Th J ten Cate (University Medical Center
Utrecht, Onderwijsinstituut, School of Medical Sciences, Utrecht, NETHERLANDS)
8T 4
Which medical skills are important? Clinical skills questionnaire
J Schulze*, S Drolshagen & F Nurnberger (Dean’s Office, JWG Universität, Frankfurt/Main,
GERMANY)
8T 5
A compendium of tools to assess professionalism
Deirdre C Lynch, Patricia M Surdyk* & Arnold R Eiser (Accreditation Council for Graduate Medical
Education, Chicago, USA)
8T 6
Self-reported attitudes and behaviours of undergraduate medical students
regarding professional integrity
D E E Rizk & M A Elzubeir* (United Arab Emirates University, Faculty of Medicine and Health Sciences,
Al-Ain, UNITED ARAB EMIRATES)
8T 7
How does postgraduate medical training in general practice affect the trainers?
Niels Kjaer* & Charlotte Tulinius (Department of Research and Postgraduate Medical Education,
Sonderborg, DENMARK)
8T 8
Ethics and professionalism: where do students obtain their value systems?
Helen Maxwell-Jones*, Ash Samanta & David Heney (Leicester Medical School, Division of Medical
Education, Leicester, UK)
8T 9
Developing 360 degrees feedback in UK postgraduate clinical tutors’
professional development
Kit Byatt* & A Long (Hereford Country Hospital, Hereford, UK)
8T 10
Evaluation of students’ professionalism at Medical Faculty, Palacky University
in Olomouc, Czech Republic – a pilot study
Petr Jindra*, Radim Licenik, Lenka Doubravska, Vit Gloger, Jan Strojil, Renata Simkova, Iveta Zedkova
& Cestmir Cihalik (Palacky University, Faculty of Medicine, Olomouc, CZECH REPUBLIC)
8T 11
Student scientific activities at Jessenius Faculty of Medicine CU in Martin –
present state and how to improve it
Juraj Mokry*, Daniela Sevecova, Branislav Kolarovszki, Rudolf Zach and Miroslav Sulaj (Jessenius
Faculty of Medicine, Comenius University, Martin, SLOVAKIA)
8T 12
Medical students’ performance on a Medline OSCE: does an intercalated
degree help?
M Dozier*, H Cameron and S Yewdall (University of Edinburgh, Erskine Medical Library, Edinburgh,
UK)
8T 13
A controlled comparison study of the efficacy of training medical students in
literature searching skills
Larry D Gruppen*, Gurpreet K Rana & Theresa S Arndt (Department of Medical Education, The
University of Michigan Medical School, Ann Arbor, USA)
8T 14
Problems and impediments of implementing Best Evidence Medical Education
(BEME) strategy in Shaheed Beheshti University of Medical Sciences (SBUMS)
Shahram Yazdani* (Educational Development Center, Shaheed Beheshti University of Medical
Sciences and Health Services, Tehran, IRAN)
– 2.57 –
Section 2: Tuesday
1645-1815
Session 9
Short Communications (4): Simultaneous themed sessions
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9A
Computers in the Curriculum
Chair:
Brigitte Grether, Switzerland
Discussant: To be announced
Location:
Room 210
1645
9A 1
Does the computer add anything to a tutorial?
P G Devitt*, E Palmer & N De Young (University of Adelaide, Department of Surgery, Adelaide,
AUSTRALIA)
1700
9A 2
Systematic integration of information technology within a medical school
curriculum
Cam Enarson* & John Boehme (Wake Forest University School of Medicine, Winston-Salem, USA)
1715
9A 3
Introducing George: initial evaluation of a new teaching method designed to
enhance the integration of knowledge and understanding across a 5 year
medical course
Patricia M Warren*, Mike Porter, Rachel H Ellaway*, Phillip Evans, A John Simpson, Gordon B
Drummond & Simon Maxwell (The University of Edinburgh, Medical Teaching Organisation Office,
Edinburgh, UK)
1730
9A 4
Wash-out of the innovation frenzy? A longitudinal evaluation of case-based
e-learning in internal medicine with the CASUS systerm
M Adler*, A Simonsohn and M R Fischer (Klinikum der univ Munchen, Med Klinik Innenstadt, Munich,
GERMANY)
1745-1815
Discussion
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9B
Assessing Communication Skills
Chair:
Ronald Nungester, USA
Discussant: Elizabeth Kachur, USA
Location:
Room 110
1645
9B 1
Medical students’ communication skills, from the supervisor’s perspective –
assessment in the final year of undergraduate medical education in
Goteborg, Sweden
M Wahlqvist*, B Mattsson, G Dahlgren, B Hamark, M Hartvig-Ericsson, B Henriques, U HosteryUgander (Department of Primary Health Care in Goteborg, Goteborg, SWEDEN)
1700
9B 2
Identifying and improving preclinical students with unsatisfactory
communication skills
Jon Dowell* & John Dent (Tayside Centre for General Practice, Dundee, UK)
1715
9B 3
Communicating information – knowledge and risk
Connie Wiskin*, Phil Croft, Selene Burn and Dawn Dodwell (University of Birmingham, Dept of Primary
Care & GP, Birmingham , UK)
1730
9B 4
Which communication skills are learnt in practice and which need to be taught?
Knut Aspegren* and Peter Loenberg Madsen (Copenhagen School of Medicine, National Board of
Health, Copenhagen, DENMARK)
– 2.58 –
Section 2: Tuesday
1745
9B 5
Communication skills performance in an OSCE depends on clinical context
and cannot be assessed in isolation
A M S Chesser*, J Cleland, Z Miedzybrodzka and M R Laing (University of Aberdeen, Undergraduate
Teaching Centre, Inverness, UK)
1800-1815
Discussion
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9C
The Curriculum (2)
Chair:
To be announced
Discussant: To be announced
Location:
Room 201
1645
9C 1
Is self-efficacy in clinical skills of medical students a tool to monitor
curricular changes?
J Juenger*, D Schellberg, C Nikendei, M Benkowitsch, S Schaefer, R Faber, C Roth, B Auler & W Herzog
(Department of Internal Medicine, University of Heidelberg, Heidelberg, GERMANY)
1700
9C 2
Problems encountered in changing a clinical curriculum – and their solutions
Sigrid Harendza*, Rolf Stahl, Gerard Majoor & Wim Gijselears (Universitätsklinikum HamburgEppendorf, Zentrum für Innere Medizin, Hamburg, GERMANY)
1715
9C 3
Evaluation of a new curriculum (HeiCuMed) – comparison before and after
implementation
Martina Kadmon*, E Gazyakan, Susann Holler, Nina Latham and J Schmidt (Surgery Clinic, University
of Heidelberg, Heidelberg, GERMANY)
1730
9C 4
Bottom-up innovation to improve medical education in surgery
M K Widmer*, T Carrel & J Steiger (University of Berne, Department of Cardiovascular Surgery, Berne,
SWITZERLAND)
1745
9C 5
Drama and medicine – a Special Study Module
Connie Wiskin, Selene Burn* & John Skelton (University of Birmingham, Department of General
Practice, Birmingham, UK)
1800-1815
Discussion
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9D
Assessment and Delivery of Postgraduate Education
Chair:
Clair du Boulay, UK
Discussant: Alistair Thomson, UK
Location:
Room 220
1645
9D 1
Patient outcomes for colon resection according to training and certification
J B Prystowsky & G Bordage* (Department of Medical Education, University of Illinois at Chicago,
Chicago, USA)
1700
9D 2
Accuracy of medical staff assessment of operative performance
A M Paisley* & S Paterson Brown (University Department of Surgery, Royal Infirmary of Edinburgh,
Edinburgh, UK)
1715
9D 3
Evaluation of key skills: a new initative within vocational training in West
Midlands Dentistry
Vickie Firmstone, Julie Bedward*, Alison Bullock, John Hall & John Frame (CRMDE, School of Education,
Birmingham, UK)
– 2.59 –
Section 2: Tuesday
1730
9D 4
A comparison of inpatient teaching evaluations by resident and peer
physicians: Who’s more reliable?
Thomas J Beckman*, Mark C Lee and Jayawant N Mandrekar (Mayo Clinic, Division of General Internal
Medicine, Rochester, USA)
1745
9D 5
Strategic planning for developing Postgraduate Medical and Dental
Education in Wales
S A Smail* and H L Young (School of Postgraduate Medical and Dental Education, University of Wales
College of Medicine, Cardiff, UK)
1800-1815
Discussion
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9E
Continuing Professional Development – Needs Assessment
Chair:
To be announced
Discussant: To be announced
Location:
Room 205
1645
9E 1
An effective learning needs assessment process for GPs
Derek Gallen and Glynis Buckle* (Oxford PGMDE, Albany House Medical Centre, Wellingborough, UK)
1700
9E 2
Training needs in sexual health: evidence from GP trainers in the West
Midlands, UK
Alison Bullock*, Wolf Markham, Philippa Matthews & Stephen Kelly (Centre for Research in Medical
& Dental Education, School of Education, Birmingham, UK)
1715
9E 3
Using multisource feedback for physicians: report of a pilot study
Joan Sargeant*, Karen Mann, Suzanne Ferrier, Donald Langille, Philip Muirhead and Douglas Sinclair
(Faculty of Medicine, Dalhousie University, Halifax, CANADA)
1730
9E 4
BEME Collaboration Systematic Review: feedback and physician performance
Jon Veloski, James Boex* and Daniel Wolfson (Office of Health Services Org & Res, NE Ohio University
College of Medicine, Rootstown, USA)
1745-1800
Discussion
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9F
Clinical training: new guidelines to a common approach
Leonardo da Vinci Project
Chair:
Paulo Costa, Portugal
Discussant: Mathieu Nendaz, Switzerland
Location:
Room 101
(Please note: the presentations times in this session will not be synchronised with the other
sessions)
1645
Introduction to the Project
P M Costa (Faculdade de Medicina de Lisboa, University of Lisbon, Portugal)
9F 1
Clinical training: new guidelines to a common approach: A Leonardo da Vinci
multi centered project at the University of Lisbon, Faculty of Medicine
M F Patricio*, J G Jordao & P M Costa (Faculdade de Medicina de Lisboa, University of Lisbon, Lisboa,
PORTUGAL)
– 2.60 –
Section 2: Tuesday
9F 2
Clinical training: new guidelines to a common approach: A Leonardo da Vinci
multi centered project at the University of Wales College of Medicine, Cardiff
Howard Young*, Helen Houston, Helen Sweetland & Richard Mills (School of Postgraduate Medical &
Dental Education, University of Wales College of Medicine, Cardiff, UK)
9F 3
Clinical training: new guidelines to a common approach: A Leonardo da Vinci
multi centered project at the School of Medicine, University of Granada
C Campoy, J M Peinado*, J Canizares, C Chung & B Gil (Department of Paediatrics, School of Medicine,
University of Granada, SPAIN)
9F 4
Clinical training: new guidelines to a common approach: A Leonardo da Vinci
multi centered project at the University of Extremadura, Faculty of Medicine
C Pizarro*, J M Moran & J A G Agundez (Extremadura University - Faculty of Medicine, Badajoz, SPAIN)
9F 5
Clinical training: new guidelines to a common approach: A Leonardo da Vinci
multi centered project at the Pecs University Faculty of Medicine
Peter Szekeres* & Anna Bukovinszky* (Pecs Medical University, Department of Trauma, Pecs,
HUNGARY)
1800-1815
Discussion
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9G
Courses for Medical Teachers
Chair:
Angel Centeno, Argentina
Discussant: To be announced
Location:
Room 120
1645
9G 1
Results from the evaluation of a faculty development program for 414
physicians as educators for a large German medical school
O Genzel-Boroviczeny*, F Christ, T Aretz, E Armstrong & R Putz (LMU Innenstadt, Neonatology,
München, GERMANY)
1700
9G 2
Studies on doctors and dentists taking university educational qualifications
David Wall* & Zoe Nuttall (West Midland Deanery, PMDE, Birmingham, UK)
1715
9G 3
Developing skills in educational appraisal: from theory to practice
Gellisse Bagnall*, William Reid & Chris Morran (NHS Education for Scotland - West Region, Glasgow,
UK)
1730
9G 4
Changing teachers’ learning skills – a pilot study
L Nasmith* & Y Steinert (University of Toronto, Department of Family & Community Medicine, Toronto,
CANADA)
1745
9G 5
The Physician-as-Teacher rule: hypothesis or fact?
Jamiu Busari (Emma Childrens Hospital, Academic Medical Center, Amsterdam, NETHERLANDS)
1800-1815
Discussion
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9H
Student Support
Chair:
Margarita Barón-Maldonado, Spain
Discussant: Nikola Borojevic, Croatia
Location:
Room 215
– 2.61 –
Section 2: Tuesday
1645
9H 1
Academic support
Norma Susswein Saks (UMDNJ-Robert Wood Johnson Medical School, Piscataway, USA)
1700
9H 2
Stressors and coping strategies in nursing students, Shiraz - 2000
Farkhondeh Sharif*, Reza Zighamiee, Hamid Ashkani and Alireza Ayatollahi (Shiraz University of
Medical Sciences, Shiraz, IRAN)
1715
9H 3
Influence of studying students’ health
Ozgur Onur (IFMSA, Aachen, GERMANY)
1730
9H 4
Student support mechanisms – implementing Best Evidence Medical Education
R Arnold* & J G Simpson (University of Aberdeen, Department of Old Age Psychiatry, Aberdeen, UK)
1745
9H 5
Impact of a mentoring program in a Brazilian Medical School: changes
acknowledged by the students
Patricia Lacerda Bellodi* & Milton de Arruda Martins (University of Sao Paulo, BRAZIL)
1800-1815
Discussion
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9I
Patient Simulation
Chair:
Amitai Ziv, Israel
Discussant: Graceanne Adamo, USA
Location:
Room 114
1645
9I 1
A portable skills lab for scenario-based training
R Kneebone*, D Nestel, B Lo, R King, J Kidd, A Barnet, L Poore, R Brown, L Edwards, G Z Yang &
A Darzi (Imperial College School of Science, Technology and Medicine, Department of Surgical Oncology
and Technology, London, UK)
1700
9I 2
Interpretation of three-dimensional structure from two-dimensional
endovascular images: how experience and training affect perception
R S Sidhu*, S J Hamstra, D Tompa, R Jang, E D Grober, R K Reznick & K W Johnston (University of
Toronto, Centre for Research in Education, Toronto, CANADA)
1715
9I 3
Teaching clinical reasoning with the Dynamic Patient Simulator
S Eggermont*, P M Bloemendaal and J M van Baalen (Leiden University Medical Center, Leiden,
NETHERLANDS)
1730
9I 4
The impact of computer-based learning in training cardiopulmonary
resuscitation
Helle Thy Ostergaard*, Doris Ostergaard, Anne Lipper, Alice Drenthe and Jan van Dalen (The Danish
Institute for Medical Simulation, Department of Anaesthesiology, Vaerlose, DENMARK)
1745
9I 5
On-site, hands-on simulation training program using a mid-fidelity simulator
for crisis resource management and teamwork training
Kitoji Takuhiro*, Hisashi Matsumoto, Toru Mochizuki, Yuji Kamikawa, Yuichiro Sakamoto, Yoshiaki
Hara, Kunihiro Mashiko & Yasuhiro Yamamoto (CCM Nippon Medical School, Chiba Hokuso Hospital,
Chiba, JAPAN)
1800-1815
Discussion
– 2.62 –
Section 2: Tuesday
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9J
Rewarding Teaching
Chair:
To be announced
Discussant: Sally Brown, UK
Location:
Room 106
1645
9J 1
Mayo Clinic Clinician Educator Award Program
Thomas R Viggiano* & Roger W Harms (Mayo Clinic, Mitchell Student Center, Rochester, USA)
1700
9J 2
Financial incentives to improve teaching
R P Nippert*, U Grawe, B Marschall & A Bockers (Institut für Ausbildung und Studienangelegenheiten, der Medizinischen Fakultät (IfAS), Munster, GERMANY)
1715
9J 3
Developing tomorrow’s leaders of healthcare education in the UK
Stewart Petersen* & Judy McKimm (Leicester Medical School, Department of Medical and Social
Care Education, Leicester, UK)
1730
9J 4
An algorithm for distributing faculty funds on the basis of quality of teaching
H van den Bussche*, M Ehrhardt & H Kaduskiewicz (Department of General Practice, University
Hospital, Hamburg, GERMANY)
1745
9J 5
Faculty recruitment and retention
M R Sandhya Belwadi (M S Ramaiah Medical College & Teaching Hospital, Bangalore, INDIA)
1800-1815
Discussion
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9K
Is the Graduate Competent?
Chair:
Michele Groves, Australia
Discussant: Rosalie Ber, Israel
Location:
Room 206
1645
9K 1
Anxieties and fears facing general residency: are we preparing students
commencing clinical practice?
Antonio Pais de Lacerda*, Paulo Seca & Maria Jose Metrass (Hospital de Santa Maria, Lisboa,
PORTUGAL)
1700
9K 2
Postgraduate education for hospital based midwives in the Netherlands
A Zuidinga*, W v d Meijs & F Scheele (St Lucas Andreas Hospital, Amsterdam, NETHERLANDS)
1715
9K 3
Is the clinical study appropriate? Students’ views
J Schulze*, S Drolshagen & P Schmucker (Dean’s Office, Frankfurt/Main, GERMANY)
1730
9K 4
Informed consent in clinical practice: experiences, knowledge and views of
Pre-registration House Officers
Jan Schildmann*, Annie Cushing, Len Doyal & Jochen Vollmann (Institute of Medical History and
Medical Ethics, Friedrich-Alexander University, Erlangen, GERMANY)
1745
9K 5
A formal assessment of the practical skills of South African medical graduates
on entry to their pre-registration year: evidence that key skills are lacking
Rae Nash*, Vanessa Birch, Tuvia Zabow, Trevor Gibbs & Richard Hift (University of Cape Town,
Department of Medicine, Cape Town, SOUTH AFRICA)
1800-1815
Discussion
– 2.63 –
Section 2: Tuesday
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9L
Postgraduate Multiprofessional Education
Chair:
To be announced
Discussant: To be announced
Location:
Room 105
1645
9L 1
Evaluation of a faculty program in palliative care education and practice
Amy M Sullivan, Antoinette S Peters* & Susan D Block (Harvard Medical School, Dana-Farber Cancer
Institute, Boston, USA)
1700
9L 2
Into the unknown: the development of a new multidisciplinary health care
professional
Kath Start (Kingston University/St George’s Hospital Medical School, Kingston upon Thames, UK)
1715
9L 3
Knowledge increase following an evidence-based multiprofessional
education program aimed at service improvement
Kirsty Foster* & Janet Vaughan (RPA Newborn Centre, Royal Prince Albert Hospital, Camperdown,
AUSTRALIA)
1730
9L 4
Team communication in the operating theatre: observations and interviews
Debra Nestel*, Jane Kidd, Krishna Moorthy & Yaron Munz (Monash University, Centre for Medical &
Health Sciences Education, Clayton, AUSTRALIA)
1745
9L 5
What makes the operating theatre an effective teaching and learning
environment? A multi-professional perspective
Jane Kidd*, Debra Nestel, Krishna Moorthy & Yaron Munz (Imperial College London, London, UK)
1800-1815
Discussion
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9M
Special Subjects in the Curriculum
Chair:
Eliot Sorel, USA
Discussant: Athol Kent, South Africa
Location:
Room 115
1645
9M 1
Preparing preclinical medical students for brief smoking cessation interventions
Linda Z Nieman*, Lewis E Foxhall, Mary M Velasquez and Janet Y Groff (UT Houston Health Science
Center, Family Practice and Community Medicine, Houston, USA)
1700
9M 2
Medical students’ perceptions of the relevance of behavioural and social
sciences towards their medical education
Christine Bundy, Lis Cordingley, Andrea Pilkington* & James Urquhart (University of Manchester,
Medical School, Manchester, UK)
1715
9M 3
Medical students’ sexual history-taking behaviour one year on from an
educational intervention
Annie Cushing* & Dason Evans (St. Bartholomews & The Royal London Queen Mary’s, School of
Medicine and Dentistry, London, UK)
1730
9M 4
Teaching leadership and management to medical students – perspectives
from UK and Portugal
H M G Martins*, D E Detmer & E Rubery (University of Cambridge, The Judge Institute of Management,
Cambridge, UK)
1745
9M 5
Teaching complementary and alternative medicine (CAM) to internists
M G Hewson*, J E Fox, H L Copeland & E Topol (The Cleveland Clinic Foundation, Cleveland, USA)
– 2.64 –
Section 2: Tuesday
1800-1815
Discussion
Evening
Optional entertainment
Conference Dinner at Kursaal Bern
Address: Kornhausstrasse 3, CH-3000 Bern 25
Directions: On foot: From the Railway Station take Spitalgasse and into Marktgasse. Turn left at
Zytglogge (old clock tower), over the bridge (Kornhausbrucke) and you will see the entrance to
Kursaal (total walking time 15 minutes).
Places still available – contact the AMEE Office. See page 3.2 for details.
– 2.65 –
Section 2: Wednesday
Wednesday 3 September
0800-1330
Registration Desk open
Location: Kultur Casino Bern
0830-1015
Session 10
Plenary 2: Professionalism of medical education
Chair: Ronald Harden, UK
0830-0855
Identifying and rewarding excellent teaching
Sally Brown (Institute of Learning and Teaching in Higher Education, York, UK)
0900-0925
Is evidence-based teaching and learning really possible?
Philip Davies (Cabinet Office, London, UK)
0930-0955
21st century physicians’ social accountabiity and professional responsibility: the
implications for medical education and for the medical teacher
Eliot Sorel (School of Medicine and Health Sciences and School of Public Health and Health Services, The
George Washington University, Washington, D.C., USA)
1000-1015
Discussion
1015-1045
Coffee at Kultur Casino
1045-1300
Session 11
Plenary 3: Teaching and Learning in the Healthcare Professions
Chair: Margarita Barón-Maldonado (University of Alcalá, Alcalá de Heneres, Spain)
1045-1100
The PBL paradox – a lighthearted view of medical education
Geoff Norman (McMaster University, Canada) and Ralph Bloch (University of Bern)
1100-1135
Born to be good, train to be great
Richard K Reznick (University of Toronto, Canada)
1135-1145
Discussion
1145-1235
Putting the learning into e-learning
Phil Race (York, UK)
1235-1245
Discussion
1245-1300
Announcement of Medical Teacher Poster Prize and AMEE Poster Quiz Winner
1300
Close of Conference, and a look ahead to AMEE 2004 in Edinburgh.
Please remember to complete and return your Conference and Workshop Evaluation
Forms, either to the registration desk on departure or by sending them to the AMEE
Office following the Conference.
– 2.66 –
Section 3
Accommodation
Please direct all reservations (on Form C, available on the AMEE website) and all queries relating
to reservations to:
Bern Tourismus
P O Box
CH-3001 Bern
Switzerland
Tel:
+41 31 328 12 28
Fax:
+41 31 328 12 99
Email: info-res@berntourism.ch
A map of Bern showing all the Conference hotels is available on the University of Bern AMEE
Conference website: http://amee03.unibe.ch/accomodation.htm
Conference Social Programme
Tickets are still available from the AMEE Office for the social events and tours (contact Tracey
Martin: amee@dundee.ac.uk). See University of Bern AMEE Conference website for pictures:
http://amee03.unibe.ch/social_programm.htm
Sunday 31 August (1900-2100 hours)
Opening Ceremony and Reception
Location:
Kultur Casino, Herrengasse 25, CH-3011 Bern (see map on page 1.19)
A short welcome address, followed by a recital of classical and jazz music, and a cocktail reception
with canapés (please note, only a light snack will be provided). (No charge – included in the
registration fee for participants and registered accompanying persons.)
Monday 1 September
Option 1: Schiller’s William Tell
Bus trip to the Open Air Theatre at Interlaken for a performance of Schiller’s William Tell, including
a buffet meal at the lakeside at Gwatt
On the live open-air stage in the wood near Interlaken, with covered seating for spectators, you
won’t miss any authentic detail of the hardship and suffering of the Swiss people some 800 years
ago in this exciting drama by Friedrich Schiller, with over 180 actors dressed in historical national
costumes, the knights on horses at a gallop or the traditional alpine procession. The play is in
German, but each scene will be summarized in English by an actor. See the website for more
information: (http://www.tellspiele.ch) On the way to Interlaken we stop at a beautiful location on the
shore of Lake Thun. You can enjoy a Swiss garden buffet meal, and if you wish, take a short walk
by the picturesque lakeside (http://www.gwatt-zentrum.ch)
Depart University and City Centre:
Return arrival at Railway Station:
Price:
1745
2330
Euros 77; £49
– 3.1 –
Section 3
Option 2: Theatre performance only, without meal
Depart University and City Centre:
Return arrival at Railway Station:
Price:
1915
2330
Euros 50; £32
Tuesday 2 September (1930-2400 hours)
Conference dinner with entertainment and dancing
Location:
Price:
Kursaal Bern, Kornhausstrasse 3, CH-3000 Bern 25
(see map on page 1.19)
Euros 65; £41
We meet on the terrace of Kursaal Bern (http://www.kursaal-bern.ch/) where hopefully there will be
a wonderful view over the city and the Alps. Enjoy a three course dinner in the Arena and relax and
laugh at the new and highly unusual performance of the LYNX visual theatre and dance performance
group (http://www.mattis.ch/) Afterwards there will be an opportunity to dance until midnight (for
those participants not presenting at 0830 on Wednesday!).
Tours
Please either reserve using Form A (the AMEE registration form) enclosed with the provisional
programme, or contact the AMEE Office. Payment is required at the time of booking.
Saturday 30 August (0840-1830 hours)
Jungfraujoch - the top of Europe (an excursion not to be missed!)
After travelling by private coach through the famous Bernese Oberland, you will take the railway
from Grindelwald Grund to Kleine Scheidegg and then the world famous Jungfrau Railway to
Jungfraujoch with spectacular mountain scenery. After lunch in Jungfraujoch you will go on by rail
to Lauterbrunne and then by coach to Interlaken for some shopping. Return to Bern by coach.
Price includes all transport, lunch and an English-speaking guide.
(Please note: occasionally, adverse weather conditions mean that less time is spent on Jungfraujoch
and more time spent in Interlaken.)
Price: Euro 180; £113
Sunday 31 August (1000-1240 hours)
City tour by coach
Meeting your guide at the Main Railway Station, join the coach for a tour of the city, through Bern’s
attractive Old Town, with its delightful arcades, monuments and fountains. Visit the rose garden, the
bear pits, the impressive cathedral, the parliament buildings and the famous clock tower, followed
by the Old Tramdepot for a performance of the Bern Show – an encapsulated history centred
around an animated model of the city.
Price includes coach transport, entry to the Bern Show and an English-speaking guide.
Price: Euro 22; £14
– 3.2 –
Section 3
Sunday 31 August (1400-1620 hours)
City tour on foot
Explore Bern’s attractive Old Town, with its delightful arcades, monuments, fountains, Cathedral
and Clock Tower. Visit the Old Tramdepot for a performance of the Bern Show – an encapsulated
history centred around an animated model of the city.
Price includes entry to the Bern Show and an English-speaking guide. A maximum of 20 persons
to each guide will ensure you hear the interesting commentary.
Price: Euro 11; £7
Monday 1 September (0900-1640 hours)
Lake Thun
Depart Bern by train to Thun, to meet the boat for Spiez. Enjoy a delicious Swiss cocktail of cheese
and wine on board. Visit the Heimat- und Rebbau museum of the native land and cultivation of
vines, and the home of carpenter Christen Linder, built in 1728. Following lunch, travel on to Thun
by train, for a guided tour through the village, with time for shopping. Return to Bern by train.
Price includes 1st class train and boat fare, Swiss cocktail, lunch (without drinks), entrance to Spiez
museum and an English-speaking guide.
Price: Euro 103; £65
Tuesday 2 September (0800-1800 hours)
Lausanne and Gstaad
Leave Bern by coach to Lausanne, to visit the Olympic Museum with its beautiful gardens and
statues. Move on to the charming village of Chexbres for wine tasting at the Caveau des Vignerons
followed by lunch at la Pinte du Paradis, next to the Castle of Aigle. After lunch travel through the
beautiful landscape to Gstaad, famous for its “high society” visitors from all over the world. After a
guided tour of the village, enjoy the shops and the scenery before returning to Bern via the Simm
valley and its typically Swiss villages.
Price includes coach transport, entry to the Olympic Museum, Wine tasting and cocktail, lunch
(without drinks) and an English-speaking guide.
Price: Euro 127; £80
Wednesday 3 September (0830-1215 hours)
Emmental
Leave Bern by coach for Emmental, a charming region rich in tradition and renowned for its
cheesemaking. Look around the dairy and enjoy a Swiss cocktail with bread and cheese. Take in
the scenery on the leisurely drive back to Bern.
Price includes coach transport, entry to the dairy, Swiss cocktail and an English-speaking guide.
Price: Euro 55; £35
Information for Students
The University of Bern medical students are looking forward to meeting you. Please see their
website for information on activities for students during the Conference.
http://amee03.unibe.ch/students.htm
– 3.3 –
Section 3
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– 3.4 –
Section 4
Abstracts
Pre-Conference Special Interest Group ..
..
..
..
..
..
4.3
Session 1:
..
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4.3
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4.4
4.5
4.6
4.8
4.9
4.11
4.12
4.13
4.15
4.16
4.17
4.19
4.20
4.21
Virtual learning environment ..
..
..
..
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Computer-based assessment ..
..
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Curriculum planning 2..
..
..
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..
Training and assessment for general practice/family medicine
Teaching and learning communication skills ..
..
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International medical education 2 ..
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Assessment of teaching
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OSCE 2
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Problem-based learning and computers
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Progress test ..
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Clinical teaching and the patient
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Professionalism 1
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The core curriculum ..
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4.23
4.24
4.25
4.27
4.28
4.29
4.30
4.32
4.33
4.35
4.36
4.37
4.38
Plenary 1 ..
..
..
..
Session 2: Short communications 1
2A
2B
2C
2D
2E
2F
2G
2H
2I
2J
2K
2L
2M
2N
E-learning
..
..
..
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The examiner’s toolkit ..
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Curriculum planning 1..
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Curriculum evaluation ..
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Teaching and learning..
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International medical education 1 ..
Staff development – training needs ..
OSCE 1
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Problem based learning
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Teaching and assessing attitudes ..
Clinical skills training ..
..
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Undergraduate multiprofessional education
Research and critical thinking
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Selection
..
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Session 3: Short communications 2
3A
3B
3C
3D
3E
3F
3G
3H
3I
3J
3K
3L
3M
Session 4: Workshops
..
..
..
..
..
..
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.. 4.40
Session 5: Large Group Sessions and Short Communications 3
5A
5B
5C
5D
5E
5F
5G
5H
Standard setting (LGS)
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Cognitive perspective on learning: implications for teaching (LGS)
BEME review of high fidelity simulation (LGS)
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Making medical education relevant to medical practice (LGS)
Complex adaptive systems and medical education (LGS) ..
Postgraduate assessment (Short communications) ..
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Community-based education (Short communications)
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Student learning (Short communications) ..
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Session 6: Workshops
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– 4.1 –
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4.46
4.46
4.46
4.46
4.46
4.46
4.48
4.49
.. 4.51
Section 4
Session 7: Short Communications 4
7A
7B
7C
7D
7E
7F
7G
7H
7I
7J
7K
7L
7M
Computer-based teaching ..
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The final exam..
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Curriculum 1 ..
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Postgraduate training in the early years
Continuing Professional Development
Assessment of the practising doctor ..
Different approaches to staff development
Student diversity
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Evaluation of problem-based learning
Management of clinical training
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Clinical training in different settings ..
Professionalism 2
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Outcome-based education ..
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4.58
4.59
4.61
4.62
4.63
4.64
4.65
4.67
4.68
4.69
4.70
4.71
Session 8: Posters
8A
8B
8C
8D
8E
8F
8G
8H
8I
8J
8K
8L
8M
8N
8O
8P
8Q
8R
8S
8T
Assessment – general
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Clinical assessment ..
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Curriculum 1 (including Multiprofessional education)
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Curriculum 2 ..
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Evaluation of the curriculum ..
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Teaching clinical skills (1)
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Teaching clinical skills (2)
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International medical education
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Problem-based learning
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Postgraduate education
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Staff development ..
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Students
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Teaching and learning (1) ..
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Teaching and learning (2) ..
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E-learning and the internet ..
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Computer-assisted learning ..
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Learning management systems and computer-based assessment
Continuing Professional Development
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Management/Selection
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Outcomes/Professionalism/Research and critical thinking ..
.. 4.73
.. 4.76
.. 4.79
.. 4.83
.. 4.87
.. 4.90
.. 4.93
.. 4.97
.. 4.99
.. 4.102
.. 4.106
.. 4.109
.. 4.112
.. 4.115
.. 4.119
.. 4.122
.. 4.126
.. 4.129
.. 4.132
.. 4.135
Session 9: Short Communications (5)
9A
9B
9C
9D
9E
9F
9G
9H
9I
9J
9K
9L
9M
Computers in the curriculum ..
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Assessing communication skills
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Curriculum (2) ..
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Assessment and delivery of postgraduate education
CPD needs assessment
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Clinical training – Leonardo project ..
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Courses for medical teachers ..
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Student support
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Patient simulation
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Rewarding teaching ..
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Is the graduate competent? ..
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Postgraduate multiprofessional education ..
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Teaching special subjects ..
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.. 4.139
.. 4.140
.. 4.141
.. 4.142
.. 4.143
.. 4.144
.. 4.146
.. 4.147
.. 4.148
.. 4.149
.. 4.150
.. 4.152
.. 4.153
Session 10: Plenary 2 ..
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.. 4.155
Session 11: Plenary 3 ..
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.. 4.155
– 4.2 –
Section 4
Special Interest Group Meeting:
National Groups Of Health Science Educators
Purpose: The purpose of this meeting will be to discuss ways that
national groups of health science educators can communicate
with each other.
Many countries have national organisations that co-ordinate the
efforts of health science educationalists. At this meeting we will
discuss how information from one group could be usefully sent to
others.
Agenda:
1 Which groups should be contacted to collaborate?
2 Who would co-ordinate this effort and how?
3 What topics would be for distribution?
Suggestions: The following organisations should be invited:
AMEE, ANZME, ASME, BEME, coHEHre, SAAHE, WFME, groups
from Canada, Holland and the US, and special interest groups.
Perhaps the Journals of Academic Medicine, Medical
Education, Medical Teacher and ASHE
Subjects for discussion:
• Conference diary with conference dates and post conference
resumes or proceedings.
• Medical student exchanges between countries.
• The advertisement of health science education jobs.
• Joint projects such as health science specialisation.
• Units of medical education offering degrees.
• Links to websites of national and other organisations.
Who should attend: Anyone interested in an information exchange
between health science educators on an international level.
Representatives of health science organisations, journals or
interested individuals will be welcome to attend.
It would be helpful if people intending to be present would
communicate with Athol Kent (atholkent@mweb.co.za) in advance
of the meeting to coordinate ideas.
Apart from national groups others such as IVIMEDS, the Ottawa
Conferences or Medical Education Centres might be interested in
collaborating.
Session 1: Plenary 1
Social responsibility of medical education
• What does society expect from its physicians and their training?
An Anonymous Health Politician
• A view from the trenches: what are the essential elements in the
education of future physicians?
Dr. H.H. Brunner, President Swiss Medical Association (FMH)
• What do medical students want to get out of their six years?
J. Scherrer & Th. Hidalgo, medical students
• Education or training: what is the role of the university in medical
education?
Prof. Ch. Schäublin, President, University of Bern
• Squaring the circle: research, teaching, clinical service and
management – what else should professors do?
Prof. P. Suter, Dean Faculty of Medicine, Geneva
Medical curricula are determined by a variety of coherent as well
as of conflicting social forces. Firstly there is society’s need for a
continuous supply of qualified health professionals fit to function
within the local health care system. National health priorities and
societal expectations, therefore, must strongly shape the
educational goals. The corps of physicians already established in
practice has a stake in the quantity and quality of budding
colleagues. Students as immediate consumers of education are
concerned not only with the adequacy of the educational outcomes
but with the personal experience of the educational process as
well. The universities see themselves as the guardians of academic
standards and as champions of pure science. They are also
confronted with medical faculties’ almost insatiable need for
resources, many of which vanish again in the black hole of health
care delivery. The dean sits at the centre of this maelstrom and has
to balance the opposing tugs of health care, research, education
and individual careers, while at the same time responding to all the
requirements listed above. Add to this the complication of federal
systems, where different levels of government vie for control, while
at the same time trying to avoid taking on expenses. The above
constitutes a challenge for medical education.
– 4.3 –
Section 4
Session 2A: E-Learning
2A 1
Virtual patients are go!
Aim: To present the first year´s experiences from
coordination of net based courses within the Swedish Net
University.
N K McManus*, R M Harden and S Smith (IVIMEDS, Tay Park House,
484 Perth Road, Dundee DD2 1LR, UK)
Summary of work: The Swedish Net University started
March 2002 and is a consortium of all universities and
university colleges in Sweden. The Netuniversity aims to
promote the use and development of IT-based distance
education. Universities may register their net based course
at the database of the Netuniversity thereby marketing it for
the users. The government supports the universities directly
to develop IT-based courses. For the autumn semesters
year 2002 there were 1300 registered courses of which
160 were within the medical and health care sector. The
courses originated from all universities. At the Swedish Net
University Agency the courses are coordinated and special
needs are met. The agency also identified areas and needs
not covered by the existing courses.
The International Virtual Medical School is a collaboration
of institutions round the world that are willing to share
curriculum development and learning materials. By pulling
together these resources from different schools,
comprehensive learning packages can be created by any
of the partner institutions. One method of delivering these
resources is by a problem-based approach, where the
learning experience is based on Virtual Patients, in the
context of a ‘Virtual Clinic’. By developing methods for
describing Virtual Patients, learning resources from the
materials ‘bank’ can be seamlessly integrated with the
delivery of the virtual clinic experience. By developing an
XML Schema, case builder tool and XSL/Servlet delivery
mechanisms, both static and interactive presentations can
be created and delivered using the same bank of resource
materials.
2A 2
Lessons learned in developing online curricula: five
tips for success
David A Cook* and Denise M Dupras (Mayo Graduate School of
Medicine, Department of Internal Medicine, 200 First Street SW,
Rochester MN 55905, USA)
Conclusions/take home messages: The Swedish Net
University fulfils a need for collaboration and promotion of
net based courses within medicine and health care and
has the potential to improve quality and effectiveness.
2A 4
David N Brigden* and Andrew D Sackville (Mersey Deanery,
University of Liverpool, Hamilton House, 24 Pall Mall, Liverpool
L3 6AL, UK)
Aim of presentation: We encountered successes and
challenges while developing two online curricula.
Highlighting lessons learned may assist others developing
online learning activities.
Background: This presentation draws on evidence from
an external evaluation of a supported online distance
learning programme, leading to a Postgraduate Certificate
in Teaching and Learning in Clinical Practice. This is
delivered by the Mersey Deanery for Postgraduate Medical
and Dental Education and Edge Hill College of Higher
Education in North-West England. The programme has
been designed to support five different types of interactivity:
• Interactivity between student and the course material
• Interactivity between students and tutors
• Interactivity between students and other course
participants
• Interactivity between students and online technology
• Interactivity between students and their professional
community
Summary of work: Our first project, an automated online
curriculum for residents in an acute care clinic, has
successfully completed fourteen cycles. Our second online
curriculum, teaching internal medicine residents
fundamentals of ambulatory care, is being compared with
an existing curriculum in a randomized trial.
Summary of results:
• Lesson 1: Secure commitment from all participants,
including administrators, faculty, and learners. Identify
and address barriers among all parties. Consider
incentives for participation (and consequences for nonparticipation).
• Lesson 2: Employ active learning. Stimulate critical
thinking, knowledge application, and self-directed
learning.
• Lesson 3: Up-front time investment will pay off later.
Create and follow a timeline.
• Lesson 4: Make the website accessible and userfriendly. Poor page design, “burying” the site under
multiple web pages, excessive passwords, and
dysfunctional hyperlinks frustrate learners and
discourage use.
• Lesson 5: Provide scheduled time for learning. Do not
simply append the course to existing learning
commitments, nor fill the time freed by an online
curriculum with other activities.
Summary of results: The research found that a sample of
students graded their interaction with the course material
and with the online technology as successful or highly
successful; interactivity with tutors was generally graded
as successful; interactivity with other course participants
was graded as partially successful; whilst interactivity with
their professional community received the widest variety of
grading – from highly unsuccessful to highly successful!
Conclusions/take home messages: These results
demonstrate the importance of evaluation in assisting the
design process. The presentation will conclude by
discussing these findings, and the steps that the course
team has taken to strengthen interactivity in areas which
received a lower grading.
Conclusions/take home messages: These tips will facilitate
successful development of online curricula.
2A 5
2A 3
Evaluating interactivity in on-line postgraduate
education
The Swedish Net University supports net based
medical and healthcare education
Reusable learning objects, content syndication and
resource discovery
David A Davies (University of Birmingham, Medical Education Unit,
School of Medicine, Edgbaston, Birmingham B15 2TT, UK)
Goran Petersson (Council for Renewal of Higher Education,
Swedish Net University Agency, PO Box 194, SE-871 24
Härnösand, SWEDEN)
Learning objects are small quanta of e-learning materials
that can be reused in contexts other than the original
learning context for which they were created. Reuse of
learning objects can also be between institutions, in which
case partner institutions must adopt common educational
– 4.4 –
Section 4
and technological interoperability standards if true reuse
of learning objects is to be achieved. The aim of this
presentation is to outline some of the educational and
technical requirements for sharing reusable learning
objects (RLOs). Particular emphasis will be placed upon
resource discovery and the creation of an economy of
RLOs and syndicated medical education materials. The
presentation will draw upon experience gained during a
collaborative project between 4 UK medical schools to
share learning objects between their institutional virtual
learning environments and with other national and
international datasets. Those attending this presentation
will gain an understanding of the current state of the art of
sharing RLOs, the syndication of medical education
content and resource discovery.
2A 6
(Kuhlen 1991). To support this tendency of human thinking
the connecting of content units is essential. In this
presentation we will show how to implement a web of
learning objects using the Unified Medical Language
System (UMLS).
Summary of work: Within the project Meducase we
developed several strategies to use the UMLS
Metathesaurus - and Semantic Web – data. A special
software, the Link-List-Generator, is able to network the
contents of the Meducase e-learning platform according
to these proceedings.
Summary of results: The results show the automatic
connection of contents is efficient and excludes the
appearance of “Broken Links” completely. Furthermore,
the network of learning objects, built on semantic relations,
provides for every knowledge object associative links to
other relevant topics.
Semantic web based knowledge management by
UMLS
Conclusions/take home messages: Semantic networking
especially of complex issues is an ideal alternative to static
learning paths. The Unified Medical Language System as
medical ontology with its data variety and wide scope is
predestined to achieve this goal. These efforts are
important steps on the way to an intelligent tutorial system.
T Schröter*, T Richter and R Schumann (Charité, Medizinische
Fakultät der Humboldt Universität, Berlin, GERMANY)
Aim of presentation: “The human mind... operates by
association. With one item in its grasp, it snaps instantly to
the next that is suggested by the association of thoughts,...”
Session 2B: The Examiner’s Toolkit
2B 1
Credibility of portfolio assessment as an alternative
for reliability evaluation
of 50%. Lower pretest scores are associated with higher
final examination failure rates. The pre-test provides
information comparable to knowing the student’s
preclinical GPA and/or USMLE Step 1 score. When
combined with teacher’s comments, it improves the
sensitivity and specificity for identifying students with
inadequate knowledge. Counseling identified students
might be an insufficient intervention.
E Driessen*, C van der Vleuten and J van Tartwijk (Maastricht
University, Faculty of Medicine, Department of Educational
Development and Research, PO Box 616, 6200 MD Maastricht,
NETHERLANDS)
When portfolios are used for summative assessment
reliability becomes a concern. The inter-rater reliability of
portfolio assessment gives rise to this concern. We plead
for another strategy to deal with the subjective nature. This
strategy involves building safeguards into the integral
judgement process. It includes timely feedback loops to
the student, preventing unexpected judgemental
outcomes, and a sequential rating procedure that
increases the number of raters in case of doubt. We will
illustrate the usefulness of this strategy by describing the
judgemental process in a first year medical school. The
strategy has general relevance for any form of professional
judgement in assessment. Instead of looking exclusively
at consistency across repeated assessments (reliability)
one strives for adding information to the judgemental
process until saturation of information is achieved. This
cannot be expressed in straightforward reliability indices.
We move from reliability of the measurement to credibility
in the assessment procedure.
2B 2
Conclusion: A clerkship pre-test is a feasible and valid
method to help identify students at risk of failure on the end
of clerkship NBME subject examination in medicine.
Collaborative studies on the appropriate intervention are
needed and we would like to discuss sharing our pretest
with other clerkships.
2B 3
Feasibility of portfolio
Kirsten Bested (Vejle Hospital, Department of Anaesthesiology,
Kabbeltoft 25, DK-7100 Vejle, DENMARK)
Specialist examination will not be implemented in
postgraduate education in Denmark in the near future.
Instead portfolios will be implemented and are expected
to document trainees’ achieved competencies and to
document achieved progress in training. In this study the
feasibility of portfolio as a learning instrument during
internship-periods was examined. Nine trainees in six
months of internship used three reflective pedagogical
tools: Personal Educational Plans, Written Patient
Descriptions and Learning Diaries. The trainees’
evaluation of the three tools’ feasibility was assessed during
semi-structured interviews. The tools were shown to
enhance educational value of internship. Before portfolio
can be successfully implemented in postgraduate
education in Denmark certain conditions will have to be
fulfilled. The clinical supervisors need education in how to
use learning strategies and in how to use clinical
assessment methods. The supervisors’ educational needs
and the difficulties in implementing portfolio will be
discussed in the presentation. It is important that both
trainers and trainees get familiar with reflective learning
strategies from their first employment. Portfolios have to be
carefully specified to the unique circumstances that each
speciality has and have to support learning to be a doctor
by being a doctor.
Medicine clerkship pre-test: the role of an early
clerkship examination to identify clerkship students
at risk of final examination failure
Alan Wimmer, Dodd Denton, Paul A Hemmer* and Louis Pangaro
(Uniformed Services University, USUHS - EDP, 4301 Jones Bridge
Road, Bethesda MD 20814, USA)
Aim: Using a clerkship examination for early identification
of insufficient knowledge.
Summary of work: On the first day students take a 100item, faculty developed, MCQ examination. Students who
score –1 SD below the mean or lower are notified and
counseled about active, goal-directed learning that
emphasizes common and serious problems.
Summary of results: The pre-test has a reliability of 0.69,
and a positive predictive value for final examination failure
– 4.5 –
Section 4
2B 4
The educational utility of the “don’t know” response
added to a five-options item format
questioning and oral feedback was identified by the group
as a strategy which could be valuably adapted to provide a
summative assessment with strong formative elements. It
is suggested that these various approaches to assessment
could be designed within programmes to ensure they meet
the learning outcomes and best serve the overall
experiences and strengths of the individual student
enhancing their learning experience.
Yolanda Marin-Campos*, Lizbeth Mendoza-Morales, Jaime
Navarro and Eusebio Contreras-Chaires (National Autonomous
University of Mexico, Departmento de Farmacologia, Facultad de
Medicina, Edificio D, primer piso, Apdo. Postal 70-297, Mexico
04510 DF, MEXICO)
Knowledge test using multiple-choice questions is an
efficient alternative for schools that handle a large number
of students. Advantages of using five-option items format
have been reported in the literature such as: wide coverage
of content domain, measurement of higher-order cognitive
abilities, familiarity to most examinees. Nevertheless it is
considered second best because the probability of
guessing the correct answer is high (20%). We present the
results of using five-options item questions adding a sixth
alternative: “don’t know”. Participants were 600 students of
a Pharmacology program at the National University of
Mexico. A total of 100 five-options questions were applied
as part of the formative assessment of the course. The
stimulus for the students to chose the “don’t know” response
was that wrong responses would be subtracted from the
sum of the correct ones. Results show the educational
utility of the “don’t know” response because the high and
low performance students indicate what they do not know.
This information is highly valuable because it allows us
not only to decrease the probability of guessing, but also to
know which contents should be reinforced, are difficult to
learn or should be addressed through other teaching
methods.
2B 5
Conclusions/take home messages:
• Educators often rely on the tried and trusted written
assignment as a means of assessing students’ levels of
knowledge and intellectual capacity;
• Creative thinking can produce a variety of different,
creative and more holistic assessments which can truly
inform both the learner and the teacher as to the efficacy
of the programmes delivered.
2B 6
Evaluation of open-book exams in an
undergraduate biochemistry course
Nadia Al Wardy*, Syed Rizvi & Sean McAleer (Sultan Qaboos
University, Department of Biochemistry, College of Medicine and
Health Sciences, PO Box 35, 123 Al Khod, SULTANATE OF OMAN)
The use of open-book examinations in a course in
Biochemistry, Metabolism, given to third year
undergraduate medical students, was evaluated. The aims
of the study were:
1 to assess the content and predictive validity of the openbook examinations, and,
2 to assess students’ satisfaction with this form of
assessment.
Content validity was studied by comparing the outcomes
assessed by open-book examinations with the outcomes
of the course. For this, the content of ten open-book
examinations and the course objectives were analysed in
terms of Bloom’s taxonomy for educational objectives.
Predictive validity was studied by correlating performance
of students in these 10 open-book exams with their
performance in the final examination of the course.
Students’ perception of this form of assessment was
studied by using questionnaires that contained both open
and closed questions.
Creating creative assessments
L A Allery*, J MacDonald and L A Pugsley (University of Wales
College of Medicine, School of Postgraduate Medical and Dental
Education, Academic Department of Medical & Dental Education,
Heath Park, Cardiff CF4 4XN, UK)
Aim: To consider some creative alternatives to written
assessments.
Summary: To report the results of an academic review
group considering a variety of strategies to provide creative
alternatives to written summative assessments.
The results showed that open-book exams assessed
higher order thinking skills rather than the lower level called
for by the course objectives; that there was a significant
positive correlation between students’ performance in
open-book exams and the final; and that although students
enjoyed this form of; assessment, they required more
guidance in performing it.
Summary of results: The results of the review provided a
range of alternatives for assessment incorporating creative
use of portfolios, individual presentations, group tasks, peer
and self assessment. Key issues were identified related to
reflective diaries and their place and value for summative
work, the reliability of video and teaching observation as
snapshots of teaching competence. The use of case
studies as an assessed presentation followed by
Session 2C: Curriculum Planning 1
2C 1
Complementary and Alternative Medicine in the
undergraduate medical curriculum: a needs analysis
were developed. These strategies were used as the basis
for a modified Delphi process involving staff. The results of
this process were used to generate overall aims and strategy
regarding CAM in the curriculum.
J Skinner and A D Cumming* (University of Edinburgh, Medical
Teaching Organisation, College of Medicine and Veterinary
Medicine, Teviot Place, Edinburgh EH8 9AG, UK)
Summary of results: The needs analysis revealed general
overall support for integration of CAM into the curriculum,
but with concerns about issues of efficacy, credibility and
regulation. Teaching staff was largely in favour of providing
students with a broad familiarisation with CAM, using an
evidence and efficacy-based approach to teaching.
Aim: With the growing popularity of Complementary and
Alternative Medicine (CAM) there has been increasing
pressure to include this in the undergraduate medical
curriculum. We therefore conducted a local needs analysis
in Edinburgh for the integration of CAM into the curriculum.
Conclusions/take home messages: Our results support the
careful integration of CAM into the undergraduate medical
curriculum.
Summary of work: The needs analysis gathered both
quantitative and qualitative data. An initial literature review
and focus group discussions revealed the broad need for
change. Questionnaires were distributed to 1,714 medical
students and members of teaching staff. A seminar was
held and 4 strategic approaches to CAM in the curriculum
– 4.6 –
Section 4
2C 2
Mapping the surgical curriculum
Aim: The presentation will outline the development of
genetics curricula for specialist registrars in dermatology,
cardiology and neurology, based on perceived learning
needs.
Anne Ellison (Royal Australasian College of Surgeons, Surgeons’
Gardens, Spring Street, Melbourne 3000, AUSTRALIA)
Traditionally, surgery has been taught through the
apprentice system as opposed to following a predetermined
curriculum. Recent developments in medical education
have resulted in the need to develop an articulated surgical
curriculum. The task of ‘mapping’ a curriculum for
apprenticeship style training raises a number of challenges
for educators. Using Harden’s concept of curriculum
mapping (Harden 2001), the Royal Australasian College
of Surgeons commenced the process of mapping the basic
and advanced surgical training programs. We developed
a generic template based on Harden’s model to ensure
that all involved were working with the same mental map.
Processes and structures were developed to steer
curriculum development. A computer program for concept
mapping was used to translate the map into an online
format. While curriculum maps were being developed they
were published on-line but were password protected until
they were complete. Curriculum mapping facilitated
collaboration and coordination of curriculum development.
Some modifications to Harden’s model were required due
to particular features of College education and training
programs. Greater emphasis was placed on the philosophy
and evaluation of the curriculum. Combined with computer
technology Harden’s model is a useful management tool
to facilitate collaboration and coordination of curriculum
development.
2C 3
Summary of work: Curriculum development was informed
by two sets of data. Firstly, a mapping exercise of current
genetics education, including curricula analysis, interviews
with educators, and a survey of specialist registrars in the
selected specialties. Secondly, an analysis of data from
meetings with specialist registrars in the selected
specialties in the West Midlands and South Western
deaneries, and an online adapted Delphi survey of a
national sample of consultant geneticists and specialty
consultants.
Summary of results: Collection of the two sets of data
enabled an evaluation of the synergy between current
teaching of genetics up to specialist registrar grade and
their identified learning needs in the modern health service.
This evaluation then formed the basis for the development
of a genetics curriculum for each of the three specialties.
Conclusions/take home messages: Curriculum
development is often based on the opinions of a small
number of experts. This project demonstrates an
alternative model, in which curriculum development draws
on a wide range of data sources.
2C 5
An innovative method of delivery of the core
curriculum in Obstetrics and Gynaecology - the
Leeds model
Farid Saleh*, Nadim Cortas and Ibrahim Salti (Department of
Human Morphology and Medical Education Unit, Faculty of
Medicine, American University of Beirut, PO Box 11-0236, Beirut,
LEBANON)
Vikram Jha*, Jayne Shillito, Judith Moore, Alison Wright and Sean
Duffy (University of Leeds, Academic Dept of Obstetrics &
Gynaecology, St James’s University Hospital, Level 9, Gledhow
Wing, Leeds LS9 7TF, UK)
Aim: To share with the international community on medical
education our thoughts and plans regarding developing
the existing medical curriculum at the American University
of Beirut (AUB).
Aim: A model to deliver the core curriculum in Obstetrics
and Gynaecology was developed in Leeds against the
background of attempting to concentrate core teaching
into designated sessions to increase time for clinical
experience in a problem-oriented curriculum.
Background: Our medical program consists of seven years
of didactic university education, three of which are spent
on covering pre-medical courses. The fourth and fifth years
contain the bulk of the knowledge offered in the whole
program and students are expected to “digest” and “absorb”
such knowledge for later clinical application. Seventeen
non-integrated basic medical science courses are offered
during the fourth and fifth years.
Summary of work: The curriculum, based on the SPICES
model, ensures a consistent standard of teaching. The
core topics are covered in three units: 1. Introductory week:
lectures, small group work and ward-based work and
covers basic topics including history taking and
examination, benign gynaecology and obstetric
emergencies; 2. ‘Theme’ sessions: interactive half-day
sessions covering other core topics in Gynaecology such
as infertility and menopause; and 3. Student-led tutorials:
covering core topics in Obstetrics. These units work
together to cover the core curriculum over the course of
the eight-week attachment.
Summary of work: Based on the feedback obtained from
both students and Faculty regarding an overcrowded
curriculum, we mapped the curriculum of the fourth and
fifth years in order to assess the issue of content overlap
among the courses, and to develop the curriculum in a
way that would create a better learning environment for the
students. We conducted such mapping by first obtaining
an updated and detailed content of each course offered in
these years. A computer macro was then written to serve
the purpose of both database management and searching
tool. The mapping task was a demanding one and it
required 378 hours of work.
Summary of results: Evaluation of the curriculum has
provided positive feedback from students who feel that it
enhances enjoyment of the clinical attachment as they
feel better prepared.
Summary of results: We searched the database for
concepts, topics, and even key words (7,458) and the
outcome of such search confirmed the presence of content
overlap and lack of cross bridging among the courses.
Moreover, the students were found to be exposed to a total
of seventy exams that are fully based on recall of facts.
Conclusions/take home messages: Quality assurance in
delivery of the core topics might be difficult in short clinical
attachments and the Leeds model represents an innovative
framework that may be used by other Medical Schools.
2C 4
The current medical program at the American
University of Beirut: problems and solutions
Conclusions/take home messages: Horizontal and vertical
integration of the medical curriculum at AUB is a necessity
rather than a luxury. It provides solutions for both content
overlap and lack of teaching in a context. We identified 13
clinical disciplines within which such integration could
evolve, and Problem Based Learning could be the
approach for delivering the content of the new integrated
curriculum.
Developing curricula based on learning needs:
genetics education for specialist registrars in nongenetics specialities
Sarah Wakefield*, Hywel Thomas, Peter Farndon and Julie Bedward
(Centre for Research in Medical & Dental Education, School of
Education, University of Birmingham, Edgbaston, Birmingham
B15 2TT, UK)
– 4.7 –
Section 4
2C 6
A survey of people’s complaints against physicians
during a five year period in Fars province
private hospitals, private offices and clinics. Most of these
complaint were made against gynecologists,
ophthalmologists, orthopedists and general surgeons. Nine
per cent (33 cases) of the cases were related to death,
15% (56 cases) to disability and 50% (183 cases) related
to inattention to communication skills. In 26% (95) of the
cases the physicians were at fault and 16% (59 cases) of
them have been settled by arbitration. In 48% (177) of cases
physicians were found to be at fault.
L Bazrafkan*, Z Tabeie and M Saberfirozi (Shiraz University of
Medical Science, Zand Avenue, Shiraz, IRAN)
Background: One of the methods of determining the
objectives of medical education in general practice is
needs assessment and one of the prominent sources of
needs assessment is a survey of complaints and medical
errors.
Conclusions/take home messages: The results of this study
indicate that the majority of the complaints were due to a
lack of a proper relationship between physician and patient,
mostly behavioral. Considering the fact that a person’s
behavior reveals his/her attitude, there is a severe
deficiency in medical education with regard to affective
and attitudinal objectives.
Summary of work: We attempted to survey people’s
complaints against physicians in Fars province in a 5-year
period. A questionnaire was prepared and the collected
data were categorized and analyzed using SPSS statistical
package.
Summary of results: The results revealed that 368
complaints were filed over 5 years against public hospitals,
Session 2D: Curriculum Evaluation
2D 1
Keep the customer satisfied: quality control in a
medical curriculum
• Reaction of participants
• Collection of data on new knowledge and skills of
participants
• Transfer from educational setting to real life
• Impact on wider community
M Maelstaf*, I Vandenreyt and M Vandersteen (LUC, Limburgs
Universitair Centrum, Faculty of Medicine, Universitair Campus,
Gebouw D, B - 3590 Diepenbeek, BELGIUM)
Aim of presentation: Quality assurance is monitored each
year by the Educational Management Team in a ‘plan-docheck-act’ cycle. The objectives cover the learning attitudes
of the students, the programme content and the
organisation and performance of the staff. Quality control
means shared responsibility of students and staff for
curriculum development and evaluation.
Summary of work: Several procedures have been
developed to improve the quality of the curriculum. Basic
conditions are staff development and coaching of the
student representatives. A compulsory format for the study
guidelines is issued for the implementation of the
programme. Registration of study time, analysis of
examinations, interviews and questionnaires provide more
information. The management team summarizes the
information and recommends changes.
Participants attending courses from March to October this
year will complete pre- and post-test MCQs, be surveyed
after the course and will subsequently be invited to
complete an online questionnaire at course + six months.
This will be supplemented by interviews and self reports
by self selected course members. The overall design is to
develop a robust evaluation strategy for this and other
provider courses in order to inform continued refinement
of the curriculum and modes of delivery.
2D 3
William Murdoch* and John Skelton (University of Birmingham,
Interactive Skills Unit, Department of Primary Care and General
Practice, Primary Care and Clinical Sciences Building, Edgbaston,
Birmingham B15 2TT, UK)
Summary of results: We diagnosed strengths (solution of
bottle-necks, uniform guidelines, transparent assessment)
and weaknesses (unclear efficacy of teaching methods,
no collaborative learning, no assessment of general
competences). Lack of time and insufficient logistic support
has jeopardized the results. At this moment we have
completed half the quality plan.
Aim: To increase awareness of a novel technique in
evaluation and to reinforce positive aspects of teaching
Community Based Medicine
Summary of work: A focus group of final year medical
students was used to develop 3 stimulus statements for a
nominal group session. The nominal group is a nonconfrontational method of generating participant-centred
opinions and allows voting on priorities. The group priorities
were then submitted to the whole year in a Likert scale
questionnaire to ensure that the group opinion represented
that of the year as a whole.
Conclusions/take home messages: Changing ambitions
are inevitable. As faculty pleads for an integral approach
the cycle be will spread over three years. Three years of
quality control will result in a general plan for optimization.
2D 2
A student centred approach to course evaluation
using the norminal group technique
Summary of results: 18 students attended the nominal group
session and they developed 124 opinions. They voted for
the top 21 (7 in response to each statement). A
questionnaire of these 21 opinions was submitted to 165
medical students. The response rate was 82% and there
was majority agreement with 20/21 of the opinions.
Evaluating MOET (Managing Obstetric Emergency
Treatment)
Mike Davis (Edge Hill, Southport Road, Ormskirk, UK)
Managing Obstetric Emergency Treatment (MOET) is a
three day residential course aimed at registrar and
consultant obstetricians. It was developed under the
auspices of Advanced Life Support Group (ALSG) in order
to improve the competence of staff dealing with obstetric
emergencies and to supplement the work of Advanced Life
Support in Obstetrics (ALSO), aimed at General
Practitioners, Midwives, Obstetricians and other staff
involved in the provision of maternity care. The purpose of
this presentation is to outline a strategy for evaluation of
the course using the 4 level Kirkpatrick Hierarchy, thus:
Conclusions/take home messages: The nominal group
technique is effective and easy to perform. It has shown
that community based medicine has many attributes,
especially its role in increasing clinical confidence and it
has an important role in professional development and
bridging the gap from being a student to becoming a doctor.
– 4.8 –
Section 4
2D 4
Teaching about the family in the community:
purposeful, coherent, integrated and well-informed?
Summary of work: This was a descriptive research study
and the population included 1,734 students in 16 academic
disciplines from 7 colleges. A five scale questionnaire (very
poor to very good) with 16 items and Cronbach á 0.95 was
delivered to students in the class and then collected after
completion. Analyses were performed by SPSS and
descriptive-inferential statistics were used.
P G Cawston*, K Mullen, M Nicholson and R A Robertson (Glasgow
University, General Practice and Primary Care, 4 Lancaster
Crescent, Glasgow G12 0RR, UK)
Aim: Medical schools in a number of countries use home
visits to teach about the family. Our aim is to discuss lessons
that are broadly applicable to community-based teaching
about the family in other medical schools.
Summary of results: Overall, Pearson test with 2 way (p =
0.05) showed a small and negative relationship between
students’ GPA and the evaluation score of the teacher,
which was practically not significant. Analysis of variance
and factor analysis indicated no significant difference
between the student evaluation score of the teacher and 3
groups of GPAs low (<14), moderate (14-17) and high (>17).
The comparison of correlation intensity between teacher
evaluation score and male and female students’ GPA by
Fisher Z showed no significant difference.
Summary of work: An evaluation instrument for the Glasgow
University Family Project was constructed using analysis
of free-text data collected from students. The baseline
survey led to a number of changes being introduced,
including: revision of documentation, tutor training, flexibility
in visits and information for the families involved. The
instrument was used to re-evaluate whether these had
impacted on student perceptions of the project.
Summary of results: A response rate of 59.8% of all students
in the relevant year (144/241) was achieved for the baseline
evaluation. Despite a median rating for both overall content
and format of ‘4’ (1=poor, 5=excellent), significant
weaknesses were identified around the themes of purpose,
coherence, integration and information. Data on how
students evaluated the course after changes were
introduced in these areas will be included in the
presentation.
Conclusion: The study showed no significant difference
between high GPA and 2 GPA groups of moderate and low
in relation to SET and also no relationship acquired
between GPA and SET.
2D 6
S Iranfar*, B Izadi, F Monsori and M Rezaee (Medical Sciences of
Kermanshah, E.D.C., Central Library of Kermanshah University
of Medical Sciences, Sheed Beheshti Bolv, Kermanshah, IRAN)
Conclusions/take home messages: Case studies involving
sequential visits to families of more than one generation
are a useful means for teaching about the family. Students
identified significant weaknesses in one such programme.
The lessons learned from their evaluation may be
applicable to other medical schools.
2D5
Teachers’ points of view about evaluation
Background: In spite of faculty evaluation designed to
improve the faculty program, it is difficult to achieve this
goal.
Aim: The purpose at this research is to determine teachers’
points of view about evaluation in Kermanshah University
of Medical Sciences.
Summary of work: A qualitative study using group discussion
was carried out on faculty members at random in 5 groups.
6-8 persons participated (men, women, M.S, Ph.D and
specialise degree) in each of group. A discussion guide
was designed and the pilot study was carried out to
determine validity and reliability of the tool. Note-taking was
used by colleagues from teachers’ ideas about evaluation.
After each session all the ideas were collected and noted.
Correlation between students’ Grade Point Average
(GPA) and evaluation score of the teacher
A Malayeri, A Alidadi and P Afshari* (Ahvaz Medical Sciences
University, Nursing and Midwifery School of Medical Science,
University of Ahwaz, Ahwaz, IRAN)
Background: Evaluation is a process for merit assessment
and quality improvement. During the past three decades
one of the most important challenges has been student
evaluation of teachers in higher education. Over the past
decade studies have shown that evaluation of teachers
has correlation with some variables such as teacher
enthusiasm, teacher rank, student expected grade etc.
Summary of results: The research showed the majority of
faculty members believed that it is necessary to carry out
evaluation but in a suitable setting. They did not know
anything about evaluation goals and they thought that
evaluation is used only for personnel decisions.
Conclusions/take home messages: It is necessary to
evaluate education activities but teachers’ points of view
are most important for improvement. The best way to
achieve evaluation goals is through teachers, not by
institute.
Aim: To determine the relationship between students’
academic performance and student evaluation of the
teacher, and also to compare correlation intensity of male
and female students’ GPA.
Session 2E: Teaching and Learning
2E 1
Factors influencing final year students’ learning
climate in Thai Medical Schools
rate the items according to their importance to the learning
climate using a 5 point Likert scale ranging from 0 (not
important at all) to 4 (absolutely important). The result
showed that the 50 most important items related to:
teachers (9 items); residents (3); friends (3); nurses and
medical personnel (2); patient care (4); learning experience
(7); assessment (2); educational resources (4); physical
environment (4); self-confidence and motivation (5);
personal life and support (6); and life after graduation (1).
In conclusion, to provide a good learning environment for
final year medical students, many aspects need to be
considered. Once the most important factors are identified,
we can develop a diagnostic instrument to provide a more
valid measure of students’ learning environment and to
subsequently enhance their learning.
Danai Wangsaturaka* and Sean McAleer (The Faculty of Medicine,
Chulalongkorn University, Dept of Pharmacology, Rama IV Road,
Patumwan, Bangkok 10330, THAILAND)
The study aimed to identify factors influencing final year
students’ learning climate in Thai medical schools.
Teachers from 5 schools and final year students from 8
clinical training centres in Thailand were asked to describe
the characteristics of good and bad learning environment
using individual and group interviews, respectively. The
data obtained were then arranged into a 143-item
questionnaire. 323 medical students from 11 clinical
training centres were selected by stratified sampling to
– 4.9 –
Section 4
2E 2
Evaluation of different lecture types in medical
education
Background: Educators tend to think that being a teacher
improves their own learning. The purpose of this study is to
determine if undergraduate peer teachers learn better than
their peers.
S Holler*, N De Cono, A Mehrabi, S Schürer, E Gazyakan, M Kadmon
and J Schmidt (Department of Surgery, University of Heidelberg,
Medical School, Im Neuenheimer Feld 110, 69120 Heidelberg,
GERMANY)
It seems difficult to satisfy students’ needs in didactic
lectures. We compared three different lecture types. Keysymptom-oriented lectures (KOL) were introduced a year
ago with our new surgical curriculum at Heidelberg
University. This lecture is a one-hour daily class held by
different academic teachers. The data were compared
with the evaluation of classical disease-oriented lecture
(DOL) held by various teachers, and case-based lectures
(CBL) held by a single teacher concentrating on differential
diagnosis. Our aim was to compare the differences in
motivation, presentation, interaction and overall grade of
these three lecture types. During the academic year a
prospective study with a standardized questionnaire (sevenpoint Likert scale) was completed after each lecture by
third-year students. We used statistical methods to compare
the differences of the three lecture types (ANOVA-analysis,
t-test, p<0.05). We evaluated 1,071 questionnaires (323
disease-oriented, 52 case-based, 696 key-symptomoriented). The data show that the KOL lecture scored in all
evaluation criteria significantly better than the DOL
(p<0,001). The CBL is even better accepted among
students than the KOL. Our study showed that two criteria
improve students’ satisfaction of didactic lectures. The
lectures should be key-symptom-oriented and held by a
single teacher.
2E 3
Summary of work: We compared the academic records of
42 students acting as teacher assistant to their junior peers.
These students had completed a course on teaching skills
for a whole year. The median of their records before and
after the course was compared with the median of the
group not participating in the program. They were matched
by academic performance, and compared using the
Wilcoxon signed rank test.
Summary of results: Both groups increased their marks
with a statistically significant difference the year before and
after the program. The increase was higher in the non
participant group (delta .625 vs .875).
Conclusions/take home messages: As students advance
in their career, they increase their academic grades.
However, increase in the participating group is smaller in
comparison to the non participant group. These data do
not confirm that peer teachers learn better than their peers.
This raises many questions: are grades a good measure
of learning? Do participants have less time to spend on
their own study? What other variables should be explored
to measure learning in these groups?
2E 5
F R Ochsendorf*, A Böer, W H Boehncke and R Kaufmann (Zentrum
Dermatologie und Venerologie, Klinikum der J W GoetheUniversität, Theodor-Stern-Kai 7, D-60590 Frankfurt/M,
GERMANY)
Clinical teachers and the new medical education
Tim Dornan*, Albert Scherpbier, Nigel King and Henny Boshuizen
(Hope Hospital, University of Manchester School of Medicine,
Stott Lane, Salford, Manchester M6 8HD, UK)
In a dermatology practical course small group teaching
was found to be superior (AMEE 2001, 8J2). Due to lack of
personnel this could not be offered to the whole class. We
investigated an interactive large group teaching approach
as a possible alternative. The class was divided in two
parts. While one half received small group bed-side
teaching in the ward, the other half had interactive teaching
in the lecture-hall. Here one tutor acted as the content
expert and presented a simulated patient. A second tutor
led the learning. He led the discussion, stimulated and
involved all students using a microphone. The groups
changed the next week. 6 topics were discussed in 12
weeks. The students (n=206) rated this course 1.6 ± 0.6
(mean ± SD; 1=excellent – 6=very poor). This rating
matched the evaluation of the small group teaching given
the year before (AMEE 2001, 8J2). The results of MC-tests
improved significantly. The part in the lecture hall was rated
better than the bed-side teaching. Interactive large group
teaching was accepted, easier to organize, needed only
few more personal and partly solved the problems of
standardization.
Background: Clinical disciplines, their traditions, and the
mastery of practitioners are taking second place to
integrative educational objectives in modern medical
education.
Aim: Explore a) how clinicians perceive their roles and b)
how those perceptions link to the official curriculum.
Summary of work: All 14 physicians in a teaching hospital
were interviewed and their narratives analysed
phenomenologically. The method included: Debating
alternative interpretations; systematically identifying bias
and disconfirmatory instances; retaining respondents’
phraseology through the process of data reduction; backreferencing interpretations to the original manuscripts.
Summary of results: Hospital wards were seen as the
primary context for learning. Pressures of practice were
felt to limit outpatient learning. Most interviewees conceived
of clinical learning as clerking interesting patients on wards
and receiving bedside teaching. They saw it as
impracticable for students to see patients that matched
their system-based learning or to participate in practice.
Problem-based learning, whilst accepted, was seen as
having undue priority over clinical teaching. Evidence of
crossover between the two processes was scant. There
were strong expressions of empathy towards students.
2E 6
Using a game format as a teaching strategy in CME:
does it work?
Maja Bujas-Bobanovic (Aventis Pharma Inc, 2150 St. Elzear Blvd.
West, Laval, Quebec H7L 4A8, CANADA)
Aim: to demonstrate how educational games can promote
learning and at the same time provide enjoyment and
encourage participants to be more creative in their CME
programs.
Conclusions/take home messages: Objective-based
education and problem-based method had permeated
clinicians’ thinking to a surprisingly limited extent.
Teaching, like learning, has to be ‘reinvented’ when a
curriculum changes.
2E 4
Interactive large group teaching is an alternative to
small-group teaching in a dermatology practical
course
Summary of work: A literature search on gaming, as a
teaching strategy, was performed with MEDLINE, ERIC,
and CINHAL. Additional articles were identified from the
bibliographies of the retrieved articles and from Web sites.
Student-teachers are not better learners than their
peers
Summary of results: Educational games are beneficial to
both children and adult learners. However, very few reports
identify gaming as a teaching strategy in CME. It is well
known that games can incorporate concepts and
principles of adult learning and meet a variety of educational
Angel M Centeno*, Cecilia Primogerio and Martin O’ Flaherty
(School of Biomedical Sciences, Universidad Austral-Medicina,
Av Juan Peron 1500, B1629 AHJ Derqui, Pilar, Pov Buenos Aires,
ARGENTINA)
– 4.10 –
Section 4
material in a dynamic, innovative manner is a constant
challenge for medical educators. The use of games, as
an aid to teaching, can results in more stimulating and
appealing CME programs. This session demonstrates
how games can easily be implemented in everyday
learning activities. The only limit is our own creativity and
imagination.
objectives. They can also involve repetition, reinforcement,
association and use of multiple senses. Unlike many other
tools, they can bring fun and enjoyment in the learning
experience. Therefore, games could significantly
contribute to the development of a wider repertoire of
teaching methods in CME.
Conclusions/take-home messages: Presenting educational
Session 2F: International Medical Education 1
2F 1
Presentation of European Medical Students’
Association (EMSA)
2F 3
Iskender K Akylbekov, Christian Guksch* and Chinara Mambetova
(Universitätsklinikum Hamburg-Eppendorf, Modellstudiengang
Medizin, Martinistr. 52, N16, D-20246 Hamburg, GERMANY)
Filip Stoma*, Anna Michalak and Tomasz Kucmin (European
Medical Students’ Association, ul. Narutowicza 33/8, 20-016
Lublin, POLAND)
Within the East/Central European and Eurasian Task Force
there is a high consensus that in order to facilitate changes
in the medical education of most universities that have
been dominated by a Soviet canon of learning with its early
specialization, efforts must include teacher training, skills
development and changes in medical education. Drawing
on my experiences as an advisor to the Commission on
Science and Education under the Kyrgyz President in
Bishkek, and in cooperation with Kyrgyz scholars, we would
like to present some aspects that need to be taken into
account to make changes possible for teachers and
students. The students‘ possibilities to study successfully
with full access to medical information require permanent
internet access and computers. Furthermore, it is our view
that a PBL-based curriculum will make a difference with
regard to the way the students are studying. And changes
within the subjects will lead the students towards an
integrative perspective of what a medical doctor should be
able to handle when facing patients. Medical doctors as
teachers on the other hand need access to research and
should receive training at selected centers not only within
their medical speciality but also in new ways of teaching.
The European Medical Students’ Association (EMSA)
integrates medical students in geographical Europe
through activities organised for and by medical students.
The idea of EMSA was created at the European Medical
Students’ Congress in Leuven (the Netherlands) in 1990
and founded at its first General Assembly in Brussels in
1991. EMSA creates a European network for
communication between medical students. What is also
important, EMSA acts upon gathered information on social,
cultural, academic, economic and ethical aspects of
Europe. Furthermore, it provides a platform for all medical
students in Europe in order to defend their interests and to
ensure the quality of medical education in Europe. The
Committee for Medical Education is working on a
permanent improvement of medical education in Europe
through reflection on the European core curriculum and
through discussions of medical education techniques and
other health issues.
2F 2
Cultural probity in medicine
R C Gupta*, S Lingam, M I Memon and D Brigden (Lancashire
Teaching Hospitals NHS Trust, Preston Road, Chorley, Lancashire
PR7 1PP, UK)
Possibilities for change?
2F 4
Aims and Objectives: This paper introduces the concept
of cultural probity in clinical practice. An increasing number
of doctors and healthcare professionals travel widely to
serve the community of different cultures. Increasingly,
nations are becoming multicultural practising multiple
faiths. It is important that the healthcare practitioners should
be prepared to deliver care to their patients without
compromising their cultural values and religious beliefs.
Increasing the relevance of health professions
education and health services: The Network:
Towards Unity for Health
Gerard D Majoor (Faculty of Medicine, Maastricht University,
Office of International Relations, PO Box 616, NL-6200 MD
Maastricht, NETHERLANDS)
Aim of presentation: Sharing the rationale of a new strategy
adopted by an international network committed to
improvement of community health.
Summary of work: This paper will highlight reasons for
delivering a culturally competent service, define cultural
probity, discuss its practical implications on the
organisations responsible to commission and deliver
healthcare including empowering the local communities.
The methods of developing this essential competency
include making them aware of medico-legal human rights
and by including aspects of cultural awareness in the
curriculum. Small projects on socio-economic status and
its implications on health can be given to students. They
should be encouraged to spend an elective period in other
countries.
Summary of work: As one of the strategies to implement
WHO’s Alma Ata “Health for All” declaration, in 1979 a
Network of Community-Oriented Educational Institutions
for Health Sciences was established to promote training
of health personnel orientated to the new paradigm.
Although this Network has been instrumental in advocating
new educational approaches like problem-based learning,
community-oriented,
community-based
and
multiprofessional education, the impact of graduates from
Network member institutions on reorientation of health
services has not met the expectations. Presumably,
innovations in health professions education must be
implemented in concert with changes in health services
to yield synergy. Therefore, in 2002 The Network
amalgamated with WHO’s “Towards Unity for Health”
(TUFH) project. This project has aimed to promote equity,
relevance, quality and cost-effectiveness in communityoriented health services by stimulating partnerships among
key stakeholders like communities, health services, health
managers, health professionals and educational
institutions.
Results/Conclusions: This will develop an essential
competency of cultural probity amongst the healthcare
professionals. In this way we are preparing them to be ready
to practice in a multicultural society and this should have a
positive impact on improving global health.
– 4.11 –
Section 4
No country with a low percentage of older persons among
the population/good training in geriatric education was
identified in the study. Action is recommended to both
increase training and to harmonize its general availability
through national standard curricula.
Conclusions/take homemessages: Activities of The
Network: TUFH combining expertise in reorientation of
health services and health professions education are
expected to act synergistically towards “Health for All”.
2F 5
Global survey on geriatrics in the medical
curriculum
2F 6
Not just another changed medical school
Trevor Gibbs* and David Taylor (Faculty of Health Sciences,
University of Cape Town, Barnard Fuller Building, Anzio Road,
Observatory, 7925 Cape Town, SOUTH AFRICA)
I Keller, N Borojevic*, A Makipaa, T Kalenscher and A Kalache
(IFMSA, P. Heruca 10, HR-10000 Zagreb, CROATIA)
In response to rapid population ageing world-wide, the
WHO Ageing and Life Course Programme devised the
“Teaching Geriatrics in Medical Education, TeGeME”
survey and invited the International Federation of Medical
Students’ Association (IFMSA) as a partner. TeGeME’s
main goal was to gain insight on if and how issues on
ageing and geriatric medicine are incorporated into
medical curricula world-wide. Two questionnaires were
used, one focused on the organisation of medical education
at national level and the other on assessing the training
offered at medical school level. Data have been received
from 268 universities in 64 countries, of which only data
from countries with an overall participation of more or equal
to 50% of all medical schools have been analysed (data
from 161 schools and 36 countries). Individual analysis
from every school and analysis according to development
status has been done. These groups of countries were
identified:
A few training possibilities/high proportion of older persons
among the population
B few training possibilities/low proportion of older persons
C good training/high proportion of older persons
Aim: To share with others faced with similar problems how
curricula can be adapted to address individual needs.
Background: Medical curricula the whole world over are
changing, with medical schools adapting to meet the
demands of modern-day health care practice. Most
schools adopt similar models based upon tried and tested
educational theory and practice. In debate is the argument
as to whether a standard approach using these methods
is applicable to all, specifically to those schools in the third
world.
Summary of work: Using two experiences, from one UK
based medical school and one South African medical
school, this paper will suggest how they worked together,
how two schools cooperated, and by sharing and
comparing their programmes were able to adapt modern
day learning technologies to suit their individual
environment.
The result is a medical programme that uses educational
theory in an adaptive, practical way.
Conclusion/take home message: These techniques should
be applicable to all those attempting to deliver medical
curricula in third world countries.
Session 2G: Staff Development – Training Needs
2G 1
Strategic direction for staff development: ensuring
relevance in times of change
2G 2
Faith Hill (University of Southampton, Medical Education
Development Unit, School of Medicine, Biological Sciences
Building, Bassett Crs East, Southampton SO16 7PX)
Educational needs of a programme director in
Denmark
Bente Malling (Silkeborg County Hospital, Mollerupvej 5, DK
8600 Silkeborg, DENMARK)
The purpose of the study was to describe the educational
needs of a programme director in the postgraduate
educational system in Denmark. A description of the
qualifications needed and the qualifications the
programme directors actually have revealed a gap, defining
the educational needs. The needs assessment was
obtained through focus group interviews with doctors at
different educational levels and coming from different
specialities, combined with semi-structured interviews with
chiefs of hospitals and departments. The results are
concentrated around the themes: Responsibility and Tasks,
Qualifications, Job-description, Time, Education - now and
in the future and Suggestions for improvement. The study
has revealed an urgent necessity for educating the
programme directors in Denmark in order to improve
postgraduate education and to implement the reform in
specialist training. According to the study the educational
programme for future programme directors will have to
involve management, administration and leadership skills
besides pedagogic knowledge. The study proposes
themes for an upcoming educational course. Together
with future blueprints and job descriptions the results of
this study can be used to create the educational programme
for future programme directors.
Aim: This presentation will share our experience of
determining strategic direction for education staff
development in the School of Medicine, University of
Southampton, UK. It will report on the benefits of adopting
a consultative approach and highlight some of the
difficulties involved.
Summary of work: During 2001-2 a review of staff
development was undertaken to ensure maximum
relevance at a time of student expansion and curriculum
change. As we have more than 800 teachers (mostly
employed by other organisations), we set up a
representative task-group to identify and prioritise staff
development needs. Recommendations from the group
were subject to wider consultation.
Summary of results: Staff development in 2002-3 has
followed the direction determined by the task-group and
consultation exercise. In particular, the main focus has
shifted from training for new teachers (which still continues)
towards the needs of our course coordinators. Leadership
training and other new courses for coordinators have been
delivered and evaluated during the year.
Conclusion: The Southampton experience suggests that
strategic direction for staff development is most relevant
when it is embedded in the expressed needs of the staff
concerned.
– 4.12 –
Section 4
2G 3
A new preparation for dental trainers
Aim: A review of the literature documents a rising demand
for education in counselling and guidance in postgraduate
medical education and many institutions make attendance
at Teaching the teachers courses compulsory for
programme directors and clinical supervisors. A few studies
show that Teaching the teachers courses have limited
effect on clinical teaching and training, despite high
satisfaction with the courses and high perceived need for
the course. The present study evaluates the effect of a
Teaching the teachers course for doctors at four levels:
level of reaction (participants assessment), level of learning
(assessment of skills), level of behaviour (use of principles
in daily practice) and level of organisation (departments’
attitude towards clinical teaching and training).
Alexander Stewart (NHS Education for Scotland, 6 High Street,
Turriff, Aberdeenshire AB53 4DS, UK)
Aim: To describe a preparation process for trainers derived
from an outcome based curriculum developed by a
representative group of trainers.
Summary of work: The curriculum was the basis for a
training needs assessment of Scottish trainers. A database
was created. A large proportion of outcomes for trainers
was rated as essential core for all trainers. An extended
preparation for new trainers was piloted. This comprised
a total of ten days of courses, devised in line with the core
outcomes, and linked by coursework. The final two days
were designed as an assessment of participants, who
presented evidence of their development on the course.
The assessment process for this course offers a
mechanism for accreditation of all trainers. The database
will direct existing trainers to training modules required to
achieve accreditation. In time all trainers will achieve
accreditation.
Summary of work: The study design is a controlled trial
with intervention (Teaching the teachers course) to all
doctors at medical/surgical departments of one hospital,
Aarhus Municipal University Hospital (N=100 doctors),
compared to the control group of doctors from medical
and surgical departments at Aalborg University Hospital
(N=130 doctors). Effect on level of reaction, learning and
behaviour will be tested by a questionnaire and a
Knowledge of Skills test performed at baseline, immediately
after intervention and 6 month after intervention. Semistructured interviews with chiefs of departments/
departmental programme directors will be performed at
baseline and 6 month after intervention to reveal possible
confounders like changes in structure, organisation and
culture.
Summary of results: Work on results will progress as new
trainers begin training in the next academic year.
Conclusions: The development of a curriculum for dental
trainers has facilitated:
• An assessment of trainers needs
• Development of assessed courses for new trainers
• Needs-assessed training for existing trainers
• Accreditation process for existing trainers
2G 4
Perspective: The study begins in June 2003, with
intervention during autumn 2003 and follow-up in spring
2004. It may provide the evidence needed to conclude that
Teaching the teachers courses are beneficial and costeffective and should be compulsory.
The effect of ‘Teaching the Teachers’ courses for
doctors
Sune Rubak*, Lene Mortensen, Bente Malling and Charlotte
Ringsted (Aarhus University, Aakjaervej 40, Falling, 8300 Odder,
DENMARK)
Session 2H: OSCE 1
2H 1
Are standardized patients able to identify poorly
performing medical students in OSCE?
2H 2
J Arnau*, T Esqué, A Zuasnabar, A Fina, A Moral, F Raspall, N
Barragán and J M Martínez-Carretero (Institute of Health
Studies, Balmes, 132-136, 08008 Barcelona, SPAIN)
Pirkko Heasman, Kaisu Pitkälä, Taina Hätönen, Niina Paganus and
Kirsti Lonka* (University of Helsinki, Faculty of Medicine, P O Box
63, PL 41, 00014 Helsingin Yliopisto, FINLAND)
This study investigates final year medical undergraduate
students’ assessment by standardized patients (SP) in
comparison to faculty assessment during an objective
structured clinical examination, OSCE. We had eighty
medical students participating in a 7-clinical station OSCE
including depression, eating disorder, lung cancer etc. After
a two minute introduction to background history of the case
the consultation takes place for 10 minutes. The students
were assessed by the faculty check lists, communication
skills rating scale and global ratings and by SP rating scales
which included interest shown by the student doctor,
listening and shared understanding of the patient´s
problem. A key finding is that SPs are not good at recognizing
poor performance, only one in four failures being detected
(failure is less than 50% correct on the clinician check
list). None of the students rated excellent by SPs failed at
the clinicians’ assessment. The results indicate the content
specificity of communication skills, also shown in other
studies. SPs are more consistent in their assessments than
the clinicians. We will discuss the topic of who should
assess the medical students’ clinical performance and
the implications for the development of communication
skills training at the medical school.
Neonatology OSCE: certification of expertise
The Neonatology Group of the Catalan Paediatrics Society
and the Institute of Health Studies have conducted 3 OSCE
examinations in the last three years (2001-2003). 48
professionals have been evaluated by means of this
assessment tool. Neonatology in Spain is not a medical
specialty, and for this reason a professional competence
certification for that particular expertise had to be
developed. The Catalan Public Health System is interested
in assessing the competences of those professionals for
specific job applications in the Catalan public hospital
network. The clinical competence profile and the results
by competence components are currently being analysed
and will be displayed. The first 3 editions of Neonatology
OSCE have proved their reliability, validity and feasibility as
well as the highly valuation by participating professionals
of that certification tool.
2H 3
A computer-based Medline objective structured
clinical examination (OSCE) for third year medical
students: aims, methods and outcomes
M Dozier*, S Yewdall, R Ellaway and H Cameron (University of
Edinburgh, Erskine Medical Library, George Square, Edinburgh
EH8 9XE, UK)
– 4.13 –
Section 4
Aim: To share the arrangements and outcomes of an OSCE
measuring third year students’ aptitude in searching
Medline and selecting sources for evidence-based
information to support clinical management decisions.
2H 5
Ernest N Skakun*, Stephen Aaron, Fraser Brenneis, Narmin
Kassam, Ramona Kearney and Peggy Sagle (Division of Studies in
Medical Education, 2J3.00 Walter Mackenzie Centre, Faculty of
Medicine and Dentistry, University of Alberta, EDMONTON,
Alberta,T6G 2R7, CANADA)
Summary of work: In the OSCE students were presented
with a short scenario from which they extracted relevant
concepts, performed a search on Medline and selected
two results suitable for addressing the scenario. The exams
were set in computer labs normally used for teaching,
therefore requiring special logistical arrangements for
exam security. The OSCE was assessed on the search
strategy and two selected records. The marking criteria
were based on the relative effectiveness and accuracy of
search terms, as well as publication type and subject
content of selected records.
One of the problems associated with assessments used
for decision-making, that is, pass/fail purposes is
determining the passing score. With respect to setting
passing scores on an objective structured clinical
examination (OSCE), the methods are rooted in
modifications of either the Angoff method or the borderlinegroup method. The purpose served by the present study is
to compare the passing scores and the resulting success
rates derived from the station-author/reviewer, the
borderline-group, and the station-examiner methods used
for a twelve-station OSCE administered to 103 final year
medical students in May 2003. Station-authors/reviewers
will be asked to establish a passing score for their
respective stations. At the conclusion of each studentstandardized patient interaction, examiners will be asked
to rate each student’s competence as either satisfactory
or unsatisfactory each defined by three levels (satisfactory
– borderline, good, excellent; unsatisfactory – borderline,
needs to improve, needs to improve a lot). At the conclusion
of the exam, station examiners will also be asked to
establish a passing score for the station in which they
examined. Passing scores, success rates and evidence
for the validity of each passing score will be presented for
each station and the total exam.
Summary of results: The exam results showed a good
spread of marks, and compared well with other OSCE
stations. The logistical issues with timing and delivery and
the marking criteria went well for such a new exam, and
show that this OSCE format can be flexible.
Conclusions/take home messages: Exam results and
student feedback show that students’ confidence in using
Medline does not necessarily match competence. The
Medline exam promises to drive student learning and inform
curriculum development in an important clinical skill.
2H 4
Evaluating physician CanMEDS competencies using
Objective Structured Clinical Examination (OSCE) in
neonatal-perinatal medicine
Brian Simmons*, Ann Jefferies, Marc Blayney, Kyong Lee, Henry
Roukema, Martin Skidmore, Jodi McIlroy and Diana Tabak
(University of Toronto, Sunnybrook & Women’s College of Health
Sciences Centre, Department of Newborn and Developmental
Paediatrics, 76 Grenville Street, Room 476, Toronto, Ontario M5S
1B2, CANADA)
A comparison of several methods for setting
passing scores on an OSCE
2H 6
Catalan Family Medicine OSCE: professional career
consequences
J M Martínez-Carretero*, C Blay, R Vilatimó, C López Sanmartin,
J Arnau, S Juncosa and J M Vilseca (Institute of Health Studies,
Balmes, 132-136, 08008 Barcelona, SPAIN)
Background: The Royal College of Physicians and
Surgeons of Canada defined 7 CanMEDS competencies
– medical expert, communicator, collaborator, manager,
health advocate, scholar and professional. Training
programs are challenged to assess these competencies.
The Institute of Health Studies and the Catalan Society of
Family Medicine have jointly conducted 14 editions of the
Family Medicine OSCEs for certification purposes. 387
family physicians have been assessed during the last 7
years (1997–2003). In those OSCEs, participants have
been family physicians exercising their specialty as well
as tutors of family and community medicine residents from
different teaching units of residency programmes. The
clinical competence profile and the results by competence
components are currently being analysed and will be
displayed. The consequences related to their professional
career for family physicians and tutors who have
participated in the OSCEs are relevant, both to get a job in
the public health system and to fulfil the criteria to obtain
and maintain accreditation as tutors at family medicine
residency units. The Family Medicine OSCE has
demonstrated its validity, reliability and feasibility and its
good acceptability on the part of candidates who went
through that assessment tool. That is why, henceforth, 8
new editions of the OSCE are foreseen on a regular basis,
for some 240 participants each year. The Institute of Health
Studies and the Catalan Society of Family Medicine are
working to establish a conceptual framework for the
recertification, every 5 or 10 years, of those professionals
who have passed the OSCE certification process.
Objective: Design an OSCE for neonatal-perinatal (NP)
medicine trainees incorporating these competencies.
Development: Ten 12-minute stations. Six stations used
standardized parents(SPs) and 4 health care workers
(simulated health professionals -SHPs). Examiners
completed station specific checklists, CanMEDS global
and overall global rating scales. SPs/SHPs completed
communication global ratings.
Results: 24 trainees participated. Each station assessed
4-6 competencies. There was significant correlation
between the checklists (67 +/-9, mean +/-SD) and
examiners overall global scores (66+/-14, r = 0.97), the
checklists and medical expert global scores (70 +/-12, r =
0.96), communicator global scores (72 +/-15, r=0.92) and
the SPs overall global ratings (62 +/-14, r = 0.92). Interstation alpha coefficient range was 0.80-0.88.
Conclusions: Using the OSCE, CanMEDS competencies
were evaluated with a high degree of reliability/validity.
Medical expert and communicator were the easiest to
incorporate; scholar the most challenging. The OSCE
allowed assessment of competencies not easily assessed
through traditional examinations.
– 4.14 –
Section 4
Session 2I: Problem Based Learning
2I 1
Achieving the best of both worlds by Integration of
PBL in PBT (Problem Based Teaching) during the
clinical years
clinical reasoning and judgment and decision making
skills; 3) To foster self-directed study and, 4) To promote
collaborative work. Specific criteria for each objective were
defined and integrated with the course objectives. A fifth
rubric, professional behavior, was added to the list, one of
the outcomes we are emphasizing throughout the
curriculum. A marking system to judge each of the criteria
was developed as well as a summative marking scale.
Three checklists were developed: 1) A checklist to assess
daily student achievement, performed by the tutor; 2) A
checklist for self-assessment and 3) A checklist for peerassessment. This criterion reference checklist system
considering the PBL objectives makes formative
assessment of tutorial sessions less subjective, more
congruent and valid.
N G Patil*, Mary Ip and J Wong (Faculty of Medicine, University of
Hong Kong, HONG KONG)
Background: The introduction of PBL tutorials during the
clinical years has been controversial. This is due to the
unfortunate perception that ‘Wards’ and other clinical
settings present difficulties to conduct PBL tutorials in a
structured format. PBL tutorials are, therefore, thought by
some institutions to be only suitable for paper/video/webbased scenarios, all of which are best held in purposebuilt tutorial rooms.
Summary of work: In 1997, PBL tutorials were introduced
by the Faculty of Medicine, The University of Hong Kong,
in the then new medical curriculum. Since then, the role of
PBL is now well established in the clinical years. This was
achieved through its integration into the traditional bedside
and outpatient teaching (PBT - Problem Based Teaching)
from year III onwards. This integration was achieved in the
following manner:
2I 3
G Maudsley*, E M I Williams and D C M Taylor (University of
Liverpool, Department of Public Health, Whelan Building,
Quadrangle, Liverpool L69 3GB, UK)
Tutorial 1:
• Students see a selected patient and discuss the case in
a PBL tutorial format using the patient’s history, clinical
findings, investigations etc. to identify the learning issues
in absence of a tutor. Students who have experienced
the paper/video case PBL tutorials in the first two years
of the system-based blocks are well versed with the PBL
process, and can manage them without a tutor.
• Students do self- and group-studies related to the
learning issues. Access to side rooms, internet ports and
libraries are given at the clinical setting. The duration
between the first and second tutorials can be as short
as two hours for students to work on their learning issues
in a busy clinical setting - and to meet their equally busy
clinician tutor!
Background: The Liverpool undergraduate medical
curriculum uses a problem-based philosophy to integrate
students’ learning around clinical relevance.
Aim: To explore interrelationships between students’
satisfaction with a problem-based medical curriculum and
their perceptions about learning, career expectations, and
relevance of wider issues (e.g. learning public health
concepts).
Summary of work: The participants comprised the Year 1
(beginning and end) and Year 3 (mid-year) medical
students in 2001/02. Each cross-sectional, self-completion
questionnaire survey included:
1 closed items about learning style (18-item Short
Entwistle Approaches and Study Skills Inventory); ideal
problem-based learning (PBL) tutors (38 items); good
doctors (1 item)*; satisfaction with problem-based
approach (3 items)*; career intentions (1 item);
2 an open item (excluding entry-study of 1999 cohort)
exploring the relevance of a population perspective to
their future work.
Tutorial 2:
• Students meet their tutor to discuss the case in the
presence of the patient or in the side-room as
appropriate. The tutor, who is usually a subject expert,
acts as a facilitator as and when necessary. It is, therefore,
crucial that all clinicians involved in this exercise must
know the process of PBL.
Conclusions:
• Students can cope very well with PBL related to real
patients.
• The culture of PBL could be promoted in clinical years
by its integration with traditional problem based
teaching.
• Clinicians as ‘subject-experts’ should also be
encouraged to become ‘PBL process-experts’.
2I 2
Formative assessment of problem-based learning
tutorial sessions using a criterion-referenced system
How medical students’ satisfaction with a problembased curriculum relates to their perceptions about
learning and future career (and the relevance of
learning about wider issues)
Summary of results: 201/283 (71.0%) and 198/279 (71.0%)
Year 1 students, and 159/204 (77.9%) Year 3 students
responded. There were complex interrelationships
between these variables. Students’ satisfaction with PBL
approaches was associated with their preferred learning
styles, expectations of tutors, and career expectations.
Conclusion/take home messages: The practical
implementation of a problem-based philosophy should
heed such interrelationships.
2I 4
Leticia Elizondo-Montemayor* and Araceli Hambleton Fuentes
(School of Medicine Tecnológico de Monterrey, Ave Morones Prieto
#3000, Pte., Colonia Los Doctores, Monterrey, Nuevo León CP
64710, MEXICO)
Assessment of students in PBL tutorials improves
attendance and correlates with academic performance
Salah Kassab*, Hafiz Shazali and Hossam Hamdy (College of
Medicine and Medical Sciences, Arabian Gulf University, PO Box
22979, Manama, BAHRAIN)
Aim: College of Medicine and Medical Sciences (CMMS),
Arabian Gulf University (AGU) adopted PBL in 1982.
Evaluation of students in tutorials was introduced in 1999
as part of the continuous assessment of students in the
pre-clerkship phase. We aimed to test the impact of
evaluating students in the PBL tutorials on their attendance
and to examine the correlation between the tutorial
evaluation and students’ academic performance.
At the School of Medicine Tecnológico de Monterrey, PBL
is the predominant instructional strategy. Thus, formative
assessment of the tutorials is most important. To assure its
validity, assessment must be focused on student
achievement of the objectives sought and offered by this
strategy. Objectives of the Nutrition and Metabolism course
were considered, as well as the four main objectives of
PBL: 1) To apply a base of knowledge; 2) To develop
– 4.15 –
Section 4
textbooks, the second was related to notes, and the third
was an ad hoc way of learning.
Summary of work: Correlation was tested between tutorial
evaluation of year 2, 3 and 4 students (n=242) and the
students’ performance in different components of end of
unit examinations. In addition, tutorial attendance was
compared in these students and another group of students
(n=153) who were not exposed to the tutorial evaluation
system in their pre-clerkship phase.
Summary of results: Assessment of students in tutorials
significantly reduced the percentage of absenteeism from
12.7% to 7.2% in tutorials. Tutorial evaluation significantly
(p<0.01) correlates (r) = 0.597, 95% confidence interval
0.40 – 0.59) with overall academic performance of all
medical students in the “end of unit” examinations in the
pre-clerkship phase.
Conclusions/take home messages: The three ways of
learning will be presented in more detail and discussed as
well as the implications for academic success.
2I 6
Stefan Herzig, Jan Matthes*, Alexander Look, Amina K Hahne,
Kain Afhakama and Ara Tekian (University of Cologne, Department
of Pharmacology, Gleueler Str.24, 50931 Cologne, GERMANY)
The level of tutor qualification was found to affect process
quality of learning groups in a PBL-course of basic medical
pharmacology. This did not translate into different learning
outcomes in a traditional exam (Matthes et al., 2002,
Naunyn-Schmiedeberg’s Arch Pharmacol 366: 58-63). We
now developed an assessment tool (Semi-structured
Triple Jump, STJ), which merges process-orientation with
the key feature format. Thirty-two randomly-assigned
learning groups of 259 3rd-year medical students were
enrolled in two sequential pharmacology courses. Process
variables were measured by a 35-item questionnaire,
containing reliable (Cronbach’s alpha=0.64-0.89) scales
on self-study, team work, tutors‘ subject-matter and
teaching-method expertise, PBL, MCQ preparation, and
pharmacology. Outcome was measured by one-case STJ
(inter-rater r=0.93 and 0.84) and 30-item MCQ tests (r=0.59
and 0.61). Multivariate linear regression revealed no
correlation between total scores of STJ or MCQ and the
process variables. However, exploratory analysis of test
components showed that tutors’ subject-matter expertise
affects STJ step 1, reflecting application of factual
knowledge (r=0.42, p<0.05, n=32). Step 3 (revision of
hypothesis on drug therapy, giving literature evidence)
depends on tutors’ teaching-method expertise (r=0.80,
p<0.01, n=16) when assessed by an external supervisor.
Thus, the influence of the tutor on process quality affects
learning outcome in PBL groups.
Conclusions/take home messages: These data indicate
that the system currently used for evaluation of pre-clerkship
medical students by tutors at the CMMS at AGU, besides
improving students’ attendance, could also be a reliable
assessment instrument in PBL medical schools.
2I 5
Group process and learning outcome in PBL: a new
assessment tool identifies the crucial role of the tutor
Medical students’ ways of learning
Are Holen (Norwegian University of Science and Technology,
Department of Neuroscience, MTFS, NO-7489 Trondheim,
NORWAY)
Aim: To inform about the development of a questionnaire
that detects medical students’ ways of learning outside
didactic sessions and PBL groups.
Summary of work: Students in the PBL curriculum were
asked to write down their individual ways of learning. The
descriptions were analysed qualitatively and a group of
items was derived. In a preliminary questionnaire, these
items were given to students and rated on a scale from 19. The items which correlated the most with the extracted
factors were included in a final questionnaire and tested
separately.
Summary or results: Three factors emerged indicating
three ways of learning: the first was related to work with
Session 2J: Teaching and Assessing Attitudes
2J 1
Using digital video to teach attitudes: gain or pain?
2J 2
A Chiado* and A Pereira da Silva (Faculty of Medicine, Laboratorio
de Genetica, Faculdade de Medicina de Lisboa, Piso 3, Av. Prof Egas
Moniz, 1649-028 Lisboa, PORTUGAL)
Development and validation of the Beersheva Survey
of Attitudes and Knowledge in international health
A Gaaserud*, A Jotkowitz, Y Gidron, C Baskin, J Urkin, M Alkan
and C Margolis (Ben Gurion University of the Negev, Faculty of
Health Sciences, The Moshe Prywes Center for Medical Education,
PO Box 653, Beer Sheva 84105, ISRAEL)
Aim: To describe the simplest technological and
educational forms to make an educative videoCD (VCD)/
DVD/Digital video (DV) and to demonstrate its applicability
in the field of teaching attitudes.
Aim: To describe the development and validation of the
Beersheva Survey of Attitudes and Knowledge in
International Health (IH), which can be used for medical
student assessment.
Summary of work: The development of computer
technology makes it possible to build a VCD/DV as a support
for communication. We are using this instrument to teach
attitudes. We identified the whole material type and
necessary methods to its construction: hardware, DV
cameras and software, as well the educational structure
of an VCD/DV and its applicability for teaching attitudes.
Summary of work: Development: A panel experienced in IH
formulated attitude, general knowledge items and clinical
cases based on personal experience, literature review and
texts. A previously validated questionnaire on openness to
experience, a personality factor, was incorporated. The
survey was reviewed by two outside IH experts. Likert scales
graded openness and attitude while multiple choice
questions scored knowledge. The survey was piloted on
the students of the BGU MD program in International Health
and Medicine.
Summary of results: A video built by the authors will be
presented, showing the educational structure, the new
technology materials and process, and demonstrating its
applicability to the teaching of attitudes. Cost is low and it
will be very easy to modify the contents when teaching
updates are needed.
Validation measurements: Internal reliability, test-retest
reliability of attitudes section, construct validity, sensitivity.
Conclusions/take-home messages: The use of an
educative structured VCD/DV allowing the insertion of text,
video, photos and sounds may be an important contribution
to the teaching of attitudes, motivating attendance and
facilitating learning, making this instrument a promising
and relevant auxiliary for teaching attitudes. This technique
will be the subject of a formal evaluation in future studies,
to identify the main strengths and weaknesses.
Summary of results: Cronbach ù“ #ø“ s á was 0.87. Testretest reliability of attitudes, R= 0.87 (P< 0.001). Correlation
of openness to attitudes, R= 0.376 (P<0.001). 3rd year IH
students scored higher than incoming students on IH
knowledge and clinical cases (P< 0.05).
– 4.16 –
Section 4
Assessment of attitude and conduct – is it feasible?
Summary of work: The 3 hour lecture attended by 240
students was under the responsibility of two doctors and
one educationalist. Key messages were selected and then
illustrated through the video. The students were asked to
identify them and to discuss respective underlying ethical
dilemmas. A voting process using cards of different colours
allowed teachers and students to be immediately aware of
the assembly’s ideas.
Helen Sweetland*, Lorna Tapper-Jones, Ania Korszun, Peter
Winterburn and Helen Houston (University of Wales College of
Medicine, University Department of Surgery, Heath Park, Cardiff
CF14 4XN, UK)
Summary of results: Results of the content analysis applied
students’ evaluation questionnaires (n=232) on the “impact
of the session” showed that the essential messages they
got as future doctors was:
Aim: To demonstrate a proforma used to assess attitude
and conduct, to evaluate its role and the problems it has
detected. Tomorrow’s Doctors (2002) states that medical
students should develop suitable attitudes and behaviour,
i.e. qualities that are appropriate to their future
responsibilities to patients, colleagues and society. Attitude
and professional behaviour need to be monitored to detect
students showing traits that may not be appropriate for
future professional practice.
• Doctors must see the patient as a person/humanization
of Medicine 41%
• Medicine can’t be reduced to scientific competency 26%
• Altruistic values and idealism are crucial in the Medical
profession 26%
• Other different messages 22% (The percentage total
exceeds 100% because some students expressed more
than one idea)
Summary of work: A proforma was designed, based on
criteria outlined in Tomorrow’s Doctors. It includes
statements relating to respect for patients and staff,
confidentiality and consent. Professional development is
monitored by assessment of reliability, initiative, honesty,
attendance and approach to learning. This has been used
since 2001 for year 4 and 5 students on all clinical
attachments. The form is completed by one assessor,
taking into account comments from other team members.
Conclusions: The video technique seems to be a powerful
tool to “teach attitudes” because it facilitates learning
bringing to classroom real situations capable of raising
conflicts and dilemmas. The discussion by different
teachers with different perspectives and life experiences
seems to be another crucial element for the teaching of
attitudes.
Conclusion/take home messages: The survey is a reliable
and valid tool to assess and compare medical students’
knowledge and attitudes toward International Health. This
survey can be used to evaluate curricular innovations in
the field.
2J 3
Summary of results: This form has allowed identification
of students with inappropriate conduct and acute problems
such as illness or psychological problems affecting their
studies. Student progress has been halted to allow remedial
action to be taken before the situation deteriorates further.
When the form is used for the 3 year clinical period, trends
in student behaviour should become apparent to enable
detection of students with chronic poor attendance, lack
of motivation and attitude problems.
2J 5
Orhan Odabasi, Melih Elcin, Iskender Sayek*, Murat Akova and
Nural Kiper (Hacettepe University, Tip Fakultesi Tip Egitimi ve
Bilisimi AD, 06100 Sihhiye, Ankara, TURKEY)
Respect, responsibility, communication and selfawareness are the main topics of professional behaviours
that are expected in medical students. The doctor-patient
relationship is central to the delivery of high quality medical
care and has been linked to a variety of other bio-psychosocial outcomes. Many faculties have implemented some
curricular changes to teach communication skills,
professional values, humanistic attitudes and behaviours
to medical students. In Hacettepe University Faculty of
Medicine, we prepared a 12 hour module for year I students
on the doctor-patient relationship. We gave students a
questionnaire on the first and the last day of sessions. The
aim of this study is to evaluate the achievement of students’
attitudes.
Conclusion/take home messages: Formative assessment
and monitoring of attitude and conduct is feasible, using
this simple proforma.
2J 4
Evaluation of attitude achievement in “doctorpatient relationship” PBL sessions
“To be a Doctor”: Learning-teaching attitudes using
commercial films for raising the discussion on
ethical dilemmas
M F Patricio*, A P Lacerda, P Sá and J Gomes-Pedro (Faculty of
Medicine, University of Lisbon, Av Prof Egas Moniz, Piso 1, 1649028 Lisboa Codex, PORTUGAL)
There were 294 students in year I and 172 of them
completed both questionnaires. There were 7 statements
and students had 5 choices for their answer. We evaluated
the results using Wilcoxon tests and the positive change in
attitudes for all 7 statements was analysed as meaningful
(p<0.05). We concluded that it was an important outcome
for year I students to achieve such attitudes in the beginning
of their medical career. They would feel themselves more
prepared for further years.
Aim: To describe the methodology for the teaching of
attitudes in the subject Introduction to Medicine (at the
FML). The process and evaluation of one specific lecture
dedicated to the theme “To be a Doctor” where a video
technique based on commercial films like Patch Adams,
Awakenings and Lorenzo’s Oil was used as a learning tool.
Session 2K: Clinical Skills Training
2K 1
Establishment of a British Heart Foundation UK
Harvey Resource Centre
the cardiology patient simulator, and ‘UMedic’, a computer
assisted interactive instruction programme, into UK
medical schools. The Harvey Resource Centre will help
maximize the potential use of ‘Harvey’ simulators in the UK
medical schools by:
• Disseminating throughout the UK, information about the
use of Harvey
• Providing assistance and advice to centres with Harvey
if required
Shihab E O Khogali*, Ronald M Harden, Jennifer M Laidlaw, Barbara
E Scott and Stewart Pringle (University of Dundee, Department of
Cardiology, Ninewells Hospital & Medical School, Dundee DD1 9SY,
UK)
The British Heart Foundation has funded the establishment
of a UK Harvey Resource Centre in Dundee to support the
introduction, by the British Heart Foundation, of ‘Harvey’,
– 4.17 –
Section 4
(79.4%) were completed. During undergraduate education
113 participants (29.4%) were trained in Ulm, 104
postgraduates (27%) had any other Mega-Code training
and 168 (43.6%) had no Mega-Code training at all. The
students who were trained in Ulm showed a significant
better performance than the two other groups. Students
who received unstructured Mega-Code training did not
perform better than students without training.
• Encouraging and facilitating the full use of Harvey
simulators in the curricula of UK medical schools
• Establishing a network of Harvey users in the UK
• Contributing to further developments and research in
the use of Harvey.
This presentation:
• describes the range of activities of the Harvey Resource
Centre. The initiatives include:
• establishment of a network of UK ‘Harvey’ users
• publication of Harvey newsletters
• establishment of a Harvey helpline
• development of a UK Harvey website
• discusses the need for such a national group to support
the introduction of new (especially complex)
technologies in medical education.
2K 2
Conclusions/take home messages: Resuscitation skills
after a sophisticated undergraduate training program
showed the highest postgraduate benefit. Unspecified
mega-code training in undergraduate education did not
improve resuscitation skills of postgraduates significantly.
2K 4
R Friedl, H Höppler, S Stracke* and A Hannekum (University of Ulm,
Dept. Heart Surgery, Steinhovelstr.9, Ulm 89075, GERMANY)
Simulation-based large scale emergency
preparedness training programs – The national role
of the Israel Center for Medical Simulation
Aim: An online multimedia teaching program about the
operative technique of aortic valve replacement addresses
medical students (www.lamedica.de). We assessed the
impact of the system in improving knowledge and skills as
required during operative procedures.
Amitai Ziv*, Tali Yohanes, Shuli Banita, Ariel Bentancur, Daphna
Barsuk, Amir Vardi, Inbal Levin and Haim Berkenstat (The Israel
Center for Medical Simulation, Chaim Sheba Medical Center, Tel
Hashomer, Ramat-Gan 52621, ISRAEL)
Simulation-based medical education is recognized as a
powerful emergency training tool. Simulators expose
clinicians to high-risk scenarios, in an effort to increase
health professionals’ competency. Global reality of terror/
war challenges health professionals to prepare for threats
including non-conventional – as confronting Israel. The
Israel Center for Medical Simulation was established as a
comprehensive, multidisciplinary facility to lead a
nationwide effort to introduce innovative approaches to
health–care training. Designed as a virtual hospital,
equipped with multiple simulation modalities, the center
rose to the challenge of urgent national needs. In
collaboration with health-care authorities, the center has
developed cutting-edge, simulation-based courses to
increase Israel’s preparedness. Trauma management
courses were designed to train military and civilian medical
teams. Over 1800 Military doctors and medics and 200 ER
team members were exposed to authentic scenarios,
recorded and debriefed constructively by trauma experts.
Furthermore, chemical warfare threats led to development
of an original training program for over 1000 military and
hospital-based professionals to treat victims of chemical
agents while wearing full protective gear. The important
challenges/lessons learned from implementation of these
national programs and an analysis of the very positive
trainee feedback will be presented.
2K 3
Multimedia driven education significantly improves
medical students’ understanding of operative
procedures in heart surgery
Summary of work: In a prospective study, we randomized
43 students to either use multimedia (n=20) or a textversion (n=23), displaying the same content. Afterwards,
both groups participated in an aortic valve replacement
during which they answered a 28 questions knowledgeinterview. A psychometric evaluation scoring from 1 (poor)
to 7 (excellent) was accomplished at the end of the study.
Summary of results: Mean percentage of correct answers
during the operation was 85 ± 4.5% in the multimedia group
and 61 ± 4.7% in the text group (p<0.0001). The
multimedia group needed significantly less study time (101
± 16 min) than the text group (121 ± 17 min), (p<0,001).
Self-reported competency in the multimedia group was
6.2 ± 0.7 and 5.5 ± 0.5 in the text group (p<0.05). Both
groups felt that the respective method they used facilitated
understanding (online group: mean scoring 5.9 ± 0.4; text
group: mean scoring 5.8 ± 0.9).
Conclusions/take home messages: Multimedia based
teaching is time-efficient and significantly improves
education in heart surgery, where understanding of
complex temporal and spatial events during operations is
essential.
2K 5
The educational impact of bench model fidelity on
the acquisition of technical skills
Ethan D Grober*, Stanley J Hamstra, Kyle R Wanzel, Keith A Jarvi,
Edward D Matsumoto, Rivindar S Sidhu and Richard K Reznick
(University of Toronto, Centre for Research in Education University Health Network, 565-1 Eaton Wing South, 200
Elizabeth Street, Toronto, Ontario M5G 2C4, CANADA)
Does systematic undergraduate training of
resuscitation skills influence postgraduate
performance of resuscitation skills?
F O Weisser*, B Dirks and M Georgieff (Universitätsklinik für
Anästhesiologie, Klinikum der Universität Ulm, Prittwitzstr.,
89070 Ulm, GERMANY)
Aim: To evaluate the impact of bench model fidelity on the
acquisition of technical skill.
Summary of work: Fifty junior surgical residents participated
in a microsurgical training course. Subjects were
randomized to 1of 3 groups: 1) high-fidelity model training
(live rat vas deferens, n=21); 2) low-fidelity model training
(silicone tubing, n=19); or 3) didactic training (n=10).
Following training, technical performance was assessed
on the high- and low-fidelity bench models. Outcomes
measures included procedure times, blinded, expert
assessment of videotaped performance using checklists
and global rating scales, immediate and delayed
anastomotic patency and the presence of sperm on
microscopy.
Aim: We are training medical students and postgraduates
in resuscitation skills using a systematic curriculum. We
were interested in the difference of the performance of our
postgraduate participants: (1) students who were trained
in our curriculum (Ulm/Germany); (2) students who were
trained Mega-Code without a special curriculum; (3)
students without Mega-Code training, during
undergraduate medical education.
Summary of work: The undergraduate training of all
participants of our postgraduate training programs was
evaluated. The evaluation data and the postgraduate results
of the performance-based assessment of resuscitation
skills were correlated.
Summary of results: Following training, checklist (p<0.001)
and global rating scores (p<0.001) were higher among
subjects who received hands-on training, irrespective of
Summary of results: In 1998 and 1999, 484 postgraduates
completed our training. The data of 385 participants
– 4.18 –
Section 4
model fidelity. Immediate anastomotic patency rates of the
rat vas deferens were higher with increasing model fidelity
(p=0.048). Delayed anastomotic patency rates were higher
among subjects who received bench model training,
irrespective of model fidelity (p=0.02). Rates of sperm
presence on microscopy were higher among subjects who
received high-fidelity model training compared to subjects
who received didactic training (p=0.039), but did not differ
among subjects who received hands-on model training
(p=0.32).
Conclusions/take home messages: Surgical skills training
on low-fidelity bench models appears to be as effective as
high-fidelity model training for the acquisition of technical
skill.
Session 2L: Undergraduate Multiprofessional Education
2L 1
Multiprofessional education: would a taxonomy help?
• Strengthens partnerships between participating
universities who are working together and sharing
responsibility for assessment and evaluation.
C Segouin and B Hodges* (Assistance Publique - Hopitaux de Paris,
AP-HP, Service de la Formation Continue des Médecins, 3 Avenue
Victoria, 75004 Paris, FRANCE)
The paper explores a taxonomy that might help organize
the field of multiprofessional education (MPE). The
concept of MPE is based on two statements: the first one is
that better healthcare is provided by teamwork than by a
sum of individual efforts. The second one is that good
functioning of the healthcare team supposes a
multiprofessional education environment. Two problems
arise: the first one is that there is little evidence that MPE
leads to better healthcare or even that it improves that much
healthcare teamwork. The second is that there is no
accepted or unique definition of MPE in the literature.
Almost all the experiences described involve physicians
and other “allied” health professionals. But the courses
differ with regards to the topics, the length of the course,
the timing of curriculum delivery (initial or continuing
education) etc. More than that, the objectives are usually
of different kinds. Most of the experiences involve “learning
together” courses. Few deal with “learning from each other”
or “learning about each other”. Further, few evaluations of
effectiveness have been carried out and most are confined
to satisfaction or a subjective evaluation of the improvement
of participants in their practice. Finally, we have only got
the “intuition” that it works.
2L 2
2L 3
Alan Thomson*, Rachelle Arnold and Jennifer Cleland (Aberdeen
Royal Infirmary, Department of Anaesthetics, Grampian
University Hospitals NHS Trust, Foresterhill, Aberdeen AB25
2ZD, UK)
Background: The importance of evidence-based
communication skills teaching is increasingly clear, as is
integration with clinical skills teaching.
Summary of work: We describe integration of a
communication “skills station” into a multi-professional (5th
year medical students, junior staff nurses) one-day “Care
of the Critically Ill” Course, developed after evidence
highlighted the need to improve ward care of critically ill
patients. Poor team-working and communication failure
has repeatedly been shown to contribute to error and suboptimal outcome. Course evaluation (a six-point Likertscale “very useful” to “not useful”) over 4 sessions, involving
23-36 participants, underpinned the development of the
session from a didactic mini-lecture to interactive
multiprofessional small group (6 students) sessions
involving vignettes, role-play and discussion. This format
supported students to a) actively identify communication
breakdown, resulting in sub-optimal care, and b) generate
solutions to minimise communication breakdown and
improve team-working.
JUMP2 shared learning for undergraduates in practice
Fanny Mitchell* and Gill Young* (c/o General Office, Central
Middlesex Hospital, North West London Hospitals NHS Trust,
Acton Lane, Park Royal, London NW10 7N, UK)
Summary of results:
a) the active learning environment for communication skills
and team-working was preferred to the original, didactic
lecture
b) medical students and nurses rate learning specific
communication skills as equally useful as learning the
necessary clinical skills
c) nurses and medical students regard the session useful
in approximately equal measure.
Aim: This session will outline how shared learning in
practice can be successfully organised, and the benefits
and challenges of this approach.
Summary of work: The joint universities Multi-Professional
Programme (JUMP2) is an ambitious programme for all
undergraduates at four West London Universities during
their placement/attachments to learn together in interactive
small groups, being taught by clinicians who work together
in patient care. Following successful piloting of a local
devised model funded by the DoH Medical Education Unit,
funding is now being continued by the Workforce
Development Confederation to roll it out of their trusts.
Communication skills in a multiprofessional critical
illness course
2L 4
Key features include:
• Development of a common assessment tool used by all
universities.
• A highly supportive organisational structure including
senior university and NHS staff and implementation
groups in each trust.
• An interactive evaluation process.
• Development of an inter-professional teaching pack for
facilitators.
• Findings and results to date:
• Facilitators/staff are working together in new ways and
learning about/from each other in non-threatening ways.
• Provides forum for developing other inter-professional
initiatives within trusts.
Inter-professional healthcare ethics programme for
undergraduate students of pharmacy, nursing and
medicine: developing and evaluating a model for
learning and teaching
Deirdre McAree*, Mairead Boohan and Sue Morison (Queens
University Belfast, School of Pharmacy, 97 Lisburn Road, Belfast
BT9 7BL, IRELAND)
Although the development of an inter-professional
education (IPE) healthcare ethics programme is not
unique, there is little published evidence showing the
benefit of this approach compared with uni-professional
learning. The Schools of Medicine, Nursing and Pharmacy
at Queen’s University Belfast have developed an interprofessional course in healthcare ethics for their final year
students. This course was delivered between January and
April 2003. The aim of the course was to provide students
with a basic knowledge and understanding of moral values,
– 4.19 –
Section 4
ethical theories and principles of human rights. A team of
educators and practitioners from each profession acted
as facilitators at nine live workshop sessions. Working in
inter-professional groups, students debated a series of
clinical case-based scenarios. Taking account of student
and facilitator perspectives, this project explored the
perceived impact of teaching healthcare ethics in an IPE
environment and evaluated their views to inform future
educational approaches. Initial results suggest that
students from all professions could relate this learning to
situations which could arise in their future professional
practice. The majority indicated that ethics was a suitable
subject for IPE. Learning was enhanced by case-based
scenarios. Facilitators indicated that the sessions provided
an excellent forum for debate.
2L 5
Conclusions/take home messages: A higher level of
learning was achieved by allowing for openness in the
choice of problem and methods, as well as for unexpected
results. Furthermore, interprofessional learning increased
the understanding, importance and relevance of having
translational projects in molecular medicine.
2L 6
Community-based interprofession education: do
the outcomes justify the effort?
Ruth McNair*, Nick Stone, Jane Sims and Caroline Curtis (The
Department of General Practice, The University of Melbourne, 200
Berkeley Street, Carlton 3053, AUSTRALIA)
Aim: The presentation will describe a pilot undergraduate
health care education placement, the challenges and
barriers to the implementation of such a program, and the
outcomes elicited using a wide range of evaluation
methods.
Medical proteomics – from bench to bedside: an
interprofessional course in molecular medicine at the
undergraduate level
Summary of work: The Rural Interprofessional Education
(RIPE) program has been running in Victoria, Australia for
2 ½ years. Students from different health disciplines are
placed together for 2 weeks in multi-disciplinary, rural
primary health care settings. Students observe and engage
in interprofessional practice whilst working together on a
range of activities including a community-based project.
Both qualitative and quantitative data have been collected
to evaluate student interprofessional learning including the
development of related attitudes, skills and knowledge.
Evaluation includes analysis of pre- and post-placement
questionnaires, tutorial transcripts, student online
discussion and reflective journals.
Annelie Brauner*, Ewa Ehrenborg*, Marie Henriksson* and Maria
Sunnerhagen (Karolinska Institutet, King Gustaf V Research
Institute, Karolinska Hospital, SE 171 76 Stockholm, SWEDEN)
Background: Interprofessional collaborations are essential
in order to obtain top-class research as well as excellent
health care. Thus, it is important to offer interdisciplinary
courses in molecular medicine already at the
undergraduate level. This course was for students from
biomedicine, medical and engineering programmes.
Aim: To promote interprofessional relations between
clinically and experimentally oriented students by working
with disease-related projects.
Summary of results: The evaluations indicate that the
experience has led to significant interprofessional learning
for both students and preceptors. Interprofessional attitudes
and knowledge show a positive shift as a result of the
placements.
Summary of work: The course was project oriented and
based upon case methodology. It contained lectures,
patient demonstrations, seminars and laboratory work. In
the laboratory work students studied disease causing
proteins with basic experimental techniques and related
their results to clinical findings. The aim was to increasingly
put the responsibility for learning on the students,
encouraging them to formulate their own hypothesis and
devise a method for testing it. This aim was reached, as
evaluated by a version of the Inquiry Matrix. At the
examination the students presented research project
proposals combining clinical and experimental aspects
of a disease.
Conclusions/take home messages: The demonstrated
outcomes of this experiential education program,
particularly the degree of attitudinal change, would be
difficult to obtain in a class-room based activity, and make
such a program worthy of inclusion in core curricula.
Session 2M: Research and Critical Thinking
2M 1
Peer education workshop on research during
medical studies
students to participate in the workshop. None of them
recommend against taking the class. Students’
assessment of their own skills for pursuing a dissertation
before and at the end of the workshop (range: 1=very good
to 5=unsatisfying) was 3.4 ± 0.8 and 1.8 ± 0.5, respectively
(p<0.001). No student believed that his skills had not
improved. Eighty-eight per cent of the respondents wanted
the workshop to continue being optional.
E Zimmermann*, E Schoenenberger and M Dewey (Charité,
Humboldt University Berlin, Fachschaftsinitiative Medizin,
Campus Charité Mitte, Schumannstr 20/21, 10117 Berlin,
GERMANY)
Aim: We sought to address the lack of adequate preparation
of students to pursue original research through a peer
education workshop.
Concept: The workshop lasted 16 hours. The
chronological sequence of a dissertation served as the
main structure and was supported by a handout. The
following topics were addressed: (1) Search for a
dissertation (2) Legal regulations (3) Literature research
and Statistics (4) Scientific writing (5) Practical work and
(6) Revision of the dissertation. The participants gained
knowledge about and started working with the appropriate
computer applications for these issues.
Conclusions/take home messages: This peer-education
approach enjoys high acceptance among students and
improves research skills among participants.
2M 2
An evaluation of scientific comprehension among
Swedish medical students: An evaluation of scientific
comprehension among Swedish medical students
G Edgren*, J Adami, O Akre and G Petersson (Karolinska
Institutet, PGSCS, Department of Medical Epidemiology, SE-171
77 Stockholm, SWEDEN)
Summary of results: Sixty students have so far participated
in four workshops. Fifty-six students responded to an
anonymous questionnaire (93%). Ninety-eight per cent of
the respondents would definitely recommend other
Aim: The purpose of this study is to compare how medical
students in their second and tenth semesters at two Swedish
medical universities read and assess a scientific report
from a peer-reviewed medical journal.
– 4.20 –
Section 4
the processes and problems of clinical research and EBM.
Each of the six modules started with an initial homework
on the web and ended with a lecture. The students had to
answer questions and small-group-work was
recommended. Also learning resources were referenced
on the web. Two weeks later the answers were put on the
web and the groups had to compare their answers with the
right ones. Each group had to formulate open questions
about the learning issue and put it on a discussion e-forum
on the web. One week later the teacher prepared a lecture
consulting the questions of the groups. A written survey
evaluated this new program. The results are disillusioning.
The initial homework was stimulating, but most students
learned by themselves and not in groups. 82% of the
students did not learn until the answers were available.
After 2 years of pbl experience more self-directed and
group-oriented learning was expected. More results will
be presented.
Summary of work: The article of choice was sent to 350
students together with instructions on how to answer
questions about the study via a web-based questionnaire.
The questions concerned specific statistical and
methodological elements of the methods and results
sections of the report. Questions were also asked about
the students’ academic background as well as about other
important scientific methods not found in the article. Finally,
the students were asked to appraise the internal validity of
the study. The information obtained from the background
questions was used to appreciate the students’ exposure
to scientific training. The exposure was then compared to
how well the student scored on the questions and how
accurately the internal validity was appraised compared
with a gold standard.
2M 3
Can our students think, and do they care?
Lynne C Hvidsten*, James R Hulbert and Warren L Moe
(Northwestern Health Sciences University, Department of Clinical
Education, 2501 West 84th Street, Bloomington, MN 554311599, USA)
2M 5
A Waage*, R Austgulen, A Brubakk, U Sonnewald, T Lindmo, M
Rekvig, O J Iversen and T Vik (Faculty of Medicine, Norwegian
University of Science and Technology, Department of Medicine, St
Olavs University Hospital, N-7006 Trondheim, NORWAY)
This presentation is directed to faculty and administrators
of clinical education programs. Ever worried that your
clinical program produces robotic technicians instead of
caring clinicians? This presentation reviews Northwestern
Health Sciences University’s systematic data collection and
analysis to answer this challenging, yet necessary,
question. The background, objective, methods, results,
and discussion of a recent study attempting to measure
the ineffable skills of clinical thinking and interpersonal
interactions will be discussed. Three theory-based subscales (information gathering, clinical thinking, and
interactive skills) will be reviewed. Results of standard
psychometric scale-construction analysis, Cronbach’s
alpha, confirmatory factor analysis and Pearson’s
correlation will be discussed.
Aim: To describe a research program offered to third year,
undergraduate medical students.
Design: The program includes 40 credits in addition to the
full curriculum. A research project includes 30 and specific
research courses 10 of the credits. To achieve this, the
medical curriculum is extended from 6 to 7 years and
students are supposed to spend two summer periods,
weekends and evenings on their research projects. After 6
½ year the students will finish the project with a written
summary preferably including a published paper. After 7
years and a qualifying examination the student receives
his Medical Degree diploma stating the research
experience, but there is no specific degree achieved.
However, the student has covered 30-50% of the work for
the degree Doctor of Medicine and is supposed to continue
the research to achieve this degree. In 2002, thirteen
students and in 2003, 9 students have been admitted to
the program.
Take-home from this presentation is two-fold: one model
of systematic data collection and evaluation of clinical skills
and motivation for non-research faculty to become involved
in research, specifically, the scholarship of assessment.
2M 4
A program for medical research integrated in the
medical curriculum
Is self-directed learning an illusion? – an evaluation
of a new student-centered course in EBM
Conclusion: The experience with the research branch is
so far very positive. The program means a more effective
utilization of resources allocated to research and a research
class for discussions of more specific student problems
related to research.
P Frey*, K Huwiler and M Battaglia (University of Bern, IAWF,
Department of Instructional Media (AUM), Inselspital 38, CH 3010 Bern, SWITZERLAND)
By using a new teaching method, third year medical
students in a pbl curriculum should become familiar with
Session 2N: Selection
2N 1
Teaching outcomes vs students’ former experience
and background
response rate to the initial test is meant to reflect chiefly
the prior educational experience of students, whereas the
results of the second test are supposed to reveal some
cultural differences between the groups as well as an input
of the teachers and school.
Jadwiga Mirecka (Department of Medical Education, Medical
College of Jagiellonian University, Str. Kopernika 19E/1, 31-501
Krakow, POLAND)
Investigation was aimed at defining to what extent students’
background and former experience determine their
progress in the first year of medical studies. Three different
cohorts of students trained in Medical College of
Jagiellonian University were compared: Polish students
attending regular 6-year program, Norwegian students
attending an English version of the 6-year program and
North American/Canadian students attending 4-year
program in English. Students from all three groups were
given the test comprising knowledge from anatomy,
histology and embryology at the beginning of the respective
courses. The same test will be given after completion of
the courses, at the end of the spring semester. The
2N 2
Selection and admission to medical schools in
Europe and USA
Ara Tekian (University of Illinois at Chicago, Department of
Medical Education (m/c 591), 808 S. Wood St, Rm 986, Chicago
IL 60612, USA)
The process of selecting medical students varies greatly
across international borders. In any discussion about
medical student selection, it is important to consider the
criteria against which candidates are judged - in other
words, what do selection committees look for in applicants?
Criteria for selection of medical students include “cognitive”
– 4.21 –
Section 4
and “non-cognitive” abilities. Cognitive factors are often
associated with academic achievement, while the majority
of non-cognitive factors can be categorized as
demographic, personal qualities and geographical factors.
This study reviews the policies, criteria and measurement
of these criteria in selection and admission, and the actual
process of decision-making. Furthermore, it explores the
effectiveness of the selection process by examining the
admission practices in European countries, and
comparing and contrasting these practices and policies
with those of U.S. and Canadian medical schools. The
United States and Canada are unique from an admissions
perspective in that only these countries require applicants
to have educational experience beyond secondary school.
General differences between European and U.S. medical
school admission systems include mean age of the
applicant, the number of available positions, the role of
achievement tests and letters of recommendation, utility of
admission interview, value of personal statements and prior
professional experience of applicants.
2N 3
the largest single professional group being practice
managers. This is a major factor in their motivation for
involvement (which is high), but raises the issue of whether
they represent ‘lay’ views. Training was praised, and the
majority of respondents (85%) felt valued within the
process.
Conclusions/take home messages: The West Midlands
experience demonstrates that lay people can be
successfully included in selection processes.
2N 5
Horatiu D Bolosiu (University of Medicine and Pharmacy “I.
Hatieganu”, Centre for Medical Education, Clinica Medicala II, 24 Clinicilor Street, 3400 Cluj-Napoca, ROMANIA)
Aim: In the last 10 years the number of candidates to be
admitted to medical schools in Romania constantly and
dramatically decreased. We were interested in finding out
what is the motivation of students-to-be in our University.
Major side effects of the introduction of entrance
selection in a medical school in Flanders (Belgium)
Summary of work: An enquiry among 150 candidates
randomly selected from about 500 who applied for
admission has been made. They have been asked to fill in
anonymously a 13 item questionnaire and to return it on
the last day of the admission procedure. The response
rate was 75%.
J Van der Veken*, A Derese, J de Maeseneer and B Morlion
(Universitair Ziekenhuis Gent (3K3), De Pintelaan 185, B-9000
Gent, BELGIUM)
Belgian higher education is freely accessible for those who
have proper qualifications. Admission to medical school
has been limited by the Flemish government through a
central examination. This was decided in 1997. In order to
detect influences of this measure, two cohorts of students
were identified in Ghent University, one of the two most
important Universities in Flanders. The first cohort (n=112)
contains students born in 1978 who started their medical
education before the introduction of entrance selection.
The second one (n=70) is the birth cohort of 1980. These
students had to pass the selection procedure. In order to
make both cohorts comparable, success in attaining a
bachelor degree was included as a second criterion.
Information was collected from about 90% of these
students. The influence is studied in terms of differences
in educational level and occupational prestige of parents
and in terms of effect on secondary school choice of the
candidates. On both items we found significant differences.
More students came out of secondary school without
classic languages but with more mathematics in the
second cohort. The higher prestige index of parents
(especially the higher representation of physician relatives)
warrants a contextual profound analysis of better
understanding.
2N 4
Changing profile of people who want to follow
medical studies in Romania
Summary of the results: Most of our candidates came from
urban areas of the country (89%) and were females (68%).
Only 14% of them previously attempted to be admitted to
studies other than medical ones. Sixty two percent did well,
but not exceptionally, with their high school studies and
about 80% underwent paid preparatory courses. The
recognized reasons to be a doctor were as follows:
willingness to help people (75%), the need to be respected
by others (50%), the possibility to work abroad (36%),
material reasons (30%), and parents’ advice (22%).
Conclusions: Our data support the idea that, in spite of
fewer people who want to study medicine, the reasons for
doing so are still of higher value. With the tendency we
observed, in the near future our problem should be how to
recruit rather than how to select students.
2N 6
Motivation and insight of school students
considering a career in medicine
Adrian Blundell*, Richard Harrison and Ben Turney (RAFT, 12
Mostyn Road, Hazel Grove, Cheshire SK7 5HL, UK)
Aim: Previous studies have demonstrated that many
medical students lack insight into medical careers and
many regret their choice. This study aimed to determine
motivation and awareness of British school students
considering medical career.
Involving lay assessors in the selection of GP
Registrars: an evaluation from the West Midlands
Stephen Kelly*, Sarah Wakefield, Celia Brown and Marilyn
Hammick (West Midlands Deanery, Institute of Research &
Development, Birmingham Research Park, Vincent Drive, PO Box
9771, Edgbaston, Birmingham B15 2SQ, UK)
Summary of work: Attendees at a medical careers
conference were asked to complete a questionnaire (prior
to the conference commencement) comprising
demographics, awareness of differing aspects of medical
careers and motivations for considering a medical career.
Aim: In the West Midlands, lay assessors have been
included on the interview panels for the selection of GP
Registrars since October 2000. This presentation will
outline the key findings of an evaluation of their involvement,
including the impact of their inclusion on selection scores.
Summary of results: 106 respondents, age range 16-18,
78% female, 8% stated parental occupation as medical
(6% fathers/2% mothers). 66% felt supported in their
decision to study medicine. 100% were aware of the 5year training, 86% realising of postgraduate exams. Few
responders were aware of recent changes in doctors’ pay,
1% perceived doctors as “overpaid”. The strongest
motivators were; “job satisfaction”, “working with people”
and “desire for challenge”, whilst the strongest demotivators
were “risk of litigation”, “poorly run Healthcare system” and
“long working hours”. The three most popular career
choices were surgery (46%), paediatrics (41%) and GP
(21%).
Summary of work: The evaluation adopted a triangulated
approach, comprising: analysis of interview scores
awarded; questionnaire to lay assessors (84% response
rate; n=47); and case studies of two lay assessors
participating for the first time, each interviewed three times
(before training, after training, and after involvement).
Summary of results: Analysis of selection scores reveals
no significant differences between mean scores given by
medically qualified and lay assessors, and score
distributions for all questions are almost identical. The
majority of questionnaire respondents (87%), whilst not
medically trained, work in professions related to medicine,
Conclusions: Whilst awareness of medical careers was
high, ignorance concerning some key aspects was
lacking, and several factors seem to strongly demotivate
potential medical students.
– 4.22 –
Section 4
Session 3A: The Virtual Learning Environment
3A 1
Sustainable development and integration of ICTsupported learning
We aim to describe a model for e-learning in undergraduate
medical education. To manage any learning environment
there must be integration of the networked learning
environment (NLE) within the teaching and learning strategy
of the educational institution. Sheffield medical school has
undergone a major revision of its undergraduate
curriculum, the educational strategy being contained in a
vision statement. The Sheffield Networked Learning
Environment (NLE), a web-based flexible database
solution, was developed initially to provide more efficient
administration of the old course in collaboration with the
University of Newcastle. The new outcome focussed
curriculum will be intensively supported by a purpose built
NLE, which has been extensively tested and modified
through pilot studies in the old curriculum. Features include
a core curriculum database developed from 95 core
problems, forming the heart of the NLE with an
underpinning relationship with course outcome objectives
developed at the strategic level to learning objectives
contained in study guides that are to be achieved by
students and supported by teachers at designated stages
in the curriculum. The core curriculum links to a variety of
other learning objects including assessment records,
learning resources, and self-directed problem based
learning activities, thus realising the vision statement.
Annette Langedijk*, Christian Schirlo and Wolfgang Gerke
(Medical Faculty, University Hospital Zurich, Frauenklinikstrasse 10, CH 8091 Zurich, SWITZERLAND)
Aim: The faculty of medicine of the University of Zurich
promotes the integration of ICT-supported learning
environments into the curriculum. The aim of the present
study is to outline a perspective for e-learning projects in
terms of resources (funding) and their role in the
curriculum.
Summary of work: In August 2002 a survey was held among
the current 21 e-learning projects to determine (1) the level
of the curricular integration, (2) the budget spent for the
development and (3) an estimation of the resources
necessary for the continuous operation of ICT-supported
learning.
Summary of results: The e-learning projects presently cover
approximately 6.6% of the total curricular teaching/learning
time. However, not all projects yet compensate the time
needed to work through the program or define credits for
the students.
The personal resources needed for development of all
projects were 26 full-time positions. The estimated
resources needed for project operation would diminish by
15% only if the projects continue to work independently of
each other. There would be a shift from programming to
content management and tutoring tasks.
3A 4
R Ellaway*, D Dewhurst and A Cumming (The University of
Edinburgh, MVM Learning Technology Section, The Medical
School, Hugh Robson Link Building, George Square, Edinburgh,
EH8 9XD, UK)
Conclusions/take-home messages: For a sustainable and
cost-effective operation of ICT-supported learning, we
propose a central ICT-coordination using synergies
between projects. Integration of e-learning in the medical
curriculum requires a close interaction between ICTdevelopers and curriculum planners.
3A 2
Aim: The use of online support systems is now widespread
in medical education. Usually taking the form of some kind
of virtual learning environment (VLE), they interact with their
courses in many ways. Only part of the utility and value that
VLEs provide may be educational. It is therefore important
when evaluating VLEs, whether prospectively or in use, to
look at the holistic relationship between a VLE and a course.
A VLE’s utility does not lie in the intrinsic properties of its
software but rather lies in the unique relationship between
a VLE and the course it has to support.
E-learning tools on a small campus
I Vandenreyt*, M Vandersteen and M Maelstaf (Limburgs
Universitair Centrum, Department MBW, Physiology,
Universitaire Campus, Gebouw D, B-3590 Diepenbeek, BELGIUM)
Aim: After implementation of Blackboard we wanted to
check how electronic tools are accepted by pre-clinical
medical students.
Summary of work: This paper will set out how the usefulness
of VLEs may be understood and modelled in similar terms
and how this can provide new ways of looking at medical
learning communities in general.
Summary of work: We interviewed five students in each
year and questionnaires were submitted to all students.
Summary of results: All freshmen have private access to a
computer, either during the week or during the weekend or
both. Accessibility on the campus is 100%. Ninety percent
of the students connect to the Internet at least once a week.
Although all students have an email address, they do not
login on a regular basis. On a small campus “beating the
drums” is a better communication tool. Educational
software is greatly appreciated by the students, except the
statistical program SAS (“press the button”). Blackboard
courses are used mainly to make announcements and to
offer learning content.
Summary of results: In order to evaluate the medical VLE
in use at the University of Edinburgh, the authors have
created a framework that analyses the VLE in a course
context by evaluating the degrees to which the course
community of practice is supported.
Conclusion: A ‘community of practice’ model has been
found useful in evaluating the holistic components of an
educational environment.
3A 5
Conclusions/take-home message: Although teachers are
pleased with the multiple possibilities Blackboard offers, it
is not used in the optimum manner. The reason for this is
an overloaded staff. Discussion board and assignments
have to be explored in the future.
3A 3
Virtual Learning Environments and Communities of
Practice
Electronic learning: premises, skills and preferences
of medical students – results of the MeducaseCharité-E-learning survey on 630 medical students
Stefan Höhne*, Götz Bosse and Ralf R Schumann (Charité, Institut
für Mikrobiologie und Hygiene, Project Meducase, Dorotheenstr.
96, 10117 Berlin, GERMANY)
Aim: Electronic learning has an increasing influence on
academic medical education. Post-time evaluations of
software usually have been performed after development
was completed. The use of electronic learning software at
the Charité medical school still is low, although numerous
programs are available. The survey presented here is
aimed at examining the premises, skills and preferences
of medical students regarding future electronic learning
software.
Managing the learning environment in undergraduate
medical education: the Sheffield approach
Chris Roberts*, Mary Lawson, David Newble and Asley Self
(Department of Medical Education, University of Sheffield,
Coleridge House, Northern General Hospital, Sheffield, UK)
– 4.23 –
Section 4
Summary of work: A survey was performed with 700 (90%,
n=630, valid returns) medical students of the Charité
medical school in 2002.
Aim: Student feedback is an essential component of course
evaluation and plays a key role in the measurement of
teaching quality. Here we describe the introduction of an
online feedback system at the University of Edinburgh
Medical School and its impact on the quality of student
feedback.
Summary of results: The desire to use electronic learning
exceeds the actual use. Learning environments should
contain the following features: a well structured layout, ease
of use, free choice of learning paths, and inclusion of
clinical procedures and practically relevant content. Selfdirected learning received top evaluation results. Medical
students showed little interest in collaborative learning
elements like chat and online learning groups.
Summary of work: The online student feedback system
has been developed and deployed for the MBChB course
and created as part of the Virtual Managed Learning
Environment (VMLE). The new student feedback system
targets students at the end of a module and generates a
questionnaire that, if active and uncompleted by the
student, will pop-up each time they login to the system.
Conclusions/take home message: There is a need for
computer-based learning in medical education. Medical
students feel capable of self-directed learning. The
Meducase project will implement the results of this survey
when developing their electronic learning program.
3A 6
Summary of results: The new system has led to major
improvements in response rates along with the speed and
quality of the reports that are generated automatically. Each
question is scored apart from those with free text comments.
The detail of reports is also greater.
Electronic submission and delivery of student
feedback
Conclusions: The system is completely anonymous and
all members of the MBChB course community can access
the reports. The improvement in the quality of the feedback
means that courses can be evaluated quickly, leading to
more rapid implementation of curriculum improvements.
R Ellaway, A Cumming, H Cameron and K Wylde* (University of
Edinburgh, ACT Office, Doorway 3, College of Medicine and
Veterinary Medicine, Teviot Place, Edinburgh EH8 9AG, UK)
Session 3B: Computer Based Assessment
3B 1
Response times as a function of examinee ability
and item difficulty in the context of a testlet-based
computer-administered adaptive examination
single entry point for both students and teachers is missing.
CASEPORT integrates five case-based e-learning systems
through an open server-sided architecture; other casebased systems will be added. An open-source learning
management system ILIAS was integrated for
communication and course administration functions.
CASEPORT allows access to more than 250 learning
modules from internal medicine, surgery, pediatrics,
neurology and psychiatry. Cases have been contributed
from 12 medical faculties in Germany plus international
partners from Switzerland, the US and Brazil. They
underwent a review process for didactical, content and
technical quality assurance. Courses for all of these content
areas are used and jointly evaluated within the
undergraduate curricula of partner schools. Studies on the
use of cases for formative and summative assessment
were carried out. We report on CASEPORT´s integrative
technical approach and our experiences with the casecreation and quality assurance process. Furthermore, we
present evaluation data on acceptance and motivation of
students and teachers in various integration scenarios. A
sustainability concept will finally be discussed.
D R Miller, A P Boulais, D E Blackmore* and T J Wood (Medical
Council of Canada, 2283 Saint Laurent Blvd, Ottawa, Ontario K1G
3H7, CANADA)
Aim: The Medical Council of Canada (MCC) administers
a computer-based examination known as the Part I of the
MCC Qualifying Examination (MCCQE Part I). The
multiple-choice (MCQ) component of this examination is
administered in 7 sections (segments) of 28 questions
each. Each examination section completed by the
examinee is marked in real time and the next section is
constructed on the basis of the examinee’s score in each
of six disciplines. The MCCQE Part I is a self-paced
examination, i.e., examinees themselves determine how
much time to spend on each section within the overall
time limit.
Summary of work: The MCCQE Part I has been
administered via the computer since the fall of 2000. Time
records have been kept for each examinee for each section
of the examination. Ability estimates based on the total
examination as well as for each of the above disciplines
have been computed.
3B 3
Bryan Vernon (School of Population and Health Sciences, The
Medical School, University of Newcastle-upon-Tyne, Newcastleupon-Tyne, NE2 4HH, UK)
Summary of results: Candidates’ scores will be presented
as a function of examination section, time and estimated
ability on the MCQ examination.
I shall describe the development of the Ethics module for
the world’s first web-based MSc in Oncology and Palliative
Care from conception to delivery, aiming to inform
colleagues about the benefits and drawbacks of online
Ethics teaching and learning from the perspective of both
teacher and learner. Using Blackboard and accessible
web-based resources, I have developed interactive course
materials. I shall discuss the way these were selected, the
course outline and its learning outcomes. I shall reflect on
the work-based summative student assessments which
are due in May and the student feedback, both formal and
informal. I shall discuss ways of building and sustaining an
online relationship between learners and teacher and
reflect on my experience of delivering the course. Initial
indications are that students are satisfied and appreciative
and that most are highly motivated. Engagement with the
discussion board has been mixed. This is a challenging
method of delivering ethics teaching. As a domain it is
Conclusion/take home messages: Examinees of varying
abilities may differ in their time-management strategies on
individual examination sections and across the
examination as a whole. Consequently, one cannot
assume that examinee ability should drive the time allotted
for a computer-based examination.
3B 2
Virtual ethics in a Masters’ course
CASEPORT – an integrative learning platform for
case-based learning
M R Fischer for the CASEPORT Consortium (University of Munich,
Medizinische Klinik, Klinikum Innenstadt, Ziemssentr 1, 80336
Munich, GERMANY)
Various case-based learning systems for medical
education have been developed with substantial financial
resources over the last years. A synergistic approach with a
– 4.24 –
Section 4
delivery systems (TopClass vs. Test pilot) and (5) to train
our team in running on-line examinations.
largely uncharted and unresearched. Those who hear the
paper will be inspired and encouraged to experiment with
some web-based teaching in their own practice, building
on the successes and failures of a colleague.
3B 4
Summary of work and results: In the presentation, the
process adopted by the team to prepare the on-line
assessment, challenges and actions taken and outcomes
of the pilot trial will be discussed, as well as students’
feedback and examples of multiple-choice questions that
suit the needs of the new curriculum and the use of on-line
testing.
Electronic MEQ – a computer based assessment
tool at the University of Witten/Herdecke, Germany
Marzellus Hofmann* and Brigitte Strahwald (University of
Witten, Faculty of Medicine, Projekt medicMED, AlfredHerrhausen-Strasse 50, Witten 58448, GERMANY)
The Faculty of Medicine at the University of Witten/
Herdecke has more than ten years of experience with PBL
in its curriculum. Within this educational construct, students
learn by working in an interdisciplinary manner on different
medical subjects using paper-patient cases. Assessment
techniques applied at the University of Witten/Herdecke
(e.g. MEQ, OSCE, PT) mirror this educational concept by
focusing on problem solving and decision making skills.
MedicMED (Multimedia Education – Internet Campus
Medicine) is a research project at the University of Witten/
Herdecke, sponsored by the German Ministry for
Education. The main focus of MedicMED is the
development and implementation of an Internet based
learning and training system. Within this system students
will be supported by PBL-case simulations. In addition
MedicMED transfers existing problem-based assessment
methods (e.g. MEQ, OSCE) into computer-based
examination tools. The uniqueness of MedicMED lies in
the complete integration of this internet-based multimedia
learning system into the existing curriculum. We report on
the educational concept, development and
implementation of a computer-based MEQ-Test.
Examination setting and curricular integration will be
illustrated. Examination results as well as evaluation and
acceptance will be presented.
3B 5
Conclusions: Where students have access to computers
and are able to use the intranet to retrieve curriculum
material and learn using computer-aided learning
programs, there is a good opportunity to introduce on-line
tests as an alternative to paper assessment. Use of coloured
images in the stem of questions and multiple-choice
questions that test cognitive skills is a useful strategy in online assessment.
3B 6
Use of web-based cases for teaching and
assessment in a medical school curriculum
Debra A Newell*, L Felipe Amador, Mukaila A Raji, Karen A
Rasmussen and Robert E Beach (University of Texas Medical
Branch, Office of Educational Development, 301 University Blvd,
Galveston TX 7755-0408, USA)
Aim: To demonstrate the effectiveness of web-based
clinical decision-making cases as tools for learning and
assessment.
Summary of work: Geriatric web-based cases are utilized
in both courses and clerkships to standardize content
delivery, teach integrated clinical decision-making (CDM)
skills, facilitate PBL small group discussions and assess
mastery of various concepts. The ability to access the cases
from on or off-campus is also a plus. Assessment is done
in two ways: 1) feedback from students on logistics of case;
and 2) student responses to clinical decision-making
questions are recorded and routed to the course or
clerkship director for comparison against a levelled rubric.
Student comparisons from the same course as well as
between courses are evaluated and utilized for modification
of CDM questions and case content.
Use of on-line summative assessment in medical
education: experience from a pilot trial at the
University of Melbourne
Samy A Azer (University of Melbourne, FEU, Faculty of Medicine,
Dentistry and Health Sciences, Medical Building, Level 7, Parkville,
Victoria 3010, AUSTRALIA)
Summary of results: Results from one case piloted in a 1st
year course and 4th year clerkship show that student
responses to CDM questions are consistent within the
same course/clerkship; differences are observed in the
complexity of the responses between groups.
Aim: To ensure successful implementation of an on-line
summative assessment for our first year medical students,
it was decided that a pilot test should be run. The aims of
the test trial were (1) to ensure that students are oriented to
on-line assessment and the style of questions to be
included in the actual test, (2) to ensure that the real
examination will operate smoothly, (3) to receive feedback
from students on the trial test and use issues raised in
improving the actual test, (4) to explore the advantages
and disadvantages of delivering the test using two different
Conclusion/take home messages: Web-based cases, with
pre-set CDM scoring rubrics are effective in teaching
standardized concepts and assessing content mastery.
Discussion will focus on implications for application in a
variety of medical education settings.
Session 3C: Curriculum Planning (2)
3C 1
Basic sciences learning in an integrated, primary
care oriented curriculum
specific knowledge regarding basic sciences is well
understood by the graduates of the program.
Fernando Mora-Carrasco*, Rosalinda Flores-Echavarria and
Irina B Lazarevich (Universidad Autónoma Metropolitana
(Xochimilco), Calzada del Hueso 1100, Colonia Villa Quietud, C P
04960 Distrito Federal, MEXICO)
Summary of work: There has been controversy in the forms
by which BBSc knowledge is best incorporated into the
students’ understanding of medical problems. In our
program BBSc are incorporated at all levels of learning,
and we do not have a basic science training in preclinical
years. It was expected that the level of basic science need
would increase as the student proceeded towards
graduation. Most medical graduates in the country take
the National Examination for Medical Residences, and
this includes a section of BBSc. We compared the results
of our students, with no independent BBSc training, with
those that had two years of BBSc teaching.
Aim of presentation: The medical curriculum at the
Metropolitan University is an integrated program oriented
towards primary care. Basic biomedical sciences (BBSc)
are not taught as such, but are presented as necessary
elements to understand clinical or epidemiological
problems that are the main focus of the curriculum. For
several reasons it is of interest to determine whether
– 4.25 –
Section 4
Conclusions/take home messages: The case-based
approach was successful in demonstrating the relevance
of the basic science and preparing students for future
clinical work. This approach will be applied more widely
in the new GKT curriculum.
Summary of results: Although the difference is small, our
students perform better in the section of basic science
questions than those with specific training in these.
Conclusions/take home messages: Learning concepts and
methods in BBSc can be achieved with innovative forms
that seek to integrate them with applied medical courses.
3C 4
3C 2
S Eychmueller* and H Neuenschwander (Kantonsspital St. Gallen,
Palliativstation, Rorschacherstr. 95, 9007 St Gallen,
SWITZERLAND
Aim of presentation: Discussion of an unusual use of a
senior field of study to stimulate learning of elementary
subjects.
Aim of presentation: To demonstrate how ‘vertical’
integration beyond medical school could be performed,
and how a ‘Fix- Flex- Design’ helps to meet participants’
needs.
Summary of work: We inverted the traditional way of teaching
trauma to senior students/postgraduates as an integration
of material previously encountered. A Trauma theme was
placed in the first year, stimulating students to investigate
basic sciences. Cardiovascular, respiratory and renal
physiology, pain, principles of head injury pathology and
management, intravenous resuscitation, haemostasis, use
of blood products, ethical and forensic aspects are
proffered. At the same time as elementary anatomy,
physiology, pathology and pharmacology are being
presented, the clinical background ensures that, while we
do not produce accomplished traumatologists, students’
interest is aroused in a field which, in national medical
schools, has not enjoyed such prominence as its incidence
warrants.
Summary of work: Over 3 years a new course in basic
Palliative Medicine was evaluated targeting physicians
from different working backgrounds. The design is a two
one-and-half-day modules design (module 1 = fixed
objectives, module 2 = chosen objectives by participants:
‘Fix-Flex-design’). For individual achievement a formative
(self-rating VAS Scales before and after the course) and
summative format (MCQ questions) were chosen; semistructured questionnaire for course- evaluation.
Summary of results: 45 “packages” were evaluated. Selfrating before and after the course showed that (a) the course
objectives met the needs of the participants adding the
right things for their practice, and (b) highest improvement
occurred in the control of rather difficult symptoms like
complex pain syndromes and bowel obstruction (p<
0.0001). The “Fix- Flex- Design’ was rated highest in the
course evaluation.
Summary of results: Students find the theme challenging
and enjoy the hands-on aspects of ambulance service,
learning to suture, etc. The Trauma theme’s place within
the undergraduate curriculum, the elements which make
up the cases week by week and our learning objectives
will be presented.
Conclusions/Take-home messages: A continuous
educational plan connecting the under- and postgraduate
level helps to allocate reasonable learning objectives. The
‘Fix- Flex- Design’ in a two module course enhances
interest, individual contributions and individual outcome.
3C 3
Structuring basic science teaching around clinical
cases: experiences at GKT
Topsy-turvey teaching: trauma as teaching tool
T E Sommerville (University of Natal, Department of Anaesthetics,
Faculty of Medicine, Private Bag 7, Congella, Durban 4013, SOUTH
AFRICA)
Postgraduate course – “ Palliative Medicine for
Doctors” – the ‘Fix- Flex- Design’
Conclusions/take-home messages: An extremely complex
yet topical subject can be ‘deconstructed’ so as to provoke
interest in its components without fear of frustration at not
seeing all of the bigger picture.
3C 5
A novel, integrated, practice-based, curricular
approach
Hettie Till (Canadian Memorial Chiropractic College, 1900 Bayview
Avenue, Toronto ON M4G 3E6, CANADA)
Mary Seabrook*, Philip Aaronson and John Rees (GKT School of
Medicine, Department of Medical and Dental Education, Sherman
Education Centre, 4th Floor, Thomas Guy House, Guy’s Hospital,
St Thomas Street, London SE1 9RT, UK)
The aim of this curricular reform was to help senior students
integrate their course material and develop their clinical
skills in preparation for the clinical year. A climate study by
means of the DREEM* Inventory indicated that the 3rd year
students found it difficult to see the relevance of course
content to clinical practice, and they were anxious about
their clinic performance in the 4th year. They felt that they
were covering a large amount of new and disparate
material and that they were not able to integrate this
material without help. It was decided to change the
curriculum to become outcome-base and practice-based
and focused around 9 central themes. A new modular
approach providing focal points around which integration
could occur was superimposed upon the existing systems
approach of the 3rd year of study. For each of the 9 resulting
modules an integrated Study Guide was developed. Each
module concluded with a Grand Rounds Forum
presentation and 3 days of performance-based
assessment – both theory and practical. Feedback from
faculty and students are positive and indicate better
preparation for the clinical experience. It is anticipated
that this format will assist with deep learning and better
retention and application of course material.
Aim of presentation: To describe a pilot programme in
which basic science teaching was reorganised around
clinical cases.
Summary of work: Clinicians and basic scientists worked
together to develop clinical cases relevant to the
cardiovascular/respiratory systems, around which teaching
was structured. A clinician presented each case; related
basic science teaching took place; and the clinician then
returned and continued the case history, showing how the
knowledge and understanding students had gained was
used in practice. A 6-month evaluation of the pilot was
undertaken using ethnographic methods to elicit teachers’
and students’ perceptions.
Summary of results: Students were very enthusiastic about
the cases and supported their use throughout the basic
science curriculum. Benefits included greater motivation
to study, and insights into how doctors think and work.
Students also picked up implicit messages from the cases,
e.g. the trial and error nature of prescribing. Educational
issues arising included uncertainties about the role of
cases in assessment, and the extent to which other teaching
should relate to them.
– 4.26 –
Section 4
Session 3D: Training and Assessment for General
Practice/Family Medicine
3D 1
Formative assessment of family medicine residents
in Catalonia: features and feasibility
a discussion of the evolution of the original concept over
the 30 years of specialty training in family practice and the
adaptations that are being made in program requirements
in response to the realities of the healthcare system.
J M Fornells*, M Ezquerra, M Bundo, D Fores, F Cordón, J M Cots,
A Casasa, J M Martinez and A Martin (Institute of Health Studies,
c/Balmes, 132-136, 08022 Barcelona, SPAIN)
Every year 200 residents start their vocational training in
family medicine in Catalonia, which means that 600
residents are currently trained in 60 primary health centres,
distributed among 15 teaching units, each one led by a
coordinator under the general guidance of a general
coordinator. Two years ago, it was decided to launch a
formative assessment strategy to improve the quality of
training by identifying and correcting the residents’
weaknesses during the learning process where feedback
provided by tutors plays a key role. At the beginning of 2002
first actions were implemented after a pilot test and
according to the following steps: 1) Define the competence
level to be achieved at every learning stage; 2) Identify the
best tools to be used to measure these competences; 3)
Assure the necessary participation of all people involved in
the process, especially teaching coordinators; 4) Establish
and assure the necessary resources and logistics to apply
the assessment procedures. After the first assessment
meeting based on a clinical case, residents and tutors
completed a questionnaire in order to assess satisfaction
and perceived usefulness of the new evaluation system.
Based on a Likert scale, items measured were: organization,
comfort during the assessment, representativeness of the
clinical case related to daily practice, information received
and good assessment method for tutors. Results will be
presented.
3D 2
3D 4
Thomas Link* and Michael Schmidts (University of Vienna,
Institute for Medical Education, Vienna General Hospital, PO Box
10, A1097 Vienna, AUSTRIA)
The Austrian GP Licensing Examination consists of case
presentations with short-answer questions. As a means for
improving the examination, the candidates are given the
opportunity to write down objections to, in their view,
problematic questions. A multi-method evaluation of the
candidates’ responses shows that (1) some candidates
have difficulties to understand what a specific question is
aiming at or what the precise difference between two
subsequent questions is. (2) Examinees who make
comments tend to have higher scores. (3) Better
examinees’ comments are longer and more complex. This
could point to better problem description capabilities that
would make their comments more valuable for identifying
ambiguities. On the other hand, comparably more of their
remarks do not refer to the case presentation but to their
own answers, which could be understood as a subliminal
effort to influence the assessors. Especially in the context
of an open short-answer examination, ambiguities in the
question wording substantially reduce the candidates’
opportunity to name the correct answer. A critical and
systematic review process of the candidates’ comments
helps us to revise the case presentations from an
examinee’s point of view.
The new scheme for specialist training of GPs in
Denmark – best in Europe??
Roar Maagaard (GP, Skoedstrup and County of Aarhus, Plantagen
22, DK-8541 Skoedstrup, DENMARK)
3D 5
A new Danish scheme for specialist training in General
Practice (GP) is launched in August 2003. This new
scheme – a dramatic revolution! – will be presented and
discussed. Total training time is expanded from 3½ years
to 5 years. The training period in hospitals changes from 3
years to 2½ years. The training in GP goes from ½ year
until 1999, to 1 year in the period 1999-2002 and to 2½
years from 2003 – a five-fold increase! Training goes from
primarily being based on time to being based on content:
the acquisition of 119 defined competences. New
strategies for training and assessment are described in
the new blueprint for GP/family medicine. A 12 week period
of research training is included. The number of training
practices in Denmark must be more than doubled to be
able to meet this challenge. The ideas behind this revolution
will be presented, the implementation process and the
obstacles discussed. We are sure it will mean better trained
GPs in Denmark – and no doubt: our vision is to create the
best training scheme for GPs in Europe.
3D 3
“Looking through students’ eyes” – evaluation of
examinees’ comments on a short-answer examination
Tutorship for family medicine students: care for the
inner world
L Debaene*, L Ferrant, R Remmen and J Denekens* (University of
Antwerp, Department of General Practice, Faculty of Medicine,
Universiteitsplein 1, 2610 Antwerp Wilrijk, BELGIUM)
In Flanders the vocational training for general practice
starts in seventh year of the core curriculum. We offer them
one semester in which they acquire basic knowledge and
skills for our discipline. This presentation offers details of
the pedagogical concepts and the organizational aspects
of tutorship. This period is very intense. At the inner world
level of each student many things go on: in the near future
they will be a real doctor which allows them to work (partly)
independently with growing responsibility. This creates fear
and uncertainty. Furthermore they have to apply for a
training practice. To deal with these uncertainties we offer
a didactical format: tutorship. Here care is given for the
feelings arising in the last months of their education. The
tutors (all staff members of our department) have a series
of discussions with a group of four pupils (students in family
medicine). How do they cope with uncertainty? What are
their choices, what is their motivation and inspiration? They
look at illness, suffering, pain, death, violence, but also
growth, birth, healing and love. Do students allow
themselves to be touched in this inner level? These tutorial
sessions increase the vitality of students. We expect the
young doctors to cope with themselves and their inner world
in a more healthy way. In addition they become more
sensitive to the inner world of others.
Continuity of care in family practice residency training
Mary Alice Parsons (ACGME, 515 N. State Street, Suite 2000,
Chicago IL 60610, USA)
Continuity of care has been one of the two major features
of training in family practice residencies in the U.S., the
other being comprehensive care. This session will present
– 4.27 –
Section 4
Session 3E: Teaching and Learning Communication Skills
3E 1
Undergraduate students’ attitudes towards
communication skills teaching
describe the development and design of the medical skills
program at a veterinary school, generalizability of the
CCOG, evaluation of the program and the nature of the
collaboration between human and veterinary medicine.
J Cleland* and K N Foster (University of Aberdeen, Department of
General Practice and Primary Care, Foresterhill Health Centre,
Westburn Road, Aberdeen AB25 2AY, UK)
Tomorrow’s Doctors (GMC, 1993, 2002) emphasises the
importance of medical students demonstrating proficiency
in communication skills, as well as appropriate attitudes
and behaviour towards patients. Few studies have explored
medical students’ attitudes to communication skills
teaching although 1) this is a core skill in the new medical
curricula and 2) teaching often encounters student apathy
(Benbassat, Israel J Med Sci 1996; 32: 217-221). This study
used the Communication Skills Attitude Scale (CSAS)
(Rees, Sheard & Davies, Med Educ 2002; 36: 141-147).
The CSAS was administered to all medical
undergraduates in Years 1-3 at the University of Aberdeen.
Students from different years had varying degrees of patient
contact and communication skills teaching. Demographic
and education-related data were also collected from the
students. 86.2% of students completed the survey. We
present the findings from our survey, comparing data from
students at different stages in undergraduate training. The
relationships between medical students’ attitudes towards
communication skills learning and their demographic and
education-related characteristics are explored. Responses
are identifiable from student number so we can follow
these students throughout under- and post-graduate
training to explore how attitudes towards communication
skills teaching evolve.
3E 2
3E 3
L Kongkam* and N Wiwutworapan (Maharat Nakhon Ratchasima
Hospital, School of Medicine, Family and Community Medicine
Department, Muang District, Nakhon Ratchasima 30000,
THAILAND)
Aim: To present a communication skills course for year IIIVI medical students at Maharat Nakhon Ratchasima
Hospital, School of Medicine.
Summary of work: We developed outcomes and a set of
skills that students should acquire in a communication
skills course. Then we narrowed down the communication
skills competencies according to rotations of clinical year
clerkship.
1 Year III: Curriculum emphasis on the basic
communication skills.
2 Year IV: emphasis on information, explaining and
influencing skills.
3 Year 5 and 6: emphasis on the difficult patients such as
breaking bad news.
We prepared teaching method, developed study guides
and resources. The students were evaluated both
formatively and summatively. The outcomes of students
and curriculum assessment were used for course
development.
Veterinary medical communication skills curricula:
“What’s up Doc?”
Summary of results: Some problems about course
management occurred but over 90% of students were
satisfied.
C L Adams and S M Kurtz* (University of Guelph, Ontario
Veterinary College, Department of Population Medicine, Guelph,
Ontario N1G 2W1, CANADA)
Conclusion: We are in the initiating phase and developing
this curriculum. The data from this course evaluation will
be used as input for future course development.
Aim: To describe an innovative communication skills
program, developed over the past 3 years, at a veterinary
school that is based on well established programs in
human medicine.
Background: Research indicates that veterinarians lack
communication skills necessary for success in practice.
Empathy and compassion toward the client have been
identified by clients of veterinarians as 2 of the top 5
attributes they look for when seeking a doctor for their pet.
Veterinary curricula are under scrutiny as they attempt to
better prepare entry-level practitioners for societal and
professional standards. One area that is poised for
development is communication.
Designing and implementing communication skills
curriculum for medical students
3E 4
Practical experiences and pitfalls in teaching
communication skills
Martina Schlünder*, Britta Jonitz, Margareta Kampmann and
Ulrich Schwantes (Institut fur Allgemeinmedizin, Charité Berlin,
Berlin, GERMANY)
Aim: Two years ago we implemented training in
communication skills as an obligatory course in medical
education at the Charité. In this time we trained about 1300
students in small groups. We will present our experiences
and reflect on the pitfalls we encountered.
Summary of work: In September 2000 the Ontario Veterinary
College mounted a new curriculum with 26 hours per
academic semester for the 4 year program allocated for
communication skills education. We have seen the
efficiency of working with well established models from
human medicine in that the Calgary-Cambridge
Observation Guides (CCOG) serve as the framework for in
class and laboratory teaching and learning regarding
medical consultations. A simulated client and patient
program has proven to be a significant method for teaching
integration of communication and medical competencies.
Veterinary practitioners and faculty have been recruited to
instruct students.
Summary of work: A lot of logistical problems had to be
overcome: 45 tutors had to be found and then they had to
be taught. A conception of the courses acceptable to the
students had to be found and simulated patients trained.
Summary of results: The courses are now popular with the
students. Crucial for successful acceptance are suitable
space in the students’ timetable, a firmly established
organisational structure, and excellent, qualified teachers
and simulated patients. Some students are bewildered by
the lack of “objectivity” that is a pertinent property of
communication processes. Their self-perception as a
physician is determined by patriarchal clichés.
Conclusions: This is the first veterinary medical
communication skills curriculum of its kind in North
America. We have learned that the development of this
program was contingent on administrative, industry, faculty
and practitioner support. The Calgary-Cambridge
Observation Guides have high applicability to veterinary
medicine, with minor modifications. This presentation will
Conclusions: Beyond the training of medical
communication skills, essential components in medical
education are contact with patients right from start as well
as a reflection of role models in medical profession.
– 4.28 –
Section 4
3E 5
Early experience of video taping encounters with
patients
3E 6
A survey of real versus simulated patients’ opinions
of 1st year students’ communication skills
Paul Bradley*, Charlotte Rees and Pamela Bradley (Peninsula
Medical School, ITTC Building, Tamar Science Park, Davy Road,
Plymouth PL6 8BX, UK)
Pamela Bradley*, Charlotte Rees and Paul Bradley (Peninsula
Medical School, Clinical Skills Resource Centre, 3rd floor, Mary
Newman Building, University of Plymouth, Plymouth, UK)
Communication skills learning at Peninsula Medical
School (PMS), UK, is introduced at the beginning of the
course and remains a longitudinal theme that continues
throughout the program. Each week students attend a
Clinical Skills Resource Centre for 2 hours for clinical and
communication skills learning. Approximately a quarter of
this time is devoted to communication skills. Reinforcement
of this learning takes place during the community
attachments. Video taping of patient encounters for analysis
and feedback represents a gold standard for
communication skills learning, although this has largely
been confined to postgraduate healthcare education. We
have introduced video taping as a tool in the
communication skills learning early in the undergraduate
course. Furthermore, we have used this to record student
interviews with real patients, thus allowing observation and
feedback of communication in vivo from peers and tutors.
This paper describes an evaluation of students’ perception
of the benefits of this activity.
Much criticism has been expressed regarding the inability
of junior doctors to communicate effectively with their
patients. Indeed, patients describe dissatisfaction with
consultations, often because the interview is driven almost
entirely by the doctor’s agenda with minimal regard for the
patient’s. At Peninsula Medical School students
commence communication skills training from the first
week. It is integrated with clinical skills training, problembased learning and community placements and continues
throughout the five year undergraduate programme. The
communication skills training programme is based on the
skills-based Cambridge-Calgary model (Silverman et al.
1996), which emphasises to students the importance of
exploring the patient’s agenda. This qualitative study will
contrast the views of real and simulated patients of 1st year
medical students about their communication skills. Both
real (n=8) and simulated patients (n=8) will participate in
semi-structured, telephone interviews to elicit their views.
The interviews will be audiotape recorded, transcribed in
full and analysed using what theme analysis (Vaughn et al.
1996). This paper will present the preliminary results of
this data analysis.
Session 3F: International Medical Education (2)
3F1
International recruitment of general practitioners
into the UK workforce – an educational approach
from West Yorkshire, England
Overseas trained doctors (OTDs) seeking medical
registration in Australia must pass the Australian Medical
Council (AMC) clinical examination. Approximately one
third of AMC candidates from countries with training
systems different from Australia’s undertake a 10-26 week
clinical bridging course (ARTD, 1999). The objective of
the Victorian Medical Postgraduate Foundation’s (VMPF)
clinical bridging program is to prepare OTDs to undertake
the AMC clinical examination. Differences in participants’
primary medical qualifications and language and cultural
background make the bridging program a challenging
course to conduct. The Research Study on Bridging
Courses for Overseas Trained Doctors (1999) found that
between 1992-1998 48% of candidates pass the clinical
examination at the first attempt and that 73% pass within
two attempts. The results of the VMPF’s bridging course of
2000-2001 were outstanding with 82% passing on their
first attempt. The possible reasons for this significant
increase in the pass rate will be explored in this paper.
Participants received medical and surgical bedside
tutorials as well as tutorials in obstetrics and gynaecology
and paediatrics. The Language Coordinator provided
extensive English language and communication skills
tuition at clinical sites.
Peter Dickson* and Lynn Stinson (Bradford City Teaching PCT,
Joseph Brennan House, Sunbridge Road, Bradford BD1 2SY, UK)
In England, there is a Government directive to increase
the general practitioner (GP) workforce (Dept of Health,
2000). GPs recruited from the European Union is one
aspect of this. These doctors have reciprocal rights to
practise medicine in England without further formal
qualifications being necessary (Council directive 93/16/
EEC, 5 April 1993). In West Yorkshire the overseas
recruitment initiative has postgraduate medical education
at its core. The Department for Postgraduate GP Education
(Yorkshire) and Bradford City Teaching Primary Care Trust
are co-ordinating the recruitment process, with other key
partners. The process involves:
• Initial interview in host country, assessing medical
experience and language skills;
• Weekend residential in West Yorkshire, addressing
medical and social aspects. An Observed Structured
Clinical Examination (OSCE) helps to determine their
educational needs. More detailed assessment of
language skills;
• Three/four month induction period within a teaching
practice environment. Personal Development Plans
(PDPs) are agreed from the OSCE. Previous experience
has shown these will include clinical management
topics and extra language tuition. Extra attention is being
paid to the social aspects of doctors and their families
moving to England, wherever possible involving GPs
from their country of origin.
3F3
W P Burdick*, P S Morahan, L M Johnson and J J Norcini
(Foundation for Advancement of International Medical Education
and Research (FAIMER), 3624 Market Street, 3rd Floor,
Philadelphia, Pennsylvania 19104-2685, USA)
Aim: To evaluate the effectiveness of an international
medical education listserv, we analyzed postings and
responses over a 2-year period on a listserv aimed at
sharing medical education knowledge and professional
progress.
The presentation will give an update on this process,
including experiences of successful applicants.
3F2
Listserv analysis as a tool for evaluation of an online international medical education program
Results of a clinical bridging course for overseas
trained doctors in Australia
Summary of work: An international medical education
fellowship has been conducted for 12 fellows each year
composed of a 2.5 week on-site component followed by
11 months of on-line discussion, with fellows returning for
1 week at the end of the year. Discussion topics have
Elma Avdi (University of Melbourne, School of Medicine, Faculty
of Medicine, Dentistry and Health Sciences, Room 234, Level 2,
Melbourne 3010, AUSTRALIA)
– 4.29 –
Section 4
included medical school selection criteria, communitybased education, student perception of mistreatment and
distance learning. Postings were analyzed by type of
information requested, subdivided into curriculum, faculty
development, research, program evaluation, human
resources, as well as response to information requested,
professional progress, and feedback on professional
progress.
Aim of presentation: As globalization forces physicians,
patients and communities into closer proximity, the
importance of ensuring the possession of competency of
all physicians becomes paramount. Using an international
network of experts, the Institute for International Medical
Education (IIME) created both an international outcome
standard and a means for evaluating it.
Summary of work: The IIME convened a task force of
international experts on assessment, reviewed the Global
Minimum Essential Requirements for graduating
physicians, identified 75 potential assessment tools, then
focused on three that could be used most effectively.
Summary of results: 22 Fellows and 7 faculty posted 1187
messages. With 386 postings analyzed, professional
progress was posted by 96% of fellows, with response to
professional progress by one third of fellows and 61% of
faculty. Requests for information were made by 10% of
fellows and constituted 8% of all postings. 16% of the
postings were responses to requests for information.
Summary of results: Of the sixty items, 36 are assessed
using a 150-item multiple-choice examination (MCQ), 15
are assessed using a 15-station Objective Structured
Clinical Examination (OSCE), and 17 are assessed using
a 15-item faculty observation form. (Some assessed by
more than one instrument). With the aid of international
consultants, and in cooperation with eight leading medical
schools in China, the MCQ, OSCE, and faculty observation
form were developed for an examination scheduled to be
given simultaneously to all 7-year Chinese students in
October, 2003.
Conclusions/take home messages: Quantitative analysis
of listserv postings can be an effective tool for program
evaluation.
3F4
An overview of the characteristics and performance
of candidates who take the ECFMG clinical skills
assessment: 5 years of testing
Conclusions/take home messages: Global essential
competencies can be agreed upon and evaluated. Further
research on reliability and international standard-setting
will be needed.
J Boulet*, G Whelan, W Burdick and J Norcini (Educational
Commission for Foreign Medical Graduates - CSA, 3624 Market
Street, 4th Floor, Philadelphia, PA19104-2685, USA)
The Educational Commission for Foreign Medical
Graduates (ECFMG) has been administering a high-stakes
standardized patient clinical skills assessment (CSA) for 5
years. The purpose of this assessment, amongst other
certification requirements, is to determine the readiness
of graduates of international medical schools (IMGs) to
enter graduate training programs in the United States. To
date, almost 29,000 candidates from over 150 countries
and 1,000 different medical schools have taken the CSA at
one of two test centers. The purpose of this paper is to
provide an overview of this high-stakes standardized patient
examination, concentrating on the characteristics,
performance, and educational outcomes of the candidates
who complete this assessment. Over the past 5 years there
has been a steady increase in the number of IMGs testing,
including over 3,000 repeat administrations. Based on the
cohort of individuals who passed CSA in the initial 4 years
of operation and were certified, over 75% eventually
obtained residency training positions in the United States.
Similar to other organizations that use clinical skills
assessments for certification and licensure decisions, the
ECFMG has found the CSA to be a useful tool for assessing
the clinical skills of graduating medical students.
3F5
3F6
Perceived stress and stress sources for Chilean and
American medical students
Meghan McKeever*, Pedro Herskovic and D Daniel Hunt (University
of Washington, 5017 40th Avenue NE, Seattle WA 98105, USA)
Medical school is recognized as stressful; studies have
shown the deleterious effects of stress on student wellbeing. Our project intends to evaluate the level of perceived
stress in Chilean and American medical students and to
determine factors contributing to stress within each group.
Second year students at the University of Chile and the
University of Washington were asked to participate in a
survey assessing demographics, perceived stress level,
and specific stressors during a period of similar academic
pressure. A total of 197 Chileans (84.5%) and 142
Americans (83.5%) responded. Average ages were 20.1 +/
- 1.69 yrs (Chile) and 26.3 +/- 3.57 yrs (US) (p< .0001). In
Chile, 99% of the students are single/non-cohabiting, versus
52% of American students (p< .0001). Seventy-nine percent
of Americans live in rented housing while 84% of Chileans
live in their parental home (p<.0001). Chilean students
scored significantly higher than Americans on the
perceived stress scale. For Chileans, the highest ranked
stressors included academic issues, while American
students felt more stress from personal concerns. In
summary, American and Chilean students have significant
demographic differences and this contributes to the
sources of stress that they identify.
The assessment of global physician competence
David T Stern*, Andrzej Wojtczak and M Roy Schwarz (University
of Michigan Health System, 300 North Ingalls, Room 7E10, Ann
Arbor, MI 48109-0429, USA)
Session 3G: Assessment of Teaching
3G 1
Feedback to faculty using the SETOC instrument –
student evaluation of teaching in outpatient clinics
of establishing a learning milieu, clinical teaching skills,
general teaching skills, clinical competence, and a globalrating item for effectiveness. The SETOC was administered
to students through course coordinators across disciplines
with outpatient experiences, at the Aga Khan University
Medical College. Student ratings were anonymous. Faculty
names were coded by departments. Inter-rater
generalizability coefficients of student ratings were 0.92
for the SETOC and >0.89 for each subscale. Frequency
tables and bar charts of total-scale and subscale mean
scores for each instructor were computed. Repeated
Measures design was used to study differences in
subscales.
Rukhsana W Zuberi* and Georges Bordage (Department of Family
Medicine, The Aga Khan University, Stadium Road, PO Box 3500,
Karachi 74800, PAKISTAN)
Aim: A faculty evaluation form (SETOC), that would reflect
challenges in outpatient clinic teaching, was developed to
provide feedback to faculty for improvement. The reliability
of student responses was determined before highlighting
ways to make feedback meaningful.
Methods: The 15-item SETOC had a 7-point Likert-type
rating scale and five subscales (SS1-5), which consisted
– 4.30 –
Section 4
Conclusions/take home messages: An objective
standardized teaching examination (OSTE) can serve well
the purpose for objective assessment of teaching skills in
residents from different specialties. It requires a significant
investment in time, effort, and personnel.
Results: Nine of the 87 instructors obtained >85% score
on the SETOC, while four obtained >90% scores on all
subscales. 14 had unsatisfactory scores. No significant
difference was found between the means of SS1 and 2, or
the means of SS4 and 5. However, each of the means of
SS1, 2, 3 was significantly lower than the means of SS4 or
5 (p = .0000).
Conclusion: The SETOC can provide individualised
feedback to faculty members, identifying overall teaching
excellence or weakness or smaller areas of excellence or
weakness. It can also identify areas for faculty development.
3G 4
Klara Bolander* and Kirsti Lonka* (Karolinska Institutet,
Berzeliusgarden 1, S-171 77 Stockholm, SWEDEN)
Messages: Only reliable student responses should be used
for feedback. Even competent clinicians need teaching
skills.
3G 2
Since 2002 all teachers at the Karolinska Institute are
required to undertake three weeks of educational training
to become an associate professor. This presents staff
developers with challenges of course design to motivate
course participants with a range of educational
backgrounds within the medical field. In this short
communication we will describe the new teacher-training
program at the Karolinska Institute, Stockholm, Sweden
(www.lime.ki.se/cul). By introducing a learning platform
called Knowledge Forum along with using activating
instruction in teacher training, social construction of
knowledge in a networked computer-based environment
course participants were given the opportunity to
collaboratively build and elaborate on new ideas to facilitate
reflection on their learning. Preliminary results show that
using the Knowledge Forum in this context was helpful in
encouraging reflection on theory and practice. We present
two groups of teachers – those who found this way of
learning to be helpful, and those who did not – and discuss
the reasons why these two groups differed in their
experiences. This presentation will also show how the
participating teachers’ ideas of learning developed during
the course. Further analyses of the results of the teachertraining program are still in progress.
Does ‘expert review’ of teaching practice lead to
increased effectiveness of teachers in the
healthcare professions?
Kay Mohanna (Staffordshire University, 19 Wyndham Wood Close,
Fradley, Lichfield, Staffs WS13 8UZ, UK)
Aim: To present early results evaluating the process of
‘expert review’ as a way to increase teaching effectiveness.
Summary of work: Expert review of teaching in the clinical
setting is one of the assessment strategies in the
postgraduate certificate in medical education at
Staffordshire University. ‘Real-life’ teaching sessions are
assessed by an expert assessor according to strict criteria.
This project aimed to develop an evaluation tool to show
that expert review, and the reflective practice that the
feedback from it engenders, is capable of increasing the
effectiveness of clinical teachers. Participants were
graduates of the award. A control group who had not
participated in a process of peer review was recruited from
those who have gone through the Teaching the Teachers
program at Staffordshire University. The main, university
dependent, unmatched variable was the process of expert
review
3G 5
To enhance the quality of medical teaching, it is important
to appreciate the existing attitudes of teachers and also
the changing of their attitudes by time and experience.
Our aim was to compare attitudes towards teaching and
teacher training before and after undergraduate medical
education had started at Hatyai Hospital (Thailand) in April
2001 under Collaborative Project to Increase Production
of Rural Doctors. We used a questionnaire assessing
attitudes to teaching and teacher training developed by
Finucane (1994) to survey our staff in January 2001 and
February 2003 respectively. The responses showed
significant differences in two attitudinal statements. There
was more agreement on “I find teaching as satisfying as
other activities” (x1 = 4.0, s.d. = 1.4, x2 = 4.9, s.d.=1.5, p =
.01, Mann-Whitney U test) and less agreement on “Sufficient
priority is given to teaching in this hospital” (x1 = 4.4, s.d.=
1.2, x2 = 3.7, s.d. = 1.2, p = .01). These differences might
be attributed to the fact that physicians had more
confidence in teaching after one year’s experience but the
hospital needed to consider “teaching role” as one of its
important missions as well.
Conclusion/take home message: Expert review in the
clinical setting can increase the effectiveness of teachers.
OSTE: Objective Standardized Teaching
Examination for a ‘residents as teachers’ course
Jesús Ibarra-Jiménez*, Ismael Piedra-Noriega, Monica del ÁngelReyes and Jorge González (Instituto Tecnológico y de Estudios
Superiores de Monterrey (ITESM), School of Medicine,
Departamento de Desarrollo Académico - DCS, Ave I Morones
Prieto, 3000 pte, Col. Doctores, Monterrey, N.L. CP 64710,
MEXICO)
Background: When training residents on how to teach, it is
necessary to assess the results of the course efforts. Only
a few studies have reported the use of objective measures.
Aim: To develop the foundation for an objective
standardized teaching examination (OSTE), for a ‘residents
as teachers’ course in Monterrey, México.
Attitudes towards teaching in a newly founded
medical school: 2 years later
Araya Khaimook* and Boonyarat Warachit (Hatyai Hospital, Dept
of Surgery, 182 Rattakarn Road, Hatyai, Sonkhla 90110,
THAILAND)
Summary of results: Teachers who have been through a
process of expert review show greater insight into their
strengths as a teacher and their areas for development.
They are able to demonstrate the skills of a reflective
practitioner and can recognise what constitutes effective
teaching. This provides a good foundation for them to
develop as effective teachers.
3G 3
Challenges in implementing a computer-based
collaborative platform in staff development
3G 6
Summary of work: Learning outcomes were identified, eight
stations were designed, an instruction book was designed,
and participants were trained. An exit survey was applied,
and results were analysed.
Feedback for physicians supervising students
during patient contacts
D H J M Dolmans*, H A P Wolfhagen, W H Gerver and A J J A
Scherpbier (University of Maastricht, Department of Educational
Development and Research, PO Box 616, 6200 MD Maastricht,
NETHERLANDS)
Summary of results: Seventeen residents underwent an
eight station OSTE, in order to measure the achieved goals
for learning how to teach. Satisfaction was high, 1.7 (scale
0=maximum to 5=minimum), including residents,
standardized students, and teachers.
Aim: To demonstrate the development of an instrument
providing physicians with feedback on their performance
in supervising students during patient contacts fitted to
physicians’ personal needs.
– 4.31 –
Section 4
theories of effective apprenticeship learning. Choi and
Hannafin (1995) distinguish several forms of facilitating
student learning in these situated learning environments:
role modelling, scaffolding, coaching, collaborating and
fading. It is demonstrated how physicians can be provided
with feedback fitted to their personal performance as
supervisor.
Summary of work: In a situated learning environment in
which students are involved with patients, it is all too often
assumed that students learn by imitation. However, although
role modelling is a powerful means, physicians should
focus the supervision to the student’s level of self-directed
learning. Instruments providing physicians with feedback
about their strengths and weaknesses in supervising
students could help them to reflect upon how they supervise
students and could help them improve their teaching
(Copeland & Hewson, 2000; Litzelman et al., 1998). At the
Maastricht Medical School, an instrument has been
developed for this purpose. The instrument is based on
Take home message: Physicians should be able to deal
with different forms of facilitation of student learning.
Providing them with feedback on their performance in this
respect could help to improve teaching.
Session 3H: The OSCE (2)
3H 1
Keeping standardized patients standardized
specifically outline issues related to the test development
and case selection process, the comparability of candidate
scores, and potential threats to the validity of assessment
decisions. This overview of key psychometric issues will
be useful to other organizations that wish to build and/or
refine existing performance-based assessments.
Tony Errichetti* and John Boulet (Philadelphia College of
Osteopathic Medicine/National Board of Osteopathic Medical
Examiners, 4170 City Avenue, Suite 108, Philadelphia PA 19131,
USA)
Aim: To outline methods that can be used to enhance the
accuracy and consistency of SP portrayal and scoring.
Summary of work: The use of performance-based
standardized patient (SP) assessments is widespread, and
currently a part of certification and licensure examinations
in several countries. A major challenge facing high-stakes
performance examination centers and medical schools is
to ensure that the standardized patients are truly
standardized, i.e. consistently accurate in case portrayal
and skills documentation. If this is not the case, the validity
of any resultant scores could be compromised.
3H 3
Marta van Zanten*, John R Boulet, John J Norcini and Danette
McKinley (Educational Commission for Foreign Medical
Graduates, 3624 Market Street, 4th floor, Philadelphia, PA 19104,
USA)
Background: The instruction and assessment of
professionalism is an important topic in medical education
today. While much work has focused on defining
professionalism and teaching medical students the
appropriate behaviours, relatively little research has looked
at meaningful ways of assessing professional attributes.
Summary of work: The ECFMG® Clinical Skills
Assessment (CSA®) uses standardised patients (SPs) to
evaluate the readiness of graduates of international
medical schools (IMGs) to enter medical training in the
United States. Physician interpersonal skills (IPS), including
professional qualities such as rapport, are evaluated as
part of the CSA. Attentiveness, attitude and empathy are
specifically targeted in the assessment. To date, over
230,000 candidates have tested, encompassing more than
320,000 individual SP encounters.
Summary of results: The results of an initial pilot study
indicated that the fidelity of patient portrayals was related
to scoring errors. In addition, the variability in some SP
performances was sufficient to warrant in depth observation
and study of selected individuals.
Conclusions/take home messages: As a result, we focused
on issues related to screening standardized patients for
employment, training and training methods, and the proper
physical conditioning of SPs to ensure focus and
concentration. While there are many reasons why the
standardization of SPs may not be perfect, with proper
training, selection and feedback, the consistency and
accuracy of portrayals and scoring can be improved.
3H 2
Summary of results: The reliability of the SP rapport ratings,
over encounters, was 0.72. Average rapport ratings for
female candidates were significantly greater than those
for males (effect size = 0.20). Rapport ratings were
negatively associated with candidate age (r = -0.07) and
positively associated with spoken English proficiency (r =
0.40). Professional qualities were only marginally related
to measures of basic science and clinical science
proficiency.
Psychometric challenges associated with
standardized patient assessments
Danette W McKinley, John R Boulet* and Ronald K Hambleton
(Educational Commission for Foreign Medical Graduates,
Research and Evaluation, 3624 Market Street, 4th Floor,
Philadelphia PA 19104, USA)
Standardized patient (SP) assessments are being used
with increasing frequency in medical education, and are
often part of certification and licensure decisions. These
assessments can provide valuable formative and
summative information regarding examinee performance
in a clinical setting. Amongst the challenges presented in
implementing these assessment programs are those that
potentially affect the validity of scores and associated
decisions. Several factors can affect examinee
performance and outcomes on these assessments,
including choice of case content, selection of raters, and
various administrative factors. This paper will focus on
various challenges encountered in administering a largescale standardized patient assessment. For the past 5
years, the Educational Commission for Foreign Medical
Graduates (ECFMG) has been administering a Clinical
Skills Assessment (CSA) to graduates for international
medical schools. Based on over 30,000 administrations,
encompassing over 320,000 SP encounters, we will
Using a standardized patient assessment to
measure professional attributes
Conclusions: While numerous professional behaviours are
probably best measured using formats such as surveys,
self and peer assessment and critical incident techniques,
certain aspects of professionalism can be reliably and
validly measured in SP examinations.
3H 4
Evaluating the effectiveness of a two-year
curriculum in a surgical skills centre
D J Anastakis*, K R Wanzel, M H Brown, J McIlroy, S J Hamstra, J
Ali, C R Hutchison, J Murnaghan, G Regehr and R Reznick
(University of Toronto, Toronto Western Hospital, 399 Bathurst
Street, 4FP-140, Toronto, Ontario, M5T 2SB, CANADA)
This study describes an evaluation of a two-year, biweekly,
structured surgical skills curriculum. To assess the quality
of individual skills sessions, residents and faculty completed
evaluation forms after each session. To assess surgical
– 4.32 –
Section 4
skill acquisition as a function of the curriculum, 50 residents
participated in the same Objective Structured Assessment
of Technical Skills (OSATS), at one of two time intervals. In
1998, 31 residents who had not completed the curriculum
were tested as historical controls and in 2000, 19 residents
who completed the curriculum were tested as the treatment
group. Participants completed 6 standardized surgical
procedures on human cadavers and were assessed using
task-specific checklists and global-rating scales. Most
comments reflecting areas requiring improvement were
directed at the syllabus and surgical models. OSATS scores
were not significantly different between treatment and
control groups on either checklist or global-rating scores.
Further comparisons between groups on individual OSATS
stations revealed no significant differences. Although
session evaluations indicated the curriculum was useful
and worthwhile, this did not manifest as a general
improvement in surgical skills, as evaluated by an OSATS
examination. Further investigation is required to better
understand the benefits of such curricula and how best to
evaluate them.
3H 5
on how to develop item weights and incorporate them into
a scoring algorithm that leads to a pass/fail decision.
Conclusions/take home messages: Weights can be an
important aspect of examination development in that
varying the weights will affect which specific examinees
pass or fail. This is most evident around the pass/fail cut
point.
3H 6
Self and peer assessment of history taking skills
Caroline Boggis*, S Cooke, M Holland and H Richardson (South
Manchester University Hospitals’ NHS Trust, Undergraduate
Medical Education, 1 st Floor Education and Research Centre,
Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT,
UK)
Aim: Self and peer assessment skills underpin life-long
learning and are used in medical practice postqualification. Also students engage better with task-based
learning when involved with its assessment. We explored
self and peer assessment based on history-taking and
presenting in the OSCE setting. The following research
questions were applied: (1) How do the students assess
their abilities? (2) What is the relationship of the students’
assessment and tutors’ assessment in final examination?
Weighted OSCE checklists: the practice at the
Medical Council of Canada
D E Blackmore*, S M Smee, T J Wood and W D Dauphinée (The Medical
Council of Canada, 2283 St. Laurent Blvd, Ottawa, Ontario K1G
3H7, CANADA)
Summary of work: Examination marking schemes were
explained to final-year medical students who then
determined their own assessment criteria. The students
practised communication skills in small groups, using roleplay scenarios. Following each scenario the students gave
each other feedback, and recorded scores on themselves
and their peers as examiner or observer. Following the
session students were asked to provide written reflection.
Aim: The use of checklists with Objective Structured
Clinical Examinations (OSCE) is widespread in the
assessment of medical students, residents and physicians
in practice. The checklist is most often used to record
whether or not an examinee adequately performed a salient
aspect of a given patient encounter/case. For scoring
purpose, the common practice is not to assign weights to
the individual checklist items; i.e. each item carries the
same weight and contributes equally to the pass/fail
decision for that case. The practice of the Medical Council
of Canada is to apply weights.
Summary of results: Preliminary analysis shows that selfassessment scores were significantly lower than peer
assessment (p<0.01). Correlation with the tutor assessment
at final examinations (May 2003) will be presented. Many
students found the programme beneficial in developing
consultation skills and increasing their understanding of
the OSCE examiner’s role.
Summary of work: This paper outlines the reasons why
checklist item weights are felt to be important in the context
of a high stake licensing examination.
Conclusions/take home messages: As research shows
student dissatisfaction with the OSCE system it is important
to increase awareness and transparency of this
assessment process.
Summary of results: Several data sets are presented to
support the use of item weights as well as a short discussion
Session 3I: Problem Based Learning and Computers
3I 1
Successful implementation of Blackboard in PBLtutorials
be paid to the instruction of the teachers with regard to the
implementation of Blackboard in the tutorial, especially
the use of the archive-options of Blackboard. The lack of
broadband connections at the students’ homes reduced
the efficacy of the communication in Blackboard.
P Room*, A H J Dierssen and F G M Kroese (FMW RuG, Department
for Educational Development and Quality Assurance, Faculty of
Medical Sciences, University of Groningen, Ant. Deusinglaan 1,
9713 AV Groningen, NETHERLANDS)
Working in PBL-tutorials is the backbone of the Groningen
Medical Curriculum. Small groups (7/8 students) reflect
on patient presentations and analyze study tasks related to
the patient problems. Study tasks are assessed in oral
examinations. All activities and results are drawn in a
logbook. In 2002 the course management program
Blackboard was introduced in the medical curriculum and
50% of the tutorial rooms was equipped with ICT facilities
(PC and beamer). The effect of Blackboard on the learning
process and communication in the tutorials was
investigated. First results of the evaluations among students
and teachers indicate that both groups appreciate working
with Blackboard. The cooperation among members in the
tutorials was stimulated, the quality of the presentations
and study tasks improved. No significant differences were
found in the results of the written and oral examinations of
students in the groups using Blackboard or not.
Furthermore, the study reveals that special attention should
3I 2
CAMPUS-Pediatrics: a flexible, interactive, caseoriented, web-based training program for multipurpose use in pediatric medical education
S Huwendiek*, S Koepf, B Hoecker, R Singer, F J Leven, G F Hoffmann
and B Toenshoff (University Children’s Hospital Heidelberg, Im
Neuenheimer Feld 150, D-69120 Heidelberg, GERMANY)
Creating an effective problem-based learning environment
for small groups can be both expensive and timeconsuming. A properly designed case-oriented, web-based
training system will help to develop, organize and reuse
well-structured multimedia cases in a flexible way. The
CAMPUS educational computer program addresses these
requirements by covering the needs of different user groups
in different application scenarios (e.g. self-study, learning
group, examination) to get the maximum benefit of
integrated medical cases. Various degrees of interactivity
– 4.33 –
Section 4
during case presentations can be chosen. The most
interactive form is ideal for students to learn basic clinical
skills and problem solving competence. Here the user
cares for his patient in a virtual Children’s Hospital by taking
a full medical history, ordering all required physical,
laboratory or technical examinations and making
diagnostic and therapeutic decisions. Less interactive
presentation forms are suitable for continuing medical
education and other types of training where it is not
desirable to overburden the user. It is planned within the
collaborative project CASEPORT to set up a
comprehensive learning and teaching platform for
paediatrics on the web that can be accessed by all medical
faculties. Taken together, CAMPUS-Paediatrics is a
valuable and flexible supplement to traditional teaching
methods in paediatrics.
3I 3
time used for the first session was evaluated as appropriate
by ten groups, whereas one group considered the case
took too much time to complete. Nine groups felt that the
number of videos used was appropriate, whereas two
groups found that there were too many videos.
Conclusions/take home messages: PBL-cases presented
on intranet may offer pedagogical advantages. The faculty
has decided that from the fall 2003, all PBL-cases shall be
available on intranet.
3I 5
F Ruderich*, R Faber, C Göggelmann, C Roth, C Nikendei, D
Schellberg, R Singer, S Riedel, F J Leven, J Jünger (University of
Heidelberg, Medizinische Universitätsklinik und Poliklinik, Innere
Medizin II, Bergheimer Strasse 58, D-69115 Heidelberg,
GERMANY)
DIPOL-Edit – a new system supporting the WWWbased delivery of course content at Dresden
Medical Faculty
In classical problem-based small group learning (PBL),
students work with paper sheets. We investigated the
introduction of working with a computer within PBL, which
makes the cases come alive due to working with
multimedia-based elements. An evaluation of paper sheet
versus computer-aided PBL with 135 students of internal
medicine was carried out. Over a period of ten weeks the
students worked in small groups alternatively dealing with
five cases on paper sheets and five cases on computer
using the simulative learning software CAMPUS. The data
of the CAMPUS-cases were projected onto a wall, while
one specially instructed student ran the computer. At the
end of the term students’ opinions about the two kinds of
small-group learning were evaluated. The majority of the
students refused the computer-aided small-group learning.
The main argument was that the computer would disturb
the communication within the group. On the other hand,
some students favoured the integration of multi-media
based elements and the possibility of the connection with
self-study by using CAMPUS. Therefore, in the next term,
we are offering it again to volunteers and will compare the
new data with the present results.
Oliver Tiebel*, Katja Liesebach, Annett Mitschick, Michael Balzer,
Rene Lange, Matthias Hinz, Ronny Hesse, Gabriele Mueller and
Hildbrand Kunath (Institute of Clinical Chemistry & Laboratory
Medicine, Medical Faculty Carl Gustav Carus, TU Dresden,
Fetscherstr 74, 01307 Dresden, GERMANY)
In order to prepare physicians for the changing demands
of future developments in medicine, the Dresden Medical
Faculty is restructuring its curriculum by implementing
elements of problem-based learning. From the early days
of the reform process the faculty worked on the creation of
a web based system for support of the PBL courses. At the
beginning of the reform - with a limited number of courses
- it was very easy to satisfy all course-organizers with an
adequate course-webpage.
However, with a growing number of courses throughout
the curriculum it became a nearly unmanageable
endeavour to provide sufficient support. In cooperation with
the Institute for Software and Multimedia Technology at
Dresden Technical University a maintenance-tool for this
system was designed and created, which seems easy
enough to be handled by faculty members without any
knowledge of programming and database management.
The result is a MySQL-based System using HTML, PHP
and JavaScript called DIPOL-Edit. This Editor enables
nearly everybody to create and maintain webpages by
themselves. It is the basis of future implementations for
collecting evaluation data, self-assessment tools and a
communication tool supporting the transfer of information
between the faculty and affiliated teaching hospitals.
3I 4
“Don’t disturb my circles” – or the use of the
computer in problem-based small group learning
3I 6
Problem based learning on the Web – an outreach
to Norwegian medical students abroad
Roar Johnsen*, Toralf Hasvold, Karin Straume, Zoltan Tot and Geir
Jacobsen (Norwegian University of Science and Technology
(NTNU), Medical Faculty, NO 7489 Trondheim, NORWAY)
Aim: Before internship registration, Norwegian graduates
from foreign universities must document skills in national
health legislation, organisation and economy. To meet this
requirement we organised a problem based learning
course, web-based, and with use of MEQ in groups.
Cases in problem based learning (PBL) presented
on intranet
Summary of work: Goals were defined for four separate
modules that focus on aspects of regular medical practice.
All information may be accessed from relevant web-sites.
Hence, no textbooks are deemed necessary. Challenges
are presented as cases with combinations of live and still
captions and written text. Groups of 6-8 students throughout
Europe and Australia and a tutor communicate via a closed
web forum. Each clinical scenario requires group answers
to learning objectives defined by the students under tutor
supervision. Several individual assignments are also
required. A final one week seminar includes a visit to a
district health centre and an individual written exam.
Torstein Vik and Andreas Haaland* (Norwegian University of
Science & Technology, Department of Community Medicine, Faculty
of Medicine, Medical Technical Center, Olav Kyrres gt 3, N-7489
Trondheim, NORWAY)
Aim: To study if PBL-cases presented on intranet may offer
pedagogical advantages.
Summary of work: The case, including 8 videos of gait and
neurological examination of a child with cerebral palsy,
each video lasting approximately 15 seconds, was
presented to second year medical students. MR images of
the brain and a brief case history were also presented.
Students were supposed to choose learning goals in
neuroanatomy and neurophysiology.
Summary of results: Twenty students completed the course
successfully. They found challenges relevant, tutor feedback adequate, workload greater than expected, and
technical solutions suboptimal. The seminar was a must
for the positive outcome.
Summary of results: At the second group meeting 11 groups
(8 students and one facilitator in each) evaluated the
functionality of the learning management system in use as
fair. However, the pedagogical gain of the case was
evaluated as being ‘considerable’ (five groups) or ‘much’
(six groups) compared with traditional paper cases. Ten
groups wanted more cases presented on intranet. The
Conclusions/take home messages: Undergraduates
abroad may benefit from medical problem solving in groups
via the web, even when prior subject knowledge is limited.
– 4.34 –
Section 4
Session 3J: The Progress Test
3J 1
Progress testing of two different medical curricula at
one faculty – preliminary results
Summary of results: Each student cohort improved on their
previous average (p=.004). Moreover, during each round
of testing, senior students scored higher than less senior
students ({year 4 > year 3, p = .045}, {year 5 > year 3, p =
.002}, {year 5 > year 4, ns}).
K Duske*, S Fuhrmann, S Hanfler, J Hoffmann, S Koelbel, D Mueller,
Z Nouns, P Wieland, S Zacharias and A Mertens (Charité Berlin,
Progress Test Medizin, Zahnklinik, Schumannstr. 20/21, 10117
Berlin, GERMANY)
5 Tests 5 Exam Taking Cohorts
At the Medical Faculty Charité in Berlin, a PBL-based
reformed medical curriculum was started in 1999 parallel
to the traditional German curriculum. In 2002 a mandatory
progress test was integrated in the traditional curriculum
as well, which gave us the chance to compare students’
progress. Each progress test consists of 200 one-bestanswer MCQ, reflecting the level of knowledge at the time
of graduation. The test is performed once per semester.
Preliminary results show significant difference in the
increase of correct answers over the first 4 semesters of
medical studies, favouring the PBL-course. The
presentation will discuss possible causes and emphasize
the problems in comparing two different curricula.
3J 2
1997 1998 1999 2000 2001
3J 4
Test 3 Year4 Jan
45.3 49.6 35.8 42.0 42.3
Test 4 Year4 Jun
41.9 57.9 45.1 51.7 48.2
Test 5 Year5 Jun
63.9 51.9 55.8 57.7
Towards a joint progress test: more quality for less
Euros
An important factor in high quality assessment is the
incorporation of quality control measures in the test
production by means of test review panels. These panels,
however, are quite expensive, because careful screening
of items is time consuming. A seemingly simple method to
lower the costs would be by establishing inter-institutional
co-operation in test production. In 1999 the medical
schools of Groningen, Nijmegen and Maastricht have
decided to join forces and construct an interfacultary
progress test. The Progress Test is an integrated factualknowledge orientated test of which the blueprint is based
on the Dutch National Blueprint for the medical study. The
test is administered four times per year, and all medical
students of all year classes of the three faculties sit this test
simultaneously. The benefits of this collaboration are
beyond the financial aspects, they include better quality
control, an improved sharing of experiences and more
multicentre research. Precautions are careful drawing of
contracts, building an item bank capable of storing items
and test results of different centres, and good care to
maintain a sense of ownership by all the partners.
Does Maastricht-style progress testing work in the
UK? The Manchester Experience
G K Mahadev*, A C Owen, P A O’Neill and G J Byrne Manchester
University, South Manchester University Hospitals Trust, Atrium
4, Education and Research Centre, Wythenshawe Hospital,
Southmoor Road, Manchester, UK)
Aim: The progress test, developed in Maastricht, examining
knowledge acquisition across the undergraduate medical
curriculum has been a benchmark for the Manchester
clinical undergraduate curriculum since 1997. We
hypothesized that in Manchester each undergraduate
cohort would perform better on each successive test, and
that senior students would score higher than less senior
students.
43.3 32.0 44.9 32.4 39.7
J Cohen-Schotanus*, L W T Schuwirth, D J Tinga, A J N M Thoben
and C P M van der Vleuten (Institute for Medical Education (OWIOK), Faculty of Medical Sciences, University of Groningen, Ant.
Deusinglaan 1, 9713 AV Groningen, NETHERLANDS)
In 1999 a new 6-year medical curriculum was introduced
at the University Medical Center Utrecht. In 2002/03 a
progress test was initiated in year 4, meant to be taken
twice yearly in year 4 and 5. The test consists of 40 cases,
each with a clinical and a biomedical short-answer key
feature question. The test focus is on core knowledge,
emphasising clinical reasoning. The test differs from the
Maastricht Progress Test in the use of open-ended
questions, the philosophy of mastery level testing and the
deliberate linking of biomedical concepts to clinical case
vignettes. Analysis of the first test results shows a high
internal consistency (Cronbach’s alpha 0.87) and
satisfactory item parameters. The effort of marking answers
is reasonable, the effort of writing case vignettes with shortanswer items is far less than writing MC-items if similar
test reliabilities are to be achieved. The process of blueprint
construction, rigorous question design, quality procedure
and marking of answers will be discussed.
3J 3
33.1 31.0 30.3 20.4 24.5
Test 2 Year3 Jun
Conclusion: When used in Manchester, progress testing
demonstrates that on average cohorts improve on
performance over the three clinical years of the problem
based undergraduate medical curriculum.
Progress testing with short-answer questions
J Rademakers*, Th J ten Cate, P R Bär and J M M van de Ridder
(UMC Utrecht, Onderwijsinstituut, Postbus 85060, (Stratenum
0.304), 3508 AB Utrecht, NETHERLANDS)
Test 1 Year3 Jan
3J 5
Cross-institution comparison of student
achievement using a progress test
A M M Muijtjens*, J Cohen-Schotanus, A Thoben, M M Verheggen
and C P M van der Vleuten (University of Maastricht, Department
of Educational Development and Research, Faculty of Medicine,
PO Box 616, NL-6200 MD Maastricht, NETHERLANDS)
Aim: To discuss test score differences for three medical
schools taking the same progress test.
Summary of work: A retrospective analysis of progress test
performance for five clinical undergraduate student
cohorts of the Manchester clinical curriculum years
between 1997 and 2001 (n=1947) was performed. Each
student took five progress tests over the three clinical years
of the MBChB course. Each progress test consisted of 250
True/False questions representative of the 4 taught
modules within the problem-based curriculum. For each
student cohort, mean and standard deviations were
calculated and mean scores compared (students t-test).
Summary of work: Three Dutch medical schools
(Universities of Maastricht, Nijmegen, Groningen)
cooperatively constructed a progress test that is taken four
times a year by all medical students. Each test consists of
250 true/false items that may concern any medical subject.
Average test scores for students of different classes indicate
growth of medical knowledge, and the effects of different
curricula may be compared. Knowledge growth is
measured at 24 moments (six classes, four times a year).
– 4.35 –
Section 4
Summary of results: For academic years 2000-2001 and
2001-2002 average scores (% correct-incorrect) increase
from 6 to 33, resp. 4 to 32 for moments 1 to 24. Between
university differences were statistically significant at 14 resp.
9 moments, the highest mean score being 10, 9 resp. 4
times obtained by Maastricht, Groningen resp. Nijmegen.
decrease, and b) Maastricht results tend to be the highest.
However, at this stage the majority of test items is
contributed by Maastricht staff, which might be
advantageous for the Maastricht results. This imbalance
complicates the interpretation of the differences, but it
certainly will encourage the staff of Nijmegen and
Groningen to increase their item production.
Conclusions/take home messages: The results indicate
that a) test score differences between universities tend to
Session 3K: Clinical Teaching and the Patient
3K 1
The gynecological patient in a teaching session
of the traditional curriculum.
Mette Haase Moen (Norwegian University of Science and
Technology, Faculty of Medicine, St Olav’s University Hospital,
Department of Obstetrics and Gynecology, 7006 Trondheim,
NORWAY)
Conclusion/take home messages: Curriculum changes
promoting communication and basic clinical skills are
highly effective and lead to an improved practical education
of tomorrow’s physicians.
Aim: To report how female patients can be motivated to
participate in the training of medical students performing
pelvic examinations.
3K 3
Summary of work: 136 women referred to the gynecological
outpatient clinic were by a letter invited to take part in a
teaching session. They were informed that a medical
student should perform the pelvic examination together
with the senior lecturer. A questionnaire was enclosed by
which they could explain why they agreed to participate or
why they refused.
Linda Kragelund (The Danish University of Education and The
Psychiatric Hospital of the County of Roskilde, Roskilde Amts
Sygehus Fjorden, Smedegade 10-16, DK-4000 Roskilde,
DENMARK)
The aim of the presentation is to study the following
questions:
1 How do student nurses learn psychiatric nursing in
practice?
2 Which learning opportunities do they have during their
training period in psychiatry?
3 Which learning processes give them the best
possibilities to reach the objectives for training in the
psychiatric ward?
Summary of results: The response rate was 97% (132 of
136). 113 (85.6%) accepted the invitation, but 26 (23%) of
them asked for a female student. 19 (14.4%) refused to
participate. In the same period 415 women were ‘in the
door’ asked to permit a medical student to take part in the
consultation. In this group 100 (24.1%) refused, and this is
significantly higher than the 14.4% refusal rate among the
women who were invited by a letter (p<0.02). With this
experience we have later composed a letter of invitation
sent to women selected for this teaching outpatient clinic
and only about 10% refuse to take part.
In the nursing profession an essential part of education
takes place in practice. Interaction (relations) and
communication is a major part of professional practice.
Based on a pilot project studying learning opportunities for
nurses in psychiatry, I will present empirical material
derived from interviews with students and through
participant observation. I am using a model of learning
processes developed by a Professor in Continuing
Education, Peter Jarvis. Through the field observation I
will try to delineate potential learning opportunities and
circumscribe factors that may have an effect on the student
nurses’ learning processes. The pilot study is a preparation
for a larger scale study that will be briefly outlined in order
to receive feedback for further planning. Answers to the
questions might make it possible to draw up guidelines for
learning processes that qualify clinical learning as a part
of education for bachelor degree professions.
Conclusion/take home messages: An explanatory letter with
the possibility to refuse may motivate the women to accept
the presence of a medical student actively taking part in
the gynecological consultation.
3K 2
Effectiveness of communication and basic clinical
skills’ curriculum in internal medicine
C Nikendei*, C Roth, A Zeuch, S Schäfer, M Benkowitsch, B Auler,
D Schellberg, W Herzog and J Jünger (University of Heidelberg,
Medizinische Universitätsklinik, Abteilung fur Allgemeine
Klinische Medizin und Psychosmatik, Bergheimerstrasse 58,
69115 Heidelberg, GERMANY)
Aim: The aim of curriculum changes in medical education
is to improve the students’ clinical and social skills.
However, there are contradicting results regarding the
effectiveness of measures taken.
Bachelor degree profession and learning in practice
– student nurses’ learning and development of
competence in psychiatric practice
3K 4
Early student-patient interactions: the views of
patients regarding their experiences
Summary of work: A study of internal medicine students
was implemented in a two term group-control design. The
intervention group, consisting of 77 students, participated
in seven lessons of communication training, seven lessons
of skills-lab training and seven lessons of bedside-teaching.
The control group of 66 students had equally as many
lessons but was only offered bedside-teaching. Students’
cognitive and practical performance was assessed with a
MC-test and an OSCE with blinded examiners.
JE Thistlethwaite* and E A Cockayne (University of Leeds,
Academic Unit of Primary Care, 20 Hyde Terrace, Leeds LS2 9LN,
UK)
Summary of results: The intervention group had a
significantly better OSCE performance (p<0.0001) than the
control group, whereas both groups did not differ in their
results of the conducted MC-test (p<0.15). This indicates
that specific training in communication and basic clinical
skills enables students to perform better in an OSCE,
whereas its effects on knowledge do not differ from those
Summary of work: A questionnaire was sent to 120 patients
who have been interviewed during the last four years. We
asked patients what they felt about the process of being
interviewed, what they understood was the purpose of the
exercise, if they felt they had benefited in any way from the
interview, whether they had any worries about the process
and if they could suggest any improvements in the course.
Aim: To investigate the attitudes of patients to being
interviewed by first year medical students during the
Personal and Professional Development (PPD) course.
One aim of these interviews is to help students to begin to
gain an insight into a patient-centred approach.
– 4.36 –
Section 4
Conclusion/take home messages: Trust and mutual
respect were positive outcomes of our setting of combined
training of technical and communication skills. As the
students reported themselves: “It will certainly help us in
our future careers.”
Summary of results: There was a 75% response rate. The
majority of respondents felt they had benefited themselves
from the process (82%), describing the experience as
useful and interesting. However only a third thought the
interview was stimulating. Some students were classified
as ‘boring’ if they did not talk much during the interview.
Conclusions/take home messages: Patients enjoy being
involved in the early education of medical students. As
patients prefer students to be well prepared it is important
that the students are adequately briefed before the exercise.
3K 5
3K 6
Enhancing reflection in communication skills
training with simulated patients
Eeva Pyörälä* and Anni Peura (University of Helsinki, Research
and Development Unit for Medical Education, PO Box 63, 00014
Helsinki, FINLAND)
Training in intimate physical examinations: a
challenge at the University of Antwerp
Aim: This paper suggests enhancement of different levels
of reflection (reflection-in-action, reflection-on-action,
reflection-for-action) in communication skills training.
K Hendrickx*, B De Winter, B Selleslags, L Debaene, F Mast, W
Tjalma, P Buytaert and J J Wyndaele (Skillslab, University of
Antwerp, 2610 Wilrijk, BELGIUM)
Summary of work: In the Faculty of Medicine in Helsinki,
Finland, a communication skills study programme was
started in 1994. New, innovative methods of learning such
as patient simulations with professional actors were
adopted, and have since then become an established part
of the curriculum. The courses with simulated patients
are today among the most popular courses in the faculty.
After each patient simulation a feedback discussion follows.
Instructions for giving and receiving constructive feedback
have been given to the teachers, actors and students. In
order to further develop the communication training with
simulated patients we suggest enhancement of the
different levels of reflection in these studies: first, to expand
the practices of reflection in feedback discussions; second,
to promote reflection across the learning situations in order
to support the learning processes; third, to activate the
teachers’ reflection while planning and developing the
courses.
Aim: Teaching intimate physical examinations in medical
schools generates practical, didactical and ethical
problems. We created a “safe” environment where fifthyear undergraduates can learn these skills in healthy
volunteers. Technical, communicative and attitude
aspects are taken into account.
Summary of work: Twenty volunteers were trained as
Intimate Examination Assistants (IEAs) to serve both as
patient and teacher after 8 hours of training. Medical staff
was trained in supervising and coordinating. The students
trained in the technical skills first on manikins. Students
performed three sessions (urological, gynaecological,
breast). Each setting consisted of two students, one IEA
and one doctor. Students, IEAs and supervisors had the
opportunity for immediate feedback. Attention was focused
on personal attitude, technical and communication skills.
Conclusions: Enhancing reflection is a challenge for
modern communication skills training. Reflection is a multilevel process which takes place before, during, after and
across the simulations, the courses and the entire
curriculum.
Summary of results: The program was evaluated at 3 levels
(students, IEA, supervising staff) by questionnaires, personal
reflections and round-table conferences. The results show
a very positive appreciation of the training. The feedback
moments were of utmost importance for mutual
understanding and appreciation. Workload and costs were
considered heavy but rewarding.
Session 3L: Professionalism (1)
3L1
Experiences of medical students with regard to
aspects of ethics, cultural awareness and legal
issues (ECL) during clinical rotations
between the E.C.L. aspects and the quality of training were
positive but rather weak (below 0.5), yet significant.
Conclusions: The students in the clinical phase lack basic
experiences, important for their professional life as
physicians. It was noted that especially during General
Surgery, students’ ethical behavior (i.e. preserving patient
privacy and asking for informed consent), should be
monitored. The relationship between the quality of training
especially of their role models - the department head and
the tutor – to E.C.L behaviors should be further studied.
Netta Notzer*, Roni Dadao-Harari, Henri Abramowitz and
Avraham Rudnick (Sackler Faculty of Medicine, Tel Aviv University,
ISRAEL)
Background: In most medical schools professional aspects
of medicine are formally being taught during pre-clinical
training. However, they are needed most in the clinical
phase. In this study we looked at students’ actual
experiences – exposures and involvement with common
behaviors, emphasizing respect for patient autonomy,
beneficence/non-maleficence and justice, as well as legal
and cultural awareness.
3L2
Laying the foundation for professionalism – case
presentations in the first year of study
Brigitte Grether (Faculty of Veterinary Medicine, University of
Zurich, Winterthurerstrasse 204, CH 8057 Zurich,
SWITZERLAND)
Aims: The aims of this study are: 1) to assess the extent of
medical students’ experiences with E.C.L. during the
clinical training, 2) to compare experiences across clinical
rotations, i.e., Internal Medicine and General Surgery. 3) to
examine the relationship between students’ experiences
to students’ reports on the quality of their clinical training.
Summary of work: A questionnaire was circulated (18 items
on 4 point scale) to students at the end of the clinical
rotations during 2002. 175 students (85%) responded.
In the general opinion of many medical educators, small
group sessions are the most adequate way to teach
attitudes and professionalism. A low cost but high impact
project in Veterinary Medicine showed that this is not always
the case. A weekly series of clinical case presentations for
students who just had started their course of study was
performed and evaluated. In spite of the high number of
students, the lessons were highly interactive. The students
appreciated the encouraging atmosphere and the
occasion to activate their previous knowledge. Not only
did they consider the course highly motivating, but they
Summary of results: The majority of the items scored below
3.00 (out of 4.00). The Internal Medicine students scored
their exposure in most aspects significantly higher than
those of the General Surgery students. All correlations
– 4.37 –
Section 4
also declared that they had learned a lot about professional
attitudes, e.g. the importance of systematic approach to
clinical cases, ethical and monetary considerations, and
“the way vets feel” when they manage a case and deal with
dilemmas. We think that from interacting with the lecturers
when solving a case, students benefit even more than from
periods of practical training where they spend most of their
time watching the vet and occasionally lending a hand. It
is also a means to make the most of the transitory phase
when students change from high school to university to
convey professional attitudes and values.
3L 3
beginning we introduced the definition of professionalism.
After ice-breaking, participants were divided into 8 small
groups. Each group discussed the strategy of how to
develop professionalism among medical students using
KJ (Kawakita Jiro) method. After one hour of group work,
all participants gathered together again. Each group was
given 3 minutes to present the product from each group
discussion.
Summary of results: The strategy to develop professionalism
for medical students includes: good teacher as role model,
early exposure to clinical setting and community health
service, more introduction of PBL, improvement of
admission policy to medical school, increase in the
number of medical teachers in each medical school, and,
paradoxically, encounter with bad teachers. The barrier to
the development of professionalism is the teacher’s
indifference to medical education, immaturity of medical
students and poor resource including shortage of teachers,
and unsatisfactory budget.
Gross anatomy curriculum as a framework to teach
professionalism
Wojciech Pawlina*, Thomas R Viggiano and Stephen W Carmichael
(Mayo Clinic, Mayo Medical School, Department of Anatomy, 200
First Street SW, Stabile Building 9-38C, Rochester MN 55905,
USA)
Rise of managed care and corporate transformations of
the health care system threaten to undermine the
professional behaviors of physicians. Erosion of
professionalism in medical educators has a negative
impact on medical students. Students’ behaviors are
influenced by role models in many different disciplines.
Currently, almost 90% of medical schools offer formal
activities to teach professionalism. For most students, initial
contact with professional role models occurs during the
gross anatomy course. The gross anatomy course provides
the first opportunity for students to reflect on altruism through
the gift of the human body that is assigned to them.
Experience of working in a small dissection group allows
students to develop skills in cooperative learning,
communication and team building. As they participate in
team dynamics, students learn to observe and evaluate
professional behavior in their classmates. The Mayo
Medical School gross anatomy faculty has created an
environment in which professionalism is acknowledged,
evaluated, and rewarded while unprofessional behavior
results in negative consequences. In the medical
curriculum gross anatomy should be viewed not only as
the basic science course to teach structure of the human
body but also as the first attempt to teach professionalism
to students entering the medical profession.
3L 4
Conclusion/take-home message: FD is a good tool to
develop professionalism.
3L 5
Are our tutors promoting professionalism through
their behavior?
Pedro Herskovic*, Eduardo Cosoi, Jocelyn Manfredi, Karen
Sepúlveda Paola Contreras, Esteban Muñoz, Roberto Verdugo,
Verónica Fuentes and Anabella Aguilera (University of Chile,
Medical School, PO Box 13898, Correo 21, Santiago, CHILE)
Aim: Professionalism is taught formally and informally. A
six week clerkship in a pediatrics outpatient clinic was
used to explore how our students perceived their tutors
practised professionalism.
Summary of work: Seven groups of students, with their tutors’
knowledge, rated weekly if they had observed them
practising the criteria of the Amsterdam Attitude and
Communication Scale: 1. Courteousness and respect, 2.
Adequate information gathering, 3. Adequate information
giving, 4. Handling emotions, empathy, 5. Structuring
communication, 6. Insight into one’s own emotions, norms,
values and prejudices, 7. Adequate cooperation with nurses
and colleagues, 8. Knowing one’s own limits, willingness
to critically assess one’s own behavior, adequate handling
of feedback, 9. Display of dedication, sense of responsibility
and engagement.
How to develop professionalism in medical education:
the Faculty Development approach
All ten tutors that supervised students were rated.
Ichiro Yoshida* and Kazuhiko Fujisaki (Office of Medical Education,
Kurume University, School of Medicine, 67 Asahi-machi, Kurume
City, 830-0011, JAPAN)
Summary of results: Six exhibited all the expected attitudes
during their time with students. Five exhibited, at least once,
attitudes opposed to the desirable competences: lack of
courteousness, inappropriate handling of emotions, lack
of insight into own emotions, lack of cooperation with
nurses and colleagues and lack of knowledge of own limits.
Since students were supervised by two tutors, all were able
to see all the competences being practised.
Aim: Professionalism is a very important concept and
outcome in medical education. However, the strategy to
develop professionalism and assessment of
professionalism is still not popular in Japan. To develop
professionalism in undergraduate medical education, we
held faculty development (FD) on professionalism.
Conclusion/take home message: There is room for
improving the informal teaching of professionalism.
Summary of work: Forty-nine participants from throughout
Japan, including medical students, attended the FD. At the
Session 3M: The Core Curriculum
3M 1
Physicians’ and basic scientists’ opinions about the
required depth of biomedical knowledge for medical
students
Summary of work: A sample of basic science (N=11) and
clinical teachers (N=20) at the University Medical Center
Utrecht, The Netherlands, rated to what extent students at
graduation should have active, passive or no knowledge at
all about biomedical topics. Respondents rated 80
biomedical questions. The questions were derived from
ten organ systems and aimed at four levels of knowledge:
clinical, organ, cellular and molecular.
Franciska Koens*, Eugène J F M Custers and Olle Th J ten Cate
(School of Medical Sciences, University of Utrecht, Universitair
Medisch Centrum, Stratenum 0.304, Onderwijsinstituut
Geneeskunde, AB Utrecht, NETHERLANDS)
Aim: Do physicians and basic scientists agree on the
required depth of biomedical knowledge graduating
medical students should possess?
Summary of results: Analysis revealed that basic science
and clinical teachers agree upon medical graduates’
– 4.38 –
Section 4
required knowledge at the clinical level, but at the organ,
cellular and molecular levels, basic science teachers judge
that more knowledge is required than clinical teachers do.
As expected, both groups consider active knowledge
increasingly less necessary at the organ, cellular and
molecular level, respectively.
Conclusions: Two possible explanations for these results
are suggested: either basic science teachers have less
insight into the depth of knowledge medical graduates
should have to become a physician, or clinical teachers
are more willing to accept shallow biomedical knowledge
from graduates.
3M 2
by feedback and discussion. Scenarios of the role-plays
related to topics such as: Dealing with angry or anxious
patients or family members; breaking bad news; enhancing
patient compliance. At the end of each workshop,
participants evaluated it. Results of this evaluation, which
reflected high appreciation of the workshop, will be
presented.
3M 4
Ann Wylie (Guy’s, Kings and St Thomas’ School of Medicine,
Department of General Practice and Primary Care, 5 Lambeth
Walk, London SE11 6SP, UK)
Incorporation of ability-based pharmacology
education in an integrated medical school curriculum
Aims: This paper argues that health promotion, as an
integral aspect of medical undergraduate curricula,
presents a challenge to curricula developers, in contrast
to the other newer themes such as communication skills.
By applying a working definition of health promotion, based
on an ethnographic study, learning outcomes relevant to
medical undergraduate curricula can be developed.
K L Franson*, E A Dubois, J M A van Gerven, J H Bolk and A F Cohen
(CHDR, Zernikedreef 10, 2333 CL Leiden, NETHERLANDS)
Aim: To develop an abilities-based method of teaching
clinical pharmacology that is incorporated throughout an
integrated curriculum.
Summary of work: The ethnographic study, conducted
between 1997-2000, involved three groups of protagonists,
namely health promoters, medical educators and a
selected group of medical students, who participated in a
health promotion special study module. Multiple qualitative
methods were used. The framework for the study involved
questions about the rationale, anticipated outcomes,
content and level of health promotion teaching; what are
the theories, the skills and evidence base relevant to health
promotion; and how can they be integrated into curricula,
which is assessment driven?
Summary of work: Five ability outcomes (understanding
pharmacological mechanisms; understanding
pathophysiological mechanisms; critically analyse drug
indications based on pathophysiology; selecting therapy;
and monitoring therapy) were identified and assigned
levels by the clinical pharmacology group. Self-study
learning strategies and assessments by which the students
could practise and evaluate their performance of the
outcomes were developed. The strategies were offered to
course co-ordinators and included active learning and
computer database programs as well as patient evaluation
and plan writing assignments.
Summary of results: Interpretative data analysis suggested
that health promotion is a contested field but a pragmatic
definition is embedded in the data, enabling concepts
familiar to health promoters to be explored within the
context medical education.
Summary of results: After two years, at least one of the
outcomes was incorporated into 60% of the curriculum.
The lowest level outcome of pharmacological
understanding was adopted in 100% of these blocks.
Higher level outcomes and assessments, which include
the ability to select and monitor drug therapy based on
pharmacotherapeutic principles was incorporated in 47%
of the blocks. Student evaluations have been positive
regarding the learning strategies and indicated a
preference for higher level assessments and integration.
Conclusions/take home messages: By developing and
using learning strategies that consistently focus on selected
outcomes, we are able to successfully incorporate clinical
pharmacology education throughout the integrated
curriculum.
3M 3
Health promotion in medical undergraduate
curricula: its relevance may depend on definition
Conclusions/take home messages: The paper argues that
health promotion can be relevant to undergraduate
curricula, if this working definition is applied, and discusses
suggested learning outcomes.
3M 5
Role definition, task analysis and educational needs
assessment of general practitioners in Islamic
Republic of Iran
Shirin Niroomanesh, Haboballah Peirovi and Shahram Yazdani*
(Shaheed Beheshti University of Medical Sciences and Health
Services, Tabnak Street, Shaheed Chamran Avenue, Evin, 19395
Tehran, IRAN)
Effective communication: an essential component of
professionalism
Information overload, increased complexity of the health
system, the rising cost of healthcare, the altered pattern of
disease burden, emerging diseases, globalization, the postrevolution baby boom, increasing attention to quality of care,
more market orientation and emerging technologies
predict a basically different future environment for the
health system in I. R. Iran. Therefore healthcare providers
including general practitioners should assume new roles
(e.g. manager, community leader, gatekeeper etc) to cope
with requirements of the new environment. Undertaking
these new roles requires new knowledge, skills and
competencies that should be considered in the
undergraduate medical education (UME) curriculum. This
article is the progress report of a joint project between (1)
Educational Deputy of Ministry of Health and Medical
Education, (2) Shaheed Beheshti University of Medical
Sciences, and (3) Management and Planning Organization
of I.R. Iran. In this national project, requirements and needs
of the health system are connected to educational
objectives of the UME program through a sequential
process of community needs assessment, role definition,
task analysis and educational needs assessment.
Hannah Kedar (The Hebrew University, Hadassah Faculty of
Medicine, Centre for Medical Education, PO Box 12272, Jerusalem
91120, ISRAEL)
Background: In recent years, the dialogue between
physicians and patients has undergone some major
changes. Most notably, patients and/or their families search
the internet and come up with questions and doubts; and
more often frustrated patients react to health professionals
in an aggressive manner. The competent physician must
develop awareness as well as specific techniques for
dealing with patients demonstrating these behaviors. In
addition, the contemporary focus on patient-centered
approach requires physicians to improve their effectiveness
of history taking and attainment of patient compliance. In
light of the growing emphasis on “professionalism” in
medicine, the present paper suggests a model for teaching
empathic communication.
Summary of work: Residents were offered a 1½ day
workshop, consisting of 3 parts: (a) Recording of personal
experiences of difficult encounters with patients or their
family members. (b) Presenting the model of empathic
communication. (c) Role-plays by the participants followed
Different stages of the project, the problems confronted
and initial results are discussed.
– 4.39 –
Section 4
Session 4: Workshops 1 (including two large groups)
4.1
‘A doctor who knows only Medicine, doesn’t even
know Medicine’ Teaching ethics and attitudes: a
global challenge for Medical Education
4.2
Background: Assessing students’ work is the most important
thing we do for them – however, students can escape bad
teaching, but they can’t escape bad assessment! (David
Boud). Also it takes us a great deal of time and energy to
get it right. This workshop will explore the premise that our
assessment is ‘broken’ – overloaded, not always as valid
or reliable as it should be, and with students often not
knowing where the goalposts are. More importantly, the
workshop will look at ways of ‘fixing’ assessment – in other
words making it more ‘fit for purpose’ and more
manageable for our students and ourselves.
Madalena Patrício (Faculty of Medicine, University of Lisbon, Av
Prof Egas Moniz, Piso 1, 1649-028 Lisbon, Portugal)
Background: Back in the sixties Bloom organized learning
into three main domains: the cognitive, the psycho-motor
and the relational concerning attitudes and values. Forty
years later I wonder how many Medical Schools include in
their curriculum the dimension of values and attitudes that
should be the framework of good practice besides the
necessary techno-scientific bio-medical knowledge. Some
studies conducted last year in our Faculty indicate that
medical students do not always value these types of
competencies. They show that students strongly value the
material aspects in professional career decisions and the
instrumental qualities in the ideal teacher. The concern
with the development of ethical attitudes in medical
students is, we believe, of major importance. Emphasis on
teaching attitudes may be one of the “turning points” in
medical education with the value dimension walking side
by side with the techno-scientific competencies. As Abel
Salazar (1889 -1946), a great professor of the University of
Oporto, already said, “a doctor who knows only Medicine
doesn’t even know Medicine”.
Objectives: By the end of the workshop, you should be better
able to:
• recognise the problems of the status quo regarding
assessment – and accept that it is not very healthy!
• explore how to make assessment more valid, reliable
and transparent to students.
• find ways of involving students in their own, and each
others’ assessment.
Proposed structure:
• Group brainstorm – symptoms of our ‘diseased’
assessment – and prioritisation of symptoms.
• Presentation – ‘Why is assessment ‘broken’?’
• A short exam (to illustrate some of the things wrong with
exams – and have some fun!).
• Ways forward, including involving students in their own
and each others’ assessment.
• Action planning.
Objectives : (1) to raise the awareness of the importance
of learning-teaching and assessing attitudes in basic
education; (2) to share participants’ experiences in that
field; (3) to identify key messages, plus facilitator factors
and barriers to the learning-teaching of attitudes; (4) to
describe, as a working example, ten years of methodology
of teaching and assessing attitudes in the Discipline of
Introduction to Medicine at the Faculty of Medicine of Lisbon;
(5) to motivate participants to think about the future
development of competencies in that area.
Who should attend:
• Anyone who spends a significant amount of time
designing assessment and/or marking students’ work.
• Anyone who suspects that not all is healthy in the world
of assessment.
• Anyone who is perfectly satisfied with the health of
assessment!
Proposed Structure: A forum of discussion on teaching
and assessing attitudes will be developed with the following
structure.
10m Welcome Introduction to participants
and to the workshop structure
Organizer &
participants
15m Briefing on teaching and assessing
attitudes at each faculty
Brainstorming
20m Learning-Teaching and assessing
attitudes at the FML. Some ideas
with concrete examples just as
as a “starting point”
Short lecture
supported by
power point &
video
30m Identifying priority actions to
undertake in each Faculty: barriers
and facilitator factors
Small Group
Work
20m Report back from groups. Present
situation in each faculty: what is
already done /what is still missing
Group
discussion
10m Synthesis and conclusions. Take
Home messages
Organizer &
participants
Why fix assessment?
Phil Race (Newcastle, UK – phil@phil-race.net)
Outcomes/Take home messages:
• Assessment is really important (not least to students);
• Assessment is becoming much more ‘public’ (if we get
it wrong, we’re ever more likely to be sued!);
• We still have a long way to go to make assessment really
fit for purpose.
• There ARE ways forward!
4.3
Learning in the new job: how to maximise education
opportunities in shifts and other new patterns of
working: an ASME workshop
Frank Smith ASME Secretary & Director of GP Education
Winchester (care of ASME Office, 12 Queen Street, Edinburgh EH2
1JE, UK), Clair du Boulay (Director of Medical Education
Southampton UK), Sarah Blacklock (Education Project Officer
Southampton UK)
Structure is flexible. Participants are free to propose changes if
accepted by the group
Who should attend: All involved with or interested in this
thematic area, including teachers, students, curriculum
experts, medical educators, etc…
Background:The changes imposed on doctors’ hours by
new contracts and the European Working Time Directive
has meant for many the traditional ‘firm’ system of clinical
work has moved to a partial or full shift. This has sometimes
meant the disruption of the traditional apprenticeship role
with a perceived negative impact on learning. How might
education be best managed and delivered for doctors in
training? What new strategies are required by the learner?
Take home message: Attention to learning-teaching and
assessing attitudes is crucial in the curricula of medical
courses. This implies considering concrete actions and
other teaching scenarios, namely teaching in the
community within the perspective of social accountability.
– 4.40 –
Section 4
supervising a student or students engaged in educational
research. These will be explored with colleagues in small
group settings.
Structure: The literature surrounding working patterns and
learning will be briefly summarised and a review presented
of some proposed learning strategies, based on a survey
and a consensus statement from a UK meeting, and an
ongoing project in a large teaching hospital (30 minutes).
Groups will then be set up to discuss the delegates’ own
experiences (40 minutes). A plenary will be held to pull
together the group discussions (20 minutes).
Who should attend: Anyone who is currently supervising
postgraduate dissertations in Medical Education or whose
careers plans may lead to this role in the near future,
Outcomes: The product of this workshop will be an
appreciation of some of the challenges inherent in
supervising students undertaking a postgraduate
qualification in Medical Education, and the development
of a set of guidelines for good practice for both the learner
and the teacher in the supervision process.
Who should attend: Training programme supervisors and
managers; Teachers; Trainees.
Outcomes: Delegates will receive a copy of the literature
review and project synopsis. A synthesis from the workshop
output will be emailed after the conference.
4.4
Depression in clinical practice: educating medical
students and primary care physicians
4.6
Eliot Sorel (School of Medicine and Health Sciences and School of
Public Health and Health Services, The George Washington
University, Washington DC, USA)
Background: Peer is defined as a person of equal social
standing or rank or in the group setting a group of individuals
of similar age. The current emphasis on small group
learning has spotlighted the students’ role in educating
themselves and their peers. However the more formal
involvement of students in teaching each other, especially
in the small group context has not been widely explored.
Depression is one of the most prevalent medical conditions
encountered in primary care in the 21st century. It is present
as a distinct and/or as a comorbid condition. Most patients
in need of care for this condition consult their primary care
physician. Reliable and specific diagnostic tools, as well
as treatment interventions, are currently available, with
effective outcomes, on a par with other medical treatments.
Objectives: The objective of the workshop is to better
understand the place for and value of peer teaching for
medical students. The workshop will draw from participants
their experiences of peer teaching within their own
institutions. The focus will be on the (dis)advantages of
medical students participating in the education of their
peers. Given the dearth of literature on the subject it will be
one of the objectives of the workshop to compile,
electronically, an archive, for participants to use for
reference. Although peer evaluation and mentoring are
important aspects of peer education the workshop will
concentrate the actual instruction and benefit derived by
students from students.
Participants in this workshop will learn about:
1 The epidemiology of depressive disorders
2 Clinical symptoms, signs, and prevalence of depression
in primary care
3 Diagnostic criteria
4 Complementary treatment strategies, including
psychotherapy, pharmacotherapy, patient and family
education
5 Choice(s) of treatment
6 Assessing potential risk to self and/or others
Structure: The workshop will begin with the introduction of
the participants and the facilitators, followed by a brief
resumé of what will and what will not be explored. There
will be a trigger presentation of peer teaching to first year
students by senior students in the field of HIV/AIDS
education at the University of Cape Town. Attendees will
then break into small groups to discuss the following
questions:
• What areas of medical student education are amenable
to peer teaching?
• Are there means of collecting data on the effectiveness
and acceptability of peer teaching?
• Is small group learning actually peer teaching?
• Is peer teaching useful in the learning of communication
or the formulating of attitudes?
• A report back will then draw together the conclusions
and a summary will be made for follow–up distribution
to participants by means of a pre-constructed listserv.
There will be ample opportunity for discussion, questions,
and answers.
4.5
Trials, tribulations and triumphs: supervising a
dissertation in medical education
Lesley Pugsley and Janet MacDonald (School of Postgraduate
Medical and Dental Education, University of Wales College of
Medicine, Heath Park, Cardiff CF4 4XN, UK)
Background: There are ever increasing commitments to
Continuing Professional Development and Life Long
Learning for Health Professionals expressed at the levels
of both policy and practice. These have been matched by
a concomitant expansion of postgraduate courses in
Medical Education and an increase in the numbers of
students undertaking educational research within this
setting. These factors raise a number of issues which need
to be addressed in terms of the roles and responsibilities
of both the tutor and the tutee in this setting.
Objectives: By the end of the Workshop participants will
have:
• Taken part in a highly interactive workshop focussing
on challenges for supervisors in Medical Education.
• Explored dilemmas relevant to this role by means of
case based scenarios
• Identified areas of concern and potential conflict in the
student/tutor relationship
• Formulated a set of working guidelines which might be
applied within a supervisory setting.
Peer teaching
Athol Kent and Trevor Gibbs (Faculty of Health Sciences,
University of Cape Town, Anzio Road, Observatory, 7925 Cape
Town, South Africa)
Outcomes: Attendees will have a clearer grasp of what can
and cannot be achieved by peer teaching and hopefully
be inspired to try peer teaching in their own institutions.
Who should attend: All conference attendees with an
interest in students teaching students, not exclusively
medical students, are welcome to participate.
4.7
Usability in computer-assisted learning programmes
Brigitte Grether (Dean’s Office, Faculty of Veterinary Medicine,
University of Zurich, Winterthurerstrasse 204, CH 8057 Zurich,
Switzerland)
Proposed structure: This highly interactive session will
require participants to bring with them a case based
scenario of a dilemma which they have encountered, or a
scenario which they anticipate could arise when
Background: Usability, defined as “The effectiveness,
efficiency, and satisfaction with which specified users
achieve specified goals in particular environments” is an
important factor that determines learning outcomes in
– 4.41 –
Section 4
Group 1
a) determine the essential aspects to assess
b) watch a clip of PBL video
c) rate an individual according to the global rating
d) list 5 main areas to improve
computer-assisted education (CAE). Caring for usability
from the beginning of CAE development and following
simple rules will save time and money and avoid frustration.
Objectives: Participants will learn:
• what Usability is
• how Usability influences learning outcomes in CAE
(Computer-assisted education)
• to apply the most important rules/to avoid the most
common errors of Usability
• how to assess Usability
• where to get further information about Usability
Proposed structure:
Part 1: Definition and importance of Usability in CAL
programmes (25 min)
Introduction; Definition of Usability
Part 2: The Do - Don’t – Approach (30 min) Small group
work; Synthesis in plenary
Break (5 min)
Part 3: Topic selected by participants (Navigation or
Fonts) (25 min); Short presentation; Discussion
Part 4: Assessing Usability (15 min); Plenary discussion;
Short lecture
Part 5: Conclusion (5min)
Group 2
a) read the checklist
b) watch a clip of PBL video
c) rate an individual according to the checklist
d) list 5 main areas to improve
Re-convene to give feedback on the use of global v checklist
Who should attend: Anyone with an interesting
psychometrics or assessment of PBL group and individual
skills.
4.9
Bjorn Bergdahl, Per Hultman and Elvar Theodorsson (Faculty of
Health Sciences, University of Linköping, 581 85 Linköping,
Sweden)
Background: Scenarios should give a relevant context for
the learning and increase students’ motivation. Web-based
scenarios increase realism by means of a variety of triggers
(video-films, sounds, pictures, and texts) that stimulate deep
learning in a broad range from molecule to community.
Our faculty introduced such scenarios in 2001 in the EDIT
project (Educational Development using Information
Technology). About 100 scenarios for seven undergraduate
programs have been produced, the majority in the medical
program (semesters 4-7). A computer and a data-projector,
handled by the students, are used to show the scenarios
on a white board.
Who should attend: Educators who are producing or
planning to produce CAE-programmes; Educators who are
responsible for purchasing CAE-programmes and
integrating them into curricula.
Take home message: Usability is crucial for the success of
computer-assisted learning programmes; do not neglect
it!
Further reading:
J. Nielsen: Designing Web Usability. New Riders
Publishing, 2000.
www.useit.com http://www.usableweb.com/
http://rnvs.informatik.tu-chemnitz.de/proseminare/www01/
doku/usability/ (in German)
4.8
Objectives: To discuss and share views about how
scenarios and triggers on the web can be constructed to
achieve learning, pros, and cons with web-based
scenarios.
Proposed structure: EDIT will be presented with examples
of scenarios and triggers for clinical medicine and basic
science. Groups of participants can work through
scenarios and are also invited to bring their own examples
of scenarios on the web.
Assessing PBL Activity
Christine Bundy and Lis Cordingley (University of Manchester
Medical School, G711 Stopford Building, Oxford Road, Manchester
M13 9PT, UK
Who should attend: Those interested in the construction
of scenarios on the web as well on paper.
Background: There is a lack of good literature on the
analysis of either group or individual PBL skills. The two
most common forms of assessment are global ratings of
competence and behavioural checklists (scales). There
are strengths and weaknesses to both methods. There is
no established scale measuring PBL skills in common
use and many scales have unknown psychometric
properties. In Manchester UK, we are developing methods
to assess PBL skills as part of our assessment suite and
this workshop is part of the on-going research programme.
Aim: to introduce the evaluation of two methods of
assessment of individual PBL activity
Scenarios for PBL on the Web – triggers for learning
Outcomes/take home messages: Web-based scenarios
should stimulate students to establish their learning goals.
In-going documents should be short and be simple to
grasp. Scenarios should not be overloaded with information
and learning materials. As students like excitement,
solutions to a problem should be withheld as long as
possible as the case develops. Our project has revitalised
PBL, changed the structure of “EDIT semesters”, and
initiated a pedagogical dialogue.
4.10
Outcomes:
• to identify some advantages and disadvantages of global
rating scales v behavioural checklists
• to construct a global measure
• to use the global and specific measure to rate an
individual’s PBL activity
• to use the global and specific measure to offer feedback
to an individual
Creating Cases to Promote Integration into
Undergraduate Medical Education
Nehad El-Sawi (University of Health Sciences, 1750 Independence
Avenue, Kansas City, MO 64106, USA)
Background: Medical students are expected to master a
constantly increasing amount of information in order to
provide high quality care for their patients. Integrating basic
and clinical sciences during educational efforts should
allow for enhanced learning by providing context and
clinical relevance for basic science concepts while
assuring more than rote memorization of clinical
algorithms. The emphasis on integration is recognized,
but many basic science and clinical faculty members find
it difficult to create resources that allow faculty to easily
integrate both basic science and clinical concepts
throughout all the years of undergraduate medical
Method:
• Introduction to assessing PBL in Manchester Medical
School
• Break into small groups
– 4.42 –
Section 4
education. This workshop will present a brief review of the
literature, description of a method for case development
and hands-on experience creating a case for use in
integration efforts.
4.12
Graceanne Adamo (Clinical Skills Teaching and Assessment,
National Capital Area Medical Simulation Center, Uniformed
Services University of the Health Sciences, 4301 Jones Bridge
Road, Bethesda, MD 20814, USA), Heiderose Ortwein
(Reformstudiengang Medizin, Charité, Humboldt University,
Berlin, Germany)
Objectives:
1 Describe common barriers to integration efforts and
identify strategies to overcome the barriers.
2 Explain the concepts needed to design an effective
integrative case.
3 Develop an integrative case that could be used anywhere
in the medical school curriculum.
4 Describe strategies for successful implementation of
integrative cases.
Content/structure: Once the decision has been made to
utilize simulated or standardized patients in the educational
process, the task of program design and materials
development begins. This “how-to”, hands-on workshop
will provide an opportunity for participants to develop a
theoretical or actual program, project, or event with
emphasis on developing a case mix (form) and/or
complete case materials. Examples from successful
programs and sample templates will be provided.
Presenters will guide workshop participants in individual
and small group activities as they build forms and cases.
Break out groups will be conducted in English and German
using examples from German and American medical
school programs.
Proposed structure: This workshop will include a brief
didactic presentation followed by application of the
knowledge and concepts learned to the development of
an integrative case during the workshop. The didactic
component will include:
• A brief review of the literature regarding integration and
learning
• A description of important concepts that need to be
considered during case development
• Presentation of examples of integrative materials already
in use
Participants will then work in small groups to identify
opportunities for integration using a common clinical
problem. Depending on the type of participants, groups
will include basic science faculty, clinicians and educators.
The workshop faculty will facilitate the small groups to aid
them in using their own knowledge and skills to identify
possible case connections to basic and clinical science
concepts. The small groups will then present their
connections to the large group and discuss other
opportunities for integration.
Outcomes: Workshop participants will develop and
address program goals for operationalizing and
maximizing potential for the use of SPs in their settings.
Who should attend: Attendees may include anyone
interested in establishing, expanding or enhancing the
integration of SPs into a program to train health
professionals including program directors, medical
educators, educational researchers and administrators.
4.13
Assessment methods: what works, what doesn’t
Geoff Norman (McMaster University Medical School, 1200 Main
Street West, Hamilton, ON L8N 3Z5, Canada)
Who should attend: Basic science AND clinical faculty
members, educators, medical students and graduate
students.
In this workshop I will review the literature on assessment
and its implications for the choice of particular assessment
methods.
Outcomes/take home messages:
• At the end of the session, the draft case will be made
available for use to participants.
• Consensus on strategies for implementing the use of
the case
4.11
Developing a teaching or examination event using
Simulated Patients (SPs): form and case materials
development
Background: There is an extensive literature on
assessment in medical education, dating back over three
decades. From this literature, it is possible to systematically
and critically examine our use of various approaches.
Regrettably, much of this literature appears to be ignored
by educational practitioners.
Outcome-Based-Education: an International
Federation of Medical Students’ Associations
Workshop
Objectives:
• To familiarize participants with the literature on
assessment
• criteria for assessing an assessment method
• general “axioms” regarding desirable and undesirable
properties of an assessment method
• To review various methods currently in use, both old
and new, from this perspective
Ozgur Onur, Nikola Borojevic and colleagues (ozzi@gmx.com)
Background: Every change and improvement of the medical
education system should lead to a better outcome, ie better
physicians. In most cases this aim is just a vision and this
focus is not taken in to consideration. Although everyone
involved in faculty development recognizes the need for an
outcome-based approach, not many succeed in its
implementation.
Structure: I will present a framework for critical examination
of various methods. I will then critically review existing
methods, both old and new, with a view to examining the
evidence of effectiveness. From this, I will make some
general inferences about the usefulness of various
methods. While there will be no “hands-on” exercises, there
will be ample opportunity for discussion and sharing of
experiences
Objectives: This session will look at how you can structure
the development of your faculty to make it outcome-based,
how you can overcome obstacles and what the students’
role could be in this process. Questions to be discussed
will be: What is outcome-based education? How can
outcome-based education be organised? What role can
students and young doctors play in outcome-based
education?
Who should attend: Individuals with responsibility for the
implementation of student assessment methods.
Take home message: Choice of an assessment method
should be based on evidence of effectiveness. From this
evidence, it is possible to identify specific essential
characteristics necessary for credible assessment
Who should attend: Students and teachers
– 4.43 –
Section 4
4.14
Scenario-based teaching and learning – an innovative
and relevant concept in medical education
the consultation process should be resumed. The
participant-in-action may decide on one of the possibilities,
or another participant may take his place trying out
something else. During the process the actor will also be
available in the “hot-seat” for interaction with the
participants.
Roger Kneebone (Imperial College School of Science, Technology
and Medicine, Faculty of Medicine, 10th Floor, QEQM Wing , St
Mary’s Hospital, Praed Street, London W2 1NY, UK), Debra Nestel
(Centre for Medical and Health Sciences Education, Monash
University, Australia)
In a clinical setting, doctors have to combine
communication skills with technical skills when carrying
out ward-based procedures on conscious patients.
Although indivisible in practice, these components of safe,
patient-centred care are often taught separately. We have
developed an innovative scenario-based approach to
teaching and learning, using inanimate models attached
to simulated patients (SPs) to create an illusion of reality.
Within the setting of a skills lab, students carry out practical
procedures such as wound closure and urinary
catheterisation on a model while interacting with the
‘patient’. Performances are watched remotely and
assessed in real time by expert faculty. Students receive
structured feedback from tutors and SPs, then immediately
review their recorded performance in private, at a time of
‘readiness to learn’. Qualitative evaluation (observation and
interview studies) with more than 120 procedures by
medical students and nurses provides strong support to
the concept and have identified several problems.
Who should attend: Teachers and students training in
communication/consultation.
Take home message: Hopefully inspiration for further
development of participants’ own teaching/learning in
communication/consultation.
4.16
Ioan Bocsan, on behalf of AMEE Executive (Iuliu Hatieganu
University of Medicine & Pharmacy, 13 Emil Isac St, RO-3400 ClujNapoca, Romania) and Stewart Mennin (University of New Mexico,
Albuquerque, USA)
Another meeting of this group, to discuss issues of
relevance to the region.
4.17
Professionalism
4.17.1 Evidence of professional development in the
learning activities of medical students, house
officers, and practicing physicians
1 Scenarios in the skills lab take place in an abstracted
context. Transplanting SP-based scenarios into the
clinical environment would heighten realism.
2 A portable alternative to our current audiovisual facilities
is therefore needed.
3 The prototype model/SP interface requires modification
to eliminate visible joins which reduce the effectiveness
of the illusion.
H B Slotnick* University of Wisconsin, 2715 Marshall Court,
Madison, WI 53705, USA) and Sean Hilton (St George’s Hospital
Medical School, London UK)
Aims: This paper reports results of a qualitative study
designed to explore how medical students, residents, and
practicing clinicians learn.
Summary: Interviews with forty medical students, residents,
and clinicians sought to identify the ways in which these
individuals approached learning – a set of competencies
central to professionalism. Interviewees described the ways
in which they approached a variety of aspects of
professionalism including (1) mastery of the esoteric skills
and knowledge required of physicians, (2) recognizing the
problems patients brought to physicians for solution, and
(3) balancing the need to remain up-to-date with the
exigencies of day-to-day practice. Information on
psychosocial development appeared in the same
interviews and was related to the above information.
Our solution combines customised models (for rapid
attachment to an SP) with a portable recording system
(the ‘Virtual Chaperone’, developed at Imperial College
London). Two miniature video cameras on a discreet freestanding mount resembling a drip stand record a digital
audiovisual output directly onto disc (DVD) within a small
computer located in an adjoining room. The procedure is
watched in real time by observers who subsequently provide
focused feedback. The procedure is played back on a
laptop computer or Virtual Chaperone with headphones.
By eliminating the need for specialised viewing facilities,
the entire process is self-contained and can take place
within a clinical setting.
Results: Findings confirm that human psychosocial
development is part and parcel of the progress medical
students cum residents cum practitioners make in striving
toward medical practice that can be described as
professional. Evidence of professionalism comes after
knowledge and skills development and in concert with
physicians’ developing an appreciation of the human
condition. The findings of this study suggest changes can
be made to medical education to better appreciate and
achieve the limits of professionalism achievable at each
stage of training.
In this workshop we will present our concept and
summarize the data which underpin it. Using the equipment
described above, we will demonstrate the process of
setting up a scenario, performing a procedure, recording
and assessing it, and providing feedback to the learner.
This will be followed by a group discussion.
4.15
Central and East European/Eurasian Task Force
Verbal reflection-on-action as a tool in consultation
training
Anders Baerheim and actress Torild Jacobsen Alræk (Institute
for Public Health and Primary Health Care, University of Bergen,
Ulriksdal 8c, N-5009 Bergen, Norway)
4.17.2 Exploring professionalism in physician-tophysician consultation
M B Shershneva* and G C Mejicano (University of WisconsinMadison Medical School, 2715 Marshall Court, Madison, WI
53705, USA
Background: Training medical students in communication/
consultation has become an essential as a part of most
medical curricula.
We sought evidence of professionalism in physician-tophysician consultation as shown by mature, competent
physicians and examined the development of behaviors
and attitudes related to consultation. We interviewed eight
physicians with 8 to 28 years of experience in Internal
Medicine finding evidence of professionalism and protoprofessionalism in physicians’ understanding of the referral
system (e.g., referral patterns), the consultation process
(e.g., consultation initiation), and personal attributes (e.g.
physicians’ attitudes and beliefs). Physicians reported that
consultation attitudes and behaviors developed most
Objectives: By an interactive approach to let the participants
experience how verbal reflection-on-action may be a tool
in consultation training.
The structure of the workshop: A consultation will be carried
forth step-by-step, and be modulated according to the
participants’ reflection-on-action. An actress provides
patient role figures, and a participant starts the consultation
as a doctor. A tutor will provide frequent time-outs, where
the participant-in-action and the audience reflect on which
possible next steps may be profitable, and at which point
– 4.44 –
Section 4
intensively during residency, fellowship, and the first years
of practice, and involved use of clinically-oriented,
immediately available, and familiar resources. They also
reported that reflection on experience, senior colleagues
and peers, mentorship, and observation were central to
becoming skilled as both consultants and referring
physicians. Changes in the health care system,
physiological changes, and life experiences also
influenced those attitudes and behaviors. Our overall
conclusion is that physicians use consultation to address
their psychosocial needs by helping physician-colleagues
and their patients satisfy their needs. We end by
recommending changes to medical education to facilitate
physicians’ moving through proto-professional stages to
professionalism within the domain of physician-tophysician consultation.
medical professionalism and the educational aspects of
those stages.
4.18
Using a collaborative work space in a rich media
educational environment
Sharon K. Krackov*, Richard I. Levin (New York University School
of Medicine, 550 First Ave, New York 10016, USA), Mike Uretsky
(Center for Advanced Technology), Martin Nachbar and Melvin
Rosenfeld (New York University School of Medicine)
Aim: We will present a new interface to enhance
collaborative learning in medical education.
Summary of work: Like many leading medical schools, NYU
is evaluating the appropriate use of technology to improve
quality and cost effectiveness of educational programs. A
university-wide research group is developing the
Infrastructure for Rich Media Educational Environments
(IRMEE), which leverages emerging advances in learning
sciences and information technology http://richmedia.med.
nyu.edu/. This work is based on several assumptions. The
new program must: complement and offset difficulties in
teaching clinical medicine; build on educational and digital
library efforts taking place at many institutions; contain a
problem-based student assessment component; and be
deliverable on a broad range of existing and future
technology platforms. One aspect of IRMEE is a
‘collaborative table,’ jointly developed by the NYU School
of Medicine and the NYU Center for Advanced Technology.
Using this table, groups of students at the same or different
locations can collaborate while: accessing remote digital
library and educational materials; sharing files; using a
cybermicroscope to examine specimens; carrying out
simulated laboratory investigations, and working with
simulated patient case studies.
4.17.3 Professionalism and proto-professionalism:
a new view of Professionalism in physiciansin-training and physicians
Sean Hilton* (St George’s Hospital Medical School, Cranmer
Terrace, London, SW17 0RE, UK) and H B Slotnick (University of
Wisconsin, USA)
Because current views of professionalism underestimate
what medical professionals do for individuals, for society,
and for the profession itself, we propose a
conceptualisation of medical professionalism arising from
humanistic psychology. Medical professionalism is a
central feature of practice exhibited by the mature,
competent practitioner. This view preserves received
concepts such the ‘social contract,’ while adding that
psychosocial development is required before medicine’s
esoteric skills and knowledge can be skillfully used to
address problems for society. This idea then leads to protoprofessionalism – stages in medical training where the
learner develops the skills and knowledge, and gains
experience and maturity needed to satisfy the new definition
of professionalism. Proto-professionalism asserts that
knowledge, skills, and experiences taught to medical
students and house officers are insufficient preparation for
medical professionalism. ‘Protoprofessionals’ nevertheless
act in ways consistent with their status and anticipate to
prepare them to be professionals later on (e.g., primo no
nocerum). This paper examines the stages leading to
Summary of results: Early prototypes include surgical
teaching modules and a growing library of histology and
pathology images. Relevant School of Medicine
departments and units are providing content and quality
control. Faculty responses are enthusiastic. A formal
evaluation is being implemented to assess student
performance and program impact.
– 4.45 –
Section 4
Session 5: Large Group Sessions
5A
Standard Setting
effect on learning. This session will also highlight
potential problems that can be avoided when using
simulation throughout the medical curriculum.
• Demonstrate that these conclusions can be based on
evidence reached through a BEME systematic review
• Provide ideas for future research in medical education
using high-fidelity simulation
Miriam Friedman Ben-David (Israel), André de Champlain (NBME,
USA), Arno Muijtjens (University of Maastricht, Netherlands),
John Norcini (FAIMER, USA) and Ronald Nungester (NBME, USA)
An international panel with expertise in the area will present
their views and address participants’ questions on a range
of issues. Approaches to standard setting for testing
purposes in education in general and in medical education
in particular will be reviewed. The recent most promising
developments in the field will be discussed.
5B
Also included will be the following handouts for participants
to review and provide feedback:
• A bibliography of high-fidelity simulation studies used in
the BEME review
• An algorithm showing how studies were selected for
review
• Practice tips for teachers on the best practices of highfidelity simulation in medical education.
A Cognitive Perspective on Learning: Implications
for Teaching
Geoff Norman, McMaster University Medical School, Dept of
Clinical Epidemiology, 1200 Main Street West, Hamilton, ON L8N
3Z5, Canada
Cognitive psychology has provided many insights into how
people learn that can inform our teaching strategies. In
this presentation I will review findings from the psychology
of learning in five domains: memory (learning and
remembering), transfer (using old concepts to solve new
problems), deliberate practice and its critical role in transfer,
experiential knowledge as a component of expertise, and
the role (if any) of general strategic skills (problem-solving,
critical thinking, reflection, etc.). In each area, I will begin
with examples, review the evidence, then draw implications
for more effective teaching.
5C
5D
Lewis Miller (Alliance for Continuing Medical Education, USA),
Dennis Wentz (American Medical Association, USA) and Hans
Karle (World Federation for Medical Education, Denmark)
(American Medical Association, 515 North State Street, Chicago
IL 60610, USA)
The objectives of the session are:
• To review the opportunities available to medical schools
in Europe and elsewhere to assist practising doctors in
their continuing professional development;
• To examine the role of faculty in needs assessment,
delivery, and evaluation of programs of continuing
medical education;
• To identify how medical schools can become part of
the process of determining the impact of medical
education on medical outcomes.
A BEME Review of High-fidelity Simulation in Medical
Education
Barry Issenberg (University of Miami, USA) and Bill McGaghie
(Northwestern University Medical School, USA) (University of
Miami School of Medicine, Centre for Research in Medical
Education, 1430 NW 11th Avenue, D41, PO Box 01690, Miami, FL
33101, USA)
High-fidelity simulation (that is, a simulator that depicts a
three-dimensional person, diagnostic test or procedure with
specific elements that can adapt and provoke responses
from the user), is being used more often in medical
education. This session will explore the use of high-fidelity
simulation and provide opportunity for audience feedback
and discussion.
Making medical education relevant to medical practice:
medical schools in the continuum of lifelong learning
5E
Complex Adaptive Systems and medical education:
a new look at how we do what we do
Stewart Mennin (University of New Mexico School of Medicine, 915
Camino de Salud NE, Albuquerque, NM 87131-5134, USA)
Complexity science and complex adaptive systems offer
new approaches and ways to think about medical
education and the organization of medical schools and
health care systems. They enable us to gain new insights
about strategies for change and management in a rapidly
expanding world. The presentation will compare and
contrast linear and nonlinear thinking in relation to
integration, curriculum, collaboration and leadership.
Aims of this session:
• Provide practice advice on the high-fidelity simulation
in medical education to medical teachers, deans and
administrators. This will include suggestions about
when high-fidelity simulation is most appropriately used
and how it can be implemented to have the greatest
Session 5F: Postgraduate Assessment (Short Communication)
5F 1
Assessment of specialist registrars in obstetrics
and gynaecology in the Netherlands
general choices to be made for amongst others the
redesign of assessment procedures, based on
contemporary educational science. The Committee of
Education of the Dutch Society of O&G has made a rough
proposal for a summative assessment of their SpRs in the
first two years of training.
F Scheele*, M Schutte, B Wolf, J Th M van der Schoot and
“Commissie Onderwijs NVOG” (St Lucas Andreas Hospital,
Department of Mother and Child Care, Jan Tooropstraat 164, Post
Box 9243, 1061 AE Amsterdam, NETHERLANDS)
Summary of results: An assessment system is designed
based on (1) the wish to assess clinical competencies, (2)
the wish to be compatible with the European log book
(European Board and College in O&G), (3) the use of the
CANMEDS 2000 roles, (4) the use of multiple approaches
of assessment and (5) the introduction of a portfolio with
Aim: To show the national redesign of assessment
procedures for specialist registrars (SpRs) in Obstetrics
and Gynaecology (O&G).
Summary of work: Three Dutch working parties concerning
the improvement of the education of SpRs have reported
– 4.46 –
Section 4
regular strength-weakness analyses and description of
remaining tasks to be fullfilled within the training module.
5F 4
Conclusions/take home messages: The training of Dutch
SpRs in O&G is increasingly based on educational
science. A portfolio based assessment procedure is being
designed for the SpRs.
5F 2
P A Johnstone (Ninewells Hospital and Medical School,
Postgraduate Department, Level 7, Dundee DD1 9SY, UK)
Aim: To report a study on the face validity and content validity
of the MRCOphth. part III clinical examination.
Summary of work: Questionnaires using a 7-point Likertscale were used to survey the opinion of candidates and
examiners. Content validity was evaluated by comparing
the clinical cases examined with the curriculum for basic
surgical training (BST).
Improving the RITA process
Robert Palmer*, Zoe Nuttall and David Wall (West Midlands
Deanery, PO Box 9771, Birmingham Research Park, 97 Vincent Drive,
Birmingham B15 2XE, UK)
Summary of results: The response rate for the questionnaire
was 92% for candidates and 96% for examiners.
Candidates and examiners agreed with the majority of
statements regarding the examination in the
questionnaires. Candidates did not agree that the BST
curriculum objectives list was helpful in preparing for the
exam. They were unconvinced about the fairness of the
exam, whether it was an accurate measure of ability or a
good assessment of competence as a future
ophthalmologist. Examiners were concerned at the lack
of clinical variety and whether the exam was a good
assessment of communication skills. Content analysis
revealed a disproportionately large amount of anterior
segment cases and relatively little vitreoretinal or ocular
motility cases.
Aim: The annual assessment of Specialist Registrars, the
RITA (Record of In-Service Training Assessment) process,
requires a meeting between trainee and trainers. This study
determines the types of assessment that are used to inform
the RITA and acquires information on the training needs of
consultants involved.
Summary of work: Questionnaires were completed by 50
of 53 (94%) Chairs of Specialty Training Committees. All
but three specialties use written trainers’ reports and many
review log books, publications and audit activities. OSCEs
and 360 degree assessments are seldom arranged. Royal
College examinations informed the process in half the
specialties. Personal portfolios, examination of CV and
communications skills were assessed by some. There were
concerns that the process was not robust or rigorous
enough, especially for border-line trainees. Some reports
from supervisors were too vague. All respondents
considered further training to be necessary for chairs and
consultant colleagues, particularly assessing attitudes,
behaviour and communication skills. Chairs thought their
colleagues were in greater need of training than they were
themselves (p<0.05). Half- and whole-day workshops were
the preferred format for delivery.
Conclusions: The MRCOphth. Part III examination has
good face validity. However, concerns remain. Therefore,
a new multi-station clinical exam including a
communication skills station is to be adopted.
5F 5
Conclusions/take home messages: The RITA process
varies between specialties and is not a robust tool. There
is a significant training need for those involved.
5F 3
Validity of the Royal College of Ophthalmologists
part III Clinical Examination
Measurement of knowledge, attitudes and practice
of medical interns about common ambulatory
pediatric diseases in teaching hospitals of Shiraz
University of Medical Sciences
Mitra Amini*, Ali Sadeghi Hassanabadi and Abdolah Karimi
(Jahrom Medical School, IRAN)
Educational impact of in-training assessment (ITA)
in postgraduate education
Aim: The present study was designed to measure
knowledge, attitude and practice of medical interns about
four common ambulatory paediatric diseases (diarrhoea,
acute respiratory infection, fever and abdominal pain) in
Shiraz Medical University. Summary of work: For each
disease a checklist was prepared and completed by the
researcher.
C Ringsted*, A H Henriksen, A M Skaarup and C van der Vleuten
(Copenhagen Hospital Corporation Postgraduate Medical
Institute, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400
Copenhagen NV, DENMARK)
Aim: The aim of this study was to explore what impact the
introduction of ITA had on the educational process: what
was the effect on training, teaching and learning, and what
were the users’ experiences and thoughts about the benefits
and drawbacks of the programme in practice. The ITAprogramme was for first year trainees in anaesthesiology
and included 21 individual elements spread out through
the first year of training. The elements included tests on
clinical performance, interpersonal skills, log of experience
and reflective assignments.
Summary of results: The results revealed that the behaviour
of interns was favourable with children and their families.
Female interns do better than males (p<0.05). Regarding
history taking by interns, the maximum grades were
obtained in the approach to diarrhoea and abdominal pain
and the minimum grades were obtained in the approach
to respiratory diseases and fever. The difference between
groups was statistically significant (p<0.05). In the context
of performing a good physical examination the highest
scores were related to approach to diarrhoea and
abdominal pain and the lowest scores were related to
approach to respiratory diseases and fever. The difference
was statistically significant (p<0.05). In the context of
diagnosis, results were favourable in all four conditions. In
the context of prescribing drugs and especially not to
prescribe a drug when it is not necessary the highest grades
were obtained in cases of diarrhoea and abdominal pain
and the lowest grades were in respiratory infection and
fever. The difference was statistically significant (p<0.05).
The interns did not spend enough time for providing
preventive recommendation and explaining the course of
disease for children and their families.
Summary of work: Semi-structured interviews were
performed with three programme directors, nine
supervisors, and fourteen trainees. Interviews were audio
taped and transcribed. Content was coded and analysed
according to the questions and organised into a framework
of categories.
Summary of results: The results demonstrate that the
programme was beneficial in making goals and objectives
clear, in structuring training, in fostering teaching and
learning, monitoring progress and handling problem
trainees. Three factors influenced the perceived value of
assessment: 1) The link to patient safety and practice; 2)
The perceived challenge and effect on learning; 3) The
assessors’ attitude and rigorousness.
Conclusions/take home messages: There is deficiency in
teaching ambulatory medicine to medical interns and there
is a need for revising the educational program for training
interns about these common diseases, especially the most
common ambulatory disease, the common cold.
Conclusions/take home messages: The administration in
practice must be tailored to the trainees’ professional
development, be used as part of the learning process and
linked to quality of practice.
– 4.47 –
Section 4
Session 5G: Community Based Education (Short Communication)
5G 1
Partnership teaching in community medical
education: a study to investigate the advantages
and disadvantages of partnership teaching as
perceived by tutors
referrals to hospital’. Following the placement, house
officers reported that general practice had different
demands and dealing with uncertainty was difficult. House
officers were less critical of general practice and conversely
became more critical of hospital doctors who made
disparaging comments about general practice.
Jo Brown*, Annie Cushing and Dason Evans (Barts and the London,
Queen Mary’s School of Medicine and Dentistry, Clinical
Communication and Learning Skills Unit, Room 232, Robin Brook
Centre, St Bartholomew’s Hospital, West Smithfield, London EC1A
7BE, UK)
Aim: The study looked at the tutor view of the advantages
and disadvantages of partnership teaching between
general practitioners and community tutors. Medical
education will increasingly be exploring this kind of
educational partnership for the future.
Conclusion/take home messages: Increased exposure to
general practice led the house officers to revise their
attitudes and to hold more positive views of general
practice.
5G 3
Regina Petroni-Mennin*, Celia Iriart, Saverio Sava, Rebecca
Radcliff, Rachel Evans, Leah Steimel and Dan Derksen (University
of New Mexico School of Medicine, Dept of Family and Community
Medicine, School of Medicine, 900 Camino de Salud NE,
Albuquerque NM 87131-5091, USA)
Summary of work: The Medicine in Society module provides
teaching for 1st year medical students. The study aimed to
undertake qualitative research to inform the design of a
questionnaire which was sent to all 42 tutors. Semi
structured interviews were carried out to establish themes
and views. From these a questionnaire was constructed.
Aim: To demonstrate the use of participatory communitybased education and research for undergraduate and
postgraduate medical students.
Summary of results:
• Relationships between partnership tutors were positive
and supportive and helped individuals to gain insight
into each other’s work.
• This method of teaching provides positive role models
for students.
• Tutors found working with students very rewarding and
felt that partnership teaching offered a richer learning
environment for students.
• Tutors felt partnership teaching offered a more holistic
view of healthcare to students.
• GPs took the lead role in the majority of teaching pairs.
• Half of the tutors wanted more training on how to teach
and a majority wanted to meet with other teaching pairs.
Summary of work: Using questions and “problematization,”
medical students and residents worked and learned in a
community-based clinic, its surrounding community and
at the university medical center. Learners worked within
the real-life context of human problems in the community.
Summary of results: Key issues included cultural and
religious barriers to family planning for Hispanic women
exemplified by husbands prohibiting wives from seeing
physicians and obtaining family planning. Other barriers
included scheduling of appointments, payment for services,
discriminatory attitudes and misinformation about services
offered. University barriers to learning about these issues
included a predominance of subspecialty teachers and a
heavy emphasis on mechanistic approaches to illness.
Conclusions/take home messages: Partnership teaching
was positively and warmly viewed by tutors and is an
example of collaborative learning that embraces modern
educational theory and models the multi-perspective view
of healthcare in a respectful way. It also models the
multiprofessional team working practices that will be the
normal working environment of tomorrow’s doctors.
5G 2
Conclusions/take-home messages: Using participatory
research as a learning strategy provides an approach to
education that collectively empowers students, community
women, university faculty and clinic health providers.
Outcome goals include enhanced access for women to
family planning at the community-based clinic and to the
use of contraception methods. The long-term goal is to
decrease unplanned pregnancies within a defined
population of Hispanic women. Secondary data from the
community clinic and State Health Department will be
utilized in this approach to education and research.
Negative views of general practice: where do they
come from and where to do they go?
Jan Illing*, Tim van Zwanenberg, Bill Cunningham, Richard
Prescott, George Taylor and Cath O’Halloran (University of
Newcastle, Postgraduate Institute for Medicine and Dentistry, 1012 Framlington Place, Newcastle-upon-Tyne NE2 4AB, UK)
Participatory community-based health education:
identification of barriers to family planning
5G 4
Using student confidence questionnaires to validate
placement recruitment procedures
R J W Phillips (Department of General Practice and Primary Care,
GKT School of Medicine, King’s College London, 5 Lambeth Walk,
London SE11 6SP, UK)
Generally in the UK, doctors only gain experience in
general practice when they start vocational training.
Therefore, the vast majority of hospital doctors have never
worked in general practice. While medical students hold
positive views on general practice, these become more
negative when they become junior hospital doctors.
Aim: To present data from questionnaires to students about
their self-confidence, comparing new placements with
established ones.
Aim: To determine if working as a general practitioner
results in a change of view or attitudes towards general
practice.
Summary of work: Final year undergraduate medical
students at GKTSM spend eight weeks in General Practice
& Community. Half attend local established teaching
practices; alternatively, students may find practices
anywhere in the UK given guidance about simple criteria,
then a practice questionnaire is used to select those offering
an appropriate learning environment. Practices have also
been recruited in two satellite centres, by local contacts,
not using the practice questionnaire. Students complete a
self-assessment questionnaire at the beginning and end
of their placement; rating their self-confidence against 24
learning objectives, on a 5-point scale.
Summary of work: Interviews were conducted with 22 house
officers who were spending four months in general
practice. Data were collected before and after the
placements. Interviews were recorded and transcribed.
Data analysis was qualitative, using grounded theory to
identify themes and an overall theory.
Summary of results: Before the placement, negative views
were expressed: ‘general practice was the easy option’;
‘general practitioners were lazy’ and ‘sent inappropriate
– 4.48 –
Section 4
to describe a change in the course which addresses these
issues.
Summary of results: For 2001-2, there were 176 pairs of
self-assessment questionnaires, showing no difference in
increments in confidence between students in “local”
practices (on average an increase of 1.39+/-0.6) compared
with new ones (1.28+/-0.6), or with those recruited in
satellites (1.2+/-0.6).
Summary of work: The course will run for 22 weeks during
which time 280 second year medical students will split
into 2 groups which will rotate:
1 Health related community profiling and focused work
groups which includes community placements;
2 Patient centred community review work where pairs of
students identify hospitalized patients and follow these
patients into the community and interview patients, carers
and voluntary or statutory agencies involved.
Conclusions/take home messages: The students have
comparably increased their confidence; there seems no
disadvantage to those in new practices vetted by a onepage questionnaire. We believe our practice questionnaire
is a useful tool in vetting new practices.
5G 5
Learning objectives have been designed to help students
gain a broader view of health and disease. Assessment
will be by oral presentation and written report.
Bringing the “Real World” of the patient into the
medical curriculum
Jean Quinn* and Lyn Brown (University of Liverpool, Community
Studies Unit, Department of Primary Care, Harrison Hughes
Building, Brownlow Hill, Liverpool L69 3GB, UK)
Summary of results: The new course has been developed
to address the issues raised by the original evaluation and
in addition to look at the hospital/community interface and
its relationship to health in the community. Evaluation
results will be available for the Conference.
Aim: Community placements are an integral component
of our curriculum. Previous evaluation indicated students
learnt about multidisciplinary team working and
interpersonal skills but reported insufficient time and lack
of focus in some large group work. The aim of this paper is
Conclusion: The evaluation will be discussed in relation to
the educational process and outcomes.
Session 5H: Students’ Learning (Short Communication)
5H 1
How do students with different learning styles
perform in formative and summative exams in the
first year of a new curriculum?
student characteristics (age, gender and race-ethnicity)
with RLOC results are presented. Additionally, the
relationship of the RLOC with companion measures
probing student perceptions of the medical school
environment (Medical School Learning Environment
Survey) and selected cognitive orientations (measured by
the Mitchell Cognitive Behavior Survey) is described. An
analysis of the RLOC and selected indicators of student
academic performance (including the National Board of
Medical Examiners, USMLE Step 1 Examination) provides
a basis for discussing this measure’s utility as a predictive
or educational diagnostic tool, particularly in regard to selfdirected and Problem-Based Learning. Finally, the topic
of use of the RLOC in medical education across cultures
and languages is introduced (the RLOC has been applied
in Arabic, Danish, English, Hebrew, Hindi, Swedish and
Spanish).
H G Kraft* and M Heidegger (University of Innsbruck, Institute
for Med. Biology, Schoepfstr.41, 6020 Innsbruck, AUSTRIA)
In 2002 a new medical curriculum started with a new
assessment system. The number of students in the 2nd
year of the curriculum is limited to 275 whereas the
entrance to medical school has no limits. Students´
performance in the exams in the first year is the major
criterion for the selection. The aim of this study was to
verify that the complete variation of medical students is
preserved.
To represent the variation of the students a learning style
test was used (comparable to Kolb’s LSI). During a “learn
how to learn” course 254 medical students participated in
this test. 27% presented with the “Diverging” learning style,
58% were “Assimilators”, 9% “Convergers” and 6%
“Accommodators”, respectively. 345 students did not
participate. The achievement of all students in the
summative and formative exams of the 1st year will be
presented and discussed. Significant differences were
detected between the different learning types. Converging
and assimilating learning types had higher points when
compared with “divergers” and “accommodators”. Those
who did not participate in the “learn how to learn” course
performed worst in 2 exams. Hence a selection to specific
learning types seems to occur.
5H 2
5H 3
Impact of continuous clinical on-duty hours in medical
students’ academic performance: a comparative study
Enrique Saldivar* and Antonio Davial (ITESM, 3000 Morones
Prieto Desp 206 Col Los Docotores, Monterrey NL. CP 64710,
MEXICO)
The following is a comparative analysis of the amount of
hours a 5th year medical student spends in clinical activities
and how much these continuous hours of duty affect his/
her academic, professional and personal development.
We compared two groups of 5th year students, one with on
call schedule every 3rd day and an other with on call
schedule ever 4th day. Our results show that more on call
hours do not necessarily translate into better academic
performance. The amount of hours a student “works” in
our obstetric wards rounds up to approximately 75 to 108
hours per week, with approximately 33 hrs of continuous
sleep-deprived work. We compared the test scores of
medical students with different working schedules and the
ones with a lighter schedule consistently scored better in
similar testing formats. Their overall personal well-being,
their willingness to study and their disposition to patient
care in a lighter working schedule were far better when
compared to on call schedule ever third day. We conclude
with this analysis that a lighter working schedule will permit
a student to perform far better at academic, professional
and personal level than an overworked and underslept
student.
Locus of control and companion measures in a
longitudinal study of medical students in a
southwestern US Medical School
Thomas Stewart*, Ann W Frye, Stephanie D Litwins and Christine
A Stroup-Benham (School of Medicine, University of Texas Medical
Branch, Office of Educational Development, Suite 1.302, Graves
Building, Galveston Texas 77550, USA)
This session presents a rationale for and results of the use
of the Rotter Locus of Control (RLOC), a brief measure of
an individual’s orientation toward action and control in life,
with medical students. The 30 year history of the RLOC’s
use in medical education is reviewed. Its application in an
extensive longitudinal study of medical students in a large
U.S. medical school is described. The relationships of
– 4.49 –
Section 4
5H 4
The educational programmes developed and
offered by medical students
5H 5
Radim Licenik*, Lenka Doubravska, Vit Gloger, Jarmila Indrakova,
Daniela Jelenova, Petr Jindra, Barbora Krajzlova, Pavel Kurfürst,
Marie Pecuchova, Jarmila Potomkova, Jan Strojil, Renata Simkova
and Cestmir Cihalik (Palacky University Faculty of Medicine,
Hnevotinska 3, 775 15 Olomouc, CZECH REPUBLIC)
Celebrated movie viewing and semi-structured
interactive discussions In neuroscience block
highly contribute to reinforcement of instruction
G.O. Peker*, S. Amado, S. Sorias, O. Akyurekli, S.A. Caliskan, U.
Seyfioglu, C. Terek, E.O. Koylu and Ege Medical Students Movie
Club (Ege University, Faculty of Medicine, Izmir, TURKEY)
Background: Medical education in Turkey is a 6-7 year
program following high school and a very competitive
central selection/placement exam. A horizontallycoordinated, high-load curriculum and a teacher-centered
and conference-based instruction have been conducted
in the preclinical years in classes of 140-420 students at
the Ege University Faculty of Medicine for the last 15 years.
In December 2001, Palacky University Medical Students’
Association established a section concerned with
undergraduate medical education. Through various
activities, the Section for Medical Education primarily aims
to contribute to medical education improvements:
• Educational Programmes: Training Programme to
Support Medical Students’ Scientific Research – The
programme corresponds to the respective steps of the
scientific research process. We offer 18 workshops and
seminars, Nurse-Physician Communication Course,
Breaking Bad News Course;
• Educational Research: Educational Evaluation Analysis,
Nurse-Physician Communication, Evaluation of
Students’ Professionalism;
• Communication Skills Group: In September 2002, a
working group for communication skills in medicine was
founded as an interdisciplinary group comprising
students, physicians, nurses, clinical psychologists, a
lawyer and a foreign language consultant. It is concerned
with various aspects of communication in general as
well as communication in medicine;
• Guidelines to Enhance Undergraduate Medical
Education: Test-Making and Test-Evaluating,
Educational Evaluation, Teaching Skills, Psychology of
Attitudes – guidelines for measurement, Instructions for
Completing a Practice Standard Review – developed
by the American International Health Alliance.
Aim: We have intended to improve active, conceptual,
durable, and relevant-to-real life learning, collective
problem-solving, bio-psycho-social awareness, early
vertical integration, class attendance and scholastic
achievement, and also extend basic neurosciences to
clinical, behavioral, community health, ethical and higher
intellectual levels in a big picture.
Procedure: In addition to providing the very first authentic
student guide/syllabus, revision for better horizontal
integration, developing rich -cast and –dramatization
cases/scenarios, introduction of clinical skills, neuro anthropological, -evolutional, -philosophical and -ethical
issues; we have more recently included the movies, “The
Awakenings”, “My Left Foot” and “Birdie” with definite
learning objectives, relevant neuroscientific and clinical
introductions, artistic and cinematographic reflections and
with provocative, inspirational semi-structured discussions.
Results: Attendance was impressive, end-block exam
reflected higher achievement and student feedback
revealed profound appreciation with requests for more
movie sessions.
Conclusion: Selectively “authentic and correct” celebrated
movies can and should be utilized for neuroscience learning
and teaching, and also for development of good
humanistic, social, scientific and professional conduct as
well as highly aesthetic and artistic perceptions.
– 4.50 –
Section 4
Session 6A: Workshops 2
6.1
The nature of curriculum change: complicated and
complex
Proposed structure: This highly participative workshop will
include individual and group tasks, elements of
presentation, discussion of short case studies and plenary
activity.
Stewart Mennin (University of New Mexico, Albuquerque, 915
Camino de Salud NE , New Mexico, NM 87131-5134 USA)
Who should attend: New and experienced staff who are
interested in making lecturing as effective as possible.
Background: Curriculum change is a complex process.
How can leaders and educational “change agents”
promote and facilitate sustainable curriculum change?
New insights and strategies that inform and support
leadership for curriculum change can be gained from the
application of principles of complexity science.
Objectives: At the end of this interactive workshop,
participants will be able to:
• Define and apply core concepts of adaptive leadership,
the change process and complex adaptive systems;
• Apply specific strategies for sustainable curriculum
change drawn from the domains of adaptive leadership,
organizational development, the change process
applied to medical education and complexity science;
• Recognize and distinguish between complicated and
complex situations in curriculum change.
Outcomes/take home messages: Lecturing is a means of
curriculum delivery that has been around a long time and
will continue to be widely use for the foreseeable future.
Let’s make sure that it is an efficient and effective means of
fostering student learning!
6.3
Background: Mapping is an effective means of representing
the curriculum. Unlike lists of modules or learning
outcomes, it has the potential to show linkages and
contributions as well as the particular topics covered. The
major publication on curriculum mapping to date is Ronald
Harden’s AMEE Guide (No 21).
Proposed Structure: The workshop will combine case
analysis, small-group discussion, dialogue, role play and
didactics. It will be fast-paced and practical.
Objectives: To explore ways in which the potentials of
curriculum mapping may be maximised in medical
education. Drawing on the theoretical basis of graphics
and cartography, it will illustrate the special significance of
the map as a non-directional communication form, which
can aid self-directed, exploratory learning within a course
in which the eventual achievement of centrally determined
outcomes is crucial. The workshop will consider the impact
of computers on mapping and the specification for a
computer generated curriculum map that will be reflexive
to the achievement, needs and interests of individual
students.
Who should attend: Individuals engaged in curriculum
change in medical and other health professions schools,
leaders, change agents in medical and health professions
education and medical educators.
Outcomes/Take home messages: Complicated solutions
and approaches to complex problems will not work.
Adaptive leadership techniques are an essential strategy
for building broad-based ownership for curriculum change.
There are clear, well defined stages to the change
process. Each stage presents its own barriers and
challenges and requires different strategies and forms of
leadership. Understanding complex adaptive systems can
help leaders to plan, shape and guide the use of available
resources to interpret and address challenges involved in
curriculum change.
Proposed structure: The workshop will include Powerpoint
presentations, facilitated group exercises and debate.
Who should attend? The workshop is designed for anyone
interested in curriculum development and implementation
and the student experience of education. Although the role
of computers will be considered, this will not be a technical
workshop.
Note: It is strongly recommended that participants wishing
to participate in the above workshop attend Stewart
Mennin’s Large Group Session: Complex Adaptive Systems
and Medical Education: a new look at how we do what we
do, scheduled on Tuesday from 0830-1000 in the session
immediately preceding the workshop.
6.2
Enhancing student learning in your lectures
A new approach to curriculum mapping
Nick Ross (University of Birmingham Medical School, Edgbaston,
Birmingham B15 2TT, UK)
Take home messages: We are only at the beginning of
exploring the huge potential of curriculum mapping for
planners, providers and consumers of education.
6.4
How to build a CIP as a method of assessment
Rosalie Ber (B. Rappaport Faculty of Medicine, Technion - Israel
Institute of Technology, P O Box 9649, Haifa 31096, Israel)
Sally Brown (Institute for Learning and Teaching in Higher
Education, Genesis 3, Innovation Way, York YO10 5DQ, UK)
Background: The comprehensive integrative puzzle (CIP)
is a novel assessment tool, aimed at assessing students’
(and physicians’) clinical reasoning and diagnostic
thinking. It is basically an “extended matching” crossword
puzzle. Its answering sheet is a grid comprised of rows and
columns. The left-hand column contains brief clinical
vignettes or diagnoses (for beginning students) to which
the student is required to match, stepwise, the various
“disciplinary investigations/findings”. When the puzzle is
completed each horizontal row reflects a coherent medical
case, i.e., integrative ability, (diagnostic-thinking and
clinical-reasoning) and the vertical columns measure the
student’s proficiency in interpreting medical history data,
physical examination findings, laboratory test results, ECG,
imaging, special tests, pathology and pharmacology. The
dual scoring system stresses the integrative elements of
diagnostic thinking and clinical reasoning, while
preserving the ability to discern proficiency in various
disciplinary elements.
Background: Lectures continue to be a principal means by
which the higher education curriculum is delivered in many
universities internationally. However, with the increasing
use of Communication and Information technologies and
distance/off campus learning methods, many today are
questioning the purposes and value of lectures in a
changing pedagogic environment. This workshop will
explore some of these issues and will encourage
participants to consider how best to make lectures a positive
learning experience.
Objectives: By the end of this workshop, participants will
have had the opportunity to:
• discuss the purposes of lectures;
• share experiences of how to build interactive elements
into their lectures;
• evaluate a range of techniques to integrate student
learning into the lecturing process.
– 4.51 –
Section 4
Objectives :
Objectives: Provide the participants with guidelines and
practice for preparing CIPs for assessment of students (at
different levels of study), interns and residents.
• To share experiences of undergraduate PPD curricula
placing emphasis on the four phases
• To review case studies of PPD curricula in order to
identify strengths and weaknesses
Proposed structure: Demonstration of an interactive
computerized webCIP on the internet. In groups of 4-5,
participants will be guided how to build a CIP. Written
guidelines and reprints of Medical Teacher 25:171-176,
2003 paper will be provided.
Outcomes :
• To highlight key issues in PPD curricula so that
participants could use this knowledge to make the
curricula more effective in their institutions
• To facilitate research in PPD curricula
Who should attend: Educators, clinicians and members of
pre-clinical divisions involved in assessment/evaluation of:
integration of preclinical and clinical studies, clinical
reasoning and diagnostic thinking.
Who should attend? All those involved in the PPD
curriculum whether as teachers or as learners
Outcomes: Confidence in heading a team for preparing
CIPs.
6.5
Content/Structure: Participants will explore their
experiences of PPD individually, in small groups and in
plenaries under the guidance of the facilitators.
Assessment in PBL medical schools: what are we
measuring?
Introductions and background (10 minutes)
Ara Tekian (University of Illinois at Chicago, Department of
Medical Education (m/c 591), 808 S. Wood St, CME 986, Chicago
IL 60612, USA) and Mathieu Nendaz (University of Geneva,
Switzerland)
Reflections and critical thinking on PPD (20 minutes)
Prioritised issues in PPD based on experiences (10
minutes)
Background: PBL has been implemented in many medical
schools; however, the match between the assessment
methods and the educational objectives associated with
PBL curricula continues to be a major challenge.
Objectives: At the completion of this workshop, participants
will be able to:
1 Identify and classify measurement instruments as a)
outcome-oriented, or b) process-oriented,
2 Examine the characteristics of these instruments, and
discuss other related issues, such as criteria setting,
scoring, grading, reporting results, and frequency of
assessment,
3 Critique the outcomes of the assessment methods used
at their institutions and examine if they match the
philosophical tenets of PBL,
4 Select appropriate instruments for each type of objective.
PPD from the students’ perspectives (Cardiff, UK), and from
a case-based curriculum (Monash, Australia) (20 minutes)
The four phases of PPD and challenges therein (30
minutes)
Summary, reflection and evaluation (10 minutes)
6.7
Celia Popovic and Bev Merricks (University of Birmingham Medical
School, Edgbaston, Birmingham B15 2TT, UK)
Background: In 1999, 3 positions called ‘Education/IT
Facilitator’ were created at Birmingham University Medical
School because the management identified the need to
bridge the gap between the design of the course in the
Medicine School and the delivery in NHS hospitals and
GP Surgeries. Following a 3 year pilot project, the posts
were made permanent and expanded to 5 positions.
Proposed structure: Short presentations, group work, and
in-depth discussion. Handouts will be distributed.
Who should attend: This is an intermediate level workshop
for educators with some experience of assessment
methods in PBL medical schools. Especially appropriate
for course directors and curricular deans.
Objectives: We will use our posts as a case study to
interactively explore the problems and opportunities
experienced by this project. We will show how these posts
proved to be a successful answer to a common and
growing problem that may be experienced by Schools of
Medicine and associated clinical teachers.
Outcomes/take home messages: Participants will reflect
on their own assessment practices in light of the
knowledge acquired during the workshop, and list two take
home points that will improve the overall assessment
system in their own institution.
6.6
Proposed structure: Short presentation followed by a small
group exercise, then a final summary of the key lessons
learnt in the Birmingham case.
Who should attend: Anyone involved in teaching
undergraduate medical students.
Creating, implementing and evaluating the personal
and professional development curriculum
Outcomes/take home messages: With the pressures of
increasing student numbers, more stringent quality
assurance procedures, and the professionalisation of
medics as teachers, it is important that all those involved in
teaching (and learning) on a Medical undergraduate
course know about and are enabled to deliver what a
central body has planned and expects. We are suggesting
that this is achievable by recruiting Education
Technologists who understand the pressures that clinicians
face and who are able to work with them to provide timely
support and advice.
Iain Robbé and Kate Drysdale (University of Wales College of
Medicine, Temple of Peace & Health, Cathays Park, Cardiff, CF10
3NW, UK) and Debra Nestel (Centre for Medical and Health Sciences
Education, Monash University, Australia)
Background : Undergraduate curricular outcomes are
based on explicit principles of professional practice. In
medical education, knowledge and skills outcomes are
well recognised and their teaching occupies a high
proportion of the curriculum. The personal and professional
development (PPD) curriculum is particularly relevant to
outcomes concerned with attitudes and behaviour e.g. self
directed learning to maintain clinical competence, effective
communication, reflective learning. This workshop will
explore the four phases of the PPD curriculum i.e.
development, implementation, assessment and evaluation
in different undergraduate courses.
Bridging the gap between curriculum development
and delivery
6.8
Reach out and “teach” someone: instructional
methods in the classroom
Steve Johnson (Carolinas HealthCare System, 10 Alexander Drive,
#514, Asheville, NC 28801, USA)
Education of adult learners in the classroom setting can
be difficult. This session is designed to discuss the ways in
– 4.52 –
Section 4
which adults learn: cognitive, affective, and psychomotor.
The session will provide insight into how to apply each of
these domains into a well-rounded educational
experience. These principals apply to all teaching areas.
Emphasis will be placed on scenario based education, as
well as motivational techniques that may be used during
the educational session, presentation organization, audio
visual selection, distance learning, and preparation for
speaking to a targeted audience. The focus of this
presentation will be allied health providers transitioning
from care provider to dynamic presenters and educators.
Background: Recent conferences have prognosticated
future approaches to health care. These are, for example,
the movement towards “Prospective Medicine” with
emphasis on risk factor identification and prevention
(Association of American Medical Colleges, 2002) and the
effects of the Internet and e-mail on the doctor-patient
relationship (International Conference on Communication
in Healthcare, 2002 & American College of Physicians/
Institute of Medicine, 2002). In order to prepare medical
trainees for their future work, we need to keep pace with
imminent changes as well as with those projected down
the road. Equally we need to look into instructional and
assessment strategies that may be required to adapt to
changes in the health care environment. The theme of the
AMEE 2000 conference was devoted to medical education
in 2020. This workshop will be an opportunity to explore
future trends further, and to draw conclusions for the
present.
Outline:
1 Three Ways Adults Learn and the Myths
2 List the 8 Steps of Presentation Organization
3 Audiovisual Selection
4 Classroom, media, and learning methods
5 Hakuna Mattata
Objectives: By the end of the workshop participants will be
able to:
a) describe the complexities of change in medical
education
b) discuss how future trends in health care could require
adjustments in medical education
c) contemplate how changes in medical education could
affect heath care
d) create a personal plan for incorporating future trends in
current practices
Objectives:
1 Understand the way adults learn and the myths that
surround them
2 Discuss the use or misuse of multimedia in the
classroom
3 Discuss Motivational Techniques and Scenarios
4 Understand topic delivery and transition from health care
provider to dynamic educator.
Teaching methods: Lecture; PowerPoint presentation;
Open discussion/audience participation; Video
Structure:
6.9
5 min Introduction and orientation
10 min Past experiences with change (exercise in pairs with
discussion)
10 min The complexities of change in medical education
(presentation)
20 min Health care in 2023 (small group exercise and
discussion)
10 min Integrating future projections into medical education
planning (presentation)
30 min Medical education in 2023 (small group exercise and
discussion)
20 min Creation of a personal strategic plan (exercise and
discussion)
Medical education – trainer or trainee’s responsibility?
Workshop for Directors of Postgraduate Medical Education
(DPGME)
Dr Alistair Thomson, Dr Andrew Long and Dr Kit Byatt (National
Association of Clinical Tutors, 1 Wimpole Street, London W1M
8AE, UK)
Background: In the 1990s systems of appraisal and
assessment for doctors in training usually required
centrally-held copies of documentation. With training
portfolios and personal development plans, trainees have
been given the responsibility for collating and storing their
own educational documentation, for presentation when
required. These will become increasingly important as
tests of competency and revalidation are introduced..
Who should attend: Individuals involved in developing
educational programs
Objectives: This workshop aims to identify the issues and
develop a model for good practice to assist Directors of
PGME (DPGME).
Outcomes/take home messages:
• Changes in medical education are influenced by many
factors
• Strategic planning requires a courageous look at the
future and a critical examination of the present
• Everyone can take part in creating the future of medical
education
Proposed structure: Participants will explore the issues
surrounding responsibilities for PGME in plenary and small
group work, under the guidance of experienced facilitators.
Who should attend: Primarily, those with strategic and
operational responsibility for postgraduate medical
education.
Outcomes/take home messages: If education proceeds
smoothly trainee responsibility works well. If problems arise
trainers may have to approve trainees whose competence
they doubt. This implies risk to trainer, trainee and ultimately
the patient. Trainees’ responsibility for their own education
and records is paradoxically arriving at a time when
disputes about educational progress are increasing.
Resolution of these disputes may rest, in legal terms, on
the production of evidence of due process correctly
conducted by trainers (e.g. Educational Supervisors,
Postgraduate Clinical Tutors). Such evidence may in future
only be available through the trainee if central copies are
not kept.
6.10
6.11
Didactics for beginners
Brigitte Grether (Dean’s Office, Faculty of Veterinary Medicine,
University of Zurich, Winterthurerstrasse 204, CH 8057 Zurich,
Switzerland), E Brenner (Institute for Anatomy, Histology and
Embryology, Faculty of Medicine, University of Innsbruck,
Austria), German Clénin (Sportwissenschaftliches Institut SWI,
Magglingen, Switzerland) and Martina Kadmon (Dept. General
Surgery, Heidelberg University, Germany)
Background: The Alumni of the MME (Master of Medical
Education) Programme in Berne would like to share the
knowledge and skills they have acquired during the
programme with those who have just – by coincidence or
special interest – entered the community of medical
educators, with those who are at the same point of their
career as medical educators as the MME participants were
BEFORE they had entered the MME programme – the
“Beginners”.
Looking towards the future: What’s in store for
medical education?
Elizabeth Kachur (Medical Education Development, 201 East 21st
Street, Suite 2E, New York NY 10010, USA)
– 4.53 –
Section 4
• Experience a broad range of SP activities including a
formative Objective Structured Clinical Examination
(OSCE)
Objectives of the workshop: Participants will:
• identify some fields of knowledge which are useful for
educators
• acquire methods to interact with students in large plenary
sessions
• compare different examination methods
• learn how to apply the most important rules/to avoid the
most common errors in visualisation
• be motivated to enter a MME or similar programme.
Proposed structure: We will use interactive and experiential
activities in large and small groups. These include:
• reflective exercises which promote exchange of ideas
• problem solving exercises
• role playing
• demonstrations, and presentations
• participation in a formative OSCE
• question and answer opportunities
Proposed structure:
1 Introduction (5 min.)
2 Interacting with students in lectures – it’s possible! (30
min)
3 Visualisation – the clue to understanding (30 min)
4 Which examination method for which purpose? (30 min)
5 Conclusion(10 min)
Who should attend: anyone interested in starting to use
standardized patients or expanding their use of standardized
patients or anyone curious about what is possible using
SP methodology
Learning outcomes: Participants will:
• learn about the countless possibilities for enriching
curriculum through SP-based educational strategies
• gain insight into how SPs may be integrated into their
own curriculum
• acquire basic knowledge of how to set up and maintain
a SP Program
• acquire practical skills needed to recruit and train SPs;
design and cost-out SP-based initiatives.
• develop confidence to proceed with initiation and
implementation of SP-based programs
Methods: Short(!) presentations, a lot of participants’ activity
and a huge list of further reading
Who should attend: “Beginners”: Educators who are in
charge of different educational tasks but who do not yet
have a systematic training in the various fields of didactics.
Educators who would like to know what you can learn in a
MME or similar programme.
Outcomes/take home message: We want to open a gate
for you. You are invited to enter and find the tools you need
to improve teaching and learning in your environment.
See also the MME website: http://www.iawf.unibe.ch/mme/
(in German); University of Illinois at Chicago, College of
Medicine, Master of Health Professions’ Education MHPE:
http://www.uic.edu/com/mcme/mhpeweb/Home.html
6.12
6.13
Mastering the Scholarly Process
William McGaghie (Northwestern University Feinberg, School of
Medicine, Ward 3-130, Mail Code - W117, 303 E Chicago Avenue,
Chicago, IL, USA)
Enriching Curriculum Through Standardized
Patient-Based Programs
Background: Medical schools worldwide are academic
environments, organizations where scholarship in several
forms is advanced in many disciplines. Academic work
done by medical school faculty – teaching, original
research, research synthesis, application and consultation
– is scholarly by definition and tradition. Individual faculty
members, especially those in early career, frequently
struggle at becoming productive scholars. This workshop
will address ways that medical faculty can increase the
quality and quantity of their scholarly work.
Anja Robb, Nancy McNaughton and Diana Tabak (University of
Toronto, Centre for Research in Education, Standardized Patient
Program, 200 Elizabeth Street, 1 Eaton S. Room 565, Toronto,
Ontario M5G 2C4, Canada)
“For the things we have to learn before we do them, we
learn by doing them.” Aristotle
Background: Standardized Patients (SPS) are more
relevant today than ever before as a methodology for
teaching and assessment in medical education. Times
and attitudes have changed profoundly in healthcare and
medical education in part as a result of extraordinary
advances in science and digitizing technology. In this ‘brave
new world’ we must ensure that students still know how to
relate to people and understand the therapeutic value of
the doctor-patient relationship. Students must be
adequately prepared to meet the complex responsibility of
patient care. Enterprising collaboration between faculty
and standardized patients is yielding a broad spectrum of
possibilities in teaching, assessment and research. SPs
are value added to teaching and assessment. They allow:
a more systematic delivery of curriculum, more objective
assessment of clinical skills, an enhanced learning
environment for students, no harm to patients, and they
promote better health outcomes. Most important of all,
Standardized Patients help keep the face of medicine
human.
Objectives: Participants will:
1 Recognize that scholarship in medical schools is
expressed in at least four ways: teaching, original
research, research synthesis, application and
consultation.
2 Practice skills of planning, organizing, self-management,
and networking toward the goal of increasing the quality
and quantity of their scholarly work.
3 Begin to form a collegial network with other faculty
interested in medical education scholarship.
4 Increase their fund of “tacit knowledge” about
scholarship in medical schools.
Structure:
• Opening remarks, framing the session, introductions
• Discussion: “tacit knowledge” about scholarship in
medical schools
• Skill development: planning, organizing, selfmanagement, and networking
• Participant reports
• Wrapup
Objectives:
• Stimulate participants’ ideas and understanding of the
vast possibilities in SP based medical education
• Discover how to enrich curriculum through SP teaching
and assessment
• Demystify logistics of starting and maintaining a
Standardized Patient Program
• Learn practical skills needed to work with standardized
patients
Who should attend:
• Medical school faculty in early career
• Senior medical faculty (prospective mentors)
Outcomes/take home messages:
• Scholarship is expressed in several ways
• Scholarly productivity does not occur by chance
– 4.54 –
Section 4
The educational philosophy includes:
• ‘just-in-time’ learning;
• ‘just-for-you’ learning;
• multiprofessional learning;
• the continuum of learning.
• Planning, organizing, self-management, and networking
are keys to success
• Medical faculty should manage their careers actively
6.14
Ibero American Group
Margarita Barón-Maldonado, on behalf of AMEE
Background: During the last decades medical education
has been the subject of considerable change in an attempt
to improve its quality. The goal is to produce doctors
capable of meeting the ever-evolving social demands who
adapt to the very rapid progress in biomedical scientific
knowledge and technology. Furthermore, as a
consequence of globalization and of strategic geopolitical
agreements, the mobility of doctors is a fact. To meet these
challenges medical educators, health and educative
authorities and others with responsibility, strive to find the
mechanisms leading to quality assurance and
improvement of the whole process of making a doctor.
Among those mechanisms, the evaluation of the process,
structure and outcomes of medical education phases of
the continuum seems to be a powerful tool to secure the
adequate level of the training of a doctor. Thus, countries
are moving towards evaluation of the process and the
outcomes and, consequently, institutional accreditation.
At first, the movement lies in a voluntary institutional
commitment of quality improvement which finally leads to
compulsory assessment and institutional accreditation.
The IVIMEDS programme offers significant advantages to
students, to academics and professional institutions and
to society.
6.16
Introduction: The session will deal with the development,
use and implementation of standards in all three phases
of the continuum of medical education. In addition a small
presentation of highlights from the recent WFME 2003
World Conference on Global Standards will be given.
Based on the presentations the participants will be invited
to debate the experiences from the use of standards in
medical education.
6.16.1 Highlights from the WFME World
Conference March 2003
Hans Karle (World Federation for Medical Education (WFME),
University of Copenhagen, Panum Institute, Blegdamsvej 3, 2200
Copenhagen N, Denmark); Jørgen Nystrup (Roskilde, Denmark) and
Lief Christensen (WFME, Denmark)
Proposed content: The AMEE Ibero American group will
discuss the specific health needs that should be taken into
account to adapt the international projects of medical
education assessment and institutional accreditation to a
number of different countries from different continents and
different socio-economic and cultural environments.
6.15
International work with Standards in Medical
Education
Working since 1997 with global standards in medical
education the World Federation for Medical Education
(WFME) recently published a Trilogy of Global Standards
covering Basic Medical Education, Postgraduate Medical
Education and Continuing Professional Development
(CPD). The Trilogy served as background material for the
World Conference in Medical Education in Lund, Sweden
and Copenhagen, Denmark, March 2003, entitled: Global
Standards in Medical Education For Better Health Care.
Some 500 colleagues from 88 countries attended this first
open World Conference. The Trilogy represents the first
attempt by a representative body within medicine to develop
standards as a toolbox for quality development of medical
education and in response to the increasing
internationalisation of the medical workforce. The
standards received fully endorsement at the Conference.
Pilot projects conducted in a number of medical schools
in the six WFME Regions about the usefulness of the
standards were presented, supporting the endorsement.
In reporting from the Conference WFME is informing about
the concept and use of the Standards as a toolbox for
quality development at the institutional level or at the
national or regional level for accreditation purpose.
The International Virtual Medical School (IVIMEDS): a
response to current challenges in medical education
Ronald M Harden (IVIMEDS, Tay Park House, 484 Perth Road,
Dundee DD2 1LR, UK)
Background: There are a number of challenges facing
medical education. These include a response to changing
medical and societal needs, opening access to medical
training, providing a continuum of training through the
different phases, the training of doctors to work as a team
and the adoption of new approaches to curriculum
planning and the use of the new learning technologies.
The International Virtual Medical School (IVIMEDS) is a
collaboration of more than 100 leading medical schools
internationally, committed to:
• improving health and tackling human disease by
providing a blend of high quality student-centred elearning and face-to-face learning for medical students,
trainees and doctors;
• setting new standards in education by drawing on
innovative and established curriculum and assessment
practice of Partner Institutions and ensuring maximum
benefit from new educational technologies;
• providing a global perspective on medical practice that
takes account of the distinctive contributions by different
members of the healthcare team.
WFME hope to join forces with WHO in working worldwide
with medical schools and agencies responsible for
postgraduate medical education and CPD to use the
WFME standards in combination with peer-support to
increase quality of medical education.
6.16.2 WFME Standards for Continuing
Professional Development
Jørgen Nystrup (Roskilde County Psychiatric Hospital, DK-4000
Roskilde, Denmark), Hans Karle (WFME) and Leif Christensen (WFME)
Key elements in the IVIMEDS programme include:
• e-learning and face-to-face learning opportunities;
• a framework of learning outcomes;
• a bank of virtual patients;
• tools for formative and summative assessment.
Early in 2003, the World Federation for Medical Education
(WFME) completed its task in defining a set of global
standards for Continuing Professional Development (CPD)
of Medical Doctors. The process leading towards these
standards was similar to the tasks of producing standards
for Basic Medical Education and for Postgraduate Medical
Education. The three sets of standards were published as
a Trilogy serving as background material for the World
Conference in Medical Education in Lund, Sweden and
Copenhagen, Denmark, March 2003. The Trilogy
represents the first attempt by a representative body within
medicine to develop standards as a toolbox for quality
development of medical education and in response to the
increasing internationalisation of the medical workforce.
Facilitation of learning is achieved by:
• a curriculum map;
• electronic study guides;
• face-to-face and on-line tutor support;
• peer-to-peer learning.
– 4.55 –
Section 4
CPD is delineated from Postgraduate Medical Education
and linked to the concept of life long learning, beginning at
admission to the medical school.
It is well known that even the most sophisticated education
can not provide student with competence sufficient for his/
her professional life. Higher institution has to make a
foundation for future professional training and continuous,
life-long education. This practice is widely accepted
worldwide including European countries. On contrary to
aforementioned, according to the existing Georgian
legislation, postgraduate and continuous medical
education has moved to the competence the Ministry of
Health Care and Academy of Advanced Training of
Physicians (track of old Soviet system). This has been
considered as the most significant and “painful” barrier for
the proper development of medical education. Despite
resistance from high medical schools, they were
“decapitated” by the regulations and orders issued by the
Ministry of Health Care. Due to this improper legislation,
the Tbilisi State Medical University, which has been the
most competent high medical school in Georgia actually
is loosing its main function - offering postgraduate and
lifelong education.
A particular problem in CPD is the complex of agents
involved, including the doctor her/himself, universities,
industry, professional trade unions, private for-profit
providers, etc. Who can be responsible for quality
development and assurance? WFME succeeded in
formulating a set of standards based on the same concept
of two levels of attainment: (a) a basic level, which must be
met, and (b) a developmental dimension that provides a
goal, which institutions should strive to achieve. Pilot
projects are now warranted!
6.16.3 Profiles of Medical Schools: the use of
WFME Standards in pilot studies
Leif Christensen (World Federation for Medical Education
(WFME), University of Copenhagen, Panum Institute, Blegdamsvej
3, 2200 Copenhagen N, Denmark)
In conclusion, it is suggested that AMEE has to elaborate
recommendations concerning standards pf postgraduate
and continuous education regarding Post-Soviet countries.
Background: More medical schools expressed an interest
and volunteered to test the WFME global standards for
basic medical education than it was possible to
accommodate within the originally planned pilot study.
Consequently, WFME decided to conduct a second pilot
study.
6.16.5 Accreditation criteria and minimum
standards for undergraduate medical
education in Gulf Council Countries:
implications on quality in medical education
Methods: The medical schools in pilot study II also agreed
to carry out a self-evaluation based on the WFME standards
and with the use of the accompanying guidelines.
Furthermore, the schools were asked to report the results
of the exercise in a highly structured and standardized way
by using 2 questionnaires. For each standard the schools
were asked to specify:
a) Information on the standard (coverage, existing or new
information and the types of information used),
b) Present status regarding fulfilment of the standard,
c) Reactions towards result of appraisal (expected or
surprising, indicating a strength or weakness),
d) Use of result in quality improvement (initiating
considerations, planning or actions).
Hossam Hamdy (Arabian Gulf University, College of Medicine and
Medical Sciences, P O Box 22979, Manama, Bahrain)
Aim: The main aim of any accreditation process is to
encourage improvement in medical education and ensure
that standards of quality in higher education are in practice.
The GCC Medical Colleges Deans Committee while
addressing their responsibility towards improvement in
medical education in the GCC, took the initiative of making
the necessary recommendations and proposals for the
development of guidelines on standards for accrediting
medical schools in the Arabian Gulf countries.
Summary of work: Domains and standards were identified
based on two concepts. The first about measuring input,
process, output and outcome of an educational
programme. The second concept on evaluation of different
curriculum dimensions which include “curriculum on
paper,” “curriculum in action,” “learned curriculum” and
the “used curriculum”.
Material: A total of 12 medical schools were included in the
pilot study II of which 10 schools has submitted their reports.
Some preliminary results: From the point of view of WFME
the purpose of the pilot study is not to evaluate the
participating medical schools but to test the standards and
their usefulness. Only in a few cases has lack of information
made it impossible for a school to undertake an appraisal
of its performance in relation to a standard. In most cases
existing information has been up to date and sufficient.
Also, it is rare that an appraisal is not undertaken because
the standard is regarded as less relevant. Differences in
fulfilment of the standards seems to reflect differences
between schools with regard to the national system they
are a part of, the size, structure and age of the institution,
etc.
The standards were grouped into seven categories:
a) mission and vision
b) the undergraduate medical education programme: (i)
aims and objectives; (ii) learning strategy; (iii) curriculum
structure and organization; (iv) programme
implementation; (v) student assessment; (vi) programme
evaluation
c) the students
d) the faculty members
e) learning resources at teaching hospitals and training
centers
f) management of the educational process
g) scientific research
From the point of view of the medical school the results of
the exercise is of interest as an indication of its quality and
possible needs for improvement. A profile of the medical
school and its programme can provide an overview of the
present status in relation to the WFME standards and draw
attention to urgent needs and fruitful avenues for quality
improvement. From the pilot study, it should be noted, that
in almost every instance, where the basic standard is not
fulfilled or only partly fulfilled and this is regarded as a major
weakness considerations of change and planning of action
for quality improvement has been initiated.
Results: A total of 50 standards related to the identified
categories were developed. A guide to the preparation of
an accreditation submission and the self-assessment
questionnaire was structured around the seven identified
areas and their related standards.
Conclusion: It is hoped that the approval of these standards
by the authorities responsible for education and health in
the GCC countries, will have a significant impact on the
quality of medical education in the region.
6.16.4 Some issues concerning postgraduate
education in Georgia
R Khetsuriani, Z Avaliani and G Simonia (Tbilisi State Medical
University, 33 Vazha Pshavela Ave, 380077 Tbilisi, GEORGIA
– 4.56 –
Section 4
Session 7A: Computer Based Teaching
7A 1
Attitude of medical students towards computerbased learning – effects of a randomized, controlled
exposure
Conclusions/take home messages: We successfully
implemented LaMedica-Nephrology into the curriculum
where it is now routinely used. Knowledge gain was equal
when using either print or online medium in a seminar
setting while the subjective assessment revealed a higher
motivation of the online group. ((Supported by the German
Ministry of Research and Education)
A K Hahne*, R Benndorf, P Frey and S Herzig (University of Cologne,
Department of Pharmacology, Gleueler Strasse 24, 50931 Koeln,
GERMANY)
Few medical students deliberately use computer-based
learning programs (CBL). Individual learner preferences
do not explain which students like CBL (Steele et al.,
Medical Education 2002;36:225-32). In our multi-centered
survey on 328 3rd-year students, learner strategies and
characteristics were not associated with expectations or
attitude towards CBL. However, (unspecified) experience
with CBL correlated with high attitude, expectations, and
inclination to use CBL.
7A 3
E A Dubois*, K L Franson, J M A van Gerven, J H Bolk and A F Cohen
(LUMC, Onderwijscentrum IG, C5-53, Albinusdreef 2, C5-Q,
Postbus 9600, 2300 RC Leiden, NETHERLANDS)
Aim: To develop learning strategies that teach clinical
pharmacological principles, which can be applied
throughout an integrated Medical School curriculum.
Question: Does a well-defined exposure to CBL change
the CBL-attitude (possibly depending on individual learner
properties)?
Summary of work: These approaches must be 1)
consistently presented across the curriculum, 2) usable
for student self-learning, 3) integrated with other subjects,
and 4) embraced by teachers. Consistent presentation was
achieved by developing a uniform icon language. The icon
language was consistently used throughout the curriculum,
in all teaching materials addressing pharmacological
mechanisms. The icons were incorporated into
Macromedia Flash® programs, challenging students to
interactively solve basic pharmacologic/physiologic
problems. Another computer program integrated basic
pharmacological principles with physiological and
pathophysiological mechanisms (ie showing drugs
interacting with diseases). This program uses a Microsoft
Access Treeview® database, and combines graphics,
explanation texts and formative feedback questions.
Design: Randomized, controlled exposure to a 66-module
cardiovascular pharmacology CBL-program, implemented
within 3rd-year courses in two medical schools.
Primary endpoint: Attitude towards CBL (validated
questionnaire).
Secondary endpoint: Specified learning outcome (30
MCQ). n=167 of 262 course participants agreed to
participate, taking a full pre-test (questionnaire, MCQ). 70
gained access to CBL (97 controls).
Summary of results: Access to (n=69) or actual use of CBL
(>1h,n=45) decreased CBL-attitude (p<0.05 vs. n=96
controls). Learner properties and duration of CBL use did
not quite explain the change in attitude (n=45,p=0.07).
MCQ results were similar between CBL users and controls.
However, duration of CBL use (b=0.24,p<0.05) and reading
(b=0.37, p<0.01) explained test performance (R2=0.16,
n=112), together with learner properties (interest,
independence, repetition-strategy).
Summary of results: Assessment was achieved by students’
utilization of and comments on the programs. Students
increasingly use the programs as they progress through
the curriculum. Students appreciate the teaching strategies
and are successfully challenged by these self-study
methods. Initial hesitation by teachers made way for
widespread use of and contributions to the graphical
materials.
Conclusions/take home messages: CBL exposure can
adversely affect attitude towards CBL.
7A 2
Teaching glomerulonephritis using the multimedia
online system LaMedica
Conclusions/take home messages: Icon language
computer programs that are integrated throughout the
curriculum provide pharmacology knowledge on which
both students and teachers increasingly rely.
S Stracke*, R Friedl, C Aymanns, N Kadlec, B Lindemann, S
Huettner and F Keller (University of Ulm, Division of Nephrology,
Robert-Koch-Str.8, Ulm 89081, GERMANY)
Aim: Complex nephrological diseases like the
glomerulonephritides are difficult to understand. The
purpose of this study is to assess the impact of a newly
developed online computer-system (www.LaMedica.de)
in improving student motivation and knowledge.
Application of an icon language for clinical
pharmacology education throughout an integrated
curriculum
7A 4
Making the virtual real: the true challenge of digital
learning
Michael Begg* and Rachel Ellaway (University of Edinburgh,
College of Medicine and Veterinary Medicine, Learning Technology
Section, Hugh Robson Link Building, 15 George Square, Edinburgh
EH8 9XD, UK)
Summary of work: We used the system in a seminar setting.
A self-study time was followed by tutor-guided patient
contacts. In a prospective study, we performed a
psychometric evaluation (HILVE, SUCA, FAM) with 32
medical students and an additional formative evaluation
in a double cross-over design with 12 students to compare
the knowledge gain using either a print version or the
LaMedica online nephrological module. Frequent
confounders were carefully controlled.
This short communication shows how a study of immersion,
interaction and narrative within the context of computer
gaming provides base material for a focused study into
learning applications for medical students. Medical
education focuses, necessarily, on that which is real: real
patients, real ethical issues, real experience of real
situations. However, it is not always possible to provide real
patients, situations, or ethically complex scenarios to
undergraduate students. While virtual learning
environments, simulations, reusable learning objects, and
other forms of digitally delivered learning content provide a
plethora of alternatives to hands-on experience, it continues
to maintain a peripheral role within the overall context of
curricula. By comparing observations of simulation training
in resuscitation technique with the conclusions of the study
of game environments, the communication suggests that
Summary of results: The system contains instructional
applications on the eight glomerulonephritides. The
psychometric evaluation revealed that medical students
are motivated to a higher degree and feel more pleasure
when learning with the nephrological online module of
LaMedica. However, the formative evaluation of the online
versus print medium showed equal results in both groups
with no significant difference.
– 4.57 –
Section 4
by offering the student a character context within a
simulated, or virtual, environment, by controlling the balance
of information input from both immediately physical and
virtual sources, and by ensuring a good trade-off between
high quality consequential interaction (agency) and
narrative momentum (the temporal aspect of immersion),
it is possible to make the virtual real, inasmuch as the
student experiences the application as a real event, and
acts/reacts, and learns, accordingly.
7A 5
Method: One region’s VDPs and trainers received elearning; another’s received a traditional one hour lecture.
Retention and understanding were tested and compared.
Personal preference was assessed in group interviews.
Summary of work: Twenty-four trainers and their VDPs
undertook an e-learning module on clinical governance
while another 24 trainers and VDPs received a traditional
lecture. The groups were subsequently assessed for their
relative retention and understanding of the key issues
concerning the topic. There followed a group evaluation
that examined preferences and observation of the
respective learning experiences.
Comparing lecture and e-learning as pedagogies for
new and experienced professionals in dentistry
Summary of results: Significantly greater retention for the
trainees occurred from lecturing rather than e-learning,
and for the trainers e-learning was significantly more
successful than lecturing.
Liz Browne* Shalin Mehra, Raj Rattan and Gary Thomas
(Westminster Institute of Education, Oxford Brookes University,
Harcourt Hill, Oxford OX9 2AT, UK)
Aims: To disseminate the results of a research project that
compared lecture and e-learning course delivery to a group
of Dentist trainers and their trainees.
Conclusions/take home messages: Small numbers in this
study preclude wide generalisation. However, the results
point to the benefits of face-to-face interaction for
inexperienced staff, and the benefits of the speed and
manageability of e-learning for busy, more experienced
staff. The need for a discussion facility to be incorporated
into ICT innovations to CPD (via, for example, online
‘chatrooms’) is also highlighted, with the potential of greatly
enhancing e-learning efficacy.
Objective: To evaluate the relative effectiveness of elearning versus lecture learning in Vocational Dental
Practitioners (VDPs) and trainers.
Design: Experimental comparison of two groups’ learning
retention.
Setting: VDPs and trainers from two regions were assessed
by independent researchers.
Session 7B: The Final Exam
7B 1
CLEO component of the Medical Council of Canada
qualifying examination Part 1: a four-year appraisal
of its incorporation
7B 2
Jacques Etienne Des Marchais*, T J Wood, D E Blackmore and W D
Dauphinée (Medical Council of Canada, 12420 rue JosephEdouard-Samson, Montréal, Québec H4K 2N9, CANADA)
Erich Brenner*, Bernhard Moriggl, Axel Pomaroli and Herbert
Maurer (Institute for Anatomy, Histology and Embryology,
University of Innsbruck, Muellerstrasse 59, A-6010 Innsbruck,
AUSTRIA)
Background: The Medical Council of Canada (MCC) is
one of the partners responsible for responding to emerging
social needs within the medical community, such as the
need to be aware of legal and ethical issues in physician
practice. In 2000, the MCC incorporated a new component
called Considerations of the Legal, Ethical, and
Organizational Aspects of the Practice of Medicine (CLEO)
into the Qualifying Examination (MCCQE) Part I, content
of which is based on the MCC Objectives, made available
to medical schools and candidates.
Anatomical dissection can contribute not only to objectives
in the cognitive domain, but also to objectives in the affective
as well as psychomotor domain, and even to the domain
of professionalism. Therefore, adequate assessment
strategies will have to be used. For objectives in the
cognitive domain, we suggest structured oral examinations.
For objectives in the psychomotor and affective domain as
well as in the domain of professionalism, we suggest three
different forms of structured observations and a portfolio.
Structured oral examinations should be individual
assessments, where each exam comprises a distinct
number of questions. Each question should be graded on
a three-point scale. Structured observations should be
individual assessments and comprise structured
observations of (1) the students’ active contributions, (2)
their work’s product, the specimen, and (3) of (selected
clinical) skills. Each structured observation should be
graded on a three-point scale.
Aim of presentation: The goal of this study is to determine
if the variability in scores between and within medical
schools will diminish as the CLEO becomes an established
examination component.
Summary of work: Candidate scores for Canadian schools
first time examination takers were compared across four
administrations of the MCCQE Part I.
Summary of results: Overall differences in scores between
the CLEO and the MCQ components of the examination
have diminished from 2000 to 2003. For individual schools,
the variability between CLEO and MCQ scores were large
when the CLEO was first administered but have diminished
over time.
Conclusions/take home messages: This study shows how
a non-biological component of clinical competence takes
time to be integrated into Canadian school curricula as
measured by this examination.
Ideas for assessing educational objectives from
different domains within the anatomical dissection
course
The portfolio should be a group assessment where all
students working on one cadaver will have to contribute to
one portfolio. This portfolio should assess the students’
teamwork and documentation, the usage of old and new
media, ethics and self-assessment. Each item of the
portfolio should be graded on a three-point scale.
7B 3
A comparative study of measures to evaluate
medical students’ performances
Samkaew Wanvarie* and Boonmee Sathapatayawongse
(Ramathibodi Hospital, Rama VI Road, Bangkok, THAILAND)
Aim of study: To assess how MCQ, MEQ and OSCE
compare with each other and with cumulative GPA on
graduation.
– 4.58 –
Section 4
Summary of work: Medical students at the Faculty of
Medicine, Ramathibodi Hospital, graduated in 2000-2002
(1994-1996 matriculated cohort) were assigned to take
the MCQ (5th year), MEQ and OSCE (6th year). The scores
and cumulative GPA were analyzed for correlation using
SPSS software.
The most important task is the objectivity of the evaluation
of graduates’ preparation for practical activity. The decision
to conduct the JCGE was promoted, and a two-year
experience of conducting the Rector’s Examination,
including testing in 22 main medical areas and clinical
skills, was conducted in three steps. The first step is the
licensed examination “KROK - General medical
preparation”, part of a state approved standard of medical
education, conducted by the Ukrainian Test Center. The
second step is the JCGE approved by the ethical committee
and the anticipated patient’s consent. It includes bedside
evaluation of the common clinical skills of a graduate.
Summary of results: Of the 443 students, 95% completed
the testing. The correlation coefficients (r) between
cumulative GPA on graduation with score of MCQ, MEQ,
and OSCE were 0.646, 0.603 and 0.601 respectively (all
p-values < 0.001).
Conclusion: There was good correlation between score of
MCQ and GPA, possibly due to high objectivity and wider
coverage of test discipline. The correlation between OSCE,
MEQ and GPA questioned the content validity of the tests
whether they were measuring skill/performances or factual
knowledge.
7B 4
Manifestation of professional competence: is it
context-dependent or skill-dependent?
This part was conducted in a multifunctional hospital and
was led by a committee of four examiners: therapeutist,
surgeon, pediatrician, gynaecologist. The third step is the
testing of the graduate’s 25 required practical skills in a
specially equipped auditorium. The results of the JCGE
exposed areas for future improvement of the existing system
of education and the quality of preparation of doctors.
7B 6
M Mrouga* and I Bulakh (Testing Board, Pushkinska St 22, Suite
307, Kyiv 01601, UKRAINE)
Julio Cesar Gomez*, Pilar Talayero and Todd W Ellwein (Universidad
Westhill, Domingo Garcia Ramos, #56, Colonia Prados de la
Montaòa 1, Santa Fe Cuajimalpa, Mexico DF 05610, MEXICO)
Professional competence is a widely-used term which is
structured under several domains (like scientific
knowledge, clinical, communication skills, values, attitudes
etc). Particular structure of competence varies across
different institutions. However, properties of competence
are studied insufficiently. For example, it is not uniformly
decided whether competence can be decontextualised
or not, whether competence is a stage in education/
profession or its final purpose and so on. The paper will
present research results that have evaluated whether
manifestation of physicians’ professional competence
during assessment primarily depends upon medical
context (diseases, symptoms) or the aspect of competence
being evaluated. In Ukraine the requirements for
physicians’ professional competence are specified by State
Standards of Higher Medical Education. Assessment is
partially done by medical licensing examination (testing
exam) that mainly covers 4 aspects of professional
competence: ability to diagnose, to cure patients, to apply
preventive measures and to understand diseases relative
to various diseases and conditions.
7B 5
The design and implementation of the professional
exam at the Dn. Santiago Ramon y Cajal Medical
School, Universidad Westhill
In January 2004, the first generation of students of the Dn.
Santiago Ramon y Cajal Medical School at Universidad
Westhill will take the school’s Professional Exam, a final
student assessment required for graduation. A faculty
committee was created to design and implement this final
student evaluation. The committee’s responsibilities are
to design an assessment that will effectively measure each
graduating student’s clinical competence. This process
includes ensuring objectivity, knowledge integration,
instrument dependability and clinical reasoning in the
evaluation process. The development of the Professional
Exam involves two phases. The theoretical phase includes:
integrating the faculty committee into the design process;
steps taken to select test items; topic and clinical cases to
include; the weight of exam questions; test item revision;
and exam implementation. The practical phase requires:
selecting the hospital settings; selecting examining board
members in basic science, clinical science, and
sociomedicine; and determining the instruments used by
the examining board for student evaluation.
The first experience of conducting the Joint Clinical
Graduation Examination (JCGE) in a medical higher
educational institution in Ukraine
G V Dzyak*, T A Pertseva* and G V Gorbunova (Dnipropetrovsk
State Medical Academy, 9 Dzerzhinsky Street, Dnipropetrovsk
49044, UKRAINE)
Session 7C: The Curriculum (1)
7C 1
Curricular Quality Assurance (CQA): twenty-five
years of curricular evolution
publications, kept our curriculum under constant review
and facilitated the sharing of outcomes of innovations with
others and in turn to learn from them. Dissemination of
lessons learned via workshops, scholarly works and
publication assures the quality of our curriculum. Welldeveloped program evaluation is an essential component
of grant applications that assists in competing for grants.
Faculty members use data to support their academic
(scholarly) advancement. Data from program evaluation
are a necessary component of yearly educational retreats.
Collaboration with other programs and institutions provides
continuous stimulation and scholarship in education.
S Scott Obenshain*, Stewart Mennin, Arthur Kaufman (University
of New Mexico, School of Medicine, Room 114 BMSB 1, Albuquerque
NM 87131, USA)
Aim: To present elements of institutional culture that allows
for curricular improvement.
Summary of work: The University of New Mexico School of
Medicine has developed a system of continuously reviewing
and modifying its curriculum. The main feature of
Curriculum Quality Assurance results from a commitment
to longitudinal program evaluation and scholarship in
education. Investing in program evaluation from the outset
has allowed for continuous short-loop feedback to
curriculum planners, provided data for scholarly works and
Summary of results: Our curriculum is continuously under
review and revision.
Conclusions/take home messages: Program evaluation
and scholarship in education are necessary components
– 4.59 –
Section 4
of a high quality institution curriculum planning and
implementation process.
7C 2
Aim of presentation: Evaluation with respect to process,
structure and outcome of the teaching and learning process
is an essential element in curriculum planning and
curriculum adaptation, particularly during a curriculum
reform. The present paper reports experiences from a focus
group approach in the evaluation of course modules in the
undergraduate medical training.
What can interns teach their junior year teachers?
Soledad Campos, Cecilia Primogerio and Angel M Centeno*
(University of Austral, School of Biomedical Sciences, Av Juan
Peron 1500, B1629 AHJ, Pilar, Buenos Aires, ARGENTINA)
Summary of work: According to a validated approach
published by D. Nestel, students were asked to participate
in an evaluation session after the completion of course
modules in surgery in the first clinical year. Every focus
group comprised 7 students, the coordinator of the module
and an educator. The evaluation session was structured
following the same items of the questionnaire administered
during the written evaluation.
Aim: Basic science teachers are seldom aware of the
impact of their subjects on their students’ careers and
development as professionals. Our purpose was to
overcome this situation by promoting meetings between
interns and teachers.
Summary of work: Faculties from five out of eight basic
sciences participated in four meetings with interns. The
aim of these meetings was to ask students to describe and
reflect on their internship experiences and to promote their
self-assessment. Participating faculties were expected to
observe and register the contents of the meeting. We
conducted individual open interviews with these faculties
to gain understanding of their reflections, and if they
modified their teaching as a result of this.
Summary of results: Students clearly indicated that the focus
group approach is a valuable addition in the evaluation
system. With respect to different teachers and different
hospitals engaged in the course module very specific
information could be gathered. Moreover less personal
and time resources were required. This evaluation
approach also allowed re-evaluation of the quality of the
questionnaire items.
Summary of results: All of the teachers were impressed
with the personal and professional development of the
students and realized and regretted how far removed they
had been from them. They reflected upon students’
learning needs and the impact of the disciplines they teach
on their careers. The courses structure was reviewed.
Conclusions/take home messages: Meeting with their
former students is a strong empowerment strategy for basic
sciences teachers.
7C 3
Conclusions/take home messages: The focus group
approach to evaluation is a useful addition to the written
format and should be discussed for integration in the
evaluation system.
7C 5
Iskender Sayek* and Bülent Kylyc (Hacettepe University, Faculty
of Medicine, Department of Medical Education, Ankara 06100,
TURKEY)
Evaluation and quality development of clinical
clerkships
Aim: The aim of this study is to highlight the changing
trends in undergraduate medical education in Turkey.
Jørgen Hedemark Poulsen (University of Copenhagen, PUCS, Teilum
Building, Section 5404, Blegdamsvej 9, DK-2100 Copenhagen,
DENMARK)
Summary of work: The results of this study are based on
the reports of the Turkish Medical Association prepared in
1997, 2000 and 2002. A questionnaire was sent to the
Deans of the medical schools and the evaluation was
performed. The return rate of the questionnaire was 100%.
Aim: To give an account of a recent attempt to enhance
the educational quality of clinical clerkships at the hospitals
affiliated with University of Copenhagen.
Summary of results: Currently there are 50 medical faculties
in Turkey. The number of medical schools was 25 in 1990.
The number of students in the medical faculties was 33,456
and 31,738; the number of educators was 5,538 and 7,833
and the number of students per educator was 6.0 and 4.05
in 1997 and 2002 respectively. There has been a significant
change in the models of education used from a pure
lecture base (68% integrated, 32% course based
curriculum) in 1997, whereas in 2002 pure lecture based
curriculum is used only in 57.5% (45% integrated, 12.5 %
course based) problem based curriculum either in a hybrid
model (37.5%) or pure model (5%). 12 departments of
medical education have been established within the last
three years and courses for “training the teachers” have
been started in numerous schools. A national core
curriculum is to be started in October 2003 for
standardization which covers topics for knowledge, skills
and behaviour.
Background: External and internal evaluations have
revealed that the educational value of clinical clerkships
at this university not infrequently is less than optimal –
typically because the students participate in clinical work
only to a limited extent.
Therefore, a committee on quality development of clinical
clerkships has been appointed. Three members of the
committee, a clinical professor, a medical student and an
educationalist make site-visits to clinical departments.
Before the visit the committee receives relevant written
material concerning the clerkship from the department’s
professor. During the visit clinical teaching staff and
students are interviewed (semi-structured) separately.
Afterwards a report on the department as “host” of clinical
clerkships is drafted by the committee. Eventually, specific
suggestions for improvement are made collaboratively by
staff, students and the committee. The final report is sent
to the vice-dean for medical education as well as the
medical director of the teaching hospital in question.
7C 4
Changing trends in undergraduate medical
education in Turkey
Conclusions/take home messages: Significant changes
have taken place in Turkish undergraduate medical
education. The integration of problem based learning in
the curriculum is increasing and a national core curriculum
is to be used next year. There is a great effort to improve
the quality in undergraduate medical education and
standardization in Turkey.
Focus group approach to evaluation – a useful
addition to the written format
C Schirlo*, F Wirth, W Vetter and W Gerke (Office for Educational
and Student Affairs, Faculty of Medicine, University of Zurich,
Zurichbergstrasse 14, CH-8091 Zurich, SWITZERLAND)
– 4.60 –
Section 4
Session 7D: Postgraduate Training in the Early Years
7D 1
An evaluation ‘of practice, in practice’ of the GPPS
curriculum for SHOs (UK)
S J Brigley* and M J Golby (School of Postgraduate Medical &
Dental Education, University of Wales, College of Medicine, Heath
Park, Cardiff CF4 4XN, UK)
Conclusions/take home messages: It is possible to train
junior students to a high degree of clinical competence
with limited calls on staff resources.
7D 3
In 2003 the Royal College of Surgeons of England
introduced a pilot curriculum General Professional Practice
in Surgery that emphasised reflective and learner-centred
approaches to the training of senior house officers (SHOs).
The intentions and values of the curriculum required an
evaluation ‘of practice, in practice’, i.e., one grounded in
the ‘lived realities’ of the surgical SHO. An adaptable
methodology was necessary if the evaluation was to capture
the diverse understandings and interactions of SHOs and
others in this on-the-job learning. The evaluation was
conducted by a team of general educators and clinical
educators with a shared philosophy of teaching, learning,
curriculum, assessment. It was formative, trying to build on
the strengths of the pilot curriculum. The evaluation sites
comprised three district general hospitals and one
university teaching hospital. The team worked
collaboratively in the evaluation design, fieldwork, analysis,
interpretation and reporting. Qualitative methods,
principally non-participant observation and depth
interviews, were applied at all sites. Familiarisation with
the hospital environments and investigative case studies
generated key issues to be addressed in the GPPS
curriculum:
• The theory-practice relationship
• Reflection and reflective practice
• The influence of assessment on learning and teaching
• The qualities of surgeons, trainees, teams,
departments, hospitals and deaneries that make for
effective education.
7D 2
Jo Vallis*, E Anne Hesketh, Mica Allen and Stuart Macpherson
(NHS Education for Scotland, The Lister, 11 Hill Square, Edinburgh
EH8 9DR, UK)
Aim: To discuss the relevance of nurse involvement in the
new, proposed Foundation Programme for Pre-registration
House Officers (PRHOs).
Summary of work: This paper presents findings from a large,
Scottish, national project which aimed to identify a
curriculum for the PRHO year. As part of this study, 40 semistructured interviews, each lasting about one hour, were
held with senior nurses. Participants were from diverse
specialties. Interviews covered their views on PRHOs’
educational progress. Data were fully transcribed and
coded in N-Vivo software.
Summary of results:
• Key themes emerging concerned the process of training
as well as educational outcomes
• Nurses prioritised development of PRHOs’ ‘softer’ skills
(e.g. communication and teamworking) as well as
knowledge and clinical skills
• Nurses themselves were skilled and guided the PRHOs
informally in these areas
• However, nurses were concerned that their own
extended roles were de-skilling PRHOs
Conclusions/take home messages: UK PRHO education
is currently undergoing change. There is also emphasis,
within the British National Health Service, on interprofessional working. Nurses are increasingly gaining
advanced professional and clinical skills and guide PRHOs
informally in these. There may be scope for formalising
their contributions to the Foundation Programme.
Learning to work with patients: innovative
programme design promotes the rapid acquisition
of mature clinical skills with minimal requirement for
staff resources
Richard Hift* and Rae Nash (University of Cape Town, Faculty of
Health Sciences, Department of Medicine, Observatory, 7925,
SOUTH AFRICA)
Aim: We describe an innovative introductory programme
for junior students’ first contact with patients which
combines educational success with the efficient use of
clinical teachers.
The relevance of nurse involvement in the proposed
Foundation Programme for new medical graduates
(PRHOs) in the UK
7D 4
Supporting poorly performing trainees in their first
postgraduate year through ward simulation
F Anderson*, D Snadden, E A Hesketh, J Ker and J Foulis (NHS
Education for Scotland, Level 7, Ninewells Hospital and Medical
School, Dundee DD1 9SY, UK
Summary of work: Teaching of the foundation skills of
interviewing, history-taking and examination technique, and
the clinical skills of patient examination, recognition of
abnormality and clinical reasoning were explicitly
separated. In the foundation skills tutorial, students learn
by discussion, demonstration and peer practice. In the
clinical tutorial, a clinician guides students through patient
assessment and diagnostic reasoning. Students participate
in both tutorials concurrently in a structured programme
promoting self-directed learning, supported by specifically
developed learning material.
Aim of Presentation: To highlight how a ward simulation
exercise can support poorly performing medical trainees
in their first postgraduate year.
Summary of work: Ward simulation exercises provide
realistic working conditions with the opportunity to practice
in a safe, patient oriented environment. The exercise
provides challenges in clinical judgement, practical,
organisational and communication skills as well as
professionalism and the ability to work within a
multidisciplinary team. Pre-registration House Officers
(PRHOs) are being screened through the PHAST process
(PRHO Appraisal and Assessment System) as described
at AMEE 2002. This identifies those who require further
assessment and their training needs. Ward simulation
exercises are being used to provide medical and nursing
undergraduate training. (Ker et al 2003) Their use in the
assessment and retraining of junior doctors is being
developed. The ward simulation exercise for PRHOs, aims
to 1) re-assess their performance in a practice setting, 2)
provide individual feedback in context, 3) promote reflective
learning and practice. Behaviour descriptors are being
developed to assess different aspects of performance
Summary of results:
• An efficient system in which 200 junior students are
accommodated for a staff requirement of one tutor, and
a 90 minute tutorial from each of 10 clinicians weekly.
• Clinician-tutors are freed to concentrate on the
acquisition of cognitive skills.
• Learning objectives, examination techniques, tutorial
format and assessment are standardised.
• Students rapidly develop personal and clinical maturity.
• A positive evaluation from students.
– 4.61 –
Section 4
Summary of work: Multiple methods were used to elicit
views of patients, pre-registration house officers (PRHOs)
and senior medical staff. A small sample of patients was
interviewed; 113 PRHOs returned questionnaires; and their
senior staff were surveyed by email or telephone.
based on observations of PRHOs in practice and
observations of students in a ward simulation. The PRHO
will be given a global rating score for each performance
area.
Summary of results: This is a pilot project where preliminary
results will be available by July 2003. These will include
data on design and early data on validity and reliability.
Summary of results: For each of the groups, practice in
obtaining informed consent was variable, both within and
between hospitals. Obtaining consent was often delegated
to PRHOs and usually left to the individual clinician to
develop, both in terms of personal skills and in the
management of organisational issues. The PRHOs
requested help in managing what they perceived to be a
very complex area. Many felt that that they were
inadequately trained in taking consent and that employers
placed inappropriate demands on them. They also said
that senior staff did not always have the skills, knowledge
or attitudes required for effective practice in achieving
informed consent.
Conclusions/take home messages: This project
demonstrates an innovative approach in the management
of poor performance.
7D 5
Obtaining the informed consent of patients: a study
into the educational and training needs of doctors
Lois Parker and Steve Field* (West Midlands Deanery and CRMDE,
Postgraduate Medical and Dental Education, PO Box 9771,
Birmingham Research Park, 97 Vincent Drive, Birmingham B15
2XE, UK)
Conclusions/take home messages: Two main areas of
educational need were identified: training in basic issues
for individual staff; and the need for organisations to develop
and manage a supportive system.
Aim: To explore the views of patients, PRHOs and senior
medical staff, identify their learning needs and use the
results to design a training programme.
Session 7E: Continuing Professional Development
7E 1
Bringing pharmaceutical representatives into the
educational loop
Summary of work: After thorough preliminary work there
followed the planning process of a concrete education
programme. including a translation of a research based
theory approach and consultants’ own judgement of
learning needs. The result of this process was the
development of a new module constructed teaching
concept rooted in five management roles/core
competencies: (1) Personal leadership; (2) Management
in a political context; (3) Management of change; (4)
Management of quality improvement; (5) Management of
professionals. Subsequently a sequence of education
modules for medical managers has been planned
consisting of basic and superimposed courses. The single
module can be chosen depending only on the needs and
qualifications of the single consultant.
Craig Campbell, Jean Claude Dairon, Paul Davis, Francois Goulet,
Gilles Lachance, Celine Monette, Joan Sargeant, Robert Thivierge
and Jane Tipping* (10987 Warden Avenue, Markham, Ontario L6C
1M9, CANADA)
Background: The role that representatives play in
maintaining high standards of CHE traditionally is not
acknowledged. Canadian pharmaceutical represent-atives
receive many opportunities to upgrade their knowledge of
disease states and management, but they receive little
training in the practice of CHE. Two years ago a Continuing
Health Education course was created by a group of
dedicated professionals from across Canada representing
academia, industry and the Council for Continuing
Pharmaceutical Education. The outcome has been a high
quality written document and an exam that is unique in its
format and congruent with the philosophy of adult
education. The coming together of the three stakeholder
groups represents an example of true partnership that
promises to offer a high impact on raising and maintaining
standards of CE across the country. The presentation
describes the course itself, collected comments of
approximately 300 representatives that have taken the
course and grade ranges.
Summary of results:
• Organisational structure: A flexible education, that may
be followed when the doctor has recognised her/his own
learning needs; A plurality of management roles to comply
with the managerial core competencies of the individual
manager; Establishing a flat structure depending on the
many tasks and needs of the individual consultant.
• Learning methods: Organisational learning meaning
that the participants try out the theory within own praxis.
The teaching outside the department is thus related
back to learning in praxis; Common basis course to
establish a common experience and networking to
create learning communities/small group learning;
Establishing a circular, segmented learning process in
which professional progress and repetition link new
knowledge to the participants’ personal professional
development and reality.
Conclusions: The goal of CHE remains consistent even
though stakeholders may vary. Through pooling the
resources of differing groups an outcome of higher quality
can be achieved. Maintaining high standards of CHE is
the responsibility of all stakeholders. The greater the
knowledge, skills and communication between these
stakeholders, the greater the outcome.
7E 2
Conclusions/take home messages: Life long learning
involves life long development, meaning that the education
and the single elements will be revised continuously
among others on the basis of the result of a thorough
evaluation.
Implementation of a new education and training in
medical management for consultants
Eva Zeuthen Bentzen, Annette Plesner Steenstrup and Helle
Nielsen* (Danish Medical Association, Dormus Medica,
Trondhjemsgade 9, 2100 Kobenhaven O, DENMARK)
7E 3
Aim: To present how a theoretical analysis of the conditions
of management within the health services, knowledge of
learning processes and a systematic needs analysis have
been translated into a concrete management education
programme for consultants.
Meeting the needs in continuing education of
paediatricians in Oltenia Region, Romania
C Gheonea*, A Cupsa, D Bulucea and S Dinescu (Postgraduate
Department, Centre for Medical Education, University of Medicine
and Pharmacy of Craiova, 4 Petru Rares St, 1100 Craiova,
ROMANIA)
– 4.62 –
Section 4
To augment the effectiveness of CME programs in
Paediatrics, the University of Medicine and Pharmacy of
Craiova (main CME provider in Oltenia Region, with 70%
of the accredited activities) sponsored a study to assess
the needs of practitioners.
Aim: To present the results of a study assessing the impact
of the Maintenance of Certification (MOC) program on the
learning habits and perceptions of specialists in a
university-affiliated hospital.
Summary of work: Comparison of the type and frequency
of learning activities of the McGill University Health Center
specialists in the 12-month period before and after the
introduction of the program.
Consensus qualitative technique by appraisal of a nominal
group was used, due to a favourable ratio between the
time and costs needed to perform the study and the
significance of the results. The design of the participants’
profile covered a wide range of professional circumstances
that influence their training needs (including particularities
of the setting, time from graduation, gender). Twenty-one
selected paediatricians completed a questionnaire on two
topics: 1) contents of CME programs and 2) the structure
and the planning of the activities. A scale that incorporated
the ranking and the number of nominations selected the
identified items for each topic (i.e. 26 and 18 items,
respectively). Multivariable linear statistics showed a
significant correlation between the preferences expressed
and certain professional circumstances of the
paediatricians questioned. By adapting the offer of
postgraduate courses to the results of the study, 43% more
participants joined in the activities of the Department of
Paediatrics than in the previous academic year.
7E 4
Summary of results: Before the introduction of the program,
specialists perceived traditional activities such as attending
formal educational programs and reading medical
literature as having the highest learning value. The lowest
value was given to activities provided by non-medical
organizations or those remote from the clinical practice.
The MOC program had a positive impact on the learning
habits. In the 12 months after its implementation, there
was a significant increase in the frequency of activities that
allowed specialists to get credits for learning opportunities
in the workplace and for reflection on their practice.
Conclusions/take-home messages: This study
demonstrates that an innovative accreditation policy, which
rewards the most valuable learning activities, may have a
positive influence on physicians learning habits. It also
suggests that non-medical organizations need to improve
their educational activities if they want to influence medical
practice.
Impact of a new accreditation system on specialists’
learning habits
Linda Snell* and Réjean Laprise (Aventis Pharma, Department of
Professional Education, 2150 St Elzear Boulevard West, Laval,
Quebec H7L 4A8, CANADA)
Session 7F: Assessing the Practising Doctor
7F 1
Sheffield Peer Review Assessment Tool (SPRAT) for
Consultants: screening for poorly performing
doctors
Aim : To improve the blueprinting of discussions of clinical
cases (CBD) with established doctors undergoing
performance assessment in practice.
J C Archer* and H A Davies (University of Sheffield, Postgraduate
Medical Education Centre, F Floor, Stephenson Wing, Sheffield
Children’s Hospital, Western Bank, Sheffield S10 2TH, UK)
Summary of work: CBD is a core method for examining the
practice of doctors within the UK General Medical Council
procedures for assessing poorly performing doctors. The
quality of the evidence included in assessors’ reports relies
on systematic selection of cases and rigorous planning
and documentation of the discussion. This evidence must
stand legal challenge. Two workshops and enhanced
assessor training preceded the introduction of the new
approach. Lay people also participate in conducting the
orals.
Assessment of doctors’ performance is rapidly developing
in the United Kingdom. Peer feedback on consultants at
the Sheffield Children’s Hospital NHS Trust was collected
using a questionnaire. The questionnaire was designed
with twenty-five questions across the six main domains of
Good Medical Practice, the General Medical Council
framework for good practice for doctors. Twenty-four
consultants were each asked to provide 15 names of staff
with whom they regularly worked. The mean response rate
was 12.95 raters (86%). The data collected were analysed
using Variance Component Analysis in SPSS v.11.0. Using
Generalisibility theory, as few as seven raters (R = 0.69)
are needed to assess consultants reliably. Only 13 are
needed for high stakes assessment such as Revalidation
when raters are doctors, nurses or other health
professionals combined (R = 0.80). Nurses were more
reliable as raters than consultant colleagues. Six nurses
are needed to achieve a reliability of 0.8 in contrast to 19
consultants. In conclusion SPRAT for Consultants is a
validated performance assessment instrument, which is
both reliable and feasible. It could be used both as a
screening tool for high stakes assessment and to provide
formative feedback.
7F 2
Summary of results: The new framework will be presented,
and anonymised evidence from three reports from
assessments in three medical specialties, conducted
under the new approach, will be shown. Methodological
problems resulting from the tension between reliability and
validity of the approach will be discussed.
Conclusions/take home messages: Planning improved the
quality and relevance of the evidence for the assessors’
report about practice performance. This evidence suits
lawyers better, but still does not completely address
problems when reliability and case specificity are
considered.
7F 3
Piloting the link between revalidation and appraisal
for the UK GMC
Pauline McAvoy*, Lesley Southgate, Jim Crossley, Brian Jolly,
Malcolm Campbell and Alan McKay (University of Newcastle,
Northern Postgradute Deanery, Postgraduate Institute for
Medicine and Dentistry, 10-12 Framlington Place, Newcastle upon
Tyne NE2 4AB, UK)
Blueprinting case based discussions for the
assessment of poorly performing doctors in the UK
General Medical Council’s performance procedures
L Southgate*, Pauline McAvoy and Jim Cox (University College
London, Academic Centre for Medical Education, Holborn Union
Building, Archway Campus, Highgate Hill, London N19 3UA, UK)
Aim: To describe the piloting of the General Medical
Council’s proposals for Revalidation for all doctors.
– 4.63 –
Section 4
Summary of work: Revalidation is the regular demonstration
that a doctor remains up to date and fit to practise. The
GMC initially proposed a submission, on a 5 yearly cycle,
of a folder of evidence demonstrating continued fitness to
practise. A technical group conducted a series of pilots to
test the feasibility of the model, to test the link with annual
appraisal, and to test methods for gathering the views of
colleagues and patients regarding aspects of fitness to
practise.
Aim: Since 1998, 59 doctors have been advised to attend
training with the Interactive Skills Unit, University of
Birmingham because they have been perceived as having
problems with communication skills. With the advent of
clinical governance we expect these numbers to rise. We
felt it was necessary to review the data on these doctors.
Summary of work: An SPSS database was established from
a review of correspondence and written reports. We
concentrated on the following: gender, speciality, country
of birth and training, native English language speaker or
English learner, why they were referred and the results of
our assessment.
Summary of results: Few doctors have ready access to
data about their performance. Views of colleagues and
patients are rarely sought. Examples of evidence
demonstrating fitness to practise have been specified.
Sampling of revalidation submissions is recommended. A
robust appraisal can provide adequate evidence for
revalidation purposes.
Summary of results: Rising numbers have been referred
each year. Of the 59 doctors, 81% were male, 64% hospitalbased, 29% UK born, 39% UK trained, 27% native English
language speakers. 61% were referred with a perceived
communication skills problem, 20% for exam support,
9.5% for job interview coaching and 9.5% for English
language support. Our assessment was often different with
very few having a pure communication skills problem.
Conclusions/take home messages: Training and support
of appraisers is paramount. Views of patients and peers
are a highly valued source of evidence. Royal Colleges
have a responsibility to their members to publish criteria,
standards and evidence of good medical practice. The
GMC must ensure adequate QA of its processes.
7F 4
Conclusion: The label “communication skills” is used as a
“catch-all” term for many kinds of non-clinical problem.
The initial perceptions of the referrers and doctors
themselves are often unsophisticated or mistaken.
Remedial training for doctors identified as “poorly
performing” in communication skills – an update on
the Birmingham experience
Jo Piercy*, John Skelton and David Wall (Department of Primary
Care and General Practice, University of Birmingham, Edgbaston,
Birmingham B15 2TT, UK)
Session 7G: Different Approaches to Staff Development
7G 1
Professionalising teaching: Scottish Clinical
Teaching Fellowships
Aim: The aim of the study was to explore the different ways
in which doctors have learned to teach and train.
J Syme-Grant* and P A Johnstone (NHS Education for Scotland,
Ninewells Hospital and Medical School, Postgraduate Office, Level
7, Dundee DD1 9SY, UK)
Context: There is no coherent theory of medical teacher
development (Grant, 1998). Doctors are experts in what
they teach; most have had little or no training in how they
teach (Elton, 1998).
Aim: Efforts to improve the quality of clinical teaching in the
United Kingdom through teacher training programs for
doctors have been criticised for failing to foster teaching
professionalism. In an effort to address this, NHS Education
Scotland has established six Clinical Teaching Fellowship
posts in conjunction with the Universities of Aberdeen and
Dundee. This presentation describes the posts and
presents the results of an evaluation in progress.
Summary of work: Semi-structured interviews with ten
experienced medical teachers. A literature review had
suggested areas to explore. Interviews were transcribed,
coded and thematic analysis and grounded theory used
as the framework for qualitative analysis.
Summary of results: Four areas were identified as important
in teacher development; acquisition of educational
knowledge and skills, modelling and practice of teaching
skills, encouragement and motivation of teachers and
constraints on teaching and learning. Results suggest a
model for teacher development that begins with doctors
as learners, learning to learn and watching teachers teach.
They then start to teach, acquiring and practising skills
and subsequently move on to reflect on their teaching. They
can be encouraged to teach but may also be prevented
from teaching.
Summary of work: Within the two Deaneries offering
Fellowships, Postgraduate Deans, Training Managers,
Post Graduate Tutors and Fellows were asked to evaluate
the Fellowship posts using a questionnaire developed from
“A framework for developing excellence as a clinical
educator” (Hesketh et.al. Medical Education 35(6);555564:2001).
Summary of results: Fellowship design, appointment
criteria, anticipated outcomes, and funding are described.
A combination of qualitative and quantitative evaluation is
in progress. Early evaluation data are extremely positive.
Conclusions/take home messages: This inductive study
proposes a model for medical teacher development that
attempts to explain how doctors learn to teach and train.
More research is needed to clarify the findings. There are
implications for faculty development.
Conclusion: Early results suggest that these Clinical
Teaching Fellowship posts contribute significantly to the
professionalisation of medical teaching in Scotland and
could act as a template for similar post creation elsewhere.
7G 3
7G 2
The development of medical teachers: interviews
with ten experienced medical teachers
Webcast audio seminars as a technique for
international faculty development
Roger W Koment*, Peter G Anderson and Julie K Hewett
(International Association of Medical Science Educators, 5535
Belfast Place, Suite A, Springfield, VA 22151, USA)
Jane MacDougall* and Mary Jane Drummond (Addenbrooke’s
Hospital, Department of Obstetrics and Gynaecology, Hills Road,
Cambridge CB2 2AW, UK)
The future of medical education can be described in two
words: Faculty Development. This is the ongoing
– 4.64 –
Section 4
professional training which allows teaching faculty to share
information, ideas, and techniques to enhance the
education of those in medical training. Traditionally, faculty
development for many has meant attending national or
international conferences where they benefit from
interaction with experts and peers. However, over the years
we have all witnessed the disturbing trend toward
reductions in medical school budgets which translate
directly into diminished funds for travel. At the same time,
economic conditions are forcing increases in the cost of
creating and delivering such national and international
meetings. Equally disturbing is the reality of heightened
security and depressed travel in all countries due to
international terrorism. Fortunately during this time period
we have seen technological advances that allow the use
of the Internet and e-mail as modes of communication
and information gathering. In consideration of these
circumstances, we in the International Association of
Medical Science Educators (IAMSE) have created a
system whereby individuals from various countries at very
low cost can participate with peers in 1-hour seminars
delivered by recognized experts in their field, yet without
leaving the convenience and security of their medical
school. Essentially a conference call, IAMSE Webcast
Audio Seminars connect 27 individuals or conference
rooms with a Presenter who controls the display of
PowerPoint slides via Internet directly onto each attendee’s
computer. Programs are offered in thematic series of six
1-hour seminars delivered at 2-week intervals. Examples
include (2002) Recent Trends in Basic Science Education
and (2003) Evaluation of Student Learning. http://
www.iamse.org/development/audioseminar_index.htm
medicine or only on education. This significantly broadens
the scope of any search.
Summary of work: As part of a Best Evidence Medical
Education (BEME) Topic Review Group, a variety of
strategies were explored to identify articles that feature
communication skills assessment tools. In the first
exploratory study results of a Medline search were
compared with references identified through review
articles. The second investigation compared references
from a general objective structured clinical exam (OSCE)
literature review with those of a communication skillsspecific OSCE review. The overlap in either inquiry was
limited, and revealed some of the current problems in
identifying medical education references.
Conclusions: As BEME is moving towards becoming part
of medical education culture, it will be necessary to develop
resources that enable educators to quickly and reliably
access the available literature. This will be a necessary
step before a full “quality and evidence debate” can unfold.
7G 5
Michael Clapham* and Alison Bullock (West Midlands Deanery,
Postgraduate Medical and Dental Education, Birmingham
Research Park, 97 Vincent Drive, Birmingham B15 2XE, UK)
Aim: Part of postgraduate medical training (UK) requires
trainees to teach other trainees. This presentation reports
the role of anaesthetic trainees in teaching and how they
learn to teach.
Summary of work: Data were gathered from semi-structured
interviews with senior anaesthetic trainees from a University
Teaching Hospital. Interviews were recorded, transcribed
and analysed using grounded theory approach. Saturation
point was reached after four interviews (2.5 hours; 12,500
words transcribed).
This presentation will discuss the mechanisms of Webcast
Audio Seminars and demonstrate how faculty development
can be implemented using affordable technology that is
available today. While face-to-face conferencing is still very
desirable, Internet technology will become ever more
important in meeting the evolving needs of individuals
around the globe.
7G 4
Anaesthetists as teachers
Summary of results: All trainees taught medical students,
anaesthetic assistants and/or other anaesthetists within
their everyday work. Most teaching was informal,
opportunistic and undertaken in the workplace. It included
theory and practical skills, usually related to the clinical
situation. However the trainees did not see this as teaching.
They viewed teaching as formal, pre-planned and
structured and this was reflected in the ‘teaching the
teachers’ courses they had undertaken. None had received
any education in teaching within the workplace. How they
had learnt about teaching, in these situations, had been
through observation and modelling senior colleagues
whom they viewed as good teachers, and by trial and error.
Hunting for medical education references – search
strategies compared
E K Kachur*, M Schwartz, C Gillespie, M Yedidia, P Kinnersley, A
Kalet, R Janicik, L Altshuler, K Mukohara and T Comerci (The ROCAT
Topic Review Group, Medical Education Development, 201 East
21st Street, Suite 2E, New York NY 10010, USA)
Background: As medical education is moving towards
evidence-based practice, there will be an increasing need
to identify and access the literature in the field. Although
there are special medical education journals, their indexing
in common databases varies significantly. Relevant articles
are also dispersed in journals that either focus only on
Conclusions: Trainee anaesthetists teach extensively and
informally within the workplace. Many do not perceive this
as teaching and current training focuses only on formal
teaching.
Session 7H: Student Diversity
7H 1
Valuing diversity: working class students and
doctors
following three weeks students are given a choice of two
sessions to attend from a variety of topics. Sessions are
interactive. Group size is up to 16. The suggestion for a
workshop on social class came from a medical student.
Barry Ewart* and Jill Thistlethwaite (School of Medicine,
University of Leeds, Medical Education Unit, Level 7, Worsley
Building, Clarendon Way, Leeds LS2 9NL, UK)
Summary of results: The workshop identified obstacles that
may restrict working class participation in higher education
in medicine. Participants explored possible obstacles
facing working class students whilst at university before
discussing the possible benefits and disadvantages to all
social classes of having working class doctors.
Aim: Valuing diversity sessions are important to help
students understand cultural and other differences across
the spectrum of the human population and to deal with
prejudice. Patients have a right to access healthcare from
professionals who understand diversity and who are able
to treat them with respect, taking into account similarities
and differences.
Conclusion/take home message: We should treat all
students at Medical School equally. We are preparing the
doctors of tomorrow, whatever their backgrounds, so that
they will be able to work with all patients, whatever their
backgrounds.
Summary of work: The sessions begin with a lecture looking
at the subject from an ethical perspective and in the
– 4.65 –
Section 4
7H 2
An educational strategy to develop disadvantaged
students into health professionals
Aim: To demonstrate personality differences between
medical students who withdrew from the course and those
who remained.
Elmi Badenhorst*, Rachel Alexander and Trevor Gibbs
(Department of Public Health and Primary Health Care, Fallmouth
Building Office 2.24, Faculty of Health Sciences, University of Cape
Town, Observatory 7925, SOUTH AFRICA)
Summary of work: A prospective longitudinal study was
conducted of 587 medical students who entered King’s
College London between 1994-98 inclusive. The students
completed an entry questionnaire giving demographic
details, reasons for applying to medical school and what
they hoped to contribute to the profession. They also
completed the Myers-Briggs Type Indicator (MBTI), which
measures normal personality differences, i.e. how
individuals prefer to use their minds. The MBTI profiles of
the students who subsequently withdrew were then
compared with those who continued their education.
Aim: This paper will inform medical educators of an
educational strategy the University of Cape Town has
designed to develop educationally disadvantaged students
into health professionals.
Summary of work: The Faculty of Health Sciences at the
University of Cape Town (UCT) is committed to redressing
past imbalances in South Africa, also recognising that a
portion of prospective medical students, who are meeting
entrance requirements, might be educationally
disadvantaged, but culturally advantaged in understanding
the spectrum of health need from a social perspective. To
compensate, an intervention program, redressing
educational imbalances has been implemented. This
programme follows a teach – test – intervene model,
situated in an authentic academic environment, providing
all students with an equal opportunity to prove academic
skills. During the intervention programme fundamental
learning happens by addressing knowledge, skills, and
attitudes; capitalising upon their social background whilst
moving the students’ learning approach into a more
academic domain. The programme is a dynamic process
and constantly evaluated.
Conclusion: We believe all prospective medical students
meeting entrance criteria should be given an opportunity,
and through our programme it has become possible to
develop educationally disadvantaged students into health
professionals.
7H 3
Summary of results: 514 students completed both
questionnaires (88% response rate). As at March, 2003,
318 had qualified (61.9%), 4 had transferred to another
medical school (0.8%), 34 (6.6%) had withdrawn from the
medical course and 158 (30.7%) are still in attendance.
The personality profiles of those who withdrew differed from
those who remained but not significantly so. Gender
differences did, however, emerge.
Conclusions/take home messages: Whilst there were
differences between the personality profiles of the leavers
and the rest of the students, these were not statistically
significant. There were, however, interesting gender
differences.
7H 5
Willemina M Molenaar*, Jan Jaap Reinders and Janke CohenSchotanus (Institute of Medical Education, University of
Groningen, P O Box 196, Ant Deusinglaan 1, 9713 AD Groningen,
NETHERLANDS)
What students think are the reasons for their
academic failure in our physiology course
Aim: The elective clerkship is often considered
determinative for specialty choice, but the actual
relationship is unclear.
Nancy Fernandez-Garza (Facultad de Medicina, Universidad
Autónoma de Nuevo Leon, Nuno de Guzmán 309, Col. Cumbres,
3er Sector, Monterrey, N.L., c.p. 64610, MEXICO)
Summary of work: A cohort of 302 medical students that
entered medical school in 1992 or 1993 and graduated
before August 2002 was interviewed about their current
specialty, preferred specialty and acceptance for a specialty
training program. These data were compared with the
elective clerkships previously chosen by the same students.
We have a high rate of students that fail our physiology
course. In an attempt to know what they believe are the
reasons for their academic failure, we apply a survey to
students taking the course at a second or third attempt.
The only question was: List three reasons for your failure in
this course. From 250 students, 179 answered the survey
with a total of 502 reasons listed. From them, 57% were
attributed directly to student attitude (little time dedicated
to study, non-attendance in class, lack of motivation to
study), 16% were related to the exam format (confused
questions, too many clinical cases for a second year
course), 12% were about the course methodology
(basically they do not like to participate in class and find
lectures better), 8% of the reasons were attributed to the
professor (the class material was not reviewed adequately),
and 12% were about others. These results encourage us
to focus our work to motivate students to study and to think
about the importance of their study for their future, as well
as about the time they are wasting because of their lack of
interest in their professional preparation.
7H 4
Does the choice of elective clerkship predict
specialty training?
Summary of results: Complete data were available from
283 students. Seventy percent of them did electives in one
of 5 major specialties (internal medicine, paediatrics,
surgery, neurology or obstetrics/gynaecology) as compared
to 2% in primary care (public health or general practice).
In contrast, 31% was currently employed in these major
specialties and 30% in primary care. Of the subgroup of
196 students (69%) that was accepted for a training
program, the vast majority (95%) declared that training was
in their preferred specialty, but in only 36% it was the same
as their elective.
Conclusions: It appears that students choose other
specialties for their elective clerkship than they prefer for
their future career. Overall, the shift from major clinical
specialties for the elective towards primary care for
specialty training is impressive.
Are there personality differences between students
who drop out of medical school and those who
remain?
Gillian B Clack*, Derek Cooper and Susan Standring (King’s College
London, c/o 51 Burbage Road, Herne Hill, London, SE24 9HB, UK)
– 4.66 –
Section 4
Session 7I: Evaluation of Problem Based Learning
7I 1
Pre-Registration House Officers (PRHOs) assess
their undergraduate education
7I 3
Brian Bailey (Napier University, School of Community Health, 13
Crewe Road South, Edinburgh EH4 2LD, UK)
Simon Watmough*, Anne Garden and David Graham (University
of Liverpool, Department of Primary Care, Quadrangle, 2nd Floor
Whelan Building, Brownlow Street, Liverpool L69 3GB, UK)
Models of learning in PBL posit that the quality of scenarios
significantly influences tutorial group functioning and
student achievement. Yet there has been little investigation
into the specific aspects of scenarios that stimulate debate
and learning.
In 1996 Liverpool University changed its curriculum from a
traditional course to integrated problem-based learning.
Five focus groups with 31 PRHOs from the first cohort of
the new PBL curriculum were arranged to gather their
views on their undergraduate education. PRHOs felt they
had been well prepared for the role, saying that due to
certain changes in the course, noticeably the clinical skills
laboratory, “shadowing” and accident and emergency
attachments, they knew how to do the job. They believed
they were particularly strong in practical and
communication skills, but didn’t know as much basic
science as the old curriculum graduates, although this
hasn’t affected their ability to perform as PRHOs and look
after patients. They enjoyed their problem-based course
and would have preferred this to the traditional course
although they wanted more structured teaching such as
lectures or tutorials or “directions” in the first couple of
years of the course. This is a follow up to a paper presented
at Lisbon in 2002 looking at the views of the last cohort
from the traditional curriculum to graduate from Liverpool
with the PBL cohort seemingly feeling better prepared to
be PRHOs.
While there are a number of descriptive, scenario-design
guidelines available, those, the author suggests, are
somewhat over-rationalistic and under-emphasise the
importance of the emotions in learning. Scenarios that
provoke emotional responses, as one exceptional study
has shown, are powerful triggers for learning. Elaborating
on a music-metaphor approach to understanding PBL
(paper presented at last year’s AMEE conference) the
author will apply a framework, derived from popular
musicology, for designing scenarios, the songs, as it were,
at the heart of PBL.
Using the song “Ode To Billy Joe” for illustration, the author
suggests that quality scenarios should, respectively: be set
in an evocative geographical and temporal context; contain
multi-vocal viewpoints; shock; mobilise a sense of selfagency; link with other discourses; provoke debate; and,
importantly, arouse ‘mimetic’ desire.
7I4
7I 2
Does PBL work? Does music? Side 2: scenario design
Comparison of three instructional methods of
teaching for medical students
Evaluation of a PBL curriculum in comparison to a
parallel conventional course at the Medical Faculty
of the University of Hamburg, Germany
Eiad Al-Faris (Department of Family and Community Medicine,
King Saud University, PO Box 2925, Riyadh 11461, SAUDI
ARABIA)
Ralf Wieking, Christian E Guksch, Olaf Kuhnigk and Monika
Bullinger* (University of Hamburg, Modellstudiengang Medzin,
Martinistrasse 52, 22761 Hamburg, GERMANY)
Aim: To compare lectures, problem-based learning (PBL)
and modified PBL regarding students’ topic
comprehension, knowledge recall and decision making.
Background: In 2001 the University of Hamburg
implemented an experimental medical curriculum, based
on PBL for the first three years of medical education. A
study comparing structure, process and results of teaching
between the reformed and the regular curriculum is
combined with this. The intent is to show strengths and
weaknesses of two didactic principles, taking place
simultaneously, from the perspective of both students and
teachers.
Summary of work: 33 4th year medical students undertaking
the Family Medicine (FM) rotation were divided into 3
separate groups randomly. Each group was taught one of
the clinical topics (headache, obesity and back pain) using
the lecture method in the first session. In the other two
sessions they rotated on the clinical topics and were taught
using the modified PBL in the second and the PBL methods
in the third session.
Summary of work: The new curriculum was offered to all
first-year students joining the medical faculty: 110 out of
160 students applied, 40 were randomly taken. Two more
study-groups from the regular curriculum were formed: 40
applicants for the new track who could not participate, and
40 who did not apply. Each semester students are evaluated
by a standardised questionnaire that allows determination
of the above-mentioned aspects.
Summary of results: In the immediate evaluation there was
a significant difference between the three instructional
methods regarding the total score (P = 0.009261), the
clinical cases of management score (P = 0.002410) and
short answers questions (P = 0.000005) which was
statistically significant in favour of PBL while for the MCQ
score the difference was not significant (P = 0.155108).
Regarding the evaluation after two weeks, there was a
statistically significant difference between the three
instructional methods only for the short answer question
score (P = 0.1802).
Summary of results: We report on the first three measuring
points. The interpretation shows PBL students having
higher satisfaction with their curriculum, difficulties coping
with perceived higher workload, better learning strategies
and better self-assessment of themselves as medical
students.
Conclusions/take home messages: There could be a case
for opponents of modified PBL instead of the lecture
method.
Conclusions: As of today the analysis can only be seen as
explorative, though it shows a positive students´ attitude
towards the new curriculum. Further evaluation will allow
for more precise interpretations.
– 4.67 –
Section 4
Session 7J: Management of Clinical Training
7J 1
The county hospital – what can it offer medical
students and what does it get in return?
funding to establish Rural Clinical Schools (RCS), has
become an agent for change in medical education. The
challenge for RCS is to ensure that medical students, who
will spend at least half their clinical training in rural areas,
have access to quality resources and are supported by
local academic clinicians so that their clinical experiences
and academic coursework are recognised as equal to
metropolitan clinical schools. This challenge is providing
a unique opportunity for innovation in medical education.
The critical issues to be explored are diffusion and
integration of these innovations in rural medical education
into the wider medical school environment in such a way
that they are not constrained by the complex cultural and
organisational issues experienced in many medical
schools. The question is: ‘how do ideas and practices get
from here to there?’ The answer will be explored through
description and analysis of a complex process. The rate
of diffusion is the result of the interplay between the
characteristics of the innovation, potential adopters and
the organisation into which that innovation has been
introduced.
Berit Eika (University of Aarhus, Unit of Medical Education,
Vennelyst Boulevard 9, 8000 Aarhus C, DENMARK)
Aim: To describe the attitudes of clerkship directors in county
hospitals about gains and costs associated with an early
clinical clerkship, and to examine how they think county
hospitals can contribute to the education of medical
students.
Summary of work: A questionnaire containing closed as
well as open questions was developed to collect data from
31 clerkship directors during a face-to-face interview.
Summary of results: The clerkships were perceived as an
overall benefit for the county hospital. The specific benefits
reported were academic stimulation, increased focus on
education and a recruitment potential. The clerkship had
not strengthened the cooperation with the university around
research and even less around patient care. Few
disadvantages were reported but approximately half of the
respondents saw the expenses of the clerkship as being
time taken from patient care and education of other health
care professionals. The specific beneficial characteristics
of the county hospital were believed to be its patient-mix,
its size and the inter-personal atmosphere.
7J 4
Richard Ayres (North Devon District Hospital, Medical Education
Centre, Raleigh Park, Barnstaple, Devon EX31 4JB, UK)
Conclusions/take home messages: The change of a county
hospital into an undergraduate teaching hospital is seen
as a welcome inspiration. The county hospital is believed
to exhibit attributes that make it suitable for the education
of medical students.
7J 2
Aim: To report on a novel project (presented as a short
communication at AMEE Berlin) to use a specialist website
to improve medical student attachments
Summary of work: We contact by email 2 weeks before
arrival all students coming to N Devon for clinical
attachments. We refer them to our website: www.medical
ed.co.uk where they can find details of all learning
experiences available (in both primary and secondary
care). Using a password, students can access their own
timetable and choose sessions. Several multi-disciplinary
modules are available. Hospital-based students can
arrange experience (such as Diabetic or asthma clinics)
in primary care. GP-based students can follow up patients
or attend sessions in the hospital.
An academy model for medical education – the
student perspective
Julia Sanday, David Mumford and Clive Roberts* (Bristol
University Medical School, Centre for Medical Education, 39-41
St Michael’s Hill, Bristol, UK)
Bristol medical school is undergoing 50% expansion whilst
clinical placements become constrained by the foundation
of a medical school close-by. A model was developed to
deliver the curriculum at high standard to an expanded
school with reduced facilities involving investment in seven
clinical academies within 50 miles of Bristol. Such
academies consist of major general hospitals able to
deliver most clinical units and to take students continuously
for periods up to 18 weeks. Following a briefing session
the opinion was sought from the current cohort of 1st, 2nd
and 3rd year medical students by questionnaire. 55% of
378 respondents approved the model whilst 12% were
against. 96% considered it would be disruptive to social
lives. Over 50% of 3rd year students judged that clinical
teaching, opportunity for practising skills and developing a
sense of belonging to a clinical unit would be better in
academies outside Bristol whilst 30% felt that for learning
facilities. However the majority of this group indicated that
had the model been operative when they applied to
medical school it would have had a negative influence on
choice. The opinion of students throughout the transition
period has been invaluable to those responsible for its
detail.
7J 3
Evaluation of a web-based project to improve the
quality of clinical attachments in North Devon
Summary of results: The new system is popular with both
students and staff. Some qualitative evaluation will be
presented.
Conclusions/take home messages: This project
encourages self-directed, multi-disciplinary and intersectoral learning.
7J 5
Development of an information system to monitor
the long-term achievement of the collaborative
project to increase production of rural doctors
Suwat Lertsukprasert and Waraporn Eoaskoon* (Office of the
Collaborative Project to Increase Production of Rural Doctors,
Floor 9, Building 6, Office of the Permanent Secretary, Ministry
of Public Health, Tiwanon Road, Nonthaburi 11000, THAILAND)
Aim: To present a continuous, sustainable and efficient
information system to support the management of the
collaborative project and to monitor/ evaluate the
achievement regarding student education and long-term
rural practice of the medical graduates.
Changing perceptions in medical education: the
emergence of rural clinical schools as levers for
change
Judi Walker (University of Tasmania, University Department of
Rural Health, Locked Bag 1372, Launceston, Tasmania 7250,
AUSTRALIA)
Summary of work: (1) To design a database and collect
essential information using 10 forms on teaching staff,
medical students and graduates; (2) To design a computer
program and user manual for database; (3) To train users
and system analysts of the OCPIRD in how to implement
the long term project.
The aim of this presentation is to critically analyse how an
imposed development, Australian Federal Government
Summary of results: (1) Baseline data on 3,000 medical
students, graduates and 1,500 teaching staff of 12 Medical
– 4.68 –
Section 4
Conclusion: (1) The data outcomes provide a framework
for planning and monitoring the project; (2) evaluation of
CPIRD graduates on achieving the project plan.
Education Centers; (2) Website relating to information
linking OCPIRD, all MECs and informing the public; (3)
Systematic spot-check on student education, better
teaching vs. workload of staff and outcome of the project.
Session 7K: Clinical Training in Different Settings
7K 1
Modelling clinical competence in a medical
internship: the impact of variation in actual clinical
experiences
7K 3
P F Wimmers*, T A W Splinter and H G Schmidt (University Medical
Centre Rotterdam, Erasmus MC, Office Ff-223, Po Box 1738,
3000 DR, Rotterdam, NETHERLANDS)
Steven J Durning*, Louis N Pangaro, Gerald D Denton, Paul A
Hemmer, Alan Wimmer, Thomas Garu, Margaret Gaglione and Lisa
Moores (Uniformed Services University, Dept of Medicine (NEP),
4301 Jones Bridge Road, Bethesda, MD 20814, USA)
Dutch undergraduate education in medicine is a six-year
program, which ends with a two-year internship. A medical
internship is based on “learning by the bedside.” The
national objectives prescribe the necessary clinical
pictures (diseases) to be seen during that period. The
reason for it is the overall agreement that a sufficient range
of clinical pictures is essential for learning medicine.
However, analysis of student logbooks reveals a large
variation between individuals and between hospitals where
those internships take place. The intention of this study is
to explore causes of the amount and variety in actual seen
clinical pictures and what the consequences for clinical
competence are. The influence and quality of supervision,
size of the hospital department, internship exam grades,
and grades of former coursework are evaluated, and
structural equation methods are used to model
hypothesized causal processes. Results indicate a direct
relationship between quality of supervision and the amount
or variety of clinical pictures. Surprisingly, size of the hospital
department did not have any relationship with amount or
variety of the clinical pictures.
Aim: To introduce “inter-site consistency” as a
measurement of programmatic evaluation and to
demonstrate the feasibility and construct validity of this
measurement on a clinical clerkship.
Summary of work: We reviewed student clerkship data in
our multi-site, geographically separated clerkship over a
10-year period (1990-2000). We hypothesized that the
clerkship site should not contribute to a student’s clerkship
outcome. We calculated mean scores for each clerkship
measurement and analyzed these data on both a yearly as
well as 10-year cumulative basis. Analysis of Variance
(ANOVA) and linear regression were used for determining
if clerkship site contributed to clerkship outcomes.
Summary of results: Data for 1632 (98%) students were
included in our study. During this 10-year study period, we
had a total of 22 different on-site clerkship directors. ANOVA
and linear regression of year-to-year and cumulative data
did not demonstrate an effect of site on student clerkship
outcomes.
In conclusion, supervision is the crucial aspect of internship
and has a direct impact on the clinical competence of the
student during that period.
7K 2
Innovations in the clerkship Internal Medicine
Inter-site consistency as a measurement of
programmatic evaluation in a medicine clerkship
with multiple, geographically separated sites
Conclusions/take home messages: Inter-site consistency
can be used as a measurement of programmatic
evaluation for multi-site clinical clerkships.
7K 4
J C G Jacobs*, S Bolhuis, J A Bulte and R S G Holdrinet (University
Medical Centre Nijmegen, Department of Medical Education, PO
Box 9101 (224 KTC), 6500 HB Nijmegen, NETHERLANDS)
A student-organized introduction to the clinical
rotation of medical education, Karolinska Institutet,
Stockholm
H Brauner*, P Grenholm, I-M Petermann, M Nyström and J
Björklund (Medical Students’ Association, Artillerigatan 84, S115 30 Stockholm, SWEDEN)
Curriculum innovations in the clerkships are
recommendable, but difficult to implement. One reason is
the diversity of clerkships as learning environments:
different hospitals (university or affiliated), different wards,
several outpatient departments and the large number of
supervisors (residents and staff members).
Background: A large part of the medical education at the
Karolinska Institutet, Stockholm is spent in hospital wards.
The clinical rotation differs markedly from what the
students have experienced during the first basic science
years. A great demand is placed on student initiatives,
knowledge and attitudes. Students have felt the need of
more introductions to the clinical rotation.
The new curriculum in Nijmegen, started in 1995, included
the clerkships. Important innovations in the clinical phase
were the introduction of core learning goals, mid-way
formative interviews, final summative interviews, a logbook,
central clerkships with attention for reflection and
preparation for the next clerkships, assignments based on
experiences and an explicit description of the supervising
role of residents and staff members. Our study will focus
on learning in the renewed clerkship Internal Medicine.
Interns can be placed in the university hospital or in one of
five affiliated hospitals. In general they stay four weeks at
the wards and four weeks on outpatient departments.
Questions are: How can the learning environments be
described? To what extent are the innovations
implemented? Are they helpful to interns’ learning, and how
do residents and staff members appreciate these
measures? The results of questionnaires completed by
interns, residents and staff members, at the six different
hospitals, will be presented.
Aim: To facilitate the process for students to find their role
at the clinic, and help them to invent strategies for getting
the most out of their time.
Summary of work: Group discussions were arranged at
two hospitals. During the first clinical weeks students met
senior students for discussions on clinically related
problems and joys that they had experienced. Six cases
covering aspects relevant to the goals of the course were
also used.
Summary of results: The course was evaluated by a written
questionnaire. The students expressed a need for a course
of this type, the topics discussed were considered relevant
and the overall impression of the course was good. The
course goals were partly fulfilled.
Conclusions/take home messages: With very simple means
we have created a complementary introduction to the
clinical rotation of medical education, which could be
made a regular part of the curriculum.
– 4.69 –
Section 4
7K 5
Acquiring clinical competence during clerkships
minimal direct supervision. We also found that students
are supposed to be responsible for their own learning
processes, but they are not expected to take part in the
production. This exclusive position excludes students from
practice. To compensate for lack of active involvement in
patient-related activities, students develop a rich repertoire
of strategies to gain access to practice. We identified these
strategies as an important part of the socialization process.
Gitte Wichmann-Hansen* and Berit Eika (Aarhus University, Unit
of Medical Education, Vennelyst Boulevard 9, Bygning 611, DK
8000 Aarhus, DENMARK)
Aim of presentation: In this study we describe and evaluate
medical students’ opportunities for acquiring clinical
competence during clerkships.
Conclusions/take home messages: We conclude that
medical students’ opportunities for acquiring clinical
competence during clerkships is limited by lack of access
to active involvement in patient-related activities. Our study
suggests that the clerkship may serve a socialization
purpose rather than a qualifying purpose.
Summary of work: We conducted a field-based multiple
case study, based on observations, diaries, interviews and
document analysis.
Summary of results: We found that students rarely take an
active part in the daily work with patients and receive
Session 7L: Professionalism (2)
7L 1
Advancing professionalism in medical education: a
view from the margins
Conclusions/take home messages: Despite the small
sample size, we wonder whether this reflects medical
school admission/selection criteria, residents’ focus on
issues of importance in day-to-day tasks, cultural or
geopolitical differences in healthcare delivery, or a
dissonance between the Charter and views of today’s young
doctors. Further information on residents’ views about
medical professionalism will be explored as the survey
proceeds.
Viv Cook* and Sandra Nicholson (Department of General Practice
and Primary Care, Barts and The London, Queen Mary’s School of
Medicine and Dentistry, Medical Sciences Building, Mile End Road,
London E1 4NS, UK)
This presentation aims to summarise the current theories
that underpin professionalism in medical education and
how collaborating with mainstream educators will facilitate
a broader and deeper approach. Discourses on
professionalism within medical education often focus on
the necessity of undergraduate students acquiring the
knowledge, skills and attitudes essential for their
“professional development” that is judged by their clinical
competence. It is argued that professionalism in medical
teachers should be concerned with not only acquiring
competence at teaching but also a consideration of the
social and political frameworks in which medical educators
engage. Medical education can be viewed as emphasising
the importance of teaching theory and methods whilst
sometimes neglecting the context in which students learn
and teachers teach. The particular complexities of being
both a doctor and a teacher and how this impacts on
professionalism also need consideration. It is with this
agenda that mainstream educators can help. Collaborative
debates around the nature of professionalism drawing upon
the work of medical and “mainstream” education will help
to inform and underpin teaching standards, evidencebased practice and facilitate change in the learning
environment of students.
7L2
7L 3
Kate Drysdale* and Iain Robbé (University of Wales College of
Medicine, Temple of Peace & Health, Cathays Park, Cardiff, CF10
3NW, UK)
Attitudes and behavioural outcomes are increasingly
important in medical education. PPD is a key element of
these outcomes. Using the Nominal Group Technique
(NGT) we sought the views of medical students concerning
their experiences of PPD in the undergraduate programme.
Students were grouped for the NGT meetings into first,
middle and third phases of the course. Strengths of the
curriculum with the highest scores across the three groups
commonly involved aspects of self-determined learning,
clinical contact, interpersonal skills and reflection over at
least two months. The group from the first phase identified
collaborative learning with other healthcare students during
interprofessional education days as a high scoring strength.
The other two groups, who had not experienced these
days, identified this as an area for improvement.
Improvements regarding PPD that were identified by all
groups involved more personalised feedback relating to
progress, wider choices and increased institutional
commitment to PPD. Further work is required to increase
the validity and reliability of the results. However there is
clear interest in PPD across all three phases. Interventions
to improve the curriculum should be tailored to the differing
maturity of learners that was apparent across the phases.
What is professionalism? A pilot study of Danish
Internal Medicine Senior House Officers’ views
D J Davis, A M Skaarup* and C Ringsted (Copenhagen Hospital
Corporation Postgraduate Medical Institute, H:S PMI, Bispebjerg
Bakke 23, 2400 Copenhagen NV, DENMARK)
Aim: The aim of this pilot study was to identify what SHOs
in internal medicine associate with professionalism.
Summary of work: We surveyed a convenience sample of
SHOs in internal medicine. They were asked to write 5
words or phrases related to professionalism as well as the
3 most important attributes they would want in their own
physician. Summary of results: Twenty-five SHOs have
completed the survey. Answers were grouped using
qualitative methods. The most common associations with
professionalism were competence (17), communication
(10), empathy (10), self-appraisal/lifelong learning (6),
respect (5), decision-maker (4), knowledge/
knowledgeable (4). SHOs wanted competence and
empathy in their own doctors, but did not mention
communication skills as frequently. The principles of
primacy of patient welfare and social justice as described
in the ABIM/ACP/EFIM Physician Charter did not figure
highly.
Student perceptions of the strengths and possible
improvements of a personal and professional
development (PPD) curriculum
7L 4
Towards assessment of professional behaviour in
vocational GP trainees: the development of the
Professional Behaviour in General Practice
instrument
K van de Camp*, M Vernooij-Dassen, R Grol and B Bottema (UMC
St Radboud, University Medical Centre Nijmegen, Dept. VOHA 254,
PO Box 9120, 6500 HB Nijmegen, NETHERLANDS)
Aim: Discuss the development of the Professional
Behaviour in General Practice instrument.
Summary of work: The development of the Professional
Behaviour in General Practice instrument consisted of
three phases: (1) selection of elements of professionalism
– 4.70 –
Section 4
relevant for general practice based on the literature on
professionalism, the overall educational objectives of
vocational training and competency models of general
practice; (2) development of items composed of
behavioural examples from everyday practice indicative of
the selected elements; (3) verifying the validity of the
instrument by an expert panel in two steps: a questionnaire
survey and a consensus meeting.
Aim: To summarize recommendations for systematic
assessment of professionalism in residency programs
made by the Accreditation Council for Graduate Medical
Education’s (ACGME) “Think Tank” group.
Summary of work: A group of experts convened by the
ACGME recommended a multi-faceted, systematic
approach to assessing professionalism based on its
essential components, principles for its development, and
practical considerations for its assessment. The approach
outlines what components to assess, how to assess them,
and which assessment tools might be used. The proposed
system includes tools for formative assessment of
knowledge and behaviours and a tool to measure values
and norms transmitted in the educational environment. To
guide implementation, the Think Tank suggested that: 1)
residents and faculty work collaboratively to determine what
professional behaviours to assess and how to assess them;
2) individuals from different roles, e.g., nurses, patients,
etc., provide input; and, 3) assessments occur on multiple
occasions.
Summary of results: The instrument consists of four major
themes: (a) professional behaviour towards patients; (b)
professional behaviour towards other healthcare
professionals; (c) professional behaviour towards the
profession; and (d) professional behaviour towards oneself.
Within these four themes 25 elements of professionalism
are represented in separate scales, each consisting of at
least 4 items. Examples of elements are respect, teamwork,
accountability and resilience.
Conclusions/take-home messages: We believe that the
strength of the instrument lies in the tight match with the
GP’s daily routine. The development of our instrument gives
the abstract concept of professionalism in general practice
a recognizable face.
7L 5
Conclusions/take-home messages: A systematic approach
to assessing professionalism requires summative and
formative aspects. Residents must receive feedback on a
regular basis and have the opportunity to alter unacceptable
or undesirable patterns of behaviour before assessments
of professionalism are used for summative evaluation.
A systematic approach to assessing professionalism
Patricia M Surdyk* and Susan R Swing (Accreditation Council for
Graduate Medical Education, 515 No. State Street, Suite 2000,
Chicago, IL 60610, USA)
Session 7M: Outcome-Based Education
7M 1
The Tecnológico de Monterrey School of Medicine’s
competence-based curriculum with emphasis in
professionalism: design and implementation of
longitudinal and integrative development of
professionalism competencies
Medical school curricula are either traditionally disciplinebased, or use a problem-based (systems) structure, or an
outcome-oriented approach. At first glance, these
concepts appear mutually exclusive. Taking into
consideration the multi-dimensionality of medical practice,
we developed a new curricular architecture integrating the
three dimensions. The existing discipline-based
curriculum was mapped and reconstructed according to
interdisciplinarity and to the outcome-dimension (i.e. skills,
attitudes, biopsychosocial continuum). Faculty described
their currently offered instructional 1h-units, including title,
free-text description, diagnostic coding (ICD-10 list) and
symptoms coding (list of 286 major health care problems).
In addition, each unit could be rated by the respective
chairperson whether it should preferably be placed into
discipline context or multidisciplinary context, and whether
it should be mandatory, elective or dismissed. Data from
2,960 instructional units (78% of entire program) containing
11,489 diagnostic/symptom codes were entered into a
Microsoft Access(R) database. Disciplines were inspected
regarding coding intensity and their use of the rating option.
Then, clusters of codes were extracted, yielding
approximately 100 multidisciplinary (5-7 units) modules
(“competence fields”). Examples include “Myocardial
infarction II”, “Aging problems I: Osteoporosis, hip fracture”.
These competence fields will be longitudinally integrated
into the curriculum, running parallel to (and in partial
overlap with) the revised discipline-based courses.
Claudia Hernández Escobar, Leticia Elizondo Montemayor*,
Graciela Medina Aguilar, Antonio Dávila Rivas and Angel Cid García
(Tecnológico de Monterrey School of Medicine, Via Asinaria No
202, Col. Fuentes del Valle, San Pedro Garza García, Nuevo León
CP 66220, MEXICO)
We have an 11-outcome model where professionalism
related competencies are gradually developed in a
longitudinal way through all the courses of the career. We
have established three levels of development: 1. The basic
level (BL), in which the student observes and imitates the
professional behavior set by his teachers; 2. The
intermediate level (IL), in which the depth of concepts
increases and the rationale of professional behavior
expected from the student by patients and society is met,
and 3. The advanced level (AL), in which the concept and
practice of professional behavior becomes part of the
student’s career and professional life. The implementation
of profess-ionalism competencies includes the following
activities: I. Design of working elements; II. Training and
inclusion of participants, longitudinal tutors and
establishment of a Professionalism Committee; III. Design
of the evaluation system, and IV. The development of
professionalism competencies in every course of the
career. The curriculum considers professionalism
competencies essential to the training of medical doctors
and to the restoration of the distinctive vocation of Medicine.
7M 2
7M 3
Required levels of competence in clinical skills at
different stages of the undergraduate medical
curriculum
I Treadwell*, J D Makin, J Blitz-Lindeque and P T Kenny (University
of Pretoria, Skills Laboratory, Faculty of Health Sciences, PO Box
667, Pretoria 0001, SOUTH AFRICA)
The Competence-based Curriculum Concept of
Cologne (4C) – a curriculum mapping procedure to
integrate discipline, problem and outcome-based
learning
Aim: Compile a list of clinical skills required at the exit level
of the undergraduate medical curriculum with their levels
of competence expected of students at different stages of
training.
S Herzig*, C Stosch, S Kruse, M Eikermann and R Mösges
(University of Cologne, Department of Pharmacology, Gleueler
Strasse 24, 50931 Koeln, GERMANY)
– 4.71 –
Section 4
Manager, Scholar, Health Advocate, and Professional. The
identified competencies were then implemented into the
standards for program accreditation, specialty training
objectives, and evaluations. We describe the rationale,
methodology, and development of the CanMEDS
competency framework. Lessons from this process and its
ongoing advances will be presented.
Summary of work: Chairpersons of the academic blocks
edited relevant parts of an existing skills list. The level of
competence for each skill was rated from 1 to 4 (adapted
Nijmegen Scale). A pilot study was done to determine the
perceptions of general practitioners (senior and junior) and
final year medical students on the required level of
competence at exit level for each of the listed skills.
Summary of results: The average competence rating per
skill of each of the three sample groups showed differences
from faculty’s rating for 38% (145) of the 380 listed skills:
senior doctors’ (29%), junior doctors (23%) and students
(23%). The block chairpersons reconsidered their ratings
and in some instances were convinced to make changes
accordingly.
7M 5
P Niall Byrne, Ian L Johnson, Anita Rachlis, Jay Rosenfield*, Xerxes
Punthakee, Katherine MacRury and Barbara McRobb (University
of Toronto, Faculty of Medicine, Centre for Research in Education,
at University Health Network, 200 Elizabeth Street, 1ES565,
Toronto, Ontario M5G 2C4, CANADA)
Conclusions/take home messages: Faculty members,
students and medical practitioners have different views on
the levels of competence students should have at exit level.
The study led to the reconsideration of skills and levels of
competence expected by faculty and awareness of
misconceptions students may have on the importance of
learning certain skills.
7M 4
Designing the undergraduate medical curriculum to
reflect postgraduate competencies and societal
needs
Social accountability implies a reciprocal relationship
between the Faculty of Medicine and the community. One
of the major aims of this accountability is that the Faculty of
Medicine graduate physicians are capable of meeting
societal needs through their changing roles and their
knowledge, skills and attitudes. Within the past decade
landmark initiatives defining the physician’s roles from a
societal perspective have stemmed from the Educating
Future Physicians for Ontario (EFPO) project, the Royal
College of Physicians and Surgeons CanMEDS 2000
project and the College of Family Physicians of Canada
Four Principles of Family Medicine project. The latter two
projects validated the roles of the physicians as medical
expert, communicator, collaborator, manager, scholar,
health advocate and professional. The University of
Toronto, Faculty of Medicine is reshaping the overall
objectives of its undergraduate medical curriculum based
on the integration of the CanMEDS competencies and the
Family Medicine Principles. Two goals will be
accomplished: (i) The undergraduate and postgraduate
programs, having common objectives, will be integrated
and (ii) graduates will be trained in roles that are responsive
to societal needs.
Development of a National Framework of Needs-based
Competency Standards: The CanMEDS project
Jason R Frank*, Nadia Mikhael and Gary Cole (Royal College of
Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa,
Ontario K1S 5N8, CANADA)
Contemporary medical organizations worldwide are faced
with the challenge of reexamining their competency
standards to ensure that they meet the needs of the
societies they serve. The Royal College of Physicians and
Surgeons of Canada is responsible for setting the standards
for all 59 medical and surgical specialties across the
country. Since 1996, the RCPSC has adopted a framework
of core competencies that were systematically derived from
the needs identified by experts and the public. These
competencies were organized around seven “physician
roles”: Medical Expert, Communicator, Collaborator,
– 4.72 –
Section 4
Session 8A: Assessment General
8A 1
Quality assurance in developing multiple choice
questions
the Faculty of Health and Life Sciences of the Pompeu
Fabra University in Barcelona. We created a 60 item MCQ
test with two questions for each subject that the participants
had studied. The questions were selected from previous
real exams and we chose those that appeared to be easier,
in order to set an allegedly very easy exam. From the 60
students that form the group, 39 anonymous volunteers
answered the test. The results confirm the existence of a
remarkable forgetfulness since 31% of the students did
not attain 50% of the maximum mark and only 2 students
(5%) achieved 70%. Also, in most of the cases, the number
of students who answered correctly each question was
lower than in the previous exams. The forgetfulness was
more or less important depending on the subject and the
kind of question.
Andreas Stein*, Waltraud Georg, Kira Flemming and Katharina
Crolow (Humboldt Universität, Reformstudiengang Medizin,
Charité, Schumannstr 20/21, 10117 Berlin, GERMANY)
Matching what is being learned and taught with what is
being assessed is of significant importance for the
relevance of assessment. Procedures with review
commitees and internal workshops in developing multiple
choice questions were implemented at the reformed
medical curriculum (RMC) at Charité, Berlin. These
procedures are a means for quality assurance of the
educational process. We present our faculty experience
with structure, process and outcomes of these
implemented tools:
1
2
3
4
5
formation of review committees
training of committee members
evaluation of the quality of questions
feedback on item characteristics
introduction of periodical workshops for review
commitee members
6 introduction of periodical workshops for item writing.
8A 2
8A 4
Jørgen Urnes*, Hilde Grimstad and Bjørn Rasmussen (NTNU,
Faculty of Medicine, Department of Community Medicine and
General Practice, MTFS, N-7489 Trondheim, NORWAY)
Aim: To present an assessment method of communication
skills using drama students as simulated patients.
Summary of work: Previous assessment of communication
skills by evaluating a live interview with a patient demanded
large logistic resources for the faculty, did not offer a good
opportunity to test students’ skills in dealing with patients’
emotions and gave unequal conditions for the students. An
approach using simulation methodology was initiated in
co-operation between Faculty of Medicine and the
Department of Drama and Theatre. A drama professor and
a medical doctor instructed drama students to develop
patient roles that matched their age and appearance.
During the exam the drama students acted as patients.
The medical students were asked to perform a medical
interview. Participants of the examination were asked to
evaluate their experience in a questionnaire.
The first partial test note as an assessment tool of
performance in first year medical students
Carlos E de la Garza-González*, Maria Esthela Morales Pérez and
Norberto López Serna (Facultad de Medicina, Universidad
Autónoma de Nuevo Leon, Administracion de Correos no 3,
Apartado postal no 712, 64460 Monterrey N.L., MEXICO)
Aim: Analyze the effectiveness of the first partial test note as
a predictor of performance.
Design: A retrospective, descriptive, transversal study.
Summary of work: We analyzed the students’ first test results
(n=386). Nine subgroups were organized according to the
notes:
• Group 1: 90 to 104 (n=15); Group 2: 80 to 88 (n=43);
Group 3: 70 to 78 (n=49); Group 4: 60 to 68 (n=85);
Group 5: 50 to 58 (n=79); Group 6: 40 to 48 (n=57);
Group 7: 30 to 38 (n=36); and Group 8: 20 to 28 (n=18);
and Group 9: <20 (n=4).
Summary of results: For group 1,100% passed the course;
98%, 96%, 86%, 76%, 40%, 31%, 17%, and 0%,
respectively for groups 2 through 9. 104 out of 107 (97%),
passed the course when they obtained 70 or higher. 133 of
164 (81%) whose notes were between 50 and 68 also
passed the course. When the note was below 50, the
number of those passing considerably decreased to 37 of
115 (32%).
Summary of results: Students (93%) and censors (92%)
experienced the simulations as “real”. Logistic workload
was reduced. Interaction between teachers at the Medical
Faculty and Department of Drama and Theatre gave
increased insight in role-play methodology for the purpose
of training and assessing communication skills.
Conclusions: Drama students simulating patients are
experienced as patients to a large degree. Our experience
encourages further co-operation.
8A 5
What contributes to the variance in NBME subject
exam scores and recommended grades from
teachers? A 10-year clerkship analysis
Steven J Durning*, Louis N Pangaro, Paul A Hemmer and Gerald D
Denton (Uniformed Services University, Dept of Medicine (NEP),
4301 Jones Bridge Road, Bethesda, MD 20814, USA)
Conclusion: According to our results, we consider the note
of the first partial test as an assessment tool for predicting
performance in embryology.
8A 3
Assessing medical students’ communication skills
by using drama students as simulated patients
Aim: To determine which measurements contributed to
the variance in NBME medicine subject examination
performance and recommended teacher grades (total
teacher points).
Knowledge acquisition and forgetfulness in health
sciences students
Summary of work: Prospective, 10-year study (1990-2000).
Potential independent variables were categorized as preclerkship, during-clerkship, and post-clerkship. We
calculated mean scores for each measurement and
analyzed this data using ANOVA and linear regression.
Maria Escriva, David Cid, Eva Bailles and Jorge Perez* (Facultat
de Ciencias de la Salut i de la Vida, Universitat Pompeu Fabra, c/Dr
Aiguader 80, 08003 Barcelona, SPAIN)
Experts in education manifest the importance to achieve
the ability to get information, that is, learn how to learn,
even more than acquiring concrete knowledge itself. One
of the most quoted reasons is that factual knowledge is
easily forgotten. The aim of our study is to establish the
forgetfulness of basic knowledge among the students of
Summary of Results: Data were available for 1,632 (98%)
students. Total clinical points followed a normal
distribution.
– 4.73 –
Section 4
10 year stepwise linear regression (year-to-year range):
Total Teacher Points
Pre-clinical GPA
z-Multi-step
z-NBME
Total
R2
.18(0-.35)
+.04(0-.20)
+.01(0-.01)
.18-.35
z-NBME Points
GPA
z-pretest
z-lab
z-multi-step
Total-clin points
Total
R2
.27(0-.42)
+.07(0-.40)
+.02(0-.03)
+.01(0-.02)
+.01(0-.04)
.07-.53
Summary of results: In 14 statements female doctors rated
their performance lower than male doctors did. The
patients, however, rated the female GPs similar, or in nine
statements even higher, than male GPs. The co-factors,
surgery and status of the GPs (registrar or principal), did
not show significant influences of the response behaviour.
Conclusion: We found a strong gender-related bias in the
self-perception of performance, which was of variance with
the perceptions of the patient group. Group differences
should be taken into account during the analysis or
interpretation of self-assessment tools in education.
8A 8
Araceli Hambleton-Fuentes*, David Cantú and Leticia ElizondoMontemayor (School of Medicine, Tecnológico de Monterrey, Ave.
Morones Prieto #3000 Pte, Colonia los Doctores, Monterrey,
Nuevo León CP 64710, MEXICO)
Conclusions: What a student “brings” to the clerkship (GPA)
is most strongly associated with these outcome
measurements. NBME exam and recommended teacher
grades explained a small, but significant, amount of
variance in both models, as perceived knowledge base
contributes to teachers’ assessment of learners. An
examination posing questions based on a videotaped
encounter (multi-step) explained a significant amount of
additional variance in both measures.
8A 6
Background: Self-assessment must be an integral part of
student training. Is there congruence between how
teachers perceive students and how they perceive
themselves?
Summary of work: At the School of Medicine Tecnológico
de Monterrey, we performed a pilot study using a criterionbased 39-item checklist developed for the purpose of selfassessment and tutor assessment of thirty-five 3rd grade
medical students. Mann-Whitney test was used; P<0.05
was considered statistically significant.
Are medical students’ examination results affected
by their gender and ethnicity?
S Kilminster*, K Boursicot, V Wass and T E Roberts (Medical
Education Unit, University of Leeds, Worsley Building, Level 7,
Clarendon Way, Leeds LS2 9JT, UK)
Summary of results: We found statistical differences in items
3, 9, 15 and 20, corresponding to rubrics of knowledge
application, self-study and clinical reasoning and decisionmaking skills. The significant differences showed that
students rated themselves higher than their teachers did.
Through self-assessment, students identified weaknesses
in rubrics such as collaborative work, self-study and clinical
reasoning and decision making skills, and strengths in
areas such as professional behavior. One of our
responsibilities as teachers is to foster student’s selfassessment skills and to induce them into reflective practice
to identify strengths and weaknesses as well as future needs
– life long learning skills they will need the rest of their
lives. Detailed results and the way ahead regarding selfassessments schemes will be presented.
Aim: To present the findings and discuss the implications
of a study investigating the effects of gender and ethnicity
on practical Objective Structured Clinical Examinations
(OSCEs) and written examination marks at three UK
medical schools.
Summary of work: OSCE and written examination results
of nearly 800 third year students were analysed. The study
was instigated due to some concerns that the OSCE format
might be disadvantageous for ethnic minority students.
Summary of results: There were small but significant
differences, in some examination results, between male
and female students or white and non white students at
each school. However, the amount of variance explained
by the relevant variable was small ( 3-6%). Combined
results from all 3 schools show no difference in
performance on written examinations between males and
females or between white and all other students. There
was a small difference (1.7 marks) between male and
female students’ OSCE scores but very little of the difference
was explained by the variable gender.
8A 9
Developing an in-training examination for
gastroenterology fellows
Amindra S Arora (Mayo Clinic, Department of GIH, 200 First
Street SW, Rochester MN 55905, USA)
The development of self-directed learning skills in our GI
fellows is a career skill. Adult learning theory demonstrates
that self-directed (ABIM) learning can result in deeper
sustained understanding. Re-certification examinations
are now aimed at stimulating this form of learning.
Conclusions: These results indicate that examination
marks are not affected by gender or ethnicity.
8A 7
Matching criterion-based student self-assessment
with teacher assessment: is there coherence?
Gender differences as observation in the
assessment of performance
Aim: Our aim was to develop a validated in-training multiple
choice examination (ITE) for our GI fellows.
Regina Conradt* and Ed Peile (University of Oxford, Department
of Primary Health Care, Institute of Health Science, Old Road,
Headington Oxford OX3 7LP, UK)
Summary of work: Patient management questions were
developed and presented to 8 faculty members for review
and 55 questions were selected. The questions were
further validated by asking recent ABIM board diplomats to
review for the content of the questions and how the
questions reflected those in the ABIM. Eight weeks after
the ITE, a survey was sent out to the GI fellows.
Background: Life-long learning is accomplished by regular
assessment, including self-assessment. However, selfperception has no absolute assessment scale. Here we
highlight the fact that a basic factor like gender can make
a difference.
Summary of results: Eighteen of the 24 GI fellows (75%)
completed the post ITE survey. Ninety-four percent agreed
that the ITE stimulated them to read more, 78% perceived
that the ITE identified areas of weakness in their GI
management skills, and 72% perceived that the content of
the ITE reflected the GI curriculum. Conclusion: This study
describes the development of a validated in-training
examination for Gastroenterology. The examination
highlighted deficiencies in our fellows’ knowledge and
Summary of work: The effect of gender differences in
doctors’ self-evaluation of performance was compared to
their patients’ perception. We asked 33 General
Practitioners (GPs) from seven surgeries to rate their own
performance and compared those with ratings of 255
patients (4-15 patients per GP). Both groups rated 34 similar
statements on a 5-point-Likert scale. We used hierarchicallinear-models for statistical analysis (MLwiN, http://
multilevel.ioe.ac.uk).
– 4.74 –
Section 4
patient management skills. The study demonstrated that
the ITE stimulated independent learning several weeks
after the test.
8A 12 Empathy as a function of gender and levels of undergraduate and graduate medical education in Mexico
Adelina Alcorta G-Gonzalez*, Mohammadreza Hojat, Juan-F
González-G, Jesús Ancer-R, María-V Bermúdez, Juan Montes-V,
Marco-V Gómez-M, A-Enrique Alcorta-G, Silvia Tavitas-H and
Sheila-M Garza (University Hospital, Palo Blanco 604, Valle de
Santa Engracia, San Pedro Garza García NL, CP 66260, MEXICO
8A 10 Clerkship preceptor handbook of core students skills
Paul Hemmer (USUHS Educational Programs Division) Uniformed
Services University, USUHS - EDP, 4301 Jones Bridge Road,
Bethesda MD 20814, USA
Aim: To investigate similarities and differences on empathy
among Mexican medical students by gender and level of
medical education.
Aim: The Handbook of student skills helps clerkship
students develop proficiency in core skills.
Summary of work: Participants: 1095 medical students (529
women, 566 men, 687 first-year, 183 third-year, 152 fifthyear, and 73 residents in specialty training). The Jefferson
Scale of Physician Empathy (JSPE, versions S (for students)
and HP (for health professionals/residents) was used. It
was translated into Spanish, by “back-translation” for
accuracy, and is supported by psychometrics data.
Analysis of variance was used for statistical analyses.
Summary of work: Based on the model of microskills
training, each of four modules is covered in a 30-minute
session with 3-5 students during teaching meetings. Each
module defines Goals, Objectives, and provides an easy
to follow outline. The modules begin with a poorly written
HPI for a patient presenting with chest pain. Through a
series of handouts, students critique the HPI, and formulate
a more developed HPI. They are given handouts that depict
both a comprehensive and focused H&P. In subsequent
modules, students use these H&Ps to develop an oral
presentation of the case (Module 2), a problem list (Module
3), and an analysis (Module 4). The case is deliberately
complex (an acute anterolateral MI complicated by acute
MR and CHF; HTN, DM, and an acute GI hemorrhage), to
help students grapple with complexity, yet act with a degree
of simplicity.
Summary of results: Statistically significant differences on
the empathy scores were observed in the favor of women,
but only at the undergraduate medical education levels.
Also, significant differences on empathy scores were found
at different levels of medical education. Findings generally
suggested that empathy scores increased with the level of
medical education.
Conclusions: The gender difference observed in this study
is consistent with findings reported with American medical
students and physicians. However, our findings about the
positive effect of medical education in improving empathy
are inconsistent with those reported for American samples.
Further research is needed to examine factors that
contribute to the improvement of empathy in Mexican and
a decline of empathy in American samples.
Summary of results: Student feedback has generally been
positive, but students in the latter part of the academic year
progress more rapidly.
Conclusion: Modules to develop core student skills can be
implemented within the core medicine clerkship. Such
modules may also be useful for those who teach ICM
courses.
8A 11 Assessment of postgraduate medical courses: the
question of how to improve their quality
8A 13 Assessment of basic practical skills in an
undergraduate medical curriculum
S Elango*, J C Ramesh, T Motilal, L C Loh, P Kandasami and C L
Teng (International Medical University, Jalan Rasah, 70300
Seremban, MALAYSIA)
Beatriz Graciela Borenstein (on behalf of the Pedagogical
Department) (Sociedad Argentina de Terapia Intensiva (SATI),
Charcas 3026 Piso 5, Ciudad Autónoma de Buenos Aires 1425,
ARGENTINA)
Aim: Basic practical skills are essential competencies that
students should develop during undergraduate medical
training. Studies have shown that the undergraduate
curriculum often fails to fulfill these expectations.
The aim of this communication is to present the
assessment program carried out by the Argentine Society
of Intensive Care (SATI) to evaluate the quality of the
postgraduate intensive care course developed in different
provinces of our country. The biannual course that is run in
our Capital City was audited by the CONEAU (Comisión
Nacional de Evaluación y Acreditación Universitaria), entity
which has given that course a high mark. However, other
courses which are offered by SATI throughout the country
should still be improved and to do so a program to evaluate
the course´s quality has been planned. Consequently, the
following steps were taken:
1 Diagnosis: Identification and analysis of problems and
their causes; Ranking according to their importance;
Structural causes; Changeable causes; Hypothetical
causes; Cause and effect diagram.
2 Improvement strategies: Positive and negative forces;
Strategies and further actions; Statement of aims and
goals; Expected outcomes.
3 Monitoring plan.
4 Biannual appraisal.
Summary of work: The International Medical University,
Malaysia, has identified a list of basic practical skills that
students should be competent in. These skills are taught
using models and are assessed during the overall end-ofsemester examination. The study aims to evaluate the
effectiveness of teaching and learning in these basic
practical skills.
Summary of results: The results of 244 students who
participated in the last three examinations were analysed.
The mean Objective Structured Practical Examination
(OSPE) score for the practical skill stations was
significantly higher than the mean overall score of the
written, practical and clinical examinations. However, the
failure rate in the practical skills stations was significantly
higher than the overall failure rate.
Conclusion: In comparison with the overall performance,
generally, students either perform competently or poorly in
the practical skills station. The study shows that OSPE
was able to discriminate the students who have learnt these
skills from those who have not. However, it is recommended
that independent summative assessment may be necessary
to ensure that all students gain competency in practical
skills.
According to the results, the main strategy would be to
certify the quality of the places where students work or
have their clinical practice. That assessment will be
conducted by a team formed both by members of the
Pedagogical Department of SATI and by its educational
counsellor.
– 4.75 –
Section 4
Session 8B: Clinical Assessment
8B 1
A new approach to a clinical final examination
8B 3
C Carvajal*, M Bustamante, R Dalmazzo, J Olivos and J Vukasovic
(Universidad de Chile, Facultad de Medicina, Camino de la Laguna
13452, Lo Barnechea, Santiago, CHILE)
Nicholas Pavlakis and Rodger Laurent* (Department of
Rheumatology, Royal North Shore Hospital, St Leonards, Sydney
2065, AUSTRALIA)
Aim: One author (CC) participated in the 2001-2002
FAIMER program (Foundation for Advancement of
International Medical Education and Research ), at
Philadelphia, USA. In that Institution knowledge and support
were obtained in order to create a new method for medical
students’ final assessment. The goal of this presentation
is to describe the method and to show the results of a pilot
application.
Aim: To determine the value of observing a long case
examination in identifying problems in the clinical
assessment of patients by junior medical staff.
Background: Assessment of long case examination
technique emphasises problem identification and
discussion of management. It assumes that history taking
and physical examination skills are adequate. These can
only be assessed by directly observing the long case
examination.
Summary of work: Six Standardized Patients (SP) portrayed
common diseases. Twelve students interacted with each
SP during a period of 15 minutes. A faculty member was
present and completed a checklist during the encounter.
After, the student completed a clinical form. The checklists
and forms results were evaluated. The SP completed a
written survey after the experience.
Summary of work: We used a structured assessment form
to observe and evaluate the overall long case performance
of nineteen doctors in their fourth post graduate year.
Summary of results: There were deficiencies in some part
of the examination for the majority of doctors. These were
not always detected during a formal presentation of the
case. Three had inadequate history taking skills and five
had inadequate physical examination skills. The
commonest problems included poor time management,
excessive time required to take the history and lack of
organisation of questions. Physical examination was
usually poorly organised, requiring the use of short cuts,
particularly in the respiratory, musculoskeletal and
neurological systems.
Summary of results: 68.7% of students correctly identified
the medical plan. 16.6% of students failed in history taking.
SP evaluation: 14% of SPs did not understand the medical
language used by the students. 18% of SPs did not get
enough information related to their medical condition.
Conclusions/take home messages: This method can
effectively identify students’ medical skills and abilities. It
is possible to use it in our medical school. It is necessary to
use an objective method of assessment in order to obtain
a medical degree.
8B 2
Conclusion/take home message: The observed long case
allowed for detection of defects in history taking and
physical examination skills and time management. These
deficiencies are not often detected on formal presentation
of the case.
The relationship of examination candidate
performances between the Medical Council of
Canada’s (MCC) computer-based examination and the
MCC clinical skills examination
D E Blackmore*, T J Wood, W D Dauphinée, S M Smee and A P Boulais
(The Medical Council of Canada, 2283 St. Laurent Blvd, Ottawa,
Ontario K1G 3H7, CANADA)
8B 4
Medical students perceive the OSCE as a fair re-sit
assessment tool
J Syme-Grant* and P A Johnstone (NHS Education for Scotland,
Ninewells Hospital and Medical School, Postgraduate Office, Level
7, Dundee DD1 9SY, UK)
Aim: In order to receive the Licentiate of the Medical
Council of Canada (LMCC), an examinee must successfully
pass a one-day computer-based examination (MCCQE
Part I) and a 14-station OSCE known as the MCCQE Part
II. The MCCQE Part I is most often taken at the end of the
MD degree while the MCCQE Part II is usually taken at the
end of 12 months of postgraduate training within a clinical
setting. The aim of this presentation is to show that a written
examination is not a clear predictor of performance on a
clinical examination.
Aim: To report a paper on the perception of fairness of an
OSCE as a re-sit examination.
Summary of work: All candidates immediately following the
4th year resit OSCE at Dundee were canvassed for their
opinion. A simple questionnaire asked if they regarded the
OSCE as a fair assessment of their abilities. ‘Yes’ and ‘No’
categories were chosen. Those that answered ‘No’ were
invited to explain why.
Summary of work: Examinees (n = 2078) who have
successfully passed the MCCQE Part I since the fall of
2000 and attempted the MCCQE Part II were analyzed in
order to ascertain if any systematic relationships were
appearing on varying aspects of the two examinations. The
clinical skills results (communication skills, data gathering
skills, and clinical decision making) were contrasted with
discipline scores, written clinical reasoning/decision
making skills, and total scores obtained from the MCCQE
Part I.
Summary of results: Response rate was 100% (30 students).
80% of students felt the OSCE to be fair. Of the six who felt
the OSCE to be unfair, three indicated time shortage as
their principle reason. Two students raised the possibility
of poor performance on the day and only one felt the OSCE
included inappropriate material. Four students failed the
exam. The relationship between students’ perception of
fairness and passing or failure is unlikely (p=0.788).
Conclusion: Students feel well constructed OSCEs are a
valid method of re-sit clinical assessment.
Summary of results: The results show that examinees with
moderately high knowledge may not possess the
wherewithal to perform adequately in a clinical setting.
Conclusion: Knowledge on a multiple-choice or written
examination is not a clear predictor of performance on a
clinical examination.
The role of the observed long case in postgraduate
medical training
8B 5
Easy as ‘pie’ - improving OSCE instructions
Cynthia Yiu, Martin Mueller* and Michael Marsh (Guy’s, King’s
and St Thomas’ Medical School, 5 Lambeth Walk, London SE11 6SP,
UK)
Background: OSCE stations frequently assess integrated
skills and it is important that, given the short time frame,
students understand what is being assessed. Evaluation
– 4.76 –
Section 4
from both students and examiners highlighted that students
were sometimes not clear despite written instructions and
that there was a need to make the focus of the stations
better understood.
8B 8
Dilbar A Mavlyanova* and Muazam A Ismailova (Tashkent
Pediatric Medical Institute, J. Obidova Street 223, Tashkent
700140, UZBEKISTAN)
Summary of work: We developed a pie chart to accompany
station instructions which were coded to illustrate the
proportion of marks allocated to skills divided:
communication, clinical examination, history taking and
practical skills. This was used in a Year 3 - first year clinical
OSCE. We chose a black and white format to avoid
difficulties for colour blind students. We asked the students
whether they found the charts useful in an evaluation
questionnaire after the OSCE.
Aim: To improve the methods of assessment clinical skills
in medical education.
Summary of work: ‘Questionnaires to registrars (100), and
final year medical students (400) on the usefulness of the
OSCE as a method of assessment.
Summary of results: 93% of respondents found the OSCE
is many-sided and multipurpose. All of the registrars and
students evaluated the OSCE as being educational,
enjoyable and “ remarkably different” from the former
methods used in summative assessment. The major
strengths of the OSCE organization mentioned were:
Process of preparing OSCE is realized; OSCE sub-group
is created; Examination process is provided by a bank of
stations and necessary paperwork; Each station is
designed to test a different skill; Direct discussion and the
immediate verbal feedback face to face are provided after
each station. The considered areas for improvement were:
Undetailed scenario of any problems; Short interval of time
given on each station (10 minutes); Not many steps for
realization of diagnostic procedures and tests.
Summary of results: 90.3% of the students responded.
57.8% agreed the charts were useful whereas 14%
disagreed. Free text indicated that students found the black
and white format difficult and would prefer colour.
Conclusion: The innovation was positively received but the
issue of using colour coding which potentially
disadvantages some students remains unresolved.
8B 6
Re-using an OSCE station and its re-take
Leila Niemi-Murola, Pirkko Heasman*, Markku Kaipainen, Timo
Kuusi and Kirsti Lonka (Research and Development Center for
Medical Education, Helsinki University, PO Box 63, FIN-00014,
FINLAND)
Test security and sharing of information by students have
been a concern when the OSCE stations are used several
times. We test the entire class of 90 fifth-year students and,
for practical reasons, the test takes three days. According
to our experience, there have been no linear trends during
these days suggesting sharing of information. According
to previous studies, stations testing communication skills
are less affected by possible shared information than are
stations testing clinical skills. Skills a student uses to
approach a patient should not change even if the patient’s
complaints are known. Thus, we tested this hypothesis by
having a re-used psychiatric OSCE-station in a re-take for
those who had failed this particular station previously. The
profiles of the stations in OSCEs 2001, 2002 and re-take
were very similar. The results are discussed in the
framework of developing expertise in medicine.
8B 7
Conclusions: The OSCE is a new and important element
of assessment of clinical skills for medical students in
Uzbekistan, but as it was estimated, its usefulness is
recognized not only by education professionals, but even
by registrars and medical students. The considered areas
for improvement should be taken into account during wider
dissemination of the formative and summative
assessments.
8B 9
Analysis of questionnaire survey of raters, students
and standardised patients on the 12-station OSCE
used at the Kurume University School of Medicine
Takato Ueno*, Ichiro Yoshida, Hiroki Inutsuka and Michio Sata
(Research Center for Innovative Cancer Therapy, Kurume
University School of Medicine, 67 Asahi-Machi, Kurume 8300011, JAPAN)
Summary of work: Objective Structured Clinical
Examinations (OSCE) covering 12 subjects were carried
out among fourth year medical students at the Kurume
University School of Medicine. The subjects were medical
interviews, writing medical records, diagnostic imaging,
physical examinations for head, neck, chest, heart sound,
abdomen, neurological system and vital signs, basic
surgical skills, cross matching and resuscitation. After
completion of the OSCE, a questionnaire survey directed
to raters, students, and standardised patients (SP) was
performed.
Assessing nurses’ clinical skills with OSCE
A Molins*, M Solà, A M Pulpón, S Juncosa and J M MartinezCarretero (Institute of Health Studies, Balmes 132-136, 08008
Barcelona, SPAIN)
Since 1995 the Insitute of Health Studies has been
assessing clinical skills of Catalan nursing students. In the
2002 OSCE experience, 144 students in the final year
nursing degree belonging to the Nursing Schools of
Barcelona University, Mar, Sant Pau, Tortosa, Blanquerna,
Vic, Manresa and Girona took part in a 13 SP simulatorsbased case (24 stations) OSCE. The clinical situations
were selected to reflect the settings in which nurses
normally practise and the competence components
analysed were: team work, history taking, identification of
patients’ problems and planning therapeutic strategies,
clinical intervention, preventative activities, communication
skills and teaching abilities. Ethics skills, research and
clinical knowledge were examined with a MCQ, to
complete the individual total score. The mean percentage
of scores obtained by students was 59.7 with a standard
deviation of 5.0. Identification of patients’ problems and
planning and management of therapeutic plans were the
components in which students obtained the lowest scores
and the highest scores were found in team work. The
purpose of that experience can guide further research in
order to: modify present cases, incorporate new cases and
begin a formative OSCE with some nursing schools.
Introduction of objective structure clinical examination
(OSCE) at TashPMI and subsequent evaluation
Summary of results: The results indicated that the 12-station
OSCE, in which each subject takes 5 minutes along with a
feedback time of 1.5 minutes, was generally well accepted
by raters, students, and SPs. Problems mentioned included
the content of subjects and the necessity for an
intermediate break, and the possibility of requiring a
physical examination by SP as part of the OSCE was
considered.
8B 10 Clinical skills assessment at medical schools –
Catalonia (Spain), 2002
E Kronfly, L Gràcia, X Julià, J Majó, J Prat, A Castro, J A Bosch, A
Urrutia, J L Gimeno, C Blay and R Pujol* (Institute of Health
Studies, Balmes 132-136, 08008 Barcelona, SPAIN)
Background: The Institute of Health Studies jointly with the
Catalan Medical Schools have conducted several projects
on Clinical Skills Assessment using OSCEs since 1994.
– 4.77 –
Section 4
or by pathologies. The results from 927 practical exams
were analyzed in 2001 and 610 practical exams in 2002.
This was accomplished on the basis of the scores obtained
from the scoring guide that was used, as well as from the
groups of pathologies faced by the students.
Summary of work: In 2002 an Objective Structured Clinical
Examination (OSCE) to assess clinical competences for
final year medical students was used in six Catalan Medical
Schools. A multiple-station examination, with 14 cases
distributed in 20 stations, and a written test, composed of
150 MCQ (20 questions with pictorials associated), was
designed to assess medical competences.
Summary of results: The OSCE scored highly on internal
consistency with a Cronbach’s alpha = 0.82 for the multiplestation examination and 0.76 for the written test. The global
mean score for the test was 60.8% (sd: 5.9). The mean
scores, obtained by the 429 medical students who
completed the OSCE, for every specific competence
assessed, were as follows: history taking 61.1% (sd: 9.2),
physical examination 51.2% (sd: 8.8), communication skills
67.0% (sd: 6.3), knowledge 59.0% (sd: 8.7), diagnosis and
problem-solving 59.7% (sd: 8.4), technical skills 72.2% (sd:
11.9), community health 59.4% (sd: 11.4), colleague
relationship 47.8% (sd: 10.1), research 69.4% (sd: 17.8)
and ethical skills 71.0% (sd: 14).
Summary of results: Results showed that regular students’
performance was higher than that from students whose
academic history was longer than the five years taken by
the regular students. The confidence interval value was
0.987 and 0.944. The highest performance was obtained
in the Pediatrics field. Pathologies with the highest
performance were the very common ones, such as
diabetes and hypertension. A similar situation was found in
the practical phase. It is concluded that professional
exams allow the integral evaluation of clinical competence.
8B 13 Rater disagreement in OSCE
J M M van de Ridder*, V Batenbrug, J Buis, V Eijzenbach, F J M
Grosfeld and M M Kuyvenhoven (University Medical Centre
Utrecht, VaardigheidsOnderwijs B.00.118, PO Box 85500, 3508
GA Utrecht, NETHERLANDS)
Conclusions: OSCE based methodology has proved to be
a feasible, valid and reliable tool to evaluate final year
medical students in our context.
Background: Often rater disagreement is a problem when
using Objective Structured Clinical Examinations (OSCE).
8B 11 The relationship between performance on a third-year
medical student OSCE and performance on the
USMLE step 1 examination
Aim: The aim of this study is to obtain more information
about causes of interrater and intrarater reliability. Different
sources of rater disagreement and methods of selfregulation used by raters during their observation of clinical
skills will be discussed. Summary of work: 13 raters of
communication and physical examinations skills were
subjected to an oral interview. Causes of rater
disagreement were determined by evaluating their
reactions to open-ended questions. Rater statements were
divided, selected, labeled and categorized according to
the theory of Glaser & Strauss. Influencing factors were
defined out of 402 statements: students, subjects, time,
standardized patients, raters and methodological aspects.
If raters were aware of influences while rating they used
different methods of self-regulation: they formulated own
rules and used personal standards.
Kelly Kirby Ortega*, Neena Natt*, Robert Tiegs and Jay Mandrekar
(Mayo Graduate School of Medicine, Mayo Clinic, 200 First
Street SW, Rochester MN 55905, USA)
Aim: To determine the relationship between performance
on a 3rd year medical school OSCE and performance on
the USMLE Step 1 examination.
Summary of work: Eighty-eight Mayo Medical School
students completed an eight station OSCE between March
2000 and July 2001. Their performance on this exam,
represented by two scores (data gathering and
interpersonal skills), was compared with their 3-digit score
on the USMLE Step 1 examination.
Summary of results: The distributions of OSCE scores in
data gathering and interpersonal skills and the 3-digit
USMLE step 1 score did not follow a normal distribution.
Hence Spearman’s rank correlation as a non-parametric
correlation was calculated. Both the correlation between
the OSCE data gathering scores vs. the 3-digit score on
USMLE Step 1 and the correlation between the OSCE
interpersonal skills scores vs. the 3-digit score on USMLE
Step 1 (-0.04) were not statistically significant, at a 5%
level of significance.
Conclusions: It is concluded that among raters of
communication skills and physical examination skills the
influencing factors differed. The findings have resulted in
improved instructions for both raters and standardized
patients
8B 14 Practical assessments used in preparing students
for their clinical year
G Till* and H Till (Canadian Memorial Chiropractic College, 1900
Bayview Avenue, Toronto ON M4G 3E6, CANADA)
Conclusion: Performance on the USMLE Step 1
examination does not correlate with performance on a 3rd
year OSCE. This is not surprising given that the focus of
the USMLE Step 1 examination is on knowledge and
interpretation of basic principles in health and disease,
whereas the OSCE is designed to assess clinical skills
such as history-taking and physical examination.
Students from the first year onwards at the Canadian
Memorial Chiropractic College spend increasing amounts
of time observing interns in the clinic dealing with patients.
However, they get very little experience in working-up
patients themselves prior to their year of internship. It was
therefore not surprising that students found it difficult to
make the transition from classroom to patient care. Previous
attempts to identify students’ preparedness for the clinic
had centered on clinic entrance OSCEs. However, these
summative assessments neither adequately identified
those students lacking basic history-taking and physical
examination skills, nor did they leave sufficient time for
remedial action prior to the start of the internship. Therefore,
a form of assessment that not only more closely simulated
the doctor/patient encounter, but which at the same time
gave the student experience in performing these tasks for
different clinical disorders, was developed. In this way, the
new assessments became formative in nature, and by
being held about every 4 weeks, allowed ample time for
remediation throughout the course of the year. This paper
describes how these assessments are conducted, and how
they form part of a new integrated curriculum for the preclinical year.
8B 12 Professional exam: an integral clinical exam with
real patients
Maria Eugenia Ponce de León*, Armando Ortiz Montalvo and Maria
del Carmen Ruiz (National Autonomous University of Mexico,
Medical School, Camino Santa Teresa 277 Casa 15, Bosques del
Pedregal, Delegación Tlalpán, CP 14010, MEXICO)
Summary of work: A descriptive, transversal study was
carried out in order to analyze the results from two
professional exams (theoretical-practical) corresponding
to the years 2001 and 2002 in the School of Medicine
(Facultad de Medicina) of the National Autonomous
University of Mexico (UNAM). 1185 students participated
in these exams in 2001, and 1159 in 2002. The results
from the theoretical exam are presented: confidence
intervals and total simple frequencies by field and subject
– 4.78 –
Section 4
Session 8C: The Curriculum (1), including
Multiprofessional Education
8C 1
Oncology – an interdisciplinary course
curriculum; (2) To survey the physicians’ style of journal
reading.
C Haag*, H Alheit, M Baumann, O Hakenberg, U Wehrmann, M
Wirth and G Ehninger (Medical Faculty, Dresden University of
Technology, Medizinische Klinik 1, Universitätsklinikum Carl
Gustav Carus, Fetscherstr. 74, 01307 Dresden, GERMANY)
Summary of work: A structured interview was carried out
among medical students and physicians at Hatyai Hospital
(a 700-bed referral center). The questionnaire included
(1) demographics of interviewee; (2) opinion on CE
teaching program; (3) journal reading habits; (4) evaluation
of basic understanding in study design and statistical
values.
At Dresden’s Medical Faculty we implemented during the
last years our DIPOL – programme (Dresden integrative
patient/problem oriented learning) for the students in the
3rd and 4th year. In 2002 we started to extend this
programme for the 5th year students, beginning with a
course in oncology. The aim of the course was to realise
interdisciplinary teaching, combining the different aspects
of cancer aetiology, diagnostic and therapy. The curriculum
of this course included topics of basic and clinical science,
lectures in epidemiology, palliative care, medical
psychology and quality of life. The course consisted of
lectures, tutorial, exercises in patient-doctor
communication and multistations. Each case in the
tutorials had different major topics in aetiology and
principles of therapeutic procedures. The multistation
sessions were focused on one cancer with minicases to
teach the different diagnostic and therapeutic procedures
in the different stage of disease. Some of the lectures were
interdisciplinary with two or three experts teaching together
in a lecture, but each form his point of view. With this course
we demonstrated, that it is possible to teach oncology
interdisciplinarily and to reflect with this approach the
modern treatment of cancer. The complete course and
the evaluation will be presented.
8C 2
Palliative care in the medical curriculum at Bern,
Switzerland: when and how
Summary of results: A total of 68 interviewees answered
the questionnaire. 60.3% have learned the basic of CE.
Most medical students have never learned it before,
significantly different compared to physicians (<0.001).
97.1% agreed with the implementation of this program.
The main advantages were: supporting evidence-based
medicine (EBM) 89.7%. The start of the program should
be in the preclinical level 39.7%; clinical level 54.4%; and
post-graduate level 4.4%. Regarding behavior of journal
reading style, after reading the title and objective, the next
favorite parts were results (35.3%) and conclusions
(30.9%). The least favorite part was methodology (50%).
However, they realized that it was the important part. The
contents of research methodology should include study
design (45.6%), biostatistics (33.8%).
Conclusions/take home messages: Most of the physicians
agreed with the CE teaching program in the medical
curriculum and the contents should include study design
and biostatistics. The journal reading style found that results
and conclusions were read and research methodology
was frequently skipped.
8C 4
S Eychmueller (Kantonsspital St. Gallen, Palliativstation,
Rorschacherstr. 95, 9007 St Gallen, SWITZERLAND)
Irina Brumboiu*, Ioan S Bocsan, Amanda Radulescu and Ofelia
Suteu (Iuliu Hatieganu University of Medicine and Pharmacy,
Epidemiology Department, 13 Emil Isac Street, 3400 Cluj-Napoca,
ROMANIA)
Aim: To demonstrate the use of the Palliative Education
Assessment Tool (PEAT) for identifying Palliative Care (PC)
content in the existing curriculum, and to argue for an ideal
localisation and teaching methods.
Aim: Teaching Epidemiology as a basic science in
preventative medicine efficiently and attractively has been
our main concern for the last decade.
Summary of work: PEAT was administered on the internetversion of the medical curriculum of Berne. Methods and
content of existing and future PC issues were elaborated
with special focus on multiprofessional learning.
Summary of work: In 1993 we started teaching Basic
Epidemiology plus PHC (one semester in the second year),
followed by Epidemiology of communicable and noncommunicable diseases (one semester in the final year)
during 37 hours of lectures and 37 hours of practical
training. New methods were also implemented (case
studies, PBL).
Summary of results: PEAT filtered out 17 different teaching
sessions (> 33hours) from year 1 to 6. Specialities
responsible for the training range from family medicine to
psychiatry and there may be doubt that PC is taught in a
comprehensive manner. An ideal blueprint would focus
(a) on a “palliative thread” integrated repetitively into clinical
cases and problems in the 4th and 6th year, and (b) on a
multiprofessional workshop in the 6th year in order to “use”
PC as a vehicle to foster team-working skills.
Summary of results: The very compliant and interested
students gained much higher marks then previously, despite
the MCQ method of exam replacing the formerly used oral
examination. Every summer students voluntarily participate
in field trials (e.g. the trial on cardiovascular diseases risk
factors involving 10,000 inhabitants in 1997). The implicit
effort of involved faculties helped two of them to get an A
mark (the only CEE candidates getting A) when competing
for MPH scholarships in the USA in 1998.
Conclusions/take home messages: PEAT is a useful
instrument to uncover “hidden” content regarding PC.
Improved coordination of PC-content (symptom control)
and special attention to multiprofessional team-work could
help to prepare students much better for a future
confrontation with far advanced disease and dying patients.
8C 3
From classic to modern: developing a new teaching
strategy in epidemiology
Conclusions/take home messages: Our experience proved
this reform can strengthen undergraduate communityoriented medical education and focused on prevention.
Two other Romanian medical schools are successfully
implementing the same model of teaching epidemiology.
Survey of clinical epidemiology teaching program
need in the Thai medical curriculum
Pairoj Boonluksiri (Hatyai Hospital, 182 Rattakam Road, Hatyai,
Songkhla 90110, THAILAND)
Aims: (1) To survey the learning need of the clinical
epidemiology (CE) teaching program in the Thai medical
– 4.79 –
Section 4
8C 5
Community based education: strategies for effective
student commitment
Aim: To describe the structure, content and evaluation of
the undergraduate course “Early Professional Contact
(EPC)”.
R G Souza, F Menezes*, L M Camarotti and J Araujo (Federal
Univesity of Roraima, Caixa Postal 495, Centro, Boa VistaRoraima, ZC- 69301-971, BRAZIL)
Summary or work: In 2001 the first EPC course started with
the aim to introduce the students to the physician’s role
and to everyday clinical work to give knowledge, skills and
inspiration for their future work and motivation for their preclinical studies. The course is given during the first four
terms and we use small-group learning with the intention
to introduce and improve skills such as observation,
description, empathy, problem-solving, cooperation and
reflection. After each year a course evaluation
questionnaire is made.
Summary: The Federal University of Roraima-Brazil,
changed its medical curriculum to a PBL/community
oriented model, but there was some resistance of the
students towards community practices. In order to change
that, the school adopted a strategy of early commitment,
based on not letting the student become “contaminated”
by the hospital before arriving at the community. An
integration between curricular content and the Brazilian
Family Health program was created, based on a schedule
beginning in the first year, with progressive involvement on
health actions. A symbolic approach was introduced using
the first day of medical school to enrol the new students in
tasks related to particular selected cases that would arouse
interest. Training of the Family Health Program
professionals on PBL principles permitted the presentation
of every day community health problems in a stimulating
way.
Conclusions/take home messages: (1) Medical schools
aiming at community based education should integrate
their curriculum to the local community health program;
(2) Training of the community health team on PBL
principles will allow the students to relate to the community
health program in a more stimulating way; (3) Delaying the
encounter with the community influences the student
towards the hospital practice.
8C 6
Summary of results: Two questionnaires have been
administered. The students have reported a high degree
of satisfaction with their tutors and the possibility to meet
doctors, staff and patients. They also report increased
confidence when meeting with patients.
Conclusion: First year medical students have been
introduced into their future profession by working together
in small groups and with a tutor. The students have
expressed a high degree of satisfaction with the course.
8C 8
M I Nurjahan*, CL Teng, K Y Loh, A R Yong Rafidah, S K Kwa, M L
Young, L C Lai, K H Ong and P C Y Chen (International Medical
University, Clinical School, Jalan Rasah, 70300 Seremban, Negeri
Sembilan, MALAYSIA)
Aim: This paper describes the objectives, educational
processes, evaluation and challenges in implementation
of a pilot programme where International Medical University
(IMU) medical students attend a five-day attachment to a
general practice (GP) in year one.
Biologic threats to society: successful integration of
a longitudinal theme into the medical school
curriculum
John F Mahoney*, Kathleen D Ryan and Steven L Kanter (University
of Pittsburgh School of Medicine, Office of Medical Education, M211 Scaife Hall, 3350 Terrace Street, Pittsburgh PA 15261, USA)
Summary of work: With changing trends, medical
educationists recommend more emphasis on communitybased education. This new programme implemented in
2002 introduces family medicine early in the IMU
undergraduate medical programme. Introductory lectures
were given. The learning was mainly experiential where
students carried out tasks at the GP and maintained a
simple portfolio. A debriefing was held after the attachment.
Evaluation of the programme using a semi-structured
questionnaire was obtained from both students and general
practitioners.
Background: 21st century society faces emerging threats
to individual and societal health: biochemical/radiological
terrorism, emerging/resistant infections, food/water
contamination, psychosocial effects of terrorism, and
technologic threats (computer viruses). Successful
mitigation of these threats depends on prompt recognition
and reaction. The ultimate goal of this longitudinal
curricular initiative is to prepare graduating medical
students to respond to the challenges posed by biologic
threats to society (BTS). Topic-related principles are core
elements of existing curricula: public health, epidemiology,
infectious diseases, pharmacology, toxicology, emergency
medicine.
Summary of results: Eighty-two percent of students provided
feedback. Of these, 90.2% said they received satisfactory
supervision from GP tutors and about 88% felt they have a
better understanding of family medicine. However, some
reservations was expressed on the amount of clinical
teaching and learning that was possible at this early stage
of training but this was offset by positive response on the
ability to clerk “real” patients, learning communication
skills, observing doctor-patient relationship and rolemodelling.
Summary of work: BTS is being integrated into existing
courses throughout the curriculum. Examples:
Neuroscience – chemical weapons agent and antidote
mechanisms; Genetics – gene mutation-counting to
estimate radiation exposure; Ethics – quarantine dilemmas.
At strategic points, students participate in simulations and
exercises that promote content assimilation.
Summary of results: Since 2000, BTS curricular integration
has been achieved by designing discrete instructional units
relevant to the goals of existing courses. Students consider
BTS content as relevant to their education and practice.
BTS coursework was perceived to be more useful after
September 11.
Conclusion: Early introduction to family medicine is
beneficial and should be incorporated into the medical
curriculum.
8C 9
Defining the content of a physiotherapy program in
Switzerland – a needs assessment
Markus Schenker (Health Education Centre AZI, School of
Physiotherapy, Murtenstrasse 10, CH-3010 Berne,
SWITZERLAND)
Conclusions: BTS theme integration requires limited
curriculum time yet is pervasive enough to enhance student
awareness. This approach is synchronous with US Centers
for Disease Control and AAMC recommendations.
8C 7
Early introduction of family medicine during
undergraduate medical training
Background: The Physiotherapy education program in the
Education Centre for Health Professions in Berne
(Switzerland) is organized as an outcome based
curriculum. Defining the needs of the society was a crucial
step in the curriculum development process. One important
step in this needs assessment (Kern) was to elaborate what
type of patients will be treated by physiotherapists.
Early professional contact (EPC) for medical
students: Gothenburg experience
Gunilla Hellquist*, Bernhard von Below, Stig Rödjer and Gudny
Sveinsdottir (Department of Primary Care, Box 454, S-40530
Göteborg, SWEDEN)
– 4.80 –
Section 4
ECG registration and auscultation of the heart) and the
perceived effects of the course on these practical skills
and attitudes towards future professional role and
multiprofessional teamwork were assessed.
Summary of work: During a two month period, the diagnoses
of all patients referred for physiotherapy treatment were
recorded by all physiotherapists in four regional hospitals,
in the university hospital of Berne and in forty physiotherapy
practices in the Canton of Berne. The diagnoses were
then screened for duplicates and synonyms. The proportion
and the exact confidence limit (95%) of each diagnose
was calculated. The total frequencies of the three main
physiotherapy domains were compared using a ?-square
test.
Summary of results: This interdisciplinary educational
approach was assessed to promote the learning of
cardiovascular practical skills in both groups. The
participants felt that these specific clinical skills should be
learned in a multiprofessional setting. The course was
further perceived to improve the role knowledge and
interprofessional attitudes among both medical and nursing
students. Interdisciplinary small group learning was finally
suggested to promote understanding of interaction skills
and emphatic patient care, especially among medical
students.
Summary of results: A total of 458 diagnoses were recorded.
After screening for duplicates and synonyms, a final set of
432 diagnoses was defined. The core set of diagnoses
consisted of 51 diagnoses, contributing 64.5% of all
recorded diagnoses. The proportion of the three main
physiotherapy domains in the three groups was significantly
different (p < 0.01). Applying the step down method, the
false discovery rate was 0.012. Using this ?-level, 75
diagnoses (77% of the analyzed 97 diagnoses) occurred
significantly more frequently in one group than in the other
two groups. 21 diagnoses (21.6% of the analyzed 97
diagnoses) were seen mainly in private practices but not
in hospitals.
Conclusions: The results of this study have an important
impact on the content and the structure of the new
curriculum. The core set of diagnoses helps to describe
the main competences of Swiss physiotherapists.
Conclusions: The results suggest that interdisciplinary
small group learning has beneficial effects on the
educational quality and developing professional attitudes
of undergraduate medical students. Development of further
multidisciplinary undergraduate education programmes
should be thus encouraged.
8C 12 Transforming a clinical team in primary care into a
community of practice (COP): the Delta project in
CME/CPD
M A Raetzo and R L Thivierge* (University of Montreal, 721
Hartland Avenue, Montreal H2V 2X5, CANADA)
8C 10 The team profile – the development of assessment
criteria for an interprofessional ward simulation
exercise
Aim: This poster will present a model of healthcare delivery
team that has been transformed from traditional actiondriven operational team of clinicians to a learning-frompractice driven group: how to create a COP in primary
care medicine.
J S Ker*, L J Mole, C L Stewart, J Syme-Grant, E Gray, S Benvie, P
Johnstone (University of Dundee, Clinical Skills Centre, Ninewells
Hospital & Medical School, Level 6, Dundee DD1 9SY, UK)
Summary of work: In 1998, a group of family physicians
and specialists from the Greater Geneva area was invited
to join a Project of healthcare delivery in a different manner
than had up to that date existed in Switzerland. A central
nucleus of physicians already practising in a specific setup where practice-reflection sessions were held regularly,
decided to lead and invite other physicians to join the Delta
Project.
Aim: This poster shares how assessment criteria have been
developed and piloted for a ward simulation exercise to
provide a team profile to health care students.
The development of a structured realistic simulated clinical
environment for health care students provides a useful
opportunity to develop both clinical competence and
confidence. In addition in preparation for practice, health
care students need to learn to collaborate in teams if they
are to fulfil patients’ health care needs.
Summary of work: A ward simulation exercise has been
developed at the University of Dundee, Clinical Skills Centre
for junior nursing and medical students. Aims of the exercise
include enabling students to learn to work collaboratively
as a team and providing an opportunity for students to
socialise interprofessionally. Written evidence from reports
from interprofessional observers has been analysed over
a four year period and has been used to develop formative
assessment criteria. Each of the agreed four criteria,
(professionalism, use of universal precautions,
communication and organisation) are now defined in terms
of observable behaviours to provide a profile for each team.
The results of the pilot will be shared and further
modifications to the instrument highlighted.
Summary of results: We will discuss results in three main
areas: 1-CME/CPD outcomes; 2-Healthcare delivery
outcomes; 3-Cost-benefit outcomes.
Conclusions: The Delta project represents an innovative
approach aimed at shifting paradigms in health care
delivery at both and simulteanously organisational level
and CME/CPD level of all the members involved in this
practice set-up. More studies are under way to examine
the CPD dynamics and different enabling tools to facilitate
the perennity of a COP.
8C 13 Integration of the dental students into the Dresden
PBL – Curriculum (DIPOL): highlights of the
emergency medicine course
M Müller*, S Weber, I Nitsche, P Dieter and T Koch (Department of
Anaethesiology and Intensive Care Medicine, University Hospital
Dresden, Fetscherstr. 74, 01307 Dresden, GERMANY)
8C 11 Interprofessional education of first-year medical and
nursing students
Background: At Dresden Medical School a new curriculum
was implemented in 2000, combining traditional elements
(lectures), new PBL-tutorials and practical training. Dental
education has been separate from medical education with
only a few courses for both medical and dental students in
some basic science subjects.
Pekka Kääpä*, Jaakko Kytölä, Susanna Vierre, Päivi Erkko and
Kirsti Ellonen (University of Turku, Research Centre of Applied and
Preventive Cardiovascular Medicine, Kiinamyllynkatu 13, 20520
Turku, FINLAND)
Aim: To promote learning of clinical skills and attitudes for
interdisciplinary teamwork in undergraduate medical and
nursing students.
Aim: The aim of this project was the integration of dental
students into the medical clinical courses, better preparing
them for the growing elderly population with increasing
numbers having chronic illnesses.
Summary of work: A 4-hour small group teaching session
of cardiovascular physiology was organized for 64 firstyear medical and 60 nursing students with guidance of
multiprofessional staff. Small group learning was focused
on basic cardiovascular practical skills (BP measurement,
Summary of work: We present here an example of the fourweek emergency medicine course. Dental students take
part in the tutorials (3 per week), the lectures (10 in 4 weeks)
and the practical training which consists of 4 sessions,
– 4.81 –
Section 4
facilitated a discussion of a clinical scenario based on an
80 year old female patient who lived alone and sustained a
fractured neck of femur. Students were asked to discuss
the contribution of all healthcare professionals during the
patient’s treatment in hospital and after discharge back
into the community. The problems of collaboration and
interaction between professional groupings were
discussed. Summary of results: Student evaluation was
very positive and most groups were surprised by the range
of healthcare professionals involved. Many thought it would
be useful to repeat the exercise in later years.
two hours each. They have exercises in BLS, iv-lines and
volume therapy, ALS and immobilisation of trauma-patients.
Summary of results: In the evaluation, overall mark was 4.2
in a scale from 1 (worst) to 6 (best). Especially the cases
with direct relation to the dentist’s job were received very
well (anaphylaxia: 5.0), critical comments were made
regarding the increased workload of the dental students
having to take part in clinical courses while simultaneously
pursuing their dental work.
Conclusion/take home message: It is important that dental
students receive teaching in clinical subjects, especially
in interdisciplinary emergency health care.
Conclusion/take home message: Although successful, the
logistics of planning, timetabling and implementing this
exercise were considerable.
8C 14 Not just another multi-professional course
Lorna Olckers, Trevor Gibbs*, Melanie Alperstein, Madeleine
Duncan, Licia Karp, Pat Mayers and Ermien van Pletzen (University
of Cape Town, Department of Public Health, Room 2.25, Falmouth
Building, Faculty of Health Sciences, University of Cape Town,
Observatory 7925, SOUTH AFRICA)
8C 16 Interprofessional education: making it happen
Hazel Chalmers (NUTS, Room A212, Coach Lane Campus (West),
Northumbria University, Benton, Newcastle upon Tyne, UK)
Aim: To explore the potential and challenges of
implementing multi, inter-professional postgraduate
education.
Aim: To inform educators of Health Science students about
the Multi-professional core curriculum being offered within
the Health Science Faculty at the University of Cape Town.
Summary of work: Central to the Primary Health Care
approach and to effective healthcare delivery is the multiprofessional team. It is, therefore, no longer sufficient for
Health Science Faculties to graduate students with
knowledge and skills related only to their specific
disciplines. Graduates need to be able to work effectively
in multi-professional teams, and with that comes the need
for individual and interpersonal development. The Health
Science Faculty at the University of Cape Town is
attempting to address these needs through the core faculty
curriculum of “Becoming a Professional” and “Becoming
a Health Professional”. All first year Health Science students
participate in these courses where small group learning,
of a mostly experiential nature, assists students in their
intra-personal and interpersonal development.
Summary of work: In the UK vocational training for general
practitioners is largely provided by general practitioners.
As an educationalist with a nursing background the
challenge of setting up inter-professional education with
GP colleagues is exciting – if at times painfully slow. The
‘journey’ involves learning and re-learning the fundamental
tenets of education, reflection, creativity and at times sheer
doggedness. The activity is on-going and some important
pointers to success will be highlighted on the poster.
Conclusions/take home messages: (1) Create the
appropriate learning environment; (2) Start small; (3)
Collaboration is central to success; (4) Be creative.
8C 17 Narrowing the gap in health – beyond the NHS?
Linda Leighton-Beck (Aberdeen University, Dept of General
Practice and Primary Care, NHS Grampian, 181 Union Street,
Aberdeen AB11 6BB, UK)
Conclusion: This paper will attempt to reflect the
excitements and challenges of students and staff who were
involved in the implementation of these courses in 2002.
In Scotland, over the last two decades we continue to have
significant inequality in health; and our health relative to
many other Western European countries remains less good.
The Scottish Executive’s White Paper (2003) commits us
to improving the health of all Scots and narrowing the gap
in health between our most advantaged and our most
disadvantaged communities. Recent planning initiatives
have, for the first time, drawn health into the wider planning
frameworks for the community and charged Local
Authorities and NHS Boards with becoming Public Health
Organisations. Our challenge is to ensure that, in building
public health capacity, the undergraduate and
postgraduate curricula reflect these changes and the
opportunities they create to revisit our conceptions of
health; to manage the clinical and non-clinical dimensions
of health synergistically and with equal regard; and to
support relevant disciplines within AND outside the NHS to
tackle their distinctive roles and (inter)related
responsibilities to improve health.
8C 15 A pilot exercise in multi-professional learning
H McKenzie* and J Harper (Medical Education Unit, Aberdeen
University Medical School, Medical Faculty Office, University
Medical Buildings, Foresterhill, Aberdeen AB25 2ZD, UK)
Aim: The aim of this exercise was to introduce students of
medicine, nursing, pharmacy, social work, physiotherapy,
radiography and occupational therapy to the roles of
different health and social care professionals in the UK.
Summary of work: The relevant courses are taught at the
University of Aberdeen (Medicine) and the Robert Gordon
University (all others) and a joint teaching board from the
two faculties co-ordinated the exercise. First year students
(n=460) from these courses (second year for Social Work)
participated, with eight students from at least five disciplines
in each tutorial group. Tutors were from all disciplines and
– 4.82 –
Section 4
Session 8D: The Curriculum (2)
8D 1
Effectiveness of first batch of graduates at Maharat
Nakhon Ratchasima Hospital School of Medicine
the XX Century, USA 1984; SPICES Model, UK 1991; ACMETRIN Report USA 1983; Strategies for Innovating Medical
Education, USA 1998; WFME Declaration, 1999) and
national agreements (Chilean Association of Medical
Schools). They, together with the changes in the practice
of medicine, government health policies and the social
environment variables have been the referents for the
process of curricular change at the School of Medicine of
the University of Concepcion. In 2002 the School of
Medicine put into practice a New Curriculum. This
curriculum will last 14 semesters, out of which the last four
correspond to internship. It reduces classroom time,
emphasizes problem based learning and problem solving,
distance education, virtual classrooms and telemedicine,
student teacher relationships, small group work, knowledge
integration, the use of standardized patients, ethics; it also
introduces integration of Biomedical Sciences,
educational technologies of information and Evidence
Based Medicine as key elements to assure the practice of
medicine. The physician, as a result of this New
Curriculum, will be able to offer the Chilean population the
new medicine that is required, contributing in this way to
the development of the country.
Ritthiya Littirong (Maharat Nakhon Ratchasima Hospital, School
of Medicine, Medical Education Center, Muang District, Nakhon
Ratchasima 30000, THAILAND)
Aim: Thai Medical education is based on sixth year high
school entry courses where the first three years emphasize
clinical learning. After leaving Mahidol University for the
first three years, the students undertake 3 years of clinical
years at Nakhon Ratchasima Hospital. We would like to
present the effectiveness of the first batch of graduates of
Maharat Nakhon Ratchasima Hospital, Thailand.
Summary of work: (1) The students have to take the
comprehensive examinations which are divided into 3
parts: Part I: Basic Science at the end of third year; Part II:
Clinical Sciences Theory at the end of fifth year; Part III:
Clinical Sciences: at the end of sixth year. (2) The
assessment tools were developed by using standard
criteria of the Thai Medical Council.
Summary of results: All students passed the Comprehensive
examinations I, II, III. The mean scores of comprehensive
I,II and III show 69.69 [46.46%], 238.00 [47.60] and 435.85
[54.48] in order.
Conclusions: (1)The effectiveness of the first batch of
Maharat Nakhon Ratchasima Hospital graduates is equal
to graduates of medical school. (2) We will follow the
students after they have graduated at 1, 3 and 7 years later.
8D 2
8D 4
N Sirisup, S Limpongsanurak, C Ittipanichpong*, A
Srikiatikhachorn, S Patumraj, D Wangsaturaka and P
Kamolratanakul (Dept of Pharmacology, Faculty of Medicine,
Chulalongkorn University, Rama IV Road, Patumwan, Bangkok
10330, THAILAND)
The transition from student to doctor: a small step
or a big leap?
Aim: To prioritise problems in curriculum development at
the Faculty of Medicine, Chulalongkorn University using
modified Delphi technique.
K Prince*, A Scherpbier, E Boshuizen and C van der Vleuten
(Maastricht University, Skillslab, Faculty of Medicine, PO Box 616,
6200 MD Maastricht, NETHERLANDS)
Summary of work: The draft of the 2002 undergraduate
medical curriculum was presented to a panel of
stakeholders comprising all heads of departments and the
curriculum committee. Each member was asked to identify
critical and potential problems of the new curriculum. The
issues raised were then arranged into a 75-item
questionnaire. The member was asked to rate the
significance of each item from 1 (least) to 10 (most). The
results obtained in the second round were presented to
the panel before conducting the other round of rating.
Aim: To present medical graduates’ evaluation of their first
experiences in practice and their preparation for practice,
and the implications of these findings for the medical
curriculum.
Summary of work: Qualitative and quantitative data were
gathered (by focus group interviews and surveys,
respectively) to explore junior doctors’ views about the
transition from medical student to medical practitioner, in
order to identify potential areas for curriculum development.
Summary of results: Mean values of department-based
problems were lower than non-department-based
problems in both rounds. Of the top 10 problems, there
were no department-based problems in both rounds.
Repeating round of rating resulted in decreasing of mean
values of most problems except 7 non-department-based
and 2 department-based problems.
Summary of results: Junior doctors experienced the sudden
increase in responsibility and workload as difficult. They
felt confident with regard to knowledge and skills, however,
they experienced difficulties with practical matters and their
role in the team. Never before did they work in a team like
in practice, did they have responsibilities, nor did they direct
other health care workers. They felt a need for more training
in planning/organising the work and team leading skills.
Conclusions: Suggestions for improvement include the
creation of a gradual increase of responsibilities during
the clerkships. Moreover, medical educators should pay
more attention to other competencies than knowledge and
skills, such as organising, teamwork and leadership
qualities.
8D 3
Using modified Delphi technique to prioritise
problems in curriculum development
Conclusion: Modified Delphi technique can be used to
prioritise problems in the curriculum development process
with the advantage of minimising confrontation between
each member.
8D 5
New curriculum of the School of Medicine of the
University of Concepcion, Chile: training physicians
capable of responding to the demands and
challenges of the new century
Structuring the first 3 blocks or semesters in the
school of medicine – Monterrey Tec – Mexico in
accordance with objectives of courses and
competencies the student must acquire
Graciela Medina*, Demetrio Arcos, Enrique F J Martínez, Jorge
Valdez and Ricardo Treviòo (School of Medicine - Monterrey Tec,
ITESM, Av Eugenio Garza Sada 2501, Depto. Cs. Basicas Medicas.
Ed. DACS-112, Monterrey NL 64849, MEXICO)
Octavio Enríquez* and Mario Muòoz (Faculty of Medicine,
University of Concepcion, Concepcion, CHILE)
In the design of the new curriculum in the School of
Medicine – Monterrey Tec, blocks and competencies were
designed for the first 4 years. Each semester had one
principal or core course and 4 or 5 support courses. All
Regarding curricular change in medical education,
worldwide agreements have been reached (Physicians for
– 4.83 –
Section 4
activities and case-problem design have to be in relation
to the content of the core course and competencies. The
content in the core courses were: cellular function, genetic,
muscle and bones, reproduction, digestive, Renal,
Cardiovascular, Respiratory, Hematology and Immune
Systems. To program all activities, we worked in
collaborative groups between tutors and teachers
participating in these courses. The activities in which the
students were engaged were designed in such a way that
they will obtain the following competencies: health
promotion, communication skills, medical information
skills, application of basic sciences to some diseases (in
accordance with morbidity and mortality in Mexico),
personal and professional development. We used OSCE,
checklist and written test to identify if the student attains
the competencies programmed.
8D 6
Conclusion/take home message: Longitudinal monitoring
of the development of student information processing is
an essential part of curricular evaluation.
8D 8
Monika Beck*, Hansruedi Kaiser*, Beat Keller* and Stefan Knoth*
(BZG Kanton Solothurn, Bildungszentrum für Gesundheitsberufe,
Areal Kantonsspital, CH-4601 Olten, SWITZERLAND)
Aim: Proposing a potent way of describing teaching and
learning goals in health care education.
Summary of work: We base our work on (1) a prominent
concept of “competence” as “the adequate coping with a
situation by means of relevant resources (knowledge, skills,
attitudes)” and (2) an integrative model of different forms of
human knowledge (declarative, procedural, sensomotoric
and situated knowledge). We describe competencies by
elaborated descriptions of concrete situations to be coped
with and by lists of resources, that may help in coping with
the situations. We propose these descriptions of
competencies as the adequate description of teaching and
learning goals: Learners have to learn competencies,
teachers have to teach competencies.
Restructuring the undergraduate medical curriculum
at the Medical Faculty Skopje, Macedonia: comparison
with some other European models
Z Gucev*, J Saveski, M Soljakova and K Boskoski (Medical Faculty
Skopje, 50 Divizija BB, 1000 Skopje, MACEDONIA)
The Medical Faculty in Skopje started a Tempus Phare
project with the Medical Faculty Victor Pachon in Bordeaux
(France) and with the Medical Faculty in Bilbao (Spain).
The aim was to modernize the undergraduate curriculum.
Differences were found among the faculties in: the number
of lectures (none of them meeting the demands of the
European Community legislation (1994) for 5,500 lectures
in theory, skills, and attitudes. No complete parallelism in
the subjects taught was found (e.g. pathophysiology is
taught in Skopje, but not in the partner countries). Some
subjects are taught in different forms: internal medicine
and surgery separately in Skopje, but urology and
nephrology as one subject in Bordeaux. Some trends are
similar: more small group learning, active participation and
training towards application of knowledge. Also a similar
trend towards: horizontal and vertical integration of studies,
team teaching, early patient contact and clerkships,
horizontal integration was found in all 3 schools. Formative
and summative assessments are found in all three schools.
However, competition among schools in regard to student
success is impossible in Skopje since this is the only
medical faculty in a small country. Such competition is
desirable for all the Medical Faculties in the region.
8D 7
Competencies as teaching and learning goals
Summary of results: We will present the results of a project,
that produces competence descriptions as the first - and
most important - step in curricula construction for two
different levels of health care education in Switzerland:
“Fachangestellte Gesundheit” and “Diplomierte
Pflegefachperson”.
Conclusion/take-home message: An adequate concept of
“competence” is the best possible base for describing
teaching and learning goals of health care education.
Learners get a clear picture of what to learn. Teachers are
guided in the selection of content and in the evaluation of
the performance of the learners. The communication
about teaching and learning goals is facilitated.
8D 9
A comparison between the instructors’ viewpoints and
students’ viewpoints on the current situation of clinical
education in SUMS
L Bazrafkan and M Alizadeh* (Shiraz University of Medical
Sciences, Zand Avenue, Shiraz, IRAN)
Aim: Regarding the importance of the clinical period in
medical education, this study aims to compare the
students’ view and faculty’s view of clinical education.
Transfer appropriate processing and schema
formation in first year students
Summary of work: This is a descriptive-analytic study in
which a questionnaire has been used. The questionnaire
concerns several variables in medical education: individual
characteristics of the clinical teacher (teacher as a role
model), teaching methodology and the content of clinical
education. The validity of the contents of the questionnaire
was determined using experts opinion and reliability of it
by test-retest. The subjects of the study randomly selected
comprised 160 academic members and 160 students. The
data obtained from the questionnaire were analyzed by
computer and the Chi-square was employed to study the
possible relation existing among the variables.
Mary Kelly*, Aileen Patterson, Bernard McCartan and Diarmuid
Shanley (Faculty of Health Sciences, Faculty Office, Trinity
College, Dublin 2, IRELAND)
Aim: This study aims to establish the capacity of first year
students for (1) summarising and comparing test stories
(schema foundation) and (2) recognition of analogous
problems, and application of their solution to previously
unseen analogues (transfer appropriate processing).
Summary of work: The study involved 329 students entering
the 6 schools of the Faculty. Students first read,
summarised and compared two stories describing
analogical problems and their solutions. They then
completed three questionnaires (distractors). They were
next asked to provide appropriate solutions for a third
problem, which was analogous to the first two stories.
Students were informed only that we were seeking to
interpret their thought process.
Summary of results: In this study no significant relation was
found between instructors’ view points score and their sex,
age and educational background (P>0.05). However, the
scores attained by the students have been lower than those
of instructors’ in several variables and this difference was
significant (P<0.05). Conclusion: The results of this study
show that there is a great gap between the present clinical
education and an ideal condition. We believe that revision
of clinical education in all areas and in staff development
in the present curriculum are necessary.
Summary of results: All students were competent at
summarising stories, values ex 10 ranged from 8-6. The
quality of the inter story comparison varied widely.
Identification of the analogous solution was demonstrated
in 50% of students in 3 of the 6 schools. Transfer of the
solution to the third analogous problem was highest in
medical students at 60%. No correlation was found
between the ability to summarise and compare and the
capacity to transfer.
– 4.84 –
Section 4
8D 10 First grade students’ interviews as physicians in the
community model
Background: One important basis for content development
of professional study programmes is the reception of
graduated student qualifications. Normally there is no feed
back from the field until years after student graduation.
Carlos Rojas Mora*, Lucía Robles Garcia and Norma Cura Garcia
(School of Medicine Tecnológico de Monterrey, Ave. Morones
Prieto # 3000 Pte, Colonia Los Doctores, Monterrey, Nuevo León
C.P. 64710, MEXICO)
Summary of work: This presentation describes an
evaluation strategy designed to support an ongoing
reconstruction of a medical education programme through
continuous dialogue with stakeholders about the criteria
of excellent medical education. Since the premises of
medical education are influenced by several stakeholders
(not only faculty, physicians and students) the evaluation
strategy includes ten different stakeholders. Initially we
asked the stakeholders what they wanted to know about
the medical training.
Background: Community orientation is one of the
characteristics of the new curriculum 2001 of the School
of Medicine Tecnológico de Monterrey. The spiral
community model is based on students’ early, continuous
and gradual exposure to community settings since first
semester up to the seventh semester.
Summary of work: During the Community Health course,
70 first semester students performed their first medical
interview. A group of teachers accompanied them. Students
were distributed in pairs. Each pair visited a family and
applied a questionnaire, one of them playing the role of
interviewer and the other of observer. Afterwards, each pair
of students inverted their roles and visited another family to
apply the questionnaire. Students were asked to write an
individual report of their experience emphasizing personal
reflection.
Summary of results: Reports show that this early experience
enriched students’ service vocation, fostered their
communication skills, made them aware of people’s
needs, of people’s opinion about the School of Medicine
and about the profile of the physician that Mexican society
needs. This experience also enhanced students’ sensitivity
about caring for people in need and increased their
motivation to become physicians since people expressed
the very high opinion and faith they have in the medical
professional.
Summary of results: We received 117 challenging and
sometimes unexpected questions. Receiving those
questions generated a platform of learning. We realized
that there were aspects to consider that we hadn’t thought
of. The stakeholders were informed about the questions
received and also the multi-method strategy that was
decided for answering the crucial ones.
Conclusion: So far the question bank has been used in
workshops with faculty, in focus group evaluation with
senior students and in course and stage evaluations with
both faculty and students. New information is
communicated to the stakeholders and new questions for
learning and educational development are generated.
8D 13 One year experience with the new curriculum at
Heidelberg Medical School
N De Cono*, E Gazyakan, S Holler, J Schmidt and M Kadmon
(Heidelberg Medical School, Kleiner Mönch 6, 69198 Schriesheim,
GERMANY)
8D 11 Physiotherapists’ “clinical reasoning” as a main
educational strategy
Background: Heidelberg Medical School has been
engaged in a major curriculum reform to improve medical
education. Our new curriculum, Heidelberg Curriculum
Medicinale (HeiCuMed), combines new approaches in
medical education such as interdisciplinary seminars,
problem-based-learning, skills-lab, standardized patients
and key-symptom-oriented lectures.
Peter Eigenmann* and Helena Luginbühl (Feusi Physiotherapieschule, Effingerstrasse 15, 3008 Bern, SWITZERLAND)
Aim: Depiction of converting the auxiliary subject “Clinical
Reasoning in Physiotherapy” to the main educational
strategy in the traditional and organ-based curriculum of
the Feusi Physiotherapy School in Bern.
Summary of work: One year after implementing HeiCuMed
in the surgery rotation we evaluated the students’
acceptance and compared the results with those gained
before the curriculum changed. A standardized
questionnaire was answered by 130 students on a regular
basis. We used statistical methods to compare the
differences between the former curriculum and HeiCuMed
in the surgical specialties (student t-test, p<0.05). Both
evaluations were based on the same questionnaire
consisting of 22 questions asking for motivation,
presentation, interaction, preparation and the overall grade.
Summary of work: “Clinical Reasoning in Physiotherapy”
has been emphasized in our school as an independent
subject since 1993. Students and supervisors of clinical
clerkships have always seen this facet of the curriculum
as a strength. That made us consider converting the course
from a mere subject to the main educational strategy. The
aims of this process were to reduce problems at the
beginning of clinical clerkships and to positively integrate
the theoretical knowledge into clinical practice. We also
hoped for higher competency in the hypothetico-deductive
clinical reasoning process.
Summary of results: The new curriculum was rated higher
with respect to all assessment criteria. The difference to
the old curriculum reached statistical significance
(p<0,01), especially for the criteria content and structure of
the lecture, interaction and subjective learning effect.
Summary of results: The implementation of this educational
strategy has the advantage of embedding different clinical
courses in the common framework of the physiotherapeutic
reasoning process. This has implications on the
formulation of objectives and the choice of teaching
methods in the single subjects.
Conclusions/take-home messages: The ability to clearly
convey your vision to your team is of prime importance.
Our experience indicates that faculty development is the
essential issue: promoting staff expertise and reaping the
full benefits of instruments such as flowchart, checklists
and glossary by fostering their availability.
8D 12 Evaluation as dialogue between stakeholders – a tool
for learning and content development of medical
education
Conclusion: HeiCuMed represents among German
faculties the most significant curricular change in medical
education. Our data show that the reform of medical
education at the Department of Surgery of University of
Heidelberg was an important and successful step towards
improving students’ satisfaction and motivation.
8D 14 Problems and perspectives of the teaching of
primary care under the new law on medical
education in Germany
M Ehrhardt*, H van den Bussche and H Kaduskiewicz (Institute of
General Practice, Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg,
GERMANY)
Mona Fjellström (Umeå University, Centre for Teaching and
Learning, 901 87 Umeå, SWEDEN)
– 4.85 –
Section 4
Since the new law for medical education was passed in
2000 every medical faculty in Germany is supposed to
develop a new curriculum. Primary care is now taking a
bigger part in the curriculum. Every student will take a one
week full time clerkship in a surgery. Furthermore, students
may choose primary care for a three months elective period
in the last year of the curriculum. General practice will
also participate in the teaching of other clinical subjects.
In reality, however, the position of primary care in a German
curriculum is still fragile. In Hamburg university hospital
the development of a new curriculum on an interdisciplinary
basis has reached an elaborated stage of development.
Difficulties in shaping such a curriculum and promising
steps towards a better integration from the point of view of
general practice will be described and discussed.
8D 17 Teaching case management for chronic illness care
in an undergraduate general practice course
Jochen Gensichen* and Ferinand Gerlach (Institute for General
Practice, University Hospital Schleswig-Holstein, ChristianAlbrechts-University of Kiel, Arnold-heller-Strasse 8, D-24105
Kiel, GERMANY)
Aim: Chronic illness care is an essential issue of the
German medical core curriculum proposed in 2002.
Germany has no gate keeping. Patients select doctors of
their choice. There is a lack of community-integrated
services. Students should be prepared to care for chronic
illness in this context in a structured way.
Summary of work: To develop the attitude, skills and
knowledge for chronic care management a two hour
session takes place for undergraduate students as part of
the general practice course. Contents: Chronic Care Model
as a systematic, trans-sectoral and evidence-based
approach for promoting continuous care for patients with
chronic diseases. Case management as a key-element
including: 1) identification, 2) assessment, 3) planning, 4)
co-ordination, 5) monitoring. This addresses the “guiding
function” of the GP.
8D 15 The social service year in medical education: a
Mexican case study
Julio Cesar Gomez, Pilar Talayero and Todd W Ellwein (Universidad
Westhill, Domingo Garcia Ramos, #56, Colonia Prados de la
Montana 1, Santa Fe Cuajimalpa, Mexico DF 05610, MEXICO)
All Mexican medical students must complete a year of
“servicio social” (social service) as part of their medical
training. This social service year is usually completed
during a student’s 6th year, and is required by Mexico’s
Ministry of Health. This poster exhibit provides a case study
of how one medical school successfully placed its 6th year
students in social service positions throughout the country.
The Dn. Santiago Ramon y Cajal School of Medicine at
Universidad Westhill established social service
agreements with 4 Mexican states: Quintana Roo, Puebla,
Mexico, and Guanajuato, and placed 13 medical students
in 2002-03. The poster exhibit describes each step of
Mexico’s social service requirements, and highlights the
importance of 1) government and accreditation standards;
2) selection of geographic location; 3) establishment of
agreements with state ministries of health; 4) student
selection and placement; 5) student evaluation; and 6)
student satisfaction.
Summary of results: Students produce a depression
management programme including diagnostic, therapeutic
and supportive procedure for outpatients in small group
discussions. Students are promoted to understand that
optimal chronic care is achieved, when a proactive practice
team interacts with an activated patient.
Conclusions/take-home messages: Medical students
should be taught in Chronic Care Model as a new
paradigm in caring for chronic illness.
8D 18 Assessment of student attitudes and knowledge
about aging: a longitudinal comparison of medical
student cohorts
Debra A Newell*, Anthony DiNuzzo, L Felipe Amador and Ann W
Frye (University of Texas Medical Branch, Office of Educational
Development, Marvin Graves 1.302, 301 University Blvd,
Galveston TX 77555 0408, USA)
8D 16 Evaluation of a new model of senior clerkship in an
undergraduate medical curriculum
Aim: To convey the value of incremental tracking and
assessment of the impact of specific and varied curricular
content infusion on measurable outcomes (e.g., students’
beliefs and knowledge regarding aging).
J C Ramesh*, A L Mohamed, T Motilal, M I Nurjahan, R Khuzaiah
and P Kandasamy (International Medical University, 33 A Jalan
17/1, Block A-3, Condo 5B, Astana Damansara, 46400 Petaling
Jaya, Selangor, MALAYSIA)
Summary of work: A longitudinal assessment was
implemented within the School of Medicine’s ongoing
initiative to determine the impact of incremental infusion
of gerontology/geriatric curricular components on students’
attitudes and knowledge towards the elderly. A 71-item
questionnaire was administered to two cohorts, pre- and
post-geriatric content exposure.
Aim: A 6-month period of senior clerkship was incorporated
within our 5-year medical programme. Commencing after
the final examination at the end of 4½ years, the main
objective was to prepare students for internship, while at
the same time focusing on the educational outcomes. The
study aims to determine if these objectives were achieved.
Summary of results: Total mean attitudes and knowledge
scores increased between baseline and follow-up for each
cohort. Attitude change for the 2000-01 cohort was striking
with an 8-point average increase score (baseline=220.3,
follow-up=228.8). Individual mean item scores varied for
each cohort. A significant change was observed on 5 of 71
questions (7%) for the 2000 matriculating cohort, and on
14 of the 71 questions (20%) for the 2001 cohort.
Summary of results: Analyses of students’ responsee show
that they were provided with greater opportunities to take
independent responsibilities in patient management. Most
had a better perception of how the health care team worked
and the majority felt confident to function as future interns.
Achievements in the educational outcomes were through
the development of portfolio consisting of 20 complete case
commentaries assessed at end of the clerkship by portfolio
review and viva. Most students perceived the portfolio as a
very useful learning tool, however, they felt it was time
consuming with most of the portfolio work occurring
towards the end of clinical attachments rather than as a
continuous process.
Conclusion: This programme prepares the students
adequately in terms of their abilities to function as interns.
Although the assessment matches the educational
outcomes, weaknesses do exist in the process of achieving
the outcomes through ward-based learning.
Conclusion: Students demonstrated positive changes in
attitudes and knowledge toward older adults when
exposed to defined geriatric curricular content. Differences
in results between cohorts are associated with the density
and diversity of geriatric content and experiential exposure
in the 1st year and 2nd year geriatric curricula. Discussion
focuses upon curriculum implications in varied settings.
8D 19 The survey of medical students’ and graduates’
awareness about concepts and benefits of
community-oriented medical education in Iran
Sedighe Najafipour*, F Azizi and M Saberfiroozi (Jahrom Medical
School, Nemazi Mottahri Clinic, Shiraz 71935-1169, IRAN)
– 4.86 –
Section 4
Summary of results: 71.3% of graduates, 32% of
physiopathology students and 60% of clinical students
stated education based on community health needs as a
principle concept of community-oriented education.
Knowledge of other concepts of community oriented
education was moderate to weak. 26% of physiopathology
students, 27% of clinical students and 70% of graduates
selected the index of decision making as an advantage of
a community oriented program.
Background: World medical schools are shifting their policy
from patient care in hospitals to the community. Iranian
medical schools take into account this community based
education in their curriculum. After one decade of a
community based education program we have done this
study in order to determine students’ and graduates’
awareness about concepts of community-oriented
education in Shiraz, Jahrom and Fasa medical schools.
Summary of work: 117 physiopathology students, 107
clinical students and 179 graduates have contributed to
our study. The viewpoint of all cases has been collected
based on questions about concepts, advantage and
doctors’ characteristics of community-oriented education.
Collected data were analyzed by SPSS, version 9.1.
Conclusion/take home message: The students and
graduates’ points of view about benefits of communityoriented education were moderate to good.
Session 8E: Evaluation of the Curriculum
8E 1
Teaching evaluation as part of interactive quality
management at the Medical Faculty of Freiburg
Summary of results: Overall, 64% of faculty responded and
96% of questionnaires and all of the interviews were
completed. 80% of faculty believed that evaluation is
important (high + very high) in university whereas a few
declared satisfaction with university success of teacher
evaluation. Overall, the survey showed that faculty agree
relatively highly with evaluation through self-assessment,
excellent students and Student Evaluation of Teaching
(SET) consecutively, but moderately with form of content
of evaluation. Also the study indicated that there is significant
correlation between faculty rank and faculty views toward
SET.
V Peus*, G Valerius, H-D Hofmann and M Berger (Studiendekanat
der Medizinischen Fakultät Freiburg, Studiendekanat Vorklinik,
Medizinische Fakultät der Albert-Ludwigs-Universität,
Elsässerstr 2m, 79110 Freiburg, GERMANY)
Background: Changed requirements and expectations
concerning a physician’s abilities and knowledge as well
as increasing international competition demand a
reorganisation of the study courses at medical faculties in
Germany. Within the scope of this change process
evaluation and quality assurance are of major relevance.
Summary of work: At the medical faculty of Freiburg a
comprehensive evaluation-based system for quality
assurance was developed over several years. It is based
on summative and formative student-evaluations and
allows differentiated statements about the actual teachingsituation. The questionnaires were developed in a
perennial validation process. To maximise positive
changes, the annual evaluation of the entire teaching
establishment entails considerable consequences such
as the publication of results, teaching awards, specific
trainings in didactics and additional formative evaluations.
Summary of results: Statistical analyses document
continuous improvements with regard to both lessons and
instructors and prove our evaluation system to be an
adequate means not only for status examination but also
for improving teaching quality.
Conclusions/take home messages: The motivation and
attitude of some of the faculty presents a barrier to SET. So
teacher evaluation will require to be reconsidered on an
administrative approach and application of evaluation
results (feedback and encouragement). In this regard,
cooperation of faculty in the setting of evaluation, close
connection of the evaluation system to the academic reward
system, and establishment of a faculty teaching
development committee must be viewed as important
factors.
8E 3
Jane Ross, Sandy Stewart* and Patrick McKinlay (NHS Education
for Scotland, The Lister, 11 Hill Square, Edinburgh EH8 9DR, UK)
Aim: Historically training has been evaluated on conclusion
of the event, from the perspective of what transpired during
the training episode. A great deal of training is not measured
beyond such participants’ “happy sheets”. What is more
beneficial is the ability to evaluate the transfer of learning
to the work setting and the ongoing impact of such learning.
The aim of this presentation is to describe an evaluation
strategy developed to measure the impact of a new trainer,
training course for dental trainers in Scotland.
Conclusions: Our experiences could serve as a model for
the establishment of similar concepts at other medical
faculties and thereby lead to a standardised structure of
quality assurance in the area of medical teaching.
8E 2
Think bigger than “happy sheets”
Faculty attitudes: a straight way to faculty
evaluation
Summary of work: A national Scottish trainer, training course
was developed to prepare new trainers. An evaluation
strategy was designed to focus on the measurement of
knowledge and skills gained, the transfer of learning and
the impact of this on the workplace. The strategy consists
of four separate tools applied at key times pre, during and
up to 12 months post completion of the course.
Abdolreza Jahanmardi, Morteza Haghirizadeh Roodani*, Hayat
Mombeini and Roya Jahanmardi (Ahvaz Medical Sciences
University, Educational Development Center (E.D.C.), IRAN)
Aim: The aim of this study was to survey the attitudes of
faculty members about different stages of faculty evaluation
system including: evaluation process, evaluation results
(feedback and encouragement) and their comments.
Summary of results: There has been a clear knowledge
gain and evidence of positive training impact within the
workplace.
Summary of work: A five scale questionnaire 1 (very low) 5
(very high) with 26 items and á chronbach 0.83 was
delivered to 150 non-clinical faculty member of Ahwaz
Medical Sciences University after content validation by
educational experts. At the time of distribution a
semistructured interview was held for those who did not
answer the questionnaire, in which 30% took part. Analyses
were performed on SPSS and frequency, frequency
percentile, mean and chi-square analysis were used.
Conclusion/take home messages: Evaluation of the transfer
of learning to the work setting and the ongoing impact of
such learning is essential to quality education experience.
We must think bigger than “happy sheets”
– 4.87 –
Section 4
8E 4
Evaluating the quality of a problem-based medical
training: experiences at the University of Hamburg
Evaluation strategy for the hybrid-curriculum at the
Faculty of Medicine, University of Basel
Monika Bullinger (Institute and Clinic for Medical Psychology,
Centre for Psychosocial Medicine, University Hospital HamburgEppendorf, Martinistr. 52, S35, 20246 Hamburg, GERMANY)
G Voigt*, B Roeers, V Exner and K Pierer (Educational Dean’s Office,
Faculty of Medicine, University of Basel, Klingelbergstrasse 23,
CH-4032 Basel, SWITZERLAND)
The attempt at improving medical training by implementing
new curricula is a continuous challenge for medical
education. Such effort should be accompanied by a
scientifically rigorous evaluation which would make it
possible to analyse the structure, process and outcome of
the new curriculum as such and in comparison to a
traditional curriculum. Evaluation research is a topic within
the social behavioural sciences which has been recently
introduced in health sciences and has gathered
importance especially in development of assurance and
quality standards. The implementation of a new curriculum
and its comparison to traditional teaching mimics a clinical
study, in which a new treatment is compared prospectively
to a control treatment, even though a randomised
comparison between two curricula is difficult.
Aim: Design of a comprehensive concept to evaluate the
undergraduate programme, reformed as a hybrid
curriculum. The concept is based on control of the
implementation process, the acceptance of new didactic
methods by teachers and students and the estimation of
learning success. Furthermore these data are correlated
to students’ results in the examinations.
Theoretical, methodological and practical issues of
evaluation will be focussed on in the paper. Using the
example of the implementation of a problem-based
learning curriculum at Hamburg University medical school
in comparison to a traditional curriculum, aims and design,
variables and indicators, conduct and analysis of the
evaluation study will be described and discussed. The 3year problem based curriculum for Hamburg medical
students is currently implemented in 2 cohorts of 40
students, admitted yearly. Within each cohort comparisons
are made between the new problem based learning
approach and the traditional curriculum. Indicators of
structure, process and outcome from the perspective of
students, medical teachers and the university organisation
are identified, operationalised and included in the study
design. On the basis of the first results relating to the
outcome of teaching from the students’ perspective, the
specific strengths and weaknesses of such evaluation
designs will be discussed.
8E 5
8E 6
Summary of work: Questionnaires have been designed for
teaching units and special teaching formats. A coding of
both the questionnaires and the examination forms
enables the evaluators to study the students’ progress in
relation to their acceptance of various teaching methods.
Additionally lecturers are evaluated by a short
questionnaire. These results will be correlated with the
implementation results of teaching formats and will be the
basis for further faculty development programmes. The
crucial point is to balance the “fill in” load for each student
and to meet the scientific requirements of questionnaire
construction. Evaluation results are reported to the faculty.
The curriculum committee is in charge of quality
improvement.
Conclusion: A reform is an ongoing process and its
evaluation will underline the need for further change and
improvement. The resulting workload in itself will influence
the acceptance of the reform by the faculty.
8E 7
D G van Vuurden*, F Scheele, J van de Lande and B H M Wolf (St
Lucas Andreas Hospital, VU Medical Centre, Nachtwachtlaan 181,
1058 EG Amsterdam, NETHERLANDS)
Aim: In the near future, Dutch teaching professors will have
to improve their educational skills in post-graduate training.
We show the opinion of Dutch paediatric registrars on the
essential characteristics of their teaching professors.
Students’ evaluation of the undergraduate
curriculum
Summary work: A questionnaire was sent to 280 Dutch
registrars in paediatrics who were asked to appraise the
three most important characteristics of the ‘ideal’ teaching
professor. The answers were divided into four categories:
‘knowledge’, ‘manual skills’, ‘educational skills’ and
‘personal interest and attitude towards the registrar’.
I Rumba* and U Vikmanis (University of Latvia, Vesetas iela. 824, Riga LV-1013, LATVIA)
Background: The Faculty of Medicine, University of Latvia
is in the 5th year of implementing a new innovative
Curriculum. To know wheter the aim to improve the learning
enviroment has been achieved, an evaluation of medical
training has been undertaken.
Summary of results: 84 out of a total of 280 responded so
far. 54% of the answers fell in the ‘interest and attitude’
category, 29% in the ‘educational skills’ category, 12% in
the ‘knowledge’ category and 0,5% in the ‘manual skills’
category. 4.5% gave an answer that was intermediate
between ‘educational skills’ and ‘interest and attitude’.
Aim: To evaluate students, opinions about the curriculum
and teaching itself.
Summary of work: A set of questions was prepared. 70
students were interviewed by using a differentiated
questionnaire. A 17 item questionnaire evaluated the
general structure of the curriculum, content and availability
of supporting teaching materials, both by closed and open
questions. Students answered about every study course
immediately after training and about general aspects of
teachers and their contributions in tutorials.
Summary of results: 93% of students were satisfied with
the curriculum in general. The remaining 7% of students
were not satisfied by some aspects of curriculum planning.
Answering open questions students pointed out the
necessity to strengthen courses such as how to study
medicine, psychology etc. The questions about teaching
showed 80% of students favor teachers with general
knowledge of content and contribution to individual learning
of students.
Registrars in paediatrics demand more personal
interest from their teaching professors
Conclusion/take home message: Personal interest and
attitude toward the registrar were found to be by far the
most desired characteristics of paediatric teaching
professors. ‘Teach-the-Teachers courses’ should therefore
focus primarily on the reinforcement of interest and attitude,
next to the development of educational skills.
8E 8
Focus group as a tool for quality assurance in
communication skills training and standardized
patient contact
Isabel Muehlinghaus*, Heiderose Ortwein and Claudia Kiessling
(Universitätsklinikum Charité Berlin, HU zu Berlin,
Reformstudiengang Medizin, Trainingszentrum für Aerztliche
Fertigkeiten (TAEF), Schumannstr. 20/21, 10117 Berlin,
GERMANY)
Conclusions: Evaluation and re-evaluation of the curriculum
and teachers by students shows how to develop the
curriculum and the teaching process itself.
Background: The Reformed Track Curriculum at Charité
Medical School in Berlin is a problem based curriculum
and includes a continuous communication skills training
employing standardized patients as an primary teaching
– 4.88 –
Section 4
tool. The process is continuously evaluated by standardized
questionnaires.
Summary of work: Our model is based on questionnaires
distributed to all students at the end of each course. The
analysis of our evaluation model was performed with the
support from the dean, vice-deans and other faculty staff
members. We performed systematic research of
documents and regulations issued by the faculty/university
concerning the educational evaluation. We completed
Practice Standard Review on topic educational evaluation
using the Instructions for Completing a Practice Standard
Review (AIHA, Washington, D.C.) We performed a survey
measuring the attitudes of students and their clinicianteachers towards a standard evaluation questionnaire.
Statistical analysis of the survey using chi-square test was
conducted.
Aim: Additional to quantitative evaluation we introduced a
facilitated, videotaped focus group to gain further
information since the first cohort students were dissatisfied
with some aspects of both coursework and methods. Our
effort was to implement a method which would generate
results better applicable to the subjective worlds of
experience (the perception of problems and ways of
conceptualising).
The aim was to discuss students‘ complaints and needs
in order to increase their motivation. Furthermore we
targeted improved realisation of teaching methods as well
as a more effective embedding of the communication skills
training within the entire curriculum.
Summary of results: We found that the “standard” evaluation
questionnaire now used is rather general and has its
limitations. Thus it cannot provide the teachers with
appropriate feedback and the students cannot express their
opinions properly. The students and teachers also lack
adequate background information concerning the whole
evaluation process. Statistical analysis showed significant
differences in the students‘ attitudes from different years
and in answer comparison of clinician-teachers and
students.
Summary of results: Identification of different categories
with content analysis led to adjustments in the following
fields: faculty development, case selection and case
design, transparency of organisational facts and
possibilities, application of teaching-video, reinforced
integration of students’ needs for curriculum planning.
Conclusion: This poster will provide discussion of methodtriangulation, findings and possible implications for further
changes.
8E 9
Evaluation of undergraduate medical education as a
part of the European Union access process – an
experience at the Jessenius Medical Faculty of
Comenius University in Martin, Slovakia
8E 11 The role of evaluation and accreditation in
improving medical education quality
Fereshted Farzianpour and colleagues (Education Development
Centre, East Nosrat Avenue, Tehran, IRAN)
Medical education that is compatible to community needs,
and the training of skillful teachers, are important subjects
attracting the attention of experts and designers throughout
the world. Various suggestions have been proposed. One
of the most significant suggestions is the role of assessment
and accreditation in improvement of medical education
quality. The main objective of this kind of accreditation is
close supervision in teaching, control of care and treatment,
improvement of quality and also promotion of quality in
medical education. This research is a type of survey
research and also it is typically field research, based on
the latest research worldwide. Everything to be examined
should be subject to accreditation and comprehensive
quality management. Survey results showed that designing
a scientific assessment model, was a means to promote
medical education quality, which itself has two basic
principles: (1) enternal quality control system, and (2)
external quality control system.
Lukáš Plank*, Ján Danko, Eva Rozborilová, Peter Galajda and Karol
Dókuš (Jessenius Faculty of Medicine, Dean’s Office, Comenius
University, Zaborskeho 2, 036 45 MARTIN, SLOVAK REPUBLIC)
Aim: To report on our experiences with undergraduate
education evaluation conducted by the team of experts
from the EU countries to evaluate education and practice
of doctors in the light of EU sectoral directives.
Summary of work: The purpose of the EU mission was to
evaluate the implementation and enforcement of relevant
requirements in the field of professional recognition in
Slovakia. The discussions were based on a EU
questionnaire completed and elaborated by Slovak experts,
including those from our faculty.
Summary of results: For undergraduate education the
following items were considered: conditions for admission,
curriculum of the faculty, duration and structure of
undergraduate courses, methods employed to test the
knowledge and qualification attained on completion.
Conclusions/take home messages: Results of the
evaluation were summarized in the document entitled
“Expert Mobilisation: Memorandum on the Profession of
Doctors in Slovakia”. The document recognises
commitment and effort at all levels to bring national
regulations regarding medical education and practice in
accord with EU requirements, including new legislation
being enacted. The undergraduate course of studies
complies with the EC directives and the credit system based
on the accepted European Credit Transfer System (ECTS)
is used. The proposals for changes stress the need to find
a correct balance between theoretical and practical
training.
8E 12 A survey about probable factors affecting the
academic staff’s evaluation by the students
R Rezaie*, A Bazargani, M Amini (EDC Center, Zand St University
of Medical Science Building, Shiraz, IRAN)
Background: The most significant and popular method
used for determining the academic staff’s success in the
university is students’ attitudes. There are different opinions
on the validity of this type of evaluation. Numerous factors
affecting students’ evaluation of instructors are usually
neglected in the evaluation process.
Aim: This study was conducted to determine these factors.
General objective: determining probable factors affecting
students’ evaluation of instructors. Specific objectives: (1)
determining the effect of the number of students in class
on their evaluation of instructors; (2) determining the effect
of the subject to be taught on this evaluation.
8E 10 Analysis of educational evaluation at the Faculty of
Medicine
Summary of work: In this research, 15 instructors and 395
students were chosen to be surveyed. The classes were
categorized into small classes (less than 40) and large
classes (more than 40). The teaching environment was
divided into basic sciences and clinical ones. The students’
scores were surveyed in the courses such as rheumatology,
medical physics, persion, microbiology, gastrology, kidney,
pathology, medical ethics, biochemistry, histology and
anatomy. The questionnaires were distributed among the
Lenka Doubravska*, Radim Licenik, Vit Gloger, Miroslav Herman,
Jarmila Indrakova, Daniela Jelenova, Petr Jindra, Barbora
Krajzlova, Pavel Kurfurst, Ivana Oborna, Katherine Ruzicka, Jan
Strojil and Cestmir Cihalik (Medical Faculty, Palacky University,
Hnevotinska 3, 775 15 Olomouc, CZECH REPUBLIC)
Aim: We present two years’ experience with educational
evaluation carried out by students at the Medical Faculty,
Palacky University.
– 4.89 –
Section 4
students and the mean of the scores were determined as
1-5.
Summary of work: The Medical Faculty at the University in
Graz started a new curriculum in October 2003. The
curriculum starts with a new fifteen hour course in the
community. Students had lectures by medical doctors and
health workers from various organisations providing health
care for patients and clients in Graz.
Summary of results: There was no significant relationship
between the number of students participating in class and
the instructors’ evaluation scores. As to the comparison of
evaluation scores in different courses, the results reveal
that the instructors of clinical courses have obtained higher
scores than those of basic sciences. This might be due to
the fact that students think clinical courses are more
relevant to their field and basic science courses are not
directly related to their future profession. On the other hand,
this might be due to the different methodologies in these
courses. Basic science courses are usually presented as
lectures by the instructors. In this type of teaching, the
relationship is usually not mutual and the student is not
actively participating in class shereas in clinical courses
the subjects are presented through group discussion,
clinical rounds, problem based learning and active learning
methods. These courses have more impact on students’
motivation, creativity and participation.
Aim: The aim was to provide students with insight into their
future working fields. Students became accustomed to the
work load of health care workers and their working
conditions. The affiliated taught according to guidelines
provided by the medical faculty.
Summary of results: The results of the students’ evaluation
of this newly established course will be presented. Students’
feedback was based on standardised written
questionnaires. Overall students appreciated their
participation in the community settings.
Conclusion: The students’ evaluation was not very helpful
in relation to concrete suggestions for improving the
educational objectives of the course. The new challenge
is working on a more detailed tool.
Take home message: Satisfaction of the students and good
evaluation results are not always an adequate source for
evaluating whether educational objectives are met.
8E 13 Quality improvement in medical student assessment
Supawadee Prakunhungsit*, Boonmee Sathapatayavongs and
Tharntip Malaisirirat (Mahidol University, Medical Education
Unit, Faculty of Medicine, Ramathibodi Hospital, Rama VI Road,
Bangkok 10400, THAILAND)
Aim: Internal quality assessment as a strategy for quality
improvement.
8E 15 Students’ opinions of the most pleasant and the
most unpleasant aspects of the first year in the
Faculty of Medicine University of Chile in 2001
Summary of work: Fourteen courses in the Faculty of
Medicine, Ramathibodi Hospital MD program are
assessed using the new set of indicators and criteria in the
year 2001 and 2002. There are 13 indicators in the category
of student assessment The results of quality assessment
are described into quality level 1-5. The basic standard
requirement is level 3. Level 5 stands for best practice, in
which all indicators in the category are achieved. After
yearly assessment, dissemination of best practice is
arranged. Expert consultation is offered for the substandard
one, in order to set up improvement plans.
Ilse Lopez, Zulema Vivanco, Manuel Castillo and Enrique Mandiola
(Facultad de Medicina, Universidad de Chile, Box 13898, Correo
21, Independencia 1027, Santiago de Chile, CHILE). (presented by
Beatriz Saavedra)
Summary of results: Compared to the year 2001,
assessment results of the year 2002 show that the number
of courses with acceptable standard performance in
student assessment increased from 4/14 (28.57%) to 9/14
(64.38%). However, there are a few courses that cannot
maintain their performance due to the discontinuation of
the quality improvement cycle from various reasons. This
problem needs further analysis and remedy.
Summary of results: Among the positive aspects indicated
were: “ new friendships”, “to be in the desired career”;
“knowledge learned interesting in quantity and quality”;
“personal development”; “value of the diversity and
pluralism to share with students from others careers”;
“Medical students pointed out the early contact with the
hospital and with patients”. The most unpleasant aspects
were “schedule too heavy with too many classes”; “poor
distribution of the curriculum courses”; “inclusion of nonuseful content”; “lack of time to be with family and friends”;
“deficient learning results”; “inconsequence between the
teaching content and the evaluation content”; “some
teachers show poor human quality”; “ill will”; “without
interest in teaching”; “arbitrarity in calification”.
Background: The first year in university means great
changes and new challenges for the students.
Summary of work: In order to identify the most positive and
the most unpleasant aspects, at the end of their first year a
group of 496 students in the eight courses was asked to
register their experiences during the year.
Conclusions: Internal quality assessment promotes quality
improvement and the learning organization.
8E 14 Students’ evaluation of an undergraduate course in
the community
Conclusions/take home messages: Negative aspects need
to be reviewed and corrected to favor the teacher-student
relationship and to promote a better well-being for the
young students.
Eva Rasky (Institute of Social Medicine and Epidemiology, KarlFranzens-University Graz, Universitätsstrasse 6/I, A-8020
Graz, AUSTRIA)
Session 8F: Teaching Clinical Skills (1)
8F 1
Does the Paediatric Advanced Life Support (PALS)
course improve confidence in knowledge and
performance of paediatric resuscitation?
Summary of work: On completion of the PALS-course,
physicians, nurses and paramedics from across The
Netherlands took three tests (skill in basic life support,
scenario-testing and a multiple choice (MCQ-test). The
pass-mark for the MCQ was 80% and for the practical
tests a re-test was permitted. The candidates’ attitude
towards the course was assessed by a standardised
questionnaire which focused on content, relevance and
impact of the various teaching sessions.
Jos M Th Draaisma* and Nigel McBeth Turner (Dutch Foundation
for the Emergency Medical Care of Children, Weezenhof 29-54,
6536 HN Nijmegen, NETHERLANDS)
Aim: To determine whether the PALS course contributes to
the confidence in knowledge and performance of
professionals.
– 4.90 –
Section 4
Summary of results: 112 professionals (29 physicians, 83
nurses/paramedics) followed one of the 5 PALS courses
in 2002. There was no statistically significant difference in
the proportion of nurses/paramedics and physicians who
passed the course, or passed after a retest. However, there
was a significant difference in the MCQ-score. The course
was regarded as very usefullfor the professional’s
confidence in knowledge and performance. Scenarios
were regarded as the most useful, followed by skill-stations
and lectures.
foetal blood sampling, showing that a systematic training
programme is effective.
8F 4
R Faber*, C Nikendei, D Schellberg, C Roth, A Zeuch, B Auler, W
Herzog and J Juenger (Department of Internal Medicine, University
of Heidelberg, Medizinische Universitätsklinik, Bergheimerstr.
58, 69115 Heidelberg, GERMANY)
Aim: To increase the learning-benefit of modified CBLgroups for final year students it is important to improve
students’ ability of self-directed learning as well as of standalone decision making and the handling of clinical cases.
Conclusions: These results show that the PALS course
promotes self-confidence and that there is a significant
difference between nurses/paramedics and physicians in
theoretical knowledge.
8F 2
Summary of work: CBL-groups consist of 6-8 last year
students; the role of tutor, case presenter and secretary are
taken over by students themselves. This hierarchic structure
promotes the above mentioned skills. In a repeatedmeasurement-design we evaluated subjective arousal,
valence, dominance, learning-benefit and level of
teamwork using a SAM and a self-developed questionnaire
after each lesson. A supervisor grades each student’s
activity and utility for the learning-benefit in every lesson.
“Paper cases” help to organize a dermatology
practical course
A Böer and F Ochsendorf* (Universitäts-Hautklinik, D.J.W.
Goethe-Universität, Theodor Stern Kai-7, 60590 Frankfurt am
Main, GERMANY
Background: A traditional dermatology practical course is
associated with a number of problems: 1) patients with
typical clinically relevant dermatological disorders are often
not available on the day of the course; 2) out-patients are
often unreliable in terms of attendance; 3) in-patients
present a rather limited spectrum of skin diseases; and 4)
patients with worthwhile demonstrable findings have to
tolerate examinations by many students. Consequently the
recruitment of patients proves to be difficult. The exact
learning issues are determined by the available patients
and are subject to chance.
Summary of work: To solve these problems written patient
scenarios were prepared (“paper-cases”) using highquality color photographs. The students work on this case
as on a live patient. These cases were used as an
alternative in bed-side teaching if a suitable patient could
not be found. 20% of patient demonstrations were
substituted by “paper cases”.
Summary of results: After two lessons a non-parametric 2sample median test showed that students with a low level
of arousal grade their learning-benefit and self-efficacy
towards case-solving (p<0.01) significantly better than
those with a high arousal. No relation could be found
between the grading of the supervisor and the selfassessment of the students.
Conclusions: For a good learning-benefit it seems
necessary that students feel comfortable during the lesson.
The benefit is not dependent on students’ activity during
the lesson.
8F 5
Student perceived benefit from a surgical specialty
theatre attendance
Michael S W Lee*, Mary-Louise Montague and S S Musheer
Hussain (Ninewells Hospital and Medical School, Dept of
Otolaryngology, Dundee DD1 9SY, UK)
Summary of results: Students (n=204) rated these cases
with a mark of 1 (very good) in 21%, with 2 in 53%, 3 in16
%, 4 in 8%, 5 and 6 each 1% (2,1 ± 0,9, mean ± SD).
8F 3
Evaluation of modified case-based-learning-lessons
Conclusions: Paper cases helped to organize and run bedside teaching and allowed to teach practically relevant skin
disorders otherwise neglected.
Aim: The value of theatre attendance by undergraduates is
uncertain. This study aims to evaluate the perceived benefit
of attending operating theatre sessions during
undergraduate otolaryngology attachment.
Skills training in obstetrics
Summary of work: Fourth year medical students were asked
to complete a questionnaire at the end of their 2 week
attachment in otolaryngology.
Jette Led Sørensen*, Morten Lebech and Tom Weber (The Clinic of
Obstetrics, Rigshospitalet, University of Copenhagen, The Juliane
Marie Centre, Section 4232, Blegdamsvej 9, DK 2100 Copenhagen
O, DENMARK)
Summary of results: 87 students returned completed
questionnaires. 42 students attended 2 theatre sessions,
34 attended 1 session, and 9 attended 3 sessions (median
2). The three most common student expectations were to
see and learn common ENT operations, understand the
indications for these operations, and see the anatomy
involved. 74% of students reported that their expectations
had been met. The most common operations observed
were tonsillectomy, myringotomy and ventilation tube
insertion and septoplasty. Students rated their theatre
teaching by surgeons to occur always (38%), occasionally
(55%), or rarely (7%). On an analogue scale from 1 (strongly
disagree) to 7 (strongly agree), the importance of theatre
attendance as part of the curriculum was rated to be 5.2
(95% C.I. 4.85 to 5.46).
Aims: (1) Introduction of training in six obstetrical skills:
vaginal delivery of breech presentations, shoulder dystocia,
ventouse delivery, amnion infusion, foetal bloodsampling
and handling of postpartum haemorrhage. (2) Evaluation
of the effect of the training programme by registrars’ selfassessment of confidence before and after training.
Confidence was described as a score 1-5, where “1” meant
not confident and always needing help, and “5” meant
confident
and
never
needing
help.
Material: Participating registrars: 44.
Summary of results: Self-assessment scores before and
after training were: Vaginal delivery of breech presentations:
median 2 versus 4 – mean 2.23 versus 3.45; Shoulder
dystocia: median 3 versus 4 and mean 2.53 versus 3.68;
Ventouse delivery: median 4 versus 4 and mean 4.0 versus
4.25; Amnion infusion: median 1 versus 4 and mean 1.84
versus 3.95; Foetal blood sampling: median 4 versus 5
and mean 3.81 versus 4.43; Postpartum haemorrhage:
median 4 versus 4 and mean 3.58 versus 4.0.
Conclusions/take home messages: Students perceive
attending otolaryngology theatre sessions to be beneficial.
This information is important in the planning of the
otolaryngology undergraduate curriculum.
8F 6
Experience of first ever batch of senior clerkship in
International Medical University Malaysia
Esha Das Gupta*, Nurjahan Mohd Ibrahim, D Motilal and C L Teng
(International Medical University, 1102 A Bukit Blossom,
Seremban 70100, MALAYSIA)
Conclusion: The changes in median self-assessment
before and after training were statistically significant (MannWhitney Test) for all skills except ventouse delivery and
– 4.91 –
Section 4
The theme of Senior Clerkship is novel in Malaysia. It was
first carried out in the International Medical University of
Malaysia. The idea is to give the medical student a better
exposure to working life. The first batch of 42 students
graduated in November 2001. A questionnaire based study
was conducted and the results were very encouraging.
The students felt it was a very good system to get a hold on
practical medicine before they became housemen. They
could manage to get study time along with ward work and
the debriefing by the lecturers was very useful to them.
Most of them found out their areas of interest during this
posting. During this period the 8 IMU outcomes were
emphasized and over all it was a very gratifying experience.
About 75% of the students agreed with the usefulness of
Senior Clerkship.
8F 7
Conclusions/take home messages: Peer tutors value the
opportunity to teach and are also known to benefit.
Comparison will be made between the senior students
who chose to teach and those who did not in their final
examinations.
8F 9
Background: This paper discusses an innovative method
of teaching pre-clinical physiotherapy students how to
assess patients and plan effective management programs
as a result of the assessment. Historically, physiotherapy
students at the University of Pretoria started clinical
education in their 3rd year of study. With the changes in
higher education that led to curriculum restructuring,
students started clinical education from 2nd year in 2002.
One of the biggest challenges the students faced was the
patient assessment. This challenge prompted me to try
and find ways of making it easier for the students to assess
patients.
Providing artificial experience through integrated,
case-based, multidisciplinary forum presentations
Hettie Till*, Oryst Swyszcz and Peter Cauwenbergs (Canadian
Memorial Chiropractic College, 1900 Bayview Avenue, Toronto ON
M4G 3E6, CANADA)
Background: Integration and relevance of course material
appear to be two of the most serious challenges facing our
undergraduate students. Clinical cases help students to
associate course material with real patient situations, but
arranging enough observations of the doctor-patient
encounter, for a large number of undergraduate students,
is a difficult task.
Summary of work: In order to help solve this problem an
integrated, case-based, multidisciplinary forum teaching
method was developed. The presentation is given to the
whole group of students at the same time and each
presentation takes the form of an elaborated clinical
problem demonstrated as an actual doctor-patient
encounter making use of real or Standardized Patients.
The presentation mimics the doctor-patient encounter in
history taking, physical examination, report of findings, plan
of management and treatment/consent. It also reinforces
all underpinning knowledge necessary for decision
making as the encounters are interspersed with learning
activities drawing disparate information together around
the patient problem.
Summary of work: Using principles of adult education, I
developed the 5W-H approach to patient assessment. The
approach requires that students reflect each step of the
patient assessment, asking themselves the questions What,
Why, How, When, Where and Who (hence 5W-H). The
theoretical underpinning of this approach is the educational
principle that reflection is foundational to problem solving,
thus reflective assessment should lead to good patient
management. The paper will also present the results of a
pilot project on the approach. The approach will is being
taught to students, and their assesment skills evaluated at
the end of their first clinical block in May 2003.
8F 10 Learning in the clinical environment of district and
university hospitals in the Netherlands
K B Boor*, F Scheele, C van Aken, J Dronkert, J Th M van der Schoot
and B Wolf (SLAZ, Department of Women and Child Health, Van
Spilbergenstraat 6-3, Amsterdam 1057RG, NETHERLANDS)
Aim: To compare the learning environment in the main
clerkships in district and university hospitals in the
Netherlands.
Conclusions: These presentations have a number of
advantages in that it is flexible, adaptable to the level of the
student, and appears to be an inexpensive and effective
alternative for “real” clinical observation. Initial quantitative
as well as qualitative evaluations were positive and
significant positive effects on teaching and learning are
anticipated.
8F 8
Summary of work: For a period of three months junior
doctors in several district and university hospitals will be
asked to fill out a validated five-point scale questionnaire
that measures the medical students’ opinions on the
educational environment (the FREEM). Co-variables are
gender and experience of the junior doctor and the type of
clerkship (Internal medicine, Surgery, Gynaecology &
Obstetrics, Neurology or Paediatrics).
Peer tutoring success in clinical skills
Clare Stewart*, Joy Crosby and Jean Ker (Dundee University,
Clinical Skills Centre, Ninewells Hospital and Medical School,
Dundee DD1 9SY, UK)
Summary of results: Data will be presented that should
answer the question whether the teaching and learning
environment is related to a certain type of hospital and/or
type of clerkship. Preliminary data indicate that the use of
the FREEM is feasible in this Dutch setting.
Aim: The aim of this study is to share the results of a peer
tutoring scheme in clinical skills.
Summary of work: Cross year peer tutoring is now
commonplace, especially in problem based learning. In
our medical school theoretical system based peer led small
group sessions have run successfully for two years as an
adjunct to the curriculum delivered by staff tutors. Building
on this experience we have implemented a peer tutoring
programme to support the development of clinical skills
within the core curriculum in the Ambulatory Care Teaching
Centre. This environment provides an ideal tutor/tutee ratio
with groups of five students per peer tutor.
The 5W-H reflective approach to patient assessment
Joyce Mothabeng (University of Pretoria, BOX 58213, Akasia
0118, Gauteng Province, SOUTH AFRICA)
Conclusions/Take-home messages: A validated
measurement of the learning environment in various
clerkships might allow an objective evaluation of the
clinical educational environment in various hospitals.
8F 11 Strengths and weaknesses of graduate medical
clinical training in Ghent, according to 2nd year
postgraduates
M van Winckel, B Morlion*, S van de Moortele, A Derese and M
Valcke (Ghent University, Universitair Ziekenhuis Gent (3K3), De
Pintelaan 185, B-9000 Gent, BELGIUM)
Summary of results: Structured satisfaction questionnaires
completed by the senior students (tutors) and the junior
students (tutees) have shown the popularity of the scheme
and the advantage of enhancing learning for both groups.
Quantitative results of any change in the tutees’
performance, especially proficiency in clinical skills,
compared with last year’s course will be reported by
comparing summative OSCE results.
Aim: The aim of this study is to explore which
competencies have been insufficiently developed during
graduate medical clinical training, according to second
year post-graduate trainees in general practice or in different
specialties.
– 4.92 –
Section 4
Summary of work: In February 2003, all 2001 graduates
from the Faculty of Medicine (Ghent University) received a
postal questionnaire covering competencies in clinical
practice (26 items), professional behaviour and personal
development (10 items), as defined in the general
objectives of the curriculum. They were also asked to
categorise characteristics of clinical rotations in order of
importance. Respondents were contacted by phone to
acquire complementary in-depth information and to ask
for remedial suggestions.
The work experience is weekly for 5 hours, one student
attending one doctor. Objectives are to train clinical and
communication skills as well as patient management and
practical procedures. Although the course was always
appreciated by students, they have been demanding clear
standards for their activities in the course evaluation. To
meet the students’ needs, physicians were asked to frame
a practice profile, and students were asked to describe to
what extent they have trained specific activities. These
pieces of information were compared and are now the
basis for the modification of the training and specification
of outcomes. Our presentation gives a critical survey of the
learning scenario, considering the students’ evaluation as
well as our own experiences and activities.
Summary of results: Preliminary results show that trainees
feel insufficiently trained in prescribing skills, in
differentiating urgent from non-urgent problems, in tackling
emergencies, in writing referral and discharge letters, in
keeping structured patient files and in performing
administrative tasks. Half the items regarding professional
behaviour and personal development scored insufficient
by most respondents. Almost all feel insufficiently prepared
to combine a busy job with a fulfilling personal life. The
presence of an enthusiastic stimulating clinical tutor was
uniformly the most valued characteristic of clinical
rotations. These results will guide the implementation of a
modular coaching tool for students during graduate clinical
rotations.
8F 13 Redefining the role of a Learning Resource Centre
in a medical school
Bruce Holmes (Learning Resource Centre, Dalhousie University,
Faculty of Medicine, 5599 Fenwick Street, Lower Level, Halifax NS
B3H 1R2, CANADA)
Aim: This presentation will describe a Learning Resource
Centre (LRC) as a multi-functional facility offering learners
a clinic-like atmosphere to learn procedural, diagnostic,
and communicative skills.
We thank last year students in educational sciences who
performed the phone interviews.
Summary of work: It is increasingly difficult to find appropriate
patients for learners to practise their skills. This problem is
compounded with increasing student enrolment and trends
for competency-based learning. The LRC has
progressively undertaken new initiatives to address this
problem and redefine its role in the medical school.
8F 12 Integration of learning situations in primary health
care: experiences from the Berlin Reformed Track at
the Charité, Germany
Claudia Kiessling*, Margareta Kampmann, Dagmar Rolle and
Ulrich Schwantes (Arbeitsgruppe Reformstudiengang Medizin,
Charité, H U Berlin, Augustenburger Platz 1, Schumann Str 20/
21, D-10117 Berlin, GERMANY)
Summary of results: Beyond procedural skills training using
simulation and a growth in the use of simulated patients,
the LRC coordinates recruiting of hospital in-patients and
volunteer patients with stable positive findings. The LRC
now has a repertoire of programs where patients are
represented as: 1. paper cases as patients; 2. mannequins
as simulated patients ; 3. simulated patients trained for
roles; 4. volunteer patients with stable findings; 5. hospital
based patients with complex findings. When appropriately
integrated, a broader choice of patients for learners to
practise is available.
Undergraduate medical education in Germany is strongly
based on learning scenarios in University hospitals.
Physicians who teach medical students focus on patients
with difficult and complex diseases which are typical for
highly specified university health care but not for the
majority of patients’ complaints. To strengthen aspects of
Community-Based Education, we implemented a training
period together with physicians practising ambulant
treatment in the field of primary health care. Medical
students partake this training from semester two to five.
Conclusions/take home messages: The presentation will
describe examples of the LRC role in the medical school
continuum of medical education.
Session 8G: Clinical Skills (2)
8G 1
Student satisfaction with standardized patient
encounters in an emergency medicine class at
Charité Medical School, Humboldt University, Berlin
satisfaction and self-perception of skills acquired because
we had not used checklists with them. Results of three
cohorts from the Traditional Track Curriculum and one
cohort from the Reformed Track Curriculum will be
presented, compared and discussed in this poster.
Heiderose Ortwein*, Torsten Schroeder and Claudia Kiessling
(Charité Medical School, Humboldt University of Berlin,
Trainingszentrum fur Aerztliche Fertigkeiten (TAEF),
Schumannstr. 20-21, 10117 Berlin, GERMANY)
Conclusion: Students satisfaction with the new EM
teaching OSCE was surprisingly high. Data suggest that
SP feedback seems to help students to reflect and improve
their communication skills in challenging situations.
Assessment of students’ skills with an assessment OSCE
is needed to further evaluate the benefit of the adapted
program.
Background: Mega-Code-Training is a core component
of Emergency Medicine (EM) for undergraduate medical
education at Charité Medical School in Berlin, Germany.
Summary of work: We implemented two new stations in
our teaching OSCE in Fall of 2001. The aim was to
enhance students’ communication skills to handle critical
situation and practical procedure skills in EM. The two
cases were designed in order to portray frequent EM
problems. Experienced standardized patients (SP) were
selected and trained. Students were asked to do a focused
history and emergency diagnostic procedures. Additionally
they were required to develop treatment strategies.
Facilitators provided formative feedback focussed on the
reflection of communication skills and case management
strategies in the German EM system.We evaluated student
8G 2
Medical students’ communication abilities prior to
training
Nicola Brown*, Kathryn Peace and John Campbell (Department of
Psychological Medicine, University of Otago, PO Box 56, Dunedin,
NEW ZEALAND)
Background: While the importance of proficiency in clinical
communication for medical professionals is widely
accepted, little is known about the extent to which medical
– 4.93 –
Section 4
as empathy, absolute acceptance of patients and involving
them in decision making to the level they wish. The training
is done in small groups. Supervised by a tutor the students
perform role plays, including simulated and real patients.
In a second course (semester 10) breaking bad news is
trained. By supervised peer-group-learning, students do
role plays on this topic. Meanwhile medical communication
training is well accepted and evaluated by the students. It
is an integrated part in the medical education of the Charité.
students are equipped with the skills required to
communicate well with patients prior to receiving specific
training in the field. This poster outlines findings from the
initial stage of a longitudinal study into the development of
students’ communication skills throughout medical
training. The aim was to investigate students’ abilities to
perform a clinical interview prior to the commencement of
training in communication.
Summary of work: Participants were 232 new entrants to
the medical training programme who each completed a
videotaped interview with a simulated patient. Interviews
were marked by trained raters, and students’ performances
were assessed regarding listening skills, verbal and nonverbal skills, responsiveness to the patient’s needs, degree
of interview structure and clinical content.
Conclusions/take home messages: It is essential and
feasible to implement a communication training in medical
education.
8G 5
Summary of results: Results demonstrated that there was
considerable variability in students’ abilities to perform this
task, suggesting that the communication skills required in
clinical settings are not necessarily present in the majority
of students prior to training. Areas of strength and weakness
for students as a group will be outlined. Implications for
medical communication skills training programmes will
be discussed in light of these findings.
8G 3
Alison Henry*, William Murdoch and Mohammed Arafa
(Department of Primary Care and General Practice, Primary Care
Sciences and Learning Centre, University of Birmingham,
Edgbaston, Birmingham B15 2TT, UK)
Aim: This poster aims to increase awareness of the needs
of overseas trained doctors recruited to work in the UK,
highlighting the potential effectiveness of intensive
communication/consultation skills training and the
potential usefulness of the nominal group technique.
Consultation skills never made easy
Summary of work: As part of the support offered to overseas
trained doctors in the West Midlands region, quarterly
weekend workshops are offered to groups of up to 40
participants with emphasis on communication and the
culture of the National Health Service [NHS]. Featured
expert presenters, interactive forums and small group
teaching using role-play are employed as methodologies.
To explore training requirements in greater depth a group
of doctors who had trained overseas were used to form a
nominal group. They were posed stimulus statements to
allow them to explore their general needs, their
communication needs and how these needs could be met
effectively. Key issues were identified. At the time of writing
we intend to submit these findings to a different group of
overseas doctors to test representation..
A Skott*, M Wahlqvist, C Björkelund, I Gause-Nilsson, B Dahlin
and B Mattsson (Sahlgrenska Academy at Göteborg University,
Department of Public Health, Box 454, SE 405 30 Goteborg,
SWEDEN)
Aim: Teaching and learning how to meet and respond to
patients should take place in a clinical setting. The
interaction between patients, students and tutors is of great
importance.
Summary of work: In 1993, a ten-week course called
‘Consultation knowledge’ started in undergraduate medical
education in Göteborg. At the beginning of clinical
clerkships students learn communication skills, clinical
examination skills and documentation in a clinical context.
Tutors were educated and supervised and also participated
in the practical examination. Feedback from students was
obtained from written evaluations and analyzed. Reports
from teachers’ follow-up meetings were used. Feedback
data functioned as an instrument in evaluation and for
development of the course. Learning objectives and core
content were made clear by refining the examination and
by structured support to tutors. The advantages of repeated
consultation skills training in the clinical curriculum are
discussed. Learning and teaching in a clinical setting is a
never-ending story, which takes a considerate and caring
tutor and a student wanting to learn.
Summary of results: The West Midlands Deanery continues
to develop sophisticated courses to prepare newly arrived
overseas doctors for UK posts. Previous evaluations have
shown these interventions to be successful. These
elements are confirmed by the use of the nominal group
technique.
Conclusions/take home messages: Overseas doctors have
complex needs. They need assistance in orientating
themselves within the NHS. They require training in
communication/consultation skills and need to have their
language skills confirmed. The nominal group technique
is demonstrably an effective evaluative tool.
Take home message: With ten years of experience we still
find ways to change the process to enhance the learning
procedures and as a means of recruiting and training tutors.
8G 6
8G 4
Consultation and communication skills for overseas
doctors: culture, training and reward
Course for breaking bad news
Daniela Jelenova*, Renata Simkova, Lenka Doubravska, Vit Gloger,
Jarmila Indrakova, Petr Jindra, Barbora Krajzlova, Pavel Kurfurst,
Radim Licenik, Jarmila Potomkova, Jan Strojil, Iveta Zedkova and
Cestmir Cihalik (Medical Faculty of Palacky University,
Hnevotinska 3, 77515 Olomouc, CZECH REPUBLIC)
Obligatory training of communication skills in the
regular curriculum of the Charité, Berlin
Margareta Kampmann*, Britta Jonitz, Martina Schlünder and
Ulrich Schwantes (Charité Berlin, Institut für Allgemeinmedizin,
Berlin, GERMANY)
Summary of work: In response to the absence of relevant
communication skills training in the regular curriculum
we decided to offer a course focused on patient-doctor
communication. The students’ interest in such a course
was determined using a questionnaire. In creating the
program of the course, we have consulted adult-learning
experts familiar with organizing similar courses for nurses.
The students and young doctors involved in the future
course organization took part in the pilot version of this
course in October 2002. Clinical psychologists,
experienced clinicians and a lawyer participated in this
weekend series of lecturers and workshops containing
theoretical and practical parts. This course covered four
main topics – delivering the diagnosis, communication
with dying people, communication with their relatives and
Background: Good communication between patient and
doctor is the prerequisite for diagnosis and therapy.
Nevertheless medical communication training is not a well
established component in medical education of most
universities in Germany. Since October 2001 students of
the Charité are taught obligatorily. The curriculum is
presented and the way we put it into practice.
Summary of work: In the basic and first course (semester
5) we train elements of “Health Oriented Talking” HOT, a
special communication technique looking for patients’
resources. It is focused on the doctor-patient-relationship,
the reasons and aims of the consultation, transference
phenomena, and self efficacy. Attitudes are demonstrated
– 4.94 –
Section 4
crisis intervention. We used standard evaluation tools - 1)
expectations of participants before the course; 2) evaluation
after the course according to Pendleton’s rules of giving
feedback; and 3) combined interview after 4 months
evaluation. According to the results we rearranged the
syllabus for a summer course intended for students of
General Medicine. If the evaluation of the course comes
off positively, our faculty authorities promised to include
this course into the regular curriculum of our school in the
future.
• The learning that occurs relates overwhelmingly to the
CRM issues, rather than the medical features of the
scenario.
Conclusions/take home messages: A high-fidelity
simulation learning environment is an effective means for
bridging the gap between theory and safe practice
providing valuable experience prior to graduation in a way
that has not been possible previously.
8G 9
8G 7
New high frequency oscillatory ventilator simulator
Training of simulated patients: the effect of a selfwritten scenario on performance and feedback quality
Abdulla Al Thari*, C A S Melville, Y Wickramasinghe and A Al Shihri
(Keele University, North Staffs Hospital, Centre for Science and
Technology in Medicine, Bio Medical Engineering, Thuronbrow
Drive, Hartshill, Stoke on Trent ST4 7QB, UK)
Kenichi Mitsunami*, Masahiko Terada, Hiroki Tamura, Hidetoshi
Matsubara and Tadao Bamba (Shiga University of Medical
Science, Department of General Medicina, Tsukinowa-cho, Seta,
Otsu, Shiga 520-2192, JAPAN)
Summary of work: We have developed a Windows™-based
simulator for training in the use of HFOV to support learning
of clinical management strategies in the neonatal and
pediatric intensive care settings. The simulator uses the
Windows™-based commercially-available Labview™
(National Instrument, Bristol, UK). This allows the creation
of a virtual ‘skin’ resembling control panel of an HFOV
ventilator with the appropriate dials and gauges
(Sensormedics™ 3100A). This is linked to underlying
algorithms, which determine system response. A selfstanding .exe file can be created for distribution. The trainee
can select from 6 Cases of respiratory diseases commonly
treated by HFOV. Each has a case presentation, plus chest
X-ray and initial blood gases whilst on conventional
ventilation. The challenge is to optimise settings to achieve
a target blood gas. When the user reaches the target of
one stage, positive feedback is given and the scenario
moves on 6 hours. The algorithms are based on real cases,
and there are 12 adjustments required for each case.
Expert help provides guidelines for HFOV use and details
on the pathophysiology of common paediatric diseases
causing respiratory failure.
Aim: Medical interview training with simulated patients
(SPs) has been recognized as essential in Japan to medical
students’ improvement in communication skills. Recently,
it has been considered necessary to ensure not only the
quantity but also the quality of SPs. In this paper, we have
examined the educational effects of self-scenario writing
by SPs on both their performance and feedback quality.
Summary of work: SPs wrote scenarios for role-play
exercises by themselves following a medical teacher’s
advice. Each SP exercised two role-play sessions with a
student, one with her/his own scenario and the other with
that written by other SPs. After all of the role-play sessions
ended, we performed group interviews with the SPs and
the students separately in order to assess the effect of selfscenario writing on SP training.
Summary of results: SPs indicated that self-scenario writing
made their performances more realistic, however, it made
their feedback quality more emotional. Meanwhile,
students could not distinguish any clear differences
between the two settings.
Conclusions: Self-scenario writing may exert a favorable
effect on the reality of SP portrayals, but not on the feedback
quality.
Summary of results: Initial feedback from 5 clinical HFOV
experts has been positive, and detailed evaluation is
underway.
8G 8
Patient safety and high fidelity simulation in
undergraduate medical education: learning the
skills of Crisis Resource Management
8G 10 Incorporating a newly developed heart sound
simulator into medical student education
Katsuya Yoshida, Yoichi Kuwabara, Keiichi Nakagawa, Masahiro
Tanabe* and Issei Komuro (Chiba University Graduate School of
Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670,
JAPAN)
Brendan Flanagan, Debra Nestel*, Michele Joseph, Michael Bujor,
Julia Harrison and Orla Lacey (Monash University, Centre for
Medical & Health Sciences Education, Faculty of Medicine, Nursing
& Health Sciences, Building 15, Clayton, Victoria 3800,
AUSTRALIA)
Aim: To incorporate a newly developed heart sound
simulator for medicalstudent education.
Summary of work: Eighty-seven medical students
participated in a 90-minute teaching program using the
heart sound simulator, which was a thorax-manikin
controlled by a Windows computer (Simulator “K”, KyotoKagaku Co., Kyoto, Japan). Built-in speakers are set at five
sites in the thorax (aortic, pulmonic, tricuspid and mitral
areas). All heart sounds were recorded from actual patients
with various heart diseases. Students auscultated eight
kinds of heart sounds using their own stethoscopes. To
evaluate the achievement, the students were asked to
answer the name of the two heart sounds, which the teacher
had randomly chosen before and after the program. Fourpoint self-rating of skill in auscultation was also performed
before and after the program.
Background: Undergraduate curricula provide limited
opportunities for medical students to develop an
understanding of the significance of contextual factors in
ensuring safe practice. Crisis Resource Management
(CRM) using high-fidelity simulation offers this opportunity.
The presentation outlines this innovative educational
intervention derived from aviation training and considers
ways in which high fidelity simulation addresses the core
issue of patient safety in undergraduate education by
bridging the gap between theory and practice.
Summary of work: Final-year medical students at Monash
University attend the Southern Health Simulation & Skills
Centre during which they participate in an evolving crisis.
All participants complete written evaluations at the end of
the year. (n=132). Thematic analysis of this qualitative data
will be presented.
Summary of results: Mean numbers of the correct answer
were significantly increased from 0.71 to 1.52 (p<0.00052,
MacNemar test) and the self-rating score was also
improved for all kinds of the sounds (mean value from 1.05
to 2.49) after the program.
Summary of results:
• High fidelity simulation and CRM is an extremely relevant,
and highly valued way to learn;
• The most valuable element is the opportunity to practise
being responsible for a patient in a realistic emergency
situation - a chance to put theory into practice.
Conclusion: The newly developed heart sound simulator
“K” was useful to increase skill in auscultation of heart
sounds for medical students.
– 4.95 –
Section 4
8G 11 Simulator based course in emergency management
for primary care dental practice teams
Summary of work: A questionnaire related to attitudes to
death and dying in medicine and law was tested in 34
students both before and after 6-hour duration of course
for evaluation the effectiveness of teaching in changing
the attitude of clerks. The course included disturbance of
consciousness and brain death (1h), vegetative state and
euthanasia (1h), introduction to hospice in adult and
children (1h), DNR and related law status at Taiwan (1h),
spiritual care (1h) and bereavement (1h). The evaluation
was performed before and after the medical students’
rotation clerkship at the department of neurology.
S Weber*, M Müller, E Armstrong and T Koch (Department of
Anaethesiology and Intensive Care Medicine, University Hospital
Dresden, Fetscherstr. 74, 01307 Dresden, GERMANY)
Aim: The aim of this project was to establish a new
curriculum for a one-day course in the management of
medical emergencies for primary care dental practice
teams.
Not only the dentist, but also its nursing staff should gain
knowledge and skills in treatment of patients in acute lifethreatening situations considering the rising life expectancy
and comorbitity of the population.
Summary of work: In cooperation with the State Dental
Council a course based on the ERC ALS guidelines was
developed consisting of two main parts. The short lecture
series (2 hours) focussed on CPR, airway management,
cardiac and circulation emergencies and special
emergency situations. The systematic skills-training
section (6 hours) performed in small groups addressed
the following subjects: BLS, airway management and
ventilation, intravenous techniques, manual and automated
external defibrillation, ALS and resuscitation routine in a
typical dental practice setting. For all skills-training stations
life-like manikins and models were utilized and the
emergency scenarios were simulated by the use of a
universal patient simulator.
Summary of results: The results indicated that the teaching
enhanced the reaction of fear and running away in the
students. There were also significant changes of
understanding in the regulatory law of the hospice in our
country, much approval of the legislative means, and much
appreciation of the real meaning and performance in
details of DNR orders.
Conclusion: The results suggested that a short course of
teaching may inspire the students in the understanding of
both medical and law aspects related to death and dying.
8G 14 Survey of staff attitudes to the daily otolaryngology
ward round
Mary-Louise Montague*, Michael S W Lee and SS Musheer
Hussain (Ninewells Hospital and Medical School, Department of
Otolaryngology, Dundee DD1 9SY, UK)
Summary of results: In the first course, 13 out of 32
participants were dentists and 19 dental nurses. In the
evaluation results 100% stated the course was appropriate
and 97% stated that the simulator based training in practice
teams was the most important experience.
Aim: The aim of this survey was to investigate the attitudes
of medical and nursing staff towards the daily
otolaryngology ward round in a teaching hospital.
Summary of work: Open-ended questionnaires generated
themes from which a structured questionnaire was
constructed. Respondents indicated on a Likert scale the
extent to which they agreed or disagreed with statements
concerning their attitudes towards the ward round and the
quality of care and teaching experience it provides.
8G 12 Attitudes and ability: is there a relationship?
Merilyn Liddell* and Sandra Davidson (Monash University,
Department of General Practice, 867 Centre Road, East Bentleigh,
Vic 3165, AUSTRALIA)
Summary of results: 18 medical staff and 17 nursing staff
were surveyed. The overall response rate was 74.3% (n=26).
The majority of staff agreed that the ward round is a
constructive use of their time and serves to promote team
spirit. Both groups agreed that the ward round allows
adequate communication between medical and nursing
staff but there was uncertainty about the provision of
adequate patient communication on ward rounds. Nursing
staff agreed that the ward round provides a valuable
learning experience. There was uncertainty about this
among medical staff.
Aim: Despite much emphasis on development of
appropriate attitudes among medical students, the
relationship of attitudes to behaviours is not clear. Many
educators use student confidence as an appropriate
outcome measure, with little evidence to support this. This
presentation aims to clarify the relationship between
students’ value judgements, their confidence, and their
assessed competence in a range of consultation skills.
Summary of work: Questionnaires were developed to
assess final year students’ views of importance of, and their
confidence in, demonstrating twenty-eight separate
consultation skills. These were administered before and
after an attachment which focused on consulting skills.
Results were compared with performance in relevant
aspects of their final examinations.
Summary of results: Following the teaching, students
viewed many of the skills as more important, and felt
significantly more confident in displaying all of the skills.
There was a direct correlation between the importance
students placed on a skill (particularly pre-existing views),
and their later performance. However there was no
relationship between students’ level of confidence (pre or
post) and their later performance.
Conclusions: These findings can be used to inform
changes in the departmental ward round structure with
specific attention directed to maximising educational
opportunities for junior medical staff.
8G 15 Assessment of quality of morning report
Akbar Derakhshan (Mashhad University of Medical Science, EDC,
Daneshgah St, Mashad, IRAN)
Aim: To assess educational quality and quantity of morning
reports in Ghaem Hospital Medical School.
Summary of work: This is a descriptive cross-sectional
study performed through a questionnaire. The resulting
data were stored and analyzed by the statistical software
SPSS/7.5.
Conclusions/take-home messages: 1. Positive pre-existing
attitudes to consulting skills are associated with better
performance, lending weight to the importance of selecting
students who exhibit appropriate attitudes; 2. Increased
confidence is not a valid surrogate for competence.
Summary of results: We received 330 filled out
questionnaires. The option showed lack of discipline, low
participation of faculty, excess attention to the theoretical
aspects, inappropriate selection of subject considering the
students’ level, undesirable room situation and it was
concluded that there was low educational efficacy of the
morning reports.
8G 13 The changes in attitudes to death and dying among
medical students
Ming-Liang Lai*, Jung-Jong Chen, Hsing-Hsing Chen and Chantal
Co-Shi Chao (School of Medicine, Tzu Chi University, 701, Sec 3,
Chung-Yang Road, Hua-Lien 970, TAIWAN)
Conclusions: Since morning report is considered an
education curriculum in the first place and takes
considerable time every day, it seems a necessity to re– 4.96 –
Section 4
evaluate the current situation, set new objectives and adapt
novel methods in medical education.
learning behaviour was determined from questionnaire
responses.
Summary of results: 619 BPE were assessed. All CE (n=13)
and 85% of 161 students returned completed
questionnaires. Students recognised BPE as a valuable
learning activity (96%) that improved clinical reasoning
skills (88%) and assessed progress in a fair manner (75%).
Feedback positively influenced factors driving learning:
informed of own level of competence (69%), advised
regarding learning needs (84%), and motivated to learn
independently, specifically, self-directed reading (81%) and
BPE (71%). Most CE (77%) integrated FA into their
educational practice, and agreed that it enhanced the
learning potential of bedside tutorials.
8G 16 Bedside tutorial-based formative assessment
promotes learning in clinical clerkships
V C Burch*, T Gibbs and J L Seggie (University of Cape Town,
Department of Medicine, J Floor, Old Main Building, Groote Schuur
Hospital, Observatory 7925, SOUTH AFRICA)
Aim: Because clinical clerkships are typically situated in
environments that lack educational structure, there is an
imperative to integrate formative assessment (FA) strategies
to enhance learning. We describe a novel FA activity, and
demonstrate its impact on learning.
Conclusions/take-home messages: (1) FA strategies can
be successfully integrated into bedside tutorials; (2) The
BPE-based tutorial is a useful FA strategy to promote
learning.
Summary of work: Clinician educators (CE) assessed
student performance during bedside tutorials based on
“blinded” patient encounters (BPE) i.e. without prior
knowledge of the clinical diagnosis or review of patient
records. Feedback was standardised using performance
rating scales. The educational value and impact of FA on
Session 8H: International Medical Education
8H 1
Implementing a women’s sexual health curriculum
for St Petersburg, Russia
students. The graduating students had significantly better
knowledge and performance on the clinical cases than
the entering students and had significantly better
knowledge than the Israeli students but had equivalent
knowledge and performance on the clinical cases as the
American students.
L Southgate*, P Toon, S Pavinski and O Kuzatova (Academic Centre
for Medical Education, Holborn Union Building, 4th Floor, Archway
Campus, Highgate Hill, London N19 2UA, UK)
Aim: To develop and implement a curriculum for women’s
sexual health to be delivered by Russian family doctors for
women in the environs of St Petersburg Russia.
Summary of work: A programme of work between London
and St Petersburg, based on surveys, literature reviews,
focus groups with patients and family doctors has been
underway since September 2002. A distance learning
programme for Doctors in Vyborg is one element,
combined with practical skills training for gynaecology and
STD. The doctors will undertake a formal assessment at
intervals during the programme.
Conclusion: The students of the new program had uniformly
positive attitudes toward IH that did not change during
medical school but they did increase their knowledge in
IH. Their knowledge was superior to one cohort of students
but not to another. Long-term studies are necessary to
further document the effects of the program.
8H 3
Mette Valbjoern (Office for Postgraduate Medical Education,
Region North, Aarhus Amt, Lyseng Alle 1, 8270 Hoejbjerg,
DENMARK)
Summary of results: The design of the distance learning
programme, the use of a journal to support it, the output
from focus groups and the learning needs assessments
for the family doctors will be presented.
Aim: The Office for Postgraduate Medical Education –
Region North, Denmark has focused on integration of
resident third country medical doctors with the purpose of
obtaining permanent authorisation. The aim of the
presentation is to give a description of the integration
programme.
Take-home messages: A curriculum for established doctors
must be based on the needs of the population they serve,
and their own learning needs. Communication about
sexual health is a sensitive and difficult area for family
doctors and their patients.
8H 2
Programme for integration of third world medical
doctors
Summary of work: The programme focuses on medical
doctors outside the EU/EEC countries. This included a
total of 124 third world medical doctors. The integration
programme includes the following items:
• Individual interview and recognition of qualifications:
Individual interview, during which the applicants’ future
possibilities are identified. The formal authorisation is
evaluated by the National Board of Health;
• Planning of practical training periods at a hospital and
specific medical language instruction;
• Probationary employment periods: Advisory guidance
relating to applications regarding probationary
employment periods. This requires a provisional
authorisation from the National Board of Health.
• Specific training courses: Participating in language
courses, integration courses and practical medical skill
courses.
• Examinations: Advisory guidance relating to the
examinations, which third country medical doctors are
required to obtain permanent authorisation.
Evaluation of a new program in international health
A Jotkowitz*, A Gaaserud, Y Gidron, J Urkin, Y Henkin and C Z
Margolis (Ben-Gurion University, The Moshe Prywes Center for
Medical Education, POB 653, Beer Sheva 84105, ISRAEL)
Aim: Ben-Gurion University in collaboration with Columbia
University inaugurated a medical school in 1997 with the
purpose of training physicians in International Health (IH).
In order to evaluate the program a previously validated
survey was used.
Summary of work: The survey consisting of questions
relating toward attitudes, knowledge and clinical cases in
IH was given to all graduates, incoming students, a random
sample of American medical students and a group of Israeli
medical students. Analysis of variances were conducted
followed by planned contrasts.
Summary of results: The graduating students had
significantly better attitudes toward IH than the American
and Israeli students but were equivalent to the incoming
– 4.97 –
Section 4
8H 4
Experience of improving the neonatal teaching at
the pediatric faculty
Summary of work: 15 medical students and residents at
one medical center who rotated internationally during
2001-2002 were asked to participate in semi-structured
interviews about their experiences. Interviews assessed
logistical issues, day-to-day activities, and perceived value
of the experience. Interviews were audiotaped and
transcribed, and open coding was conducted by two
investigators to identify common themes and develop a
conceptual framework. Member checking and review of
results by a group of experts in bioethics were used to
validate the results.
M A Ismailova*, D A Mavlyanova and Z G Rachmankulova (Tashkent
Pediatric Medical Institute, J. Obidova Street 223, 700140
Tashkent, Uzbekistan)
Aim: To study the effectiveness of the introduction of new
pedagogic technology into a modern medical school in
the pediatric faculty.
Summary of work: Experience of new methods of teaching
received from the international seminars with help of USAID,
Zdravplus Project, Global Project and DFID were
introduced into undergraduated medical education in
Uzbekistan in 2001.
Reforms in the Health Care System of Uzbekistan show a
great gap between the level of professional training of
students. There are some objective and subjective reasons
for this problem, including conservative approaches of
traditional medical schools and poor experience in using
the advanced educational technologies.
We applied the following active methods of training: brain
storming, problem based learning, small group discussion,
role play, interactive video. It gave the opportunity to increase
the level of knowledge and understanding in neonatology.
Conclusions: New methods of teaching help to improve
quality learning, to develop competence and performance
of teachers and to motivate student activity for individual
practice. Exchange of experience with international
colleagues is important support for developing medical
education in Uzbekistan.
8H 5
Summary of results: 10 medical students and 5 residents
were interviewed. Attitudinal changes that emerged
included increased empathy for non-native language
speakers, shifting point of view about Western medicine,
more positive attitudes toward public service, and personal
growth.
Conclusions: This preliminary study indicates that
international rotations have diverse and powerful effects
on the students who participate. These experiences are
expensive in time and resources, so as more students
chose them, further research is needed to measure their
effects.
8H 7
Andrzej Wojtczak*, David T Stern and M Roy Schwarz (Institute
for International Medical Education, 106 Corporate Park Drive,
Suite 100, White Plains, New York NY 10604-3817, USA)
Aim: The Institute for International Medical Education
(IIME) was created to develop the global minimum
essential requirements of medical education that are
necessary to equip all physicians, regardless of where they
are trained, with medical knowledge, skills and
professional attitudes of universal value.
Expanding the boundaries of medical education:
evidence for cross-cultural exchanges
Ian S Mutchnick, Cheryl A Moyer and David T Stern* (University
of Michigan Health System, 300 North Ingalls, Room 7E10, Ann
Arbor, MI 48109-0429, USA)
Summary of work and results: The IIME Project consists of
three phases. In phase I, sixty essential outcomes were
developed by an international panel of medical education
experts, categorized into seven major domains including
professionalism, basic medical sciences, and information
management. In the phase II of the project, the graduates
of the eight leading medical schools in China are being
evaluated for the presence of these outcomes in graduating
medical students. Using the best available assessment
tools, guided by a team of international assessment
experts, this evaluation will occur in October 2003. In phase
III, the lessons learned in China will be applied to other
medical schools worldwide.
Aim: Cross-cultural experiences are in increasing demand
by both graduate and undergraduate medical students,
yet the benefits of these experiences are not clearly
established. The aim of this study was to identify and
summarize the existing qualitative and quantitative data
regarding the impact of international rotations on health
care providers in training.
Summary of work: We conducted a comprehensive review
of the literature to identify articles on the outcomes of crosscultural experiences during medical training. Themes
were identified and categorized into domains.
Summary of results: Forty-two studies were found; 27
articles used qualitative methods, 9 used quantitative
methods and 6 used both. Most (24) were from the nursing
literature, 18 were from the medical literature. All studies
reported positive outcomes along four domains: students’
professional development, students’ personal
development, medical school benefits, and host population
benefits.
Conclusions: Studies reviewed were primarily casecontrolled or case series. Future research is needed that
more clearly defines outcome measures and uses more
rigorous methods. While results suggest positive outcomes
in all domains, further research is needed before crosscultural rotations can be supported based on evidence.
8H 6
Assessing global essential competencies in the
leading Chinese medical schools: The IIME Project
Conclusions: Global agreement on outcome-based
assessment of medical education is possible. International
experts can agree on the content and assessment
measures of global medical competency. Results of this
assessment can be used as part of a process to ensure
the quality of medical schools worldwide.
8H 8
A Harvard program for German final year students
H Baschnegger*, A S Peters, H T Aretz and F Christ (LMU Munich,
Klinik für Anaesthesiologie, Klinikum der Universität, 83177
Munich, GERMANY)
Aim: Ludwig Maximilians University (LMU) and Harvard
Medical International (HMI) formed an Alliance for Medical
Education in 1996. To increase the momentum of the
curricular reform LMU and HMI created a special program,
Introduction to American Medicine and Medical Education,
for LMU’s best final year students.
The effect of international medical rotations on
students’ attitudes: a qualitative study
Cheryl A Moyer and David T Stern* (University of Michigan Health
System, 300 North Ingalls, Room 7E10, Ann Arbor, MI 481090429, USA)
Summary of work: Each year 10 LMU students are enrolled
at Harvard for 6 months. In addition to clinical electives the
special program is held one afternoon per week as well as
during two entire weeks. It covers learning theory, tutor
training; case writing; lecturing and bedside teaching skills;
feedback; student and program evaluation; course design;
academic leadership; patient-doctor communication;
palliative care and evidence based medicine.
Aim: To date, little is known about the impact of international
rotations on the attitudes of medical students and residents.
This study aimed to identify how trainees who rotated
internationally were affected by the experience.
– 4.98 –
Section 4
incoming non-Scandinavian exchange students, 2)
increase student competence in English and 3) stimulate
teacher/researcher exchange. The basic idea is bilateral
exchange.
Summary of results: After graduation, 41 of 55 former
program participants stayed at LMU. They have participated
in core course planning groups, as case writers, tutors
and instructors. Moreover, the class of 2001 developed a
course to teach and reinforce skills in interviewing and
examining patients. The class of 2002 designed a course
for ambulatory care. Both will be used to generate new
courses at LMU.
Summary of work: In 2003 spring semester, 20 of 94
students are exchange students. The same number of Oslo
students are in partner universities for equivalent ninth
semester learning. All our students are thus exposed to
English medical language in plenary teaching as well as
contact with foreign students. The Faculty support teacher
exchange with established and potential partner
universities. Pronunciation courses in English and help in
preparing teaching material in English is offered.
Information and discussion meetings for the involved
teachers aim to foster group identity and ownership to the
project.
Conclusion: So far 4 new problem based interdisciplinary
courses have been successfully implemented at LMU. A
change in German law forces all universities to reform
their curricula by fall 2003. LMU feels very well prepared
for this challenge since it started this process ahead of
time with the help of HMI and its own final year students.
8H 9
Internationalisation of medical education in the
Netherlands
Summary of results: The student evaluation after two
semesters identifies problems and areas for
improvements. The overall picture is however positive. The
teacher competence in English is crucial.
Gerard D Majoor* and Susan Niemantsverdriet (Maastricht
University, Faculty of Medicine, POB 616, NL 6200 MD
Maastricht, NETHERLANDS)
Conclusion: English as the language of instruction for a
whole semester has increased student exchange into our
Norwegian Medical Faculty. It additionally represents
“Internationalisation at Home” for the non-exchanging
Norwegian students.
Aim: Description of the state of the art in internationalisation
of medical education in The Netherlands.
Summary of work: Internationalisation co-ordinators of
seven out of the eight Dutch medical Faculties responded
to a brief questionnaire.
Summary of results: In 2000/2001 on average 107 students
per Faculty went abroad (range: 53-243) out of an average
student population of 1506 (range: 1303-1679). Visiting
foreign students ranged from 12-77 (mean: 38). Research
was the dominant activity for study abroad in industrialised
countries and clinical work in developing countries. All
Faculties have installed procedures to assure the quality
of study periods abroad. Visiting students predominantly
participated in the regular educational programme and in
research. In the curricula of all Dutch Faculties attention is
given to international aspects of medicine, like training in
foreign languages (particularly English); intercultural
aspects of medicine; tropical (imported) diseases; and
foreign health care systems. Most of these topics are not
incorporated in the Faculties’ core curricula but offered as
elective courses. Incentives for internationalisation provided
by the home University and Faculty were perceived as most
effective.
8H 11 Correlations to attitudes and knowledge about
international health
A Gaaserud*, A Jotkowitz, Y Gidron, C Baskin, M Alkan, Y Henkin
and C Margolis (Ben Gurion University of the Negev, Faculty of
Health Sciences, The Moshe Prywes Center for Medical Education,
PO Box 653, Beer Sheva 84105, ISRAEL)
Aim: There is increasing awareness of the importance of
international health (IH) but there is a paucity of data
regarding medical students’ attitudes and knowledge
towards IH. Furthermore there is little known about
students’ attributes that correlate with positive attitude and
increased knowledge in IH.
Summary of work: 126 medical students from 26 countries
were assessed using the Beersheva Survey of Attitudes and
Knowledge in International Health. Data were analyzed for
correlations between demographic, educational and
occupational variables with attitudes and knowledge in IH.
Conclusions: Student mobility is established in all Dutch
medical Faculties although considerable quantitative
differences exist. Internationalisation at home can be
further advanced by incorporating more aspects of
internationalisation in core curricula.
Summary of results: IH knowledge positively correlated with
clinical IH knowledge (P<0.01). Previous IH work
experience correlated with openness to experience, a
personality factor, (P<0.001) and with attitude (P<0.001).
US-born students had more positive attitudes (P<0.05).
Female gender shows more positive attitude (P<0.05).
Attitude negatively correlated with number of languages
spoken R=-0.198 (P<0.05).
8H 10 English taught semester in medicine at the
University of Oslo
Conclusion: Medical students’ attitudes toward IH are
positively correlated with female gender, US-born, and prior
IH experience. General knowledge in IH was correlated
with clinical IH knowledge but not attitude or openness.
Further studies are needed to validate the importance of
these findings on education in IH.
Borghild Roald*, Sverre Bjerkeset and Babill Stray-Pedersen
(University of Oslo, Department of Pathology, Medical Faculty,
Ullevål University Hospital, 0407 OSLO, NORWAY)
Aim: We present one year’s experience with semester 9 (of
12), “Reproduction, Women and Children’s diseases”,
taught in English. The aim is to 1) increase the number of
Session 8I: Problem Based Learning
8I 1
The correlation between students’ perceptions of
PBL session and their scores on MCQ exams at the
end of the session
Background: PBL is an effective way of delivering medical
education by motivating the students, encouraging them
to set their own learning goals and giving them a role in
decisions that affect their own learning. In PBL, true-to-life
clinical problems become the stimulus for learning in small
group tutorials.
Melih Elcin, Orhan Odabasi, Iskender Sayek*, Murat Akova and
Nural Kiper (Hacettepe University, Tip Facultesi Tip Egitimi ve
Bilisimi AD, 06100 Sihhiye, Ankara, TURKEY)
– 4.99 –
Section 4
Summary of work: In Hacettepe University Faculty of
Medicine, we had one module in each committee and the
students had a MCQ exam at the end of each module. To
evaluate their perceptions of PBL sessions, students are
also asked to answer a questionnarie at the end of each
module. The aim of this study is to investigate the
correlation between perceptions and the exam scores. We
have 24 groups with 13 students in year III. We evaluate the
results of the questionnaire and the exam scores by means
of groups. We had 6 statements in the questionnaire and
the students used a 5-point Likert scale to answer. We
analysed the results using Pearson correlation coefficient.
linked often diverged from the structure envisioned by the
course planners. A content analysis of the interviews and
curriculum structure task showed a wide range of reported
strategies for individual study using PBL cases.
Conclusion: We will argue for the need for curriculum
designers to have access to more information about what
students do when they are working with the curriculum,
and how they perceive the structure and linkages.
8I 4
Summary of results: We got no significant correlation
between perceptions and scores.
David C M Taylor* and Trevor J Gibbs (University of Liverpool,
Faculty of Medicine Office, Duncan Building, Daulby Street,
Liverpool L69 3GA, UK)
Conclusion: We concluded that assessment methods used
in any educational approach should be appropriate to
curriculum outcomes. It is hard to measure the outcomes
of PBL using MCQ examinations.
8I 2
Background: The Faculty of Health Sciences of the
University of Cape Town introduced a new medical
curriculum in 2002, which is based around supported
problem-based learning (PBL).
PBL: what do students think about it?
Summary of work: The students underwent a short PBL
training programme before they embarked on the course
and each student completed a 20-item questionnaire at
the start and the end of their first year.
R Davidova, St Jochkova, P Moushatova, N Narlieva and D
Dimitrov* (31 Sergey Rumiantcev Str, Student Hostel, Room 80,
Pleven 5800, BULGARIA)
Summary of results: From the start the students realised
that they would need to be highly motivated, that PBL would
develop them as active learners, and that they would need
support. There was relatively little change in the students’
responses to most of the items on the questionnaire when
it was completed again at the end of the year. The only
major differences were that the students were less worried
about PBL after experiencing it for a year, and they were
more confident that their knowledge of basic sciences was
sufficient to enable them to do well in problem based
learning.
Background: A hybrid PBL program has been implemented
in the Medical University Pleven since 1999. It includes
PBL sessions, lectures and laboratory classes.
Summary of work: Eighty-two PBL students answered a
questionnaire concerning learning by PBL, student feelings
and expectations about it. The answers were statistically
processed. The results are summarised in terms of:
knowledge of PBL method and reasons for participation;
learning process management concerning student
selection, resource provision, teaching and assessment;
PBL curriculum – start time and subjects included; clinical
cases; group dynamics; how PBL helps learning in
medicine.
Summary of results: Students’ opinions are: The basic
reasons for choosing the PBL method are curiosity and
willingness to change, as well as disappointment in the
conventional program; All disciplines should be studied by
PBL; Resource provision should be enriched with audiovisual techniques and more computers; Thematic PBL
guidance will be helpful too; Assessment should be more
related to PBL; Clinical cases are clear enough and suitable
for learning basic disciplines; The friendly group spirit
improves learning; Continuing tutor training would increase
the quality of learning; PBL helps the acquired knowledge
to become deeper and long-lasting and to cultivate critical
thinking.
8I 3
Students show increased confidence in supported
PBL
Conclusion/take home message: It is clear from this that
although training is important, experiencing PBL is at least
as valuable in building confidence in the process.
8I 5
Plenary session as a tool for standardization of
objectives and conclusions in a diversified
environment where heterogeneity of small groups and
tutors’ expertise are the rule
Enrique F J Martinez*, Graciela Medina, Demetrio Arcos, Ricardo
Trevino and Jorge Valdez (School of Medicine - Monterrey Tec,
ITESM, Av Eugenio Garza Sada 2501, Depto. Cs. Basicas Medicas.
Ed. DACS-112, Monterrey NL 64849, MEXICO)
Summary of work: In the School of Medicine, Monterrey
Tec, Mexico, tutors with different profiles participate in the
tutorial courses. We classified the tutors regarding different
aspects in the teaching and learning process: content and
didactic technical (PBL) expert tutors, tutors expert in the
topics but non-expert in PBL methodology and expert in
methodology but non-expert in the topics. Therefore, to
get feedback about the case problem, a tutorial guide, to
learn from the others and homogenize all the steps in PBL,
we carry out a plenary session once a week. We join
together 4 small groups in the classroom with the
respective tutor and give the case-problem to each small
group. After that, each small group discusses for about 30
minutes the different steps in PBL before self-study. After
that, one of them presents the results obtained during the
various steps and the others teams comment and discuss.
At the end of the discussion all teams and tutors know what
kind of the topics or objective must be studied and which
conclusions were obtained.
Putting it all together: Medical students’
understanding of the curriculum
Agnes Dodds*, Mosepele Mosepele, Glen Evans, Susan Elliott and
Jeanette Lawrence (The University of Melbourne, Faculty
Education Unit, Faculty of Medicine, Dentistry and Health
Sciences, Level 7, Medical Building, Victoria 3010, AUSTRALIA)
Background: Among the many papers reporting the
introduction of Problem Based Learning (PBL) in medical
curricula, there is little reported research on how students
actually learn with these new curriculum tools. This
presentation reports the results of a study into how students
take up the implicit and explicit messages of a hybrid PBL
curriculum in their own study.
Summary of work: Second and third year medical students
(n = 420) completed a 43 item questionnaire designed to
elicit students’ preferred use of curriculum components in
their independent study. A sub-set of 40 students were
interviewed and completed a computer-based curriculum
structure task.
Conclusion: The plenary sessions have demonstrated that
they help the students and teachers to improve their
respective roles.
Summary of results: Students reported high levels of
satisfaction with the PBL course overall, but student
understanding of how the parts of the curriculum were
– 4.100 –
Section 4
8I 6
Background: This study attempts to observe physicians’
education process and how to humanize students with the
care of the elderly by looking at the actual observation made
by students and the elderly themselves.
Improving the quality of PBL cases – experiences
with the implementation of quality criteria
Ragna Raschke*, Walter Burger, Claudia Kiessling, Rita Leidinger,
Dagmar Rolle, and Kai Schnabel (Reformstudiengang Medizin,
Charité, HU Berlin, Schumannstr. 20/21, 10117 Berlin, GERMANY)
Aims: To analyze students’ perceptions of problem based
learning (PBL) as it is used at FAMEMA and how it functions
as a space for training of doctors to be sensitive to care of
the elderly; and to analyze students’ and elderly people’s
impressions of what it is to be a doctor sensitive to the
aging process.
Background: The central teaching and learning method of
the Reformed Curriculum at the Charité (Berlin, Germany)
is problem-based (PBL). Thus the quality of the papercases based on real patients is crucial for the learning
process.
Summary of work: We collected data through a
questionnaire applied to medical students finishing their
4th year of medical education. In-depth interviews with
elderly people and with students at the end of 6th year
were developed. Thematic analysis was used for data
inference.
Summary of work: In order to improve the quality of cases
continuously, a feedback process with PBL students and
experts of the review group has been implemented. Based
on a survey with nine quality criteria for construction of PBL
problems (Des Marchais, 1999), a self-developed modified
questionnaire was introduced to answer the following
questions:
• Which cases have been rated as “good” by the students
and how many of the advised criteria do these cases
meet?
• What are the differences in the evaluation done by
students compared to the experts of the review group?
Results and discussion: Students at the end of 4th and 6th
years are coincident in relation to: quality and pertinence
of Unit 17 – “Aging”. They also match in terms of the Unit’s
contribution to personal development, acquisition of skills
and competences “to learn how to learn”, to reason, to
rescue the human aspect of our lives, and to know how to
provide care of the elderly. Still, the pathological-medical
model prevails over the one that looks at illness, as a
person’s ailment. Practice and theory remain poorly
integrated. Paper problems, regardless of how well they
have been developed or appropriately used in tutorials,
cannot beat the real experience, especially for the
development of professional skills required for proper
health care. Recognition for the need to rescue humane
approaches in health care was identified, as this is not
always included as an integral part of the care provided to
the elderly. Elderly people expect to find a doctor who
understands their illness as well as how this is manifested
in their life. The latter will permit a relationship based on
hope and trust - key elements in health care - as well as
what should be the proper care of health problems. How
the elderly person looks at the doctor, and how the doctor
looks at the elderly person, are mirror images: they will
project new ideas about the elderly, and of each other.
The modified questionnaire with 31 questions relating to 4
cases of an integrated block on ‘respiration´, was
completed by all students of the class and by the members
of the case review team.
Conclusion: The results of this evaluation provide useful
information for further construction or modification of cases
and thereby assist in assuring the quality of the PBL
program.
8I 7
Critical assessment of factors affecting the exam
performance and study motivation of preclinical
phase medical and dental students in integrated
PBL teaching
Tiina Immonen*, Kirsi Sainio, Sanna Partanan, Tuula Nurminen,
Juha Okkeri and Timo Sorsa (Institute of Biomedicine,
Developmental Biology, University of Helsinki, Biomedicum
Helsinki CS14a, Po Box 63, 00014 Helsinki, FINLAND)
8I 9
Summary of work: We followed the success of medical
and dental students during the first two terms. The methods
included interviews, comparison of results from faculty
student selection and first year exams, analysis of student
evaluations of courses, PBL sessions and teachers.
Educational skills of tutors were also evaluated.
M McLean and J Botha* (Department of Experimental and Clinical
Pharmacology, Nelson R Mandela School of Medicine, Pvt Bag 7,
Congella 4013, SOUTH AFRICA)
Aim: To determine whether first year students in a problembased learning (PBL) curriculum were able to recognise
unprofessional behaviour among different individuals (e.g.
students, staff, health care workers) with whom they had
contact during their medical studies.
Summary of results: The differences in exam performance
between PBL groups were not explained by the skill or
popularity of the tutors. Instead, the results of medical
students were fairly consistent and were strongly correlated
to their success in the faculty admission exam. The results
of dental students displayed much greater variation and
weaker correlation to the faculty student selection exam.
The variation between PBL group performances was
mostly explained by differences in the results of their dental
student members. Some of the dental students
experienced the teaching as medical student-centered and
attitudes of some teachers discriminating. The dental
students had also poor knowledge of their possible
professional tracks, which is reflected in their low interest
in Ph.D. education.
Summary of work: A PBL curriculum, with early clinical
exposure, was implemented at the Nelson R Mandela
School of Medicine in January 2001. At the end of the 2001
and 2002 academic years, a survey was undertaken to
determine whether students had witnessed unprofessional
behaviour during their studies. Students were also asked
to identify anyone who epitomised professionalism.
Summary of results: Both cohorts of students recognised
unprofessional behaviour among their colleagues, senior
students and Faculty staff members. They were particularly
critical of the disrespectful manner in which some health
care workers treated patients. Of the individuals selected
as epitomising professionalism, students generally
identified Faculty staff members.
Conclusions/take home messages: Thus re-evaluation and
correction of attitudes among teachers and better
integration of outstanding dental professionals in early
education might have critical impact on the motivation and
success of the preclinical phase dental students.
8I 8
Is unprofessional behaviour recognised by first
year problem-based learning students?
Conclusions/take home messages: With early exposure to
the practice of medicine in PBL, first year students need to
be formally introduced to the concept of professionalism
in medicine. Faculty should also recognise staff members
who are identified by students as epitomising
professionalism, as these staff members could serve as
role models.
Problem based learning at Marilia Medical School
Ricardo Shoiti Komatsu (Faculdade de Medicina de Marilia Directoria de Graduacao, Marilia Medical School/Famema, Rua
Monte Carmelo 800, 17519-030 Marilia SP, BRAZIL)
– 4.101 –
Section 4
8I 10
Teaching and learning for what? Curriculum change
and the challenge to produce doctors better
equipped to serve community health needs
8I 11
Trevor Gibbs* and J Grossman (University of Cape Town, Faculty
of Health Sciences, Cape Town, SOUTH AFRICA). To be presented
by M Alperstern.
DIPOL® (Dresden Integrative Problem-Oriented
Learning): a problem-based, interdisciplinary
patient and student-oriented curriculum covering
Year 1 and 2, Medical Faculty, TU Dresden
A Morgner, M Witt, M Kasper, A Deussen, V Zürich, T Kriegel, R
Scheibe, J Oehler, H E Krinke, S Albrecht, F Schönhöfer, G
Tchitchekian and P Dieter* (Medical Faculty TU Dresden,
Studiendekanat, Fetscherstrasse 74, D-01307 Dresden,
GERMANY)
Introduction: In 1994 the Faculty of Health Sciences at the
University of Cape Town South Africa adopted a Primary
health care approach as the guiding principle for its
curriculum. In 1999 the Faculty adopted commitments to
Problem Based Learning (PBL) as the primary method of
instruction and to systematic development of communitybased learning. These decisions represented decisive
change and commitment to better serving the actual health
needs of the society around us.
Aim: Years 3 to 6 of the Dresden medical curriculum have
been redesigned in alliance with Harvard Medical School,
incorporating case-based PBL-, practical- and clinical
courses and primary care in an interdisciplinary way. Here,
we present the design of a problem-based, interdisciplinary,
patient- and student-oriented curriculum covering Year 1
and 2 (Basic Sciences).
The Faculty claims a proud record of technically excellent
training, but has acknowledged historical complicity in
prioritising the health needs of a privileged minority.
Summary of work: The reform is focused on 3 main goals:
1) “Get Students Started” (finding/filling gaps of knowledge
in Biology (B), Chemistry (C), Physics (P), 2)
“Interdisciplinary Courses”, and 3) “Integration of Clinical
Medicine (CM) and Medical Psychology/Sociology (MPS)”.
The design includes 4 modules, in which inappropriate
redundancies are eliminated, and topics, goals and
teaching modes are coordinated. Module 1 (Basic
Sciences) includes B, C, P; Module 2 (Patient & Doctor)
includes CM, MPS, Medical Terminology (MT) (training
of students to gain communication skills and to obtain
patient’s history); Module 3 (The Human Body I) is run by
Anatomy (ANA), CM (combines anatomy with physical
examination skills and clinical seminars); Module 4 (The
Human Body II) is organized by Physiology (PHY),
Biochemistry (BC), ANA, MPS with integration of specific
clinical aspects, and comprises interdisciplinary blocks
with a) regulation of cell and organ function, b)
neurofunctions and behaviour, c) seeing, hearing, taste
and smell, and d) applied physiology and biochemistry.
Aims: To explore the process of change in relation to the
guiding principles, considering its challenges for both
teachers and learners. We pursue this aim in the context,
since 2002, of implementation of a new PBL driven
curriculum.
Summary of work: Using surveys, design team reviews,
participant observation, group discussions and interviews
we consider the following:
• what steps have been taken to ensure better-equipped
teachers and learners;
• what does the evidence to date suggest about the
effectiveness of those steps;
• what major obstacles have become evident during the
implementation;
• what steps are suggested in dealing with these obstacles.
Results and take-home message: There is a set of tensions
between stated commitments and actual implementation.
These highlight continuing key obstacles in educating
medical students to better serve community health needs.
Conclusions: A “preclinical” curriculum is designed which
addresses potential starting problems of medical students
with natural sciences, integrates structure- and functionoriented sciences, and links basic skills of clinical medicine
with life sciences.
Session 8J: Postgraduate Education
8J 1
Progress in paradigm shift: the RCPSC CanMEDS
implementation survey
their priority areas for further support. Qualitative analysis
of the 192 codable comments received identified 18%
positive statements, 18% less favourable responses, and
60% described needs or suggestions for further
implementation.
J R Frank*, G Cole, C Lee, N Mikhael and M Jabbour (Royal College
of Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa,
Ontario K1S 5N8, CANADA)
Background: In 1996, the Royal College of Physicians and
Surgeons of Canada (RCPSC) adopted a new framework
for specialist education called the 7 CanMEDS Roles. This
has come to be highly influential around the world, but little
is known about its implementation in postgraduate
programs in Canada.
Conclusions: There has been significant progress in
implementing the new RCPSC CanMEDS framework in
Canada.
8J 2
Specialist registrars’ views on training in non-clinical
competencies
Aims: To (i) evaluate the implementation of the CanMEDS
Roles in specialty programs in Canada, and (ii) identify
priorities for support of further implementation.
Kathryn Gunn*, David Wall and Robert Palmer (West Midlands
Deanery, PO Box 9771, Birmingham Research Park, 97 Vincent Drive,
Edgbaston, Birmingham B15 2XE, UK)
Summary of work: Web-based survey of Canadian specialty
program directors (PDs), specialty committee chairs (SCs),
and postgraduate deans (PGs). Data were analyzed both
qualitatively and quantitatively. Proportions were compared
using the X2 statistic.
Background: The importance of training in non-clinical
competencies for junior doctors is being increasingly
recognised by trainers. This study has determined the views
of specialist registrars (SpRs) themselves.
Summary of work: A one in four sample of all SpRs in the
West Midlands Deanery completed a questionnaire listing
10 competencies; they stated the importance of these
skills, the best timing for training and the method of delivery.
The competencies included understanding of the NHS,
management, leadership and team-building.
Summary of results: The overall response rate was 62% (n
= 572). Perceived knowledge of the CanMEDS Roles was
greater among PGs than SCs and PDs (p<.05).
Implementation of the 7 physician Roles stratified into 3
tiers (p<.05 for all groups). Respondents rated educational
objectives, teaching materials, and evaluation methods as
– 4.102 –
Section 4
Summary of results: There were 164 responses (58%),
with good representation of the specialties and the different
years of training. Training in all competences was
considered important with interpersonal skills scoring
higher than those relating to the organisation of the NHS.
The proposed year for training and the importance of the
subject were inversely related (r=0.70, p<0.02). Training
blocks of one or two days were preferred to other options.
The preferred mode of delivery was the interactive seminar
with on-line learning being the least desirable. There was
ambivalence about training in multi-professional groups.
8J 5
Mette Engholm Dremstrup (Aarhus AMT, Lyseng Alle 1, 8270
Hoejbjerg, DENMARK)
Background: The Office of Postgraduate Medical
Education, County of Aarhus, Denmark, monitors the quality
of postgraduate education of medical doctors. This
presentation describes one of several instruments:
Administration of evaluation at clinical wards.
Conclusions/take home messages: This study shows that
SpRs view non-clinical competency skills as core training.
It is important that a curriculum is properly established and
that the training and assessments match it closely. The
postgraduate deaneries have a central role in its delivery.
8J 3
Summary of work: Evaluation of the wards is based on a
mandatory national standardized questionnaire filled out
by postgraduates in specialist training. It passes through
different levels of administration, from the ward to the
political administration.
Summary of results:
• Evaluation system from postgraduates to wards has been
established.
• All levels of specialist training were involved by requesting
comments on results.
• Difficult to estimate response rate.
• Anonymity in relation to wards was impossible.
Introduction of an e-learning course of health
economy in Hungarian Postgraduate Medical
Education
Anna Bukovinszky*, Gábor Biró, Tibor Ertl and Arpád Gógl (Centre
for Postgraduate Education, University of Pecs, Medical Center,
Szigeti u. 12, 7624 Pecs, HUNGARY)
Background: The new residency programme was
introduced in Hungary in 1999 and since then more than
1,500 physicians have participated in the obligatory course
of health economy. The course – in the form of traditional
lectures of 40 hours – has been delivered at 4 university
sites. Since the residents are placed in more than 100
teaching hospitals, their travel expenses amount to a
substantial sum, and it was most desirable to design a
unified and common curriculum with the participation of
the experts of the four Hungarian Medical Schools.
Summary of work: Our aim is to present how we have
planned to introduce a new, e-learning course built in the
trunk education of the residency programme. The course
is based on the relevant topics of health management,
health law, ethics, quality insurance and health
administration. The authors are requested to develop the
learning materials in an integrated, interactive form
adopting information technology. The software/hardware
environment for e-learning has already been established
by a former project.
The administration procedure of the questionnaires has
made it difficult to identify the response rate. This limits the
possibility of commenting on the actual impact of the
evaluation on the clinical wards.
Conclusions/take home messages: The creation of the
evaluation from postgraduates to wards has increased
attention to the specialist training on all levels: The ward,
the hospital and the political administration. We expect
this to have a positive influence on the education supplied
by the wards.
8J 6
An evaluation of the role of the Pre-registration
House Officer tutor
Pramod Luthra* and Catherine Smith (North Western Deanery, The
University of Manchester, 4th Floor, GMWDC, Barlow House,
Minshull Street, Manchester M1 3DZ, UK)
Aims: This project aimed to evaluate the benefits to PreRegistration House Officers (PRHOs) of the appointment
of a Tutor to address the specific needs of this grade of
doctor in training. It evaluates the effect of the appointment
by the North Western Deanery of 14 PRHO Tutors at 13
hospital sites across the North West Region. PRHO Tutors
were introduced to support the existing role of the
Postgraduate Clinical Tutor in managing PRHO education,
training, and raising the profile of PRHOs and providing
pastoral support where necessary. The North Western
Deanery recognised the high level of training and support
needed by PRHOs and the difficulty of Postgraduate
Clinical Tutors in fully meeting these needs in addition to
those of the other training grades.
Conclusion: In comparison with the traditional oral
presentation, our course provides all the advantages of
distance learning. In addition, as the result of an interuniversity collaboration, it will be available for every
Hungarian medical trainees.
8J 4
Administration of the postgraduate doctors’
evaluation of educational functions supplied by
clinical wards
New ways of teaching basic surgical trainees: the
experience of the Yorkshire School of Surgery
Margaret Ward*, Zoe Fleet, Mark Lansdown and Mike Gough
(Postgraduate Department, 2nd Floor, Ashley Wing, St James’s
University Hospital, Leeds LS9 7TF, UK)
Summary of work: Between March 2002 and December
2002, the impact of a PRHO Tutor was evaluated using
structured interviews and questionnaires of key
stakeholders in the 13 Trusts with a Tutor and a sample of
Trusts where no PRHO Tutor was appointed. Specific note
was made of the impact of the Tutor on PRHO teaching
programmes and attendance at teaching sessions.
Aim: To present alternative ways of providing teaching to
surgical SHOs on a regional basis.
Summary of work: The Yorkshire School of Surgery was
set up in 2000 to provide formal supervision and a structured
educational programme to 150 SHOs on the 3-year
rotation. Teaching took the form of half-day release. The
reduction in junior doctors’ hours and the move towards
shift working meant these sessions were no longer viable.
The new programme provides local teaching, together with
centrally organised compulsory education weeks. Each
SHO attends 2 teaching weeks per year. Two pilots have
been run to date, both of which were well evaluated.
Summary of results/conclusions: The project has
concluded that the role of PRHO Tutor is generally
considered to be sufficiently effective to be a worthwhile
addition to the Postgraduate Clinical Tutor in addressing
PRHOs’ educational and pastoral needs. Its conclusions
have led to the formulation of a set of recommendations
for PRHO Tutors, to enable them to share their own best
practice and use their role to maximum effect. These
conclusions and recommendations will also assist in the
decision as to whether to place PRHO Tutors at other
teaching hospital sites. The introduction of the PRHO Tutor
has impacted upon the quality of PRHOs’ education, the
Conclusions: This is proving to be an effective method of
ensuring the SHOs receive appropriate teaching and may
form the regional model for the surgery programme under
‘Modernising Medical Careers’.
– 4.103 –
Section 4
extent and delivery methods of their teaching, the ability to
address individual PRHO’ difficulties, and provided a
specific forum for the discussion of all PRHO-related
issues.
8J 9
Uladzimir Adaskevich (Medical University, Department of
Dermatovenereology, Frunze str. 27, 210602 Vitebsk, BELARUS)
The project has been supported by the North Western
Deanery’s ‘Blending Service With Training’ Initiative.
8J 7
Background: Postgraduate training in the Republic of
Belarus is conducted at five medical universities. The
departments of dermatovenereology (DV) at these
educational institutions provide their residents with special
programs for specializing in DV which last from 1 to 3 years.
But in most European countries the program of
postgraduate training in DV envisages a four year course.
Our aim was to work out approaches on the way of unifying
the postgraduate training in DV in Belarus and bringing it
into line with European guidelines.
The tasks of an internist: how well prepared are
trainees?
D J Davis*, A M Skaarup and C Ringsted (Copenhagen Hospital
Corporation Postgraduate Medical Institute, H:S PMI, Bispebjerg
Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, DENMARK)
Summary of work: Danish postgraduate medical education
is evolving to include training in 7 aspects of competency.
As a baseline to evaluate reforms, we surveyed trainees in
Internal Medicine departments in Copenhagen. Trainees
rated (scales 1-10) comfort levels and usefulness of the
introduction year as preparation for 23 tasks in internal
medicine.
Summary of results: 162 trainees returned the survey (80
men, 82 women). 103 had completed an introduction year.
Most respondents had comfort levels of >6 for acute illness,
inpatient care, heart and lung auscultation skills, and
neurological examination skills. Comfort with
ophthalmoscopy was low. Trainees felt reasonably
comfortable speaking with patients or relatives about
serious illness or stopping treatment, but less comfortable
talking about palliative care, medical error, unexpected
events, or difficult ethical situations. Respondents felt
reasonably comfortable with tasks related to the roles of
health advocate, leader, manager, but less comfortable
with the role of scholar. Comfort levels increased between
training levels. Women had lower comfort levels than men
in 9 tasks but found the introduction year more useful.
Conclusions/take home messages: Overall, the introduction
year was not perceived as useful in preparation for most of
the tasks addressed in this survey. Reforms in postgraduate
medical education should improve some of these
weaknesses.
8J 8
Summary of work: A special questionnaire has been
designed and send to all educational institutions in Belarus
responsible for postgraduate teaching in DV.
Summary of results: Replies were received from all medical
universities. According to them 20-22 residents are annually
specialized in DV under the guidance of experienced
professors. The postgraduate training in DV is conducted
according to a unified program recommended by the
Public Heath Ministry. The training is exercised on the base
of corresponding DV dispensaries which are multi-profile
institutions. The respondents consider that the system of
postgraduate training in DV must consist of two stages: 2
year clinical intership + 3 year research studentship at the
clinical base of the corresponding medical university.
Conclusions: Postgraduate training which lasts for 1 or 2
years is not sufficient for being specialized in dermatology.
A changeover to a four year training course is necessary
for which a special program it to be worked out.
8J 10 Assessment of the medical sign-out in postgraduate
training in obstetrics and gynaecology
Jeroen van Bavel*, Fedde Scheele, Casper Jansen and Bart Wolf (St
Lucas Andreas Hospital, Coornhertstraat 12, 2013 EW Haarlem,
NETHERLANDS)
Aim: To assure continuity of medical care, sign outs
(morning rounds) are of increasing importance. We show
our approach for an improvement of the quality of the
clinical morning sign out in an Obstetrics & Gynaecology
setting.
A new and innovative postgraduate programme in
clinical pharmacology
J Botha*, A Gray and M McLean (Department of Experimental and
Clinical Pharmacology, Nelson R Mandela School of Medicine, Pvt
Bag 7, Congella 4013, SOUTH AFRICA)
Summary of work: We designed a yardstick, reviewed by
experts, for the assessment of the quality of the sign out
measuring a combination of structure and medical
content. The structure is composed of a general outline,
prioritisation of patient cases and conciseness of
presentation. The medical content is scored on lists with
minimally required clinical items of patients in the right
order. Sign outs were recorded on audiotape for two months
and analysed by two separate investigators. Co-variants
were year of training and sex of the registrars.
Aim: In South Africa during 1998, drug expenditure
accounted for 11.7 and 36.6% of the recurrent health
budget in the public and private sectors, respectively. This
presentation reports on a Masters programme in Clinical
Pharmacology aimed to promote the more rational and
cost-effective use of drugs.
Summary of work: The course, for doctors and pharmacists,
involves drug selection based on evidence of efficacy,
safety, suitability and cost. It encourages problem-solving
skills and clinical application of knowledge. Prescriptions
of new students and those already in the programme were
compared.
Summary of results: All 10 exposed students agreed with
the statement “I found this new approach to learning very
different from my undergraduate courses”. They all
indicated that they had gained up-to-date pharmacology
knowledge, which they were able to apply better. Ninety
percent made use of computer resources (CDs and
internet searches), compared with 54% of the 12 new
students. Students exposed to the course cited their new
competence to critically review papers and assess
evidence as highlights. They reported an improved ability
to select drugs and prescribe rationally.
Post-graduate training in dermatovenereology in
Belarus: current status and problems
Summary of results: An interim analysis of 24 sign outs
shows that the designed measurement instrument is a
useful tool. The overall quality of sign outs is moderate.
The lowest scored items were the general outline and the
prioritisation of patients. The order of the clinically required
items scored fair.
Conclusions: In particular the structure of the medical
morning sign out deserves to be an important issue in the
training of registrars.
8J 11 Assessment of the medical sign-out in postgraduate
training in pediatrics
Casper Jansen*, Bart Wolf, Jeroen van Bavel and Fedde Scheele (St
Lucas Andreas Hospital, Department of Pediatrics, Postbus
9243, 1006 AE Amsterdam, NETHERLANDS)
Conclusions: This programme appears to develop critical
thinking and a more analytical approach to using drugs
rationally in the face of limited resources.
Aim: To assure continuity of medical care, the sign out
(morning report) is of increasing importance. We show
– 4.104 –
Section 4
our approach for an improvement of the quality of the sign
out in a pediatric setting.
and emotional care, a mentoring programme was started.
Five years later, a written survey was performed amongst
21 and 14 mentors, and 22 and 13 registrars in Paediatrics
and O&G, respectively.
Summary of work: We designed a measuring instrument,
reviewed by experts, for the assessment of the quality of
the sign out. This tool measures a combination of both
structure and medical content. Points were given for
general outline, priority of patient cases and conciseness
of presentation. The medical content was evaluated by
means of purpose-made lists with a minimum of required
items in the right order. Twenty sessions were recorded on
audiotape and analysed by two separate investigators. Covariates were year of training and sex of the registrars.
Summary of results: Responses were achieved from 10/21
and 7/14 mentors and from 14/22 and 9/13 registrars. Less
than half of the contacts between mentor and registrar were
organised in a structural way. 81% of the mentors and 55%
of the registrars experienced confidentiality. Differences in
position did not affect the mentorship according to 88% of
the mentors and 56% of the registrars. In the Paediatric
department 80% of mentors and 42% of registrars
answered that emotional reflection was adequate and 80%
of mentors and 29% of registrars believed that the
mentorship added to a safe educational environment.
Summary of results: An interim analysis of 20 sign out
sessions shows that the measuring instrument is a useful
tool. The overall quality was moderate. The lowest scored
items were the general outline of the sign out and the
establishment of priority of patient cases. The order of the
clinically required items scored fair.
Conclusions/take-home messages: The structure of the
medical sign out deserves to be an important issue in the
training of registrars.
Conclusion/take home message: In order to succeed, a
mentoring programme for registrars should be well
structured and contain clear agreements on confidentiality.
Achievable goals should be set and regularly evaluated.
8J 14 Continuity clinic in gynecology and obstetrics
Antonio Dávila* and Claudia Hernandez (Escuela de MedicinaTecnologico de Monterrey, Av Morones Prieto 3000 pte,
Consultorio 206, CP 64710 Monterrey, MEXICO)
8J 12 The role of the logbook in the training of
gynaecologists in the Netherlands: time for change?
S Mahesh*, F Scheele and B H M Wolf (St Lucas Andreas Hospital
Amsterdam, Department of Gynaecology and Obstetrics, Jan
Tooropstraat 164, 1006 AE Amsterdam, NETHERLANDS)
The continuity clinic in gynecology and obstetrics is an
academic-assistential program with the fundamental
objective of providing to all residents in training an
ambulatory private environment during their training period,
supervised by a highly qualified clinical professor-tutor. A
consultant professor-tutor is assigned to residents from
the first year of their residency and they will finish their
ambulatory rotation when their residency program has been
completed. The resident will be exposed to an excellent
ambulatory medical care model where he/she can
intervene and manage, during the training period, a
preestablished population of patients. In addition the
resident will acquire experience in the clinical and
administrative procedures needed for the establishment
of a private office for women’s healthcare.
Aim: To show the results of a survey concerning the use
and improvement of a logbook for Dutch registrars in
Obstetrics and Gynaecology.
Summary of work: All Dutch registrars in Obstetrics and
Gynaecology were asked to answer a questionnaire
divided into 3 main categories: daily use, its role in
assessment and possible improvement of the logbook. A
five-point scale was used. Co-variables were year of training
and type of teaching hospital.
Summary of results: 269 questionnaires were sent out. The
response rate after six weeks was 55% (156). The logbook
was: (a) in 70% regularly updated, (b) in 55% never used
for appraisal, (c) in 45% used for authorisation, (d) in 55%
used for self-assessment and (e) in 70% used to evaluate
the number of learning moments in a rotation. 80% of the
registrars were in favour of its renewal.
8J 15 A study on prescription-writing of the interns in
Bandar Abbas School of Medicine
O Safa, Sh Zare and R Amiri* (Hormozgan University of Medical
University, Office of Vice-Chancellor for Education and Research,
Shahid Mohammadi Hospital, Jomhoori Eslami Blvd, PO Box
79145-4545, Bandar Abbas, Hormozgan, IRAN)
Conclusions/take home messages: About half of the Dutch
registrars in Obstetrics and Gynaecology do not use the
logbook adequately. Our plan for the future is to introduce
a portfolio. This study suggests that portfolio learning can
only be introduced with proper guidance and motivation of
both registrars and teaching professors.
Background: In Iran, medical students are taught
pharmacology within the stage of physio-pathology through
a four-unit course. They get familiar with prescription-writing
during training stage in hospital wards, however, they have
difficulties in prescrption-writing.
8J 13 Pitfalls in postgraduate mentoring
Summary of work: Since there is not a course entitled
“prescription-writing”, the newly-admitted interns
underwent a study in 2001. They were divided into two
groups. The test-group was taught prescription-writing and
drug-interaction before begining the internship stage while
the control group was not.
B Wolf*, F Scheele, J Roord and J van der Schoot (SLAZ,
Amsterdam, Department of Mother and Child Health, St Lucas
Andreas Ziekenhuis, PO Box 9243, 1006 AE Amsterdam,
NETHERLANDS)
Aim: To show the evaluation of a mentoring programme
for registrars in Paediatrics and Obstetrics & Gynaecology
(O&G) in Amsterdam.
Results and Conclusion: The comparison of the two
groups shows that students do not have enough information
regarding drug-prescription and drug-interaction and
undertaking a course or a workshop before internship stage
is necessary.
Summary of work: As teaching professors were judged
inadequate for the supervision of personal development
– 4.105 –
Section 4
Session 8K: Staff Development
8K 1
Training of teachers in general/family practice – 20
years of experience
In conclusion, the poster seeks to raise awareness of the
range of activities that LTSN-01 is involved in and how we
can offer support to teaching staff in veterinary medicine
but also in dentistry and medicine too.
M Vrcic-Keglevic*, W Betz, P Heyerick, Z Jaksic, P Owens, H Tiljak
and I O Virjo (“A.Stampar” School of Public Health, Medical School,
University of Zagreb, Rockefellerova 4, 10000 Zagreb, CROATIA)
The course “Training of Teachers in General/Family
Practice”, is held annually at the Inter-University Centre in
Dubrovnik. The course was established by the members
of the first Leeuwenhorst group in 1983. It offers the unique
opportunity for the teachers in General Practice (GP)
coming from different countries with different health care
systems and cultural backgrounds, to get together and
share ideas in an environment that is as educationally
stimulating as it is visually stunning. The main aims of the
course are: promotion of learning by experience, exploring
the common ground of GP as a specific medical discipline
and fostering social relationships to promote collaborative
work. The format of the course is non-directive, and for
some participants, GP teachers, this is their first exposure
to meaningful learning which is practice-based, where the
content is tailored to the needs of an individual and draws
on prior experience. Until now, seventeen different topics
were discussed and 517 participants from 25 countries,
mostly European, participated in the courses.
8K 3
F Christ*, O Genzel-Boroviczeny, T Aretz, E Armstrong and R Putz
(LMU Anesthesiology, Marchioninistr.15, 81377 Munchen,
GERMANY)
Aim: To asses the impact of professional faculty
development courses designed by the LMU Munich
Medical School and Harvard Medical International to
create more self-directed teachers with a higher degree of
commitment to the organizational change.
Summary of work: A nine-question survey was sent to 414
participants in the nine courses since 1997.
Summary of results: All (92/92; 23% return rate) benefited
from the workshop and would recommend it to others. Most
attended out of personal interest (64/73) or because of
recommendation by colleagues (39/73), whereas only (6/
73) were sent by the department head. On a scale of 0
(strongly disagree) to 5 (strongly agree) the attendants
stated that the course improved their teaching skills (3.7),
moderately influenced the network in the university (2.7)
and had advanced their career to some degree (2.4). It did
however not improve their interaction with patients (1.8).
The majority (70/73) would attend an advanced level
workshop of faculty training.
At the beginning, the topics are predominantly educational
– developing educational module by formulating objectives,
choosing methods, tools, and defining evaluation and
assessment. Afterwards, discussion is concentrated on
teaching and learning about the working methods used in
everyday GPs’ work. The last stage is concentrated on the
content specific for GP. Different educational methods that
have been employed through the courses will be presented
and the collected experience will be shared with
Conference participants.
8K 2
Conclusion: These findings indicate that there is a high
level of interest in faculty development workshops directed
at teaching, resulting in significant perceived benefits to
individual faculty members and change in teaching
behavior.
Enhancing learning and teaching in veterinary
medicine
Sarah Marshall (LTSN-01, Learning and Teaching Support
Network, Subject Centre for Medicine, Dentistry and Veterinary
Medicine, 16/17 Framlington Place, University of Newcastle,
Newcastle NE2 4AB, UK). To be presented by Gill McConnell.
Individual and institutional impact of professional
development courses for physicians as educators
8K 4
Changing teachers’ roles and responsibilities in a
new interdisciplinary learner-centered curriculum at
the Higher Medical Institute – Pleven, Bulgaria
Z Radionova*, T Pencheva, R Gindeva, B Rousseva (University
School of Medicine - Pleven, Department of Physiology, 1 St.
Kliment Ohridsky str., 5800 Pleven, BULGARIA)
LTSN-01 is the Learning and Teaching Support Network
subject centre for medicine, dentistry and veterinary
medicine. The aim of this poster presentation is to highlight
some of the worked carried out by LTSN-01 to enhance
learning and teaching in veterinary medicine. LTSN-01
aims to identify and promote innovation in veterinary
education and share good practice by:
• Answering email and telephone enquiries relating to
L&T
• A website highlighting upcoming educational funding
opportunities and events; features a good practice
database and educational news items
• Releasing small project grants
• A workshop programme including veterinary public
health, virtual learning environments and extra mural
studies
• A newsletter (3 per year)
• Organising conferences and national meetings
• Involvement with national projects e.g. Disability in
Veterinary Education Resources for Sustainable
Enhancement (DIVERSE); Optimising Computer and
Traditional Assessment in Veterinary Education
(OCTAVE); Computer-aided Learning In Veterinary
Education (CLIVE).
A survey of faculty in 2002 showed that the most important
reason for teachers to work on a curriculum change was
the challenge and interest in experiencing something new,
compared to the boredom and disappointment with some
traditional methods of education. The major difficulties
faced in changing the curriculum from a teacher- to a
learner-centered approach were attitudes, and
coordination of programs across departments in an
interdisciplinary, problem-based learning curriculum.
Working together to create clinical cases that matched
instructional objectives was a new and difficult experience
for most teachers. Mastering new methods of teaching
and stimulating students to participate actively in the
learning process was another challenge. Three quarters
of the teachers still have difficulty giving and receiving
assessment/feedback. Workshops organized by the school
have been the most useful way for developing practical
teaching skills. Infrastructure challenges, typical for our
school, country and Eastern Europe (e.g. making copies
of cases, providing a learning environment for students,
access to electronic media, etc.) had to be overcome in
the new settings. Strategies in faculty development and
coordinated leadership between the rector and
departments have enabled significant progress to occur.
Additional examples and details of strategies will be
presented.
Other resources that we offer are examples of evaluated
freely available on-line learning and teaching resources;
FAQs on teaching, assessment, learning environments,
legislation.
– 4.106 –
Section 4
8K 5
Broadening medical teachers’ pedagogical thinking
– an interdisciplinary challenge
Summary of work: Tuebingen started the statewide initiative
in cooperation with the Faculties of Medicine of Freiburg
and Ulm. The training network is affiliated with every dean’s
office in the cooperating faculties in order to ensure that
important functions in support of the training curriculum
will be performed.
Anni Peura*, Juha Nieminen, Eeva Pyörälä and Aija Helander
(University of Helsinki, Research and Development Unit for
Medical Education, PO Box 63, 00014 Helsinki, FINLAND)
Aim: The Faculty of Medicine in Helsinki has arranged
educational training for teachers since 1993. A renewed
course in university pedagogy aims to promote interplay
between educational sciences and medicine. The purpose
was to awaken teachers’ pedagogical awareness,
strengthen a community of teachers, and create
opportunities for collaboration.
Summary of work: It may be difficult for medical teachers to
appreciate pedagogical ideas and to apply them.
Therefore, the goals were to help teachers 1) begin a
process of reflection, 2) understand theoretical knowledge
about learning and teaching, and 3) become familiar with
promising strategies of teaching. The training included
seven one-day and one two-day workshops. The main
themes of the workshops were: conceptions of learning
and teaching, co-operation and interaction in learning
situations, and educational planning and evaluation.
Teaching methods and learning tasks were intended to
support the reflection of participants’ prior experiences and
present competence in the light of educational theories.
Conclusions/take home messages: A meaningful course
requires relevant topics and a confidential environment for
teachers to discuss teaching from theoretical, practical,
and personal viewpoints. The structure of the course,
examples of the learning tasks, and evaluations of the
teaching methods will be presented.
8K 6
Conclusions: Via the statewide network the available
resources and expertise are used more effectively and
efficiently. After successful implementation, sustained
improvement and cooperation in medical teaching are
widely spread.
8K 8
To determine faculty members’ information about
and practice of validity and reliability of exams
P Abedi* and S H Najar (Ahwaz Medical University, Nursing and
Midwifery School, Ahwaz, IRAN)
Aim: To determine awareness and practice of faculty
members about validity and reliability in exams.
Challenging the ‘what works’ culture in medical
education: what kind of research might support the
development of teaching in clinical contexts?
Summary of work: We used a questionnaire with 22
questions about validity and reliability on 100 faculty
members in Ahvaz University. Descriptive statistics were
used for analysis.
Kath Green (Postgraduate Medical and Dental Education, The KSS
Deanery, 7 Bermondsey Street, London, SE1 2DD, UK)
Summary of results: 80% of subjects had prior information
about content validity and half of them closed with split
halves; but only half of the subjects used these methods in
exams.
It has been argued that, in order to improve the quality of
teaching in medical education we need a more ‘rigorous’
approach to research with many more randomised
controlled trials to ‘prove’ which teaching methods ‘work’.
Within the literature, reports on the ‘results’ of various
teaching interventions are common. However, any episode
of teaching is not a stable intervention in its own right but
an ongoing engagement between teacher and learner
which, by its very nature, will vary for any group of learners.
In this paper I will seek to argue that, if our aim is to improve
the quality of teaching in clinical contexts, we need to
develop more detailed and analytical accounts of the
development of educational practice in these settings
thereby allowing readers to gain insights about the
complexities of any teaching encounter with a view to
becoming more intellectually engaged with their own
practice as educators. In presenting these arguments I
will be drawing on the written evidence of my observations
of postgraduate medical teaching in a variety of clinical
contexts over the last four years and my experience of
supporting the action research of educators working in
these settings.
8K 7
Summary of results: The faculty development program
consists of three columns: (1) a basic training program
including two 3-full days trainings, each followed by
(collegial) coaching in real practice; (2) workshops and
seminars for completion and reinforcement; (3) a special
offer of consultant and information service as well as
special events. The successful attendance of the program
(200 units, 45 min each) is rewarded by a ministerial
certificate. Another important incentive is to consider the
participation in faculty development program for the
achievement-oriented funding. Since SS 2000 360
persons were trained. Until 2005 we plan to train at least
300 persons per year.
Conclusion: Despite the acceptable information about
validity and reliability, subjects did not use these methods.
8K 9
The effect of an educational program based on
PRECEDE model on the level of academic advisors’
ability and the medical students’ satisfaction
S M M Hazavehei (Department of Health Education and Health
Promotion, School of Health, Isfahan University of Medical
Sciences, Isfahan, IRAN)
Background: Universities have responsibilities to train,
educate and develop students, as well as prevent any
physical, emotional, social and academic problems during
their study. Therefore universities must offer effective
academic advisory services to students. The purpose of
this study was to investigate academic advisors’ (AAs) ability
and medical students’ satisfaction with academic
guidance.
Summary of work: All 90 AAs and about 2,500 students in
Hamadan University of Medical Sciences (HUMS), 72 AAs
and 445 students from four colleges (Medicine, Health
Sciences, Dentistry, Nursing and Midwifery) voluntarily
participated in a pretest section of the study. 87 AAs and
961 student students randomly participated in the
educational program. The AAs divided randomly into two
groups (1) PRECEDE model Educational Workshop
Program and (2) Educational Material Program). Students
divided into group 1 (n=363 - AAs participated in PRECEDE
workshop program), group 2 (n=408 - AAs received
educational material), and group 3 (n=190; students had
no AAs). Data collection was by questionnaires, pre- and
post-test (after one academic semester of the intervention).
Competence Centre for University Teaching in
Medicine: Tuebingen – Freiburg – Ulm: concept and
experiences with the cooperation project
Maria Lammerding-Koeppel*, U U Haering, Kerstin Mueller, H-D
Hofmann, Hubert Liebhardt and T Mertens (University of
Tuebingen, Faculty of Medicine, Geissweg 5/1, D-72076 Tuebingen,
GERMANY)
Aim: For promotion and reward of higher education, the
dean’s office of the Faculty of Medicine, University of
Tübingen was mandated by the regional ministry in 2000
to develop a faculty development program for medical
teachers integrated with other universities in BadenWürttemberg.
– 4.107 –
Section 4
Summary of results: Mean scores of knowledge
(M=14.77,SD=3.01) and attitude (M=61.79,SD=5.78) of AAs
about offering effective academic advice to the students
increased significantly in group I (n=43), which was more
effective than group II (M=11.54,SD=2.76;
M=59.23,SD=8.6) (n=44), when compared to the pre-test
(M=10.67,SD=4.2; M=57.2,SD=11.6). Comparison of
students’ satisfaction (SS) indicated the level of SS between
the 3 groups of students was significantly (p< 0.0001)
different, but the difference in group I was more than in
other groups. Furthermore, students in group 1 significantly
had more consultation about academic, continuing
education, and job seeking aspects compared to the other
groups.
Conclusion: The PRECEDE model educational workshop
program was more effective for changing AAs’ ability to
give effective academic advice, guidance and consultation.
Summary of results: Fifty two percent of the questionnaires
were returned. Results indicate that the training needs of
teachers have changed since 1994. While up to 30% of
respondents requested workshops on small group teaching
and lecturing skills there was an increase in the demand
for workshops focusing on learning theories,
communication skills and student motivation. The main
barrier to participation in training was lack of time.
This paper will explore the reasons for the change in the
training requirements of teachers.
8K 12 The effects of educational workshops held by EDC
of Tehran University of Medical Sciences on the
participant faculty
S Soheili* and A A Zeinanaloo (Tehran University of Medical
Sciences, Faculty of Medicine, Poursina Avenue, Tehran, IRAN)
Aim: To determine the effects of educational workshops
held by EDC of TUMS on the participant faculty.
8K 10 Registrars still in favour of teaching professors with
sufficient personal attention
Summary of work: The subjects of this cross-sectional
descriptive study were 375 faculty members of TUMS and
the tool for data gathering was a validated questionnaire.
J van de Lande*, F Scheele, B Wolf, D van Vuurden and J Th M van der
Schoot (MCVU, De Boelelaan 1117, 1081 HV Amsterdam,
NETHERLANDS)
Summary of results: About 73.2% of TUMS faculty members
participated in the Teaching/Learning Process workshop,
55% Lesson Planning, 59.8% participated in Student
Evaluation and Test Construction, and 28.1% participated
in Designing the Educational workshop.
Aim: A previous needs assessment amongst registrars in
Obstetrics and Gynaecology (O&G) in 1994 urged us to
assign mentors to care for more personal attention. The
mentor system, however, received unfavourable criticism.
In this presentation the results of a repeated needs
assessment is shown.
Summary of results: The faculty mentioned that they
benefited more from the Teaching/Learning Process
workshop, Lesson Planning and Student Evaluation and
Test Construction in their educational activities. Among
the seven different teaching methods, they chose the
workshop as the most suitable method. The faculty
members suggested that it would be better for them to
participate in workshops that were held in the morning
and in the summer.
Summary of work: A questionnaire was sent to all 276 Dutch
registrars in O&G. Three open questions were asked to
appraise the skills and attitudes of their ‘ideal’ teaching
professor. The answers have been divided in four
categories: clinical knowledge, surgical skills, educational
skills and attitude, including giving personal attention to
the registrars.
Summary of results: 110 out of 276 registrars responded:
67% of the answers fell in the attitude category, 22% in
educational skills, 9.4% in clinical knowledge and 0 percent
in surgical skills. Only 1.6% of the answers could not be
evaluated. These results resemble those from the previous
survey in 1994.
Conclusion/take home message: The needs of the Dutch
registrars in O&G do not show important changes over
time. Sufficient personal attention remains the most wanted
quality in their teaching professor. Simply assigning
mentors appeared to be an inadequate solution.
Conclusions: Adult learning is most effective when it is
related to perceived needs, and the faculty members
consider the workshop as a tool for the improvement of
their educational skills.
8K 13 Which faculty teaching skills require improvement?
– a comparison of faculty and student perceptions
Neena Natt*, Charles H Rohren and Jayawant N Madrekar (Mayo
Graduate School of Medicine, Mayo Clinic, 200 First St SW,
Rochester MN 55905, USA
Aim: To compare faculty and student perceptions of faculty
teaching skills that could benefit from further training. To
use the results to design a faculty teaching skills course.
8K 11 Identifying the training and development needs of
teachers in a medical school
Summary of work: A questionnaire addressing a broad range
of faculty teaching skills was sent to all medical students
(n=168) and a random selection of medical school faculty
(n=150). Using a 5-point Likert scale and open-ended
format, faculty and medical students were asked which
faculty teaching skills they believed would benefit from
further training.
Mairead Boohan (Queen’s University of Belfast, Medical
Education Unit, Room 145 Whitla Medical Building, 97 Lisburn
Road, Belfast BT9 7DL, UK)
Background: The School of Medicine at QUB offers a wide
range of faculty development programmes. This
programme was developed following a survey of the
training needs of staff in the Medical School in 1994. Recent
feedback from participants indicates that the programme
is no longer meeting their training requirements.
Summary of results: 126 (75%) medical students and 95
(63%) faculty returned completed questionnaires. When
compared to faculty, medical students believed that faculty
could benefit from further training in the areas of test
question-writing, giving lectures, and teaching in the
inpatient setting (p <0.05). Qualitative analysis of the
opened-ended question revealed that almost 30% of
students believed that over-use of technology in lectures
detracted from the learning. When compared to students,
faculty believed that they could benefit from further training
in the areas of promoting critical thinking and establishing
a positive learning environment (p <0.05).
Summary of work: To identify the current training needs of
staff a 15 item postal questionnaire was sent to staff in the
Medical School.
The questionnaire was designed to identify the:
• training needs of staff contributing to the design, delivery
and evaluation of undergraduate medical education at
QUB
• most convenient time(s) of the day to deliver workshops
• optimum duration of workshops for clinical teachers
• barriers to participating in training programmes.
Conclusion: The differences between faculty and student
perception of teaching skills highlights the importance of
surveying both groups when designing faculty development
courses.
– 4.108 –
Section 4
8K 14 Assessment of academic staff evaluation program
and open ended questions about the evaluation process.
To increase the reliability and validity of the questionnaire,
it was piloted first. It was distributed and then collected by
the researchers.
N Zarghami, B Rahimi* and R Mokari (Tabriz University of Medical
Sciences, Department of Medical Education Development Centre,
Tabriz University of Medical Sciences, Tabriz, IRAN)
Summary of results: The findings of this study revealed that
64% of academic staff was male and 36% was female.
35.65% indicated no knowledge of an existing evaluation
process during teaching. 44.33% indicated lack of
commitment for implementation of an evaluation process
and 47.19% indicated lack of commitment of the authorities
and disadvantages of evaluation. 63.5% of academic staff
agreed to be evaluated at the end of courses and 70%
agreed to take part in educational workshops as a feedback
system.
Background: The teaching capability of academic staff has
a significant relationship with their awareness of the
educational process and the evaluation program. It is
necessary that academic staff are aware of their own
teaching capability and are able to improve continuously
the quality of their practice.
Aim: To determine an evaluation program for academic
staff.
Summary of work: The subjects of this analytical descriptive
study include 70 of 150 academic staff of Urmia University
of Medical Sciences who responded to questionnaires.
Initially a questionnaire was prepared, containing closed
Conclusion: It is speculated that evaluation could improve
teaching skills.
Session 8L: Students
8L 1
To cure or not to cure? Career choices of final year
medical students in Germany
for vocational reasons. In their opinion, doctors have a
professional position which, through their work, gives them
humanistic and existential rewards. The majority of
students state that medical studies are difficult, complex,
stressful but interesting and if they had the opportunity again,
they would make the same choice.
Goetz Fabry* and Niko Michaelis (Department of Medical
Psychology, University of Freiburg, Rheinstrasse 12, 79104
Freiburg, GERMANY)
Aim: It is said that a growing percentage of medical students
– roughly 50% at the moment – are not going to work
clinically but in alternative fields e.g. pharmaceutical
industry, business consultancy or media. By using a
questionnaire we asked medical students in their last year
(“Praktisches Jahr” - PJ) if they had already decided where
they were going to work after their exams. We were
especially interested in reasons and motives if students
decided to work in alternative fields and asked for attitudes
to clinical work.
8L 3
Ana Marchandón A (Universidad de Chile, Cesar Cascabel 4385,
Dpto 51, Las Condes, Santiago, CHILE)
Background: With the aim of contributing to the
methodological elements that guide the training of the
medical student, an exploratory study was carried out on
the sociodemographic characteristics of the young people
who enter the educational experience during 1998-2002.
Summary of work: Many different reasons might be
responsible for the “brain drain” in alternative occupational
fields. Deteriorating working conditions in hospitals and
private practices namely the increasing proportion of
bureaucratic tasks as well as the overall dominance of
financial considerations seem to blur the perspective of
working with patients. With our survey we want to clarify
how students come to career decisions. The results of our
presently accomplished survey will be presented and
discussed.
Summary of work: A sample of first year medical students
who took part in the annual course on ‘conceptual and
practical basis of medicine’ was obtained.
During this period quantitative and qualitative instruments
were applied and the results and conclusions will be
presented.
8L 4
8L 2
Students’ expectations of medicine, on the medical
role and its formation: 1998-2002
The motivation of medical students for their
university career
Ethnic diversity and intercultural medical experience
at Erasmus Medical Centre Rotterdam
V J Selleger*, B Bonke and Y A M Leeman (Department of
Educational Sciences, University of Amsterdam, Spoorstraat 6,
3743 EG Baarn, NETHERLANDS)
M Diez, A F Compañ*, J Medrano, R Calpena and M T Pérez Vázquez
(University Miguel Hernández, Departamento de Patología y
Cirugía, San Juan de Alicante, SPAIN)
Aim: To discuss research on the influence of a mixed
student population on intercultural curriculum experiences
of medical students.
Aims: The main aim of this study is to find out what motivates
students to choose a medical career and if this motivation
changes during the time they are at the Faculty of Medicine.
Summary of work: In December 2001, first-year medical
students filled out a questionnaire on ethnic background,
religion and mastery of languages. In March 2003, twelve
of these were interviewed extensively about how Erasmus
Medical Centre deals with intercultural education and
about contacts between students of different backgrounds.
Summary of work: A questionnaire was given to students at
the Faculty of Medicine of the University Miguel Hernández
during different academic years. We studied 260 valid
questionnaires. The results were analyzed using the Chisquare test.
Summary of results: Response was 90% (277/308; 63%
females); 18% were first or second generation ‘non-western
immigrants’, which outrated the 5% found in a national
survey on medical students; 8% were ‘western immigrants’.
Immigrants had their roots in 30 foreign countries and spoke
26 different languages. 48% of responders had no religious
denomination, 33% were Christians, 7% Muslims and 3%
Hindus. The interviewed students (6F/6M, with varying
backgrounds) mostly felt they were treated equally; several
feared they had lower chances to enter medical
Summary of results: Many students had always thought
about choosing a career in Medicine (34.61%). The most
important motive for studying medicine was vocational
(84.23%). When medical students get to know the
professional medical world, for 53.07% of them, the image
they have of their professional role is the same as it was
before they started studying Medicine.
Conclusions: We concluded that the majority of medical
students from our Faculty decided on a career in Medicine
– 4.109 –
Section 4
8L 5
specialisation. Most students wanted more education in
intercultural medicine. They appreciated intercultural
contacts in small scale education. Between lectures,
immigrants of different origins did mix, but less often than
with native Dutch students.
the weak student-teacher relationship outside the
classrooms. Analysis of the Middlesex Questionnaires
showed that the psychological states, which satisfy the
diagnostic criteria for a disorder, were not operative as a
cause of the students’ underachievement.
Conclusion: A mixed student population facilitates, but does
not guarantee, professional intercultural experience.
Conclusions/take home messages: We recommend great
attention to students’ dwellings (‘students’ cities’) and
additional and extensive courses in English language for
junior medical students. Active participation of the students
in the educational process and in cultural and social
activities with their teachers in the Faculty of Medicine is
highly recommended.
Women with authority, men with empathy – gender
equality in medical school in Uppsala, Sweden
Karin Grave and Christine Werner (Uppsala Medical School,
Uppsala, SWEDEN)
Background: Earlier studies of undergraduate students in
medical schools have found that women experience more
mistreatment and gender discrimination than men.
8L 8
A Kuimov*, K Popov, A Antonov and I Kuimova (Selesneva 52-20,
Novosibirsk 630112, RUSSIA)
Summary of work: All medical students in Uppsala, Sweden
(n=680) were asked to fill out a questionnaire about gender
perspective and gender discrimination during education.
Fifty-six percent answered; 60% were females and 40%
males. Fifty-two percent of the women and 27% of the men
believe that there are different requirements on male and
female doctors. A majority of the students think that this
needs to be discussed more during education. Of the
female students, 32% had experienced being ignored
because of their gender, compared to 16% of the males.
Background: The student scientific society (SSS) is a very
important part of high medical education.
Aim: To show different activities of SSS in the common
and clinical education of high degree students.
Summary of work: The students’ participation in SSS is a
strong stimulus for intellectual and professional
advancement. The options of SSS activity are the following:
the examination of difficult patients, panel discussion on
different topics, students’ participation in trials of drugs,
personal scientific work and so on. The important part of
SSS activity is the annual university conference of young
scientists and students, with awards for the best ones. The
best works are published in medical journals and issues.
Seventy-eight percent of the students had at one or several
times experienced stereotypical comments about women
and men. Over 90% of the students answered that biological
differences between the sexes need to be addressed more
during education. The results indicate that a gender
perspective needs to be integrated into medical education.
8L 6
Significance of scientific competitions between
medical students
M M Jafarov* and J J Ergashev (The Department of International
Cooperation, TashPMI, Tashkent, UZBEKISTAN)
Conclusions: SSS is a very effective faculty option to
advance intellectual and medical education and to
introduce the student to clinical practice.
8L 9
Medical scientific competitions were considered as a new
method in the process of education. The goal of this
competition was to determine specialty knowledge. Since
1989 our Institute has been organising medical scientific
competitions. Every year this competition takes place in
different scientific directions and subjects. This year the
competition was devoted to surgery and the students of 46 courses participated. The competition related to two
areas: theoretical knowledge and practical skills. The
winners were given presents and they were invited to the
special surgically gifted groups of TashPMI. These assist
the acquisition of deeper professional knowledge. Such
events have been giving beneficial results.
8L 7
Student Scientific Society – background of clinical
education
The role of the Office of Medical Education in the
Faculty of Medicine of the The role of the Office of
Medical Education in the Faculty of Medicine of the
University of Porto as the interface between high
and secondary education in the medical course
M A F Tavares* and A Bastos (Office of Medical Education, Faculty
of Medicine of the University of Porto, Alameda Hernani Monteiro,
4200-319 Porto, PORTUGAL)
Aim: This work demonstrates the role of the Office for
Medical Education of the Faculty of Medicine of the
University of Porto (Gem-FMUP) in the promotion of the
quality of educational outcomes, by approaching the
transition problems caused by the profound gap existing
between higher and college education.
Summary of work: A multilevel approach and the disciplines
of the study plan, were the foundations of a planned strategy.
A course on study competences specifically directed to
freshman medical students was provided (200 students in
groups of 25), before the start of the 2002-2003 academic
year. A preventive approach was developed in a dynamic
sequence of study strategies, disciplines and
idiosyncrasies leading to academic success. The
multilevel model considers general, specific and personnel
levels. Summary of results: The multilevel model was
approached by general orientations, application and
appropriation and the evaluation data support the
importance of this innovative activity that involved the
disciplines and academic staff of the first year.
Academic underachievement of junior medical
students
Mohamed B Awad (Faculty of Medicine, Zagazig University,
Zagazig, EGYPT)
Background: This study was carried out to explain the first
year medical students’ underachievemen