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Introduction:Good communication skills (CSs) are not only the crux of a good doctor–patient relationship but also the foundation over which any human relationship is based. The aim of this study was to assess the impact of training on CS in Phase I MBBS students in a Government Medical College in West Bengal, India. MaterialsandMethods: One hundred and eighty‑four Phase I medical students were trained on how to communicate properly with their peers, seniors, teachers, college authorities, department staff, patient relatives, and other health professionals. Each participant underwent a set of three assessments (presession, postsession, and late postsession) for both knowledge and skills in CS. After postsession assessment, feedback by the faculties and peers was provided and reflections were obtained from the participants. A prevalidated questionnaire and Gap‑Kalamazoo CS Assessment Form (with some modification) were used for knowledge and skill’s assessment, respectively. At the end of the module, feedback was collected from the participants. Data were tabulated and results were compared and interpreted. Results: Mean score and standard deviation for knowledge assessment were 5.29 ±1.35, 9 ±1.20 and 8.55 ±0.97 in T1, T2, and T3 and for skills’ score were 17.78 ±4.89, 26.32 ±5.04 and 30.77 ±3.66 in SA1, SA2, and SA3, respectively. Most participants showed improvement in T2 with mean improvement score (T2–T1) of 79.57 ±47.25 and mean retention score (T3–T1) of 71.9 ±47.84. About 52% of participants showed deterioration in T3 with late deterioration score (T3–T2) of−4.06±11.42. 33% showed no change in knowledge, i.e., they retained their improvements, whereas 15% showed further improvement. Fifty‑two percent of participants showed skills’ improvement by scores of 7–12, 43% showed retention by 13–18, and late deterioration was shown by 82%, their scores dropped by 0–6. Conclusion: The training module was successfully implemented, and participants appreciated this type of participant centric assessment‑based teaching learning module. They learned about the effective ways of communication in a fun manner and were determined to apply all that they have learned
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INTRODUCTION: Evidence-Based Medicine (EBM) is a discipline when used judiciously and considering the preferences of patients, means benefits in clinical contexts and in health care management. It provides tools for a correct analysis of the scientific literature, which would improve decision-making by clinicians. It is a competition that has been trained at the Faculty of Medicine of the UCM. However, there are no formal measurements of the impact of these courses on the development of EBM competencies. OBJECTIVE: this study aims to carry out a brief analysis of knowledge and skills in EBM of family medicine students. MATERIAL AND METHOD: we applied an instrument - ACE Tool as a descriptive approximation of the management level in EBM in medicine students, who have previously had formal training. This instrument evaluates the different stages of EBM. RESULTS: the statistical analysis has reported a level of performance that qualifies students with results below what is desirable, classifying them as a "novice" level of performance. There are no statistically significant differences according to gender.
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Humans , Male , Female , Clinical Competence , Evidence-Based Practice/education , Students, Medical/statistics & numerical data , Cross-Sectional Studies , Surveys and Questionnaires , Evidence-Based Medicine , Family Practice , Internship and ResidencyABSTRACT
Objectives To design an objective and structured evaluation system for the clinical competence of orthopedic postgraduates in the diagnosis and treatment of distal radius fractures, and to ana-lyze its reliability and validity. Methods 28 orthopaedic postgraduates representing six levels of surgical training were tested for competence in performing surgical approach for distal radius fracture on cadaver specimens during which four measures were used to assess competency: examination of basic theory based on network item bank, objective structured operation assessment,overall assessment and operation examina-tion results. In addition, the time for completion of the surgery was also recorded. Each assessment tool was correlated with the others as well as with the resident’s level of training. Results There was a significant correlation between the seniority of candidates and the score of theoretical examination (F=6.193, P=0.000), the score of structured operation examination (F=6.374, P=0.002), the score of overall assessment (F=2.321, P=0.030), and the passing rate of final operation examination (F=36.300, P=0.000). No significant differ- ences were found between seniority and time to completion of the surgical approach exposure (F=2.282, P<0.073). Conclusions The results of the present study suggested that both theoretical examination and cadaver testing discriminate between novice and accomplished postgraduates. However, although the theo-retical test scores could predict the operational test results, but the theoretical results can not guarantee excellent operational skills.
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OBJECTIVE: To evaluate the ability of health emergency drill for sudden poisoning incidents in Guangdong Province. METHODS: A double-blinded method was used to organize 22 teams in Guangdong Province to conduct a health emergency drill which contained preliminary and repeated drill. The preliminaries contained blind sample analysis,theoretical examination and skills assessment. The repeated drills was desktop network exercise carried out for the teams ranked top 10 in the preliminaries. RESULTS: In the preliminary round,the median( M) of total score among the 22 teams was 72. 5. Among them,blind sample analysis,theoretical examination and skills assessment were 71. 0,61. 4 and 76. 5,respectively. The total score of skill assessment was higher than that of theoretical assessment( P < 0. 05). The passing rate of 22 teams was 68. 2%(15/22),and the failure rate was 31. 8%(7/22). The failing teams all came from the nonPearl River Delta region. The total preliminary scores,passing rate,the total scores of blind sample analysis and skills assessment of the teams in Pearl River Delta Region were higher than that in the non-Pearl River Delta region( P < 0. 01).In the theoretical examination,the scores of detection and investigation were both higher than that of medical rescue( P <0. 05). For the skills assessment,the scores of decision-making,personal protection and poisoning detection were in the top three,the scores of the medical rescue and investigation were relatively low( P < 0. 05). In the repeated round,the M of desktop exercise was 55. 0,passing rate was 20. 0%,and the failure rate was 80. 0%. CONCLUSION: The health emergency response capacity for sudden poisoning incidents in Guangdong Province needs to be improved. The construction of emergency response capacity for emergency poisoning in the non-Pearl River Delta region should be strengthened,especially the training on strengthening theoretical and practical knowledge of poisoning medical treatment and poisoning investigation.
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PURPOSE: The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). METHODS: A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. RESULTS: A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%–48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. CONCLUSION: Pharmacy skills assessment was supported by the majority of respondents.
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Humans , Licensure , Patient Care , Pharmacists , Pharmacy , Schools, Pharmacy , Surveys and QuestionnairesABSTRACT
Objective To understand the status quo of our young doctors' doctor-patient communi-cation and related influencing factors. Methods Among the doctors under the age of 40 in various clinical departments, according to 30% proportion, we randomly selected 32 doctors, and combined with revised Liverpool communication skills assessment scale (LCSAS) and standardized patients (SP), the doctors' ability of doctor-patient communication was evaluated. Descriptive statistics, t test and variance analysis were per-formed by SPSS 21.0 lines. Results The average score of communication etiquette of young doctors was (2.00±0.15), and the average score of their communication skills was (1.74±0.29), and the average score of their communication technical ability was (3.74±0.39). The detection rate of communication etiquette, communication skills and communication skills evaluation (less than 2) was 33.3%, 81.5%, and 85.2%, respectively. Physicians and surgeons' scores in communication etiquette and communication skills dimen-sion had significant difference (P<0.05). Significant difference was found in different ages doctor communi-cation protocol (F=3.641, P=0.028), and 20 to 25 years old doctors' score in communication manners was significantly lower than other ages (P<0.05). There were significant differences in the scores of doctors of different title in communication etiquette (F=4.410, P=0.023), and the trainee doctors' communication etiquette score was significantly lower than the physician and surgeon (P<0.05). Conclusion The commu-nication skills of young doctors in our hospital are generally in the middle state, and their communication etiquette is good, communication skills are general. There are great individual differences. Hospital should begin from those whose communication ability are low, cultivate their biology-psychology-social medicine thinking mode of the doctor-patient relationship , help new employees complete the role transformation , emotion management, and professional commitment, and encourage patients to participate in the medical process, so as to improve the doctors' communication ability in all directions and at different levels.
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ABSTRACT Background Assessments of motor-functional aspects in cerebral palsy are crucial to rehabilitation programs. Objective To introduce the Sarah motor-functional evaluation scale and to report the initial results of its measurement properties. This scale was created based on the experience of the Sarah Network of Rehabilitation Hospitals in the care of children and adolescents with cerebral palsy. Method Preliminary results concerning the measurement properties of the scale were obtained via assessment of 76 children and adolescents with cerebral palsy. Experts' opinions were used to determine an expected empirical score by age group and to differentiate severity levels. Results The scale exhibited a high Cronbach’s alpha coefficient (0.95). Strong correlation was observed with experts’ classification for severity levels (0.81 to 0.97) and with the scales Gross Motor Function Measure and Pediatric Evaluation of Disability Inventory (0.80 to 0.98). Regression analysis detected a significant relationship between the scale score and the severity of the child’s motor impairment. The inter-rater reliability was also strong (intraclass correlation coefficient ranging from 0.98 to 0.99). The internal responsiveness of the scale score was confirmed by significant differences between longitudinal evaluations (paired Student’s t test with p<0.01; standardized response mean of 0.60). Conclusion The Sarah scale provides a valid measure for assessing the motor skills and functional performance of children and adolescents with cerebral palsy. The preliminary results showed that the Sarah scale has potential for use in routine clinical practice and rehabilitation units.
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Humans , Child , Adolescent , Cerebral Palsy/physiopathology , Disability Evaluation , Motor Skills/physiology , Activities of Daily Living , Reproducibility of ResultsABSTRACT
Objective: To assess Accredited social health activists’ (ASHAs) ability to recognize illness in infants aged less than 2 months. Methods: Investigators observed 25 ASHAs conducting 47 visits. Results: ASHA-investigator agreement on the need to further assess infants was intermediate (kappa 0.48, P<0.001). Using IMNCI’s color codes, ASHAs misclassified 80% of infants. ASHAs did not follow home-based newborn care formats and skipped critical signs. Overall ASHA-investigator agreement on diagnosis was poor (kappa=0.23, P=0.01). Conclusion: There is a need for improved training, tools, and supportive supervision.
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Objective: To assess Accredited social health activists’ (ASHAs) ability to recognize illness in infants aged less than 2 months. Methods: Investigators observed 25 ASHAs conducting 47 visits. Results: ASHA-investigator agreement on the need to further assess infants was intermediate (kappa 0.48, P<0.001). Using IMNCI’s color codes, ASHAs misclassified 80% of infants. ASHAs did not follow home-based newborn care formats and skipped critical signs. Overall ASHA-investigator agreement on diagnosis was poor (kappa=0.23, P=0.01). Conclusion: There is a need for improved training, tools, and supportive supervision.
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Objective To investigate doctor-patient communication skills status and the influencing factors so as to pu forward to develop the proposal.Methods We selected undergraduate students in fourth grade which participated in the 2012 Shanghai Jiaotong University School of Medicine OSCE examinations before practice of clinical medicine by cluster sampling 1 and we selected four western and chinese medicine hospitals randomly sample 2,which are three level of first-class hospitals in Shanghai.We design the questionnaire and observe sampling with the SEGUE framework.Application of SPSS 13.0 data for statistical analysis,descriptive statistics analysis,u test,t test,ANOVA,rank sum test and correlation analysis method.Results The test with SEGUE framework shows that the scores of samplingl were 12.54 points(out of 24),the score rate is low which was 52.25％,and in the score rate of the dimensions,the end of inquiry dimension is 4％ which is the lowest.There are significant statistical differences between different groups of influencing factors such as Medical occupation interest score and so on.There is no statistically significant difference between the SEGUE score of traditional Chinese medicine and western medicine clinical Intern.The communication skills of western medical students are higher.Doctor-patient communication skills related factors such as recognition of the importance of doctor-patient communication skills and other groups are statistically significant,the correlation coefficients are very small which is between 0.1 and 0.3.Conclusion The overall level of doctor-patient communication skills on clinical internship are not high,through the guidance and training on the occupation interest of medical students,we can strengthen the recognition of the importance of doctor-patient communication skills,so that we will improve the doctor-patient communication skills for the medical students.SEGUE framework should be used to routine medical students communication skills evaluation.
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・We visited the National Board of Medical Examiners and the Clinical Skills Evaluation Collaboration Center to discuss with the examiners the present state of the USMLE （United States Medical Licensing Examination）, to which clinical skills evaluation has been introduced.<br>・Evidence that the introduction of clinical skills evaluation to the USMLE has affected the reform of medical schools curricula in the United States supports the necessity of introducing clinical skills evaluation to the Medical Board Examination of Japan.
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PURPOSE: To evaluate the clinical performance through the Korean Medical Licensing Examination clinical skills assessment (KMLE CSA) this survey was done. METHODS: A survey of 130 interns and residents (46 applicants and 84 non-applicants for the KMLE CSA) at a university hospital in Seoul was conducted in January and February 2012. The data were gathered using a structured and self-administered questionnaire. For the items that assessed the clinical performance of these subjects, we selected 15 items that are mostly frequently used by Delphi's technique, and difficult procedural skills based on the results of medical students' performance. We also used subcomponents of the clinical problems test of the KMLE CSA. RESULTS: The total score on the KMLE CSA improved by 1.33 points (a perfect score is 10), 1.49 points for procedural skills, and 0.84 points for clinical problems by multiple regression analysis. The variables that influenced clinical skills were sex (females had 0.86 more points than males), experience in military or public services (1.04 points higher than persons without experience), and type of school (graduates of medical school had 1.41 more points than graduates of professional graduate school). CONCLUSION: Implementation of the KMLE CSA improved the clinical performance of medical graduates.
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Humans , Clinical Competence , Licensure , Military Personnel , Schools, Medical , Surveys and QuestionnairesABSTRACT
En el presente trabajo, de tipo exploratorio-descriptivo, se propuso realizar una modificación del Test de Habilidades Cognitivas de Solución de Problemas Interpersonales para niños (EVHACOSPI), de García Pérez y Magaz Lago. Estas modifcaciones suponen un enfoque centrado en los recursos psicológicos propios de la psicología positiva. En este estudio participaron 30 escolares, con edades entre los 7 y los 9 años, quienes provienen de contextos de vulnerabilidad social. Los resultados señalan que, en la mayoría de los casos, los niños(as) identificaron correctamente las pautas de solución, hallaron difcultades para describirlas y visualizaron consecuencias emocionales positivas. Se concluye que la versión modificada del test podría utilizarse como complemento de la versión original y contribuir a la evaluación y promoción de las habilidades de solución de problemas.
This exploratory and descriptive study presents a modification of the EVHACOSPI test developed by García Pérez and Magaz Lago and intended to evaluate children's interpersonal problem-solving cognitive abilities. These modifications draw upon a Positive Psychology approach which brings together psychological resources. The responses were obtained from a sample of 30 children aged 7-9 from poverty-stricken contexts. The findings suggest that most children were capable of identifying solutions, had dificulties describing them and displayed positive emotional consequences. The study concludes that the modified version of the test can be used as a complement of the original version and can contribute to the evaluation and development of problem-solving abilities.
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Child , Child, Preschool , Interpersonal Relations , Problem Solving , Psychometrics/methods , Child Development , Decision Making , Emotions , Primary PreventionABSTRACT
Introduction: Health educators and accrediting bodies have defined objectives and competencies that medical students need to acquire to become a safe doctor. There is no report in Malaysia, about the ability of medical students to perform some of the basic surgical skills before entering the houseman ship. The aim of this study is to determine whether the teaching/ learning methods of practical skills in our undergraduate program have been effective in imparting the desired level of competencies in these skills. Methods: A list of basic practical skills that students should be competent has been identified. These skills are taught in a structured way and assessed as part of the composite end- of- semester examination. Practical skills stations form part of an Objective structured practical examination (OSPE). Results: The results of 244 students who participated in three ends of semester examinations were analyzed. The mean score for the practical skills stations were higher than the mean OSPE (of all 18 stations) and overall score (of the written, practical and clinical examination). However the failure rate in the practical skills stations is higher in most of the stations (7 out of 8 stations) compared to overall failure rates. Conclusions: In spite of the formal skills training many students failed to demonstrate the desired level of competencies in these stations. Assessment of practical skills as part of overall composite examination may not be effective in ensuring that all students have achieved the required level of competency. Practical skills should be assessed through dedicated formative assessments to make sure that all the students acquire the required competencies.