First aid and basic life support of junior doctors: A prospective study in Nijmegen, the Netherlands.

According to the Dutch medical education guidelines junior doctors are expected to be able to perform first aid and basic life support. A prospective study was undertaken to assess the level of first aid and basic life support (BLS) competence of junior doctors at the Radboud University Nijmegen Medical Centre (RUNMC), the Netherlands. Fifty-four junior doctors (18%), of the medical students in their final years, were submitted to a theoretical test, composed of multiple-choice questions concerning first aid and basic life support. This test was followed by a practical test consisting of two out-of-hospital first aid and basic life support scenarios including cardiopulmonary resuscitation (CPR). In total, 19% of the junior doctors passed the theoretical test. The first scenario was performed correctly in 11%. The CPR situation was correctly performed by 30% of the students as observed by the examiners but when assessed by the checklists of Berden only 6% of the students performed correct CPR. It is concluded that the level of first aid and basic life support of the junior doctors at the RUNMC is low and does not meet the required level as stated in the guidelines for practice of medical education in the Netherlands.

Core characteristics of the competent general practice trainer, a Delphi study.

INTRODUCTION: The specific skills, attitude, knowledge, and personality characteristics, which should define the competent GP-trainer have been subject of research for many years. What are the most important of these characteristics have yet to be delineated. AIM: The aim of this study is to identify which characteristics are prerequisite for a competent GP-trainer. METHOD: A modified Delphi procedure was used to answer the research question. Earlier qualitative research using focus groups identified 43 characteristics defining the competent GP-trainer. These characteristics were the subject of the Delphi procedure in which 48 experts chosen from the entire field of Dutch General Practice Training participated. RESULTS: After two rounds of the Delphi procedure, 37 characteristics were identified as being important for a competent GP-trainer. The characteristics which were ranked as the most important were 1. a competent GP-trainer is good at giving feedback, 2. dares to give feedback, 3. is critical of the GP-trainee and the learning process, 4. is good at communicating with the GP-trainee, and 5. has respect for the trainee. An important new characteristic has been identified: "being able to inspire reflection in the trainee". CONCLUSION: The core characteristics of the GP-trainer as identified in this research project, form a profile for the ideal GP-trainer to be used as a blueprint for objectives of schooling and for the assessment of GP-trainers.

Problem-based learning versus lecture-based learning in postgraduate medical education.

OBJECTIVES: The objective of this study was to investigate the effectiveness of problem-based learning in comparison with lecture-based learning in a postgraduate medical training program concerning the management of mental health problems for occupational health physicians. METHODS: A randomized controlled trial in 1999, with a mean follow-up of 14 months after the educational intervention, was used involving postgraduate medical education and training for occupational health physicians in The Netherlands, with 118 physicians in training as occupational health physicians. The experimental program was based on the principles of problem-based learning; the control program used the traditional lecture-based approach. Both programs were aimed at improving knowledge of and performance in the occupational management of work-related mental health problems. As the main outcome measures, knowledge tests consisting of true-or-false and open-answer questions and performance in practice based on self-reports and performance indicators were used. Satisfaction with the course was rated by the participants. RESULTS: In both groups, knowledge had increased equally directly after the programs and decreased equally after the follow-up. The gain in knowledge remained positive. The performance indicator scores also increased in both groups, but significantly more so in the problem-based group. The problem-based group was less satisfied with the course. CONCLUSIONS: Both forms of postgraduate medical training are effective. In spite of less favorable evaluations, the problem-based program appeared to be more effective than the lecture-based program in improving performance. Both programs, however, were equally effective in improving knowledge levels.