ABSTRACT
BACKGROUND: This study explores whether long and short cases performed in the workplace during training could be integrated into an overall summative assessment. Less examiner training and a less formalized structure might compromise reliability, but increased testing time might improve it. METHODS: Results of practice long and short cases, undertaken in preparation for the Royal Australasian College of Physicians clinical examination, were compared with actual examination results. The effects on reliability of the examination were compared by modelling varying combinations of practice and examination long and short cases. RESULTS: Fifty-nine candidates in two centres undertook 256 practice long cases and 154 practice short cases. Two practice long cases correlated with two examination long cases (r= 0.46). The reliability of a single long case was 0.22 under practice conditions and 0.36 under examination conditions. The reliability of a single short case was similar under either condition (0.18 vs 0.21). Reliability of over 0.80 could be achieved by assimilating two examination long cases and four examination short cases with varying combinations of seven practice cases. CONCLUSIONS: Long cases undertaken in the workplace are not as reliable those undertaken under examination conditions, but short cases have similar reliability under either condition.
Subject(s)
Education, Medical, Graduate/methods , Internal Medicine/education , Teaching , Australasia , Clinical Competence/standards , Comprehensive Health Care/standards , Evaluation Studies as Topic , Humans , Reproducibility of Results , Task Performance and Analysis , Teaching/methods , Test Taking Skills/methods , Test Taking Skills/psychology , Time FactorsABSTRACT
Allupurinol is a commonly prescribed drug. However, the use of this drug is not based on evidence and guidelines. We audited Allopurinol prescriptions in patients aged 65 years and over in a teaching hospital over 22 weeks. In 47% of patients the dose was higher than recommended and in 40% it was lower. Quality use of medications is an important issue to maintain quality of life in the elderly.
Subject(s)
Allopurinol/therapeutic use , Drug Utilization Review , Gout Suppressants/therapeutic use , Gout/drug therapy , Aged , Aged, 80 and over , Female , Hospitals, Teaching , Humans , Male , Quality of Health CareABSTRACT
Bed-side teaching is the process of active learning in the presence of a patient. A cross-sectional study was conducted in a teaching hospital to obtain the opinions of clinical teachers about bed-side teaching including perceived hindrances to its implementation. Of 152 teachers, 78% responded to the questionnaire. Ninety-five per cent reported that bed-side teaching is an effective way to teach professional skills. Time constraints, noisy wards and patients not being available were reported as the most frequently experienced hindrances to bed-side teaching. The survey found strong support for bed-side teaching but a substantial number of barriers to its implementation. Further research is required to study methods that will improve bed-site teaching.
Subject(s)
Education, Medical, Undergraduate/methods , Teaching/methods , Australia , Cross-Sectional Studies , Female , Humans , Male , Problem-Based Learning , Surveys and QuestionnairesSubject(s)
Attitude , Names , Patients/psychology , Adult , Female , Humans , Male , Middle Aged , Physician-Patient Relations , Public Opinion , Surveys and QuestionnairesABSTRACT
A cross-sectional study was undertaken to elicit patient and learner opinions about bedside teaching (BST). Only 48% of learners reported that they had been given enough BST during their undergraduate training, while 100% thought BST to be the most effective way of learning clinical skills. Seventy seven per cent of patients enjoyed BST and 83% said that it did not make them anxious. The preferred site for case presentations was the conference room. Further quantitative studies are needed to investigate perceived impediments to BST from the teachers' point of view.
Subject(s)
Attitude , Education, Medical, Undergraduate , Physician-Patient Relations , Students, Medical/psychology , Teaching/methods , Australia , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Professional PracticeABSTRACT
The quality of medical education during internship is a cause for concern. This paper describes a structured educational programme for interns that was based around learning modules, clinical attachments and bedside teaching. The programme was incorporated into the term rotation of interns within an Area Health Service, and evaluated. Learning modules were timetabled by a Programme Coordinator and interns were reminded to attend. Clinical attachments were organized by the interns from a list of willing supervisors. Attendance at timetabled learning modules averaged 67%, which was greater than the 27% attendance at clinical attachments. Both sessions received high ratings for quality and clinical relevance. This structured education programme was based upon adult learning methods and was both feasible and well received by interns. Intern training programmes need to be programmed into the working week to ensure attendance, and modified following evaluation by interns. Such programmes should be considered by all hospitals to which interns are allocated.
Subject(s)
Education, Medical, Continuing , Internship and Residency/organization & administration , Australia , Curriculum , HumansSubject(s)
Accreditation/standards , Foreign Medical Graduates/standards , Australia , Humans , New South WalesABSTRACT
Swallowing difficulties are very common in patients who have suffered cerebrovascular accidents. An inexpensive and simple device called the Palatal Training Appliance was tried successfully in four patients. This appliance could be beneficial for more patients and is under-utilized at present.
