[The Danish introductory position provides a qualified choice of specialty]. / Introduktionsstillingen giver et godt grundlag for kvalificeret specialevalg.

The Danish introductory position is unique. It is placed between internship and the main part of specialist education. Workplace-based assessment according to central objectives is central. The purpose of the introductory position is twofold: the resident is introduced to the specialty - the specialty choice is thus based on a context-based personal experience, and the specialties can assess the potential and suitability of the resident. Also opportunities for career counselling are strengthened. In this way both choice of specialty and selection into the specialties is qualified.

[High standards of educational climate in Danish anaesthesiological departments]. / Godt uddannelsesmiljø inden for anæstesiologien.

For the first time since the implementation of the Danish national medical educational reform in 2004 the effects on the educational programme are investigated by means of a nation-wide questionnaire. Mandatory concepts introduced with the educational reform such as supervisor involvement, appraisal meetings and personal learning plans are almost completely implemented in the anaesthesiological departments. Doctors, who do not currently undertake specialist training, were also contented with the implementation. The educational climate is reported to be of high standards. Hopefully, this survey can inspire other specialities to identify how education can be improved.

[Rater bias in postgraduate medical education]. / Bedømmerbias i speciallægeuddannelsen.

In-training assessment is a cornerstone in outcome based postgraduate medical education. When assessing the trainee the trainer should be aware of potential pitfalls and biases and how to avoid these. This paper summarises assessor biases and pitfalls and gives recommendations on how to avoid these.

[Implementation of a national training assessment programme in anaesthesiology]. / Implementering af nationalt kompetenceprogram i anaestesiologi.

INTRODUCTION: In 2004, outcome-based education and in-training assessment was introduced by a reform of postgraduate medical education in Denmark. An assessment programme covering the introductory year of anaesthesiology was constructed. The purpose of this study was to explore to which degree this programme was implemented in daily practice in the clinical departments and whether the recommended assessment protocol was followed. MATERIALS AND METHODS: A questionnaire was distributed to 26 departments and 38 trainees. RESULTS: The response rate for both groups exceeded 90%. Individual learning plans were prepared by (2/3) of the trainees according to both trainees and departments. The various methods in the assessment programme were implemented to a high degree. The use of structured clinical observations was reported by more than 70% of both groups. Global assessments were applied in more than 70% according to both groups. Fifty percent of the trainees and 70% of the departments reported that these were used in accordance with recommendations. The trainees profited from preparing the written assignments, but only half of them found that they were used in accordance with recommendations. In contrast, more than 90% of the departments reported that the assignments were implemented according to recommendations. Practical completion of in-training assessment was considered difficult by 67% of the departments and 30% of trainees. The workload was the primary difficulty reported. CONCLUSION: In conclusion, the in-training assessment programme of the introductory year of anaesthesia has been implemented to a high degree and the assessment protocol is used according to recommendations.

[Are Danish medical students concerned about their future job? A questionnaire study]. / Er danske medicinstuderende bekymrede i relation til deres fremtidige virke? En spørgeskemaundersøgelse.

INTRODUCTION: Knowledge about the thoughts of Danish medical students regarding their job future is limited. The aim of this study was to investigate whether medical students are concerned about their future work, and if so, to describe the types of concerns they have, to what degree they are concerned, possible reasons for and consequences of their concerns; furthermore, to evaluate if gender and semester influate on the concerns. METHOD: A questionnaire was developed based on focus group interviews with medical students. The questionnaire was sent to 596 medical students from 3rd, 8th, and 13th semester at Copenhagen University. RESULTS: The response rate was 69.9%. A substantial number of students (47-90%) were very concerned or concerned to a certain degree with regard to aspects of working life that related to the patient and working conditions. A positive relation was seen between being highly concerned or concerned to a certain degree and daily or often worrying. Possible causes of the concerns were related to their experience through their clinical stays, the curriculum, comments about the job made by medical doctors and others and their own personality. Every sixth student had considered leaving university or refraining from entering clinical training due to these concerns. CONCLUSION: Medical students from 3rd, 8th, and 13th semester are concerned about their future work, especially in relation to the patient, regarding, for example, the risk of committing an error or being incompetent in relation to practical skills, but also work-related concerns are mentioned.

[Skills in management, co-operation and communication in the Pre-Registration House Officership]. / Faerdigheder i ledelse, samarbejde og kommunikation i turnusuddannelsen.

INTRODUCTION: In aviation, it has been realised that technical training ensures competence in specific procedures, but does not counter errors due to communication or decision making in a dynamic environment. As a consequence, Crew Resource Management, consisting of training in co-operation, management, and communication skills, was introduced in order to serve as a countermeasure towards human errors. In the same way, medical school ensures academic and technical insight, but rarely offers systematic training in such non-technical skills. The aim of this study is to identify the standard of competence in skills of co-operation, management, and communication at the end of the Pre-Registration House Officership. METHOD: 30 skills of management, co-operation, and communication divided into five main areas were identified. Using the Delphi method through two rounds of questionnaires, an expert panel of 50 doctors evaluated six different standards of competence for each skill. RESULTS: The Panel reached consensus at a 75% level for five skills, all within the main area "Team communication in the acute situation". Consensus was not reached within any of the other four main areas. None of the 30 skills was evaluated as being irrelevant for the Pre-Registration House Officer by more than one panel member. CONCLUSION: There was broad agreement on the need for high standards of competence within the area of team communication. There was considerable disagreement within the panel with regard to the other main areas, but all of the skills listed in this study were found relevant to the Pre-Registration House Officer in the acute situation.