Genital examination training: assessing the effectiveness of an integrated female and male teaching programme.

BACKGROUND: Learning to undertake intimate female and male examinations is an important part of medical student training but opportunities to participate in practical, supervised learning in a safe environment can be limited. A collaborative, integrated training programme to provide such learning was developed by two university teaching departments and a specialist sexual health service, utilising teaching associates trained for intimate examinations in a simulated clinical educational setting. The objective of this research was to determine changes in senior medical students' self- reported experience and confidence in performing male and female genital examinations, before and after participating in a new clinical teaching programme. METHODS: A quasi-experimental mixed methods design, using pre and post programme questionnaires and focus groups, was used to assess the effectiveness of the programme. RESULTS: The students reported greatly improved skill, confidence and comfort levels for both male and female genital examination following the teaching programme. Skill, confidence and comfort regarding male examinations were rated particularly low on the pre-teaching programme self- assessment, but post-programme was rated at similar levels to the female examination. CONCLUSIONS: This integrated female-male teaching programme (utilising trained teaching associates as simulated patients in a supervised clinical teaching environment) was successful in increasing senior medical students' skills and levels of confidence in performing genital examinations. There were differences between female and male medical students in their learning. Suggestions for improvement included providing more detailed instruction to some clinical supervisors about their facilitation role in the session.

Transition: health professionals as medical students.

BACKGROUND: It has long been acknowledged that health professionals who retrain as doctors make a significant contribution to the medical profession. Having a background as a health professional sets this group apart from the other medical students, including mature students. It is therefore important to understand more about how health professionals adapt to their role as medical students. METHODS: A qualitative approach was adopted, in which interviews were conducted with 12 of the possible 30 medical students who met the inclusion criterion: namely that they were or had been registered health professionals. FINDINGS: The most common driver to retrain was a desire to seek a fresh challenge, and they described their previous roles as limited; however, returning to student status after life as an autonomous health professional was initially very uncomfortable. Once they loosened their grip on their previous role and embraced life as a medical student the students eventually realised that, irrespective of their previous health profession, they had a set of core professional abilities that they could bring to their role as a doctor. DISCUSSION: There has been considerable focus on the support required for mature students, graduate students and students from disadvantaged backgrounds. Little attention has been afforded to the experience of health professionals as medical students. This category of individual already possesses a wealth of experience, knowledge and attitudes relevant to health care work. This experience should be built upon so that the transition from 'expert' to 'novice' is as comfortable as possible for all parties. Health professionals who retrain as doctors make a significant contribution to the medical profession.

Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme.

INTRODUCTION: Interprofessional education (IPE) has been shown to enhance interprofessional practice among health professionals. Until recently there has been limited opportunity to undertake such initiatives within existing pre-registration degree courses in New Zealand. AIM: This study aimed to test the feasibility of delivering an interprofessional component within existing health professional courses for medicine, physiotherapy and dietetics at the University of Otago, Wellington, New Zealand. METHODS: An interprofessional case-based course component (on chronic condition management) was developed by academic clinical teachers from schools of medicine, physiotherapy and dietetics at the same location. Evaluation was undertaken using a previously validated pre- and post-survey tool, to ascertain changes in attitude among students towards interprofessional practice, IPE and the effectiveness of health care teams. Focus groups were conducted with students and teachers. RESULTS: Survey results indicated pre-existing positive attitudes to interprofessional practice and education among students. There was a statistically significant increase in positive attitude towards such practice and education, and increased confidence in the effectiveness of heath care teams. Focus group findings were consistent with the survey results for students, and highlighted challenges experienced by the teachers. DISCUSSION: Students and teachers alike enjoyed the interprofessional interaction and benefited from a collaborative approach to chronic condition management. The timing and nature of learning activities and assessment methods created logistical challenges. Such course components have potential to improve collaborative practice and the quality and safety of health care among graduates. Interprofessional course components need to be equitable across disciplines and embedded in the unidisciplinary courses.

Developing the One-Minute Preceptor.

BACKGROUND: Learning from experienced doctors in real clinical settings is very important for medical students. However, the busy and at times unpredictable nature of clinical work means that clinical work must take priority over teaching. What clinicians want is to be able to offer quality learning experiences for students without significant disruption to their clinical work. CONTEXT: In the context of medical education, students are learning in a variety of physical locations. These various locations require different sets of teaching skills. This article describes how as faculty educational developers we worked with clinicians to enhance their role as teachers within busy clinical contexts. More specifically, we will describe how we augmented an established programme of travelling workshops for clinical teachers by incorporating the key principles associated with the development of the One-Minute Preceptor. INNOVATION AND IMPLICATIONS: We combined classroom training with observation of teaching in the clinical area, and by doing so were more able to translate classroom theory into authentic workplace practice.

Mum's the word: factors that influenced young adults' participation in the New Zealand Meningococcal B immunisation programme.

AIMS: To identify the factors that influenced young adults (aged 16-19 years) when deciding whether or not to be immunised during the MeNZB campaign. METHOD: Semi-structured interviews were held with 11 young adults (7 who consented to the Meningococcal B immunisation and 4 who did not) to explore their immunisation decision. A qualitative descriptive data analysis was then undertaken to reveal the latent and manifest themes arising from the interviews. RESULTS: Similar influences on the decision-making process were described by all the young adults, regardless of the outcome. These included weighing up the risks involved, and making collaborative decisions with their families, especially their mothers. Situating the decision in a personal context required the young adults to consider factors such as needle-phobia, herd immunity, and the accessibility of the immunisation. CONCLUSION: The information used in immunisation campaigns involving young adults must be carefully balanced so that the situation becomes real to the target group, while also helping inform others, especially parents, who will be involved in the decision-making process.