Exploring recent trends (2014-21) in preferencing and accepting Queensland medical internships in rural hospitals.

BACKGROUND: Medical internship is a key transition point in medical training from student to independent (junior) doctor. The national Regional Training Hubs (RTH) policy began across Australia in late 2017, which aims to build medical training pathways for junior doctors within a rural region and guide students, interns and trainees towards these. This study aims to explore preferencing and acceptance trends for rural medical internship positions in Queensland. Moreover, it focuses on internship preference and acceptance outcomes prior to and following the establishment of RTHs, and their association with key covariates such as rural training immersions offered by medical schools. METHODS: Data from all applicants to Queensland Health intern positions between 2014-2021 were available, notably their preference order and location of accepted internship position, classified as rural or metropolitan. Matched data from Queensland's medical schools were added for rural training time and other key demographics. Analyses explored the statistical associations between these factors and preferencing or accepting rural internships, comparing pre-RTH and post-RTH cohorts. RESULTS: Domestic Queensland-trained graduates first preferencing rural intern positions increased significantly (pre-RTH 21.1% vs post-RTH 24.0%, p = 0.017), reinforced by a non-significant increase in rural acceptances (27.3% vs 29.7%, p = 0.070). Rural interns were more likely to have previously spent ≥ 11-weeks training in rural locations within medical school, be rurally based in the year applying for internship, or enrolled in the rural generalist pathway. CONCLUSIONS: The introduction of the RTH was associated with a moderate increase of graduates both preferencing and accepting a rural internship, though a richer understanding of the dominant reasons for and against this remain less clear. An expansion of graduates who undertook longer periods of undergraduate rural training in the same period did not diminish the proportion choosing a rural internship, suggesting there remains an appetite for these opportunities. Overall, domestic graduates are identified as a reliable source of intern recruitment and retention to rural hospitals across Queensland, with entry to the rural generalist pathway and extended rural placement experiences enhancing uptake of rural practice.

Key elements of effective postgraduate GP educational environments: a mixed methods study.

OBJECTIVES: Evidence in the literature suggests that satisfaction with postgraduate general practice (GP) training is associated with the quality of the educational environment. This study aimed to examine GP registrars' level of satisfaction with a distributed model of training in a regional educational environment and investigate the relationship between satisfaction and academic performance. STUDY DESIGN: A longitudinal 3-year study was conducted among GP registrars at James Cook University using a sequential explanatory mixed methods research design. GP registrars' satisfaction was obtained using the scan of postgraduate educational environment domains tool. A focus group discussion was conducted to explore GP registrars' perceptions of satisfaction with the educational environment. SETTING: James Cook University General Practice Training (JCU GPT) programme. PARTICIPANTS: Six hundred and fifty one (651) GP registrars enrolled between 2016 and 2018 at JCU GPT programme. RESULTS: 651 registrars completed the satisfaction survey between 2016 and 2018. Overall, 92% of the registrars were satisfied with the educational training environment. Registrars who had become fellows reported higher satisfaction levels compared with those who were still in training (mean=4.39 vs 4.20, p=0.001). However, academic performance had no impact on level of satisfaction with the educational environment. Similarly, practice location did not influence registrars' satisfaction rates. Four themes (rich rural/remote educational environment, supportive learning environment, readiness to continue with rural practice and practice culture) emerged from the thematic data analysis. CONCLUSION: A clinical learning environment that focuses on and supports individual learning needs is vital for effective postgraduate medical training. This study suggests that JCU GPT programme's distributed model fostered a satisfying and supportive training environment with rich educational experiences that enhance retention of GP registrars in rural/remote North Queensland, Australia. The findings of this study may be applicable to other settings with similar training models.

Role of formative assessment in predicting academic success among GP registrars: a retrospective longitudinal study.

OBJECTIVES: The James Cook University General Practice Training (JCU GPT) programme's internal formative exams were compared with the Royal Australian College of General Practitioners (RACGP) pre-entry exams to determine ability to predict final performance in the RACGP fellowship exams. DESIGN: A retrospective longitudinal study. SETTING: General Practice (GP) trainees enrolled between 2016 and 2019 at a Registered Training Organisation in regional Queensland, Australia. PARTICIPANTS: 376 GP trainees enrolled in the training programme. EXPOSURE MEASURES: The pre-entry exams were Multiple-Mini Interviews (MMI), Situational Judgement Test (SJT) and Candidate Assessment and Applied Knowledge Test. The internal formative exams comprised multiple choice questions (MCQ1 and MCQ2), short answer questions, clinical skills and clinical reasoning. PRIMARY OUTCOME MEASURE: The college exams were Applied Knowledge Test (AKT), Key Feature Problems (KFP) and Objective Structured Clinical Examination (OSCE). RESULTS: Correlations (r), coefficients of determination (R2) and OR were used as parameters for estimating strength of relationship and precision of predictive accuracy. SJT and MMI were moderately (r=0.13 to 0.31) and MCQ1 and MCQ2 highly (r=0.37 to 0.53) correlated with all college exams (p<0.05 to p<0.01), with R2 ranging from 0.070 to 0.376. MCQ1 was predictive of failure in all college exams (AKT: OR=2.32, KFP: OR=3.99; OSCE: OR=3.46); while MCQ2 predicted failure in AKT (OR=2.83) and KFP (OR=3.15). CONCLUSION: We conclude that the internal MCQ formative exams predict performance in the RACGP fellowship exams. We propose that our formative assessment tools could be used as academic markers for early identification of potentially struggling trainees.

Australian University Student Perceptions of Health Messages on Cigarette Sticks.

University students are exposed to casual smoking, increasing their risk of developing nicotine addiction, which can extend into adulthood. A novel anti-tobacco intervention being investigated is the use of health warnings on individual cigarette sticks. We explored the perceptions of university students on the effectiveness of health warnings on cigarette packaging and individual cigarette sticks. An online survey was distributed to first-year university students enrolled at a regional university in North-Eastern Australia. Participants rated on 5-point Likert scales and commented using open-text comment boxes, the effectiveness of current cigarette packaging warnings, and 12 text warnings (divided into four themes; immediate and short-term consequences [ISC], long-term and mortality consequences [LMC], social and financial consequences [SFC], and supportive messages to quit [SMQ]) on individual cigarette sticks, in preventing non-smokers from smoking, and in encouraging current smokers to quit. Participants (n = 479; Mean age = 22 years) rated three themes (ISC, LMC, and SFC) as being overall more effective (all p < .001) than current packaging warnings (Odds Ratios = 5.93 [4.51-7.80], 3.60 [2.79-4.64], and 2.86 [2.21-3.69] respectively). Participants described a desensitisation to current packaging warnings, and the novel warnings displayed potentially overcoming this issue, with over 85% agreeing that individual cigarette sticks should include health warnings. Health warnings on cigarette sticks may serve as an effective means in reducing tobacco use, with the provision of this additional intervention for communicating the health and other negative consequences of smoking likely reinforcing the effects of current packaging warnings.

Smoker perceptions of health warnings on cigarette packaging and cigarette sticks: A four-country study.

INTRODUCTION: Innovations in tobacco control interventions are required to ensure continued reductions in global tobacco use, and to minimise attributable morbidity and mortality. We therefore aimed to investigate the perceived effectiveness of current cigarette packaging warnings and the potential effectiveness of cigarette-stick warnings across four countries. METHODS: An online survey was distributed to adult smokers in Australia, Canada, the United Kingdom, and the United States. Participants rated (using a 5-point Likert scale) and commented on the effectiveness of current cigarette packaging warnings and text warnings on eight cigarette sticks that prompted smokers to quit. Ratings were analysed using proportional odds logistic regression, and comments were analysed using content analysis. RESULTS: Participants (N=678, mean age=44.3 years) from all four countries perceived cigarette packaging warnings as being minimally effective in prompting smokers to quit, citing desensitisation and irrelevance of the warnings, with US participants particularly critical of the text-only warnings. Compared to packaging warnings, the cigarette-stick warnings describing the financial costs of smoking and the effect of smoking on others, were the highest rated in all four countries (OR=3.42, 95% CI: 2.75-4.25, p<0.001 and OR=2.85, 95% CI: 2.29-3.55, p<0.001, respectively) and cited as strong messages to reduce smoking. Half of the participants either 'agreed' or 'strongly agreed' to the use of cigarette-stick warnings. CONCLUSIONS: The findings of this study suggest that cigarette packaging warnings may experience a loss of effectiveness over time, eventually resulting in minimal impact on smoker behaviour. Health and non-health focused warnings and messages on individual cigarette sticks represent a novel and potentially effective method for reducing tobacco use. This would complement tobacco control interventions currently employed, resulting in public health benefits.

Perceived clinical relevance and retention of basic sciences across the medical education continuum.

Medical programs are under pressure to maintain currency with scientific and technical advances, as well as prepare graduates for clinical work and a wide range of postgraduate careers. The value of the basic sciences in primary medical education was assessed by exploring the perceived clinical relevance and test performance trends among medical students, interns, residents, and experienced clinicians. A pilot study conducted in 2014 involved administration of a voluntary 60-item multiple-choice question test to 225 medical students and 4 interns. These participants and 26 teaching clinicians rated the items for clinical relevance. In 2016, a similarly constructed test (main study) was made a mandatory formative assessment, attempted by 563 students in years 2, 4, and 6 and by 120 commencing general practice residents. Test scores, performance trends, clinical relevance ratings, and correlations were assessed using relevant parametric and nonparametric tests. Rank order and pass-fail decisions were also reviewed. The mean test scores were 57% (SD 7.1) and 52% (SD 6.1) for the pilot and main studies, respectively. Highest scores were observed in pathology and social sciences. Overall performance increased with increasing year of study. Test scores were positively correlated with perceived relevance. There were moderate correlations (r = 0.50-0.63; P < 0.001) between participants' scores in the basic science and summative exams. Assessments may be key to fostering relevance and integration of the basic sciences. Benchmarking knowledge retention and result comparisons across topics are useful in program evaluation.

Do health warnings on cigarette sticks dissuade smokers and non-smokers? A focus group and interview study of Australian university students.

Introduction: Young adults are a vulnerable population for experimentation with tobacco, which can lead to lifelong addiction. In an effort to ensure reductions in tobacco use through improved health promotion materials, we explored young adults' perceptions of current Australian packaging warnings, and novel health warnings on individual cigarette sticks. Methods: Focus groups and interviews were conducted with smoking and non-smoking first-year undergraduate university students at a regional Australian university. Semi-structured questions were used to gather participant perceptions. Sixteen students participated across three focus groups, and eleven students participated in the phone interviews. Data were analyzed using thematic analysis in NVivo. Results: Six emergent themes were identified. Current cigarette packaging warnings were seen as ineffective, being disregarded by current smokers (theme 1), and seen as irrelevant by young adult smokers and non-smokers (theme 2). Several cigarette stick warnings were perceived as engaging and effective, due to the novelty of the cigarette stick as a medium (theme 3), and the proximal nature of the warnings used (theme 4). The warning depicting the financial consequences of smoking was considered the most effective, followed by the impact of smoking on personal appearance, and the "minutes of life lost" warning. Social media (theme 5), and the use of more supportive messages to assist smokers (theme 6) were considered the best next steps as tobacco control interventions. Conclusions: Supplementing packaging warnings which were seen as minimally effective in this study, using cigarette stick warnings and social media may lead to further reductions in tobacco use. New and relatable warnings such as the financial consequences of smoking and impact on personal appearance may be the most effective in dissuading young adults from smoking, particularly within the university environment.

Validity of the scan of postgraduate educational environment domains (SPEED) questionnaire in a rural general practice training setting.

BACKGROUND: The educational environment is critical to learning and is determined by social interactions. Trainee satisfaction translates to career commitment, retention and a positive professional attitude as well as being an important factor in assessing the impact of the training program. This study aimed to validate the Scan of Postgraduate Educational Environment Domain (SPEED) tool and assess its appropriateness in evaluating the quality of General Practice (GP) rural postgraduate educational environment. METHODS: A questionnaire containing the 15-item SPEED tool was administered to GP registrars to examine their perceptions of the educational environment. Principal component analysis (PCA) and exploratory factor analysis (EFA) were used to gather evidences of the validity of the instrument based on its internal structure. Additional validity evidence and reliability estimates were obtained using many-facet Rasch model analysis (MFRM). RESULTS: The survey was completed by 351 registrars with a response rate of 60%. Parallel analysis performed using principal component analysis and exploratory factor analysis suggests that the SPEED tool is unidimensional. The MFRM analysis demonstrated an excellent degree of infit and outfit for items and training sites, but not for persons. The MFRM analysis also estimated high reliability levels for items (0.98), training sites (0.95) and persons within training sites (ranging from 0.87 to 0.93 in each training sites). Overall, the registrars agreed that the educational environment had high quality, with most (13 out of 15) of the items rated above 4 out of 5. CONCLUSIONS: This study demonstrated a high degree of validity and reliability of the SPEED tool for the measurement of the quality of the educational environment in a rural postgraduate GP training context. However, when applied in a new setting, the tool may not function as a multidimensional tool consistent with its theoretical grounding.

A systematic review of the perceptions of adolescents on graphic health warnings and plain packaging of cigarettes.

BACKGROUND: Graphic health warnings on tobacco packaging and the plain packaging of tobacco products are key tobacco control interventions. This systematic review investigates the perceptions of adolescents towards these packaging interventions. METHODS: Published, original-research, English-language articles from 1 January 2000 to 1 September 2017 were identified through a systematic literature search of the PubMed, CINAHL, PsycINFO, Web of Science, and Scopus databases. Articles describing investigations into the perceptions of adolescents aged 11 to 19 years towards graphic health warnings and/or plain-packaged cigarettes were included in this review. RESULTS: Nineteen articles, involving 15,935 adolescent participants, of which 72.85% were non-smokers or ex-smokers and 27.15% occasional or daily smokers, met the eligibility criteria. Graphic health warnings were perceived as more effective than text-only warnings, with warnings depicting lung cancer, and oral diseases being perceived as particularly effective. Health warnings increased viewer fear, anxiety, shock, and guilt and were considered effective in preventing non-smokers from experimenting with tobacco and prompting current smokers to quit. Plain packaging reduced the attractiveness and other positive attributes of cigarette packaging, with darker colours found to be the most effective. When used in combination, plain packaging increased the visibility of graphic health warnings, with participants also perceiving them as having an increased tar content and having more serious health risks, and increased thoughts of quitting amongst smokers. CONCLUSIONS: Graphic health warnings and plain packaging appear to increase adolescent awareness of the dangers of tobacco use. Further research into the most effective warnings to use in combination with plain packaging is needed to ensure the greatest reduction in tobacco use and prevent tobacco-attributable morbidity and mortality in this vulnerable population.

Australian community pharmacist experiences with smoking cessation and opinions of health warnings on individual cigarette sticks.

OBJECTIVES: We aimed to identify the experiences of Australian community pharmacists with smokers and their associated perceptions of effective health warnings on individual cigarette sticks. METHODS: A mixed-methods online survey was distributed to Australian pharmacists through pharmacy-specific social media pages, and the Pharmaceutical Society of Australia, followed by semi-structured face-to-face interviews with pharmacists in Townsville, Australia, who were purposively sampled. The interviews continued until data saturation was achieved. Participants described their experiences with smokers, perceptions and effectiveness ratings of current cigarette packaging warnings, and 12 text warnings (divided into four themes) on individual cigarette sticks, and their general opinions on effective anti-tobacco health warnings. KEY FINDINGS: Seventy pharmacists participated in the survey and 17 pharmacists in the interviews. Both groups of pharmacists cited smoking-related personal or close-contact illness, pressure by family members or physicians and the financial costs of smoking as being the main drivers for quit attempts. Most interviewed pharmacists interact with smokers several times per week. Cigarette stick warnings describing mortality consequences (especially the 'minutes of life lost' warning) and the financial consequences of tobacco use were rated as significantly more effective than current packaging warnings (odds ratio [OR] = 2.23; 95% confidence interval [CI]: 1.12-4.12, P = 0.02, and 1.97; 95%CI: 1.01-3.84, P = 0.04, respectively). CONCLUSIONS: Pharmacists have considerable experience assisting smokers with quitting and based on these experiences believe that novel and tangible health warnings on cigarette sticks may be an effective future measure to combat tobacco use. Further research on the opinions of a more diverse range of health professionals and the general community will generate more robust findings regarding this method of intervention.

Australian School Student Perceptions of Effective Anti-tobacco Health Warnings.

Background: Recent research posits that anti-tobacco health warnings on cigarette packaging may gradually lose their effectiveness in dissuading adolescents from tobacco products several years after implementation. Health warnings on individual cigarette sticks represent a novel warning medium, and may further educate adolescents on the dangers associated with smoking, and reduce tobacco experimentation amongst this vulnerable population. Methods: In an online survey of school students in Queensland, Australia, participants were requested to rate (on five-point Likert scales) and comment on the perceived effectiveness of current cigarette packaging warnings, and 12 text warnings on cigarette sticks, in preventing non-smokers from smoking, and encouraging current smokers to quit. The warnings were divided into four themes to establish the most effective types of anti-tobacco messages: mortality statistics, health condition consequences, social and financial consequences, and supportive messages. These themes were based on current anti-tobacco interventions within Australia, and the rising cost of tobacco products, and designed to align with the Health Belief Model. Results: Participants (N = 150; Age = 15-18) from five schools completed the survey, and generally viewed current packaging warnings as gross and disgusting, and rating them as somewhat effective in preventing non-smokers from smoking. Current warnings were however considered less effective in prompting current smokers to quit with participants describing them as being un-relatable to teenagers, and smokers as having become desensitized to the warnings used. One theme of cigarette-stick warning (mortality statistics) was rated as significantly more effective (p < 0.001) than current cigarette packaging, with an odds ratio (OR) of 2.77 (95% confidence interval [CI]: 1.67-4.62). Overall, warnings were considered to be 4.71 times (95%CI: 2.72-6.43, p < 0.001) more effective on non-smokers than on smokers. Over three-quarters of participants supported using health warnings on individual cigarette sticks. Conclusions: Current cigarette packaging warnings have retained some effectiveness in dissuading adolescents from smoking, though novel and thought-provoking text-only warnings on cigarette sticks may serve as an additional intervention in reducing tobacco use. Further research requires identification of the most effective warnings, and the perceptions of a more diverse participant base.

Correction to: Risk factors associated with academic difficulty in an Australian regionally located medical school.

Following publication of the original article [1], one of the authors reported that prior to publication her surname had changed from 'Kerlen' to 'van der Kruk', but that this change had not been incorporated in the final version.

Correction to: Strengthening medical training programmes by focusing on professional transitions: a national bridging programme to prepare medical school graduates for their role as medical interns in Botswana.

Following publication of the original article [1], one of the authors reported that prior to publication her surname had changed from 'Kerlen' to 'van der Kruk', but that this change had not been incorporated in the final version.

A systematic review of smoker and non-smoker perceptions of visually unappealing cigarette sticks.

INTRODUCTION: Cigarette stick appearance can significantly contribute to perceptions of cigarette taste, harm, and appeal, and may be modified to reduce positive perceptions of cigarettes and other tobacco products. A systematic review was conducted to investigate how smokers and non-smokers identify cigarettes as being attractive or unattractive, and the resulting perceptions of cigarette appeal, perceived harm, and impact on quit intentions. METHODS: Eligible articles were identified using database searches conducted with a date range of January 1990 to May 2017 in PubMed, CINAHL, PsycINFO, Google Scholar and Web of Science. Articles were included if they evaluated participant (any smoking status) perceptions of visual cigarette stick attributes. We identified studies describing visual attributes of cigarette sticks and the resulting perceptions of participants. Changes or differences in quitting intentions, cigarette appeal, perceptions of taste, and cigarette harm, and the likelihood of smoking uptake were recorded. Data were grouped into two main categories: those of physical cigarette design, and those including health messages on cigarette sticks. RESULTS: Of the 950 identified non-duplicated records, 9 matched the eligibility criteria. These studies were all conducted in developed countries, and largely enrolled adolescent and young adult smokers and non-smokers. Slim, lighter coloured and branded cigarettes were favoured over longer, broader, or darker coloured cigarettes, and those without any branding or embellishments. Health warnings including 'Minutes of life lost', 'Smoking kills', and the names of carcinogenic constituents in cigarettes, reduced cigarette attractiveness and increased participant quit intentions. CONCLUSIONS: Cigarette appeal and resulting smoking behaviours can be influenced by several visual attributes of individual cigarettes. Unappealing visual attributes of cigarette sticks, including modifications to the size and colour of cigarettes, and the inclusion of health warnings on cigarette sticks may serve as an effective tobacco control method, potentially leading to a reduction in tobacco use.

Risk factors associated with academic difficulty in an Australian regionally located medical school.

BACKGROUND: Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal. METHODS: This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated. RESULTS: The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them. CONCLUSIONS: This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

A collaborative comparison of objective structured clinical examination (OSCE) standard setting methods at Australian medical schools.

BACKGROUND: A key issue underpinning the usefulness of the OSCE assessment to medical education is standard setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard-setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between 10 Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates. METHODS: This research used 5256 examinee scores from seven shared OSCE stations to calculate cut scores and failure rates using two different compromise standard-setting methods, namely the Borderline Regression and Cohen's methods. RESULTS: The results of this study indicate that Cohen's method yields similar outcomes to the Borderline Regression method, particularly for large examinee cohort sizes. However, with lower examinee numbers on a station, the Borderline Regression method resulted in higher cut scores and larger difference margins in the failure rates. CONCLUSION: Cohen's method yields similar outcomes as the Borderline Regression method and its application for benchmarking purposes and in resource-limited settings is justifiable, particularly with large examinee numbers.

Addressing varenicline adherence through repackaging in a dose administration aid.

BACKGROUND: Ensuring adherence to prescribed smoking cessation medications, such as Champix® (varenicline), is essential during a quit attempt as non-adherence can significantly reduce the likelihood of achieving prolonged smoking abstinence. The use of dose administration aids may improve adherence, though medication stability on repackaging is not guaranteed, due to a lack of available data from manufacturers supporting this practice. OBJECTIVE: To determine the suitability for repackaging varenicline tartrate tablets into a dose administration aid, by assessing its physical and chemical stability after being repackaged and stored at ambient conditions for 6 weeks. METHODS: Varenicline tartrate (1.0 mg) tablets were repackaged into commercially available Webster-pak® blister compartments and stored for 42 days at ambient conditions characteristic of a Zone IVB climate (30 ± 2°C and 75 ± 5% relative humidity) according to the World Health Organization (WHO) guidelines on pharmaceutical stability testing. Physical and chemical tests were performed on the repackaged and control tablets, including an assessment of: tablet thickness, hardness, weight uniformity, friability, dissolution, disintegration, and content uniformity after exposure to ambient conditions and light according to International Council on Harmonisation of Technical Requirements of Pharmaceuticals for Human Use guideline Q1B. RESULTS: Weight, friability, and thickness of the tablets complied with compendial standards. A validated high performance liquid chromatography method was used to confirm that after exposure to light, and repackaging at 30°C/75% relative humidity, the tablets remained within the required 95%-105% of the stated drug content. However, tablet hardness and disintegration decreased over time, with tablets becoming softer and undergoing more rapid disintegration in water. CONCLUSION: Repackaging 1.0 mg varenicline tartrate tablets into a dose administration aid can be undertaken to improve adherence rates and therefore smoking abstinence rates. This can be performed without compromising either the physical or chemical stability of the tablets.

Improving assessment practice through cross-institutional collaboration: An exercise on the use of OSCEs.

BACKGROUND: This study was undertaken to improve assessment practice on OSCEs through collaboration across geographically dispersed medical schools in Australia. METHODS: A total of eleven OSCE stations were co-developed by four medical schools and used in summative 2011 and 2012 examinations for the assessment of clinical performance in the early clinical and exit OSCEs in each school's medical course. Partial Credit Rasch Model was used to evaluate the psychometric properties of the shared OSCE data. Evaluation of the quality assurance reports was used to determine the beneficial impact of the collaborative benchmarking exercise on learning and teaching outcomes. RESULTS: The data for each examination demonstrated sufficient fit to the Rasch model with infit mean square values ranging from 0.88 to 0.99. Person separation (1.25-1.63) indices indicated good reliability. Evaluation of perceived benefits showed that the benchmarking process was successful as it highlighted common curriculum areas requiring specific focus and provided comparable data on the quality of teaching at the participating medical schools. CONCLUSION: This research demonstrates the validity of the psychometric data and benefits of evaluating clinical competence across medical schools without the enforcement of a prescriptive national curriculum or assessment.