Views of professionalism: a veterinary institutional perspective.

In many western countries, there has been a marked change in the demographic profile of those entering the veterinary profession, with a shift from a predominantly male to a predominantly female intake. There have been parallel changes in society, with greater emphasis on human rights and work-life balance. It is, therefore, timely to consider what constitutes correct professional conduct for the profession, as there is the potential for problems to arise over the interpretation of 'professionalism' due to cultural and generational differences. A cross-section of staff and students within one veterinary institution were invited to take part in a survey exploring their prioritisation of 10 aspects of the professional role. A cluster analysis was performed, and four distinctly different profiles were established according to the views held by the cluster members. Cluster membership was found to significantly correlate to career stage, with altruism and social justice progressively giving way to professional autonomy and dominance. All four clusters in this educational environment prioritised technical and interpersonal competences above all other aspects of the professional role.

Approaches to defining day-one competency: a framework for learning veterinary skills.

Competency at graduation, in a variety of physical and attitudinal skills, is an essential outcome measure for courses training veterinary surgeons. The approach adopted by the Royal Veterinary College, London, to identify and define the expected skill competencies required of our veterinary undergraduates by the time of graduation is described. In addition, we demonstrate how this skill set was built into a framework that was aligned with other student learning objectives. This two-year project resulted in the publication of a day-one skills handbook, which was introduced to the college staff and students in 2007.

Retention of drug administration skills after intensive teaching.

We have identified deficiencies in medical students' drug administration skills, and we attempted to address them with interactive online teaching modules and simulated critical incident scenarios. Short-term improvements have been evident with this intensive effort, but medium-term retention of skills has not been measured. A drug administration lecture, an online module and a simulated emergency scenario were offered to final year clinical students. None of the teaching was compulsory but participation was recorded, along with students' simulator performances and marks in an objective structured practical examination 9 months later. A poor simulator score predicted a poor performance in the later examination. Participation in the simulated scenario only significantly improved examination scores when supplemented by online teaching (p = 0.002). Intensive drug administration teaching using an online module and high fidelity simulation improves drug administration skills in the medium term. Students found simulation much more engaging than online teaching.

The effect of additional teaching on medical students' drug administration skills in a simulated emergency scenario.

Medical students have difficulty calculating drug doses correctly, but better teaching improves their performance in written tests. We conducted a blinded, randomised, controlled trial to assess the benefit of online teaching on students' ability to administer drugs in a simulated critical incident scenario, during which they were scored on their ability to administer drugs in solution presented as a ratio (adrenaline) or percentage (lidocaine). Forty-eight final year medical students were invited to participate; 44 (92%) attended but only nine of the 20 students (45%) directed to the extra teaching viewed it. Nevertheless, the teaching module significantly improved the students' ability to calculate the correct volume of lidocaine (p = 0.005) and adrenaline (p = 0.0002), and benefited each student's overall performance (p = 0.0007). Drug administration error is a very major problem and few interventions are known to be effective. We show that focusing on better teaching at medical school may benefit patient safety.

Influence of improved teaching on medical students' acquisition and retention of drug administration skills.

BACKGROUND: Drug administration error is a major problem causing substantial morbidity and mortality worldwide. Lack of education about drug administration appears to be a causative factor. We devised an online teaching module for medical students and assessed its short- and long-term efficacy. METHODS: One hundred and thirty clinical medical students were invited to undertake additional, online, teaching about drug administration. Those participating were identified and the number of web pages viewed recorded. The students' knowledge retention was tested by means of drug administration questions incorporated into routine assessments and examinations over the next 6 months. Other indices of all students' performance were recorded to correct for confounding factors. RESULTS: Just over half (52%) responded to the invitation to participate. The amount of interest they showed in the teaching module correlated positively with their performance in questions about drug administration, although the latter waned over time. Surprisingly, correcting for students' general ability and keenness revealed that the less able students were most likely to undertake the teaching module. CONCLUSIONS: Additional online teaching about drug administration improves students' knowledge of the topic but clearly requires reinforcement; however, only about half the students took up the option. Medical students must acquire these fundamental skills, and online teaching can help. Medical educators must ensure that drug administration is taught formally to all students as part of the curriculum and must understand that it may require additional teaching.

A web-based system for teaching, assessment and examination of the undergraduate peri-operative medicine curriculum.

Today's students are generally computer literate and have high expectations of university information technology resources. Most United Kingdom medical schools now provide networked computers for learning, research, communication and accessing the worldwide web. We have exploited these advances to augment and improve the teaching of peri-operative medicine and anaesthesia to medical students in our university, who are taught in several hospitals over a wide geographical area. Course material such as departmental induction information, lecture notes and assessment sheets can be accessed online, contributing to the smooth running of the course. Streamed videos and simulations allow students to familiarise themselves with common practical procedures in advance. Development of a web-based end of course assessment has resulted in substantially less administration and bureaucracy for course organisers and proved to be a valuable research tool. Students' and teachers' opinions of the new course structure have been overwhelmingly positive.

Collusion detection in multiple choice examinations.

OBJECTIVE: To develop and test a novel method for collusion detection in multiple choice examinations. SUBJECTS AND METHODS: Answers from two negatively marked medical prize examinations for two different years were analysed. Both examinations were administered electronically. One examination was formally invigilated, while the second was not; instead, candidates were able to sit the test at any time and at any computer with an internet connection. We examine pairs of students and compare correlations between their answers. Our approach allows us to correct for the difficulty of individual questions and for the estimated ability and the degree of risk aversion of the students. We compare the results of this statistical analysis with other information on the timing of the answers and the physical location of the computer, both of which are available to the web-server. RESULTS: Significant correlation between several candidates who either admitted having cheated or could be linked to other corroborating evidence of collusion was found. CONCLUSION: It is possible to detect collusion in multiple choice examinations in a statistical way by examining the patterns of answers between pairs of candidates. In examinations that are delivered on-line, information is often available on the location of the candidates and the timings of their answers, and can be used as additional corroborative evidence.