Differences in the Assessed Performance of Medical Interns in a Comparison of Competency-based and Subject-based Curricula: a Qualitative Study

2021 ◽  
Author(s):  
Titi Savitri Prihatiningsih ◽  
Prattama Santoso Utomo ◽  
Hikmawati Nurrokhmanti ◽  
Mora Claramita ◽  
Albert Scherpbier
Keyword(s):  
Medical School ◽  
Information Literacy ◽  
Cultural Awareness ◽  
Clinical Skills ◽  
Working Environment ◽  
Constructive Feedback ◽  
Medical Graduates ◽  
District Hospitals ◽  
Competency Based ◽  
Medical Interns

Abstract Background: An internship is a transitional training period a medical school graduate undertakes prior to attaining full registration as a medical doctor. Numerous studies have shone a light on the unpreparedness of medical school graduates for the realities of medical practice. Implementation of a competency-based curriculum (CBC) is thought to produce better prepared medical graduates because this curriculum is more structured and integrated; moreover, learning outcomes, the learning process, and assessment are better aligned in the cognitive, affective, and psychomotor domains. During 2006–2011, Indonesia conducted a nation-wide reform shifting to a CBC from a subject-based curriculum (SBC) and launched an internship program in 2013. This study aimed to compare the performances of medical interns training under these two different curricula. Methods: This study was conducted in Yogyakarta Province, involving six supervisors and six interns from six different types of district hospitals. Qualitative, semi-structured interview methods, and thematic analysis were applied. Results: In total, 1,296 initial codings were identified and grouped under the following topics: overall experience (327), effective communication (97), scientific foundation (47), clinical skills (48), information management (23), management of health problems (194), self-insight and professional development (351), and professionalism (209). Eighteen themes emerged, namely understanding the internship, authority, practice context, interprofessional communication, patient communication, cultural awareness in communication, gap and fulfillment in clinical skills, knowledge gap and enhanced knowledge, assumption of a General Practitioner role, progression to profiency, information literacy, internal motivation, learning opportunities, constructive feedback, transition, and working culture. There were irregular patterns of performance from both of the CBC and SBC interns. Interestingly, compared with the SBC group, the CBC group revealed less confidence and assertiveness in handling patients. This group also lacked communication skills when interacting with nurses and patients alike. Moreover, the SBC group demonstrated the ability to learn and adapt quickly to the working environment. Neither group paid much attention to information literacy. Conclusion: We cannot conclude that a CBC would yield better prepared medical graduates. The results of this study showed irregular patterns in eight areas. Hospital contexts and variation in the characters of interns might have contributed to this irregularity. More exposure to the working context and greater contributions from the healthcare system are recommended in the medical curriculum, whether it be a CBC or a SBC. WC:338

scholarly journals A comparative assessment of the impact of computer assisted learning of knowledge and skill based competencies among undergraduate students in a medical college in South India

2018 ◽  
Vol 7 (4) ◽  
pp. 612
Author(s):  
Jeyalalitha Rathinam ◽  
Divakar R. ◽  
Subahan S. P. ◽  
Preethi A. ◽  
Vanitha G. ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Clinical Skills ◽  
Integrated Approach ◽  
Computer Assisted ◽  
Medical College ◽  
Medical Graduates ◽  
Study Results ◽  
Competency Based ◽  
Teaching Pattern ◽  
The Impact

Background: Pharmacology has always been one subject ultimatum and a cornerstone in building up competency, based on applied therapeutics among medical graduates in prescribing and practicing skills. A focus on an integrated strategical approach towards teaching pharmacology for better proficiency in achieving clinical skills is mandatory. Thus, this study has been done to assess the impact and retainment of overall knowledge gained on various domains, based on a revised method of teaching in pharmacology.Methods: An observational, questionnaire based comparative study was done in a medical college, in Chennai. The study included two group of students, one who have completed their pharmacology course based on the revised pattern of teaching with a comparative group of students who have not been exposed to the revised pattern of teaching. A feedback survey was also done.Results: The study results indicated that the average scoring based on the questionnaire was 84% with the students who have been exposed to revised pattern of teaching in comparison to the average scoring of 70% with the students who have not been exposed to the new pattern of teaching. The average scoring of the students who were found to agree to several questions on the new method of teaching was 74% and 22% of the students were found to disagree. 4% of students were non responders.Conclusions: The ultimate improvement in the outcome of health care education can be achieved through appropriate skill building through a simple strategical modification of the regular teaching pattern with an integrated approach involving pharmacologists and clinicians. A refresher course in pharmacology in the final year curriculum and CRRI involving pharmacologists is mandatory.

scholarly journals Student Perceived Value of Anatomy Pedagogy, Part I: Prosection or Dissection?

2015 ◽  
Vol 2 ◽  
pp. JMECD.S17496 ◽  
Author(s):  
Jonathan J. Wisco ◽  
Stephanie Young ◽  
Paul Rabedeaux ◽  
Seth D. Lerner ◽  
Paul F. Wimmers ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Student Perceptions ◽  
Medical Curriculum ◽  
Clinical Skills ◽  
School Experience ◽  
First Year ◽  
Biomedical Sciences ◽  
Medical Specialties ◽  
Preclinical Medical Education

A series of three annual surveys of David Geffen School of Medicine (DGSOM) at UCLA students and UCR/UCLA Thomas Haider Program in Biomedical Sciences students were administered from 2010 to 2012 to ascertain student perceptions of which anatomy pedagogy—prosection or dissection—was most valuable to them during the first year of preclinical medical education and for the entire medical school experience in general. Students were asked, “What value does gross anatomy education have in preclinical medical education?” We further asked the students who participated in both prosection and dissection pedagogies, “Would you have preferred an anatomy curriculum like the Summer Anatomy Dissection during your first year in medical school instead of prosection?” All students who responded to the survey viewed anatomy as a highly valued part of the medical curriculum, specifically referring to four major themes: Anatomy is (1) the basis for medical understanding, (2) part of the overall medical school experience, (3) a bridge to understanding pathology and physiology, and (4) the foundation for clinical skills. Students who participated in both prosection and dissection pedagogies surprisingly and overwhelmingly advocated for a prosection curriculum for the first year of medical school, not a dissection curriculum. Time efficiency was the dominant theme in survey responses from students who learned anatomy through prosection and then dissection. Students, regardless of whether interested in surgery/radiology or not, appreciated both pedagogies but commented that prosection was sufficient for learning basic anatomy, while dissection was a necessary experience in preparation for the anatomical medical specialties. This suggests that anatomy instruction should be integrated into the clinical years of medical education.

Appraisal of the Current Pharmacology Curriculum, Teaching Methodology and Effectiveness in Undergraduate Medical Education: A Student-Centric, Questionnaire-Based Study

2021 ◽  
Vol 8 (1) ◽  
pp. 30-33
Author(s):  
Sujit Kumar Sarker ◽  
Geethanjali Bhas ◽  
Priyanka Moitra ◽  
Ratna Paul ◽  
Md. Abdullah Yusuf ◽  
...  
Keyword(s):  
Medical Education ◽  
Cross Sectional Study ◽  
Course Delivery ◽  
Teaching Methodology ◽  
Sectional Study ◽  
Cross Sectional ◽  
Problem Solving Skills ◽  
Medical College ◽  
Constructive Feedback ◽  
Medical Graduates

Background: Periodic students’ feedback ensures and enhances the effectiveness of the curriculum of medical subject. Objective: This study was designed to obtain students appraisal of the undergraduate pharmacology curriculum and teaching methodology. Methodology: This cross-sectional study was conducted in the Department of Pharmacology at Colonel Malek Medical College, Manikganj, Bangladesh from May to June, 2019 for a period of two months. Questionnaire-based data were collected from students of both sexes who had completed 3rd Professional examination. Likert Scale was applied to collect students’ feedback on pharmacology. Results: A total number of 40 students were recruited for this study of which 60.0% students were strongly agreed about organized teaching. About 47.5% students were agreed that the course was appropriate at their level and achieved their goals in Pharmacology. However, 55% of them strongly agreed that teacher provided clear constructive feedback during class. Total 60%, were agreed that the course improved their problem-solving skills. Overall, 55% students were agreed regarding their satisfaction on Pharmacology course delivery and conduction. Conclusion: In conclusion, periodic appraisal from students regarding evaluation of the student-centric undergraduate pharmacology curriculum is vital in developing efficient medical graduates. Journal of Current and Advance Medical Research, January 2021;8(1):30-33

scholarly journals Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

2016 ◽  
Vol 10 (7-8) ◽  
pp. 281
Author(s):  
Kristen McAlpine ◽  
Stephen Steele
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Clinical Skills ◽  
Medical Schools ◽  
Clinical Settings ◽  
Undergraduate Medical Students ◽  
Canadian Medical School ◽  
Competency Based ◽  
English Speaking ◽  
And Training

<p><strong>Introduction:</strong> The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.</p><p><strong>Methods:</strong> This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.</p><p><strong>Results:</strong> A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.</p><p><strong>Conclusions:</strong> To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.</p>

Promoting Fundamental Clinical Skills: A Competency-Based College Approach at the University of Washington

2005 ◽  
Vol 80 (5) ◽  
pp. 423-433 ◽  
Author(s):  
Erika A. Goldstein ◽  
Carol F. MacLaren ◽  
Sherilyn Smith ◽  
Terry J. Mengert ◽  
Ramoncita R. Maestas ◽  
...  
Keyword(s):  
Clinical Skills ◽  
University Of Washington ◽  
Competency Based ◽  
The University

scholarly journals Obstructive sleep apnea knowledge and attitudes among recent medical graduates training in Ecuador

2019 ◽  
Vol 13 ◽  
Author(s):  
Iván Chérrez-Ojeda ◽  
Juan Carlos Calderón ◽  
Andrea Fernández García ◽  
Donna B. Jeffe ◽  
Ilka Santoro ◽  
...  
Keyword(s):  
Medical School ◽  
Latin American ◽  
Educational Interventions ◽  
Categorical Variables ◽  
Clinical Disorder ◽  
Medical Graduates ◽  
Knowledge And Attitudes ◽  
Obstructive Sleep ◽  
Recent Graduates ◽  
Practicing Physicians

Background: We aimed to assess recent Latin American medical school graduates’ knowledge and attitudes about OSA and examine whether their knowledge and attitudes about OSA differed from practicing physicians. Methods: Recent medical graduates completed the Spanish translation of the OSA Knowledge and Attitudes (OSAKA) questionnaire at the 2013 national primary-care residency-placement meeting in Ecuador. The OSAKA includes 18 knowledge and five attitudinal items about OSA. We compared recent graduates’ data with data collected in 2010–2011 from practicing physicians using chi-square tests of associations among categorical variables and analysis of variance of differences in mean knowledge and attitude scores. Unadjusted logistic regression models tested the odds that recent graduates (vs. practicing physicians) answered each item correctly. Results: Of 265 recent graduates, 138 (52.1%) were male, and mean age was 25.9 years. Although mean knowledge was low overall, scores were lower for recent graduates than for the 367 practicing physicians (53.5% vs. 60.4%; p < 0.001). Practicing physicians were significantly more likely to answer specific items correctly with one exception—recent graduates were more likely to know that < 5 apneas-hypopneas/h is normal (OR 1.47, 1. 03–2.07). Physicians in practice attributed greater importance to OSA as clinical disorder and the need for identifying patients with OSA; but recent graduates reported greater confidence in managing patients with OSA and CPAP. Conclusions: OSA-focused educational interventions during medical school should help to improve recent medical graduates’ abilities to diagnose and treat OSA. We recommend a greater number of hours of medical students’ exposure to sleep education.

scholarly journals Evaluation of a course to prepare international students for the United States Medical Licensing Examination step 2 clinical skills exam

2017 ◽  
Vol 14 ◽  
pp. 25 ◽  
Author(s):  
Rachel B. Levine ◽  
Andrew P. Levy ◽  
Robert Lubin ◽  
Sarah Halevi ◽  
Rebeca Rios ◽  
...  
Keyword(s):  
United States ◽  
Medical School ◽  
Clinical Skills ◽  
The United States ◽  
International Medical ◽  
Pass Rate ◽  
Pass Rates ◽  
Medical Licensing ◽  
Licensing Examination ◽  
Usmle Step

Purpose: United States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016.Methods: Students completed pre- and post-course questionnaires. The paired t-test was used to measure students’ perceptions of knowledge, preparation, confidence, and competence in CS pre- and post-course. To test for differences by gender or country of birth, analysis of variance was used. We compared USMLE step 2 CS pass rates between the 5 years prior to the course and the 5 years during which the course was offered.Results: Ninety students took the course between 2012 and 2016. Course evaluations began in 2013. Seventy-three students agreed to participate in the evaluation, and 64 completed the pre- and post-course surveys. Of the 64 students, 58% were US-born and 53% were male. Students reported statistically significant improvements in confidence and competence in all areas. No differences were found by gender or country of origin. The average pass rate for the 5 years prior to the course was 82%, and the average pass rate for the 5 years of the course was 89%.Conclusion: A CS course delivered at an international medical school may help to close the gap between the pass rates of US and international medical graduates on a high-stakes licensing exam. More experience is needed to determine if this model is replicable.

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