Comparison of OSCE performance between 6- and 7-year medical school curricula in Taiwan

Background The year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan’s Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students’ performance in objective structured clinical examinations (OSCEs). Methods We retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan’s largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical sub-internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their sub-internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their sub-internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.” Results Between November 2016 and July 2020, 361 undergraduates underwent clinical sub-internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p < 0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p = 0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p = 0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p = 0.001). After clinical sub-internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p = 0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p = 0.492). Conclusions At the beginning of the sub-internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical sub-internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical sub-internship is crucial for the development of clinical skills and performance in the national OSCE.

The Influence of Training Methods and Students Work Ethos on Work Competency

The purpose of this study was to analyze the effect of training methods and work ethic on students' work competencies. The focus of teaching implementation is observed using two training methods, namely: on the job training method using internship training and simulasi method using simulation. The initial work ethic of students is limited to low and high categories. This type of research is a quasi-experimental with a 2 × 2 factorial design. The research population is all students of class XI of the Hospitality Accommodation Department at SMK Negeri 7 Bengkulu City, totaling 123 people. The sample was selected using the intact group technique from four classes selected to be two learning classes as the experimental group. The selected class is drawn by lottery to determine the treatment of the internship training and simulasi methods. Each treatment group was grouped based on low work ethic and high work ethic. The research instrument is a work competency assessment sheet and student work ethic. The data analysis technique used is 2-way analysis of variance. The results of the study can be concluded that: (1) the average work competence of students using the internship training method is higher than those using the simulation method. (2) The average work competence of students who have a high work ethic is higher than students with a low work ethic. (3) There is an interaction effect between training methods and work ethic on the work competence of students. (4) Students with a high work ethic who take part in the internship training method have higher work competencies compared to the simulation method. (5) Students with a low work ethic who take part in the internship training method have lower work competencies than those using the simulation method.

Research on the Cultivation Model of Collaborative Innovative Talents for Interdisciplinary Engineering Training

Through school-enterprise cooperation, jointly formulate industry-university cooperation and collaborative education programs, build innovative talent training models and curriculum systems, strengthen internship training, highlight practical capabilities, and cultivate the combination of knowledge and skills, technology and management, ability and quality combining applied talents. Establish cross-disciplinary and professional innovation courses, explore the establishment of a new mechanism for cross-faculty, cross-disciplinary, and cross-professional training of innovative and entrepreneurial talents, and promote the transformation of talent training from a single type of discipline to a multi-disciplinary integration.

Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study

BACKGROUND India has been facing various challenges in the past decade, which include outbreaks of different communicable diseases and the rising of slow pandemics of non-communicable diseases. The current COVID 19 pandemic brings to light the need to revamp the training in public health during the internship. A standardized and outcome-based approach to internship training is the need of the hour for the Indian medical graduate (IMG). The internship program in community medicine should train the Indian medical graduate to develop patient management and administrative skills to promote health care through a health facility. The training provided is not standardized or evaluated across the medical colleges. Hence, it was aimed to study the effectiveness of educational interventions on internship training during the posting at the rural training health centre (RTHC). METHODS A quasi-experimental study was conducted among the interns posted in the rural training health centre using a validated semi-structured questionnaire as a pretest followed by a post-test after two weeks of training on the primary health care system. The perception of the students towards the training was assessed using the Likert 5 point scale. RESULTS The pre-test score was 5.30 (SD 2.105) and the post-test mean score was 9.35 (SD 2.033) [P < 0.01]. The gender-based analysis also showed significance within genders. Student perception revealed 80 % found the training useful, 90 % agreed that the guidance provided by the field staff helped them and 90 % agreed that the intervention changed their outlook towards the internship training in community medicine. CONCLUSIONS The study has brought a positive outlook towards giving adequate guidance to acquire knowledge and skills to interns by the active involvement of faculty. Rethinking and re-implementation of the existing internship training in the community is the need of the hour. KEYWORDS Internship Training, Community Medicine, Medical Education, Kerala, GMR 2019

The Influence of Training Methods and Students Work Ethos on Work Competency

The purpose of this study was to analyze the effect of training methods and work ethic on students' work competencies. The focus of teaching implementation is observed using two training methods, namely: on the job training method using internship training and simulasi method using simulation. The initial work ethic of students is limited to low and high categories. This type of research is a quasi-experimental with a 2 × 2 factorial design. The research population is all students of class XI of the Hospitality Accommodation Department at SMK Negeri 7 Bengkulu City, totaling 123 people. The sample was selected using the intact group technique from four classes selected to be two learning classes as the experimental group. The selected class is drawn by lottery to determine the treatment of the internship training and simulasi methods. Each treatment group was grouped based on low work ethic and high work ethic. The research instrument is a work competency assessment sheet and student work ethic. The data analysis technique used is 2-way analysis of variance. The results of the study can be concluded that: (1) the average work competence of students using the internship training method is higher than those using the simulation method. (2) The average work competence of students who have a high work ethic is higher than students with a low work ethic. (3) There is an interaction effect between training methods and work ethic on the work competence of students. (4) Students with a high work ethic who take part in the internship training method have higher work competencies compared to the simulation method. (5) Students with a low work ethic who take part in the internship training method have lower work competencies than those using the simulation method.

Characterising hospitals’ suitability for medical officer internship training in Kenya: analysis of the Kenya Harmonized Health Facility Assessment

Background Kenya has significantly expanded its medical school numbers and internship training hospital numbers to address its workforce gap. The majority of newly accredited internship hospitals are first-level referral/district hospitals, which are considered to have shortage of staff, medications, have limited service capacity and are described as “not organized for training purpose”. Using data from the Kenya Harmonized Health Facility Assessment (KHFA) 2018, we characterise the readiness and capacity of 61 internship hospitals to understand whether they are suitable to provide internship training for medical doctors. Methods We used secondary data from KHFA 2018, which sampled 61 out of all 74 internship hospitals in Kenya. Comparing against the minimum requirement outlined in the national guidelines for medical officer interns, we filtered and identified 166 indicators from the KHFA survey questionnaire and grouped them into 12 domains. An overall readiness and capacity index was calculated as the mean of 12 domain-specific scores for each facility. We compared the readiness and capacity of each domain and overall between Level 4 small hospitals, Level 4 large hospitals and Level 5 & 6 hospitals. Results The average overall capacity and readiness index is 69% for all internship training centres. Hospitals have moderate capacity and readiness (over 60%) for most of the general domains, though there is huge variation between hospitals and only 29 out of 61 hospitals have five or more specialists assigned, employed, seconded or part-time - as required by the national guideline. Quality and safety score was low across all hospitals with an average score of 40%. As for major specialties, all hospitals have good readiness and capacity for surgery and obstetrics-gynaecology, while mental health was poorest in comparison. Level 5 & 6 facilities have higher capacity scores in all domains when compared with Level 4 hospitals. Conclusion Major gaps exist in staffing, equipment and service availability of Kenya internship hospitals. Level 4 hospitals are more likely to have a lower readiness and capacity index, and should be reviewed and improved to provide appropriate and well-resourced training for interns and to utilise appropriate resources to avoid improvising .

Comparison of OSCE Performance Between 6- and 7-Year Medical School Curricula in Taiwan

BackgroundThe year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan's Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students' performance in objective structured clinical examinations (OSCEs). MethodsWe retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan's largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their internship. The parameters for performance in OSCEs included “percentage of scores above the qualification standard” and “percentage of qualified stations.” ResultsBetween November 2016 and July 2020, 361 undergraduates underwent clinical internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0–35.7] vs. 28.2% [95% CI 25.9–30.4], p<0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4–91.4] vs. 84.0% [95% CI 81.5–86.4], p=0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1–93.8] vs. 86.1% [95% CI 83.8–88.3], p=0.001). After clinical internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2–34.9] vs. 34.6 [95% CI 32.9–36.3], p=0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1–90.7] vs. 90.2% [95% CI 88.6–91.8], p=0.492). ConclusionsAt the beginning of the internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical internship is crucial for the development of clinical skills and performance in the national OSCE.