Medical education
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To examine changes in formal teaching about death, dying and bereavement in undergraduate medical education in UK medical schools. ⋯ The preparation for palliative care work provided for current undergraduate medical students appears to be of a better quality than that provided in 1983.
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Randomized Controlled Trial Clinical Trial
Teaching medical students exposure therapy for phobia/panic - randomized, controlled comparison of face-to-face tutorial in small groups vs. solo computer instruction.
To compare the teaching value of one session of computer-guided solo instruction in exposure therapy for phobias with that of one face-to-face small-group tutorial. ⋯ The knowledge gain from a solo computer session resembled that from a small-group face-to-face tutorial, and required far less teacher time, but was less enjoyable. Enjoyment might rise if the computer session was group-oriented and aimed at students rather than patients. In general computer teaching might be best used to complement rather than replace conventional teaching.
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The General Medical Council procedures to assess the performance of doctors who may be seriously deficient include peer review of the doctor's practice at the workplace and tests of competence and skills. Peer reviews are conducted by three trained assessors, two from the same speciality as the doctor being assessed, with one lay assessor. The doctor completes a portfolio to describe his/her training, experience, the circumstances of practice and self rate his/her competence and familiarity in dealing with the common problems of his/her own discipline. ⋯ The content and structure of the peer review are designed to assess the doctor against the standards defined in Good Medical Practice, as applied to the doctor's speciality. The assessment methods are based on validated instruments and gather 700-1000 judgements on each doctor. Early experience of the peer review visits has confirmed their feasibility and effectiveness.
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This paper describes the development of the tests of competence used as part of the General Medical Council's assessment of potentially seriously deficient doctors. It is illustrated by reference to tests of knowledge and clinical and practical skills created for general practice. SUBJECTS AND TESTS: A notional sample of 30 volunteers in 'good standing' in the specialty (reference group), 27 practitioners referred to the procedures and four practitioners not referred but who were the focus of concern over their performance. Tests were constructed using available guidelines and a specially convened working group in the specialty. ⋯ Tests performed highly reliably, showed evidence of construct validity, intercorrelated at appropriate levels and, at the standards employed, demonstrated good separation of reference and referred groups. Likelihood ratios for above and below standard performance based on competence were large for each test. Seven of 27 doctors referred were shown not to be deficient in both phases of the performance assessment.