Medical education
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Little attention has been paid to the differential emphasis undergraduate and graduate medical education programmes place on the broad competencies that will be needed for practice in an increasingly managed health care environment. The purpose of this study was to determine differences in emphasis that undergraduate and primary care graduate medical education programmes are currently placing on 33 broad practice competencies, compared with the emphasis they ideally would like to give them, and the barriers they perceive to curriculum change. ⋯ The differences in curriculum emphases and perceived barriers to curriculum change most probably reflect the different realities of undergraduate and graduate medical education programmes, i.e. academics vs. a focus on immediate practice realities.
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To compare outcomes when answers to objective type problem-solving questions are marked with and without consideration of students' explanations of their answers. ⋯ The data suggest that when students arrived at the correct answers, their information and reasons were usually correct and that answers alone discriminate adequately among students with different levels of knowledge and ability. By dispensing with the requirement for explanations, we would be able to ask more questions and mark objectively, so competent students should not be disadvantaged by the lack of opportunity to explain their reasoning.
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Comparative Study
Analysis by training status of performance in the certification examination for Australian family doctors.
Following recent changes to eligibility requirements for recognition as a general practitioner in Australia, an increasing proportion of candidates select the non-training, or practice-eligible, route to the RACGP Fellowship Examination, without the benefit of formal general practice training. ⋯ The observed difference in performance is more probably due to different preparation for the examination than any systematic bias against particular groups of candidates. All candidates for the examination would benefit from exposure to the general practice curriculum and supervised experience in Australian general practice.
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This paper shows the findings from a survey of 439 senior house officers undertaken as part of the British Medical Association cohort study of 1995 medical graduates. The aim of the study was to assess the quality of senior house officer training in the United Kingdom. ⋯ The study revealed wide variability in the quality of training received by senior house officers in the United Kingdom. Whilst some respondents - notably those in general practice, accident and emergency, paediatrics and psychiatry - had enjoyed a high standard of education and training, it was clear that a minority of posts continue to offer little if any educational value to the post holder. The results point to a need for a more systematic approach to maintaining standards in senior house officer training with greater incentives for under-performing trusts.