Medical teacher
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The medical community is coming under increased scrutiny. Challenges to the integrity of the healthcare system have been raised due to reports about the prevalence of medical errors. A heightened level of vigilance is required. ⋯ An understanding of health services is necessary to assess how well this goal is being met in the context of the changing healthcare system. A partnership between medical education and health services research is essential for academic health centers and health services institutions in assessing issues of health manpower and for the public good. Academic health centers have an important role in this partnership providing an infrastructure and expertise for both education and health services research.
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Randomized Controlled Trial Comparative Study Clinical Trial
A feasibility study comparing checklists and global rating forms to assess resident performance in clinical skills.
This study evaluated the feasibility of two different scoring forms for assessing the clinical performance of residents in anaesthesiology. One of the forms had a checklist format including task-specific items and the other was a global rating form with general dimensions of competence including 'clinical skills', 'communication skills' and 'knowledge'. Thirty-two clinicians representing 25 (83%) of the 30 training hospitals in the country participated in the study. ⋯ The checklist format was rated significantly higher compared with the global rating form (mean 4.6, 0.5 vs. mean 3.5, 1.4, p < 0.001). The inter-rater agreement regarding pass/fail decisions was poor irrespective of the scoring form used. This was explained by clinicians' leniency as assessors rather than by lack of vigilance in the observations or disagreements on standards for good performance.
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In 1995 Dundee medical school introduced an integrated, systems-based spiral curriculum with a number of innovative features. The medical school has now had eight years' experience of the curriculum. ⋯ Evidence from internal and external reviews and student examination data are used to identify the lessons learned from implementing the curriculum. The Dundee experience, the approaches to the curriculum described and the conclusions reached are relevant to all with an interest in medical education.
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Editorial Comment Review
Competency-based assessment: making it a reality.
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Many medical students wish to begin developing clinical teaching skills before residency. Faculty at the University of California, Irvine developed a 60-hour, longitudinal 'service elective' in teaching skills, which 50 third-year and fourth-year students have completed since 2001. ⋯ Participating students gave the elective a mean rating of 5.24 on a seven-point Likert-type scale, which fell between 'very good' (5) and 'excellent' (6). Narrative comments showed that students believed the elective--and in particular the OSTE training--prepared them well for teaching as residents.