BMC medical education
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BMC medical education · May 2017
"A steep learning curve": junior doctor perspectives on the transition from medical student to the health-care workplace.
The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition. ⋯ Findings may assist educators in refining their intern preparation and intern training curricula, and ensuring that medical school and intern preparation priorities are not seen as competing. Insights from non-medical disciplines into the organisational and relational challenges facing junior doctors and their health-care teams may enhance inter-professional learning opportunities. Workplace support and teaching, especially from junior colleagues, is highly valued during the demanding intern transition.
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BMC medical education · May 2017
ReviewA real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.
Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM. ⋯ We have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a strategy for actual practice.
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BMC medical education · Apr 2017
Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification.
The demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns. ⋯ The rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors' sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors working in the UK are competent.
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BMC medical education · Mar 2017
Randomized Controlled TrialConveying practical clinical skills with the help of teaching associates-a randomised trial with focus on the long term learning retention.
Ensuring that all medical students achieve adequate clinical skills remains a challenge, yet the correct performance of clinical skills is critical for all fields of medicine. This study analyzes the influence of receiving feedback by teaching associates in the context of achieving and maintaining a level of expertise in complex head and skull examination. ⋯ The use of teaching associates for teaching complex practical skills is effective for short- and long-term retention. We anticipate the method could be easily translated to nearly every patient-based clinical skill, particularly with regards to a competence-based education of future doctors.
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BMC medical education · Mar 2017
The first nationwide survey of MD-PhDs in the social sciences and humanities: training patterns and career choices.
While several articles on MD-PhD trainees in the basic sciences have been published in the past several years, very little research exists on physician-investigators in the social sciences and humanities. However, the numbers of MD-PhDs training in these fields and the number of programs offering training in these fields are increasing, particularly within the US. In addition, accountability for the public funding for MD-PhD programs requires knowledge about this growing population of trainees and their career trajectories. The aim of this paper is to describe the first cohorts of MD-PhDs in the social sciences and humanities, to characterize their training and career paths, and to better understand their experiences of training and subsequent research and practice. ⋯ In general, MD-PhDs in the social sciences and humanities have careers that fit the goals of agencies providing public funding for training physician-investigators: they are involved in mutually-informative medical research, clinical practice, and teaching - working to improve our responses to the social, cultural, and political determinants of health and health care. These findings provide strong evidence for continued and improved funding and programmatic support for MD-PhD trainees in the social sciences and humanities.