The clinical teacher
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The clinical teacher · Dec 2010
Comparative StudyTeaching and learning spinal anaesthesia: anaesthetists' attitudes.
To identify the determinants of learning for one medical procedural skill, spinal anaesthesia, by eliciting the opinions of anaesthetists in Ireland and Hungary. This objective is one component of a research project, Medical Competence Assessment Procedure (MedCAP) funded by the EU Leonardo da Vinci Lifelong Learning Programme. ⋯ Anaesthetists in Ireland and Hungary believe that learning spinal anaesthesia is determined by factors related to the trainee (motivation, knowledge), the trainer (motivation, communication) and the training programme (feedback, demonstration prior to clinical performance). Differences between respondents from the two countries were identified in regard to attitudes towards problem-based learning and self-awareness. These findings can be used to inform the design of training programmes and simulators.
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The clinical teacher · Dec 2010
CUSUM analysis to assess competence: what failure rate is acceptable?
Cumulative sum (CUSUM) analysis is used to assess competency in practical procedures. Previous studies have used CUSUM to assess competence in administering labour epidural, but these assessments were mainly performed with novice trainees. Different acceptable failure rates for the same procedure, such as administering labour epidural, have been used. In this article, we describe our experience of using CUSUM for the continuing assessment of competence among experienced trainees. We also tested the hypothesis that setting different failure rates can lead to different conclusions about a trainee's competency. ⋯ Our study shows that CUSUM analysis can be successfully used for the continued assessment of competence in experienced trainees. It also shows that setting different failure rates can produce different results, leading to confusion and inconsistency when comparing CUSUM results. With the increasing use of CUSUM analysis, we believe that the organisations responsible for training, such as the Royal College of Anaesthetists, should provide guidance on what is an acceptable failure rate for different procedures, such as the administration of an epidural during labour, at different stages of training.
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A problem faced by health professions education throughout the world is a lack of full-time clinical teachers. This is particularly serious in dentistry and nursing, but is increasingly also true in medicine. To make up for this shortfall there is a growing reliance on part-time clinical teachers. ⋯ As part-time teachers take on more responsibility, it is important that they take part in orientation and training sessions to assist them in developing the skills they need to succeed. This will require a significant commitment from the institution as well as the part-time teacher, but is critical for maintaining the academic quality of the clinical training programmes. This also represents an untapped area for research into how to ensure the success of part-time clinical teachers.
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Problem-based learning (PBL) in the UK began with the first version of Tomorrow's Doctors, published in 1993. About 12 of the 32 UK medical schools deliver PBL programmes. At a recent workshop, representatives from 10 UK medical schools, one dental school and one veterinary school discussed implementations, strengths and weaknesses of their PBL curricula. ⋯ Points emerging from the workshop were that strong support from senior leadership is critical, people who will not 'sign up' must not be allowed to undermine the effort, tutors should want the role rather than being co-opted, tutors should be integrated into faculty and curriculum design, induction for staff and students with ongoing tutor development is essential and, finally, personal experience shows that PBL, performed well, works well!