Medical teacher
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Step 2 Clinical Skills (CS) was recently introduced into the United States Medical Licensing Examination (USMLE) to ensure that successful candidates for licensure possess the clinical skills to provide safe and effective patient care. ⋯ Over a third of medical schools are implementing changes to the objectives, content, and/or emphasis of their curriculum, at least partially in response to the institution of Step 2 CS.
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Changes in UK Junior Doctor working patterns, reduced training hours and increased patient expectations have resulted in less exposure of Juniors to surgical procedures. Validated methods of assessment are therefore required to assure the surgical competency of future Consultants. Objective Structured Assessment of Technical Skills (OSATS) forms are one possible tool. ⋯ Trainees and trainers perceive OSATS to be a valuable and valid tool for the objective assessment of surgical skills in the work place. More research is required to assess their criterion-related, content, construct and predictive validity as well as their reliability in the workplace.
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In 2004, the Japanese government reformed the monospecialty-oriented postgraduate medical education (PGME) program and introduced a new PGME program to develop the primary care skills of physicians by mandatory rotation through different clinical departments. ⋯ The new PGME program appears to have been successful at improving both the clinical experience and confidence levels of medical residents, especially at university hospitals.
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Medical boards around the world face the challenge of creating competency-based postgraduate training programs. Recent legislation requires that all postgraduate medical training programmes in The Netherlands be reformed. In this article the Dutch Advisory Board for Postgraduate Curriculum Development shares some of their experiences with guiding the design of specialist training programs, based on the Canadian Medical Educational Directives for Specialists (CanMEDS). ⋯ Finally, for each task an assessment method is chosen to focus on a limited number of CanMEDS roles. This leads to a three step training cycle: (i) based on their in-training assessment and practices, trainees will gather evidence on their development in a portfolio; (ii) this evidence stimulates the trainee and the supervisor to regularly reflect on a trainee's global development regarding the CanMEDS roles as well as on the performance in specific tasks; (iii) a personal development plan structures future learning goals and strategies. The experiences in the Netherlands are in line with international developments in postgraduate medical education and with the literature on workplace-based teaching and learning.
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The mini-clinical evaluation exercise (mini-CEX) is a 30 minute observed clinical encounter which allows assessment of a resident's clinical competence with feedback on their performance. ⋯ Residents' perceptions of the mini-CEX reflected a tension between the tool's dual roles of assessment and education.