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Facutly of Medicine - L&T Publications
| Author(s) / Presenter(s) | Abstract / Summary |
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| Balasooriya, C., Toohey, S., & Hughes, C. (2005). What Do Deep and Surface Approaches to Learning Mean for Medical Students and Medical Education? Focus on Health Professional Education: A Multi-disciplinary Journal, 6(3), 29-42. | Aims and Objectives: Approaches to learning refer to the manner in which students engage in learning tasks. Approaches encompass two significant aspects of learning - motivation to learn and the choice of learning strategies that students make. Research has identified two distinctly different approaches that can be broadly categorised as deep or surface approaches to learning. A number of studies have established an association between deep approaches to learning and qualitatively better learning outcomes, which are characterised by a high level of understanding. Although recent increases in graduate admissions have clouded the issues somewhat, medical students, on entry to undergraduate medicine programs are the highest achieving group among their peers. How do their approaches to learning fit the paradigm? Are they consistently deep learners? This article explores the literature on approaches to learning. Method: Preliminary data from 44 Australian and 34 Sri Lankan medical students, who completed Biggs's revised two-factor Study Process Questionnaire (R-SPQ-2F), are reported. Conclusions: Some of the implications for medical education are considered, and further questions about the factors that determine students' approaches to learning are raised. |
| Balasooriya, C. D., Hughes, C., & Toohey, S. (2009). Impact of a new integrated medicine program on students’ approaches to learning. Higher Education Research & Development, 28(3), 289 - 302. | This paper presents the results of a study on the impact of a new integrated medical educational design on students’ approaches to learning. Although the new program was based on curriculum features identified in the research literature as likely to promote deeper approaches to learning, the results revealed a more complex response from students. While a proportion of students reacted as expected and changed to deeper approaches, a significant subgroup moved in the opposite direction and adopted more surface approaches. Further analysis revealed that specific features of the new curriculum – integration of content, requirement for both independent and collaborative learning – were likely to polarise students. The findings suggest that shifting students towards deeper approaches to learning may be a more complex task than previously understood. The authors suggest some ways in which such major curriculum change may be moderated so that all learners are more likely to benefit. |
| Bloomfield, L., Harris, P., & Hughes, C. (2003). What do students want? The types of learning activities preferred by final year medical students. Medical Education, 37(2), 110-118. | CONTEXT: A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment.
OBJECTIVES: To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship.
SUBJECTS: Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors.
METHOD: A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations.
RESULTS: The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care.
CONCLUSION: Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment. |
| Bloomfield, L., Magney, A., & Segelov, E. (2007). Reasons to try 'RIME'. Medical Education, 41(11), 1104. | |
| Bloomfield, L., & Subramaniam, R. (2008). Development of an instrument to measure the clinical learning environment in diagnostic radiology. Journal of Medical Imaging and Radiation Oncology, 52(3), 262-268. | Summary: A clinical learning environment survey instrument was developed that provided insights into diagnostic radiology trainees’ perceptions of the culture and context of the hospital-based training programme. The survey was completed by trainees allocated to 37 important training hospitals in Australia, New Zealand and Singapore in 2006. The main findings were that most obvious strengths of the diagnostic radiology programme are the wide variety of work-based learning opportunities and the social atmosphere. These were well regarded in all training sites. Work overload was seen as a significant problem in most hospitals and will probably remain a challenge. The areas that are most likely to repay efforts to bring about change are supervision and feedback. The study provides baseline data against which the influence of changes to the training programme may be evaluated. |
| Brawley, S., Clark, S., Cockburn, T., Cowley, J., Eijkman, H., Marshall, N., Quinnell, R., Russell, C., Thompson, R., & Zamberlan, L. (2009). Learning and Teaching Fellows in the Australian Higher Education Sector. HERDSA News, 31(3), 12-14. | |
| Bydder, S., Bloomfield, L., Dally, M., Harris, P., Dorset, L., & Semmens, J. (2007). Preparing to sit the Royal Australia and New Zealand College of Radiologists Faculty of Radiation Oncology Fellowship Part 2 examination: the value of a workshop including practice and feedback. Australasian Radiology, 51(5), 465-471. | A workshop has been held annually to help prepare candidates to sit the Royal Australia and New Zealand College of Radiologists Part 2 Faculty of Radiation Oncology examination. This study examined the value of such a course and its component parts and assessed attendees' learning environments. We collected detailed information from participants before and after the training workshop in 2005. A specific feature of this workshop included the use of an examination technique feedback form to facilitate the provision of systematic and comprehensive feedback to individual candidates after mock examination. Participants completed course evaluation forms and a learning environment survey. There were 22 candidate participants. The course and its components of this course were perceived very positively - including the examination technique feedback forms and written advice. Only three of the 24 questions regarding the registrars learning environment had less than 80% favourable responses - two of these questions related to workload. The course design described seems reasonably satisfactory in that it included the components ranked most highly by candidates. We also identified a number of variations that may be useful for future workshops. Although learning environments were generally good, we identified a perceived problem with workloads affecting a significant number of registrars. |
| Bye, A. M. E., Connolly, A. M., Netherton, C., Looker, P., Burgess, A., & Lonergan, A. (2007). A triangulated approach to the assessment of teaching in childhood epilepsy. Medical Teacher, 29(2-3), 255-257. | BACKGROUND: A comprehensive methodology is needed to assess student teaching. The present study employed a triangulated approach evaluating participant perceptions of learning, critical reflection by the lecturer and peer observation to measure confidence, interest and usefulness of the subject matter.
METHODS: Using an interactive lecturing style, seven teaching sessions were delivered to medical students and junior doctors. Rating scales, open-ended questions and focus group discussions evaluated participant perceptions. Critical reflections and observations were made by the lecturer and independent learning consultants.
RESULTS: Seventy per cent of participants rated the lecture on the highest scale for usefulness and interest. There was a significant post-lecture increase in clinical confidence in seizure identification (p < 0.0005). Open-ended questions showed that videos were most useful (81/149) and interesting (109/149), and that the presentation of the syndromal classification provided a useful approach (114/149). Focus group discussion, lecturer and peer observation cross-validated these findings and highlighted the importance of expert commentary to the videos and the clinical relevance of material. |
| Cozzi, P. J. (1999). A fellowship in the USA: essential information for the Australasian medical graduate. Australian & New Zealand Journal of Surgery, 69(7), 527-530. | BACKGROUND: There have been many recent changes to the immigration and educational requirements necessary to obtain both clinical and research positions in the USA. This paper describes these requirements in detail and examines the cost of obtaining a position. METHODS: An extensive review of Medline and relevant documents from educational and immigration bodies is undertaken in addition to personal and peer experience of the processes necessary to fulfil educational and immigration requirements for funded medical positions in the USA. A cost analysis is performed based upon the latest charges for exam requirements and visa fees. A 'minimum' cost for fulfilling exam and visa requirements only and a 'likely' cost (which represents a more realistic appraisal of the expenses likely to be incurred) are investigated. RESULTS: This review shows that many recent changes have made the attainment of a position difficult and expensive. Much foresight and planning is required to obtain the necessary requirements for medical licensure and to obtain working visa status in addition to the application for the position itself. The cost analysis reveals that the minimum cost is $4050 (AU$) and the 'likely' cost is $8600 (AU$).
CONCLUSION: Australasian trainees and Fellows need to be fully aware of the difficulties and expenses likely to be encountered in order to make an informed decision with regard to overseas training in the USA. |
| Duncan, P., & Pather, N. (2007). Anatomy: How essential is it in eventual practice. Paper presented at the 37th Annual Conference of the Anatomical Society of Southern Africa (ASSA). | In many parts of the world, the use of cadaveric dissection in professional courses is being replaced with seemingly more advantageous alternatives, such as problem-based learning (PBL), with and without the use of prosected specimens. There is little consensus on paradigm shifts and the core syllabus in anatomy. Recently, the success of these shifts in anatomy teaching practice is beginning to be questioned. This study aims to compare the views of undergraduate students and practicing clinicians on the importance of anatomical knowledge in clinical practice and the value of the different tools in learning anatomy. A total of 405 health sciences students, which included 121 medical, 67 occupational therapy and physiotherapy students in their second year of study, and graduate entry medical students in their third (122) and fourth (95) year of study, respectively, were surveyed. Forty seven medical professionals from the same disciplines were surveyed. A significant difference in the perceptions of the adequacy of the anatomy training between the physiotherapy/occupational therapy group (97.0%) and the second year medical students (73.9%) was evident. However, more than 85% of all students in each group found dissections a useful tool in learning anatomy. Furthermore, problems were identified with the use of PBL and prosected specimens. All of the professionals that were surveyed agreed that anatomical knowledge is essential to eventual practice. However, only 57.7% thought that dissection complemented by lectures is the preferable method for learning anatomy. In light of modern trends in education and an explosion of information that students are faced with, it is essential that teaching methodology is continuously assessed and reviewed. In South Africa, in particular, the role of anatomy in training potential doctors out of a community with specific educational dilemmas (e.g. language) needs to reviewed to ensure that the traits of the discipline like professionalism and respect of mankind are upheld. |
| Dziegielewski, M., Velan, G. M., & Kumar, R. K. (2003). Teaching pathology using 'hotspotted' digital images. Medical Education, 37(11), 1047-1048. | |
| Emilia, O., Bloomfield, L., & Rotem, A. (2006). Replication of a Clinical Learning Environment Survey for Junior Medical Officers: A Study of Medical Students in an Indonesian Hospital. Focus on Health Professional Education: A Multi-disciplinary Journal, 7(3), 40-51. | Background: Monitoring medical students' hospital learning experiences requires an instrument that probes organisational and educational aspects of the environment. The study investigated the validity, reliability and practicality of a survey tool for probing the clinical learning environment and reports on its use in the clinical learning environment of a major teaching hospital in Indonesia. Methods: A cross-sectional survey of 209 clinical clerkship students was conducted in an Indonesian hospital. Methods of analysis included factor analysis, reliability studies, cross-tabs and univariate analysis of variance. Results: The survey tool revealed departmental differences in the clinical learning environment, as perceived by senior medical students. The clinical learning environment was described by three factors, which together account for 61.8% of the variance. The major factor, which we named the Conditions for Learning, is the organisational and psychosocial aspects, which consists of seven inter-correlated scales. Structural aspects of the environment are described by two factors, which cover opportunities to practise clinical skills, assessment, learning activities and resources. Conclusion: The instrument is valid, reliable, practical, and shows promise as a culture-neutral instrument for monitoring medical students' perceptions of clinical learning environments. |
| Farrar, M., Connolly, A. M., Lawson, J., Burgess, A., Lonergan, A., & Bye, A. M. E. (2008). Teaching doctors how to diagnose paroxysmal events: a comparison of two educational methods. Medical Education, 42(9), 909-914. | OBJECTIVES: Two educational methods, facilitated case discussion and a computerised tutorial, were compared for teaching about childhood epilepsy. We used a comprehensive and clinically relevant assessment method to evaluate the hypothesis that a computerised tutorial more effectively increases knowledge acquisition than a facilitated case discussion.
METHODS: Paediatric trainees (n = 66) were arbitrarily allocated to facilitated case discussion or computerised tutorial. The analysis of paroxysmal events was taught by the same teacher, using a standardised protocol and principles of active learning. Outcome measures included knowledge acquisition, clinical confidence and usefulness pre- and post-teaching, and at 3 months follow-up.
RESULTS: Computerised tutorial participants scored significantly higher on knowledge acquisition post-teaching. There was gain in clinical confidence in both modalities post-teaching which did not differ between the groups. Confidence and knowledge were not related post-teaching. Both groups found the teaching relevant to clinical practice. However, facilitated case discussion participants rated the session as more enjoyable, and more useful in reinforcing and acquiring knowledge, and felt more motivated for further learning. At 3 months follow-up, participants in both modalities showed significant increases in knowledge acquisition, with no difference between modalities.
CONCLUSIONS: The computerised tutorial more effectively imparted knowledge immediately post-teaching. However, facilitated case discussion is the preferred modality in terms of participant enjoyment and perceived usefulness. |
| Gibson, K. A., Boyle, P., Black, D. A., Cunningham, M., Grimm, M. C., & McNeil, H. P. (2008). Enhancing evaluation in an undergraduate medical education program. Academic Medicine, 83(8), 787-793. | Approaches to evaluation of medical student teaching programs have historically incorporated a range of methods and have had variable effectiveness. Such approaches are rarely comprehensive, typically evaluating only a component rather than the whole program, and are often episodic rather than continuous. There are growing pressures for significant improvement in academic program evaluation. The authors describe an initiative that arose after a radical reorganization of the undergraduate medical education program at the University of New South Wales in part in response to feedback from the accrediting authority. The aim was to design a comprehensive, multicomponent, program-wide evaluation and improvement system. The framework envisages the quality of the program as comprising four main aspects: curriculum and resources; staff and teaching; student experience; and student and graduate outcomes. Key principles of the adopted approach include the views that both student and staff experiences provide valuable information; that measurement of student and graduate outcomes are needed; that an emphasis on action after evaluation is critical (closing the loop); that the strategies and processes need to be continual rather than episodic; and that evaluation should be used to recognize, report on, and reward excellence in teaching. In addition, an important philosophy adopted was that teachers, course coordinators, and administrators should undertake evaluation and improvement activities as an inherent part of teaching, rather than viewing evaluation as something that is externally managed. Examples of the strategy in action, which provide initial evidence of validation for this approach, are described. |
| Gooneratne, I. K., Munasinghe, S. R., Siriwardena, C., Olupeliyawa, A. M., & Karunathilake, I. (2008). Assessment of psychometric properties of a modified PHEEM questionnaire. Annals of the Academy of Medicine, Singapore, 37(12), 993-997. | BACKGROUND: An effective tool in analysing the learning environment, customised to the Sri Lankan setting, is vital for the assessment and delivery of quality healthcare training of preregistration house officers. Such a tool should be reliable and valid. We assessed psychometric properties such as internal reliability and construct validity of a modified version of the Postgraduate Hospital Educational Environment Measure (PHEEM).
MATERIALS AND METHODS: A modified PHEEM questionnaire customised to the Sri Lankan context was developed in accordance to the Sri Lanka Medical Council guidelines. The questionnaire was distributed to all interns at the National Hospital of Sri Lanka, Colombo North Teaching Hospital and Wathupitiwala Base Hospital during a calendar year (n = 100, response rate = 86%). Internal reliability and construct validity of the inventory were assessed by using Cronbach's alpha and exploratory factor analysis respectively as statistical methods.
RESULTS: PHEEM consists of 3 subscales: perceptions of autonomy, social support and teaching, which are factors perceived to be influencing the educational environment. This administration demonstrated high internal reliability as reflected by a Cronbach's alpha value of 0.84. Exploratory factor analysis identified 12 factors with eigenvalue >1. However, the first factor had an eigenvalue of 6.7 (accounting for 19.7% of variance), while the rest had eigenvalues < 2.5. These results suggest a single predictive factor and thus a one-dimensional scale as opposed to the three-dimensional scale which is used in the current questionnaire. CONCLUSIONS: The psychometric properties of this tool reflect a high degree of internal reliability in assessing the educational environment of intern doctors in Sri Lanka. It is possible that the clinical educational environment is collectively represented as a single dimension. This may be due to the complex interplay between individual items in the questionnaire. Therefore the psychometric properties do not justify the interpretation of the educational environment through specified subscales. |
| Harris, P., Hughes, C., & Toohey, S. (2002). Beyond PBL: Building an undergraduate medical curriculum on adult education principles. Paper presented at the AMEE 2002 Conference: Approaches to Better Teaching. | |
Harris, P., Hughes, C. S., Toohey, S. M., Balasooriya, C. D., O’Sullivan, A. J., Kumar, R. K., Velan, G.M. &
McNeil, H. P. (2008). A Method for Assessment to Drive Learning toward Desired Graduate Capabilities. Paper presented at the 13th Ottawa International Conference on Clinical Competence. | |
| Harris, P., Snell, L., Talbot, M., & Harden, R. M. (2010). Competency-based medical education: implications for undergraduate programs. Medical Teacher, 32(8), 646-650. | Changes in educational thinking and in medical program accreditation provide an opportunity to reconsider approaches to undergraduate medical education. Current developments in competency-based medical education (CBME), in particular, present both possibilities and challenges for undergraduate programs. CBME does not specify particular learning strategies or formats, but rather provides a clear description of intended outcomes. This approach has the potential to yield authentic curricula for medical practice and to provide a seamless linkage between all stages of lifelong learning. At the same time, the implementation of CBME in undergraduate education poses challenges for curriculum design, student assessment practices, teacher preparation, and systemic institutional change, all of which have implications for student learning. Some of the challenges of CBME are similar to those that can arise in the implementation of any integrated program, while others are specific to the adoption of outcome frameworks as an organizing principle for curriculum design. This article reviews a number of issues raised by CBME in the context of undergraduate programs and provides examples of best practices that might help to address these issues. |
| Hettiarachchi, T., Wickramasinghe, S., Peiris, W., Karunathilake, I., & Olupeliyawa, A. (2009). Effectiveness of a training programme in facilitation skills for SGD facilitators. Paper presented at the 6th Asia Pacific Medical Education Conference (APMEC) 2009: "Energising the Educational Mission of Medical Schools". | |
| Hughes, C. (2009). eMed Portfolio: Tracking graduate attributes in an aligned medical curriculum. Paper presented at the Australian ePortfolio Symposium AeP2. | |
| Hughes, C., Toohey, S., & Velan, G. (2008). eMed Teamwork: a self-moderating system to gather peer feedback for developing and assessing teamwork skills. Medical Teacher, 30(1), 5-9. | Students in the six-year undergraduate medicine program at UNSW must submit a portfolio which demonstrates inter alia their development in teamwork skills. Much of the feedback they need to develop these skills, as well as the evidence they require to document their achievements, can only come from their peers. The eMed Teamwork system, developed for this purpose, is a computer-based system which gathers feedback from peers in project groups. The feedback submitted to the system is available to the recipient for formative purposes, and becomes part of both the author's and the recipient's portfolios for later summative assessment. This dual use ensures that the feedback is thoughtful and constructive and the system operates without significant moderation by teachers. |
| Hughes, C. S., Di Corpo, S. K., & Hewson, L. (2007). Investigating online contribution rates and other indicators of deep elearning. Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. | A number of accessible metrics are explored as potential indicators of quality elearning processes, through data gained from 28 classes that used one of two virtual learning environments. Quantitative indicators including contribution rates, and qualitative indicators such as coded content are examined. Some cross tabulations with group size are presented, and we consider how data may be collected to support the indicators, what they might mean, and some limitations on their interpretation. |
| Hunt, J. E., Scicluna, H., & McNeil, H. P. (2011). Development and Evaluation of a Mandatory Research Experience in a Medical Education Program: The Independent Learning Project at UNSW. Medical Science Educator, 21(1s), 78-85. | As part of the reform of its undergraduate 6-year medical program, the University of New South Wales developed an in-depth research experience of 24 weeks full-time duration, which all students are required to undertake. Central aims of this Independent Learning Project (ILP) are to develop the generic capability of self-directed learning and critical evaluation, to understand how knowledge is created within a field and its limitations, and to reinforce the scientific basis of medical practice through personal research experience. The ILP is taken in either year 3 or 4 in any area of research relevant to medicine, including biomedical science, public health, and clinical research. Assessment includes supervisor grades and a report in the form of a scientific manuscript. High achieving and motivated students have the option of substituting the ILP period with a formal Bachelor of Science (Medicine) Honours degree, which is 28 weeks in duration with a more rigorous assessment. Currently, this Honours option is limited to the academically best (~30) students each year. Between 2006 and 2010, 846 students completed an ILP and 159 undertook an Honours project in lieu. At least 64 peer-reviewed manuscripts have been published as a result of ILP projects. Student evaluations are generally positive with 65% of respondents undertaking an ILP in 2009-2010 reporting that they were satisfied with their experience. Motivation, interest, and recognition were the key factors which characterized students who reported satisfaction with their ILP experiences. In open-ended comments, students reported key intellectual outcomes related to research as the highest ranked "best aspects" of their ILP. The most frequent negative comments reflected resistance to the compulsory nature of the ILP, a need for better selection or training of supervisors, and interruption to their clinical learning. |
| Imison, M., & Hughes, C. (2008). The virtual patient project: Using low fidelity, student generated online cases in medical education. Paper presented at the ascilite Melbourne 2008. Retrieved from http://ascilite.org.au/conferences/melbourne08/procs/imison.pdf | Objectives: This paper reports on an in-progress study of low-fidelity virtual patients (VPs) created by and for medical students at the University of New South Wales. Its goals were to advance the diagnostic reasoning and patient management skills of all participating students. Methods: Two groups of volunteers from among the University’s fifth-year medical students were trained in the use of software programs that enabled them to produce virtual patients. The cases they subsequently created were then reviewed for accuracy by clinical specialists, and are soon to be trialled with more junior student readers. Results: Student authors, who came to the project with varying levels of technical confidence and ability, were all able to create interesting and engaging cases. Thus far they have produced eleven VPs, and qualitative analysis indicates positive impacts for their confidence in diagnostic pathways, treatment options and consolidation of knowledge. Quantitative analysis of changes in their clinical reasoning abilities is ongoing. Conclusion: Given the success of the project, it is highly likely that student-created virtual patients will become an optional assessment task for senior medical students in the future, with the added benefit that this will develop a bank of VPs for future use in the program. |
| Iobst, W. F., Sherbino, J., Cate, O. T., Richardson, D. L., Dath, D., Swing, S. R., Harris, P., Mungroo, R., Holmboe, E. S. & Frank, J. R. (2010). Competency-based medical education in postgraduate medical education. Medical Teacher, 32(8), 651-656. | With the introduction of Tomorrow's Doctors in 1993, medical education began the transition from a time- and process-based system to a competency-based training framework. Implementing competency-based training in postgraduate medical education poses many challenges but ultimately requires a demonstration that the learner is truly competent to progress in training or to the next phase of a professional career. Making this transition requires change at virtually all levels of postgraduate training. Key components of this change include the development of valid and reliable assessment tools such as work-based assessment using direct observation, frequent formative feedback, and learner self-directed assessment; active involvement of the learner in the educational process; and intensive faculty development that addresses curricular design and the assessment of competency. |
| Jones, P., O’Sullivan, A. J., Hughes, C., & Harris, P. (2010). Validity of a Summative Portfolio. Paper presented at the 7th International Medical Education Conference. | |
| Karunathilake, I., Munasinghe, R., Samarasekera, D. D., & Olupeliyawa, A. M. (2009). Curriculum development to produce professionals in allied health sciences. Paper presented at the 6th Asia Pacific Medical Education Conference. | |
| Karunathilake, I., Samarasekera, D., Dias, R., & Olupeliyawa, A. (2006). Medical Education Reforms in Sri Lanka. Asia Pacific Biotech News, 10(15), 809-811. | The article discusses medical education reforms in Sri Lanka. There was a shift of the teaching/learning methods from traditional lecture-based teaching activities towards methods involving greater student participation. The curriculum at the University of Peradeniya was changed into a more integrated curriculum, with the objectives of reducing information overload, improving generic skills and imparting skills necessary to deliver better primary healthcare. The curricular changes have taken place in a very conservative background with medical schools of long-established traditions. |
| Karunathilake, I. M., Olupeliyawa, A. M., Gooneratne, I. K., Thilakaratne, M. S. B., & Wickramasinghe, W. A. K. K. (2007). Graduates’ perceptions regarding their final year training. Paper presented at the 4th Asia Pacific Medical Education Conference. | |
| Karunathilake, I. M., Olupeliyawa, A. M., Ranasinghe, P., Wickramasinghe, S. A., & Galappaththi, H. (2008). Development of a Disaster Management Course for Healthcare Workers. Paper presented at the 3rd Conference of Asia Pacific Action Alliance for Human Resources for Health. | |
| Koritschoner, E. E., & Booth, B. (2007). Developing communication skills in an undergraduate medical program: Challenges and dilemmas in teaching, learning and assessing intangibles. Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. | We will present some student evaluations that highlight dilemmas in the teaching and learning of communication skills in medicine. Teaching communication is more than the presentation and practice of a defined skills set. Yet this is often what is taught and assessed. An evaluation of teaching in early training is contrasted with student perceptions in year 5 giving rise to important questions of how to improve and suggesting future research directions. |
| Kramer, B., Pather, N., & Ihunwo, A. O. (2008). Anatomy: spotlight on Africa. Anatomical Sciences Education, 1(3), 111-118. | Anatomy departments across Africa were surveyed regarding the type of curriculum and method of delivery of their medical courses. While the response rate was low, African anatomy departments appear to be in line with the rest of the world in that many have introduced problem based learning, have hours that are within the range of western medical schools and appear to be well resourced. Human body dissection is a constant and strong aspect of the majority of the courses surveyed. The staff to student ratio appears to be relatively high in Africa, but in many of the responding African institutions, there appears to be little difficulty in attracting suitable faculty (including those who are medically qualified) to teach anatomy. Retaining this faculty, in some cases, may be difficult because of a global demand for anatomy educators. |
| Kramer, B., Pather, N., & Ihunwo, A. O. (2008). Anatomy: The African spotlight unfurls. Anatomical Sciences Education, 1(5), 231-232. | |
| Kumar, R. K., Freeman, B., Velan, G. M., & De Permentier, P. J. (2006). Integrating histology and histopathology teaching in practical classes using virtual slides. Anatomical Record, New Anatomist. 289(4), 128-133. | The new medicine program at the University of New South Wales employs scenario-based learning with vertically integrated classes of year 1 and year 2 students, as well as horizontally integrated teaching with no discipline-specific courses. Coinciding with its introduction, we undertook comprehensive revision of the approach to teaching microscopic anatomy and pathology. We designed practical classes around virtual slides, which are high-magnification digital images of tissue sections stored in a multi-resolution file format, viewable in a Web browser in a manner closely simulating conventional microscopy. In these classes, we integrated the teaching of histology and histopathology, introducing students to the microscopic features of tissues and organs, and giving them the opportunity to compare and contrast the normal with the abnormal in various disease states. Members of academic staff from both anatomy and pathology were present to promote discussion and respond to questions. Worksheets defined learning objectives and provided clinical cases as contexts for learning in each class. Evaluation revealed that students strongly supported the integrated approach. The efficiency of the teaching method meant that it was possible to work through 5-8 virtual slides per 2-hr class without difficulty. Students displayed considerable initiative in exploring the histological features of tissues, identifying the changes in various pathological states, and recognizing their relationship to clinical manifestations. We believe that the approach we have developed should help to minimize the potential adverse impact of curriculum reform on the teaching of morphology, while ensuring that learning remains both meaningful and interesting. |
| Kumar, R. K., Hawkins, N. J., Harris, P., & Velan, G. M. (2004). Bridging the Gap Between the Scientific and Societal Aspects of Medical Education. Journal of the International Association of Medical Science Educators (JIAMSE), 14(1), 15-17. | Integrated assessments which are aligned with learning objectives and teaching methods may help to reinforce the linkage of the medical sciences with the professional practice of medicine. In the existing discipline-based medicine program at the University of New South Wales, a project-based assessment in pathology was introduced in 1996, which required students to focus on the cost vs. benefit of investigative procedures. Students have performed well in this individualized assessment, which has experiential and reflective components and is highly rated as a learning exercise. In the new integrated medicine program commencing in 2004, students will undertake a series of project-based assessments linking medical sciences to societal aspects of health and disease. Whether undertaking such assessments contributes to a long-term change in clinical behaviour will require follow-up with graduates from our new program. |
| Kumar, R. K., Velan, G. M., Korell, S. O., Kandara, M., Dee, F. R., & Wakefield, D. (2004). Virtual microscopy for learning and assessment in pathology. Journal of Pathology, 204(5), 613-618. | Virtual slides are high-magnification digital images of tissue sections, stored in a multi-resolution file format. Using appropriate software, these slides can be viewed in a web browser in a manner that closely simulates examination of glass slides with a real microscope. We describe the successful implementation of teaching microscopic pathology with virtual slides and, for the first time, their use in summative assessment. Both students and teaching staff readily adapted to the use of virtual microscopy. Questionnaire feedback from students strongly indicated that virtual slides solved a number of problems in their learning, while providing good to excellent image quality. A deliberate policy of allocating two students per workstation promoted collaboration and helped to maintain interest in microscopic pathology. The use of a secure browser facilitated assessment using virtual slides, with no technical or security issues arising despite high peak demand. The new Medicine programme at the University of New South Wales will exclusively utilize virtual microscopy for the study of both histology and histopathology. We believe that the use of high-quality learning resources such as virtual slides can ensure that microscopic examination of tissues remains both meaningful and interesting. |
| Kumar, R. K., Velan, G. M., Korell, S. O., Kandara, M., Dee, F. R., & Wakefield, D. (2004). Virtual microscopy for learning and assessment in pathology. Journal of Pathology, 204(5), 613-618. | Virtual slides are high-magnification digital images of tissue sections, stored in a multi-resolution file format. Using appropriate software, these slides can be viewed in a web browser in a manner that closely simulates examination of glass slides with a real microscope. We describe the successful implementation of teaching microscopic pathology with virtual slides and, for the first time, their use in summative assessment. Both students and teaching staff readily adapted to the use of virtual microscopy. Questionnaire feedback from students strongly indicated that virtual slides solved a number of problems in their learning, while providing good to excellent image quality. A deliberate policy of allocating two students per workstation promoted collaboration and helped to maintain interest in microscopic pathology. The use of a secure browser facilitated assessment using virtual slides, with no technical or security issues arising despite high peak demand. The new Medicine programme at the University of New South Wales will exclusively utilize virtual microscopy for the study of both histology and histopathology. We believe that the use of high-quality learning resources such as virtual slides can ensure that microscopic examination of tissues remains both meaningful and interesting. |
| Lane, C. A., & Brown, M. A. (2009). Nephrology: a specialty in need of resuscitation? Kidney International, 76(6), 594-596. | Nephrology trainee recruitment is essential if we are to address the shortage of nephrologists in countries such as the USA, Canada, the UK and Australia. This Australian study determines barriers, following clinical exposure, to trainees' pursuing a career in nephrology. |
| Lane, C. A., Healy, C., Ho, M.-T., Pearson, S.-A., & Brown, M. A. (2008). How to attract a nephrology trainee: quantitative questionnaire results. Nephrology, 13(2), 116-123. | AIM: Global health workforce shortages are being experienced across many specialties. Australia faces a nephrology workforce shortage coupled with increased demand for nephrology services. This study examines issues impacting on the choice of nephrology as a career and identifies factors that can be modified to improve trainee recruitment. This study provides evidence to inform those seeking to address nephrology, and by extrapolation, other specialty workforce shortages.
METHODS: In Australia in 2005, a mailed self-administered questionnaire was sent to all basic physician trainees eligible for the clinical component of the Royal Australasian College of Physicians' examination. Trainees were asked about the main influences on career choice; including perceived motivators and detractors surrounding a career in nephrology. RESULTS: Of the 531 doctors surveyed, 222 (42%) responded. Younger respondents and those with previous nephrology experience were more likely to consider nephrology. Perceptions deterring respondents from considering nephrology included inflexible work hours, an absence of positive role models, the perceived restriction of the subspecialty to a hospital-based practice and poor remuneration relative to other specialties.
CONCLUSION: Exposure to a nephrology term in early postgraduate years is an important factor in a decision to undertake nephrology training. During these rotations; trainees need to experience positive role modelling. Effective trainee recruitment strategies should utilize the positive influence of role models, and must consider restructuring workforce and training activities to improve work hour flexibility and remuneration. Negative perceptions, acting as barriers to the pursuit of a career in nephrology, must be addressed and any misinformation corrected. |
| Lane, C. A., Holt, J., & Brown, M. A. (2005). Nephrology training in Australia: is there a problem? [Editorial]. Nephrology, 10(2), 106-108. | |
| LeBard, R., Thompson, R., Micolich, A., & Quinnell, R. (2009). Identifying common thresholds in learning for students working in the 'hard' discipline of Science. Paper presented at the UniServe Conference. Retrieved from http://sydney.edu.au/science/uniserve_science/images/content/2009_papers/LeBard.pdf | |
| Liyanage, P. C., Olupeliyawa, A. M., Munasinghe, S. R., Karunathilake, I. M., & Mendis, L. N. (2007). Evaluation Cycle of an Orientation Course for New Entrants to the Faculty of Medicine, Colombo, Sri Lanka. Paper presented at the 4th Asia Pacific Medical Education Conference. | |
| McNeil, H. P. (2008). Enhancing academic physician training. [Comment Letter]. Internal Medicine Journal, 38(7), 616-617. | |
| McNeil, H. P., & Grimm, M. C. (2005). Achieving equal standards in medical student education: is a national exit examination the answer? [Comment Letter]. Medical Journal of Australia, 183(3), 166-167; author reply 168. | |
| McNeil, H. P., Hughes, C. S., Toohey, S. M., & Dowton, S. B. (2003). An innovative outcome-based integrated medical education program that emphasises life-long learning capabilities. Paper presented at the 1st Asia Pacific Medical Education Conference: Changing Paradigms. | |
| McNeil, H. P., Hughes, C. S., Toohey, S. M., & Dowton, S. B. (2006). An innovative outcomes-based medical education program built on adult learning principles. Medical Teacher, 28(6), 527-534. | An innovative medical curriculum at the University of New South Wales (UNSW) has been developed through a highly collaborative process aimed at building faculty ownership and ongoing sustainability. The result is a novel capability-based program that features early clinical experience and small-group teaching, which offers students considerable flexibility and achieves a high degree of alignment between graduate outcomes, learning activities and assessments. Graduate capabilities that focus student learning on generic outcomes are described (critical evaluation, reflection, communication and teamwork) along with traditional outcomes in biomedical science, social aspects, clinical performance and ethics. Each two-year phase promotes a distinctive learning process to support and develop autonomous learning across six years. The approaches emphasize important adult education themes: student autonomy; learning from experience; collaborative learning; and adult teacher-learner relationships. Teaching in each phase draws on stages of the human life cycle to provide an explicit organization for the vertical integration of knowledge and skills. A learning environment that values the social nature of learning is fostered through the program's design and assessment system, which supports interdisciplinary integration and rewards students who exhibit self-direction. Assessment incorporates criterion referencing, interdisciplinary examinations, a balance between continuous and barrier assessments, peer feedback and performance assessments of clinical competence. A portfolio examination in each phase, in which students submit evidence of reflection and achievement for each capability, ensures overall alignment. |
McNeil, H.P., Scicluna, H. A., Boyle, P., Grimm, M. C., Gibson, K. A. and Jones, P. D. (2011) Successful development of generic capabilities in an undergraduate medical education program. Higher Education Research & Development.
http://dx.doi.org/10.1080/07294360.2011.559194 | Abstract:
The development of generic capabilities or graduate attributes in communication, teamwork, critical analysis of information, problem solving and ethical practice is widely recognised as a desired outcome of higher education. This emphasis on generic capabilities has emerged despite ongoing debates about the concept and development of such capabilities. A recent review of comprehensive audits of Australian universities has found little evidence that such outcomes are being achieved. We used data from four different evaluations, both qualitative and quantitative, to explore whether these important generic capabilities are being learned by undergraduate students in the University of New South Wales (UNSW) new Medicine Program. University of New South Wales medical students are significantly more positive than other UNSW students that their university experience is developing several generic capabilities. Measurements concerning generic skills development from the Australian 2009 Learning and Teaching Performance Fund process support these findings. Analyses of qualitative data from two methodologically different student surveys found consistent evidence that medical students value generic capability development in the UNSW program. Furthermore, we report evidence that current UNSW medical students rate their clinical learning in professional placements as a significantly better experience than students in the previous discipline-based program. We believe this is a consequence of generic capability learning in the early years of the new program, such that our students are better prepared to maximise the value of learning from professional experiences. Our results represent consistent evidence of successful generic capability development as a result of a program-wide innovation in undergraduate education. To validate further our conclusions, external assessments of our graduates' generic capabilities in-action in the workplace are currently being obtained. |
| Meyer, L. D., Hodgkinson, A. R., Knight, R., Ho, M. T., di Corpo, S. K., & Bhalla, S. (2007). Graduate capabilities for health service managers: reconfiguring health management education @UNSW. Australian Health Review, 31(3), 379-384. | The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the health management program within the Faculty of Medicine. It outlines the method and considerations undertaken, particularly in identifying and embedding new graduate capabilities within the program. The paper concludes that using an outcomes-based approach and engaging with key stakeholders provides opportunity to identify and promote critical capabilities needed by managers to support the challenges confronting health services, including workforce flexibility. Further research is required on how such curriculum initiatives might impact on the performance of health service managers, but initial indications are that the health industry recognises the need and value of this approach. |
| Olupeliyawa, A. M. (2010). An assessment strategy to drive learning of collaborative competencies essential for an intern. Paper presented at the ANZAME Conference. | |
| Olupeliyawa, A. M. (2010). Preparing health workers for teamwork: ways forward for education and training. Paper presented at the Inaugural Forum on Human Resources for Health in the Asia and Pacific Regions. | |
| Olupeliyawa, A. M., Balasoooriya, C. D., & Hughes, C. (2009). A review of the literature on teamwork competencies in healthcare practice and training: Implications for undergraduate medical education. South East Asian Journal of Medical Education, 3(2), 61-72. | Successful teamwork is being recognized as a necessity for many aspects of effective healthcare and team training has proved effective in improving teamwork in healthcare. Therefore it is important to recognize the competencies of teamwork relevant to undergraduate medical education. This review of the literature draws on the teamwork competencies as discussed through diverse contexts of healthcare practice and health professions education and summarizes the competencies that are required with emphasis on undergraduate medical education. It highlights some practice points to medical educators; such as understanding the contexts of healthcare teams, understanding generic competencies of healthcare teamwork and understanding the specific team contexts and teamwork competencies required of trainees that should be emphasized in undergraduate education. |
| Olupeliyawa, A. M., Balasoooriya, C. D., & Hughes, C. (2010). Developing teamwork as an outcome in an outcome-based medical education program. Paper presented at the 7th Asia Pacific Medical Education Conference. | |
| Olupeliyawa, A. M., Balasoooriya, C. D., & Hughes, C. (2010). Teamwork competencies in healthcare for undergraduate medical education: Understanding the context. Paper presented at the 7th Asia Pacific Medical Education Conference. | |
| Olupeliyawa, A. M., Balasooriya, C., & Hughes, C. (2010). Facilitating the transition from medical student to competent intern through the assessment of collaborative competencies. Paper presented at the MEdEX 2010 Medical Education Conference. | |
| Olupeliyawa, A. M., Balasooriya, C., & Hughes, C. (2010). Facilitating the transition from medical student to intern: how can the assessment of clinical collaborative competencies help? . Paper presented at the Association for Medical Education in Europe (AMEE) conference. | |
| Olupeliyawa, A. M., De Abrew, A., Karunathilake, I. M., Kuruppu, O., & Brahmana, M. (2008). The Reliability and Predictive Validity of a Structured Oral Examination. Paper presented at the International Medical Education Conference. | |
| Olupeliyawa, A. M., Goonaratne, K., Tilakeratne, S., Wickramasinghe, K., Karunathilake, I., & Samarasekera, D. (2007). Graduates’ perceptions regarding their final year training. South East Asian Journal of Medical Education, 1(1), 25-29. | |
| Olupeliyawa, A. M., Gooneratne, I. K., Munasinghe, S. R., Karunathilake, I. M., Ediriweera, E., Kaluarachchi, A., & De Abrew, A. (2008). Evaluation of an initiative to introduce Family Medicine to undergraduate medical students. Paper presented at the 40th Conference of Asia Pacific Academic Consortium for Public Health. | |
| Olupeliyawa, A. M., Gooneratne, I. K., Thilakaratne, M. S. B., Wickramasinghe, W. A. K. K., & D.D., S. (2007). Teaching Behavioural Sciences: looking back at the Colombo experience. Paper presented at the 4th Asia Pacific Medical Education Conference | |
| Olupeliyawa, A. M., Gooneratne, I. K., Wickramasinghe, W. A. K. K., Thilakaratne, M. S. B., Karunathilake, I. M., & Samarasekera, D. D. (2008). Teaching behavioural sciences: looking back at the Colombo experience. South East Asian Journal of Medical Education, 2(1), 83-88. | PURPOSE: To review studies conducted to evaluate the output of the Behavioural Sciences Stream (BSS) of the Faculty of Medicine, Colombo in terms of achieving its objectives and with regards to its teaching/ learning and assessment methods.
DATA SOURCES, STUDY SELECTION AND DATA EXTRACTION: A manual search was conducted using official faculty publications, reports of student research and conference proceedings.
Pubmed/Medline indexed articles were also reviewed using the keywords; communication skills, ethics & professionalism, teaching / learning methods, evaluation methods, behavioural sciences. From a total of 384 hits 19 articles were reviewed.
RESULTS: Studies conducted to evaluate the outcome of BSS conclude that the majority of students felt that they achieved the objectives of developing the necessary skills and professionalism. However the patients thought that some aspects were not adequately practiced. Suggestions for improving teaching/ learning methods to achieve these skills included interactive activities, simulated and standardized patient interviews, and reinforcement of BSS inputs during professorial clinical rotations. Similar methods are practiced successfully worldwide. Many studies showed that students prefer to be assessed in the ward setting. Such methods of assessment in other medical curricula include assessment of videotaped student patient interactions, stations assessing behavioural skills at Objective Structured Clinical Examinations (OSCE) and assessments as part of clinical evaluations. |
| Olupeliyawa, A. M., Hughes, C., & Balasoooriya, C. D. (2010). Teamwork roles and competencies for a junior medical officer: their context in clinical practice and in outcome-based curricula. Paper presented at the ANZAME 2010 Conference. | |
| O'Sullivan, A. J., Harris, P., Ham, J., Toohey, S., Velan, G., Balasooriya, C., Hughes, C. & McNeil, H. P. (2005). Linking Assessment to Undergraduate Medical Student Capabilities through Portfolio Examination. Paper presented at the ANZAME 2005 Conference “Mind the Gaps”. | |
| O'Sullivan, A. J., Toohey, S., Velan, G., Harris, P., Hughes, C., Ham, J., Reid, S., Balasooriya, C. & Kumar, R. K. (2007). An aligned assessment scheme in a medicine program. Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. Locating Learning: Integrative Dimensions in the Scholarship of Teaching and Learning. | In UNSW’s medicine program all teaching and assessment activities are linked to one or more of the program’s eight graduate capabilities, and these links are recorded in a curriculum map. Grades and comments from assignments and group projects in each subject are organised according to relevant capabilities and contribute to an online portfolio that presents a developmental view of student progress towards the required standard in each graduate capability. |
| O'Sullivan, A. J., Toohey, S. M., Hughes, C. S., Harris, P., Velan, G., Ham, J., Balasooriya, C., Kumar, R. K. & McNeil, H. P. (2004). Linking assessment to undergraduate medical student capabilities: a method for assessment to drive learning. Paper presented at the AMEE Conference. | |
O'Sullivan, A. J., Harris, P., Hughes, C. S., Toohey, S. M., Balasooriya, C., Velan, G., Kumar, R. K. &
McNeil, H. P. (2011). Linking assessment to undergraduate student capabilities through portfolio examination. Assessment & Evaluation in Higher Education, 1-13. | Portfolios are an established method of assessment, although concerns do exist around their validity for capabilities such as reflection and self-direction. This article describes an e-portfolio which closely aligns learning and reflection to graduate capabilities, incorporating features that address concerns about portfolios. Students are required to complete assessments linked to graduate capabilities. In Year 3, a portfolio review occurs (205–248 students per year), focusing on students' grades and feedback from assessments and a reflective essay is submitted. In the essay, students reflect on their progress, identify areas of weakness and detail plans for improvement. Progress in each capability is summatively graded against specific criteria and feedback is provided. Students progressively accumulate evidence of learning linked to the graduate capabilities. The provision of sufficient structure prevents evasion of areas of weakness. Importantly, the equal weighting given to all graduate capabilities emphasises that competence in all areas is required. The requirement for a degree of self-direction and reflection in all assessments promotes regular review of progress. This e-portfolio explicitly links graduate outcomes with assessment in order to drive learning. Further research is required to evaluate acceptability to students, as well as the efficacy of portfolios in developing reflective practice and self-directed learning. |
| O'Sullivan, A. J., & Toohey, S. M. (2008). Assessment of professionalism in undergraduate medical students. Medical Teacher, 30(3), 280-286. | BACKGROUND: Professionalism is comprised of a set of values and behaviours that underpin the social contract between the public and the medical profession. Medical errors are reported to result in significant morbidity and mortality and are in-part related to underdeveloped professionalism. AIMS: The aim was to determine whether specific aspects of professionalism were underdeveloped in medical students. METHOD: A questionnaire with 24 vignettes was taken by Year 2, 4, and 6 medical students and their responses were compared to responses from practicing Medical Academics.
RESULTS: Second, fourth and sixth Year medical students' responses differed from Academics in two aspects of professionalism, firstly, high ethical and moral standards and secondly, humanistic values such as integrity and honesty. Only Year 2 medical students' responses were different from Academics when it came to responsibility and accountability. CONCLUSIONS: Certain aspects of professionalism seem to be underdeveloped in medical students. These aspects of professionalism may need to be targeted for teaching and assessment in order that students develop as professionally responsible practitioners. In turn, students with well-developed professionalism may be less involved in medical error, and if involved they may have the personal values which can help them deal with error more honestly and effectively. |
| Pather, N. (2006). Medical Education in South Africa: trends in Anatomy. Paper presented at the 36th annual Anatomical Society of Southern Africa conference. | In recent years, modern trends in education and an explosion of information has led many institutions, both nationally and internationally, to rethink their approach to teaching medicine. These trends have had a drastic impact on the subject of Anatomy, with continuous pressure being applied to condense curricular, decrease contact hours and increase throughput of students. In addition, a global shortage of anatomy educators and cadaveric resources and concerns about the health of the student has resulted in the quest for new techniques of teaching and learning. This study aimed to survey the current mode of teaching anatomy at South African medical schools. A questionnaire was circulated to the eight Heads of Anatomy departments teaching medical students in South Africa. The questionnaire was aimed to obtain information on curriculum changes since 2000 and the number and qualifications of academic staff and student numbers. Of the eight questionnaires circulated, four (50%) were returned. All four of these institutions employed vertical and horizontal integration of Anatomy in the medical programme. Anatomy teaching is largely practically based. The number of students enrolled for Anatomy in the medical curricula ranged from 110 to 240 students. The staff:student ratio in the dissecting/practical laboratory ranged from 1 : 25 to 1 : >35. Only one institution claimed difficulty in attracting suitably qualified staff. It is evident from this survey that South African medical curricula are undergoing rapid changes. In light of this and the global trend of assessing teaching methodology, it is imperative that anatomists step back and reassess their role in training potential doctors in South Africa. |
| Pather, N. (2006). Teaching and learning Anatomy : experiences from South Africa. Paper presented at the 10th Turkish Anatomy Congress. | |
| Pather, N., & Kramer, B. (2007). The Wits Experience: teaching and learning anatomy in a “mixed” entry level, problem-based medical programme. Paper presented at the XVI Pan-American Congress of Anatomy. | |
| Pather, N., & Maheter, R. (2006). Students perceptions on anatomy teaching. Paper presented at the 36th Anatomical Society of Southern Africa Conference. | Educational trends have impacted on many facets of anatomical teaching. Traditionally taught anatomy courses based on dissection have given way to problem-based learning (PBL) utilizing an array of modern innovative teaching aids. The use of cadavers, traditionally the chief pillar for learning Anatomy (Azis et al., 2002; Cabral and Barbosa, 2005), is becoming less common for a number of reasons (McLaghlan et al., 2004). Few studies, especially in South Africa where a large number of students are not taught in their first language, have surveyed students’ perceptions to the curricula and to the use of dissection (or lack thereof) to facilitate learning. The aims of the study was therefore to evaluate the perceptions of students on the importance and relevance of the anatomy that was being taught at the University of Witwatersrand (Wits) and to ascertain the students preferred way of leaning anatomy. All students attending the first practical of the third block and studying Anatomy towards a medical degree in 2005 were surveyed. The students were divided into two groups: Group A (n ¼ 221), students in the traditional second year anatomy programme; Group B (n ¼ 82), students in the 1st and 2nd years of the graduate entry medical programme being taught in a PBL curriculum. The mean student’s age (years) was Group A, 20 6 1.6, and Group B, 23 6 3.75. In both groups, 44% of the students were taught in their second language. Both groups (A, 97%, and B, 95%) perceived dissection as contributing significantly to the process of learning anatomy even though 58.7% in Group A and 12% in Group B felt that it significantly increased their work load and added a stress to the year. The opinions of both groups of the calibre of teaching and the adequacy of the anatomy taught was significantly different: 84% of Group A and 64% of Group B students felt that they had sufficient knowledge of anatomy to practice medicine. The results of this study showed that students are overwhelmingly in favour of dissection despite realizing that it requires a lot of time and input from them. Dissection is perceived as the best tool for visualizing and thus understanding the relations of anatomical structures. Furthermore, those students in Group B who had prior exposure to dissection were perceived as being advantaged. |
| Peiris, W., Wickramasinghe, S., Hettiarachchi, T., Olupeliyawa, A. M., Karunathilake, I., & Gooneratne, I. (2009). Continuing Professional Development programmes of professional colleges/ associations in medicine: A Sri Lankan perspective. Paper presented at the 6th Asia Pacific Medical Education Conference. | |
| Pham, M., Chan, B., Williams, K., Zwi, K., & White, L. (2010). Introducing clinical paediatrics to medical students: a novel hospital visitation programme involving Kindergarten children. Medical Teacher, 32(7), e276-281. | BACKGROUND: Increasing numbers of medical students in Australia and shorter paediatric hospitalisations require new and creative ways to teach clinical paediatric medicine. At the University of New South Wales, Sydney, we developed a programme involving well Kindergarten children visiting Sydney Children's Hospital to introduce medical students to clinical paediatric medicine. AIM: The aim was to teach medical students how to engage children and gain their cooperation while performing paediatric examinations.
METHODS: Eight sessions were conducted involving 240 Kindergarten students from seven local primary schools and 217 medical students. School children were escorted by medical students through five activities comprising examination of gross motor skills, testing visual acuity and otoscopy, measuring growth parameters, chest auscultation, pulse counting and blood pressure cuff inflation. Questionnaires were used to gather quantitative and qualitative evaluation data. RESULTS: The programme achieved its main objective, with 94% of students rating highly their learning about interacting with children and appreciating the challenges in examining them. Medical students (94%), tutors (100%) and participating schools (100%) thought the programme should be continued. CONCLUSION: This new, innovative programme involving well children introduces medical students to clinical paediatric medicine. |
| Pilotto, L. S., Duncan, G. F., & Anderson-Wurf, J. (2007). Issues for clinicians training international medical graduates: a systematic review. Medical Journal of Australia, 187(4), 225-228. | OBJECTIVE: To ascertain the specialised communication issues clinicians need to understand when preparing international medical graduates (IMGs) for clinical practice in Australia.
STUDY DESIGN: Systematic review.
DATA SOURCES: A series of searches using MEDLINE (1990-2006) was conducted with relevant keywords. Literature from countries with experience in the integration of IMGs into their medical workforces was included. All except four articles were published between 1997 and 2006. STUDY SELECTION: The initial search identified 748 articles, which reduced to 234 evidence-based English language articles for review. Of these, only articles relating to postgraduate medical training and overseas trained doctors were selected for inclusion.
DATA EXTRACTION: Titles and abstracts were independently reviewed by two reviewers, with a concordance rate of 0.9. Articles were included if they addressed communication needs of IMGs in training. Any disparities between reviewers about which articles to include were discussed and resolved by consensus.
DATA SYNTHESIS: Key issues that emerged were the need for IMGs to adjust to a change in status; the need for clinicians to understand the high level of English language proficiency required by IMGs; the need for clinicians to develop IMGs' skills in communicating with patients; the need for clinicians to understand IMGs' expectations about teaching and learning; and the need for IMGs to be able to interact effectively with a range of people.
CONCLUSION: Training organisations need to ensure that clinicians are aware of the communication issues facing IMGs and equip them with the skills and tools to deal with the problems that may arise. [References: 21] |
| Pratt, D. D., Harris, P., & Collins, J. B. (2009). The power of one: looking beyond the teacher in clinical instruction. Medical Teacher, 31(2), 133-137. | BACKGROUND: Research on clinical teaching in medicine tends to focus on preceptors and senior attending physicians as the primary source of learning for medical students. As a result, there is an artificial separation of 'teacher' from context in much of the research on clinical teaching in medicine. AIMS: The central aim of this study was to challenge the taken-for-granted assumption that student learning can be attributed primarily to a preceptor or attending physician on a rotation. METHODOLOGY: Twenty-two medical students and forty-one clinical faculty members generated explanations for a study that showed a positive effect on NMBE results for 3rd year clerkship students who had at least one highly effective clinical teacher during their clinical rotation in medicine.
RESULTS: Student and faculty explanations resulted in fourteen factors and six propositions describing the nature of highly effective clinical teaching. Students believed contextual factors influenced their own learning, but did not comment on that possibility in the study (Griffith CH, Georgesen JC, Wilson JF. 2000. Six-year documentation of the association between excellent clinical teaching and improved student examination performance. Acad Med 75(10): October Supplement). Most clinical faculty did question the assumption that one teacher could have that effect.
CONCLUSIONS: We recommend refocusing research on clinical instruction toward engagement within a community of professionals, rather than attributing 'power' to a single clinical teacher. |
Quinnell, R., Russell, C., Thompson, R., Marshall, N., & Cowley, J. (2009). Evidence-based narratives to reconcile academic disciplines with the scholarship of teaching and learning. Paper presented at the HERDSA International Teaching and Learning conference.
Abstract of presentation available: http://conference.herdsa.org.au/2009/concurrent05.html#357 | |
| Quinnell, R., Russell, C., Thompson, R., Marshall, N., & Cowley, J. (2010). Evidence-Based Narratives to Reconcile Teaching Practices in Academic Disciplines with the Scholarship of Teaching and Learning. Journal of the Scholarship of Teaching and Learning, 10(3), 20-30. | Connecting discipline scholars with the scholarship of teaching and learning (SoTL) is accepted as an essential part of professional academic practice across the higher education sector irrespective of discipline. To connect meaningfully with teaching practice, SoTL needs to be translated by the discipline scholar and narratives related to the discipline context constructed. Previous work on disciplinary diversity suggests that there is a need to take a more grounded approach to the development of discipline-based educational scholarship. How SoTL is defined is critical to how SoTL is interpreted within discipline contexts and some of the numerous models and definitions of SoTL transcend disciplinary boundaries, but there is no single agreed definition of what is meant by SoTL. This paper reviews some of the models of scholarly teaching and raises some questions about how the links between pedagogical theory and discipline teaching practice are made by discipline scholars. We advocate that by providing discipline scholars with ways to map and then collectively view their practices within disciplines that this is likely to provide information essential for exploring SoTL in each discipline and reconciling SoTL with academic disciplines. |
| Quinnell, R., & Thompson, R. (2008). Re-viewing academic numeracy in the tertiary education sector as a threshold concept. Paper presented at the Second Biennial International Threshold Concepts Symposium. | |
| Quinnell, R., & Thompson, R. (2010). Conceptual Intersections: Re-viewing Academic Numeracy in the Tertiary Education Sector as a Threshold Concept. In J. H. F. Meyer, R. Land & C. Baillie (Eds.), Threshold Concepts and Transformational Learning. (Vol. 42, pp. 147-164). Rotterdam: Sense Publishers. | |
| Quinnell, R., Thompson, R., LeBard, R., & Micolich, A. (2010). Numeracy as an obstacle to learning for students entering the discipline domains of science and medicine. Paper presented at the 3rd Threshold Concept Symposium. | |
| Ranasinghe, P., Wickramasinghe, W., Wickramasinghe, S., Peiris, W., Olupeliyawa, A. M., & Karunathilake, I. (2009). The Students’ Voice: strengths and weaknesses of the undergraduate medical curriculum at Faculty of Medicine, Colombo, Sri Lanka. Paper presented at the 6th Asia Pacific Medical Education Conference. | |
| Strkalj, G., Schroder, T., Pather, N., & Solyali, V. (2011). A preliminary assessment of the fifth-year chiropractic students' knowledge of anatomy. J Altern Complement Med, 17(1), 63-66. | INTRODUCTION: Anatomy has been at the foundation of medical students' training. In recent decades, medical programs in many countries have undergone major reform in both pedagogy and content. These reforms generated intense debates, focusing mainly on the way the new programs affected medical graduates' knowledge of anatomy and their clinical capabilities. Anatomy, however, is not only core to medicine, but also to a number of allied and complementary health disciplines. While the evaluation of anatomy teaching and learning in the medical programs has been heavily scrutinized, anatomy education in the complementary and alternative medicine (CAM) professions, including those, such as chiropractic, in which anatomy has traditionally been one of the main preclinical subjects, has been less frequently evaluated.
OBJECTIVES: The study aimed to make a preliminary assessment of the final year chiropractic students' knowledge of anatomy using the "carpal bone test."
SUBJECTS AND METHODS: The testing was conducted on the final-year chiropractic students at Macquarie University in 2009. In this test, the students were given 5 minutes to label an illustration of the bony skeleton of the carpal region. The results of this assessment were then compared to results of previously published surveys using the "carpal bone test." RESULTS: A total of 84 students participated in the study. Thirty-eight percent (38%) of students identified all eight bones, while 60% of students identified five or more carpal bones. The most frequent correctly identified bone was the pisiform, followed by the scaphoid bone (82% and 74% of students, respectively). The trapezium and trapezoid bones were least frequently identified: both by 52% of students each. These results were generally better than those of the previously tested final-year medical students.
DISCUSSION AND CONCLUSIONS: The importance of anatomy in chiropractors' education has been generally acknowledged. This study suggests that the comparatively high number of hours devoted to anatomy in Macquarie University chiropractic curriculum and underpinning of clinical skills to anatomy knowledge in the senior year have increased retention of anatomy knowledge. The study, preliminary in nature, has also recognized the need for more detailed assessment of teaching and learning of the basic medical sciences in chiropractic and other CAM disciplines. |
| Thompson, R. (2006). Resuscitating medical statistics: A group project that aligns learning and assessment for one of the most unpopular subjects in the medical curriculum. Paper presented at the Annual Learning and Teaching Forum, UNSW. | |
| Thompson, R. (2007). Crossing the threshold: the problems of teaching threshold concepts online. . Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. | This presentation discusses the difficulties encountered when teaching threshold concepts (Meyer and Land 2003) in an online learning format. It details lessons learnt from an online evidence-based medicine course that are applicable to other learning formats and disciplines and argues the reasons behind the problems encountered. |
| Thompson, R. (2008). Sexing up stats: dealing with numeracy issues and threshold concepts in an online medical statistics course. Paper presented at the ANZAME 2008 Conference. . Retrieved from http://www.anzame.unsw.edu.au/PDF/conference/Conference%20Handbook%202008.pdf | |
| Thompson, R., & Hughes, C. (2009). PeArLs presentation: Moderating and Evaluating a Wiki Assignment @ UNSW. Paper presented at the ANZAME Annual Conference. | |
| Thompson, R., & Quinnell, R. (2010). The advantages of a discipline “tour guide” approach to teaching statistics in medicine and biology. Paper presented at the 3rd Threshold Concept Symposium. | |
| Toohey, S., & Kumar, R. (2003). A New Program of Assessment for a New Medical Program. Focus on Health Professional Education: A Multi-disciplinary Journal, 5(2), 23-33. | The undergraduate Medicine program at the University of New South Wales is undergoing substantial reform, with changes in the organisation of teaching which include an integration of basic and medical sciences into modules focussed on medical practice and an emphasis on students' personal and professional development. The new curriculum demanded a reassessment of the traditional assessment methods which have been used previously and provided an opportunity to develop an assessment scheme from first principles. This paper describes significant features of the proposed new approach to assessment, which include (1) a dramatic shift of emphasis towards formative assessment (2) the abolition of discipline-specific assessments (3) coarse grading of summative assessments, with repeated sampling (4) the use of a variety of techniques tailored towards assessment of graduate capabilities in the areas of personal attributes and interactional abilities, as well as applied knowledge and skills (5) flexible and individualised summative assessments in the later years of the program. The new assessment scheme is designed to encourage active learning and support interdisciplinary integration. In addition, it focuses attention on the development of those capabilities and skills that have long been underemphasised in 'traditional' programs. As such the new assessment scheme is integral to achieving the goals of the new program. |
| Toohey, S. M., Hughes, C. S., Kumar, R. K., O’Sullivan, A. J., & McNeil, H. P. (2004). Planning portfolio assessment at the University of New South Wales. Paper presented at the 1st Asia Pacific Medical Education Conference. Changing Paradigms. | |
| Toohey, S. M., Hughes, C. S., Kumar, R. K., O’Sullivan, A. J., & McNeil, H. P. (2004). Using portfolios to develop and assess student autonomy and reflective practice. Paper presented at the Ottawa conference. | |
| Toohey, S. M., Hughes, C. S., Velan, G. M., & Harris, P. (2007). Gathering peer feedback on teamwork contributions for formative and summative purposes. Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. | At UNSW a self-moderating system for gathering qualitative peer feedback on teamwork contributions for both formative and summative purposes has been developed. The feedback submitted is included in both the author’s and the recipient’s portfolios as evidence, respectively, of their ability to give and receive constructive feedback. The dual use of the feedback ensures that the comments submitted to the system are thoughtful and constructive, and the system operates without significant modification by teachers. |
| Torda, A. (2007). Innovations in Teaching Ethics to Medical Students - Am I wasting my time? Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. | In this paper, I will explore changes in teaching ethics to medical students – new teaching methods, new content and new timing, with a focus on student engagement, contextual learning and small group facilitation. I will discuss the aim of teaching this component of the medical curriculum, and the relevant literature on the impact of these kinds of innovations. I will discuss the data from student feedback and explore ways to make this course more effective. |
| Velan, G., Ben-Naim, D., Kumar, R. K., Bain, M., Kan, B., & Marcus, N. (2009). Adaptive tutorials using virtual slides to enhance learning of microscopic morphology. Paper presented at the E-Learn 2009 - World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education. Retrieved from http://www.aace.org/conf/ELearn/sessions/index.cfm/fuseaction/PaperDetails?presentation_id=40170 | |
| Velan, G. M. (1997). Clinicopathological case studies on the internet with interactive images and automated self assessment and feedback. Paper presented at the ANZAME Annual Conference. | |
| Velan, G. M. (1997). Evaluation of an innovative student manual in an undergraduate course in Pathology. Paper presented at the ANZAME Annual Conference. | |
| Velan, G. M., Jones, P., McNeil, H. P., & Kumar, R. K. (2008). Integrated online formative assessments in the biomedical sciences for medical students: benefits for learning. [Evaluation Studies]. BMC Medical Education, 8, 52. | BACKGROUND: Online formative assessments have a sound theoretical basis, and are prevalent and popular in higher education settings, but data to establish their educational benefits are lacking. This study attempts to determine whether participation and performance in integrated online formative assessments in the biomedical sciences has measurable effects on learning by junior medical students.
METHODS: Students enrolled in Phase 1 (Years 1 and 2) of an undergraduate Medicine program were studied over two consecutive years, 2006 and 2007. In seven consecutive courses, end-of-course (EOC) summative examination marks were analysed with respect to the effect of participation and performance in voluntary online formative assessments. Online evaluation surveys were utilized to gather students' perceptions regarding online formative assessments.
RESULTS: Students rated online assessments highly on all measures. Participation in formative assessments had a statistically significant positive relationship with EOC marks in all courses. The mean difference in EOC marks for those who participated in formative assessments ranged from 6.3% (95% confidence intervals 1.6 to 11.0; p = 0.009) in Course 5 to 3.2% (0.2 to 6.2; p = 0.037) in Course 2. For all courses, performance in formative assessments correlated significantly with EOC marks (p < 0.001 for each course). The variance in EOC marks that could be explained by performance in the formative assessments ranged from 21.8% in Course 6 to 4.1% in Course 7.
CONCLUSION: The results support the contention that well designed formative assessments can have significant positive effects on learning. There is untapped potential for use of formative assessments to assist learning by medical students and postgraduate medical trainees. |
| Velan, G. M., Killen, M. T., Dziegielewski, M., & Kumar, R. K. (2002). Development and evaluation of a computer-assisted learning module on glomerulonephritis for medical students. Medical Teacher, 24(4), 412-416. | An interactive computer-assisted learning (CAL) module on glomerulonephritis, previously identified by fourth-year medical students as a difficult topic, was developed. The module comprised background material, case studies, graphics, animation, video and supporting quizzes with feedback. The impact of the module on student learning was evaluated by comparing the performance of two matched groups of students, only one of which accessed the CAL module, in an online assessment. The analysis examined the effect of having completed a clinical term in renal medicine. A significant improvement in the performance of those students who used the CAL module was demonstrated. Unexpectedly, completing a renal medicine term had no beneficial influence on students' performance. Students who used the CAL module perceived a significant decrease in the difficulty of the topic. It is concluded that the module is an effective learning tool, but important caveats are noted associated with using CAL modules in redesigned medical curricula. |
| Velan, G. M., & Kumar, R. K. (2000). Effectiveness of on-line formative assessments as well as criterion-referenced and project-based summative assessments. Paper presented at the Fourth National Teaching Forum on Assessment in Higher Education. | |
| Velan, G. M., & Kumar, R. K. (2007). Integrated Online Formative Assessment in the Biomedical Sciences. Paper presented at the ISSOTL, The International Society for the Scholarship of Teaching & Learning 4th Annual Conference. . | Formative assessment with appropriate feedback is effective in promoting learning. Integrated online formative assessments in the biomedical sciences were embedded in a scenario-based undergraduate Medicine program. These assessments, authored using Questionmark Perception™, have received high ratings in feedback surveys. Students perceived that formative assessments assisted learning in biomedical sciences and guided their study. Open-ended feedback indicates that the assessments motivated student learning. Furthermore, there is evidence that students have mastered the content of formative assessments. |
| Velan, G. M., Kumar, R. K., Dziegielewski, M., & Wakefield, D. (2002). Web-based self-assessments in pathology with Questionmark Perception. Pathology, 34(3), 282-284. | Formative assessment with appropriate feedback is an effective method of promoting learning. Software tools are now available to facilitate the delivery of formative self-assessments via the World Wide Web. For the past 5 years, we have offered on-line formative self-assessments in pathology to undergraduate medical students. These assessments, which have been authored using Questionmark Perception, have proved particularly popular and have received high ratings in course evaluation surveys. Furthermore, they appear to have been effective in promoting student learning, with evidence that students made a genuine attempt to answer the questions in the assessment and that they learnt from doing so. The potential of on-line formative self-assessments for postgraduate training and continuing education in pathology so far remains untapped. |
| Velan, G. M., Lattimore, M., Lindeman, R., & Kumar, R. K. (2010). A web-based module on lymphoma for senior medical students: benefits for learning. Journal of the International Association of Medical Science Educators (JIAMSE), 20(1), 32-40. | |
| Watson, E. G. S., Moloney, P. J., Toohey, S. M., Hughes, C. S., Mobbs, S. L., Leeper, J. B., & McNeil, H. P. (2007). Development of eMed: a comprehensive, modular curriculum-management system. Academic Medicine, 82(4), 351-360. | In 2001 the University of New South Wales Faculty of Medicine embarked on designing a curriculum-management system to support the development and delivery of its new, fully integrated, outcome-based, six-year undergraduate medicine program. The Web-enabled curriculum-management system it developed is known as eMed, and it comprises a suite of integrated tools used for managing graduate outcomes, content, activities, and assessment in the new program. The six main tools are a curriculum map, timetable, student portfolio, peer feedback tool, assessment tracking, and results tools. The eMed functions were determined by organizational and curricular needs, and a business management perspective guided its development. The eMed project was developed by a multidisciplinary team, and its successful development was achieved mostly by methodically identifying the scope of each tool and the business processes it supports. Evaluation results indicated a high level of user acceptance and approval. The eMed system is a simple yet effective educational technology system that allows users to evaluate and improve the curriculum in real time. As a second-generation curriculum-management system, eMed is much more than an educational administration system; it is a knowledge network system used by staff and students to transform data and information into knowledge and action. The integration of learning and assessment activities data in the one system gives a depth of curriculum information that is unusual and that allows for data-based decision making. Technologically, eMed helps to keep the medicine program up to date. Organizationally, it strengthens the school's data-driven decision-making process and knowledge network culture. |
| Watson, E. G. S., Toohey, S. M., Hughes, C., McNeil, H. P., Mobbs, S. L., & Leeper, J. B. (2004). Uses of a curriculum map in the new medical curriculum at UNSW. Paper presented at the Ottawa conference. | |
| Watson, E. G. S., Toohey, S. M., Hughes, C. S., McNeil, H. P., Mobbs, S. L., & Leeper, J. B. (2003). Mapping the New Medical Curriculum at UNSW. Paper presented at the 1st Asia Pacific Medical Education Conference: Changing Paradigms. | |
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