Curriculum ; Education, Medical ; methods ; trends ; Education, Medical, Graduate ; Humans ; Schools, Medical ; Singapore

Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; Emergency Medicine ; education ; Humans ; Internship and Residency ; methods ; Singapore

AIMTo determine the attitudes of training grade (Senior House Officer - SHO, Specialist Registrar - SpR) and non-training grade doctors (both Staff Grade and senior or Consultant level) towards the place of research in the curriculum for junior doctors and also the pursuit of research by senior (but non-academic) clinicians.

MATERIALS AND METHODSA survey of a range of doctors from differing grades (above) was sent to all doctors of the employing Trust (comprising most of the regional training scheme) with a number of fixed questions but also an opportunity to provide free-text responses. Percentages of the fixed responses were estimated and free-text responses were grouped into main themes and miscellaneous items.

RESULTSDespite much criticism of the current protected research time for higher trainees in psychiatry in the UK and the anticipated abolition of this within the new training structure after August 2007, we found surprising and strong support for structured research training, experience and the opportunity to pursue this at senior level even for non-academic clinical consultants.

CONCLUSIONSUrgent review of the new training grade curriculum is needed with emphasis on how to address the research opportunities for trainees and seniors without compromising clinical, teaching and managerial obligations. A better use of such opportunities was strongly supported rather than the proposed abolition, which seems to be fast approaching.

Biomedical Research ; education ; Education, Medical, Graduate ; methods ; Humans ; Psychiatry ; education ; Referral and Consultation ; standards ; United Kingdom

OBJECTIVES: This study was conducted to evaluate the gender differences in stress-coping methods that affect stress responses in graduate medical students.METHODS: The participants were 209 students of C medical school in Daejeon, Korea. Stress response was measured using the Stress Response Inventory. Coping methods were measured through the Ways of Coping Checklist and Problem-solving Style Scale. Data were analyzed using T-Tests, a correlation analysis, and stepwise multiple regression analysis.RESULTS: The mean±standard deviation score of the stress response inventory was 23.56±20.20 in males and 32.34±23.44 in females. The stepwise multiple regression analysis revealed the following factors related to stress response: helplessness, problem-solving control, approach style in males and helplessness, social readjustment rating scale, problem-solving confidence in females. No relationship between stress-coping style and academic performance was found in both genders.CONCLUSION: Hopelessness seemed to be the main reason for the stress response in medical students of both genders. We also found differences in coping methods affecting the stress response by genders. Future studies need to identify more such factors that lead to differences in coping methods and help adapt to stress in medical education.
Adaptation, Psychological ; Checklist ; Education, Medical ; Education, Medical, Graduate ; Female ; Humans ; Korea ; Male ; Methods ; Schools, Medical ; Stress, Psychological ; Students, Medical

INTRODUCTIONThe purpose of this study was to understand the learning of internal medicine of 7th year medical students through records of the "Learning Passport".

MATERIALS AND METHODSBetween June 2005 and June 2006, data from the learning passport (a type of logbook) of 207 7th year medical students at the Department of Internal Medicine, National Taiwan University Hospital (NTUH) were collected.

RESULTSAmong the 19 symptoms/signs listed in the logbook, a large number of students did not learn well on low back pain, skin rash, oedema, oliguria and anxiety/depression; only a few students rated themselves as knowledgeable about anxiety/depression, malaise, skin rash, headache and anorexia. Among the 16 diseases listed, a large number of students did not learn well on chronic obstructive pulmonary disease, stroke, hypertension, coronary artery disease and cirrhosis; only a few students rated themselves as knowledgeable about shock, respiratory failure, consciousness disturbance, sepsis and renal failure. Among the 21 physical examination skills listed, a large number of students did not learn well on the male genitalia, eyes, cognitive status, mental state and the digital rectal examination; only a few students rated themselves as fully competent about cognitive status, mental state, eyes, neurology examination and ENT examination. Among the 11 laboratory skills and image interpretation skills listed, a large number of students did not learn well on blood smear, Gram's stain and specimen sampling; only a few students rated themselves as fully competent about the interpretation of brain computed tomographic (CT) scan, blood smear and Gram's stain. Among the 12 procedures and therapeutic skills listed, a large number of students did not learn well on observation of lumbar puncture, basic cardiopulmonary resuscitation (CPR) and aseptic procedure; only a few students rated themselves as fully competent about basic CPR and transfusion management.

CONCLUSIONSThe weak points of intern training conducted by the Department of Internal Medicine, NTUH were revealed by analysis obtained from their logbooks. Thus, we need to strengthen the learning of the interns in these specific parts and assess their performance based on the use of portfolios.

Clinical Competence ; Education, Medical, Graduate ; standards ; Educational Measurement ; methods ; Hospitals, University ; Internal Medicine ; education ; Self Efficacy ; Taiwan

INTRODUCTIONThis study aimed to develop a realistic and lifelike uterine model for the training of hysteroscopy skills.

MATERIALS AND METHODSA lifelike "uterine" model was constructed using female pig bladder. The pig bladder was enclosed within a malleable mould, with both ureters blocked by pins. Both rigid and flexible hysteroscopes were used in this study.

RESULTSBasic diagnostic hysteroscopy can be performed in the usual fashion using this lifelike model. The cost of each learning station is minimal. Pig bladder accurately simulates the human uterus with its realistic tactile feel, and conditions in the surgical environment, including obscuration of vision by debris, uterine "folds", realistic "ostia", incomplete shearing of tissue, "uterine" perforation, etc.

CONCLUSIONThis low-cost novel model provides realistic tissue resistance and yields an almost anatomically accurate hysteroscopic training tool, thereby allowing trainees to effectively acquire both diagnostic and therapeutic hysteroscopic skills.

Animals ; Education, Medical, Graduate ; methods ; Female ; Gynecology ; education ; Hysteroscopes ; Hysteroscopy ; education ; instrumentation ; Models, Anatomic ; Obstetrics ; education ; Singapore ; Swine ; Urinary Bladder ; Uterus

INTRODUCTIONThis study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships.

METHODSThis retrospective study involved 63 applicants to a residency programme conducted at the Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with the clinical performance of the applicants during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while the clinical performance of the applicants as fourth year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE).

RESULTSThe performance of the applicants as interns was positively correlated with their clinical performance as fourth year medical students, as measured by CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interactions items addressing communication and interpersonal skills in the CPX.

CONCLUSIONThe clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills, through actual encounters with patients or simulated encounters using manikins, so that they are able to become competent doctors.

Clinical Competence ; Education, Medical, Graduate ; methods ; Educational Measurement ; methods ; Female ; Humans ; Internship and Residency ; Male ; Republic of Korea ; Retrospective Studies ; Schools, Medical ; Students, Medical ; psychology

Biomedical Research ; Blindness ; etiology ; prevention & control ; surgery ; Corneal Diseases ; complications ; prevention & control ; surgery ; Corneal Transplantation ; education ; methods ; Education, Medical, Graduate ; Health Promotion ; Humans ; Ophthalmology ; education ; Singapore

INTRODUCTIONThe emergence of operative laparoscopy has brought a great demand for training surgical residents, but there are no clear guidelines regarding choice of procedure for training, proficiency assessment and accreditation. We aim to examine from a trainee's point of view, the safety and efficacy of laparoscopic appendicectomy (LA) as a laparoscopic training procedure.

MATERIALS AND METHODSA retrospective analysis of all the consecutive cases of LA done by a trainee in paediatric laparoscopic surgery from September 2003 to February 2005 was done.

RESULTSA total of 70 consecutive patients (37 males and 33 females) aged 3 to 15 years (mean, 10.5 +/- 2.5) with suspected appendicitis underwent LA. Twelve (17.1%) patients had acute appendicitis, 25 (35.7%) had acute suppurative appendicitis adherent to the caecum with localised and/or pelvic pus pocketing, 29 (41.4%) had perforated appendicitis with generalised peritonitis and 4 (5.7%) had normal appendix [mesenteric adenitis (1), omental infarct (1), torted Meckel's diverticulum (1) and primary peritonitis (1)]. There were no operative complications and none required conversion to open surgery. The operative duration ranged from 25 to 110 minutes (mean, 55.6 +/- 23.4). There were two complications; one had adhesive intestinal obstruction and underwent successful laparoscopic adhesiolysis and one had umbilical wound infection.

CONCLUSIONSLA is a safe and effective laparoscopic training procedure, in addition to being effective for all stages of appendicitis, as well as concurrent lesions encountered in children with suspected appendicitis.

Acute Disease ; Adolescent ; Appendectomy ; education ; methods ; Appendicitis ; surgery ; Child ; Child, Preschool ; Education, Medical, Graduate ; Female ; Hospitals, Pediatric ; standards ; Humans ; Internship and Residency ; Laparoscopy ; Male ; Retrospective Studies ; Safety ; Singapore

In response to the demands of an ageing nation, the postgraduate medical education in Singapore is currently in the early stage of transition into the American-styled residency programme. This study assessed the expectations of both radiology trainees and faculty on their ideal clinical learning environment (CLE) which facilitates the programme development. A modified 23-item questionnaire was administered to both trainees and faculty at a local training hospital. All items were scored according to their envisioned level of importance and categorised into 5 main CLE domains-supervision, formal training programme, work-based learning, social atmosphere and workload. 'Supervision' was identified as the most important domain of the CLE by both trainees and faculty, followed by 'formal training programmes', 'work-based learning' and 'social atmosphere'. 'Workload' was rated as the least important domain. For all domains, the reported expectation between both trainees and faculty respondents did not differ significantly. Intragroup comparison also showed no significant difference within each group of respondents. This study has provided valuable insights on both respondents' expectations on their ideal CLE that can best train competency in future radiologists. Various approaches to address these concerns were also discussed. The similarities in findings between ours and previous studies suggest that the 'supervision', 'formal training programmes' and 'work-based learning' domains are crucial for the success of a postgraduate medical training and should be emphasised in future curriculum. 'Workload' remains a challenge in postgraduate medical training, but attempts to address this will have an impact in future radiology training.
Attitude of Health Personnel ; Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; organization & administration ; Faculty, Medical ; Female ; Humans ; Internship and Residency ; methods ; organization & administration ; Male ; Radiology ; education ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires ; Workload