Audit and summative assessment: two years' pilot experience

An audit project has been submitted by all trainees in the West of Scotland since 1992 as part of a pilot process for summative assessment. The impact of 2 consecutive years of audit was assessed on 117 trainees in May 1994. A response rate of 89% was achieved. For 82 trainees (79%) this was their first practical experience of audit and as a result of it 85% felt more confident in introducing change to their next practice. Protected time was still a problem for the majority (53%) and one-third wanted more help from their trainer. Thirty trainees (29%) had attended four or fewer formal practice meetings in their 10 months of training, with 10% never having attended one. The previous trainee's audit project was rarely or never discussed with 70 trainees (87%) and only 12 trainees were evaluating changes recommended. An audit project as part of summative assessment may be encouraging trainees to think about change after they leave their training practices. Few, however, are evaluating change and protected time and support are still required. The marking of the summative assessment audit project may need to address this.     

哲学素养——医学研究生必备的素质

针对医学研究生的特点 ,分析了哲学素养对医学研究生全面发展的重要性。加强哲学素养是医学研究生适应医学模式转变的需要 ,是提高思维能力的需要 ,也是提高研究生道德水平的需要     

A new method of assessment of clinical teaching: ROC analysis

Twenty-five clinical dental students with varying clinical experience were presented with case records consisting of a clinical history and a panoramic radiograph for 25 patients with bilateral lower third molars ('wisdom teeth'). The students were asked to indicate how certain they were that each lower third molar tooth needed removal using a 6-point rating scale. Immediately following the task, the students were presented with information on the indications for removal of lower third molars in the form of a lecture by a senior academic clinical teacher. One week later the students were asked to repeat the rating study, under the same conditions as before, using a further 25 clinical cases. Receiver operating characteristics (ROC) analysis, which provides a graphical and quantitative assessment of a group of observers' ability to detect need for treatment, was utilized to examine differences between junior and senior students and between the matched pre-training and post-training experiments. The ability of junior students to assign lower third molars for surgery was statistically no better than random selection of cases. Formal clinical teaching significantly improved this group's performance, but had no effect on the performance of senior students. Senior students were significantly better able correctly to assign lower third molars for surgical intervention than junior students. Therefore this study shows that clinical experience has a significantly greater influence on treatment-planning ability than formal teaching. ROC analysis is a useful tool for assessing the effectiveness of methods of undergraduate training.     

学生毕业前的心态调查

调查了一所中等卫校两个专业毕业生的心态，并与低年级在校生心态比较，发现多数学生关心的问题是毕业分配（占６９％），而学生中存在着毕业后去向基层的思想有距离。本文讨论了这一问题。     

药学人才需求与就业流向的调查与分析

经对中国药科大学2000年至2002年毕业生就业流向调查，结果表明药学人才需求紧俏，在省城的就业率有所下降，地区流向仍以沿海经济发达城市为主，继续深造的势头不减。提出药学教学改革应拓宽培养口径，由化学模式向生物—管理—药学模式转变，以主动适应市场需求，培养复合型、应用型、服务型药学人才。     

中医研究生教育模式的探讨

笔者探讨中医研究生教育的模式与发展思考。回顾其发展过程表明，我国中医研究生教育起步较晚，但发展较快，结合当今的中医教育现状，提出中医研究生培养教育必须注重传统中医理论知识、中医临床技能和现代医药知识及科研技术三个方面的培养，以创新型、复合型和应用型人才为培养目标，使中医研究生成为具有坚实的中西医药专业知识和实际创造能力的高级医学人才。     

Reliability of peer and self-assessment scores compared with trainers' scores following third molar surgery

Context It is sometimes claimed that self‐assessment is inaccurate and that clinicians over‐rate their performance. There is a need to find out why this should be. Is poor self‐assessment caused by some clinicians' inability to accurately judge performance? Or does over‐scoring result from a desire to convey a more favourable impression? Peer assessment is widely advocated and is said to be of benefit to both assessor and assessee. Methods In this study, we wanted to see if postgraduates were able to peer‐assess and if this form of assessment was more reliable than self‐assessment when compared with assessment by a trainer. We used checklist and global rating scales to evaluate surgical skills in removing a mandibular third molar tooth. Results There was no statistically significant difference between peer‐assessed and trainer‐assessed scores. We found that, on average, peer assessment (especially global rating scales) reflected trainer scores more accurately than self‐assessment of surgical skills. Self‐assessment scores were significantly higher on average than those given in peer assessment. Discussion Although peers and trainee surgeons came from the same group, the surgeons were more likely to over‐score when measuring their own performances. The greatest variability (and over‐scoring) between assessor and trainee surgeon appeared to occur in those with lower mean scores. Formative peer assessment may be a useful and less stressful mechanism for encouraging reflection.     

Stakeholders' perception of the desired Master's program for Kenya in community health nursing: Areas of competency*

Introduction: After the World Health Assembly approved the WHA 45.5 in 1992, which addressed the nursing shortage by refocusing nurses and midwives to meet community health needs, community demands for educated nurses and the needs of higher nursing education in developing countries increased. However, in developing countries that suffering from multiple resource deficiencies, such as Kenya, the strategic direction of higher education in nursing was unclear. Therefore, in Kenya, a major university school of nursing initiated a collaborative study with a well‐established Japanese nursing college to determine the service‐providers' perspective about upgrading the Master's community nursing curriculum. Purpose: The aim of the study was to describe the Kenyan stakeholders' perspective and the expected roles and abilities of Master's graduates in community nursing. Methods: This qualitative, cross‐sectional study used convenience sampling to obtain 21 participants. The content analysis of the data was based on 19 semistructured interviews. Results: Sixteen categories and 42 subcategories were derived from the five key questions that related to the expectations of the Master's program. The Master's graduates were expected to acquire knowledge and skills relating to administration, management, epidemiology, research, and education. The participants recognized that epidemiology, important for preventive care, was minimal among the current community health nurses. Also, Master's graduates must be prepared to manage health programs. Conclusion: The stakeholders expected that Master's graduates would become leaders in community health nursing, with a broad range of knowledge and skills, most notably in the areas of management and administration, epidemiology, and research. Those abilities should be reflected in the curriculum content.