The multiple mini‐interview: how long is long enough?

Objectives  The multiple mini-interview (MMI) overcomes the limitations of the traditional panel interview by multiple sampling to provide improved objectivity and reliability. Reliability of the MMI is affected by number of stations; however, there are few data reporting the influence of interview duration on MMI outcome and reliability. We aimed to determine whether MMI stations can be shortened without affecting applicant rankings or compromising test reliability.
Methods  A total of 175 applicants were interviewed and assessed at 10 8-minute stations. Applicants were scored once after 8 minutes at five control stations and twice after 5 minutes and 8 minutes at five experimental stations. Scores at 5 and 8 minutes were compared using t -tests and correlation coefficients. Rankings of applicants based on 5- and 8-minute scores were compared using Spearman's rank order coefficient. The reliability of the MMI was examined for 5- and 8-minute scores using generalisability theory.
Results  Mean scores at 5 minutes were lower than mean scores at 8 minutes. Cumulative scores at 5 minutes were also lower. There were highly significant correlations between 5- and 8-minute scores at all experimental stations (0.82–0.91; P  < 0.01) and between the cumulative scores at 5 and 8 minutes (0.92; P  < 0.01). There was a strong correlation between applicant rankings based on cumulative 5- and 8-minute scores (Spearman's rank order coefficient 0.92). Reliability was not affected.
Conclusions  Reducing the duration of MMI stations from 8 to 5 minutes conserves resources with minimal effect on applicant ranking and test reliability.     

"双轨合一"模式下中医学专业硕士研究生针灸学规范化培训的教学方案探讨

目前对"双轨合一"临床专业硕士研究生培养计划缺乏完整统一的内容和要求,本文以中医学主干学科《针灸学》为例,制定了亚专科层面统一的教学培养方案细则,在方案中明确了教学管理构建,创新了教学方法和考核办法.我们将以制定单一亚专科层面的规范化培训教学培养方案为基础,再逐步形成多学科人才培养方案体系,以期培养合格优秀的规范化培训住院医师.     

中医研究生教育培养调查问卷分析

通过对中医研究生教育培养调查问卷进行整理分析,切实了解目前中医研究生教育的培养模式、课程设置、教学方式、考核方法、科研论文以及培养中的突出问题等方面的情况,发现中医研究生教育中的瓶颈和探讨中医高等人才培养规律,以期在中医研究生教育方面提供新的思路和方案。     

The effects of a continuing medical education programme in interpersonal communication skills on doctor practice and patient satisfaction in Trinidad and Tobago

This study investigates the effects of a brief training programme on the communication skills of doctors in ambulatory care settings in Trinidad and Tobago. Evaluation of doctor performance is based on analysis of audiotapes of doctors with their patients during routine clinic visits and on patient satisfaction ratings. A pre-test/post-test quasi-experimental study design was used to evaluate the effects of exposure to the training programme. Doctors were assigned to groups based on voluntary participation in the programme. Audiotapes of the 15 participating doctors (nine trained and six control) with 75 patients at baseline and 71 patients at the post-training assessment were used in this analysis. The audiotapes were content-coded using the Roter Interaction Analysis System (RIAS). Doctors trained in communication skills used significantly more target skills post-training than their untrained colleagues. Trained doctors used more facilitations in their visits and more open-ended questions than other doctors. There was also a trend towards more emotional talk, and more close-ended questions. Patients of trained doctors talked more overall, gave more information to their doctors and tended to use more positive talk compared to other patients. Trained doctors were judged as sounding more interested and friendly, while patients of trained doctors were judged as sounding more dominant, responsive and friendly than patients of untrained doctors. Consistent with these communication differences, patient satisfaction tended to be higher in visits of trained doctors.     

Primary care residents self assessment skills in dementia

The ability to accurately self-assess is a critical component of professionalism and is included in the newly required Accreditation Council of Graduate Medical Education (ACGME) core competencies. To assess residents' ability to accurately self-assess their competencies related to a commonly presenting problem in geriatrics, a Standardized Patient, portraying an individual with early signs of dementia, was inserted into family medicine residents' clinic schedules. Immediately post the encounter, each resident self-assessed his/her performance using a four category (Communication, History of Present Illness, Social History, Functional Assessment), 17-item behavioral checklist. The items in each category highlighted items specific to a dementia-screening interview (e.g., HPI: Used a standardized exam which includes orientation, memory, recall and registration). Resident ratings were compared to ratings from two faculty assessors who independently viewed the videotape of each resident's SP interview. While statistically significant differences between the self-assessment and expert assessors appeared in only one of the four major check list categories (functional assessment), item specific analysis revealed significant differences on discrete items within the dementia screening interview. Implications for teaching and assessment consistent with the ACGME required competency assessment category of professionalism are discussed. This revised version was published online in September 2006 with corrections to the Cover Date.     

Feasibility analysis of a personalized training plan for learning research methodology

OBJECTIVES: To determine the performance in learning clinical research methodology (CRM) by means of the Keller Plan (KP), to assess its impact on attitudes towards research (AR) and to estimate its acceptability. DESIGN: An educational intervention trial was employed with control group (CG) and random assignment. SETTING: The Family and Community Medicine Teaching Unit in Valencia, Spain, 1997. SUBJECTS: Third-year family residents. RESULTS: In the KP both specific written self-teaching material and interactive computer programme were used, focusing on the tutored resident, with compulsory assessments to continue. In the CG a conventional course was followed. Knowledge of CRM and the AR test (previously validated in another study) were measured at the start. Four tests of successive knowledge, time spent studying, tutorials, final AR test and acceptability were conducted. Non-parametric tests were used. Forty (89%) residents participated, 22 were assigned to KP and 18 to CG. Similar basic characteristics, with exception of AR test (medians 55 Keller, 58 control). KP knowledge tests significantly higher (P = < 0.05) than the CG (medians 101, 88) along with time spent studying (medians 53, 23.4 h). There were no significant differences in AR test, although there was an improvement in both groups, significant in KP but not in CG (median increase of 4.5 and 2). Nine residents used and positively assessed the computer programme. Better acceptability was obtained by the KP in overall evaluation, recommendation of the method and learning dynamic. CONCLUSIONS: The KP obtained better knowledge, motivated studying and was positively accepted.     

Training Hungarian primary health care teachers: the relevance of a UK postgraduate course for health educators

OBJECTIVES: This study constituted a formative evaluation of the relevance of the MSc course to the needs of Hungarian primary health care educators. DESIGN: A qualitative, naturalistic approach using in-depth interviews was used to construct the meaning of the experience of the MSc for the Hungarian participants. Interviews were triangulated using observation and documentary analysis. SETTING: The University of Exeter's Institute of General Practice. SUBJECTS: Eight Hungarian primary health care professionals. RESULTS: The evaluation data revealed that the attitude of the Hungarian students to their role as medical educators had been substantially changed by exposure to western models of adult education. There were a number of 'clashes of expectation' between the Hungarian students and the course staff in relation to the course requirements. Reconciliation of these differing expectations required a sequence of ongoing adjustments to the course content and delivery. CONCLUSIONS: Existing postgraduate courses for health educators can accommodate the needs of medical teachers from countries who are developing their primary health care education systems. Successful accommodation is facilitated by ensuring an adequate preparation in relation to language fluency, academic requirements of the course, familiarization with modern approaches to adult education as well as with the local health care delivery system.     

Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors

Introduction: Nutrition leaders surmised graduate medical nutrition education was not well addressed because most medical and surgical specialties have insufficient resources to teach current nutrition practice. A needs assessment survey was constructed to determine resources and commitment for nutrition education from U.S. graduate medical educators to address this problem. Methods: An online survey of 36 questions was sent to 495 Accreditation Council for Graduate Medical Education (ACGME) Program Directors in anesthesia, family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery. Demographics, resources, and open‐ended questions were included. There was a 14% response rate (72 programs), consistent with similar studies on the topic. Results: Most (80%) of the program directors responding were from primary care programs, the rest surgical (17%) or anesthesia (3%). Program directors themselves lacked knowledge of nutrition. While some form of nutrition education was provided at 78% of programs, only 26% had a formal curriculum and physicians served as faculty at only 53%. Sixteen programs had no identifiable expert in nutrition and 10 programs stated that no nutrition training was provided. Training was variable, ranging from an hour of lecture to a month‐long rotation. Seventy‐seven percent of program directors stated that the required educational goals in nutrition were not met. The majority felt an advanced course in clinical nutrition should be required of residents now or in the future. Conclusions: Nutrition education in current graduate medical education is poor. Most programs lack the expertise or time commitment to teach a formal course but recognize the need to meet educational requirements. A broad‐based, diverse universal program is needed for training in nutrition during residency.     

An Innovative Seminar Course in Business Etiquette for Pharmacy Graduate Students

Objectives. To develop and implement a seminar course for graduate students in the social and administrative pharmaceutical sciences to enhance knowledge and confidence with respect their abilities to demonstrate appropriate business etiquette.Design. A 1-credit graduate seminar course was designed based on learner-centered constructivist theory and application of Fink’s Taxonomy for Significant Learning.Assessment. Eleven students participated in the spring 2011 seminar course presentations and activities. Students completed pre- and post-assessment instruments, which included knowledge and attitudinal questions. Formative and summative assessments showed gains in student knowledge, perceived skills, and confidence based on observation and student-reported outcomes.Conclusion. Graduate student reaction to the course was overwhelmingly positive. The etiquette course has potential application in doctor of pharmacy education, other graduate disciplines, undergraduate education, and continuing professional development.