Students accept and support a formal consent process. PPE participation rates are similar to predictions. The experience must match the promises made. Formal preparation alone might have produced similar student outcomes. Female students are more selective about tasks undertaken. The influence of ethnicity and the effect on future behaviour and attitudes needs further exploration.

BackgroundProgress Tests (PTs) draw on a common question bank to assess all students in a programme against graduate outcomes. Theoretically PTs drive deep approaches to learning and reduce assessment-related stress. In 2013, PTs were introduced to two year groups of medical students (Years 2 and 4), whereas students in Years 3 and 5 were taking traditional high-stakes assessments. Staged introduction of PTs into our medical curriculum provided a time-limited opportunity for a comparative study. The main purpose of the current study was to compare the impact of PTs on undergraduate medical students’ approaches to learning and perceived stress with that of traditional high-stakes assessments. We also aimed to investigate the associations between approaches to learning, stress and PT scores.MethodsUndergraduate medical students (N = 333 and N = 298 at Time 1 and Time 2 respectively) answered the Revised Study Process Questionnaire (R-SPQ-2F) and the Perceived Stress Scale (PSS) at two time points to evaluate change over time. The R-SPQ-2F generated a surface approach and a deep approach score; the PSS generated an overall perceived stress score.ResultsWe found no significant differences between the two groups in approaches to learning at either time point, and no significant changes in approaches to learning over time in either cohort. Levels of stress increased significantly at the end of the year (Time 2) for students in the traditional assessment cohort, but not in the PT cohort. In the PT cohort, surface approach to learning, but not stress, was a significant negative predictor of students’ PT scores.ConclusionsWhile confirming an association between surface approaches to learning and lower PT scores, we failed to demonstrate an effect of PTs on approaches to learning. However, a reduction in assessment-associated stress is an important finding.

cient use of the 45 minutes available. The diversity task was undertaken by 68 students, with eight facilitators. Evaluation of results and impact Evaluation surveys, using 5-point Likert scales, were completed by students and facilitators. No student or facilitator found the discussion uncomfortable or embarrassing. Overall, 82% of students and 88% of facilitators rated this session as good or excellent as a tool for discussion about diversity; 97% of students and all facilitators agreed that the task was suitable for use with all students in this context, and 85% of students found the discussion points either interesting or very interesting.We concluded that this task successfully met the primary aim of facilitating a more comfortable environment for discussing diversity. We were also interested to know whether it had strengthened students' awareness of diversity as an important issue; 90% of students felt the task had achieved this. A possible limitation of the task is its initial focus on one specific aspect of diversity. Participants may feel less comfortable discussing alternative triggers, focusing, for example, on socio-economic or ethnic diversity. We would like to develop our research by asking wheelchair users their thoughts and feelings about the task, and by using other examples of diversity in the trigger material.We hope our description of this problem-based diversity task may stimulate dialogue between medical schools on how discussion of diversity may be approached. Context and setting Cultural competency is associated with improved health outcomes. To ensure that our students are both clinically and culturally competent, they learn cultural competency throughout their medical training. Why the idea was necessary Indigenous Maori children receive a lower standard of health care and have poorer health outcomes than other children in New Zealand. In our paediatric rotation we therefore wanted our students to learn and be assessed on cultural competency as it pertains to indigenous Maori children and their families. What was done We introduced a lecture on Maori health at the beginning of the paediatric rotation. In this the students were reminded of the poorer health outcomes of Maori children, were shown how they receive a lower standard of health care and were informed about the difficulties the children and their families encounter in accessing health services. Students submit three case reports as part of their paediatrics assessment. We required one of these to be on a Maori child and his or her family. The clinical teachers who marked the other case reports also marked the Maori cases against specific criteria. These required demonstration of: consideration of the child's health within the context of the wider determinants of health; recognition of the inequalities in health outcomes; an understanding of the family dynamics; a management plan that was consistent with the family context; a conscious effort to address the barriers to health care; a critical reflection on the interaction with t...

Peer Physical Examination (PPE) is an educational tool used globally for learning early clinical skills and anatomy. In quantitative research, there are differences in students' preferences and actual participation in PPE by gender. This novel study qualitatively explores the effect that gender has on medical students' experiences of learning physical examination through PPE. We employ an interpretative approach to uncover the PPE experiences of students from a European, graduate-entry medical school. Volunteers participated in either individual or group interviews. The data were transcribed, de-identified and analysed using thematic analysis. There was evidence of gender inequity in PPE, with students describing significant imbalances in participation. Male students adopted roles that generated significant personal discomfort and led to fewer experiences as examiners. Assumptions were made by tutors and students about gender roles: male students' ready acceptance of exposure to be examined and female students' need to be protected from particular examinations. In contrast with the first assumption, male students did feel coerced or obliged to be examined. Students described their experiences of taking action to break down the gender barrier. Importantly, students reported that tutors played a role in perpetuating inequities. These findings, whilst relating to one university, have implications for all settings where PPE is used. Educators should be vigilant about gender issues and the effect that they may have on students' participation in PPE to ensure that students are not disadvantaged in their learning.

Objective To introduce and evaluate a short clinical examination skills course in a BPharm programme. The study objectives were to assess needs, explore attitudes, record perceived competence requirements and assess the value of physical examination skills learning. Setting BPharm programme in Auckland, New Zealand. Participants were students enrolled in years 3 and 4 of the programme (2003). Method The design was a longitudinal, dual cohort, educational intervention evaluation using a self-completed questionnaire. An examination skills component was added to the fourth year of the pharmacy programme. Year 3 and 4 students were recruited, and completed the questionnaire at two points. Year 3 students were sampled one year before and soon after the skills sessions. Year 4 students were sampled after the sessions and 18 months later (once registered). The questionnaire sought their attitudes towards clinical skills training and practical relevance for future practice, and evaluated their learning experience. Key findings Response rates at the four points were 42-67%. Year 3 students identified a similar set of appropriate skills to those actually taught in year 4. Overall, attitudes to introducing examination skills learning were positive at all points. At follow-up, both cohorts agreed more strongly that examination skills training should be core (significantly for registered pharmacists versus year 3, P < 0.006). Measuring manual blood pressure was deemed the most difficult skill. All taught skills were used in practice except for respiratory rate; most used were body mass index (BMI), temperature and peak flow measurement. Conclusions There was a close correlation between what was offered in the course, what students felt they needed to learn and what was relevant in practice. Once registered, pharmacists were aware of their limitations and level of competence in relation to clinical skills. The small changes in attitudinal scores appear to reflect maturity and experience. The study design allowed us to adapt the educational component to student need. Health professional educators need to be aware of and respond to changes in professional scopes of practice.