A pilot Tuning Project-based national study on recently graduated medical students’ self-assessment of competences - the TEST study

Abstract

BackgroundThe Tuning Project is an initiative funded by the European Commission that developed core competences for primary medical degrees in Europe. Students' grouped self-assessments are used for program evaluation and improvement of curricula. The TEST study aimed to assess how do Portuguese medical graduates self-assess their acquisition of core competences and experiences of contact with patients in core settings according to the Tuning framework.MethodsTranslation of the Tuning's competences (Clinical Practice - CP), Knowledge (K) items and Clinical Settings (CS) was performed. Questionnaires were created in paper and electronic formats and distributed to 1591 graduates from seven Portuguese medical schools (July 2014). Items were rated in a 6-point Likert scale (0-5) of levels of competence. Exploratory factor analysis (EFA) was conducted and Cronbach's alpha was used to evaluate the internal consistency of the questionnaire. Kruskal-Wallis and Dunn's tests were used for multiple comparisons.ResultsThree hundred eighty seven questionnaires were analyzed, corresponding to 24 % of the target population. EFA yielded an 11-factor solution for CP and a 6-factor solution for K items. The median value of CP factors was 2.8 (p25 = 2.0; p75 = 3.5) and the median value of K factors was 2.6 (2.0; 3.2). Factor scores ranged from 1.3 (Legal principles) to 4.0 (Ethical principles). Clinical presentations, psychological aspects of illness, evidence-based medicine and promotion of health showed the highest results. Lower scores were detected in medical emergencies, practical procedures, prescribing drugs and legal principles. More than 90 % of graduates experienced having contact with patients in 8 CS but only 24 % of graduates had contact in all 14 CS. Graduates had the least contact with patients in the emergency rooms, intensive care units, palliative, rehabilitation and anesthetic care. Significant differences (p < 0.05) among schools were detected in 8 factors and 7 settings.ConclusionsWe developed a valid questionnaire supporting national SWOT analysis on the acquisition of core competences in medical education. Results suggest that Portuguese graduates are not fully prepared for clinical practice. Curricular improvements in core competences and the educational development of the transition period between undergraduate and postgraduate education ought to be considered. Outcome-based program evaluation relying on graduates’ grouped self-assessments contributes to inform changes in medical education.

Practice analysis of junior doctors in Ethiopia: implications for strengthening medical education, practice and regulation

“…A study in Nepal also recommended continuing professional development for doctors on procedural skills and public health tasks [ 25 ]. However, our findings differ from a Portuguese study which claimed that doctors demonstrated sufficient level of procedural and public health competencies [ 19 ].…”

“…Another study in Western Europe reported that general practitioners had gate keeping roles and wider scope of work [ 18 ]. A Portugal based study found out that over 80% of new doctors had managed few surgical, obstetric, gynaecologic and emergency patients [ 19 ]. A study from Vietnam showed that psychiatry, ophthalmology, and gynecology and obstetrics were infrequently performed [ 20 ].…”

From the lens of the clinical residents: undergraduate to postgraduate medical education and the transition process

“…As expected, the residents differed in the areas where they felt ready. These findings support the studies that reveal the opinions of students, 37 supervisors, 38 specialist registrars and consultant opinions. 39 Preparing graduates for their professional responsibilities will reduce the inequality between what they expect as a physician and what they contribute to the profession.…”

Self-perception of the acquisition of transferable competencies by the participants in a research congress for undergraduate students: A cross-sectional study

“…Various curricular initiatives have been developed to improve the acquisition of research skills by Health Science students [ 18 , 19 , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] ] but these are rarely discussed by the students themselves, although creating opportunities for authentic inquiry and metacognitive reflection are two of the most important pedagogical practices to help students think like scientists [ [38] , [39] , [40] ].…”

“…In response to involve future HP in scientific research, curricular initiatives have been developed to improve the acquisition of research skills in undergraduate medical and, by extension, Health Science students [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] ]. These skills, which consist of the ability to detect a problem, collect sufficient data relevant to the problem from reliable sources, evaluate and effectively apply those data to solve the problem, have been progressively framed in terms of global competencies [ 31 ] as it is considered that the future will be shaped by the adoption of competencies to specific contexts of information and knowledge [ 3 , 31 ].…”