How was the intern year?: self and clinical assessment of four cohorts, from two medical curricula

Abstract

BackgroundProblem-based curricula have provoked controversy amongst educators and students regarding outcome in medical graduates, supporting the need for longitudinal evaluation of curriculum change. As part of a longitudinal evaluation program at the University of Adelaide, a mixed method approach was used to compare the graduate outcomes of two curriculum cohorts: traditional lecture-based ‘old’ and problem-based ‘new’ learning.MethodsGraduates were asked to self-assess preparedness for hospital practice and consent to a comparative analysis of their work-place based assessments from their intern year. Comparative data were extracted from 692 work-place based assessments for 124 doctors who graduated from the University of Adelaide Medical School between 2003 and 2006.ResultsSelf-assessment: Overall, graduates of the lecture-based curriculum rated the medical program significantly higher than graduates of the problem-based curriculum. However, there was no significant difference between the two curriculum cohorts with respect to their preparedness in 13 clinical skills. There were however, two areas where the cohorts rated their preparedness in the 13 broad practitioner competencies as significantly different: problem-based graduates rated themselves as better prepared in their ‘awareness of legal and ethical issues’ and the lecture-based graduates rated themselves better prepared in their ‘understanding of disease processes’.Work-place based assessment: There were no significant differences between the two curriculum cohorts for ‘Appropriate Level of Competence’ and ‘Overall Appraisal’. Of the 14 work-place based assessment skills assessed for competence, no significant difference was found between the cohorts.ConclusionsThe differences in the perceived preparedness for hospital practice of two curriculum cohorts do not reflect the work-place based assessments of their competence as interns. No significant difference was found between the two cohorts in relation to their knowledge and clinical skills. However results suggest a trend in ‘communication with peers and colleagues in other disciplines’ (χ2 (3, N = 596) =13.10, p = 0.056) that requires further exploration. In addition we have learned that student confidence in a new curriculum may impact on their self-perception of preparedness, while not affecting their actual competence.

Does a problem-based learning MBBS curriculum prepare resident medical officers for paediatric practice in Papua New Guinea?

“…There are few studies of preparedness for clinical practice from lower/middle income countries. There is no compelling evidence that PBL itself prepares the student for the role of RMO better than traditional curricula, but studies indicate that it may well have advantages (Dean et al, 2003;Laven et al, 2014).…”

Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

“…internship. An anonymous questionnaire with quantitative and qualitative elements was used with permission from the University of Stellenbosch (34), which in turn had adapted it from an Australian study (7). The instrument was modified to make it suitable for supervisors as well as interns (the source instrument was for interns only) since we believed it would add to the validity of the study:…”

Integrative Teaching in Radiology – A Survey

“…Based on the present questionnaire in radiology and according to the plans for the National Competency-based Catalog of Learning Objectives, disciplinebased teaching is becoming less important. Several studies have shown that this development increases practical skills but decreases understanding of fundamental sciences and formal understanding of disease processes [31,32]. Points of criticism on the part of radiology disciplines regarding the current version of the National Competency-based Catalog of Learning Objectives are learning objectives that are too general, a lack of mandatory examination content, and underrepresentation of cross-disciplinary subjects [33].…”