Showing papers by "Brian Jolly published in 1997"

Can students learn clinical method in general practice? A randomised crossover trial based on objective structured clinical examinations

Abstract: Objective: To determine whether students acquired clinical skills as well in general practice as in hospital and whether there was any difference in the acquisition of specific skills in the two environments Design: Randomised crossover trial Subjects and setting: Annual intake of first year clinical students at one medical school Intervention: A 10 week block of general internal medicine, one half taught in general practice, the other in hospital Students started at random in one location and crossed over after five weeks Outcome measures: Students9 performance in two equivalent nine station objective structured clinical examinations administered at the mid and end points of the block: a direct comparison of the two groups9 performance at five weeks; analysis of covariance, using their first examination scores as a covariate, to determine students9 relative improvement over the second five weeks of their attachment Results: 225 students rotated through the block; all took at least one examination and 208 (92%) took both For the first half of the year there was no significant difference in the students9 acquisition of clinical skills in the two environments; later, however, students taught in general practice improved slightly more than those taught in hospital (P=0007) Conclusions: Students can learn clinical skills as well in general practice as in hospital; more work is needed to clarify where specific skills, knowledge, and attitudes are best learnt to allow rational planning of the undergraduate curriculum

Assessment and appraisal.

Abstract: At a workshop in Cambridge in 1989 about 40 examiners from undergraduate schools and Royal Colleges were asked to define the purpose of assessment. They came up with 13 different issues, from ‘protecting the public’ to ‘generating finances to underpin collegiate activities’. To many, especially to students, assessment is the curriculum; activity cycles, motivation, type and intensity of workload, and psychological problems frequently follow a pattern related to the assessment system. Yet progression from school leaver to practising doctor is, unfortunately, not determined by a coherent policy on, and consistent practice of assessment. The achievement of academic and professional goals, and the delivery of assessments appropriate to them, is the responsibility of various bodies, ranging from the GMC and Royal Colleges, to departments of universities that may not be located within a medical or even a health science framework. Nevertheless there seems now to be an attempt to ensure that appropriate assessment mechanisms are used at each level of training. Pre-university, there are efforts to improve selection procedures (Whitehouse 1997). In undergraduate courses effort is being directed towards assessment that complements innovations in teaching. In the general and specialist training years the GMC and the Department of Health have highlighted the need for dedicated assessment and appraisal managed by senior clinicians leading to a defined standard of performance. The GMC has designed a comprehensive package of assessment and appraisal aimed at confirming and remediating poor performance. Hence, there now exists a canopy over the whole of professional development, albeit an uncoordinated and fragmented one, which was missing only a few years ago. The purpose of t h i s paper is to identlfy the main issues arising from recent developments in assessment and to identify the implications for the transition from student to practitioner. DEFINITIONSANDTECHNICAL CHARACTERISTICS OF ASSESSMENT AND THEIR IMPACT ON TRANSITION

Evaluation of the Effectiveness of Clinical Skills Teaching in the Community

Abstract: Background: There are many advantages claimed for community based teaching, but as yet, little data on its efficacy c.f. hospital based teaching. At University College London Medical School a traditional hospital based attachment for first year clinical students has been replaced with one taught in General Practice. The aims of the attachment are to teach the core clinical skills of history taking, physical examination and communication with patients. Aim: To determine whether students taught in General Practice acquire their basic clinical skills as well as those taught in hospital. Method: A crossover design using a nine station Objective Structured Clinical Examination (OSCE). Results: Students taught in General Practice performed as well as those taught in hospital. Conclusion: General Practice is an appropriate place for students to learn their basic clinical skills.

Alternative Routes to Vocational Training for General Practitioners in Australia

Abstract: The authors were appointed by the Federal Government of Australia to investigate General Practitioner (GP) training and advise on the need for and format of alternative training routes.