Showing papers by "Brian Jolly published in 2007"

AMEE Guide No. 27: effective educational and clinical supervision

Abstract: Background: This guide reviews what is known about educational and clinical supervision practice through a literature review and a questionnaire survey It identifies the need for a definition and for explicit guidelines on supervision There is strong evidence that, whilst supervision is considered to be both important and effective, practice is highly variable In some cases, there is inadequate coverage and frequency of supervision activities There is particular concern about lack of supervision for emergency and ‘out of hours work’, failure to formally address under-performance, lack of commitment to supervision and finding sufficient time for supervision There is a need for an effective system to address both poor performance and inadequate supervision Supervision is defined, in this guide as: ‘The provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainee’s experience of providing safe and appropriate patient care’ A framework for effective supervision is provided: (1) Effective supervision should be offered in context; supervisors must be aware of local postgraduate training bodies’ and institutions’ requirements; (2) Direct supervision with trainee and supervisor working together and observing each other positively affects patient outcome and trainee development; (3) Constructive feedback is essential and should be frequent; (4) Supervision should be structured and there should be regular timetabled meetings The content of supervision meetings should be agreed and learning objectives determined at the beginning of the supervisory relationship Supervision contracts can be useful tools and should include detail regarding frequency, duration and content of supervision; appraisal and assessment; learning objectives and any specific requirements; (5) Supervision should include clinical management; teaching and research; management and administration; pastoral care; interpersonal skills; personal development; reflection; (6) The quality of the supervisory relationship strongly affects the effectiveness of supervision Specific aspects include continuity over time in the supervisory relationship, that the supervisees control the product of supervision (there is some suggestion that supervision is only effective when this is the case) and that there is some reflection by both participants The relationship is partly influenced by the supervisor’s commitment to teaching as well as both the attitudes and commitment of supervisor and trainee; (7) Training for supervisors needs to include some of the following: understanding teaching; assessment; counselling skills; appraisal; feedback; careers advice; interpersonal skills Supervisors (and trainees) need to understand that: (1) helpful supervisory behaviours include giving direct guidance on clinical work, linking theory and practice, engaging in joint problem-solving and offering feedback, reassurance and providing role models; (2) ineffective supervisory behaviours include rigidity; low empathy; failure to offer support; failure to follow supervisees’ concerns; not teaching; being indirect and intolerant and emphasizing evaluation and negative aspects; (3) in addition to supervisory skills, effective supervisors need to have good interpersonal skills, good teaching skills and be clinically competent and knowledgeable

'I'm pickin' up good regressions': the governance of generalisability analyses.

Abstract: CONTEXT Investigators applying generalisabilitytheory to educational research and evaluation havesometimes done so poorly. The main difficulties haverelated to: inadequate or non-random sampling ofeffects, dealing with naturalistic data, and interpret-ing and presenting variance components.METHODS This paper addresses these areas ofdifficulty, and articulates an informal consensusamongst medical educators from Europe, Australiaand the USA, who are familiar with generalisabilitytheory.RESULTS We make the following recommendations.• Ensure that all relevant factors are sampled,and that the sampling meets the theory’s assump-tion that the conditions represent a random andrepresentative sample of the factor’s ‘universe’.Research evaluations will require large samples ofeach factor if they are to generalise adequately.• Where feasible, conduct 2 separate studies (pilotand evaluation, or Generalisability and Decisionstudies).• For unbalanced data, use either ur

What does it take? The influence of rural upbringing and sense of rural background on medical students' intention to work in a rural environment

Abstract: Introduction There is abundant evidence that rural origin is an influence on rural career choice. Rural origin is widely used to select students to be supported into programs designed to address the rural medical workforce shortage. What is not as clear is how many years of rural upbringing are required to have a maximal effect on rural career choice. Neither is the place of having a sense of rural background well understood. Methods A cross-sectional self-completed paper-based survey of all students in years one through four of the Monash University medical course was undertaken in 2003. The survey included a scale to measure stated rural career intention as well as questions about the number of years of rural upbringing and whether students had a sense of rural background. The Rural Intention score was divided into three categories: strong urban intent, strong rural intent, and an intermediate, less certain intent. Results There was an 88% (n = 399) response rate from students holding Commonwealth Supported Places. Approximately 30% of these claimed a sense of rural background, and 28% had more than 8 years of rural upbringing. Twenty-five percent stated a strong intention to choose a rural career and 34.5% had strong urban intent. The remaining 40.5% were in the intermediate group. Almost all students (97.5%) with over 5 years of rural upbringing had developed a sense of rural background, and almost all (97.5%) with less than 5 years' rural upbringing denied a sense of rural background. Rural intent was high for those with a sense of rural background and those with more than 8 years of rural upbringing, but the students who had had from 4 to 8 years of rural upbringing mainly fell into the 'uncertain' category. Discussion In this cohort of almost 400 Australian medical students, a sense of rural background developed at a clear point, around 5 years of rural upbringing. Students with a sense of rural background were likely to develop a strong rural intent several years before similar students who had failed to make this connection with a rural community. This latter group displayed uncertainty toward a rural career choice, possibly due to unfamiliarity. Unlike those with strong urban intent, these students have not excluded a rural career and should be supported. The inclusion of a measure of the intention of students to work in a rural environment is likely to increase the reliability and validity of selection procedures.

The new curriculum framework and assessment practices: current challenges for postgraduate years 1 and 2.

Abstract: • The new curriculum framework for doctors in postgraduate years 1 and 2 is a step towards seamless medical education. • The framework will need additional components to make "the curriculum" deliverable. • Assessment is an essential element of most curricula, and assessment systems should be carefully planned. • Diligent observation and rating in the workplace may provide a suitable approach. • In the future, Australia must also thoroughly engage with the debate on continuing validation of competence.

Jigsaws and the march of time

Abstract: 1993;68:52–81. 7 Smits PBA, Verbeek JHAM, de Buisonje CD. Problem-based learning in continuing medical education: a review of controlled evaluation studies. BMJ 2002;324:153–6. 8 Colliver JA. Effectiveness of problem-based learning curricula: research and theory. Acad Med 2000;75:259–66. 9 Norman GR, Schmidt HG. Effectiveness of problem-based learning curricula: theory, practice and paper darts. Med Educ 2000;34: 721–8. 10 Colliver JA. Call for greater emphasis on effect-size measures in published articles in Teaching and Learning in Medicine. Teach Learn Med 2002;14:206–10. 11 Albanese MA. Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skills. Med Educ 2000;34: 729–38.