Working Committe in Estonia, March Meeting 2003

Schedule

Introduction and Good Education
Objective Structured Clinical Examination (OSCE)

Projects:

Teaching Geriatrics in Medical Education (TeGeME)
Residency Database (RD)
Curriculum Database (CD)

Evaluation training session
Communication training session

Results of Evaluation on the committee

Schedule

Monday

9.00-9.15
Introduction

9.15-10.00
Team-Building

10.00-10.30
Aims of the working committee

10.30-10.45
Break

10.45-12.00
"Good Education"

12.00-12.30
What is going on in SCOME?

12.30-13.00
What is going on in the NMOs

16.00-19.00
Topic-Based-Session    

Abandoning Female Genital Mutilation               by SCORA, SCORP

War - The Largest Threat to Public Health        by SCOPH, SCORP

Health Education/Preventive Medicine              by SCOME, SCOPH

Medical Students abroad                                  by SCOPE, SCORE

Exchanges in the curricula                               by SCOME,SCOPE/RE

***********************************************************

Tuesday

9.00-11.00
OSCE

11.00-13.00
Projects fair

***********************************************************

Thursday

9.00-9.15
Projects-Introduction

9.15-10.00
Projects-working groups

10.00-10.30
Projects-results

10.30-11.00
Presentation of Liaison Officers

***********************************************************

Friday

9.00-11.00
Evaluation Training

11.00-13.00
Communication Training

15.00-16.00
Recapitulation
future sessions
Fotos
Good-bye

"Good Education"

Participants were asked to reflect upon their educational system and write down what they like about it. This was supposed to make them view their educations in a positive manner, and also to provide information for the other participants, where they could get informations that would help them solve their own problems.

The answers were grouped and posted on a wall for every one to see. The following positive aspects were mentioned:

Student-Teacher-relation (few students per teacher, approachability of teachers, cooperation)

-Greece, Malta, Slovakia, Lebanon

Student influence (on curricula, faculty decisions, etc.)

-Denmark, UK, Germany

Curriculum/Teaching Methods

-Taiwan (Chinese Traditional Medicine, New Technologies),

-UK (Mixing of Pre-Clinical/Clinical),

-Switzerland (PBL)

-Catalonia (Clerkships)

-Norway (Traditional and PBL, good recources)

-Portugal

Communication

-UK, Catalonia, USA, Israel, Netherlands

Practical/Clinical Skills

-Israel, Ukraine, Finland, Bulgaria, Norway, Taiwan, Lebanon, Latvia, Croatia

Theoretical Knowledge

- Israel, Ukraine, Norway, Slovenia, Latvia, Germany, Spain

Flexibility

-Germany, Netherlands, UK

Easy Access to Medical Education (free of charge, no entrance exams, etc.)

-Slovenia, Germany, Austria, Netherlands, Ukraine, Croatia, Norway

The participants were also asked to write down what they personally think of as the most important thing in medical education. The most common answers were:

-Social skills (11)

-Communication skills (10)

-Clinical skills (7)

-Offers of non-medical things (courses, recreation, free coffee, more smoking areas) (4)

-Close contact to patients (3)

-Teamwork (with other health care professions) (2)

-Public/global health (2)

-Close student-teacher contact (1)

Objective Structured Clinical Examination (OSCE)

Four cases with simulated Patients (one of them a special member of the Swiss delegation).

All of them were found on the internet:

1. Social History

http://www.shef.ac.uk/~smtw/2000/cs/cs0527a.htm

2. Single Rescuer - Basic Life Support for Adults

http://www.nottingham.ac.uk/nursing/students/osce/printer.html

(We used case number four in this list.)

3. Ethics OSCE

http://wings.buffalo.edu/faculty/research/bioethics/osce.html

(We used "Truth Telling & Pancreatic Cancer")

4. Respiratory System -

http://www.kcl.ac.uk/teares/gktvc/vc/medical/year3/progress/15.pdf

In order to save time, we had four groups of four people rotate through the OSCE stations. Each student had to complete one station. We also had students as Examiners and Simulated Patients.

During the Discussion after the OSCE was completed we talked about the advantages and disadvantages of checklists, simulated patient programs, and OSCE in general.

Some of the results:

Some general information about OSCE:

OSCE Reading List

OSCE Experience

Cizek, G.  (2001).  Setting Performance Standards: Concepts, Methods, and Perspectives.  Mahwah, New Jersey: Lawrence Erlbaum Associates, Publishers.

Duerson, M.C., Romrell, L.J., & Stevens, C.B.  (2000).  Impacting faculty teaching and student performance: nine years' experience with the objective structured clinical examination.  Teaching and Learning in Medicine, 12 (4), 176-182.

Selby, C., Osman, L., Davis M., & Lee, M.  (1995).  Set up and run an objective structured clinical exam.  British Medical Journal, 310, 1187-1190. 

Using/Training SPs

Humphris, G.M., & Kaney, S.  (2001).  Examiner fatigue in communication skills objective structured clinical examination.  Medical Education, 35, 444-449.

King, A.M., Perkowski-Rogers, L.C., & Pohl, H.S.  (1994).  Planning stadardized patient programs: case development, patient training, and costs.  Teaching and Learning in Medicine, 6 (1), 6-14.

Ladyshewsky, R.  (1999).  Simulated patients and assessment.  Medical Teacher, 21 (3), 266-270.

Vu, N.V., Barrows, H.S., Marcy, M.L., Verhulst, S.J., Colliver, J.A., & Travis, T.  (1992).  Six years of comprehensive, clinical, performance-based assessment using standardized patients at the Southern Illinois University School of Medicine.  Academic Medicine, 67 (1), 42-50. 

Statistical Issues

Burrows, P.J., Bingham, L., & Brailovsky, C.A.  (1999).  A modified contrasting groups method used for setting the passmark in a small scale standardized patient examination.  Advances in Health Sciences Education, 4, 145-154.

Kane, M.T., Crooks, T.J., & Cohen, A.S.  (1999).  Designing and evaluating standard-setting procedures for licensure and certification tests.  Advances in Health Sciences Education, 4, 195-207.

Kaufman, D.M., Mann, K.V., Muijtjens, A.M., & van der Vleuten, C.P.  (2000).  A comparison of standard-setting procedures for an OSCE in undergraduate medical education.  Academic Medicine, 75 (3), 267-271.

Shavelson, R.J.  (1989).  Generalizability theory.  American Psychologist, 44 (6), 922-932.

Swanson, D.B., Clauser, B.E., & Case, S.M.  (1999).  Clinical skills assessment with standardized patients in high-stakes tests: a framework for thinking about score precision, equating, and security.  Advances in Health Sciences Education, 4, 67-106.

Woodburn, J., & Sutcliffe, N.  (1996).  The reliability, validity and evaluation of the objective structured clinical examination in podiatry (chiropody).  Assessment & Evaluation in Higher Education, 21 (2), 131-147. 

OSCE Development

Ben, D., & Friedman, M.  (2000).  The role of assessment in expanding professional horizons.  Medical Teacher, 22 (5), 472-479.

Harden, R.M., & Gleeson, F.A.  (1979).  Assessment of clinical competence using an objective structured clinical examination (OSCE).  Medical Education, 13, 41-54.

Heard, J.K., Ruth R.M, et al.  (1998).  Practical issues in developing a program for the objective assessment of clinical skills.  Medical Teacher, 20 (1), 15-22.

Schwabbauer, M.  (2000).  But can they do it?  Clinical competency assessment.  Clinical Laboratory Science, 13 (1), 47-52. 

Other Issues

Black, N.M., & Harden, R.M.  (1986).  Providing feedback to students on clinical skills by using the Objective Structured Clinical Examination.  Medical Education, 20, 48-52.

Remmen, R.  (2001). Correlation of a written test of skills and a performance based test: a study in two traditional medical schools.  Medical Teacher, 23 (1), 29-33. 

OSCE in Nursing

Borbasi, S.A., & Koop, A.  (1994).  The Objective Structured Clinical Examination: its application in nursing education.  The Australian Journal of Advanced Nursing, 11 (2), 33-40.

Prakash, R.  (1999).  Undergraduate nursing evaluation.  The OSCE approach.  The Nursing Journal of India, 39 (5), 101-104.

Tuazon, J.A. (1999).  Objective Structured Clinical Evaluation for Nursing Foundation courses.  Philippine Journal of Nursing, 69 (3-4), 9-44.

Another Sample OSCE:

http://www.kmrrec.org/KM/osce/pdf/Knee.pdf

Standardized Patients:

http://depts.washington.edu/hsasf/clinical/sp.html

A great homepage about how to be a SP, how to train a SP, etc.

download pdf with suggestions how to run an OSCE

Teaching Geriatrics in Medical Education

download doc-files

research protocol
questionnaire

Residency Database

Coordinator: Kostas Stellos (stellosk@freemail.gr )

Participants: 

Goal of the working group:

The development of the Residency Database Project

Methods:

Brainstorming and round-table discussions on the following themes:

1.    The content of the Residency Database Questionnaire

2.    The goals of the RDb Questionnaire

3.    The promotion of the project

Results:

1.    We went through each question of the RDb Questionnaire in order to examine their clarity and importance. We also  rephrased two questions and added other two to the questionnaire.

2.    We saw the need of redefining the goals of the RDb Questionnaire in order to keep it simple and international

3.    We discussed about the participantsÕ benefits of joining the project and the dissemination of the RDb

Conclusions:

1.    We shall continue working on the finally form of the RDb Questionnaire

2.    We agreed to continue our work  through a mailing list. This list is the ifmsa-rdb@yahoogroups.com.

Curriculum Database

In the curriculum database session we all had a look through the database and decided that some of the questions need some thinking about and the English needs improving in some sections of the site. Ciprian will retain responsibility for the site and we are to email him suggestions for improvements. We were invited to join the curriculum database yahoo group.

Evaluation Training Session

download power point presentation

Communication

download power point presentation

Results of Evaluation on the working committee

Did you gain knowledge about how to change medical education?

More                         -                              less

                                                           O         O          O         O          O         O

                                                           6          7          9          -           2          1                      25

Was this meeting of value to you?

more                         -                              less

                                                           O         O          O         O          O         O

                                                           13        9          1          1          1          -                       25

Did the facilitators encourage you to improve medical education? 

more                         -                              less

                                                           O         O          O         O          O         O

                                                           4          17         3          1          -           -                       24

Did you have difficulties in understanding certain parts of the meeting? 

more                         -                              less

                                                           O         O          O         O          O         O

                                                           -           1          3          1          9          11                    24

Did you feel well integrated into the working committee? 

more                         -                             less

                                                           O         O          O         O          O         O

                                                           10        10         3          2          -           -                       25

Are you more motivated to change curricula at your local university/medical school than before?

more                         -                             less

                                                           O         O          O         O          O         O

                                                           4          12         7          1          -           -                       25

What is the monkeys name?

Mami    Kiki      Tina      Susi      Uli       Monkey             (Ozzy)

                                   O          O         O         O          O         O                      (was not on scale)

                                   -           24        -           -           -           -                       1                      25

Did you have enough time for each session?                        

more                         -                             less

                                                           O         O          O         O          O         O

                                                           3          8          7          3          4          -                       25

Were there too many training sessions in this committee?

more                         -                            less

                                                           O         O          O         O          O         O

                                                           1          2          1          7          6          7                      24

Do you think the working committee was well organized?

more                         -                             less

                                                           O         O          O         O          O         O

                                                           11        9          3          1          1          0                      25

Did you like the Fetish-Party?

more                         -                             less

                                                           O         O          O         O          O         O

                                                           9          6          4          2          1          2                      25

Give an overall ranking for the part "introduction and what is good education"? (Monday)

good                         -                            bad

                                                           O         O          O         O          O         O

                                                           2          13         5          1          2          1                      24

Give an overall ranking for the part "OSCE" (Tuesday)

good                         -                             bad

                                                           O         O          O         O          O         O

                                                           12        10         -           1          -           -                       23

Give an overall ranking for the part "projects" (Thursday).

good                         -                             bad

                                                           O         O          O         O          O         O

                                                           6          9          5          2          -           -                       22

Give an overall ranking for the part "communication skills" (Friday)

good                         -                             bad

                                                           O         O          O         O          O         O

                                                           12        6          5          -           -           -                       23

Give an overall ranking for the part Òevaluation (Friday)Ó

good                         -                            bad

                                                           O         O          O         O          O         O

                                                           4          7          9          -           -           -                       20

Give an overall ranking of the working committee

interesting                  -                            boring

                                                           O         O          O         O          O         O

                                                           11        11         1          1          -           -                       24

Will you attend the August meeting in The Netherlands

                                                           Yes       No        Do not know

                                                           9          2          14                                                        25

If yes, will you attend the SCOME-Sessions

                                                           Yes       No        Do not know

                                                           15        -           2                                                         17

Are you interested in contributing in the work of SCOME-International

more                         -                             less

                                                           O         O          O         O          O         O

                                                           15        7          3          -           -           -                       25

Which part did you like best? / Which part gave you the most information?

-        " Good Education" (3x)

-        Projects session (6x)

-        OSCE (10x)

-        Evaluation (4x)

-        Communication skills (6x)

-        SCOMoviE (1x)

-        Trainings (2x)

-        Shios music (1x)

-        Introduction (1x)

-        Small groups (1x)

Which part didn´t you like at all? / Is there a part, which wasn´t necessary in your opinion?

-        Evaluation (2x)

-        Political discussion with president (3x)

-        Communication (1x)

-        Liaison officer presentation (1x)

-        Games were to many (2x)

-        To less discussion about SCOME´s job (1x)

-        Introduction (2x)

-        "Good Education" (1x)

What could be improved?

-        deeper trainings, more specific (5x)

-        pens, markers, papers were to less -OC? (1x)

-        focus not only on discussions and presentation, but work on implementation and conclusions (4x)

-        more small groups (1x)

-        on time issue (1x)

-        more time for projects (2x)

-        communication between participants (1x)

-        more exchange experiences rather than presentation (1x)

-        plans, conclusion and strategies not only for Europeans (2x)

-        curriculum database (1x)

-        more diversity (1x)

-        integrated sessions (1x)

Are there any other topics you would like to have a workshop on medical education?

-        access to education (1x)

-        Ethics (2x)

-        Effective teaching techniques (2x)

-        Statistics in evaluation (1x)

-        More SCOME-SCOPE (1x)

-        First aid (1x)

-        Promotion for SCOME (2x)

-        Internet (2x)

-        Alternative medicine (1x)-        Culture (1x)

-        Implementing research and science in ME (1x)

-        Global Health (1x)

-        Relation doctors-teachers-patients-students  (1x)

Do you have comments on the evaluation form J ?

-        n/a is missing (1x)

-        the scale is not appropriate, more-less is confusing (3x)

-        evaluation should have consequences (2x)

-        results should be published (1x)

(SORRY: some comments are missing as I could not read all of them L, Ozzi)