AMEE 2005 Abstracts

241 Pages·2005·1.91 MB·English

AMEE 2005
in collaboration with Vrije Universiteit
and the VU university medical center, Amsterdam
Abstracts
30 August – 3 September 2005
RAI Congress Centre
Amsterdam, The Netherlands
Association for Medical Education in Europe
Tay Park House, 484 Perth Road, Dundee DD2 1LR, Scotland, UK
Tel: [phone] Fax: [phone]
Email:
INDEX OF ABSTRACTS
Index of Abstracts
Wednesday 31 August (blue section)
Session 1 Plenary: What makes a good doctor? .. .. .. .. .. 7
Session 2 2AUD Symposium: Attitudes and professionalism .. .. .. .. 8
2A Symposium: Project GLOBE: A new initiative to provide quality CPD for Generalist Physicians .. 8
2B Short communications: Problem-based learning: the presenting problem .. .. 8
2C Short communications: Training for leadership .. .. .. .. 10
2D Short communications: Student characteristics .. .. .. .. 11
2E Short communications: Approaches to Multiprofessional education .. .. 13
2F Short communications: Methods of teaching and learning .. .. .. 14
2H Workshop: How to improve oral examinations in medical practice .. .. 16
2L Short communications: Selection for graduate entry to medicine .. .. 16
2M Short communications: Clinical assessment .. .. .. .. 17
2N Short communications: e-Learning: instructional design .. .. .. 19
2O Short communications: Continuing Professional Development/Continuing Medical Education 1 .. 20
2R Workshop: Emergency and Trauma management: training providers and instructors .. 22
2S Workshop: Active learning on the Web: how to develop an effective instructional web site .. 22
2T Workshop: Multi source (360 degree) feedback for assessment, feedback and learning
across the medical education continuum .. .. .. .. 22
2U Workshop: Developing and using standardized video cases for computerized assessment of
communication skills for pre-clinical medical students .. .. .. 22
2 Onyx 1 Posters: e-Learning in medical education .. .. .. .. 23
2 Onyx 2 Posters: Staff/Faculty development .. .. .. .. 26
2 Topaz 1 Posters: Curriculum evaluation and change .. .. .. .. 29
2 Topaz 2 Posters: Written assessment .. .. .. .. .. 32
2 Ruby 1 Posters: Evaluation of medical schools and students .. .. .. 34
2 Ruby 2 Posters: Curriculum evaluation .. .. .. .. .. 36
Session 3 3AUD Symposium: e-Learning in medical education .. .. .. .. 39
3A Short communications: Curriculum planning .. .. .. .. 39
3B Short communications: Problem Based Learning: role of the tutor .. .. 40
3C Short communications: Multiprofessional education in the workplace .. .. 41
3D Short communications: Teaching and learning communication skills 1 .. .. 43
3E Short communications: Continuing Professional Development/Continuing Medical Education 2 .. 44
3F Workshop: East European/Central Asian Special Interest Group .. .. .. 45
3H Workshop: Keeping an eye on quality: how the LCME trains and evaluates its survey teams .. 45
3L Short communications: Methods of selection .. .. .. .. 46
3M Short communications: Portfolios in teaching and assessment 1 .. .. .. 47
3N Short communications: Assessment of professionalism .. .. .. 48
3O Short communications: Best Evidence Medical Education and other review methodologies .. 50
3R Workshop: Case material development, recruiting and training for standardization with
Standardized Patients .. .. .. .. .. 51
3S Workshop: Effective use of questioning during teaching .. .. .. 51
3T Workshop: The Case Method .. .. .. .. .. 51
3U Workshop: Questionnaire design and analysis for new researchers .. .. 51
– 1 –
INDEX OF ABSTRACTS
3 Onyx 1 Posters: Use of simulators in medical education .. .. .. .. 52
3 Onyx 2 Posters: Methods of teaching and learning .. .. .. .. 54
3 Topaz 1 Posters: Student support .. .. .. .. .. 57
3 Ruby 1 Posters: Education environment .. .. .. .. .. 58
3 Ruby 2 Posters: Basic sciences .. .. .. .. .. 60
Session 4 4AUD Symposium: Accreditation of institutions and programmes in medical education .. .. 62
4A Symposium: Complex Adaptive Systems .. .. .. .. 63
4B Short communications: Problem Based Learning: implementing a course .. .. 63
4C Short communications: Teaching and learning communication skills 2 .. .. 64
4D Short communications: Multiprofessional education and teamwork .. .. 66
4E AMEE Fringe 1 .. .. .. .. .. .. 67
4F Workshop: Feedback: Closing the teaching-learning loop in clinical skills .. .. 68
4H Workshop: Preparing and delivering better lectures .. .. .. 68
4L Short communications: E-Learning: the virtual learning environment .. .. 68
4M Short communications: Portfolios in teaching and assessment 2 .. .. .. 70
4N Short communications: Different approaches to evaluating a curriculum .. .. 71
4O Short communications: Postgraduate assessment .. .. .. 72
4R Workshop: Learning to teaching: peer assisted learning .. .. .. 74
4T Workshop: Implementing Competency Frameworks: lessons from the CanMEDS Project .. 74
4U Workshop: Supporting trainers in promoting professionalism .. .. .. 74
4 Onyx 1 Posters: Clinical teaching and learning .. .. .. .. 75
4 Onyx 2 Posters: Curriculum strategies .. .. .. .. .. 77
4 Topaz 1 Posters: Postgraduate speciality training .. .. .. .. 79
4 Ruby 1 Posters: The setting for clinical teaching and learning .. .. .. 81
4 Ruby 2 Posters: Students; Gender issues in medical education .. .. .. 83
Thursday 1 September (yellow section)
Session 5 Plenary: Medical education research and its translation into teaching and clinical practice .. 87
Session 6 6AUD Symposium: Bologna Process and medical education .. .. .. 88
6A Symposium: Research in education .. .. .. .. 89
6B Short communications: e-Assessment 1 .. .. .. .. 89
6C Short communications: Teaching and learning about research .. .. .. 90
6D Short communications: Student support .. .. .. .. 91
6E Workshop: Designing and organizing reliable case-based tests with Short-Answer-Questions .. 92
6F Workshop: Personal and professional development – effective practices .. .. 93
6G Workshop: Effective communication in the health professions .. .. .. 93
6H Workshop: Standardized assessment of reasoning in the context of uncertainty: the Script
Concordance Test .. .. .. .. .. 93
6L Short communications: Doctors practising in a different country .. .. .. 94
6M Short communications: Written assessment .. .. .. .. 95
6N Short communications: Standardized/simulated patients .. .. .. 96
o
6O Short communications: Postgraduate 360 assessment .. .. .. 98
6R Workshop: The International Virtual Medical School – IVIMEDS .. .. .. 99
6S Workshop: Making education count in the promotion and tenure process .. .. 99
6T Workshop: A multidisciplinary initiative to create a resource for integrating women’s
health into the curriculum .. .. .. .. .. 99
6U Workshop: Clinical skills – where next? .. .. .. .. 100
– 2 –
INDEX OF ABSTRACTS
6 Onyx 1 Posters: Continuing Professional Development/Continuing Medical Education .. .. 100
6 Onyx 2 Posters: e-Learning and the virtual learning environment .. .. .. 102
6 Topaz 1 Posters: Problem Based Learning 1 .. .. .. .. 105
6 Ruby 1 Posters: Postgraduate training: the early years .. .. .. .. 107
6 Ruby 2 Posters: Selection for medicine .. .. .. .. .. 109
Session 7 7AUD Symposium: Evidence based teaching .. .. .. .. 112
7A Short communications: e-Problem Based Learning .. .. .. 112
7B Short communications: The Objective Structured Clinical Examination 1 .. .. 113
7C Short communications: Community based medical education .. .. .. 115
7D Short communications: Evaluation of teachers .. .. .. .. 116
7E Short communications: Evaluating the international medical student and doctor .. .. 117
7F Workshop: Ibero-American Group .. .. .. .. 118
7G Workshop: Crisis resource management for healthcare professionals – a new six step approach .. 118
7H Workshop: Towards a core curriculum for Psychology in undergraduate medicine .. 119
7L Short communications: e-Learning: virtual patients .. .. .. 119
7M Short communications: What is professionalism? .. .. .. 120
7N Short communications: Understanding teaching and learning .. .. .. 122
7O Short communications: General Practice/Family Medicine 1 .. .. .. 123
7R Workshop: Tobacco treatment education .. .. .. .. 124
7S Workshop: A framework for analyzing the quality of multiple-choice items .. .. 125
7T Workshop: Student involvement in quality improvement of medical education .. .. 125
7U Workshop: The role of needs assessments in designing teacher training programmes for
medical residents .. .. .. .. .. 125
7 Onyx 1 Posters: Curriculum planning .. .. .. .. .. 125
7 Onyx 2 Posters: Self assessment and formative assessment .. .. .. 128
7 Topaz 1 Posters: Outcome based education .. .. .. .. 130
7 Ruby 1 Posters: Postgraduate assessment .. .. .. .. 131
7 Ruby 2 Posters: Standardized patients and clinical teaching .. .. .. 133
Session 8 8AUD Symposium: Assessment in the context of postgraduate training .. .. 136
8A Short communications: e-Learning and postgraduate education .. .. .. 136
8B Short communications: The Objective Structured Clinical Examination 2 .. .. 137
8C Short communications: Staff/faculty development 1: Staff/faculty development in action .. 138
8D Short communications: The education environment .. .. .. 140
8E AMEE Fringe 2 .. .. .. .. .. .. 141
8F Short communications: Introductory/transitional courses in medicine .. .. 142
8H Workshop: Teaching professionalism: principles and practices .. .. .. 143
8J Workshop: Lab coat pocket knowledge: the PDA as an aid to medical and teaching
decision-making: a course for beginners .. .. .. .. 144
8L Short communications: Teaching and learning clinical skills 1 .. .. .. 144
8M Short communications: General Practice/Family Medicine 2 .. .. .. 145
8N Short communications: Competency based postgraduate education .. .. 147
8O Short communications: Curriculum management and the stakeholders .. .. 148
8R Workshop: Let’s agree to disagree: quality assurance procedures in standardized patient
assessments .. .. .. .. .. .. 149
8S Workshop: Substituting for nature: a continuing education challenge .. .. 150
8T Workshop: Young Educators’ Group .. .. .. .. 150
8U Workshop: Mastering the scholarly process .. .. .. .. 150
– 3 –
INDEX OF ABSTRACTS
8 Onyx 1 Posters: Problem Based Learning 2 .. .. .. .. 150
8 Onyx 2 Posters: Postgraduate medical training .. .. .. .. 152
o
8 Topaz 1 Posters: Assessment: clinical, 360 and portfolio.. .. .. .. 153
8 Ruby 1 Posters: Teacher evaluation .. .. .. .. .. 156
8 Ruby 2 Posters: Teaching and learning theory; Peer-to-Peer learning .. .. .. 158
Friday 2 September (green section)
Session 9 9AUD Symposium: Student involvement in medical education .. .. .. 161
9A Short communications: International medical education; the Bologna Declaration .. 161
9B Short communications: Standard setting .. .. .. .. 163
9C Short communications: Staff/faculty development 2: learning outcomes and rewards .. 164
9D Workshop: Mastering bedside cardiology using Harvey, the Cardiopulmonary Patient Simulator .. 166
9E Short communications: e-Learning in action .. .. .. .. 167
9F Short communications: Teaching and learning about public health and health promotion .. 168
9H Short communications: e-Assessment 2 .. .. .. .. 170
9L Short communications: Education and professionalism .. .. .. 172
9M Short communications: Diversity and admission to medical school .. .. 173
9N Short communications: Postgraduate education 1 .. .. .. 174
9O Short communications: Outcome based education 1 .. .. .. 176
9R Workshop: A consumer’s guide to Generalisability Theory .. .. .. 178
9S Workshop: Using Team Learning teaching methods to promote multiple professional competencies 178
9T Workshop: Portfolios: joy or burden? Lessons learned from experience in undergraduate
medical training .. .. .. .. .. .. 179
9U Workshop: Accept, Revise, Reject: reviewing educational research manuscripts .. .. 179
9 Onyx 1 Posters: Assessment of communication skills .. .. .. .. 180
9 Onyx 2 Posters: Multiprofessional education .. .. .. .. 181
9 Topaz 1 Posters: Evaluation of Problem Based Learning .. .. .. .. 183
9 Ruby 1 Posters: Postgraduate education and Continuing Professional Development .. .. 186
9 Ruby 2 Posters: Teaching and learning communication skills .. .. .. 187
Session 10 10AUD Symposium: Selection for medicine .. .. .. .. 190
10A Short communications: Use of simulators .. .. .. .. 190
10B Short communications: Problem Based Learning: results from different approaches to evaluation 192
10C Short communications: Staff/faculty development 3 .. .. .. 193
10D Workshop: Best evidence simulation-based training using Harvey, the Cardiopulmonary
Patient Simulator .. .. .. .. .. 195
10E Short communications: Clinical teaching and learning .. .. .. 195
10F Short communications: The student in difficulty .. .. .. .. 197
10H Short communications: New challenges for the curriculum .. .. .. 198
10L Short communications: Approaches to assessment .. .. .. 200
10M Short communications: e-Learning clinical skills .. .. .. .. 201
10N Short communications: Postgraduate education 2 .. .. .. 202
10O Short communications: Outcome based education 2 .. .. .. 204
10R Workshop: Playing the game – the role of games and simulations in medical education .. 206
10S Workshop: Integration of Ethics in the undergraduate medical curriculum .. .. 206
10T Workshop: Reflective Practice: how to use it to improve your clinical teaching .. .. 206
10U Workshop: Consent for patient recordings in healthcare education .. .. .. 207
– 4 –
INDEX OF ABSTRACTS
10 Onyx 1 Posters: International medical education; Language proficiency .. .. .. 207
10 Onyx 2 Posters: The Objective Structured Clinical Examination .. .. .. 210
10 Topaz 1 Posters: Professionalism and attitudes .. .. .. .. 213
10 Ruby 1 Posters: Teaching and learning about research methods and Evidence Based Medicine .. 216
10 Ruby 2 Posters: Undergraduate training in primary care .. .. .. .. 219
Session 11 Plenary: New learning technologies .. .. .. .. .. 222
Web posters (white section)
WBS The Basic Sciences .. .. .. .. .. 223
WCA Clinical Assessment .. .. .. .. .. 224
WCS Communication Skills .. .. .. .. .. 226
WCEL Computers and e-Learning .. .. .. .. .. 227
WCE Curriculum Evaluation .. .. .. .. .. 228
WCP Curriculum Planning .. .. .. .. .. 230
WPG Postgraduate Education and CPD/CME .. .. .. .. 232
WP Professionalism .. .. .. .. .. .. 234
WSD Staff/Faculty Development .. .. .. .. .. 235
WSS Special Subjects in the Curriculum .. .. .. .. 235
WS Students .. .. .. .. .. .. 236
WTL Teaching and Learning .. .. .. .. .. 237
– 5 –
INDEX OF ABSTRACTS
– 6 –
Session 1 WEDNESDAY 31 AUGUST Session 1
Plenary What makes a good doctor?
1.1 Attitudes and professionalism: The Miriam to culturally competent. It starts with understanding oneself
Friedman Ben-David Lecture as a cultural being with insecurities and prejudices (cultural
awareness). It demands some cultural knowledge on values
David Stern (University of Michigan Medical School, Division and expectations of other members of our societies. It
of General Medicine, 300 North Ingalls, Ann Arbor, MI 48109-
leads to cultural skills, so that professional care providers
0429, USA)
are capable of developing culturally sensitive interventions,
What makes a good doctor? The characteristics of a good and it results in a cultural exchange, where continuing
doctor are well-defined by the ideals of our profession communication leads to respect and further development
and the expectations of our patients. But what makes a of cultural competence.
good doctor? That is, what is the recipe for a good doctor?
Certainly it takes training in the foundations of knowledge,
clinical skills, and ethical understanding. However, these 1.3 Clinical Reasoning
foundations are of little practical use until forged in the Geoff Norman (McMaster University Medical School,
context of practice. Dealing with uncertainty, accepting Department of Clinical Epidemiology, 1280 Main Street West,
responsibility, and reflecting on practice in an environment Hamilton, Ontario L8N 3Z5, Canada)
conducive to professional formation can create the good
This presentation is a review of 3 decades of research
doctors we expect.
into the nature of clinical reasoning. I highlight three
distinct periods in our understanding of the process. In
1.2 Cultural Competence the first period, reasoning was viewed as a general skill,
like problem-solving, which experts acquired in the course
Ivan Wolffers (Vrije Universiteit, Amsterdam, Netherlands) of their training, and which could be elucidated by
Interaction between people looking for care and providers observation and introspection as experts and novices
of care is a meeting place of cultures. Providers of care worked their way though a clinical problem in a realistic
need professional training for what is expected from them setting. In the end, little evidence of a general skill
in this interaction. Internationally this has been labelled emerged, and it became evident that success was more
as a process of ‘Interculturalisation’. This process involves directly related to knowledge in a particular domain. The
two or more cultures, because providers of care as well as second period was characterized by attempts to identify
care seekers of care belong to cultures. Cultures are the organization of knowledge used by experts. Various
systems of interpretation that help people make sense of researchers have hypothesized that expert knowledge is
what happens to them. Though in Western countries based on individual exemplar cases, semantic axes,
professionals often think that others belong to a culture, propositional networks, conditional probabilities, and illness
while they themselves work in a scientific way and belong scripts. Clearly not all can be right, and we are now entering
to a culture of truth, reality is different. All human beings a third broad research program in which the central issue
are cultural beings. Cultures are not homogenous and is how experts coordinate various kinds of knowledge to
people belong to more cultures. In multicultural societies, solve particular problems. In concluding, I will draw
a ‘good doctor’ is trained to move from culturally destructive implications for clinical teaching.
– 7 –
Session 2 WEDNESDAY 31 AUGUST Session 2
Symposia
2AUD & 2A
2AUD Attitudes and professionalism opportunities in a cost-effective product oriented way. This
will require formal cooperation among professional medical
Trudie Roberts (University of Leeds, Medical Education Unit,
organizations, national health systems, governments,
Level 7, Worsley Building, Clarendon Way, Leeds LS2 9NL,
medical schools and practicing physicians. Project GLOBE
UK), Robert Galbraith (National Board of Medical Examiners,
Philadelphia, USA), David Stern (University of Michigan initiative is a new worldwide partnership aimed at
Medical School, Ann Arbor, USA), Anne Garden (University improving the capability and competence of generalist
of Liverpool, UK) and Moira Maley (University of Western doctors (with an emphasis on GPs and FPs) to deliver
Australia) health and medical care of the highest possible quality
within their own countries and practice settings. A Steering
What do we mean by professionalism and what are
Committee of international leaders in medical education,
professional attitudes? What are the implications for
general practice, and family medicine as well as information
selection? What is the role of the teacher? If we had a
technology was convened in March 2005 and has
basket containing professional attitudes/professional
developed an initial assessment of the needs and ways to
attributes what qualities would be in it and what wouldn’t?
enhance the competence of GPs, FPs and health systems
How are attitudes taught and assessed? Can we only
in a group of representative countries around the world.
address behaviours which are visible rather then attitudes
This session will report on the progress made during the
which are often hidden? Does it matter that an individual
first months of the initiative and provide a forum for
may hold what we consider to be a non professional
discussion by AMEE attendees about the future directions
attitude if their behaviour is exemplary? Can attitudes be
of the project. Brief presentations will focus on these four
changed and if so how? If a student fails a knowledge or
areas: 1) GP/FP educational and professional development
skills test then we provide remedial teaching – can this
needs from selected countries; 2) effective methods, tools
apply to attitudes? The world of work and societies’ values
and resources that will be applicable to deliver CME-CPD
are changing – can we offer a framework for attitudes
globally or regionally; 3) a report on currently available
and professionalism which covers this? These are some of
core-curricula and learning experiences for the education
the issues that will be addressed in the session, together
of generalist physicians, and 4) the development of a
with others raised by participants.
consensus declaration of the need for such an initiative to
foster its widespread adoption. This is a multi-purposed
2A Project GLOBE: A new initiative to provide CPD initiative aimed at the front lines of medical practice,
quality CPD for Generalist Physicians to be studied initially in a few countries but eventually to
be made available worldwide. The goal is straightforward:
Pablo A Pulido M Co-chair, Project GLOBE (PanAmerican to assure the highest possible quality of health care for
Federation of Associations of Medical Schools, Venezuela),
populations and for individual patients all over the world
Dennis K. Wentz (WentzMiller & Associates, USA) Co-chair,
through equally high quality CME and CPD. During the
Project GLOBE, Lewis A. Miller (WentzMiller & Associates,
USA) and Members of Project GLOBE Steering Committee open discussion, AMEE attendees will 1) share their
thoughts about the need for developing such a world-
Generalist physicians provide most of the first line care to wide effort to assist practicing generalist doctors in
the world’s population. Yet, there is a need for better access remaining competent, 2) help identify areas for further
by these physicians to quality continuing medical education cooperation and collaboration in developing CME and CPD
and professional development opportunities in order to for this target audience, and 3) discuss the practical aspects
help them maintain their competence to practice. New of providing assurance to society that medical practitioners
systems of thinking are needed to maximize such are well-educated and competent.
Short Communications
2B PBL: the presenting problem
2B 1 Comparing a video case with a text case in a frequencies of clause categories were calculated and
postgraduate problem-based learning format compared using chi-square tests. Greater improvements
in clause frequency after the video case compared with
STc Bhearlpslbeive*r12, (W1A rSh udse UGnriavveer2s,i tAy HMo sMp itMalu, ijStkjenjbs2y , aDndE NAM JA JR KA the equivalent text were seen in data exploration, theory
and 2University of Maastricht, NETHERLANDS) building and theory evaluation.
The use of patient video recordings may be a valuable
In domains with a strong visual component video cases
supplement to postgraduate paediatric training, particularly
may be a valuable addition to the training programme,
pertaining to movement disorders.
since they can show characteristic signs and symptoms of
patient cases, are easy to obtain and highly authentic.
This study was performed to investigate whether adding 2B 2 What determines the perceived quality of a
a brief video case instead of an equivalent written text
problem-solving case?
improves cognitive and metacognitive processes (data
exploration, theory building, theory evaluation and Johan Beullens*, Elke Struyf and Bo Van Damme (Centre of
metareasoning) of residents in problem-based learning. Medical Education, Faculty of Medicine, K.U. Leuven,
Minderbroederstraat 17, Leuven B-3000, BELGIUM)
Eleven pediatric residents were assigned to one of two
groups. Both groups analysed an identical vignette of a Background: Problems used in medical education vary in
patient case. Immediately after this, one group watched a structure and complexity. We developed a questionnaire
2.5-minute video recording and the other group read a measuring both aspects in patient cases used as starting
description of the same video recording. The groups then points in problem solving clinical seminars. We assessed
re-analysed the case. Thinking processes were tapped by the reliability of the questionnaire and checked which items
recording and analysing the verbal group interaction. The determine the perceived quality of a case.
– 8 –
Session 2 WEDNESDAY 31 AUGUST Session 2
What was done: 159 final year medical students judged received lower points than those with “functional” learning
113 cases. 5043 forms were collected. The developed objectives (physiology, pathophysiology, pathology)
questionnaire consists of 17 statements judged on a 6- regarding the first 3 categories.
point-scale. Factor analysis and multiple regression analysis
were performed. Reliability was assessed with Cronbach
alpha. 2B 5 Patient encounters as the stimulus for
student learning in problem based learning:
Conclusions: Cronbach alpha of the total scale was 0.87.
a first evaluation of the Maastricht
Factor analysis resulted in two reliable subscales: Structure
(10 items; alpha = 0.88) and Complexity (7 items; alpha experience
= 0.79). Multiple regression analysis showed that the Agnes D Diemers*, Diana H J M Dolmans, Marijke S A van
quality of a case depends positively on authenticity, Santen, Scheltus van Luijk, Ameike Janssen and Albert J J A
relevance of pathology, coherence, challenge, structure Scherpbier (Universiteit van Maastricht, FdG, Skillslab,
and instructive value and negatively on lack of information, Postbus 616, Maastricht 6200 MD, NETHERLANDS)
incoherence and high level of complexity. Perceived quality
Aim of Presentation: To overcome the gap between theory
is more determined by Structure than by Complexity.
and practice it is suggested to implement patient
Take-home messages: Medical teachers should develop encounters as the ultimate stimulus for learning. But several
well-structured, complete, coherent cases concerning not problems may arise when integrating patient encounters
too complex, frequent pathologies. in PBL. We developed a model in which patients are used
as a starting point for learning, consisting of four phases:
preparation, patient encounter, self-study and reporting
2B 3 A letter from the sufferer in PBL tutorial phase. The aim of the study is to evaluate students’
perceptions of these four phases.
Ariyuki Hori*, Naohiro Kuroda, Noriko Ainoda, Yukio Yasuda,
Yoshiro Ohara and Koji Suzuki (Kanazawa Medical University, Summary of Work: Students filled out an evaluation
Medical Education Center, 1-1 Daigaku, Uchinada-machi,
questionnaire about the four phases.
Kahoku-gun, Ishikawa-ken 920-0293, JAPAN)
Summary of Results: Students are highly satisfied with
The curriculum before clinical exposure is structured with
the patient encounter phase, especially with the
PBL tutorials, lectures and exercises in our University. Since
instructiveness of the patient encounter. The reporting
paper-based PBL cases are used in these tutorials, students
phase is also highly rated, particularly the integration of
are not able to feel patients’ and families’ emotional issues
theory and practice. Students are less satisfied with the
with reality. In such a situation, it is difficult to cover
preparation phase and the generation of learning issues
education of the affective domain. To address the affective
after the patient encounter.
domain before clinical exposure, we introduced a letter
from the patient’s family as a sheet in a PBL tutorial. The Conclusions: This study demonstrates that real patient
case was written based on a real patient who was suffering encounters can be implemented in PBL and in the
from lung cancer with multiple brain metastases. He died perceptions of students lead towards a better integration
three months after the first visit to our hospital. We asked of theory and practice. An explanation for this finding is
his wife to write a letter about the story of his illness to that the patient is used as the driving force for student
our medical students. The letter was used at PBL tutorial learning. Nevertheless this study demonstrates that some
as the last page of the case. Most students realized they points need improvement to further optimize student
have to consider not only about diseases but also patients learning.
as human beings. They wrote letters to his wife about
how they felt from the letter and what they could learn as
2B 6 Standardized patients and multimedia:
medical students. The application of letters from sufferers
such as patients or families in PBL tutorials could be one powerful PBL tools for medical education
educational way for the affective domain. Sandor Vigh, Delia Anderson* and Julius L Levy (Tulane
School of Medicine, Standardized Patient Program, Dean’s
Office, SL 93, 1430 Tulane Avenue, New Orleans LA 701121,
2B 4 The evaluation of PBL scenarios by tutors USA)
Ozden Palaoglu*, Meral Demiroren, Filiz Yalcin, Sabri The use of standardized patients and SmartBoard©
Kemahli and I.Hakki Ayhan (Ankara University, Faculty of
presentations in a problem-based learning setting facilitate
Medicine, Departments of Medical Education and Pediatrics,
a medical student’s understanding of the interrelation
Karanfil Sokat 29/2, Kizilay, Ankara 06650, TURKEY)
between human anatomy and disease processes. The
The traditional discipline-based and lecture-based presentation of an actual clinical case of a patient with
curriculum of Ankara University Faculty of Medicine has pancreatic cancer is used as the basis of a small group
been changed to a problem-based hybrid curriculum PBL session during the freshman students’ study of
starting from the academic year of 2002-2003. Faculty abdominal anatomy. The session consists of the use of
members taking part in the organisation of modules are SPs and SmartBoards© for training students in the arts of
also responsible for writing scenarios appropriate to the history taking, physical examination, test ordering, and
predetermined learning objectives. However, some differential diagnosis. The SP simulates the patient; the
inevitable inaccuracies were observed in the first year. All SmartBoard© displays tests, results, and tutorials. The
scenarios were reviewed and some were re-written in the development at Tulane of an incorporated CT/MRI viewer
second year of the new curriculum. As another result of and ZoomImage© technology permits easy navigation,
this dynamic process the faculty members have gained panning and zooming of images in full screen size. A
experience in tutoring. In order to evaluate the scenarios clinician-facilitator guides the exercise and keeps the
and the PBL process, surveys were distributed to tutors at discussions on track. The integration of methodologies
the end of every module and they were requested to reply enhances the students’ ability to use the framework of an
to the questions on a 5-point Likert scale in 4 categories: actual clinical case to combine knowledge of anatomy and
(1) appropriateness of the scenario, (2) achieving learning a complex clinical problem. This exercise teaches problem
objectives, (3) PBL process and (4) the informativeness solving, encourages teamwork and self-directed learning,
of tutor copies. Average scores for each category are and instructs interpretation of diagnostic imaging. This
calculated and items with scores above 4 are considered entire process and the early interaction between students
acceptable. Generally it has been found that scenarios with and patients add to the students’ enjoyment of gross
more “structural” learning objectives (anatomy, histology) anatomy.
– 9 –