|
Title |
How was the intern year?: self and clinical
assessment of four cohorts, from two medical
curricula |
Author(s) |
Gillian Laven, Dorothy Keefe, Paul Duggan and Anne Tonkin - Personal Name
|
Subject |
Health and Medical Education |
Publisher |
Bio Med Central Ltd |
Publishing Year |
2014 |
Specific Detail Info |
Background: Problem-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.
Methods: Graduates 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.
Results: Self-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.
Conclusions: The 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. |
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