Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation

Pediatric Dental Education Improves Interprofessional Healthcare Students’ Clinical Competence in Children’s Oral Health Assessment

Primary care and healthcare providers can facilitate children’s timely referral to a dental home. However, there are few studies of providers’ oral health knowledge and clinical skills. This study aims to improve future healthcare providers’ knowledge, confidence, attitude and clinical competence in assessing children’s oral health. Sixty-five health professional students participated in a 10-week didactic and clinical curriculum on children’s oral health. They completed pre- and post-training questionnaire to assess changes in knowledge, confidence and attitude. Calibrated faculty graded students’ clinical skills on a 24-point grading criterion. Descriptive statistics, paired sample t-test and Pearson correlation were used in data analyses. Students were in dentistry (46%), nursing (28%), medicine (22%), and pharmacy (3%). Students significantly improved in knowledge (t=-7.71, p<.001), confidence (t=-10.30, p=<.001) and attitude (t=-4.24, p=<.001). Students on average scored 83% on clinical competence, with the highest average for fluoride varnish application (96%) and lowest for providing anticipatory guidance (69%). There was a moderate correlation between improvement in knowledge and their clinical skills (r=.39, p=.010). Interprofessional education improves students’ knowledge, confidence, attitude and clinical competence in assessing children’s oral health. Such education is necessary in guiding future providers to gain adequate competence in serving the children’s oral health needs.Keywords: Pediatric Dentistry; Primary Care; Children’s Oral Health; Interprofessional Education; Oral Health Education; Public Health Dentistry; Oral Health Disparity; Access to Care; Clinical Competency; Oral Health Assessmen

Key factors in children's competence to consent to clinical research

Background: Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children's consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children's competence to consent to clinical research and to what extent they explain the variation in competence judgments. Methods: From January 1, 2012 through January 1, 2014, pediatric patients aged 6 to 18 years, eligible for clinical research studies were enrolled prospectively at various in- and outpatient pediatric departments. Children's competence to consent was assessed by MacArthur Competence Assessment Tool for Clinical Research. Potential determining child variables included age, gender, intelligence, disease experience, ethnicity and socio-economic status (SES). We used logistic regression analysis and change in explained variance in competence judgments to quantify the contribution of a child variable to the total explained variance. Contextual factors included risk and complexity of the decision to participate, parental competence judgment and the child's or parents decision to participate. Results: Out of 209 eligible patients, 161 were included (mean age, 10.6 years, 47.2 % male). Age, SES, intelligence, ethnicity, complexity, parental competence judgment and trial participation were univariately associated with competence (P∈∈0.05). Conclusions: Age is the factor that explaines most of to the variance in children's competence to consent, followed by intelligence. Experience with disease did not affect competence in this study, nor did other variables. Clinical trial registration: Development and use of a standardized instrument for assessing children's competence to consent in drug trials: Are legally established age limits valid?, NTR3918

Reply to the comment by Carmelo Anile on the paper "Complexity analysis of the cerebrospinal fluid pulse waveform during infusion studies"

Veterinary technology is an emerging profession within the veterinary and allied animal health fields in Australia and affords graduates the opportunity to contribute to the small but growing body of literature within this discipline. This study describes the introduction of a contextualised assessment task to develop students’ research capability, competence and confidence in professional writing, and to engage them with the academic publishing process. Students worked in self-selected dyads to author a scientific case report, of publishable standard, based on authentic cases from their clinical practicum. Intrinsic to the task, students attended a series of workshops that explored topics such as critiquing the literature, professional writing styles and oral presentation skills. Assessment was multi-staged with progressive feedback, including peer review, and culminated with students presenting their abstracts at a mock conference. Students reported the task to be an enjoyable and valuable learning experience which improved their competence and confidence in scientific writing; supported by a comparison of previously submitted work. Linking scientific writing skills to clinical practice experiences enhanced learning outcomes and may foster the professionalisation of students within this emerging discipline

LGBTQ+ Health-a Novel Course for Undergraduate Students.

The concept of providing focused, competency-based LGBTQ+ health education outside the setting of health professional programs, specifically for undergraduates, is quite uncharted. However, the issue at the core of our rationale is one shared by those with and without clinical exposure: how to best support the development of cultural competence in providers who are or will be caring for LGBTQ+ patients. Traditional health professional education programs have enacted a number of curricular initiatives in this regard, designed for advanced learners. By focusing specifically on the undifferentiated learner, we offer a new perspective on the timing of LGBTQ+ health-related education. Our course is not intended to supplant the critical learning and application that must occur in the clinic or hospital room. Rather, we present a framework for cultivating understanding of the healthcare issues faced by the LGBTQ+ community that may help a learner to acquire and apply skills subsequently with greater cultural competence

Physiotherapist-patient communication in entry-level physiotherapy education: a national survey in Nigeria

Background: Clinical communication impacts on physiotherapy treatment outcome and its competence warrants being assessed during training for physiotherapists given the increasing need to improve patient outcomes. Objective: This study aimed to investigate the assessment of clinical communication in entry-level physiotherapy programs in Nigeria. Methods: In a cross-sectional survey, questionnaires were sent by e-mail or hand-delivered to the heads of physiotherapy programs, asking them to consult with faculty members involved in the assessment of clinical communication in undergraduate education. Results: Six of seven physiotherapy programs responded (an 86% response rate). Assessment of clinical communication and methods of assessing clinical communication by the programs showed wide variation. There was an average of two assessments per year. The objective structured clinical examination with patients (21; 38%) and written communications (report/chart) (13; 23%) were the most commonly used assessment methods. Perceived challenges included a lack of facilities, validity, inexperienced examiners, and difficulties in integrating processes and content. Conclusion: A variety of assessment methods are being used in entry-level physiotherapy programs in Nigeria, which target different components of clinical communication skills acquisition. More effort is needed to improve limited facilities and human resources training to enhance clinical communication assessment in Nigerian physiotherapy programs

Case study: obesity, genital oedema and lower limb compression bandaging

The purpose of this article is to present an evidenced based rationale for lymphoedema compression bandaging one aspect of treatment for a patient with complex lower limb lymphoedema. The current health care climate requires treatment decisions to be transparent based on the best available evidence. The challenge faced by community nurses is to formulate treatment plans which incorporate the patients’ preferences and best utilise limited resources provided by clinical environments. The article appraises research in order to formulate a suitable treatment plan and provides discussion and reflection regarding the challenges faced by the nursing profession in achieving evidence based practice. Evidence based practice is beneficial in formulating patient centred and cost effective treatment plans, developing competence is not straightforward, however clinical guidelines can provide much needed guidance