Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety

The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training

Physicochemical characteristics and green microalgae composition of selected rivers in Ogun State, Nigeria

The river system is the most complex of the freshwater bodies in the world and is prone to pollution especially from anthropogenic activities and the quality of water, as partially determined by physicochemical properties, is very crucial for primary productivity in the aquatic environment. This study determined the physicochemical characteristics and green microalgae of water collected from Majopa, Ogunpa and Uren rivers in Ogun State, Nigeria. Surface water samples were collected from three different rivers using direct collection method into the labelled bottles for physicochemical characteristics determination, culturing and ecological studies. Water samples for ecological studies were fixed in 4% unbuffered formalin while sample for culturing were not fixed but growth stimulated using Bold Basal Medium (BBM) and Blue- Green Medium (BG-11). The physicochemical parameters varied widely with the profile of water sample from Ogunpa River being the most favourable for widest diversity of green microalgae of all three. The pH of the water samples were slightly acidic ranging between 6.3 and 6.5 for the rivers, while the lower dissolved oxygen (2.61-3.01 mg/L) recorded pointed to a stressed environment which probably accounted for lower number of microalgae taxa observed, especially in Majopa River. The ecological studies showed the presence of ten taxa from the division Chlorophyta with nine taxa from Ogunpa River and Scenedesmus sp. being dominant genus across the rivers. The microalgae diversity of the river water was Ogunpa River˃Uren River˃Majopa River. BBM supported growth of the microalgae much better. The physicochemical properties portrayed Majopa and Ogunpa River water as unfit for drinking, while that of Uren River is relatively fit for drinking. It is highly recommended that the microalgae reported therein be further characterised for various possible economic benefits. Keywords: Growth, Microalgae, Nutrient, Ogun State, River, WaterDepth, Geothermal Energ

Seasonal Transmitting Potential of Malaria Vectors in Six Communities in Ekiti State, Nigeria

Malaria vectors are found virtually in all communities of Nigeria. Understanding the transmitting potential of these vectors in&nbsp; relationship with the malaria parasite (MP) infection is essential to design a sustainable community base control programme. This study aimed at determining this relationship in six communities in Ekiti State, Nigeria. The communities were randomly selected through a multistage sampling. Blood samples were screened for MPinfection among human volunteers during dry and rainy seasons in each community. Adult mosquitoes were collected indoors for twelve months in the communities using light traps. Female&nbsp; Anopheles mosquitoes collected were characterized by Polymerase Chain Reactions and circumsporozoite proteins of the infected mosquitoes were detected by Enzyme-Linked Immunosorbent Assay. Prevalence of MP infection, human biting rates (HBR), sporozoite rates and entomological inoculation rates (EIRs) were determined using appropriate formulae. Overall prevalence of MPinfection was 26% in dry season and 38% in rainy season (P=0.001). Female Anopheles mosquitoes collected were 428. Strong relationship existed between HBR and MP infection in rainy&nbsp; season (R2 = 0.671) but the relationship was weak (R2 = 0.209) in dry season. Sporozoites were detected in 2.3% of the female Anopheles mosquitoes collected. EIRs were between 0.100 - 0.252 infective bites/person/night.&nbsp; Transmission of malaria parasites occurred throughout the year particularly during rainy season when there were recorded EIRs. Malaria control interventions will be more appropriate during raining season in this region. Keywords: Anophelesmosquitoes, Nigeria, transmission, malaria, seaso

Identification, Ecology, and Distribution of Heliozoa, scaled flagellates and scaled ciliates from western Nigeria

A total of 15 scale-bearing protista belonging to the genera Acanthocystis, Choanocystis, Cyathobodo, Lepidotrachelophyllum, Pterocystis, Polyplacocystis, Raineriophrys, Raphidiophrys, and Raphidocystis was observed from both lotic and lentic freshwater Nigerian sites. Three of the taxa have been previously reported from Nigeria, while 12 are new records including a description of a new species of Acanthocystis. Tropical Freshwater Biology Vol. 16 (1) 2007: pp. 1-1