Identifying barriers that affect medical doctors’ learning of dental trauma

BackgroundIt is important that medical doctors are familiar with the management of emergency dental trauma before referring a patient to a dentist. Correct diagnosis and treatment techniques are essential for a predictable and optimal long-term prognosis.AimsThe aim is to identify and categorize statements from the literature related to barriers (factors that hinder learning) on dental trauma for medical doctors.MethodsThe authors reviewed ten papers pertaining to medical doctors’ knowledge of dental trauma and identify some common barriers to learning.ResultsThe barriers identified were classified as internal (factors associated with the learner) or external (factors associated with the learning environment). Internal barriers negatively impact learners and may cause medical doctors to lose enthusiasm or interest in the subject. External barriers, on the other hand, often arise from within the university or teaching hospital and may affect medical students’ and doctors’ theoretical learning of dental trauma or hamper their clinical experience. ConclusionFrom a limited body of literature, this report has identified some common barriers that affect doctors’ learning of dental trauma. Consequently, to further investigate the relevance of these barriers and their impact on dental trauma learning, a systematic review in this area is indicated

Evaluating the Guideline Enhancement Tool (GET): an innovative clinical training tool to enhance the use of hypertension guidelines in general practice

Background: This project aims to evaluate the effectiveness of an innovative educational intervention in enhancing clinical decision making related to the management of hypertension in general practice. The relatively low level of uptake of clinical practice guidelines by clinicians is widely recognised as a problem that impacts on clinical outcomes. This project addresses this problem with a focus on hypertension guidelines. Hypertension is the most frequently managed problem in general practice but evidence suggests that management of Hypertension in general practice is sub-optimal. Methods/design: This study will explore the effectiveness of an educational intervention named the ‘Guideline Enhancement Tool (GET)’. The intervention is designed to guide clinicians through a systematic process of considering key decision points related to the management of hypertension and provides a mechanism for clinicians to engage with the hypertension clinical guidelines. The intervention will be administered within the Australian General Practice Training program, via one of the regional training providers. Two cohorts of trainees will participate as the intervention and delayed intervention groups. This process is expected to improve clinicians’ engagement with the hypertension guidelines in particular, and enhance their clinical reasoning abilities in general. The effectiveness of the intervention in improving clinical reasoning will be evaluated using the ‘Script Concordance Test’. Discussion: The study design presented in this protocol aims to achieve two major outcomes. Firstly, the trial and evaluation of the educational intervention can lead to the development of a validated clinical education strategy that can be used in GP training to enhance the decision-making processes related to the management of hypertension. This has the potential to be adapted to other clinical conditions and training programs and can benefit clinicians in their clinical decision-making. Secondly, the study explores features that influence the effective use of clinical practice guidelines. The study thus addresses a significant problem in clinical education

The Impact of the Employment Relations Act 2000 on Collective Bargaining

This study carried out by the Department of Labour in 2007/08 aims to assess whether there have been any significant changes in the coverage of collective bargaining that can be attributed to the Employment Relations Act 2000. The research draws on administrative data relating to union membership and collective bargaining coverage, as well as qualitative data from employers, employees, union representatives and other employment relations stakeholders. The research shows that collective bargaining has yet to regain pre Employment Relations Act levels. Collective bargaining remains concentrated in the public sector, with low density in the private sector. The study concludes that the effects of the Act on collective bargaining are chiefly observed in the recovery of collective bargaining in the public sector, and the continued decline (in general) in the private sector. The research offers no indications that these patterns will change

Appropriate management of traumatic dental injuries at the hospital emergency department provides a positive impact on patient outcomes

The objective of this case study is to highlight the importance of medical doctors’ management of acute dental trauma. Correct diagnosis and treatment techniques are essential for an optimal long-term prognosis of restored function and aesthetics for the patient. The aim of correct management of acute traumatic dental injuries (TDI) to permanent teeth is to protect patients from inaccurate diagnosis, poor treatment by clinicians and to stabilize the condition before referring to a dentist for permanent dental care. This case shows that appropriate management of acute dental injuries by the emergency doctor prevented the loss of teeth at an earlier age

Breadth of knowledge vs. grades: What best predicts achievement in the first year of health sciences programmes?

This study aimed to identify those features within secondary school curricula and assessment, particularly science subjects that best predict academic achievement in the first year of three different three-year undergraduate health professional programmes (nursing, pharmacy, and health sciences) at a large New Zealand university. In particular, this study compared the contribution of breadth of knowledge (number of credits acquired) versus grade level (grade point average) and explored the impact of demographic variables on achievement. The findings indicated that grades are the most important factor predicting student success in the first year of university. Although taking biology and physics at secondary school has some impact on university first year achievement, the effect is relatively minor

Factors predicting rural location employment intent and choice among medical students and graduates

Purpose Workforce shortage is a contributing cause of health inequality in rural Australia. There is inconclusive evidence demonstrating which factors cause doctors to choose rural practice. This study’s objective is to determine predictive factors for medical students’ intent to work rurally and for graduates’ current rural employment location choice. Methods This prospective cohort study, utilized data gathered from the University of New South Wales about students and graduates who had spent one or more years in a Rural Clinical School. Participants were final year students and graduates already working in Australia. Stepwise logistic regression was used to determine predictive factors for the two outcomes. Results Predictors for student intent to work rurally are rural background (odds ratio [OR], 7.16; 95% confidence interval [CI], 2.59–19.53), choosing to study at the Rural Clinical School (OR, 8.72; 95% CI, 1.32–57.63), and perceiving rural areas as opportunistic for career advancement (OR, 1.69; 95% CI, 1.15–2.49). Predictors for graduates currently working in a rural location are Bonded Medical Program participation (OR, 6.40; 95% CI, 1.15–35.59) and personal altruism (OR, 1.91; 95% CI, 1.02–3.57). Conclusion While intent is predicted by having a rural background, choosing to study at the Rural Clinical School and perception of rural areas as having positive career opportunities, a current rural workplace location among graduates is predicted by holding a bonded medical position and a desire to serve an under-resourced population. Maintaining the Bonded Medical Program and clear communication regarding training pathways may increase numbers of rural doctors

Selection into medicine using interviews and other measures: Much remains to be learned

The objectives of this study were to identify the effectiveness of the panel admission interview as a selection tool for the medical program and identify improvements in the selection tools battery. Data from 1024 students, representing four cohorts of students were used in this study. Exploratory factor analysis using principal component analysis was used to identify underlying factors within the admission tools. A series of hierarchical linear regressions was employed to identify the predictability of performance in the medical program by the admission tools. Although the admission tools yielded low correlations with one another (r<.30), correlations between interview sub-scores were high (.435<r<.640). All interview sub-scores loaded on to a single factor explaining over 60% of the variance. The admission tools and the interview overall scores explained less than 13.5% and 3.8% (respectively) of the variance in the key outcome measures. We concluded that each admission tool measured different attributes, and suggest that admission interview procedures and the interview questions should be assessed independently

The Impact of the Employment Relations Act 2000 on Collective Bargaining

This study carried out by the Department of Labour in 2007/08 aims to assess whether there have been any significant changes in the coverage of collective bargaining that can be attributed to the Employment Relations Act 2000. The research draws on administrative data relating to union membership and collective bargaining coverage, as well as qualitative data from employers, employees, union representatives and other employment relations stakeholders. The research shows that collective bargaining has yet to regain pre Employment Relations Act levels. Collective bargaining remains concentrated in the public sector, with low density in the private sector. The study concludes that the effects of the Act on collective bargaining are chiefly observed in the recovery of collective bargaining in the public sector, and the continued decline (in general) in the private sector. The research offers no indications that these patterns will change

Building Capacity for Research and Audit: Outcomes of a Training Workshop for Pacific Physicians and Nurses

Building the research capacity of clinicians in the Pacific Island countries is important in addressing evidence gaps relevant to local policy and clinical practice. This paper aimed to assess the effectiveness of a reproductive health research workshop in increasing research knowledge and intention to perform research amongst a diverse group of clinicians. An online survey of clinicians and stakeholders in the Pacific Islands informed a research workshop curriculum. Physicians and nurses/midwives (n = 28) from six Pacific Island countries were selected as workshop participants as part of a research capacity building program. Questionnaires before after the workshop were used to measure the changes in knowledge, confidence, competence, attitudes and intention to perform research and these were analysed thematically. Sixty-three of 85 (74%) stakeholders and clinicians responded to an online survey, which informed workshop curriculum development. Of the 28 workshop participants, seven were obstetrician-gynaecologists, eight junior physicians and eleven nurses/midwives. The mean pre-test score was 36% (±10) and the post-test was 43% (±6) (p<0.01). By profession, the obstetricians had higher prior research knowledge whereas nurses had a higher knowledge gain after the workshop. Attitude, intention and motivation to perform research was high and the participants learnt that research is important, to start small; to use routinely collected data; to encourage others to do research; and to network regionally. This paper has confirmed that online surveys, in low resource settings, can have an acceptable response rate. It has also shown that a research workshop for a diverse group of clinicians can be effective in increasing knowledge although knowledge gained was more significant amongst nurses/midwives compared to physicians. The other benefits of the research workshop were increased motivation and attitudes for research, which if well supported, should result in an increase in research output in the Pacific Islands. Future evaluation will assess the long-term effectiveness of annual research workshops and mentoring support in improving research performance and evidence utilisation in care

Facilitators and barriers to doctoral supervision: A case study in health sciences

Supervision capacity is becoming an issue that may restrict the ability of universities to meet eligible students’ needs. Although there has been considerable research into the methods of supervision and the supervisor-student relationship, at this time there is little specific research into reasons why qualified academics choose or otherwise to put their names forward to be doctoral supervisors. This research explores the facilitating factors and barriers to supervision as viewed by academics in the Faculty of Medical and Health Sciences, The University of Auckland. The research was carried out via face-to-face semi-structured interviews with academics eligible to supervise doctoral candidates. Four themes were identified from the interview data, namely workload agreements, time pressures, quality of students and recognition of the supervisor’s contribution. The results provide a platform for more research into this area as well as identify possible ways to enhance the facilitators and alleviate the barriers