Using the Ages and Stages Questionnaire to teach medical students developmental assessment: a descriptive analysis

BACKGROUND: After a survey of medical graduates' skills found a lack of confidence in developmental assessment, a program was introduced with the broad aims of increasing medical student confidence and respect for the parents' role in childhood developmental assessment. Research has shown that parents' concerns are as accurate as quality screening tests in assessing development, so the program utilised the Ages and Stages Questionnaire, a parent completed, child development assessment tool. METHOD: To evaluate the program, an interpretative analysis was completed on the students' reports written during the program and a questionnaire was administered to the parents to gain their perception of the experience. As well, student confidence levels in assessing growth and development were measured at the end of the paediatric term. RESULTS: Although there was an increase in student confidence in developmental assessment at the end of the term, it was not statistically significant. However the findings indicated that students gained increased understanding of the process and enhanced recognition of the parental role, and the study suggested there was increased confidence in some students. Parents indicated that they thought they should be involved in the teaching of students. CONCLUSION: The ASQ was shown to have been useful in an education program at the level of advanced beginners in developmental assessment

Real patient learning integrated in a preclinical block musculoskeletal disorders. Does it make a difference?

Although musculoskeletal disorders are the most common reason for general practitioner visits, training did not keep pace. Implementation of learning from patients with rheumatologic disorders linked together with the teaching of theoretical knowledge in the preclinical medical education might be an important step forward in the improvement of quality of care for these patients. The Leiden Medical School curriculum has implemented two non-obligatory real patient learning (RPL) practicals integrated within the preclinical block musculoskeletal disorders. This study investigates the educational effectiveness of the practicals, the expectations students have of RPL, and students’ satisfaction. Participants’ grades on the end-of-block test served as the test results of the educational effectiveness of the practicals and were compared with those of the non-participants. Qualitative data was collected by means of questionnaires generated by focus groups. The participants in practicals scored significantly higher at the end-of-block test. The expected effects of the contact with real patients concerned positive effects on cognition and skills. ‘Contextualizing of the theory’, ‘better memorizing of clinical pictures’, and ‘understanding of the impact of the disease’ were the most frequently mentioned effects of the practicals. Overall, the participants were (very) enthusiastic about this educational format. The RPL practicals integrated within a preclinical block musculoskeletal disorders are a valuable addition to the Leiden medical curriculum. This relatively limited intervention exhibits a strong effect on students’ performance in tests. Future research should be directed towards the long-term effects of this intervention

An expert patient-led approach to learning and teaching: the case of physiotherapy

With patient expertise being afforded greater legitimacy in healthcare provision, there is a strengthening case for involving patients more creatively in the education of healthcare professionals. This paper reports on the results of a small-scale educational research project designed to explore how third-year physiotherapy students experienced a teaching session on the subject of strokes, led by two expert patients, and what they learnt from it. Applying a qualitative methodology, six students were interviewed in depth about the experience. Four key pedagogic themes emerged from the analysis of the interview transcripts. The first related to the differences between the expert patients in terms of their backgrounds and their reactions to experiencing a stroke and of their respective contributions to the session. A second concerned the anxieties students felt in participating in a session of this kind, since there were various departures from the norm, and what they should take from it in terms of their learning. A third theme was uncertainty regarding the relationship between the presenters and students. The fourth theme was the impact on student learning given that it had not been a conventional session. Notwithstanding any misgivings the session helped to validate the contribution that those who have direct experience of a clinical condition can make to the education of healthcare professionals, particularly in the affective domain. In planning sessions of this kind it is recommended that presenters are chosen with a view to challenging stereotypes and that they are encouraged to tell their stories in an open and flexible manner, albeit within a framework of intended learning outcomes. Students need to approach the session with an open mind and, above all, tutors need to be prepared to take risk

Patient perceptions of innovative longitudinal integrated clerkships based in regional, rural and remote primary care: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Medical students at the University of Wollongong experience continuity of patient care and clinical supervision during an innovative year-long integrated (community and hospital) clinical clerkship. In this model of clinical education, students are based in a general practice ‘teaching microsystem’ and participate in patient care as part of this community of practice (CoP). This study evaluates patients’ perceptions of the clerkship initiative, and their perspectives on this approach to training ‘much-needed’ doctors in their community.</p> <p>Methods</p> <p>Semi-structured, face-to-face, interviews with patients provided data on the clerkship model in three contexts: regional, rural and remote health care settings in Australia. Two researchers independently thematically analysed transcribed data and organised emergent categories into themes.</p> <p>Results</p> <p>The twelve categories that emerged from the analysis of transcribed data were clustered into four themes: learning as doing; learning as shared experience; learning as belonging to a community; and learning as ‘becoming’. Patients viewed the clerkship learning environment as patient- and student-centred, emphasising that the patient-student-doctor relationship triad was important in facilitating active participation by patients as well as students. Patients believed that students became central, rather than peripheral, members of the CoP during an extended placement, value-adding and improving access to patient care.</p> <p>Conclusions</p> <p>Regional, rural and remote patients valued the long-term engagement of senior medical students in their health care team(s). A supportive CoP such as the general practice ‘teaching microsystem’ allowed student and patient to experience increasing participation and identity transformation over time. The extended student-patient-doctor relationship was seen as influential in this progression. Patients revealed unique insights into the longitudinal clerkship model, and believed they have an important contribution to make to medical education and new strategies addressing mal-distribution in the medical workforce.</p