Victorian junior doctors' perception of their competency and training needs in healthcare management

Introduction. Australian medical speciality colleges have adapted and integrated the CanMEDS Physician Competency Framework into their training programs. The role as manager is one of the competencies and is presently thought to receive little attention during training. The objective of our study was to investigate the perceptions of Australian junior doctors regarding their management skills and their perceived need for management education. Methods. In November and December 2011, 1376 junior doctors from eight Victorian metropolitan health services were invited via email to participate in this study. Participating junior doctors received a questionnaire regarding their self-perceived management skills and knowledge and a medical management training needs assessment. Results. The response rate of one of the health centres was too low (6%) and therefore insufficient for credible conclusions to be drawn. Of the other health services, 194 (16%) out of 1213 junior doctors responded to the survey. Overall, the junior doctors rated their perceived competency on a 1-5 Likert scale as moderate (mean 3.45; s.d. 0.42). Of the 194 residents who responded, 71.3% (n = 139) reported a need for management training. Discussion. The junior doctors of Victoria, Australia perceived their knowledge on medical management as moderate. The results of this study showed that there is a perceived need among junior doctors for more management training. This need seems to confirm that management skills are thought to be valuable in medical practice. Our study also suggests that before the development of specific interventions, there is a need for a gap analysis between the perceived and actual management skills desired in medical residents. The attention paid to the role 'as manager' should therefore be embedded in training of all junior doctors

Flipping the classroom to teach Millennial residents medical leadership:a proof of concept

INTRODUCTION: The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. EVIDENCE: The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. DISCUSSION: Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners’ preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education

Medical residents’ perceptions of their competencies and training needs in health care management: an international comparison

<p>Abstract</p> <p>Background</p> <p>Previous research has shown that Dutch medical residents feel inadequate in certain management areas: 85% had a need for management training and reported preferences on the format of such training. Our objective was to explore if the perceived deficiencies and needs among Dutch residents were similar to those of their peers in other countries, and if a longer duration of the incorporation of the CanMEDS competency framework into curricula as well as management training had an influence on these perceptions.</p> <p>Methods</p> <p>Medical residents from Denmark, Canada and Australia were approached for participation. The questionnaire used to survey the perceptions of Dutch residents was slightly modified, translated into English and sent by email to all international participants.</p> <p>Results</p> <p>Response rates were; Denmark 719/2105 (34%), Canada 177/500 (35%) and Australia 194/1213 (16%) respectively. The Danish as well as the Canadian residents rated their negotiating skills poorly. In Australia the residents found their knowledge on how their specialist department was organized to be insufficient, while residents in the Netherlands rated their knowledge on how the healthcare system was organized as inadequate. In all of the countries, more than 70% of the residents reported a perceived need for management training.</p> <p>Conclusions</p> <p>A majority of the residents in all countries felt the need for specific training in developing their management competencies. The adoption of the CanMEDS framework alone seems to be insufficient in meeting residents’ perceived educational needs in this area.</p

Malignant transformation in sacrococcygeal teratoma and in presacral teratoma associated with Currarino syndrome : A comparative study

Background/purpose The risk of malignant transformation of sacrococcygeal teratoma (SCT) and of presacral teratoma in Currarino syndrome (CS) may differ despite the similar position and appearance. Methods Malignant transformation and teratoma recurrence were assessed in a national retrospective comparative analysis of 205 SCT and 16 CS patients treated in one of the six pediatric surgical centers in the Netherlands between January 1981 and December 2010. Results The malignancy free survival of patients with SCT was lower than for patients with a presacral teratoma associated with CS (80% and 58% after one and two years in SCT versus 100% after two years in CS, p = 0.017) Conclusions In SCT, malignancy and recurrence risk are high. Therefore, early and complete resection is mandatory. Our data show that the risk of malignant transformation of a presacral teratoma in CS is small

Malignant transformation in sacrococcygeal teratoma and in presacral teratoma associated with Currarino syndrome : A comparative study

Background/purpose The risk of malignant transformation of sacrococcygeal teratoma (SCT) and of presacral teratoma in Currarino syndrome (CS) may differ despite the similar position and appearance. Methods Malignant transformation and teratoma recurrence were assessed in a national retrospective comparative analysis of 205 SCT and 16 CS patients treated in one of the six pediatric surgical centers in the Netherlands between January 1981 and December 2010. Results The malignancy free survival of patients with SCT was lower than for patients with a presacral teratoma associated with CS (80% and 58% after one and two years in SCT versus 100% after two years in CS, p = 0.017) Conclusions In SCT, malignancy and recurrence risk are high. Therefore, early and complete resection is mandatory. Our data show that the risk of malignant transformation of a presacral teratoma in CS is small