The World Health Organization Multi-Professional Patient Safety Curriculum : implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.

Why do medical graduates choose rural careers?

Introduction: This study is based on the metaphor of the ‘rural pipeline’ into medical practice. The four stages of the rural
pipeline are: (1) contact between rural secondary schools and the medical profession; (2) selection of rural students into medical
programs; (3) rural exposure during medical training; and (4) measures to address retention of the rural medical workforce.
Methods: Using the rural pipeline template we conducted a literature review, analysed the selection methods of Australian
graduate entry medical schools and interviewed 17 interns about their medical career aspirations.
Results: Literature review: The literature was reviewed to assess the effectiveness of selection practices to predict successful
gradation and the impact of rural pipeline components on eventual rural practice. Undergraduate academic performance is the
strongest predictor of medical course academic performance. The predictive power of interviews is modest. There are limited data
on the predictive power of other measures of non-cognitive performance or the content of the undergraduate degree. Prior rural
residence is the strongest predictor of choice of a rural career but extended rural exposure during medical training also has a
significant impact. The most significant influencing factors are: professional support at national, state and local levels; career
pathway opportunities; contentedness of the practitioner’s spouse in rural communities; preparedness to adopt a rural lifestyle;
educational opportunities for children; and proximity to extended family and social circle. Analysis of selection methods: Staff
involved in student selection into 9 Australian graduate entry medical schools were interviewed. Four themes were identified:
(1) rurality as a factor in student selection; (2) rurality as a factor in student selection interviews; (3) rural representation on student
selection interview panels; (4) rural experience during the medical course. Interns’ career intentions: Three themes were identified:
(1) the efficacy of the rural pipeline; (2) community connectedness through the rural pipeline; (3) impediments to the effect of the
rural pipeline, the most significant being a partner who was not committed to rural life
Conclusion: Based on the literature review and interviews, 11 strategies are suggested to increase the number of graduates
choosing a career in rural medicine, and one strategy for maintaining practitioners in rural health settings after graduation.

Comparison of the traditional problem-based learning format and larger, directed, independent study groups

 Problem based learning has been implemented as a pedagogical tool world-wide across a range of health professions since its inception at McMaster University, Canada, in 1969 (Neville & Norman, 2007). In addition to enhancing knowledge and understanding it is also claimed that PBL develops communication skills, encourages teamwork, sharing of information and respect for others, furthers problem solving skills, and allows students to assume responsibility for their own learning (Wood, 2003). However, the cognitive outcomes of PBL and traditional pedagogy (based on didactic teaching) are similar and hence widespread adoption of PBL has been questioned (see Colliver, 2000). Criticisms of PBL include its resource hungry nature, requiring, as it does, experienced tutors to facilitate .learning across several clusters of students dealing with the same problem. Given the actual and anticipated increase in numbers of medical students in Australia other strategies that retain the advantages of PBL, while minimising the demands on faculty, should now be explored. This paper reports our experience with a modification of the traditional PBL approach, termed PBLplus. This innovation was trialled in a regional clinical school, attached to a hospital, with a group of 19 graduate entry students, who had completed an integrated Year 1 / 2 of the MBBS. PBLplus involved allocating students from the whole class to three task directed groups. Groups had specified assignments to complete to facilitate learning across the whole class. A tutor listened to student presentations and provided an interactive presentation. Hence use of tutors was made more efficient, and faculty input was more specialised.

Differences between the personal, social and emotional profiles of teaching and computer engineering professionals and students

The evidence suggests that emotional intelligence and personality traits are important qualities that workers need in order to successfully exercise a profession. This article assumes that the main purpose of universities is to promote employment by providing an education that facilitates the acquisition of abilities, skills, competencies and values. In this study, the emotional intelligence and personality profiles of two groups of Spanish students studying degrees in two different academic disciplines – computer engineering and teacher training – were analysed and compared. In addition, the skills forming part of the emotional intelligence and personality traits required by professionals (computer engineers and teachers) in their work were studied, and the profiles obtained for the students were compared with those identified by the professionals in each field. Results revealed significant differences between the profiles of the two groups of students, with the teacher training students scoring higher on interpersonal skills; differences were also found between professionals and students for most competencies, with professionals in both fields demanding more competencies that those evidenced by graduates. The implications of these results for the incorporation of generic social, emotional and personal competencies into the university curriculum are discussed.

Teamwork in Health and Rehabilitation Sciences: Evaluation of a multiprofessional workshop

This paper outlines a multiprofessional education workshop piloted and subsequently conducted with a cohort of 81 graduate entry students of occupational therapy, physiotherapy, speech pathology and audiology. The rationale for, and format of, the workshop is outlined, followed by comparisons between students' knowledge about teamwork prior to and after the four-hour workshop. The workshop was based on a real case scenario of a child with Developmental Coordination Disorder (DCD). Students completed pre- and post-workshop questionnaires about their knowledge of DCD, teamwork and the roles of various professionals and parents; and a post-workshop questionnaire about their views regarding the utility of the workshop, its strengths, and learning outcomes. The evaluation indicated that the workshop was overwhelmingly successful from the students' perspective in: (1) enhancing their understanding about DCD and its multifaceted impact on school age children; (2) developing a deeper appreciation of the importance of teamwork itself; (3) refining their understanding of their own profession's role and (4) developing an appreciation of the role of other professions and parents in working with children with complex needs, and their families. Limitations of this study and directions for future research are discussed.

Responding to our customers' needs: modifications to assessment in Obstetrics and Gynaecology over 20 years

Background and Objectives: This paper reports on historical changes in assessment culminating in the experience of one discipline with negotiated student feedback that has helped design and modify assessment to cater for the requirements of both students and teachers. The standard of assessment required to pass Obstetrics and Gynaecology in the four year graduate entry program in the School of Medicine at The University of Queensland, Brisbane, Australia has become less formalised and more collaborative. Changes in assessment in this discipline over the last 20 years reflect the development of an understanding of the educational principles associated with adult teaching and learning. Assessment has evolved from being teacher focussed, with questionable reliability, validity, and emphasis on outcomes, to being focussed on learning and the student. Multiplechoice examinations, combined with a collaborative approach to the reliability and validity of questions and answers and a debrief or feedback session have been found to provide an assessment format that is art acceptable measure oflearning for both teachers and students. Changes in assessment reflect a collaborative process between teachers and students based on principles of adult learning and involving negotiated student feedback. Our experience with this form of negotiated outcome for assessment is presented together with suggestions for improvement and is contrasted with assessment methods used in this department over the last 20 years. Change and refinement will continue as medical programs strive to meet the learning needs of students and assessment outcomes that are acceptable to its teachers.

Comparative academic performance of medical students in rural and urban clinical settings

OBJECTIVE To determine whether the academic performance of medical students learning in rural settings differs from those learning in urban settings. DESIGN Comparison of results of assessment for 2 full cohorts and 1 part cohort of medical students learning in rural and urban settings in 2002 (209 students), 2003 (226 students) and 2004 (220 students), including results for each specialist rotation in the 3rd year and end-of-year examinations in the 2nd and 4th years. SETTING University of Queensland School of Medicine, Brisbane. Students spent the whole 3rd year (of a 4-year graduate entry programme) conducting 5 specialist 8-week rotations in either the rural clinical division (rural students) or in Brisbane (urban students), all following the same curriculum and taking the same examinations. RESULTS For the 2002 cohort there were no statistically significant differences in academic performance between rural and urban students. For the 2003 cohort the only significant difference was a higher score for rural students in the end of the 4th-year clinical skills examination (65.7 versus 62.3%, P = 0.025). For the 2004 cohort, rural students scored higher in the 3rd-year mental health rotation (79.3 versus 76.2%, P = 0.038) and lower in the medicine rotation (65.5 versus 68.6%, P = 0.037). CONCLUSION Academic performance among students studying in rural and urban settings is comparable.

Management and management education in a less developed economy: the case of Malawi

Malawi is seen as a society in transition, and as a consequence, it is argued, Malawian managers face particular problems where traditional and Western values intersect. The role of the Polytechnic of Malawi as a provider of management education in this environment is thus problematical. The thesis begins with a description of the Malawian business environment in its geographical, historical, political, cultural, economic and institutional forms, and then goes on to examine the problems practising managers themselves feel they face, and attempts to explain these problems in terms of the environmental factors described, and the environmental changes taking place. It is concluded, from the analysis conducted, that the environmental features discussed interact in a complex way to make Malawian managers averse to exercising initiative and taking decisions. The question of what the Polytechnic can do to help overcome this aversion is addressed. The field research was conducted in Malawi in the seven months January to July, 1980, during which time 207 questionnaires were administered to junior and middle managers working in all sectors of the economy at levels equivalent to Polytechnic graduate entry. In addition, a number of senior managers (both Malawian and expatriate) were interviewed, a case study was conducted in a manufacturing organisation, and a second questionnaire was administered to all business students at the Polytechnic. Extensive use of official statistics was also made where appropriate.

Relevance of anatomy to medical education and clinical practice: perspectives of medical students, clinicians, and educators

Introduction: Against a backdrop of ever-changing diagnostic and treatment modalities, stakeholder perceptions (medical students, clinicians, anatomy educators) are crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. This study compared perceptions of students, practising clinicians, and anatomy educators with respect to the relevance of anatomy education to medicine. Methods: A quantitative survey was administered to undergraduate entry (n = 352) and graduate entry students (n = 219) at two Irish medical schools, recently graduated Irish clinicians (n = 146), and anatomy educators based in Irish and British medical schools (n = 30). Areas addressed included the association of anatomy with medical education and clinical practice, mode of instruction, and curriculum duration. Results: Graduate-entry students were less likely to associate anatomy with the development of professionalism, teamwork skills, or improved awareness of ethics in medicine. Clinicians highlighted the challenge of tailoring anatomy education to increase student readiness to function effectively in a clinical role. Anatomy educators indicated dissatisfaction with the time available for anatomy within medical curricula, and were equivocal about whether curriculum content should be responsive to societal feedback. Conclusions: The group differences identified in the current study highlight areas and requirements which medical education curriculum developers should be sensitive to when designing anatomy courses.

The graduate: Spillovers from the entry of the first worker with a college degree in a firm

A Work Project, presented as part of the requirements for the Award of a Double Degree in Economics from NOVA School of Business and Economics and Maastricht School of Business and Economics

Using critical incident interviews to identify the mental health knowledge, skills and attitudes of entry-level dietitians

Aim: This paper aims to explore new graduates experience working with clients with mental health issues using critical incident interviews. Methods: The qualitative research techniques were based on phenomenology. A purposive sample of 19 new graduate dietitians was drawn from a range of work settings and locations throughout Australia. Data was gathered using thirty minute Critical Incident Interviews. Audio-taped data was transcribed, coded to identify common themes, compared for congruence and then categorised into knowledge, skills and attitudes. Results: New graduates encountered a range of situations involving a variety of mental health, wellbeing, dietetic and clinical issues. Common themes highlighted the mental health knowledge, skills and attitudes required for entry-level dietitians which then informed the review of the National Competency Standards for Entry-Level Dietitians. Conclusion: New graduates encounter a variety of mental health and wellbeing issues in their everyday practice and therefore require training to address these situations competently.

Sustainability, Fashion Design, and Consumerism: Undergraduate Entry Level Fashion Students' Knowledge, Attitudes, and Habits

This qualitative inquiry explored 7 undergraduate students' attitudes, habits, and knowledge of consumerism, fashion design, and sustainability. The postmodern study employed crystallization as its methodological framework to gain insight into how participants' knowledge is manifested in their daily habits, and used 4 methods of data gathering: semistructured interviews, visual exercises, journal entries, and the researcher's own reflections. Four major themes emerged: Knowledge-Concepts Linked and Fragmented; Dissonance Between Knowledge Versus Attitudes and Consumer Habits; Surrendering to the Unsustainable Structures; Design Process and Caring Attitude. Findings indicate that participants possessed some knowledge of sustainability but lacked a well-rounded understanding of environmental and humanitarian implications of Western consumer society. Findings also reveal a dissonance between participants' knowledge and attitudes-affecting how their knowledge influences their behaviour-and how reflection, creative thinking, and drawing initiate change in participants' underlying attitudes. Recommendations are made to merge a variety of theoretical frameworks into the educational system in order to create curricula that offer a holistic overview and unique insights into sustainability challenges, particularly in specialized areas of the fashion industry.

Construction graduate salaries : the real story

Construction degrees are in significant demand in Australian universities. Entry students believe that graduation will lead to well-paid industry employment. Previous studies have identified trends in graduate starting salaries, but often combine categories of graduates to produce inadequate generalisations and salary averages. This study, conducted at RMIT University, Melbourne, examined a specific cohort of construction management students and provided an insight into their employment conditions and starting salaries. The results provide useful up to date information for undergraduate students and academic staff alike.