Further concerns about self-assessment: are medical students aware of their progress in clinical skills during clerkship

Background: Medical students do not accurately self-assess their competence. However, little is known about the awareness of change of competence over time. The aim of this study was to evaluate if students are aware of their progress. Summary of work: Twenty-two fourth year medical students had self- and expert-assessments of their clinical skills in musculoskeletal medicine in an OSCE like station (4 point Likert scale) at the beginning (t0) and end (t1) of their eight weeks clerkship in internal medicine. Thirteen students were assigned to the intervention of a 6x1 hour practical examination course; nine took part in the regular clinical clerkship activities only and served as controls. Summary of results/Conclusions: The intervention students significantly improved their skills (from 2.78 ± 0.36 to 3.30 ± 0.36, p<0.05) in contrast to the control students (from 3.11 ± 0.58 to 2.83 ± 0.49, n.s.). At t0, 19 students, at t1 21 out of 22 students underestimated their competence. Correlations between the change of self- and expert-assessment were r=0.43, p<0.05 (all), r=0.47, n.s. (control) and r=-0.12, n.s. (intervention), respectively. Take-home message: Medical students improving their clinical skills by an interactive course in addition to their regular clerkship activities are not aware of their progress

Self-assessment insufficiently predicts performance in emergency skills

Background: Residents demonstrate a broad range of performance levels for clinical skills, with some at an inadequate level. Adequate self-assessment is important for life long learning. However, its accuracy is questioned extensively. The aim of this study was to evaluate how far the residents’ self-assessment predicts their performance in an expert assessment of emergency skills. Summary of work: Twelve skills were identified as being relevant for the emergency duties of residents in smaller hospitals. Fifteen first-year residents from the departments of internal medicine and general surgery at a district hospital rated their performance on a questionnaire (self-assessment). This was followed by a structured, practical in vivo assessment by an anaesthesiologist (expert assessment). For both, a visual analogue scale from 0 to 10 was used, on which 0 stands for novice and 10 for expert. Predictive validity was described by Spearman’s correlation, which was significant in 3 out of 12 skills only. Median correlation (r) was 0.50 (range 0.16 to 0.93). Conclusion: At the beginning of postgraduate training, self-assessment alone is not sufficient to guide self-directed learning. Take-home message: At the beginning of their residency, physicians need structured feedback in emergency skills which can be offered by anaesthesiologists.

Developing Higher-level Cognitive Skills In a Fire Protection Course

In an ideal world, all instructors of safety and health courses would be masters of course subject matter as well as the theories and practices for effective teaching. In practice, however, most instructors are much stronger in one or the other. This paper provides an example of how some fundamental knowledge from educational experts can be useful for improving a traditional safety course. Is there a problem with the way traditional safety and health (S&H) courses are taught? It is asserted by this author that S&H education, in general, places too much emphasis on acquisition and comprehension of facts at the expense of helping students develop higher-level cognitive abilities. This paper explains the basis for the assertion and reports an experience upgrading a traditional fire protection course to include more assignments involving the higher-level ability known in the education community as synthesis.

Effektive Schulführung: Chancen und Risiken des Public Managements im Bildungswesen

"Effektive Schulführung"widmet sich in insgesamt elf Fachbeiträgen namhafter Autorinnen und Autoren aus der Schulpraxis und der Wissenschaft der Einführung neuer Führungskonzepte im Bildungswesen. Wie können Schulen im heutigen gesellschaftlichen und bildungspolitischen Umfeld ihrer schwierigen Aufgabe nach gleichzeitig pädagogisch wirkungsvoller und wirtschaftlicher Leistungserbringung nachkommen? Drei zentrale Aspekte einer"effektiven Schulführung"werden in diesem Buch gezielt vertieft: Der erste Teil widmet sich den Kernelementen des Public Managements an Schulen aus einer umfassenden Perspektive unter Berücksichtigung der finanziellen und produktorientierten Steuerung. Zweitens soll anhand unterschiedlicher Instrumentarien die Notwendigkeit eines professionellen Qualitätsmanagements aufgezeigt werden. Im dritten Teil werden organisatorische Aspekte und kritische Fragen bezüglich der Beurteilung und Entlöhnung von Lehrpersonen sowie der empirisch festgestellten Ansprüche an Sch ulleistungen thematisiert. Den Abschluss des Buches bildet eine umfangreiche Fallstudie mit Lösungsbeispielen zur Erprobung der erforderlichen Schritte beim Prozess in die schulische Teilautonomie.Das Buch"Effektive Schulführung"enthält praxisorientiertes Wissen und Erfahrungsberichte für Mitglieder von Erziehungsdirektionen/Bildungsministerien, Schulbehörden, Schulleitungen, aber auch für Lehrpersonen und Beraterinnen sowie Berater.

Depressive symptoms from kindergarten to early school age: longitudinal associations with social skills deficits and peer victimization

BACKGROUND: Depressive symptoms in children are associated with social skills deficits and problems with peers. We propose a model which suggests different mechanisms for the impact of deficits in self-oriented social skills (assertiveness and social participation) and other-oriented social skills (pro-social, cooperative and non-aggressive behaviors) on children's depressive symptoms. We hypothesized that deficits in self-oriented social skills have a direct impact on children's depressive symptoms because these children have non-rewarding interactions with peers, whereas the impact of deficits in other-oriented social skills on depressive symptoms is mediated through negative reactions from peers such as peer victimization. METHOD: 378 kindergarten children (163 girls) participated at two assessments (Age at T1: M = 5.8, T2: M = 7.4). Teachers completed questionnaires on children's social skills at T1. Teacher reports on peer victimization and depressive symptoms were assessed at both assessment points. RESULTS: Our study partially confirmed the suggested conceptual model. Deficits in self-oriented social skills significantly predicted depressive symptoms, whereas deficits in other-oriented social skills were more strongly associated with peer victimization. Longitudinal associations between other-oriented social skills and depressive symptoms were mediated through peer victimization. CONCLUSION: The study emphasizes the role of deficits in self-oriented social skills and peer victimization for the development of internalizing disorders.

Unterstützung des Managements von großen Netzen in der Logistik durch die systematische Bereitstellung von Methodenwissen

Das Management komplexer, interorganisatorischer und durch eine Vielzahl unterschiedlicher Beziehungen miteinander verknüpfter Strukturen und Prozesse, wie sie großen Netzen der Logistik zu-grunde liegen, stellt für die verantwortlichen Akteure eine anspruchsvolle Aufgabe dar. Der nachfolgende Beitrag stellt einen systematischen Ansatz vor, mit dem Netzwerkmanager bei der Erfüllung dieser Auf-gabe durch eine verbesserte Informationsgrundlage über verfügbare Methoden und Gestaltungsoptionen unterstützt werden sollen. Exemplarisch demonstriert wird die Funktionsweise dieses Ansatzes anhand des umfangreichen Instrumentariums des Netzwerk-Controlling, welches zur Schaffung von Transparenz in den unternehmensübergreifenden Prozessen zur Verfügung steht.

Social Work Skills in Working with Survivors of Earthquake: A Social Work Intervention - Iran

The Loss, grief and other problems are events that most of people experience them during their Life. The earthquake is a disaster that makes people experience loss, grief and problems simultaneously. This crisis affects on survivors as much as they face to dangers in their lives. Thus, most of them need to being supported until they can solve their problems, be relaxed and do their daily activities. We know that the profession of social workers is to assist individuals who are seeking help. But there is a Problem, how do they help the clients efficiently? Especially, those clients who have suffered earthquake. Generally, the role of social workers in helping the survivors of earthquake is significant. To this end, the present paper tries to describe the process of social casework and those skills required for social workers to help the survivors. These skills include: situational supporting, hopefulness making, consoling, assuring, concentrating, solutions developing and refer.

Intelligent Virtual Patients for Training Clinical Skills

The article presents the design process of intelligent virtual human patients that are used for the enhancement of clinical skills. The description covers the development from conceptualization and character creation to technical components and the application in clinical research and training. The aim is to create believable social interactions with virtual agents that help the clinician to develop skills in symptom and ability assessment, diagnosis, interview techniques and interpersonal communication. The virtual patient fulfills the requirements of a standardized patient producing consistent, reliable and valid interactions in portraying symptoms and behaviour related to a specific clinical condition.

An innovative blended learning approach using virtual patients as preparation for skills laboratory training: perceptions of students and tutors

BACKGROUND Currently only a few reports exist on how to prepare medical students for skills laboratory training. We investigated how students and tutors perceive a blended learning approach using virtual patients (VPs) as preparation for skills training. METHODS Fifth-year medical students (N=617) were invited to voluntarily participate in a paediatric skills laboratory with four specially designed VPs as preparation. The cases focused on procedures in the laboratory using interactive questions, static and interactive images, and video clips. All students were asked to assess the VP design. After participating in the skills laboratory 310 of the 617 students were additionally asked to assess the blended learning approach through established questionnaires. Tutors' perceptions (N=9) were assessed by semi-structured interviews. RESULTS From the 617 students 1,459 VP design questionnaires were returned (59.1%). Of the 310 students 213 chose to participate in the skills laboratory; 179 blended learning questionnaires were returned (84.0%). Students provided high overall acceptance ratings of the VP design and blended learning approach. By using VPs as preparation, skills laboratory time was felt to be used more effectively. Tutors perceived students as being well prepared for the skills laboratory with efficient uses of time. CONCLUSION The overall acceptance of the blended learning approach was high among students and tutors. VPs proved to be a convenient cognitive preparation tool for skills training.