Abstract: Anderson, EM; Johnston, K; Gunnarsson, R; Larkins, S Content: Although clinician-researchers are an essential part of the health workforce, the number of clinical researchers is declining. Student participation in research during medical school has been shown to promote a future interest in research. Therefore, to promote clinical research, it is important to evaluate educational pathways and the impediments to students undertaking research at medical school.
Methods: Semi-structured interviews were conducted to identify the challenges, benefits and enablers for students who are undertaking or have graduated from an embedded research honours degree in the Bachelor of Medicine, Bachelor of Surgery (BMBS) degree. Two researchers performed an ongoing thematic analysis. Data collection continued until data saturation was reached. Codes were reviewed and organised into overarching themes.
Results: Participants' two main reasons for undertaking honours were an interest in research and to enhance career prospects. Lack of research skills, workload and support were identified as challenges, and peer relationships and available support were enablers.
Conclusions: The embedded honours model provides research training and the opportunity to engage with and contribute to the research arena.
Abstract: Weston, KM; Garne, DL; Bushnell, JA; Hudson, JN Background: Rural clinical placement during medical training has been identified as important in addressing workforce mal-distribution in Australia. The University of Wollongong (UOW) medical school is unique in Australia in that all students undertake a 12-month continuous longitudinal-integrated-clerkship (LIC) placement in rural or regional NSW, or in the non-capital city urban centre where the university main campus is located. This paper investigates whether origin is important in medical students' intentions and preferences for future practice.
Methods: Between 2010 and 2015, rural clinical school (RCS) students from Australian medical school programmes, including UOW, completed the same survey. The responses from UOW students were compared to other students. The main outcome measures investigated were preference for location of future practice and training, and career preferences. These were investigated with respect to location of origin of students.
Results: UOW students preferred regional city/large town locations for future practice compared to other RCS students. This finding strongly correlated with the non-capital city origin of UOW students. General practice/rural medicine was the career preference for one third of UOW students compared to one quarter of other students. Generalist specialist was the preference for almost half of other students. Skills development experiences and outcomes were similar in both groups.
Abstract: Moore, K; Vaughan, B; Butterworth, P Background: The Direct Observation of Procedural Skills (DOPS) is a workplace-based assessment tool widely used in medicine to assess a learner's ability to execute a technical skill. The aim of this paper is to report on the development phase of the adaptation of the DOPS for the assessment of podiatry learners' procedural skills. Podiatry learners are required to practise and demonstrate a variety of procedural skills in the management of foot complaints. Such skills include the use of scalpel blades, needles and local anaesthetic applied to a variety of disorders. The DOPS provides an avenue by which a learner's procedural skills can be assessed and timely feedback provided in the workplace or in simulated environments.
Methods: The DOPS was initially adapted for podiatry by a faculty team consisting of a podiatry educator, a clinical education specialist and a clinical educator from another allied health discipline. The first iteration was circulated among podiatry faculty at three other Australian universities. The second iteration was reviewed by clinical supervisors from Southern Cross University (SCU). The third iteration was administered by two clinical supervisors at SCU working with 12 learners during real-time clinical events. Eleven learners used DOPS to assess their peers during five real-time and six simulated learning events.
Results: A new tool, the Direct Observation of Procedural Skills in Podiatry (DOPS-P) has emerged from this process. Face and construct validity have been confirmed, and faculty and students consider DOPS-P contributes to learning.
Conclusions: Further research is necessary to confirm the validity and reliability of the DOPS-P to support assessment decisions about students' achievement of podiatry competencies.
Abstract: Angus, LM; Chur-Hansen, A; Duggan, P Introduction: Clinical reasoning is an essential part of medical practice. Training medical students to reason competently is, therefore, an essential skill for clinical teachers. Ongoing debate over what clinical reasoning entails and difficulty explicitly teaching and assessing it makes this a challenging task. This study explored clinical teachers' understanding of the concept of clinical reasoning.
Methods: Nine experienced clinical teachers participated in semi-structured interviews about clinical reasoning, exploring concepts, experiences, teaching and assessment. Interviews were transcribed and analysed thematically.
Results: Ten key themes were identified in relation to participants' understanding of clinical reasoning. These include the findings that clinical reasoning is: essential to medical practice, goal oriented, an applied cognitive process and an unconscious process. Clinical reasoning has several requirements, including knowledge, communication skills, experience and reflection. Participants reported that clinical reasoning is difficult, perhaps impossible, to teach.
Conclusions: In this qualitative study, clinical teachers concurred with many of the characteristics of clinical reasoning as it is understood in the literature, but they also challenged assumptions made in medical education research regarding the conceptualisation of clinical reasoning. This has implications for teaching, assessment, student selection and professional development.
Abstract: Grace, S; Streckfuss, J Background: During clinical training, osteopathy students are required to develop skills and attitudes that challenge their capabilities and viewpoints. The aim of this project was to inform pedagogical processes that could reduce the stress associated with beginning clinical practice.
Methods: Data were collected from two sources: (1) semi-structured interviews and (2) audiovisual material prepared by students for other purposes but which also shed light on their experiences of clinical placement. With participants' consent, data were thematically analysed using constant comparison.
Results: Osteopathic students entering clinical practice experienced high levels of performance anxiety that caused physical and psychological stress. Despite achieving objectively-measured competencies in clinical assessments, students perceived they were not ready to perform as practitioners (e.g., appear confident, overcome nervousness and manage the consultation time).
Conclusions: To reduce performance anxiety associated with the transition to beginning practitioner, professional education needs to expand to include timely opportunities to learn practice performance skills.
Abstract: Saad, SL; Craig, P; Rychetnic, L; Lord, S; Everingham, F Background: Providing evidence-based, high-quality medical education requires a solid research base with ongoing development. Academic teachers in medical schools are expected to establish and maintain research involvement as part of their university appointment. This paper used a mix of methods to explore teaching interest as a vehicle for increasing research capacity among clinician teachers.
Methods: Ten clinician teachers participated in semi-structured one-on-one interviews exploring their experiences and attitudes to medical education and biomedical research. Data were analysed thematically. From this, a quantitative survey focusing on clinical teachers' research interest and involvement was developed and administered across the medical school.
Results: Two common themes from the interviews were an expressed interest in participating in medical education research and a perceived value and relevance to clinician teachers' academic appointments. The two major inhibiting factors that were identified were a lack of time and unclear pathways to research participation. Of those surveyed, 51% were currently involved in research and 24% were interested in becoming involved in research. Perceived barriers to research participation were time (73%), lack of skills (22%) and funding (36%).
Conclusions: Increasing teacher participation in medical education research represents a significant untapped source of research output for the school, an area of important professional development for the teachers and an avenue for attaining excellence in education for the students and the institution. These are in addition to the opportunity to contribute to scholarship in teaching and learning.
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