scholarly journals Time for an Undergraduate Curriculum in General Practice for Nepal

2010 ◽  
Vol 49 (179) ◽  
Author(s):  
K Butterworth ◽  
R Pradhan
Keyword(s):  
General Practice ◽  
Core Curriculum ◽  
Medical Curriculum ◽  
Clinical Care ◽  
Undergraduate Curriculum ◽  
Delphi Process ◽  
Institute Of Medicine ◽  
Commitment To Change ◽  
Emergency Situations ◽  
Medical Undergraduate

Introduction: This is a qualitative study, to generate a framework for a core curriculum in General Practice in the undergraduate setting, designed specifically for Nepal. Methods:  A Delphi process was used to involve representatives from the GP faculty in Institute of Medicine, BP Koirala institute BPKIHS, Patan Hospital/National Academy Medical Sciences and Tansen mission hospital. The Delphi involves getting input from an identified group of experts and progressively feeding back the results from each round of enquiry so that subsequent views are influenced until a point of convergence is reached. In effect the Delphi not only analyses problems and identifies solutions, but can begin the process of commitment to change. Results: A prioritized list of the key outcomes for an undergraduate GP curriculum was developed and a broad list of knowledge, skills and attitudes were defined. A balance was observed between the need to train doctors who are skilled in communication, who have compassion for their patients, who are also required to be excellent rational clinicians able to respond to emergency situations. There was also the need for doctors to be competent not just in individual clinical care, but in the care of communities. Conclusions: General Practice, as a core component of primary care, should be an obligatory part of every undergraduate medical curriculum. This Delphi process has produced an important framework for a national undergraduate curriculum in General Practice, designed specifically for Nepal. Keywords: curriculum; delphi technique; education medical undergraduate; family practice; needs assessment  

scholarly journals Understanding Medical Students’ Attitudes Toward Learning eHealth: Questionnaire Study (Preprint)

2019 ◽  
Author(s):  
Kjeld Vossen ◽  
Jan-Joost Rethans ◽  
Sander M J van Kuijk ◽  
Cees P van der Vleuten ◽  
Pieter L Kubben
Keyword(s):  
Medical Students ◽  
Medical Curriculum ◽  
Mobile Apps ◽  
Real Life ◽  
Undergraduate Curriculum ◽  
Mean Value ◽  
Successful Implementation ◽  
Medical Undergraduate ◽  
Technological Developments ◽  
Students Attitudes

BACKGROUND Several publications on research into eHealth demonstrate promising results. Prior researchers indicated that the current generation of doctors is not trained to take advantage of eHealth in clinical practice. Therefore, training and education for everyone using eHealth are key factors to its successful implementation. We set out to review whether medical students feel prepared to take advantage of eHealth innovations in medicine. OBJECTIVE Our objective was to evaluate whether medical students desire a dedicated eHealth curriculum during their medical studies. METHODS A questionnaire assessing current education, the need for education about eHealth topics, and the didactical forms for teaching these topics was developed. Questionnaire items were scored on a scale from 1 (fully disagree with a topic) to 10 (fully agree with a topic). This questionnaire was distributed among 1468 medical students of Maastricht University in the Netherlands. R version 3.5.0 (The R Foundation) was used for all statistical procedures. RESULTS A total of 303 students out of 1468, representing a response rate of 20.64%, replied to our questionnaire. The aggregate statement “I feel prepared to take advantage of the technological developments within the medical field” was scored at a mean value of 4.8 out of 10. Mean scores regarding the need for education about eHealth topics ranged from 6.4 to 7.3. Medical students did not favor creating their own health apps or mobile apps; the mean score was 4.9 for this topic. The most popular didactical option, with a mean score 7.2, was to remotely follow a real-life patient under the supervision of a doctor. CONCLUSIONS To the best of our knowledge, this is the largest evaluation of students’ opinions on eHealth training in a medical undergraduate curriculum. We found that medical students have positives attitudes toward incorporating eHealth into the medical curriculum.

scholarly journals Improving Neurosurgery education using Social-Media Case-based discussions: A Pilot Study (Preprint)

2020 ◽  
Author(s):  
Nicola Newall ◽  
Brandon George Smith ◽  
Ollie Burton ◽  
Brainbook Brainbook Charity ◽  
Aswin Chari ◽  
...  
Keyword(s):  
Social Media ◽  
Medical Education ◽  
Medical Curriculum ◽  
Demographic Data ◽  
Undergraduate Curriculum ◽  
Learning Needs ◽  
Medical Undergraduate ◽  
School Teaching ◽  
Acceptable Method ◽  
Case Based

BACKGROUND The increasing shift towards a more generalised medical undergraduate curriculum has led to limited exposure to sub-specialities including neurosurgery. The lack of standardised teaching may result in insufficient coverage of the core learning outcomes. Case-based discussions (CbDs) are often utilised in the undergraduate medical curriculum to link theory to practice and develop clinical reasoning. Social media (SoMe) in medical education is becoming an increasingly accepted and popular way for students to meet learning objectives outside of formal medical school teaching. OBJECTIVE We delivered a series of CbDs over SoMe to attempt to meet core learning needs in neurosurgery and determine whether SoMe-based CBDs were an efficient and acceptable method of education. METHODS Twitter was used as a medium to host nine CbDs pertaining to common neurosurgical conditions in practice. A sequence of informative and interactive ‘Tweets’ were formulated prior to the live CbDs and were tweeted in progressive order. Users interacted by replying to tweets to answer questions and raise discussions, as well as liking and retweeting. Moderation was performed by a neurosurgery resident, with oversight from an attending. Demographic data and participant feedback were collected using Qualtrics (Qualtrics LLC. USA). RESULTS 277 participants were recorded across the nine CbDs with 654,584 impressions generated. Feedback responses were received from 135 participants (48.7%). Participants indicated an increase of 77% in their level of knowledge after participating. 57% (n=77) had previous CbD experience as part of traditional medical education, with 62% (n=84) receiving a form of medical education previously through SoMe. All participants (n=135, 100%) felt the CbDs objectives were met and would attend future sessions and 99% of participants (n=134) indicated that their expectations were met by the SoMe CbDs. CONCLUSIONS SoMe has been demonstrated to be a favourable and feasible medium to host live, text-based interactive CbDs. Delivering CbDs over SoMe is a useful approach to teaching undergraduate neurosurgery and is easily translatable to all domains of medicine and surgery. CLINICALTRIAL

scholarly journals Introducing complementary medicine into the medical curriculum

1997 ◽  
Vol 90 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Hagen Rampes ◽  
Fiona Sharples ◽  
Sarah Maragh ◽  
Peter Fisher
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Complementary Medicine ◽  
Medical Curriculum ◽  
Great Increase ◽  
General Medical Council ◽  
Undergraduate Curriculum ◽  
Medical Schools ◽  
Medical Council ◽  
Medical Undergraduate

We surveyed the deans of British medical schools to determine the provision of complementary medicine in the undergraduate curriculum. We also sampled medical students at one British medical school to determine their knowledge of, and views on instruction in, complementary medicine. There is little education in complementary medicine at British medical schools, but it is an area of active curriculum development. Students' levels of knowledge vary widely between different therapies. Most medical students would like to learn about acupuncture, hypnosis, homoeopathy and osteopathy. We conclude that complementary medicine should be included in the medical undergraduate curriculum. This could be done without a great increase in teaching of facts, and could serve as a vehicle to introduce broader issues, as recommended by the General Medical Council.

scholarly journals sScope and Challenges of Self-Directed Learning in Undergraduate Medical Education: A Systematic Review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Archana Chirag Buch ◽  
Hetal Rathod ◽  
Mukta Durgesh Naik
Keyword(s):  
Systematic Review ◽  
Time Management ◽  
Medical Curriculum ◽  
Undergraduate Curriculum ◽  
Learning Goals ◽  
Self Directed Learning ◽  
Self Regulated Learning ◽  
Medical Undergraduate ◽  
Assessment Time ◽  
Directed Learning

Context: Self-directed learning (SDL) is an individual’s ability to effectively use various strategies to reach his/her learning goals. We conducted this systematic review to explore the different methods, advantages, and challenges in SDL. Method: A systematic and comprehensive literature search on PubMed, Scopus, and Google Scholar databases was carried out using keywords such as “self-directed learning”, “self-regulated learning”, and “medical undergraduate curriculum” among articles published between 2010 and 2020. Original articles having methods, advantages, or challenges were included. The data were summarized and analyzed thematically. Results: Out of the total number of 1781 screened articles, sixteen eligible studies were included in the systematic review. Flipped classrooms, problem-based learning, case-based scenarios, video lectures, and e-learning were the commonly used methods. Self-assessment, time management, motivation, teamwork, and critical thinking were the advantages. Faculty guidance, time constraints, distraction due to technology, lack of organizational skills, and difficulty to learn complex topics were the common challenges of SDL. Conclusions: Most of the articles in recent years explain the growing interest in SDL in the medical curriculum. Despite numerous advantages of SDL, there are several challenges and limitations due to the lack of specific and defined guidelines on its implementation. Further research is required for structured methods and strategies for SDL effective implementation.

scholarly journals Understanding Medical Students’ Attitudes Toward Learning eHealth: Questionnaire Study

10.2196/17030 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e17030
Author(s):  
Kjeld Vossen ◽  
Jan-Joost Rethans ◽  
Sander M J van Kuijk ◽  
Cees P van der Vleuten ◽  
Pieter L Kubben
Keyword(s):  
Medical Students ◽  
Medical Curriculum ◽  
Mobile Apps ◽  
Real Life ◽  
Undergraduate Curriculum ◽  
Mean Value ◽  
Successful Implementation ◽  
Medical Undergraduate ◽  
Technological Developments ◽  
Students Attitudes

Background Several publications on research into eHealth demonstrate promising results. Prior researchers indicated that the current generation of doctors is not trained to take advantage of eHealth in clinical practice. Therefore, training and education for everyone using eHealth are key factors to its successful implementation. We set out to review whether medical students feel prepared to take advantage of eHealth innovations in medicine. Objective Our objective was to evaluate whether medical students desire a dedicated eHealth curriculum during their medical studies. Methods A questionnaire assessing current education, the need for education about eHealth topics, and the didactical forms for teaching these topics was developed. Questionnaire items were scored on a scale from 1 (fully disagree with a topic) to 10 (fully agree with a topic). This questionnaire was distributed among 1468 medical students of Maastricht University in the Netherlands. R version 3.5.0 (The R Foundation) was used for all statistical procedures. Results A total of 303 students out of 1468, representing a response rate of 20.64%, replied to our questionnaire. The aggregate statement “I feel prepared to take advantage of the technological developments within the medical field” was scored at a mean value of 4.8 out of 10. Mean scores regarding the need for education about eHealth topics ranged from 6.4 to 7.3. Medical students did not favor creating their own health apps or mobile apps; the mean score was 4.9 for this topic. The most popular didactical option, with a mean score 7.2, was to remotely follow a real-life patient under the supervision of a doctor. Conclusions To the best of our knowledge, this is the largest evaluation of students’ opinions on eHealth training in a medical undergraduate curriculum. We found that medical students have positives attitudes toward incorporating eHealth into the medical curriculum.

Pilot Project: Does formal bedside training of medical students with a FAST exam increase their knowledge and comfort level with ultrasound use in a community family medicine practice setting?

POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 15-17
Author(s):  
Rimi Sambi, MD ◽  
Heather Sawula, MD ◽  
Brent Wolfrom, MD ◽  
Joseph Newbigging, MD
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Point Of Care ◽  
Training Session ◽  
Undergraduate Curriculum ◽  
Knowledge Retention ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Medical Undergraduate ◽  
Fast Exam

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.

scholarly journals Breathlessness and opioid prescribing in COPD in general practice: a cross-sectional, observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 00299-2019
Author(s):  
David C. Currow ◽  
Miriam J. Johnson ◽  
Allan Pollack ◽  
Diana H. Ferreira ◽  
Slavica Kochovska ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Pain Patient ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Obstructive Pulmonary Disease ◽  
Health Database

Chronic breathlessness is a disabling syndrome, prevalent in people with advanced chronic obstructive pulmonary disease (COPD). Regular, low-dose, oral sustained-release morphine is approved in Australia to reduce symptomatic chronic breathlessness. We aimed to determine the current prescribing patterns of opioids for chronic breathlessness in COPD in Australian general practice and to define any associated patient and practitioner characteristics.Five years (2011 to 2016) of the Bettering the Evaluation and Care of Health database, an Australian national, continual, cross-sectional study of clinical care in general practice were used. The database included 100 consecutive clinical encounters from almost 1000 general practitioners annually (n=488 100 encounters). Descriptive analyses with subsequent regression models were generated.Breathlessness as a patient-defined reason for encounter was identified in 621 of 4522 encounters where COPD was managed. Opioids were prescribed in 309 of 4522 encounters where COPD was managed (6.8%; (95% CI) 6.1–7.6), of which only 17 were prescribed for breathlessness, and the rest for other conditions almost entirely related to pain. Patient age (45–64 years versus age 80+ years, OR 1.68; 1.19–2.36), Commonwealth Concession Card holders (OR 1.70; 1.23–2.34) and socioeconomic disadvantage (OR 1.30; 1.01–1.68) were associated with increased likelihood of opioid prescription at COPD encounters. The rate of opioid prescriptions rose over the 5 years of study.In primary care encounters for COPD, opioids were prescribed in 6.8% of cases, but almost never for breathlessness. These data create a baseline against which to compare changes in prescribing as the treatment of chronic breathlessness evolves.

scholarly journals The Effectiveness of a Foundation Year 1 Doctor Preparation Course for Final Year Medical Students

2021 ◽  
Vol 8 ◽  
pp. 238212052098418
Author(s):  
William Beedham ◽  
Kasun Wanigasooriya ◽  
Georgia R Layton ◽  
Ley Taing Chan ◽  
Adnan Darr ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Core Curriculum ◽  
Junior Doctor ◽  
Hidden Curriculum ◽  
Medical Curriculum ◽  
Primary Objective ◽  
Rank Test ◽  
Significant Difference ◽  
Curriculum Topics

Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course ( P = .004). Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.

scholarly journals Datasets collected in general practice: an international comparison using the example of obesity

2018 ◽  
Vol 42 (5) ◽  
pp. 563 ◽  
Author(s):  
Elizabeth Sturgiss ◽  
Kees van Boven
Keyword(s):  
Primary Care ◽  
General Practice ◽  
The Netherlands ◽  
Care Management ◽  
Clinical Care ◽  
International Comparisons ◽  
Health Condition ◽  
Practice Management ◽  
Number Of Patients ◽  
Primary Care Management

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

Vascular surgery: What increases the flow of students to the speciality?

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 338-344 ◽  
Author(s):  
Mohammed Adil A Turki ◽  
Alexander Zargaran ◽  
Aasim Murtaza ◽  
Amal Thomas ◽  
Harry Spiers ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Medical Curriculum ◽  
Research Work ◽  
Academic Research ◽  
Undergraduate Curriculum ◽  
Significant Rise ◽  
Surgical Skills ◽  
Positive Perception ◽  
Vascular Surgeon ◽  
Diverse Range

Objectives Vascular surgery is in increasing demand due to the higher prevalence of cardiovascular disease in the general population. Meanwhile, applications to join the speciality have been in decline in the last few years. St George’s Surgical Society held a one-day conference to expose undergraduates to the speciality in the hope that this will inspire more undergraduates to pursue it as a career. Methods The conference consisted of introductory lectures delivered by a consultant vascular surgeon, followed by practical skills workshops simulating aortic anastomosis on porcine aortas. Pre-course and post-course questionnaires assessed positive and negative perceptions of vascular surgery, knowledge of and self-reported confidence in practical surgical skills and utility of the course in their decision to potentially pursue a career in vascular surgery. Results There was a significant increase of 27% ( p = 0.03) in the positive perception that vascular surgery includes a diverse range of procedures and subspecialties. Attendees reported a 27% significant increase ( p = 0.02) in the perception that vascular surgery had a wide array of opportunity for academic/research work. Finally, there was an 18% decrease ( p = 0.03) in the negative perception that vascular surgery is somehow female-unfriendly or discriminatory against females. There was also a significant rise in both interest (33%) and understanding (73%) of vascular surgery. Conclusions A one-day conference can significantly impact students’ perception especially when there is a lack of exposure within the undergraduate curriculum. This course helped to increase positive perception and dispute negative misconceptions about the speciality. The simulation workshops held at this conference increased students’ confidence and awareness of relevant surgical skills. This conference provided a unique experience that positively impacted and inspired students and thus served as an important supplement to core medical curriculum.

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