AMEE Berlin 2002 Programme

5K4 Could we improve on what patients
our pediatrics students saw in
outpatient clinics?
Pedro Herskovic*, Alicia Vasquez, Cristian Breinbauer,
Patricia Gomez, Viviana Herskovic, Marcela Jacard,
Claudio Missarelli and Erika Troncoso
Pediatrics Department, University of Chile, Faculty of Medicine,
Campus Oriente, Casilla 16117, Correo 9, Providencia,
Santiago, CHILE
For the last two years we have registered every contact
of fifth year medical students with pediatric outpatients.
In 1999 we found that exposure to pathologies included
in the contents for the rotation ranged from 43.5% to
71.7%. In year 2000 an intervention was made with
the students’ tutors to increase their awareness about
the need of contact with more pathologies. Our
objective was to check if such intervention would
improve on the deficiencies detected in 1999. In year
2000 six student groups attended 50 sessions in
outpatient clinics. Patients were registered with up to
three diagnoses, which were compared with the 46
pathologies included in our learning objectives. Patient
encounters ranged from 38 to 127 per group. Exposure
to pathologies ranged from 43.0% to 80.4%, which was
similar to what was observed in 1999. Correlation was
found between the number of patients seen and contact
with more pathologies. A briefing session for tutors
did not improve the completion of the rotation
objectives. We have to keep assessing what is going on
in clinical rotations.
5K5 Using the ward round for teaching
and learning: how do junior
doctors learn from consultants
through ward-based teaching?
Alan Bleakley
Cornwall Postgraduate Education Centre, Royal Cornwall
Hospital, Truro Cornwall TR1 3LJ, UK
Traditional psychological models of knowledge and
skills transmission fail to tell the entire story of how
junior doctors are effectively taught on ward rounds,
moving from novice to expert status through
‘professional adhesion’. This paper presentation reports
an ongoing combined qualitative methods research
project with a mixed speciality group of twenty-five
consultants in a large rural hospital in Britain. Data
analysis of semi-structured interviews responding to
examples of videotaped ward practice, has led to a more
anthropological, rather than the conventional
psychological, exploration of the working modes of
specific communities of practice in a complex teaching
and learning context. Contemporary models of
constructed, distributed and situated learning, of
cognitive apprenticeship, of adaptation to a ‘habitus’
(informal rules and regulations of a community of
practice) and of the construction of practitioner
identities, are used as an exploratory, and in some cases
explanatory, framework for the data collected from the
study.
Tuesday 4 September
- 4.46 -
5K6 Clinical skills training needs of final
year medical students and PRHOs -
a comparison
D MacLeod*, E Gill, J Gate and J Rees
NHS, University Hospital Aintree, Longmoor Lane, Liverpool
L9 4EL, UK
We compared the clinical skills training needs of final
year medical students and PRHOs. We surveyed 257
final year medical students undergoing clinical skills
training, including a ‘Harvey’ cardiac patient simulator
and communication training. Then, 22 PRHOs
completed a questionnaire assessing training needs to
plan clinical skills teaching. The most frequent student
revision requests were all commonly encountered
OSCE stations; catheterization, suturing,
ophthalmoscopy, IV fluid management and breast
examination (100%, 95%, 79% and 58% of student
sessions respectively). By contrast, PRHOs requested
training on infrequently performed skills (joint
aspiration, pneumothorax aspiration, central vein
cannulation) or common but complex skills. Selfassessed
training needs of final year medical students
reflect impending OSCE assessment, whilst degree of
exposure and skill complexity drive training needs for
the PRHOs. This suggests some adjustment in student
skills training and the need for further skills training
sessions for PRHOs.
5K7 The impact of a precepted diabetic
foot care program
Linda Z Nieman, Lewis E Foxhall*, Frank Sifuentes and
Lee Cheng
UT Houston Health Science Center, Family Practice and
Community Medicine, 6431 Fannin, Suite JJL324, Houston TX
77030, USA
Diabetes is a growing international health problem that
too often leads to foot amputation. Over a two summer
period, 156 preclinical students in the Texas Statewide
Family Practice Preceptors hip Program screened the
feet of more than 300 diabetics, 30% of whom had
loss of pedal sensation. Screening was accomplished
with the Semmes Weinstein 5.07/10g, monofilament.
Students also taught these patients diabetic foot care.
From the analysis of the copies of the patient
evaluations submitted to us, we found that patients
whose age was greater than 60 years and patients who
received their care in rural settings were more likely to
have a greater number of foot problems than those
patients who were younger and those who received care
in metropolitan areas. The students’ participation in
diabetic screening and patient education has saved
preceptors time and is considered helpful by patients.
This program is transferable to other settings.