AMEE Berlin 2002 Programme

In Flanders the Departments of General Practice in
different universities worked together to organise a
common final assessment procedure. This takes place
at the end of the vocational training period in General
Practice and takes the form of a certification exam.
This assessment procedure is built out of four different
components: a well-designed written knowledge test,
a structured oral exam, a large scale OSCE type exam
and a structured report from the trainers. A pass-fail
standard is defined for each separate module using
appropriate procedures. A final pass-fail decision is
based on a combination of the scores obtained from
the different modules. This presentation discusses the
Wednesday 5 September
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different approaches that can be used to combine the
different component scores. From a pure reliability
perspective the reliability analysis of composite scores
can be computed using a multivariate reliability
analysis. The discussion is illustrated with data collected
from the final assessment procedure in 1996-2000. The
impact of using different approaches and computation
methods is simulated and discussed. The choice for a
specific combination method should be inspired by the
psychometric characteristics of the assessment tools
but the final decision is made on an empirical basis.
Session 8E Postgraduate education/career choice
8E1 Teaching with patients: moving
beyond ‘learning by osmosis’
Kath Green
South Thames Department of Postgraduate Medical and Dental
Education, 33 Millman Street, London WC1N 3EJ, UK
Teaching with patients in everyday workplace contexts
(such as ward rounds, clinics, theatre etc.) provides a
unique opportunity for postgraduate doctors to gain
insight into the complex thinking that lies at the heart
of professional practice in medical education. It is easy
to assume, however, that these inexperienced doctors
will ‘pick up’ a range of important generic skills (e.g.
communicating with patients, working in multiprofessional
teams, understanding patient anxiety etc.)
merely by accompanying a more experienced clinician
in one of the above contexts. Could it be that some of
the excellent role models of good practice being
provided by experienced colleagues are going largely
unnoticed by postgraduate doctors whose personal
agendas may be narrowly focused on exam preparation?
Some ideas for raising the status of this kind of
‘teaching by example’ will be outlined and opened up
for further discussion.
8E2 The effect of an interactive
postgraduate education
programme on parenteral treatment
in Macedonia
M Ivanovski, P D Toon*, K Zafirovska, F Tozija and B Gomes
University College London, 137 Roding Road, London E5 0DR,
UK
Macedonia has no formal system of postgraduate or
continuing education for doctors working in primary
care. These doctors are poorly equipped and have little
access to current medical information. Treatment is
therefore often inappropriate; overuse of antibiotics and
injected drugs, and high referral rates are particular
problems. To improve matters the Chamber of
Physicians encouraged the Ministry of Health to
support a programme of continuing education using
World Bank funds and foreign technical assistance.
Evidence-based guidelines were customised and
translated, and an 18 day course based around these
was developed. This was piloted in the Prilep region in
1999. It was well received by participants, and is now
being extended throughout the country. We will present
details of the course and data demonstrating a fall in
the cost of injectable drugs in the Prilep region by 26%
in the four months following the course, compared with
the previous year.
8E3 Promoting innovation in
postgraduate education through
the accreditation process
Judith Armbruster
ACGME, 5555 N Sheridan, Apt 601, Chicago IL 60640, USA
U.S. residency programs and their institutions are
subject to many destabilizing influences, eg, economic
pressures for clinical productivity, shortened
hospitalizations, decentralization of patient care, all of
which may negatively impact teaching. The ACGME,
the U.S. accrediting agency for postgraduate medical
education, has initiated a project to help programs meet
these challenges. An invitation was issued to programs
and institutions to submit proposals for innovative
approaches to teaching and evaluation. The proposals,
which must also ensure the training quality is not
compromised, should result in initiatives that may be
adopted by other institutions. Principal benefits of the
RFP (request for proposals) approach are that it will
stimulate creativity and flexibility in teaching
institutions, recognize and reward viable innovation,
and promote the sharing of information among
programs. Over 100 proposals were received. This
presentation will explain future plans for the project
and describe some of the most promising proposals.
8E4 A new development in
postgraduate surgical education:
the Intermediate Breast Course - a
distance learning course
H M Sweetland*, E Hoadley-Maidment and M Galea
Raven Dept of Education, Royal College of Surgeons of England
(RCS), University of Wales College of Medicine, University
Department of Surgery, Heath Park, Cardiff CF4 4XN, UK