A Survey of Medical Oncology Training in Australian Medical Schools: Pilot Study.
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ABSTRACT:
SUBMITTER: George M
PROVIDER: S-EPMC5743919 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PURPOSE: The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators' and librarians' participation in EBM training, and (3) barriers to EBM training. METHODS: A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom's taxonomy. RESULTS: One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom's categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches. CONCLUSIONS: Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment. IMPLICATIONS: Findings can provide a starting point for discussion to develop a standardized competency framework.
| S-EPMC4076124 | biostudies-literature
Project description:BackgroundCancer was the fifth leading cause of death in Sudan general hospitals in 2020, and its incidence is increasing. Medical students' cancer education is key in cancer control. Evaluating the current education is the first step in optimizing it. The aim of this study was to assess undergraduate oncology education in Sudan public medical schools as reflected by the graduates of the year 2021-2022.MethodThis was a cross-sectional institution-based study. A validated online questionnaire was sent between 8 September and 11 November 2022 to graduates who were selected using a stratified random sampling technique from 17 Sudan public medical schools. The data were collected using Google Forms and analyzed using R software version 4.2.2 and Microsoft Excel 2022.ResultsA total of 707 graduates completed the questionnaire. They reported generally poor exposure to oncology. Palliative and radiation oncology in addition to chemotherapy daycare units were never attended by 76.0%, 72.0%, and 72.0% of graduates, respectively. The massed oncology curriculum was associated with increased hours of lectures dictated to medical (p = 0.005), radiation (p < 0.001), and palliative oncology (0.035). It was associated with an increased likelihood of assessment in breaking bad news (p < 0.001), counseling cancer patients (p = 0.015), and oncology-related knowledge (p < 0.001). The massed curriculum was associated with a decrease in interest in pursuing an oncology career (p = 0.037). Students were generally confident in their oncology competencies, and no difference was observed in relation to the curriculum approach (p > 0.05).ConclusionThis study reflected poor exposure to oncology at the undergraduate level in Sudanese public medical schools. The massed oncology curriculum was associated with formal assessment of oncology-related competencies and better exposure to some disciplines, such as radiation and palliative oncology. Nonetheless, it was associated with decreased interest in an oncology career. In spite of the poor exposure, graduates were confident in their skills in oncology-related competencies. Further objective analysis of competence is needed.
| S-EPMC10712034 | biostudies-literature
Project description:BackgroundElectronic decision support is commonplace in medical practice. However, its adoption at the point-of-care is dependent on a range of organisational, patient and clinician-related factors. In particular, level of clinical experience is an important driver of electronic decision support uptake. Our objective was to examine the way in which Australian doctors at different stages of medical training use a web-based oncology system (http://www.eviq.org.au).MethodsWe used logfiles to examine the characteristics of eviQ registrants (2009-2012) and patterns of eviQ use in 2012, according to level of medical training. We also used a web-based survey to evaluate the way doctors at different levels of medical training use the online system and to elicit perceptions of the system's utility in oncology care.ResultsOur study cohort comprised 2,549 eviQ registrants who were hospital-based medical doctors across all levels of training. 65% of the cohort used eviQ in 2012, with 25% of interns/residents, 61% of advanced oncology trainees and 47% of speciality-qualified oncologists accessing eviQ in the last 3 months of 2012. The cohort accounted for 445,492 webhits in 2012. On average, advanced trainees used eviQ up to five-times more than other doctors (42.6 webhits/month compared to 22.8 for specialty-qualified doctors and 7.4 webhits/month for interns/residents). Of the 52 survey respondents, 89% accessed eviQ's chemotherapy protocols on a daily or weekly basis in the month prior to the survey. 79% of respondents used eviQ at least weekly to initiate therapy and to support monitoring (29%), altering (35%) or ceasing therapy (19%). Consistent with the logfile analysis, advanced oncology trainees report more frequent eviQ use than doctors at other stages of medical training.ConclusionsThe majority of the Australian oncology workforce are registered on eviQ. The frequency of use directly mirrors the clinical role of doctors and attitudes about the utility of eviQ in decision-making. Evaluations of this kind generate important data for system developers and medical educators to drive improvements in electronic decision support to better meet the needs of clinicians. This end-user focus will optimise the uptake of systems which will translate into improvements in processes of care and patient outcomes.
| S-EPMC3750334 | biostudies-literature
Project description:ObjectivesTo determine if increased exposure to clinical specialties at medical school is associated with increased interest in pursuing that specialty as a career after foundation training.DesignA retrospective observational study.Setting31 UK medical schools were asked how much time students spend in each of the clinical specialties. We excluded two schools that were solely Graduate Entry, and two schools were excluded for insufficient information.Main outcome measuresTime spent on clinical placement from UK undergraduate medical schools, and the training destinations of graduates from each school. A general linear model was used to analyse the relationship between the number of weeks spent in a specialty at medical school and the percentage of graduates from that medical school entering each of the Core Training (CT1)/Specialty Training (ST1) specialties directly after Foundation Year 2 (FY2).ResultsStudents spend a median of 85 weeks in clinical training. This includes a median of 28 weeks on medical firms, 15 weeks in surgical firms, and 8 weeks in general practice (GP). In general, the number of training posts available in a specialty was proportionate to the number of weeks spent in medical school, with some notable exceptions including GP. Importantly, we found that the number of weeks spent in a specialty at medical school did not predict the percentage of graduates of that school training in that specialty at CT1/ST1 level (ß coefficient=0.061, p=0.228).ConclusionsThis study found that there was no correlation between the percentage of FY2 doctors appointed directly to a CT1/ST1 specialty and the length of time that they would have spent in those specialties at medical school. This suggests that curriculum adjustments focusing solely on length of time spent in a specialty in medical school would be unlikely to solve recruitment gaps in individual specialties.
| S-EPMC6661606 | biostudies-literature
Project description:PURPOSE:Medically-focused journal clubs have been used as an educational tool for over 100 years with research indicating that they improve knowledge, reading behaviour, and critical appraisal skills. However, it is not known how widespread their use is among Australian medical schools, nor the opinions of medical education leaders as to their value. METHODS:A nationwide cross-sectional study was performed on academic leaders from every Australian medical school. Individuals were asked to complete a survey detailing their attitudes towards journal clubs using single or multiple answer questions, Likert scales, and ranked data. They were asked whether students at their institutions were able to partake in journal clubs, and if so, details of their implementation. RESULTS:At least one response was collected from 18 of 19 Australian medical schools. This represented 60 responses of a possible 147 (40.8%), the vast majority of whom were heads of clinical schools, 36 (60.0%). The prevalence of journal clubs among medical institutions was high, with 15 of 18 (83.3%) stating that they had a journal club. Of these 23 (65.7%) were metropolitan and 12 (34.3%) were rural institutions. Most were clinician-led, 18 (51.4%), run through specific hospital departments, 13 (37.1%), and most frequently occurred during clinical years, 23 (65.7%). The vast majority stated that the primary aim of the journal club was to develop critical appraisal skills, 20 (57.1%). CONCLUSION:Journal clubs are a highly regarded educational tool in the armoury of medical school educators, with significant heterogeneity in their structure, geographic prevalence and intended purpose. Further studies into their efficacy in teaching evidence-based medicine is warranted in the medical student cohort.
| S-EPMC7365995 | biostudies-literature
Project description:BackgroundThe Australian Medical Council, which accredits Australian medical schools, recommends medical leadership graduate outcomes be taught, assessed and accredited. In Australia and New Zealand (Australasia) there is a significant research gap and no national consensus on how to educate, assess, and evaluate leadership skills in medical professional entry degree/programs. This study aims to investigate the current curricula, assessment and evaluation of medical leadership in Australasian medical degrees, with particular focus on the roles and responsibilities of medical leadership teachers, frameworks used and competencies taught, methods of delivery, and barriers to teaching leadership.MethodsA self-administered cross-sectional survey was distributed to senior academics and/or heads or Deans of Australasian medical schools. Data for closed questions and ordinal data of each Likert scale response were described via frequency analysis. Content analysis was undertaken on free text responses and coded manually.ResultsSixteen of the 22 eligible (73%) medical degrees completed the full survey and 100% of those indicate that leadership is taught in their degree. In most degrees (11, 69%) leadership is taught as a common theme integrated throughout the curricula across several subjects. There is a variety of leadership competencies taught, with strengths being communication (100%), evidence based practice (100%), critical reflective practice (94%), self-management (81%), ethical decision making (81%), critical thinking and decision making (81%). Major gaps in teaching were financial management (20%), strategic planning (31%) and workforce planning (31%). The teaching methods used to deliver medical leadership within the curricula are diverse, with many degrees providing opportunities for leadership teaching for students outside the curricula. Most degrees (10, 59%) assess the leadership education, with one-third (6, 35%) evaluating it.ConclusionsMedical leadership competencies are taught in most degrees, but key leadership competencies are not being taught and there appears to be no continuous quality improvement process for leadership education. There is much more we can do as medical educators, academics and leaders to shape professional development of academics to teach medical leadership, and to agree on required leadership skills set for our students so they can proactively shape the future of the health care system.
| S-EPMC7792303 | biostudies-literature
Project description:BackgroundSub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region.MethodsThe SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable.ResultsSurveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to infrastructure and faculty limitations, respectively. Significant correlations were seen between schools implementing increased faculty salaries and bonuses, and lower percentage loss of faculty over the previous five years (P = 0.018); strengthened institutional research tools (P = 0.00015) and funded faculty research time (P = 0.045) and greater faculty involvement in research; and country compulsory service requirements (P = 0.039), a moderate number (1-5) of post-graduate medical education programs (P = 0.016) and francophone schools (P = 0.016) and greater rural general practice after graduation.ConclusionsThe results of the SAMSS survey increases the level of data and understanding of medical schools in Sub-Saharan Africa. This data serves as a baseline for future research, policies and investment in the health care workforce in the region which will be necessary for improving health.
| S-EPMC3311571 | biostudies-literature
Project description:BackgroundThe international migration of physicians is a global public health problem. Lebanon is a source country with the highest emigration factor in the Middle East and North Africa and the 7th highest in the World. Given that residency training abroad is a critical step in the migration of physicians, the objective of this study was to survey students of Lebanese medical schools about their intentions to train abroad and their post training plans.MethodsOur target population consisted of all students of Lebanese medical schools in the pre-final and final years of medical school. We developed the survey questionnaire based on the results of a qualitative study assessing the intentions and motives for students of Lebanese medical schools to train abroad. The questionnaire inquired about student's demographic and educational characteristics, intention to train abroad, the chosen country of abroad training, and post-training intention of returning to Lebanon.ResultsOf 576 eligible students, 425 participated (73.8% response rate). 406 (95.5%) respondents intended to travel abroad either for specialty training (330 (77.6%)) or subspecialty training (76 (17.9%)). Intention to train abroad was associated with being single compared with being married. The top 4 destination countries were the US (301(74.1%)), France (49 (12.1%)), the United Kingdom (31 (7.6%)) and Canada (17 (4.2%)). One hundred and two (25.1%) respondents intended to return to Lebanon directly after finishing training abroad; 259 (63.8%) intended to return to Lebanon after working abroad temporarily for a varying number or years; 43 (10.6%) intended to never return to Lebanon. The intention to stay indefinitely abroad was associated male sex and having a 2nd citizenship. It was inversely associated with being a student of one of the French affiliated medical schools and a plan to train in a surgical specialty.ConclusionAn alarming percentage of students of Lebanese medical schools intend to migrate for post graduate training, mainly to the US. A minority intends to return directly to Lebanon after finishing training abroad.
| S-EPMC2424042 | biostudies-literature
Project description:BackgroundResearch into how medical schools support students who are pregnant or with current parental responsibilities has been mostly limited to the US context.ObjectivesTo review pregnancy and parental leave policies for students at Australian/New Zealand medical schools.DesignA cross-sectional survey.MethodsData were collected between June and September 2021. Websites of Australian/New Zealand medical schools (n = 23) were searched for freely available information on pregnancy and parental leave policies. Each school was contacted to provide supplementary information on the processes to support students who apply for pregnancy and/or parental leave. Outcome harvesting techniques were used to analyse the key attributes and processes used by medical schools.ResultsNone of the 23 accredited Australian/New Zealand medical schools had specific pregnancy and/or parental leave policies. Fourteen of the 23 Australian/New Zealand medical schools responded to the request for more information. All confirmed, beyond their University's general student leave policies, they had no additional pregnancy and parental leave policy. Analysis of each school's processes identified the following themes: lack of school specific pregnancy and/or parental leave policies; lack of public statements of support for medical students who are pregnant and/or with current parental responsibilities; and lack of attention to the specific needs of medical students who are pregnant and/or with current parental responsibilities, including those with pregnant partners or are a birth support person.ConclusionThere was a lack of documentation and formalized processes related to the support of this group of students. By creating easily accessible information on pregnancy and parental leave which is nuanced to the challenges of medical school and clinical placements, medical schools and medical education accreditation bodies in Australia/New Zealand can address the needs of medical students who are pregnant and/or with current parental responsibilities and normalize pregnancy and parental status within entry-to-practice medical courses.
| S-EPMC9751152 | biostudies-literature
Project description:BackgroundSince June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work.MethodsUsing a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures.ResultsData from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6).ConclusionEmergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.
| S-EPMC2689168 | biostudies-literature