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Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses.

ABSTRACT: AIM: The efficacy of postgraduate practical training courses is frequently evaluated by self-assessment instruments. The present study analyses the effect of a basic course in laparoscopic surgery on self-assessed medical competencies. METHODS: The 3-day course included teaching of knowledge and training of practical skills. In relation to course evaluation, a questionnaire for self-assessment was applied at the beginning of the course ('pre-course'), at the end of the course ('post-course') and at the end of the course to reassess pre-course competencies ('retrospective pre-course'). RESULTS: 89 out of 110 participants (81%) attending 10 courses completed all the questionnaires; 83% were postgraduate trainees in surgery and 82% were inexperienced as an independent surgeon. At the beginning of the course most trainees rated themselves as 'moderately competent' or 'fully competent' with respect to the various task levels as well as to specific areas of medical competencies. At the end of the course however pronounced retrospective revisions of self-assessment to lower ratings became apparent. Statistically significant differences were seen for the task 'performing surgical procedures under supervision' and for most of the practical skills trained during the course (p <0.01). In contrast, no significant differences were observed for knowledge taught during the course as well as for 'ability to work in a team' and 'ability to concentrate', which were not foci of the course. CONCLUSIONS: Surgeons with little experience change their self-assessment of pre-course competencies to a lower level after participation in a practical postgraduate training course. Evaluations comparing 'pre-course' and 'post-course' ratings only - without 'retrospective pre-course' ratings - may underestimate the training effects. This phenomenon needs to be taken into account when evaluations are dependent exclusively on self-assessment instruments.

SUBMITTER: Nagler M

PROVIDER: S-EPMC3374141 | biostudies-other | 2012

REPOSITORIES: biostudies-other

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Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses.

Nagler Michael M Feller S S Beyeler Christine C

GMS Zeitschrift fur medizinische Ausbildung 20120515 3

<h4>Aim</h4>The efficacy of postgraduate practical training courses is frequently evaluated by self-assessment instruments. The present study analyses the effect of a basic course in laparoscopic surgery on self-assessed medical competencies.<h4>Methods</h4>The 3-day course included teaching of knowledge and training of practical skills. In relation to course evaluation, a questionnaire for self-assessment was applied at the beginning of the course ('pre-course'), at the end of the course ('post ...[more]

PMID: 22737200

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Project description:OBJECTIVE:To assess health informatics (HI) training in UK postgraduate medical education, across all specialties, against international standards in the context of UK digital health initiatives (eg, Health Data Research UK, National Health Service Digital Academy and Global Digital Exemplars). DESIGN:A mixed methods study of UK postgraduate clinician training curricula (71 specialties) against international HI standards: scoping review, curricular content analysis and expert consultation. SETTING AND PARTICIPANTS:A scoping literature review (PubMed until March 2017) informed development of a contemporary framework of HI competency domains for doctors. National training curricula for 71 postgraduate medical specialties were obtained from the UK General Medical Council and were analysed. Seven UK HI experts were consulted regarding findings. OUTCOMES:The International Medical Informatics Association (IMIA) Recommendations for Biomedical and Health Informatics Education were used to develop a framework of competency domains. The number (maximum 50) of HI competency domains included in each of the 71 UK postgraduate medical specialties was investigated. After expert review, a universal HI competency framework was proposed. RESULTS:A framework of 50 HI competency domains was developed using 21 curricula from a scoping review, curricular content analysis and expert consultation. All 71 UK postgraduate medical curricula documents were mapped across 29 of 50 framework domains; that is, 21 domains were unrepresented. Curricula mapped between 0 (child and adolescent psychiatry and core surgical training) and 16 (chemical pathology and paediatric and perinatal pathology) of the 50 domains (median=7). Expert consultation found that HI competencies should be universal and integrated with existing competencies for UK clinicians and were under-represented in current curricula. Additional universal HI competencies were identified, including information governance and security and secondary use of data. CONCLUSIONS:Postgraduate medical education in the UK neglects HI competencies set out by international standards. Key HI competencies need to be urgently integrated into training curricula to prepare doctors for work in increasingly digitised healthcare environments.

Project description:BACKGROUND:Sexual health problems are common. Therefore, training in sexual health is relevant for the clinical practice of trainees and early-career specialists in several specialties who deal with patients with sexual health problems. However, little is known about how sexual health training is provided across countries and specialties. AIM:To assess (i) sexual health training during postgraduate training programs in psychiatry, obstetrics and gynecology, urology, and endocrinology across Europe; (ii) the confidence of trainees and early-career specialists in dealing with patients with sexual health problems; and (iii) their need for further training in sexual health during postgraduate training programs. METHODS:The study was based on a collaboration among European societies of trainees in these 4 specialties. An online survey was developed and conducted from January 2015 through June 2016. MAIN OUTCOME MEASURES:Self-reported questionnaire. RESULTS:We collected 366 completed surveys from 40 countries. Sexual health training was considered an important or very important part of specialty training by 78.7% of participants. Overall, 62.3% of participants had not received any training in sexual health. Especially in obstetrics and gynecology, the large majority did not have training in sexual health (82.8%), followed by psychiatry (59.8%), urology (58.4%), and endocrinology (56.1%). There were statistically significant differences among specialties in the confidence of participants in managing patients with sexual health problems. In general, trainees and early-career specialists who had received sexual health training felt more confident in dealing with patients with gender dysphoria (P = .011), need for sexual therapy (P = .0004), paraphilic disorders (P = .0003), and sexual dysfunction (P = .0017). CONCLUSIONS:Trainees and early-career specialists found sexual health training important for their future medical practice; however, less than half received it during their postgraduate training. Participants felt more confident in managing patients with sexual health problems when sexual health training was included in the postgraduate training program. Kristufkova A, Pinto Da Costa M, Mintziori G, et al. Sexual Health During Postgraduate Training-European Survey Across Medical Specialties. Sex Med 2018;6:255-262.

Project description:PurposeTo describe a practical, self-assembled continuous curvilinear capsulorhexis (CCC) self-training system to facilitate resident self-training and shorten the CCC learning curve.MethodsThis was a prospective experimental study that included a total of 600 capsulorhexis cases. A device for CCC practice was self-assembled and used for training and testing. Based on capsulorhexis manipulation experience, three main groups of residents (A, capsulorhexis experience with <50 cases; B, capsulorhexis experience with 400-500 cases; and C, capsulorhexis experience with >1000 cases) were created. Furthermore, based on different capsulorhexis conditions, each main group was divided into four subgroups (1, CCC without an anterior chamber cover and capsulorhexis marker; 2, CCC with an anterior chamber cover without a capsulorhexis marker; 3, CCC with an anterior chamber cover and a capsulorhexis marker; and 4, CCC with an anterior chamber cover and a capsulorhexis marker under 2.5 times magnification). Three CCC-related parameters, including acircularity index (AI), axis ratio (AR), and capsulorhexis time, were statistically evaluated.ResultsWe compared the differences in study parameters among 50 consecutively completed capsulorhexis cases by one trainee with different capsulorhexis experience in each subgroup. The CCC-related parameter values in subgroups 1 and 4 were significantly different among the three groups (P < 0.001). The capsulorhexis time in subgroup 2 was significantly different among the three groups (P < 0.001). The capsulorhexis time and AI in subgroup 3 were significantly different among the three groups (P < 0.001). Moreover, with increasing manipulation experience (from group A-C), the capsulorhexis time, the AI, and AR tended to decrease. With the help of the CCC marker, in subgroups 3 and 4, the AI and AR were closer to 1.0.ConclusionThis self-assembled CCC self-training system is practical. The CCC marker seems helpful for size specification and centration during self-training.

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Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses.

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Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses.

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