Abstract
The Tuning-Medicine Project produced a set of 'level one' and 'level two' learning outcomes/ competences to be met by European medical graduates. In the learner-centered era self-assessment becomes more and more important. Our aim was to develop a self-completion questionnaire ('iCAN!') evaluating graduates' learning outcomes. The Tuning 'level two' learning outcomes were transformed to a 104 closed items questionnaire, tested with a convenient sample of 512 graduates from the seven Greek medical schools during the 2009-2011 graduation cohorts, 21 practitioners, and seven different undergraduate student groups. Cronbach alpha, factor analysis, and mean score comparisons were used to check internal consistency, construct validity, and sensitivity respectively. Question mean scores were used to differentiate weak and strength areas of competence. Among graduates, all overall alphas were >0.95 and all subscale alphas higher than expected, indicating an at least acceptable internal consistency. Factor analysis produced one factor per 'level one outcome', except for 'practical procedures' which was split in two meaningful factors. Overall mean score was 44.4%, 52.2%, 61.2%, 73.4%, 81.4% among 2 nd -year, 4 th -year, 6 th -year students, graduates, and practitioners respectively (p<0.001); improvement through progressively matured groups suggest good sensitivity, indicating also good responsiveness. Among graduates, question mean scores ranged from very weak (blood transfusion, 39%) to very strength (measuring blood pressure, 95%), indicating good differentiation of strengths and weaknesses. A consistent, well-structured, and sensitive version of a questionnaire is hereby released for graduates' abilities and professionalism self-assessment and differentiation of strengths and weaknesses that could be
Highlights
Medical Education moved successively from delivering the content by medical teachers to objectives-based, competence-based, and outcome-based education with special guides and journal themed issues [1,2,3,4,5,6,7,8,9,10,11,12,13]
Since the Tuning learning outcomes were set and described in two granularity levels (‘level one’ and ‘level two') by consensus of a large qualitative group of teaching staff from over ninety European schools through the whole Medical Education in Europe (MEDINE) process rather than by statistical methods [2], we considered more appropriate to base our analysis on ‘level one’ in order to test the properties of each Tuning ‘level one’ learning outcome and to identify whether their ‘level two’ learning outcomes compose a single factor or can be best described with a two or more factors model
Out of 899 graduates of twelve graduating cohorts between July 2009 and November 2011 from all seven Greek medical schools, 512 participated; 43% male, 57% female; 77% graduated in July 2009, 23% afterwards; 148 out of 310 from Athens University (48%), 32/68 (47%) from Crete, 12/72 (17%) from Ioannina, 61/120 (51%) from Patras, 147/208 (71%) from Thessaloniki, 74/74 (100%) from Thessaly, and 38/47 (81%) from Thrace
Summary
Medical Education moved successively from delivering the content by medical teachers (content-based) to objectives-based, competence-based, and outcome-based education with special guides and journal themed issues [1,2,3,4,5,6,7,8,9,10,11,12,13]. In Europe, landmarks of this trend could be considered the European Core Curriculum: the Students’ Perspective [26,27] and mainly ‘The Tuning Project’ (medicine): Learning Outcomes/Competences for Undergraduate Medical Education in Europe, i.e. the teachers’ perspective, developed by the thematic network of ninety-three European medical schools on Medical Education in Europe (MEDINE), and accepted by the European Union [2]. These documents indicate a rather broad agreement on what medical graduates should be able to do at their graduation. Though relevant attempts have been published [24, 30, 31] no tool exists for measuring the end-product of a medical
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