Prioritising the Pipeline: Updating Undergraduate Medical Genetics Education to Support the Future of Genomic Medicine in Australia

ADMSEP Leaders Adapt Milestones to Medical Student Education

Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are "practicing" on them, clinical medicine is becoming focused more on patient safety and quality than on bedside teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap. This article reviews the evidence for the utility of simulation in medical education. We conducted a MEDLINE search of original articles and review articles related to simulation in education with key words such as simulation, mannequin simulator, partial task simulator, graduate medical education, undergraduate medical education, and continuing medical education. Articles, related to undergraduate medical education, graduate medical education, and continuing medical education were used in the review. One hundred thirteen articles were included in this review. Simulation-based training was demonstrated to lead to clinical improvement in 2 areas of simulation research. Residents trained on laparoscopic surgery simulators showed improvement in procedural performance in the operating room. The other study showed that residents trained on simulators were more likely to adhere to the advanced cardiac life support protocol than those who received standard training for cardiac arrest patients. In other areas of medical training, simulation has been demonstrated to lead to improvements in medical knowledge, comfort in procedures, and improvements in performance during retesting in simulated scenarios. Simulation has also been shown to be a reliable tool for assessing learners and for teaching topics such as teamwork and communication. Only a few studies have shown direct improvements in clinical outcomes from the use of simulation for training. Multiple studies have demonstrated the effectiveness of simulation in the teaching of basic science and clinical knowledge, procedural skills, teamwork, and communication as well as assessment at the undergraduate and graduate medical education levels. As simulation becomes increasingly prevalent in medical school and resident education, more studies are needed to see if simulation training improves patient outcomes.

Reconciling competencies in undergraduate medical genetics education: APHMG versus PCME competencies.

Integrative medicine and the search for the best practice of medicine.

ACGME, Osteopaths Fail to Reach Deal on Accreditation: 18-Month Negotiations Collapse

Introduction and Objective: In Australia and overseas, use of complementary medicines (CMs) is high and there is an increasing amount of high-quality research available to support this use. Because of CM’s popularity, medical practitioners are increasingly placed in a position of needing to be CM literate. Without active inquiry and involvement by medical practitioners regarding CM use, patients will continue to seek practices without appropriate medical guidance. However, despite growing expectations from patients, the level of, and need for, CM education within medical education (ME) in Australia is largely unknown. The objective of this study was to explore CM literacy education development in Australian medical curricula and generate theory about the processes involved. Methodology: This research utilised a constructivist grounded theory method. The theoretical framework, underpinned by symbolic interactionism and social constructivism, provided a rich and powerful means of understanding need for, and processes of, CM education through interpretations of core stakeholders’ (medical students) curriculum experiences. Thirty medical students from metropolitan and rural campuses and clinical schools across the top 10 ranked Australian university medical schools in five states and one territory participated. Data were generated from 30 in-depth semi-structured one-on-one interviews with medical students, contemporaneous field notes and analytic theoretical memos. Data analysis was conducted concurrently and simultaneously with data generation so that theory construction was progressively guided by the data. Use of reflexive memos, theoretical sampling, the constant comparative method, data categorisation and finally, data abstraction, resulted in development of the constructivist grounded theory (CGT) for the topic of inquiry. Findings: In this study, the central problem is described as ensuring that medical students become CM literate while they undertake their ME. The basic social process (core category) constructed to deal with this problem is conceptualised as practical CM education development. Six interrelated categories represent various strategies participants identified. The first category, clarifying CM terminology ambiguity, explicates CM terminological difficulties, categorisations, and value implications intrinsic within medicine. The second category, exploring the extent of CM education, explores the scope of, and extent to which, Australian medical students are being educated about CMs in their curriculum. The third category, determining the need for CM education, highlights student-identified need for CM education in Australian medical schools. The fourth category, identifying key influences impacting on CM education, identifies key macro-level influences, including issues of socialisation and enculturation, as well as meso-level organisational factors found to impact CM teaching in medical curricula. The fifth category, identifying key facilitators enabling CM education, explicates key institutional enablers identified to facilitate CM education development in medical curricula in the Australian context. The final category, identifying baseline CM literacy educational needs, encompasses key elements of educational requirements and key strategies identified for integrating CM education in medical curricula. Conclusion: The CGT of practical CM education development offers a theoretical account of CM education development within medical curricula in Australia. The primary goal of CM education is not to create CM experts or practitioners, but rather to facilitate informed advisers. The dilemma facing many medical educators is how such information can be incorporated into an already dense curriculum. The CGT demonstrates that complex dynamics exist between socio-political expectations and ME realities that govern health care in practice. A collaborative and integrative approach to CM education is flexible, inclusive, and socially relevant, and has a substantial and far-reaching contribution to make to the quality of primary health care. The findings of the study contribute significantly towards a body of knowledge that may result in better educational reform and practice guidelines for medicine.

University of Alabama School of Medicine

Medical Student Education

Evaluating the outcomes of undergraduate medical education

University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Council on Medical Student Education in Pediatrics

To survey the use of computer-assisted instruction (CAI) in undergraduate medical student education in Australia. A postal questionnaire survey of medical school deans, and department heads, in all Australian medical schools. 90% of deans, and 88% of department heads responded to the questionnaires. There were considerable variations between departments and faculties in the use of CAI. Overall, 36% of departments were using CAI and 65% of those not currently using it were either developing CAI or would like to introduce it into their teaching programs. Some medical faculties had well-developed policies for CAI, and provided considerable resources, while others did not. Some departments had large numbers of student work stations (up to 64), and multiple teaching packages (up to 200). CAI packages were generally thought to be popular with students, and to have improved the standard of learning. This form of teaching is currently undergoing rapid expansion, but in an uncoordinated manner that is likely to lead to greatly increased overall development costs.

Funding for graduate medical education (GME) and undergraduate medical education (UME) in the United States is being debated and challenged at the national and state levels as policy makers and educators question whether the multibillion dollar investment in medical education is succeeding in meeting the nation's health care needs. To address these concerns, the authors propose a novel all-payer system for GME and UME funding that equitably distributes medical education costs among all stakeholders, including those who benefit most from medical education. Through a "Medical Education Workforce (MEW) trust fund," indirect and direct GME dollars would be replaced with a funds-flow mechanism using fees paid for services by all payers (Medicaid, Medicare, private insurers, others) while providing direct compensation to physicians and institutions that actively engage medical learners in providing clinical care. The accountability of those receiving MEW funds would be improved by linking their funding levels to their ability to meet predetermined institutional, program, faculty, and learner benchmarks. Additionally, the MEW fund would cover learners' UME tuition, potentially eliminating their UME debt, in return for their provision of health care services (after completing GME training) in an underserved area or specialty. This proposed model attempts to increase transparency and enhance accountability in medical education by linking funding to the development of a physician workforce that is able to excel in the evolving health delivery system. Achieving this vision requires physician educators, leaders of academic health centers, policy makers, insurers, and patients to muster the courage to embrace transformational change.

Introduction: Changes to medical education in Australia include a proliferation of medical schools, shorter courses, shifts toward problem-based learning, and large-scale medical knowledge expansion. Students also spend less time on university campuses and more time at clinical teaching sites which are often non-specialised, regional and remote from the parent university. These changes leave little room for teaching anatomy as a pure discipline. Aims: 1 Analyse contemporary anatomy teaching and assessment in Australasian medical schools. 2 Develop problem based, clinically integrated anatomy teaching as an extension to pure discipline anatomy instruction, and as an adjunct to undergraduate and Pre-Set surgical education. Methods: 1 Using a mailed questionnaire survey to the 21 Australian and New Zealand medical schools, examine the time-allocation, content, delivery and assessment of anatomy for 2008. 2 A problem based, clinically integrated approach to teaching anatomy developed at The University of Wollongong Graduate School of Medicine will be presented as a generic template and a worked example. Discussion: Currently, without reliable evidence, the degree of divergence between anatomy curricula at the various Australian medical schools is unclear. The questionnaire survey findings will help clarify this, and could be used to inform an RACS policy or consensus statement on anatomy teaching in our medical schools. Our example of a clinically integrated approach to teaching anatomy may serve to illustrate adjustment of anatomy teaching from a pure to a clinically integrated discipline and may also be of pedagogical benefit to anatomical and surgical educators in Australian medical schools.

The Pharmacology Knowledge Objectives (KOs)-Current Status