Formal Postgraduate Education Research Articles

Barriers to postgraduate education in primary dental care: a qualitative study

ObjectivesPostgraduate education for primary care dentists offers numerous benefits in terms of advancing clinical skills and career opportunities, culminating in improved treatment and patient outcomes. There is a strong desire amongst primary care dentists to enhance skills and provide contemporaneous evidence-based dentistry, accredited by higher educational qualifications. However, significant barriers hinder their pursuit of further training and career advancement. The aim of this study is to explore the barriers to undertaking formal postgraduate education for dental practitioners working in primary dental care. Exploration of these perceptions should help to identify further areas of study to help alleviate some of these obstacles, enabling more primary care dentists to access postgraduate education and improve patient care. MethodA qualitative study was undertaken through individual narrative interviews with primary care dental practitioners (n = 20) with varying levels of experience and located across the UK. All interviews were conducted using a study guide, transcribed and analysed thematically. ResultsThe participants indicated that there is a strong desire to undertake postgraduate study amongst primary care dental practitioners. Significant barriers were identified, with three major themes emerging:1.Personal Cost: Time constraints and accessibility, Financial Burden, Family Commitments.2.Business Viability: Business time constraints, Inability to use Enhanced Skills, Remuneration systems.3.Business Culture and Team Dynamics: Stage of Career, Current Practice Business Model, Leadership and Vision.These barriers appear to be multifaceted and interconnected, however participants also identified significant opportunities to address them. ConclusionStudy participants identified a range of personal and professional barriers to undertaking postgraduate dental education whilst working in primary dental care. Practitioners working within predominately NHS orientated practices perceived more professional barriers than those in private practice. The majority of participants indicated their preference for hybrid models of education which would work around clinical commitments. Further research and engagement with stakeholders should be undertaken to help reduce these barriers.

Exploring Irish Faculty Members' Experiences of Delivering a Multi-modal Medical Education Course in a Resource-limited Environment

Introduction:In November 2022, a group of eleven Irish doctors traveled to St. Joseph’s Hospital, Nyabondo, Kenya with Global Emergency Care Skills (GECS), an Irish NGO. The group delivered a training course to healthcare staff in the hospital, in advance of the scheduled opening of a regional Major Trauma Center on site. This course incorporated didactic lectures, skills stations and simulated clinical scenarios and covered commonly encountered emergency presentations in low and middle income countries (LMICs).Method:A qualitative study was conducted using a free text questionnaire with faculty, exploring their experiences of education in a resource-limited environment. Responses were interpreted by performing thematic analysis to identify recurring themes.Results:All eleven faculty members completed the survey in full. An interrogation of the responses identified commonalities across the majority of faculty members. The main themes encountered were increased recognition of the lack of postgraduate training in LMICs, the challenge of devising material appropriate to a resource-limited setting, a growth in confidence and individual teaching ability, and a reaffirmation of the effectiveness of simulation teaching in medical education.Conclusion:This survey demonstrates the significant impact of teaching such a course on faculty members. Despite the challenges encountered, faculty members strongly felt that simulation training offered significant benefits. Survey respondents noted that moulage could be adapted to suit the needs of course participants without compromising on educational goals. In the absence of formal postgraduate education in LMICs, external agencies continue to play an important role in the delivery of structured training programs.

Postgraduate Dental Education in Ghana: Past, Present and Future

The origins of formal postgraduate dental education in Ghana may be traced to 1986, when three dental surgeons, who had passed a Ministry of Health qualifying examination, were enrolled in the department of Oral and Maxillofacial Surgery of the Korle-Bu Teaching Hospital. This was to enable them prepare for both the primary examinations of the Royal College of Surgeons of England and the West African College of Surgeons. Twenty-six years later, the Ghana College of Physicians and Surgeons, which is only ten years old, has produced sixteen Members and recently, two Fellows. The West African College of Surgeons (WACS), on the other hand, is yet to produce its first batch of Ghanaian Fellows by examination following training in Ghana, although it has been holding examinations since 1988. With the establishment of two dental schools in Ghana, and the resultant improvement in retention of dental graduates in the country, the need and demand for postgraduate dental education has become pressing. No known review of postgraduatedental education has been carried out in Ghana. This paper seeks to give a historical overview of postgraduate dental education in Ghana and to describe its current status.

READINESS FOR INNOVATIVE ACTIVITY OF HEADS OF GENERAL SECONDARY EDUCATION INSTITUTIONS AS A COMPONENT OF PROFESSIONAL CULTURE

The article is devoted to the analysis of the state of readiness of heads of general secondary education institutions for innovative activities in the context of professional culture. The purpose of the study was to theoretically substantiate and experimentally test the state of readiness for innovation of heads of general secondary education institutions as part of professional culture. The hypothesis of the study was based on the premise that the readiness of GSEI leaders to implement innovative educational and management technologies is based on such a component of professional culture as continuous training in formal, non-formal and informal education. Objectives of the study: to analyze the state of readiness of the leaders of GSEI for innovation; experimentally prove the research hypothesis; identify the most important pedagogical conditions and make recommendations to increase the readiness of GSEI leaders to innovate at the level of GSEI. It was found that GSEI leaders have a sufficient and high level of readiness for innovation. The pedagogical conditions include the presence of positive motivation for professional development and self-development of GSEI leaders in the conditions of formal, non-formal and informal postgraduate education. The necessity of creation and implementation in each GSEI of the program and methods of development of readiness for innovative activity of pedagogical collective which would be directed on improvement of professional-pedagogical, scientific-methodical and administrative skill and self-educational activity of heads and teachers is proved. An important recommendation is to create a modern communicative environment in GSEI, in which the subject-subject interaction of the head with teachers in the system of «tutoring – coaching» will take place. We see the prospect of scientific research in the development of innovative technologies, forms and methods of professional development of leaders of GSEI in the context of globalization of education.

Integrative Medicine in General Practice in Australia: A Mixed-Methods Study Exploring Education Pathways and Training Needs.

BackgroundGlobally, a substantial proportion of general practitioners (GPs) incorporate integrative medicine (IM) into their clinical practice.ObjectiveThis study aimed to map the IM education and training pathways and needs of a cohort of Australian GPs who are members of the Royal Australian College of General Practitioners’ IM Specific Interest Network, which is a group of GPs with interest in IM.MethodsWe conducted a mixed-methods study comprising of an online, cross-sectional survey supplemented with in-depth semi-structured interviews. Data from the survey and interviews were initially analysed separately and then combined.ResultsEighty-three (83) of 505 eligible GPs/GPs in training (16.4%) participated in the survey, and 15 GPs were interviewed. Results from the two datasets either converged or were complementary. Almost half (47%) of survey respondents had undertaken formal undergraduate or postgraduate IM education, a short course (63%), informal education (71%) or self-education (54%), in at least one of 20 IM modalities listed. Interviewees affirmed there was no single education pathway in IM. Survey respondents who identified as practicing IM were significantly more likely to have IM education, positive attitudes towards IM, particularly natural products, and higher self-rated IM knowledge and competencies. However, knowledge gaps were identified in professional skills domains of population health and context, and organisational and legal dimensions of applied IM practice. Interviewees also highlighted a range of professional and systemic barriers to the practice of IM, education, and training. There was broad support for recognition of IM as a sub-specialty through formalised post-graduate training and accreditation. Most survey respondents (62%) expressed interest in post-fellowship recognition of GPs with advanced skills in IM.ConclusionOur findings demonstrate that it is important to define best practice in IM for GPs in Australia and provide a standardised pathway towards recognition of advanced skills in IM.

The impact and translation of postgraduate leadership education on practice in healthcare

BackgroundRecommendation’s from key health reports support leadership development. There is considerable work published around formal leadership development education but very little that demonstrates the effectiveness of formal postgraduate leadership education in healthcare. AimTo explore how participants who completed a postgraduate leadership subject in a regional University in Australia have applied content and learning to their own leadership and practice. MethodsA descriptive qualitative study was conducted to explore comprehensively what and how participants who had previously completed the subject translated the knowledge into practice. Data was collected through group interviews. Thematic content analysis was conducted. FindingsThree major themes emerged; ‘Learning to Lead’, ‘Academic Study’, and ‘Teamwork.’ Participants indicated raised confidence and political savvy to collaborate and engage with others at micro, meso and macro levels of their organisation. DiscussionThe impact and application of leadership knowledge was demonstrated through translation of skills and behaviors learned to the healthcare context. This included raised self-awareness and enhanced behaviours and practices related to organisational culture, interpersonal relationships, processes and systems. ConclusionThere is clear evidence of impact and translation of knowledge and skill into healthcare practice through completing a university postgraduate leadership subject.

A CHIP FELLOW'S TRANSITION INTO PRACTICE: BUILDING A COMPLEX CORONARY THERAPEUTICS PROGRAM

Both the prevalence and complexity of CAD are on the rise, leading to a resurgence in novel techniques and equipment utilized to treat complex coronary disease. However, declining PCI volumes and lack of formal post-graduate education opportunities have created a gap in treatment delivery. Several

New Zealand general practice registrars’ views on their academic learning needs during vocational training: online survey

ABSTRACT Most doctors working in New Zealand general practice undertake vocational training through the Royal New Zealand College of General Practitioners. We aimed to explore general practice registrar views on their academic learning needs during and following vocational training. An online survey of all current NZ GP trainees in 2019 was completed by 314 registrars (54% response rate). The majority (88%, 275/314) were completing RNZCGP Fellowship only, and of these half (55%, 152/275) were planning a further postgraduate qualification. A minority (12%, 33/275) indicated a desire to undertake a masters or PhD degree. Almost all (99%, 310/314) intended to work in general practice; 9% (8/314) intending to also work as rural hospital doctors. The five most common areas of interest for further training were clinical skills (68%), practice-based teaching (66%), specific clinical conditions (63%), age or life-stage specific (47%) and non-clinical areas (41%). There is a considerable gap between completing RNZCGP Fellowship, intending to undertake further (formal postgraduate) education and actually enrolling. This is concerning given the need for lifelong learning and critical evaluation of practice and health service delivery. The future New Zealand general practice workforce needs GPs to be diverse and highly skilled members or leaders of expert teams.

Engineering Educators Pedagogical Training and System of Pedagogical Education Quality Assessment Based on Multi-Criteria Approach

The EngineeriNg educaTors pEdagogical tRaining (ENTER) project aims at creating a novel multicultural and international approach for formal post-graduate professional and pedagogical education for engineering educators. It is focused on low cost and convenience, thus strongly based on e-learning technologies, whenever feasible, and designed with the objective of being internationally recognized and accredited. It is proposed a hierarchy of 3 structured educational programs for engineering educators, in the context of the European Qualifications Framework for Lifelong Learning. The methodology and quality assessment system of the developed programs are based on a multi-criteria approach and provide an adequate level of engineering educators training.

Professional Autonomy as Centrality in Best Practices in Nursing.

to reflect on professional, user and family autonomy as a centrality in Best Practices in nursing in Brazil. this is a theoretical-reflective study. from a retrospective look at the creation and evolution of nursing autonomy in its knowledge and care practices, it exposes the use of autonomy in nursing care and foster the participation of the user and his family as the center of Best Practices in nursing. the text suggests the institutional commitment of health services to the formal postgraduate education of nurses and the prospect of more autonomy and quality for the expression of Best Practices in nursing.

Humanistic medicine in anaesthesiology: development and assessment of a curriculum in humanism for postgraduate anaesthesiology trainees

BackgroundAn unintended consequence of medical technologies is loss of personal interactions and humanism between patients and their healthcare providers, leading to depersonalisation of medicine. As humanism is not integrated as part of formal postgraduate anaesthesiology education curricula, our goal was to design, introduce, and evaluate a comprehensive humanism curriculum into anaesthesiology training. MethodsSubject-matter experts developed and delivered the humanism curriculum, which included interactive workshops, simulation sessions, formal feedback, and patient immersion experience. The effectiveness of the programme was evaluated using pre- and post-curriculum assessments in first-year postgraduate trainee doctors (residents). ResultsThe anaesthesiology residents reported high satisfaction scores. Pre-/post-Jefferson Scale of Patient Perceptions of Physician Empathy showed an increase in empathy ratings with a median improvement of 12 points (range; P=0.013). After training, patients rated the residents as more empathetic (31 [4] vs 22 [5]; P<0.001; 95% confidence interval [CI]: 7–12) and professional (47 [3] vs 35 [8]; P<0.001; 95% CI: 9–16). Patient overall satisfaction with their anaesthesia provider improved after training (51 [6] vs 37 [10]; P<0.001; 95% CI: 10–18). Patients rated their anxiety lower in the post-training period compared with pretraining (1.8 [2.3] vs 3.6 [1.6]; P=0.001; 95% CI: 0.8–2.9). Patient-reported pain scores decreased after training (2.3 [2.5] vs 3.8 [2.1]; P=0.010; 95% CI: 0.4–2.8). ConclusionsImplementation of a humanism curriculum during postgraduate anaesthesiology training was well accepted, and can result in increased physician empathy and professionalism. This may improve patient pain, anxiety, and overall satisfaction with perioperative care.

Education and training in adult metabolic medicine: Results of an international survey.

Adult metabolic medicine (AMM) is an expanding medical subspecialty, due to the increasing number of adult patients with inherited metabolic diseases (IMD). However, a formal training and postgraduate education in this field is not available in the majority of countries. Existing adult metabolic specialists (AMS) come from many different backgrounds. The aim of this survey was to assess the state of play as regards education and training in AMM worldwide. Members of the Society for the Study of Inborn Error of Metabolism adult metabolic group (n = 89) were asked to take part in this survey. Forty‐two AMS (47.2%) from 18 different countries completed the questionnaire. The most common specialties were internal medicine (38.1%), endocrinology (26.2%), genetics (21.4%), and neurology (21.4%). Ninety‐five percent of respondents considered that practical clinical experience had contributed importantly for their professional development, while only 27% felt the same for formal academic education. The current state of available education and training was judged as generally poor or fair (73% of the respondents). The most suggested ways of improving education and training in AMM were: to facilitate international internships; to implement courses on adult‐IMD; and to create a formal academic education. The skills considered most important for AMS were: recognition of signs and symptoms of diseases, knowledge of the available treatments, and ability to perform a correct follow up. In conclusion, worldwide, current available education and training in AMM is considered inadequate. This survey emphasizes the need for development of new, formal training opportunities to improve knowledge, and competence in this rapidly expanding field.

Stuðningur við skólastjóra í námi og starf

Í þessari grein eru kynntar niðurstöður rannsóknar þar sem markmiðið var að varpa ljósi á viðhorf og reynslu skólastjóra leik- og grunnskóla af stuðningi við þá af hálfu fræðsluyfirvalda sveitarfélaga sem og annarra, bæði í starfi og til að sækja meistaranám í skólastjórnun. Gagna var aflað með viðtölum við 14 skólastjóra sem höfðu samtals starfað sem skólastjórar í um 14 sveitarfélögum. Niðurstöður benda til þess að sá stuðningur sem skólastjórarnir fengu skipti þá miklu máli. Hann hafði áhrif á það hvernig þeir upplifðu starfið og hvernig þeim fannst sér ganga að sinna því og vinna samkvæmt eigin sannfæringu og þekkingu. Stuðningur fræðsluyfirvalda sveitarfélaga var skólastjórum einna mikilvægastur en hann var breytilegur. Skólastjórarnir túlkuðu stuðning fræðsluyfirvalda aðallega út frá því að hvaða marki þeir upplifðu velvilja og skilning af hálfu sveitarfélaganna gagnvart sér og skólastarfinu. Skólastjórarnir töldu þó að fræðsluyfirvöld þyrftu yfirhöfuð að taka meiri ábyrgð á stuðningi við þá og skólana, og að stuðningur þyrfti að vera meiri, markvissari og betur lagaður að þeirra eigin aðstæðum. Jafnframt komu fram vísbendingar um að huga þyrfti sérstaklega að stuðningi við skólastjóra sem koma að sameiningarferli skóla. Niðurstöður benda til þess að stuðningur fræðsluyfirvalda sveitarfélaga sé fremur lítill þegar kemur að meistaranámi í skólastjórnun og virðist vera litið á slíkt nám sem einkamál skólastjóra (og kennara). Annars sóttu skólastjórar helst stuðning í eigið tengslanet, til maka, aðstoðarskólastjóra og stjórnendateymis, auk annarra skólastjóra.

Postgraduate radiology education in Nigeria: Looking backward and forward.

Formal postgraduate radiology education (residency training) in Nigeria commenced in 1976 at the University College Hospital, Ibadan, Oyo State. Currently, two postgraduate medical colleges (one national and the other international or regional) are saddled with the responsibility of superintending the training programme. This is a chronicle of the evolution of radiology in Nigeria with emphasis on the current status of the training programme and areas that require improvement. Though the programme has delivered a quality healthcare workforce for the country and the international community since inception, significant but surmountable difficulties still exist. It is hoped that all stakeholders and policy-makers will take note and safeguard the future of the specialty.

Challenges to laboratory hematology practice: Egypt perspective.

Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading.

Postgraduate Nurse Practitioner Education: Impact on Job Satisfaction

Programs to facilitate nurse practitioner (NP) transition-to-practice have been developed at public and private institutions across the United States, yet there is no published evidence of their influence on NP job satisfaction. The Misener Nurse Practitioner Job Satisfaction Scale was administered to a convenience sample of two groups of NPs: one group with a formal postgraduate education and another group without formal postgraduate education. Postgraduate education has a statistically significant positive impact on NP job satisfaction. Knowledge of factors that influence job satisfaction is advantageous to employers, policymakers, and NPs considering postgraduate education opportunities.

Research is ‘a step into the unknown’: an exploration of pharmacists’ perceptions of factors impacting on research participation in the NHS

ObjectiveThis study explored National Health Service (NHS) pharmacists’ perceptions and experiences of pharmacist-led research in the workplace.DesignSemistructured, face-to-face discussions continued until distinct clusters of opinion characteristics formed. Verbatim transcripts of...

A Survey of the Competency of Ambulance Service Personnel in the Diagnosis and Management of Sepsis

BackgroundFew studies have evaluated the current status of knowledge of sepsis in ambulance service personnel. ObjectiveOur aim was to ascertain the levels of competency and proficiency of ambulance service personnel in the diagnosis and management of severe sepsis. MethodsA questionnaire was submitted to a sample of 208 participants in a professional ambulance service conference, and was recovered on site. The study probed eight areas of sepsis diagnosis and management based on modifications of a questionnaire used in a previous study. ResultsThe term sepsis in Japanese, Haiketsushou, was familiar to 99% of Japanese certified emergency life-saving technicians (ELST) (Group I) and to 92% of noncertified ambulance service personnel (Group II), although 15% of participants in Group I and 44% in Group II ignored the meaning of sepsis. The definition of sepsis as “body's response to infection,” “blood poisoning,” or “shock due to bacteria in blood” were selected by 17%, 16%, and 37%, respectively, in Group I, and 4%, 6%, and 22%, respectively, in Group II. The mortality associated with sepsis was underestimated by 57% in Group I and 78% in Group II. Vital signs raising a suspicion for sepsis and their pertinent ranges were correctly chosen by only 50% of certified ELST. Hypothermia was prominently undervalued as a sign raising the suspicion of sepsis. ConclusionsInsufficient knowledge and perception for sepsis in Japanese ambulance services is revealed. A higher level of onsite or formal postgraduate education needs to be provided with a view to improve the prehospital management of sepsis.

Becoming an expert: A Masterclass in developing clinical expertise

This Masterclass explores how practitioners may develop clinical expertise. The terms expert and expertise are initially outlined along with the attributes of a practitioner with expertise. This is followed by an exploration of the literature in relation to three key ways to develop expertise: through experience with patients, formal postgraduate education and through direct observation of practice with a mentor. The theoretical basis of these activities is critically reviewed to highlight their underpinning educational value and pedagogy. It is proposed that critical reflection on practice enhanced by direct observation of practice with a mentor and formal postgraduate education each provide a potentially powerful tool for learning and the development of clinical expertise. This Masterclass explores how practitioners may develop clinical expertise. The terms expert and expertise are initially outlined along with the attributes of a practitioner with expertise. This is followed by an exploration of the literature in relation to three key ways to develop expertise: through experience with patients, formal postgraduate education and through direct observation of practice with a mentor. The theoretical basis of these activities is critically reviewed to highlight their underpinning educational value and pedagogy. It is proposed that critical reflection on practice enhanced by direct observation of practice with a mentor and formal postgraduate education each provide a potentially powerful tool for learning and the development of clinical expertise.

Continuing Professional Development (CPD); What should we do?

Patient and the general people expect that doctors remain up-to-date and professionally competent. The formal undergraduate and postgraduate education and training are conducted to bring a behavioral change in a medical practitioner to meet that expectation. The rate and magnitude of change in medical science is such that the contents of text books are not sufficiently up-to-date rather somewhat out of date at the time of publication. CME is continuing education in knowledge and skill of medical practice through which doctors will remain up-to date. Due to rapid changes in health care delivery system; health professionals needs to transform from a continuing education (CME) to a continuous professional development (CPD) model so that they remain “up-to-date” in their knowledge and competency in total care. CPD is a broader concept for continuing development of multifaceted competencies inherent in medical practice including medical, managerial, social and personal subjects which are needed for high quality professional performance in modern health care delivery system. CPD is complementary to formal undergraduate and postgraduate education; completing the educational trilogy. Undergraduate and postgraduate medical education is regulated by specific rules and regulation but CPD is the process where the responsibility rests on professionals and individual doctor. People expect what is ‘best’ rather than what is ‘right’ for a particular situation and for that level; professional competence should be combined with improvisation and general oversight. That is why, all over the world the concept of CPD is emerging and developing as a dynamic educational process to improve and upgrade ones professional performance. As a part of the ‘global resident’ we should be familiar to cope with and should be trying to contribute in these progress and development. This article will help us to initial understanding and formulating an approach to that. DOI: http://dx.doi.org/10.3329/bjme.v1i1.12857 Bangladesh Journal of Medical Education Vol.1(1) 2010 pp.37-44