Graduate Entrants Research Articles

Implementation of an on-site simulation programme during COVID-19 and the assessment of its impact on medical students’ competence

BackgroundCOVID-19 has greatly impacted medical students’ clinical education. This study evaluates the usefulness of a rapidly implemented on-site simulation programme deployed to supplement our disrupted curriculum.MethodsStudents on surgical rotations received 4-hour tutor-led simulated patient sessions (involving mannikins with remote audio-visual observation) respecting hospital and public health protocols. Attitudes were questionnaire-assessed before and after. Independent, blinded, nonacademic clinicians scored students’ clinical competencies by observing real patient interactions using the surgical ward assessment tool in a representative sample versus those completing same duration medicine clinical rotations without simulation (Mann–Whitney U testing, p < 0.05 denoting significance) with all students receiving the same surgical e-learning resources and didactic teaching.ResultsA total of 220 students underwent simulation training, comprising 96 hours of scheduled direct teaching. Prior to commencement, 15 students (7% of 191 completing the survey) admitted anxiety, mainly due to clinical inexperience, with only two (1%) anxious re on-site spreading/contracting of COVID-19. A total of 66 students (30%, 38 females and 29 graduate entrants) underwent formal competency assessment by clinicians from ten specialties at two clinical sites. Those who received simulation training (n = 35) were judged significantly better at history taking (p = 0.004) and test ordering (p = 0.01) but not clinical examination, patient drug chart assessment, or differential diagnosis formulation. Of 75 students providing subsequent feedback, 88% stated simulation beneficial (notably for history taking and physical examination skills in 63%) with 83% advocating for more.ConclusionOur rapidly implemented simulation programme for undergraduate medical students helped mitigate pandemic restrictions, enabling improved competence despite necessarily reduced clinical activity encouraging further development.

Assessment strategies and employability in the environmental and engineering sectors

This case study builds on material presented at the HEA Advance STEM conference held in Birmingham, England, in January 2019 which raised the issue of assessment strategies, suggesting that, for example, examinations do little to prepare students for the workplace. The initial research has been developed to provide an analysis of the current assessments in ecology/environmental management and civil engineering and the relevance to the tasks new entrants carry out in their roles as young professionals. We have developed our initial research, carried out in spring/early summer 2019, to explore this in more depth, using a survey to investigate early career professionals’ perceptions of the usefulness of the various types of assessment they experienced at university and to the requirements of their jobs. At the same time, we asked the employers of graduate ecologists/environmental managers and civil engineers how well prepared they feel graduate entrants are for their job roles and whether they are finding it difficult to recruit applicants with the appropriate competency, with respect to both transferable and technical skills. We argue that greater links and communication between employers and education providers would benefit the employability outcomes for graduates and ease the transition between university and the workplace and we make recommendations for competency-based assessment strategies. This research was supported by the University of Greenwich Learning and Teaching Fund.

Are graduate entrant medical students better prepared for hospital practice than school entrant medical students?

To assess the preparedness for hospital practice among graduate and school entry medical students at King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). This cross-sectional study was conducted at KSAU-HS College of Medicine, during the academic year 2016-2017. A validated self-administered questionnaire was used for data collection. Data were analyzed using SPSS version 22, and non-parametric testing was performed. The sample consisted of 312 medical students with 103 (33%) graduate entrants. The comparison of overall preparedness showed that students were best prepared for holistic care with median (Q1-Q3) score of 3 (2.6-3.5). The final year clinical students were significantly better among all of the batches in terms of management (p =0.008). Graduate entry students were significantly more prepared compared to school entry students in all areas except science and holistic care (p = 0.508 and p = 0.582, respectively). Female students were better prepared compared to male students. This study demonstrated that graduate entrants are more prepared for future careers compared to school entrants. In addition, females showed better preparedness in general compared to males. Although the preclinical students perceived that they were well prepared, the graduating senior most students thought they were not ready to deal with real patients.

Does initial postgraduate career intention and social demographics predict perceived career behaviour? A national cross-sectional survey of UK postgraduate doctors

ObjectiveStudies indicate that initial career intentions and personal characteristics (eg, gender) can influence medical career decision-making. However, little is known about how personal characteristics and intention interact with career decision-making....

Relative progress and academic performance of graduate vs undergraduate entrants to an Australian medical school

BackgroundWhether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial. Differences in the discipline backgrounds of graduates may, at least in part, have accounted for differences in the results of comparative studies reported to date. This study aimed to address the dual issues of whether academic performance and progression rates were different between GE and UG students and the extent to which the discipline background of GE students may underpin any differences observed.MethodsRelative academic performance as well as indicators of student progression (supplementary examinations, repeat years, leave of absence, withdrawal from the programme) were compared between graduate entrants (GE) (N = 410) and both school leaver entrants (SLE) (N = 865) and non-standard entrants (some prior tertiary education) (NSE) (N = 148) who combined for the final 4 yr. of a 6 yr. MBBS undergraduate programme in 8 consecutive cohorts from 2006 to 2013 in Western Australia.ResultsExamination scores were generally at or very close to a distinction grade or higher across all groups. Higher mean examination scores were seen for GE versus both SLE and NSE in the first 2 years with no significant differences in the final 2 years. GE from biological science / science backgrounds (N = 241) or physical science backgrounds (N = 26) performed the same as SLE and NSE throughout the programme. GE with a health / allied health background (N = 91), however, performed better throughout. They also performed better when compared to their GE counterparts from a humanities (N = 32) or a biological science / science background. GE had increased odds of withdrawing when compared to SLE (OR 2.50, 95% CI 1.30, 4.79, P = 0.006), but not compared to NSE. NSE had increased odds of repeating at least one level when compared to either GE (OR 2.74, 95% CI 1.21, 6.21, P = 0.016) or SLE (OR 4.10, 95% CI 1.93, 8.70, P < 0.001). There were no differences by entry category in the odds of sitting at least one supplementary examination during the programme. There was an increase in the odds of taking at least one leave of absence in both SLE (OR 2.55, 95% CI 1.79, 3.63, P < 0.001) and NSE (OR 2.47, 95% CI 1.50, 4.07, P < 0.001) compared to GE.ConclusionsBetter academic performance by GE compared to SLE and NSE was predominantly due to higher scores for GE with a health / allied health background. GE were also less likely to have impeded progress during the course.

Books: Brushstrokes. Thoughts, Poems and Reflections on Having Had a Small Stroke at 34 Years Old: Recovering from Stroke.

Giles Dawnay CreateSpace Independent Publishing Platform, 2016 , PB, 196 pp, £14.99 , 978-1533198624 Giles Dawnay is a graduate entrant into medicine. When he was 34, he suffered an embolic stroke, which presented with expressive dysphasia and facial weakness while he was talking to his wife. He moved swiftly from being a junior doctor to being a patient, going through all the familiar processes and stages of grief. This book is a collection of his poems, …

Impact of accelerated, graduate-entry medicine courses: a comparison of profile, success, and specialty destination between graduate entrants to accelerated or standard medicine courses in UK

BackgroundLittle research has compared the profile, success, or specialty destinations of graduates entering UK medical schools via accelerated, 4-yr, standard 5-yr and 6-yr programmes. Four research questions directed this investigation:-What are the success rates for graduates entering graduate-entry vs. undergraduate medicine courses?How does the sociodemographic and educational profile differ between these two groups?Is success – in medical school and foundation training – dependent on prior degree, demographic factors, or aptitude test performance at selection?What specialty do graduate entry medicine students subsequently enter?MethodsThe data from two cohorts of graduates entering medical school in 2007 and 2008 (n = 2761) in the UKMED (UK Medical Education Database) database were studied: 1445 taking 4-yr and 1150 taking 5-yr medicine courses, with smaller numbers following other programmes.ResultsCompletion rates for degree programmes were high at 95%, with no significant difference between programme types. 4-yr entrants were older, less likely to be from Asian communities, had lower HESA (Higher Education Statistics Agency) tariff scores, but higher UKCAT (UK Clinical Aptitude Test) and GAMSAT (Graduate Medical School Admissions Test) scores, than 5-yr entrants.Higher GAMSAT scores, black or minority ethnicity (BME), and younger age were independent predictors of successful completion of medical school. Foundation Programme (FPAS) selection measures (EPM – educational performance measure; SJT – situational judgment test) were positively associated with female sex, but negatively with black or minority ethnicity. Higher aptitude test scores were associated with EPM and SJT, GAMSAT with EPM, UKCAT with SJT. Prior degree subject, class of degree, HESA tariff, and type of medicine programme were not related to success.ConclusionsThe type of medicine programme has little effect on graduate entrant completion, or EPM or SJT scores, despite differences in student profile.Aptitude test score has some predictive validity, as do sex, age and BME, but not prior degree subject or class. Further research is needed to disentangle the influences of BME.

Bridging the gap: online materials to equip graduate entrants to a law degree with essential subject knowledge and skills

ABSTRACTGraduate entrants to law degrees can be disadvantaged by being exempted from Level 4 modules. Many lack the law-specific knowledge and skills that they would have gained from their first-year studies, making it more difficult for them to achieve mastery of higher-level modules. This poses risks to their retention and progression. The Open University Law School sought to bridge this gap by providing optional online “catch-up” materials, including 12 sessions of knowledge-based learning. Each session was followed by a brief Moodle poll so that we could ascertain that session’s fitness for purpose, and which students had studied it. The sessions were highly rated by respondents, and most had been studied in the target time of around 15 minutes. Studying the sessions was statistically associated with academic success. This finding does not prove that the sessions contribute towards student's attaining higher grades, but it is encouraging. Only a small percentage of students studied any sessions, and most of those did not study all of them. Since the sessions met their intended purpose for those who studied them, the Law School has now decided on a range of initiatives designed to increase the number of LLB students who study most of them.

Enhancing graduate prospects by recording and reflecting on part-time work

Business leaders are becoming increasingly explicit regarding the skills, attributes and behaviours expected of graduate entrants. These skills are often developed through a combination of academic studies and work experience. While universities are increasingly providing opportunities for experiential learning, typically a placement year or internship, a growing number of students are undertaking self-initiated part-time work alongside their full-time degree studies. This part-time employment, typically in retail or hospitality, will help develop the skills, attributes and behaviours that employers demand. However, it is important that graduates are able to elucidate their learning to future employers during the graduate recruitment process. The purpose of this viewpoint article is to challenge full-time degree students who are working part-time to record (perhaps through a logbook) and reflect on their work experience so that they will be able to provide concrete examples to reinforce their skills and experience. The article concludes by discussing the role of universities in the process.

Entry routes into the Institute of Chartered Accountants of Scotland training: Status versus sustainability

Education plays a pivotal role in establishing the elite status of a profession. This article sets out to understand the role of social and political influences in the determination of entry routes to professional accounting training with the Institute of Chartered Accountants of Scotland (ICAS). The article charts the development of various entry routes which converted ICAS from an Institute with few graduate entrants in the mid-1950s to an Institute with almost 100 per cent graduate entrants today.

Realizing the latent potential in the part-time student workforce

The purpose of this article is to challenge employers to make the best use of the latent potential of their part-time student workforce and to retain this talent postgraduation. The authors report research which shows that increasing numbers of university students are working part-time alongside their degree studies, while at the same time businesses are becoming more explicit about their requirements for graduate entrants, specifying a range of traits, behaviours and soft skills. The authors argue that this developing scenario affords an opportunity for university students working part-time to develop skills and business-related knowledge that are desirable to their respective employers in the longer term. However, the desire to nurture and retain those individuals on graduation appears to be lacking. This article concludes by challenging both employers and students to embrace a longer term perspective for their mutual benefit.

Attitudes towards abortion in graduate and non-graduate entrants to medical school in Ireland

BackgroundRecent legislation has sought to clarify abortion law in Ireland, allowing abortion where pregnancy endangers a woman's life, including through risk of suicide. Previous studies have shown that medical students’...

Telling stories out of school: Experiencing the paramedic's oral traditions and role dissonance

Role dissonance is an uncomfortable experience for graduate paramedics, and some blame their university education for the problem. For paramedics the conflict is between identifying as a rescuer and acting largely as a care giver. With vocational pathways into so many uniformed professions closing down in preference for graduate entrants, young new professionals have to negotiate a rapidly changing work culture. Their older colleagues may be challenged and threatened by the new order. For paramedics the problem is compounded by the newness of its place in the tertiary landscape. Since 9/11 young people have been increasingly attracted to rescue roles. Yet in Australia there is increasing need and scope for health workers in remote and aging populations, a preference not immediately attractive to young people hoping for a more heroic future. While the near professions such as nursing have established their discourses around culture, role and pedagogy, paramedics is still trying to chisel its identity. The myths of paramedic glories past tend to add to the confusion of graduates. Due to a lack of empirical studies of non-clinical aspects of paramedicine, a bricolage methodology was used to refresh data from two discrete qualitative research projects conducted in 2011. Both projects had originally been interested in optimal paramedic preceptorship before and after graduation, but neither had explored the implicit theme which revealed the role of rescue experiences in paramedic culture and identity. The bricolage included a new search of literature from near professions and applied new theoretical frameworks to the analysis of the extant data, to demonstrate how storytelling as an element of paramedic collegiality perpetuates rescue stories that are then used to define paramedic work.

Studying medicine - a cross-sectional questionnaire-based analysis of the motivational factors which influence graduate and undergraduate entrants in Ireland.

SummaryObjectivesThe number of places available in Ireland for graduate entry to medical school has steadily increased since 2006. Few studies have, however, characterized the motivational factors underlying decision to study medicine via this route. We compared the factors motivating graduate entrants versus undergraduate entry (UGE) students to choose medicine as a course of study.DesignThe present study was a quantitative cross-sectional questionnaire-based investigation.SettingThe study was conducted in University College Cork and University of Limerick, Ireland.ParticipantsIt involved 185 graduate entry (GE) and 120 UGE students.Outcome measuresQuestionnaires were distributed to students addressing the following areas: demographic/academic characteristics; factors influencing the selection of academic institution and motivation to study medicine; and the role of career guidance in choice of study.ResultsWhen asked to list reasons for selecting medicine, both groups listed a wish to help and work with people, and a desire to prevent and cure disease. UGE students were significantly more motivated by intellectual satisfaction, encouragement by family/friends, financial reasons, and professional independence. Approximately half of GE students selected their first degree with a view to potentially studying medicine in the future. GE and UGE students differed significantly with respect to sources consulted for career guidance and source of study information.ConclusionsThis study is the first systematic examination of study and career motivation in GE medical students since the programme was offered by Irish universities and provides insight into the reasons why graduate entrants in Ireland choose to study medicine via this route.

Outside the Box: Letter to my son

![][1] Dear Al. Congratulations. Subject to achieving your predicted grades, you have won a place at medical school. Countless hours spent volunteering, shadowing doctors (both here and abroad), and making your 4000-character personal statement stand out from hundreds of others, have paid off. We have done the high-fives, the celebratory meal, and the phone calls to your proud grandmothers. We have started a spreadsheet to work out how, as a graduate entrant, you will find the money for your fees, rent, living expenses, and books, even with help from a parent in receipt of a Clinical Excellence Award. The figures stack up, but only just. … [1]: /embed/graphic-1.gif

Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nursing students — A mixed method study

Clinical skills education must accommodate the different needs of nursing students, particularly in view of increasing numbers of graduate entrants. E-learning has been promoted for its ability to engage learners and customise the learning process and evidence supports its use for clinical skill acquisition. However, graduate nursing students have unique needs, and their perceptions and experiences of e-learning require exploration. The aim of the study was to explore graduate first year nursing students' perceptions and experiences of e-learning when used to supplement traditional methods to learn clinical skills. Mixed methods, employing qualitative and quantitative approaches, were used. Eighty-three (46%) participants were recruited from a cohort of graduate students (n=180) enrolled in an accelerated pre-registration nursing programme. Participants completed e-learning educational materials prior to attendance at clinical skills sessions. Focus groups (n=2) explored participants' (n=15) experiences and perceptions of e-learning and identified common issues. Discussions were transcribed verbatim and analysed using a thematic approach. Findings informed the development of a questionnaire which sought to confirm perceptions of e-learning and the perceived value for clinical skills acquisition in the larger student group. Data from questionnaires (n=83) were analysed using descriptive statistics. Students found e-learning valuable for developing clinical skills and, although they viewed it positively, they did not want to relinquish conventional teaching methods, preferring both in combination. Video clips were perceived as the most useful feature while online readings were viewed as the least useful. An underestimate of time requirements, navigational issues and technical difficulties were reported frustrations. Although limited by potential volunteer bias, findings contribute to the ongoing discourse on how e-learning can support clinical skills education and provides insights from the perspective of graduate nursing students. E-learning does not suit the needs of all learners. This must be recognised to enhance the learning experience.

Reflections of students graduating from a transforming medical curriculum in South Africa: a qualitative study

BackgroundThe six year medical programme at the University of the Witwatersrand admits students into the programme through two routes – school entrants and graduate entrants. Graduates join the school entrants in the third year of study in a transformed curriculum called the Graduate Entry Medical Programme (GEMP). In years I and 2 of the GEMP, the curriculum is structured into system based blocks. Problem-based learning, using a three session format, is applied in these two years. The curriculum adopts a biopsychosocial approach to health care, which is implemented through spiral teaching and learning in four main themes – basic and clinical sciences, patient-doctor, community- doctor and personal and professional development. In 2010 this programme produced its fifth cohort of graduates.MethodsWe undertook a qualitative, descriptive and contextual study to explore the graduating students’ perceptions of the programme. Interviews were conducted with a total of 35 participants who volunteered to participate in the study. The majority of the participants interviewed participated in focus group discussions. The interviews were transcribed verbatim and analysed thematically, using Tesch’s eight steps. Ethics approval for the study was obtained from the Human Research Ethics Committee of the University of the Witwatersrand. Participants provided written consent to participate in the interviews and for the interviews to be audio-taped.ResultsSix themes were identified. These were: two separate programmes, problem-based learning and Garmins® (navigation system), see patients for real, being seen as doctors, assessment: of mice and MCQ’s, a cry for support and personal growth and pride. Participants were vocal in their reflections of experiences encountered during the programme and made several insightful suggestions for curriculum transformation. The findings suggest that graduates are exiting the programme confident and ready to begin their internships.ConclusionsThe findings of this study have identified a number of areas which need attention in the curriculum. Specifically attention needs to be given to ensuring that assessment is standardized; student support structures and appropriate levels of teaching. The study demonstrated the value of qualitative methods in obtaining students’ perceptions of a curriculum.

Lessons from the class of 1970: male school leaver entrants to medical school versus male graduate entrants and women

Do men who went straight to medical school from secondary school differ in their contribution to medicine from male graduate entrants and women? Alison Leak and Toby Humphrey review the evidence from a qualitative survey of a 1970 London medical school cohort

Clinical assessment performance of graduate- and undergraduate-entry medical students

Background: Recent evidence suggests that graduate-entry medical students may have a marginal academic performance advantage over undergraduate entrants in a pre-clinical curriculum in both bioscience knowledge and clinical skills assessments. It is unclear whether this advantage is maintained in the clinical phase of medical training.Aim: The study aimed to compare graduate and undergraduate entrants undertaking an identical clinical curriculum on assessments undertaken during clinical training in the medical course.Methods: Clinical assessment results for four cohorts of medical students (n = 713) were compared at the beginning and at the end of clinical training for graduate and undergraduate entrants.Results: Results showed that graduate- and undergraduate-entry medical students performed similarly on clinical assessments. Female students performed consistently better than male students.Conclusion: The findings of this study suggest that any academic performance advantage held by graduate-entry medical students is limited to the early years of the medical course, and is not evident during clinical training in the later years of the course.

Personality profile of students entering dentistry, hygiene/therapy and dental nursing at one London dental institute

King's College London Dental Institute (KCLDI) is the largest school in the UK, training dental professionals: Dentists, Hygienists/Therapists and Dental Nurses. Although previous work has examined dental students, there is a dearth of studies on the personality profile of students of hygiene/therapy and dental nursing. To investigate the personality profile of students studying dentistry, hygiene/therapy and dental nursing at KCLDI, by programme, sex and ethnicity. All entrants into dentistry, hygiene/therapy and dental nursing at KCLDI were invited to participate in the study. A self report questionnaire including the brief version of the Five-Factor Model and personal details was administered to the 218 recruited students in groups and under supervised conditions. One-way ANOVA on data from 148 questionnaires revealed significant differences; the medical graduate entrants to dentistry appeared to have a more extraverted profile than hygiene/therapy entrants (P<0.04). The graduate entrants to dentistry were more open to experiences than the direct entrants (P<0.03) and the dental nursing trainees (P<0.03). The medical graduate entrants also appeared more open to experiences than the dental nursing trainees; the latter also appeared to have a more sensitive profile compared to the medical entry students (P<0.03). No differences were found between groups in agreeableness and conscientiousness. The findings suggest the presence of personality differences between entrants to dentistry, hygiene/therapy and dental nursing. The implications of these findings are discussed.