Medical Schools In Australia Research Articles

Exploring the approaches used to teach concepts of hand hygiene to Australian medical students.

Recent audit data has revealed that the hand hygiene (HH) rates of Australian medical students is suboptimal. It has been suggested that new approaches are needed to teach students about infection control. As a first step, we undertook a study to determine the current educational approaches used to teach Australian medical students about HH. Secondly, this study aimed to explore the perceived barriers and to explore what other teaching approaches could be used to improve the levels of knowledge and compliance. A self-administered questionnaire was sent to the Dean of Medical Education at each of the medical schools in late 2012. Of the 19 medical schools in Australia, 17 agreed to participate. The most commonly reported approaches currently used to teach students about HH are skills stations (17/17) and case scenarios/lectures (15/17). Clinical practical exams (15/17) and competency checks (11/17) are mostly used to assess the HH practices of medical students. Participants nominated the following as barriers to improving HH compliance: negative role modelling by senior doctors, and negative attitudes of students. Practical exercises (15/17), online teaching (12/17) and reflection (12/17) were suggested as other useful approaches that could be used to teach these concepts. Practical laboratory-based approaches were suggested as the most useful teaching and learning approach. Given the trend towards blended learning, universities may want to consider new HH teaching approaches that combine campus-based learning with online components and reflection. Early exposure and the continued reinforcement of HH concepts through the student's medical degree are essential.

Ian Anderson: transforming Indigenous medicine and education

Ian Anderson: transforming Indigenous medicine and education

Mentoring schemes for new consultants are too rigid, researchers say

Mentoring schemes for new consultants are often hampered by overly rigid structural frameworks, researchers have said. A group of researchers led by Reema Harrison, of Sydney Medical School in Australia, interviewed 31 doctors working across nine UK hospitals in the Yorkshire and Humber region about their experiences of mentoring. They looked specifically at the benefits that mentoring could offer to newly …

Socio-economic predictors of performance in the Undergraduate Medicine and Health Sciences Admission Test (UMAT)

BackgroundEntry from secondary school to Australian and New Zealand undergraduate medical schools has since the late 1990’s increasingly relied on the Undergraduate Medicine and Health Sciences Admission Test (UMAT) as one of the selection factors. The UMAT consists of 3 sections – logical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). One of the goals of using this test has been to enhance equity in the selection of students with the anticipation of an increase in the socioeconomic diversity in student cohorts. However there has been limited assessment as to whether UMAT performance itself might be influenced by socioeconomic background.MethodsBetween 2000 and 2012, 158,909 UMAT assessments were completed. From these, 118,085 cases have been identified where an Australian candidate was sitting for the first time during that period. Predictors of the total UMAT score, UMAT-1, UMAT-2 and UMAT-3 scores were entered into regression models and included gender, age, school type, language used at home, deciles for the Index of Relative Socioeconomic Advantage and Disadvantage score, the Accessibility/Remoteness Index of Australia (ARIA), self-identification as being of Aboriginal or Torres Strait Islander origin (ATSI) and current Australian state or territory of abode.ResultsA lower UMAT score was predicted by living in an area of relatively higher social disadvantage and lower social advantage. Other socioeconomic indicators were consistent with this observation with lower scores in those who self-identified as being of ATSI origin and higher scores evident in those from fee-paying independent school backgrounds compared to government schools. Lower scores were seen with increasing age, female gender and speaking any language other than English at home. Divergent effects of rurality were observed, with increased scores for UMAT-1 and UMAT-2, but decreasing UMAT-3 scores with increasing ARIA score. Significant state-based differences largely reflected substantial socio-demographic differences across Australian states and territories.ConclusionsBetter performance by Australian candidates in the UMAT is linked to an increase in socio-economic advantage and reduced disadvantage.This observation provides a firm foundation for selection processes at medical schools in Australia that have incorporated affirmative action pathways to quarantine places for students from areas of socio-economic disadvantage.

Variation in personality traits of medical students between schools of medicine

Introduction: While there have been studies exploring the impact of personality on medical student selection and performance there has not been an investigation of the personality of students at different schools.Method: Demographic data and responses to the NEO measure of personality traits were collected from medical students in the first two weeks of their enrolment (2011) in seven medical schools in Australia. Personality traits were analysed by school features, gender and age using logistic regression.Results: Differences were detected between schools in the personality traits of Agreeableness and Conscientiousness. Higher Agreeableness and Conscientiousness were associated with attending an Undergraduate school (OR = 1.07 and 1.03, respectively) and a rural or community focussed school (1.06 and 1.03). Students attending a school that used interviews for selection had higher levels of Agreeableness (1.04) and lower levels of Neuroticism (0.96).Discussion: This is the first study to demonstrate that personality traits differ between students entering different medical schools. While there seems to be logic behind some differences, others are perplexing. Further research should expand on these findings and the implications to schools in regards to attracting students through selection processes, mission statements and their broader social focus.

Preparation for Cardiopulmonary Resuscitation in Medical Schools in Australia: A Survey of Current Practice

Introduction. Cardiopulmonary resuscitation (CPR) is acknowledged worldwide as a stressful clinical activity for all young doctors. The extent of standardisation of preparation for CPR within Australian curricula is unknown. Recent trends in the UK suggest the emergence of a common endpoint, Immediate Life Support (ILS) certification. The support for a similar shared endpoint in Australia is unknown. Methodology. A telephone questionnaire survey about the preparation for teaching CPR to medical students was undertaken in all Australian medical schools in early 2012; 88% of schools replied. Results. The majority favoured early basic CPR training. There was marked variation in how schools taught advanced CPR and how CPR competence was assessed. Only one school considered their graduates to be less than well prepared for CPR and all schools agreed that a common endpoint was desirable. Discussion. There is broad support for Immediate Life Support as a common end in resuscitation competence. Medical schools where students are prepared for a rural placement on graduation may still require a higher standard of competence.

Survey of the current status of teaching intensive care medicine in Australia and New Zealand medical schools

The place of Intensive Care Medicine education within Medical Schools in Australia and New Zealand was investigated by survey in 2009. All intensive care units in Australia and New Zealand were invited to take part in the survey. The survey included commitment to intensive care medicine training, teaching methods, curriculum content, assessment, and hours of student contact. All university teaching hospitals were identified and results analyzed. None. From recognized tertiary referral teaching hospitals, the response was 60%. A mandatory teaching program was offered by 56%, with a further 22% offering an optional program. The medical school curricula were primarily a mix of problem-based learning and traditional, lecture-based courses. Intensive care experience was usually undertaken in the latter years of the course. Contact hours allocated under the curriculum was less than 1 wk in the great majority. Assessment of students, where it existed, was undemanding. Intensive care medicine, although growing in stature within medical schools, still appears to occupy only a small place in the overall curriculum. A survey was undertaken to determine the extent of intensive care medicine training undertaken in medical student courses in Australia and New Zealand. A small majority of university hospitals had mandatory programs, with nearly a quarter having neither a mandatory or optional program. This is a higher proportion than identified in previous international surveys, but the results indicate considerable deficits requiring ongoing development within the undergraduate program.

Developing a medical school: Expansion of medical student capacity in new locations: AMEE Guide No. 55

Background: A concern about an impending shortage of physicians and a worry about the continued maldistribution of physicians to medically underserved areas have encouraged the expansion of medical school training places in many countries, either by the creation of new medical schools or by the creation of regional campuses.Aims: In this Guide, the authors, who have helped create new regional campuses and medical schools in Australia, Canada, UK, USA, and Thailand share their experiences, triumphs, and tribulations, both from the views of the regional campus and from the views of the main Medical School campus. While this Guide is written from the perspective of building new regional campuses of existing medical schools, many of the lessons are applicable to new medical schools in any country of the world. Many countries in all regions of the world are facing rapid expansion of medical training facilities and we hope this Guide provides ideas to all who are contemplating or engaged in expanding medical school training places, no matter where they are.Description: This Guide comprises four sections: planning; getting going; pitfalls to avoid; and maturing and sustaining beyond the first years. While the context of expanding medical schools may vary in terms of infrastructure, resources, and access to technology, many themes, such as developing local support, recruiting local and academic faculty, building relationships, and managing change and conflict in rapidly changing environments are universal themes facing every medical academic development no matter where it is geographically situated.Further information: The full AMEE Guide, printed separately, in addition contains case examples from the authors’ experiences of successes and challenges they have faced.

Evaluation of sexual health medicine teaching at medical schools in Australia and New Zealand

In the absence of guidelines for sexual health medicine (SHM) curriculum for medical schools in Australia and New Zealand, little is known about the current curriculum. We therefore, sought to quantitatively and qualitatively measure the existing SHM teaching at medical schools in the region. SHM specialists and Deans (or their nominated delegates) were requested to complete a questionnaire with respect to the SHM teaching in their associated medical schools. Forty-two specialists completed the questionnaire. Wide variations were found in the time spent on various topics in SHM. 'Training to teach' was found to be a major unmet need of SHM specialists. Four (16.7%) of 24 medical schools completed the questionnaire. The total time allocated to SHM in these medical schools varied from 13.6 to 39.0 h, with a median of 31.1 h. At least 70% of key SHM topics were covered in all curricula. SHM teaching varied markedly in terms of subject matter, allocated time and teaching modalities. National guidelines for the teaching of SHM to medical students could facilitate the development of more consistent standards within the medical workforce. Training in teaching and learning methods to specialists may improve dissemination of sexual health skills to the wider medical workforce.

Driving change in rural workforce planning: the Medical Schools Outcomes Database

The Medical Schools Outcomes Database (MSOD) is an ongoing longitudinal tracking project ofmedical students from all medical schools in Australia and New Zealand. It was established in 2005 to track the career trajectories of medical students and will directly help develop models of workforce flow, particularly with respect to rural and remote shortages. This paper briefly outlines the MSOD project and reports on key methodological factors in tracking medical students. Finally, the potential impact of the MSOD on understanding changes in rural practice intentions is illustrated using data from the 2005 pilot cohort (n = 112). Rural placements were associated with a shift towards rural practice intentions, while those who intended to practice rurally at both the start and end of medical school tended to be older and interested in a generalist career. Continuing work will track these and future students as they progress through the workforce, as well as exploring issues such as the career trajectories of international fee-paying students, workforce succession planning, and the evaluation of medical education initiatives.

Longitudinal Integrated Clerkships for Medical Students: An Innovation Adopted by Medical Schools in Australia, Canada, South Africa, and the United States

Integrated clinical clerkships represent a relatively new and innovative approach to medical education that uses continuity as an organizing principle, thus increasing patient-centeredness and learner-centeredness. Medical schools are offering longitudinal integrated clinical clerkships in increasing numbers. This report collates the experiences of medical schools that use longitudinal integrated clerkships for medical student education in order to establish a clearer characterization of these experiences and summarize outcome data, when possible. The authors sent an e-mail survey with open text responses to 17 medical schools with known longitudinal integrated clerkships. Sixteen schools in four countries on three continents responded to the survey. Fifteen institutions have active longitudinal integrated clerkships in place. Two programs began before 1995, but the others are newer. More than 2,700 students completed longitudinal integrated clerkships in these schools. The median clerkship length is 40 weeks, and in 15 of the schools, the core clinical content was in medicine, surgery, pediatrics, and obstetrics-gynecology. Eleven schools reported supportive student responses to the programs. No differences were noted in nationally normed exam scores between program participants and those in the traditional clerkships. Limited outcomes data suggest that students who participate in these programs are more likely to enter primary care careers. This study documents the increasing use of longitudinal integrated clerkships and provides initial insights for institutions that may wish to develop similar clinical programs. Further study will be needed to assess the long-term impact of these programs on medical education and workforce initiatives.

Implementation of Indigenous Mental Health Training in Victoria

This article aims to describe the process of implementation of the 2004 Indigenous Mental Health Royal Australian and New Zealand College of Psychiatrists (RANZCP) Training By-Laws within Victoria. It is likely that the challenges of ensuring access to this training experience, within the Victorian RANZCP Training Program, have been experienced to varying degrees within other Australian training programs. The vertical integration of an Indigenous health curriculum extends work being done in all undergraduate medical schools in Australia and New Zealand, and which the Australian Medical Council has incorporated into the accreditation of medical schools.

Social and Emotional Wellbeing Training of Psychiatrists in Victoria: Preliminary Communication

The aim of this paper is to document the processes towards ensuring that all psychiatrists in training in Victoria have appropriate Indigenous mental health experience and training. This paper describes the process of implementation of the 2004 Indigenous Mental Health Royal Australian and New Zealand College of Psychiatrists (RANZCP) Training By-Laws within Victoria. It is likely that the challenges of ensuring access to this training experience, within the Victorian RANZCP Training Program, have been experienced to varying degrees within other Australian training programs. The vertical integration of Indigenous health curriculum extends work being done in all undergraduate medical schools in Australia and New Zealand, and which the Australian Medical Council have incorporated into their accreditation of medical schools.

Sexual harassment during medical training: the perceptions of medical students at a university medical school in Australia

Sexual harassment during medical training: the perceptions of medical students at a university medical school in Australia

Education for communication: much already known, so much more to understand

Education for communication: much already known, so much more to understand

An International Perspective on Behavioral Science Education in Medical Schools

The behavioral sciences are taught in medical curricula around the world. In the current paper psychologists teaching in medical schools in Australia, Mexico, Saudi Arabia, Thailand, the United Kingdom and the United States share their experience and reflections. Whilst direct comparisons between countries are not made, the themes that are evident within and between accounts are instructive. As behavioral scientists around the globe are struggling to maintain a presence in medical education many of the reasons behind this are shared, regardless of the country. Challenges discussed include those related to the impact of unrealized potential contributions of psychologists as health care professionals, teaching of behavioral sciences by other professions, domination of the biomedical model without a corresponding recognition of psychology as science, and modern medical pedagogies such as problem-based learning, which favor biomedicine. Systemic and political barriers over which we as a discipline may have little control are also highlighted.

Undergraduate Teaching of Child and Adolescent Psychiatry in Australia: Survey of Current Practice

To identify the goals, content, and time allocated for undergraduate child psychiatry teaching programmes in Australian medical schools. A structured questionnaire designed specifically for the present study was used to identify the goals, content, and time allocated to child psychiatry teaching for undergraduate medical students. Staff responsible for child psychiatry teaching programmes at all 15 medical schools in Australia were contacted and those in 12 schools (80%) agreed to participate. All 12 medical schools provided some teaching relevant to child psychiatry. Teaching was commonly provided as part of general psychiatry and/or paediatric teaching programmes. Between 4 and 12 h were allocated for child psychiatry teaching, with the exception of one school, which assigned 46 h. Ten schools (83%) offered clinical placements in child psychiatry to some or all students, with placements ranging in length from 0.5 days to 8 weeks. However, only four schools (33%) offered clinical placements to all students. Two schools (17%) offered no clinical placements or electives in child psychiatry. The skills required to assess children and families, and knowledge about normal child development were identified as key teaching goals. Barriers to teaching child psychiatry included the lack of academic child psychiatrists in Australia, and the limited time allocated for this teaching in medical school curricula. The amount of time allocated for teaching child psychiatry in Australian medical schools is relatively small and not consistent with the size of the public health problem posed by child and adolescent mental disorders. Staff responsible for teaching child psychiatry need to coordinate their activities more effectively at a national level to identify teaching goals, design curricula, and advocate for high-quality child psychiatry teaching programmes in medical schools.

The Ideal Oncology Curriculum for Medical Students

TO THE EDITOR: We have read with interest the article by Gaffan and colleagues on educating undergraduate medical students about oncology. The authors focus on teaching methodology rather than curriculum content and comment that there is no consensus on what should be learned. The readers of the Journal of Clinical Oncology may be interested to know of the Ideal Oncology Curriculum, which provides some progress toward the consensus of what the content of cancer education should be. The Ideal Oncology Curriculum was developed in 1999 by an Oncology Education Committee of the Cancer Council of Australia—a multidisciplinary group of cancer clinicians and educators representing all medical schools in Australia, whose objectives are monitoring and improvement of standards of cancer education in Australian medical schools. The development of this consensusbased curriculum involved extensive consumer consultation across the country. Since then, the Ideal Oncology Curriculum has served as a basis of newly developed medical school curricula and as a guide to development of cancer teaching in other areas, for example, nurse practitioner training and professional development of cancer professionals. As Gaffan and colleagues point out, cancer teaching can be fragmented across disciplines with resulting risk of duplication or omission of cancer knowledge and skills. An Ideal Oncology Curriculum provides a comprehensive checklist for course design that allows adaptation to local conditions, as well as a checklist against which outcomes can be monitored. Perhaps evidence for the value of the Ideal Oncology Curriculum lies in its endorsement by the International Union Against Cancer and in the Curriculum’s similarities (albeit in the more limited version) to the recently developed American Society of Clinical Oncology Core Curriculum.

Increasing diversity at the cost of decreasing equity? Issues raised by the establishment of Australia's first religiously affiliated medical school

Medical education in Australia is about to undergo major changes, with the founding of six new medical schools, including the first private medical school and the first religiously affiliated medical school in Australia. The establishment of medical schools at Bond University on the Gold Coast, Queensland, and the University of Notre Dame in Fremantle, Western Australia, are particularly noteworthy developments. A recent article in the Journal claimed the new medical schools will foster diversity and are commited to fill “particular workforce needs”. 1 We argue that increasing the range of options for medical education is not an unquestionable good, as it may threaten academic freedom and equity in medical education as well as just provision of health care. This article aims to stimulate awareness, conversation and debate on these issues, not only within the medical community but in the wider Australian community.

Can medical students learn specialist disciplines based in rural practice: lessons from students' self reported experience and competence

Medical schools in Australia are being funded by the Commonwealth Government Department of Health and Aging to move a considerable amount of undergraduate clinical education into rural and remote settings. There are concerns that these students may be disadvantaged in terms of exposure to appropriate clinical learning opportunities. This study compared learning opportunities for students undertaking an entire clinical year based in a rural primary care setting, a remote secondary hospital, or a traditional urban tertiary teaching hospital. Twenty-nine students, six from rural primary care, eight from the remote secondary hospital, and 15 from the urban tertiary teaching hospital, completed a retrospective survey of their experience and perceived competence to manage 78 common procedural skills and 62 common conditions. Students in rural primary care reported a pattern of increased clinical exposure to common clinical conditions and procedures in comparison with their hospital-based peers. In comparing the two hospital-based programs, the students in the remote secondary care hospital reported increased exposure to common conditions and no significant difference in the opportunity to undertake common procedures. The data also demonstrated that there was a positive correlation between reported experience and self-perceived competence, and that this was greater for procedural skills than competence in managing common conditions. This study provides further evidence that rural primary care is an excellent setting for high quality clinical and educational experiences. These findings should serve to encourage students and staff involved with the new Rural Clinical School programs.