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This paper deals with the lack of interest shown by family medicine residents in Quebec (Canada) in home follow-up or monitoring of the elderly. By collecting and analyzing data from sixteen family medicine residents before and after their first experience of home follow-up, and from four medical supervisors, we found that residents experience a rapid loss of interest in this practice over a very short period. We show that this lack of interest stems first from the difficulty of applying the principle of patient-centered care, wherein medical interventions must meet the needs of the elderly in their entirety. Secondly, residents complain that they have to deal with many administrative tasks. They call for implementation of professional features to better integrate services such as case management. © 2014 Canadian Association on Gerontology.

Although lectures are one of the most common methods of knowledge transfer in medicine, their effectiveness has been questioned. Passive formats, lack of relevance and disconnection from the student′s needs are some of the arguments supporting this apparent lack of efficacy. However, many authors have suggested that applying adult learning principles (i.e., relevance, congruence with student′s needs, interactivity, connection to student′s previous knowledge and experience) to this method increases learning by lectures and the effectiveness of lectures. This paper presents recommendations for applying adult learning principles during planning, creation and development of lectures to make them more effective.

Health professionals need preparation and support to work in collaborative practice teams, a requirement brought about by an aging population and increases in chronic and complex diseases. Therefore, health professions education has seen the introduction of interprofessional education (IPE) competency frameworks to provide a common lens through which disciplines can understand, describe, and implement team-based practices. Whilst an admirable aim, often this has resulted in more confusion with the introduction of varying definitions about similar constructs, particularly in relation to what IPE actually means.The authors explore the nature of the terms competency and framework, while critically appraising the concept of competency frameworks and competency-based education. They distinguish between competencies for health professions that are profession specific, those that are generic, and those that may be achieved only through IPE. Four IPE frameworks are compared to consider their similarities and differences, which ultimately influence how IPE is implemented. They are the Interprofessional Capability Framework (United Kingdom), the National Interprofessional Competency Framework (Canada), the Core Competencies for Interprofessional Collaborative Practice (United States), and the Curtin University Interprofessional Capability Framework (Australia).The authors highlight the need for further discussion about establishing a common language, strengthening ways in which academic environments work with practice environments, and improving the assessment of interprofessional competencies and teamwork, including the development of assessment tools for collaborative practice. They also argue that for IPE frameworks to be genuinely useful, they need to augment existing curricula by emphasizing outcomes that might be attained only through interprofessional activity.

Background: Assessing surgical competency in otolaryngology is challenging, and residency programs are now responsible for ensuring the surgical competency of their graduates. Therefore, more objective assessment tools are being incorporated into the evaluation process. Objective structured assessment of technical skills (OSATSs) tools have been developed for multiple otolaryngology procedures. These include tonsillectomy, endoscopic sinus surgery, thyroidectomy, mastoidectomy, direct laryngoscopy, and rigid bronchoscopy. The purpose of this study was to develop and test a new assessment tool for septoplasty surgery and ensuring its feasibility, reliability, and construct validity. This study was designed to develop and test a valid, reliable, and feasible evaluation tool designed to measure the development of trainees' surgical skills in the operating room for septoplasty surgery. Methods: A new OSATSs-based instrument form for septoplasty was developed. During the study period of 2 years, 21 otolaryngology - head and neck surgery residents (ranging from postgraduate year 2 to 5) were evaluated intraoperatively by one faculty member obtaining a total of 175 evaluations. Surgical performance was rated using a seven-item task-specific checklist (TSC) and a global rating scale (GRS). The TSC assessed specific septoplasty technical skills, and the GRS assessed the overall surgical performance. Results: Our tool showed construct validity for both components of the assessment instrument, with increasing mean scores with advancing clinical levels. Cronbach's α, a measure of internal consistency, was 0.911 for TSC and 0.898 for GRS. Strong correlation between the TSC and GRS was established (r=0.955; p < 0.01). Conclusion: This study proved our educational tool to be a valid, reliable, and feasible method for assessing competency in septoplasty surgery. It can be integrated into surgical training programs to facilitate direct formative feedback. Assessing trainees' learning curves enables insight into their progression, ensuring their appropriate development. Copyright © 2014, OceanSide Publications, Inc.

In recent years, there has been a renewed interest in measuring perceptions regarding different aspects of the medical educational environment. A reliable tool was developed for measuring perceptions of the educational environment as it relates to evidence-based medicine as part of a multicountry randomised controlled trial to evaluate the effectiveness of a clinically integrated evidence-based medicine course. Participants from 10 specialties completed the questionnaire. A working dataset of 518 observations was available. Two independent subsets of data were created for conducting an exploratory factor analysis (n=244) and a confirmatory factor analysis (n=274), respectively. The exploratory factor analysis yielded five 67-item definitive instruments, with five to nine dimensions; all resulted in acceptable explanations of the total variance (range 56.6-65.9%). In the confirmatory factor analysis phase, all goodness-of-fit measures were acceptable for all models (root mean square error of approximation ≤0.047; comparative fit index≥0.980; normed χ2 ≤1.647; Bentler-Bonett normed fit index ≥0.951). The authors selected the factorisation with seven dimensions (factor-7 instrument) as the most useful on pragmatic grounds and named it Evidence-Based Medicine Educational Environment Measure 67 (EBMEEM-67). Cronbach's α for subscales ranged between 0.81 and 0.93. The subscales are: 'Knowledge and learning materials'; 'Learner support'; 'General relationships and support'; 'Institutional focus on EBM'; 'Education, training and supervision'; 'EBM application opportunities'; and 'Affirmation of EBM environment'. The EBMEEM-67 can be a useful diagnostic and benchmarking tool for evaluating the perceptions of residents of the environment in which evidence-based medicine education takes place.

Introduction. - The aim of this study was to assess the feelings of residents in respiratorymedicine regarding the quality and organization of their training and towards their careerprospects.Methods. - A prospective survey conducted over the Internet among all the members of theFrench Young Pulmonologists Association (AJPO2).Results. - One hundred and thirty-two (71.5%) members responded. The rating given to theo-retical training was 6 [5-7] whereas the practical training was rated at 7 [6-8] out of 10. Themajority of the residents considered that the length of their course should be adapted (80.3%).Of them, 74.2% wanted to add a mandatory semester. The proposed mandatory semester was inbronchoscopy (40.3%). Seventy-two percent of the resident wanted to acquire a specialisation,the most common of which was in oncology (36.6%). Among the residents, 96.2% wanted toconduct a fellowship. The main reason for this was their feeling of inability to correctly handlepatients at the end of their residency. Of the residents, 55.3% were considering working in apublic hospital.Conclusion. - There are opportunities to improve the French respiratory residency training bothin its theory and practical aspects. The modalities of this training could also be adapted. Accessto a fellowship is a major concern for the residents. © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Objectives The study examined the course of neck and shoulder pain among a cohort of technical school students entering working life. We also aimed to identify work-related and individual risk factors for neck and shoulder pain during this transition period. Methods The study was designed as a prospective cohort study following 420 technical school students (167 student hairdressers, 118 student electricians, and 135 media/design students) from school, through their apprenticeship and into working life. Every 4thmonth over a 6.5 year period (2002-2009), the participant`s neck and shoulder pain for the preceding four weeks was assessed. Mechanical and psychosocial workplace factors as well as individual factors were evaluated at baseline and/or during the follow-up period. Data were analyzed by generalized estimating equations (GEE). Results We found a significant increase in neck and shoulder pain over time in the transition from technical school to working life. High mechanical workload was associated with neck and shoulder pain among women, while a high level of shoulder muscle endurance capacity was associated with lower rates of neck and shoulder pain among men. Perceived muscle tension and ethnicity were the most consistent predictors for neck and shoulder pain, found among both women and men. Conclusion Increased neck and shoulder pain was found in the transition from technical school to working life, and both work-related and individual factors were associated with pain development. © Scandinavian Journal of Work, Environment & Health.

Background General practice supervisors are increasingly being expected to assess their registrars. Objective In this article we explore the issues this raises for supervisors, and discuss the literature, which suggests that global assessments are the most accurate and feasible. Discussion We suggest the following guidelines for supervisors: inform registrars at the beginning of the term about how and when they will be assessed; be clear that the aim is to decide if the registrars' practice is safe for patients and appropriate for their stage of training; observe registrars at work; make an initial judgement of registrars' performance; test the initial judgement on performance applying qualitative research methods to improve trustworthiness and reduce potential biases; use the working diagnosis of registrar performance to guide the level of support and clinical oversight needed and flag registrars who require further assessment by educational organisations for remediation decisions.

This study tackles the question, whether and to what extent labour market integration is achieved by young rehabilitants participating in an apprenticeship provided by the Federal Employment Agency. In order to identify salient determinants for the entry into as well as the sustainability of first employment, event history analyses are applied. After a relatively short period, first integrated rehabilitants mostly find unsubsidised employment. The entry into employment is determined by factors similar to those influencing the labour market transition of young adults without disabilities: higher educational achievements, a successfully completed apprenticeship at best within an establishment, high regional mobility and good structural conditions favour labour market integration. Furthermore, physically disabled graduates and those with shorter unemployment and sickness periods stay longer in first employment than graduates showing other disabilities and those with longer periods in unemployment and sickness. © Georg Thieme Verlag KG Stuttgart New York ISSN 0034-3536.

It is increasingly common for universities to provide cross-curricular education in bioethics as part of contemporary attempts to produce 'global citizens.' In this article I examine three perspectives drawn from research into pedagogy that has been conducted from the perspective of cognitive anthropology and consider its relevance to bioethics education. I focus on: two metaphors of learning, participation and acquisition, identified by Sfard; the psychological notion of moral development; and the distinction between socialization and enculturation. Two of these perspectives have been particularly fruitful in understanding the processes of teaching and learning in a variety of domains. The third perspective has been developed in relation to the formal ethical education of medical students. I examine their relevance for 'non-professional' bioethics education suggesting that if we take seriously the idea that it is part of 'educating for citizenship' then the distinction between 'ethics' and 'politics' is blurred as such programmes aim at the development of student's political subjectivity. © W. S. Maney & Son Ltd 2014.