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Background: General practitioners need the skills to perform a core set of procedures. The increase in community based medical education gives GPs more opportunity and responsibility to facilitate medical students and junior doctors' acquisition of these core skills. Objective: This article summarises how procedural skills are learned and describes a practical framework for constructing a supportive learning environment that is safe for patients and learners. Discussion: Procedural skills are learned in stages starting with a 'big picture' concept of the skill and its place in clinical care. Next the skill becomes fixed through deliberate practice with specific, constructive feedback based on observation. Autonomous practice is reached after further practice and exposure to increased complexity. General practitioners can facilitate skill development by using a staged learning cycle, building on their learner's prior knowledge and skill.

Aims and objectives: This paper presents findings from a small piece of interpretive research into the lived experience of trained nurses who fulfilled the role of workplace mentors for Foundation degree students. The interprofessional landscape of workplace learning is also examined. Background: The participants were all employed in acute care settings in a large UK National Health Service hospital and provided mentorship to Healthcare Assistants studying the adult pathway of a Foundation degree in Health and Social Care; in preparation for the role of the Assistant Practitioner. Design: A purposive sample of eight workplace mentors (who had supported at least one Foundation degree student) were interviewed using a semi-structured questionnaire. Method: All interviews were audio recorded and subsequently transcribed. A hermeneutic phenomenological approach was used to uncover the lived experience of workplace mentors and 10 major themes were generated from the data. Results: The findings suggest that the mentorship of work-based learners presents mentors with a range of challenges that are quite different from pre-registration students given the situatedness of the learner in their clinical team. Conclusion: While the mentorship of work-based learners in busy clinical environments is challenging, the relationship between mentor and mentee appears to have greater equality due to the situatedness of the student in the clinical team. As a result workplace mentors seem to benefit from a relationship lacking in the hierarchical features that characterise traditional mentoring. Awareness of the unique experience of work-based learners and mentors needs to be raised, particularly where students are seeking to complete their Foundation degree to emerge as Assistant Practitioners. Relevance to clinical practice: Trained nurses undertaking the role of workplace mentor in support of Foundation degree students, do so to provide coaching that (in a developmental relationship), places them in the vanguard of an emerging professional group; the Assistant Practitioner. © 2011 Blackwell Publishing Ltd.

Background: The ability to place sutures is an essential skill in dentistry. In our institution, the introduction of a video teaching aid and a checklist-based assessment has improved the standardisation of teaching as well as the transparency and objectivity of the assessment of suture skills. The aim of this study was to determine whether this skill once acquired is retained in the short term.Materials and methods: The same cohort of 67 fourth-year students performed the same assessment at two different time points 2 months apart. The first was a formative assessment and the second was a summative assessment. Feedback was collected on both occasions.Results: On the first sitting of the assessment, 93% of the students were successful compared with 79% on the second occasion. Student feedback was similar on both occasions with 77% and 75% reporting that they thought it was an easy exam. On the first occasion, 27% thought that it was a stressful examination compared with 43% on the second occasion, which may have affected their performance.Conclusions: These findings suggest that regular reinforcement is required to avoid deterioration of suturing skills even in the short term. This might involve exposing the students to surgery earlier in the course and introducing regular formative assessments which the students appear to associate with less stress. © 2011 John Wiley & Sons A/S.

[No abstract available]

Purpose: The purpose of this study was to gain an understanding of the opportunities and challenges involved in providing clinical inter-professional education (IPE) to physical therapy (PT) students in the acute-care setting from the perspective of PT clinical instructors (CIs). Methods: Focus groups were conducted in four acute-care hospitals in Toronto. Participants were recruited using a purposive and convenience sampling approach in order to enhance our understanding of the perceptions of acute-care PT CIs. Eighteen full-time PT CIs with an average of 11 years in practice participated. A constant comparative process was employed to identify recurrent issues and themes within and between groups Results: Three main themes emerged from the focus groups: (1) Clinical IPE happens when inter-professional collaboration (IPC) occurs; however, IPC differs according to setting, access to other professions, time, support, and structure. (2) IPE is a lifelong learning process that applies to both CIs and students. (3) Student preparedness is a prerequisite for clinical IPE. Conclusions: IPC is an integral part of clinical IPE that requires ongoing commitment and reflection by CIs to ensure that they are ready to instruct students who have some preparation in formal IPE. More knowledge about providing clinical IPE in a structured manner, through academic and health institutions, will allow CIs to become role models for future generations of PT students.

Background: Family medicine has some constraints, which may be considered critical for physicians' career choice, and motivation may be one of them. Motivation should be seen as a determinant of career success, particularly in educational context. The aim of this study was to develop an understanding about the family medicine residents' professional motivation, based on psychological and cognitive factors. Objectives: The following objectives were set: (1) to characterize the residents, in terms of cognitive-motivational variables; (2) to evaluate their assertive skills during the vocational training. Method: In 2005, we designed a mail survey applied to all graduates entering Family Medicine, in Portugal (N = 228), at the start of their specialty program. As part of a larger observational study, a 57 Likert scale items questionnaire was designed to collect descriptive data. In this cross sectional study we present data from professional project, professional commitment, intrinsic motivation, self-efficacy expectancies, results control expectancies, initial motivation to the specialty and assertiveness skills (cross sectional study). Results: From the target population, 109 completed questionnaires (47.8%) were returned. Most of the participants indicated high levels of professional orientation (77.1%) for family medicine and 92.6% had been globally committed in practice. At the beginning of the residency, the participants had medium (59.6%) or high (33.9%) levels of motivation for choosing this specialty, 89% were intrinsically motivated and 60.5% proved to be quite assertive in their patient approach. Conclusions: These findings suggest that medical graduates, studied in this research, were globally motivated for practicing in a Family Medicine context, contradicting the overall perception of a physicians' declined interest for this specialty. These results may have implications in the design of real-life training programs for postgraduate education in Family Medicine, a time when physicians are forming expectations about their career performance and professional well being. Future researches should continue studying more deeply the professional motivation of that population, throughout the vocational training in Family Medicine residency. © 2011 CELOM.

Aim: The aim of this study was to describe the self-reported confidence levels of final year students at the School of Dentistry, Cardiff University and at the University Dental School & Hospital, Cork, Ireland in performing a variety of dental procedures commonly completed in primary dental care settings. Method: A questionnaire was distributed to 61 final year students at Cardiff and 34 final year students at Cork. Information requested related to the respondents confidence in performing a variety of routine clinical tasks, using a five-point scale (1=very little confidence, 5=very confident). Comparisons were made between the two schools, gender of the respondent, and whether or not a student intended completing a year of vocational training after graduation. Results: A response rate of 74% was achieved (n=70). The greatest self-reported confidence scores were for 'scale and polish' (4.61), fissure sealants (4.54) and delivery of oral hygiene instruction (4.51). Areas with the least confidence were placement of stainless steel crowns (2.83), vital tooth bleaching (2.39) and surgical extractions (2.26). Students at Cardiff were more confident than those at Cork in performing simple extractions (Cardiff: 4.31; Cork: 3.76) and surgical extractions (Cardiff: 2.61; Cork: 1.88), whilst students in Cork were more confident in caries diagnosis (Cork: 4.24; Cardiff: 3.89) fissure sealing (Cork: 4.76; Cardiff: 4.33) and placement of preventive resin restorations (Cork: 4.68; Cardiff: 4.22). Conclusion: Final year students at Cardiff and Cork were most confident in simpler procedures and procedures in which they had had most clinical experience. They were least confident in more complex procedures and procedures in which they had the least clinical experience. Increased clinical time in complex procedures may help in increasing final year students' confidence in those areas. © 2011 John Wiley and Sons A/S.

Problem-based learning (PBL) emphasizes the student's individual needs, their ability to solve complex clinical problems, and a professional attitude that facilitates communication among colleagues. Thus, PBL appears to provide a perfectly suitable didactic format for postgraduate training of medical specialties. To date, it is only rarely used in this area though. In a pilot project, we implemented PBL into the curriculum of postgraduate training in psychiatry and psychotherapy, and evaluated the program over a period of 12 months, using structured questionnaires. A total of 41 PBL courses were held, with 447 residents participating. Participants as well as tutors assessed 19 of 21 aspects as good or very good (5-point Likert scale, mean value >4). Overall, PBL was rated as highly suitable for advanced training (participants: 4.5±0.8; tutors: 5.0±0.2). The results of this pilot project suggest that PBL might be a useful element of multifaceted advanced training programs, strengthening their practical component and the applicability of knowledge in the daily clinical routine. © 2010 Springer-Verlag.

Background: We sought to assess the way future general practitioners are promoted by their chief physicians. Methods: Semi quantitative questionnaires sent to 54 chief physicians (hospitals in cantons Zurich and Berne). Results: 42 (77.8%) questionnaires were returned. 41 (97.6%) chief physicians asked the assistant physicians about their intended career. 23 (54.8%) discussed with future general practitioners (GPs) specific learning objecsteiger tives. 32 (76.2%) chief physicians would have appreciated an official catalogue of learning objectives for future GPs. A GP-specific traineeship was lacking in most of the hospitals. Conclusions: The upcoming shortage of future GPs could be inhibited by an appropriate GP curriculum during the vocational training. © 2011 by Verlag Hans Huber, Hogrefe AG.

The goal of this article is to contribute to the validation of a self-evaluation method, which can be used by schools to evaluate the quality of their Competence Assessment Program (CAP). The outcomes of the self-evaluations of two schools are systematically compared: a novice school with little experience in competence-based education and assessment, and an innovative school with extensive experience. The self-evaluation was based on 12 quality criteria for CAPs, including both validity and reliability, and criteria stressing the importance of the formative function of assessment, such as meaningfulness and educational consequences. In each school, teachers, management and examination board participated. Results show that the two schools use different approaches to assure assessment quality. The innovative school seems to be more aware of its own strengths and weaknesses, to have a more positive attitude towards teachers, students, and educational innovations, and to explicitly involve stakeholders (i.e., teachers, students, and the work field) in their assessments. This school also had a more explicit vision of the goal of competence-based education and could design its assessments in accordance with these goals. © 2011 Elsevier Ltd.