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Background: Several investigations suggest inadequate emphasis of basic clinical procedures during internship training. Many trainees had reported lack of competence, while some expressed confidence to manage conditions although not sufficiently experienced. Aims: This study aimed at ascertaining the perceptions of new medical graduates regarding the performance of core clinical skills during training and confidence of performing them later. It also aimed at determining any gender variability in the confidence in performing selected clinical skills in Obstetrics & Gynaecology. Methods: Interns trained during 2005/06 responded anonymously to a questionnaire that listed 48 core clinical skills. The 124 subjects eligible for the study comprised graduates from Kuwait (64), other Gulf Cooperation Council countries (29), Ireland (27) and Egypt. They indicated whether they felt confident to perform the skills in future, and the number of times they had performed them during training. We received 91 completed questionnaires. Results: The majority felt confident in performing routine skills (basic ECG and X-ray interpretations, insertion of intravenous line, inserting urethral catheter and nasogastric feeding). Approximately two thirds had performed generic skills related to emergency resuscitation, with a half of them confident in performing them in the future. A third felt confident in performing artificial ventilation and endotracheal intubation. The confidence to perform common skills in Obstetrics & Gynaecology varied, with no significant gender variation. Approximately a fifth was confident in performing lumbar puncture, needle aspiration of joints, insertion of thoracic drainage, insertion of central venous catheter, venous cut-down and indirect laryngoscopy. A small proportion reported confidence in performing different clinical procedures although they had not undertaken them during training. Conclusions: Substantial proportions of trainees lacked confidence in performing emergency resuscitative measures and some routine clinical skills. Training needs to be closely monitored and interns who are not competent identified early for taking remedial measures.

[No abstract available]

Background. The quality of child care is of social and economic significance worldwide. The beliefs that child care workers hold about knowing and knowledge (epistemological beliefs) influence the quality of their professional work. However, attention to epistemological beliefs is rarely a focus in vocational education programmes. Aim. The aim of this study was to investigate the nature of child care students' epistemological beliefs. Sample(s). All first- and second-year students completing a Diploma of Children's Services at three separate training institutes in a large metropolitan area in Australia were invited to participate in the study. There were 46 first- and 31 second-year students (77 in total, 71 females). Method. This study used semi-structured interviews based on a child care scenario to enable students to articulate their epistemological beliefs. A descriptive-interpretative approach in which interviews were analysed for patterns of meaning was used in the content analysis. The categories, based on the work of Kuhn and Weinstock (2002), included objectivism, subjectivism, and evaluativism. While this proved to be a useful framework, the authors remained open to new categories emerging. This constituted the interpretive component of the analysis. Therefore, the data were analysed using both data-driven and theory-led approaches to analysis, which still made it possible to take account of many viewpoints before arriving at the categories of beliefs. The categories were audited by a second researcher to establish trustworthiness and credibility. Results. The findings of this study revealed a range of epistemological beliefs; however, a new way of thinking about evaluativistic beliefs called 'basic evaluativism' emerged. This view of knowledge relates to the construction of evidence-based practice rather than knowledge as is typically the case in evaluativistic beliefs. Conclusions. Implications for the need to address epistemological beliefs in vocational education programmes for child care workers are discussed. © 2008 The British Psychological Society.

PURPOSE OF REVIEW: The present review focuses on the education needs and related pedagogical aspects of education in forensic psychiatry. RECENT FINDINGS: Physicians specializing in other fields generally deal with concepts that are thoroughly addressed in forensic psychiatry, such as the ability of patients to consent to treatment, confidentiality, victimization, and risk factors for auto and hetero-lesive behaviour. Present practices like the advance of e-health and patients? rights call for ethical and responsible attitudes. There are a variety of programs providing specific training for psychiatrists willing to work in the forensic area and renewed pedagogical trends are gradually being incorporated. Many articles point out the need to enforce the teaching of expert communication abilities while others warn of the poor economic incentive of forensic psychiatry as a career. SUMMARY: Forensic psychiatry teaching is undergoing a period of significant evolution and expansion. New didactic trends, specific pedagogical research and an increase in training needs in other fields of medicine are promising. It is important to ensure that the formal training provided in every country is comparable and that those who teach and learn this complex field are acknowledged. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.

All thought and talk about learning involves the use of metaphors. Whilst metaphors aid our understanding of things by suggesting novel insights, they can also mislead if too much is read into the supposed likenesses. Acquisition and transfer are easily the most popular metaphors used to understand learning. This article argues that these metaphors commonly mislead when we take them to mean that learning is located inside of learners, and, hence, that the individual is the appropriate unit for understanding learning. This article discusses the strengths and limitations of the alternative metaphors invoked in some more recent theories of learning, metaphors including participation, construction/re-construction, and becoming. A consideration of these alternative metaphors reveals the multi-facetted nature of learning. It also highlights important kinds of learning, by groups, teams or communities, learning that are not plausibly located inside of individuals. Any rich account of professional practice needs to encompass the roles of both individual and group learning.

Background: Portfolios, often described as collections of evidence, are discussed as a means of teaching or assessing the Accreditation Council for Graduate Medical Education competencies. Yet, it is unclear how many residency programs utilize portfolios. The purpose of this article is to (a) review the literature on portfolio use in graduate medical education; (b) examine efficacy of portfolio use, based upon studies in the field; and (c) offer a discussion of considerations for implementing portfolios. Summary: Two searches of PubMed, OVID, JSTOR, SCOPUS, and FirstSearch Wilson Select were conducted between October 2006 and April 2007 to identify studies and articles related to portfolio usage. Thirty-nine articles met criteria and were reviewed. Conclusions: There is wide variation in how portfolios are utilized within U.S. residency programs. The challenge for graduate medical education is to create consensus on the definition and purpose of portfolios, such that best practices in portfolio implementation and assessment can be achieved. Copyright © 2008, Taylor & Francis Group, LLC.

Background/Objective: As financial arrangements for vocational training (VT) in general practice/family medicine seemed to differ among European countries, the VT committee of EURACT compiled an overview to permit comparison. Methods: A questionnaire with open and closed questions wase-mailed in March 2006 to representatives of the 34 different countries on the EURACT Council. Results: Thirty completed questionnaires were returned (88% response rate). The salary of the GP trainee during clinical training in GP/FM is paid by the state on its own or with others in 19 countries (63%), and is the same during community and hospital rotations in 22 countries (73%). The GP trainer gets extra payment for supervision and teaching in only 14 countries (47%). Structured VT programmes are fully or partly financed by the state in 17 countries (57%), with trainees being paid for working hours spent in seminars/coursework in 19 countries (63%). Funding was cited as the commonest challenge and strength regarding VT programmes (cited 20 and 11 times, respectively). Conclusion: Recommendations made regarding the provision of vocational training across Europe include a structured curriculum supported by adequate funding, the professional recognition of GP trainers, which includes a fair and appropriate salary, and equity of salary for GP trainees.

Much attention has been focused on integrating competency-based curricula into educational programs in health management. Achieving the benefits of competency-based curricula requires substantial effort to identify competencies that are both specific and comprehensive, and that reflect consensus among faculty and stakeholders. The objective of this paper is to describe an approach to competency-based curriculum development and monitoring of students' progress toward competency achievement. Our approach identifies 20 competency areas, organized in technical, analytical/conceptual, and interpersonal domains. We demonstrate how individual courses can be mapped to these 20 competency areas and provide survey data on students' and graduates' self-rated competencies. We find the self-rated competencies of new graduates were significantly higher than the self-rated competencies of entering students in 17 of the 20 areas. Our work illustrates an approach to competency-based education that is feasible and helpful for program planning and evaluation. The list of competencies is tractable; the mapping of competencies to didactic coursework and practical experiences is clear and reflects reasonable consensus among faculty and preceptors. Finally, the approach is flexible, as competency areas can be added and removed to be responsive to new research evidence and the changing needs of the field.

This paper summarises the issues involved in promoting interprofessional learning in practice both on campus and within placement areas with reference to one particular university. National drivers of Interprofessional Learning (IPL) are outlined and then explored in relation to the portfolio of pre qualifying programmes within a large, multiprofessional School of Health and Social Care. In this particular context, rapid development of campus based IPL require equally robust developments in practise based learning. Integration of IPL across the whole curriculum is considered in the light of current practice based learning initiatives and projects. From this discussion an approach to integration emerges, built on the need to explicitly articulate examples of interprofessional collaboration as they arise in every placement. These interprofessional learning opportunities need to inform assessment strategies both on campus and in practice. Inherent in this approach is the assumption that IPL does occur in practice but is not explicitly articulated or celebrated. © 2006 Elsevier Ltd. All rights reserved.

There is a recognised gap in information and communications technology (ICT) learning and teaching in higher education for entry-level healthcare professionals. This paper proposes a research model for understanding the dimensions of this gap. We describe methodological approaches to understanding present practices, identifying levers for change and learning by doing. We discuss issues faced in getting started and sustaining momentum on the research that is an essential prerequisite to effectively build the ICT capacity required by the clinical workforce in a sustainable healthcare system. © 2007 The authors. All rights reserved.