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Biomedical subjects

D Newble

Publications and source records attributed to D Newble.

12 recordsLinked to original sources
PubMed2003

Evaluation of high fidelity patient simulator in assessment of performance of anaesthetists.

BACKGROUND: There is increasing emphasis on performance-based assessment of clinical competence. The High Fidelity Patient Simulator (HPS) may be useful for assessment of clinical practice in anaesthesia, but needs formal evaluation of validity, reliability, feasibility and effect on learning. We set out to assess the reliability of a global rating scale for scoring simulator performance in crisis management. METHODS: Using a global rating scale, three judges independently rated videotapes of anaesthetists in simulated crises in the operating theatre. Five anaesthetists then independently rated subsets of these videotapes. RESULTS: There was good agreement between raters for medical management, behavioural attributes and overall performance. Agreement was high for both the initial judges and the five additional raters. CONCLUSIONS: Using a global scale to assess simulator performance, we found good inter-rater reliability for scoring performance in a crisis. We estimate that two judges should provide a reliable assessment. High fidelity simulation should be studied further for assessing clinical performance.

Anesthesia↗
PubMed2001

Sheffield Assessment Instrument for Letters (SAIL): performance assessment using outpatient letters.

CONTEXT: Well-designed assessments of performance are urgently required for training doctors, and to provide indicators of the quality of practice. OBJECTIVES: To design an assessment process that uses routine outpatient letters, and to evaluate its validity, feasibility, reliability (reproducibility and discrimination) and potential educational impact. PARTICIPANTS: All 26 paediatric registrars in North Trent attending annual assessment panel in 1999 participated. STUDY DESIGN: An assessment instrument (SAIL) was developed from a consensus framework for good practice in written communication. It comprises an 18-point checklist and a global rating scale. Three judges applied the instrument to 260 letters from the routine clinical practice of the 26 participants. Results We achieved consensus on good practice in written communication. This was in keeping with the published literature. All participants completed the assessment. Scoring took 3-6 min per judge per letter. The reliability coefficient in this test situation is 0.72. Modelling predicts that a coefficient of 0.8 (the threshold for high-stakes judgements about performance) can be achieved with more judges or letters. The assessment results are well suited to formative feedback. CONCLUSIONS: SAIL uses letters as a face valid indicator of written communication performance. The instrument is feasible to use, and produces reliable results when applied to paediatric registrars to inform the annual Record of In-Training Assessment (RITA). Feedback from the assessment should help doctors to improve their written communication. Its use may extend to other specialities and settings including revalidation.

Communication↗
PubMed2000

The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice.

INTRODUCTION: In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students' experience of the course. METHODS: Independent external evaluators undertook a thematic analysis of a series of structured interviews of students and faculty involved in both the PRCC and the traditional curriculum. The mean examination results were determined and a rank order comparison of student academic performance was undertaken. RESULTS: The eight selected volunteer students reported greater access to patients and clinical learning opportunities than their mainstream counterparts and learned clinical decision making in the context of the whole patient, their family, and the available community resources. They identified patients with 'core' clinical conditions and had a longitudinal exposure to common diseases, whereas hospital-based peers had a cross-sectional exposure to highly filtered illness. The PRCC students' academic performance improved in comparison with that of their tertiary hospital peers' and in comparison to their own results in previous years. CONCLUSION: The PRCC curriculum has cut across the traditional clinical discipline boundaries by teaching in an integrated way in rural general practice. It has affirmed the potential role of true generalist physicians in undergraduate medical education.

Community Medicine↗
PubMed2000

Strategic planning in medical education: enhancing the learning environment for students in clinical settings.

BACKGROUND: The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning. It provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical education across a number of countries. PURPOSE: This paper describes the issues raised by the practical challenges posed by the current environment and how they might be addressed in ways that could promote more effective learning in clinical settings. METHOD: A SWOT analysis is a tool that can help in forward planning by identifying the strengths, weaknesses, opportunities and threats presented by any situation. Our SWOT analysis was used to generate a list of items, from which we chose those most feasible and most likely to promote positive change. RESULTS: Twenty different issues were identified, with four of them chosen by consensus for further elaboration. The discussion gave rise to four main recommended strategies: ensuring that clinical teachers thoroughly understand the purpose and process of learning in clinical settings; equipping learners with 'survival skills'; making the best use of learning resources within different clinical environments and making judicious use of information technology to enhance learning efficiency. CONCLUSIONS: The four strategies were selected not only because of their inherent importance, but also because of their feasibility. Modest changes can motivate students to feel part of a clinical team and a 'community of practice' and enhance their capacity for self-regulated practice.

Clinical Clerkship↗
PubMed1990

Jet lag.

Jet lag is the loss of wellbeing associated with rapid travel across time zones. An understanding of its causes and the factors which influenced its severity may help in its prevention and management.

Circadian Rhythm↗