PubMed · 16262846
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Vanessa Celeste Burch, Janet Seggie. 2005. Portfolio assessment using a structured interview.. https://doi.org/10.1111/j.1365-2929.2005.02281.x
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A key principle in problem-based learning (PBL) is the student linking learning from different sources to enrich understanding. We have explored how medical students based in a clinical environment use clinical experience within PBL groups. We recorded the discussion of 12 third-year groups, which were meeting for the second time on a PBL case, where students report back on the learning objectives. Discussions covering five separate PBL paper cases were recorded. Analysis of the transcripts was based on constant comparative method using a coding framework. The range of discussion segments of clinical experience was 2-15, with 9 of 12 groups having at least five separate segments. Our initial coding framework covered 10 categories, of which the most common were: a specific patient encounter (19%); an experience in the community (15%); and a personal health experience (15%). Students often used emotive phrases with 37 examples in the clinical experience segments compared with 9 from the longer non-clinical discussion. Most clinical descriptions triggered further discussion with almost half leading to some related medical topic. The discussion segments were subsequently coded into; 'confirming' (40); 'extending' (40); and 'disconfirming' (16) the understanding of the group for that topic. Discussion of clinical experience encouraged students to connect to the affective aspects of learning. It helped students to bridge between the tutorial and real clinical contexts. A clinical experience was often a powerful pivotal point, which confirmed, extended or refuted what was being discussed.
BACKGROUND: Many medical students experience that they do not get satisfactory feedback during their general practice preceptorship. We wanted to explore whether an evaluation questionnaire answered by patients could be a useful tool for students and tutors. MATERIAL AND METHODS: The Department of General Practice and Community Medicine at the University of Oslo invited medical students who attended general practice preceptorship during spring 2005 to participate. The questionnaire consisted of eight questions regarding the consultation. Both tutors and students also considered the benefits of the evaluation form in a subsequent questionnaire. The answers to both of the questionnaires were analysed statistically. Some students were organised into focus groups that discussed the use of patient questionnaires before and after the preceptorship period. RESULTS: 648 patients answered questionnaires following 36 students' independent consultations. The patient, the observing tutor and the student assessed 63 of these consultations. The patients scored eight issues with mean values from 4.3 to 5.0, with 5.0 being the best possible result. The questionnaires from the observed consultations showed that the tutors' assessment did not differ from the patients' on five out of seven compared issues. The tutors gave higher scores on the subject of the student's use of complicated language, and lower on the subject of physical examination. The students' self-assessment was significantly lower in six out of seven issues. The reactions to the questionnaire from both tutors and students were mixed. The students expressed that the use of questionnaires might contribute to better feedback from the preceptors or to obtain more independent consultations. INTERPRETATION: The students' consultations received a very high score from both patients and tutors, while the students themselves scored their own achievements lower. The evaluation questionnaires may be useful tools to improve feedback to students on their consultations in the preceptorship period.