BackgroundMedical student selection and assessment share an underlying high stakes context with the need for valid and reliable tools. This study examined the predictive validity of three tools commonly used in Australia: previous academic performance (Grade Point Average (GPA)), cognitive aptitude (a national admissions test), and non-academic qualities of prospective medical students (interview).MethodsA four year retrospective cohort study was conducted at Flinders University Australia involving 382 graduate entry medical students first enrolled between 2006 and 2009. The main outcomes were academic and clinical performance measures and an indicator of unimpeded progress across the four years of the course.ResultsA combination of the selection criteria explained between 7.1 and 29.1 % of variance in performance depending on the outcome measure. Weighted GPA consistently predicted performance across all years of the course. The national admissions test was associated with performance in Years 1 and 2 (pre-clinical) and the interview with performance in Years 3 and 4 (clinical). Those students with higher GPAs were more likely to have unimpeded progress across the entire course (OR = 2.29, 95 % CI 1.57, 3.33).ConclusionsThe continued use of multiple selection criteria to graduate entry medical courses is supported, with GPA remaining the single most consistent predictor of performance across all years of the course. The national admissions test is more valuable in the pre-clinical years, and the interview in the clinical years. Future selections research should develop the fledgling research base regarding the predictive validity of the Graduate Australian Medical School Admissions Test (GAMSAT), the algorithms for how individual tools are combined in selection, and further explore the usefulness of the unimpeded progress index.
ObjectiveTo evaluate the effects of a postnatal home-visiting programme delivered by community health nurses to socially disadvantaged mothers in South Australia.DesignThe intervention group of 428 mothers lived in metropolitan Adelaide and the comparison group of 239 mothers lived in regional towns where the programme was not yet available. All participating mothers met health service eligibility criteria for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age=14.4 weeks SD=2.3), prior to programme enrolment, and again when the children were aged 9, 18 and 24 months.SettingState-wide community child health service.Participants667 socially disadvantaged mothers enrolled consecutively. 487 mothers (73%) completed the 24-month assessment.InterventionTwo-year postnatal home-visiting programme based on the Family Partnership Model.Primary outcome measuresParent Stress Index (PSI), Kessler Psychological Distress Scale and the Ages and Stages Questionnaire.ResultsMixed models adjusting for baseline differences were used to compare outcomes in the two groups. The mothers in the home-visiting group reported greater improvement on the PSI subscales assessing a mother's perceptions on the quality of their relationship with their child (1.10, 95% CI 0.06 to 2.14) and satisfaction with their role as parents (0.46, 95% CI −0.15 to 1.07) than mothers in the comparison group. With the exception of childhood sleeping problems, there were no other significant differences in the outcomes across the two groups.ConclusionsThe findings suggest that home-visiting programmes delivered by community health nurses as part of routine clinical practice have the potential to improve maternal–child relationships and help mothers adjust to their role as parents.Clinical Trial RegistrationAustralian and New Zealand Clinical Trials Registry ACTRN12608000275369.
In sub-Saharan Africa (SSA), a rapidly aging population is presenting challenges to health care systems. Doctors need specialized knowledge to be prepared for the increase in age-related medical conditions. This study aims to investigate the current provision of geriatrics education (GE) in SSA medical schools and discover some of the barriers faced in its implementation. Questionnaires were sent to a list of medical schools in SSA, supplied by the sub-Saharan African Medical Schools Study. Responses were received from 25/135 institutions (19%), representing 11 countries in SSA. Of these institutions, 4% taught geriatrics and 40% had no geriatrics teaching. The largest perceived barriers to GE were a lack of staff expertise (72%), lack of funding (52%), and absence of geriatrics in the national curricula (48%). There are still a large number of medical schools in SSA who do not teach geriatrics. Improvements in GE should be implemented through local approaches and national policy, while appreciating the cultural context and economic constraints of each country to prepare future doctors for the increasing challenges of an aging population.
Aims: Nurse home-visiting programs are employed to enhance the functioning of disadvantaged mothers and young children. Despite the key role played by nurses, there is little empirical evidence describing the views and experiences of nurses who deliver home-visiting programs. This study compared the views and experiences of nurses delivering home-visiting programs in England and South Australia. Methods: Participants were 108 nurses delivering the South Australian Family HomeVisiting program (2008 -2011), and 44 nurses delivering the Family Nurse Partnership program in England (2007England ( -2009). Data were collected using a standard questionnaire that was completed by nurses in each country. The questionnaire asked nurses about their level of influence on program outcomes, approaches they used to retain maternal engagement with the home-visiting programs, barriers to effective program delivery and the effectiveness of supervision.Results: Both groups of nurses considered that their greatest influence was improving mothers' confidence with parenting skills and increasing mothers' knowledge about children's development. Each group identified quality of nurse-mother relationships as the factor most relevant to retaining maternal engagement. Other influential factors were flexibility of timing for visits and the capacity of the programs to meet specific needs of mothers. 4Conclusion: There was consistency in the nurses' views about the home-visiting programs delivered in England and Australia. Future studies should utilise prospective designs to identify the mechanisms by which factors influence the quality of nursemother relationships, approaches used by nurses to solve family problems, and elements of mother-nurse relationships that have the strongest influence on program outcomes.Keywords: home visits, maternal-child health, nurse perceptions, children, nurses 5 What is already known about this topicNurse home-visiting programs are employed to enhance the functioning of disadvantaged mothers and young children.Several qualitative studies have highlighted the importance of nurse-mother relationships for the successful implementation of home-visiting programs.Despite the key role played by nurses, there is little empirical evidence describing the views and experiences of nurses who deliver home-visiting programs. What this paper addsNurses delivering home-visiting programs in England and South Australia had similar views about factors influencing program delivery.Nurses considered that their greatest influence was on improving mothers' confidence with parenting skills and increasing mothers' knowledge about children's development.The availability of advice from other nurses or supervisors is important to minimise maternal attrition from home-visiting programs and ensure optimal delivery. 6Nurse home-visiting programs are one approach that can be used to enhance the social, emotional and cognitive development of young children. In home-visiting programs, trained nurses work in partnership with disadvanta...
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