The results of this questionnaire study lead to the conclusion that while there are many differences between countries, there appear to be six dominant models. The models vary in structure and length of medical training, point of full registration and degrees that are granted.
Receiving feedback on daily clinical activities, in whatever form, is crucial for the development of clinical proficiency. Multisource or 360-degree feedback procedures have been recommended to include various co-workers as sources of feedback. In 2008, a web-based multisource feedback (MSF) tool for medical residents was developed at the University Medical Center Utrecht and launched nationally in the Netherlands and has been widely used since then. In 2012, an evaluation was carried out to collect opinions on its use, on the quality of the instrument and on its experienced effectiveness. We approached 408 residents and 59 residency programme directors with an anonymous online survey.Completed surveys were received from 108 residents (26 %) and 22 programme directors (37 %). The tool was well received among the respondents and proved to be a simple, efficient and effective instrument to prepare for information-rich progress interviews of programme directors with their residents. Despite a relatively low response rate, indications were found for the effectiveness of MSF use at four levels of Kirkpatrick’s hierarchy based on user impressions: reaction, learning, behaviour change, and impact. This MSF tool, designed for effective formative feedback, was found to meet its purpose and was well received.
BackgroundThe overuse of laboratory tests and radiology imaging and their possible hazards to patients and the health care system is observed with growing concern in the medical community. With this study the authors wished to determine whether ordering patterns for laboratory and radiology tests by medical students close to their graduation are related to undergraduate training.MethodsWe developed an assessment for near graduates in the setting of a resident’s daily routine including a consultation hour with five simulated patients, three hours for patient work up with simulated distracting tasks, and thirty minutes for reporting of patient management to a supervisor. In 2011, 60 students participated in this assessment: 30 from a vertically integrated (VI) curriculum (Utrecht, The Netherlands) and 30 from a traditional, non-VI curriculum (Hamburg, Germany). We assessed and compared the number of laboratory and radiology requests and correlated the results with the scores participants received from their supervisors for the facet of competence “scientifically and empirically grounded method of working”.ResultsStudents from a VI curriculum used significantly (p < .01) less total laboratory requests (N = 283 versus N = 466) which correlated with their scores for a “scientifically and empirically grounded method of working” (Pearson’s r = .572). A significantly (p < .01) higher number of radiology imaging was ordered with a large effect size (V = .618) by near graduates from a non-VI curriculum (N = 156 versus N = 97) even when this was not supporting the diagnostic process.ConclusionThe focused ordering patterns from VI students might be a result of their early exposure to the clinical environment and a different approach to clinical decision making during their undergraduate education which further studies should address in greater detail.
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