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Biomedical subjects

A Chur-Hansen

Publications and source records attributed to A Chur-Hansen.

13 recordsLinked to original sources
PubMed2005

Mental health nurses' and psychiatrists' views on the prognosis of schizophrenia and depression: an exploratory, qualitative investigation.

This study uses a qualitative methodology to explore mental health literacy, specifically perceptions of prognosis, which is typically investigated with a quantitative, questionnaire-based approach. Two vignettes--one of a person with schizophrenia and one with depression--were shown to three mental health nurses and three psychiatrists. During semi-structured, open-ended interviews, they were asked to discuss their thoughts about the prognosis for the patient presented in each vignette. Participants tended to use the terms 'prognosis' and 'outcome' interchangeably. Psychiatrists tended to be more guarded in determining a prognosis than nurses. Both groups emphasized the importance of clinical experience in formulating views. However, nurses also discussed the role of the multidisciplinary team, whilst psychiatrists emphasized their reliance upon the scientific literature in shaping opinions. Participants identified information relevant for incorporating into future vignettes, to allow more informed research into literacy. The results of quantitative mental health literacy research should be interpreted with caution. Simplifying responses to allow comparative analysis is necessary, but masks more complex and important interpretations. Further qualitative research is recommended, the results of which can inform more comprehensive quantitative studies in the area.

Adult↗
PubMed2000

Medical students' essay-writing skills: criteria-based self- and tutor-evaluation and the role of language background.

OBJECTIVES: An exercise is described which aimed to make clear to first-year undergraduate medical students the expected writing skills required for an essay examination in one discipline. SUBJECTS: Many students were from a non-English speaking background and over one-third of students, regardless of language background, had limited experience in this type of essay writing. PROCEDURE: For this exercise, a practice essay was written by each student for formative assessment. The essay was rated by a tutor and by the student according to well-defined criteria. This allowed for comparisons to be made in a structured and objective way between the judgements of the student and the assessor. RESULTS: Students found the exercise to be very useful, although whether essay writing skills actually improved could not be established. Students from non-English speaking backgrounds tended to be most harsh in their self-evaluations, yet tutor-evaluations generally showed these students to have better writing skills than other students. Indeed, correlations between self- and tutor-evaluations were quite low. CONCLUSIONS: It is evident that students and their educators may be unclear about each others' expectations. By making explicit the requirements of an exercise, misunderstandings may be minimized and it is possible that student performance could improve, though further research is required to verify these hypotheses. It is suggested that students should be encouraged to evaluate their own work and should be instructed in writing skills throughout their medical degree education.

Education, Medical, Undergraduate↗
PubMed2000

Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase?

BACKGROUND: While the literature shows the clinical value for medical practitioners of skill in communicating with patients in an empathetic manner, objective evaluations of methods to teach empathy are few. PURPOSES: This paper describes a method of teaching entry-level medical students the elements of effective communication with patients, in preparation for their first practical exercises. The paper focuses on how the outcomes of the teaching were evaluated with special attention to empathy. METHODS: Student evaluative ratings were collected after training, and students also completed a pencil-and-paper test of empathy, both before and after the training. While all data were anonymous, student pre- and post-training empathy scores could be compared to assess individual changes in knowledge of empathy after training. RESULTS: Most students (81%) felt better prepared to interview after the training. The pencil-and-paper measure of empathy has good reliability, both internal (alpha 0.83 and 0.91) and inter-rater (kappa 0.96). Overall, students made significant gains in their ability to make empathetic responses, although some (30%) showed no gains. CONCLUSIONS: Further research is required to identify students who fail to acquire skill in expressing empathy after undergoing training, and to validate the pencil-and- paper measure of empathy against real-life performance.

Clinical Competence↗
PubMed2000

The evaluation of undergraduate students' written English language skills.

CONTEXT: Writing is an important skill for practitioners and students, yet this is a skill rarely taught in a formal capacity at medical school. At the University of Adelaide many students are from non-English speaking backgrounds and have varying proficiencies in English. We wished to devise a method and instrument which could identify students who may benefit from formative feedback and tuition in writing. OBJECTIVES AND METHOD: Students' written account of a short clinical interview with a standardized patient was assessed using a new instrument (the Written Language Rating Scale) designed especially for this study. The assessment of writing was made by one rater with qualifications in teaching English as a second language. SUBJECTS: 127 second-year medical students enrolled at the University of Adelaide, Australia. INSTRUMENTS AND RESULTS: The scale appeared to have good internal consistency, face and construct validity, and test security was not an issue. However, it had questionable concurrent validity with a standardized language test, although this may be partly due to the period of time which had elapsed between administration of the two tests. CONCLUSIONS: This study was useful in providing a means to objectively rate students' written English language skills and to target students in need of formative feedback and tuition. However, further research is necessary for both evaluation of medical writing and interventions for its improvement.

Adolescent↗
PubMed1999

Teaching support in the behavioural sciences for non-english speaking background medical undergraduates.

INTRODUCTION: This paper reports on a teaching strategy designed to support first year undergraduate medical students from non-English speaking backgrounds in a behavioural science course taught at an Australian university. METHOD: The strategy is described, as is the language profile of students from two successive cohorts who participated in the teaching programme. The effectiveness of the intervention in improving students' academic performance is explored, as gauged by summative assessment and student perceptions. CONCLUSIONS: Findings suggest that students disadvantaged by difficulties with language and/or knowledge of Australian culture were able to perform at least as well as other students on a number of summative criteria. Non-English speaking background students perceived the behavioural science course to be difficult, and indicated that they found the teaching support offered to them to be useful. The methodological difficulties and limitations involved in the evaluation of a teaching programme such as this are discussed and the conclusions that can be validly drawn are considered.

Australia↗
PubMed1999

Using standardized patients to evaluate undergraduate medical students' proficiency in speaking English.

PURPOSE: To explore the use of standardized patients for evaluating medical student's proficiency in speaking English. METHOD: In 1995, using a language rating scale constructed by the authors, six standardized patients evaluated the English-language proficiencies of 127 second-year medical student undergraduates enrolled at the University of Adelaide, Australia, many of whom were from a non-English speaking background. RESULTS: An earlier standardized test (Screening Test for Adolescent Language) had identified approximately one third of the students as potentially experiencing difficulties in using English in their training. Students so identified were rated lower than were their peers by the standardized patients. CONCLUSION: The study proved useful both in identifying aspects of speech that can be reasonably rated by standardized patients and also in identifying students who might benefit from language interventions. Replication studies with the new instrument are required to further establish its reliability, validity, and generalizability across different student cohorts.

Adolescent↗
PubMed1998

Clinical teachers' perceptions of medical students' English language proficiency.

Medical educators from the Faculty of Medicine at the University of Adelaide, South Australia, have expressed reservations about the adequacy of some undergraduate medical students' English language proficiency for satisfactory academic and clinical performance. This study explores the occurrence and nature of the comments made in writing by clinical teachers about the English language proficiency of 568 students over a period of 4 years. The frequency and nature of the comments made by clinicians have important implications for the planning and implementation of pedagogical strategies to support non-English-speaking background medical students experiencing difficulties with their course due to language. Although the University of Adelaide has introduced initiatives in response to some of the problems that have been identified, it is recommended that any teaching interventions require careful evaluation through a longitudinal research design to ensure that their aims are being achieved.

Australia↗
PubMed1997

Language background, proficiency in English, and selection for language development.

With a diverse language background profile in an Australian medical student population, teaching interventions are necessary for students whose English language proficiency is not adequate for the study of medicine. This paper describes the screening of written and aural English language proficiency in 143 first year undergraduate students using a standardized instrument. Students identified as experiencing language difficulties were subsequently assessed by interview and allocated to faculty-based Language Development Programme. Students with the greatest need for language support participated in a full 2 year programme. Those requiring less assistance were offered more limited support in the form of specific modules within the programme. Students allocated to the full programme were significantly weaker in language proficiency compared to those offered specific modules and those not offered a placement. The information gathered during the structured interview is valuable in establishing for medical educators specific areas in which language-related teaching for students who require it can be directed. Future research is required to evaluate the effectiveness of faculty-based language interventions in terms of improvement in language proficiency over time and the effect of any improvements in language proficiency on academic and clinical performance.

Adolescent↗
PubMed1997

Language background, English language proficiency and medical communication skills of medical students.

Associations between language background, English language proficiency and medical communication skills were investigated in a group of 149 third year undergraduate medical students studying at an Australian university. Written and aural English proficiency were assessed with the Screening Test for Adolescent Language (STAL). Medical communication skills and the fluency of spoken language were scored during an Observed Structured Clinical Interview (OSCI), rated by a standardized patient and a clinician. An association was found between language background, performance on the STAL and spoken language proficiency. Satisfactory performance in medical communication skills was not associated with language background or overall performance on the STAL. In this study it was the global rating of unsatisfactory spoken language fluency that was associated with poorer performance in medical communication skills under examination conditions.

Adult↗
PubMed1996

Teaching colloquial Australian English to medical students from non-English speaking backgrounds.

Lack of fluency in the language of instruction can form a barrier to medical education. There has been an effort within Australian universities to teach English to students from non-English speaking backgrounds (NESB), but little systematic attention has been given to the teaching of informal or colloquial English. This paper provides evidence that colloquial language is a pervasive and important aspect of doctor-patient communication. It describes a teaching project for NESB medical students which aimed to introduce them to colloquial English, and to provide them with a contextual approach to learning this form of language. Forty-four first year medical students enrolled at the University of Adelaide were required to gather examples of colloquial language by interviewing a native English speaker. Ninety-four examples of colloquial sayings were recorded. These were compiled in the form of a handbook which served as a student resource. Student evaluation of this exercise was positive. The benefits of an interactive method of teaching local and setting-specific language are discussed, and the implications of this approach for clinical teaching and for medical practice are explored.

Australia↗
PubMed1995

Initial responses of first-year medical students to problem-based learning in a behavioural science course: role of language background and course content.

A trial of problem-based learning (PBL) was conducted with first-year undergraduate medical students who had no background knowledge of behavioural science and who included a substantial proportion with a first language other than English. Responses to standardized and open-ended evaluation questions showed greater variability and there was no clear preference for PBL over traditional methods. Students found the PBL exercise time-consuming and felt they needed more guidance. Feedback from clinicians and working in groups were seen as positive aspects of the exercise. Students with a first language other than English reported that language, but not cultural background, was an impediment to effective participation. It is recommended that this group of students be offered extra support for PBL in a subject-based setting, and that all students would benefit from a formal induction session.

Adolescent↗
PubMed1995

Interrater reliability of the scoring of the screening test of adolescent language.

Group administrations of the Screening Test of Adolescent Language have been successful in identifying students with English-language problems among groups of university students who include many recent immigrants from southeastern Asia. However, scoring several items requires subjective judgement. Accordingly, interrater reliability was investigated by having two independent examiners score the written responses of 299 first-year medical students at two Australian universities. The examiners produced very similar distributions of total scores with means of 20.36 and 19.36 and achieved a high agreement in the categorisation of students with English problems. The Spearman rank-order correlation of 0.83 was high and statistically significant from zero.

Adolescent↗