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Charlotte Ringsted

Publications and source records attributed to Charlotte Ringsted.

9 recordsLinked to original sources
PubMed2006

Accreditation of undergraduate and graduate medical education: how do the standards contribute to quality?

Accreditation organizations such as the Liaison Committee for Medical Education (LCME), the Royal College of Physicians and Surgeons of Canada (RCPSC), and the Accreditation Council for Graduate Medical Education (ACGME) are charged with the difficult task of evaluating the educational quality of medical education programs in North America. Traditionally accreditation includes a more quantitative rather than qualitative judgment of the educational facilities, resources and teaching provided by the programs. The focus is on the educational process but the contributions of these to the outcomes are not at all clear. As medical education moves toward outcome-based education related to a broad and context-based concept of competence, the accreditation paradigm should change accordingly.

Accreditation↗
PubMed2006

Are some of the challenging aspects of the CanMEDS roles valid outside Canada?

CONTEXT: Many countries have adopted the CanMEDS roles. However, there is limited information on how these apply in an international context and in different specialties. OBJECTIVES: To survey trainee and specialist ratings of the importance of the CanMEDS roles and perceived ability to perform tasks within the roles. METHODS: We surveyed 8749 doctors within a defined region (eastern Denmark) via a single-issue, mailed questionnaire. Each of the 7 roles was represented by 3 questionnaire items to be rated for perceived importance and confidence in ability to perform the role. RESULTS: Responses were received from 3476 doctors (42.8%), including 190 interns, 201 doctors in the introductory year of specialist training, 529 residents and 2152 specialists. The overall mean rating of importance (on a scale of 1-5) of the aspects of competence described in the CanMEDS roles was 4.2 (standard deviation 0.6) and did not differ between trainee groups and specialists. Mean ratings of confidence were lower than ratings of importance and increased across the groups from interns to specialists. Differences between specialty groups were evident in both importance and confidence for many of the roles. For laboratory, technical and, to a lesser extent, cognitive specialties, the role of Health Advocate scored the lowest in importance. For general medicine specialties, the roles of Medical Expert, Collaborator, Manager and Scholar all scored lower for importance and confidence. CONCLUSIONS: This study provides a sketch of the content and construct validity of the CanMEDS roles in a non-Canadian setting. More research is needed in how these aspects of competence can be best taught and applied across specialties in different jurisdictions.

Adult↗
PubMed2005

A pilot survey of junior doctors' confidence in tasks related to broad aspects of competence.

Medical authorities and society are recommending that postgraduate medical education prepare physicians for broad aspects of competence. The most effective ways to prepare physicians for these are not known. The aim of this pilot study was to survey junior doctors' growth in confidence in different physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared. Confidence in the roles of medical expert, communicator and collaborator increased between PRHOs and SHOs. Confidence levels increased in all roles between PRHOs and SpRs, but confidence between SHOs and SpRs increased only in the roles of collaborator and scholar. Confidence in the role of professional was low and did not increase significantly between training levels. The SHO year was rated as only moderately useful in facilitating learning of the tasks. These results suggest that growth of confidence in the physician roles proceeds at different rates during postgraduate training. Additional research is needed to identify effective ways for junior doctors to learn broad aspects of competence. Longitudinal tracking will be important to evaluate the effect of educational interventions on patient care.

Clinical Competence↗
PubMed2004

Validation of a checklist to assess ward round performance in internal medicine.

BACKGROUND: Ward rounds are an essential responsibility for doctors in hospital settings. Tools for guiding and assessing trainees' performance of ward rounds are needed. A checklist was developed for that purpose for use with trainees in internal medicine. OBJECTIVE: To assess the content and construct validity of the task-specific checklist. METHODS: To determine content validity, a questionnaire was mailed to 295 internists. They were requested to give their opinion on the relevance of each item included on the checklist and to indicate the comprehensiveness of the checklist. To determine construct validity, an observer assessed 4 groups of doctors during performance of a complete ward round (n = 32). The nurse who accompanied the doctor on rounds made a global assessment of the performance. RESULTS: The response rate to the questionnaire was 80.7%. The respondents found that all 10 items on the checklist were relevant to ward round performance and that the item collection was comprehensive. Checklist mean-item scores differed between levels of expertise: junior house officers 1.4 (1.0-1.9); senior house officers 2.0 (1.5-2.9); specialist trainees 2.5 (1.8-2.8), and specialists 2.7 (2.3-3.5); median (range) (P < 0.001). A significant correlation was found between global observer scores and nurse scores (r = 0.56, P < 0.001). CONCLUSION: The checklist, developed for assessing trainees' performance of ward rounds in internal medicine, showed high content validity. Construct validity was supported by the higher scores of experienced doctors compared to those with less experience and the significant correlation between the observer's and nurses' global scores. The developed checklist should be valuable in guiding and assessing trainees on ward round performance.

Clinical Competence↗
PubMed2004

The effect of in-training assessment on clinical confidence in postgraduate education.

INTRODUCTION: The literature on how in-training assessment (ITA) works in practice and what educational outcomes can actually be achieved is limited. One of the aims of introducing ITA is to increase trainees' clinical confidence; this relies on the assumption that assessment drives learning through its content, format and programming. The aim of this study was to investigate the effect of introducing a structured ITA programme on junior doctors' clinical confidence. The programme was aimed at first year trainees in anaesthesiology. METHODS: The study involved a nationwide survey of junior doctors' self-confidence in clinical performance before (in 2001) and 2 years after (in 2003) the introduction of an ITA programme. Respondents indicated confidence on a 155-item questionnaire related to performance of clinical skills and tasks reflecting broad aspects of competence. A total of 23 of these items related to the ITA programme. RESULTS: The response rate was 377/531 (71%) in 2001 and 344/521 (66%) in 2003. There were no statistically significant differences in mean levels of confidence before and 2 years after the introduction of the ITA programme - neither in aspects that were related to the programme nor in those that were unrelated to the programme. DISCUSSION: This study demonstrates that the introduction of a structured ITA programme did not have any significant effect on trainees' mean level of confidence on a broad range of aspects of clinical competence. The importance of timeliness and rigorousness in the application of ITA is discussed.

Anesthesiology↗
PubMed2001

Medical students' experience in practical skills is far from stakeholders' expectations.

This study compares medical graduates' experience in practical skills with a range of stakeholders' expectations. A questionnaire listing 58 practical skills was sent out to a group of graduating medical students. The medical students were asked to indicate their experience in each skill during medical school. A similar questionnaire was sent out to five groups of stakeholders asking for their expectations regarding graduates' experience. The stakeholders were: faculty members; consultants at clinical departments with interns in training; general practitioners; nurses; recently graduated junior doctors. A total of 472 questionnaires were sent out and 315 (67%) were returned. Medical graduates showed substantial variation in level of experience, and their experience was substantially lower than the expectations of the stakeholders. Nurses and junior doctors tended to have higher expectations compared with faculty members and consultants. Differences between our results and reports in the literature from elsewhere emphasize the importance of performing local needs assessments, and in this process stakeholders apart from faculty members should be involved.

Journal Article↗