Biomedical subjects

Paul A O'Neill

Publications and source records attributed to Paul A O'Neill.

7 recordsLinked to original sources

PubMed2006

Learning the house officer role: reflections on the value of shadowing a PRHO.

In the new integrated undergraduate medical programme at the University of Manchester, fifth-year students spend several weeks shadowing the pre-registration house officer (PRHO) whose post they will take over. The concept of 'shadowing' emerged from a set of interviews conducted with graduates during their first PRHO job. Graduates felt that shadowing helped them to gain familiarity with the work environment; with orientation to the role of a PRHO; and with specific learning, such as disease management, on which they could then get feedback. We hypothesize that shadowing provides an opportunity for focused apprenticeship learning of the future PRHO role. Further research may clarify the specific values of shadowing and how it might lessen the stresses faced by new graduates during the transition from student to doctor.

Education, Medical, Undergraduate↗

PubMed2006

Views, behaviours and perceived staff development needs of doctors and surgeons regarding learners in outpatient clinics.

INTRODUCTION: The need to use outpatient clinics as a major learning environment in hospitals for students and doctors-in-training is clear. However, consultant supervisors perceive major barriers to this and continue to rely heavily on traditional inpatient learning. This quantitative study examines what approaches consultant supervisors employ in outpatient learning, together with what they perceive themselves to use and what they would value in further training. METHODS: We observed learning episodes for students and doctors-in-training in medical and surgical clinics. A questionnaire on outpatient teaching was also sent to consultant doctors and surgeons. This was based on these observations and focus groups with students and doctors-in-training. RESULTS: There was an overall survey response rate of 62% (194/311). The dominant forms of learning we observed were 'arms-length' supervision for doctors-in-training and 'modelling' for students. Only 7% of learning episodes involved a doctor-in-training doing something under direct supervision. In contrast to the observation results, consultants considered that students and doctors-in-training received a lot of direct supervision and interaction. For example, 45% considered that doctors-in-training 'may see patients with me in a joint consultation'. Only 30% of respondents would be interested in staff development in learning in outpatient clinics. CONCLUSIONS: Although consultants reported that they frequently used an active approach to learning in outpatient clinics, modelling was used predominantly for students and arms-length supervision was used for doctors-in-training.

Ambulatory Care↗

PubMed2003

A qualitative study of the attitudes to teamwork of graduates from a traditional and an integrated undergraduate medical course.

INTRODUCTION: In 1994 the University of Manchester medical school introduced an integrated undergraduate course using problem-based learning throughout. This study explores differences between the new and old (traditional) course graduates' attitudes to, and conceptualization of, teamwork. METHODS: Semi-structured interviews were conducted with 24 graduates of the traditional course (graduating in 1998) and 23 from the new course (1999 graduates), representing approximately 14% of graduates from each cohort. Theories were then developed from concepts emerging from the data. RESULTS: The new course graduates (NCGs) had a broader view of members of a health professional team. The NCGs believed that the medical team should provide support and were more comfortable consulting them when faced with problems. CONCLUSIONS: The new curriculum has had some impact on conceptualization and attitude to teamwork. However, further development is required if graduates are to see themselves as part of a multi-professional team.

Attitude↗

PubMed2003

Does a new undergraduate curriculum based on Tomorrow's Doctors prepare house officers better for their first post? A qualitative study of the views of pre-registration house officers using critical incidents.

INTRODUCTION: In 1994 Manchester University introduced an integrated undergraduate medical course using problem-based learning (PBL) throughout. The study reported here explored whether there were any differences between the new course graduates (NCGs) and the traditional course graduates (TCGs) in the types of scenarios they recalled as 'critical incidents', or challenging cases, while working as pre-registration house officers (PRHOs). The focus is on differences rather than causal links. METHOD: We used semistructured interviews to generate our data. Twenty-four traditional course graduates and 23 new course graduates were interviewed approximately 3 months after starting their first PRHO placement. RESULTS: We identified 4 types of critical incidents relating to: clinical practice; limitations of competence; emotional involvement; and communication. Traditional course graduates reported difficulties in making patient management decisions, whereas the NCGs were better at dealing with uncertainty, knowing their limits and asserting their rights for support. Communication difficulties and coping with emotional involvement were common across both groups of graduates and hence remain problems in relation to being prepared for the role of a PRHO. CONCLUSIONS: Graduates of the new, integrated curriculum seemed to be much better at dealing with uncertainty, knowing their personal limits and asserting their rights for support when they felt these limits had been reached. Communication difficulties and emotional involvement remain major factors in the transition from student to PRHO.

Clinical Competence↗

PubMed2002

Perceptions of how well graduates are prepared for the role of pre-registration house officer: a comparison of outcomes from a traditional and an integrated PBL curriculum.

INTRODUCTION: Most medical schools in the UK have been engaged in major curriculum reform based on their premises of what might improve undergraduate medical education. In 1994 the course at the medical school of the University of Manchester changed to an integrated course using problem-based learning throughout and with increased emphasis on community-based medical education. This study explores whether the new curriculum has produced any differences in perceptions of how well graduates are prepared for the role of pre-registration house officer. METHODS: A postal questionnaire was used to survey 1998 Manchester graduates (traditional course) and 1999 Manchester graduates (new course), three months into their first pre-registration house officer placement. A similar questionnaire was sent to the educational supervisors who were supervising the graduates. The questionnaire was designed to measure perceptions of levels of preparedness for the role of pre-registration house officer, using a list of broad areas of competence and specific skills listed in the General Medical Council's 'The New Doctor'. RESULTS: Graduates rated the new course significantly more effective for 12 of the 19 broad competences and eight of the 13 specific skills that were listed. The 'new' graduates rated their understanding of disease processes lower than the 'traditional' graduates, but there was no difference in the ratings given by the educational supervisors for this. Overall the educational supervisors rated the new course as better preparing graduates in five of the competences. CONCLUSIONS: Overall, the evaluation shows that a major change in curriculum approach has changed the profile of the perceived preparedness of graduates for entering professional practice.

Clinical Competence↗

PubMed2002

Student access and use of IT during general practice attachments.

As universities change the delivery of their medical undergraduate courses, many have started to develop the community as a learning resource. In Manchester, part of the rationale behind problem-based learning is that students become familiar with the tools for finding information. Within the medical school and its main teaching hospitals, students have access to varied information resources using IT. These are often less available from off-campus sites and particularly within general practice. Even where available, students may not use them. Initial evaluation suggests that IT facilities are particularly useful for students who have longer placements. However, students prioritize their use of time in the community and furnishing general practices with a computer and other IT equipment does not, in itself, promote use by the students unless there is a perceived need. Training and support within the practice needs to be undertaken to enhance the learning environment for the undergraduates.

Computer Literacy↗

PubMed2002

A model of how students link problem-based learning with clinical experience through "elaboration".

PURPOSE: In 1994, the medical school at the University of Manchester introduced a new integrated course that uses problem-based learning (PBL) throughout the clinical clerkships as the major approach for delivery of the core curriculum. This study explored how students linked PBL and clinical experiences. METHOD: All third- and fourth-year students were asked to respond to an open-ended question on the end-of-module course evaluation. Their responses were analyzed and grouped into themes. The authors also conducted three focus groups of third-year students and a further three focus groups of fourth-year students to explore how students viewed the links between PBL and clinical experiences. The discussions were taped and subsequently analyzed by the researchers independently. RESULTS: The authors found that the students used clinical experience as a means of elaborating their knowledge either at the time of encountering an appropriate patient (outside the group) or by bringing their experiences back to the PBL group for discussion (inside the group). Major facilitators of elaboration were the match between the clinical clerkship and the content of the PBL case, the role of the tutor, and the self-directedness of the student. A theoretical model of how students linked PBL with their clinical experience was derived based on a cognitive psychological approach to learning. CONCLUSIONS: The model will be of benefit as the authors try to improve the course for those students who were unable to use their clinical experiences to achieve the goals of their PBL discussions.

Clinical Clerkship↗