General emergency medicine skills for rural doctors.
Explore the source record for details and available documents.
Alberta↗
Biomedical subjects
Wayne Woloschuk
Publications and source records attributed to Wayne Woloschuk.
Career preferences of new medical students at four Australian universities: rural family medicine versus the rest.
Explore the source record for details and available documents.
Adult↗
Does blueprint publication affect students' perception of validity of the evaluation process?
CONTEXT: A major goal of any evaluation is to demonstrate content validity, which considers both curricular content as well as the ability expected of learners. Whether evaluation blueprints should be published and the degree of blueprint transparency is controversial. OBJECTIVES: To examine the effect of blueprint publication on students' perceptions of the validity of the evaluation process. METHODS: This study examined students' attitudes towards the Renal Course evaluation before and after blueprint publication. There was no significant change in the course objectives, blueprint or evaluation between the two time periods. Students' attitudes were evaluated using a questionnaire containing four items related to evaluation. Also collected were the overall course ratings, minimum performance level (MPL) for evaluations and students' performance on each exam. RESULTS: There were no significant differences in the MPL or evaluation scores between the two time periods. A significantly greater proportion of students perceived that the Renal Course evaluation was a fair test and was reflective of both important subject matter and the delivered curriculum. The increased satisfaction process did not appear to be a reflection of their overall satisfaction with the course as there was a trend towards reduced overall satisfaction with the course. CONCLUSIONS: Publication of the evaluation blueprint appears to improve students' perceptions of the validity of the evaluation process. Further studies are required to identify the reasons for this attitude change. We propose that blueprint transparency drives both instructors teaching and student learning towards key educational elements.
Alberta↗
Preparedness for rural community leadership and its impact on practice location of family medicine graduates.
OBJECTIVE: To identify non-clinical dimensions of preparedness for rural practice and to determine whether preparedness for rural practice is predictive of rural practice location. DESIGN: Cross-sectional postal survey mailed in 2001. SETTING: Communities across Canada where graduates were practising. SUBJECTS: Graduates (n = 369) of the family medicine residency program at the universities of Alberta (U of A) and Calgary (U of C) between 1996 and 2000, inclusive. INTERVENTIONS: Using a 4-point scale, graduates rated the extent to which the residency program prepared them for eight dimensions of rural practice: clinical demands of rural practice, understanding rural culture, small community living, balancing work and personal life, establishing personal/professional boundaries, becoming a community leader, handling a 'fish bowl' lifestyle, and choosing a suitable community. MAIN OUTCOME MEASURE: Identification of non-clinical dimensions of preparedness for rural practice and whether scores on preparedness scales are predictive of rural practice location. RESULTS: The overall response rate was 76.4%. Factor analysis of the eight preparedness items produced two factors, 'rural culture' and 'rural community leader' which explained 72% of the variance. The alpha coefficient for each factor was 0.87. Odds ratios revealed that family medicine graduates prepared for rural community leadership roles were 1.92 (CI = 1.03-3.61) times more likely to be in rural practice. Rural physicians were also 2.14 (CI = 1.13-4.03) times as likely to have a rural background. CONCLUSIONS: Preparedness to be a rural community leader and having a rural background were predictive of rural practice. Educators should consider this in both family medicine residency admissions policy and practice and when designing and implementing family medicine residency curricula.
Adult↗
Career choice of new medical students at three Canadian universities: family medicine versus specialty medicine.
BACKGROUND: Over the last 10 years the number of medical students choosing family medicine as a career has steadily declined. Studies have demonstrated that career preference at the time that students begin medical school may be significantly associated with their ultimate career choice. We sought to identify the career preferences students have at entry to medical school and the factors related to family medicine as a first-choice career option. METHODS: A questionnaire was administered to students entering medical school programs at the time of entry at the University of Calgary (programs beginning in 2001 and 2002), University of British Columbia (2001 and 2002) and University of Alberta (2002). Students were asked to indicate their top 3 career choices and to rank the importance of 25 variables with respect to their career choice. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choice were also calculated. A logistic regression was performed using career choice (family v. other) as the criterion variable and the factors plus demographic characteristics as predictor variables. RESULTS: Of 583 students, 519 (89%) completed the questionnaire. Only 20% of the respondents identified family medicine as their first career option, and about half ranked family medicine in their top 3 choices. Factor analysis produced 5 factors (medical lifestyle, societal orientation, prestige, hospital orientation and varied scope of practice) that explained 52% of the variance in responses. The 5 factors demonstrated acceptable internal consistency and correlated in the expected direction with the choice of family medicine. Logistic regression revealed that students who identified family medicine as their first choice tended to be older, to be concerned about medical lifestyle and to have lived in smaller communities at the time of completing high school; they were also less likely to be hospital oriented. Moreover, students who chose family medicine were much more likely to demonstrate a societal orientation and to desire a varied scope of practice. INTERPRETATION: Several factors appear to drive students toward family medicine, most notably having a societal orientation and a desire for a varied scope of practice. If the factors that influence medical students to choose family medicine can be identified accurately, then it may be possible to use such a model to change medical school admission policies so that the number of students choosing to enter family medicine can be increased.
Adult↗
Do students from rural backgrounds engage in rural family practice more than their urban-raised peers?
INTRODUCTION: In a previous prospective study, students from rural backgrounds were found to be significantly more likely to consider rural practice than their urban-raised peers. The purpose of this study was to determine whether the students with rural backgrounds who participated in the original investigation were more likely than their urban-raised peers to be currently engaged in rural family practice. METHOD: In Canada, family doctors have the greatest opportunity to practise in rural communities. Consequently, rural and urban background students from the original study who entered the discipline of family medicine as a career were identified for practice location follow-up. Participants were categorised as either rural (population less than 10 000) or urban practitioners according to the population of the community in which they practised. The proportion of rural and urban background students engaged in rural or urban practice was analysed using chi-square and relative risk probability. RESULTS: A total of 78 students from the original cohort were found to be practising family medicine; 22 of them had been rurally raised. Seven (32%) of the rural background students were practising in a rural community, compared to 7 (13%) of the 56 urban background students (RR = 2.55; P < 0.05). CONCLUSIONS: Rural background students who went on to complete family medicine residency training were approximately 2.5 times more likely to be engaged in rural practice than their urban-raised peers. Altering medical school admission policy to recruit more rural background applicants should be part of a multi-dimensional approach to increasing the number of rural practitioners.
Canada↗
Attitude change during medical school: a cohort study.
BACKGROUND: Attitudes influence behaviour. Developing and maintaining proper attitudes by medical students can impact on the quality of health care delivered to their patients as they assume the role of doctors. There is a paucity of longitudinal research reports on the extent to which students' attitude scores shift as they progress through medical school. OBJECTIVE: This study examined the change in attitude scores of a large student cohort as they progressed through medical school. Whether student gender is related to attitude change was also investigated. METHOD: Medical students from 3 consecutive classes (1999-2001) participated in this study. Students completed 2 instruments that included the Attitudes Toward Social Issues in Medicine and an in-house tool referred to as the Medical Skills Questionnaire. The instruments were administered at 3 milestones during the course of medical school training (entry, end of preclinical training and end of clerkship). RESULTS: Reliability estimates for total (0.82-0.91) and subscale (0.41-0.81) attitudinal scores were in the acceptable range. Multivariate analyses of variance of mean attitudinal scores indicated a persistent decline in several attitude scores as students progressed through the medical educational programme. Females demonstrated higher attitude scores than males. CONCLUSIONS: As students progress through medical school their attitude scores decline. The reasons for the shift in attitude scores are not clear but they may relate to a ceiling of high attitude scores at entry, loss of idealism and the impact of the unintended curriculum. Further study of the impact of medical education on student attitudes is warranted.
Adult↗
Retention of basic science knowledge: a comparison between body system-based and clinical presentation curricula.
BACKGROUND: When the University of Calgary implemented the clinical presentation (CP) curriculum in 1994, it was prospectively decided to administer the National Board of Medical Examiner's Comprehensive Basic Science Exam (CBSE) as a measure of students' basic science knowledge retention. PURPOSE: The exam performance from 2 classes (1995, 1996) of the previous system-based (SB) curriculum was compared to exam performance of 2 classes (2000, 2002) of the CP curriculum. METHODS: Data analyses employed 2 statistical models (covariate multiple linear regression and hierarchical mixed effects), and effect sizes were computed. RESULTS: Differences between CBSE mean scores produced by students from the SB and CP curricula showed a curricular effect on students' retention of basic science knowledge. However, preexisting differences between groups were found to be in the small-to-medium range. CONCLUSION: Evidence supporting the potential of schemes within a CP curriculum and their relation to basic science knowledge retention was observed. Effect size for the CP curriculum on students' retention of basic science knowledge was substantial; however, a notable part of that difference can be accounted for by extraneous and confounding factors. Further research utilizing more rigorous designs to investigate the relation between schemes and basic science retention is warranted.
Alberta↗
Does a rural educational experience influence students' likelihood of rural practice? Impact of student background and gender.
CONTEXT: The family medicine clerkship at the University of Calgary is a 4-week mandatory rotation in the final year of a 3-year programme. Students are given the opportunity to experience rural practice by training at 1 of several rural practices. OBJECTIVE: To determine whether exposure to a rural educational experience changes students' likelihood of doing a rural locum or rural practice and whether student background and gender are related to these practice plans. METHOD: Clinical clerks from the Classes of 1996-2000, who trained at rural sites, responded to questionnaire items both before and after the rural educational experience. Responses to the questionnaire items and discipline of postgraduate training served as dependent variables. Student background and gender were independent variables. RESULTS: As a result of the rural educational experience all students were more likely to do a rural locum. Compared to their urban-raised peers, students from rural backgrounds reported a significantly greater likelihood of doing a rural locum and practising in a rural community, irrespective of gender or participating in a rural educational experience. There was no relationship between background and career choice. CONCLUSION: A rural educational experience at the undergraduate level increases the stated likelihood of students participating in rural locums and helps to solidify existing rural affiliations. Students with rural backgrounds have a more favourable attitude toward rural practice. This pre-post study provides further support for the preferential admission to medical school of students with rural backgrounds to help alleviate the rural physician shortage.
Alberta↗
Where Canadian family physicians learn procedural skills.
BACKGROUND AND OBJECTIVES: Little is known about where family physicians learn procedural skills. In this study, we examine where Canadian family medicine graduates learned to do the procedures they perform. METHODS: In 2001, a cross-sectional postal survey was conducted of the 369 family medicine graduates from the University of Alberta and the University of Calgary between 1996 - 2000. From a list of 31 procedures, respondents identified procedures regularly performed over the past 2 years and indicated which procedures they had stopped performing. Respondents indicated whether the procedures performed were learned primarily during medical school and residency, through formal skills training following residency, or in the practice setting. RESULTS: The 282 (76.4% response rate) respondents reported performing a mean of 10.5 (SD=5.3) procedures. The vast majority reported learning procedural skills in medical school or during family medicine residency training (91.1%), followed by the clinical practice setting (12.6%), then formal skills training (6.4%). Those in rural practice learned a relatively greater proportion of procedural skills through formal skills training. CONCLUSIONS: For Canadian family physicians, procedural skill acquisition occurs across the learning continuum. Medical schools and residency training programs play a role in facilitating the learning of procedural skills and supporting self-directed learning.
Adult↗