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David B Swanson - One of the best experts on this subject based on the ideXlab platform.
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The impact of Postgraduate Training and timing on USMLE Step 3 performance.
Academic Medicine, 2003Co-Authors: Amy J Sawhill, Gerard F Dillon, Douglas R Ripkey, Richard E Hawkins, David B SwansonAbstract:AbstractPurpose.This study examined the extent to which differences in clinical experience, gained in Postgraduate Training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE).Method.Subjects in the study were 36,805 U.S. and Canadian medical school grad
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The impact of Postgraduate Training and timing on USMLE Step 3 performance.
Academic medicine : journal of the Association of American Medical Colleges, 2003Co-Authors: Amy J Sawhill, Gerard F Dillon, Douglas R Ripkey, Richard E Hawkins, David B SwansonAbstract:This study examined the extent to which differences in clinical experience, gained in Postgraduate Training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE). Subjects in the study were 36,805 U.S. and Canadian medical school graduates who took USMLE Step 3 for the first time between November 1999 and December 2002. Regression analyses examined the relation between length and type of Postgraduate Training and Step 3 score after controlling for prior performance on previous USMLE examinations. Results indicate that Postgraduate Training in programs that provide exposure to a broad range of patient problems, and continued Training in such areas, improves performance on Step 3. Study data reaffirm the validity of the USMLE Step 3 examination, and the information found in the pattern of results across specialties may be useful to residents and program directors.
Jan C. C. Borleffs - One of the best experts on this subject based on the ideXlab platform.
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vertical integration in medical school effect on the transition to Postgraduate Training
Medical Education, 2010Co-Authors: Marjo Wijnenmeijer, Olle Ten Cate, Marieke Van Der Schaaf, Jan C. C. BorleffsAbstract:OBJECTIVES Recently, many medical schools' curricula have been revised so that they represent vertically integrated (VI) curricula. Important changes include: the provision of earlier clinical experience; longer clerkships, and the fostering of increasing levels of responsibility. One of the aims of vertical integration is to facilitate the transition to Postgraduate Training. The purpose of the present study is to determine whether a VI curriculum at medical school affects the transition to Postgraduate Training in a positive way. METHODS We carried out a questionnaire study among graduates of six medical schools in the Netherlands, who had followed either a VI or a non-VI curriculum. Items in the questionnaire focused on preparedness for work and Postgraduate Training, the time and number of applications required to be admitted to residency, and the process of making career choices. RESULTS In comparison with those who have followed non-VI programmes, graduates of VI curricula appear to make definitive career choices earlier, need less time and fewer applications to obtain residency positions and feel more prepared for work and Postgraduate Training. CONCLUSIONS The curriculum at medical school affects the transition to Postgraduate Training. Additional research is required to determine which components of the curriculum cause this effect and to specify under which conditions this effect occurs.
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The influence of a vertically integrated curriculum on the transition to Postgraduate Training.
Medical teacher, 2009Co-Authors: Marjo Wijnen-meijer, Olle Ten Cate, Jany Rademakers, Marieke Van Der Schaaf, Jan C. C. BorleffsAbstract:Background: Recently, many medical curricula have been changed into vertically integrated programmes. One of the aims of vertical integration is to facilitate the transition from theoretical to clinical education and from medical school to Postgraduate Training. Aims: The aim of this study was to determine whether a vertically integrated curriculum affects the transition from medical school to Postgraduate Training. Method: We carried out a survey study among graduates of two cohorts of the Utrecht Medical School, who followed either the traditional or the innovative, vertically integrated, curriculum. Topics of the questionnaire were: (a) activities since medical school, (b) required amount of time and number of applications to get admitted to residency, (c) the process of making career choices. Results: Graduates from the vertically integrated curriculum had made their definite career choice earlier compared to those who followed a traditional programme. Graduates of the new curriculum also needed less time and fewer applications to obtain a residency position. Conclusions: A vertically integrated curriculum at medical school positively affects the transition to Postgraduate Training. Additional research, among a larger population, is required to determine which components of the curriculum cause this effect and to specify under which conditions these effect occurs.
Amy J Sawhill - One of the best experts on this subject based on the ideXlab platform.
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The impact of Postgraduate Training and timing on USMLE Step 3 performance.
Academic Medicine, 2003Co-Authors: Amy J Sawhill, Gerard F Dillon, Douglas R Ripkey, Richard E Hawkins, David B SwansonAbstract:AbstractPurpose.This study examined the extent to which differences in clinical experience, gained in Postgraduate Training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE).Method.Subjects in the study were 36,805 U.S. and Canadian medical school grad
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The impact of Postgraduate Training and timing on USMLE Step 3 performance.
Academic medicine : journal of the Association of American Medical Colleges, 2003Co-Authors: Amy J Sawhill, Gerard F Dillon, Douglas R Ripkey, Richard E Hawkins, David B SwansonAbstract:This study examined the extent to which differences in clinical experience, gained in Postgraduate Training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE). Subjects in the study were 36,805 U.S. and Canadian medical school graduates who took USMLE Step 3 for the first time between November 1999 and December 2002. Regression analyses examined the relation between length and type of Postgraduate Training and Step 3 score after controlling for prior performance on previous USMLE examinations. Results indicate that Postgraduate Training in programs that provide exposure to a broad range of patient problems, and continued Training in such areas, improves performance on Step 3. Study data reaffirm the validity of the USMLE Step 3 examination, and the information found in the pattern of results across specialties may be useful to residents and program directors.
C. P.m. Van Der Vleuten - One of the best experts on this subject based on the ideXlab platform.
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Acquisition of communication skills in Postgraduate Training for general practice
Medical Education, 2004Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, J.j.m. Jansen, Richard Ptm Grol, C. P.m. Van Der VleutenAbstract:PURPOSE: The evidence suggests that a longitudinal Training of communication skills embedded in a rich clinical context is most effective. In this study we evaluated the acquisition of communication skills under such conditions. METHODS: In a longitudinal design the communication skills of a randomly selected sample of 25 trainees of a three-year Postgraduate Training programme for general practice were assessed at the start and at the end of Training. Eight videotaped real life consultations were rated per measurement and per trainee, using the MAAS-Global scoring list. The results were compared with each other and with those of a reference group of 94 experienced GPs. RESULTS: The mean score of the MAAS-Global was slightly increased at the end of Training (2.4) compared with the start (2.2). No significant difference was found between the final results of the trainees and the reference group. According to the criteria of the rating scale the performance of both trainees and GPs was unsatisfactory. CONCLUSION: The results of this study indicate that communication skills do not improve in a three-year Postgraduate Training comprising both a rich clinical context and a longitudinal Training of communication skills, and that an unsatisfactory level still exists at the end of Training. Moreover, GPs do not acquire communication skills during independent practice as they perform comparably to the trainees. Further research into the measurement of communication skills, the teaching procedures, the role of the GP-trainer as a model and the influence of rotations through hospitals and the like, is required.
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Effect of extension of Postgraduate Training in general practice on the acquisition of knowledge of trainees
Family practice, 2003Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, Richard Ptm Grol, Koos J. J. M. Jansen, C. P.m. Van Der VleutenAbstract:BACKGROUND: Postgraduate Training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of competence. OBJECTIVE: Our aim was to investigate whether 3 years of Postgraduate Training in general practice leads to a higher level of knowledge than 2 years Training while maintaining the same structure and educational objectives. METHODS: This retrospective study had a mixed longitudinal design. Trainees of the Dutch Postgraduate Training in general practice participated. Knowledge was assessed by written progress testing of knowledge relevant to general practice embedded in real life situations. Test results were collected from 1992 to 1999. The results of trainees who received the 2-year and 3-year curriculum were compared. RESULTS: Both curricula started with the same entrance level and showed the largest acquisition of knowledge at the start and towards the end of Training. Both curricula showed stagnation in growth at the end of the Training period in which trainees rotate through hospitals, nursing homes and mental health institutions. The level of knowledge at the end of Training was significantly higher for the 3-year curriculum. CONCLUSION: This study shows that Postgraduate Training contributes to an increase in knowledge and that a 3-year programme leads to a higher level of knowledge than a 2-year programme. The stagnation in growth found at the end of rotations through hospitals, nursing homes and mental health institutions questions the impact of these rotations on the development of competence and the efficacy of the Training as a whole. Further study is needed to draw more firm conclusions.
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Acquisition of clinical skills in Postgraduate Training for general practice.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, C. P.m. Van Der Vleuten, Koos J. J. M. Jansen, Richard Ptm GrolAbstract:BACKGROUND: Postgraduate Training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of clinical skills. AIM: To assess the acquisition of clinical skills during a 3-year Training programme and to evaluate whether a satisfactory level is achieved towards the end of Training. DESIGN OF STUDY: Cross-sectional design. SETTING: Dutch Postgraduate Training in general practice from 1995 to 1998. METHOD: Clinical skills were assessed using a written knowledge test of skills and by an Objective Structured Clinical Examination (OSCE). The written test was administered to trainees in all 3 years. Trainees at completion of their Training took the OSCE. The results of both tests were compared with a standard of adequacy and to a reference group of general practitioner (GP) trainers. RESULTS: An increase in the level of clinical skills and pass rate was found throughout the Training, being most prominent during the first 6 months. At completion of their Training, trainees scored higher than the GPs on the written test (48% versus 39%) and on the OSCE (69% versus 63%). Eighty-eight per cent of the trainees would have passed the written test against 70% of the GPs and 94% would have passed the OSCE against 80% of the GPs. CONCLUSION: A 3-year Postgraduate Training period in general practice contributes to a satisfactory acquisition of clinical skills. Further research into when and where acquisition takes place, and the role of the GP trainer, is needed.
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Selection for Postgraduate Training for general practice: the role of knowledge tests.
The British journal of general practice : the journal of the Royal College of General Practitioners, 1997Co-Authors: Y.d. Van Leeuwen, C. P.m. Van Der Vleuten, Richard Ptm Grol, S.j. Mol, M. Pollemans, M.j. DropAbstract:BACKGROUND: Postgraduate Training for general practice is a legal requirement in most countries of the European Community, and includes posts in general practice as well as in hospitals. The effectiveness of the Training has not been fully evaluated, and it is largely unknown whether the results are satisfactory or what the impact of the separate Training components is--nor is it known which characteristics or prior achievements of the trainee influence the end-of-Training performance. AIM: To determine the value of knowledge tests in the context of entry selection for Postgraduate Training in general practice. METHODS: Three (equated) knowledge tests were administered during the two years' Postgraduate Training of 85 Dutch trainees. The first test was taken at entrance, the second eight months later, and the third shortly before the end of the entire Training period. Complete data for 57 trainees were available for analysis. A multiple regression analysis was performed to estimate the predictive values of test 1 and test 2 scores, separately and in combination, for test 3 scores. Since the knowledge test may be used for selection purposes, the analysis was repeated using logistic regression with two pass/fail criteria: a 'minimum criterion' and an 'excellence criterion'. RESULTS: Neither of the two analyses yielded a predictive value of test 1 that was high enough to warrant the use of knowledge tests in the context of entry selection. A 'below minimum' score on test 2 correlated 100% with a 'below minimum' score on test 3. However, the positive predictive value of an above minimum score on test 2 was only 86%. CONCLUSIONS: The knowledge tests used in this study are not suitable in the context of entry selection. However, trainees that score 'below minimum' after eight months of Training may be regarded as 'at risk' in that they will probably score 'below minimum' at the end of Training.
A. W.m. Kramer - One of the best experts on this subject based on the ideXlab platform.
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Acquisition of communication skills in Postgraduate Training for general practice
Medical Education, 2004Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, J.j.m. Jansen, Richard Ptm Grol, C. P.m. Van Der VleutenAbstract:PURPOSE: The evidence suggests that a longitudinal Training of communication skills embedded in a rich clinical context is most effective. In this study we evaluated the acquisition of communication skills under such conditions. METHODS: In a longitudinal design the communication skills of a randomly selected sample of 25 trainees of a three-year Postgraduate Training programme for general practice were assessed at the start and at the end of Training. Eight videotaped real life consultations were rated per measurement and per trainee, using the MAAS-Global scoring list. The results were compared with each other and with those of a reference group of 94 experienced GPs. RESULTS: The mean score of the MAAS-Global was slightly increased at the end of Training (2.4) compared with the start (2.2). No significant difference was found between the final results of the trainees and the reference group. According to the criteria of the rating scale the performance of both trainees and GPs was unsatisfactory. CONCLUSION: The results of this study indicate that communication skills do not improve in a three-year Postgraduate Training comprising both a rich clinical context and a longitudinal Training of communication skills, and that an unsatisfactory level still exists at the end of Training. Moreover, GPs do not acquire communication skills during independent practice as they perform comparably to the trainees. Further research into the measurement of communication skills, the teaching procedures, the role of the GP-trainer as a model and the influence of rotations through hospitals and the like, is required.
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Effect of extension of Postgraduate Training in general practice on the acquisition of knowledge of trainees
Family practice, 2003Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, Richard Ptm Grol, Koos J. J. M. Jansen, C. P.m. Van Der VleutenAbstract:BACKGROUND: Postgraduate Training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of competence. OBJECTIVE: Our aim was to investigate whether 3 years of Postgraduate Training in general practice leads to a higher level of knowledge than 2 years Training while maintaining the same structure and educational objectives. METHODS: This retrospective study had a mixed longitudinal design. Trainees of the Dutch Postgraduate Training in general practice participated. Knowledge was assessed by written progress testing of knowledge relevant to general practice embedded in real life situations. Test results were collected from 1992 to 1999. The results of trainees who received the 2-year and 3-year curriculum were compared. RESULTS: Both curricula started with the same entrance level and showed the largest acquisition of knowledge at the start and towards the end of Training. Both curricula showed stagnation in growth at the end of the Training period in which trainees rotate through hospitals, nursing homes and mental health institutions. The level of knowledge at the end of Training was significantly higher for the 3-year curriculum. CONCLUSION: This study shows that Postgraduate Training contributes to an increase in knowledge and that a 3-year programme leads to a higher level of knowledge than a 2-year programme. The stagnation in growth found at the end of rotations through hospitals, nursing homes and mental health institutions questions the impact of these rotations on the development of competence and the efficacy of the Training as a whole. Further study is needed to draw more firm conclusions.
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Acquisition of clinical skills in Postgraduate Training for general practice.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003Co-Authors: A. W.m. Kramer, H. Düsman, L. H.c. Tan, C. P.m. Van Der Vleuten, Koos J. J. M. Jansen, Richard Ptm GrolAbstract:BACKGROUND: Postgraduate Training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of clinical skills. AIM: To assess the acquisition of clinical skills during a 3-year Training programme and to evaluate whether a satisfactory level is achieved towards the end of Training. DESIGN OF STUDY: Cross-sectional design. SETTING: Dutch Postgraduate Training in general practice from 1995 to 1998. METHOD: Clinical skills were assessed using a written knowledge test of skills and by an Objective Structured Clinical Examination (OSCE). The written test was administered to trainees in all 3 years. Trainees at completion of their Training took the OSCE. The results of both tests were compared with a standard of adequacy and to a reference group of general practitioner (GP) trainers. RESULTS: An increase in the level of clinical skills and pass rate was found throughout the Training, being most prominent during the first 6 months. At completion of their Training, trainees scored higher than the GPs on the written test (48% versus 39%) and on the OSCE (69% versus 63%). Eighty-eight per cent of the trainees would have passed the written test against 70% of the GPs and 94% would have passed the OSCE against 80% of the GPs. CONCLUSION: A 3-year Postgraduate Training period in general practice contributes to a satisfactory acquisition of clinical skills. Further research into when and where acquisition takes place, and the role of the GP trainer, is needed.