Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion.

Background: Development of diagnostic reasoning (DR) is fundamental to medical students' training, but assessing DR is challenging. Several written assessments focus on DR but lack the ability to dynamically assess DR. Oral assessment formats have strengths but have largely lost favour due to concerns about low reliability and lack of standardization.

Tensions in post-examination feedback: information for learning versus potential for harm.

Objective: Self-regulation is recognised as being a requisite skill for professional practice This study is part of a programme of research designed to explore efficient methods of feedback that improve medical students' ability to self-regulate their learning. Our aim was to clarify how students respond to different forms and content of written feedback and to explore the impact on study behaviour and knowledge acquisition.

Methods: Year 2 students in a 4-year graduate entry medical programme completing four formative progress tests during the academic year were randomised into three groups receiving different feedback reports.

Beyond Selection: The Use of Situational Judgement Tests in the Teaching and Assessment of Professionalism.

Problem: Professionalism is a critical attribute of medical graduates. Its measurement is challenging. The authors sought to assess final-year medical students' knowledge of appropriate professional behavior across a broad range of workplace situations.

The effectiveness of the internship in meeting established learning objectives: A qualitative study.

Objective: To identify and explore variations in intern (Postgraduate Year 1 doctors) exposure to clinical activities defined by an established early postgraduate curriculum within the contemporary health service environment.

Methods: A mixed methods study was undertaken in seven health services comprising (1) a questionnaire regarding interns' exposure to a range of clinical activities within a two-year early post-graduate curriculum and (2) group interviews with intern supervisors and managers to explore barriers and facilitators of interns' clinical exposure.

Results: One hundred and eleven interns completed the questionnaire and seventeen intern supervisors and managers participated in group interviews.

Medical Teachers' Humanistic Perspective on Pedagogy: A New Starting Point for Faculty Development.

Introduction: This study investigated the perspectives on pedagogy held by medical teachers in hospitals.

Methods: The teachers were interviewed after they had been observed in both clinical and classroom settings.

Results: The study showed the teachers' reliance on the relational aspects of pedagogy more than on technical pedagogical knowledge.

Medical student stories of participation in patient care-related activities: the construction of relational identity.

Professional identity formation is acknowledged as one of the fundamental tasks of contemporary medical education. Identity is a social phenomenon, constructed through participation in everyday activities and an integral part of every learning interaction. In this paper we report from an Australian ethnographic study into how medical students and patients use narrative to construct their identities.

Medical school benchmarking - from tools to programmes.

Background: Benchmarking among medical schools is essential, but may result in unwanted effects.

Aim: To apply a conceptual framework to selected benchmarking activities of medical schools.

Methods: We present an analogy between the effects of assessment on student learning and the effects of benchmarking on medical school educational activities.

Conducting patient assessments as a medical student: frequency, barriers, and facilitators.

Background: Opportunities for medical students to engage in deliberate practice through conducting patient assessments may be declining, but data on the numbers of patients assessed by students during training are lacking.

Purposes: The study described relationships between the frequency of patient assessments, student confidence, belief they had seen sufficient patients, and their perceptions of barriers and facilitators of seeing patients.

Methods: We employed survey methodology to estimate the number of patient assessments conducted across 6 rotations in the 1st year of clinical training, gather ratings of confidence and student belief they had conducted sufficient patient assessments, and barriers and facilitators of seeing patients.

An approach to neck pain for the family physician.

Background: Neck pain is a common presentation in general practice. Nevertheless, recommendations for the investigation and management of neck pain lack a strong evidence base and are predominantly extrapolated from low back pain studies.

Objective: This review provides an investigation and treatment paradigm to help primary care physicians assess and manage cervical spine pain.

Adverse outcomes associated with elective knee arthroscopy: a population-based cohort study.

Purpose: The aims of this study were to quantify the frequency of adverse outcomes after elective knee arthroscopies in Victoria, Australia, and to identify risk factors associated with adverse outcomes.

Methods: We performed a retrospective, longitudinal cohort study of elective orthopaedic admissions using the Victorian Admitted Episodes database, a routinely collected public and private hospital episodes database linked to death registry data, from July 1, 2000, to June 30, 2009. Adverse outcome measures included pulmonary embolism (PE), deep vein thrombosis (DVT), hemarthrosis, effusion and synovitis, cellulitis, wound infection, synovial fistula, acute renal failure, myocardial infarct, stroke, and death.

Trends in elective knee arthroscopies in a population-based cohort, 2000-2009.

Objective: To assess the use of elective knee arthroscopy procedures for all adults 20 years and older, and for adults with a concomitant diagnosis of osteoarthritis (OA) in Victoria.

Design, Setting And Patients: Retrospective, longitudinal cohort study of 807 030 elective orthopaedic admissions using routinely collected public and private hospital data from 1 July 2000 to 30 June 2009.

Main Outcome Measure: Trends in rates of elective knee arthroscopy in the time period (defined as a statistically significant change in the incident rate ratio for each financial year with respect to the reference year).

The requirement for bioscience knowledge in medical education.

The recent 100-year anniversary of the Flexner review and the release of the Australian Medical Education Study have stimulated vigorous debate about the role of bioscience knowledge in medical education. Two critical questions define debate in this area: does bioscience learning assist in educating medical students to become competent doctors, and, if so, what are the most effective teaching and learning methods to facilitate this outcome? There is tacit acceptance that specific bioscience knowledge is critical for the development of clinical expertise; however, there are few empirical data to support this notion. Two differing theories have been proposed to describe the role of bioscience learning in the development of clinical reasoning skills - the "two-worlds" model and the "encapsulation" model.

Clinical assessment performance of graduate- and undergraduate-entry medical students.

Background: Recent evidence suggests that graduate-entry medical students may have a marginal academic performance advantage over undergraduate entrants in a pre-clinical curriculum in both bioscience knowledge and clinical skills assessments. It is unclear whether this advantage is maintained in the clinical phase of medical training.

Aim: The study aimed to compare graduate and undergraduate entrants undertaking an identical clinical curriculum on assessments undertaken during clinical training in the medical course.