Professional Skills – Response to Student Feedback



To: Med 1 students

From: Meredith McKague, Course Coordinator MED 105

Date: Feb 12 2010

Re: Professional Skills – Response to Student Mid-Term Feedback

Thank-you very much for taking the time to provide mid-term feedback on the Professional Skills course. I appreciate your feedback and will try to incorporate it to improve the course.

This response to some of your comments and suggestions is also available to view on the Curriculum Committee wiki at

Summarized below are some of the key issues I heard from you and my responses to try to act on your suggestions:

Overall:

Your overall response to the course is positive and you commented that you value what you are learning in the course. You particularly commented positively on small group work especially with the patient volunteers.

Communication Skills

• Your overall response to this module was positive, especially the small group sessions.

• Your class gave mixed feedback about the large group session. We only had one large group session prior to Communication Basics, which provided an overview of types of communication skills (content, process and perceptual) and the patient-centred approach. Some people gave positive feedback and requested more large group sessions on particular topics; others said they were not very valuable.

Response:

You have a series of 4 more large group sessions coming up in March 2010 prior to the Advanced Communication Module. Topics are (1) Communicating with elderly patients/ families/ with a language barrier; (2) Breaking bad news; (3) Coping with anger and other difficult emotions; (4)Communicating about relationship and sexual behaviour. For those who prefer to learn outside of the classroom, I will make these available as podcasts with powerpoint presentations on One45. Just a reminder that attendance at large group sessions is not mandatory, and attendance at small group sessions is mandatory.

One student commented that the text was too detailed but my handout for the Communication Skills Intro session was too brief. I can provide more detail on my handouts in the Advance Communication Skills large group session in March.

One or two students asked for video demonstrations of a medical interview. A resource developed at U of Toronto has demonstration interviews and is available to you for free at:



Please note that you will have further large and small group Communication Skills session in 3rd year.

Physical Examination Modules:

Main suggestions for change relate to:

• having more time available to practice your physical examination skills, both on your own/ with classmates as well as with preceptors.

Response:

I will request that the College of Medicine provide a receptionist to be available in order to keep the CLRC open some evenings throughout the year in order to allow you more time for practice on your own/ with classmates. It is unlikely that this would be possible this year, but hopefully may be available to you in the future.

We will arrange to have a tutor/ patient volunteer available in the CLRC two afternoons per week to answer questions/ give you an opportunity to practice and receive feedback about physical examination skills you are uncertain about. We will attempt to institute these “Drop-in Practice Sessions” for the final 3 weeks of Physical Exam C. Further details will come by e-mail.

• Greater standardization of teaching content and techniques between different small group tutors

Response:

This is a challenge. We strongly encourage all tutors to attend the tutor orientation sessions we offer, in order to help standardize the teaching approach and content. Because tutors have busy clinical schedules it is difficult to make orientation sessions mandatory (we likely would not be able to get enough tutors if we did this). We include a detailed resource package for tutors about what they are supposed to teach, and how.

Different physicians do have different approaches to the interview and physical exam techniques, and many different approaches are equally valid. I can assure you that on the OSCE, any valid approach will be accepted in the marking scheme for each station.

Several students expressed concerns that you would like reassurance that the interviewing or physical exam techniques you are learning are valid. The “Drop-in Practice Sessions” described above will hopefully address some of these concerns.

• Not enough time to do a full interview and physical examination on the final week of the module.

Response:

It is important to review and practice your interviewing throughout the year. It is also important to recognize that your physical examination is linked to, and influenced by, what you learn from your patient during the interview. In physical exam C, we normally have each student complete a full interview and head-to-toe screening physical examination each of the last two weeks. That makes the interview and physical exam pretty rushed.

This year, we will change the structure of Physical Exam C so that two students in the group do a full interview and head-to-toes examination the 3rd week, and two students do the same the 4th week. The students who are not doing the interview/ physical examination will be able to observe, and give feedback to, their peer. This will allow you more time, and also allow more time for you to practice “presenting” your patient’s findings, as well as to receive patient/ peer/ preceptor feedback at the end of the session.

• Individual and group feedback from tutors was really valued. Some of you requested more feedback in your small groups.

Response:

During our tutor orientations and in tutor orientation materials, we will continue to emphasize the need for lots of constructive feedback.

Informatics

• Feedback from the majority of students was positive about the module, including the opportunity to practice in small group sessions. Some students who already have had extensive literature searching experience reported that the small group sessions felt redundant.

Response:

I will share this feedback with the Informatics Instructors.

In the past the Informatics instructors have tried asking student to self-identify as “novice, intermediate or experienced” in their use of the search engines and then organized groups accordingly to try to make it more challenging for experienced users. However, they found that the students didn’t do a great job of self-assessing their expertise and often over-estimated or under-estimated their competence at literature searching.

I will confer with the Informatics instructors about any other ways that students who are experienced might be “screened” at the start of the year (for e.g. students who have already taken an Informatics course might challenge the assignments at the start of the year, and if they pass the assignments then have the option to opt out of the small group sessions.) Any other suggestions you have would be appreciated.

Ethics

• Feedback was generally very positive.

I will share feedback with Dr. Ogle for his consideration

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