Wonca ws ece maja


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Wonca ws ece maja

  1. 1. Early clinical exposure in primary care – an experience from Slovenia Marija Petek Šter Janko Kersnik Department for family medicine University of Ljubljana Slovenia Department for family medicine University of Maribor Slovenia Corresponding author: marija.petek-ster@mf.uni-lj.si
  2. 2. Fieldwork • Interview with nursing home residents: • Six to eight nursing homes in a neighborhood of the Medical faculty - contraction with Medical faculty • Nursing home staff: rules of behavior, ethical principals • Students in pairs: one of the student performing a semi-structured one-hour interview according to the instructions and the second one is an observer • After the first interview with the first patients, the role with the second patient was changed (an observer became an interviewer)
  3. 3. Clinical visit • One day attachment in general practice • General practices all over Slovenia (chosen by the student, tutors trained in giving feedback) • Student is an observer of GPs’ work and communication • Protocols for observation (20 consultations)
  4. 4. Assessment • Students have to pass theoretical and practical part of the exam. Each part contributes 50% of final mark. • Theoretical part: MCQ questions (60% of points) • Practical part: seminar and analysis of the communication at office visit (written, oral), criteria for evaluation was prepared in advance
  5. 5. Students feedback • During the curriculum: we appreciated students’ oral feedback • At the end of the curriculum: students’ written feedback with the evaluation of the overall curricula and parts of the curricula using evaluation form (Likert scale from 1 to 5) • Students’ feedback is of most importance for future improvement of the curriculum
  6. 6. Students’ feedback and assessment of the curriculum – overall • Students’ assessed ECE as of outmost important for their personal and professional development • They found that good relationship is important part of treatment • They would like to have more practical work and opportunity for communication
  7. 7. Students’ feedback and assessment of the curricula – interview with nursing home residents • Fears that their skills of communication is inadequate (welcome and respect by the staff and patients) • Emphatic relationship with the elderly • They found that elderly people are much more positive and more vital in their mind that they thought before • An opportunity to learn from life experiences of elderly people
  8. 8. Students’ feedback and assessment of the curricula – office visit • White coat – they observed themselves as future physicians • They found that the physicians’ work is complex with many dilemmas • Motivation for future study • Confirmed that decision to become physician is appropriate
  9. 9. Teachers’ and tutors’ experiences Positive experiences: • feasible to organize: enthusiasm of the staff in nursing homes and offices • acceptable to patients: most of the patients find the ECE as important and participate in the curriculum, • educationally effective: students greatelly valid their extensive contact with patients Evaluation: subjective in assessing of practical part of the curricula
  10. 10. Dilemmas • Inadequate knowledge and experiences in communication • Personal immaturity: problems with acceptance of professional and ethical norms • Interview with elderly nursing home residents is too demanding (no knowledge about the characteristics of residents, problem with empathy, dealing with emotional reactions, ethical issues)