iPURSE 2016

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https://ir.lib.pdn.ac.lk/handle/20.500.14444/40

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Browsing iPURSE 2016 by Author "Alwis, S.B."

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    Developing a self-appraisal tool for intern medical officers in Sri Lanka
    (University of Peradeniya, 2016-11-05) Mudiyanse, R.M.; Pallegama, R.; Alwis, S.B.; Olupeliyawa, A.; Marambe, K.; Chandratilake, M.; Krupat, E.
    Medical graduates are expected to have a wide spectrum of competencies that extend beyond knowledge and skills. Current practices of evaluation in medical education do not support assessment of the entire spectrum of competencies, hindering the possible drive of assessment for learning and teaching, resulting in marginalized attention to competencies other than knowledge and skills. The practice of compulsory workplace based assessment during internship, which assesses all doctors during a period of six months by a senior consultant, would provide valuable feedback to medical faculties. Therefore, developing a comprehensive tool for appraisal of intern doctors was undertaken. A tool for appraisal of competencies was developed by three stages. Initially, a 30-item tool was developed following a literature review. Secondly, it was refined by expert opinion and thirdly, further improvement after field-testing and discussion with stakeholders was done. The research team further refined the checklist to 20-items after several informal focus group discussions. A suitable guide to express responses in a Likert scale was developed. The items in the final tool includes: demonstrating and applying basic and clinical sciences knowledge; history taking and examination skills; managing emergencies, non-emergency patient management of common conditions, procedural skills related to patient care; written communication skills, solving non-medical problems, communication with patients, parents and relatives; showing empathy and compassion for patients, showing respect for patients and other health care workers; effective collaboration with the team, interest in non-medical activities, administrative and managerial skills; teaching students, colleagues, and other health workers; research, audit and critical thinking skills; commitment for work, commitment for further learning, acknowledging own limitations and seeking help when appropriate; and taking responsibilities according to the role as an intern. The appraisal checklist was administered to 540 intern doctors as filed testing. Results show a segregation of items into 4 groups: core knowledge, psychosocial aspects, scholarship and commitment for work. Results of this study were presented to a forum representing all the medical faculties, the Sri Lanka Medical Council (SLMC) and the Ministry of Health. The workshop participants evaluated the tool and modified items and suggested developing a shorter version with 18 items with evaluation of feasibility and expression of personal opinion. A useful tool for self-appraisal of intern medical officers’ competencies was developed that could be used for appraisal on intern doctors’ performances. Information gathered could be utilized to monitor teaching programs in medical faculties. This study is limited only to self-appraisal, but the real value of the tool would be harnessed only when a supervisor completes it after the observation of performance as a doctor over a period of time.
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    Patient centered attitudes of Sri Lankan medical graduates assessed by Patient Practitioner Orientation Scale (PPOS)
    (University of Peradeniya, 2016-11-05) Mudiyanse, R.M.; Pallegama, R.; Alwis, S.B.; Olupeliyawa, A.; Marambe, K.; Chandratilake, M.; Krupat, E.
    Patient centeredness is a trainable attribute for health care professionals that could be influenced positively as well as negatively by the undergraduate curriculum. Patient centeredness denotes compassionate and respectful delivery of care, adopting a parallel position in sharing information and collaborative planning. The value of such an approach with regard to patient satisfaction, cost effectiveness, therapeutic efficacy and doctor satisfaction has been documented. Assessment of patient centeredness of doctors becomes valuable for research and evaluation of educational interventions. The objective of this study was to determine patient centeredness among graduates of six medical faculties in Sri Lanka, just before they start practicing. The validated Sinhala version of the patient practitioner orientation scale (PPOS), which is a widely used, validated, 18 itemed, self-reporting instrument that measures the caring and sharing attitudes, was used. The questionnaire was administered to 1200 doctors who had received appointments as interns in June 2013, at a common lecture at the beginning of internship. Participants were given the choice of selecting either the Sinhala or English version of the PPOS. Fifty six percent were females. The average sharing, caring and total PPOS values were 3.00(0.66), 2.4(0.67) and 2.7(0.589). Sharing, caring and total PPOS values for females and males were 2.97(0.65), 2.33(0.63), 2.65(0.55) and 3.05(0.68), 2.49 (0.72) and 2.77(0.61) respectively. Sharing, caring and total PPOS values for the top 1/3 in merit order and the bottom 1/3 in merit order were 3.05 (0.47), 2.26(0.51), 2.65 (0.36) and 2.99(0.77), 2.39(0.76) and 2.69(0.68) respectively. After eliminating 4 faculties with a very small number of respondents sharing, caring and total PPOS values for foreign graduates, medical faculties with highest and lowest PPOS scores were 3.26 (0.75), 2.67(0.46), 2.78 0.56) and 3.09(0.84), 2.48(0.88) 2.78(0.78) and 2.81(0.57), 2.13(0.52) and 2.48(0.57) respectively. Overall, PPOS values of Sri Lankan medical graduates are lower than that observed in medical graduates in western countries and slightly higher than those graduating from Nepal, Pakistan and India. A Higher PPOS value among foreign graduates is a notable observation even though it is not statistically significant. A Lower PPOS value seen among females is also an unusual finding compared with the international literature which consistently documents higher PPOS values among females.