Gillian Laven

Impact of undergraduate and postgraduate rural training, and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors

Objective  To determine the association between rural undergraduate training, rural postgraduate training and medical school entry criteria favouring rural students, on likelihood of working in rural Australian general practice.

Developing and evaluating the GriefLink web site: processes, protocols, dilemmas and lessons learned

Despite a profusion of recommendations regarding the quality of web sites and guidelines related to ethical issues surrounding health-related sites, there is little guidance for the design and evaluation of sites relating to loss and grief. This article, which addresses these deficiencies, results from a community consultation process of designing and evaluating a web site—GriefLink—for bereaved consumers and for the professionals who help them. It presents the literature review that informed the project, the recommendations for design and content, the lessons learned through the process itself, and the difficulties of evaluating the benefits of a grief-related web site. Some ethical and legal dilemmas in developing grief-related web sites are discussed and issues of design, content, process, evaluation, and general features are addressed, which may also be applied to other communication forms for loss and grief matters, such as the print media.

Student non‐completion of an undergraduate degree: wrong program selection or part of a career plan?

Institution wide comparisons of students who leave university before completing their degree and students who complete their studies, have identified ‘wrong course selection’ and a lack of vocational focus as common reasons for non‐completion. It is not fully understood, though, whether these trends are constant across different disciplines and programs and whether all relevant contributing factors, in particular career intentions, have been considered. This study was undertaken to explore reasons for student non‐completion in more detail in one program. Students enrolled in an undergraduate health sciences degree completed a questionnaire at enrolment and another 12 months later, regarding their reasons for enrolment, career intentions and expectations for/experiences of learning. Students who did not re‐enrol after the first year were invited to complete a separate exit questionnaire regarding their reasons for not re‐enrolling. Many students who did not re‐enrol after the first year of study transferred to another degree that was more aligned with their career intentions. In this context rather than a ‘wrong’ selection, non‐completion of the initial undergraduate degree formed part of a career plan.

How was the intern year?: self and clinical assessment of four cohorts, from two medical curricula

BackgroundProblem-based curricula have provoked controversy amongst educators and students regarding outcome in medical graduates, supporting the need for longitudinal evaluation of curriculum change. As part of a longitudinal evaluation program at the University of Adelaide, a mixed method approach was used to compare the graduate outcomes of two curriculum cohorts: traditional lecture-based ‘old’ and problem-based ‘new’ learning.MethodsGraduates were asked to self-assess preparedness for hospital practice and consent to a comparative analysis of their work-place based assessments from their intern year. Comparative data were extracted from 692 work-place based assessments for 124 doctors who graduated from the University of Adelaide Medical School between 2003 and 2006.ResultsSelf-assessment: Overall, graduates of the lecture-based curriculum rated the medical program significantly higher than graduates of the problem-based curriculum. However, there was no significant difference between the two curriculum cohorts with respect to their preparedness in 13 clinical skills. There were however, two areas where the cohorts rated their preparedness in the 13 broad practitioner competencies as significantly different: problem-based graduates rated themselves as better prepared in their ‘awareness of legal and ethical issues’ and the lecture-based graduates rated themselves better prepared in their ‘understanding of disease processes’.Work-place based assessment: There were no significant differences between the two curriculum cohorts for ‘Appropriate Level of Competence’ and ‘Overall Appraisal’. Of the 14 work-place based assessment skills assessed for competence, no significant difference was found between the cohorts.ConclusionsThe differences in the perceived preparedness for hospital practice of two curriculum cohorts do not reflect the work-place based assessments of their competence as interns. No significant difference was found between the two cohorts in relation to their knowledge and clinical skills. However results suggest a trend in ‘communication with peers and colleagues in other disciplines’ (χ2 (3, N = 596) =13.10, p = 0.056) that requires further exploration. In addition we have learned that student confidence in a new curriculum may impact on their self-perception of preparedness, while not affecting their actual competence.