Explore the vast range of titles available.

Simulation has been widely adopted in medical education. Traditionally, the design of simulation activities was through a hierarchical approach where experts within a specialty contributed to the development of content and assessment processes. Whilst this has proved to be a reliable method, the effectiveness from the perspective of students has rarely been examined. The Ward Simulation Exercise (WSE) was delivered in the final six months of the undergraduate medical curriculum at the University of Dundee. It was designed to assess the capabilities of medical students to prioritise competing demands and work collaboratively within a simulated environment. Students were observed by two assessors (normally consultants), who determined whether the student had met the required standard or not. The University of Dundee WSE was unique – no comparable assessment could be identified in the literature. This thesis examined whether the WSE enhanced or inhibited the development of student self-knowledge. In the context of this thesis, self-knowledge can be considered as the aggregation of wisdom derived from internal and external stimuli that informs a substantial comprehension of one’s character, values, abilities, aptitudes, attitudes and emotions (Cassam, 2014). The literature (which varied in rigour and quality and was not extensive) reported that simulations predominantly assessed a singular skill and that student voice was rarely appreciated within this process. There was scant evidence that the medical profession engaged with the concept of student self-knowledge. WSE assessment data from 2010, 2012 and 2014 were analysed using a mixed methods approach. The qualitative aspects utilised Grounded Theory and Cluster Analysis to better understand the lived experience of students and determine the reliability of the assessment from the student perspective. The students’ perspective was contrasted with that of the assessors. In total, 412 data sets (87%) from the first run of the WSE and 127 data sets (89%) from the second run met the inclusion criteria. In all years the WSE was a reliable form of assessment. The professional role of an assessor and their gender influenced whether they felt a student had met the required standard or not. Analysis identified where the opinion of students differed from that of assessors. Recurring themes related to the submissive role that students experienced during the WSE and the hierarchical nature of the assessment. This thesis is one of the first research studies to examine student self-knowledge within medical education. The medical profession arguably needs to be more inclusive of students within curriculum design and assessment. Empowering students could challenge hierarchical practices and address an expectation for a more transactional approach to education. This could allow students to develop self-knowledge appropriate to their stage of professional development.

The authors report final-year ward simulation data from the University of Dundee Medical School. Faculty who designed this assessment intend for the final score to represent an individual senior medical student’s level of clinical performance. The results are included in each student’s portfolio as one source of evidence of the student’s capability as a practitioner, professional, and scholar. Our purpose in conducting this study was to illustrate how assessment designers who are creating assessments to evaluate clinical performance might develop propositions and then collect and examine various sources of evidence to construct and evaluate a validity argument. The data were from all 154 medical students who were in their final year of study at the University of Dundee Medical School in the 2010–2011 academic year. To the best of our knowledge, this is the first report on an analysis of senior medical students’ clinical performance while they were taking responsibility for the management of a simulated ward. Using multi-facet Rasch measurement and a generalizability theory approach, we examined various sources of validity evidence that the medical school faculty have gathered for a set of six propositions needed to support their use of scores as measures of students’ clinical ability. Based on our analysis of the evidence, we would conclude that, by and large, the propositions appear to be sound, and the evidence seems to support their proposed score interpretation. Given the body of evidence collected thus far, their intended interpretation seems defensible.

BackgroundThere is an acknowledged performance gap that students experience when transiting from academia to practice.1 Mentorship is a core component of undergraduate teaching and is a catalyst for academic success and productivity.2 We present findings from a pilot study designed to support the transition from undergraduate study to becoming a Foundation Doctor (FD). The Medical Mentorship Programme (MMP) supports the professional development of final year medical students via a programme of clinical mentorship and simulation based workshops.MethodologyThe authors explored the perceptions of a ‘gap’ with FD’s within NHS Tayside. FD’s completed a short anonymous questionnaire which asked them to critique their experiences of becoming a doctor. The results of this questionnaire informed the development of the MMP. MMP consists of 3 workshops:Preparing to be a Mentor (For FD’s only)Improving your Clinical PracticeBecoming an Effective Practitioner7 FD’s were recruited to this pilot study and trained to become mentors. Each FD was allocated 2–3 medical students. These mentorship groups attended a programme of simulation workshops. To encourage skill transference, mentors then conducted teaching shifts within their clinical area. We examined the effectiveness of this approach using a modified capabilities and transference questionnaire which gathered data at specific time intervals.3Expected resultsThe pilot study will conclude in June 2014. We anticipate that the construct of the mentorship group will have a positive impact on a student’s professional development. We expect that FD’s will recognise the importance of effective mentorship.ConclusionMMP has been designed to improve the confidence and capabilities of senior medical students and subsequently to be better prepared to become FD’s. Our institution and external organisations are keen to explore the possibility of rolling this model out to increase patient safety, and work efficiency particularly during the early transition phase.ReferencesYardley S, Irvine A, Lefroy J. Minding the gap between communication skills simulation and authentic experience. Medical Education 2013;47:495–510Sambunjak D, Straus S, Marušic´ A. Mentoring in Academic Medicine: A Systematic Review. JAMA 2006;296(9):1103–1115The Canadian Society for Training and Development. Investing In People: Tools and Resources. [Accessed 03.06.14]

Previous research examining causal explanations to achievement outcomes has illustrated that individuals consistently make attributions to factors internal to themselves following winning and attributions to factors external to themselves following losing. Two explanations of this common pattern of attributions exist. One explanation assumes that individuals process information in an essentially logical fashion by assessing the relative impact of various elements and attributing the occurrence to those elements with which the outcome covaries. A second explanation assumes that individuals have a need to maintain self-esteem and suggests that by attributing success to internal factors and failure to external factors, individuals enhance and protect their ego or self-esteem. It has been noted that the magnitude of this motivational effect depends on the extent to which concern for self-esteem or ego-involvement is aroused. Male college undergraduates (n = 136), enrolled in introductory racquetball courses at a major university, participated in a field study designed to compare the information-processing approach with the self-serving approach to explaining causal attributions. Data permitting a comparison between the two competing explanations were collected from individuals participating in a racquetball game under high or low levels of ego-involvement. The ego-involvement levels were induced by varying the importance of the racquetball game to the individual. Players were asked to provide expectancies and feelings of ego-involvement prior to the game and causal attributions, perceptions of performance, and affective reactions following the game. Pretests indicated that the game importance manipulation effectively induced disparate levels of ego-involvement while not influencing the individual's expectancy. Multivariate multiple regression indicated that outcome causal attributions were based on the individual's perception of his performance and not on the level of ego-involvement. Individuals who won and perceived their performance as high attributed to internal factors while those who perceived their performance as low attributed the win to external factors regardless of the level of ego-involvement. In terms of the losing outcome, individuals who perceived their performance as low attributed the outcome to internal factors while those who perceived their performance as high attributed the loss to external factors regardless of the level of ego-involvement. Further analyses revealed that individuals who perceived their performance as high felt more competent and were more satisfied with their performance than individuals who perceived their performance as low, regardless of whether they won or lost. From these results, it was argued that individuals make logical attributions when both objective outcome and perceived performance were taken into consideration. It was also evident that perceived performance was a much more salient mediator of outcome causal attributions than was level of ego-involvement. The results of the present study provide support for the logical, information-processing approach as the most salient method to explaining causal attributions.