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					TUNING PROJECT (MEDICINE)

    INTERIM ANALYSIS OF SURVEY
          QUESTIONNAIRE
              May 2006

http://www.surveymonkey.com/s.asp?u=814901931463
     INTERIM ANALYSIS OF SURVEY
           QUESTIONNAIRE
                  1st May 2006
• 279 responses since 10th April 2006

ACADEMICS 162
GRADUATES 49
EMPLOYERS 7

• All member states apart from Estonia, Greece,
  Hungary, Latvia, Luxembourg, Malta, Slovenia
29. Where are you located?

Austria                                 23
Belgium                                 15
Czech Republic                           1
Denmark                                  7
Estonia                                  0
Finland                                  2
France                                   1
Germany                                  1
Greece                                   0
Hungary                                  0
Ireland                                  1
Italy                                    4
Latvia                                   0
Lithuania                                1
Luxembourg                               0
Malta                                    0
Netherlands                              5
Poland                                  18
Portugal                                 3
Slovakia                                76
Slovenia                                 0
Spain                                   30
Sweden                                   5
UK                                      35

Bulgaria                                1
Croatia                                 1
Former Yugoslav Republic of Macedonia   0
Romania                                 1
Turkey                                  8

Switzerland                             0
Iceland                                 0
Norway                                  1
30. Which category of respondent describes you best?

Academic                                                              162
Medical Graduate                                                       49
Medical student                                                        10
Other (please specify)                                                 10
Employer of medical graduates                                           7
Patient                                                                 1


31. What kind of role(s) do you carry out in your organisation?

ACADEMIC - Academic responsibility for a medical curriculum           36
ACADEMIC - Academic responsibility for part of a medical curriculum   40
ACADEMIC - Teacher in a medical curriculum (non-clinical)             64
ACADEMIC - Teacher in a medical curriculum (clinical)                 78
ACADEMIC - Administrative support for medical teaching                10
ACADEMIC - Administrative support for student exchange                 1
ACADEMIC - Educational support for medical teaching                   35
ACADEMIC - other                                                       7
MEDICAL GRADUATE - less than 5 years since graduation                 28
MEDICAL GRADUATE - more than 5 years since graduation                 41
EMPLOYER of medical graduates - health service manager                 2
EMPLOYER of medical graduates - clinician                             11
EMPLOYER of medical graduates - other                                  4
MEDICAL STUDENT - pre-clinical                                         4
MEDICAL STUDENT - clinical                                             7
Other (please specify)                                                12
1. Please rate these Tuning generic competences for importance for graduates from a primary medical degree programme (MBChB or equivalent). GRADUATES SHOULD
HAVE THE FOLLOWING COMPETENCES:
                                                                                                   NI              QI            VI           E            Ave
capacity to learn (including lifelong self-directed learning)                                       0              10            84         168             3.6
ability to solve problems                                                                           2              15            76         172            3.58
probity (honesty maintaining good practice)                                                         0              19            79         162            3.55
capacity for applying knowledge in practice                                                         2              16            90         154            3.51
ability to make decisions                                                                           0              19            92         149             3.5
ability to recognise limits and ask for help                                                        0              26            79         152            3.49
ethical commitment                                                                                  1              31            87         141            3.42
critical and self-critical abilities                                                                2              31           111         117            3.31
concern for quality                                                                                 2              31           119         105            3.27
capacity to adapt to new situations                                                                 0              41           132          86            3.17
interpersonal skills                                                                                1              47           116          94            3.17
empathy                                                                                             3              43           127          87            3.15
ability to work in a multidisciplinary team                                                         1              53           111          95            3.15
capacity for analysis and synthesis                                                                 1              37           140          78            3.15
ability to communicate with experts in other fields                                                 3              60           133          62            2.98
ability to work autonomously                                                                        6              64           132          61            2.94
capacity for organisation and planning (including time management)                                  6              79           136          38             2.8
appreciation of diversity and multiculturality                                                    16               81           104          53            2.76
knowledge of a second language                                                                    31               75            98          57            2.69
will to succeed                                                                                   17               97           112          32            2.62
ability to teach others                                                                           16              108           107          29            2.57
basic general knowledge OUTSIDE medicine                                                          19              133            77          31            2.46
understanding of cultures and customs of other countries                                          23              120            96          21            2.44
ability to lead others                                                                            23              132            90          16            2.38
initiative and entrepreneurial spirit                                                             30              115            97          14            2.37
research skills                                                                                   34              122            85          18            2.34
creativity                                                                                        35              115            97          13            2.34
ability to work in an international context                                                       35              120            88          13            2.31
ability to design and manage projects                                                             44              123            84           9            2.22
     1. Please rate these Tuning generic competences for importance for graduates from a primary medical degree
     programme (MBChB or equivalent). GRADUATES SHOULD HAVE THE FOLLOWING COMPETENCES:
                                                                   Tuning    NI        QI         VI         E    Ave
1    capacity to learn (including lifelong self-directed learning)      3     0        10         84       168     3.6
2    ability to solve problems                                                2        15         76       172    3.58
3    probity (honesty maintaining good practice)                              0        19         79       162    3.55
4    capacity for applying knowledge in practice                        5     2        16         90       154    3.51
5    ability to make decisions                                         12     0        19         92       149     3.5
6    ability to recognise limits and ask for help                             0        26         79       152    3.49
7    ethical commitment                                                13     1        31         87       141    3.42
8    critical and self-critical abilities                               6     2        31        111       117    3.31
9    concern for quality                                                      2        31        119       105    3.27
10   capacity to adapt to new situations                                7     0        41        132        86    3.17
11   interpersonal skills                                              14     1        47        116        94    3.17
12   empathy                                                                  3        43        127        87    3.15
13   ability to work in a multidisciplinary team                       10     1        53        111        95    3.15
14   capacity for analysis and synthesis                                2     1        37        140        78    3.15
15   ability to communicate with experts in other fields                      3        60        133        62    2.98
16   ability to work autonomously                                             6        64        132        61    2.94
17   capacity for organisation and planning                                   6        79        136        38     2.8
18   appreciation of diversity and multiculturality                    17   16         81        104        53    2.76
19   knowledge of a second language                                    15   31         75         98        57    2.69
20   will to succeed                                                        17         97        112        32    2.62
21   ability to teach others                                                16        108        107        29    2.57
22   basic general knowledge OUTSIDE medicine                           1   19        133         77        31    2.46
23   understanding of cultures and customs of other countries               23        120         96        21    2.44
24   ability to lead others                                                 23        132         90        16    2.38
25   initiative and entrepreneurial spirit                                  30        115         97        14    2.37
26   research skills                                                   11   34        122         85        18    2.34
27   creativity                                                         4   35        115         97        13    2.34
28   ability to work in an international context                            35        120         88        13    2.31
29   ability to design and manage projects                                  44        123         84         9    2.22
3. Please rate the following competences/learning outcomes in terms of importance for medical graduates and for the practice of
medicine in Europe immediately after graduation.


                                                                                   NI       QI        VI        E         Ave


Abililty to carry out a consultation with a patient (history, examination ...)     1         7        55      190         3.72
Ability to provide immediate care of medical emergencies including First Aid
                                                                                   1        13        70      168         3.61
and resuscitation
Ability to apply ethical and legal principles in medical practice                  1        26        93      131         3.41
Ability to assess clinical presentations order investigations make differential
                                                                                   1        31        90      131         3.39
diagnoses and negotiate a management plan
Ability to communicate effectively in a medical context                            4        29       110      109         3.29
Ability to carry out practical procedures (e.g. venepuncture)                      7        40       103      103         3.19
Ability to assess psychological and social aspects of a patient's illness          5        41       117       89         3.15
Ability to apply the principles skills and knowledge of evidence-based medicine    5        41       124       80         3.12
Ability to prescribe drugs                                                         8        52        99       93         3.1
Ability to apply scientific principles method and knowledge to medical practice
                                                                                   3        59       116       74         3.04
and research
Ability to use information and information techology effectively in a medical
                                                                                   3        53       144       51         2.97
context
Ability to work effectively in a health care system and engage with population
                                                                                   10       69       111       63         2.9
health issues
5. Please rate these competences under the heading "Ability to carry out a
consultation with a patient".
                                                                                          NI        QI        VI        E             Ave
Ability to take a history                                                                 0         11        43       190            3.73
Ability to carry out physical examination                                                 2          8        51       183             3.7
Ability to make clinical judgements and decisions                                         3         11        93       137            3.49
Ability to provide explanation and advice                                                 3         23       109       110            3.33
Ability to assess the patient's mental state                                              3         27       119        96            3.26
Ability to provide reassurance and support                                                3         34       123        84            3.18


6. Please rate these competences under the heading "Ability to assess clinical presentations order investigations make differential
diagnoses and negotiate a management plan".
                                                                                         NI         QI         VI      E              Ave
Ability to recognise and assess the severity of clinical presentations                    1        14          92     136             3.49
Ability to make differential diagnoses                                                    2        14         106     122             3.43
Ability to order appropriate investigations and interpret the results                     1        21         113     109             3.35
Ability to negotiate an appropriate management plan with patients and carers              3        48         114      76             3.09


7. Please rate these competences under the heading "Ability to provide immediate care of medical emergencies including First Aid and
resuscitation". Graduates should be able to carry out the following according to current European guidelines -
                                                                                          NI      QI         VI      E           Ave
Ability to recognise and assess acute medical emergencies                                  0       4         49     189          3.76
Ability to provide basic First Aid                                                         1       8         41     193          3.75
Ability to provide Basic Life Support and Cardio-Pulmonary Resuscitation according to
                                                                                           1      12         57     172          3.65
European guidelines
Ability to treat acute medical emergencies                                                 2      19        100     120           3.4
Ability to provide Advanced Life Support according to European guidelines                  9      52        101      80          3.04
Ability to provide trauma care according to European ATLS guidelines                      16      58        103      64          2.89
8. Please rate these competences under the heading "Ability to prescribe drugs".
                                                                                          NI   QI   VI     E    Ave
Ability to match appropriate drugs to the clinical context                                2    30   98    112   3.32
Ability to prescribe clearly and accurately                                               5    31   98    108   3.28
Ability to review the appropriateness of medication and evaluate the potential benefits
                                                                                          5    37   98    101   3.22
and risks
Ability to prescribe drugs to treat pain and distress                                     3    52   99    87    3.12


9. Please rate these competences under the heading "Ability to communicate
effectively in a medical context".
                                                                                          NI   QI    VI    E    Ave
Ability to communicate with patients                                                      1    11    49   182    3.7
Ability to communicate with colleagues                                                    0    18   102   123   3.43
Ability to communicate orally                                                             0    23   103   117   3.39
Ability to communicate in breaking bad news                                               3    29   110    98   3.26
Ability to communicate with relatives                                                     2    34   109    98   3.25
Ability to communicate in writing (including medical records where patient has access
                                                                                          2    33   121   87    3.21
to them)
Ability to communicate with disabled people                                               3    40   113   84    3.16
Ability to communicate in seeking informed consent                                        1    52   104   83    3.12
Ability to communicate by telephone                                                       4    71    97   73    2.98
Ability to communicate in dealing with aggression                                         5    60   113   65    2.98
Ability to communicate with those who require an interpreter                              9    81   106   46    2.78
10. Please rate these competences under the heading "Ability to carry out
practical procedures (e.g. venepuncture)".
                                                                                   NI   QI   VI     E    Ave
Ability   to measure blood pressure                                                6    22   43    172   3.57
Ability   to carry out venepuncture                                                5    31   64    143   3.42
Ability   to carry out subcutaneous and intramuscular injection                    9    35   75    123   3.29
Ability   to administer oxygen                                                     5    43   93    103    3.2
Ability   to carry out cannulation of veins                                        8    50   88    94    3.12
Ability   to adminster IV therapy and use infusion devices                         7    56   79    98    3.12
Ability   to carry out electrocardiography                                         22   60   81    79     2.9
Ability   to carry out suturing                                                    12   72   85    70    2.89
Ability   to carry out bladder catheterisation                                     18   65   89    71    2.88
Ability   to carry out blood transfusion                                           29   64   66    83    2.84
Ability   to move and handle patients                                              19   80   86    56    2.74
Ability   to carry out urinalysis                                                  33   79   74    56    2.63
Ability   to carry out respiratory function tests                                  33   95   71    43    2.51


11. Please rate these competences under the heading "Ability to assess
psychological and social aspects of a patient's illness".
                                                                                   NI   QI    VI   E     Ave
Ability   to assess psychological factors in presentations and impact of illness   3    54   120   62    3.01
Ability   to detect stress in relation to illness                                  4    65   111   60    2.95
Ability   to detect alcohol and substance abuse dependency                         4    61   120   54    2.94
Ability   to assess social factors in presentations and impact of illness          5    68   122   44    2.86
12. Please rate these competences under the heading "Ability to apply scientific
principles method and knowledge to medical practice and research".
                                                                                       NI    QI    VI   E     Ave
Ability to apply scientific principles to the practice of medicine                      3    50   104   84    3.12
Ability to analyse and disseminate experimental results                                52    95    77   18    2.25
Ability to design research experiments                                                 68   110    54    8    2.01
Ability to carry out practical laboratory research procedures                          94    98    41    8    1.85


13. Please rate these competences under the heading "Ability to apply the principles
skills and knowledge of evidence-based medicine".
                                                                                       NI    QI    VI   E     Ave
Ability to apply evidence to practice                                                   6    44   123   66    3.04
Ability to define and carry out an appropriate literature search                        8    52   102   76    3.03
Ability to critical appraise published medical literature                               7    56   109   65    2.98
Ability to generate evidence through clinical audit                                    17    84   113   21    2.59
Ability to apply statistical analysis to data                                          35   112    76   15     2.3


14. Please rate these competences under the heading "Ability to use information and
information techology effectively in a medical context".
                                                                                       NI   QI     VI    E    Ave
Ability to use computers                                                               2    23     73   143   3.48
Ability to keep accurate and complete clinical records                                 3    18     91   127   3.43
Ability to access information sources                                                  1    23     96   121    3.4
Ability to store and retrieve information                                              4    42    103    91   3.17
15. Please rate these competences under the heading "Ability to apply ethical and
legal principles in medical practice".
                                                                                        NI   QI    VI    E    Ave
Ability to maintain confidentiality                                                      1   20    53   165    3.6
Ability to apply ethical principles and analysis to clinical care                        3   16    75   147   3.52
Ability to certify death                                                                 8   34    63   132   3.35
Ability to obtain and record informed consent                                            3   47    96    93   3.17
Ability to apply national and European law to clinical care                              7   47   100    87   3.11
Ability to request autopsy                                                              23   65    91    59   2.78
Ability to provide evidence to a court of law                                           33   88    87    31   2.49


16. Please rate these competences under the heading "Ability to work effectively in a
health care system and engage with population health issues".
                                                                                        NI   QI   VI     E    Ave
Ability to provide patient care which minimises the risk of harm to patients            1    16   89    136   3.49
Ability to apply measures to prevent the spread of infection                            2    19   94    127   3.43
Ability to recognise own health needs and ensure own health does not interfere with
                                                                                        5    53   87    93    3.13
professional responsibilities
Ability to conform with professional regulation and certification to practise           4    46   106   81    3.11
Ability to receive and provide professional appraisal                                   6    63   115   55    2.92
Ability to make informed career choices                                                 9    78   117   33    2.73
18. Please rate these knowledge outcomes under the heading "Basic Sciences". The most relevant biomedical disciplines are indicated in
brackets although in some integrated curricula they may not be learned by students under these headings. Graduates should be able to
demonstrate knowledge of (in man) -
                                                                                        NI        QI      VI       E          Ave
Normal function (physiology)                                                             0        14      67      153         3.59
Normal structure (anatomy)                                                               1        37      81      116         3.33
Normal body metabolism and hormonal function (biochemistry)                              4        50      97       84         3.11
Normal immune function (immunology)                                                      2        51     110       72         3.07
Normal cell biology                                                                     15        84      81       54         2.74
Normal molecular biology                                                                21        89      81       43         2.62
Normal human development (embryology)                                                   25        97      73       40         2.54


19. Please rate these knowledge outcomes under the heading "Behavioural and
social sciences" Graduates should be able to demonstrate knowledge of -
                                                                                      NI        QI        VI       E          Ave
Psychology                                                                             1        75       110       48         2.88
Human development (child/adolescent/adult)                                             8        83        97       46         2.77
Sociology                                                                             22       111        75       26         2.45


20. Please rate these topics under the heading "Clinical Sciences" Graduates
should be able to demonstrate knowledge of -
                                                                                      NI        QI        VI        E         Ave
Abnormal structure and mechanisms of disease (pathology)                              0         16        84       135        3.51
Infection (microbiology)                                                              2         18       114        99        3.33
Immunity and immunological disease                                                    1         51       109        74        3.09
Genetics and inherited disease                                                        7         67       103        58         2.9
21. Please rate these knowledge outcomes under the heading "Drugs and
prescribing". Graduates should be able to demonstrate knowledge of -
                                                                                         NI   QI     VI    E    Ave
use of antibiotics and antibiotic resistance                                             0    14    110   111   3.41
principles of prescribing                                                                3    33     81   118   3.34
drug side effects                                                                        0    36    123    77   3.17
drug action and pharmacokinetics                                                         3    48     97    87   3.14
use of blood transfusion and blood products                                              6    53     84    92   3.11
drug interactions                                                                        2    44    121    67   3.08
individual drugs                                                                         7    71    104    51   2.85
the different types of complementary and alternative medicine and their use in patient
                                                                                         48   116   52    17    2.16
care


22. Please rate these knowledge outcomes under the heading "Public Health".
Graduates should be able to demonstrate knowledge of -
                                                                                         NI    QI    VI   E     Ave
disease prevention                                                                        1    33   119   80    3.19
lifestyle diet and nutrition                                                              4    50   117   63    3.02
screening for disease and disease surveillance                                            4    65   122   43    2.87
health promotion                                                                          9    69   108   49    2.84
epidemiology                                                                              6    80   102   47    2.81
disability                                                                                6    85   111   32    2.72
gender issues relevant to health care                                                    12   103    90   29    2.58
cultural and ethnic influences on health care                                            16   109    79   31    2.53
resource allocation and health economics                                                 19   123    73   17    2.38
global health and inequality                                                             32   108    75   18    2.34
23. Please rate these knowledge outcomes under the heading "Ethical and legal
principles in medical practice". Graduates should be able to demonstrate
                                                                                    NI   QI   VI     E    Ave
rights of patients                                                                  0    37   84    112   3.32
rights of disabled people                                                           1    51   89     92   3.17
responsibilities in relation to colleagues                                          2    51   98     82   3.12


24. Please rate these knowledge outcomes under the heading "Role of the doctor in
health care systems". Graduates should be able to demonstrate knowledge of
                                                                                    NI   QI    VI   E     Ave
laws relevant to medicine                                                            4   69   111   50    2.88
systems for health care delivery                                                     8   87   100   39    2.73
systems of professional regulation                                                  13   90    97   35    2.66
principles of clinical audit                                                        18   89    88   34     2.6
26. PRACTICE SETTINGS THESE ARE AREAS OF CLINICAL EXPERIENCE WHERE STUDENTS WILL GAIN KNOWLEDGE AND
SKILLS RELEVANT TO PARTICULAR PATIENT GROUPS AND LEARN ABOUT THE TYPICAL CLINICAL CONDITIONS WHICH ARE
CARED FOR IN THESE PRACTICE SETTINGS. PLEASE RATE HOW IMPORTANT YOU THINK IT IS THAT ALL MEDICAL
                                                                        NI QI       VI     E      Ave
care of general (internal) medical patients in medical admission units   0 22       93    118     3.41
care of acutely ill patients in Casualty / Accident and Emergency units  3 24       95    112     3.35
care of general surgical patients in surgical admission units            3 50      107     74     3.08
care in the community/family practice/primary care                       9 55       94     75     3.01
care for sick children                                                   5 60      111     57     2.94
care for elderly patients                                                9 52      122     51     2.92
obstetric and gynaecological care                                        5 76      112     41     2.81
care for the dying palliative care                                      13 76       98     47     2.76
care for mentally ill patients                                          15 74      104     41     2.73
care for critically ill patients in Intensive Care Units                25 78       80     50     2.67
anaesthetic care                                                        27 94       82     29     2.49
care of patients with specialised medical conditions (eg haematology renal medicine)   22   98    98   16   2.46
rehabilitation medicine                                                                29   117   69   18   2.33
care of patients with specialised surgical conditions (eg cardiac surgery urology)     37   105   74   18   2.31
28. Please could you AGAIN rate the following subject-specific competences in terms of importance for medical graduates for the practice of
medicine in Europe immediately after graduation - WITHOUT REFERRING TO PREVIOUS RESPONSES?
                                                                                        NI       QI         VI       E           Ave
Abililty to carry out a consultation with a patient (history examination ...)            0        7         58      164          3.69
Ability to provide immediate care of medical emergencies including First Aid and
                                                                                         1       13         49      169          3.66
resuscitation
Ability to apply ethical and legal principles in medical practice                        2       26         95      108          3.34
Ability to communicate effectively in a medical context                                  0       26        102      103          3.33
Ability to assess clinical presentations order investigations make differential
                                                                                         2       28         96      105          3.32
diagnoses and negotiate a management plan
Ability to carry out practical procedures (e.g. venepuncture)                            3       37         83      108          3.28
Ability to prescribe drugs                                                               5       34         92       99          3.24
Ability to apply the principles skills and knowledge of evidence-based medicine          3       41        108       79          3.14
Ability to use information and information techology effectively in a medical context    5        32        123       72         3.13
Ability to assess psychological and social aspects of a patient's illness                1        52        121       56         3.01
Ability to apply scientific principles method and knowledge to medical practice and
                                                                                         5        56        101       68         3.01
research
Ability to work effectively in a health care system and engage with population health
                                                                                         3        67        106       52         2.91
issues
                                        DISCUSSION
•   Review of interim analysis of responses to date
    - issues around quality control of responses, achieving balanced population of respondents
    - good construct validity, consistency of responses
•   Strategies for enhancing response rate
    - ? A published league table of countries
    - ? A database of who has responded, accessible via MEDINE website
    - various useful contact ideas – patients, students
    - circulate url to all MEDINE members
•   Analysis methodology
    - ? medians; ? majority vote
    - many interesting comparisons and correlations
•   Strategies for reaching consensus
    - ? include everything, but with levels – “must” and “should”
    - omit very low ranked items – criterion-based
    - depends on use to which document will ultimately be put
•   Collaboration with other groups – “parent” Tuning Project; discipline-based or country-based
    working groups
•   Opportunities for further work
    - little enthusiasm for “Bachelor of Medicine”
    - appraisal by national professional bodies and regulating agencies
    - develop linked database of learning and assessment tools as “best practice”
•   Future meetings – probably October/November to review final analysis

				
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