OPME Research Projects

Current OPME projects are listed below. Please also see the list of recently completed OPME projects.

Current OPME projects

• BEME Review: Work-based assessment in health professional education
• Development of a patient safety curriculum for medical schools
• Evaluation of the reliability, validity, and feasibility of the Multiple Mini Interview (MMI)
• Explanations of behaviour following professionalism dilemma situations: an international study
• New structured teaching model in the clinical years: Clinical reasoning sessions
• Prevocational doctors and the practice of evidence-based medicine
• Prevocational doctors in NSW: A workforce study
• Program delivery partnerships to increase participation of new and emerging prescribers in quality use of medicine (QUM) activities
• Strengthening Cancer Care: Professional Development Packages
• Students' patient-centred learning in clinical feedback sessions
• The Psychological Impact of Complaints and Negligence Suits on Doctors
• Use of Personal Digital Assistants (PDAs) in Medical Education

PHD Projects

• Transfer of self-regulated learning (SRL) between PBL tutorials and the clinical setting
• Development and role of professionalism in healthcare teams

This review aims to identify best practice with regards to assessment methods used in the workplace to judge the performance of health care professionals in medicine, dentistry and nursing. We will report a range of outcomes for each assessment method including information regarding context of use, instrument quality, and challenges and recommendations for use. This review is being carried out as part of the Best Evidence Medical Education (BEME) Collaboration.

Project team: A/Prof Jill Thistlethwaite, A/Prof Chris Roberts, A/Prof Tim Shaw, Stewart Barnet & Koshila Kumar from OPME; Daniel Simpkins a 2nd year UsydMP student; Professor Russell Jones (Director of Education at the Australian and New Zealand College of Anaesthetists); and affiliate member Professor Gordon Page (Director, Division of Educational Support and Development at the Department of Medicine at the University of British Columbia).

Duration of project:
April 2007 - 2009

Funding body: OPME

Contact: Jill Thistlethwaite,

Funding has been provided by the World Health Organization’s (WHO) World Alliance for Patient Safety to develop a patient safety curriculum guide for medical schools. With input from a reference group comprised of patient safety and medical education experts from around the world, the project team will undertake an extensive literature review, perform an audit of patient safety tools and resources freely available on the internet, and write a curriculum guide for a global audience incorporating what and how to teach patient safety. Topic areas for the guide will be derived from the internationally validated Australian Patient Safety Education Framework and will incorporate a variety of methods for teaching and assessment.

Project team:
A/Prof Merrilyn Walton (OPME; Project Lead), A/Prof Tim Shaw (OPME), A/Prof Chris Roberts (Director of OPME), A/Prof Brendan Flanagan (Monash University), Dr Julia Harrison (Monash University), Mr Stewart Barnet (OPME), Ms Samantha Van Staalduinen (OPME)

Duration of project: March 2008 - June 2008

Funding body: World Health Organization’s World Alliance for Patient Safety

Contact:
Phone: (+612) 9351 3678


Phone: (+612) 9351 3687

This longitudinal project was established in 2006 to examine the reliability, validity, including predictive validity, feasibility and acceptability of the Multiple-Mini-Interview (MMI), which is being used as part of the admissions process into the University of Sydney Medical Program (USydMP), and in 2007, the Faculty of Dentistry’s Bachelor of Dentistry program (BDent).

Project team: A/Prof Chris Roberts (Director, OPME) Prof David Tiller (A/ Dean-Planning & Development, School of Rural Health), A/Prof Merrilyn Walton (OPME), A/Prof Charlotte Rees, Dr Tricia Lyon (OPME), Ms Imogene Rothnie (OPME) and Ms Koshila Kumar (OPME).

Duration of project:
2006 - Ongoing

Contact: ,

Outcomes:

• Roberts, C., Walton, M., Rothnie, I., Crossely, J., Kumar, K., Lyon, P. M., et al. (2008). Factors affecting the utility of the Multi-Mini-Interview in selecting candidates for graduate entry medical school. Medical Education, 42, 396-404. http://dx.doi.org/10.1111/j.1365-2923.2008.03018.x
• Kumar, K., Roberts, C., Walton, M., Rothnie, I., Du Fresne, C., & Lyon, P. (2008). The Multiple Mini Interview (MMI) as an assessment method for entry into graduate medical school: a qualitative analysis of candidate and interviewer experiences of the process, Paper presented at the 13th Ottawa International Conference on Clinical Competence (Ozzawa). Melbourne, Australia. 5-8 March 2008.
• Roberts, C., Rothnie, I., Walton, M., Crossley, J., Kumar, K., & Tiller, D. (2008). The impact of examiner subjectivity in a Multi-Mini-Interview to select candidates to a graduate entry medical school, Poster presented at the 5th Asia Pacific Medical Education Conference. Singapore. Jan 2008.
• Roberts, C., Walton, M., Rothnie, I., Crossley, J., Kumar, K., & Tiller, D. (2007). The usefulness of the Multi-Mini Interview in selecting for graduate entry medical schools, Paper presented at the Association of Medical Educators of Europe. Trondheim, Norway, 25-29 August 2007.

Professional development in medical students is of paramount importance in medical education. Although students are taught good professional practice throughout their education, they are sometimes exposed to unprofessional practice. Final year medical students at one Canadian school reported that they witnessed doctors committing communications violations to (or about) patients, objectifying patients and causing them physical harm. Furthermore, many students admit to behaving unethically themselves following the observation of such behaviour.

Although previous research has begun to explore students’ explanations of professionalism lapses, these studies have methodological and theoretical limitations. We have recently urged medical educators to examine students’ explanations of their own (and others’) behaviours using a theoretically sophisticated model known as Malle’s folk-conceptual theory of behavioural explanations (Knight & Rees 2006; Rees & Knight 2007). The current research study addresses the methodological weaknesses in existing research by examining medical students’ explanations of their own and others’ professionalism behaviours during focus group discussions and individual interviews at three geographically and culturally diverse medical schools in different countries (Wales, England, and Australia).

Project team: Lynn Knight (University of Cardiff, UK), Charlotte Rees (University of Sydney, Australia), Kieran Sweeney (Peninsula, UK)

Duration of project: September 2007 - August 2009

Funding body: British Academy Larger Research Grant (£76041, full economic costing)

Lynn Knight has also been awarded an international visiting research fellowship from the University of Sydney (July - August 2008) to help Charlotte Rees with the data collection in Australia.

Contact: , +61 2 9351 2814

We are proposing Clinical Reasoning Sessions (CRS) as an alternative to PBL in Stages 3 and 4 of the USydMP. The need for an alternative is supported by student and staff feedback and recent doctoral research conducted within the Faculty. The new model has been designed in consultation with key stakeholders, including curriculum designers, clinicians and students. The advantages of the new model are reduced structured teaching time for students and staff, greater integration with clinical experience, greater authenticity of material presented, and expected increased student motivation for meeting the learning outcomes of the BCS theme material. The new model will offer an opportunity to develop clinical reasoning and decision-making ability by monitoring, critiquing and discussing reasoning about a specific “real” patient for patient-centred care. This new model will also provide a supported forum for students to discuss ‘messy’ thinking, errors in reasoning, and evaluate outcomes of reasoning. One principle outcome of this model will be further development of the capacity to self-monitor and critique own and others’ reasoning, and promote ability to self-regulate own learning in a clinical environment (i.e. develop reflexive practice). This new model is therefore grounded in theory and practice and has been developed in consultation with stakeholders such as curriculum planners, students, clinicians, and senior faculty staff members.

Project team: Rola Ajjawi (project manager), Vicki Langendyk, Sarah Hyde, Graham Hendry, Stewart Barnet, Helen Wozniak, Jill Thistlethwaite and Chris Roberts

Duration of project:
Nov 2006 – Planned implementation for Oct 2008, pilot to commence Oct 2007

Contact:

This project is a prospective study to evaluate the practice of evidence based medicine (EBM) by prevocational doctors in New South Wales in their first and second postgraduate years (PGY1 and PGY2). The aim is to determine current patterns of engagement, identify/examine factors that influence the practice of EBM and measure competence in EBM. The findings will inform future training initiatives and methods for improving the practice of EBM by prevocational doctors in relation to patient care.

The participation of PGY1 and PGY2 doctors is fundamental to the success of the study, and is on a voluntary basis. All volunteers have been asked to participate by
completing short self-evaluation questionnaires and an EBM competency test based on a previously validated measure, as well as by giving consent to automatically track their access of the Clinical Information Access Program (CIAP) over one year (each participant is provided with a unique username and password).

Those completing the study will be entered into a draw to win 1 of 4 Personal Digital Assistants (PDAs), each valued at approximately $500.

Project team: Dr Kumara Mendis (School of Rural Health), A/Prof Chris Roberts (OPME), A/Prof Merrilyn Walton (OPME), A/Prof Alexandra Barrett (School of Public Health), Adjunct A/Prof Joe Canalese (School of Rural Health), A/Prof Martin Stockler (RPA Hospital), Dr Michael Sinclair (Dubbo Base Hospital), Associate Dean Tessa Ho (OME), Dr Hudson Birden (NRU Department of Rural Health)

Duration of project:
Jan 2008 - Jul 2009

Funding body:
Medical Training Review Panel; National Priority Projects in Prevocational Medical Education and Training

Contact:

The project examines the educational, training and work experience of all pre vocational (non specialist) doctors in the New South Wales health system. In addition to reviewing the literature, the researchers will engage in extensive data collection using a number of methods including: surveys of newly appointed non-specialist doctors in the NSW health system; surveys of key personnel such as Directors of Clinical Training, managers of junior medical officers, Chief executive officers of area One or two paragraphs providing background to project (aims, methods, progress etc.):
The project examines the educational, training and work experience of all pre vocational (non specialist) doctors in the New South Wales health system. In addition to reviewing the literature, the researchers will engage in extensive data collection using a number of methods including: surveys of newly appointed non-specialist doctors in the NSW health system; surveys of key personnel such as Directors of Clinical Training, managers of junior medical officers, Chief executive officers of area health services; surveys of key organisations including hospitals; and focus groups with targeted participants from key organisations and associations in rural locations.

Project team: This project is to be carried out by a consortium led by the University of Sydney (including the Northern Rivers University Department of Rural Health) in collaboration with the University of New South Wales and the NSW Rural Doctors Network. A/Prof Merrilyn Walton is the chief investigator on this project

Duration of project:
Feb 2008 - Dec 2008

Project Funding:
NSW Health

Contact:

Doctors are bombarded with a tremendous amount of information every day about new drugs, changes in evidence-based guidelines and to the PBS. GP registrars are also tackling new knowledge and learning new skills related to general practice, while IMGs have to learn how to navigate a new health system and prescribing policy (often not recognising common drug names as these vary from country to country). It is little wonder therefore that some educational material is never opened nor read. Doctors search for information when necessary during a consultation and want easily accessed information that is relevant to everyday practice and to the patient sitting in the consultation room. This project aims to identify barriers and enablers to the QUM message leading to an improvement in delivery and content of quality prescribing learning material and activities to align with GP registrars and IMGs practical experience.

Project team: Jill Thistlethwaite (project manager- OPME), Rola Ajjawi (OPME), Tim Shaw (OPME), Jackie Ross (OPME), Parisa Aslani (Pharmacy), Jeremy Bunker (SIGPET), Frank Meumann

Duration of project: August 2007 - Jan 2009

Funding body: National Prescribing Service

Contact: ,

This national project examines the professional development requirements of health professionals working in cancer care, and is being carried out by a consortium including OPME, the Clinical Oncological Society of Australia (COSA), the National Breast Cancer Centre (NBCC), the Royal Australian College of General Practitioners (RACGP), and The Cancer Council of Australia,

Phase 1 of this study was conducted in 2006 and included an analysis of health care professionals' education needs in cancer-care, the scope of existing professional education and training packages in Australia, and made recommendations about strategies for improving this training. The 2nd phase of this study, which is currently underway, aims to use information generated in Phase 1 to develop and implement education and training packages for healthcare professionals working in cancer-care.

Project team: A/Prof Tim Shaw, Jackie Ross (Project Manager), Mr Stewart Barnet (Educational Design), Gemma Connolly (Project Officer) and consortium representatives.

Duration of project:
Jan 2006 - 2008

Project funding:
Commonwealth Department of Health and Ageing

Contact: ,

Outcomes:
A report of findings and recommendations for Phase 1 was submitted to the Commonwealth in 2006. Phase 2 is currently underway.

During 2006 we conducted an observational study of 27 clinical feedback sessions during which pairs of third and fourth year medical students at Peninsula Medical School (UK) presented patient cases to clinical teachers. Each session was observed, audiotaped and followed by debrief sessions with students and clinicians to explore what and how students were learning during these sessions. Underpinned by symbolic interactionism, we are currently analysing these audiotapes to identify how patient-centred issues are covered in the feedback sessions and how the student-clinician interaction influences the development of students’ professional identities as patient-centred practitioners. We will also be analysing additional topics relevant to our other work on interaction such as the use (and function) of humour within clinical feedback sessions.

Project team: Lynn Knight (Cardiff, UK) and Charlotte Rees (Sydney, Australia)

Duration of project: January 2006 - indefinite

Funding body: None, but we are seeking out possible streams of funding to help us transcribe and analyse the vast amount of data we have collected.

Contact: , +61 2 9351 2814

Outcomes:

• Rees CE & Knight LV (2007) "Touchy feely stuff" and "new wave fluffiness": Clinician-student interaction around patient-centred issues and its influence on students' professional identity formation. To be presented at the ANZAME Annual Conference, 12-15th September, Canberra, Australia.
• Knight LV & Rees CE (2007) "Fair, female, forty, fertile and fat": The role of clinicians' talk in patient-centred professional identity formation. To be presented at the International Conference in Communication in Healthcare, 9-12th October, Charleston, South Carolina, USA.

This is a collaborative research project between UNITED Medical Protection (UMP) and the University of Sydney. The purpose of the research is to assess the impact of litigation, complaints and inquiries on doctors' health and well-being. The results will be used to better inform medical schools and the specialty colleges to prepare students and doctors for the realities of medical practice, of which litigation, complaints and coronial inquiries are a component.

Project team: The Principal Investigator for this project is Christopher Tennant (HOD, Department of Psychological Medicine, RNS) and co-investigators are Dr Louise Nash (psychiatrist/lecturer, RNS), A/Prof Merrilyn Walton (OPME), Dr Simon Willcock (OPME) and Dr Brad Curtis (PhD student, Dentistry and PT lecturer), and Elizabeth Van Ekert (currently undertaking a Masters in Medical Humanities Sydney Uni). Chief Investigators from UNITED Medical Protection (UMP) are Ms Cheryl Payne (National Professional Development Manager) and Ms Maree Johnson (Research Manager).

Outcomes:
The data for this project has been collected and is currently being analysed.

A survey will investigate students’ experience with and support needs in using PDAs.

Funding has provided for up to 40 PDAs to be distributed to student volunteers at RPAH clinical school, and the SRH in Orange and Dubbo. The PDAs will be used in clinical assessments, with both student and supervisors completing the innovative mini-CEX assessment form. Once submitted the information will be stored in a database and collated to feed back a visual display to students of their areas of strength in the mini-CEX and areas to improve on. The long term aim of this project is to facilitate the implementation of an e-portfolio for all medical students.

Project team: Sarah Hyde, A/Prof Chris Roberts (Director of OPME), Prof Chris Liddle (A/Dean for IT), A/Prof Joe Canalese (A/Dean SRH), Prof Craig Mellis (A/Dean, Central clinical school), Mr Daniel Burn (Senior faculty programmer), Mr Robert Pearce (Helpdesk manager)

Duration of project:
June 2006 - December 2007

Project funding:
OPME, School of Rural Health, SESQUI

Contact:

Outcomes:
Report of online survey conducted of students’ experiences with and their support needs for using PDA’s. Student sample to be selected by August 2007.

Transfer of self-regulated learning (SRL) between PBL tutorials and the clinical setting

Researcher: Sarah Hyde

This is my PhD research and has been ongoing since 2003. Essentially, two Year 2 PBL groups were recruited to participate in 2003. They were observed over a five week period and two individual interviews were conducted with each student. Surveys, observation, and interviews enabled an understanding of each students’ ability to self-regulate their learning in the PBL tutorials and on the hospital ward. Factors which influenced the take up and use of these skills have also been established. Each of the students was followed up in Year 3 in 2004 and again, observed over 4 PBL cases and interviewed in depth about their learning in this part of the course. In Year 3, 11 PBL groups were observed over each of the 5 main clinical school sites. Wide variation in the implementation of PBL was found between and within sites. It was discovered that most SRL skills students were observed to use in the PBL tutorials were seen to be used in the clinical setting, and so, transfer did occur. However, there was significant disparity in the way students self-regulated their learning in year 2 and in year 3. The concept of transfer is being reconceptualised using a socio-cultural approach and analysis is still underway as of March 2007

Development and role of professionalism in healthcare teams

Researcher: Koshila Kumar

My PhD research initiated in 2007 was generated based on what I perceived to be was a lack of understanding about the development and role of professionalism in multidisciplinary team contexts, in a healthcare system with an increasing emphasis on collaborative team approaches to patient care. Most of the current knowledge and discourse about professionalism is encapsulated within discipline or profession specific research and education and in profession-centric codes for practice. Similarly, although the interprofessional education (IPE) literature provides considerable insight into the processes and practices of healthcare teams’, the dynamics of authority and responsibility, and allegiances to different professional bodies and codes of professionalism, adds to the complexity of team professionalism. An extensive review of the sociology of the professions, the appeal of professionalism, and analysis of teamwork literature, augmented by qualitative research methodologies will facilitate greater insight into how professionalism develops and the nature of its role within healthcare teams.