Cycle 15 - 2015

Now showing 1 - 2 of 2

Clinical reasoning and its challenges at workplace: A qualitative study with novice medical graduates in Sri Lanka
(Staff Development Center, University of Kelaniya, Sri Lanka, 2015) Karunaratne, W.C.D.; Chandratilake, M.B.N.; Marambe, K.
Background and rationale: Clinical reasoning is a major determinant of clinical competence among medical professionals (Barrows & Feltovich, 1987). However, even after 40 years of research, diverging opinions still persist on the diagnostic decision making process adopt by medical professionals proving the complexed nature of the phenomenon (Eva, 2004). Aim: This study aims to explore how novice medical graduates working at four main clinical specialties (medicine, surgery, paediatrics and obstetrics & gynaecology) learn and perform clinical reasoning during internship training and the challenges encountered. Theoretical underpinning: Theories of diagnostic decision making range from hypotheticodeductive reasoning described in 1970’s to the dual process theory, discussed recently in the medical education literature (Norman, 2005; Pelaccia, Tardif, Triby, & Charlin, 2011). Proposed methodology: Interpretive paradigm research using phenomenology will be conducted on novice medical graduates working in medicine, paediatric, surgery and obstetrics & gynaecology wards at the North Colombo Teaching Hospital, Ragama, Sri Lanka. The study will be conducted in two phases using purposive sampling (a combined total of 16) with gender balance and equal representation of specialties. During the study each participant will undergo three (3) interviews. The first interview will be on their experience of clinical reasoning as an intern and the challenges faced. The subsequent two interviews are based on audio-recorded patient encounters using the technique of stimulated recall. Two experts from each specialty will review the audio-recordings of patient encounters and determine the relevance of questions to the diagnosis. The interviews will be anonymised and transcribed verbatim. A coding framework will be developed using the five-stage process proposed by Ritchie &Spencer (Analyzing qualitative data, 1994). Thematic analysis of the data will be done using ATLASti. Expected outcomes: The study findings will provide meaningful insights in to organizing and re-structuring medical internship training to facilitate learning and on measures for improving clinical reasoning during undergraduate medical training.
Knowledge on effects of alcohol among medical undergraduates in Sri Lanka
(Staff Development Center, University of Kelaniya, Sri Lanka, 2015) Perera, K.M.N.
Background: Alcohol is a major determinant of morbidity and mortality (WHO, 2004). Medical profession plays a key role in controlling alcohol related problems. Global evidence suggest medical undergraduates have inadequate knowledge on effects of alcohol, leading to impaired control of alcohol related problemsin thesociety and increasing riskforthemselvesto becomeaddicted(Jeremy et al, 2001; Smit et al, 2009; Odeyemi et al, 2014). Aim:Todescribe the level and gaps of knowledge on effects of alcohol among medical undergraduates of Sri Lanka Theoretical underpinning: It is documented that inadequacy of knowledge generates a vicious cycle resulting in poor knowledge and attitudes among medical professionals. This will lead to poor knowledge, skills and attitudes among teachers, resulting in inadequate curricula and lack of role models to the undergraduates in the profession (Miller et al, 2001). Proposed Methodology: A descriptive cross-sectional study would be conducted among 500 fourth year undergraduates registered in state medical faculties, recruited using a multi-stage cluster sampling method.A self-administered questionnaire, developed based onWorld Health Organization guidelines on expected competencies from medical professionals at primary health care level and expert opinions of a multi-disciplinary panelwill be used to assess the knowledge level.Prevalence of ‘good knowledge’ would be calculated and presented with 95% Confidence Intervals and knowledge gapswould be identified based on pre-determinedquestions. Expected outcomes: If the knowledge level is found to be low, it can be used as an advocacy tool to improve attitudes of the medical professionals. Identified knowledge gaps would be shared with the curriculum development committees of all the Faculties of Medicine. A model curriculum will be developed based on the findings, available literature and expert opinion and will be disseminated to the Faculties of Medicinein Sri Lanka.

Cycle 15 - 2015

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