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 162GRADUATES 49EMPLOYERS 7

• All member states apart from Estonia, Greece, Hungary, Latvia, Luxembourg, Malta, Slovenia

29. Where are you located?

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

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

Switzerland 0Iceland 0Norway 1

30. Which category of respondent describes you best?

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

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

ACADEMIC - Academic responsibility for a medical curriculum 36ACADEMIC - Academic responsibility for part of a medical curriculum 40ACADEMIC - Teacher in a medical curriculum (non-clinical) 64ACADEMIC - Teacher in a medical curriculum (clinical) 78ACADEMIC - Administrative support for medical teaching 10ACADEMIC - Administrative support for student exchange 1ACADEMIC - Educational support for medical teaching 35ACADEMIC - other 7MEDICAL GRADUATE - less than 5 years since graduation 28MEDICAL GRADUATE - more than 5 years since graduation 41EMPLOYER of medical graduates - health service manager 2EMPLOYER of medical graduates - clinician 11EMPLOYER of medical graduates - other 4MEDICAL STUDENT - pre-clinical 4MEDICAL STUDENT - clinical 7Other (please specify) 12

NI QI VI E Avecapacity to learn (including lifelong self-directed learning) 0 10 84 168 3.6ability to solve problems 2 15 76 172 3.58probity (honesty maintaining good practice) 0 19 79 162 3.55capacity for applying knowledge in practice 2 16 90 154 3.51ability to make decisions 0 19 92 149 3.5ability to recognise limits and ask for help 0 26 79 152 3.49ethical commitment 1 31 87 141 3.42critical and self-critical abilities 2 31 111 117 3.31concern for quality 2 31 119 105 3.27capacity to adapt to new situations 0 41 132 86 3.17interpersonal skills 1 47 116 94 3.17empathy 3 43 127 87 3.15ability to work in a multidisciplinary team 1 53 111 95 3.15capacity for analysis and synthesis 1 37 140 78 3.15ability to communicate with experts in other fields 3 60 133 62 2.98ability to work autonomously 6 64 132 61 2.94capacity for organisation and planning (including time management) 6 79 136 38 2.8appreciation of diversity and multiculturality 16 81 104 53 2.76knowledge of a second language 31 75 98 57 2.69will to succeed 17 97 112 32 2.62ability to teach others 16 108 107 29 2.57basic general knowledge OUTSIDE medicine 19 133 77 31 2.46understanding of cultures and customs of other countries 23 120 96 21 2.44ability to lead others 23 132 90 16 2.38initiative and entrepreneurial spirit 30 115 97 14 2.37research skills 34 122 85 18 2.34creativity 35 115 97 13 2.34ability to work in an international context 35 120 88 13 2.31ability 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 Ave1 capacity to learn (including lifelong self-directed learning) 3 0 10 84 168 3.62 ability to solve problems 2 15 76 172 3.583 probity (honesty maintaining good practice) 0 19 79 162 3.554 capacity for applying knowledge in practice 5 2 16 90 154 3.515 ability to make decisions 12 0 19 92 149 3.56 ability to recognise limits and ask for help 0 26 79 152 3.497 ethical commitment 13 1 31 87 141 3.428 critical and self-critical abilities 6 2 31 111 117 3.319 concern for quality 2 31 119 105 3.2710 capacity to adapt to new situations 7 0 41 132 86 3.1711 interpersonal skills 14 1 47 116 94 3.1712 empathy 3 43 127 87 3.1513 ability to work in a multidisciplinary team 10 1 53 111 95 3.1514 capacity for analysis and synthesis 2 1 37 140 78 3.1515 ability to communicate with experts in other fields 3 60 133 62 2.9816 ability to work autonomously 6 64 132 61 2.9417 capacity for organisation and planning 6 79 136 38 2.818 appreciation of diversity and multiculturality 17 16 81 104 53 2.7619 knowledge of a second language 15 31 75 98 57 2.6920 will to succeed 17 97 112 32 2.6221 ability to teach others 16 108 107 29 2.5722 basic general knowledge OUTSIDE medicine 1 19 133 77 31 2.4623 understanding of cultures and customs of other countries 23 120 96 21 2.4424 ability to lead others 23 132 90 16 2.3825 initiative and entrepreneurial spirit 30 115 97 14 2.3726 research skills 11 34 122 85 18 2.3427 creativity 4 35 115 97 13 2.3428 ability to work in an international context 35 120 88 13 2.3129 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:

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 and resuscitation 1 13 70 168 3.61

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 diagnoses and negotiate a management plan 1 31 90 131 3.39

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 and research 3 59 116 74 3.04

Ability to use information and information techology effectively in a medical context 3 53 144 51 2.97

Ability to work effectively in a health care system and engage with population health issues 10 69 111 63 2.9

5. Please rate these competences under the heading "Ability to carry out a consultation with a patient".

NI QI VI E AveAbility to take a history 0 11 43 190 3.73Ability to carry out physical examination 2 8 51 183 3.7Ability to make clinical judgements and decisions 3 11 93 137 3.49Ability to provide explanation and advice 3 23 109 110 3.33Ability to assess the patient's mental state 3 27 119 96 3.26Ability to provide reassurance and support 3 34 123 84 3.18

NI QI VI E AveAbility to recognise and assess the severity of clinical presentations 1 14 92 136 3.49Ability to make differential diagnoses 2 14 106 122 3.43Ability to order appropriate investigations and interpret the results 1 21 113 109 3.35Ability to negotiate an appropriate management plan with patients and carers 3 48 114 76 3.09

NI QI VI E AveAbility to recognise and assess acute medical emergencies 0 4 49 189 3.76Ability to provide basic First Aid 1 8 41 193 3.75Ability to provide Basic Life Support and Cardio-Pulmonary Resuscitation according to European guidelines 1 12 57 172 3.65

Ability to treat acute medical emergencies 2 19 100 120 3.4Ability to provide Advanced Life Support according to European guidelines 9 52 101 80 3.04Ability to provide trauma care according to European ATLS guidelines 16 58 103 64 2.89

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 -

6. Please rate these competences under the heading "Ability to assess clinical presentations order investigations make differential diagnoses and negotiate a management plan".

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 3.32Ability to prescribe clearly and accurately 5 31 98 108 3.28Ability to review the appropriateness of medication and evaluate the potential benefits and risks 5 37 98 101 3.22

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 AveAbility to communicate with patients 1 11 49 182 3.7Ability to communicate with colleagues 0 18 102 123 3.43Ability to communicate orally 0 23 103 117 3.39Ability to communicate in breaking bad news 3 29 110 98 3.26Ability to communicate with relatives 2 34 109 98 3.25Ability to communicate in writing (including medical records where patient has access to them) 2 33 121 87 3.21

Ability to communicate with disabled people 3 40 113 84 3.16Ability to communicate in seeking informed consent 1 52 104 83 3.12Ability to communicate by telephone 4 71 97 73 2.98Ability to communicate in dealing with aggression 5 60 113 65 2.98Ability 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 AveAbility to measure blood pressure 6 22 43 172 3.57Ability to carry out venepuncture 5 31 64 143 3.42Ability to carry out subcutaneous and intramuscular injection 9 35 75 123 3.29Ability to administer oxygen 5 43 93 103 3.2Ability to carry out cannulation of veins 8 50 88 94 3.12Ability to adminster IV therapy and use infusion devices 7 56 79 98 3.12Ability to carry out electrocardiography 22 60 81 79 2.9Ability to carry out suturing 12 72 85 70 2.89Ability to carry out bladder catheterisation 18 65 89 71 2.88Ability to carry out blood transfusion 29 64 66 83 2.84Ability to move and handle patients 19 80 86 56 2.74Ability to carry out urinalysis 33 79 74 56 2.63Ability 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 AveAbility to assess psychological factors in presentations and impact of illness 3 54 120 62 3.01Ability to detect stress in relation to illness 4 65 111 60 2.95Ability to detect alcohol and substance abuse dependency 4 61 120 54 2.94Ability 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 AveAbility to apply scientific principles to the practice of medicine 3 50 104 84 3.12Ability to analyse and disseminate experimental results 52 95 77 18 2.25Ability to design research experiments 68 110 54 8 2.01Ability 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 AveAbility to apply evidence to practice 6 44 123 66 3.04Ability to define and carry out an appropriate literature search 8 52 102 76 3.03Ability to critical appraise published medical literature 7 56 109 65 2.98Ability to generate evidence through clinical audit 17 84 113 21 2.59Ability 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 AveAbility to use computers 2 23 73 143 3.48Ability to keep accurate and complete clinical records 3 18 91 127 3.43Ability to access information sources 1 23 96 121 3.4Ability 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 AveAbility to maintain confidentiality 1 20 53 165 3.6Ability to apply ethical principles and analysis to clinical care 3 16 75 147 3.52Ability to certify death 8 34 63 132 3.35Ability to obtain and record informed consent 3 47 96 93 3.17Ability to apply national and European law to clinical care 7 47 100 87 3.11Ability to request autopsy 23 65 91 59 2.78Ability 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 AveAbility to provide patient care which minimises the risk of harm to patients 1 16 89 136 3.49Ability to apply measures to prevent the spread of infection 2 19 94 127 3.43Ability to recognise own health needs and ensure own health does not interfere with professional responsibilities 5 53 87 93 3.13

Ability to conform with professional regulation and certification to practise 4 46 106 81 3.11Ability to receive and provide professional appraisal 6 63 115 55 2.92Ability to make informed career choices 9 78 117 33 2.73

NI QI VI E AveNormal function (physiology) 0 14 67 153 3.59Normal structure (anatomy) 1 37 81 116 3.33Normal body metabolism and hormonal function (biochemistry) 4 50 97 84 3.11Normal immune function (immunology) 2 51 110 72 3.07Normal cell biology 15 84 81 54 2.74Normal molecular biology 21 89 81 43 2.62Normal 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 AvePsychology 1 75 110 48 2.88Human development (child/adolescent/adult) 8 83 97 46 2.77Sociology 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 AveAbnormal structure and mechanisms of disease (pathology) 0 16 84 135 3.51Infection (microbiology) 2 18 114 99 3.33Immunity and immunological disease 1 51 109 74 3.09Genetics and inherited disease 7 67 103 58 2.9

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) -

21. Please rate these knowledge outcomes under the heading "Drugs and prescribing". Graduates should be able to demonstrate knowledge of -

NI QI VI E Aveuse of antibiotics and antibiotic resistance 0 14 110 111 3.41principles of prescribing 3 33 81 118 3.34drug side effects 0 36 123 77 3.17drug action and pharmacokinetics 3 48 97 87 3.14use of blood transfusion and blood products 6 53 84 92 3.11drug interactions 2 44 121 67 3.08individual drugs 7 71 104 51 2.85the different types of complementary and alternative medicine and their use in patient care 48 116 52 17 2.16

22. Please rate these knowledge outcomes under the heading "Public Health". Graduates should be able to demonstrate knowledge of -

NI QI VI E Avedisease prevention 1 33 119 80 3.19lifestyle diet and nutrition 4 50 117 63 3.02screening for disease and disease surveillance 4 65 122 43 2.87health promotion 9 69 108 49 2.84epidemiology 6 80 102 47 2.81disability 6 85 111 32 2.72gender issues relevant to health care 12 103 90 29 2.58cultural and ethnic influences on health care 16 109 79 31 2.53resource allocation and health economics 19 123 73 17 2.38global 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 Averights of patients 0 37 84 112 3.32rights of disabled people 1 51 89 92 3.17responsibilities 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 Avelaws relevant to medicine 4 69 111 50 2.88systems for health care delivery 8 87 100 39 2.73systems of professional regulation 13 90 97 35 2.66principles of clinical audit 18 89 88 34 2.6

NI QI VI E Avecare of general (internal) medical patients in medical admission units 0 22 93 118 3.41care of acutely ill patients in Casualty / Accident and Emergency units 3 24 95 112 3.35care of general surgical patients in surgical admission units 3 50 107 74 3.08care in the community/family practice/primary care 9 55 94 75 3.01care for sick children 5 60 111 57 2.94care for elderly patients 9 52 122 51 2.92obstetric and gynaecological care 5 76 112 41 2.81care for the dying palliative care 13 76 98 47 2.76care for mentally ill patients 15 74 104 41 2.73care for critically ill patients in Intensive Care Units 25 78 80 50 2.67anaesthetic 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 2.33care of patients with specialised surgical conditions (eg cardiac surgery urology) 37 105 74 18 2.31

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 AveAbililty to carry out a consultation with a patient (history examination ...) 0 7 58 164 3.69Ability to provide immediate care of medical emergencies including First Aid and resuscitation 1 13 49 169 3.66

Ability to apply ethical and legal principles in medical practice 2 26 95 108 3.34Ability to communicate effectively in a medical context 0 26 102 103 3.33Ability to assess clinical presentations order investigations make differential diagnoses and negotiate a management plan 2 28 96 105 3.32

Ability to carry out practical procedures (e.g. venepuncture) 3 37 83 108 3.28Ability to prescribe drugs 5 34 92 99 3.24Ability 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 3.01Ability to apply scientific principles method and knowledge to medical practice and research 5 56 101 68 3.01

Ability to work effectively in a health care system and engage with population health issues 3 67 106 52 2.91

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?

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