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clinmed/2002050005v1 (May 16, 2002)
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Title: Influence of school education on attitudes towards transferable skills in medical undergraduates

Names of authors:

DR.P.Ravi Shankar M.D.

Mr.Pranaya Mishra M.Pharm

Running title: School education and transferable skills

Institution where the work has been carried out:

Manipal College of Medical Sciences

Pokhara, Nepal.

Address for correspondence and reprints:

DR.P.Ravi Shankar

Department of Pharmacology

Manipal College of Medical Sciences

P.O.Box 155

Deep Heights

Pokhara, Nepal.

Fax: 00977-61-22160

E-mail: mcoms{at}mos.com.np

pathiyilravi{at}rediffmail.com

 

Abstract:

Background: The increasing importance of self-learning in medical education places a greater responsibility on individual students to develop good ‘transferable’ skills. Objectives: To assess the attitudes of second year undergraduates towards transferable skills, and to investigate the influence of schooling on these skills. Methods: Second year students were given a questionnaire asking them to rate the importance, their level of competence and influence of teaching on transferable skills and to note the influence of exposure to computers, self-learning sessions and problem-solving sessions on these skills. To assess any influence of the importance of self-learning in school on these skills. Results: Responses were obtained from 68 students. Only 25 students were exposed to problem-solving sessions in school while 42 students were exposed to presentations. The majority of the students rated self-learning as important in school. Those students who had not been exposed to computers, self-learning and problem-solving in school rated the influence of integrated teaching on skill development higher than those not exposed. The students who rated the importance of self-learning in school as not important rated the influence of integrated teaching on the development of individual skills lower than the students who rated self-learning as important. Conclusion: The influence of schooling on transferable skills development should be further investigated.

 

 

Introduction:

Kathmandu university to which the Manipal college of medical sciences, Pokhara is affiliated is in the process of revising the undergraduate curriculum for basic sciences. This will precipitate many changes in the teaching of medical students. It is proposed to reduce the factual content of medical courses and the number of didactic lectures together with an increased emphasis on ‘self-directed’ and ‘problem-based’ learning and the development of a ‘capacity for self-education’. This is in keeping with trends the world over.1,2 These proposed changes highlights the need for students to develop a good standard of transferable skills.

In the medical colleges affiliated to Kathmandu university an integrated approach to teaching the basic science subjects is followed. This approach will help in the development of integrative thinking which implies the ability to extract bits of information from seemingly disparate disciplines, and synthesise them into something that is meaningful.3

We have not come across many studies on the influence of schooling on the development of transferable skills. High school marks in physics, chemistry and biology and the results of entrance tests have been shown to predict academic performance in medical college, especially the pre-clinical years.4

The aims of the present study are:

  1. to assess any influence of exposure to problem-solving sessions in school on the attitude towards, level of competence and influence of integrated teaching on transferable skills
  2. to assess any influence of exposure to presentations in school on the attitude towards, level of competence and influence of integrated teaching on transferable skills
  3. to assess any influence of the importance of self-learning in school on the attitude towards, level of competence and influence of integrated teaching on transferable skills and
  4. to assess any influence of exposure to computers in school on the attitude towards, level of competence and influence of integrated teaching on transferable skills.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Method:

A survey was undertaken of 96 medical undergraduates during the fourth semester (end of second year) of the MBBS course at the Manipal college of medical sciences, Pokhara. The students were asked to complete a questionnaire which asked them to consider 33 transferable (key) skills grouped into two main categories, namely: general skills and skills specific to pharmacology. The general skills were subdivided in to: information handling, organisational skills, IT skills, self-learning skills and presentation skills. The skills specific to pharmacology were subdivided into: problem-solving, selection of drugs and prescription writing and communication skills. The students were also asked to respond to questions asking about their exposure to problem-solving sessions, presentations and computers in school with a simple ‘yes’ or ‘no’ answer. They were asked to rate the importance of self-learning in school as follows: not important, important or very important.

For scoring the skills students were asked to use the following scoring system: 0 (no or least importance) or values from 1 to 4 in order of increasing importance. The students were allowed to only use whole numbers like 0,1,2,3 etc.

Results were analysed using the SPSS statistical package and Mann-Whitney tests were performed as the test of significance.

 

 

 

 

Results:

Responses were obtained from 68 students. 53 students (77.9%) had studied in English medium schools and 15 students (22.15) were from Vernacular medium schools. Only 25 students (36.8%) were exposed to problem-solving sessions in school while 42 students (61.8%) were exposed to presentations in school. 88.2 % of the students were exposed to computers in school. Regarding the importance of self-learning in school 22 students (32.4%) rated it as important, 36 students (52.9%) rated it as very important while only 14.7% rated it as not important.

How important they considered the skill to be in medicine: Students were clearly aware of the value of transferable skills in medical education. Within the general skills category, organisational skills and presentation skills were rated the highest and IT skills the lowest. Within the specific skills category all three categories of skills had similar ratings.

How good they thought they were at the skill: Students, in general, had a high level of confidence in their transferable skills. In the general category skills students considered themselves least good at IT skills. In the specific skills category the differences were slight. In general, students rate their own skills less highly than they rate the importance of that skill in medicine.

Influence of integrated teaching on skills development: Students considered that the course had helped to develop their presentation and information handling skills the most, and their IT skills the least. In the skills related to pharmacology students considered that the course had helped to develop their skills in problem-solving and drug selection the most and in communication skills the least.

Influence of exposure to problem-solving sessions in school on the attitude towards, level of competence and influence of teaching on transferable skills: Students who had not been exposed to problem-solving sessions in school rated the influence of integrated teaching on the development of problem-solving skills marginally higher than those who had been exposed (p=0.076). In the individual skills the students who had been exposed to problem-solving sessions in school rated the influence of integrated teaching on the skills extracting information from the library and interpreting information significantly higher than the exposed students (p=0.048, p=0.015). Similar trends were observed regarding the influence of integrated teaching on the skill decision making in the category self learning (p=0.042) and the skills application of textbook knowledge and development of logical thinking in the category problem solving (p=0.013, p=0.013). The non-exposed students rated the influence of integrated teaching higher.

Influence of exposure to presentation sessions in school on the attitude towards, level of competence and influence of teaching on transferable skills: There was a marginal difference in rating the contribution of integrated teaching to communication skills development with those exposed to presentations rating the contribution higher (p=0.087). The students who had not been exposed rated the importance of the skills oral presentation and presentation to doctors within the category presentation skills higher than the exposed students (p=0.014, p=0.009).

Influence of the importance of self-learning in school on the attitude towards, level of competence and influence of teaching on transferable skills: The students who came from schools where self-learning had a minor role rated the influence of integrated teaching on the development of self-learning skills and the importance of information handling skills lower than the other two categories (p=0.056,p=0.056). There were also significant differences in the rating of the importance of the skill decision making within the category self-learning and the skill relevance to clinical practice within the category problem solving. There were also differences in the rating of the individual skills within the category problem solving.

Influence of exposure to computers in school on the attitude towards, level of competence and influence of teaching on transferable skills: The students exposed to computers in school rated their ability in word processing skills (MS Word) higher than those not exposed.

 

 

 

 

 

 

 

 

 

Discussion:

Importance of transferable skills: Students in this study demonstrate a high awareness level of the value of transferable skills in medicine. The results are similar to those obtained in a previous study.5 This will help the students to succeed in the revised curriculum of Kathmandu university with its emphasis on self-directed learning.

Students’ perception of their skills: The students’ opinion of their skills is lower than that reported from a previous study.5 It could be because the undergraduates are mature enough to evaluate their skills effectively. Limitations to student grading of the curricula have been reported in the literature.6 self-evaluation is important in learning and may provide additional valuable information regarding the student performance.7 The increased emphasis on problem-based learning will be helpful in the development of information management, critical reasoning, communication and team building skills as shown in a previous study.8

Influence of integrated teaching on skills development: Students felt that integrated teaching had contributed to the development of transferable skills. The low influence on IT skills may because students feel they have a sufficient skill level for their future career needs. In the specific skills section, the low influence on communication skill development might be due to the use of simulated patients and lack of integration with the clinical disciplines.

Influence of exposure to problem-solving sessions in school: The higher score of the non-exposed students on the influence of integrated teaching on problem-solving skills development might be because of the effectiveness of the course and the initial low value of the skills. A longitudinal study on students at the time of admission and after a course of integrated teaching might help in the clarification of the observed differences.

Influence of exposure to presentation sessions in school: The differences observed are difficult to explain within the scope of the present study and further studies are needed.

Influence of the importance of self-learning in school: The lower rating of the importance of individual skills and the lower ability in transferable skills in students who came from schools where self-learning had a low priority is to be expected. However, further studies are needed as to why this factor had no influence on the other skills.

Influence of exposure to computers in school: Word processing skills are the most commonly taught IT skill in schools and so the increased influence of exposure to computers in school on word processing skills is to be expected.

This can be regarded as a pilot study to assess the influence of schooling on transferable skills development. Further studies using more refined methodologies will help to clarify this very important issue further.

 

References:

  1. Bligh J, Lloyd Jones G, Smith G. Early effects of a new problem-based clinically oriented curriculum on students' perceptions of teaching. Med Educ 2000;34(6):487-89.
  2. Miflin BM, Campbell CB, Price DA. A conceptual framework to guide the development of self-directed, lifelong learning in problem-based medical curricula. Med Educ 2000;34(4):299-06.
  3. Rosch PJ. Integrative thinking: the essence of good medical education and practice. Integr Physiol Behav Sci 1998;33(2):141-50.
  4. Hoschl C, Kozeny J. Predicting academic performance of medical students: the first three years. Am J Psychiatry 1997;154:87-92.
  5. Whittle SR, Eaton DGM. Attitudes towards transferable skills in medical undergraduates. Med Educ 2001;35:148-53.
  6. Guest AR, Roubidoux MA, Blane CE, Fitzgerald JT, Howerman RA. Limitations of students evaluations of curriculum. Acad Radiol 1999;6(4):229-35.
  7. Sullivan ME, Hitchcock MA, Dunnington GL. Peer and self assessment during problem-based tutorials. Am J Surg 1999;177(3):266-69.
  8. Hammel J, Royeen CB, Bagatell N, Chandler B, Jensen G, Loveland J, Stone G. Student perspectives on problem-based learning in an occupational therapy curriculum: a multiyear qualitative evaluation. Am J Occup Ther 1999;53(2):199-206.

 

 

TABLE 1: TRANSFERABLE SKILLS QUESTIONAIRE:

Medium of instruction till class 10:

Were you exposed to problem-solving sessions in school? Yes/no

Were you exposed to presentations in school? Yes/no

How important was the role of self-learning in school? Important/ not important/ very important

Were you exposed to computers in school? Yes/no

GENERAL SKILLS:

Information handling:

Extracting information from library

Extracting information from CD-ROM

Selecting information

Interpreting information

Organisational skills:

Managing time

Planning tasks

IT skills:

Word processing

Spread sheets

PowerPoint

Statistical techniques

Self-learning in integrated teaching:

Managing stress

Teamwork

Decision making

Learning from others

Taking the lead

Constructive feedback

Presentation skills:

Oral presentation

Written communication

Presentation to scientists/doctors

Presentation to patients

SPECIFIC SKILLS:

Problem solving:

Relevance to clinical practice

Application of textbook knowledge

Development of logical thinking

Selection of drugs and prescription writing:

Relevance to clinical practice

Patient factors

Rational prescribing

Importance of format of prescription

Communication skills:

Confidence in dealing with patients

Empathy

Imparting drug related information

Imparting knowledge of non-drug measures

Importance of feedback

 

 

 

 

 

Table 2. Influence of exposure to problem-solving sessions in school on transferable skills

Skills

Importance of skill

Own ability

Influence of teaching

Exposed

Not exposed

Exposed

Not exposed

Exposed

Not exposed

General skills

3.23

3.3

2.6

2.47

2.21

2.35

Information handling

3.34

3.36

2.51

2.51

2.23

2.57

Organisational skills

3.34

3.52

2.66

2.66

2.26

2.49

IT skills

2.92

2.82

1.89

2.37*

1.73

1.43

Self-learning skills

3.22

3.34

2.67

2.66

2.3

2.6

Presentation skills

3.36

3.48

2.55

2.48

2.44

2.61

Specific skills:

3.48

3.56

2.85

2.71

2.72

2.98

Problem solving

3.53

3.57

2.91

2.66

2.7

3.09

Selection of drugs

3.43

3.54

2.73

2.64

2.87

3

Communication skills

3.43

3.58

2.97

2.86

2.64

2.83

* p=0.058

 

 

 

Table 3: Influence of the importance given to self-learning in school on transferable skills

 

Skill

Importance of skill

Your own ability

Influence of teaching

Not imp.

Imp.

V. Imp

Not imp.

Imp.

V. Imp

Not imp.

Imp.

V. Imp

General skills

3.21

3.26

3.31

2.42

2.58

2.64

2.14

2.27

2.42

Information handling

3.32

3.35

3.47

2.36

2.42

2.79

2.32

2.5

2.62

Organisational skills

3.4

3.4

3.57

2.59

2.74

2.75

2.2

2.35

2.5

IT skills

2.4

2.81

3

2.1

2.18

1.99

1.47

1.64

1.5

Self-learning skills

3.21

3.3

3.34

2.68

2.59

2.79

2.11

2.39

2.82

Presentation skills

3.36

3.46

3.47

2.39

2.44

2.74

2.42

2.51

2.66

Specific skills

3.45

3.48

3.59

2.62

2.85

2.96*

2.86

2.86

3.07

Problem solving

3.36

3.44

3.68* *

2.54

2.84

3.04+

2.82

3.08

3.16

Selection of drugs and prescription writing

3.49

3.5

3.51

2.58

2.67

2.85

3.22

2.77

2.99

Communication skills

3.34

3.58

3.62

2.77

3.04

3.1++

2.73

2.76

2.82

* p=0.099, * * p=0.056, + p=0.027, ++p=0.092

 




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Ravi P Shankar
ClinMed NetPrints, 27 Jan 2003 [Full text]

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Right arrow Articles by Mishra, P.
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Right arrow Medical Education:
Undergraduate

Right arrow CLINICAL:
Medicine in Developing Countries


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