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      How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries

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          Abstract

          Background

          A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools.

          Methods

          The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country.

          Results

          The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043).

          Conclusions

          The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.

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          Most cited references15

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          Global minimum essential requirements in medical education.

          (2002)
          The process of globalization is increasingly evident in medical education and makes the task of defining global essential competences required by 'global physicians' an urgent matter. This issue was addressed by the newly established Institute for International Medical Education (IIME). The IIME Core Committee developed the concept of 'global minimum essential requirements' ('GMER') and defined a set of global minimum learning outcomes that medical school students must demonstrate at graduation. The 'Essentials' are grouped under seven broad educational domains with a set of 60 learning objectives. Besides these 'global competences', medical schools should add national and local requirements. The focus on student competences as outcomes of medical education should have deep implications for curricular content as well as the educational processes of medical schools.
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            Global minimum essential requirements: a road towards competence-oriented medical education.

            With the growing globalization of medicine and the emerging concept of a 'global profession of physicians', the issue of the essential competences that all physicians must possess becomes sharply focused. If defined, these competences would help indicate what teachers are supposed to teach, what students are expected to learn and what educational experiences all physicians must have. The 'minimum essential competences' that all graduates must have if they wish to be called physicians were identified by the Institute for International Medical Education (IIME), sponsored by the China Medical Board of New York, through working groups of educational and health policy experts and representatives of major international medical education organizations. In the first phase of the project, seven domains have been identified that define the knowledge, skills, professional behavior and ethics that all physicians must have, regardless of where they received their general medical training. Appropriate tools to assess each of the domains have been identified. In the second phase of the project the 'global minimum essential requirements' (GMER) will be implemented experimentally in a number of Chinese medical schools. The aim of the third phase will be to share the outcomes of this educational experiment, aimed at improving the quality of medical education, with the global education community.
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              Clarifying the concepts of confidence and competence to produce appropriate self-evaluation measurement scales.

              This paper reviews the literature on self-evaluation and discusses the findings of a small-scale qualitative study which explored the terms 'confidence' and 'competence' as useful measures in a self-evaluation scale. Four pre-registration house officers took part in interviews and completed a provisional instrument to assess their perceived competence. Competence and confidence are useful terms for house officers expressing beliefs about their ability to perform their job but the terms should not be used synonymously. In our study, 'competent' represented what individuals knew about their ability and was based on the individual's previous experience of the task. 'Confident' described a judgement which influenced whether an individual was willing or not to undertake an activity. Confidence was not necessarily based on known levels of competence and therefore performance of tasks which were unfamiliar to the house officer also involved the assessment of risk. The authors give examples of task and skill scales which may be useful in the process of self-evaluation by pre-registration house officers. The authors suggest that the process of assessing oneself is complicated, and by its very nature can never be objective or free from the beliefs and values individuals hold about themselves. Therefore self-evaluation instruments are best used to help individuals analyse their work practices and to promote reflection on performance. They should not be used to judge the 'accuracy' of the individual's evaluation.
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                Author and article information

                Journal
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2011
                25 May 2011
                : 11
                : 24
                Affiliations
                [1 ]Center for Medical Education, Faculty of Medicine, University of Porto, (Al. Prof. Hernâni Monteiro), Porto, (4200-319), Portugal
                [2 ]Department of Hygiene and Epidemiology, Faculty of Medicine, University of Porto, (Al. Prof. Hernâni Monteiro), Porto, (4200-319), Portugal
                [3 ]Center for Advanced Studies in Medical Education, Faculty of Medicine, University Agostinho Neto, (Av. Hoji ya Henda), Luanda, (116), Angola
                [4 ]Faculty of Medicine, University Eduardo Mondlane, (Av. Salvador Allende), Maputo, (257), Mozambique
                [5 ]Institute of Anatomy, Faculty of Medicine, University of Porto, (Al. Prof. Hernâni Monteiro), Porto, (4200-319), Portugal
                [6 ]Institute of Public Health, University of Porto, (Rua das Taipas), Porto (4050-600), Portugal
                Article
                1472-6920-11-24
                10.1186/1472-6920-11-24
                3123652
                21612609
                051ade05-899c-48b8-a00a-ce01d1367fab
                Copyright ©2011 Barbosa et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 September 2010
                : 25 May 2011
                Categories
                Research Article

                Education
                Education

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