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Let's have the courage to train young doctors to conduct ophthalmic surgery! - This is the final plea of this theoretical article, which appeals for greater collaboration between medical and educational sciences in the training of ophthalmic surgeons. It will be discussed whether surgery-based training is adequate, from the point of view of both medical knowledge and learning theory. Standard requirements for the specialist qualification in ophthalmic surgery are presented for Bavaria, Austria and Switzerland; these are then compared and contrasted with the experience-based practice of vocational training. Assuming that vocational training can be understood as providing the context for action-oriented learning, the relevance of procedural knowledge will be discussed for the development of practical surgical skills. A model for expertise in ophthalmic surgery will be outlined. Instructors' didactic skills and expertise will be discussed in relation to the requirements and guidelines for receiving the license to train assistants. In general, the article highlights the relevance of performance in learning surgery, and calls for the provision of sufficient possibilities to learn surgery in the course of assistant doctors' vocational training. This article addresses those who are involved in ophthalmologists' and ophthalmic surgeons' vocational training (e.g. medical instructors, medical associations, assistant doctors) and who welcome thought-provoking impulses from unfamiliar academic disciplines on key questions and concerns in practical vocational training.

Background: Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. Objective: To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care. Design and intervention: Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone. Participants: First-year internal medicine residents. Main measures: Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure. Key results: We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop (p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores. Conclusion: Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose. © The Author(s) 2016.

Emphasizing the aspects of soft skills among students is an important element to produce graduates who are competitive when facing any situations in the workplace. Various efforts have been taken by the Ministry of Education (MOE) and the Ministry of Higher Education Malaysia (MOHE) to improve the education system in Malaysia. Learning methods were introduced to ensure the education systems achieve the educational goals and to produce individuals who are well-balanced with spiritually, emotionally and physically. However, the issue of unemployment among graduates often being spoken in the community and it was regarded as a failure of educational institutions to produce quality graduates. Thus, the method of Work-Based Learning (WBL) was seen as a way to improve the soft skills among the graduates. The study was conducted using quantitative research survey as the design of the study used a questionnaire that was adapted as an instrument. Data were analysed using Statistical Package of Social Science (SPSS) version 20.0. The respondents were consisted of 97 students who attended WBL programs at the community college. Data were obtained from questionnaires using descriptive statistics for the calculation of the mean and one-way ANOVA test. The findings of the level of soft skills among community colleges were high where the communication skills obtained (mean = 4.1218), critical and problem solving skills (mean = 4.0946), teamwork skills (mean = 4.2297), learning and information management (mean = 4.1219), entrepreneurial skills (mean = 4.0240), professional ethics and moral (mean = 3.9410) and leadership skills (mean = 4.2104). The findings also showed the differences in term of communication skills among the community colleges. This study was significant to the community colleges to identify the level of soft skills among students who performed WBL methods in order to reduce the number of unemployment. © Published under licence by IOP Publishing Ltd.

While portfolios have seen an unprecedented surge in popularity, they have also become the subject of controversy: learners often perceive little gain from writing reflections as part of their portfolios; scholars question the ethics of such obligatory reflection; and students, residents, teachers and scholars alike condemn the bureaucracy surrounding portfolio implementation in competency-based education. It could be argued that mass adoption without careful attention to purpose and format may well jeopardize portfolios’ viability in health sciences education. This paper explores this proposition by addressing the following three main questions: (1) Why do portfolios meet with such resistance from students and teachers, while educators love them?; (2) Is it ethical to require students to reflect and then grade their reflections?; (3) Does competency-based education empower or hamper the learner during workplace-based learning? Twenty-five years of portfolio reveal a clear story: without mentoring, portfolios have no future and are nothing short of bureaucratic hurdles in our competency-based education programs. Moreover, comprehensiveportfolios, which are integrated into the curriculum and much more diverse in content than reflective portfolios, can serve as meaningful patient charts, providing doctor and patient with useful information to discuss well-being and treatment. In this sense, portfolios are also learner charts that comprehensively document progress in a learning trajectory which is lubricated by meaningful dialogue between learner and mentor in a trusting relationship to foster learning. If we are able to make such comprehensive and meaningful use of portfolios, then, yes, portfolios do have a bright future in medical education. © 2016, The Author(s).

Objective: To investigate older patients' encounters with general practice registrars (GPRs) to inform training and clinical practice. Methods: Cross-sectional analysis of data from GPR consultations across five regional training providers in Australia. Data were analysed using simple and multiple logistic regression models. Results: Our analysis included details of 118 831 consultations, 20 555 (17.6%, 95% CI 17.4–17.8) with patients aged ≥65 years. Older patient encounters had an increased likelihood of including chronic disease (OR 1.77, 95% CI 1.70, 1.86) and more problems (OR 1.24, 95% CI 1.20, 1.27). However, in-consultation information or advice was less likely to be sought (OR 0.92, 95% CI 0.88, 0.97), and consultations were briefer (OR 0.99, 95% CI 0.99, 1.00). Conclusion: Our results suggest relatively limited GPR exposure to older patients coupled with less complex consultations than expected. Solutions will need to be carefully constructed not only to increase caseloads, but also to address training and supervision concerns. © 2016 AJA Inc.

Graduates of the German dual system of vocational education and training differ in their chances of directly entering horizontally and vertically matching labour market positions. This article discusses how structural characteristics of training occupations impact such differences. I focus on three characteristics: the average training costs, the degree of occupational closure and how broadly applicable the qualifications are. Using data from the National Educational Panel Study (NEPS), I analyse the first labour market position for individuals who graduated from apprenticeship training between 1974 and 2004 in West Germany. I develop measures for occupational characteristics based on data from the BIBB Cost Benefit Studies and the BIBB/IAB Employment Surveys and merge these measures with the individual-level data. Applying multinomial logistic regression models, I simultaneously analyse the influence of the occupational characteristics on the probability to find employment in the first place and to reach horizontally and vertically matching positions. The results show that the occupational characteristics provide different opportunities within the training occupation but also within other occupations. The article, thus, helps us understand how occupational characteristics structure individual labour market chances and sheds light on the long-term consequences of unequal access to training occupations. © 2017, Springer Fachmedien Wiesbaden.

Background: Practice-based learning is an essential aspect of nursing education, and evaluating this form of learning is vital in determining whether students have the competence required to enter nursing practice. However, limited knowledge exists about the influences that shape how competence development is recognized in nursing programs. The purpose of this study was to explore the evaluation of practice-based learning from the students’ standpoint. Method: A qualitative design based on institutional ethnography was used to investigate evaluation of practice-based learning with students, preceptors, and faculty in a preceptorship practicum. Results: The findings revealed how work associated with evaluation was organized by coexisting and often disparate influences within a nursing program and the workplaces where learning took place. Conclusion: The implications and recommendations of the inquiry are intended to encourage dialogue and action among stakeholders from education and practice to improve evaluation practices in preparing new members of the nursing profession. © SLACK Incorporated.

The ability of health professionals to collaborate effectively has significant potential impact on patient safety and quality-care outcomes, especially given the increasingly complex and dynamic clinical practice environments of today. Educators of the health professions are faced with an immediate challenge to adapt curricula and traditional teaching methods to ensure graduates are equipped with the necessary interprofessional competencies and (inter)professional values for their future practice. The World Health Organization’s “Framework for action in interprofessional education (IPE) and collaborative practice” promotes IPE as a key strategy to enhance patient outcomes by preparing a “collaborative practice-ready health workforce.” Logistical and attitudinal barriers can hinder integration of IPE into curricula. Lessons learned through the implementation of a planned change to establish four interprofessional seminars (team communication, medical error communication, healthcare English, and small business management) at Heidelberg University Medical Faculty, Germany, are described. A key factor in successfully anchoring IPE seminars in the undergraduate curricula was the structured approach drawing on change management concepts. © 2017 Taylor & Francis.

This appraisal considers the role and impact of vocational education and training (VET) in Australia and New Zealand, and suggests directions such policy might take in other Asia-Pacific countries. It identifies key issues and constraints in making VET more responsive to emerging labour market needs in the region as an important factor in sustaining high economic growth. It focuses on the way in which the demands of the government, industry, trainees, and, in particular, shifts in political ideology that have influenced the education and training sectors in both countries. It addresses points of specific relevance for the delivery of VET in the broader Asia-Pacific context and concludes with a consideration of lessons and experiences of Australia and New Zealand with VET that may hold for other countries in the region in formulating priorities and implementing strategies in meeting their current and emerging needs for skills development. © 2017 Informa UK Limited, trading as Taylor & Francis Group.

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches. A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education. Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa. © 2017 by the Association of American Medical Colleges.