Graduates’ perceptions regarding their final year training

Abstract

Introduction: Educational experiences of graduates’ as primary consumers reflect the effectiveness of the educational environment. The final year of the Faculty of Medicine, Colombo, Sri Lanka consists of clinical rotations in Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology and Psychiatry. The Final examination consists of a clinical component (short and long cases) and a theory component. Objective: To assess the perception of recent graduates regarding the final year educational environment – teaching/ learning methods and content, student evaluation methods, interpersonal and social interactions. Method: The study population consisted of 180 new graduates. Focus Group Discussions (FGD) were held to gather data and formulate a questionnaire on their learning environment. Sampling was representative of: ethnicity, gender, academic achievement. The two FGDs attended by 18 and 12 participants respectively were conducted by a trained moderator. The data was recorded verbatim, collated and analyzed. A self-administered questionnaire was developed on the educational environment where key questions were based on several themes emerging from the FGDs. The questionnaire was pre tested and mailed to all graduates and the response rate was 33.33%. Results: Majority of graduates found most teaching learning activities in all subjects to be useful for future practice as a competent house officer; specially practicing ward procedures (97.5%). However 56.7% disagreed that monitoring of very ill patients by final year students was useful. The following situations were highly stressful: consultants’ behaviour towards students (30%), monitoring of patients (60%) and limited facilities for students in wards (21.7%). The behaviour of the consultant teachers towards the students was highly stressful as some ridiculed students in front of patients, were abusive towards students and not appreciative. Majority of graduates thought studentdoctor and student-patient relationships were helpful towards learning in all disciplines. The benefit of the studentnursing staff relationship towards learning was rated comparatively low, some reasons being nurses being rude towards students and uncooperative. Time was inadequate for recreation, relationships and other interests during the final year (85%, 83.3% and 83.3% respectively). Reasons being: inadequate rest between clinical appointments, tight schedule, work load, pressure of exams and long hours at the ward. Graduates thought that they were fairly assessed most of the time in all disciplines yet a proportion of graduates stated that they were ‘bullied' by examiners during the final cases. Conclusion and recommendations: The learning environment of the final year teaching programme prepared a graduate for future practice with effective learning methods, fair assessment and healthy interactions. However the learning environment needs improvement as some aspects contribute to increased levels of stress and do not promote healthy life styles. Teaching sessions and assessments should be conducted based on adult learning principles.