Postgraduate emergency medicine education in Australasia training and assessment - the trainee's perspective

2017-02-15T04:28:22Z (GMT) by Craig, Simon
This thesis describes a comprehensive survey of trainees of the Australasian College for Emergency Medicine (ACEM) about their views on assessment and feedback during their training. This is the first survey of its kind in Australasia. The paper begins with a detailed description of emergency medicine training in Australasia, providing a context in which to place the trainees' perspective. The relevant educational literature is then reviewed, with a focus on the current assessment methods used in emergency medicine training, as well as potential additional workplace based assessment tools. Following the literature review, the methodology of the survey is presented. The anonymous web-based survey was conducted in mid-2009, and addressed trainees' perceptions of training, supervision and feedback. Specific questions were asked regarding mandatory assessments during training - the primary examination, fellowship examination, and the trainee research requirement. Qualitative data were analysed using thematic analysis. 622 trainees responded to the survey (response rate of 37%). Trainees report that general clinical supervision is adequate, however, direct supervision at the bedside and feedback could be significantly improved. They perceive that the primary examination is necessary, although they feel it is irrelevant to their development as emergency trainees and are keen for more clinically applied knowledge to be tested. They dislike mandatory trainee research, feel inadequately supported, and distracted from other aspects of their training. The fellowship examination was overall thought to be fair, however, there were concerns with the time pressures and restrictions to the written component of the examination. Additionally, the structured clinical examination component was viewed favourably, while short cases and long cases were viewed negatively. A detailed discussion with reference to the educational literature is then presented. Recommendations from ACEM's recent review of training and assessment (which commenced in 2010) are compared with trainees' views and relevant publications. The thesis concludes with a discussion of potential limitations, and an overview of possible future research on the education of emergency medicine trainees in Australasia.