Jill Gordon | The University of Sydney (original) (raw)
Papers by Jill Gordon
Journal of General Internal Medicine, 1992
Objective:To determine whether interns’ performances of technical, preventive, and communication ... more Objective:To determine whether interns’ performances of technical, preventive, and communication aspects of patient care improve during the intern year. Design:A descriptive study. At the beginning and end of the intern year, interns’ consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel. Problems simulated were urinary tract infection, bronchitis, and tension headache. Setting:The casualty outpatient department in a general teaching hospital in New South Wales, Australia. Participants:Twenty-eight interns rotated to the casualty department. Results:Little improvement over the intern year in technical competence or preventive care was observed, even though initial levels of compliance with criteria were quite low for some items. Greater improvement was apparent in the area of communication skills. Conclusions:The results suggest that the internship should be restructured to more adequately teach the skills required for primary care.
Medical Education, 1988
Summary. Fifty-four interns agreed to a study in which their clinical performance in an outpatien... more Summary. Fifty-four interns agreed to a study in which their clinical performance in an outpatient unit with standardized patients was recorded on videotape. In order to examine whether they could distinguish standardized from real patients, the interns were asked to note any patients who they thought might be simulating their complaints and report these to the researchers at the end of each 2-day period of study. Thirty-two of the interns were assessed again at the end of their internship, using the same clinical problems presented by different simulators. The consultations took place in the casualty department of a large urban hospital. At the beginning of the year there were 152 consultations with standardized patients and 328 consultations with appropriate genuine patients. Standardized patients were identified definitely as ‘not genuine’ in only 12 of the 152 consultations (sensitivity 7.8%) whereas 320 of the 328 genuine consultations were accepted by the interns as genuine (specificity 97.8%). When the level of confidence required to distinguish the two groups was reduced from ‘definite’ to ‘probable’, the number of correctly identified simulator consultations increased to 36/152 (27%) but the rate of misclassification of genuine patients also increased from 8 to 37 out of 328 consultations (11%). At the end of the year there were 81 consultations with standardized patients and 149 consultations with genuine patients. Identification rates were only slightly changed. We conclude that simulator identification is not a problem in applying standardized patients to evaluate the quality of care provided in a hospital casualty.
The Medical Journal of …, Jan 1, 1995
To describe current mental health care practices of general practitioners and to identify their e... more To describe current mental health care practices of general practitioners and to identify their educational priorities and training preferences. Self-administered questionnaire to a stratified random sample of New South Wales general practitioners. 721 full-time general practitioners, of whom 534 (74%) responded. Mental health problems recognised by general practitioners at least once per week were psychosomatic (93%), emotional (89%), addiction (79%), social/economic (71%) and family (69%). At least two-thirds recognised sexual problems, sexual abuse and major psychiatric problems less frequently than once per week. Sixty-four per cent of general practitioners reported that patients felt uncomfortable about being referred to psychiatrists; 53% that referral service waiting lists were too long; 51% that there were insufficient local mental health services; and 25% that communication difficulties between referring general practitioners and mental health specialists obstructed optimal care. Educational priorities were diagnostic and counselling skills, with particular emphasis on crisis, family, individual and marital counselling and strategies to prevent general practitioner burn-out. General practitioners are interested in improving their mental health counselling and diagnostic skills but barriers remain. Both structural and educational initiatives are essential to enhance the quality of mental health care in general practice.
Medical …, Jan 1, 1995
A clinical supervisors rating form addressing 13 competencies was used to assess the clinical com... more A clinical supervisors rating form addressing 13 competencies was used to assess the clinical competence of graduates one year after qualification in New South Wales (NSW), Australia. Data from 485 interns (97.2%) showed that graduates from the problem-based medical school were rated significantly better than their peers with respect to their interpersonal relationships, 'reliability' and 'self-directed learning'. Interns from one of the two traditional NSW medical schools had significantly higher ratings on 'teaching', 'diagnostic skills' and 'understanding of basic mechanisms'. Graduates from international medical schools performed worse than their peers on all competencies. These results were adjusted for age and gender. Additionally, women graduates and younger interns tended to have better ratings. Junior doctors have differing educational and other background experiences and their performance should be monitored.
Journal of behavioral …, Jan 1, 1991
This research examines the effect of patient gender on the detection of psychological disturbance... more This research examines the effect of patient gender on the detection of psychological disturbance. In Study 1, primary-care patients were requested to complete the General Health Questionnaire (GHQ), a measure of nonpsychiatric psychological disturbance, prior to their consultation. The patient's GHQ score was compared with physician judgments about the level of disturbance in that patient (N = 1913). Although there were a similar number of GHQ high scorers among males and females, the physicians classified significantly more females than males as disturbed. The doctors classified as disturbed a larger proportion of nondisturbed women than nondisturbed men. In order to explore the behavior of recent medical graduates, Study 2 examined the detection behavior of interns in an outpatient department with 384 of their patients. The interns behaved in a similar manner to the primary-care physicians.
Medical Education, Jan 1, 2003
Context Altruism, accountability, duty, integrity, respect for others and lifelong learning are q... more Context Altruism, accountability, duty, integrity, respect for others and lifelong learning are qualities that have been identified as central to medical professionalism. However, we do not have a systematically developed understanding of what is needed to optimise medical students' personal and professional development (PPD). We need some level of agreement on how to teach and assess PPD, but traditional educational methods may not be strong determinants of students' or graduates' actual behaviour in clinical settings.
Advances in health sciences education, Jan 1, 2009
The importance of reflection and reflective practice are frequently noted in the literature; inde... more The importance of reflection and reflective practice are frequently noted in the literature; indeed, reflective capacity is regarded by many as an essential characteristic for professional competence. Educators assert that the emergence of reflective practice is part of a change that acknowledges the need for students to act and to think professionally as an integral part of learning throughout their courses of study, integrating theory and practice from the outset. Activities to promote reflection are now being incorporated into undergraduate, postgraduate and continuing medical education, and across a variety of health professions. The evidence to support and inform these curricular interventions and innovations remains largely theoretical. Further, the literature is dispersed across several fields, and it is unclear which approaches may have efficacy or impact. We, therefore, designed a literature review to evaluate the existing evidence about reflection and reflective practice and their utility in health professional education. Our aim was to understand the key variables influencing this educational process, identify gaps in the evidence, and to explore any implications for educational practice and research.
Medical Education, Jan 1, 2003
Background and Purpose Medical schools are placing more emphasis on students' personal and profes... more Background and Purpose Medical schools are placing more emphasis on students' personal and professional development (PPD) and are seeking ways of assessing student progress towards meeting outcome goals in relation to professionalism. The Faculty of Medicine at the University of Sydney sought an assessment method that would demonstrate the value of reflection in attaining PPD, provide feedback and encourage students to take responsibility for setting and achieving high standards of performance.
Journal of General Internal Medicine, 1992
Objective:To determine whether interns’ performances of technical, preventive, and communication ... more Objective:To determine whether interns’ performances of technical, preventive, and communication aspects of patient care improve during the intern year. Design:A descriptive study. At the beginning and end of the intern year, interns’ consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel. Problems simulated were urinary tract infection, bronchitis, and tension headache. Setting:The casualty outpatient department in a general teaching hospital in New South Wales, Australia. Participants:Twenty-eight interns rotated to the casualty department. Results:Little improvement over the intern year in technical competence or preventive care was observed, even though initial levels of compliance with criteria were quite low for some items. Greater improvement was apparent in the area of communication skills. Conclusions:The results suggest that the internship should be restructured to more adequately teach the skills required for primary care.
Medical Education, 1988
Summary. Fifty-four interns agreed to a study in which their clinical performance in an outpatien... more Summary. Fifty-four interns agreed to a study in which their clinical performance in an outpatient unit with standardized patients was recorded on videotape. In order to examine whether they could distinguish standardized from real patients, the interns were asked to note any patients who they thought might be simulating their complaints and report these to the researchers at the end of each 2-day period of study. Thirty-two of the interns were assessed again at the end of their internship, using the same clinical problems presented by different simulators. The consultations took place in the casualty department of a large urban hospital. At the beginning of the year there were 152 consultations with standardized patients and 328 consultations with appropriate genuine patients. Standardized patients were identified definitely as ‘not genuine’ in only 12 of the 152 consultations (sensitivity 7.8%) whereas 320 of the 328 genuine consultations were accepted by the interns as genuine (specificity 97.8%). When the level of confidence required to distinguish the two groups was reduced from ‘definite’ to ‘probable’, the number of correctly identified simulator consultations increased to 36/152 (27%) but the rate of misclassification of genuine patients also increased from 8 to 37 out of 328 consultations (11%). At the end of the year there were 81 consultations with standardized patients and 149 consultations with genuine patients. Identification rates were only slightly changed. We conclude that simulator identification is not a problem in applying standardized patients to evaluate the quality of care provided in a hospital casualty.
The Medical Journal of …, Jan 1, 1995
To describe current mental health care practices of general practitioners and to identify their e... more To describe current mental health care practices of general practitioners and to identify their educational priorities and training preferences. Self-administered questionnaire to a stratified random sample of New South Wales general practitioners. 721 full-time general practitioners, of whom 534 (74%) responded. Mental health problems recognised by general practitioners at least once per week were psychosomatic (93%), emotional (89%), addiction (79%), social/economic (71%) and family (69%). At least two-thirds recognised sexual problems, sexual abuse and major psychiatric problems less frequently than once per week. Sixty-four per cent of general practitioners reported that patients felt uncomfortable about being referred to psychiatrists; 53% that referral service waiting lists were too long; 51% that there were insufficient local mental health services; and 25% that communication difficulties between referring general practitioners and mental health specialists obstructed optimal care. Educational priorities were diagnostic and counselling skills, with particular emphasis on crisis, family, individual and marital counselling and strategies to prevent general practitioner burn-out. General practitioners are interested in improving their mental health counselling and diagnostic skills but barriers remain. Both structural and educational initiatives are essential to enhance the quality of mental health care in general practice.
Medical …, Jan 1, 1995
A clinical supervisors rating form addressing 13 competencies was used to assess the clinical com... more A clinical supervisors rating form addressing 13 competencies was used to assess the clinical competence of graduates one year after qualification in New South Wales (NSW), Australia. Data from 485 interns (97.2%) showed that graduates from the problem-based medical school were rated significantly better than their peers with respect to their interpersonal relationships, 'reliability' and 'self-directed learning'. Interns from one of the two traditional NSW medical schools had significantly higher ratings on 'teaching', 'diagnostic skills' and 'understanding of basic mechanisms'. Graduates from international medical schools performed worse than their peers on all competencies. These results were adjusted for age and gender. Additionally, women graduates and younger interns tended to have better ratings. Junior doctors have differing educational and other background experiences and their performance should be monitored.
Journal of behavioral …, Jan 1, 1991
This research examines the effect of patient gender on the detection of psychological disturbance... more This research examines the effect of patient gender on the detection of psychological disturbance. In Study 1, primary-care patients were requested to complete the General Health Questionnaire (GHQ), a measure of nonpsychiatric psychological disturbance, prior to their consultation. The patient's GHQ score was compared with physician judgments about the level of disturbance in that patient (N = 1913). Although there were a similar number of GHQ high scorers among males and females, the physicians classified significantly more females than males as disturbed. The doctors classified as disturbed a larger proportion of nondisturbed women than nondisturbed men. In order to explore the behavior of recent medical graduates, Study 2 examined the detection behavior of interns in an outpatient department with 384 of their patients. The interns behaved in a similar manner to the primary-care physicians.
Medical Education, Jan 1, 2003
Context Altruism, accountability, duty, integrity, respect for others and lifelong learning are q... more Context Altruism, accountability, duty, integrity, respect for others and lifelong learning are qualities that have been identified as central to medical professionalism. However, we do not have a systematically developed understanding of what is needed to optimise medical students' personal and professional development (PPD). We need some level of agreement on how to teach and assess PPD, but traditional educational methods may not be strong determinants of students' or graduates' actual behaviour in clinical settings.
Advances in health sciences education, Jan 1, 2009
The importance of reflection and reflective practice are frequently noted in the literature; inde... more The importance of reflection and reflective practice are frequently noted in the literature; indeed, reflective capacity is regarded by many as an essential characteristic for professional competence. Educators assert that the emergence of reflective practice is part of a change that acknowledges the need for students to act and to think professionally as an integral part of learning throughout their courses of study, integrating theory and practice from the outset. Activities to promote reflection are now being incorporated into undergraduate, postgraduate and continuing medical education, and across a variety of health professions. The evidence to support and inform these curricular interventions and innovations remains largely theoretical. Further, the literature is dispersed across several fields, and it is unclear which approaches may have efficacy or impact. We, therefore, designed a literature review to evaluate the existing evidence about reflection and reflective practice and their utility in health professional education. Our aim was to understand the key variables influencing this educational process, identify gaps in the evidence, and to explore any implications for educational practice and research.
Medical Education, Jan 1, 2003
Background and Purpose Medical schools are placing more emphasis on students' personal and profes... more Background and Purpose Medical schools are placing more emphasis on students' personal and professional development (PPD) and are seeking ways of assessing student progress towards meeting outcome goals in relation to professionalism. The Faculty of Medicine at the University of Sydney sought an assessment method that would demonstrate the value of reflection in attaining PPD, provide feedback and encourage students to take responsibility for setting and achieving high standards of performance.