Quality Use of Pathology Services Education Program (2006)
Description
A structured program for teaching diagnostic pathology by pathologists and scientific staff was developed and delivered to year three medical students at the University of Sydney’s School of Rural Health (formally Dubbo Clinical School) over a four-year period (2003-2006).
to achieve improvement in the health and economic outcomes of the use of pathology in health care through the pursuit of better practice amongst requesters and providers of pathology services
to produce a greater understanding of pathology tests by medical students
to equip medical students with the capacity to act more confidently in clinical situations in which pathology services may not be readily available
to provide medical students with a better understanding of the pathological process of disease and the realistic role of the pathology laboratory.
These aims and objectives were achieved by this project.
Outcomes
A program to provide a structured program for the teaching of diagnostic pathology by pathologists and scientists was developed for students at The School of Rural Health.
Pathology teaching was incorporated into the year three medical students’ academic timetable to make it an integrated part of medical training at The School of Rural Health.
Part of the course demonstrated that a clinician can make an accurate diagnosis in rural/remote practice with simple equipment and basic point of care technology.
The students spent eight half days covering the major disciplines of pathology, and were involved in autopsies and formal tutorials.
Independent evaluations of the course were submitted.
Findings
The School of Rural Health noted the value of teaching pathology, and student opinion was in favour of pathology teaching.
Pathology departments at both sites acknowledge the benefits of the project and indicated that teaching would continue in the short term.
A independent external reviewer noted the following strengths of the program:
it had a strong correlation with clinical practice
the involvement of a broad range of stakeholders (scientists, technicians, pathologists and physicians) to deliver the program objectives
enthusiastic, engaging and committed staff at both campuses
the close location between The School of Rural Health, the hospitals and the hospital pathology laboratories
good physical teaching facilities
positive feedback about the program from the medical students
willingness of staff to improve the program.
A second independent external reviewer noted:
the program had the potential to provide a model for teaching laboratory medicine in the senior years of medical courses
the initial funding had been well-utilised to build an excellent teaching program with great potential as a model to advance the better use of pathology in health care.
Recommendations
The School of Rural Health will consider another submission in consultation with the Australian Government Department of Health and Ageing.
Independent external reviews recommended:
Develop strategies to ensure that students can participate in all aspects of the program such as ensuring the student’s timetables are compatible with the pathology sessions or introducing a pathology prize.
Ensure more consistency in the delivery of the program between the campuses.
Greater clarity for students and some staff regarding the learning objectives and outcomes of the program such as the learning standards required.
More detailed planning on how the medical school will manage the delivery of the program if pathologist numbers are reduced further, including possibly developing links between the private pathology services and The School of Rural Health.
Development of formal assessment processes to align with the learning objectives involving the University of Sydney Medical Education Unit.
More access to staff development programs to help with the program development and delivery.
The University of Sydney and the Area Health Service must provide more academic teaching staff for this teaching program to continue and develop successfully.
Secure, long-term funding arrangements, probably involving the Australian Government Department of Health and Ageing, must be negotiated to ensure continuation of the teaching program.
Consider networking with similar programs in other medical schools.
Further support of this program is strongly recommended.
Key Project Learnings
The time and resources spent by academics and support staff was not factored into the agreement with the Australian Government Department of Health and Ageing.
The School of Rural Health identified a lack of administrative support and formal coordination between their campuses in Orange and Dubbo and the pathology tutors as a small barrier to the successful delivery of the program to students. This factor must be addressed to make the program sustainable.
Casebook/skills logbooks were developed and supplied to students at both campuses, however, since their completion was not a requirement of the University’s medical course there was limited success with students filling them out. New assessment methods will need to be standardised and developed across both campuses.
