RP-13 Professional year at FMUL: students and residents' perceived autonomy in achieving learning outcomes - curricular implications

Resumo

Introduction and Goal
Medical schools through their curricula play a major role in the success of the newly graduated
doctors, being socially responsible for offering the best opportunities for students to develop the

knowledge, skills and attitudes expected from a highly professional doctor. At FMUL, the sixth-
final-year is a professional year with well-defined transversal and specific competences to be

acquired in all rotations (Surgery/Medicine/Paediatrics/Obstetrics-Gynaecology/Family-
Medicine/Mental-Health), being a decisive medical education milestone mainly in preparing to the

transition from the academic years to professional practice. The objectives of the study are: to
identify the perceptions from 2018/2019 final-year students and first-year residents on their
autonomy (scale: 0=null/1=low/2=medium/3=high) concerning the curricular competences
requiring the highest degree of autonomy, number of opportunities to practice them, reasons for
insufficient practice and suggestions for improvement.
Material and Methods
The 118 competences requiring the highest degree of autonomy were identified. An anonymous
online-survey was sent to all
participants (n=724) inquiring about their perception on study objectives. Response rate was
»13%.
Results and Discussion
Higher autonomy was reported on the transversal competences common to all rotations (1.9) and
Paediatrics (1.7), while Medicine (1) and Surgery (0.9) were the rotations with lower perception of
autonomy. Paediatrics is the rotation offering more practice per competence (average=5.6), with
Mental-Health, Medicine and Surgery being the rotations with fewer opportunities (average=2.9-
2.9-2.6). A very high correlation (r2»95) was found between perceived autonomy and
opportunities to practice. Regarding the reasons for insufficient practice, 89% answered that they
had no contact with the required competency. Participants also suggested 10 competences to be
introduced/removed and alerted for 28 competences not clearly defined.
Conclusion
Despite the low response-rate, a study limitation, the very high correlation seems to indicate the
insufficient practice as a major factor for a low perception of autonomy. According to this result,
improvement is needed in order that rotations can guarantee the necessary practice to allow
students to achieve the expected autonomy. Therefore, it is essential to:
• increase practice opportunities
• review the curriculum – relevance, clarity and missing competences