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Arch Hellen Med, 28(5), September-October 2011, 647-666


I CAN! A graduate self-completion questionnaire for evaluating medical curriculum outcomes:
How to use it, and preliminary findings on Greek medical education outcomes

I.D.K. Dimoliatis,1 T. Tzamalis,1 G. Bazoukis,1 X. Tseretopoulou,1 G. Lyrakos,2 C. Gogos,3
K. Thermos,4 K.N. Malizos,5 I.N. Papadopoulos,6 I. Pneumatikos,7 K. Siamopoulos,8 A. Benos9

1Department of Hygiene & Epidemiology, School of Medicine, University of Ioannina, Ioannina,
2Second Department of Anesthesiology, Medical School, National and Kapodistrian University of Athens, Athens,
3Department of Infections, Clinic of Internal Medicine, University Hospital of Rion, Medical School, Patra,
4Department of Pharmacology, Section of Basic Sciences, Faculty of Medicine, University of Crete, Heraklion,
5Orthopedic Clinic, Medical School, University of Thessaly, Larissa,
64th Surgical Clinic, Faculty of Medicine, National and Kapodistrian University of Athens, Athens,
7Intensive Care Unit, School of Medicine, Democritus University of Thrace, Alexandroupolis,
8Department of Nephrology, University Hospital, Medical School, University of Ioannina, Ioannina,
9Laboratory of Hygiene, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

OBJECTIVE Although valid instruments are available for measuring the educational environment during the 6-year period of undergraduate medical study, there was no tool for measuring the end-product of the medical curriculum, i.e. the abilities of the "medical graduate". The I CAN! questionnaire, based on the tuning-medicine project, is an instrument designed to measure this. The construction and validation of the questionnaire Greek, and graduates' answers to the open question "if you could change one thing in your school, what would this be?" have been described elsewhere. The aim of this paper was to present how of the instrument works and the responses of medical graduates to its closed questions.

METHOD The I CAN! questionnaire consists of 104 randomly arranged closed questions, based on the tuning-medicine level-two learning outcomes for undergraduate medical education in Europe, organized into 16 level-one outcomes, 12 for medical competencies and 4 for professionalism. The questionnaire was distributed to the graduates of Greek medical schools during the summer and autumn 2009 graduation. Their responses were coded (disagree absolutely=0, disagree=20, disagree moderately=40, agree moderately=60, agree=80, agree absolutely=100). The mean question, level-one outcomes and overall scores were calculated, and interpreted as: <50 very poor, 50−60.9 poor, 61−70.9 fairly poor, 71−78.9 fairly good, 79−88.9 good, 89−100 very good.

RESULTS Completed questionnaires were provided by 408 graduates of 6 medical schools, representing 55% of the total graduate population: 45% male, 55% female. They were graduates of the Universities of: Athens 148 (48% of graduates), Thessaloniki 147 (71%), Thrace 38 (81%), Ioannina 12 (17%), Crete 32 (47%), and Thessaly 31 (100%). On average they self-assessed their overall ability at 74% (i.e., in the "moderately good" interpretation zone), their ability to prescribe drugs 65% and to apply evidence-based medicine 68%, being a global doctor 80% and possessing professional atributes 83%. They considered themselves weaker in specific areas: Carrying out blood transfusion (37%), requesting autopsy (52%), administering intravenous therapy and using infusion devices (55%), completing correctly a death certificate (57%), matching appropriate drugs and other treatment to the clinical context (58%), and using diagnostic and therapeutic options available through other health professions (59%). They reported strength in: messuring blood pressure (96%), carrying out electrocardiography (92%), will to succeed (92%), maintaining confidentiality (91%), recognizing their own limits and asking for help (88%).

CONCLUSIONS The I CAN! self-assessment questionnaire can identify the perceived strengths and weaknesses of medical graduates, offering the basis for implementation of a SWOT analysis (strengths, weaknesses, opportunities, threats) and evidence-based educational policy. Medical schools could use the instrument to monitor progress towards competence of tomorrow's doctors, and to assess effectiveness of policy changes. If all Εuropean medical schools were to use it on every graduate cohort, a time series database could be created to serve administrative, research and other purposes.

Key words: Competence, Educational environment/climate, Graduate, Greece, Medical education, Outcome, Outcome-based education, Questionnaire I CAN!, Student.

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