10-Year Evolution of Quality Control on Medical

Degree Courses in Italy, pros and cons

MOSCOW - April, 5th 2012

Project TEMPUS IV 159328 – 1 – 2009 – FR – TEMPUS - SMHES

Life Long Learning Framework for Medical Teaching Staff

Prof. Giulia Donadel, Department of Internal Medicine, Italy

Prof. Stefano Elia, Department of Surgery, Italy Tempus Coordinator

The main goals of Medical Faculty

• To improve student’s learning process

• To ensure it

• To evaluate it

Evaluation of the University at the beginning

In Italy we find the most ancient Universities ever built in Europe: University of Bologna (X cent. a.C.) and University of Pisa (X-XI cent. a.C.).

In particular, Law and Medicine have been the first school assembly of students and teachers.

The evaluation was determined by the number of new students enrolled every year while the satisfaction of students would determine teachers’ salaries.

Evaluation of the University today

In the last ten years the Italian Ministry of Instruction University and Research (MIUR) established public precise criteria to evaluate the University.

As far as Medical School the criteria are focused on: services (busses, library, number of classrooms and sitting positions, laboratories, cafeteria, multimedia workstation, guesthouse), university hospital, number of patients, number of medical specialists, number of professors)

National Evaluation of University

From 2006 (law no.262)Agenzia Nazionale di Valutazione del Sistema Universitario e della

Ricerca (ANVUR)National Agency for Evaluation of

University System and Research

Nucleo di Valutazione di Ateneo

(University Evaluation Committee)• According to present law it has to provide by

30th April each year the National Committee for Evaluation of University System (CNVSU) the following data :• Educational offer• Students’ data • Personnel’s data • Financial data• Structures• Scientific research data

Quality control system • Efficiency of training process is evaluated through:

a) Mean teaching hours per year and average number of CFU per student University Education Credits One credit = 25 working hours (comprehensive of lesson, individual study, lab, verification, etc.).

b)  Enrolled/attending studentsc) External yearly evaluation of quality system by CNVSU (Comitato Nazionale per la Valutazione del Sistema Universitario)d) Tracking of educational process by means of : withdrawal rate in the first two years, average yearly CFUs per student and yearly percentage of graduates within planned course duration.

• Efficacy of training process is evaluated through:a)  Level of students’ satisfaction (anonymous questionnaire)b)Employment rate at one, two and three years from graduation.

Faculty of Medicine &

Surgery

Evaluation by Written Test in Multimedia Class-room EXAMS

This is equipped with 40 multimedia workstations. Answers to multiple choice quizzes will be automatically evaluated and the student can see the result directly on their private site.

University Hospital

Number of Professors per academic year 2010-2011

Full Profs = 32%

Associate Profs = 27%

Assistant Profs = 41%

Full Professor = 75

Associate Professor = 62

Assistant Professor = 94

Professors = 231

Students EnrollmentThe parameters that determine the number

of students enrolled each year at the medical school are: 1.The standard quality (accreditation services) of the University and Hospital

And2. The number of general practitioners in service within the Italian public structures

Number of STUDENTS per academic year 2010-2011

STUDENTS 1°year = 264

STUDENTS 2°year = 311

STUDENTS 3°year = 273

STUDENTS 4°year = 240

STUDENTS 5°year = 245

STUDENTS 6°year = 382

TOTAL N. STUDENTS 1715

Evaluation of students in entrance

• Since 1997, to be admitted in public university, students from high school have to pass a very selective national multiple choice test on different issues: general culture-logics (40), biology (20), chemistry (10), math-physics (10).

• The Admission Test is determined by a Ministry Board of examiners.

• The student attend the same multiple choice test at the same day at the same time in all the Italian universities.

• Each elaborate is anonymous and a barrel code correlates the single test to the single student

• The test evaluation is determined by digital scanin a centralized ministry location for all university

Evaluation during the six years of M&S course

• Student’s attendance at frontal and practice lessons during each semester of academic year.

• Accrual of credits (ECTS) per year obtained by passing the exams (periodical written test and final oral exam) within each academic year for each discipline.

• Progress Test: multiple choice quizzes of basic and clinical knowledge attended by students during every academic year to evaluate the progression of acquired information.

Example of Classroom Attendance Evaluation 2011-2012

Exams and ECTS per year of Medicine and Surgery Course 2011-2012

Final Evaluation to become a practising Medical Doctor

At the end of study course each student is evaluated by internal university board on his own “curriculum studiorum” and, then, on experimental or clinical thesis, that is prepared during the last semester of the sixth year of course.

Professional Evaluation today and…..

• At present to become a practising MD it is necessary to pass an accreditation exam organized in two parts:

1. The first part is made of four-week training soon after Medical Degree in the Department of internal medicine and surgery, respectively, plus four weeks at a general practitioner’s public outpatient clinic;

2. The second part is a multiple choice test organized in basic and clinical quizzes like as the Progress Test attended by MD students during the M&S course. Finally, a board composed by University Professors and members of MIUR examines the evaluations obtained by the single doctor at the end of the two proofs and decides the accreditation to the MD profession.

……Professional Evaluation tomorrow

• In the very close future the accreditation to the MD Profession could be extended in the Final Exam of MD Degree due to the increased ECTS of practice and training in general medicine public institution during the six years M&S course and including the written test and the presence of the ministry examiners in the board.

Conclusions• In the past 10 years the Italian M&S course went

through two important reforms: low n.509 and the last one n.270

• ECTS were introduced each year of course to increase practice lesson. In particular, during the sixth year, each student is followed by a medical doctor or specializing student for five weeks in internal medicine and surgery department, respectively.

• Both of new course of study introduced variations on the programmed medical courses to uniform the Italian Medical Degree to the European standard