Family physicians who have focused practices in oncology: results of a national survey

OBJECTIVE

To characterize the demographic characteristics, practice profile, and current work life of general practitioners in oncology (GPOs) for the first time.

DESIGN

National Web survey performed in March 2011.

SETTING

Canada.

PARTICIPANTS

Members of the national GPO organization. Respondents were asked to forward the survey to non-member colleagues.

MAIN OUTCOME MEASURES

Profile of work as GPOs and in other medical roles, training received, demographic characteristics, and professional satisfaction.

RESULTS

The response rate was 73.3% for members of the Canadian Association of General Practitioners in Oncology; overall, 120 surveys were completed. Respondents worked in similar proportions in small and larger communities. About 60% of them had participated in formal training programs. Most respondents worked part-time as GPOs and also worked in other medical roles, particularly palliative care, primary care practice, teaching, and hospital work. More GPOs from cities with populations of greater than 100 000 worked solely as GPOs than those from smaller communities (P = .0057). General practitioners in oncology played a variety of roles in the cancer care system, particularly in systemic therapy, palliative care, inpatient care, and teaching. As a group, more than half of respondents were involved in the care of each of the 11 common cancer types. Overall, 87.8% of respondents worked in outpatient care, 59.1% provided inpatient care, and 33.0% provided on-call services; 92.8% were satisfied with their work as GPOs.

CONCLUSION

General practitioners in oncology are involved in all cancer care settings and usually combine this work with other roles, particularly with palliative care in rural Canada. Training is inconsistent but initiatives are under way to address this. Job satisfaction is better than that of Canadian FPs in general. As generalists, FPs bring a valuable skill set to their work as GPOs in the cancer care system.

Residents' perception of a novel end-of-rotation evaluation method

RATIONALE AND OBJECTIVES

With the advent of the new core and certifying examinations, a need has arisen to restructure learning and assessment to better reflect the emphasis on continuous learning throughout residency. We developed a multiparametric end-of-rotation (EOR) evaluation tool to assess medical knowledge, oral presentation, and written communication skills administered to the residents at the end of each core subspecialty rotation. The benefit of continual assessment is obvious from a program perspective; the purpose of this article is to evaluate the residents' perception of the process.

MATERIALS AND METHODS

All residents (n = 31, 28 postgraduate years two through five and 3 postgraduate year one) participate in the mandatory EOR evaluation as a required component of the residency program. After receiving Institutional Review Board approval, informed consent was obtained from the residents wishing to participate in quarterly 16-question online surveys assessing their experience. Each survey consists of 15 questions with Likert scale responses (1 through 5 from strongly disagree to strongly agree) and one free text answer. Data are collected quarterly, starting in September 2011.

RESULTS

Overall, the residents' response has been positive. The new evaluation method is felt to be more meaningful than (average 3.9, standard deviation 0.9) and is favored by the residents over the traditional competency-based evaluation (average 4.0, standard deviation 1.0). However, residents retain neutral attitudes regarding preparation for boards or changes in study habits (average score 3.6, standard deviation 0.9 and 3.6, and standard deviation 1.1, respectively).

CONCLUSION

Residents rate the EOR evaluation experience positively, although they do not report changes in study habits or increased preparedness for the new certifying examination.

The e-learning programmes in Greek Universities: a literature review

This paper presents an on-line research in Greek universities websites and an international literature review on electronic learning in the field of Health Informatics. The results reveal that there are a lot of e-learning programs offered by universities in Greece, but unfortunately none of them related to Health Informatics domain. On the other hand, the finding of the international literature shows that other European universities conduct e-learning studies in Health Informatics field. Future actions for the enrichment of e-learning service in Greek Health Informatics education are necessary.

Evolving impressions: undergraduate perceptions of graduate teaching assistants and faculty members over a semester

Undergraduate experiences in lower-division science courses are important factors in student retention in science majors. These courses often include a lecture taught by faculty, supplemented by smaller sections, such as discussions and laboratories, taught by graduate teaching assistants (GTAs). Given that portions of these courses are taught by different instructor types, this study explored student ratings of instruction by GTAs and faculty members to see whether perceptions differed by instructor type, whether they changed over a semester, and whether certain instructor traits were associated with student perceptions of their instructors' teaching effectiveness or how much students learned from their instructors. Students rated their faculty instructors and GTAs for 13 instructor descriptors at the beginning and near the end of the semester in eight biology classes. Analyses of these data identified differences between instructor types; moreover, student perception changed over the semester. Specifically, GTA ratings increased in perception of positive instructional descriptors, while faculty ratings declined for positive instructional descriptors. The relationship of these perception changes with student experience and retention should be further explored, but the findings also suggest the need to differentiate professional development by the different instructor types teaching lower-division science courses to optimize teaching effectiveness and student learning in these important gateway courses.

Snapshot of anatomy teaching in physician assistant education

PURPOSE

Cadaver dissection has been a defining part of the culture of medical education for centuries. Currently there is an active debate regarding the advantages of dissection versus other forms of teaching anatomy.

METHODS

De-identified data from the 2010 Curriculum Survey were obtained from the Physician Assistant Education Association, with 82 PA programs responding to anatomy curriculum questions. SPSS 21 was used for descriptive statistics, t-tests, and Mann-Whitney tests.

RESULTS

Programs reported a mean of 102.4 and median of 91 contact hours in anatomy (range 4-270). The "average" PA program anatomy course used 57.4% lecture, 4.6% simulation, 25.9% dissection, and 12.1% prosection. Private programs had significantly fewer total and lab contact-hours than public programs.

DISCUSSION

Teaching anatomy through cadaver dissection poses many challenges for health professions educators. Based on the results presented, PA programs are addressing this challenge in a variety of ways in their curricula.

Changes in physical activity levels, lesson context, and teacher interaction during physical education in culturally and linguistically diverse Australian schools

BACKGROUND

Recent data show that only 15% of Australian adolescents participate in adequate amounts of physical activity (PA) and those students from Asian and Middle-Eastern backgrounds in Grades 6-12 are significantly less active than their English-speaking background peers. Schools have recently been recognised as the most widely used and cost-effective setting for promoting PA among youth and one domain within schools where PA can occur regularly for all youth, regardless of cultural background or socio-economic status, is during physical education (PE).

METHODS

This study describes changes in physical activity (PA), lesson context and teacher interaction in physical education over the first two years in culturally and linguistically diverse secondary schools. Grade 7 PE classes in six schools were randomly observed using systematic direct observation (n = 81) and then followed up over the same period (n = 51) twelve months later.

RESULTS

There was no significant decline in moderate-to-vigorous physical activity (MVPA) during PE (MD = -4.8%; p = .777), but a significant decline and medium negative effect in time spent in vigorous physical activity (VPA) (MD = -7.9%; p = .009) during PE was observed. Significant declines and large negative effects over time in percentage of PE time spent in management (MD = -8.8%; p < .001) and the number of observations where teachers promoted PA (MD = -20.7%; p < .001).

CONCLUSIONS

The decline of VPA and teacher promotion of PA in culturally and linguistically diverse schools is of concern. Given the declines in VPA and the increases in time spent in game play, further research is needed to ascertain whether PE instruction could be improved by focussing on skill instruction and fitness in a games-based PE instruction model. Further research for increasing teacher promotion of PA during PE is needed.

Research ethics capacity development in Africa: exploring a model for individual success

The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has offered a fully-funded, one-year, non-degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub-Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees. Our data show that since 2001, the 28 former FABTP trainees have authored or co-authored 105 new bioethics-related publications; were awarded 33 bioethics-related grants; played key roles on 78 bioethics-related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post-training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs.

The teacher, the physician and the person: how faculty's teaching performance influences their role modelling

Objective

Previous studies identified different typologies of role models (as teacher/supervisor, physician and person) and explored which of faculty's characteristics could distinguish good role models. The aim of this study was to explore how and to which extent clinical faculty's teaching performance influences residents' evaluations of faculty's different role modelling statuses, especially across different specialties.

Methods

In a prospective multicenter multispecialty study of faculty's teaching performance, we used web-based questionnaires to gather empirical data from residents. The main outcome measures were the different typologies of role modelling. The predictors were faculty's overall teaching performance and faculty's teaching performance on specific domains of teaching. The data were analyzed using multilevel regression equations.

Results

In total 219 (69% response rate) residents filled out 2111 questionnaires about 423 (96% response rate) faculty. Faculty's overall teaching performance influenced all role model typologies (OR: from 8.0 to 166.2). For the specific domains of teaching, overall, all three role model typologies were strongly associated with “professional attitude towards residents” (OR: 3.28 for teacher/supervisor, 2.72 for physician and 7.20 for the person role). Further, the teacher/supervisor role was strongly associated with “feedback” and “learning climate” (OR: 3.23 and 2.70). However, the associations of the specific domains of teaching with faculty's role modelling varied widely across specialties.

Conclusion

This study suggests that faculty can substantially enhance their role modelling by improving their teaching performance. The amount of influence that the specific domains of teaching have on role modelling differs across specialties.

[Intensity of depression in pedagogy students]

The teacher's profession is regarded to be susceptible to professional burnout. Its early markers include high neuroticism and tendency to depressive reactions. The aim of the study was to assess the depression intensity and the occurrence of mood disorders in the population of full-time and extramural course students of pedagogy aged 19-30, as well as the difference in intensity of the measured constructs between men and women.

MATERIAL AND METHODS

The study was carried out on the group of 223 women and 162 men aged 19-30 studying pedagogy at Piotrków Trybunalski Division of Jan Kochanowski Memorial University in Kielce in the years 2008-2011. The control group consisted of 76 women and 88 men studying economics. Students of full-time and extramural courses were included. All the participants were assessed with Beck Depression Inventory. Depression as a syndrome was diagnosed if the score of 10 of more was obtained.

RESULTS

Among female students of pedagogy, 21 out of 223 obtained Beck Depression Inventory scores equal to, or above 10; whereas among female students of economics 1 out of 76 obtained such a result. The relative risk of developing depression (understood as Beck Depression Inventory result of 10 or more) was found to be significantly higher among female pedagogues (OR 7.797; CI 1.0306 to 58.9856) than among female economists. Among male pedagogy students, 2 out of 162 obtained 10 points, or more. It means that the risk of depression in female pedagogues was as much as over eight-fold higher than in male pedagogues (OR 8.3168; CI 1.9215 - 35.9979). The risk of depression in men studying pedagogy was not higher than in men studying economics, who obtained the Beck Depression Inventory scores of 10 or more in 1 case out of 88 (OR 1.1; CI 0.0983 to 12.3032). Considering all pedagogues irrespectively of gender versus all economists, the risk of depression in the group of pedagogues is over five-fold higher than among economists (OR 5.1464; CI 1.1991 to 22.0885). In the whole group of women, irrespectively of the study profile, the risk of Beck Depression Inventory result equal to, or exceeding was six-fold higher than among men (OR 6.5391; CI 1.9336 to 22.1144). There was no statistically significant correlation between the Beck Depression Inventory scores obtained in the studied group and the subjects' ages. The mean scores obtained in the particular groups are presented in table. The Beck Depression Inventory scores obtained by women studying pedagogy was found to differ with statistical significance from the scores obtained by male pedagogy students (p = 0.001925), female economics students (p = 0.015781) and female economics students (p = 0.000611). The mean intensity of depression in men studying pedagogy did not differ from the mean intensity of depression in women studying economics (p = 0.94128) and in men studying economics (p = 0.330382). No differences in the mean Beck Depression Inventory scores of female and male students of economics were noted, either (p = 0.444554). The mean intensity of depression in women representing both fields of study was 6.094 +/- 3.13, vs 4.97 +/- 2.45 in men; the difference was statistically significant at the significance level of p = 0.00005. The mean intensity of depression in pedagogy students of both sexes was 5.92 +/- 3.024 vs 4.79 +/- 2.39 in students of economics; the difference was statistically significant at the significance level of p = 0,000026.

CONCLUSIONS

Women studying pedagogy demonstrate higher depression intensity than men studying pedagogy, as well as male and female students of economics. Students of pedagogy demonstrate higher depression intensity than students of economics. On the overall, women in the whole studied population have higher depression intensity than men; however, no such gender-related differences were observed among students of economics.

[Work intensity and arterial hypertension]

The authors presented dependence of arterial hypertension on work intensity, exemplified by two occupational groups--teachers and electricians, and demonstrated modifying influence of occupation on prevalence of traditional cardiovascular risk factors.

[Factors enhancing teachers' occupational wellbeing scale: psychometric analysis]

BACKGROUND

The aim of this work was to elaborate the Factors Enhancing Teachers' Occupational Wellbeing Scale for use with teachers from health promoting schools and to provide its psychometric analysis.

MATERIAL AND METHODS

The sample consisted of 270 teachers from the health promoting schools. The instrument consisted of 45 statements divided into five subscales (working conditions, teachers' community, students and parents' community, organization and workload, professional competences), which are measured from two points of view: assessment of a current situation (a 5-point rating scale from 5 (strongly yes) to 1 (strongly no)) and assessment of needs for the improvement (a 5-point rating scale from 1 (no need) do 5 (very strong need)). Psychometric analysis included the assessment of: reliability (using Cronbach-alpha coefficient), theoretical validity (factor analysis with principal axis extraction) and construct validity (using data concerning self-assessment of general occupational being and assessment of general occupational being of other teachers at school, two hypothesis were tested) and unidimensionality (principal component analysis).

RESULTS

Cronbach's a for subscales, assessment of a current situation: 0.75-0.86, and for subscales assessment of needs for the improvement: 0.80-0.93. Factor structure of the scale was convergent with the expected one. Construct validity of the subscales was satisfactory--all hypotheses were confirmed. All subscales were also unidimensional.

CONCLUSIONS

Psychometric analysis of the scale gave satisfactory results concerning its quality. The scale can be used as a tool in staffs health promotion, especially in the health promoting schools.

Teaching neuroscience to science teachers: facilitating the translation of inquiry-based teaching instruction to the classroom

In science education, inquiry-based approaches to teaching and learning provide a framework for students to building critical-thinking and problem-solving skills. Teacher professional development has been an ongoing focus for promoting such educational reforms. However, despite a strong consensus regarding best practices for professional development, relatively little systematic research has documented classroom changes consequent to these experiences. This paper reports on the impact of sustained, multiyear professional development in a program that combined neuroscience content and knowledge of the neurobiology of learning with inquiry-based pedagogy on teachers' inquiry-based practices. Classroom observations demonstrated the value of multiyear professional development in solidifying adoption of inquiry-based practices and cultivating progressive yearly growth in the cognitive environment of impacted classrooms.

The social media revolution

BACKGROUND

The growing popularity and use of social media tools such as Facebook, YouTube, Twitter, blogging, and wikis have led to a social media revolution. Given this widespread influence, it is important for educators, administrators, and technologists to understand the risks of using social media in the classroom and workplace.

OBJECTIVE

To investigate popular social media sites and their effect on radiologic technology education and business practices.

METHOD

A comprehensive search of literature was performed to examine social media and its applications in education, health care, and business.

RESULTS

Social media use is on the rise, affecting all aspects of mainstream society. Leaders in the radiologic sciences should be familiar with social media and cognizant of its risks.

CONCLUSION

Future studies regarding social media use in the radiologic sciences are necessary to determine its effect on the radiologic science community.

Review of teaching methods and critical thinking skills

BACKGROUND

Critical information is needed to inform radiation science educators regarding successful critical thinking educational strategies. From an evidence-based research perspective, systematic reviews are identified as the most current and highest level of evidence. Analysis at this high level is crucial in analyzing those teaching methods most appropriate to the development of critical thinking skills.

OBJECTIVES

To conduct a systematic literature review to identify teaching methods that demonstrate a positive effect on the development of students' critical thinking skills and to identify how these teaching strategies can best translate to radiologic science educational programs.

METHODS

A comprehensive literature search was conducted resulting in an assessment of 59 full reports. Nineteen of the 59 reports met inclusion criteria and were reviewed based on the level of evidence presented. Inclusion criteria included studies conducted in the past 10 years on sample sizes of 20 or more individuals demonstrating use of specific teaching interventions for 5 to 36 months in postsecondary health-related educational programs.

RESULTS

The majority of the research focused on problem-based learning (PBL) requiring standardized small-group activities. Six of the 19 studies focused on PBL and demonstrated significant differences in student critical thinking scores.

CONCLUSION

PBL, as described in the nursing literature, is an effective teaching method that should be used in radiation science education.

New tools for systematic evaluation of teaching qualities of medical faculty: results of an ongoing multi-center survey

Background

Tools for the evaluation, improvement and promotion of the teaching excellence of faculty remain elusive in residency settings. This study investigates (i) the reliability and validity of the data yielded by using two new instruments for evaluating the teaching qualities of medical faculty, (ii) the instruments' potential for differentiating between faculty, and (iii) the number of residents' evaluations needed per faculty to reliably use the instruments.

Methods and Materials

Multicenter cross-sectional survey among 546 residents and 629 medical faculty representing 29 medical (non-surgical) specialty training programs in the Netherlands. Two instruments—one completed by residents and one by faculty—for measuring teaching qualities of faculty were developed. Statistical analyses included factor analysis, reliability and validity exploration using standard psychometric methods, calculation of the numbers of residents' evaluations needed per faculty to achieve reliable assessments and variance components and threshold analyses.

Results

A total of 403 (73.8%) residents completed 3575 evaluations of 570 medical faculty while 494 (78.5%) faculty self-evaluated. In both instruments five composite-scales of faculty teaching qualities were detected with high internal consistency and reliability: learning climate (Cronbach's alpha of 0.85 for residents' instrument, 0.71 for self-evaluation instrument, professional attitude and behavior (0.84/0.75), communication of goals (0.90/0.84), evaluation of residents (0.91/0.81), and feedback (0.91/0.85). Faculty tended to evaluate themselves higher than did the residents. Up to a third of the total variance in various teaching qualities can be attributed to between-faculty differences. Some seven residents' evaluations per faculty are needed for assessments to attain a reliability level of 0.90.

Conclusions

The instruments for evaluating teaching qualities of medical faculty appear to yield reliable and valid data. They are feasible for use in medical residencies, can detect between-faculty differences and supply potentially useful information for improving graduate medical education.

[Education of medical students in urology in Germany: present status]

BACKGROUND

There is a growing demand for doctors in Germany and diseases of the genitourinary tract have become more prevalent in recent years. Politicians plan to increase the number of students in an already heavily overloaded system but data on quality and structure of medical education in Urology are lacking. The purpose of this study was to investigate the extent and quality of undergraduate medical education in urology.

MATERIAL AND METHODS

Departments of Urology at German University Hospitals were surveyed using a questionnaire. Questions covered four different fields of medical education and answers were analyzed by descriptive statistics.

RESULTS

Of the teachers involved in medical education 97% are physicians and 4% of these have special didactic qualifications. On average 1 teacher is responsible for 13 students and 44% of departments also have to carry out medical duties during teaching lessons. More than half of the departments offer modern learning forms, such as e-learning, problem-oriented learning or skills laboratory training.

CONCLUSIONS

Urology departments at German University Hospitals spend much time on medical education. Nearly all physicians are involved in medical education, whether they are experienced or not and in many cases teaching is carried out in parallel to patient care. In more than half of the cases modern education tools were employed which implies a good standard of quality but there are no data on outcome.

[Work-related stress in nursery school educators in the Venice and Marghera districts]

BACKGROUND

Based on an investigation on organizational well-being in the Municipality of Venice (2009), we examined 110 public nursery school and preschool teachers working in the Venice and Marghera districts.

OBJECTIVES

The aim of this study was to develop and implement a procedure for work-related stress assessment and management in Municipality of Venice, in the light of Law 81/2008.

METHODS

Occupational stress and its impact on teachers' well-being and health were assessed by means of self-administered questionnaires and semi-structured interviews. Descriptive analyses were conducted to compare teachers' data with those concerning employees operating in other services in the Venice and Marghera districts.

RESULTS

According to the results, while nursery school and preschool teachers work with considerable commitment, vigor, dedication and involvement, problems were observed related to: assignment of administrative tasks without appropriate support from the district offices; difficult access to support services; shortage of temporary teachers and auxiliary personnel and, limited to some facilities, lack of adequate physical space devoted to teaching activities. Such adverse conditions result in an increase in vigilance levels required to ensure children's safety. Personnel also suffer from a lack of career prospects, with scarce opportunities for contact with other facilities in the area and inadequate involvement in the decisional processes at Municipality level.

CONCLUSIONS

Improving such adverse conditions could solve the current marginalization of public nursery school and preschool teachers and encourage mutual exchange of information, which would in turn favour more appropriate methods of managing each single facility.

Disaster preparedness of nationally certified emergency medical services professionals

OBJECTIVES

During disasters, the public expects that emergency care will be available at a moment's notice. As such, an emergency medical services (EMS) workforce that is trained and prepared for disasters is imperative. The primary objectives of this study were to quantify the amount of individual-level training EMS professionals receive in terrorism and disaster-preparedness, as well as to assess EMS professionals' participation in multiagency disaster drills across the United States. Characteristics of those most likely to have received individual-level training or participated in multiagency disaster drills were explored. The secondary objectives were to assess EMS professional's perception of preparedness and to determine whether the amount of training individuals received was correlated with their perceptions of preparedness.

METHODS

A structured survey was administered to nationally certified EMT-Basics and paramedics as part of their 2008 recertification paperwork. Outcome variables included individual-level preparedness training, participation in multiagency disaster drills, and perception of preparedness. Descriptive statistics and logistic regression modeling were used to quantify the amount of training received. Spearman rank correlation coefficients were used to analyze whether training was correlated with an individual's perception of preparedness.

RESULTS

There were 46,127 EMS professionals who had the opportunity to complete the recertification questionnaire; 30,570 (66.3%) responded. A complete case analysis was performed on 21,438 respondents. Overall, 19,551 respondents (91.2%) reported receiving at least 1 hour of individual-level preparedness training, and 12,828 respondents (59.8%) reported participating in multiagency disaster drills, in the prior 24 months. Spearman rank correlation coefficients revealed that hours of individual-level preparedness training were significantly correlated with the perception of preparedness.

CONCLUSIONS

While areas where EMS should focus attention for improvement were identified, a majority of nationally certified EMT-Basics and paramedics reported participating in both individual and multiagency disaster-preparedness training. A large majority of respondents reported feeling adequately prepared to respond to man-made and natural disasters and the perception of preparedness correlated with hours of training.

Radiology resident teaching skills improvement: impact of a resident teacher training program

RATIONALE AND OBJECTIVES

Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course.

MATERIALS AND METHODS

Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition.

RESULTS

Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers.

CONCLUSIONS

Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills.

Anesthesia residents' preference for learning interscalene brachial plexus block (ISBPB): traditional Winnie's technique vs. ultrasound-guided technique

There is a recent shift from traditional nerve stimulation (NS) to ultrasound-guided (UG) techniques in regional anesthesia (RA). This shift prompted educators to readdress the best way to teach these two modalities. Development of a more structured curriculum requires an understanding of student preferences and perceptions. To help in structuring the teaching curriculum of RA, we examined residents' preferences to the methods of instruction (NS Vs. UG techniques). Novice residents (n=12) were enrolled in this parallel crossover trial. Two groups of 6 residents received a didactic lecture on NS or UG techniques. The groups then crossed over to view the other lecture. After they observed a demo of ISBPB on two patients using NS and US. The residents completed a questionnaire regarding their impression of each technique and the learning experience. UG technique was perceived to be safer and to have more educational value than NS. However, residents felt both techniques should be mandatory in the teaching curriculum.

Simulation-based teaching to improve cardiovascular exam skills performance among third-year medical students

BACKGROUND

Evidence supports the need for improvement in cardiac physical examination skills training.

PURPOSE

This study evaluates whether the addition of simulation offers added benefit over training utilizing standardized patients only.

METHODS

All 124 third-year students who completed the required clerkship in one academic year received cardiac examination skills training utilizing a standardized patient and a cardiac simulator. The control group, comprising 281 students from 2 previous academic years, received training utilizing a standardized patient only. All students' physical exam skills were assessed in an objective structured clinical examination.

RESULTS

Students trained with cardiac simulation performed significantly better than the control group in all 5 cardiac skills. The number of students who correctly performed all 5 cardiac exam skills increased significantly (p=.004). Pulmonary exam skills were unchanged.

CONCLUSION

The use of simulation in addition to standardized patient teaching can improve students' performance of cardiac examination skills.

Effects of varying inpatient attending physician rotation length on medical students' and attending physicians' perceptions of teaching quality

BACKGROUND

Patient care needs and work hour restrictions have altered inpatient internal medicine educational experiences.

PURPOSE

The goal is to compare different attending physician rotation lengths on medical students' and attending physicians' experiences.

METHODS

We studied clerkship students' evaluations (N= 86) and internal medicine attending surveys (N=21). We divided attending experiences into 2-week and 4-week rotations. We assessed exam scores and evaluations with 5-point Likert questions (5=strongly agree). Means were compared with t tests, Wilcoxon Ranked Sums, and logistic regression.

RESULTS

More than 90% of students and attending physicians responded. Students and attending physicians generally evaluated their 2- and 4-week experiences similarly. Attending physicians favored 4 weeks for evaluating students' performance (3.30 vs. 4.36, p<.01). Exam scores were similar in the 2- and 4-week student groups (M=78.2, SD=5.0 vs. 76.5, SD=8.5, p=.43).

CONCLUSIONS

Shorter rotations do not negatively impact students' experiences. Obtaining quality evaluations may be difficult for shorter rotations.