51
|
Englar RE. Tracking Veterinary Students' Acquisition of Communication Skills and Clinical Communication Confidence by Comparing Student Performance in the First and Twenty-Seventh Standardized Client Encounters. JOURNAL OF VETERINARY MEDICAL EDUCATION 2018; 46:235-257. [PMID: 30285598 DOI: 10.3138/jvme.0917-117r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The American Veterinary Medical Association's Council on Education mandates that veterinary students graduate with competence in clinical communication. Communication competence facilitates the successful transition of students into clinical practice by improving veterinary client satisfaction and reducing the risk of litigation. Curricular experimentation with communications training has led to innovative approaches to this content area, including the adoption of standardized patients from human health care education. Although the use of standardized clients (SCs) is time and resource intensive, their use by veterinary educators has allowed students to work through authentic cases in a safe learning environment in which learner goals drive training. Despite the increasing popularity of SC-based communications curricula, outcomes assessment studies that track the resultant student growth are lacking. Ninety students in the inaugural class of 2018 at Midwestern University College of Veterinary Medicine participated in 27 SC encounters over eight consecutive quarters. Students' use of Calgary-Cambridge Guide communication skills was compared in the first and twenty-seventh encounters. On the basis of SC evaluations of student performance, students increased their use of all communication skills in the final encounter compared with baseline. Students were also more likely to take a comprehensive patient history, build rapport, and retain the client. Mean scores for pre- and post-encounter communication confidence, as self-reported by students, also increased. These findings support that a SC-rich curriculum facilitates student acquisition of communication skills and promotes confidence when students approach entry-level clinical tasks such as history taking.
Collapse
|
52
|
Leep Hunderfund AN, Starr SR, Dyrbye LN, Gonzalo JD, George P, Miller BM, Morgan HK, Hoffman A, Baxley EG, Allen BL, Fancher TL, Mandrekar J, Skochelak SE, Reed DA. Value-Added Activities in Medical Education: A Multisite Survey of First- and Second-Year Medical Students' Perceptions and Factors Influencing Their Potential Engagement. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1560-1568. [PMID: 29794526 DOI: 10.1097/acm.0000000000002299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE To describe attitudes of first- and second-year U.S. medical students toward value-added medical education, assess their self-reported desire to participate in value-added activities, and identify potentially modifiable factors influencing their engagement. METHOD The authors conducted a cross-sectional survey of first- and second-year students at nine U.S. medical schools in 2017. Survey items measured students' attitudes toward value-added medical education (n = 7), desire to participate in value-added activities (n = 20), and factors influencing potential engagement (n = 18). RESULTS Of 2,670 students invited to participate, 1,372 (51%) responded. Seventy-six percent (1,043/1,368) moderately or strongly agreed they should make meaningful contributions to patient care. Students' desire to participate was highest for patient care activities approximating those traditionally performed by physicians, followed by systems improvement activities and lowest for activities not typically performed by physicians. Factors increasing desire to participate included opportunities to interact with practicing physicians (1,182/1,244; 95%), patients (1,177/1,246; 95%), and residents or fellows (1,166/1,246; 94%). Factors decreasing desire to participate included making changes to the health care system (365/1,227; 30%), interacting with patients via phone or electronic communication (410/1,243; 33%), and lack of curricular time (634/1,233; 51%). CONCLUSIONS First- and second-year medical students agree they should add value to patient care, but their desire to participate in value-added activities varies depending on the nature of the tasks. Medical schools may be able to increase students' desire to participate by enabling face-to-face interactions with patients, embedding students in health care teams, and providing dedicated curricular time.
Collapse
Affiliation(s)
- Andrea N Leep Hunderfund
- A.N. Leep Hunderfund is assistant professor of neurology, Mayo Clinic, and associate director, Mayo Clinic Program in Professionalism and Values, Rochester, Minnesota. S.R. Starr is associate professor of pediatrics and director, Science of Health Care Delivery Education, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota. L.N. Dyrbye is professor of medical education and medicine, Mayo Clinic, Rochester, Minnesota. J.D. Gonzalo is associate professor of medicine and public health sciences and associate dean, Health Systems Education, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. P. George is associate professor of family medicine and associate professor of medical science, Alpert Medical School, Brown University, Providence, Rhode Island. B.M. Miller is professor of medical education and administration and professor of clinical surgery, associate vice chancellor, Health Affairs, and senior associate dean, Health Sciences Education, Vanderbilt University School of Medicine, Nashville, Tennessee. H.K. Morgan is associate clinical professor of obstetrics and gynecology and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. A. Hoffman is assistant clinical professor of medicine, Division of Hospital Medicine, University of California, San Francisco School of Medicine, San Francisco, California. E.G. Baxley is professor of family medicine and senior associate dean, Academic Affairs, Brody School of Medicine, East Carolina University, Greenville, North Carolina. B.L. Allen is associate professor of clinical medicine and senior associate dean, Medical Student Education, Indiana University School of Medicine, Indianapolis, Indiana. T.L. Fancher is associate professor of medicine, University of California, Davis School of Medicine, Sacramento, California. J. Mandrekar is professor of biostatistics and neurology, Mayo Clinic, Rochester, Minnesota. S.E. Skochelak is group vice president for medical education, American Medical Association, Chicago, Illinois. D.A. Reed is associate professor of medical education and medicine and senior associate dean, Academic Affairs, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
53
|
Use of Real Patients and Patient-Simulation-Based Methodologies for Teaching Gastroenterology to Pre-Clinical Medical Students. Healthcare (Basel) 2018; 6:healthcare6020061. [PMID: 29895762 PMCID: PMC6023447 DOI: 10.3390/healthcare6020061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 12/30/2022] Open
Abstract
In recent years, there has been an increasing focus on the need to integrate formal knowledge with clinical experience in the pre-clinical years since the initial years of medical education play an important role in shaping the attitudes of medical students towards medicine and support the development of clinical reasoning. In this study, we describe approaches that involve real patients and patient-simulation-based methodologies to teach gastroenterology to second year medical students. Our goals were to (i) demonstrate bio-psychosocial aspects of clinical practice, (ii) demonstrate commonality of gastrointestinal ailments, and (iii) help understand complex gastroenterology concepts. We used two main approaches including brief, pre-prepared questions and answers discussing with the patients in various sessions throughout the course and a two-hour session that included patient participation, patient simulation modalities with high fidelity mannequins, a lightening round of interactive cases, and a Patient Oriented Problem Solving (POPS) session. The approaches improved the effectiveness of the delivery of the content-heavy, fast-paced GI course and provided opportunities for the students to think about gastroenterology from both basic and clinical points of view. The approaches involved peer teaching, which supports knowledge acquisition and comprehension. Very positive feedback and overall engagement of students suggested that these approaches were well-received.
Collapse
|
54
|
Abstract
In light of the chronic shortage of health professionals willing to care for HIV/AIDS patients, and rising epidemics in many Muslim countries, this qualitative study examined susceptibility and resistance to courtesy stigma as experienced by nurses, doctors, and social workers in Morocco. Forty-nine in-depth interviews provided rich insights into the process of courtesy stigma and how it is managed, within the context of interactions with Islam, interactions within the workplace (patients, other health professionals), and interactions outside the workplace (the general public, friends, and family). Theoretically, the findings extend understanding of courtesy stigma and the dirty work literature. The findings also offer practical suggestions for the development of culturally appropriate strategies to reduce susceptibility to courtesy stigmatization. This study represents the first to explore courtesy stigma as a process experienced by health professionals providing HIV/AIDS care in an Islamic country.
Collapse
Affiliation(s)
| | - Leila El Menzhi
- a School of Business Administration , Al Akhawayn University
| |
Collapse
|
55
|
Willoughby K, Rodríguez C, Boillat M, Dove M, Nugus P, Steinert Y, Lalla L. Comparing Medical Students' and Preceptors' Views of a Longitudinal Preclerkship Family Medicine Course. PRIMER : PEER-REVIEW REPORTS IN MEDICAL EDUCATION RESEARCH 2018; 2:7. [PMID: 32818181 DOI: 10.22454/primer.2018.554037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Introduction Despite the increasing popularity of longitudinal primary care experiences in North America and beyond, there is a paucity of work assessing these medical undergraduate experiences using reliable and valid questionnaires. Our objective in this study was to evaluate a new preclerkship longitudinal family medicine experience (LFME) course at McGill University by assessing family physician preceptors' self-reported ratings of the perceived effects of this course, and to compare their responses with ratings provided by medical students who completed the course. Methods This study is part of a larger evaluative research project assessing the first edition of the LFME. Students (N=187) and preceptors (N=173) of the 2013-2014 cohort were invited to complete separate online questionnaires in the spring through summer of 2014. The preceptor survey contained 53 items, 14 of which were nearly identical to items in the student survey (published elsewhere) and served as the basis for comparing preceptor and student ratings of the LFME. Results Ninety-nine preceptors (57% response rate; 55% female) and 120 students (64% response rate; 58% female) completed the surveys. Preceptors and students did not significantly differ in their overall ratings of the course, as both groups were satisfied with the quality of the LFME and felt it was an appropriate and valuable educational experience. However, preceptors had more positive ratings regarding their role and the benefits of the course than did medical students. Conclusion This study corroborates prior work showing extensive perceived benefits of longitudinal preclerkship exposure to primary care; however, preceptors were found to report more positive reviews of the course than students. This study also provides new innovative tools to assess students' and preceptors' perceptions of longitudinal, preclerkship family medicine courses available for use over time and in different educational contexts.
Collapse
Affiliation(s)
- Karen Willoughby
- Department of Family Medicine, Faculty of Medicine, Memorial University, Canada
| | | | - Miriam Boillat
- Department of Family Medicine and Center for Medical Education, Faculty of Medicine, McGill University, Canada
| | - Marion Dove
- Department of Family Medicine, Faculty of Medicine, McGill University, Canada
| | - Peter Nugus
- Department of Family Medicine and Center for Medical Education, Faculty of Medicine, McGill University, Canada
| | - Yvonne Steinert
- Center for Medical Education and Department of Family Medicine, Faculty of Medicine, McGill University, Canada
| | - Leonora Lalla
- Department of Family Medicine, Faculty of Medicine, McGill University, Canada
| |
Collapse
|
56
|
Brooker R, Hu W, Reath J, Abbott P. Medical student experiences in prison health services and social cognitive career choice: a qualitative study. BMC MEDICAL EDUCATION 2018; 18:3. [PMID: 29291725 PMCID: PMC5748951 DOI: 10.1186/s12909-017-1109-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND One of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve. Amongst the most medically underserved groups of society are people in prison and those with a history of incarceration. In this study we examined the experiences of medical students undertaking General Practice placements in a prison health service. We used the theoretical framework of the Social Cognitive Career Theory (SCCT) to explore the potential of these placements to influence the career choices of medical students. METHODS Questionnaire and interview data were collected from final year students, comprising pre and post placement questionnaire free text responses and post placement semi-structured interviews. Data were analysed using inductive thematic analysis, with reference to concepts from the SCCT Interest Model to further develop the findings. RESULTS Clinical education delivered in a prison setting can provide learning that includes exposure to a wide variety of physical and mental health conditions and also has the potential to stimulate career interest in an under-served area. While students identified many challenges in the work of a prison doctor, increased confidence (SCCT- Self-Efficacy) occurred through performance success within challenging consultations and growth in a professional approach to prisoners and people with a history of incarceration. Positive expectations (SCCT- Outcome Expectations) of fulfilling personal values and social justice aims and of achieving public health outcomes, and a greater awareness of work as a prison doctor, including stereotype rejection, promoted student interest in working with people in contact with the criminal justice system. CONCLUSION Placements in prison health services can stimulate student interest in working with prisoners and ex-prisoners by either consolidating pre-existing interest or expanding interest into a field they had not previously considered. An important aspect of such learning is the opportunity to overcome negative preconceptions of consultations with prisoners.
Collapse
Affiliation(s)
- Ron Brooker
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Jennifer Reath
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Penelope Abbott
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| |
Collapse
|
57
|
Eagles JM, Wilson S, Murdoch JM, Brown T. What impact do undergraduate experiences have upon recruitment into psychiatry? PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.bp.106.010801] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The Scottish Division of the Royal College of Psychiatrists conducted a survey of members and fellows in 2003 on recruitment and retention within psychiatry. Responses relating to retirement intentions of consultants have been published previously (Eagleset al, 2005). Respondents were asked to give views about improving recruitment, and by far the most common suggestion was that this could be achieved by enhancing undergraduate teaching in psychiatry. This paper will discuss the ways in which undergraduate experiences may have an impact upon recruitment.
Collapse
|
58
|
Bhattacharrya H, Medhi GK, Pala S, Sarkar A, Kharmujai OM, Lynrah W. Early community-based teaching of medical undergraduates for achieving better working skills in the community. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:161. [PMID: 30693298 PMCID: PMC6332666 DOI: 10.4103/jehp.jehp_153_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/22/2018] [Indexed: 05/13/2023]
Abstract
INTRODUCTION It has been perceived that there is a lack of community exposure and active learning in the community for the first-year undergraduates in Community Medicine. This study is designed to evaluate an early community exposure given to the students to help overcome these lacunae. METHODOLOGY In this study, the first-year students (n = 44) were provided an early community exposure and evaluated to understand their perceptions by a prevalidated, pre- and post exposure questionnaire. The community exposure was given to the students by allocating them families in community with designated tasks A core group of mentors monitored the students and scored the students on every visit. Attendance of students, scores marked by the mentors, and pre- and postexposure responses were used to evaluate the impact of community exposure. RESULTS A total of 44 students were evaluated in this study. A total of 22 h (36.6%) were dedicated to community-based learning in the 1st year. A positive response was observed in the postexposure responses with regard to the understanding of the subject and interest in the subject in comparison to preexposure responses (P < 0.05). A statistically significant difference was observed in the first and final visit scores by the mentors with respect to communication skills, elicitation of history, team spirit, and attitude toward community (P < 0.00001). CONCLUSIONS Students were exposed to the concept of community service and inculcated an interest in public health. Early community exposure of medical undergraduate students is important in developing better working skills in the community.
Collapse
Affiliation(s)
- Himashree Bhattacharrya
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Gajendra Kumar Medhi
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Star Pala
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
- Address for correspondence: Dr. Star Pala, Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong - 793 018, Meghalaya, India. E-mail:
| | - Amrita Sarkar
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Ophelia Mary Kharmujai
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Wallambok Lynrah
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| |
Collapse
|
59
|
Bandiera G, Kuper A, Mylopoulos M, Whitehead C, Ruetalo M, Kulasegaram K, Woods NN. Back from basics: integration of science and practice in medical education. MEDICAL EDUCATION 2018; 52:78-85. [PMID: 28994457 DOI: 10.1111/medu.13386] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/10/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT In 1988, the Edinburgh Declaration challenged medical teachers, curriculum designers and leaders to make an organised effort to change medical education for the better. Among a series of recommendations was a call to integrate training in science and clinical practice across a breadth of clinical contexts. The aim was to create physicians who could serve the needs of all people and provide care in a multitude of contexts. In the years since, in the numerous efforts towards integration, new models of curricula have been proposed and implemented with varying levels of success. SCOPE OF REVIEW In this paper, we examine the evolution of curricular integration since the Edinburgh Declaration, and discuss theoretical advances and practical solutions. In doing so, we draw on recent consensus reports on the state of medical education, emblematic initiatives reported in the literature, and developments in education theory pertinent to the role of integrated curricula. CONCLUSIONS Interest in integration persists despite 30 years of efforts to respond to the Edinburgh Declaration. We argue, however, that a critical shift has taken place with respect to the conception of integration, whereby empirical models support a view of integration as pertaining to both cognitive activity and curricular structure. In addition, we describe a broader definition of 'basic science' relevant to clinical practice that encompasses social and behavioural sciences, as well as knowledge derived from biomedical science.
Collapse
Affiliation(s)
- Glen Bandiera
- PostMD Education, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ayelet Kuper
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
| | - Maria Mylopoulos
- The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cynthia Whitehead
- The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Mariela Ruetalo
- PostMD Education, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kulamakan Kulasegaram
- The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nicole N Woods
- The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
60
|
|
61
|
Dehghan A, Amini M, Sagheb MM, Shidmoosavi SM, Nabeiei P. Early clinical exposure program in learning renal physiology. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2017; 5:172-176. [PMID: 28979911 PMCID: PMC5611426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 08/12/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Teaching renal physiology for undergraduate medical students in an understandable way using methods which improve their deep learning has always been a problem. In this study, Early Clinical Exposure (ECE) was used in teaching renal physiology for the second year medical students in Shiraz Medical School. This article aims to introduce and develop this program and also measure the attitude of medical students toward ECE in learning renal physiology. METHODS This is a mixed method study conducted on 120 second year undergraduate students. After performing the course, both qualitative and quantitative methods were used for measuring the viewpoints of the students. In the qualitative part, 10 high rank medical students were selected. These students participated in brain storming sessions to express their opinion about the program based on the strengths and weaknesses. For trustworthiness of the qualitative part, member check and peer check were done. In the quantitative part, a researcher-made questionnaire was used based on the objectives of the program in a 4 point Likert scale. The validity of questionnaire was determined by medical education experts and reliability was determined after a pilot study. RESULTS Based on the results of the quantitative part of the study, 98 percent of the students stated that the ECE program was generally a useful program. In the qualitative part, the students' comments were obtained. The benefits of the program were summarized in 4 main themes. These themes are "understanding of renal physiology", "Integration of basic and clinical knowledge", "Improvement of attitude toward importance of physiology", and "encouragement to study". In response to the questions about negetive aspects of this program in qualitative part, the two main themes were insufficient time and large grup size. CONCLUSION Students reported that ECE was useful, but they stated that they needed to have more encounter with patients and more hospital teaching. The results also reveal that this ECE program is an excellent approach to strengthen learning in a difficult subject like renal physiology. This approach is adjustable to other basic science topics and subjects as well.
Collapse
Affiliation(s)
- Arman Dehghan
- Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Amini
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mahdi Sagheb
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Nabeiei
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
62
|
Beitsch L, Geletko K, Bellamy G, Aubrey A, Myers K, Dunn L, Littles A, Fogarty J. Student and Preceptor Perceptions of the Summer Clinical Practicum: An Assessment of the First Year Clinical Skills Capstone. MEDEDPUBLISH 2017; 6:140. [PMID: 38406394 PMCID: PMC10885285 DOI: 10.15694/mep.2017.000140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Objective: As the first new medical school chartered in the 21 st century, FSUCOM adopted a unique approach to medical education. Beyond the expected basic science courses, first year students participate in a year-long Doctoring and Clinical Skills Course. The first year culminates in a three week Summer Clinical Practicum (SCP) emphasizing mission centric populations. We designed a survey to assess medical student and clinical preceptor impressions of the SCP for purposes of quality improvement. Methods: Students in their second, third, and fourth years and their preceptors were included in a cross sectional descriptive study. All participants responded to an electronic web based survey developed and administered in Summer 2016. The overall student response rate was 32%, while 53% of preceptors participated. Results: Survey results indicated that the SCP first year capstone experience is highly valued by students and preceptors alike. We found a high concordance of perceptions between student cohorts spanning three years and faculty preceptor respondents. For purposes of programmatic planning and quality improvement there was strong support for maintaining the current length for the SCP at three weeks. Additionally, survey findings appear to support ongoing perceived benefit from the early clinical exposure summer experience, with students agreeing that the SCP helped focus their learning as M-2s, and influenced their readiness for subsequent clinical clerkships. Conclusion: Our study supports the growing body of knowledge that early clinical experience for matriculating medical students is not only feasible, but desirable, and has lasting effects throughout their undergraduate medical education.
Collapse
Affiliation(s)
| | | | | | | | - Karen Myers
- Florida State University College of Medicine
| | - Luckey Dunn
- Florida State University College of Medicine
| | | | | |
Collapse
|
63
|
O'Brien BC, Bachhuber MR, Teherani A, Iker TM, Batt J, O'Sullivan PS. Systems-Oriented Workplace Learning Experiences for Early Learners: Three Models. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:684-693. [PMID: 27254010 DOI: 10.1097/acm.0000000000001243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Early workplace learning experiences may be effective for learning systems-based practice. This study explores systems-oriented workplace learning experiences (SOWLEs) for early learners to suggest a framework for their development. METHOD The authors used a two-phase qualitative case study design. In Phase 1 (spring 2014), they prepared case write-ups based on transcribed interviews from 10 SOWLE leaders at the authors' institution and, through comparative analysis of cases, identified three SOWLE models. In Phase 2 (summer 2014), studying seven 8-week SOWLE pilots, the authors used interview and observational data collected from the seven participating medical students, two pharmacy students, and site leaders to construct case write-ups of each pilot and to verify and elaborate the models. RESULTS In Model 1, students performed specific patient care activities that addressed a system gap. Some site leaders helped students connect the activities to larger systems problems and potential improvements. In Model 2, students participated in predetermined systems improvement (SI) projects, gaining experience in the improvement process. Site leaders had experience in SI and often had significant roles in the projects. In Model 3, students worked with key stakeholders to develop a project and conduct a small test of change. They experienced most elements of an improvement cycle. Site leaders often had experience with SI and knew how to guide and support students' learning. CONCLUSIONS Each model could offer systems-oriented learning opportunities provided that key elements are in place including site leaders facile in SI concepts and able to guide students in SOWLE activities.
Collapse
Affiliation(s)
- Bridget C O'Brien
- B.C. O'Brien is associate professor, Department of Medicine, and research faculty member, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California. M.R. Bachhuber is associate clinical professor, Department of Medicine, University of California, San Francisco, and deputy associate chief of staff for education, San Francisco VA Medical Center, San Francisco, California. A. Teherani is professor, Department of Medicine, and research faculty member, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California. T.M. Iker was research assistant, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California, at the time this work was completed. J. Batt is clinical research coordinator, Department of Nephrology, University of California, San Francisco, San Francisco, California. P.S. O'Sullivan is professor, Department of Medicine and Surgery, and director, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California
| | | | | | | | | | | |
Collapse
|
64
|
Krishnan K, Thoma B, Trueger NS, Lin M, Chan TM. Gestalt assessment of online educational resources may not be sufficiently reliable and consistent. PERSPECTIVES ON MEDICAL EDUCATION 2017; 6:91-98. [PMID: 28243948 PMCID: PMC5383576 DOI: 10.1007/s40037-017-0343-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Online open educational resources are increasingly used in medical education, particularly blogs and podcasts. However, it is unclear whether these resources can be adequately appraised by end-users. Our goal was to determine whether gestalt-based recommendations are sufficient for emergency medicine trainees and attending physicians to reliably recommend online educational resources to others. METHODS Raters (33 trainees and 21 attendings in emergency medicine from North America) were asked to rate 40 blog posts according to whether, based on their gestalt, they would recommend the resource to (1) a trainee or (2) an attending physician. The ratings' reliability was assessed using intraclass correlation coefficients (ICC). Associations between groups' mean scores were assessed using Pearson's r. A repeated measures analysis of variance (RM-ANOVA) was completed to determine the effect of the level of training on gestalt recommendation scale (i. e. trainee vs. attending). RESULTS Trainees demonstrated poor reliability when recommending resources for other trainees (ICC = 0.21, 95% CI 0.13-0.39) and attendings (ICC = 0.16, 95% CI = 0.09-0.30). Similarly, attendings had poor reliability when recommending resources for trainees (ICC = 0.27, 95% CI 0.18-0.41) and other attendings (ICC = 0.22, 95% CI 0.14-0.35). There were moderate correlations between the mean scores for each blog post when either trainees or attendings considered the same target audience. The RM-ANOVA also corroborated that there is a main effect of the proposed target audience on the ratings by both trainees and attendings. CONCLUSIONS A gestalt-based rating system is not sufficiently reliable when recommending online educational resources to trainees and attendings. Trainees' gestalt ratings for recommending resources for both groups were especially unreliable. Our findings suggest the need for structured rating systems to rate online educational resources.
Collapse
Affiliation(s)
| | - Brent Thoma
- Department of Emergency Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - N Seth Trueger
- Department of Emergency Medicine, Northwestern University, Chicago, IL, USA
| | - Michelle Lin
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Teresa M Chan
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
65
|
Cho KK, Marjadi B, Langendyk V, Hu W. Medical student changes in self-regulated learning during the transition to the clinical environment. BMC MEDICAL EDUCATION 2017; 17:59. [PMID: 28327147 PMCID: PMC5361773 DOI: 10.1186/s12909-017-0902-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 03/14/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Self-regulated learning (SRL), which is learners' ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors. METHODS Medical students were invited to complete a questionnaire at the commencement of their first clinical year (T0), and 10 weeks later (T1). The questionnaire included the Motivated Strategies for Learning Questionnaire (MSLQ) and asked about previous clinical experience. Information about the student's background, demographic characteristics and first clinical rotation were also gathered. RESULTS Of 118 students invited to participate, complete paired responses were obtained from 72 medical students (response rate 61%). At T1, extrinsic goal orientation increased and was associated with gender (males were more likely to increase extrinsic goal orientation) and type of first attachment (critical care and community based attachments, compared to hospital ward based attachments). Metacognitive self-regulation decreased at T1 and was negatively associated with previous clinical experience. CONCLUSIONS Measurable changes in self-regulated learning occur during the transition from preclinical learning to clinical immersion, particularly in the domains of extrinsic goal orientation and metacognitive self-regulation. Self-determination theory offers possible explanations for this finding which have practical implications and point the way to future research. In addition, interventions to promote metacognition before the clinical immersion may assist in preserving SRL during the transition and thus promote life-long learning skills in preparation for real-world practice.
Collapse
Affiliation(s)
- Kenneth K Cho
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia.
| | - Brahm Marjadi
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Vicki Langendyk
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| |
Collapse
|
66
|
Morteza Bagi HR, Balafar M, Shakouri SK, Nouriasl H, Khoshmaram N, Abdollahi F, Mohammadzadeh A, Sheykhalizadeh R. Report: Holding clinical competency examination among medical students in Faculty of Medicine, Tabriz, Iran. JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2017. [DOI: 10.15171/jarcm.2017.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
67
|
E Knight S, J Ross A, Mahomed O. Developing primary health care and public health competencies in undergraduate medical students. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2016.1272229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Stephen E Knight
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew J Ross
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Ozayr Mahomed
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
68
|
DAS P, Biswas S, Singh R, Mukherjee S, Ghoshal S, Pramanik D. Effectiveness of early clinical exposure in learning respiratory physiology among the newly entrant MBBS students. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2017; 5:6-10. [PMID: 28124016 PMCID: PMC5238496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/01/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Early Clinical Exposure has been conceptualized to orient medical students towards actual clinical scenario and help them correlate their theoretical knowledge with real life situations in early years of MBBS courses. In the present study we explored the outcome of early clinical exposure in the context of basic science topics (Physiology) in fresh MBBS entrants and compared their performance with a conventionally taught control group. METHODS One hundred fifty voluntary students of 1st year MBBS (2015-16) batch consisted the sample of this study. They were divided into two groups through the simple random method (using computer generated random number table with roll numbers of the students). They were evaluated by MCQ (Multiple Choice Question) and OSCE (Objective Structured Clinical Examination) before and after being taught a basic Physiology topic (respiratory system) theoretically. The study group underwent clinical exposure before the post-test while the control group did not. Performance of the students was compared between the two groups by unpaired student's t-test whereas marks of pre and post-test within the same group were compared by paired Student's t-test. Everywhere p<0.05 was considered to be significant. RESULTS The marks of each group in the pre and post-tests differed significantly (P<0.05 in each case). Post-test marks were significantly greater in each group though the level of improvement was strikingly higher in the study group (p=0.01). Though there was no significant difference in pre-test marks of both groups (P=0.73), post-test marks were significantly higher in the study group (P=0.04). Among the exposed students, majority (92%) opined that ECE was a better technique being practically oriented and more interesting while some (8%) found it to be more time and energy-consuming, suitable for selective portions of basic science topics. CONCLUSION Early clinical exposure may be an effective technique to supplement the traditional theoretical teaching and improve the performance of fresh medical entrants in Physiology. It has better acceptability by the students and may be considered for inclusion in the existing pre-clinical curriculum with proper allocation of time and manpower.
Collapse
Affiliation(s)
- Piyali DAS
- Physiology, Bankura Sammilani Medical College, Bankura, India
| | - Subhradev Biswas
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Ramji Singh
- Physiology, All India Institute of Medical Sciences, Patna, India
| | | | | | | |
Collapse
|
69
|
Kar M, Kar C, Roy H, Goyal P. Early Clinical Exposure as a Learning Tool to Teach Neuroanatomy for First Year MBBS Students. Int J Appl Basic Med Res 2017; 7:S38-S41. [PMID: 29344456 PMCID: PMC5769168 DOI: 10.4103/ijabmr.ijabmr_143_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Early clinical exposure (ECE) is one of the important tools to teach basic science to the MBBS students. It is one form of vertical integration between basic science and clinical subjects. This study is an effort at exploring the use of ECE as a motivational tool toward better learning in neuroanatomy for first year MBBS students. Aim This study aims to make the students interested and motivated to study neuroanatomy by using ECE as learning tool in neuroanatomy and to make the students enable to retain the knowledge of neuroanatomy more efficiently and correlate the knowledge of neuroanatomy with neuromedicine. Settings and Design This study was conducted in collaboration with the Departments of Anatomy, General Medicine and Medical Education Unit in the year 2016. This was cross-sectional study. Subjects and Methods One hundred and fifty students of 1st Professional MBBS were subdivided into two groups. After preliminary classes on brain, brainstem, and spinal cord for both groups, conventional lecture classes were taken for Group A only on upper motor neuron (UMN) and lower motor neuron (LMN) paralysis, and only Group B visited General Medicine ward where HOD, General Medicine showed and examined patients of UMN paralysis and LMN paralysis, elicited different symptoms, and discussed different investigation. It was followed by assessment of all by problem-based multiple choice questions (MCQ) and short answer questions. Then, Group B attended lecture class on different cranial nerve palsy whereas Group A visited medicine ward. It was followed by assessment of both groups by problem-based MCQ and short answer questions. The performance was compared. Then, the feedback of the students on ECE was collected by means of reflection writing followed by administration of questionnaire. Then, the perception of teachers regarding ECE was recorded by focused group discussion. Statistical Analysis Used Student's t-test was used to compare the performance of both batches. Reflection writing and focus group discussion were analyzed qualitatively. Results There was a significant difference in Group A (P = 0.019) but no significant difference in Group B (P = 0.679). All the teachers opined that ECE was an efficient method but more time and interdepartmental collaboration were necessary. Conclusions Group A improved performance due to ECE but Group B maintained the motivational effect of it. Therefore, ECE can be used as an effective learning tool.
Collapse
Affiliation(s)
- Maitreyee Kar
- Department of Anatomy, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
| | - Chinmaya Kar
- Department of Anatomy, Regional Blood Transfusion Centre, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
| | - Hironmoy Roy
- Department of Anatomy, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
| | - Parmod Goyal
- Department of Forensic Medicine and Toxicology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| |
Collapse
|
70
|
Sun L, Gao Y, Yang J, Zang XY, Wang YG. The impact of professional identity on role stress in nursing students: A cross-sectional study. Int J Nurs Stud 2016; 63:1-8. [DOI: 10.1016/j.ijnurstu.2016.08.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 01/30/2023]
|
71
|
Walker B, Wallace D, Mangera Z, Gill D. Becoming ‘ward smart’ medical students. CLINICAL TEACHER 2016; 14:336-339. [DOI: 10.1111/tct.12571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Beth Walker
- Academic Centre for Medical Education; University College; London UK
| | - Deirdre Wallace
- Academic Centre for Medical Education; University College; London UK
| | - Zaheer Mangera
- Academic Centre for Medical Education; University College; London UK
| | - Deborah Gill
- Academic Centre for Medical Education; University College; London UK
| |
Collapse
|
72
|
Bates J, Ellaway RH. Mapping the dark matter of context: a conceptual scoping review. MEDICAL EDUCATION 2016; 50:807-16. [PMID: 27402041 DOI: 10.1111/medu.13034] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/07/2015] [Accepted: 01/20/2016] [Indexed: 05/08/2023]
Abstract
CONTEXT Like dark matter, the contexts for medical education are largely invisible to those within them, although context can have profound influences on teaching, learning and practice. For something that is so intrinsic to the field of medical education, the concept of context remains troubling to scholars and those running medical education programmes. This paper reports on a critical and conceptual review of the concept of context within the medical education literature and beyond. METHODS A review was undertaken drawing on two sources: concepts of context in the medical education literature, and concepts of context across multiple academic disciplines. This body of material was iteratively, discursively and inductively synthesised. RESULTS Few of the articles from the medical education literature described or defined context directly, tending instead to focus on describing specific elements of context, such as clinical disciplines, physical settings and political pressures, that could or did influence learning outcomes. The results were framed in terms of what context 'is', how context works (in terms of context-mechanism-outcome), and how context can be represented using patterns. The authors propose a definition of context in medical education, along with the means to model, contrast and compare different contexts based on recurring patterns. CONCLUSIONS Context matters in medical education and it can, despite many challenges, be considered systematically and objectively. The findings from this study both represent a catalyst and challenge medical education researchers to look at context afresh.
Collapse
Affiliation(s)
- Joanna Bates
- Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachel H Ellaway
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
73
|
Khabaz Mafinejad M, Mirzazadeh A, Peiman S, Khajavirad N, Mirabdolhagh Hazaveh M, Edalatifard M, Allameh SF, Naderi N, Foroumandi M, Afshari A, Asghari F. Medical students' attitudes towards early clinical exposure in Iran. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:195-9. [PMID: 27318794 PMCID: PMC4939216 DOI: 10.5116/ijme.5749.78af] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/28/2016] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study was carried out to investigate the medical students' attitudes towards early clinical exposure at Tehran University of Medical Sciences. METHODS A cross-sectional study was conducted during 2012-2015. A convenience sample of 298 first- and second-year students, enrolled in the undergraduate medical curriculum, participated in an early clinical exposure program. To collect data from medical students, a questionnaire consisting of open-ended questions and structured questions, rated on a five-point Likert scale, was used to investigate students' attitudes toward early clinical exposure. RESULTS Of the 298 medical students, 216 (72%) completed the questionnaires. The results demonstrated that medical students had a positive attitude toward early clinical exposure. Most students (80.1%) stated that early clinical exposure could familiarize them with the role of basic sciences knowledge in medicine and how to apply this knowledge in clinical settings. Moreover, 84.5% of them believed that early clinical exposure increased their interest in medicine and encouraged them to read more. Furthermore, content analysis of the students' responses uncovered three main themes of early clinical exposure, were considered helpful to improve learning: "integration of theory and practice", "interaction with others and professional development" and "desire and motivation for learning medicine". CONCLUSIONS Medical students found their first experience with clinical setting valuable. Providing clinical exposure in the initial years of medical curricula and teaching the application of basic sciences knowledge in clinical practice can enhance students' understanding of the role they will play in the future as a physician.
Collapse
Affiliation(s)
| | - Azim Mirzazadeh
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Khajavirad
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Edalatifard
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Farshad Allameh
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Naderi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Foroumandi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Afshari
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Asghari
- Department of Medical Ethics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
74
|
Dwyer CP, Durand H, MacNeela P, Reynolds B, Hamm RM, Main CJ, O'Connor LL, Conneely S, Taheny D, Slattery BW, O'Neill C, NicGabhainn S, Murphy AW, Kropmans T, McGuire BE. Effectiveness of a biopsychosocial e-learning intervention on the clinical judgements of medical students and GP trainees regarding future risk of disability in patients with chronic lower back pain: study protocol for a randomised controlled trial. BMJ Open 2016; 6:e010407. [PMID: 27231000 PMCID: PMC4885315 DOI: 10.1136/bmjopen-2015-010407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Chronic lower back pain (CLBP) is a major healthcare problem with wide ranging effects. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions that identify biopsychosocial barriers to recovery have been observed to lead to successfully reduced pain-related work absences and increased return to work for individuals with CLBP. Modern conceptualisations of pain adopt a biopsychosocial approach, such as the flags approach. Biopsychosocial perspectives have been applied to judgements about future adjustment, recovery from pain and risk of long-term disability; and provide a helpful model for understanding the importance of contextual interactions between psychosocial and biological variables in the experience of pain. Medical students and general practitioner (GP) trainees are important groups to target with education about biopsychosocial conceptualisations of pain and related clinical implications. AIM The current study will compare the effects of an e-learning intervention that focuses on a biopsychosocial model of pain, on the clinical judgements of medical students and trainees. METHODS AND ANALYSIS Medical student and GP trainee participants will be randomised to 1 of 2 study conditions: (1) a 20 min e-learning intervention focused on the fundamentals of the flags approach to clinical judgement-making regarding risk of future pain-related disability; compared with a (2) wait-list control group on judgement accuracy and weighting (ie, primary outcomes); flags approach knowledge, attitudes and beliefs towards pain, judgement speed and empathy (ie, secondary outcomes). Participants will be assessed at preintervention and postintervention. ETHICS AND DISSEMINATION The study will be performed in agreement with the Declaration of Helsinki and is approved by the National University of Ireland Galway Research Ethics Committee. The results of the trial will be published according to the CONSORT statement and will be presented at conferences and reported in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN53670726; Pre-results.
Collapse
Affiliation(s)
- Christopher P Dwyer
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Hannah Durand
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Pádraig MacNeela
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Bronagh Reynolds
- Centre for Pain Research, National University of Ireland, Galway, Ireland
| | - Robert M Hamm
- Department of Family & Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Christopher J Main
- Department of Behavioural Medicine, Keele University, Staffordshire, England
| | - Laura L O'Connor
- Centre for Pain Research, National University of Ireland, Galway, Ireland
| | - Sinéad Conneely
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Darragh Taheny
- Centre for Pain Research, National University of Ireland, Galway, Ireland
| | - Brian W Slattery
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Ciaran O'Neill
- Discipline of Economics, National University of Ireland, Galway, Ireland
| | - Saoirse NicGabhainn
- Discipline of Health Promotion, National University of Ireland, Galway, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - Thomas Kropmans
- Discipline of Medical Informatics and Education, National University of Ireland, Galway, Ireland
| | - Brian E McGuire
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- School of Psychology, National University of Ireland, Galway, Ireland
| |
Collapse
|
75
|
A mixed methods evaluation of a patient care clinic located within a pharmacy school. Int J Clin Pharm 2016; 38:924-30. [PMID: 27166829 DOI: 10.1007/s11096-016-0313-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/30/2016] [Indexed: 12/30/2022]
Abstract
Background The Medication Assessment Center is a faculty and student run patient care clinic located within the pharmacy school at the University of Saskatchewan (Canada). It was created as a novel experiential education site for pharmacy students and to provide clinical pharmacist services for complex patients who have trouble accessing services elsewhere. Objective To determine if the clinical services provided by faculty and students at the Medication Assessment Center are valuable to patients who are referred to the program. Setting The Medication Assessment Center, which is faculty and student run patient care clinic. Method Convergent mixed methods design comprised of a retrospective patient chart audit and a paper based patient experience survey. All patients who attended at least one appointment at the Medication Assessment Center between March 1, 2014 and July 31, 2015 were included in the chart audit. All new patients who were referred between April 1, 2015 and October 26, 2015 were included in the survey. Main outcome measures Recommendations made by the pharmacist and patient experience survey indicators. Results 173 patients were included in the chart audit, which found that patients were elderly (64.8 years), highly medically complex (13.8 medications and 6.5 diagnoses each), and had a large number of recommendations made by the pharmacist to adjust drug therapy (6.2 per patient). 121 questionnaires were mailed to patients with a response rate of 66.9 % (n = 81). The survey found high levels of support and satisfaction for the program, including more than half of patients (59.2 %) who reported that their health had improved as a result of the Medication Assessment Center. Conclusion The patient care and experiential education program offered by the Medication Assessment Center provides a valuable service to patients who are referred to the clinic.
Collapse
|
76
|
Willoughby KA, Rodríguez C, Boillat M, Dove M, Nugus P, Steinert Y, Lalla L. Assessing students’ perceptions of the effects of a new Canadian longitudinal pre-clerkship family medicine experience. EDUCATION FOR PRIMARY CARE 2016; 27:180-7. [DOI: 10.1080/14739879.2016.1172033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
77
|
Chaitoff A, Niforatos J, Vega J. Exploring the effects of medical trainee naming: a randomized experiment. PERSPECTIVES ON MEDICAL EDUCATION 2016; 5:114-121. [PMID: 26975743 PMCID: PMC4839008 DOI: 10.1007/s40037-016-0260-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE There is no rigorous exploration of how the different titles used by medical trainees in medical school affect patients' perceptions of trainees. This study has two aims: (1) to understand the effects of medical trainee title on subjects' perceptions, and (2) to understand the effects of informing subjects about the medical education system on comfort with trainees. METHODS A survey was distributed utilizing Amazon's Mechanical Turk (n = 432). To explore aim 1 and 2, the survey included one randomized experimental treatment asking participants to imagine they were partaking in a hypothetical clinical encounter with a medical trainee using one of three titles. To explore aim 2, the survey instrument included an educational section and assessed changes in subjects' comfort with trainees. RESULTS There was no association between trainee title and subjects' perceptions of trainee responsibility, education level, or comfort with being examined. However, 41.4 % (n = 179) of subjects were not aware of the medical trainees' training level, and education resulted in significant increases in comfort with being interviewed and examined by a trainee (p < 0.001). CONCLUSIONS While trainee naming was not directly associated with subjects' perceptions, educating patients about the medical education system may increase comfort level when they are with medical trainees.
Collapse
Affiliation(s)
| | | | - José Vega
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| |
Collapse
|
78
|
Swanepoel E, Tweedie J, Maher J. Building dietetic student confidence and professional identity through participation in a university health clinic. Nutr Diet 2016. [DOI: 10.1111/1747-0080.12268] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Elizabeth Swanepoel
- School of Health and Sports Science; University of the Sunshine Coast; Maroochydore Queensland Australia
| | - Judith Tweedie
- School of Health and Sports Science; University of the Sunshine Coast; Maroochydore Queensland Australia
| | - Judith Maher
- School of Health and Sports Science; University of the Sunshine Coast; Maroochydore Queensland Australia
| |
Collapse
|
79
|
Yiend J, Tracy DK, Sreenan B, Cardi V, Foulkes T, Koutsantoni K, Kravariti E, Tchanturia K, Willmott L, Shergill S, Reedy G. Post graduate clinical placements: evaluating benefits and challenges with a mixed methods cross sectional design. BMC MEDICAL EDUCATION 2016; 16:64. [PMID: 26882894 PMCID: PMC4754931 DOI: 10.1186/s12909-016-0575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course. METHODS Data were collected over academic years 2010/11- 2013/14, from participating students (n = 20 to 58) and clinician supervisors (n = 10-12), using a mixed-methods cross-sectional design. Quantitative evaluation captured information on uptake, dropout, resource use, attitudes and experience, using standardized (the Placement Evaluation Questionnaire; the Scale To Assess the Therapeutic Relationship - Clinical version and the University of Toronto Placement Supervisor Evaluation) and bespoke questionnaires and audit data. Qualitative evaluation comprised two focus groups (5 clinicians, 5 students), to investigate attitudes, experience, perceived benefits, disadvantages and desired future developments. Data were analysed using framework analysis to identify a priori and emergent themes. RESULTS High uptake (around 70 placements per annum), low dropout (2-3 students per annum; 5 %) and positive focus group comments suggested placements successfully provided added value and catered sufficiently to student demand. Students' responses confirmed that placements met expectations and the perception of benefit remained after completion with 70 % (n = 14) reporting an overall positive experience, 75 % (n = 15) reporting a pleasant learning experience, 60 % (n = 12) feeling that their clinical skills were enhanced and 85 % (n = 17) believing that it would benefit other students. Placements contributed the equivalent of seven full time unskilled posts per annum to local health care services. While qualitative data revealed perceived 'mutual benefit' for both students and clinicians, this was qualified by the inherent limitations of students' time and expertise. Areas for development included fostering learning around professionalism and students' confidence on placement. CONCLUSIONS The addition of healthcare placements to academic postgraduate taught courses can improve their attractiveness to applicants, benefit healthcare services and enhance students' perception of their learning experiences. Well-positioned and supported placement learning opportunities could become a key differentiator for academic courses, over potential competitors. However, the actual implications for student employability and achievement remain to be established.
Collapse
Affiliation(s)
- Jenny Yiend
- />Department of Psychosis Studies, King’s College London, Denmark Hill, London, UK
| | - Derek K. Tracy
- />Department of Psychosis Studies, King’s College London, Denmark Hill, London, UK
- />Oxleas NHS Foundation Trust, London, UK
| | - Brian Sreenan
- />Department of Psychosis Studies, King’s College London, Denmark Hill, London, UK
| | - Valentina Cardi
- />Department of Psychological Medicine, King’s College London, Denmark Hill, London, UK
| | - Tina Foulkes
- />Education Support Team, King’s College London, Denmark Hill, London, UK
| | | | - Eugenia Kravariti
- />Department of Psychosis Studies, King’s College London, Denmark Hill, London, UK
| | - Kate Tchanturia
- />Department of Psychological Medicine, King’s College London, Denmark Hill, London, UK
| | - Lucy Willmott
- />Institute of Criminology, University of Cambridge, London, UK
| | - Sukhi Shergill
- />Department of Psychosis Studies, King’s College London, Denmark Hill, London, UK
| | - Gabriel Reedy
- />King’s Learning Institute, King’s College London, Waterloo, London, UK
| |
Collapse
|
80
|
Dilly M, Tipold A, Geuenich K. Stressed out or subjective acquisition of competence--how do veterinary students see their curative work placement? GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc9. [PMID: 26958657 PMCID: PMC4766928 DOI: 10.3205/zma001008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
Abstract
Veterinary studies in Germany are regulated by the Veterinary Certification Act (TAppV). The practical part of the education consists of 1,170 hours, whereby up to 850 hours can be spent on the curative work placement. A curative work placement can result in physical and psychological stress in the sense of a professional overload. It is the aim of this study to find out in what areas and to what extent competence is acquired and psychological stress exists in students during their work placement. Veterinary students (n=142) from all German education institutes participated in a voluntary online-study based on Burnout Screening Scales (BOSS) as well as a questionnaire regarding the acquisition of competence and excessive stress during the work placement (FKÜP). The distribution of values for work placement related stress show that such work placement related stress is generally slightly increased (T=60) and lies above that of occupational stresses within the normal population. Work placement related physical complaints also show a significant slight increase (T=61). A value (T=42) within the normal range was determined for the resource values. Few of the students questioned considered themselves to be excessively stressed in favour of a high subjective acquisition of competences. The largest increase regarding the acquisition of competence was noted for the areas of animal handling/restraint and application and injection techniques. In the sense of a perceived excessive demand regarding practical capabilities the areas of emergency management, surgery and medication dispensation were mentioned. With regard to the load structure and the acquisition of competence by veterinary students during their work placement, more support of the individual and a balancing of teaching/learning goals would be desirable and represents a promising approach.
Collapse
Affiliation(s)
- Marc Dilly
- University of Veterinary Medicine Hannover, Foundation, Clinical Skills Lab, Hannover, Germany
| | - Andrea Tipold
- University of Veterinary Medicine Hannover, Foundation, Small Animal Clinical, Hannover, Germany
| | - Katja Geuenich
- Park Clinic Röhrer, Academy for Psychosomatics in the World of Work, Eschweiler, Germany
| |
Collapse
|
81
|
Quince T, Thiemann P, Benson J, Hyde S. Undergraduate medical students' empathy: current perspectives. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2016; 7:443-55. [PMID: 27536168 PMCID: PMC4976762 DOI: 10.2147/amep.s76800] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Empathy is important to patient care. It enhances patients' satisfaction, comfort, self-efficacy, and trust which in turn may facilitate better diagnosis, shared decision making, and therapy adherence. Empathetic doctors experience greater job satisfaction and psychological well-being. Understanding the development of empathy of tomorrow's health care professionals is important. However, clinical empathy is poorly defined and difficult to measure, while ways to enhance it remain unclear. This review examines empathy among undergraduate medical students, focusing upon three main questions: How is empathy measured? This section discusses the problems of assessing empathy and outlines the utility of the Jefferson Scale of Empathy - Student Version and Davis's Interpersonal Reactivity Index. Both have been used widely to assess medical students' empathy. Does empathy change during undergraduate medical education? The trajectory of empathy during undergraduate medical education has been and continues to be debated. Potential reasons for contrasting results of studies are outlined. What factors may influence the development of empathy? Although the influence of sex is widely recognized, the impact of culture, psychological well-being, and aspects of undergraduate curricula are less well understood. This review identifies three interrelated issues for future research into undergraduate medical students' empathy. First, the need for greater clarity of definition, recognizing that empathy is multidimensional. Second, the need to develop meaningful ways of measuring empathy which include its component dimensions and which are relevant to patients' experiences. Medical education research has generally relied upon single, self-report instruments, which have utility across large populations but are limited. Finally, there is a need for greater methodological rigor in investigating the possible determinants of clinical empathy in medical education. Greater specificity of context and the incorporation of work from other disciplines may facilitate this.
Collapse
Affiliation(s)
- Thelma Quince
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- Correspondence: Thelma Quince, Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK, Tel +44 1223 33 0364, Fax +44 1223 76 2512, Email
| | - Pia Thiemann
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - John Benson
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Sarah Hyde
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
| |
Collapse
|
82
|
Rawekar A, Jagzape A, Srivastava T, Gotarkar S. Skill Learning Through Early Clinical Exposure: An Experience of Indian Medical School. J Clin Diagn Res 2016; 10:JC01-4. [PMID: 26894088 DOI: 10.7860/jcdr/2016/17101.7022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/05/2015] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Indian Medical curriculum being discipline based, there is a line of demarcation between preclinical and clinical subjects. The challenges in medical education include the methods that would enhance the clinical education quality; one such method been Early Clinical Exposure (ECE). ECE can help to instill the skill component of medical education in the first year students helping to minimize the line of demarcation. Hence this study was undertaken to assess the skill learning of students through early clinical exposure and to collate the perception of them. MATERIALS AND METHODS In the present study, students of 1(st) MBBS were exposed to ECE as an adjunct teaching method with preset modules. They were evaluated by Objectively Structured Clinical Examination (OSCE). Feedback was obtained from 1(st) MBBS and also from the same students after passing the 1(st) MBBS in 4(th) semester. RESULTS Significant differences in pre and post OSCE scores were noted (p<0.0001). Seventy six percent students rated ECE as an excellent tool. Second year students also perceived ECE held in 1(st) year was helpful to correlate topics and increasing confidence. CONCLUSION ECE had an effective influence on learning as manifested in skills gained by the students and their perceptions of ECE being helpful prospectively in their routine clinical posting.
Collapse
Affiliation(s)
- Alka Rawekar
- Professor, Department of Physiology, JN Medical College , Sawangi (M) Wardha, Maharashtra, India
| | - Arunita Jagzape
- Assistant Professor, Department of Physiology, JN Medical College , Sawangi (M) Wardha, India
| | - Tripti Srivastava
- Professor, Department of Physiology, JN Medical College , Sawangi (M) Wardha, India
| | - Shashank Gotarkar
- Junior Resident, Department of Community Medicine, JN Medical College , Sawangi (M) Wardha, India
| |
Collapse
|
83
|
Ellaway RH, O'Gorman L, Strasser R, Marsh DC, Graves L, Fink P, Cervin C. A critical hybrid realist-outcomes systematic review of relationships between medical education programmes and communities: BEME Guide No. 35. MEDICAL TEACHER 2016; 38:229-45. [PMID: 26646982 DOI: 10.3109/0142159x.2015.1112894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The relationships between medical schools and communities have long inspired and troubled medical education programmes. Successive models of community-oriented, community-based and community-engaged medical education have promised much and delivered to varying degrees. A two-armed realist systematic review was undertaken to explore and synthesize the evidence on medical school-community relationships. METHOD One arm used standard outcomes criteria (Kirkpatrick levels), the other a realist approach seeking out the underlying contexts, mechanisms and outcomes. 38 reviewers completed 489 realist reviews and 271 outcomes reviews; 334 articles were reviewed in the realist arm and 181 in the outcomes arm. Analyses were based on: descriptive statistics on both articles and reviews; the outcomes involved; the quality of the evidence presented; realist contexts, mechanisms, and outcomes; and an analysis of underlying discursive themes. FINDINGS The literature on medical school-community relationships is heterogeneous and largely idiographic, with no common standards for what a community is, who represents communities, what a relationship is based on, or whose needs are or should be being addressed or considered. CONCLUSIONS Community relationships can benefit medical education, even if it is not always clear why or how. There is much opportunity to improve the quality and precision of scholarship in this area.
Collapse
Affiliation(s)
- R H Ellaway
- a Northern Ontario School of Medicine , Canada
- b University of Calgary , Canada
| | - L O'Gorman
- a Northern Ontario School of Medicine , Canada
- c Laurentian University , Canada
| | - R Strasser
- a Northern Ontario School of Medicine , Canada
| | - D C Marsh
- a Northern Ontario School of Medicine , Canada
| | - L Graves
- a Northern Ontario School of Medicine , Canada
- d University of Toronto , Canada
| | - P Fink
- a Northern Ontario School of Medicine , Canada
| | - C Cervin
- a Northern Ontario School of Medicine , Canada
| |
Collapse
|
84
|
Eppich W, Rethans JJ, Teunissen PW, Dornan T. Learning to Work Together Through Talk: Continuing Professional Development in Medicine. PROFESSIONAL AND PRACTICE-BASED LEARNING 2016. [DOI: 10.1007/978-3-319-29019-5_3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
85
|
Tayade MC, Latti RG. Perception of Medical Faculties towards Early Clinical Exposure and MCI Vision 2015 Documents in Western Maharashtra. J Clin Diagn Res 2015; 9:CC12-4. [PMID: 26816885 PMCID: PMC4717811 DOI: 10.7860/jcdr/2015/15875.6986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/22/2015] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The Medical Council of India (MCI) has advocated early clinical exposure for students in medical colleges. In its 'Vision-2015' document for further reforms in undergraduate medical education, the MCI underlined the need for clinical teaching from first year onwards in medical colleges. AIM Our aim was to collect and analyse perception of medical faculties towards early clinical exposure and MCI Vision 2015 and to study the awareness, depth and interest among medical faculties towards these changes. MATERIALS AND METHODS We used 10-item self developed survey questionnaires, which was validated from experts in medical education. 10-item questionnaire was based on awareness, depth and interest among medical faculties towards early clinical exposure and MCI Vision 2015 documents released by MCI in 2011. Qualitative data was assessed using percentage scale. We were approached to 182 preclinical medical faculties, however responses were received from 127 medical faculties from first year medical course subjects from six different college's viz. two from Deemed University, two from Government sector and two from private sector but affiliated to Maharashtra University of Health sciences, Nasik, India. RESULTS A 94.48% faculty members were aware regarding MCI Vision 2015 documents released by MCI in 2011. Average 12% faculties could answer specific approach MCQs based on MCI Vision 2015 documents. However, 82.67% faculties agreed early clinical exposure will be definitely helpful if implemented in curriculum. CONCLUSION The present work underlines need of special coaching and attention towards this important issue in medical education.
Collapse
Affiliation(s)
- Motilal Chandu Tayade
- Assistant Professor and PhD Scholar, Department of Physiology, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Tal. Rahata, District Ahmednagar, India
| | - Ramchandra G Latti
- Professor and HOD, Department of Physioloy, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Tal. Rahata, District Ahmednagar, India
| |
Collapse
|
86
|
|
87
|
Schoenbaum SC, Crome P, Curry RH, Gershon ES, Glick SM, Katz DR, Paltiel O, Shapiro J. Policy issues related to educating the future Israeli medical workforce: an international perspective. Isr J Health Policy Res 2015; 4:37. [PMID: 26430508 PMCID: PMC4590268 DOI: 10.1186/s13584-015-0030-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 06/23/2015] [Indexed: 11/12/2022] Open
Abstract
A 2014 external review of medical schools in Israel identified several issues of importance to the nation's health. This paper focuses on three inter-related policy-relevant topics: planning the physician and healthcare workforce to meet the needs of Israel's population in the 21(st) century; enhancing the coordination and efficiency of medical education across the continuum of education and training; and the financing of medical education. All three involve both education and health care delivery. The physician workforce is aging and will need to be replenished. Several physician specialties have been in short supply, and some are being addressed through incentive programs. Israel's needs for primary care clinicians are increasing due to growth and aging of the population and to the increasing prevalence of chronic conditions at all ages. Attention to the structure and content of both undergraduate and graduate medical education and to aligning incentives will be required to address current and projected workforce shortage areas. Effective workforce planning depends upon data that can inform the development of appropriate policies and on recognition of the time lag between developing such policies and seeing the results of their implementation. The preclinical and clinical phases of Israeli undergraduate medical education (medical school), the mandatory rotating internship (stáge), and graduate medical education (residency) are conducted as separate "silos" and not well coordinated. The content of basic science education should be relevant to clinical medicine and research. It should stimulate inquiry, scholarship, and lifelong learning. Clinical exposures should begin early and be as hands-on as possible. Medical students and residents should acquire specific competencies. With an increasing shift of medical care from hospitals to ambulatory settings, development of ambulatory teachers and learning environments is increasingly important. Objectives such as these will require development of new policies. Undergraduate medical education (UME) in Israel is financed primarily through universities, and they receive funds through VATAT, an education-related entity. The integration of basic science and clinical education, development of earlier, more hands-on clinical experiences, and increased ambulatory and community-based medical education will demand new funding and operating partnerships between the universities and the health care delivery system. Additional financing policies will be needed to ensure the appropriate infrastructure and support for both educators and learners. If Israel develops collaborations between various government agencies such as the Ministries of Education, Health, and Finance, the universities, hospitals, and the sick funds (HMOs), it should be able to address successfully the challenges of the 21st century for the health professions and meet its population's needs.
Collapse
Affiliation(s)
| | - Peter Crome
- />University College London, Gower St, London, WC1E 6BT United Kingdom
| | - Raymond H. Curry
- />University of Illinois College of Medicine, 1853 West Polk Street, Chicago, IL 60612 USA
| | - Elliot S. Gershon
- />Department of Psychiatry and Behavioral Neuroscience University of Chicago Medicine, 5841 S. Maryland Ave., MC 3077, Rm M344A, Chicago, Illinois 60637 USA
| | - Shimon M. Glick
- />Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, 8410501 Israel
| | - David R. Katz
- />University College London, Gower St, London, WC1E 6BT United Kingdom
| | - Ora Paltiel
- />Faculty of Medicine Hebrew University Hadassah School of Medicine, Braun School of Public Health and Community Medicine, Ein Kerem Campus, Jerusalem, Israel
| | - Jo Shapiro
- />Division of Otolaryngology Department of Surgery, Brigham and Women’s Hospital, 45 Francis St, Boston, MA 02115 USA
| |
Collapse
|
88
|
Powell K, Stocks N, Laurence C. A new venture in interdisciplinary student learning in a co-located health service. AUST HEALTH REV 2015; 40:205-209. [PMID: 26342675 DOI: 10.1071/ah14241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 07/09/2015] [Indexed: 11/23/2022]
Abstract
Learning about interdisciplinary health approaches is important for students of health professions. Yet, interdisciplinary learning programs are sparse within primary health clinics. Larger health care complexes, such as superclinics in Australia, offer interdisciplinary learning opportunities for health, but also pose difficulties. This case study describes the introduction of an interdisciplinary student learning program in Adelaide, South Australia, over a 1-year period. The objectives of the program were for students to: (1) understand the range of patient needs in primary healthcare (PHC); (2) identify circumstances in which the involvement of another professional may benefit patients; and (3) learn more about team work. Despite barriers, the practice environment was found to be suitable for student learning. Program modifications were made in response to the need for scheduled time for clinic staff to work with students, non-simultaneous student placements, a need for a coordinator, the availability of discipline-specific supervision and the need to provide incentives for students to participate, particularly giving course credits or recognition. Embedding interdisciplinary programs in a clinic setting requires time and resources. The present case study demonstrates that larger PHC clinics have the potential to implement interdisciplinary learning programs based on an authentic learning approach.
Collapse
Affiliation(s)
- Kathryn Powell
- Discipline of General Practice, School of Population Health, The University of Adelaide North Terrace, Adelaide, SA 5005, Australia.
| | - Nigel Stocks
- Discipline of General Practice, School of Population Health, The University of Adelaide North Terrace, Adelaide, SA 5005, Australia.
| | - Caroline Laurence
- Discipline of General Practice, School of Population Health, The University of Adelaide North Terrace, Adelaide, SA 5005, Australia.
| |
Collapse
|
89
|
González Quiñones JC, Restrepo Chavarriaga GL, Hernandez Rojas AD, Ternera Saavedra DC, Galvis Gómez CA, Pinzón Ramírez JA. Satisfacción de pacientes que acudieron al primer nivel de atención durante el 2012 en Bogotá. Rev Salud Publica (Bogota) 2015. [DOI: 10.15446/rsap.v16n6.38192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
<p><strong>Objetivo</strong> Estimar la percepción de los pacientes sobre la atención médica en el primer nivel de atención.</p><p><strong>Metodología</strong> Se aplicó una encuesta telefónica a pacientes atendidos en dos meses diferentes del 2012, indagando por variables sociodemográficas, relaciones médico-paciente y acerca del proceso de atención médica.</p><p><strong>Resultados </strong>Se encuestaron 804 pacientes. El tiempo promedio de acceso a la atención fue de 9,6 días. El 78 % refiere haber podido contar todo lo que sentía al médico, el 60 % que el médico le explicó lo que tenía y, uno de cuatro, que indagó por su familia. El 30 % sintió alivio completo luego de la atención médica. La calificación promedio de la atención médica fue de 7,9 (DE ± 1,7). Las variables relacionadas con las calificaciones más altas fueron: Poder contarle todo al médico (OR 7,5 IC 95 % 1,8-31), ser examinado (OR 7,5 IC 95 % 1,5-38,5, explicarle qué tiene (OR 5,2 IC 95 % 1,8-15), preguntar por la familia (OR 5,8 IC 95 % 2,1-16,1) y haberlo atendido antes (OR 3,5 IC 95 % 1,4-8,6).</p><p><strong>Conclusiones </strong>La comunicación extensa con el paciente es tan importante como el enfrentar la enfermedad en el acto médico.</p>
Collapse
|
90
|
Holden MD, Buck E, Luk J, Ambriz F, Boisaubin EV, Clark MA, Mihalic AP, Sadler JZ, Sapire KJ, Spike JP, Vince A, Dalrymple JL. Professional identity formation: creating a longitudinal framework through TIME (Transformation in Medical Education). ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2015; 90:761-7. [PMID: 25853688 DOI: 10.1097/acm.0000000000000719] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The University of Texas System established the Transformation in Medical Education (TIME) initiative to reconfigure and shorten medical education from college matriculation through medical school graduation. One of the key changes proposed as part of the TIME initiative was to begin emphasizing professional identity formation (PIF) at the premedical level. The TIME Steering Committee appointed an interdisciplinary task force to explore the fundamentals of PIF and to formulate strategies that would help students develop their professional identity as they transform into physicians. In this article, the authors describe the task force's process for defining PIF and developing a framework, which includes 10 key aspects, 6 domains, and 30 subdomains to characterize the complexity of physician identity. The task force mapped this framework onto three developmental phases of medical education typified by the undergraduate student, the clerkship-level medical student, and the graduating medical student. The task force provided strategies for the promotion and assessment of PIF for each subdomain at each of the three phases, in addition to references and resources. Assessments were suggested for student feedback, curriculum evaluation, and theoretical development. The authors emphasize the importance of longitudinal, formative assessment using a combination of existing assessment methods. Though not unique to the medical profession, PIF is critical to the practice of exemplary medicine and the well-being of patients and physicians.
Collapse
Affiliation(s)
- Mark D Holden
- M.D. Holden is vice chair, Undergraduate and Continuing Medical Education, and professor and director, General Internal Medicine, University of Texas Medical Branch, Galveston, Texas. E. Buck is senior medical educator, Office of Educational Development, University of Texas Medical Branch, Galveston, Texas. J. Luk is assistant professor of medicine and assistant dean for interprofessional integration, University of Texas Dell Medical School, Austin, and clinical associate professor of pediatrics and assistant dean for regional medical education, University of Texas Medical Branch, Galveston, Texas. F. Ambriz is clinical assistant professor and chair, Physician Assistant Department, University of Texas Pan American, Edinburg, Texas. E.V. Boisaubin is distinguished teaching professor of medicine, University of Texas Medical School at Houston, Houston, Texas. M.A. Clark is visiting scholar, Lincoln Center for Applied Ethics, Arizona State University, Tempe, Arizona. A.P. Mihalic is associate dean for student affairs and professor of pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas. J.Z. Sadler is professor of psychiatry and clinical sciences and Daniel W. Foster, MD Professor of Medical Ethics, University of Texas Southwestern Medical Center, Dallas, Texas. K.J. Sapire is professor of anesthesiology and perioperative medicine, University of Texas MD Anderson Cancer Center, Houston, Texas. J.P. Spike is professor, McGovern Center for Humanities and Ethics, University of Texas Medical School at Houston, Houston, Texas. A. Vince is medical anthropologist and director, University Health Professions Office, University of Texas at San Antonio, San Antonio, Texas. J.L. Dalrymple is assistant dean for clinical integration, and associate professor and division director of gynecologic oncology, Department of Obstetrics and Gynecology, University of Texas Dell Medical School, Austin, Texas
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
91
|
Mills BW, Carter OBJ, Rudd CJ, Mills JK, Ross NP, Ruck JD. Quantification of opportunities for early-stage paramedicine students to practice clinical skills during clinical placements compared with an equal dose of simulation-based workshops. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2015; 1:24-28. [DOI: 10.1136/bmjstel-2015-000040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2015] [Indexed: 12/30/2022]
Abstract
IntroductionA reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.MethodsN=37 first-year paramedicine students completed activity diaries during 3 days of CP and 3 days of SLE. Opportunities to practice clinical skills were quantified and coded as either: level-appropriate, beyond-level or of non-discipline relevance.ResultsDuring SLE, the average student was exposed 226 times to 11 level-appropriate clinical procedures. During CP the average student was exposed 48 times to 24 clinical procedures, the majority relevant to paramedicine (63%), but a minority level-appropriate (38%). Students’ opportunities for supervised, ‘hands on’ practice represented only 10% of exposures in either SLE or CP but in terms of raw numbers of level-appropriate opportunities, SLE provided more than CP (n=23 vs 2).DiscussionOur results confirm that SLE provides substantially more opportunities than CP for students to practice level-appropriate skills and is therefore more appropriate for repetitive practice. However, CP is likely to remain useful to students for practicing interpersonal skills and contextualisation of knowledge within the broader health system. Educators should therefore carefully articulate learning objectives before choosing between SLE and CP.
Collapse
|
92
|
AlHaqwi AI, Taha WS. Promoting excellence in teaching and learning in clinical education. J Taibah Univ Med Sci 2015. [DOI: 10.1016/j.jtumed.2015.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
93
|
Yardley S, Cottrell E, Rees E, Protheroe J. Modelling successful primary care for multimorbidity: a realist synthesis of successes and failures in concurrent learning and healthcare delivery. BMC FAMILY PRACTICE 2015; 16:23. [PMID: 25886592 PMCID: PMC4343192 DOI: 10.1186/s12875-015-0234-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/29/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND People are increasingly living for longer with multimorbidity. Medical education and healthcare delivery must be re-orientated to meet the societal and individual patient needs that multimorbidity confers. The impact of multimorbidity on the educational needs of doctors is little understood. There has been little critique of how learning alongside healthcare provision is negotiated by patients, general practitioners and trainee doctors. This study asked 'what is known about how and why concurrent healthcare delivery and professional experiential learning interact to generate outcomes, valued by patients, general practitioners and trainees, for patients with multimorbidity in primary care?' METHODS This realist synthesis is reported using RAMESES standards. Relationship-centred negotiation of needs-based learning and care was the primary outcome of interest. Healthcare, social science and educational literature were sought as evidence. Data extraction focused on context, mechanism and outcome configurations within studies and on data which might assist understanding and explain; i) these configurations; ii) the relationships between them and; iii) their role and place in evolving programme theories arising from data synthesis. Mind-mapping software and team meetings were used to aid interpretative analysis. RESULTS The final synthesis included 141 papers of which 34 contained models for workplace-based experiential learning and/or patient care. Models of experiential learning for practitioners and for patient engagement were congruent, frequently referencing theories of transformation and socio-cultural processes as mechanisms for improving clinical care. Key issues included the perceived impossibility of reconciling personalised concepts of success with measurability of clinical markers or adherence to guidelines, and the need for greater recognition of social dynamics between patients, GPs and trainees including the complexities of shared responsibilities. A model for considering the implications of concurrency for learning and healthcare delivery in the context of multimorbidity in primary care is proposed and supporting evidence is presented. CONCLUSIONS This study is novel in considering empirical evidence from patients, GPs and trainees engaged in concurrent learning and healthcare delivery. The findings should inform future interventions designed to produce a medical workforce equipped to provide multimorbidity care. TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42013003862.
Collapse
Affiliation(s)
- Sarah Yardley
- Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
| | - Elizabeth Cottrell
- Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
| | - Eliot Rees
- Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
| | - Joanne Protheroe
- Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
| |
Collapse
|
94
|
Goldstein PA, Storey-Johnson C, Beck S. Facilitating the initiation of the physician's professional identity: Cornell's urban semester program. PERSPECTIVES ON MEDICAL EDUCATION 2014; 3:492-499. [PMID: 25395231 PMCID: PMC4263797 DOI: 10.1007/s40037-014-0151-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Calling for major reform in medical education, the Carnegie Institute report 'Educating Physicians' espoused the importance of assisting student trainees in forming their professional identities. Here, we consider the question: At what educational stage should future physicians begin this process? The literature suggests that the process begins when students matriculate in medical school; we posit, however, that premedical students can begin their proto-professional development as college undergraduates. We describe here the pedagogy of Cornell University's urban semester program (USP), which enables college students to participate in shadowing experiences as part of an integrated structured study programme. USP students report improved communicative competency, changes in their perceptions and attitudes toward medical practice, and powerful influences on their personal and professional development upon completion of the programme. We suggest the solution to the question of 'When and under what conditions should shadowing take place?' is to utilize a structure that combines the exposure of college students to the professional environment with a didactic and self-reflective curriculum, thereby supporting students in their early professional development. We conclude that educational efforts aimed at developing professional identity and behaviour can begin before students enter medical school.
Collapse
Affiliation(s)
- Peter A Goldstein
- Department of Anesthesiology, Weill Cornell Medical College, 1300 York Avenue, Room A-1050, New York, NY, 10065, USA.
| | - Carol Storey-Johnson
- Department of Medicine and the Office of Academic Affairs, Weill Cornell Medical College, New York, NY, USA
| | - Sam Beck
- Urban Semester Program, College of Human Ecology, Cornell University, Ithaca, NY, USA
| |
Collapse
|
95
|
Dornan T, Tan N, Boshuizen H, Gick R, Isba R, Mann K, Scherpbier A, Spencer J, Timmins E. How and what do medical students learn in clerkships? Experience based learning (ExBL). ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2014; 19:721-49. [PMID: 24638146 DOI: 10.1007/s10459-014-9501-0] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/03/2014] [Indexed: 05/05/2023]
Abstract
Clerkship education has been called a 'black box' because so little is known about what, how, and under which conditions students learn. Our aim was to develop a blueprint for education in ambulatory and inpatient settings, and in single encounters, traditional rotations, or longitudinal experiences. We identified 548 causal links between conditions, processes, and outcomes of clerkship education in 168 empirical papers published over 7 years and synthesised a theory of how students learn. They do so when they are given affective, pedagogic, and organisational support. Affective support comes from doctors' and many other health workers' interactions with students. Pedagogic support comes from informal interactions and modelling as well as doctors' teaching, supervision, and precepting. Organisational support comes from every tier of a curriculum. Core learning processes of observing, rehearsing, and contributing to authentic clinical activities take place within triadic relationships between students, patients, and practitioners. The phrase 'supported participation in practice' best describes the educational process. Much of the learning that results is too tacit, complex, contextualised, and individual to be defined as a set of competencies. We conclude that clerkship education takes place within relationships between students, patients, and doctors, supported by informal, individual, contextualised, and affective elements of the learned curriculum, alongside formal, standardised elements of the taught and assessed curriculum. This research provides a blueprint for designing and evaluating clerkship curricula as well as helping patients, students, and practitioners collaborate in educating tomorrow's doctors.
Collapse
Affiliation(s)
- Tim Dornan
- Department of Educational Development and Research, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands,
| | | | | | | | | | | | | | | | | |
Collapse
|
96
|
Whitford DL, Hubail AR. Cultural sensitivity or professional acculturation in early clinical experience? MEDICAL TEACHER 2014; 36:951-957. [PMID: 24820057 DOI: 10.3109/0142159x.2014.910296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM This study aimed to explore the early clinical experience of medical students following the adaptation of an Early Patient Contact curriculum from a European culture in Ireland to an Arab culture in Bahrain. METHODS Medical students in Bahrain took part in an Early Patient Contact module modelled on a similar module from a partner medical school in Ireland. We used a qualitative approach employing thematic analysis of 54 student reflective logbooks. Particular attention was placed on reflections of cultural influences of experience in the course. RESULTS Medical students undergoing this module received reported documented benefits of early clinical experience. However, students in Bahrain were exposed to cultural norms of the local Arab society including gender values, visiting the homes of strangers, language barriers and generous hospitality that led to additional challenges and learning for the medical students in acculturating to norms of the medical profession. CONCLUSION Modules intended for curriculum adaptation between two cultures would be best served by a group of "core" learning outcomes with "secondary" outcomes culturally appropriate to each site. Within the context of the Arab culture, early clinical experience has the added benefit of allowing students to learn about both local and professional cultural norms, thereby facilitating integration of these two cultures.
Collapse
Affiliation(s)
- David L Whitford
- Royal College of Surgeons in Ireland - Medical University of Bahrain , Kingdom of Bahrain
| | | |
Collapse
|
97
|
Sullivan GM, Simpson D, Cook DA, DeIorio NM, Andolsek K, Opas L, Philibert I, Yarris LM. Redefining Quality in Medical Education Research: A Consumer's View. J Grad Med Educ 2014; 6:424-9. [PMID: 26294940 PMCID: PMC4542451 DOI: 10.4300/jgme-d-14-00339.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Despite an explosion of medical education research and publications, it is not known how medical educator consumers decide what to read or apply in their practice. OBJECTIVE To determine how consumers of medical education research define quality and value. METHODS Journal of Graduate Medical Education editors performed a literature search to identify articles on medical education research quality published between 2000 and 2013, surveyed medical educators for their criteria for judging quality, and led a consensus-building workshop at a 2013 Association of American Medical Colleges meeting to further explore how users defined quality in education research. The workshop used standard consensus-building techniques to reach concept saturation. Attendees then voted for the 3 concepts they valued most in medical education research. RESULTS The 110 survey responses generated a list of 37 overlapping features in 10 categories considered important aspects of quality. The literature search yielded 27 articles, including quality indexes, systematic and narrative reviews, and commentaries. Thirty-two participants, 12 facilitators, and 1 expert observer attended the workshop. Participants endorsed the following features of education research as being most valuable: (1) provocative, novel, or challenged established thinking; (2) adhered to sound research principles; (3) relevant to practice, role, or needs; (4) feasible, practical application in real-world settings; and (5) connection to a conceptual framework. CONCLUSIONS Medical educators placed high value on rigorous methods and conceptual frameworks, consistent with published quality indexes. They also valued innovative or provocative work, feasibility, and applicability to their setting. End-user opinions of quality may illuminate how educators translate knowledge into practice.
Collapse
|
98
|
Huenges B, Gulich M, Böhme K, Fehr F, Streitlein-Böhme I, Rüttermann V, Baum E, Niebling WB, Rusche H. Recommendations for undergraduate training in the primary care sector--position paper of the GMA-Primary Care Committee. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc35. [PMID: 25228937 PMCID: PMC4152999 DOI: 10.3205/zma000927] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 04/24/2014] [Accepted: 06/22/2014] [Indexed: 12/30/2022]
Abstract
During their studies to become medical professionals, all students are obliged to become familiar with various aspects of primary care. The aim is to provide all students with a high quality training which ensures the best possible cooperation across all sectors of the medical system. Primary care comprises the primary use of the medical service by an unfiltered set of patients as well as continued patient care – including home-care. This position paper was developed together with representatives of the German Society of University Teachers of General Practice (GHA), the German Society for Ambulatory General Paediatrics (DGAAP), the German Society of General Practice and Family Medicine (DEGAM) and the German Society for Internal Medicine (DGIM). It includes recommendations for teaching in the field of primary care in four different types of internships such as preclinical work experience (“Hospitation”), 4-week clinical traineeships of a casual nature (“Famulatur”) and 2-week courses of structured and assessed clinical training (“Blockpraktikum”) as well as a broad-based 4-month elective clinical placement in the final year (known as a practical year, “PJ”). The recommendations encompass structural and process criteria for internships in different general practices. In addition, for the first time recommendations for teaching on campus – in the fields of general medicine, paediatrics, numerous cross-sectional areas and other clinical fields, but also for clinical skills training – are set down here. In this position paper the intention is to demonstrate the possible ways in which more aspects of primary care could be integrated into undergraduate medical training.
Collapse
Affiliation(s)
- Bert Huenges
- Universität Bochum, Abteilung für Allgemeinmedizin, Bochum, Deutschland
| | - Markus Gulich
- Universität Ulm, Abteilung Allgemeinmedizin, Ulm, Deutschland
| | - Klaus Böhme
- Uniklinik Freiburg, Lehrbereich Allgemeinmedizin, Freiburg, Deutschland
| | - Folkert Fehr
- Facharzt für Kinderheilkunde und Jugendmedizin, Sinsheim an der Elzenz, Deutschland
| | | | | | - Erika Baum
- Universität Marburg, Abteilung für Allgemeinmedizin, Marburg, Deutschland
| | | | - Herbert Rusche
- Universität Bochum, Abteilung für Allgemeinmedizin, Bochum, Deutschland
| |
Collapse
|
99
|
|
100
|
Application of Educational Theory and Evidence in Support of an Integrated Model of Clinical Education. ACTA ACUST UNITED AC 2014. [DOI: 10.1097/00001416-201400001-00005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|