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Teo MYK, Ibrahim H, Lin CKR, Hamid NABA, Govindasamy R, Somasundaram N, Lim C, Goh JL, Zhou Y, Tay KT, Ong RRS, Tan V, Toh Y, Pisupati A, Raveendran V, Chua KZY, Quah ELY, Sivakumar J, Senthilkumar SD, Suresh K, Loo WTW, Wong RSM, Pei Y, Sng JH, Quek SQM, Owyong JLJ, Yeoh TT, Ong EK, Phua GLG, Mason S, Hill R, Chowdhury AR, Ong SYK, Krishna LKR. Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education. BMC MEDICAL EDUCATION 2024; 24:726. [PMID: 38970020 PMCID: PMC11225364 DOI: 10.1186/s12909-024-05707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS). METHODS A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion. RESULTS Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes. CONCLUSION Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
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Affiliation(s)
- Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Casper Keegan Ronggui Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nur Amira Binte Abdul Hamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Medical Social Services, Singapore General Hospital, Block 3, Singapore, 169854, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yi Zhou
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ryan Rui Song Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vanessa Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Youru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jeevasuba Sivakumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Samyuktha Dhanalakshmi Senthilkumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keerthana Suresh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Wesley Teck Wee Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yiying Pei
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Julia Huina Sng
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Simone Qian Min Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ting Ting Yeoh
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Road, Singapore, 574627, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Ruaraidh Hill
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Anupama Roy Chowdhury
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Department of Geriatric Medicine, Singapore General Hospital, Academia, Level 3, College Road, Singapore, 169608, Singapore
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Haque WZ, Coias J, Pollio EW, Yazdani R, Wagner JM, North CS, Pollio DE. Key Attributes of a Medical Learning Community Mentor at One Medical School: The Mentee Perspective. EVALUATION REVIEW 2023; 47:504-531. [PMID: 36480918 DOI: 10.1177/0193841x221144338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
To assess the elements necessary to be a successful learning community (ClinCalc) mentor to medical students from the mentee's perspective. Few such studies have utilized the in-depth and richness of detail obtained in qualitative studies. This qualitative study analyzed four focus group discussions lasting 45-90 min conducted at the University of Texas Southwestern Medical School, which has an established LC, in the year 2018. The groups included 14 pre-clerkship and 8 clerkship students. Investigators evaluated transcriptions of the focus group discussions using ATLAS.ti software. Three overarching categories of discussion emerged from the group discussions: (1) Relationship Competence, (2) Teaching Competence, and (3) Ethical and Compassionate Medical Practice Competence. Relationship Competence themes included "walk with me," relationship is most important, and one-on-one. Teaching Competence themes included above and beyond, recognize and address mentor limitations, and safe and enriching environment. Ethical and Compassionate Medical Practice Competence themes included ethical decision making and compassionate care for diverse patient populations. Mentees focused on various aspects of the mentor-mentee relationship as the single most essential competence. Themes mentees discussed as important qualities of a successful mentor may denote qualities to be prioritized in faculty development and mentor recruitment. Future studies could investigate how the LC environment informs former medical students and promotes patient outcomes.
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Affiliation(s)
| | - Jennifer Coias
- Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - E Whitney Pollio
- The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
| | - Rana Yazdani
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James M Wagner
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carol S North
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David E Pollio
- The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
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Sabirov A, Chludzinski M, Eminof E, Eddy A, Gallagher J, Jung I. Learning abnormal physical examination signs: an introductory course. J Osteopath Med 2023; 123:295-299. [PMID: 36998103 DOI: 10.1515/jom-2022-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
CONTEXT The acquisition of clinical skills is an essential part of the osteopathic medical school curriculum. Preclinical medical students, especially at osteopathic medical schools, have limited exposure to abnormal physical examination (PE) findings that are not typically seen in a student's peers or in a standardized patient (SP). The early exposure of first-year medical students (MS1s) to normal and abnormal findings in the simulation settings better equips them to identify abnormalities when they encounter them in a clinical setting. OBJECTIVES The aim of this project was to develop and implement the introductory course on learning abnormal PE signs and pathophysiology of abnormal clinical findings to address the educational needs of MS1s. METHODS The didactic part of the course consisted of PowerPoint presentations and lecture on the topics related to the simulation. The practical skill session was 60 min, during which time students first practiced PE signs and then were assessed on their ability to accurately identify abnormal PE signs on a high-fidelity (HF) mannequin. Faculty instructors guided students through clinical cases and challenged them with probing questions in clinically relevant content. Before- and after-simulation evaluations were created to assess students' skills and confidence. Student satisfaction levels after the training course were also assessed. RESULTS This study demonstrated significant improvements in five PE skills (p<0.0001) after the introductory course of abnormal PE clinical signs. The average score for five clinical skills increased from 63.1 to 88.74% (before to after simulation). The confidence of students in performing clinical skills and their understanding of the pathophysiology of abnormal clinical findings also increased significantly (p<0.0001) after simulation activity and educational instruction. The average confidence score increased from 3.3 to 4.5% (before to after simulation) on a 5-point Likert scale. Survey results demonstrated high satisfaction with the course among learners with mean satisfaction score 4.7 ± 0.4 on 5-point Likert scale. The introductory course was well received by MS1s and they left positive feedback. CONCLUSIONS This introductory course offered MS1s with novice PE skills the ability to learn a variety of abnormal PE signs, including heart murmurs and rhythms, lung sounds, measurement of blood pressure (BP), and palpation of the femoral pulse. This course also allowed abnormal PE findings to be taught in a time-efficient and faculty-resource-efficient manner.
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Affiliation(s)
- Albert Sabirov
- Department of Basic Science, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | | | - Emin Eminof
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Alexis Eddy
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - John Gallagher
- Department of Internal Medicine, Millcreek Community Hospital, Erie, PA, USA
| | - Ichabod Jung
- Department of Basic Science, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
- Urology Residency Research Director, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Working Conditions and Satisfaction with Working Conditions among Slovenian Family Medicine Trainees: A Cross-sectional Study. Zdr Varst 2021; 60:237-243. [PMID: 34917192 PMCID: PMC8643115 DOI: 10.2478/sjph-2021-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/30/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction In order to achieve a high standard in training programmes for future family medicine specialists, it is essential to have good tutors with well-organised family medicine practices. Proper working conditions for young doctors are essential for their satisfaction and future professional development. The aim of our study was to check the current working conditions of family medicine trainees in the practical modular part of the training programme in Slovenia, and to determine their satisfaction with working conditions. Methods A cross-sectional study was conducted. The data was collected through a questionnaire distributed to 105 family medicine trainees undergoing the practical modular part of their training programme. Results The study showed that the following 7 out of 25 organisational and labour law factors are significantly associated with a trainee’s general satisfaction with working conditions: the location where work with patients takes place, the privacy of the premises, the accessibility of the main tutor, a constant patient population, suitable places for rest, paid out-of-hours substitutions, and appropriate pay grade. Conclusion The results we obtained can be used to address certain aspects of trainees’ working conditions in Slovenia that need improvement. By determining which working conditions significantly affect a trainee’s satisfaction, we have the opportunity to modify these conditions and thereby improve the training programme. This could result in a less stressful and more efficient residency programme.
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Zheng M, Ruzgar NM, Angoff NR, Rosenthal DI. Tips for Building a Community for Incoming Medical Students Virtually in the COVID-19 Era. MEDICAL SCIENCE EDUCATOR 2021; 31:2033-2040. [PMID: 34754599 PMCID: PMC8567972 DOI: 10.1007/s40670-021-01447-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
Abstract
A sense of community benefits medical trainees by preserving mental well-being, nurturing collegiality and mentorship, and grounding ties with partnering organizations and services. Within medical school, building these support relationships often begins shortly after matriculation. In the current pandemic and the accompanying shift to a virtual class format, we believe that a dedicated effort to foster this sense of community is crucial for students who otherwise may feel untethered to their new learning environment. Here, we detail tips for building a medical school community virtually in the COVID-19 era between peers, within the school institution, and within the surrounding environment. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01447-z.
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Affiliation(s)
- Melanie Zheng
- Yale University School of Medicine, New Haven, CT USA
| | | | - Nancy R. Angoff
- Yale University School of Medicine, New Haven, CT USA
- Yale School of Medicine, Section on General Internal Medicine, New Haven, CT USA
| | - David I. Rosenthal
- Yale University School of Medicine, New Haven, CT USA
- Yale School of Medicine, Section on General Internal Medicine, New Haven, CT USA
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Tseng TC, Chen TY, Chu SY, Wang HC, Chang CY. Survey of the triple-mentoring program for students at a religious medical school. BMC MEDICAL EDUCATION 2021; 21:159. [PMID: 33726739 PMCID: PMC7970779 DOI: 10.1186/s12909-021-02593-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Tzu Chi University in Taiwan offers a unique mentoring program. This program differs from others as it comprises triple mentorship, namely, faculty mentors, Tzu Cheng/Yi De (TC/YD; senior volunteers), and school counselors. This study aimed to survey the role functions of the mentors from the perspective of medical students. METHODS The Role Functions of the Mentoring Program Scale (RFMPS) was developed on the basis of literature reviews and focus groups and it underwent exploratory factor analysis for internal consistency and reliability. RFMPS comprises four role functions, namely, mental, educational, career, and humanistic/moral guidance counseling. The survey was distributed to 171 medical students via an online network with two-month intervals and was analyzed using multivariate analysis of variance. RESULTS The overall response rate was 64% (116/171). The mean scores of the four role functions in descending order belonged to faculty mentors, TC/YD, and school counselors. For humanistic/moral guidance, students had an equal preference for the faculty mentors and TC/YD over school counselors. As for educational, career, and mental guidance counseling, students preferred faculty mentors over TC/YD and school counselors. Faculty mentors provided students with the required guidance counseling for all the four role functions, especially educational guidance; TC/YD in particular offered prominent humanistic/moral guidance and career counseling; school counselors were less preferred but guided students in need. CONCLUSIONS Medical students value different role functions provided by faculty mentors, TC/YD, and school counselors. A diversified focus could be provided by the faculty mentors, particularly in educational, career, mental, and humanistic/moral counseling; TC/YD specialized in humanistic/moral guidance; and the school counselors carried out their role function only when needed. Humanistic/moral guidance is equally preferred to other types of guidance, which can be equally valuable in future mentoring programs.
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Affiliation(s)
| | - Tsung-Ying Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Shao-Yin Chu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Hung-Che Wang
- Department of Education and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan
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Yeh PC, Gilbert-Baffoe E, Michael A, Frontera J. Assessing Physical Medicine and Rehabilitation Residency Education Using the Neurological Assessment Competency Evaluation System. Am J Phys Med Rehabil 2021; 100:S40-S44. [PMID: 33252472 DOI: 10.1097/phm.0000000000001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Competent neurologic examination and clinical skills are essential components in the care for patients in acute hospital and rehabilitation settings. To enhance the evaluation and education of Physical Medicine and Rehabilitation residents, the authors developed an educational objective structured clinical examination, the Neurological Exam Assessment Competency Evaluation System, and gathered 2 yrs of baseline data. The Neurological Exam Assessment Competency Evaluation System consisted of nine 9-min examination stations, seven with written clinical scenario with instructions for junior residents to complete the appropriate examination (stations: Altered Mental Status, Mild Traumatic Brain Injury, Dementia, Stroke, Falls, and the International Standards for Neurological Classification of Spinal Cord Injury Sensory and Motor Examinations). Examinees provided written responses to posed questions for the other two stations-Modified Ashworth Scale and brachial plexus. The assessment tools for this examination were designed for residency programs to evaluate the basic competencies as outlined by the Accreditation Council for Graduate Medical Education and Physical Medicine and Rehabilitation milestones. Based on the feedback received from the examinees and examiners, the Neurological Exam Assessment Competency Evaluation System can serve as an educational objective structured clinical examination for the improvement of trainee core competencies.
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Affiliation(s)
- Peter Chia Yeh
- From the H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (PCY, EG-B, AM); and Department of Physical Medicine and Rehabilitation, UT Health, The University of Texas Health Science Center at Houston, Texas (JF)
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Sonne C, Persch H, Rosner S, Ott I, Nagy E, Nikendei C. Significant differences in written assessments as a result of a blended learning approach used in a clinical examination course in internal medicine: a randomized controlled pilot study. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc42. [PMID: 33763527 PMCID: PMC7958916 DOI: 10.3205/zma001438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/14/2020] [Accepted: 09/30/2020] [Indexed: 05/21/2023]
Abstract
Background: Taking a medical history and performing a physical examination represent basic medical skills. However, numerous national and international studies show that medical students and physicians-to-be demonstrate substantial deficiencies in the proper examination of individual organ systems. Aim: The objective of this study was to conduct a randomized controlled pilot study to see if, in the context of a bedside clinical examination course in internal medicine, an additional app-based blended-learning strategy resulted in (a) higher satisfaction, better self-assessments by students when rating their history-taking skills (b1) and their ability to perform physical examinations (b2), as well as (c) higher multiple-choice test scores at the end of the course, when compared to a traditional teaching strategy. Methods: Within the scope of a bedside course teaching the techniques of clinical examination, 26 students out of a total of 335 students enrolled in the 2012 summer semester and 2012/2013 winter semester were randomly assigned to two groups of the same size. Thirteen students were in an intervention group (IG) with pre- and post-material for studying via an app-based blended-learning tool, and another 13 students were in a control group (CG) with the usual pre- and post-material (handouts). The IG was given an app specifically created for the history-taking and physical exam course, an application program for smartphones enabling them to view course material directly on the smartphone. The CG received the same information in the form of paper-based notes. Prior to course begin, all of the students filled out a questionnaire on sociodemographic data and took a multiple-choice pretest with questions on anamnesis and physical examination. After completing the course, the students again took a multiple-choice test with questions on anamnesis and physical examination. Results: When compared to the CG, the IG showed significantly more improvement on the multiple-choice tests after taking the clinical examination course (p=0.022). This improvement on the MC tests in the IG significantly correlated with the amount of time spent using the app (Spearman's rho=0.741, p=0.004). Conclusion: When compared to conventional teaching, an app-based blended-learning approach leads to improvement in test scores, possibly as a result of more intensive preparation for and review of the clinical examination course material.
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Affiliation(s)
- Carolin Sonne
- Technische Universität München, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen des Erwachsenen, Munich, Germany
- *To whom correspondence should be addressed: Carolin Sonne, Technische Universität München, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen des Erwachsenen, Munich, Germany, Phone: +49 (0)178/6139340, E-mail:
| | - Hasema Persch
- Technische Universität München, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen des Erwachsenen, Munich, Germany
- Universitätsklinikum Ulm, Innere Medizin II, Sektion Sport- und Rehabilitationsmedizin, Ulm, Germany
| | - Stefanie Rosner
- Technische Universität München, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen des Erwachsenen, Munich, Germany
| | - Ilka Ott
- Technische Universität München, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen des Erwachsenen, Munich, Germany
| | - Ede Nagy
- Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik, Heidelberg, Germany
| | - Christoph Nikendei
- Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik, Heidelberg, Germany
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Skjevik EP, Boudreau JD, Ringberg U, Schei E, Stenfors T, Kvernenes M, Ofstad EH. Group mentorship for undergraduate medical students-a systematic review. PERSPECTIVES ON MEDICAL EDUCATION 2020; 9:272-280. [PMID: 32820416 PMCID: PMC7550430 DOI: 10.1007/s40037-020-00610-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Mentoring has become a prevalent educational strategy in medical education, with various aims. Published reviews of mentoring report very little on group-based mentorship programs. The aim of this systematic review was to identify group-based mentorship programs for undergraduate medical students and describe their aims, structures, contents and program evaluations. Based on the findings of this review, the authors provide recommendations for the organization and assessment of such programs. METHODS A systematic review was conducted, according to PRISMA guidelines, and using the databases Ovid MEDLINE, EMBASE, PsycINFO and ERIC up to July 2019. Eight hundred abstracts were retrieved and 20 studies included. Quality assessment of the quantitative studies was done using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS The 20 included studies describe 17 different group mentorship programs for undergraduate medical students in seven countries. The programs were differently structured and used a variety of methods to achieve aims related to professional development and evaluation approaches. Most of the studies used a single-group cross-sectional design conducted at a single institution. Despite the modest quality, the evaluation data are remarkably supportive of mentoring medical students in groups. DISCUSSION Group mentoring holds great potential for undergraduate medical education. However, the scientific literature on this genre is sparse. The findings indicate that group mentorship programs benefit from being longitudinal and mandatory. Ideally, they should provide opportunities throughout undergraduate medical education for regular meetings where discussions and personal reflection occur in a supportive environment.
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Affiliation(s)
| | - J Donald Boudreau
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Canada
| | | | - Edvin Schei
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Monika Kvernenes
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Eirik H Ofstad
- Institute of Social Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Ong YT, Kow CS, Teo YH, Tan LHE, Abdurrahman ABHM, Quek NWS, Prakash K, Cheong CWS, Tan XH, Lim WQ, Wu J, Tan LHS, Tay KT, Chin A, Toh YP, Mason S, Radha Krishna LK. Nurturing professionalism in medical schools. A systematic scoping review of training curricula between 1990-2019. MEDICAL TEACHER 2020; 42:636-649. [PMID: 32065016 DOI: 10.1080/0142159x.2020.1724921] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Introduction: Professionalism is an evolving, socioculturally informed multidimensional construct that influences doctor-patient relationships, patient satisfaction and care outcomes. However, despite its clinical significance there is little consistency in how professionalism is nurtured amongst medical students. To address this gap a systemic scoping review of nurturing professionalism in medical schools, is proposed.Methods: Levac's framework and the PRISMA-P 2015 checklist underpinned a 6-stage systematic review protocol. Concurrent use of Braun and Clarke's approach to thematic analysis and directed content analysis was used to identify the key elements in nurturing professionalism.Results: 13921 abstracts were identified from six databases, 854 full-text articles reviewed, and 162 full-text included articles were included. The 4 themes identified through thematic analysis are consistent with findings of the directed content analysis. These were the definition of professionalism, the approaches, content, barriers and enablers to teaching professionalism.Conclusion: Informed by a viable definition of professionalism and clear milestones nurturing professionalism nurturing professionalism begins with culturally appropriate training in clinical competence, humanistic qualities and reflective capacity. This process requires effective evaluations of professional identity formation, and the impact of the learning environment underlining the need for longitudinal assessments of the training process.
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Affiliation(s)
- Yun Ting Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheryl Shumin Kow
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yao Hao Teo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lorraine Hui En Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicholas Wei Sheng Quek
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kishore Prakash
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Clarissa Wei Shuen Cheong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiu Hui Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Qiang Lim
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jiaxuan Wu
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Laura Hui Shuen Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Annelissa Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore, Singapore
| | - Ying Pin Toh
- Family Medicine Residency, National University Health System, Singapore, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, Liverpool, England
| | - Lalit Kumar Radha Krishna
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, Liverpool, England
- Education Department, Duke-NUS Graduate Medical School, Singapore, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
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Haque W, Gurney T, Reed WG, North CS, Pollio DE, Pollio EW, Wagner JM. Key Attributes of a Medical Learning Community Mentor at One Medical School. MEDICAL SCIENCE EDUCATOR 2019; 29:721-730. [PMID: 34457537 PMCID: PMC8368459 DOI: 10.1007/s40670-019-00746-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE The purpose of this study was to discover the elements required for a successful learning community (LC) faculty member educator of medical students. METHOD The authors in this qualitative study evaluated six 90-min focus groups of faculty members. The groups included 31 experienced and 19 inexperienced LC faculty members at the University of Texas Southwestern Medical School. After achieving excellent interrater reliability, transcriptions of the discussions were subjected to thematic analysis using ATLAS.ti software. RESULTS Five major themes emerged: (1) LC faculty characteristics/competency, (2) suggested faculty development methods, (3) factors outside the LC environment influencing student relationships, (4) student attributes influencing teaching techniques, and (5) measuring and improving history and physical skills. Faculty characteristics/competency subthemes included role-modeling, mentoring, and teaching competence. Suggested faculty development methods subthemes included assessing and giving feedback to faculty, peer development, and learning from experts. Experienced LC faculty focused more attention on teaching competence and mentoring competence than inexperienced LC faculty. DISCUSSION The themes with the most extensive discussion among the experienced LC faculty groups may represent qualities to be sought in future mentor recruitment and faculty development. Future studies could build on this study by similarly investigating student perceptions.
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Affiliation(s)
- Waqas Haque
- University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75390-9006 USA
| | - Troy Gurney
- University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75390-9006 USA
| | - W. Gary Reed
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX USA
| | - Carol S. North
- University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75390-9006 USA
- Altshuler Center for Education & Research at Metrocare Services, Dallas, TX USA
| | - David E. Pollio
- Department of Social Work, University of Alabama at Birmingham College of Arts and Sciences, Birmingham, AL USA
| | - E. Whitney Pollio
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL USA
| | - James M. Wagner
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX USA
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Benjamin JC, Groner J, Walton J, Noritz G, Gascon GM, Mahan JD. A Blended Curriculum to Improve Resident Physical Exam Skills for Patients With Neuromuscular Disability. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10792. [PMID: 30800992 PMCID: PMC6354795 DOI: 10.15766/mep_2374-8265.10792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/24/2018] [Indexed: 06/01/2023]
Abstract
Introduction Children with neuromuscular disabilities (NMD) receive care in a wide variety of clinical settings. Residents lack training to develop physical examination skills for evaluating patients with NMD. We devised a curriculum to teach residents how to examine patients with NMD using a systematic and simplified approach. Methods Creation of this resource was a response to a survey of final-year residents that revealed the need for education focused on developing physical examination skills. The curriculum has four components-multimedia PowerPoint with embedded video, knowledge assessment, clinical exam (CEX) assessment, and module feedback-and was completed by 37 residents over an 8-month period from January to September 2016. We utilized knowledge assessment, direct clinical skills observation using the CEX, and module-feedback responses as part of the evaluation. Results All 37 residents completed the curriculum, with an overall knowledge score of greater than 80%. Residents demonstrated most of the desired patient care behaviors on the CEX assessment and provided positive feedback on the quality, usefulness, and applicability of the module, in addition to requesting more curricula to develop their physical examination skills. Discussion The CEX assessment provided a unique opportunity for faculty feedback on residents' physical exam performance. After completing the module, residents achieved high scores in most areas of the standardized CEX and were able to conduct the NMD physical exam in a sensitive manner. The assessment highlighted the need to improve residents' skills of detecting abnormal clinical findings and communicating with the patient during the physical exam.
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Affiliation(s)
- Jennifer C. Benjamin
- Assistant Professor, Department of Pediatrics, Baylor College of Medicine; Assistant Professor, Department of Pediatrics, Texas Children's Hospital
| | - Judith Groner
- Academic Pediatrics Fellowship Director, Ohio State University College of Medicine; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Nationwide Children's Hospital; Clinical Professor of Pediatrics, Division of Ambulatory Pediatrics, Ohio State University College of Medicine
| | - Jennifer Walton
- Co-Director, Williams Syndrome Program, Nationwide Children's Hospital; Co-Director, Williams Syndrome Program, Ohio State University College of Medicine; DBP Resident Rotation Director, Nationwide Children's Hospital; DBP Resident Rotation Director, Ohio State University College of Medicine; Assistant Professor of Clinical Pediatrics, Department of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital; Assistant Professor of Clinical Pediatrics, Department of Developmental and Behavioral Pediatrics, Ohio State University College of Medicine
| | - Garey Noritz
- Medical Director, Complex Health Care Program, Nationwide Children's Hospital; Medical Director, Complex Health Care Program, Ohio State University College of Medicine; Medical Director, Cerebral Palsy Program, Nationwide Children's Hospital; Medical Director, Cerebral Palsy Program, Ohio State University College of Medicine; Associate Professor, Department of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital; Associate Professor, Department of Developmental and Behavioral Pediatrics, Ohio State University College of Medicine
| | - Gregg M. Gascon
- Advanced Analytics Consultant, Ohio State University Health Plan; Assistant Professor of Biomedical Informatics, Ohio State University College of Medicine
| | - John D. Mahan
- Associate Director, Center for Faculty Advancement, Mentoring and Engagement (FAME), Ohio State University College of Medicine; Professor, Department of Pediatrics, Ohio State University College of Medicine; Program Director, Pediatric Residency Fellowship Program, Nationwide Children's Hospital; Program Director, Pediatric Residency Fellowship Program, Ohio State University College of Medicine; Program Director, Pediatric Nephrology Fellowship Program, Nationwide Children's Hospital; Program Director, Pediatric Nephrology Fellowship Program, Ohio State University College of Medicine
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Roussel D, Anderson K, Glasgow T, Colbert-Getz JM. Evaluation of a Preclerkship Learning Community Model for Delivering Clinical Skills Curriculum. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519855061. [PMID: 31259252 PMCID: PMC6585236 DOI: 10.1177/2382120519855061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Medical schools are increasingly using learning communities (LCs) for clinical skills curriculum delivery despite little research on LCs employed for this purpose. We evaluated an LC model compared with a non-LC model for preclerkship clinical skills curriculum using Kirkpatrick's hierarchy as an evaluation framework. METHODS The first LC cohort's (N = 101; matriculating Fall 2013) reaction to the LC model was assessed with self-reported surveys. Change in skills and learning transfer to clerkships was measured with objective structured clinical examinations (OSCEs) at the end of years 2 and 3 and first and last clerkship preceptor evaluations; the LC cohort and the prior cohort (N = 86; matriculating Fall 2012) that received clinical skills instruction in a non-LC format were compared with Mann-Whitney U tests. RESULTS The LC model for preclerkship clinical skills curriculum was rated as excellent or good by 96% of respondents in Semesters 1 to 3 (N = 95). Across multiple performance domains, 96% to 99% of students were satisfied to very satisfied with their LC faculty preceptors (N varied by item). For the end of preclerkship OSCE, the LC cohort scored higher than the non-LC cohort in history gathering (P = .003, d = 0.50), physical examination (P = .019, d = 0.32), and encounter documentation (P ⩽ .001, d = 0.47); the non-LC cohort scored higher than the LC cohort in communication (P = .001, d = 0.43). For the end of year 3 OSCE, the LC cohort scored higher than the non-LC cohort in history gathering (P = .006, d = 0.50) and encounter note documentation (P = .027, d = 0.24); there was no difference in physical examination or communication scores between cohorts. There was no detectable difference between LC and non-LC student performance on the preceptor evaluation forms at either the beginning or end of the clerkship curriculum. CONCLUSIONS We observed limited performance improvements for LC compared with non-LC students on the end of the preclerkship OSCE but not on the clerkship preceptor evaluations. Additional studies of LC models for clinical skills curriculum delivery are needed to further elucidate their impact on the professional development of medical students.
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Affiliation(s)
- Danielle Roussel
- Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Katherine Anderson
- Department of Internal Medicine, Division of Geriatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Tiffany Glasgow
- Department of Pediatric, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jorie M Colbert-Getz
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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Shochet R, Fleming A, Wagner J, Colbert-Getz J, Bhutiani M, Moynahan K, Keeley M. Defining Learning Communities in Undergraduate Medical Education: A National Study. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519827911. [PMID: 30937385 PMCID: PMC6434432 DOI: 10.1177/2382120519827911] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/27/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Learning communities (LCs) are intentionally designed groups that are actively engaged in learning with and from each other. While gaining prominence in US medical schools, LCs show significant variability in their characteristics across institutions, creating uncertainty about how best to measure their effects. OBJECTIVE The aim of this study is to describe the characteristics of medical school LCs by primary purpose, structures, and processes and lay the groundwork for future outcome studies and benchmarking for best practices. METHODS Medical school LC directors from programs affiliated with the Learning Communities Institute (LCI) were sent an online survey of program demographics and activities, and asked to upload a program description or summary of the LC's purpose, goals, and how it functions. Descriptive statistics were computed for survey responses and a qualitative content analysis was performed on program descriptions by 3 authors to identify and categorize emergent themes. RESULTS Of 28 medical school LCs surveyed, 96% (27) responded, and 25 (89%) provided program descriptions for qualitative content analysis. All programs reported longitudinal relationships between students and faculty. Most frequently cited objectives were advising or mentoring (100%), professional development (96%), courses (96%), social activities (85%), and wellness (82%). Primary purpose themes were supporting students' professional development, fostering a sense of community, and creating a sense of wholeness. Structures included a community framework, subdivisions into smaller units, and governance by faculty and students. Process themes included longitudinal relationships, integrating faculty roles, and connecting students across class years. CONCLUSIONS Medical school LCs represent a collection of high-impact educational practices characterized by community and small-group structures, relational continuity, and collaborative learning as a means to guide and holistically support students in their learning and development as physicians. In describing 27 medical school LCs, this study proposes a unifying framework to facilitate future educational outcomes studies across institutions.
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Affiliation(s)
- Robert Shochet
- Colleges Advisory Program, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amy Fleming
- Department of Pediatrics and Medical Student Affairs, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - James Wagner
- Department of Internal Medicine, University of Texas Southwestern School of Medicine, Austin, TX, USA
| | - Jorie Colbert-Getz
- Department of Internal Medicine and Education Quality Improvement, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Monica Bhutiani
- Division of Anesthesia Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kevin Moynahan
- College of Medicine—Tucson, The University of Arizona, Nashville, TN, USA
| | - Meg Keeley
- Department of Pediatrics and Student Affairs, University of Virginia School of Medicine, Charlottesville, VA, USA
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Johnson M, Goldberg C, Willies-Jacobo L, Wan L, Guluma K, Smith S. Implementation and Outcomes of a Community Assessment Service-Learning Activity Within Academic Learning Communities. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519864403. [PMID: 31523714 PMCID: PMC6728661 DOI: 10.1177/2382120519864403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 06/10/2023]
Abstract
A community needs assessment and engagement activity was implemented in 2013 in the core preclinical curriculum as part of the doctoring course within Academic Communities at UC San Diego School of Medicine. This required educational experience included curricular learning objectives as well as goals to strengthen community service within academic communities. This activity was implemented and sustained within the academic communities with each community serving a different community of San Diego. Survey data from preclinical students from 2014 to 2017 consistently reported that the community assessment activity helped sustain or develop a service project in the academic community (67.1%-79.6% strongly agree or agree) and increased students' knowledge of the needs in the assigned San Diego community (76.3%-80.6% strongly agree or agree). Students felt that the community assessment and engagement activity was a valuable learning experience (62.5%-77.8% strongly agree or agree). As a result of this educational intervention, 14 projects were implemented in the community. A subset of particularly interested and motivated medical students then took on leadership roles in these projects. Student-led scholarly assessment of the impact of some of these interventions resulted in 2 peer-reviewed publications thus far and 9 national presentations at the time of this publication. These assessments demonstrate not only educational impact, but health-system-level changes and meaningful change in patient outcomes.
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Affiliation(s)
- Michelle Johnson
- University of California, San Diego
School of Medicine, La Jolla, CA
| | - Charlie Goldberg
- University of California, San Diego
School of Medicine, La Jolla, CA
| | | | - Lori Wan
- University of California, San Diego
School of Medicine, La Jolla, CA
| | - Kama Guluma
- University of California, San Diego
School of Medicine, La Jolla, CA
| | - Sunny Smith
- University of California, San Diego
School of Medicine, La Jolla, CA
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Ngo TL, Whipple M. Faculty Benefits From Medical Student Learning Communities: A Junior and Senior Faculty Members' Perspectives. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519827887. [PMID: 30801034 PMCID: PMC6378423 DOI: 10.1177/2382120519827887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/01/2019] [Indexed: 06/09/2023]
Abstract
Medical school learning communities have many benefits for students. In this perspective, the authors briefly describe how learning communities have benefited them as faculty. These include finding other like-minded faculty, improving communication and clinical skills, career advancement through scholarly work associated with the learning community, and above all, developing mutually beneficial relationships with students. Here, they offer viewpoints from junior and senior faculty members on how the learning community has positively affected them.
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Affiliation(s)
- Thuy L Ngo
- School of Medicine, The Johns Hopkins
University, Baltimore, MD, USA
| | - Mark Whipple
- School of Medicine, University of
Washington, Seattle, WA, USA
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Gheihman G, Jun T, Young GJ, Liebman D, Sharma K, Brandes E, Ogur B, Hirsh DA. A review of longitudinal clinical programs in US medical schools. MEDICAL EDUCATION ONLINE 2018; 23:1444900. [PMID: 29542394 PMCID: PMC5907349 DOI: 10.1080/10872981.2018.1444900] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Longitudinal clinical experiences are a common component of undergraduate medical curricula, yet these programs have not been systematically characterized in US medical schools. OBJECTIVE Our study sought to identify and characterize longitudinal clinical programs (LCPs) in US medical schools and measure associations between programs' structures and goals. DESIGN Using a mixed-methods approach, we conducted a secondary analysis of data from publicly available websites. We conducted a systematic keyword search of the websites of 137 LCME-accredited US medical schools to identify LCPs. We included programs with student-patient interactions of at least six months. We categorized programs using qualitative thematic analysis and compared associations between program structures and goals. RESULTS We identified 98 LCPs in 69 schools. Half (52.0%) of LCPs occurred during the core clinical year. Program structures included 'clinic attachments' (50.0%), 'longitudinal integrated clerkships' (26.5%), and 'patient attachments' (20.4%). We identified goals in 89 programs, including 'exposing students to specific topics, patient demographics, or practice settings' (78.7%); 'clinical or professional skill development' (65.2%); and 'understanding the patient experience' (19.1%). Patient attachments were associated with 'exposure to specific patient demographics' (P = .04) and 'understanding the patient experience' (P = .03). Pre-clinical programs were associated with clinical skills development (P = .01). CONCLUSIONS Our study identifies the scope and nature of LCPs in US medical schools. Understanding connections between educational structures and goals may guide program design and research investigations of educational processes and outcomes.
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Affiliation(s)
| | - Tomi Jun
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | - Barbara Ogur
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA
| | - David A. Hirsh
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA
- CONTACT David A. Hirsh Department of Medicine, Cambridge Health Alliance (CHA), Macht Building 4th floor, 1493 Cambridge St, Cambridge, MA02139, United States
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Baloescu C. Diagnostic Imaging in Emergency Medicine: How Much Is Too Much? Ann Emerg Med 2018; 72:637-643. [PMID: 30146444 DOI: 10.1016/j.annemergmed.2018.06.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Cristiana Baloescu
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
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Benjamin J, Groner J, Walton J, Noritz G, Gascon GM, Mahan JD. Learning in a Web-Based World: An Innovative Approach to Teach Physical Examination Skills in Patients with Neurodisability. Acad Pediatr 2018. [PMID: 29518544 DOI: 10.1016/j.acap.2018.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Despite increasing numbers of patients with neurodisability, residents lack training to develop physical examination skills. Following a blended educational intervention combining online and bedside teaching, residents demonstrated desired patient-care behaviors on standardized clinical exam assessment.
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Affiliation(s)
- Jennifer Benjamin
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Tex.
| | - Judith Groner
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
| | - Jennifer Walton
- Developmental and Behavioral Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
| | - Garey Noritz
- Developmental and Behavioral Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
| | - Gregg M Gascon
- Ohio Health Group Clinically Integrated Network, Columbus, Ohio
| | - John D Mahan
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
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Bericht aus der Praxis/Practice Report: How to successfully establish PAL in medical education. 10 tips to succeed in PAL-based courses in undergraduate medical education (UGME). ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2017; 125:80-84. [PMID: 28760684 DOI: 10.1016/j.zefq.2017.05.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article aims to provide useful suggestions for the implementation of new courses with peer-assisted learning (PAL) in undergraduate medical education (UGME). It presents 10 key tips for needs assessment, clarification of goals and objectives for internal marketing, the choice of teaching formats, fund raising, recruiting of educators, qualification of peer tutors, the fun factor, how to establish a structured and longitudinal curriculum, assessment methods and motivation, collecting feedback and the use of its results. These 10 tips are linked to scientific evidence in the educational literature and elucidated by specific examples, based upon a major PAL project on diagnostic imaging, which can be transferred to other teaching topics as well. In conclusion, the described tips represent a helpful tool to avoid common pitfalls in the planning, implementation, evaluation and quality-assurance of PAL-based educational projects.
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Schäfer M, Pander T, Pinilla S, Fischer MR, von der Borch P, Dimitriadis K. A prospective, randomised trial of different matching procedures for structured mentoring programmes in medical education. MEDICAL TEACHER 2016; 38:921-9. [PMID: 26822503 DOI: 10.3109/0142159x.2015.1132834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Spontaneous formation of mentoring relationships can be seen as the gold standard in mentoring. Unfortunately, it happens very infrequently. The purpose of structured mentoring programmes is to facilitate the formation of mentoring relationships. This remains a challenging task, especially for large institutions. AIMS We set out to investigate and compare three methods of matchmaking in the setting of our structured mentoring programme. In a prospective, randomised trial we compared personal matching (PM) by an experienced expert to two different electronic data processing (EDP)-supported matching procedures: "online algorithm" (OA) versus "online search" (OS). METHODS PM was performed after structured interviews of prospective protégés by one founder of our mentoring programme. The OA provides students with a choice of 10 potential mentors based on comparison of online profiles. OS lets students filter and search through all available mentor profiles. One hundred and ninty medical students were randomised into the three groups. One year later, we evaluated the endpoints 1. "establishment of a mentoring relationship" and 2. "satisfaction with the mentoring relationship". Satisfaction with the mentoring relationship was assessed using Munich-Evaluation-of-Mentoring-Questionnaire (MEMeQ). RESULTS One hundred sixty-five out of the 190 study participants found a mentor. With regards to endpoint one we found an advantage of PM compared to both EDP-supported matching procedures. There was no significant difference between OA and OS. Concerning endpoint two the differences between the investigated matching procedures were not significant. CONCLUSION PM is superior as to the number of mentoring relationships formed per participating student compared to EDP-supported methods. In our data, there was no significant difference in the level of satisfaction. Considering the high investments associated with PM of mentors and protégés, EDP-supported matching procedures seem a viable compromise between effectiveness and efficiency especially for large-scale structured mentoring programmes in medical education.
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Affiliation(s)
| | - Tanja Pander
- a Klinikum der Ludwig-Maximilians-Universität (LMU) , Germany
| | - Severin Pinilla
- a Klinikum der Ludwig-Maximilians-Universität (LMU) , Germany
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Fünger SM, Lesevic H, Rosner S, Ott I, Berberat P, Nikendei C, Sonne C. Improved self- and external assessment of the clinical abilities of medical students through structured improvement measures in an internal medicine bedside course. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc59. [PMID: 27579359 PMCID: PMC5003141 DOI: 10.3205/zma001058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/15/2016] [Accepted: 06/30/2016] [Indexed: 05/30/2023]
Abstract
BACKGROUND Bedside courses are of outstanding importance when training medical students. The fact that less and less teaching is taking place nowadays at the patient's bedside makes it all the more important that the available time be put to effective use. The aim of this study was to check whether structured improvement measures in the course (scripts, lecturer briefing, e-learning cases) would improve the abilities of the students on the basis of a subjective self-assessment as well as an external assessment by the lecturers with respect to clinical abilities. METHODS Bedside teaching takes place in the fourth study year in the Medical Clinics of the TU Munich. Both students and lecturers had the chance to hand in an anonymous, quantitative self- and external assessment of the clinical abilities of the students (German grading system) after every course date. This assessment took place online in the three categories "Medical history & examination", "Diagnosis" and "Therapy". An overall period of four semesters, each with 6 course dates, was investigated. After two of the total of four semesters in the study, the course was changed by introducing scripts, lecturer briefing as well as interactive e-learning cases. The self- and external assessment was compared both within the semester (date 1-3: A; date 4-6: B), during the course as well as before and after introducing the improvement measures ("before" (T0): SS 2012, SS 2013, "after" (T1): WS 2013/2014, SS 2014). RESULTS There was a significant improvement in one's own abilities on the basis of the self-assessment within each semester when comparing the first (A) and the last (B) course dates. Moreover, there was a significant improvement in the performances in all three categories when T0 was compared with T1, from both the point of view of the students ("Medical history & examination": T0 =2.5±0.9, T1=2.2±0.7, pp<0.001; "Diagnosis" T0=3.1±1.0, T1=2.8 ±0.9, pp<0.001; "Therapy": T0=3.8±1.3, T1=3.5±1.2, pp<0.018) and in two of the three categories from the point of view of the lecturers ("Diagnosis": T0=3.0±1.0, T1=2.7±0.7, p.=0.028; "Therapy": T0=3.8±1.1, T1=3.1±1.0, p<0.001). SUMMARY The structured measures to improve the course including the interactive e-learning cases could have contributed to improved practical abilities with respect to the medical history and examination techniques as well as diagnostic and therapeutic thinking. The external evaluation by lecturers confirmed the improvement with respect to the diagnostic and therapeutic abilities. They only saw no dynamic change in the student's taking histories and clinical examinations.
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Affiliation(s)
- S M Fünger
- Technical University Munich, German Heart Centre, Munich, Germany
| | - H Lesevic
- Technical University Munich, German Heart Centre, Munich, Germany
| | - S Rosner
- Technical University Munich, German Heart Centre, Munich, Germany
| | - I Ott
- Technical University Munich, German Heart Centre, Munich, Germany
| | - P Berberat
- Technical University Munich, Klinikum Rechts der Isar, TUM MeDiCAL, Centre of Medical Education, Munich, Germany
| | - C Nikendei
- Heidelberg University Hospital, Department of General Internal Medicine & Psychosomatic, Heidelberg, Germany
| | - C Sonne
- Technical University Munich, German Heart Centre, Munich, Germany; Praxis, Maroussi, Greece
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Mizuno A, Kawai F, Shimizu T. Physical Examination Has Been Paid Less Attention to Compared to Diagnostic Imaging: from a Bibliometric Analysis of PubMed. J Gen Fam Med 2016. [DOI: 10.14442/jgfm.17.1_109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Park JJH, Adamiak P, Jenkins D, Myhre D. The medical students' perspective of faculty and informal mentors: a questionnaire study. BMC MEDICAL EDUCATION 2016; 16:4. [PMID: 26746690 PMCID: PMC4706722 DOI: 10.1186/s12909-016-0526-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/05/2016] [Indexed: 05/13/2023]
Abstract
BACKGROUND Student mentoring is an important aspect of undergraduate medical education. While medical schools often assign faculty advisors to medical students as mentors to support their educational experience, it is possible for the students to pursue mentors informally. The possible role of these informal mentors and their interactions with the students in a faculty mentorship program has not been reported. This study builds upon previous work that suggested many students have informal mentors, and that there might be interplay between these two types of mentors. This study was conducted to report the experience of undergraduate medical students in a faculty mentorship program of their faculty mentors and if applicable, of their informal mentors. METHODS One month before residency (post-graduate training for Canadians) ranking, the survey was administered to the graduating class of 2014 at the University of Calgary's Cumming School of Medicine. The survey was created from focus groups of the previous graduating class of 2013. The survey investigated meeting characteristics and the students' perceptions of faculty advisors and informal mentors, and the students' intended choice for residency. RESULTS The study response rate was 86% (95 of 111); 58% (54 of 93) of the students reported having an informal mentor. There was no reported difference in satisfaction ratings of the Faculty mentorship program between students with only faculty mentors and those with also informal mentors. Students' reporting of their satisfaction with the Faculty mentorship program and the faculty mentors did not differ between the students with informal mentors and those with faculty mentors only. The students' meeting frequency, discussed topics, and perceived characteristics of faculty mentors were not associated with having an informal mentor. The students generally perceived their informal mentors more positively than their faculty mentors. The reported student career intention was associated with the discipline of informal mentors and not with the discipline of faculty mentors. CONCLUSIONS Informal mentorship was common for medical students. The presence of an informal mentor was not associated with dissatisfaction with the Faculty advisor or with the mentorship program. It is likely students may pursue informal mentorship for career-related reasons.
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Affiliation(s)
- Jay J. H. Park
- Faculty of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Paul Adamiak
- Faculty of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Deirdre Jenkins
- Faculty of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Doug Myhre
- Faculty of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
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Mizuno A, Tsugawa Y, Shimizu T, Nishizaki Y, Okubo T, Tanoue Y, Konishi R, Shiojiri T, Tokuda Y. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan. Intern Med 2016; 55:1553-8. [PMID: 27301504 DOI: 10.2169/internalmedicine.55.6293] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.
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Affiliation(s)
- Atsushi Mizuno
- Department of Cardiology, St. Luke's International Hospital, Japan
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Vogel D, Harendza S. Basic practical skills teaching and learning in undergraduate medical education - a review on methodological evidence. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc64. [PMID: 27579364 PMCID: PMC5003143 DOI: 10.3205/zma001063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/04/2016] [Accepted: 05/09/2016] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Practical skills are an essential part of physicians' daily routine. Nevertheless, medical graduates' performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students' learning of these skills. METHODS Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. RESULTS 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students' performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. CONCLUSION A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills.
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Affiliation(s)
- Daniela Vogel
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Deutschland
| | - Sigrid Harendza
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Deutschland
- *To whom correspondence should be addressed: Sigrid Harendza, Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Martinistraße 52, D-20246 Hamburg, Deutschland, Phone: +49 (0)40/7410-5390, Fax: +49 (0)40/7410-40218, E-mail:
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Schäfer M, Pander T, Pinilla S, Fischer MR, von der Borch P, Dimitriadis K. The Munich-Evaluation-of-Mentoring-Questionnaire (MEMeQ)--a novel instrument for evaluating protégés' satisfaction with mentoring relationships in medical education. BMC MEDICAL EDUCATION 2015; 15:201. [PMID: 26553241 PMCID: PMC4640154 DOI: 10.1186/s12909-015-0469-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 10/20/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND Despite the widespread recognition of the importance of mentoring in medical education, valid and reliable instruments for evaluating the relationship of mentors and protégés are lacking. The aim of this study was to develop a feasible instrument to measure the satisfaction with mentoring relationships. METHODS Based on two existing questionnaires, the authors developed an instrument to evaluate the weighted satisfaction of mentoring relationships, emphasizing the protégés' individual expectations and needs. Protégés first define individual areas of interest in their mentoring relationship, then assign relative levels of personal importance to them and finally rate their individual level of satisfaction with their mentors' support in each area of interest. In order to evaluate psychometric properties as well as acceptance and feasibility the investigators conducted a multi-method-study. RESULTS 134 protégés were included in the study. The instrument was neither perceived as distressing nor time-consuming. The two scores of the questionnaire correlated closely with the overall satisfaction regarding mentoring relationships (OSM, Rho: 0.66, p <.001 and Rho: 0.53, p < .001). CONCLUSIONS The authors propose MEMeQ as a reliable, valid and flexible instrument for measuring the weighted satisfaction of protégés with their individual mentoring relationship in medical education. Further research is needed to evaluate the generalizability of MEMeQ across other institutions and mentoring programs to add to its validity.
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Affiliation(s)
- Matthias Schäfer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Ludwig-Maximilians-Universität (LMU), Munich, Germany.
| | - Tanja Pander
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Ludwig-Maximilians-Universität (LMU), Munich, Germany.
| | - Severin Pinilla
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Ludwig-Maximilians-Universität (LMU), Munich, Germany.
- Department of Neurology, Munich University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany.
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Ludwig-Maximilians-Universität (LMU), Munich, Germany.
| | - Philip von der Borch
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336, München, Deutschland.
| | - Konstantinos Dimitriadis
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Ludwig-Maximilians-Universität (LMU), Munich, Germany.
- Department of Neurology, Munich University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany.
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Wenrich MD, Jackson MB, Maestas RR, Wolfhagen IHAP, Scherpbier AJJ. From Cheerleader to Coach: The Developmental Progression of Bedside Teachers in Giving Feedback to Early Learners. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2015; 90:S91-S97. [PMID: 26505108 DOI: 10.1097/acm.0000000000000901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Medical students learn clinical skills at the bedside from teaching clinicians, who often learn to teach by teaching. Little is known about the process of becoming an effective clinical teacher. Understanding how teaching skills and approaches change with experience may help tailor faculty development for new teachers. Focusing on giving feedback to early learners, the authors asked: What is the developmental progression of clinician-teachers as they learn to give clinical skills feedback to medical students? METHOD This qualitative study included longitudinal interviews with clinician-teachers over five years in a new clinical skills teaching program for preclinical medical students. Techniques derived from grounded theory were used for initial analyses. The current study focused on one theme identified in initial analyses: giving feedback to students. Transcript passages were organized by interview year, coded, and discussed in year clusters; thematic codes were compared and emergent codes developed. RESULTS Themes related to giving feedback demonstrated a dyadic structure: characteristic of less experienced teachers versus characteristic of experienced teachers. Seven dominant dyadic themes emerged, including teacher as cheerleader versus coach, concern about student fragility versus understanding resilience, and focus on creating a safe environment versus challenging students within a safe environment. CONCLUSIONS With consistent teaching, clinical teachers demonstrated progress in giving feedback to students in multiple areas, including understanding students' developmental trajectory and needs, developing tools and strategies, and adopting a dynamic, challenging, inclusive team approach. Ongoing teaching opportunities with targeted faculty development may help improve clinician-teachers' feedback skills and approaches.
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Zundel S, Blumenstock G, Zipfel S, Herrmann-Werner A, Holderried F. Portfolios Enhance Clinical Activity in Surgical Clerks. JOURNAL OF SURGICAL EDUCATION 2015; 72:927-935. [PMID: 26002535 DOI: 10.1016/j.jsurg.2015.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 02/26/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES A change in German licensing legislation imposed a portfolio for surgical clerks. We aimed to analyze whether the implementation of the portfolio changed the amount of clinical exposure and activities during surgical clerkships. DESIGN The study was conducted with a modified pre-post design at the University Hospital of Tuebingen, Germany. Before and after the implementation of the portfolio on April 1, 2013, final-year students (n = 557) who had just finished their surgical clerkship were interviewed with an online questionnaire. A total of 21 basic surgical skills were evaluated. RESULTS Overall, 230 questionnaires were returned and analyzed; 51% were preintervention. Overall clinical activity for the whole study cohort varied for different activities between 98% and 32%. For 16 of 21 parameters, there was more clinical activity in the postintervention (portfolio) group. This difference was statistically significant for the following 7 activities: discharge, analgesia, local infiltration, patient positioning, drain in, blood transfusion, and emergency diagnostics. CONCLUSION The implementation of the portfolio did enhance clinical activity for surgical clerks in the study cohort. Nevertheless, overall exposure is still unsatisfactory low for some activities. Additional changes and studies are necessary to further improve surgical education.
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Affiliation(s)
- Sabine Zundel
- Department of Pediatric Surgery, University Hospital of Tuebingen, Germany.
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine, University Hospital of Tuebingen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Medical Faculty Tuebingen, Germany; Multidisciplinary Skills Lab "DocLab", University Hospital of Tuebingen, Germany
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Wagner JM, Fleming AE, Moynahan KF, Keeley MG, Bernstein IH, Shochet RB. Benefits to faculty involved in medical school learning communities. MEDICAL TEACHER 2015; 37:476-81. [PMID: 25159341 DOI: 10.3109/0142159x.2014.947940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE Job satisfaction plays a large role in enhancing retention and minimizing loss of physicians from careers in academic medicine. The authors explored the effect of learning communities (LCs) on the faculty members' job satisfaction. METHODS Between October 2011 and May 2012, the authors surveyed 150 academic clinical faculty members serving as LC mentors for students at five US medical schools. Factor analysis was used to explore satisfaction themes and relationships between these themes and other characteristics. RESULTS Factor analysis revealed two major sources of this satisfaction: a Campus Engagement factor (e.g., feeling happier, improved sense of community, better communication skills, and feeling more productive) and a skills factor (e.g., improved clinical skills, being a better doctor). Higher Campus Engagement factor satisfaction was associated with less desire to leave the learning community (p = 0.01) and more FTE support for role in LC (p = 0.01). Higher skills factor satisfaction was associated with the school that provided more structured faculty development (p = 0.0001). CONCLUSION Academic clinical faculty members reported serving as a mentor in an LC was a strong source of job satisfaction. LC may be a tool for retaining clinical faculty members in academic careers.
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Olajide T, Seyi-Olajide J, Ugburo A, Oridota E. Self-Assessment of Final Year Medical Students’ Proficiency at Basic Procedures. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Procedural tasks are important in patient management, with varying degrees of proficiency expected at different levels of medical training. Little has been done in this region to assess the medical students’ proficiency at performing basic procedures.AIM: The aim of this study is to determine their self-assessed proficiency, degree of participation in performing these procedures and the use of skill-lab training.MATERIALS AND METHODS: The study is questionnaire-based, amongst final year medical students of University of Lagos, Nigeria.RESULTS: One hundred and forty students participated in the study. A significant number (82{58.6%}) self-reported level of proficiency for venepuncture was above average or excellent; for IV line placement it was a little less than half (65{46.4%}) and for urethral catheterisation 44 (31.7%); however it was quite low for the other procedures. Many students self-reported high level of participation for venepuncture (83{59.2%}); sixty one (43.6%) for IV line placement and 30 (21.7%) for urethral catheterization. The correlations between self-assessed levels of proficiency and participation were significant for all procedures. There was no exposure to the use of mannequins.CONCLUSION: Self-reported proficiency is lacking for basic procedures in a significant proportion of students with a low level of participation.
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Smith S, Shochet R, Keeley M, Fleming A, Moynahan K. The growth of learning communities in undergraduate medical education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:928-33. [PMID: 24871245 DOI: 10.1097/acm.0000000000000239] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To determine the presence and characteristics of learning communities (LCs) in undergraduate medical education. METHOD The authors updated an earlier Web-based survey to assess LCs in medical education. Using a cross-sectional study design, they sent the survey to an LC leader or dean at each Association of American Medical Colleges member medical school (n = 151) between October 2011 and March 2012. The first survey item asked respondents to indicate if their institution had LCs. Those with LCs were asked to provide details regarding the structure, governance, funding, space, curricular components, extracurricular activities, and areas addressed as part of the LCs. Those without LCs were asked only if they were considering developing them. The full survey instrument contained 35 items including yes/no, multiple-choice, and open-ended questions. The authors analyzed data using descriptive statistics and examined open-ended responses for recurrent themes. RESULTS The response rate was 83.4% (126/151). Sixty-six schools (52.4%) had LCs. Of the 60 remaining schools without LCs, 29 (48.3%) indicated that they were considering creating them. Of the 52 schools that provided the year their LCs were established, 27 (51.9%) indicated they began in 2007 or later. LC characteristics varied widely. CONCLUSIONS The number of medical schools with LCs is increasing rapidly. LCs provide an opportunity to transform medical education through longitudinal relationships and mentoring. Further study is needed to document outcomes and best practices for LCs in medical education.
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Affiliation(s)
- Sunny Smith
- Dr. Smith is associate clinical professor, Department of Family and Preventive Medicine, University of California, San Diego, School of Medicine, San Diego, California. Dr. Shochet is assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. Dr. Keeley is assistant dean for student affairs and associate professor, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia. Dr. Fleming is director of medical student education, college mentor, and associate professor, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee. Dr. Moynahan is associate professor and deputy dean for education, University of Arizona College of Medicine, Tucson, Arizona
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Wenrich MD, Jackson MB, Wolfhagen I, Ramsey PG, Scherpbier AJJ. What are the benefits of early patient contact?--A comparison of three preclinical patient contact settings. BMC MEDICAL EDUCATION 2013; 13:80. [PMID: 23731514 PMCID: PMC3674974 DOI: 10.1186/1472-6920-13-80] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 05/29/2013] [Indexed: 05/10/2023]
Abstract
BACKGROUND Despite increasing attention to providing preclinical medical students with early patient experiences, little is known about associated outcomes for students. The authors compared three early patient experiences at a large American medical school where all preclinical students complete preceptorships and weekly bedside clinical-skills training and about half complete clinical, community-based summer immersion experiences. The authors asked, what are the relative outcomes and important educational components for students? METHODS Medical students completed surveys at end of second year 2009-2011. In 2009, students compared/contrasted two of three approaches; responses framed later survey questions. In 2010 and 2011, students rated all three experiences in relevant areas (e.g., developing comfort in clinical setting). Investigators performed qualitative and quantitative analyses. RESULTS Students rated bedside training more highly for developing comfort with clinical settings, one-on-one clinical-skills training, feedback, active clinical experience, quality of clinical training, and learning to be part of a team. They rated community clinical immersion and preceptorships more highly for understanding the life/practice of a physician and career/specialty decisions. CONCLUSIONS Preclinical students received different benefits from the different experiences. Medical schools should define objectives of early clinical experiences and offer options accordingly. A combination of experiences may help students achieve clinical and team comfort, clinical skills, an understanding of physicians' lives/practices, and broad exposure for career decisions.
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Affiliation(s)
- Marjorie D Wenrich
- Office of the CEO, UW Medicine and Executive Vice President for Medical Affairs, University of Washington, Box 356350, Seattle, WA 98195-6350, USA
| | - Molly B Jackson
- Department of Medicine, University of Washington School of Medicine, Box 356429, Seattle, WA 98195-4328, USA
| | - Ineke Wolfhagen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Paul G Ramsey
- Office of the CEO, UW Medicine and Executive Vice President for Medical Affairs, University of Washington, Box 356350, Seattle, WA 98195-6350, USA
| | - Albert JJ Scherpbier
- Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
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Sonne C, Vogelmann R, Lesevic H, Bott-Flügel L, Ott I, Seyfarth M. Significant improvement of a clinical training course in physical examination after basic structural changes in the teaching content and methods. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2013; 30:Doc21. [PMID: 23737918 PMCID: PMC3671317 DOI: 10.3205/zma000864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 01/04/2013] [Accepted: 11/30/2012] [Indexed: 11/30/2022]
Abstract
Background: Regular student evaluations at the Technical University Munich indicate the necessity for improvement of the clinical examination course. The aim of this study was to examine if targeted measures to restructure and improve a clinical examination course session lead to a higher level of student satisfaction as well as better self-assessment of the acquired techniques of clinical examination. Methods: At three medical departments of the Technical University Munich during the 2010 summer semester, the quantitative results of 49 student evaluations (ratings 1-6, German scholastic grading system) of the clinical examination course were compared for a course before and a course after structured measures for improvement. These measures included structured teaching instructions, handouts and additional material from the Internet. Results: 47 evaluations were completed before and 34 evaluations after the measures for improvement. The measures named above led to a significant improvement of the evaluative ratings in the following areas: short introduction to the topic of each clinical examination course (from 2.4±1.2 to1.7±1.0; p=0.0020) and to basic measures of hygiene (from 3.8±1.9 to 2.5±1.8; p=0.004), structured demonstration of each clinical examination step (from 2.9±1.5 to 1.8±1.0; p=0.001), sufficient practice of each clinical examination step (from 3.1±1.8 to 2.2±1.4; p=0.030) structured feedback on each clinical examination step (from 3.0±1.4 to 2.3±1.0; p=0.0070), use of handouts (from 5.2±1.4 to 1.8±1.4; p<0.001), advice on additional learning material (from 5.0±1.4 to 3.4±2.0; p<0.001), general learning experience (from 2.4±0.9 to 1.9±0.8; p=0.017), and self-assessment of the acquired techniques of clinical examination (from 3.5±1.3 to 2.5±1.1; p<0.01). Conclusion: Structured changes led to significant improvement in the evaluative ratings of a clinical examination course session concerning preparation of the tutors, structure of the course, and confidence in performing physical examinations.
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Alexander EK, Osman NY, Walling JL, Mitchell VG. Variation and imprecision of clerkship grading in U.S. medical schools. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:1070-1076. [PMID: 22722356 DOI: 10.1097/acm.0b013e31825d0a2a] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Despite standardized curricula and mandated accreditation, concern exists regarding the variability and imprecision of medical student evaluation. The authors set out to perform a complete review of clerkship evaluation in U.S. medical schools. METHOD Clerkship evaluation data were obtained from all Association of American Medical Colleges-affiliated medical schools reporting enrollment during 2009-2010. Deidentified reports were analyzed to define the grading system and the percentage of each class within each grading tier. Inter- and intraschool grading variation was assessed in part by comparing the proportion of students receiving the top grade. RESULTS Data were analyzed from 119 of 123 accredited medical schools. Dramatic variation was detected. Specifically, the authors documented eight different grading systems using 27 unique sets of descriptive terminology. Imprecision of grading was apparent. Institutions frequently used the same wording (e.g., "honors") to imply different meanings. The percentage of students awarded the top grade in any clerkship exhibited extreme variability (range 2%-93%) from school to school, as well as from clerkship to clerkship within the same school (range 18%-81%). Ninety-seven percent of all U.S. clerkship students were awarded one of the top three grades regardless of the number of grading tiers. Nationally, less than 1% of students failed any required clerkship. CONCLUSIONS There exists great heterogeneity of grading systems and imprecision of grade meaning throughout the U.S. medical education system. Systematic changes seeking to increase consistency, transparency, and reliability of grade meaning are needed to improve the student evaluation process at the national level.
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Barker TA, Ngwenya N, Morley D, Jones E, Thomas CP, Coleman JJ. Hidden benefits of a peer-mentored 'Hospital Orientation Day': first-year medical students' perspectives. MEDICAL TEACHER 2012; 34:e229-e235. [PMID: 22455714 DOI: 10.3109/0142159x.2012.642833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Entering the clinical environment is potentially stressful for junior medical students. AIMS We evaluated first-year medical student feedback on a peer-mentored 'Hospital Orientation Day' designed to provide insight into future clinical training. METHOD Using a mixed methodology approach data were collected from first-year medical students. Responses to a questionnaire were used to develop a topic guide for focus groups held the next academic year. The questionnaire was completed by 230 first-year students and 32 second years participated in the interviews. Thematic analysis was used to draw conclusions. RESULTS Analysis of questionnaire responses indicated that students gained insight into future learning. Focus groups then generated five themes: (1) entering the hospital without fear, (2) linking the present with the future, (3) understanding the culture of learning in the clinical years, (4) a 'Backstage Pass' to the clinical world and (5) peer mentors make or break the day. CONCLUSIONS Using peer mentors during the Hospital Orientation Day allowed insight into future learning. We highlight the importance of student Mentors in the success of hospital orientation. To maximise the benefits for first years, we recommend a mentor selection procedure, mentor training opportunities and incentives to optimise mentor performance.
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Taylor JS, Hunter N, Basaviah P, Mintz M. Developing a national collaborative of medical educators who lead clinical skills courses. TEACHING AND LEARNING IN MEDICINE 2012; 24:361-364. [PMID: 23036005 DOI: 10.1080/10401334.2012.730452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The majority of US medical schools now have pre-clerkship clinical skills (PCCS) courses. Course directors for these often logistically complicated courses may be in different medical specialties and, historically, have had few formal opportunities for communication and collaboration with their counterparts at other institutions. As such, we hypothesized that leaders of PCCS courses would benefit from a national network. SUMMARY In this paper, we outline the methodology used to form a national collaborative from grass roots interest. Over three years, a self-identified eleven-person task force with national representation has created an organization for PCCS course directors from US medical schools called Directors Of Clinical Skills courses (DOCS) that meets annually. CONCLUSIONS Through iterative presentations at regional and national medical education meetings, we have produced an inventory of educational issues for those developing, administering, and evaluating PCCS courses. Further development of this nascent organization is ongoing. Our process is generalizable.
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Affiliation(s)
- Julie Scott Taylor
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA. Julie
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Abstract
Standardized patient (SP) performances are staged clinical encounters between health-professional students and people who specialize in role-playing the part of patients. Such performances have in recent years become increasingly central to the teaching and assessment of clinical skills in U.S. medical schools. SP performances are valued for being both "real" (in that they involve interaction with a real person, unlike written examinations) and "not real" (in that the SP does not actually suffer from the condition portrayed, unlike an actual patient). This article considers how people involved in creating SP performances reconcile a moral commitment to avoid suffering (to keep it "not real"), with an aesthetic commitment to realistically portray it (to keep it "real"). The term "moral aesthetic" is proposed, to indicate a sensibility that combines ideas about what is morally right with ideas about what is aesthetically compelling. Drawing on ethnographic research among SPs and SP program staff and medical faculty who work closely with them, this article argues that their work of creating "realism" in simulated clinical encounters encompasses multiple different (and sometimes conflicting) understandings and practices of realism, informed by three different moral aesthetics: (1) a moral aesthetic of induction, in which an accurate portrayal with a well-documented provenance serves to introduce experientially distant forms of suffering; (2) a moral aesthetic of inoculation, in which the authenticity and emotional impact of a performance are meant to inoculate students against the impact of future encounters with suffering; (3) a moral aesthetic of presence, generating forms of voice and care that are born out of the embodied presence of suffering individuals in a clinical space. All are premised on the assumption that risk and suffering can be banished from SP performances. This article suggests, however, that SP performances necessarily raise the same difficult, important, fundamentally ethical questions that are always involved in learning from and on human beings who are capable of suffering, and who need and deserve recognition and respect as well as care.
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Oelschlager AMA, Smith S, Tamura G, Carline J, Dobie S. Where do medical students turn? The role of the assigned mentor in the fabric of support during medical school. TEACHING AND LEARNING IN MEDICINE 2011; 23:112-117. [PMID: 21516596 DOI: 10.1080/10401334.2011.561664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The University of Washington School of Medicine implemented an assigned mentoring program in 2002. The College Mentors are assigned at matriculation, advise students throughout medical school, and teach and evaluate students in the 2nd-year Introduction to Clinical Medicine course. PURPOSE The purpose of the study was to determine from whom students report they would seek advice and support for academic, professional, personal, and research issues. METHODS A cross-sectional cohort survey asking students whom they would first contact about academic, personal, professional, and research issues was administered to three cohorts of students in 2007. RESULTS Students reported that they would contact their College Mentor first for general academic progress (49.6%), personal issues (36.2%), and professional issues (64.1%) but not for research issues. CONCLUSIONS Students identified their College Mentor as a primary contact for academic, professional, and personal issues, suggesting that neither the mentors' assigned status or evaluator role were barriers to the mentoring relationship.
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Affiliation(s)
- Anne-Marie Amies Oelschlager
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington 98195-6460, USA.
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Dobie S, Smith S, Robins L. How Assigned Faculty Mentors View their Mentoring Relationships: An Interview Study of Mentors in Medical Education. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/13611267.2010.511842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Geraci SA, Devine DR, Babbott SF, Hollander H, Buranosky R, Kovach RA, Berkowitz L. AAIM report on master teachers and clinician educators Part 3: finances and resourcing. Am J Med 2010; 123:963-7. [PMID: 20920701 DOI: 10.1016/j.amjmed.2010.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 06/11/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Stephen A Geraci
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Mississippi School of Medicine, Jackson, USA.
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Wenrich M, Jackson MB, Scherpbier AJ, Wolfhagen IH, Ramsey PG, Goldstein EA. Ready or not? Expectations of faculty and medical students for clinical skills preparation for clerkships. MEDICAL EDUCATION ONLINE 2010; 15:10.3402/meo.v15i0.5295. [PMID: 20711483 PMCID: PMC2919534 DOI: 10.3402/meo.v15i0.5295] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 07/07/2010] [Accepted: 07/13/2010] [Indexed: 05/16/2023]
Abstract
BACKGROUND Preclerkship clinical-skills training has received increasing attention as a foundational preparation for clerkships. Expectations among medical students and faculty regarding the clinical skills and level of skill mastery needed for starting clerkships are unknown. Medical students, faculty teaching in the preclinical setting, and clinical clerkship faculty may have differing expectations of students entering clerkships. If students' expectations differ from faculty expectations, students may experience anxiety. Alternately, congruent expectations among students and faculty may facilitate integrated and seamless student transitions to clerkships. AIMS To assess the congruence of expectations among preclerkship faculty, clerkship faculty, and medical students for the clinical skills and appropriate level of clinical-skills preparation needed to begin clerkships. METHODS Investigators surveyed preclinical faculty, clerkship faculty, and medical students early in their basic clerkships at a North American medical school that focuses on preclerkship clinical-skills development. Survey questions assessed expectations for the appropriate level of preparation in basic and advanced clinical skills for students entering clerkships. RESULTS Preclinical faculty and students had higher expectations than clerkship faculty for degree of preparation in most basic skills. Students had higher expectations than both faculty groups for advanced skills preparation. CONCLUSIONS Preclinical faculty, clerkship faculty, and medical students appear to have different expectations of clinical-skills training needed for clerkships. As American medical schools increasingly introduce clinical-skills training prior to clerkships, more attention to alignment, communication, and integration between preclinical and clerkship faculty will be important to establish common curricular agendas and increase integration of student learning. Clarification of skills expectations may also alleviate student anxiety about clerkships and enhance their learning.
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Affiliation(s)
- Marjorie Wenrich
- Office of the Dean, University of Washington School of Medicine, Seattle, WA, USA.
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The effects of being spurned and self-esteem on depersonalization and coping preferences in kindergarten teachers: the case of Hong Kong. SOCIAL PSYCHOLOGY OF EDUCATION 2010. [DOI: 10.1007/s11218-010-9138-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Frei E, Stamm M, Buddeberg-Fischer B. Mentoring programs for medical students--a review of the PubMed literature 2000-2008. BMC MEDICAL EDUCATION 2010; 10:32. [PMID: 20433727 PMCID: PMC2881011 DOI: 10.1186/1472-6920-10-32] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 04/30/2010] [Indexed: 05/02/2023]
Abstract
BACKGROUND Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. METHODS A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. RESULTS The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. CONCLUSION Mentoring is obviously an important career advancement tool for medical students. In Europe, more mentoring programs should be developed, but would need to be rigorously assessed based on evidence of their value in terms of both their impact on the career paths of juniors and their benefit for the mentors. Medical schools could then be monitored with respect to the provision of mentorships as a quality characteristic.
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Affiliation(s)
- Esther Frei
- Research Center for Career Development, Zurich University Hospital, Zurich, Switzerland
| | - Martina Stamm
- Research Center for Career Development, Zurich University Hospital, Zurich, Switzerland
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Shochet RB, Cayea D, Levine RB, Wright SM. Commentary: using medical student case presentations to help faculty learn to be better advisers. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:578-579. [PMID: 20354368 DOI: 10.1097/acm.0b013e3181da4ab6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The case presentation is a time-honored tradition in clinical medicine, and medical journals and national conferences have provided a forum for this type of scholarship for more than a century. Case presentations can also be used by educators as a means to understand challenging learner experiences, and by doing so, lead to advances in the practice of medical education. Medical school faculty are asked to serve in student advisor roles, yet best practices for student advising are not known. Unlike clinicians, who often discuss difficult patient cases, medical educators do not typically have opportunities to discuss challenging student cases to learn how best to support trainees. In this commentary, the authors-from the Johns Hopkins University School of Medicine Colleges Advisory Program (CAP), a longitudinal advising program with the goal of promoting personal and professional development of students-describe the novel quarterly Advisory Case Conference, where medical student cases can be confidentially presented and discussed by faculty advisors, along with relevant literature reviews, to enhance faculty advising skills for students. As medical student advising needs often vary, CAP advisors employ adult learning principles and emphasize shared responsibility between advisor and advisee as keys to successful advising. Unlike traditional clinical case conferences, the Advising Case Conference format encourages advisors to share perspectives about the cases by working in small groups to exchange ideas and role-play solutions. This model may be applicable to other schools or training programs wishing to enhance faculty advising skills.
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Affiliation(s)
- Robert B Shochet
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland 21205, USA.
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Bicket M, Misra S, Wright SM, Shochet R. Medical student engagement and leadership within a new learning community. BMC MEDICAL EDUCATION 2010; 10:20. [PMID: 20187953 PMCID: PMC2837871 DOI: 10.1186/1472-6920-10-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 02/26/2010] [Indexed: 05/08/2023]
Abstract
BACKGROUND Many medical schools are establishing learning communities to foster cohesion among students and to strengthen relationships between students and faculty members. Emerging learning communities require nurturing and attention; this represents an opportunity wherein medical students can become involved as leaders. This study sought to understand issues related to active involvement among students who chose to become highly engaged in a newly developed learning community. METHODS Between April and June 2008, 36 students who assumed leadership roles within the Colleges Program were queried electronically with open-ended questions about their engagement. Qualitative analysis of the written responses was independently performed by two investigators; coding was compared for agreement. Content analysis identified major themes. RESULTS 35 students (97%) completed the questionnaire. Motives that emerged as reasons for getting involved included: endorsing the need for the program; excitement with the start-up; wanting to give back; commitment to institutional excellence; and collaboration with talented peers and faculty. Perceived benefits were grouped under the following domains: connecting with others; mentoring; learning new skills; and recognition. The most frequently identified drawbacks were the time commitment and the opportunity costs. Ideas for drawing medical students into new endeavors included: creating defined roles; offering a breadth of opportunities; empowering students with responsibility; and making them feel valued. CONCLUSIONS Medical students were drawn to and took on leadership roles in a medical school curricular innovation. This example may prove helpful to others hoping to engage students as leaders in learning communities at their schools or those wishing to augment student involvement in other programs.
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Affiliation(s)
- Mark Bicket
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Satish Misra
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Scott M Wright
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Shochet
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Kalén S, Stenfors-Hayes T, Hylin U, Larm MF, Hindbeck H, Ponzer S. Mentoring medical students during clinical courses: a way to enhance professional development. MEDICAL TEACHER 2010; 32:e315-21. [PMID: 20662566 DOI: 10.3109/01421591003695295] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Mentoring is known to develop professional attributes and facilitate socialization into a profession. Only a few structured mentoring programmes for medical students have been reported in the literature. AIM The objective of this study was to investigate undergraduate medical students' experiences and perceptions of one-to-one mentoring and whether they felt that the mentorship promoted their personal and professional development. METHODS Medical students (n = 118) during their third and fourth years of their studies were offered a personal mentor for 2 years and followed up via a questionnaire when the mentoring programme was completed. Statistical software was used to compute data. Open-ended questions were analyzed by content analysis. RESULTS Most of the respondents experienced that the mentoring programme had facilitated their professional and personal development. The role of the mentor was experienced as being more supportive than supplying knowledge. The students appreciated talking to a faculty not connected with their courses. The few barriers to a successful mentorship were mainly related to timing logistics and 'personal chemistry'. CONCLUSIONS One-to-one mentoring during clinical courses seems to enhance the medical student's professional and personal development. Future studies are needed to get a deeper understanding and knowledge about factors of importance for successful mentorship.
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Affiliation(s)
- Susanne Kalén
- Department of Clinical Science and Education, Sodersjukhuset, Stockholm, Sweden.
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Sastre EA, Burke EE, Silverstein E, Kupperman A, Rymer JA, Davidson MA, Rodgers SM, Fleming AE. Improvements in medical school wellness and career counseling: A comparison of one-on-one advising to an Advisory College Program. MEDICAL TEACHER 2010; 32:e429-35. [PMID: 20854149 DOI: 10.3109/0142159x.2010.498486] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND Medical students have unmet needs in the areas of career and wellness advising. AIMS The goal of this study is to describe the development of an Advisory College Program (ACP) and assess its effectiveness compared to a traditional one-on-one faculty advisor system. METHODS The ACP, consisting of four colleges co-led by Advisory College Directors and supported by key Faculty, was developed to provide structured career and wellness advising. The authors compared the ACP to the former Faculty Advisory Program (FAP) using two parallel questionnaires. RESULTS Surveys were completed by 74% of first-year students, 60% of second-year students, and 88% of third-year students. Survey data demonstrated a significant increase in the number of students who could identify their advisor, the frequency of student-advisor contacts, and the perceived accessibility of advisors in the ACP compared to the FAP. While an ordinal logistic regression model did not demonstrate a significant effect of the new advising system on overall satisfaction, univariate analysis demonstrated a significant increase in student satisfaction with wellness and career counseling. CONCLUSIONS The ACP was more effective in promoting student wellness and career counseling than the traditional one-on-one faculty advisor system. Similar college-based programs may be beneficial to students at other medical school programs.
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Affiliation(s)
- Elizabeth Ann Sastre
- Department of Internal Medicine, Vanderbilt University Medical Center, Medical Center East, 7th Floor, Suite 4, Nashville, TN 37232, USA.
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Jackson MB, Keen M, Wenrich MD, Schaad DC, Robins L, Goldstein EA. Impact of a pre-clinical clinical skills curriculum on student performance in third-year clerkships. J Gen Intern Med 2009; 24:929-33. [PMID: 19521738 PMCID: PMC2710476 DOI: 10.1007/s11606-009-1032-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 02/09/2009] [Accepted: 05/08/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research on the outcomes of pre-clinical curricula for clinical skills development is needed to assess their influence on medical student performance in clerkships. OBJECTIVE To better understand the impact of a clinical-skills curriculum in the pre-clinical setting on student performance. DESIGN We conducted a non-randomized, retrospective, pre-post review of student performance evaluations from 3rd-year clerkships, before and after implementation of a clinical-skills curriculum, the Colleges (2001-2007). MAIN RESULTS Comparisons of clerkship performance data revealed statistically significant differences favoring the post-Colleges group in the Internal Medicine clerkship for 9 of 12 clinical-skills domains, including Technical Communication Skills (p < 0.023, effect size 0.16), Procedural Skills (p < 0.031, effect size 0.17), Communication Skills (p < 0.003, effect size 0.21), Patient Relationships (p < 0.003, effect size 0.21), Professional Relationships (p < 0.021, effect size 0.17), Educational Attitudes (p < 0.001, effect size 0.24), Initiative and Interest (p < 0.032, effect size 0.15), Attendance and Participation (p < 0.007, effect size 0.19), and Dependability (p < 0.008, effect size 0.19). Statistically significant differences were identified favoring the post-Colleges group in technical communication skills for three of six basic clerkships (Internal Medicine, Surgery, and Pediatrics). CONCLUSIONS Implementation of a pre-clinical fundamental skills curriculum appears to be associated with improved clerkship performance in the 3rd year of medical school, particularly in the Internal Medicine clerkship. Similar curricula, focused on teaching clinical skills in small groups at the bedside with personalized mentoring from faculty members, may improve student performance. Continued efforts are needed to understand how to best prepare students for clinical clerkships and how to evaluate outcomes of similar pre-clinical skills programs.
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Affiliation(s)
- Molly Blackley Jackson
- Department of Medicine, University of Washington, 1959 N.E. Pacific St., Campus Box 356429, Seattle, WA 98195, USA.
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Arnold RW, Losh DP, Mauksch LB, Maresca TM, Storck MG, Wenrich MD, Goldstein EA. Lexicon creation to promote faculty development in medical communication. PATIENT EDUCATION AND COUNSELING 2009; 74:179-183. [PMID: 18842387 DOI: 10.1016/j.pec.2008.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2008] [Revised: 06/13/2008] [Accepted: 08/18/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Most medical educators have little or no training in teaching and assessing medical communication, and they are not consistent in what they teach. The authors set out to reach consensus in our educational community on a lexicon of communication terms for use in teaching physician-patient communication skills to second-year medical students. METHODS An interdisciplinary medical school physician-patient communication committee assembled 23 important terms and agreed on definitions for each term. Thirty core preclinical faculty representing nine medical specialties reviewed the lexicon. Faculty were surveyed about lexicon definitions, barriers to use, and methods of using during educational encounters. RESULTS All preclinical faculty members agreed on 19 out of 23 definitions and most respondents agreed on the definitions of the remaining four terms. Sixty-nine percent of respondents said they used the terms during their teaching encounters. CONCLUSION Implementing a process to create a shared language around physician-patient communication may help unify and enhance faculty educational efforts. We were able to establish that medical educators can agree on the content of a medical communication lexicon for use with students. The use of defined and consistently used terms in multiple venues may reduce ambiguity, standardize teaching, enhance recognition of communication skills, and promote effective reinforcement and remediation by faculty. PRACTICE IMPLICATIONS Evidence suggests that most medical educators have little or no training in teaching and assessing medical communication and that they are not consistent in what they teach. Asking a community of faculty to share responsibility for creating a communication lexicon may be an efficient and effective way to educate faculty and unify their educational effort.
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Affiliation(s)
- Richard W Arnold
- University of Washington School of Medicine, Seattle, WA 98105-6920, United States.
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