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Atalla M, Yacoub A, Al-Ali H, Lupia B, Ezzeddine L, Barzani S, Moussa M, Coey J, Alambrouk T, Hilal H. Investigating the Skill Development of Medical Students in Focused Assessment With Sonography for Trauma (FAST) Ultrasound: A Comparative Analysis Across Different Stages of Medical Training. Cureus 2023; 15:e44414. [PMID: 37664275 PMCID: PMC10469331 DOI: 10.7759/cureus.44414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Focused assessment with sonography for trauma (FAST) ultrasound (US) is a valuable medical examination used in trauma settings, particularly for rapid responses to events such as natural disasters. Although the efficacy and benefits of FAST in patient care have been extensively studied, there is limited research on training medical students in FAST. Previous studies have found that medical students can proficiently perform a FAST US after two days of training. However, these studies exclusively included first-year medical students without considering variations in their medical knowledge. Particularly, the advantage of medical students having US experience before undergoing FAST training has not been previously examined. OBJECTIVES Assess the performance and knowledge acquisition of medical students with and without prior US experience after completing a FAST training course. METHODS The study included a total of 71 students, consisting of 33 males and 38 females, who were between the ages of 18 and 31, with an average age of 24.6 and a standard deviation of 2.4. The inclusion criteria targeted first- and second-year medical school students who participated on a volunteer basis. Students were divided into two groups: group A, consisting of those without prior US experience, and group B, made up of those who had previous US experience. All students completed a pre-training survey to share their comfort and confidence in US use and knowledge. A baseline FAST exam was conducted to establish initial performance. A comprehensive three-hour training session was then provided. Post-training, students performed another FAST exam to assess improvement, followed by a post-training survey to evaluate comfort and confidence. RESULTS Medical students who had prior experience in the US (group B) performed significantly better (p<0.01) in both the pre- and post-training FAST exams when compared to students without previous US experience. Specifically, in locating the liver, right kidney, hepatorenal recess, and left kidney, as well as detecting fluid accumulation when in a supine position. Additionally, medical students with prior US experience (group B) exhibited higher baseline confidence (p<0.005-p<0.01) in their ability to perform a FAST exam, as indicated by the results of the pre-testing survey. CONCLUSION Previous experience with US significantly boosted confidence and knowledge gains following FAST training. This emphasizes the value of including US training in medical school programs after earlier exposure, offering evident benefits. The study reveals the unexplored benefit of having prior US experience for medical students undergoing FAST training, thus addressing a previously unexplored area in current research. The conclusions stress the necessity of integrating US training into medical school curricula after initial exposure. This understanding can direct medical educators in refining the education process, enabling students to be better equipped for real-world medical situations involving FAST.
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Affiliation(s)
- Michael Atalla
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
- Medical Imaging, University of Toronto, Toronto, CAN
| | - Andrew Yacoub
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Hasan Al-Ali
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Bianca Lupia
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Layal Ezzeddine
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Shaliz Barzani
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Michelle Moussa
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
- Faculty of Science, University of Waterloo, Waterloo, CAN
| | - James Coey
- Anatomy, St. George's University School of Medicine, Newcastle upon Tyne, GBR
| | - Tarek Alambrouk
- School of Medicine, St. George's University School of Medicine, Newcastle upon Tyne, GRD
| | - Haider Hilal
- School of Medicine, St. George's University School of Medicine, Newcastle upon Tyne, GBR
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Zhang C. A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4487. [PMID: 36901496 PMCID: PMC10002261 DOI: 10.3390/ijerph20054487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.
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Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Sunlight South Road 1, Beijing 102488, China
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Orsi A, Watson A, Wijegoonewardene N, Botan V, Lloyd D, Dunbar N, Asghar Z, Siriwardena AN. Perceptions and experiences of medical student first responders: a mixed methods study. BMC MEDICAL EDUCATION 2022; 22:721. [PMID: 36242030 PMCID: PMC9561313 DOI: 10.1186/s12909-022-03791-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Medical Student First Responders (MSFRs) are volunteers who respond to emergency calls, managing patients before ambulance staff attend. The MSFR role provides opportunities to manage acutely unwell patients in the prehospital environment, not usually offered as part of formal undergraduate medical education. There are few previous studies describing activities or experiences of MSFRs or exploring the potential educational benefits. We aimed to investigate the activity of MSFRs and explore their experiences, particularly from an educational perspective. METHODS We used a mixed methods design, combining quantitative analysis of ambulance dispatch data with qualitative semi-structured interviews of MSFRs. Dispatch data were from South Central and East Midlands Ambulance Service NHS Trusts from 1st January to 31st December 2019. Using propensity score matching, we compared incidents attended by MSFRs with those attended by other Community First Responders (CFRs) and ambulance staff. We interviewed MSFRs from five English (UK) medical schools in those regions about their experiences and perceptions and undertook thematic analysis supported by NVivo 12. RESULTS We included 1,939 patients (median age 58.0 years, 51% female) attended by MSFRs. Incidents attended were more urgent category calls (category 1 n = 299, 14.9% and category 2 n = 1,504, 77.6%), most commonly for chest pain (n = 275, 14.2%) and shortness of breath (n = 273, 14.1%). MSFRs were less likely to attend patients of white ethnicity compared to CFRs and ambulance staff, and more likely to attend incidents in areas of higher socioeconomic deprivation (IMD - index of multiple deprivation) (p < 0.05). Interviewees (n = 16) consistently described positive experiences which improved their clinical and communication skills. CONCLUSION MSFRs' attendance at serious medical emergencies provide a range of reported educational experiences and benefits. Further studies are needed to explore whether MSFR work confers demonstrable improvements in educational or clinical performance.
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Affiliation(s)
- Andrew Orsi
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
- East Midlands School of Anaesthesia, Health Education England, Leeds, UK
| | - Adam Watson
- Medical Science Division, University of Oxford, Oxford, UK
| | | | - Vanessa Botan
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
| | - Dylan Lloyd
- Medical School, University of Buckingham, Buckingham, UK
| | - Nic Dunbar
- South Central Ambulance Service NHS Foundation Trust, Otterbourne, UK
| | - Zahid Asghar
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
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Ayoola AS, Acker PC, Kalanzi J, Strehlow MC, Becker JU, Newberry JA. A qualitative study of an undergraduate online emergency medicine education program at a teaching Hospital in Kampala, Uganda. BMC MEDICAL EDUCATION 2022; 22:84. [PMID: 35135519 PMCID: PMC8822823 DOI: 10.1186/s12909-022-03157-5] [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: 02/21/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Globally, half of all years of life lost is due to emergency medical conditions, with low- and middle-income countries (LMICs) facing a disproportionate burden of these conditions. There is an urgent need to train the future physicians in LMICs in the identification and stabilization of patients with emergency medical conditions. Little research focuses on the development of effective emergency medicine (EM) medical education resources in LMICs and the perspectives of the students themselves. One emerging tool is the use of electronic learning (e-learning) and blended learning courses. We aimed to understand Uganda medical trainees' use of learning materials, perception of current e-learning resources, and perceived needs regarding EM skills acquisition during participation in an app-based EM course. METHODS We conducted semi-structured interviews and focus groups of medical students and EM residents. Participants were recruited using convenience sampling. All sessions were audio recorded and transcribed verbatim. The final codebook was approved by three separate investigators, transcripts were coded after reaching consensus by all members of the coding team, and coded data were thematically analyzed. RESULTS Twenty-six medical trainees were included in the study. Analysis of the transcripts revealed three major themes: [1] medical trainees want education in EM and actively seek EM training opportunities; [2] although the e-learning course supplements knowledge acquisition, medical students are most interested in hands-on EM-related training experiences; and [3] medical students want increased time with local physician educators that blended courses provide. CONCLUSIONS Our findings show that while students lack access to structured EM education, they actively seek EM knowledge and practice experiences through self-identified, unstructured learning opportunities. Students value high quality, easily accessible EM education resources and employ e-learning resources to bridge gaps in their learning opportunities. However, students desire that these resources be complemented by in-person educational sessions and executed in collaboration with local EM experts who are able to contextualize materials, offer mentorship, and help students develop their interest in EM to continue the growth of the EM specialty.
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Affiliation(s)
| | - Peter C. Acker
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Joseph Kalanzi
- Department of Emergency Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Matthew C. Strehlow
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Joseph U. Becker
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jennifer A. Newberry
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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Müller A, Wagner FM, Schuster AK, Günal B, Pfeiffer N, Schmidt F, Prokosch V. [Ophthalmic emergencies: training via interactive key feature cases for medical students]. Ophthalmologe 2022; 119:48-55. [PMID: 34057586 PMCID: PMC8763746 DOI: 10.1007/s00347-021-01409-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/13/2021] [Accepted: 04/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Autonomous diagnosis and assessment of medical emergencies are important skills to acquire for medical students. Ophthalmology features certain specialty-specific "red flag" signs and symptoms, which pose a challenge for educators in ophthalmology. To support medical students in identifying those "red flags" we developed and implemented interactive cases for our e‑learning platform. MATERIAL AND METHODS A total of seven interactive cases with key feature problems regarding potentially dangerous signs and symptoms, such as painless loss of vision or red eye were developed. Medical students were guided through a case and performed formative assessments. The interactive cases were created with e‑learning authoring software and were available on the learning management system presence of the department of ophthalmology. They were mandatory for medical students in the ophthalmology course. Students evaluated the cases after the course. RESULTS The interactive cases were rated on average at 1.51 ± 0.68 (mean ± standard deviation; n = 163) on a grade scale (1 = best, 6 = worst). On a Likert scale they were perceived as helpful for individual learning at 1.60 ± 0.81 (1 = very helpful, 7 = not helpful at all; n = 164). The information provided on the cases and selection of scenarios was positively evaluated. CONCLUSION To support students in identifying and managing ophthalmic emergencies in the context of limited time in tightly packed curricula, interactive key feature cases can be part of corresponding e‑learning resources. An integration of such cases was evaluated as desirable.
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Affiliation(s)
- Andreas Müller
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Felix M Wagner
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Betül Günal
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Franziska Schmidt
- Zentrum für Qualitätssicherung und -entwicklung, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Verena Prokosch
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Zentrum für Augenheilkunde, Uniklinik Köln, Köln, Deutschland
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de Araujo Guerra Grangeia T, de Jorge B, Franci D, Martins Santos T, Vellutini Setubal MS, Schweller M, de Carvalho-Filho MA. Cognitive Load and Self-Determination Theories Applied to E-Learning: Impact on Students' Participation and Academic Performance. PLoS One 2016; 11:e0152462. [PMID: 27031859 PMCID: PMC4816554 DOI: 10.1371/journal.pone.0152462] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 03/15/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Emergency clerkships expose students to a stressful environment that require multiple tasks, which may have a direct impact on cognitive load and motivation for learning. To address this challenge, Cognitive Load Theory and Self Determination Theory provided the conceptual frameworks to the development of a Moodle-based online Emergency Medicine course, inspired by real clinical cases. METHODS Three consecutive classes (2013-2015) of sixth-year medical students (n = 304) participated in the course, during a curricular and essentially practical emergency rotation. "Virtual Rounds" provided weekly virtual patients in narrative format and meaningful schemata to chief complaints, in order to simulate real rounds at Emergency Unit. Additional activities such as Extreme Decisions, Emergency Quiz and Electrocardiographic challenge offered different views of emergency care. Authors assessed student´s participation and its correlation with their academic performance. A survey evaluated students´ opinions. Students graduating in 2015 answered an online questionnaire to investigate cognitive load and motivation. RESULTS Each student produced 1965 pageviews and spent 72 hours logged on. Although Clinical Emergency rotation has two months long, students accessed the online course during an average of 5.3 months. Virtual Rounds was the most accessed activity, and there was positive correlations between the number of hours logged on the platform and final grades on Emergency Medicine. Over 90% of students felt an improvement in their clinical reasoning and considered themselves better prepared for rendering Emergency care. Considering a Likert scale from 1 (minimum load) to 7 (maximum load), the scores for total cognitive load were 4.79±2.2 for Virtual Rounds and 5.56±1.96 for real medical rounds(p<0,01). CONCLUSIONS A real-world inspired online course, based on cognitive and motivational conceptual frameworks, seems to be a strong tool to engage students in learning. It may support them to manage the cognitive challenges involved in clinical care and increase their motivation for learning.
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Affiliation(s)
- Tiago de Araujo Guerra Grangeia
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Bruno de Jorge
- Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Daniel Franci
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Thiago Martins Santos
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | | | - Marcelo Schweller
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Marco Antonio de Carvalho-Filho
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
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Tews MC, Ditz Wyte CM, Coltman M, Hiller K, Jung J, Oyama LC, Jubanyik K, Khandelwal S, Goldenberg W, Wald DA, Zun LS, Zinzuwadia S, Pandit K, An C, Ander DS. Implementing a third-year emergency medicine medical student curriculum. J Emerg Med 2015; 48:732-743.e8. [PMID: 25825161 DOI: 10.1016/j.jemermed.2014.12.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 11/05/2014] [Accepted: 12/22/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emergency medicine (EM) is commonly introduced in the fourth year of medical school because of a perceived need to have more experienced students in the complex and dynamic environment of the emergency department. However, there is no evidence supporting the optimal time or duration for an EM rotation, and a number of institutions offer third-year rotations. OBJECTIVE A recently published syllabus provides areas of knowledge, skills, and attitudes that third-year EM rotation directors can use to develop curricula. This article expands on that syllabus by providing a comprehensive curricular guide for the third-year medical student rotation with a focus on implementation. DISCUSSION Included are consensus-derived learning objectives, discussion of educational methods, considerations for implementation, and information on feedback and evaluation as proposed by the Clerkship Directors in Emergency Medicine Third-Year Curriculum Work Group. External validation results, derived from a survey of third-year rotation directors, are provided in the form of a content validity index for each content area. CONCLUSIONS This consensus-derived curricular guide can be used by faculty who are developing or revising a third-year EM medical student rotation and provide guidance for implementing this curriculum at their institution.
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Affiliation(s)
- Matthew C Tews
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Collette Marie Ditz Wyte
- Department of Emergency Medicine, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan
| | - Marion Coltman
- Department of Emergency Medicine, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan
| | - Kathy Hiller
- Department of Emergency Medicine, University of Arizona Health Network, Tucson, Arizona
| | - Julianna Jung
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Leslie C Oyama
- UCSD Emergency Medicine, University of California, San Diego, San Diego, California
| | - Karen Jubanyik
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut
| | - Sorabh Khandelwal
- Department of Emergency Medicine, The Ohio State University Medical Center, Columbus, Ohio
| | - William Goldenberg
- Department of Emergency Medicine, Naval Medical Center, San Diego, California
| | - David A Wald
- Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Leslie S Zun
- Department of Emergency Medicine, Mount Sinai Hospital, Chicago Medical School, Chicago, Illinois
| | - Shreni Zinzuwadia
- Department of Emergency Medicine, New Jersey Medical School-University Hospital, Newark, New Jersey
| | - Kiran Pandit
- Department of Emergency Medicine, Columbia University, New York, New York
| | - Charlene An
- Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Douglas S Ander
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
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Robinson D, Chin D, Kong A. Debunking myths and enhancing medical student learning within the emergency department. Emerg Med Australas 2015; 27:72-4. [PMID: 25586745 DOI: 10.1111/1742-6723.12354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Danielle Robinson
- Austin Clinical School, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia
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Iyer MS, Mullan PB, Santen SA, Sikavitsas A, Christner JG. Deliberate apprenticeship in the Pediatric Emergency Department improves experience for third-year students. West J Emerg Med 2014; 15:424-9. [PMID: 25035748 PMCID: PMC4100848 DOI: 10.5811/westjem.2014.5.19647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/22/2014] [Accepted: 05/05/2014] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The Pediatric Emergency Department (PED) provides medical students with learning in a high-volume, fast-paced environment; characteristics that can be stressful for new students. Shadowing can improve transitioning, yet this alone does not facilitate students’ development of independent medical care competencies. This study evaluates if third-year medical students’ deliberate apprenticeship with senior residents increases students’ comfort and patient exposure in the PED. METHODS This study took place over the 2011–2012 academic year, and study participants were all third-year medical students during their pediatric clerkship rotation. This was a prospective educational intervention assigning students to randomized control blocks of deliberate apprenticeship (DA) intervention or control. DA students were paired with a senior resident who oriented and worked with the student, while control students were unpaired. All students completed a 20-question structured survey at shift end, which included questions about their perception of the learning environment, comfort with, and number of patient care responsibilities performed. We used independent Mann-Whitney and t-tests to compare experiences between the groups. Statistical significance was defined as p<0.05. We used the constant comparative method to qualitatively analyze students’ comments. RESULTS Response rate was 85% (145/169). Students also rated on 5-point Likert-scale their level of comfort with defined aspects of working in the PED. DA students (n=76) were significantly more comfortable obtaining histories (4.2 versus 3.8) and formulating differential diagnoses (3.9 versus 3.4). DA students also performed more physical exams (2.9 versus 2.4). We categorized themes from the qualitative analysis of the students’ comments about their PED experience. The titles for these themes are as follows: PED provides a good learning experience; uncertainty about the medical student’s role in the PED; third-year medical students compete with other learners for teaching attention; opportunities provided to medical students for inclusion in patient care; personal knowledge deficits limit the ability to participate in the PED; PED pace affects learning opportunities. CONCLUSION DA constitutes a feasible approach to the clinical learning environment that increases students’ patient care experiences and may ease transitioning for undergraduate medical students to new clinical environments.
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Affiliation(s)
- Maya Subbarao Iyer
- Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Department of Pediatrics, Division of Emergency Medicine, Pittsburgh, Pennsylvania
| | - Patricia B Mullan
- University of Michigan Medical School, Department of Medical Education, Ann Arbor, Michigan
| | - Sally A Santen
- University of Michigan, Department of Medical Education and Department of Emergency Medicine, Ann Arbor, Michigan
| | - Athina Sikavitsas
- University of Michigan, Department of Emergency Medicine and Department of Pediatrics, Ann Arbor, Michigan
| | - Jennifer G Christner
- State University of New York at Syracuse, Department of Medical Education and Department of Pediatrics, Syracuse, New York
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Cox M, Chandra A. Undergraduate emergency medicine in an African medical school – Experiences from Botswana. Afr J Emerg Med 2013. [DOI: 10.1016/j.afjem.2013.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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