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Klasen JM, Schoenbaechler Z, Bogie BJM, Meienberg A, Nickel C, Bingisser R, LaDonna K. Medical students' perceptions of learning and working on the COVID-19 frontlines: '… a confirmation that I am in the right place professionally'. MEDICAL EDUCATION ONLINE 2022; 27:2082265. [PMID: 35638171 PMCID: PMC9176629 DOI: 10.1080/10872981.2022.2082265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic caused complex and enduring challenges for healthcare providers and medical educators. The rapid changes to the medical education landscape forced universities across the world to pause traditional medical training. In Basel, Switzerland, however, medical students had the opportunity to work on the COVID-19 frontlines. Our purpose was to understand how they perceived both learning and professional identity development in this novel context. We conducted semi-structured interviews with 21 medical students who worked in a COVID-19 testing facility at the University Hospital of Basel. Using constructivist grounded theory methodology, we collected and analyzed data iteratively using the constant comparative approach to develop codes and theoretical themes. Most participants perceived working on the pandemic frontlines as a positive learning experience, that was useful for improving their technical and communication skills. Participants particularly valued the comradery amongst all team members, perceiving that the hierarchy between faculty and students was less evident in comparison to their usual learning environments. Since medical students reported that their work on the pandemic frontlines positively affected their learning, the need to create more hands-on learning opportunities for medical students challenges curriculum developers. Medical students wish to feel like full-fledged care team members rather than observing sideliners. Performing simple clinical tasks and collaborative moments in a supportive learning environment may promote learning and professional development and should be encouraged in the post-pandemic era.
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Affiliation(s)
- Jennifer M. Klasen
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland
| | | | - Bryce J. M. Bogie
- MD/PhD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Christian Nickel
- Emergency Department, University Hospital, University of Basel, Basel, Switzerland
| | - Roland Bingisser
- Emergency Department, University Hospital, University of Basel, Basel, Switzerland
| | - Kori LaDonna
- Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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2
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Clay AS, Leiman ER, Theiling BJ, Song Y, Padilla BBI, Hudak NM, Hartman AM, Hoder JM, Waite KA, Lee HJ, Buckley EG. Creating a win-win for the health system and health Profession's education: a direct observation clinical experience with feedback iN real-time (DOCENT) for low acuity patients in the emergency department. BMC MEDICAL EDUCATION 2022; 22:66. [PMID: 35086549 PMCID: PMC8796635 DOI: 10.1186/s12909-022-03133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Clinical education across the professions is challenged by a lack of recognition for faculty and pressure for patient throughput and revenue generation. These pressures may reduce direct observation of patient care provided by students, a requirement for both billing student-involved services and assessing competence. These same pressures may also limit opportunities for interprofessional education and collaboration. METHODS An interprofessional group of faculty collaborated in a sequential quality improvement project to identify the best patients and physical location for a student teaching clinic. Patient chief complaint, use of resources, length of stay, estimated severity of illness and student participation and evaluation of the clinic was tracked. RESULTS Clinic Optimization and Patient Care: Five hundred and thirty-two emergency department (ED) patients were seen in the first 19 months of the clinic. A clinic located near the ED allowed for patients with higher emergency severity index and greater utilization of imaging. Patients had similar or lower lengths of stay and higher satisfaction than patients who remained in the ED (p < 0.0001). In the second clinic location, from October 2016-June 2019, 644 patients were seen with a total of 667 concerns; the most common concern was musculoskeletal (50.1%). Student Interprofessional Experience: A total of 991 students participated in the clinic: 68.3% (n = 677) medical students, 10.1% (n = 100) physician assistant students, 9.7% (n = 96) undergraduate nursing students, 9.1% (n = 90) physical therapy students, and 2.8% (n = 28) nurse practitioner students. The majority (74.5%, n = 738) of student participants worked with students from other professions. More than 90% of students reported that faculty set a positive learning environment respectful of students. However, 20% of students reported that faculty could improve provision of constructive feedback. Direct Observation: Direct observation of core entrustable professional activities for medical students was possible. Senior medical students were more likely to be observed generating a differential diagnosis or management plan than first year medical students. CONCLUSIONS Creation of a DOCENT clinic in the emergency department provided opportunities for interprofessional education and observation of student clinical skills, enriching student experience without compromising patient care.
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Affiliation(s)
- Alison S Clay
- Department of Medicine, School of Medicine, Duke University School of Medicine, 8 Searle Center Drive, TSCHE 1074, Durham, NC, 27710, USA.
| | - Erin R Leiman
- Department of Surgery, School of Medicine, Duke University, Durham, USA
| | | | - Yao Song
- Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, USA
| | | | - Nicholas M Hudak
- Department of Neurology, School of Medicine, Duke University, Durham, USA
| | | | - Jeffrey M Hoder
- Department of Orthopedic Surgery, School of Medicine, Duke University, Durham, USA
| | - Kathleen A Waite
- Department of Medicine, School of Medicine, Duke University School of Medicine, 8 Searle Center Drive, TSCHE 1074, Durham, NC, 27710, USA
| | - Hui-Jie Lee
- Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, USA
| | - Edward G Buckley
- Department of Ophthalmology, School of Medicine, Duke University, Durham, USA
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Nagji A, Yilmaz Y, Zhang P, Dida J, Cook‐Chaimowitz L, Dong JK, Colpitts L, Beecroft J, Chan TM. Converting to Connect: A Rapid RE-AIM Evaluation of the Digital Conversion of a Clerkship Curriculum in the Age of COVID-19. AEM EDUCATION AND TRAINING 2020; 4:330-339. [PMID: 33150275 PMCID: PMC7592819 DOI: 10.1002/aet2.10498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND With the advent of the 2019 coronavirus pandemic, a decision was made to remove medical students from clinical rotations for their own safety. This forced students on a core emergency medicine (EM) rotation at McMaster University to immediately cease all in-person activities. An urgent need for a virtual curriculum emerged. METHODS A virtual curriculum consisting of asynchronous case-based learning on Slack, ask-me-anything webinars, and online e-modules was created to fill the need. We describe a program evaluation using the RE-AIM framework and a social networking analysis of participants. RESULTS Medical students (n = 23) and 11 facilitators (five residents, six faculty members) participated in this pilot study. Faculty members sent a mean (±SD) of 115 (±117) messages (n = 6), and mean (±SD) message counts for students and residents were 49.96 (±25; n = 23) and 39 (±38; n = 5), respectively. A total of 62,237 words were written by the participants, with a mean of 1,831 per person. Each message consisted of a mean (±SD) of 25 words (±29). Students rapidly acquitted themselves to digital technology. Using the RE-AIM framework we highlight the feasibility of a virtual curriculum, discuss demands on faculty time, and reflect on strategies to engage learners. CONCLUSIONS The use of asynchronous digital curricula creates opportunities for faculty-resident interaction and engagement. We report the successful deployment of a viable model for undergraduate EM training for senior medical students in the COVID-19 era of physical distancing.
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Affiliation(s)
- Alim Nagji
- From theDepartment of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Yusuf Yilmaz
- theMcMaster University Education Research, Innovation and Theory (MERIT) ProgramFaculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- theDepartment of Medical EducationFaculty of MedicineEge UniversityIzmirTurkey
| | - Peter Zhang
- theFamily Medicine Training ProgramDepartment of Family MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Joana Dida
- Royal College Emergency Medicine Training Program, Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Lauren Cook‐Chaimowitz
- Royal College Emergency Medicine Training Program, Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Junghwan Kevin Dong
- From theDepartment of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Lorraine Colpitts
- From theDepartment of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
- theWaterloo Regional CampusMichael G. DeGroote School of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - James Beecroft
- From theDepartment of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
- theNiagara Regional CampusMichael G. DeGroote School of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Teresa M. Chan
- From theDepartment of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
- theMcMaster University Education Research, Innovation and Theory (MERIT) ProgramFaculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- and theProgram for Faculty DevelopmentFaculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
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Hanson JL, Wallace CM, Bannister SL. Assessment for Learning: How to Assess Your Learners' Performance in the Clinical Environment. Pediatrics 2020; 145:peds.2019-3966. [PMID: 32029683 DOI: 10.1542/peds.2019-3966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Janice L Hanson
- Medicine, Office of Education, Washington University in Saint Louis, Saint Louis, Missouri; .,Departments of Medicine and Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Susan L Bannister
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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Ewid M. Medical students accept virtual patients as a helping tool to achieve their study plan objectives. SAUDI JOURNAL FOR HEALTH SCIENCES 2019. [DOI: 10.4103/sjhs.sjhs_155_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mills DM, Friesinger MK, Jackson SM, McBurney PG. Medical Student H&Ps: Do You Have to Observe Them All At Once? South Med J 2018; 111:727-732. [DOI: 10.14423/smj.0000000000000904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Carney PA, Palmer RT, Fuqua Miller M, Thayer EK, Estroff SE, Litzelman DK, Biagioli FE, Teal CR, Lambros A, Hatt WJ, Satterfield JM. Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:730-42. [PMID: 26796091 PMCID: PMC4846480 DOI: 10.1097/acm.0000000000001090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. METHOD The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. RESULTS Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. CONCLUSIONS These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development.
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Affiliation(s)
- Patricia A Carney
- P.A. Carney is professor of family medicine and of public health and preventive medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. R.T. Palmer is assistant professor of family medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. M.F. Miller is senior research assistant, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. E.K. Thayer is research assistant, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. S.E. Estroff is professor, Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. D.K. Litzelman is D. Craig Brater Professor of Medicine and senior director for research in health professions education and practice, Indiana University School of Medicine, Indianapolis, Indiana. F.E. Biagioli is professor of family medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. C.R. Teal is assistant professor, Department of Medicine, and director, Educational Evaluation and Research, Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas. A. Lambros is active emeritus associate professor, Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina. W.J. Hatt is programmer analyst, Department of Family Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. J.M. Satterfield is professor of clinical medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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McKenzie CT. Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.5.tb06116.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Carly T. McKenzie
- Department of Clinical and Community Sciences; School of Dentistry; University of Alabama at Birmingham
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Sullivan SA, Bingman E, O'Rourke A, Pugh CM. Piloting Virtual Surgical Patient Cases with 3rd-year medical students during the surgery rotation. Am J Surg 2016; 211:689-696.e1. [DOI: 10.1016/j.amjsurg.2015.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/23/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
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Bannister SL, Hanson JL, Maloney CG, Dudas RA. Practical Framework for Fostering a Positive Learning Environment. Pediatrics 2015; 136:6-9. [PMID: 26077478 DOI: 10.1542/peds.2015-1314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Susan L Bannister
- University of Calgary, Faculty of Medicine, Calgary, Alberta, Canada;
| | | | - Christopher G Maloney
- University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, Utah; and
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Affiliation(s)
- Amy Fleming
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9225, USA
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Affiliation(s)
- Janice L Hanson
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Martinez JM, Hembre KM, Ebright AB, Newman JS. Jump-start to the wards: a hospitalist model. CLINICAL TEACHER 2011; 8:164-7. [PMID: 21851562 DOI: 10.1111/j.1743-498x.2011.00467.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In recent years, pursuing a second degree during medical school has become an increasingly attractive option. Interested students choose to leave medical school for one or several years, and then return to finish their clinical rotations. However, they often have minimal clinical exposure while completing these degree programmes, and may have difficulty adapting to the clinical environment when returning for their third or fourth year of medical school. CONTEXT Whereas MD and PhD students tend to have clinical re-entry courses at their medical schools, there are no formal reintegration programmes for medical students who choose to pursue 1- or 2-year degrees. INNOVATION We designed a 5-day reintegration course based on a hospital service model, with physician assistants or nurse practitioners to aid in student transition to clinical rotations, and describe the experience of a dual-degree medical student participating in this re-entry model. IMPLICATIONS This model provides the student with both didactic and patient care training, as well as the experience of working with professionals from different backgrounds. As the demand for dual-degree opportunities increases, the implementation of formal re-entry programmes should be considered to ensure students returning to medical school are prepared to begin clinical rotations.
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Affiliation(s)
- Jennifer M Martinez
- College of Medicine, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN 55905, USA
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Bannister SL, Hanson JL, Maloney CG, Raszka WV. Using the student case presentation to enhance diagnostic reasoning. Pediatrics 2011; 128:211-3. [PMID: 21746722 DOI: 10.1542/peds.2011-1469] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Susan L Bannister
- Department of Pediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada.
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Abstract
This article is the fourth in a series by the Council on Medical Student Education in Pediatrics (COMSEP) reviewing the critical attributes and skills of superb clinical teachers. The previous article in this series reviewed the vital importance of direct observation of students.(1) The purpose of this article is to describe how to use the information gained from the direct observation, namely the role of feedback. Although too often used interchangeably, encouragement, evaluation, and feedback are quite distinct. Encouragement (eg, "good job!") is supportive but does nothing to improve the learner's skills. Evaluation is summative and is the final judgment of the learner's performance. Feedback, however, is designed to improve future performance. This article focuses on feedback-what it is, why it is important, some of the barriers to effective feedback, and how to give helpful feedback.
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Affiliation(s)
- Joseph Gigante
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9225, USA.
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