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Wisco JJ, Moussavi M, White SE. A Near-Peer Interprofessional Educational Fellowship Program for Training Pre-Clinical Medical Students in the Best Practices of Teaching and Learning. MEDICAL SCIENCE EDUCATOR 2024; 34:181-191. [PMID: 38510391 PMCID: PMC10948728 DOI: 10.1007/s40670-023-01936-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 03/22/2024]
Abstract
Medical school often has opportunities for students to engage in peer or near-peer teaching, however structured teacher training is rarely conducted. We present an Educational Fellowship for rising M2 students as teaching assistants for first year Physician Assistant students. In this near-peer interprofessional teaching model, the M2 students learn pedagogical theory and best practices for teaching and learning. The curriculum and experience may be used by any healthcare profession. Since many healthcare professions have classes during the summer, we present our program as a conceptual model for other institutions.
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Affiliation(s)
- Jonathan J. Wisco
- Department of Anatomy and Neurobiology, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, 72 E Concord St, L-1004 Boston, MA 02118, USA
| | - Mina Moussavi
- Department of Physiology and Biophysics, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, MA 02118 USA
| | - Susan E. White
- Physician Assistant Program, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, MA 02118 USA
- Department of Obstetrics and Gynecology, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, MA 02118 USA
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Witt L, Nilsen KM, Kohman M, Petz A, Moser S, Walling A. Unintended Consequences? Assessing the Impact of Curricular Change on Medical Student Participation in a Student-Run Free Clinic. MEDICAL SCIENCE EDUCATOR 2021; 31:1653-1662. [PMID: 34603837 PMCID: PMC8446137 DOI: 10.1007/s40670-021-01356-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In a prior qualitative study of the impact of a new (ACE) medical school curriculum, students and faculty reported decreased participation in the student-run free clinic (SRFC) attributed to more intensive scheduling and more frequent testing compared to the previous (Legacy) curriculum. MATERIALS AND METHODS To verify and understand this perception formed during curriculum reform, we conducted a mixed method study to measure student participation in the SRFC before and after curricular change and assessed student beliefs and motivations about SRFC participation using focus groups. RESULTS Overall SRFC participation did not decrease among students in the ACE cohort following curriculum change. Additionally, both Legacy and ACE groups showed lower participation during test weeks, but the decrease was not significantly different between the ACE and Legacy cohorts. Focus groups confirmed the pervasive misbelief that SRFC participation was indeed lower among ACE students and attributed to reduced student discretionary time plus increased preparation time for frequent testing. Focus groups also revealed several "values" about volunteering at the SRFC which should be endorsed and promoted by schools considering curricular change. Participants valued the SRFC for educational items that were most effectively taught in the SRFC, notably social determinants of health, interprofessional practice, and interviewing with medical interpreters. They also valued the SRFC for professional validation, opportunities to apply course content, practice clinical skills, form important professional relationships, and provide community service. CONCLUSIONS Our findings validate the value of SRFC experience as reported by students and demonstrate that, contrary to misbeliefs, participation was not negatively impacted by curricular reform.
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Affiliation(s)
- Laurel Witt
- Department of Family Medicine and Community Health, University of Kansas School of Medicine- Kansas City (KUSM-KC), Kansas City, KS USA
| | - Kari M. Nilsen
- Department of Family & Community Medicine, University of Kansas School of Medicine-Wichita (KUSM-W), Wichita, KS USA
| | | | | | - Scott Moser
- Department of Family & Community Medicine, University of Kansas School of Medicine-Wichita (KUSM-W), Wichita, KS USA
| | - Anne Walling
- Department of Family & Community Medicine, University of Kansas School of Medicine-Wichita (KUSM-W), Wichita, KS USA
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Nuuyoma V, Makhene A. Community engagement in the Faculty of Health Science: A concept analysis. Health SA 2020; 25:1403. [PMID: 33354358 PMCID: PMC7736662 DOI: 10.4102/hsag.v25i0.1403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 09/02/2020] [Indexed: 12/01/2022] Open
Abstract
Background Community engagement has been given different interpretations by scholars and organisations; in addition, current scientific literature has not reached a consensus on how it is defined. This difference in conceptualisation may lead to confusion regarding the meaning. The researcher observed that academic staff from the Faculty of Health Science at an institution of higher education in Namibia are not certain of what counts as community engagement. This has led to some activities from the faculty being cancelled from the institutional review reports as they were not recognised as community engagement. Aim The aim of this article is to describe the concept analysis of community engagement. Setting the study took place at a faculty of health science at a university in Namibia. Method Concept analysis was done in accordance with the eight steps of the Walker and Avant model. A literature search was conducted to capture all potential definitions and uses of community engagement. A total of 225 definitions and uses of community engagement were recorded and used in the concept analysis. A list of definitions and uses of the concept of community engagement were documented with their citations, in a table with three columns. The first column (analysis) consisted of the identified definitions and uses of community engagement from the relevant literature. The second column (synthesis) consisted of reduced statements of the content presented in the first column. The third column (derivation) consisted of the final reduction into categories and connotations derived from the second column. Findings Three broad categories were revealed as findings: (1) the antecedents of community engagement, which included community challenges, health inequalities, societal needs and the need for a social responsive approach in education, research and services; (2) a three-phase process of community engagement; and (3) the outcomes of community engagement. A theoretical definition and a conceptual map for the concept of community engagement were drawn from the findings. Recommendation The results of the concept analysis of community engagement will be used to develop strategies for its facilitation in the Faculty of Health Science.
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Affiliation(s)
- Vistolina Nuuyoma
- Department of Nursing, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Agnes Makhene
- Department of Nursing, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
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Playford D, Bailey S, Fisher C, Stasinska A, Marshall L, Gawlinski M, Young S. Twelve tips for implementing effective service learning. MEDICAL TEACHER 2019; 41:24-27. [PMID: 29171333 DOI: 10.1080/0142159x.2017.1401217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Service learning is an educational methodology that facilitates transformation of students' knowledge, attitudes and attitudes around holistic care through work with community organizations. To implement academically, defensible service learning requires faculty endorsement, consideration of course credit, an enthusiastic champion able to negotiate agreements with organizations, organizations' identification of their own projects so they are willing to both fund and supervise them, curricular underpinning that imparts the project skills necessary for success, embedding at a time when students' clinical identity is being formed, small packets of curriculum elements delivered "just in time" as students engage with their project, flexible online platform/s, assessment that is organically related to the project, providing cross cultural up-skilling, and focused on the students' responsibility for their own product. The result is a learning experience that is engaging for medical students, links the university to the community, and encourages altruism which is otherwise reported to decline through medical school.
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Affiliation(s)
- Denese Playford
- a The Rural Clinical School of Western Australia , The University of Western Australia , Crawley , Australia
| | - Susan Bailey
- b Social Work, School of Population Health , The University of Western Australia , Crawley , Australia
| | - Colleen Fisher
- c School of Population Health , The University of Western Australia , Crawley , Australia
| | - Ania Stasinska
- c School of Population Health , The University of Western Australia , Crawley , Australia
| | - Lewis Marshall
- d The School of Medicine , The University of Western Australia , Crawley , Australia
| | - Michele Gawlinski
- a The Rural Clinical School of Western Australia , The University of Western Australia , Crawley , Australia
| | - Susan Young
- b Social Work, School of Population Health , The University of Western Australia , Crawley , Australia
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de Villiers M, van Schalkwyk S, Blitz J, Couper I, Moodley K, Talib Z, Young T. Decentralised training for medical students: a scoping review. BMC MEDICAL EDUCATION 2017; 17:196. [PMID: 29121923 PMCID: PMC5680751 DOI: 10.1186/s12909-017-1050-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 11/02/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Increasingly, medical students are trained at sites away from the tertiary academic health centre. A growing body of literature identifies the benefits of decentralised clinical training for students, the health services and the community. A scoping review was done to identify approaches to decentralised training, how these have been implemented and what the outcomes of these approaches have been in an effort to provide a knowledge base towards developing a model for decentralised training for undergraduate medical students in lower and middle-income countries (LMICs). METHODS Using a comprehensive search strategy, the following databases were searched, namely EBSCO Host, ERIC, HRH Global Resources, Index Medicus, MEDLINE and WHO Repository, generating 3383 references. The review team identified 288 key additional records from other sources. Using prespecified eligibility criteria, the publications were screened through several rounds. Variables for the data-charting process were developed, and the data were entered into a custom-made online Smartsheet database. The data were analysed qualitatively and quantitatively. RESULTS One hundred and five articles were included. Terminology most commonly used to describe decentralised training included 'rural', 'community based' and 'longitudinal rural'. The publications largely originated from Australia, the United States of America (USA), Canada and South Africa. Fifty-five percent described decentralised training rotations for periods of more than six months. Thematic analysis of the literature on practice in decentralised medical training identified four themes, each with a number of subthemes. These themes were student learning, the training environment, the role of the community, and leadership and governance. CONCLUSIONS Evident from our findings are the multiplicity and interconnectedness of factors that characterise approaches to decentralised training. The student experience is nested within a particular context that is framed by the leadership and governance that direct it, and the site and the community in which the training is happening. Each decentralised site is seen to have its own dynamic that may foreground certain elements, responding differently to enabling student learning and influencing the student experience. The insights that have been established through this review have relevance in informing the further expansion of decentralised clinical training, including in LMIC contexts.
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Affiliation(s)
- Marietjie de Villiers
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Susan van Schalkwyk
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Julia Blitz
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kalavani Moodley
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Zohray Talib
- Departments of Medicine and Health Policy, George Washington University, Washington DC, USA
| | - Taryn Young
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Miller RK, Michener J, Yang P, Goldstein K, Groce-Martin J, True G, Johnson J. Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants. J Am Geriatr Soc 2017; 65:E130-E134. [PMID: 28734046 DOI: 10.1111/jgs.14968] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults.
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Affiliation(s)
- Rachel K Miller
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of General Internal Medicine, Division of Geriatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer Michener
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Phyllis Yang
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Karen Goldstein
- Division of General of Medicine, School of Medicine, Duke University, Durham, North Carolina.,Health Services Research and Development, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Jennine Groce-Martin
- Department of General Internal Medicine, Division of Geriatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gala True
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana
| | - Jerry Johnson
- Department of General Internal Medicine, Division of Geriatrics, University of Pennsylvania, Philadelphia, Pennsylvania
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Hanson ER, Finley EP, Petershack JA. What Do Pediatric Residents Gain From an Experience in Juvenile Justice? A Qualitative Analysis of Community-Based Learning. Acad Pediatr 2017; 17:296-302. [PMID: 27988206 DOI: 10.1016/j.acap.2016.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Training in advocacy and community pediatrics often involves the use of community site visits. However, data on the specific knowledge, skills, and attitudes gained from these experiences are limited. In this study we used qualitative analysis of written narratives to explore the response of residents to a juvenile justice experience. METHODS Pediatric residents participated in a week-long experience in the juvenile probation department and completed a written narrative. Narratives were analyzed using grounded theory to explore the effects of this experience on residents' views of youth in the juvenile justice system. RESULTS Analysis of 29 narratives revealed 13 themes relating to 5 core concepts: social determinants of behavior, role of professionals and institutions, achieving future potential, resolving discrepancies, and distancing. A conceptual model was developed to explore the interactions of these concepts in the resident view of youth in the juvenile justice system. Of the themes only 3 (23%) were related to content explicitly covered in the assigned reading materials. CONCLUSIONS Several important concepts emerged as elements of this experience, many of which were not covered in the explicit curriculum. Variability in attitudinal response to the experience raised important questions about the influence of the ideological framework of the learner and the hidden curriculum on the learning that occurs in community settings. We propose a theoretical model that delineates the factors that influence learning in community settings to guide educators in planning these types of experiences.
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Affiliation(s)
- Elizabeth R Hanson
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
| | - Erin P Finley
- Departments of Medicine and Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas; South Texas Veterans Health Care System, San Antonio, Texas
| | - Jean A Petershack
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Lee WK, Harris CCD, Mortensen KA, Long LM, Sugimoto-Matsuda J. Enhancing student perspectives of humanism in medicine: reflections from the Kalaupapa service learning project. BMC MEDICAL EDUCATION 2016; 16:137. [PMID: 27159976 PMCID: PMC4862178 DOI: 10.1186/s12909-016-0664-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 05/05/2016] [Indexed: 05/13/2023]
Abstract
BACKGROUND Service learning is endorsed by the Liaison Committee on Medical Education (LCME) as an integral part of U.S. medical school curricula for future physicians. Service learning has been shown to help physicians in training rediscover the altruistic reasons for pursuing medicine and has the potential to enhance students' perspectives of humanism in medicine. The Kalaupapa service learning project is a unique collaboration between disadvantaged post-baccalaureate students with an underserved rural community. This study was conducted to determine whether the Kalaupapa service learning curricula enhanced student perspectives of humanism in medicine at an early stage of their medical training. METHOD Program participants between 2008 and 2014 (n = 41) completed written reflections following the conclusion of the service learning project. Four prompts guided student responses. Reflections were thematically analyzed. Once all essays were read, team members compared their findings to condense or expand themes and assess levels of agreement. RESULTS Emerging themes of resilience and unity were prominent throughout the student reflections. Students expressed respect and empathy for the patients' struggles and strengths, as well as those of their peers. The experience also reinforced students' commitment to service, particularly to populations in rural and underserved communities. Students also gained a deeper understanding of the patient experience and also of themselves as future physicians. CONCLUSION To identify and address underserved and rural patients' health care needs, training programs must prepare an altruistic health care workforce that embraces the humanistic element of medicine. The Kalaupapa service learning project is a potential curricular model that can be used to enhance students' awareness and perspectives of humanism in medicine.
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Affiliation(s)
- Winona K Lee
- The University of Hawai'i at Mānoa - John A. Burns School of Medicine, MEB 306H, 651 Ilalo Street, Honolulu, HI, 96813, USA.
| | - Chessa C D Harris
- Department of Native Hawaiian Health, John A. Burns School of Medicine, 677 Ala Moana Blvd, Suite1016B, Honolulu, HI, 96813, USA
| | - Kawika A Mortensen
- The University of Hawai'i at Mānoa - John A. Burns School of Medicine, MEB 306H, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Linsey M Long
- Department of Psychiatry, Research Division, The University of Hawai'i at Mānoa, Suite 301, 677 Ala Moana Blvd, Honolulu, HI, 96813, USA
| | - Jeanelle Sugimoto-Matsuda
- Department of Psychiatry, Research Division, The University of Hawai'i at Mānoa, Suite 301, 677 Ala Moana Blvd, Honolulu, HI, 96813, USA
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Herlihy NS, Brown C. Innovations in service learning: a novel program for community service at NYU School of Medicine. MEDICAL EDUCATION ONLINE 2015; 20:28379. [PMID: 26387908 PMCID: PMC4576510 DOI: 10.3402/meo.v20.28379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/23/2015] [Accepted: 08/13/2015] [Indexed: 05/23/2023]
Abstract
PROBLEM As NYU medical students, the authors determined that there was no structured form of service learning in their curriculum. They sought to establish a service program that recognizes students for their dedication to community service in both the NYU and NYC communities. APPROACH In 2012, with the support of the Office of Student Affairs (OSA), the authors created the NYU School of Medicine Community Service Program (CSP). The program tracks and verifies students' participation in service projects. It sets a goal for students to complete 100 service hours through at least five unique service initiatives. Two reflective essays at the completion of pre-clinical and core clerkship curricula challenge students to express how their service experiences will inform their future careers in medicine. The authors developed an innovative online portal for students to track their service involvement and allow the committee to easily approve hours. They created the Community Service Committee, made up of two representatives from each class year, to be in charge of regulating the program together with the OSA. OUTCOMES The class of 2015 is the first class to participate; thus far, 13 students have met program requirements. In the classes of 2016 and 2017, 20 and 41 students, respectively, are expected to receive the award. Total participation has significantly increased in successive class years. NEXT STEPS The authors seek to gather data on CSP participants' changing perspectives and hope the program can serve as a model for other schools to build service learning into their curricula.
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Affiliation(s)
- Nola Seta Herlihy
- Office of Student Affairs, NYU School of Medicine, New York, NY, USA;
| | - Christina Brown
- Office of Student Affairs, NYU School of Medicine, New York, NY, USA
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Nie JB, Smith KL, Cong Y, Hu L, Tucker JD. Medical Professionalism in China and the United States: A Transcultural Interpretation. THE JOURNAL OF CLINICAL ETHICS 2015. [DOI: 10.1086/jce2015261048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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