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Nicholson J, Ark TK, Wargo E, Zabar S, Kalet A. Observing and Assessing Competence in Evidence-Based Medicine in Graduating Medical Students: A 5-Year Multi-Institution Report. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S186. [PMID: 37983430 DOI: 10.1097/acm.0000000000005396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Joey Nicholson
- Author affiliations: J. Nicholson, NYU Langone Health, NYU Grossman School of Medicine, NYU Health Sciences Library; T.K. Ark, A. Kalet, Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin; E. Wargo, S. Zabar, NYU Langone Health, NYU Grossman School of Medicine
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Barr A. Initial efforts to improve medical student information-seeking behavior with embedded library instruction. J Med Libr Assoc 2023; 111:823-828. [PMID: 37928120 PMCID: PMC10621726 DOI: 10.5195/jmla.2023.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Background Medical students must develop self-directed information-seeking skills while they are learning vast amounts of foundational and clinical skills. Students will use different resources for different phases of their training. Information literacy training provided to students will be more impactful when it is embedded into courses or assignments that mimic real-world scenarios. The retention of these skills is also improved by early and frequent instruction sessions, paired with formative feedback from librarian-educators. Case Presentation Librarians received student responses to an information literacy question during two cycles of a Grand Rounds activity. Data were analyzed as follows: sources were grouped according to resource type and assessed for quality, and search terms were aggregated and analyzed to determine frequency of use. A librarian-educator presented the compiled data, making suggestions for improving searching and clarifying expectations for how to improve their resource choices for a second Grand Rounds session. Comparing the M2 Grand Rounds case to the M1 case of the same cohort, the frequency of evidence summary and diagnostic tool use increased and the frequency of search engine, textbook/lecture material, and journal article/database use decreased. Discussion In the real-world application of back-to-back Georgetown University's Medical Center Grand Rounds exercises, librarian-led instruction on clinical-specific resources appears to be correlated with an improvement in medical students' searching behavior. This trend supports the argument that introducing students early to librarian-led education on clinical-specific resources, and providing feedback on their searches, improves students' information-seeking behavior.
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Affiliation(s)
- Angela Barr
- , Reference and Digital Information Services Coordinator, Dahlgren Memorial Library Georgetown University School of Medicine, Washington, DC
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Eliasz KL, Nick MW, Zabar S, Buckvar-Keltz L, Ng GM, Riles TS, Kalet AL. Viewing Readiness-for-Residency through Binoculars: Mapping Competency-Based Assessments to the AAMC's 13 Core Entrustable Professional Activities (EPAs). TEACHING AND LEARNING IN MEDICINE 2023; 35:436-441. [PMID: 35668557 DOI: 10.1080/10401334.2022.2082432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
Construct: The construct being assessed is readiness-for-residency of graduating medical students, as measured through two assessment frameworks. Background: Readiness-for-residency of near-graduate medical students should be but is not consistently assessed. To address this, the Association of American Medical Colleges (AAMC), in 2014, identified and described 13 core Entrustable Professional Activities (EPAs), which are tasks that all residents should be able to perform unsupervised upon entering residency. However, the AAMC did not initially provide measurement guidelines or propose standardized assessments. We designed Night-onCall (NOC), an immersive simulation for our near-graduating medical students to assess and address their readiness-for-residency, framed around tasks suggested by the AAMC's core EPAs. In adopting this EPA assessment framework, we began by building upon an established program of competency-based clinical skills assessments, repurposing competency-based checklists to measure components of the EPAs where possible, and designing new checklists, when necessary. This resulted in a blended suite of 14 checklists, which theoretically provide substantive assessment of all 13 core EPAs. In this paper, we describe the consensus-based mapping process conducted to ensure we understood the relationship between competency and EPA-based assessment lenses and could therefore report meaningful feedback on both to transitioning students in the NOC exercise. Approach: Between January-November 2017, five clinician and two non-clinician health professions educators at NYU Grossman School of Medicine conducted a rigorous consensus-based mapping process, which included each rater mapping each of the 310 NOC competency-based checklist items to lists of entrustable behaviors expected of learners according to the AAMC 13 core EPAs. Findings: All EPAs were captured to varying degrees by the 14 NOC checklists (overall Intraclass Correlation Coefficient (ICC) = 0.77). Consensus meetings resolved discrepancies and improved ICC values for three (EPA-9, EPA-10, EPA-12) of the four EPAs that initially showed poor reliability. Conclusions: Findings suggest that with some limitations (e.g., EPA-7 "form clinical questions/retrieve evidence") established competency-based assessments can be repurposed to measure readiness-for-residency through an EPA lens and both can be reported to learners and faculty.
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Affiliation(s)
- Kinga L Eliasz
- Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Michael W Nick
- Program on Medical Education and Technology, New York University Grossman School of Medicine, New York, New York, USA
| | - Sondra Zabar
- Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Lynn Buckvar-Keltz
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Grace M Ng
- New York Simulation Center for the Health Sciences, A Partnership of the City University of New York and New York University Grossman School of Medicine, New York, New York, USA
| | - Thomas S Riles
- Departments of Surgery and Medical Education and Technology, New York University Grossman School of Medicine, New York, New York, USA
| | - Adina L Kalet
- Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education at Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
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Tsang R. Practical Applications of ChatGPT in Undergraduate Medical Education. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231178449. [PMID: 37255525 PMCID: PMC10226299 DOI: 10.1177/23821205231178449] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/10/2023] [Indexed: 06/01/2023]
Abstract
ChatGPT is a chatbot developed by OpenAI that has garnered significant attention for achieving at or near a passing standard on the United States Medical Licensing Exam (USMLE). Currently, researchers and users are exploring ChatGPT's broad range of potential applications in academia, business, programming, and beyond. We attempt outline how ChatGPT may be applied to support undergraduate medical education during the preclinical and clinical years, and highlight possible concerns regarding its use which necessitates the creation of formal policies and training by medical schools.
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Affiliation(s)
- Ricky Tsang
- Department of Medicine, Faculty of Medicine, University of British
Columbia, Vancouver, BC, Canada
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Petersen D, Earl M, Wilson AQ. Looking at Library Resource Usage Trends in Medical Residents & Fellows: Survey Results from 2006-2021. Med Ref Serv Q 2022; 41:280-295. [PMID: 35980625 DOI: 10.1080/02763869.2022.2095817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Since 2006, the University of Tennessee's Preston Medical Library has collected survey feedback from exiting residents through targeted emails or at the required exit process in the library. Questions ask residents which types of articles or sources they use to find information and address the resident's use of the library's physical space. Survey results from 2006 to 2021 were examined for trends and changes in resident utilization of resources to better inform future library decisions on instruction and marketing. Resident resource usage varied over time and demonstrated an encouraging increase in attention to evidence-based tools. UpToDate's consistent popularity shows the durability of the product. A reported increase in use of reviews, randomized controlled trials, case reports, and practice guidelines reflects greater employment of more in-depth resources than merely expert opinion. At the same time, residents clearly valued the library's physical space. Survey results will inform future outreach focus.
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Affiliation(s)
- David Petersen
- Preston Medical Library, University of Tennessee Graduate School of Medicine, Knoxville, USA
| | - Martha Earl
- Preston Medical Library, University of Tennessee Graduate School of Medicine, Knoxville, USA
| | - Alexandria Q Wilson
- Preston Medical Library, University of Tennessee Graduate School of Medicine, Knoxville, USA
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Mass-Hernández LM, Acevedo-Aguilar LM, Lozada-Martínez ID, Osorio-Agudelo LS, Maya-Betancourth JGEM, Paz-Echeverry OA, Paz-Echeverry MJ, Castillo-Pastuzan HS, Rojas-Pimentel JC, Rahman S. Undergraduate research in medicine: A summary of the evidence on problems, solutions and outcomes. Ann Med Surg (Lond) 2022; 74:103280. [PMID: 35127067 PMCID: PMC8807964 DOI: 10.1016/j.amsu.2022.103280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/22/2022] [Indexed: 12/04/2022] Open
Abstract
Scientific research plays a fundamental role in current medical practice and it is of great importance that medical students relate to it from the beginning of their professional career, since it generates multiple benefits that will be reflected during the course of their careers as university students and future professionals. However, getting involved in research during the undergraduate years is not always easy, as there are different obstacles and challenges that result in a reduced number of research students. Because of this, it is necessary to adopt appropriate strategies and measures to help facilitate this process, in order to foster the early development of essential skills that will facilitate responsible clinical practice. Knowing the evidence on this issue is fundamental to propose educational solutions depending on each context. Undergraduate research is the best way to promote the curriculum. Undergraduate research increases the likelihood of publishing articles of higher quality. Undergraduate research increases the likelihood of publishing more articles.
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Affiliation(s)
- Laura Marcela Mass-Hernández
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Cartagena, Colombia
| | | | - Ivan David Lozada-Martínez
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Cartagena, Colombia
- Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clinicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia
| | | | | | | | | | | | | | - Sabrina Rahman
- Independent University, Dhaka, Bangladesh
- Corresponding author.
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Lozada-Martínez ID, Acevedo-Aguilar LM, Mass-Hernández LM, Matta-Rodríguez D, Jiménez-Filigrana JA, Garzón-Gutiérrez KE, Barahona-Botache SA, Vásquez-Castañeda DL, Caicedo-Giraldo SDR, Rahman S. Practical guide for the use of medical evidence in scientific publication: Recommendations for the medical student: Narrative review. Ann Med Surg (Lond) 2021; 71:102932. [PMID: 34659747 PMCID: PMC8503847 DOI: 10.1016/j.amsu.2021.102932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022] Open
Abstract
Currently, the adaptation of scientific evidence in clinical problem solving is based on the evidence-based medicine method. Medical students and health professionals should have an adequate knowledge of this method and thus provide adequate health care and increasingly provide high quality scientific publications that can be subsequently integrated in different clinical scenarios. Several scales and tools have been proposed as guides to recognize the different levels of quality of the available evidence, their degrees of recommendation and the biases and fallacies that may occur both in the clinical and research areas, with the aim of identifying the best available evidence. However, few students and professionals are aware of them and make proper use of them. Therefore, it is necessary to synthesize these tools in an understandable and practical way.
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Affiliation(s)
| | | | | | - Duván Matta-Rodríguez
- School of Medicine, Universidad de Ciencias Aplicadas y Ambientales, Bogotá, Colombia
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Resende KA, Cavaco AM, Luna-Leite MD, Acacio BR, Pinto NN, Neta MD, Melo AC. Training and standardization of simulated patients for multicentre studies in clinical pharmacy education. Pharm Pract (Granada) 2020; 18:2038. [PMID: 33224323 PMCID: PMC7672484 DOI: 10.18549/pharmpract.2020.4.2038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/25/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the training and standardization methods of multiple simulated
patients (SPs) performing a single scenario in a multicenter study. Methods: A prospective quasi-experimental study, using a multicenter approach,
evaluated the performance of five different individuals with the same
biotype during a simulation session in a high-fidelity environment. The SPs
training and standardization process consisted of four steps and six web or
face-to-face mediated: Step 1: simulation scenario design and pilot test.
Step 2: SPs selection, recruitment and beginning training (Session 1:
performance instructions and memorization request.) Session 2: check the
SPs’ performances and adjustments). Step 3 and session 3: training
role-play and performance’s evaluation. Step 4: SPs’
standardization and performances’ evaluation (Sessions 4 and 5: first
and second rounds of SPs’ standardization assessment. Session 6:
Global training and standardization evaluation. SPs performance consistency
was estimated using Cronbach’s alpha and ICC. Results: In the evaluation of training results, the Maastricht Simulated Patient
Assessment dimensions of SPs performances “It seems
authentic”, “Can be a real patient” and
“Answered questions naturally”, presented “moderate or
complete agreement” of all evaluators. The dimensions “Seems
to retain information unnecessarily”, “Remains in his/her role
all the time”, “Challenges/tests the student”, and
“Simulates physical complaints in an unrealistic way”
presented “moderate or complete disagreement” in all
evaluations. The SPs “Appearance fits the role” showed
“moderate or complete agreement” in most evaluations. In the
second round of evaluations, the SPs had better performance than the first
ones. This could indicate the training process’s had good influence
on SPs performances. The Cronbach’s alpha in the second assessment
was better than the first (varied from 0.699 to 0.978). The same improvement
occurred in the second round of intraclass correlation coefficient that was
between 0.424 and 0.978. The SPs were satisfied with the training method and
standardization process. They could perceive improvement on their role-play
authenticity. Conclusions: The SPs training and standardization process revealed good SPs reliability
and simulation reproducibility, demonstrating to be a feasible method for
SPs standardization in multicenter studies. The Maastricht Simulated Patient
Assessment was regarded as missing the assessment of the information
consistency between the simulation script and the SPs provision.
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Affiliation(s)
- Karina A Resende
- MSc. Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
| | - Afonso M Cavaco
- PhD. Associate Professor in Social Pharmacy. Faculty of Pharmacy, University of Lisbon. Lisbon (Portugal).
| | - Márcia D Luna-Leite
- PhD. Foundation for Scientific and Technological Development in Health (FIOTEC). Rio de Janeiro, RJ (Brasil).
| | - Bianca R Acacio
- MSc. Federal University of Mato Grosso do Sul. Pioneiros, MS (Brasil).
| | - Núbia N Pinto
- Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
| | - Maria D Neta
- MSc. Federal University of Piauí. Teresina, PI (Brasil)
| | - Angelita C Melo
- PhD. Associate Professor in Clinical Pharmacy. Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
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