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Hoffman M, Dedow L, Boscamp J. Competency-based and less time-bound: a new approach to the macro-structure of a medical school curriculum. Med Educ Online 2024; 29:2343205. [PMID: 38626425 PMCID: PMC11022905 DOI: 10.1080/10872981.2024.2343205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 04/11/2024] [Indexed: 04/18/2024]
Abstract
Shifting to a competency-based (CBME) and not time-bound curricular structure is challenging in the undergraduate medical education (UME) setting for a number of reasons. There are few examples of broad scale CBME-driven interventions that make the UME program less time-bound. However, given the range of student ability and varying speed of acquisition of competencies, this is an area in need of focus. This paper describes a model that uses the macro structure of a UME program to make UME curricula less time-bound, and driven more by student competency acquisition and individual student goals. The 3 + 1 curricular model was derived from the mission of the school, and includes a 3-year core curriculum that all students complete and an individualized phase. Students have an 18 month individualized educational program that meets their developmental needs and their educational and professional goals. This is achieved through a highly structured advising system, including the creation of an Individualized Learning Plan, driven by specific goals and targeted Entrustable Professional Activities (EPA). Students who struggle in achieving core competencies can use individualized time to support competency development and EPA acquisition. For students who have mastered core competencies, options include obtaining a masters degree, clinical immersion, research, and community-based experiences. Students can also graduate after the 3-year core curriculum, and enter residency one year early. Structural approaches such as this may contribute to the norming of the developmental nature of medical education, and can advance culture and systems that support CBME implementation at the UME level.
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Affiliation(s)
- Miriam Hoffman
- Department of Family Medicine, Hackensack Meridian School of Medicine, Nutley, NJ, USA
- Office of Medical Education, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Lindsey Dedow
- Office of Student Affairs and Wellbeing, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Jeffrey Boscamp
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, USA
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Rahman F, Bhat V, Ozair A, Detchou DKE, Ahluwalia MS. Financial barriers and inequity in medical education in India: challenges to training a diverse and representative healthcare workforce. Med Educ Online 2024; 29:2302232. [PMID: 38194431 PMCID: PMC10778416 DOI: 10.1080/10872981.2024.2302232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.
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Affiliation(s)
- Faique Rahman
- Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (AMU), Aligarh, UP, India
| | - Vivek Bhat
- St. John’s Medical College, Bangalore, KA, India
| | - Ahmad Ozair
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Faculty of Medicine, King George’s Medical University, Lucknow, UP, India
| | - Donald K. E. Detchou
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Manmeet S. Ahluwalia
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
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Park SH, Pinto-Powell R, Thesen T, Lindqwister A, Levy J, Chacko R, Gonzalez D, Bridges C, Schwendt A, Byrum T, Fong J, Shasavari S, Hassanpour S. Preparing healthcare leaders of the digital age with an integrative artificial intelligence curriculum: a pilot study. Med Educ Online 2024; 29:2315684. [PMID: 38351737 PMCID: PMC10868429 DOI: 10.1080/10872981.2024.2315684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
Artificial intelligence (AI) is rapidly being introduced into the clinical workflow of many specialties. Despite the need to train physicians who understand the utility and implications of AI and mitigate a growing skills gap, no established consensus exists on how to best introduce AI concepts to medical students during preclinical training. This study examined the effectiveness of a pilot Digital Health Scholars (DHS) non-credit enrichment elective that paralleled the Dartmouth Geisel School of Medicine's first-year preclinical curriculum with a focus on introducing AI algorithms and their applications in the concurrently occurring systems-blocks. From September 2022 to March 2023, ten self-selected first-year students enrolled in the elective curriculum run in parallel with four existing curricular blocks (Immunology, Hematology, Cardiology, and Pulmonology). Each DHS block consisted of a journal club, a live-coding demonstration, and an integration session led by a researcher in that field. Students' confidence in explaining the content objectives (high-level knowledge, implications, and limitations of AI) was measured before and after each block and compared using Mann-Whitney U tests. Students reported significant increases in confidence in describing the content objectives after all four blocks (Immunology: U = 4.5, p = 0.030; Hematology: U = 1.0, p = 0.009; Cardiology: U = 4.0, p = 0.019; Pulmonology: U = 4.0, p = 0.030) as well as an average overall satisfaction level of 4.29/5 in rating the curriculum content. Our study demonstrates that a digital health enrichment elective that runs in parallel to an institution's preclinical curriculum and embeds AI concepts into relevant clinical topics can enhance students' confidence in describing the content objectives that pertain to high-level algorithmic understanding, implications, and limitations of the studied models. Building on this elective curricular design, further studies with a larger enrollment can help determine the most effective approach in preparing future physicians for the AI-enhanced clinical workflow.
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Affiliation(s)
- Soo Hwan Park
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Thomas Thesen
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Joshua Levy
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Rachael Chacko
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Connor Bridges
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Adam Schwendt
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Travis Byrum
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Justin Fong
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Smeltz L, Carpenter S, Benedetto L, Newcomb N, Rubenstein D, King T, Lunsford C, Shaw T, DeWaters AL. Introduction to Disability and Antiableist Health Care: A Pilot, Student-Led Module for Preclinical Medical Students. Am J Phys Med Rehabil 2024; 103:e54-e57. [PMID: 38261784 PMCID: PMC11031297 DOI: 10.1097/phm.0000000000002399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
ABSTRACT Physical medicine and rehabilitation physicians often care for disabled patients, who comprise America's largest marginalized population. Despite medical students' and physicians' discomfort with caring for disabled patients and the pervasiveness of ableism in health care, medical education lacks disability-focused education. Kern's approach to curriculum development and disability community input were used to design a three-part, elective curriculum for first-year medical students. Part one introduced disability models and language. Part two described how to perform a comprehensive history and physical examination for a disabled patient using ADEPT-CARE. Part three provided an overview of disability history and the disability rights movement. The curriculum's goal was to improve students' attitudes regarding disability health and self-perceived knowledge and confidence in caring for patients with disabilities. The curriculum was evaluated through presurvey and postsurvey. Students favorably reviewed the curriculum. One hundred percent of students ( n = 21) agreed or strongly agreed that the curriculum improved their knowledge of disability health, increased their perceived confidence in caring for patients with disabilities, and enhanced their medical education. There were no statistically significant differences in students' attitudes toward patients with disabilities after curriculum completion. Our asynchronous module provides one potential curriculum for increasing preclinical medical students' self-perceived knowledge of disability health.
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Affiliation(s)
- Lydia Smeltz
- Medical Student, Penn State College of Medicine, Hershey, PA
| | | | | | - Nora Newcomb
- Medical Student, University of South Florida Morsani College of Medicine
| | | | - Tonya King
- Adjunct Professor of Biostatistics within the Division of Biostatistics & Bioinformatics, Department of Public Health Sciences at Penn State College of Medicine, Hershey, PA
| | - Christopher Lunsford
- Assistant Professor of Orthopaedics and Pediatrics, Duke University School of Medicine
| | - Tanya Shaw
- Curriculum Manager, Penn State College of Medicine
| | - Ami L. DeWaters
- Associate Professor of Medicine, Interim Director of Health Systems Science at Penn State College of Medicine, Hershey, PA
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Whitfield S, Hazard C, Haynes B, Coffey T, Lynch L, Davis S. On-site peer mentorship's effect on personal and professional development, stress reduction, and ease of transition into the medical education system. J Osteopath Med 2024; 0:jom-2023-0086. [PMID: 38632894 DOI: 10.1515/jom-2023-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 02/27/2024] [Indexed: 04/19/2024]
Abstract
CONTEXT Mentorship aids in the transition into the medical education system, which is a demanding and stressful time for learners. The development of new medical schools to offset the physician shortage has posed a challenge in that the inaugural class of students lacks an upperclassman cohort as a resource for advice and mentorship. Mentorship has proven to have positive impacts on three domains: personal and professional development (PPD), stress reduction (SR), and ease of transition (ET) into medical school. OBJECTIVES The purpose of this study was to identify sources of mentorship within the medical education system and compare the subjective growth of the inaugural and second classes of a newly established medical school in the three domains. METHODS The inaugural and second classes at a newly established medical school completed an Institutional Review Board (IRB)-approved anonymous survey with questions pertaining to unidentifiable demographics, sources of mentorship, and a five-point Likert scale assessing characteristics related to the three domains. RESULTS Twenty-three students responded to the survey. The second class (n=9) rated their growth higher in all three domains compared to the inaugural class (n=14). The inaugural class utilized the faculty mentor the most (11/14, 78.6 %). The second class utilized the on-site peer mentor the most (9/9, 100 %). Qualitative data analysis led to the emergence of three themes: (1) students utilizing their faculty mentor had the greatest growth in PPD and ET; (2) students utilizing on-site peer mentorship reporting the greatest growth in SR; and (3) informal peer mentorship utilization correlating with less growth in the three domains. CONCLUSIONS Our study demonstrates the profound impact that mentorship has on growth in the three domains regardless of the type of mentorship utilized. The benefits, specifically with regard to SR, of an on-site peer mentorship program may not have been satisfied by other sources of mentorship.
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Affiliation(s)
| | - Caryn Hazard
- 518097 Idaho College of Osteopathic Medicine , Meridian, ID, USA
| | - Brittnee Haynes
- 518097 Idaho College of Osteopathic Medicine , Meridian, ID, USA
| | - Todd Coffey
- Department of Research and Biostatistics, 518097 Idaho College of Osteopathic Medicine , Meridian, ID, USA
| | - Launa Lynch
- Department of Biomedical Sciences and Pharmacology Department, 518097 Idaho College of Osteopathic Medicine , Meridian, ID, USA
| | - Sarah Davis
- Department of Osteopathic Principles & Practice, 518097 Idaho College of Osteopathic Medicine , Meridian, ID, USA
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Nikolla DA, Bowers KM, Smith B, Elsayed CL, Daniels A, Sandoval T, Hitchman KJ, Asar I, Kolacz DC, Mudrakola V. DO seniors and IMGs have lower match probabilities than MD seniors after adjusting for specialty choice and USMLE Step 1 score. J Osteopath Med 2024; 0:jom-2023-0143. [PMID: 38607677 DOI: 10.1515/jom-2023-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 03/07/2024] [Indexed: 04/14/2024]
Abstract
CONTEXT It is unknown if US residency applicants of different educational backgrounds (US allopathic [MD], Doctor of Osteopathic Medicine [DO], and international medical graduates [IMG]) but comparable academic performance have similar match success. OBJECTIVES Our objective was to compare match probabilities between applicant types after adjusting for specialty choice and United States Medical Licensing Examination (USMLE) Step 1 scores. METHODS We performed a secondary analysis of published data in National Resident Matching Program (NRMP) reports from 2016, 2018, 2020, and 2022 for US MD seniors, DO seniors, and IMGs (US citizens and non-US citizens). We examined the 10 specialties with the most available spots in 2022. Average marginal effects from a multiple variable logistic regression model were utilized to estimate each non-MD senior applicant type's probability of matching into their preferred specialty compared to MD seniors adjusting for specialty choice, Step 1 score, and match year. RESULTS Each non-MD applicant type had a lower adjusted percent difference in matching to their preferred specialty than MD seniors, -7.1 % (95 % confidence interval [CI], -11.3 to -2.9) for DO seniors, -45.6 % (-50.6 to -40.5) for US IMGs, and -56.6 % (-61.5 to -51.6) for non-US IMGs. Similarly, each non-MD applicant type had a lower adjusted percent difference in matching than MD seniors across almost all Step 1 score ranges, except for DO seniors with Step 1 scores <200 (-2.0 % [-9.5 to 5.5]). CONCLUSIONS After adjusting for specialty choice, Step 1 score, and match year, non-US MD applicants had lower probabilities of matching into their preferred specialties than their US MD colleagues.
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Affiliation(s)
- Dhimitri A Nikolla
- Research Director and Core Faculty, Department of Emergency Medicine, Allegheny Health Network, Erie, PA, USA
| | - Kaitlin M Bowers
- Adjunct Faculty, Department of Emergency Medicine, Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Brittany Smith
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Christina L Elsayed
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Abigail Daniels
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Thomas Sandoval
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Kyle J Hitchman
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, NC, USA
| | - Irtaza Asar
- Core Faculty, Department of Emergency Medicine, Allegheny Health Network, Erie, PA, USA
| | - Dillon C Kolacz
- Resident, Department of Emergency Medicine, Allegheny Health Network, Erie, PA, USA
| | - Vishnu Mudrakola
- Research Director and Core Faculty, Department of Emergency Medicine, Summa Health, Akron, OH, USA
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Grierson L, Lee M, Mahmud M, Profetto J, Sibbald M, Whyte R, Vanstone M. A survey of medical school aspirant perceptions of an unexpected lottery-facilitated admissions adaptation. J Eval Clin Pract 2024. [PMID: 38622886 DOI: 10.1111/jep.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/19/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Due to the COVID-19 pandemic, the Undergraduate Medical Doctor (MD) Programme at McMaster University (Hamilton, Canada) was unable to run in-person medical school interviews in March 2020, prompting an alternate solution that maximised admission opportunities for Indigenous applicants, prioritised admission for those rated most highly in the interview determination process, and allocated subsequent offers via lottery. METHODS A short survey was administered to applicants who had been offered an admissions interview and were subsequently impacted by the admissions adaptations. The survey elicited perceptions of the adaptation through Likert scale ratings and free-text responses. Survey data were analysed via a sequential (quantitative to qualitative) mixed-methods design. RESULTS 196 of 552 potential participants completed the survey. Across quantitative and qualitative analyses, respondents reported that the adaptation had a negative impact on their professional development and personal life. Ratings of negative perception were greater for those who did not receive an offer than for those who accepted or declined an offer. Free text responses emphasised considerable criticism for the lottery portion of the adaptation and displeasure that efforts made in constructing applications were less relevant than anticipated. DISCUSSION The negative responses to this unexpected change highlight the profound upstream impact admission policies have on the preapplication behaviours of aspiring medical students. The outcomes support a refined understanding of the value candidates place on the interview in appraising their own suitability for a career as a physician.
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Affiliation(s)
- Lawrence Grierson
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mark Lee
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meera Mahmud
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jason Profetto
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Undergraduate MD Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Matthew Sibbald
- McMaster Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Undergraduate MD Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Robert Whyte
- Undergraduate MD Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meredith Vanstone
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Knutsen JS, Bondevik GT, Hunskaar S. To be or not to be supervisors for medical students in general practice clinical placements: a questionnaire study from Norway. Scand J Prim Health Care 2024:1-8. [PMID: 38602196 DOI: 10.1080/02813432.2024.2337063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Many countries experience challenges in recruiting and retaining general practitioners (GPs) as supervisors for medical students in clinical placements. We aimed to investigate the opportunities, capacities and limitations of Norwegian GPs to become supervisors. DESIGN Web-based cross-sectional questionnaire study. SETTING Norwegian general practice. SUBJECTS All GPs in Norway, including locums and those on leave, both active supervisors, and GPs who are not presently supervising medical students. MAIN OUTCOME MEASURES GPs' terms of salary, office facilities, limiting factors, capacity and needs for becoming or continuing as supervisors. RESULTS Among 5145 GPs, 1466 responded (29%), of whom 498 (34%) were active supervisors. Lack of a dedicated student office was the most reported limitation for both active supervisors (75%) and other GPs (81%). A high proportion (67%) of active supervisors reported that they could host more students per year, given financial support for equipped offices and higher salaries. With this kind of support, 48% (n = 461) of the GPs who were not supervisors for medical students were positive about a future supervisor role. By adjusted regression analysis, female GPs had lower likelihood of being supervisors, OR (95% CI) 0.75 (0.59-0.95) than male colleagues. GPs in the North, Mid and West regions had higher odds (OR 3.89, 3.10 and 2.42, respectively) than those in the South-East region. Teaching experience also increased the odds (2.31 (1.74-3.05). CONCLUSIONS There seems to be capacity among both active and potential supervisors if increased salaries and financial support for office facilities are made available.
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Affiliation(s)
- Julie Solberg Knutsen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gunnar Tschudi Bondevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Steinar Hunskaar
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
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Ebeling US, de Leeuw RA, Georgiadis JR, Scheele F, Wietasch JKG. Early Bird or Night Owl: Insights into Dutch Students' Study Patterns using the Medical Faculty's E-learning Registrations. Teach Learn Med 2024:1-13. [PMID: 38587887 DOI: 10.1080/10401334.2024.2331649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 02/28/2024] [Indexed: 04/09/2024]
Abstract
Phenomenon: Educational activities for students are typically arranged without consideration of their preferences or peak performance hours. Students might prefer to study at different times based on their chronotype, aiming to optimize their performance. While face-to-face activities during the academic schedule do not offer flexibility and cannot reflect students' natural learning rhythm, asynchronous e-learning facilitates studying at one's preferred time. Given their ubiquitous accessibility, students can use e-learning resources according to their individual needs and preferences. E-learning usage data hence serves as a valuable proxy for certain study behaviors, presenting research opportunities to explore students' study patterns. This retrospective study aims to investigate when and for how long undergraduate students used medical e-learning modules. Approach: We performed a cross-sectional analysis of e-learning usage at one medical faculty in the Netherlands. We used data from 562 undergraduate multimedia e-learning modules for pre-clinical students, covering various medical topics over a span of two academic years (2018/19 and 2019/20). We employed educational data mining approaches to process the data and subsequently identified patterns in access times and durations. Findings: We obtained data from 70,805 e-learning sessions with 116,569 module visits and 1,495,342 page views. On average, students used e-learning for 16.8 min daily and stopped using a module after 10.2 min, but access patterns varied widely. E-learning was used seven days a week with an hourly access pattern during business hours on weekdays. Across all other times, there was a smooth increase or decrease in e-learning usage. During the week, more students started e-learning sessions in the morning (34.5% vs. 19.1%) while fewer students started in the afternoon (42.6% vs. 50.8%) and the evening (19.4% vs. 27.0%). We identified 'early bird' and 'night owl' user groups that show distinct study patterns. Insights: This retrospective educational data mining study reveals new insights into the study patterns of a complete student cohort during and outside lecture hours. These findings underline the value of 24/7 accessible study material. In addition, our findings may serve as a guide for researchers and educationalists seeking to develop more individualized educational programs.
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Affiliation(s)
- U S Ebeling
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R A de Leeuw
- Amsterdam University Medical Center, Department of Obstetrics and Gynecology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - J R Georgiadis
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - F Scheele
- Faculty of Science, Athena Institute for Trans-Disciplinary Research, Vrije Universiteit, Amsterdam, The Netherlands
| | - J K G Wietasch
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Trout J, Powers B. Community food insecurity experts may improve medical student attitudes and self-efficacy in caring for older adults. J Am Geriatr Soc 2024. [PMID: 38572852 DOI: 10.1111/jgs.18918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/23/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Jonathan Trout
- Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Becky Powers
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, UT Health San Antonio, San Antonio, Texas, USA
- Geriatrics Research Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, Texas, USA
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11
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Kraus AC, Dalrymple JL, Schwartz E, Marzan G, Nelson S, Morgan HK, Hammoud MM, Young OM. Mixed Signals: Navigating the Obstetrics and Gynecology Signaling Initiative. J Surg Educ 2024; 81:525-534. [PMID: 38413356 DOI: 10.1016/j.jsurg.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/14/2023] [Accepted: 12/30/2023] [Indexed: 02/29/2024]
Abstract
OBJECTIVE There are few published accounts of the obstetrics and gynecology (OBGYN) specialty-specific experience with a formal signaling program. Prior studies examining other medical specialties' experiences with signaling are quantitative, having not examined the complexity of the residency applicant experience by directly engaging applicants; therefore, this study aimed to describe the lived experiences of OBGYN residency applicants who employed a formal signaling program during the 2022-2023 residency application cycle to assist and guide future residency applicants. DESIGN A phenomenological approach was chosen to prescribe a common meaning for OBGYN residency applicants' experiences. purposeful sampling was employed to ensure racial, ethnic, and institutional geographic diversity in participant representation. Semi-structured interviews were conducted virtually between April and May 2023. RESULTS Twenty-five OBGYN residency applicants participated. Fourteen identified as underrepresented in medicine. Four themes emerged: non-uniform decision-making processes, inconsistent guidance, mental health effect, and signaling reflections. Some themes had associated subthemes. Critical aspects of the applicants' journey were revealed, including decision-making dynamics and reliance on trusted advisors. Applicants described tensions and complexities when navigating signaling strategy in relation to abortion education opportunities in a post-Dobbs era. They also conveyed concerns about inconsistencies in signaling guidance, the emotional toll on well-being, and persistent inequities in the application process. They ultimately made recommendations for future directions, including suggestions for more robust advising and improved signaling execution. CONCLUSIONS This study offers a comprehensive exploration of the experiences of OBGYN residency applicants with formal program signaling. To ensure equity and transparency in the residency application process, it is crucial to not only provide OBGYN residency applicants with clear guidance on signaling, but also encourage a standardized approach for its utilization by residency programs.
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Affiliation(s)
- Alexandria C Kraus
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina; Harvard Medical School, Boston, Massachusetts.
| | - John L Dalrymple
- Harvard Medical School, Boston, Massachusetts; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Gimena Marzan
- Harvard Medical School, Boston, Massachusetts; St. Matthews University, West Bay, Cayman Islands
| | | | - Helen K Morgan
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Maya M Hammoud
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Omar M Young
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina
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Clare CA, Woodland MB, Buery-Joyner S, Whetstone S, Ogunyemi D, Sims SM, Moxley M, Baecher-Lind LE, Hampton BS, Pradhan A, Katz NT. Educational guidelines on sexual orientation, gender identity and expression, and sex characteristics biases in medical education. Am J Obstet Gynecol 2024:S0002-9378(24)00422-8. [PMID: 38432411 DOI: 10.1016/j.ajog.2024.02.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
A commitment to diversity, equity, inclusion, and belonging in medical education requires addressing both explicit and implicit biases based on sexual orientation, gender identity and expression, and sex characteristics and the intersectionality with other identities. Heterosexism and heteronormative attitudes contribute to health and healthcare disparities for lesbian, gay, bisexual, transgender and queer or questioning, intersex, asexual individuals. Student, trainee, and faculty competencies in medical education curricula regarding the care of lesbian, gay, bisexual, transgender and queer or questioning, intersex, asexual patients and those who are gender nonconforming or born with differences of sex development allow for better understanding and belonging within the clinical learning environment of lesbian, gay, bisexual, transgender and queer/questioning, intersex, asexual learners and educators. The Association of Professors of Gynecology and Obstetrics issued a call to action to achieve a future free from racism and bias through inclusivity in obstetrics and gynecology education and healthcare, which led to the creation of the Association of Professors of Gynecology and Obstetrics Diversity, Equity, and Inclusion Guidelines Task Force. The task force initially addressed racism, racial- and ethnicity-based bias, and discrimination in medical education and additionally identified other groups that are subject to bias and discrimination, including sexual orientation, gender identity and expression, and sex characteristic identities, persons with disabilities, and individuals with various religious and spiritual practices. In this scholarly perspective, the authors expand on previously developed guidelines to address sexual orientation, gender identity and expression, and sex characteristics bias, heterosexism, and heteronormative attitudes in obstetrics and gynecology educational products, materials, and clinical learning environments to improve access and equitable care to vulnerable individuals of the lesbian, gay, bisexual, transgender and queer or questioning, intersex, asexual community.
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Affiliation(s)
- Camille A Clare
- Department of Obstetrics and Gynecology, Downstate Health Sciences University College of Medicine and Department of Health Policy and Management, School of Public Health, Brooklyn, NY.
| | - Mark B Woodland
- Department of OBGYN, Drexel University College of Medicine, Philadelphia, PA
| | - Samantha Buery-Joyner
- Department Ob/Gyn, Inova Fairfax Medical Campus, Division of Medical Education, University of Virginia School of Medicine, Inova Campus, Fairfax, VA
| | - Sara Whetstone
- Division of Obstetrics, Gynecology, and Gynecologic Surgery, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA
| | - Dotun Ogunyemi
- Division of Graduate Medical Education, Department of Obstetrics & Gynecology, Charles Drew University of Medicine and Science, Los Angeles, CA
| | - Shireen Madani Sims
- Department of Obstetrics & Gynecology, University of Florida College of Medicine, Gainesville, FL
| | - Michael Moxley
- Department of Obstetrics/Gynecology, Roper St. Francis Healthcare, Division of Diversity, Inclusion and Health Equity, Georgetown University School of Medicine, Washington, DC
| | - Laura E Baecher-Lind
- Division of Educational Affairs, Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA
| | - B Star Hampton
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Archana Pradhan
- Rutgers Robert Wood Johnson Medical School, Department of Obstetrics, Gynecology and Reproductive Sciences, General Division, New Brunswick, NJ
| | - Nadine T Katz
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
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13
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Hussain I, Dsouza C, Yip SWL, Flynn M, Rashid MA. #Anatomynotes: A temporal content analysis of anatomy education posts on Instagram. Anat Sci Educ 2024; 17:227-238. [PMID: 37943092 DOI: 10.1002/ase.2356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
Social media platforms such as Instagram are becoming increasingly popular sources for students to access anatomy educational resources. This review used content analysis to examine posts under the hashtag #anatomynotes and is the first to map the characteristics of anatomy education posts on Instagram and determine any temporal changes. Sample posts were gathered from April 2019 and April 2021 and categorized according to the technical format, purpose and author credentials. Engagement was recorded in the form of likes and comments. Overall, posts depicting illustrations remained the most popular format within both time periods. Three-dimensional models saw an increase in popularity with a 62.5% rise. Students remained the most common author type throughout and increased further in 2021 by 25%. Clinician authors and posts focusing on clinical education also increased in 2021 by 17.9% and 227%, respectively. Humor-based posts saw the greatest increase among the post purposes, with 1000% more recorded in 2021. Engagement overall saw a decline with notably significant reductions in average likes per post among all text-based posts (-72%, p < 0.0001), all illustrative posts (-51%, p = 0.0013), and a decline in the presence of comments among all text-based posts (-65.1%, p = 0.0158). These findings highlight that Instagram is a popular platform for facilitating near-peer teaching while increasingly providing a space where students and clinicians can interact. Additionally, it highlights the benefits of the platform for visually focused learners. However, future research should seek to determine whether Instagram can facilitate deeper learning and have an impact on academic and clinical performance.
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Affiliation(s)
| | - Ciana Dsouza
- Medical School, King's College London, GKT School of Medical Education, London, UK
| | | | - Matthew Flynn
- Medical School, University College London, London, UK
| | - Mohammed Ahmed Rashid
- Centre for International Medical Education Collaborations, University College London Medical School, London, UK
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14
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Cheung RCC, Yang J, Fang C, Leung MF, Bridges SM, Tipoe GL. Show them what they can't see! An evaluation of the use of customized 3D printed models in head and neck anatomy. Anat Sci Educ 2024; 17:379-395. [PMID: 38095147 DOI: 10.1002/ase.2361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/21/2023] [Accepted: 11/13/2023] [Indexed: 12/22/2023]
Abstract
Difficulty in visualizing anatomical structures has been identified as a challenge in anatomy learning and the emergence of three-dimensional printed models (3DPMs) offers a potential solution. This study evaluated the effectiveness of 3DPMs for learning the arterial supply of the head and neck region. One hundred eighty-four undergraduate medical students were randomly assigned to one of four learning modalities including wet specimen, digital model, 3DPM, and textbook image. Posttest scores indicated that all four modalities supported participants' knowledge acquisition, most significantly in the wet specimen group. While the participants rated 3DPMs lower for helping correct identification of structures than wet specimens, they praised 3DPMs for their ability to demonstrate topographical relationships between the arterial supply and adjacent structures. The data further suggested that the biggest limitation of the 3DPMs was their simplicity, thus making it more difficult for users to recognize the equivalent structures on the wet specimens. It was concluded that future designs of 3DPMs will need to consider the balance between the ease of visualization of anatomical structures and the degree of complexity required for successful transfer of learning. Overall, this study presented some conflicting evidence of the favorable outcomes of 3DPMs reported in other similar studies. While effective for anatomy learning as a standalone modality, educators must identify the position 3DPM models hold relative to other modalities in the continuum of undergraduate anatomy education in order to maximize their advantages for students.
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Affiliation(s)
| | - Jian Yang
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Christian Fang
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Man Fai Leung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Susan M Bridges
- Centre for the Enhancement of Teaching and Learning, Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - George L Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, Hong Kong
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15
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Hanson JL, Christy C, Clarke D, Green CM, Jirasevijinda TJ, Khidir A, Kind T, Levine L, Paul CR, Powers M, Rocha MEM, Sanguino SM, Schiller J, Tenney-Soeiro R, Trainor JL, Tewksbury LR. What Do Pediatric Subinterns Say About Their Learning and Assessment? A Qualitative Analysis of Individual Learning Plans. Acad Pediatr 2024; 24:359-368. [PMID: 37907127 DOI: 10.1016/j.acap.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To perform a qualitative content analysis of learning and assessment strategies that pediatric subinterns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning. METHODS We analyzed ILPs from medical students enrolled in pediatric subinternships at 10 US medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record 3 or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes. RESULTS Two hundred and four ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in 5 categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students' ability to make and assess progress on their selected learning objectives. CONCLUSIONS Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessment strategies. The strategies that students identified in this study provide a menu of learning and assessment options for subinterns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment.
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Affiliation(s)
- Janice L Hanson
- Department of Medicine (JL Hanson), Uniformed Services University of the Health Sciences, Bethesda, Md. Dr Hanson is now with the Washington University in St. Louis School of Medicine, St. Louis, Mo.
| | - Cynthia Christy
- Department of Pediatrics (C Christy), University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Daxa Clarke
- Department of Pediatrics (D Clarke), The University of Arizona College of Medicine-Phoenix, Phoenix, Ariz.
| | - Cori M Green
- Department of Pediatrics (CM Green and TJ Jirasevijinda), Weill Cornell Medical College, New York, NY.
| | - T J Jirasevijinda
- Department of Pediatrics (CM Green and TJ Jirasevijinda), Weill Cornell Medical College, New York, NY.
| | - Amal Khidir
- Department of Medical Education (A Khidir), Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar.
| | - Terry Kind
- Department of Pediatrics (T Kind), George Washington University, Children's National Hospital, Washington, DC.
| | - Leonard Levine
- Department of Pediatrics (L Levine), Drexel University College of Medicine, Philadelphia, Pa. Dr Levine is now with the Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pa.
| | - Caroline R Paul
- Department of Pediatrics (CR Paul), University of Wisconsin School of Medicine and Public Health, Madison, Wis. Dr Paul is now with the Department of Pediatrics, NYU Grossman School of Medicine, New York, NY.
| | - Makia Powers
- Department of Pediatrics (M Powers), Morehouse School of Medicine, Atlanta, Ga. Dr Powers is now with Morehouse School of Medicine, Aetna, a CVS Health Company, Blueberry Pediatrics, Atlanta, Ga.
| | - Mary Esther M Rocha
- Department of Pediatrics (MEM Rocha), Baylor College of Medicine, Houston, Tex.
| | - Sandra M Sanguino
- Department of Pediatrics (SM Sanguino and JL Trainor), Northwestern University Feinberg School of Medicine, Chicago, Ill.
| | - Jocelyn Schiller
- Department of Pediatrics (J Schiller), University of Michigan Medical School, Ann Arbor, Mich.
| | - Rebecca Tenney-Soeiro
- Department of Pediatrics (R Tenney-Soeiro), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.
| | - Jennifer L Trainor
- Department of Pediatrics (SM Sanguino and JL Trainor), Northwestern University Feinberg School of Medicine, Chicago, Ill.
| | - Linda R Tewksbury
- Department of Pediatrics (LR Tewksbury), NYU Grossman School of Medicine, New York, NY.
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16
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Wang L, Du B, Fang D, Gao Y, Liu L. Flipped classroom assisted by Rain Classroom for anatomy practical classes: Challenges and opportunities of anatomy education. Anat Sci Educ 2024; 17:297-306. [PMID: 37932884 DOI: 10.1002/ase.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 10/01/2023] [Indexed: 11/08/2023]
Abstract
Anatomy practical classes are an essential part of learning human anatomy. The flipped classroom teaching model has been used in medical education in recent years. However, its precise impacts on anatomical knowledge acquisition and learning outcomes remain controversial. With the development of information technology, new educational tools, such as Rain Classroom, have recently attracted much interest. The Rain Classroom is an application that can easily connect students and teachers through smartphones or computers. However, whether and how to apply it to the flipped classroom in anatomy practical classes needs to be evaluated. In this study, we designed a teaching model of flipped classroom assisted by Rain Classroom and carried it out in anatomy practical classes at our university. Results showed that the final exam scores of the experimental group were significantly improved, compared with the control group (p < 0.01); the final exam score was significantly correlated with both the pre-class quiz score (p < 0.05) and the in-class quiz score (p < 0.001). Student satisfaction was measured by a questionnaire on a Likert scale of 1-5. All the mean scores were greater than 4.5, indicating that most students had positive attitudes toward this teaching model. The present study suggests that the Rain Classroom helps support students throughout the learning processes of the flipped classroom, and the model of flipped classroom assisted by Rain Classroom could improve students' learning efficiency and ultimately increase their exam performance in anatomy practical classes.
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Affiliation(s)
- Lulu Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Baopu Du
- Department of Human Anatomy, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Dongliang Fang
- Department of Human Anatomy, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Yan Gao
- Department of Human Anatomy, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Experimental Center for Basic Medical Teaching, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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17
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Brenner JM, Fulton TB, Kruidering M, Bird JB, Willey J, Qua K, Olvet DM. What have we learned about constructed response short-answer questions from students and faculty? A multi-institutional study. Med Teach 2024; 46:349-358. [PMID: 37688773 DOI: 10.1080/0142159x.2023.2249209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
PURPOSE The purpose of this study was to enrich understanding about the perceived benefits and drawbacks of constructed response short-answer questions (CR-SAQs) in preclerkship assessment using Norcini's criteria for good assessment as a framework. METHODS This multi-institutional study surveyed students and faculty at three institutions. A survey using Likert scale and open-ended questions was developed to evaluate faculty and student perceptions of CR-SAQs using the criteria of good assessment to determine the benefits and drawbacks. Descriptive statistics and Chi-square analyses are presented, and open responses were analyzed using directed content analysis to describe benefits and drawbacks of CR-SAQs. RESULTS A total of 260 students (19%) and 57 faculty (48%) completed the survey. Students and faculty report that the benefits of CR-SAQs are authenticity, deeper learning (educational effect), and receiving feedback (catalytic effect). Drawbacks included feasibility, construct validity, and scoring reproducibility. Students and faculty found CR-SAQs to be both acceptable (can show your reasoning, partial credit) and unacceptable (stressful, not USMLE format). CONCLUSIONS CR-SAQs are a method of aligning innovative curricula with assessment and could enrich the assessment toolkit for medical educators.
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Affiliation(s)
- Judith M Brenner
- Department of Science Education, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, New York, USA
| | - Tracy B Fulton
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, USA
| | - Marieke Kruidering
- Department of Cellular and Molecular Pharmacology, University of California San Francisco,San Francisco, California, USA
| | - Jeffrey B Bird
- Department of Science Education, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, New York, USA
| | - Joanne Willey
- Department of Science Education, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, New York, USA
| | - Kelli Qua
- Center for Medical Education, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Doreen M Olvet
- Department of Science Education, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, New York, USA
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18
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Agarwal M, Sharma P, Goswami A, Mittal R. A 2023 nationwide study on adjustment disorder among first year MBBS students in India. Bioinformation 2024; 20:190-195. [PMID: 38497077 PMCID: PMC10941775 DOI: 10.6026/973206300200190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Amidst the complex transition to medical college, encompassing a myriad of academic, social, and personal adjustments, MBBS students in India confront multifaceted challenges that can precipitate adjustment disorder, a phenomenon understudied within the Indian context. Therefore, it is of interest to assess adjustment disorder among first-year MBBS students within six months of enrolment. We used a Google form encompassing adjustment disorder new-module 20 for data collection and found that 67% of the 401 responses from first-year medical students exhibited adjustment disorder. The top stressors identified included time pressure, work pressure, financial problems, moving to a new home, and termination of important leisure activities. Female gender, age group 21-25, conflicts in working life, financial problems, own serious illness, family conflicts, pressure to meet deadlines, and excessive workload showed significant associations with adjustment disorder.
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Affiliation(s)
- Mayank Agarwal
- Department of Physiology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Priyanka Sharma
- Department of Physiology, School of Medical Sciences and Research, Sharda University, Greater Noida, India
| | - Ayan Goswami
- Department of Physiology, Santiniketan Medical College, Bolpur, West Bengal, India
| | - Roopali Mittal
- Department of Physiology, School of Medical Sciences and Research, Sharda University, Greater Noida, India
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19
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Krishnamoorthi VR, Johnson DY, Asay S, Beem A, Vuppaladhadiam L, Keegan GE, Zietowski ML, Chen S, Jain S, Arora VM. An Op-Ed Writing Curriculum for Medical Students to Engage in Advocacy Through Public Writing. J Gen Intern Med 2024:10.1007/s11606-024-08629-6. [PMID: 38413538 DOI: 10.1007/s11606-024-08629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Op-ed writing can be a powerful and accessible advocacy tool for physicians, but training is lacking in undergraduate medical education. AIM To train and engage first-year medical students in op-ed writing. SETTING Midwestern research-intensive medical school. PARTICIPANTS All students in a required first-year health policy course in 2021 and 2022. PROGRAM DESCRIPTION For their health policy course's final assignment, students could opt to write an op-ed on a healthcare issue of their choice. All students received written instruction on op-ed writing. Additionally, they could access a seminar, coaching and editing by peers and faculty, and publication guidance. PROGRAM EVALUATION Of 179 students over 2 years, 105 chose to write op-eds. Fifty-one attended the seminar, 35 attended peer coaching sessions, 33 accessed structured peer editing, and 23 received faculty assistance. Thirty-eight students submitted a total of 42 op-eds for publication. Twenty-two pieces were published in major outlets and 17 in the university's health policy review. Of the 22 in major outlets, 21 received editing from either peers or faculty. DISCUSSION An op-ed writing curriculum can be integrated into an existing medical school health policy course, resulting in a high level of engagement and in published op-eds by medical students.
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Affiliation(s)
- V Ram Krishnamoorthi
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.
| | - Daniel Y Johnson
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Spencer Asay
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Alexandra Beem
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Grace E Keegan
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Samuel Chen
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Shikha Jain
- University of Illinois Cancer Center, University of Illinois College of Medicine, Chicago, IL, USA
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
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20
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Tolchin DW, Ankam NS, Rydberg L. Twelve tips for including disability education in undergraduate medical education. Med Teach 2024:1-8. [PMID: 38386799 DOI: 10.1080/0142159x.2024.2317913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools. This article provides twelve tips that any medical school faculty can utilize to integrate meaningful disability education within existing core medical education.
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Affiliation(s)
- Dorothy W Tolchin
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spauling Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, MassGeneral Brigham, Boston, Massachusetts, USA
| | - Nethra S Ankam
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leslie Rydberg
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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21
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Nathan AS, Del Campo D, Garg PS. Where are we now? Evaluating the one year impact of an anti-racism curriculum review. Med Teach 2024:1-6. [PMID: 38382447 DOI: 10.1080/0142159x.2024.2316852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/06/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Undergraduate medical education has had a call to action to acknowledge racist practices that are impacting learners throughout their training. In 2020, our school performed a detailed curricular review and provided recommendations to address racism in the curriculum. Many schools have now undergone a similar curricular review process, but little is known about whether suggested antiracist curricular changes impact faculty teaching behavior or the overall curriculum. MATERIAL AND METHODS In 2021, as part of the medical school's annual educational quality improvement process, course directors were required to answer a question about the changes they made to address racism in their courses based on recommendations provided the year prior from an antiracism curricular review. The documented changes were analyzed for themes and then organized by course and curricular year. These changes were compared with the suggested recommendations to analyze the number and types of changes implemented after one year. To evaluate student perceptions of change the general comments from academic years 2019-2021 were reviewed. RESULTS After 1 year, approximately, 74% of our school's 328 anti-racism curricular review recommendations were implemented in courses. Over 80% were implemented in curricular year 1. The greatest number of recommendations implemented were related to the theme of critiquing the strength of evidence in race-based medical practices. The least amount change was made around the theme of challenging the biologic notion of race. CONCLUSIONS An antiracism curricular review followed by an embedded continuous quality improvement process can be an effective approach to address racism in medical school curricula. Addressing racism in medical education requires medical schools to regularly identify curricular gaps, faculty needs and monitor their progress.
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Affiliation(s)
- Ajay S Nathan
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Daniela Del Campo
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Priya S Garg
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA
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22
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Roy M, Lee RS, Furfari K. Centering equity in a longitudinal health systems science curricula. Med Teach 2024:1-4. [PMID: 38350437 DOI: 10.1080/0142159x.2024.2313575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
What was the educational challenge?Health inequity impedes care at every level of the health care system. Despite this, health equity is not the foundation for most health systems science (HSS) curricula.What was the solution?We reframed our HSS curricula to focus on health equity.How was the solution implemented?We integrated equity concepts into all HSS content areas. First-year content emphasizes structural competency and is delivered through didactics, discussions, interprofessional education, panels, and service-learning requirements. Second-year content applies HSS principles in the clinical space through direct patient care and assignments. Third- and fourth-year content focuses on HSS advocacy and leadership.What lessons were learned that are relevant to a wider global audience?It is crucial to center health equity in medical curricula to improve patient outcomes. Proper faculty development, non-judgmental discussions, and integration with clinical and medical sciences are critical to successful implementation.What are the next steps?We will address feedback, emphasize relevance to patients and populations, and refine outcome measures.
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Affiliation(s)
- Micaela Roy
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Rita S Lee
- University of Colorado School of Medicine, Aurora, CO, USA
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Sagin A, Balmer D, Rose S, Musheno R, Olenik JM, Dingfield L, Dine CJ, Bennett NL. Evaluation of a Palliative Care Longitudinal Curriculum for Medical Students Using the Context-Input-Process-Product Model. Am J Hosp Palliat Care 2024; 41:158-166. [PMID: 36945136 PMCID: PMC10751966 DOI: 10.1177/10499091231165504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Palliative care (PC) longitudinal curricula are increasingly being recognized as important in Undergraduate Medical Education (UME). They are however, not yet commonplace, and where they do exist may be implemented without a systematic, prospective approach to curriculum evaluation. This paper describes an implementation of a new longitudinal curriculum at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. We used the Context Input Process Product (CIPP) model, a holistic evaluation model, to assess the local environment, design the curriculum, guide the improvement process, and evaluate outcomes. Comprehensive models such as CIPP provide a more robust approach to curriculum evaluation than outcomes-only models and may be of use to other programs who are implementing new curricula or improving upon existing programs.
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Affiliation(s)
- Alana Sagin
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dorene Balmer
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Suzanne Rose
- Medicine/Academic Programs, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rosie Musheno
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jennifer M. Olenik
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Laura Dingfield
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C. Jessica Dine
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nadia L. Bennett
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Rowe KA, Ouchi K, Kennedy M, Breu A, Tolchin DW, Schwartz AW. Preparing Preclinical Medical Students for Routine Code Status Discussions: A Mixed-Methods Study. J Pain Symptom Manage 2024; 67:138-146. [PMID: 37863372 DOI: 10.1016/j.jpainsymman.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/01/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023]
Abstract
CONTEXT Medical students are expected to gain competency in inquiring about patients' goals of care, per the Association of American Medical Colleges' Entrustable Professional Activities. While students may be part of teams that conduct routine code status discussions (CSDs), formal training in this skill prior to clinical clerkships is lacking. OBJECTIVES We aimed to address this training gap by designing a curriculum to teach preclinical medical students about routine CSDs. METHODS We designed and conducted an interactive workshop for preclinical medical students to learn about routine CSDs and practice this skill, using Kern's Six Steps to Curriculum Design. A qualitative and quantitative pre- and postsurvey was administered. A convergent, parallel, mixed methods analysis was performed. RESULTS Students (n = 135) named more options for code status following the workshop (presurvey 1.3 vs. postsurvey 4.3, P < 0.01). There was an increase in the proportion of students reporting that they felt "somewhat comfortable" or "extremely comfortable" conducting a CSD (presurvey 19% vs. postsurvey 64%, P < 0.01), and a decrease in those reporting that they felt "extremely uncomfortable" or "somewhat uncomfortable" (presurvey 53% vs. postsurvey 18%, P < 0.01). Thematic analysis revealed that students were concerned about knowledge gaps, communication tools, personal discomfort, and upsetting patients or family. CONCLUSION A workshop to train medical students to conduct routine CSDs can be included as part of a preclinical medical education curriculum. Students reported that the workshop increased their confidence in conducting CSDs and demonstrated an increase in corresponding knowledge, preparing them to deliver person-centered care on their clerkships.
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Affiliation(s)
- Katherine A Rowe
- Department of Surgery (K.A.R.), Massachusetts General Hospital, Boston, MA, USA.
| | - Kei Ouchi
- Department of Emergency Medicine (K.O.), Brigham and Women's Hospital, Boston, MA, USA
| | - Maura Kennedy
- Department of Emergency Medicine (M.K.), Massachusetts General Hospital, Boston, MA, USA
| | - Anthony Breu
- VA Boston Healthcare System and Center for Bioethics (A.B.), Harvard Medical School, Boston, MA, USA
| | - Dorothy W Tolchin
- Department of Physical Medicine and Rehabilitation (D.W.T.), Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Andrea Wershof Schwartz
- New England Geriatrics Research Education and Clinical Center (A.W.S.), Veterans Affairs Boston Healthcare System, Boston, MA, USA
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Silva CS, Vasconcellos C, Souza MB, Fernandes JD, Rego VRPDA. Comparison of Blended Learning With Traditional Dermatology Learning for Medical Students: Prospective Evaluation Study. JMIR Form Res 2024; 8:e49616. [PMID: 38300698 PMCID: PMC10870203 DOI: 10.2196/49616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Novel internet-based applications and associated technologies have influenced all aspects of society, ranging from commerce and business to entertainment and health care, and education is no exception. In this context, this study was designed to evaluate the impact of a dermatology e-learning program on the academic performance of medical students in dermatology. OBJECTIVE The aim of this study is to develop a dermatology blended-learning course for undergraduate medical students, evaluate the knowledge gained by students exposed to this course, and compare the results to those of traditional teaching methods. METHODS In this prospective study, we evaluated the performance of fourth-semester medical students at the Federal University of Bahia, Brazil. Students who had been in their second year of the medical course in 2019 were considered the control group, while students in their second year in 2020 were considered the blended or hybrid group. The first group attended traditional classes, using printed material (books and handouts), while the second group used our web-based course and e-book as a supplement in a hybrid web-plus-traditional fashion. Neither participants nor evaluators were blinded. The students in both groups were subjected to the same pre- and postcourse face-to-face, multiple-choice, paper-based evaluations, and we compared their performances. The content of the classes was the same for both groups. All didactic activities were developed by a team of certified dermatologists and professors from the university. RESULTS A total of 129 students were selected and divided into 2 groups: the control group (n=57) and the hybrid group (n=72). The precourse tests did not indicate any difference between the control group (mean score 2.74, SD 1.25) and the hybrid group (mean score 3.2, SD 1.22 SD; P>.05). The hybrid group had better final-term grades (mean 8.18, SD 1.26) than the traditional group (mean 7.11, SD 1.04). This difference was statistically significant (P<.05). CONCLUSIONS This study explores pedagogical possibilities in the field of dermatology teaching for medical school students. The results suggest that the performance of undergraduate students who attended the course with additional e-learning material was superior when compared to the performance of those who participated in the traditional course alone.
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Kadden D, Weber M, Herbst L, Weber DE. The Impact of Words: Multisource Feedback Provides Students With a Deeper Understanding and Reflection on Goals of Care Discussions. Am J Hosp Palliat Care 2024; 41:173-178. [PMID: 37248859 DOI: 10.1177/10499091231175907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Background: Physician communication during goals of care (GOC) discussions impact experiences for patients and families at end-of-life (EOL). Simulation allows training in a safe environment where feedback from simulated patients (SP), clinicians, and self-reflection can be incorporated. Objectives: To determine if multisource feedback from SP scenarios enriches feedback provided to trainees. Design: Fourth-medical students participated in two SP GOC discussions during an advanced care planning (ACP) curriculum. Students received feedback from SPs and faculty and completed a video review with self-reflection. Setting and Subjects: Forty-seven fourth-year medical students at the University of Cincinnati College of Medicine participated in the curriculum from 2019-2021. Measurements: An inductive thematic analysis of the narrative data was performed examining all sources of feedback from the SP sessions. Results: Six themes emerged from the feedback: the warning shot: words to say and why it helps; acknowledging emotion: verbal vs non-verbal responses; organization: necessity of a clear path; body language: adding to and distracting from the conversation; terminology to avoid: what jargon encompasses and how it impacts patients; and silence: perceived importance by everyone. SP feedback focused on the personal emotional impact of a student's word choice and body language. Faculty feedback focused on specific learning points through examples from the conversation and expanded to hypothetical scenarios. Student self-reflection after video review allowed students to see challenges that they did not notice while immersed in the encounter. Conclusion: Multisource feedback from simulated GOC discussions provides unique insights for students to guide their development in leading difficult conversations.
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Affiliation(s)
- Daniel Kadden
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Madeline Weber
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lori Herbst
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Department of Family and Community Medicine, Division of Palliative Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Danielle E Weber
- University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
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Aniort J, Trefond J, Tanguy G, Bataille S, Burtey S, Pereira B, Garrouste C, Philipponnet C, Clavelou P, Heng AE, Lautrette A. Impact of reference panel composition on scores of script concordance test assessing basic nephrology knowledge in undergraduate medical education. Med Teach 2024; 46:110-116. [PMID: 37544894 DOI: 10.1080/0142159x.2023.2239441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE In the assessment of basic medical knowledge, the composition of the reference panel between specialists and primary care (PC) physicians is a contentious issue. We assessed the effect of panel composition on the scores of undergraduate medical students in a script concordance test (SCT). METHODS The scale of an SCT on basic nephrology knowledge was set by a panel of nephrologists or a mixed panel of nephrologists and PC physicians. The results of the SCTs were compared with ANOVA for repeated measurements. Concordance was assessed with Bland and Altman plots. RESULTS Forty-five students completed the SCT. Their scores differed according to panel composition: 65.6 ± 9.73/100 points for nephrologists, and 70.27 ± 8.82 for the mixed panel, p < 0.001. Concordance between the scores was low with a bias of -4.27 ± 2.19 and a 95% limit of agreement of -8.96 to -0.38. Panel composition led to a change in the ranking of 71% of students (mean 3.6 ± 2.6 places). CONCLUSION The composition of the reference panel, either specialist or mixed, for SCT assessment of basic knowledge has an impact on test results and student rankings.
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Affiliation(s)
- Julien Aniort
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
- Human Nutrition Unit, Clermont Auvergne University INRAE UMR 1019, Clermont-Ferrand, France
| | - Jeromine Trefond
- General Practitioner Department, Clermont-Ferrand Medical School, Clermont Auvergne University, Clermont-Ferrand, France
| | - Gilles Tanguy
- General Practitioner Department, Clermont-Ferrand Medical School, Clermont Auvergne University, Clermont-Ferrand, France
| | - Stanislas Bataille
- Phocean Nephrology Institute, ELSAN, Clinique Bouchard, Marseille, France
- C2VN, Aix-Marseille Univ, INSERM, INRAE UMR 1076, Marseille, France
| | - Stephane Burtey
- C2VN, Aix-Marseille Univ, INSERM, INRAE UMR 1076, Marseille, France
- Centre de Néphrologie et Transplantation Rénale, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Bruno Pereira
- Biostatistics Unit, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Cyril Garrouste
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
| | - Carole Philipponnet
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
| | - Pierre Clavelou
- Neuro-Dol, INSERM, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Anne-Elisabeth Heng
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
- Human Nutrition Unit, Clermont Auvergne University INRAE UMR 1019, Clermont-Ferrand, France
| | - Alexandre Lautrette
- Intensive Care Unit, Centre Jean Perrin, Clermont-Ferrand, France
- LMGE (Laboratoire MicroOrganisme Genome et Environnement), Clermont Auvergne University CNRS UMR 6023, Clermont-Ferrand, France
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Nagarajappa A, Kaur S. Simulation in contemporary medical education: Current practices and the way forward. Indian J Anaesth 2024; 68:17-23. [PMID: 38406335 PMCID: PMC10893808 DOI: 10.4103/ija.ija_1203_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 02/27/2024] Open
Abstract
Integration of theoretical knowledge and practical skills is critical for effective medical education. Simulation is crucial in bridging the gap to prepare medical professionals for high-quality patient care in a safe environment. Simulation-based teaching has become the standard practice in medical education, especially in postgraduate courses like Anaesthesia. However, undergraduate medical education and other doctoral courses are still nascent. In line with the current National Medical Commission guidelines, it is imperative to complement the existing curriculum with a simulation-based approach as early as the first year of medical school. This review focuses on the current practices related to simulation-based medical education during undergraduate and postgraduate courses, particularly on anaesthesiology. We aim to discuss different types of simulation, the advantages of integration, students' perspectives, and the role of simulation in assessment and feedback. Finally, recommendations for future advancements of simulation in medical education and the way forward will be laid.
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Affiliation(s)
- Abhishek Nagarajappa
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Growdon AS, Oñate A, Staffa SJ, Berger S, Callas C, Chitkara MB, Crook TW, Daniel DA, Huth K, Lehmann S, Len KA, Murray AM, Neeley M, Devon EP, Pingree E, Rose S, Weinstein A, Wolbrink TA. The Effect of Providing Protected Time for Utilization of Video-Based Learning in the Pediatric Clerkship: A Randomized Trial. Acad Pediatr 2024; 24:139-146. [PMID: 37148969 DOI: 10.1016/j.acap.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/19/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Amanda S Growdon
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass.
| | - Alma Oñate
- Harvard Medical School (A Oñate), Boston, Mass
| | - Steven J Staffa
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Stephanie Berger
- Department of Pediatrics (S Berger), University of Alabama at Birmingham Heersink School of Medicine
| | - Christina Callas
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Maribeth B Chitkara
- Department of Pediatrics (MB Chitkara), Renaissance School of Medicine at Stony Brook University, NY
| | - Travis W Crook
- Department of Pediatrics (TW Crook and M Neeley), Vanderbilt Children's Hospital and Vanderbilt University School of Medicine, Nashville, Tenn
| | - Dennis A Daniel
- Department of Anesthesiology (DA Daniel and TA Wolbrink), Critical Care and Pain Medicine, Boston Children's Hospital, Department of Anaesthesia, Harvard Medical School, Mass
| | - Kathleen Huth
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass
| | - Sonja Lehmann
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Kyra A Len
- Department of Pediatrics and Office of Medical Education (KA Len), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Ann M Murray
- Department of Pediatrics (AM Murray), Massachusetts General Hospital and Harvard Medical School, Boston
| | - Maya Neeley
- Department of Pediatrics (TW Crook and M Neeley), Vanderbilt Children's Hospital and Vanderbilt University School of Medicine, Nashville, Tenn
| | - Erin Pete Devon
- Department of Pediatrics (EP Devon and S Rose), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | - Elizabeth Pingree
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass
| | - Stacey Rose
- Department of Pediatrics (EP Devon and S Rose), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | - Adam Weinstein
- Department of Pediatrics and Medical Education (A Weinstein), Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Traci A Wolbrink
- Department of Anesthesiology (DA Daniel and TA Wolbrink), Critical Care and Pain Medicine, Boston Children's Hospital, Department of Anaesthesia, Harvard Medical School, Mass
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Abraham C. Transition From Normative to Criterion-Based Grading in the Obstetrics and Gynecology Clerkship. J Med Educ Curric Dev 2024; 11:23821205241239201. [PMID: 38500498 PMCID: PMC10946066 DOI: 10.1177/23821205241239201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To compare grades, National Board of Medical Examiners (NBME) Shelf Exam scores, and student satisfaction with the Obstetrics and Gynecology (OB/GYN) clerkship after transitioning from normative to criterion-based grading. METHODS Between July 2021 and July 2022, the Icahn School of Medicine at Mount Sinai (ISMMS) adhered to a normative grading scheme in which ∼60% of students achieved a grade of Honors, 30% achieved a grade of High Pass and 10% achieved a grade of Pass for the OB/GYN clerkship. In July 2022, ISMMS transitioned to a criterion-based scheme. In this scheme, 6 competencies were created. Criteria were determined for each competency, delineating achieving a score of "Pass" versus "Honors" for the specific objective. Students needed to meet the criteria for Honors for 4 out of 6 of the competencies in order to ultimately receive a grade of Honors for the clerkship. The number of students achieving Honors, NBME shelf exam scores, and student clerkship satisfaction ratings between the normative and criterion-based schemes were compared. RESULTS The number of students studying in academic year (AY) 2021-2022 and AY 2022-2023 were 134 and 137, respectively. A significantly lower percentage of students received Honors in AY 2021-2022 than in AY 2022-2023 (66% vs. 96%, P < .01). Mean exam scores were significantly higher for those receiving Honors in AY 2021-2022 than in AY 2022-2023 (P < .05); scores for AY 2021-2022 and AY 2022-2023 were 78.9, 95% CI [77.6, 80.1] and 76.7, 95% CI [75.6, 77.8], respectively. Mean exam scores for all students were not significantly different between the 2 academic cohorts (77.8 vs. 76.2, P = .06). Clerkship satisfaction rating was significantly higher in AY 2022-2023 than in AY 2021-2022 (4.1 vs. 3.7, P < .05). CONCLUSIONS These findings support a paradigm that compares learner performance to predefined measures as opposed to peer performance.
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Affiliation(s)
- Cynthia Abraham
- Department of Obstetrics, Gynecology and Reproductive Science, Department of Medical Education at the Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
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Stillman MD, Mallow M, Ankam N, Ojeda J, Stephens M, Heckert K, Gustafson K. The Dearth of Disability Medical Education and a Partial Solution. Teach Learn Med 2024; 36:83-88. [PMID: 36082770 DOI: 10.1080/10401334.2022.2119239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Issue: While over one-quarter of adult Americans have a disability, there is a paucity of disability-specific curricula in American medical schools and residency programs. Potential consequences of this educational dearth include persistent inaccessibility of health care facilities and delivery of inequitable health care to individuals with disabilities. Evidence: Several working groups have proposed disability-specific competencies for health professions education and means by which to integrate them into existing curricula. A limited number of medical schools and residency programs have formally introduced disability-specific materials into their curricula. To our knowledge, however, there are no generalist (internal medicine or family medicine) residency programs that offer specialized training in the clinical care of people with disabilities. Implications: Offering generalist physicians the opportunity to acquire the clinical and cognitive skills required to provide thorough and equitable health care to people with disabilities is critically important. There are too few physiatrists to see to their care needs. In this manuscript, we present a novel concentration in an Internal Medicine residency program in the care of individuals with a variety of disabilities. Our hope is that this work will initiate discussions among educational leaders about how to address the lack of graduate medical education-level training in disability care. We also hope it will afford program directors the opportunity to implement similar concentrations and tracks and will eventually produce a generation of generalists who are well-equipped to help care for people with disabilities.
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Affiliation(s)
- Michael D Stillman
- Department of Internal Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael Mallow
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nethra Ankam
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jason Ojeda
- Department of Internal Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mary Stephens
- Department of Family & Community Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kimberly Heckert
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kirstin Gustafson
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Choi A, Murtha TD, Morrison LJ, Talwalkar JS. A Comparison Between In-Person and Virtual Communication Skills OSCE for Medical Students. J Med Educ Curric Dev 2024; 11:23821205241241375. [PMID: 38532857 PMCID: PMC10964456 DOI: 10.1177/23821205241241375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
Objectives This study investigates the effectiveness of a virtual format of an advanced communication skills observed structured clinical examination (OSCE) for senior medical students in comparison to an in-person format. The study also examines the emotional support students experience in the virtual setting. Our analysis was based on quantitative data collected through objective checklists and post-OSCE survey results. Methods The virtual OSCE was a revision of an earlier in-person formative advanced communication skills OSCE for fourth-year medical students. Student performances were assessed by self and peers using objective checklists-the modified Master Interview Rating Scale (mMIRS) and Communication Behavior Checklist (CBC). The mMIRS measured interview process such as avoiding jargon and demonstrating empathy. The CBC examined interview content which included tasks specific to the content of the case. The OSCE was followed by a faculty-led debrief and quantitative survey. The virtual OSCE was conducted in 2021, and the results of the checklists and survey were compared with those collected from two earlier in-person OSCEs. Results Eighty-three students participated in the virtual OSCE. There was no difference in mMIRS scores between the virtual and in-person OSCE. Overall CBC scores were lower in the virtual OSCE compared to in-person (p < 0.05). Sixty-seven out of 83 (80.7%) students completed the post-OSCE survey. There were no differences between the virtual and in-person OSCE in terms of educational value, whether the OSCE would change the way participants talk to patients, and preparedness to have serious conversations with patients. All respondents somewhat or strongly agreed with feeling emotionally supported during the virtual OSCE. Conclusion The virtual format was a suitable alternative to an in-person, formative, advanced communication skills OSCE for medical students. The virtual OSCE was educationally effective and was met with student satisfaction and a sense of emotional support. Future virtual iterations must ensure adequate instruction on interview content.
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Affiliation(s)
- Alex Choi
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Tanya D. Murtha
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Jaideep S. Talwalkar
- Departments of Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT, USA
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Congdon M, Goldstein L, Maletsky KD, Craven M, Rose S, Devon EP. Pediatric Intersession: An Upfront Flipped-Classroom Curriculum to Promote Pediatric Clerkship Readiness. J Med Educ Curric Dev 2024; 11:23821205241229774. [PMID: 38327827 PMCID: PMC10848795 DOI: 10.1177/23821205241229774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Best practices for content selection, mode of delivery, and timing of pediatric clerkship readiness curricula for medical students have, by and large, not been established. Capitalizing on changes in structure of the clinical clerkships during the COVID-19 pandemic, we created an upfront clerkship readiness curriculum, termed Pediatric Intersession (PI), to replace the existing weekly lecture-based clerkship didactics. METHODS Our goal was to develop an interactive curriculum with innovative instructional design methodology intended to promote broad foundational pediatric knowledge and clerkship preparedness using case-based learning. We first conducted a needs assessment and crafted curriculum content using guiding principles from the 2019 Council on Medical Student Education in Pediatrics (COMSEP) curriculum. We then organized material into four daily modules prior to the start of the clerkship and employed flipped classroom (FC) methodology. RESULTS Sixty-six percent of students completed course evaluations, and >90% of the 100 respondents reported that the PI enhanced their clinical learning. Pre-/post-testing demonstrated some knowledge gain following the small-group sessions and there was no change on the National Board of Medical Examiners (NBME) Subject Exam mean scores compared to prior cohorts of students. CONCLUSIONS The global pandemic provided an opportunity to re-envision our pediatric clerkship didactics content, while also incorporating instructional design methodology preferred by students. Our curriculum promotes a small group-based, interactive approach to clerkship readiness that fosters learning in the clinical environment that can be adapted for various settings. Our evaluation suggests that the transition to a FC readiness curriculum can be done successfully while effectively preparing students for their pediatric clerkship.
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Affiliation(s)
- Morgan Congdon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Goldstein
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Kristin D. Maletsky
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Meghan Craven
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Rose
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Erin Pete Devon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
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Chen KT, Baecher-Lind L, Morosky CM, Bhargava R, Fleming A, Royce CS, Schaffir JA, Sims SM, Sonn T, Stephenson-Famy A, Sutton JM, Morgan HK. Current practices and perspectives on clerkship grading in obstetrics and gynecology. Am J Obstet Gynecol 2024; 230:97.e1-97.e6. [PMID: 37748528 DOI: 10.1016/j.ajog.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/14/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Clerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past 2 decades in our specialty. OBJECTIVE This study aimed to investigate obstetrics and gynecology clerkship directors' practices and perspectives in grading. STUDY DESIGN A 12-item electronic survey was developed and distributed to clerkship directors with active memberships in the Association of Professors of Gynecology and Obstetrics. RESULTS A total of 174 of 236 clerkship directors responded to the survey (a response rate of 73.7%). Respondents reported various grading systems with the fewest (20/173 [11.6%]) using a 2-tiered or pass or fail system and the most (72/173 [41.6%]) using a 4-tiered system. Nearly one-third of clerkship directors (57/163 [35.0%]) used a National Board of Medical Examiners subject examination score threshold to achieve the highest grade. Approximately 45 of 151 clerkship directors (30.0%) had grading committees. Exactly half of the clerkship directors (87/174 [50.0%]) reported requiring unconscious bias training for faculty who assess students. In addition, some responded that students from groups underrepresented in medicine (50/173 [28.9%]) and introverted students (105/173 [60.7%]) received lower evaluations. Finally, 65 of 173 clerkship directors (37.6%) agreed that grades should be pass or fail. CONCLUSION Considerable heterogeneity exists in obstetrics and gynecology clerkship directors' practices and perspectives in grading. Strategies to mitigate inequities and improve the reliability of grading include the elimination of a subject examination score threshold to achieve the highest grade and the implementation of both unconscious bias training and grading committees.
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Affiliation(s)
- Katherine T Chen
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY.
| | | | - Christopher M Morosky
- Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT
| | - Rashmi Bhargava
- Department of Obstetrics and Gynecology, University of Saskatchewan College of Medicine, Regina, Saskatchewan, Canada
| | - Angela Fleming
- Department of Obstetrics and Gynecology, Corewell Health, Farmington Hills, MI
| | - Celeste S Royce
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jonathan A Schaffir
- Department of Obstetrics and Gynecology, Ohio State University Wexner Medical Center, Columbus, OH
| | - Shireen Madani Sims
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL
| | - Tammy Sonn
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | | | - Jill M Sutton
- Department of Obstetrics and Gynecology, East Carolina University Brody School of Medicine, Greenville, NC
| | - Helen Kang Morgan
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
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Liao J, Wright RR, Vora GK. The Decline of Basic Ophthalmology in General Medical Education: A Scoping Review and Recommended Potential Solutions. J Med Educ Curric Dev 2024; 11:23821205241245635. [PMID: 38596233 PMCID: PMC11003344 DOI: 10.1177/23821205241245635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This literature review aims to explore research and conceptual pieces on the state of ophthalmology education and suggest potential ways to address current challenges. METHODS A search was conducted in PubMed, ERIC, Web of Science, and Google Scholar with combinations of the following search terms: "ophthalmology education," "undergraduate medical education," "medical student," "United States," and "Canada." Eliminating irrelevant articles yielded 47 articles. Three were excluded because of region and focus, leaving 44. After examining the citations, we generated an additional 22 texts for review, totaling 66 articles. RESULTS Four primary themes were identified: (1) challenges to ophthalmological education in the U.S. and Canada, (2) potential remedies for optimizing ophthalmology curriculum, (3) technology in ophthalmology education, and (4) innovative ophthalmology teaching approaches. Major challenges included the lack of a standardized curriculum and inadequate clinical exposure and skills training. A number of remedies were proposed, such as standardizing curriculum and furthering faculty involvement, utilizing technology as time-effective learning aids, and employing innovative teaching approaches such as service learning. CONCLUSION In light of challenges in ophthalmology education, curriculum designers should consider Cognitive Load Theory (CLT) to assist students to remember meaningful exposures to ophthalmology knowledge and techniques. Based on CLT, we suggest two potential approaches to incorporating ophthalmology curriculum. The first is to embrace interdisciplinary collaborations and place ophthalmology knowledge in varied contexts to facilitate schema construction. The second is to incorporate ophthalmology diagnostics requirements into OSCEs and utilize simulation models for students to gradually increase the fidelity of tasks and devote cognitive resources fully to learning.
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Affiliation(s)
- Jennifer Liao
- Department of Ophthalmology, The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
| | - Robin Redmon Wright
- Department of Behavioral Sciences and Education, Pennslyvania State University Harrisburg, Middletown, PA, USA
| | - Gargi K Vora
- Department of Ophthalmology, Yale School of Medicine, New Haven, CT, USA
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Wilson E, Choy M, Nunney I, Ta NH, Tailor BV, Smith ME. How do medical students want to learn ENT? Perspectives from a consensus forum. J Laryngol Otol 2024; 138:10-15. [PMID: 37212034 DOI: 10.1017/s0022215123000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The UK Medical Licensing Assessment curriculum represents a consensus on core content, including ENT-related content for newly qualified doctors. No similar consensus exists as to how ENT content should be taught at medical school. METHOD A virtual consensus forum was held at the 2nd East of England ENT Conference in April 2021. A syllabus of ENT-related items was divided into 'Presentations', 'Conditions' and 'Practical procedures'. Twenty-seven students, 11 foundation doctors and 7 other junior doctors voted via anonymous polling for the best three of nine methods for teaching each syllabus item. RESULTS For 'Presentations' and 'Conditions', work-based or clinical-based learning and small-group seminars were more popular than other teaching methods. For 'Practical procedures', practical teaching methods were more popular than theoretical methods. CONCLUSION Students and junior doctors expressed a clear preference for clinical-based teaching and small-group seminars when learning ENT content. E-learning was poorly favoured despite its increasing use.
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Affiliation(s)
- Emily Wilson
- ENT, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Matthew Choy
- Department of Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Nunney
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ngan Hong Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Matthew E Smith
- Department of ENT Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Reidy JA, Chan SH, Boelitz KM, Chavez M, Clark MA, Epstein SK, Gosline A, Healy R, Livne E, Peirce H, Schaefer KG, Streid J, Vesel T, Young ME, Zehm A, Garg PS. A Call to Action: Using Curriculum Mapping at Four Medical Schools in Massachusetts to Advance Serious Illness Communication Training in Undergraduate Medical Education. J Palliat Med 2024; 27:39-46. [PMID: 37976143 DOI: 10.1089/jpm.2022.0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background: Practicing physicians require serious illness communication (SIC) skills to ensure high-quality, humanistic care for patients and families as they face life-changing medical decisions. However, a majority of U.S. medical schools do not require formal training in SIC and fail to provide students deliberate practice before graduation. The Massachusetts Medical Schools' Collaborative was created to ensure that students receive foundational SIC training in undergraduate medical education. This Collaborative developed a curriculum-mapping tool to assess SIC at four medical schools. Objective: We aimed to understand existing educational activities across four medical schools and identify opportunities to build longitudinal, developmentally based curricular threads in SIC. Design: From July 2019 to April 2021, faculty, staff, and medical students assessed current educational activities related to five core competencies in SIC, adapted for students from national competencies for palliative medicine fellows, using a curriculum mapping tool. Measurements: The group selected 23 keywords and collected metrics to describe the timing, instruction and assessment for each school's educational activities. Results: On average, there were only 40 hours of required curricula in SIC over four years. Over 80% of relevant SIC hours occurred as elective experiences, mostly during the postclerkship phase, with limited capacity in these elective experiences. Only one school had SIC educational activities during the clerkship phase when students are developing clinical competencies. Assessment methods focused on student participation, and no school-assessed clinical performance in the clerkship or postclerkship phase. Conclusions: Medical schools are failing to consistently train and ensure basic competency in effective, compassionate SIC. Curriculum mapping allows schools to evaluate their current state on a particular topic such as SIC, ensure proper assessment, and evaluate curricular changes over time. Through the deliberate inclusion of SIC competencies in longitudinal curriculum design, we can fill this training gap and create best practices in undergraduate medical education.
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Affiliation(s)
- Jennifer A Reidy
- UMass Memorial Medical Health Care, Division of Palliative Care, Worcester, Massachusetts, USA
- UMass Chan Medical School, Departments of Medicine, Pediatrics and Surgery, Worcester, Massachusetts, USA
| | - Stephanie H Chan
- Massachusetts Coalition for Serious Illness Care, Boston, Massachusetts, USA
- Blue Cross Blue Shield of Massachusetts, Boston, Massachusetts, USA
| | - Kris M Boelitz
- UMass Chan Medical School, Departments of Medicine, Pediatrics and Surgery, Worcester, Massachusetts, USA
| | - Melissa Chavez
- Boston Medical Center, Departments of Neurology and Otolaryngology, Boston, Massachusetts, USA
| | - Melissa A Clark
- UMass Chan Medical School, Departments of Medicine, Pediatrics and Surgery, Worcester, Massachusetts, USA
- Brown University School of Public Health, Department of Health Services, Policy and Practice, Providence, Rhode Island, USA
| | - Scott K Epstein
- Tufts University School of Medicine, Department of Medicine, Boston, Massachusetts, USA
| | - Anna Gosline
- Massachusetts Coalition for Serious Illness Care, Boston, Massachusetts, USA
- Blue Cross Blue Shield of Massachusetts, Boston, Massachusetts, USA
| | - Rose Healy
- Boston Medical Center, Departments of Neurology and Otolaryngology, Boston, Massachusetts, USA
| | - Emma Livne
- Hasbro Children's Hospital, Department of Pediatrics, Providence, Rhode Island, USA
| | - Hayden Peirce
- UMass Chan Medical School, Departments of Medicine, Pediatrics and Surgery, Worcester, Massachusetts, USA
| | - Kristen G Schaefer
- Care Dimensions, Inc., Danvers, Massachusetts, USA
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA
| | - Jocelyn Streid
- Brigham and Women's Hospital, Department of Anesthesiology, Boston, Massachusetts, USA
| | - Tamara Vesel
- Tufts University School of Medicine, Department of Medicine, Boston, Massachusetts, USA
- Tufts Medical Center, Division of Palliative Care, Boston, Massachusetts, USA
| | - Megan E Young
- Boston University School of Medicine, Departments of Medicine and Pediatrics, Boston, Massachusetts, USA
| | - April Zehm
- Medical College of Wisconsin, Department of Medicine, Milwaukee, Wisconsin, USA
| | - Priya S Garg
- Boston University School of Medicine, Departments of Medicine and Pediatrics, Boston, Massachusetts, USA
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Schmude M, Adonizio T, Ellison HB, Shoemaker M. Fostering Students' Personal and Professional Growth: Responding to Error During the Internal Medicine Clerkship. J Med Educ Curric Dev 2024; 11:23821205241236594. [PMID: 38425719 PMCID: PMC10903198 DOI: 10.1177/23821205241236594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Developing professionalism is critical to medical education; accordingly, professionalism curricula may be implemented longitudinally throughout undergraduate medical education. Here we share our experiences addressing student response to medical error as a component of professionalism education during the core clerkship year. METHODS This pretest-posttest study reports medical students' knowledge regarding learning and growing in response to medical error. Students complete an online module, Beyond Recovery: Learning and Growing in the Wake of an Error, during the Internal Medicine Clerkship. We analyzed matched pre- and posttest responses using the Wilcoxon signed-rank test. RESULTS Pre- and posttest queries addressed 5 key elements during clinician assessment of medical error: self-expectations of perfection, long-term guilt following an error, likelihood of leaving the medical profession following an error, ability to address error with patients and families, and ability to grow in response to medical error. Results indicate students felt significantly more comfortable after completing the module in key components of managing emotions and responses in the wake of an error. CONCLUSION Benefits observed in medical students' perspectives include improved ability to move forward following medical error, ability to engage with affected patients and families, and capacity to learn from mistakes. Despite these positives, students' high self-expectations of perfectionism were unchanged.
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Affiliation(s)
- Michelle Schmude
- Department of Medical Education, Geisinger College of Health Sciences, Scranton, PA, USA
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Annapureddy D, Teaw S, Kumar P, Turlington WM, Wang E, Speed S, Gimpel N. Assessing Educational and Attitudinal Outcomes of a Student Learner Experience Focused on Homelessness. Fam Med 2024; 56:30-34. [PMID: 37725769 PMCID: PMC10836624 DOI: 10.22454/fammed.2023.112960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Patient navigation programs help guide vulnerable populations, such as those experiencing homelessness, through the health care system. Medical students developed the student-run Patient Navigator Program (PNP) to serve persons experiencing homelessness (PEH) in the Dallas area. The objective of this study was to build on previously published data to determine how medical student attitudes, knowledge, and confidence working with PEH changed during involvement in the PNP, particularly after participating as a patient navigator. METHODS Student fellows completed a survey prior to a training elective (time point 1), immediately after the training elective (time point 2), and after acting as a patient navigator (time point 3). The PNP survey, which intended to measure student attitudes and knowledge regarding PEH, included the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI) and the Student-Run Free Clinic Project (SRFCP) surveys. In our analysis, we compared responses among the different time points. RESULTS Seventy-six of 88 students who completed the training elective chose to participate in the PNP fellowship. Skills, knowledge, and self-efficacy improved from time points 1 to 2, 1 to 3, and 2 to 3. Social advocacy also improved from time points 1 to 2 and 1 to 3. CONCLUSIONS Improvements from time point 1 to 2 demonstrated the value of didactic learning, while further improvements from time point 2 to 3 demonstrated the added benefit of hands-on experiential learning. Our study illustrates the potential educational benefits that a PNP provides to medical students who may encounter or care for this population during their careers.
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Affiliation(s)
| | - Shannon Teaw
- University of Texas Southwestern Medical SchoolDallas, TX
| | - Pooja Kumar
- University of Texas Southwestern Medical SchoolDallas, TX
| | | | - Ethan Wang
- University of Texas Southwestern Medical SchoolDallas, TX
| | - Shelley Speed
- Department of Family and Community Medicine, University of Texas
Southwestern Medical CenterDallas, TX
| | - Nora Gimpel
- University of Texas Southwestern Medical SchoolDallas, TX
- Department of Family and Community Medicine, University of Texas
Southwestern Medical CenterDallas, TX
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Frydman JL, Gelfman LP, Farquhar D, Ramaswamy R, Dow LA. Goals, Values, and Priorities of Hospitalized Patients: Using a Structured Communication Tool to Engage Medical Students in Serious Illness Communication. J Palliat Med 2024; 27:99-103. [PMID: 37878370 DOI: 10.1089/jpm.2023.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Background: To build third-year medical students' serious illness communication skills, we implemented a structured communication tool-the VALUES tool-focused on patients' goals, values, and priorities and described students' experiences using this tool. Methods: Medical students participated in a social worker-led VALUES didactic and discussion with a patient on the palliative care consult service and, subsequently, completed an anonymous survey about their comfort with the VALUES tool and its usefulness for learning (5-point Likert scales). Results: Of the 142 medical students who participated in the VALUES didactic, 37 completed the survey (26%). The VALUES tool was rated highly in terms of usefulness (mean 4.5; standard deviation [SD] 0.7) and rated lower in terms of overall comfort (mean 3.7; SD 0.7). Conclusion: Our project explored the integration of a VALUES tool into medical student education, and we show that the tool is well rated by learners in terms of comfort and usefulness.
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Affiliation(s)
- Julia L Frydman
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Laura P Gelfman
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Geriatric Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Diane Farquhar
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ravishankar Ramaswamy
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lindsay A Dow
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Plöger R, Abramian A, Egger EK, Mustea A, Sänger N, Plöger H, Weber E, Gembruch U, Walter A, Strizek B, Recker F. Evaluation of an OSCE's implementation and a two-step approach for a theoretical and practical training program in Obstetrics and Gynecology. Front Med (Lausanne) 2023; 10:1263862. [PMID: 38179276 PMCID: PMC10765409 DOI: 10.3389/fmed.2023.1263862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024] Open
Abstract
Objective structured clinical examination (OSCE) is a well-known assessment method to evaluate clinical skills and competence in healthcare. Following the recently reformed National Competence-Based Catalog of Learning Objectives in Medicine, the implementation of this assessment method in the training program for medical students is now obligatory in Germany. This major change requires a reorganization not only of the training programs but also of the students themselves and the way they learn. We performed a poll evaluating the students' opinions regarding these major changes and the implementation of the OSCE with a new training program. To implement this assessment method and to evaluate the OSCE, Kern's six-step approach comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback was applied. To evaluate and gather feedback, a poll was used to analyze the student's opinions regarding OSCE in gynecology and obstetrics and OSCE in general, in addition to the regular analysis of the students' results. To reform the educational strategy, a two-step approach was developed: First, the students completed the regular training program and a written examination, and second, they participated in a 1-week clerkship, in small group teaching, and in the OSCE. The OSCE stations were developed primarily based on the National Competence-Based Catalog and the German Catalog of Learning Objectives in Medicine, as well as on the feedback of experts reflecting their expectations for physicians beginning their careers. The students performed well in the OSCE and gave positive feedback regarding this examination method. Furthermore, they welcomed the upcoming changes by considering OSCE a valuable assessment tool, and they showed appreciation for the two-step approach by supporting the combination of an OSCE and a written examination. Thus, this article presents the implementation of an OSCE and a strategy for the adaptation of the curriculum to fulfill the new OSCE requirements and-to our knowledge-reveals students' primary opinions regarding the changes in their medical training program for the first time.
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Affiliation(s)
- Ruben Plöger
- Department of Obstetrics and Gynecology, University Hospital Bonn, Bonn, Germany
| | - Alina Abramian
- Department of Senology, University Hospital Bonn, Bonn, Germany
| | - Eva Katharina Egger
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Nicole Sänger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Bonn, Bonn, Germany
| | - Hannah Plöger
- Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany
| | - Eva Weber
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Perinatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Adeline Walter
- Department of Obstetrics and Perinatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Perinatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Florian Recker
- Department of Obstetrics and Perinatal Medicine, University Hospital Bonn, Bonn, Germany
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Pfarrwaller E, Maisonneuve H, Laurent C, Abbiati M, Sommer J, Baroffio A, Haller DM. Dynamics of Students' Career Choice: a Conceptual Framework-Based Qualitative Analysis Focusing on Primary Care. J Gen Intern Med 2023:10.1007/s11606-023-08567-9. [PMID: 38102409 DOI: 10.1007/s11606-023-08567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Increasing primary care's attractiveness as a career choice is an important task of socially accountable medical schools. Research has broadly studied influences on medical students' career choice. However, a deeper understanding of the processes behind career decision-making could support medical schools in their efforts to promote primary care careers. OBJECTIVE To explore the dynamics of career choice during medical school with a focus on primary care, based on a previously developed conceptual framework. APPROACH Qualitative study using a phenomenological, inductive-deductive approach DESIGN AND PARTICIPANTS: Individual interviews were conducted from May 2019 to January 2020 with 14 first-year postgraduate trainee physicians, graduates of the Faculty of Medicine in Geneva, Switzerland, purposively sampled based on their interest in primary care during undergraduate studies. The interview guide was developed to elicit narratives about career-related decision-making. Two authors coded the transcripts. Thematic analysis alternated with data collection until thematic saturation was reached. Emerging themes were discussed and refined within the research team. KEY RESULTS Two main themes emerged: (1) developing professional identity, expressed as a changing professional image from unprecise and idealistic to concrete and realistic; priorities changed from content-based to lifestyle-based preferences; (2) individual trajectories of career-related decision-making, determined by different stages of refining professional interests; students navigated this process by employing various strategies, ranging from active exploration to passive behaviors. CONCLUSIONS This study's narrative approach illustrates the dynamic nature of career choice and refines elements of a conceptual framework previously developed by the authors. Its findings underline the importance of exploration, for which personal experiences and observations of physicians' work are crucial. To advance efforts to make primary care a more attractive career, students must be sufficiently exposed to primary care in a safe and individualized environment and should be supported in all stages of their career choice process.
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Affiliation(s)
- Eva Pfarrwaller
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Hubert Maisonneuve
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University College of General Medicine, Faculty of Medicine, University Claude Bernard Lyon 1, Lyon, France
| | - Camille Laurent
- University College of General Medicine, Faculty of Medicine, University Claude Bernard Lyon 1, Lyon, France
| | - Milena Abbiati
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Johanna Sommer
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anne Baroffio
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Dagmar M Haller
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Zavorotnyy M, Klatte S, Yang Y, Liu W, Wagner U, Kircher T. The effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders as held by German medical students. Front Psychiatry 2023; 14:1306403. [PMID: 38144478 PMCID: PMC10748402 DOI: 10.3389/fpsyt.2023.1306403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background According to the United Nations, access to medical care is a fundamental human right. However, there is widespread stigmatization of severe mental illnesses and this appears to seriously hamper the quality of healthcare in people with psychiatric co-morbidity. Thus, interventions that help reduce stigma among healthcare providers are urgently needed. Purpose The objective of the current study was to investigate the effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders held by medical students. Methods Between 2018 and 2019, a total of 256 third- and fourth-year students from Marburg University Medical School (Germany) completed two surveys-one before and one after a 2 week clerkship program that was designed to prioritize direct interaction with the patients. For measuring stigma, the questionnaires contained questions about students' attitudes toward psychiatry (ATP), including the Opening Minds Scale for Healthcare Providers (OMS-HC), Community Attitudes Toward the Mentally Ill (CAMI), and measurements according to the Stereotype-Content Model (SCM). We conducted pre-vs.-post comparisons using the Wilcoxon signed rank test with continuity correction or paired t-test and employed the Spearman method for correlational analysis. We considered p < 0.05 significant and adjusted all p-values reported here using the Benjamini-Hochberg procedure to account for family-wise error. Results After the clerkship, a significantly reduced stigma was found, as assessed with ATP (mean p < 0.001), OMS-HC (sum and subscale "attitudes" p < 0.001; subscale "disclosure" p = 0.002), and both SCM subscales (p < 0.001). Moreover, we observed significant associations between stigma expression (e.g., OMS-HC sum) and the willingness of students to choose psychiatric residency after finishing medical school (before clerkship: p < 0.001; ρ = -0.35; change after clerkship: p = 0.004; ρ = -0.2). Conclusion Our findings indicate that a psychiatric clerkship that involves students in direct interaction with patients may effectively reduce stigma. Therefore, we advocate the incorporation of components of direct interaction in medical education to combat stigma and unequal treatment, as this could improve outcomes in patients with severe mental illnesses.
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Affiliation(s)
- Maxim Zavorotnyy
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Academic Hospital of the University of Zurich, Windisch, Switzerland
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Simon Klatte
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Yunbo Yang
- Department of Experimental Psychopathology, Institute of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Wei Liu
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Ulrich Wagner
- Department of Social Psychology, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
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Spicer JO, Ujunwa KC, Witt LS, Meka J, Gooding HC. Using instructor-developed study resources to increase evidence-based learning strategies among medical students: A mixed-methods study. Med Teach 2023; 45:1380-1386. [PMID: 37270765 PMCID: PMC11002966 DOI: 10.1080/0142159x.2023.2218537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Applying effective learning strategies to address knowledge gaps is a critical skill for lifelong learning, yet prior studies demonstrate that medical students use ineffective study habits. METHODS To address this issue, the authors created and integrated study resources aligned with evidence-based learning strategies into a medical school course. Pre-/post-course surveys measured changes in students' knowledge and use of evidence-based learning strategies. Eleven in-depth interviews subsequently explored the impact of the learning resources on students' study habits. RESULTS Of 139 students, 43 and 66 completed the pre- and post-course surveys, respectively. Students' knowledge of evidence-based learning strategies was unchanged; however, median time spent using flashcards (15% to 50%, p < .001) and questions (10% to 20%, p = .0067) increased while time spent creating lecture notes (20% to 0%, p = .003) and re-reading notes (10% to 0%, p = .009) decreased. In interviews, students described four ways their habits changed: increased use of active learning techniques, decreased time spent creating learning resources, reviewing content multiple times throughout the course, and increased use of study techniques synthesizing course content. CONCLUSION Incorporating evidence-based study resources into the course increased students' use of effective learning techniques, suggesting this may be more effective than simply teaching about evidence-based learning.
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Affiliation(s)
- Jennifer O. Spicer
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Katherine C. Ujunwa
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy S. Witt
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jennifer Meka
- Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Holly C. Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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Twardowski DA, Montemayor J, Payton M, Waller J. Impact of the USMLE Step 1 and COMLEX Level 1 transition to Pass/Fail on osteopathic medical student stress levels and board preparation. J Osteopath Med 2023; 123:563-569. [PMID: 37665166 DOI: 10.1515/jom-2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023]
Abstract
CONTEXT The United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Exam (COMLEX) Level 1 transitioned from a numeric scoring system to a Pass/Fail designation in 2022. This transition intended to decrease stress, improve medical student well-being, and encourage residency program directors to emphasize other aspects of residency applications. Pass/Fail score transitions in the undergraduate medical education curriculum have improved medical student psychological well-being and satisfaction; whether these same benefits translate to the board examination period is unknown. OBJECTIVES The objectives of this study are to assess the impact of USMLE Step 1 and COMLEX Level 1 grade scale transition on medical student stress, wellness, board preparation decisions, and future residency selection processes. Investigators hypothesized that students under the Pass/Fail designation would experience less stress during the intensive study period leading up to USMLE Step 1 and COMLEX Level 1 and devote more time to other aspects of their residency applications. METHODS To examine the impact on osteopathic medical student (OMS) stress and approach to board preparation, two surveys were administered to Rocky Vista University College of Osteopathic Medicine (RVU-COM) students before (Class of 2023) and after (Class of 2024) the transition to a Pass/Fail designation. All students within the RVU-COM Classes of 2023 and 2024 were invited to participate. The Cohen Perceived Stress Scale (PSS-10) was administered at the beginning of the focused board study period in May 2021 and 2022 to the Class of 2023 and 2024, respectively. The investigator-designed Licensing Exam Questionnaire (LEQ), meant to capture board preparation patterns, residency application perspectives, and wellness during examination preparation, was administered immediately after the board examination deadline in July 2021 and 2022 to the Class of 2023 and 2024, respectively. Statistical analysis included the use of independent t tests (numeric variables) and chi-square tests (categorical data). This project was considered exempt from full Institutional Review Board review. RESULTS Approximately one-third of the Class of 2023 (PSS-10: n=86; LEQ: n=93) and 2024 (PSS-10=89; LEQ: n=92) responded. No difference was detected in mean PSS-10 score, 20.14 (SD=7.3) compared to 19.92 (SD=6.56) for the Class of 2023 and 2024 (p=0.84), respectively. The Class of 2023 reported more weeks studying (mean 6.27 weeks, SD=0.79) vs. the Class of 2024 (mean 5.44 weeks, SD=0.007), p<0.001, more practice examinations taken X 2 (1, n=182)=13.75, p<0.001, and a greater proportion scheduled examinations after June 20 X 2 (1, n=182)=29.01, p<0.001. No difference existed in hours studying per day, sequence of Step 1/Level 1, time between examinations, money spent, or type of study resources utilized. CONCLUSIONS The transition of USMLE Step 1 and COMLEX Level 1 to a Pass/Fail designation did not reduce stress for OMSs at a single, multicampus COM. Respondents, however, altered board preparation practices in meaningful ways. As student behaviors and board-study patterns emerge, these insights must be connected to outcomes in the future.
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Affiliation(s)
| | - Jennifer Montemayor
- Office of Preclinical Education, Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA
| | - Mark Payton
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA
| | - Jacquelyn Waller
- Rocky Vista University Montana College of Osteopathic Medicine, Billings, MT, USA
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Gonzalo JD, Graaf D, Wolpaw DR, Lehman E, Thompson BM. Non-physician and physician preceptors in Landscapes of Practice: a mixed-methods study exploring learning for 1 st-year medical students in clinical experiences. Med Educ Online 2023; 28:2166386. [PMID: 36642918 PMCID: PMC9848231 DOI: 10.1080/10872981.2023.2166386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 02/22/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Medical education has traditionally relied on physician educators. With expanding Health Systems Science competencies, non-physician healthcare providers are required. To investigate preceptor-role types, communication frequency, and importance of preceptors in value-added patient navigator roles (PN) and clinical preceptorships (CP). Using a mixed-methods approach, medical students participating in PN and CP during the first year of medical school (n=191) identified individuals with whom they communicated and communication frequency (1=never, 7=frequently), and importance of preceptors to work/education (1=not important, 7=extremely important; open-ended responses). Quantitative data were analyzed via repeated measures using a mixed-effects model and McNemar's test; effect size was calculated via Cohen's d or Cohen's h; qualitative data was analyzed using thematic analysis. Comparing ratings for non-physicians to physician healthcare professionals in PN, communication frequency (5.54 vs 3.65; p<0.001, d=1.18), importance to work (5.77 vs 4.28, p<0.001, d=0.89) and education (5.02 vs 4.12, p<0.001; d=0.49) were higher for non-physician educators. Comparing ratings for non-physicians to physician healthcare professionals in CP, communication frequency (4.93 vs. 6.48, p<0.001, d=1.33), importance to work (5.12 vs 6.61 vs, p<0.001, d=1.29) and education (4.32 vs 6.55, p<0.001, d=1.89) were higher for physician educators. Qualitative analysis indicated that non-physician healthcare providers in PN focused on Health Systems Science concepts, including social determinants of health and healthcare delivery. In PN, students observed collaboration from the perspective of multiple providers. In CP, healthcare providers, mainly physicians, focused on physician-centric clinical skills and interprofessional collaboration from the physician's perspective. Educational benefits of non-physician healthcare professionals related to Health Systems Science in work-based clinical settings - or Landscapes of Practice - can help students understand systems-based concepts such as social determinants of health, healthcare delivery systems, and interprofessional collaboration. Differences in the educational value of non-physician healthcare educators perceived by students should be further explored.
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Affiliation(s)
- Jed D. Gonzalo
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Deanna Graaf
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Daniel R. Wolpaw
- Department of Medicine, Penn State College of Medicine in Hershey, Pennsylvania, USA
| | - Erik Lehman
- Penn State College of Medicine, Hershey, Pennsylvania, USA
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Rieffestahl AM, Mogensen HO, Morcke AM, Risør T. 'If you had taken the lead…' - a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students. Chronic Illn 2023; 19:692-703. [PMID: 35918800 DOI: 10.1177/17423953221115437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients' experiences relate to trust. METHODS Twenty-one video-recorded sessions of patients' feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes. RESULTS In the patients' feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe. DISCUSSION The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.
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Affiliation(s)
- Anne Marie Rieffestahl
- Capital Region of Denmark, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
- Section of General Practice and The Research Unit for general Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Hanne O Mogensen
- Department of Anthropology, Faculty of Social Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne Mette Morcke
- Centre for Educational Development, Aarhus University, Aarhus, Denmark
| | - Torsten Risør
- Section of General Practice and The Research Unit for general Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
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Scholz A, Gehres V, Schrimpf A, Bleckwenn M, Deutsch T, Geier AK. Long-term mentoring relationships in undergraduate longitudinal general practice tracks - a qualitative study on the perspective of students and general practitioners. Med Educ Online 2023; 28:2149252. [PMID: 36463500 PMCID: PMC9728122 DOI: 10.1080/10872981.2022.2149252] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Longitudinal general practice tracks have been established in medical faculties in Europe and worldwide to attract more graduates to general practice careers. In many programs, long-term mentoring relationships play an important role in providing students with positive role models, regular practical experiences, and acquisition of clinical skills in a community context. However, little is known about students' and general practitioner mentors' expectations, experiences, challenges, and ideas for improvement within these long-term mentoring relationships in general practice in our medical education system. METHODS Qualitative study based on semi-structured interviews with 15 students and 13 mentors. Interviews were audio-recorded and transcribed verbatim. MAXQDA was used for data analysis, following a mixed deductive/inductive approach. RESULTS Both groups had few and rather unstated expectations, particularly regarding their relationships. Consequently, expectations were often not clearly communicated. Nevertheless, a high level of satisfaction and good opportunities for teaching were achieved for both sides. The evolving familiarity facilitated a positive learning environment. Students valued independent medical tasks continuously adjusted to their current abilities. However, some felt a reluctance to demand their mentor's time and consideration. Conversely, the mentors criticized a lack of initiative from some of the students and wished that they would get more actively involved. Students, in contrast, wished for more guidance at the start of the project and joint events to deepen the relationship. CONCLUSIONS With this study, we gained detailed insights into and understanding of the nature of long-term relationships between students and mentors. Points for improvement revealed included: 1) education of both participating groups on the goals and benefits of mentoring, including binding expectations for the participants; 2) intensified support and training of teaching physicians; 3) structured and accompanied establishment of initial contact between mentor and mentee; and 4) encouraged additional shared (teaching) time, individualized timing, and intensification, if desired.
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Affiliation(s)
- Anna Scholz
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Vera Gehres
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Anne Schrimpf
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Markus Bleckwenn
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Tobias Deutsch
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Anne-Kathrin Geier
- Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
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Varachotisate P, Siritaweechai N, Kositanurit W, Thanprasertsuk S, Chayanupatkul M, Thongsricome T, Bumphenkiatikul T, Chuleerarux N, Watanatada P, Werawatganon D, Somboonwong J, Siriviriyakul P, Sanguanrungsirikul S, Bongsebandhu-Phubhakdi S, Ratanasirisawad V, Jaroenlapnopparat A, Burana C, Somsirivattana P, Kulaputana O, Kaikaew K. Student academic performance in non-lecture physiology topics following the abrupt change from traditional on-site teaching to online teaching during COVID-19 pandemic. Med Educ Online 2023; 28:2149292. [PMID: 36419226 PMCID: PMC9704068 DOI: 10.1080/10872981.2022.2149292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pre-clerkship medical education, including all physiology classes, was obliged to change to online teaching due to limitations of on-site (face-to-face) classes. However, the effectiveness of online teaching in non-lecture physiology topics during the COVID-19 pandemic has not been thoroughly investigated. METHOD We conducted a prospective study to evaluate the students' academic achievement and opinions on online teaching during the COVID-19 academic year. Academic achievement of 312 students in the COVID-19 year was compared with that of 299 students in the pre-COVID-19 year. Student opinions regarding social interactions and the preferred learning method were also collected. RESULTS We found that student academic achievement in the non-lecture physiology topics, assessed by summative scores, was 4.80±0.92 percent higher in the pre-COVID-19 year than in the COVID-19 year (P < 0.01, Cohen's d = 0.42). Students rated that online classes tended to reduce their interactions with peers and teachers; however, students preferred online learning over traditional on-site learning. CONCLUSIONS This study pointed out that students' academic performance related to the physiology topics taught by online non-lecture methods during the COVID-19 pandemic was lower than their performance when the topics were taught by the traditional (on-site) methods, although students reported that they preferred the online teaching. Hence, we suggest that medical teachers should deliberately plan and utilise a variety of tools and techniques when developing online non-lecture classes to preserve the interactivity of the classes, which might overcome this gap in students' academic performance.
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Affiliation(s)
- Pachara Varachotisate
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Natakorn Siritaweechai
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Weerapat Kositanurit
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sekh Thanprasertsuk
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Maneerat Chayanupatkul
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thana Thongsricome
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Nipat Chuleerarux
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pasakorn Watanatada
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Duangporn Werawatganon
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Juraiporn Somboonwong
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Prasong Siriviriyakul
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Varis Ratanasirisawad
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Chuti Burana
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Onanong Kulaputana
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kasiphak Kaikaew
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Stryker SD, Conway K, Kaeppler C, Porada K, Tam RP, Holmberg PJ, Schubert C. Underprepared: influences of U.S. medical students' self-assessed confidence in immigrant and refugee health care. Med Educ Online 2023; 28:2161117. [PMID: 36594616 PMCID: PMC9815430 DOI: 10.1080/10872981.2022.2161117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/19/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND United States (U.S.) census data from 2017 indicates that the percentage of persons born outside of the U.S. is increasing. However, no studies describe the amount of class time focused on immigrant and refugee health during medical school in the U.S. nor on incoming residents' confidence in providing culturally sensitive care. The objective of this study is to characterize final-year medical students' exposure to immigrant and refugee health and their confidence in caring for these populations. METHODS A voluntary, cross-sectional survey was sent electronically to fourth-year medical students at twelve U.S. medical schools in 2020, with 707 respondents (46% response rate). Questions addressed respondents' curricular exposure to immigrant and refugee health care during medical school and their confidence in providing culturally sensitive care. Chi-square tests were used to assess relationships between categorical variables, and odds ratios were calculated for dichotomized variables. RESULTS Most students (70.6%) described insufficient class time dedicated to culturally sensitive care, and many (64.5%) reported insufficient clinical exposure in caring for immigrants/refugees. The odds that incoming residents felt 'usually' or 'always' confident in their ability to provide culturally sensitive care to immigrants and refugees were higher in those with more class time on culturally sensitive care (OR 5.2 [3.6-7.4]), those with more clinical opportunities to care for immigrants and refugees (OR 7.2 [5.1-10.2]), and those who participated in a domestic low-resource or international elective (OR 1.4 [1.02-1.9]). More than half (55.3%) of respondents reported feeling 'not at all' or only 'sometimes' confident in their ability to provide culturally sensitive care to immigrants/refugees. CONCLUSIONS Most fourth-year U.S. medical students entering residency feel unprepared to deliver culturally sensitive care to immigrants and refugees. This may be mediated by increased exposure to didactic curricula class time and/or experiential clinical activities, as those factors are associated with improved student confidence.
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Affiliation(s)
- Shanna D. Stryker
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Katharine Conway
- Department of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
| | - Caitlin Kaeppler
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,USA
| | - Kelsey Porada
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,USA
| | - Reena P. Tam
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Charles Schubert
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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