22,390 research outputs found

    Skills Training in Laboratory and Clerkship: Connections, Similarities, and Differences

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    Context: During the third semester of a 6 year long curriculum medical students train clinical skills in the skills laboratory (2 hours per week for 9 weeks) as well as in an early, 8 week clinical clerkship at county hospitals. Objectives: to study students’ expectations and attitudes towards skills training in the skills laboratory and clerkship. Subjects: 126 medical students in their 3rd semester. Methods: During the fall of 2001 three consecutive, constructed questionnaires were distributed prior to laboratory training, following laboratory training but prior to clerkships, and following clerkships respectively. Results: Almost all (98%) respondents found that training in skills laboratory improved the outcome of the early clerkship and 70% believed in transferability of skills from the laboratory setting to clerkship. Still, a majority (93%) of students thought that the clerkship provided students with a better opportunity to learn clinical skills when compared to the skills laboratory. Skills training in laboratory as well as in clerkship motivated students for becoming doctors. Teachers in both settings were perceived as being committed to their teaching jobs, to demonstrate skills prior to practice, and to give students feed back with a small but significant more positive rating of the laboratory. Of the 22 skills that students had trained in the laboratory, a majority of students tried out skills associated with physical examination in the clerkship, whereas only a minority of students tried out more intimate skills. Female medical students tried significantly fewer skills during their clerkship compared to male students. Conclusions: Students believe that skills laboratory training prepare them for their subsequent early clerkship but favour the clerkship over the laboratory

    An Integrated Approach for Evaluating Students' Achievement of Clinical Objectives

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    During the clinical phase of undergraduate medical education (UME) students are often geographically dispersed and assigned to preceptors throughout the community. Monitoring, documenting, and evaluating their clinical experiences and achievement of clinical objectives in this venue becomes a challenge, especially for large UME programs. The purpose of this manuscript is to discuss a method for developing and implementing a school-wide evaluation system for the clinical phase of UME. This type of evaluation system links students' clinical experiential data with the objectives of a clerkship, using technological advances, such as the Personal Digital Assistant (PDA), Internet, and intranet. Clerkship directors are provided real-time reports on student's progress toward achieving clerkship objectives and are able to monitor the clinical activities of the clerkship. Students on the other hand, will be empowered to take more control of their educational experiences by monitoring their own progress

    Family Centered Rounds Simulation and Medical Students\u27 Perceptions

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    Background: Studies show that family centered rounds (FCR) improve family satisfaction by involving the families in their children’s care. Medical students consistently find FCR beneficial to families but have differing attitudes regarding benefits to the medical team. Some concerns raised by the students include longer rounds, decreased bedside teaching, and lack of opportunities to improve FCR skills. We developed a FCR simulation to aid medical students in FCR presentation. Methods: On the first day of the clerkship, medical students presented a patient admission to two evaluators playing a parent and an attending physician. The patient admission note was emailed to the students prior to the simulation. Students were provided immediate feedback and asked to complete a survey. The survey asked if they thought FCR would benefit family, nurses, physicians, students, and efficiency of rounds. The students provided answers based on five point Likert scale. Finally, they completed a similar survey at the end of the clerkship. Results: The vast majority (95%) of the students had never participated in FCR prior to the simulation. The simulation made students more comfortable presenting in FCR (average score 4.5 on 5 point Likert Scale). There were no significant differences in positive attitudes towards FCR to families, nursing, physician, and medical education in the pre and post clerkship surveys. Most (67%) students’ perception towards FCR changed positively by the end of the clerkship. Discussion: Most of the medical students had never participated in FCR presentation prior to the start of the clerkship, and they found the simulation helpful in preparing for FCR. Although specific attitudes about the benefit of FCR to the family and medical team did not change likely due to ceiling effect, most of the students did have positive perception of FCR by the end of the clerkship

    'Can you take a student this morning?' Maximising effective teaching by practice nurses

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    <p><b>Objectives:</b> Little is known about the contribution that nurses make to medical student learning. This study set out to explore the nature of practice nurse teaching during the general practice clerkship and to explore ways in which the teacher and learner (the practice nurse and the medical student) can be best supported to maximise learning.</p> <p><b>Method:</b> Mixed focus groups were conducted with general practitioner educational supervisors and practice nurses. Further focus groups were conducted with students on completing a clerkship.</p> <p><b>Results:</b> There is wide variation in the delivery, organisation and expectations of practice nurse teaching. While there is some evidence of a passive learning experience the learning dynamic and the student-nurse relationships are regarded highly.</p> <p><b>Conclusions:</b> Time spent with practice nurses is an important part of the clerkship in general practice. The nature of the practice nurse-medical student relationship is different to the educational supervisor-medical student relationship and can be built upon to maximise learning during the clerkship. The experience for the practice nurse, the medical student, and the supervisor can be enhanced through formal preparation for delivering teaching</p&gt

    A student-led clerkship primer: a near-peer orientation to clerkship

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    Implication Statement The transition between pre-clerkship and clerkship can be difficult for medical students. Near-peer teaching may fill knowledge gaps within curricular clerkship orientation, leveraging recent, relatable, and up-to-date experiences from near-peers. These benefits have not been formally evaluated in the context of a clerkship orientation. We therefore created the Clerkship Primer, a near-peer teaching initiative that aimed to introduce incoming clerks to clerkship through a curricular session facilitated exclusively by senior clerkship students. Sessions had high satisfaction among students. This pilot project suggests that curricular near-peer teaching is a valuable component of clerkship orientation

    Mission: Improbable - Practicing Law in Ukraine

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    Peter Teluk chooses Baker & McKenzie\u27s Kiev office over a federal clerkship and mixes multinational business with cowboy law at its finest

    Student Perceptions of the Professional Behavior of Faculty Physicians

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    This study was conducted to obtain a baseline understanding of the professional behavior of clinical faculty physicians from the medical students’ perspective. Students completed a professionalism evaluation of supervising faculty at the end of each required third-year clerkship over a one year period. Results were analyzed by specific behaviors and across clerkships. Differences were noted in the frequency of the types of problems seen, and varied by clerkship discipline. The most common transgressions of professional behavior reported were the use of derogatory language towards other services or patients and the disrespectful treatment of others. Our study served to provide objective feedback to the faculty about student perceptions of faculty as role models for professionalism while on clinical rotations

    Improving clerkship preparedness: a hospital medicine elective for pre-clerkship students.

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    BackgroundMedical students often struggle to apply their nascent clinical skills in clerkships. While transitional clerkships can orient students to new roles and logistics, students may benefit from developing clinical skills in inpatient environments earlier in their curriculum to improve readiness for clerkships.InterventionOur four- to six-session elective provides pre-clerkship students with individualized learning in the inpatient setting with the aim of improving clerkship preparedness. Students work one-on-one with faculty who facilitate individualized learning through mentoring, deliberate practice, and directed feedback. Second-year medical students are placed on an attending-only, traditionally 'non-teaching' service in the hospital medicine division of a Veterans Affairs (VA) hospital for half-day sessions. Most students self-select into the elective following a class-wide advertisement. The elective also accepts students who are referred for remediation of their clinical skills.OutcomeIn the elective's first two years, 25 students participated and 47 students were waitlisted. We compared participant and waitlisted (non-participant) students' self-efficacy in several clinical and professional domains during their first clerkship. Elective participants reported significantly higher clerkship preparedness compared to non-participants in the areas of physical exam, oral presentation, and formulation of assessments and plans.ConclusionsStudents found the one-on-one feedback and personalized attention from attending physicians to be a particularly useful aspect of the course. This frequently cited benefit points to students' perceived needs and the value they place on individualized feedback. Our innovation harnesses an untapped resource - the hospital medicine 'non-teaching' service - and serves as an attainable option for schools interested in enhancing early clinical skill-building for all students, including those recommended for remediation.AbbreviationsA&P: Assessment and plan; H&P: History and physical; ILP: Individual learning plan

    Using area health education centers to promote interest in rural practice

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    Introduction: In the USA, area health education centers (AHECs) work to recruit and educate students to serve in medically underserved communities, primary care, and rural settings. One important aspect of their work is connecting students with rural clinical experiences. Within these experiences, AHECs incorporate a community health/socioeconomic experience within the family medicine clerkship that may not be as prevalent in the standard family medicine clerkship experiences. The purpose of the study was to assess the relationship between AHEC-sponsored family medicine clerkships with a self-reported intent to practice in a rural setting upon graduation. Methods: The study compared third-year medical students with the Indiana University School of Medicine, which participated in AHEC-sponsored family medicine clerkships to the standard family medicine clerkship. Following the 4-week clerkship, students were asked to report their intent to work in a rural setting using a five-point Likert scale. A χ2 test was used to determine the association of AHEC sponsorship, clerkship site location (rural/urban) and intent to practice in a rural setting. Results: The study consisted of 587 students. There was a statistically significant association between self-reported intent and rural clerkship site, χ2 (1, N=587)=6.542, p=0.01. Furthermore, 21.6% (n=25) of students with a rural clerkship experience reported a greater intent compared to 12.3% (n=58) of students with non-rural clerkship experience. Conclusions: The study confirmed a significantly positive association between participation in medical clerkship experiences in a rural primary care setting and the intent to practice in a rural setting upon graduation. The results also support the potential value-added benefits through academic–community partnerships with AHECs, family medical and other primary care specialty clerkship programs may perhaps succeed in increasing student interest in pursuing a practice serving in rural communities upon graduation

    Access to Mobile Resources: How Does It Affect the Clerkship Experience?

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    Objectives: To evaluate the perceived benefits of access to library-licensed mobile clinical decision support resources in clinical medical education. Methods: A cohort of medical students was surveyed midway through the clerkship year. Dana Medical Library offered instruction on clinical mobile resources at the beginning of the year. Students were offered a subject guide and assistance with authentication. Assessment methods included web analytics measuring the utility of the subject guide and a survey. Survey questions gathered data on access to mobile devices, relevance of instruction, use of library-licensed mobile resources, and benefits and barriers to their use in the clinical setting. Students were also asked whether access to mobile resources facilitated comparable educational experiences across clerkship sites. Results: The survey was sent to all 111 students from the University of Vermont College of Medicine class of 2014; 31 completed the survey, with a completion rate of 28%. All respondents owned a mobile device, despite efforts to recruit both users and non-users. Nearly 75% of respondents reported using an iPhone. About 90% of respondents brought their mobile device on rotation. Generally, the wireless access at each clerkship site was rated good or excellent. Of the 60% of respondents who attended the instruction session on mobile resources, 94% found the class helpful. Half of the respondents looked at the Mobile Apps subject guide; 70% of those who did found it helpful. A significant increase in page views was reflected in subject guide usage statistics immediately following the instruction session. Approximately 25% of respondents sought out individual assistance at the library. Conclusions: Respondents suggested improvements to library instruction such as distributing access codes during the class and demonstrating installation of an app. A large number of students did not seek additional assistance from the library, citing they did not have any questions. While that may be because they found the subject guide and/or class sufficiently helpful, a significant number of respondents indicated they were unaware of the subject guide. This suggests a need for further promotion and marketing efforts. Researchers were surprised that nonlibrary licensed apps (ePocrates or Medscape) were valued over resources such as DynaMed, and that the most common barrier cited was not having access to appropriate apps. Finally, almost all of the participants who reported taking a mobile device on a rotation agreed it facilitated access to clinical information and improved the clerkship experience
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