Teaching Medical Students How to Use Interpreters: A Three Year Experience

Disparities in health exist among ethnic/racial groups, especially among members with limited English proficiency (LEP). The session described in this paper aimed to teach medical students the skills needed to communicate with patients with LEP. Description – We created a required session titled “Cross-Cultural Communication-Using an Interpreter” for third-year medical students with learning objectives and teaching strategies. The session plans evolved over three years. Program Evaluation – Students’ perceived efficacy using retrospective pre/post test analysis (n = 110, 86% response rate) administered 7 weeks post-session revealed that 77.3% of students felt “more prepared to communicate with a patient with LEP”, 77.3% to “give proper instructions to an untrained interpreter” and 76.4% to “access a hospital language line”. Conclusion – Our curricular intervention was effective in increasing students’ perceived efficacy in communicating with a patient with LEP, using untrained interpreters and accessing a hospital language line. Skills practice and discussion of using interpreters should be a part of medical education

Preparing Einstein Students to Practice in Twenty-first Century Medicine

The current trend in medical education is to introduce clinical teaching early in the medical school curriculum to help students understand the relevance of the basic sciences to clinical practice. The Introduction to Clinical Medicine (ICM) Program for students in the first two years at the Albert Einstein College of Medicine (AECOM) is comprised of three, required, integrated courses providing skills training in both medical interviewing and physical examination, training in diagnostic reasoning skills, and opportunities to discuss broad themes in medicine and the doctor-patient relationship. Competency evaluation of students’ clinical skills is an essential part of the ICM Program. Innovative strategies for weaving themes related to cultural competency have been incorporated into the ICM program to address the wide spectrum of cultural issues affecting medical care and the doctor/patient relationship, including diversity, spirituality, complementary and alternative medical practices, and end-of-life care. A total of 300 medical school faculty members teach in the various ICM courses. Much effort goes into keeping the faculty current, happy, and rewarded for their dedication and hard work in teaching the students. The ICM Program continues to strive for excellence as we prepare AECOM students to face the demands of medical practice in the twenty-first centur

INNOVATIVE MEDICAL EDUCATION Preparing Einstein Students to Practice Twenty-first Century Medicine

ABSTRACT The current trend in medical education is to introduce clinical teaching early in the medical school curriculum to help students understand the relevance of the basic sciences to clinical practice. The Introduction to Clinical Medicine (ICM) Program for students in the first two years at the Albert Einstein College of Medicine (AECOM) is comprised of three, required, integrated courses providing skills training in both medical interviewing and physical examination, training in diagnostic reasoning skills, and opportunities to discuss broad themes in medicine and the doctor-patient relationship. Competency evaluation of students' clinical skills is an essential part of the ICM Program. Innovative strategies for weaving themes related to cultural competency have been incorporated into the ICM program to address the wide spectrum of cultural issues affecting medical care and the doctor/patient relationship, including diversity, spirituality, complementary and alternative medical practices, and end-of-life care. A total of 300 medical school faculty members teach in the various ICM courses. Much effort goes into keeping the faculty current, happy, and rewarded for their dedication and hard work in teaching the students. The ICM Program continues to strive for excellence as we prepare AECOM students to face the demands of medical practice in the twenty-first century

Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

Introduction: Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development. Methods/Analysis: A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment. Results: We found significant differences among all three comparison arms on students’ reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students’ reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance. Discussion/Conclusions: Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students’ reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects

Additional file 1: of Who’s misbehaving? Perceptions of unprofessional social media use by medical students and faculty

Einstein Medical Student Survey on Social Media. (PDF 437 kb

Incident cardiovascular disease events in metabolically benign obese individuals

Objective: While several studies have demonstrated a high prevalence of metabolically benign obesity, little is known about the incidence of cardiovascular disease (CVD) in this group. Research design and methods: Using pooled data from the Atherosclerosis Risk in Communities and Cardiovascular Health Studies, we assessed the association of metabolically benign obesity with incident CVD (coronary heart disease and stroke) using three existing definitions of metabolically benign obesity: (1) the ATP-III metabolic syndrome definition (≤2 of the ATP-III components, excluding waist), (2) the expanded ATP-III definition (≤1 of: the ATPIII components, HOMA-IR\u3e75th percentile, systemic inflammation [WBC\u3e75th percentile]), and (3) the insulin resistance (IR) based definition (sex-specific lowest quartile of the HOMA-IR distribution among non-diabetic obese). Results: The sample included 4,323 normal weight and 6,121 obese individuals. Among obese, 27.0%, 18.1%, and 20.4% were metabolically benign by the three definitions, respectively. CVD incidence among metabolically benign obese defined by the three definitions (mean followup 11.8 years) was 8.7%, 7.2%, and 10.3%, respectively, versus 7.9% in low-risk normal weight individuals. Multivariate-adjusted hazard ratios (95% CI) of incident CVD in metabolically benign obese compared to low-risk normal weight individuals were 1.24 (0.99-1.57), 1.16 (0.86-1.56), and 1.28 (1.01-1.62), respectively. Conclusions: Regardless of the definition used, we observed a high prevalence of metabolically benign obesity. All three commonly used definitions were similar in terms of both classification and subsequent risk of CVD, with the expanded ATP-III criteria perhaps identifying the obese group at lowest risk of CV