Student Perceptions of the Professional Behavior of Faculty Physicians

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

A National Survey of Undergraduate Clinical Education in Internal Medicine

BACKGROUND: In the present milieu of rapid innovation in undergraduate medical education at US medical schools, the current structure and composition of clinical education in Internal Medicine (IM) is not clear. OBJECTIVE: To describe the current composition of undergraduate clinical education structure in IM. DESIGN: National annual Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey. PARTICIPANTS: One hundred twenty-nine clerkship directors at all Liaison Committee on Medical Education accredited US medical schools with CDIM membership as of September 1, 2017. MAIN MEASURES: IM core clerkship and post-core clerkship structure descriptions, including duration, educational models, inpatient experiences, ambulatory experiences, and requirements. KEY RESULTS: The survey response rate was 83% (107/ 129). The majority of schools utilized one core IM clerkshipmodel (67%) and continued to use a traditional block model for a majority of their students (84%). Overall 26% employed a Longitudinal Integrated Clerkship model and 14% employed a shared block model for some students. The mean inpatient duration was 7.0 ± 1.7 weeks (range 3–11 weeks) and 94% of clerkships stipulated that students spend some inpatient time on general medicine. IM-specific ambulatory experiences were not required for students in 65% of IM core clerkship models. Overall 75% of schools did not require an advanced IM clinical experience after the core clerkship; however, 66% of schools reported a high percentage of students (> 40%) electing to take an IM sub-internship. About half of schools (48%) did not require overnight call or night float during the clinical IM sub-internship. CONCLUSIONS: Although there are diverse core IM clerkship models, the majority of IM core clerkships are still traditional block models. The mean inpatient duration is 7 weeks and 65% of IM core clerkship models did not require IM-specific ambulatory education

Student response to reports of unprofessional behavior: assessing risk of subsequent professional problems in medical school

Background: An early concern note (ECN) program is used by some medical schools to identify, counsel, and intervene when students exhibit unprofessional behavior. Student maturity, insight, propensity for reflection, and receptiveness to feedback have been suggested as predictors of future behavior. Objective: We hypothesized that (a) classifying students with a first ECN based on their response to the report would identify students at risk of repeat ECNs better than the action that prompted it and (b) receipt of multiple ECNs would identify students at risk of adverse academic events. Design: For this study, 459 ECNs were classified based on students’ (1) recognition that their behavior was inappropriate and (2) acceptance of responsibility for the behavior. Student academic progress and receipt of subsequent ECNs were tracked. Results: Students who recognized their behavior was inappropriate and accepted responsibility after an initial ECN received subsequent ECNs at lower rates (14–19%) than students who disagreed with the significance of their behavior or were resistant to accepting responsibility (36–59%). Students with limited insight and adaptability appeared to be at highest risk. Seventy-one percent of students with three or more ECNs encountered adverse academic events during enrollment. Conclusion: Student reactions to reports of unprofessional behavior may be useful as a tool to help assess risk of recurrent lapses. Students with diminished capacity to recognize behaviors as unprofessional or accept responsibility for them appear to be at highest risk for additional adverse academic and professionalism events while in medical school

Clinical reasoning education at US medical schools: results from a national survey of internal medicine clerkship directors.

BACKGROUND: Recent reports, including the Institute of Medicine\u27s Improving Diagnosis in Health Care, highlight the pervasiveness and underappreciated harm of diagnostic error, and recommend enhancing health care professional education in diagnostic reasoning. However, little is known about clinical reasoning curricula at US medical schools. OBJECTIVE: To describe clinical reasoning curricula at US medical schools and to determine the attitudes of internal medicine clerkship directors toward teaching of clinical reasoning. DESIGN: Cross-sectional multicenter study. PARTICIPANTS: US institutional members of the Clerkship Directors in Internal Medicine (CDIM). MAIN MEASURES: Examined responses to a survey that was emailed in May 2015 to CDIM institutional representatives, who reported on their medical school\u27s clinical reasoning curriculum. KEY RESULTS: The response rate was 74% (91/123). Most respondents reported that a structured curriculum in clinical reasoning should be taught in all phases of medical education, including the preclinical years (64/85; 75%), clinical clerkships (76/87; 87%), and the fourth year (75/88; 85%), and that more curricular time should be devoted to the topic. Respondents indicated that most students enter the clerkship with only poor (25/85; 29%) to fair (47/85; 55%) knowledge of key clinical reasoning concepts. Most institutions (52/91; 57%) surveyed lacked sessions dedicated to these topics. Lack of curricular time (59/67, 88%) and faculty expertise in teaching these concepts (53/76, 69%) were identified as barriers. CONCLUSIONS: Internal medicine clerkship directors believe that clinical reasoning should be taught throughout the 4 years of medical school, with the greatest emphasis in the clinical years. However, only a minority reported having teaching sessions devoted to clinical reasoning, citing a lack of curricular time and faculty expertise as the largest barriers. Our findings suggest that additional institutional and national resources should be dedicated to developing clinical reasoning curricula to improve diagnostic accuracy and reduce diagnostic error

Medical Teacher How to write an educational research grant: AMEE Guide No. 101 How to write an educational research grant: AMEE Guide No. 101

Abstract Writing an educational research grant in health profession education is challenging, not only for those doing it for the first time but also for more experienced scholars. The intensity of the competition, the peculiarities of the grant format, the risk of rejection, and the time required are among the many obstacles that can prevent educational researchers with interesting and important ideas from writing a grant, that could provide the funding needed to turn their scholarly ideas into reality. The aim of this AMEE Guide is to clarify the grant-writing process by (a) explaining the mechanics and structure of a typical educational research grant proposal, and (b) sharing tips and strategies for making the process more manageable

How to write an educational research grant: AMEE Guide No. 101

© 2015 AMEE. Writing an educational research grant in health profession education is challenging, not only for those doing it for the first time but also for more experienced scholars. The intensity of the competition, the peculiarities of the grant format, the risk of rejection, and the time required are among the many obstacles that can prevent educational researchers with interesting and important ideas from writing a grant, that could provide the funding needed to turn their scholarly ideas into reality. The aim of this AMEE Guide is to clarify the grant-writing process by (a) explaining the mechanics and structure of a typical educational research grant proposal, and (b) sharing tips and strategies for making the process more manageable