The Open Medical Education Journal最新文献

{"title":"Reducing the Dosage: Decreasing Pediatric Clerkship Didactics","authors":"Amy B. Guiot, Michael Fitzgerald, C. Lehmann","doi":"10.2174/1876519X01407010001","DOIUrl":"https://doi.org/10.2174/1876519X01407010001","url":null,"abstract":"Background: While case-based learning (CBL) sessions and Computer assisted Learning in Pediatrics Project (CLIPP) modules can be effective teaching modalities, there is little information about the optimal number and types of cases to require of medical students. Aims: The aims of this investigation were to determine if a greater than 50% reduction in CBL and CLIPP improved student perceptions regarding: 1) reasonableness of the time required to complete CBL and CLIPP 2) educational effectiveness of CBL and CLIPP 3) and assess potential impact on shelf exam scores. Methods: The Class of 2013 completed 25 CBL and 6 CLIPP modules; a reduction from the 50 CBL and 16 CLIPP required of the 2012 class. A survey was emailed to students to assess their perceptions regarding the above aims. Results: The class of 2013 indicated the number of CLIPP required was more reasonable. The two classes reported similar levels of perceived effectiveness. There was no difference in mean shelf exam scores. Conclusion: We reduced by over 50% the number of CBL and CLIPP without negatively impacting the perceived effectiveness of those methods or exam scores. Perhaps clerkship directors can be selective and more learner-centered when choosing required CBL or CLIPP.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132026146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Students’ Experiences of Education with Blended Learning: A Qualitative Study of Perceived Advantages and Challenges","authors":"Susanne Nielsen, C. Furåker, A. Jakobsson","doi":"10.2174/1876519X01306010055","DOIUrl":"https://doi.org/10.2174/1876519X01306010055","url":null,"abstract":"The aim of the study was to explore medical students' experiences of e-learning and face-to-face meetings (blended learning) with a specific focus on the possibilities of and hindrances to the learning process. A pilot study was conducted with 14 medical students and a main study followed, with 119 medical students participating in three social medicine courses. Of the 119 medical students, 25 took part in a qualitative study evaluating the approach through inter- views. These were analysed using manifest content analysis. The findings indicated that blended learning was an appro- priate way for medical students to learn about medical insurance issues. The balance between e-learning and face-to-face meetings was satisfactory and the students used a variety of learning strategies when solving authentic patient cases. Some found the pedagogical approach frustrating, since they had to take more responsibility than previously and some were not interested in sharing their knowledge with their fellow students.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131036118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention of Knowledge and Clinical Skills by Medical Students: A Pro- spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model","authors":"Amaral Ft, L. Troncon","doi":"10.2174/1876519X01306010048","DOIUrl":"https://doi.org/10.2174/1876519X01306010048","url":null,"abstract":"Background: Retention of early-taught knowledge and fundamental clinical skills, albeit essential in medical education, has not been extensively investigated. This study is aimed at assessing prospectively the retention of knowledge and skills related to communication with patients and the physical examination by fourth year medical students after an introductory course in basic pediatric cardiology. Methods: Three cohorts of fourth year medical students aged 21-26 years volunteered for the study. All students (N = 130) were assessed immediately after the teaching period and after six months (N = 42) and after one year (N = 21) later. Assessments included a 40 multiple-choice question (MCQ) test and an 8-station objective structured clinical examination (OSCE) focused on communication with patients, physical examination and interpretation of diagnostic tests (chest radio- graphs and electrocardiograms). Cases were portrayed by either real, rehearsed patients or standardized patients. Student performance was assessed by trained staff members using structured checklists. Results: For all aspects of knowledge assessed, scores obtained in the second and the third assessment were significantly lower than those verified in the first assessment. There were no significant differences between the three assessments re- garding overall clinical performance and data for communication with patients and physical examination. Concerning di- agnostic tests interpretation, scores obtained in the second and third assessment were significantly lower than those veri- fied in the first assessment. Paired analysis of the results obtained for the 21 students who took the three assessments showed similar results, except for a trend for improvement in clinical skills. Conclusions: Medical student retention of clinical sciences knowledge follows a pattern similar to that found in other scientific domains, characterized by progressive decay after initial acquisition. In contrast, fundamental clinical skills, such as communication with patients and physical examination are substantially retained, which could be ascribed to con- tinuous practice. These findings should be taken into account for devising instructional strategies for enhancing student knowledge and clinical skills maintenance.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123268761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of How Studying a Clinical Case Influences Medical Students' Capabilities for Performing a Lumbar Puncture Four Weeks Later","authors":"H. Storm","doi":"10.2174/1876519X01306010035","DOIUrl":"https://doi.org/10.2174/1876519X01306010035","url":null,"abstract":"Objective: The objective of this study is to evaluate medical students' perceptions of acceptability of a simula- tion-based lumbar puncture (LP) course and its effect on standardized LP performance four weeks later. Tests were also conducted to find out whether skills were improved by including a clinical case to establish the relevance of the learning material in the LP course. Methods: Medical students in their pediatric term (n=45) were invited to participate and were randomly divided into three groups. The simulation group was offered only the LP course, while the simulation and clinical case group was offered a clinical case leading to performing LP on an infant before attending the actual LP course. The groups were tested four weeks after the LP courses together with a control group that had attended neither the LP course nor the clinical case. The testing was conducted by awarding points, up to a maximum of 26, for the different correct actions performed during the LP procedure. Results: The medical students in the skill group (n=11) performed similarly to the students in the skill and clinical case group (n=9), 14.2 (+/- 4.4) and 13.9 (+/- 4.3) respectively, and better than the control group, (n=10) 5.6 (+/-4.8) (p<0.01). Conclusions: When tested, the medical students who had completed the LP course performed better than the control group that had not been offered this course during their pediatric term. Hence, introducing a clinical case in the LP course did not improve LP skills.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126711009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Resident Screening for Social Determinants of Health: The Development and Assessment of a Structured Direct Observation Tool","authors":"Karen E Jerardi, Jennifer K O'Toole, Melissa D. Klein","doi":"10.2174/1876519X01306010029","DOIUrl":"https://doi.org/10.2174/1876519X01306010029","url":null,"abstract":"Background: Physicians must gain competency engaging and screening families from all socioeconomic back- grounds with the growing number of children living in poverty. Traditional medical training lacks sufficient education in screen- ing for social determinants of health. We developed a direct observation tool to evaluate resident screening for social determi- nants of health, assessed its reliability, and determined if the tool could detect practice change after an educational intervention. Methods: A quasi-experimental interventional study of pediatric residents in a primary care setting using a direct observation tool during patient encounters was undertaken. Descriptive test statistics of individual question frequency and discrimination as well as overall test reliability were completed. Changes in the total time discussing social history and number of questions asked after an educational intervention were analyzed. Results: Increase in mean number of questions from 6.6 pre intervention to 8.5 post- intervention (p=.04). Residents spent a statistically significant greater amount of time (97 to 184 seconds, p=.01) discussing the social history with patients after education. Point biserial calculations for all items in the tool were positive. Conclusions: This direct observation tool was reliable and detected practice changes in this innovative pilot study. This structured tool may improve compliance with direct observation requirements and help provide residents with objective feedback.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121824019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter; Are Students Who do not Complete their Medical School Education Abandoned? Is More Help Needed?","authors":"P. Mancias, R. Bick","doi":"10.2174/1876519X01306010022","DOIUrl":"https://doi.org/10.2174/1876519X01306010022","url":null,"abstract":"During our teaching we have been confronted with a number of stressed students over the years and yet there have been relatively few discussions, workshops or group meetings no, how to help them face life after medical school if they should fail to complete their studies. We were concerned about this, especially as there are relatively easy steps that can be taken to help, and the cost of medical school increasing leading to increased debt with nothing to show for it. Tui- tion this year will range from $28,000 to $50,000 at a public and private institution respectively, with total costs from $50- $70,000. Using a simple search of a number of medical school and blog sites, we formulated a simple tool that would at least, we hope, give some guidance to students that leave medical school early. It is hoped that this link table will be developed, updated and expanded further in the future so that these bright, degree-holding people do not find themselves suddenly cast adrift.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133989774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse Practitioner and Physician Preceptors Perceptions of Student Nurse Practitioner Training and Practice: Expectations, Comparison with Medical Students and Faculty Experience","authors":"E. Giardino, A. Giardino","doi":"10.2174/1876519X01306010012","DOIUrl":"https://doi.org/10.2174/1876519X01306010012","url":null,"abstract":"Purpose: To determine the perceptions of nurse practitioner and physician preceptors towards student nurse practitioners focusing specifically on what preceptors expect from student nurse practitioners at the beginning and at the end of the clinical training experience, how each views the student nurse practitioners as compared to medical students at various years in medical school, and the preceptors own faculty experience. Results: The overall adjusted response rate for the survey was 58% (94/161). Nurse practitioner and physician preceptors found student nurse practitioners to be at an expected level of practice when starting clinical experiences in a primary care setting in these areas: completing a history, adjusting med doses, diagnosing common problems, determining treatment meds and teaching about home care responsibilities. Nurse practitioner and physician preceptors thought student nurse practitioners were weaker than expected in the areas of generating differential diagnoses and prioritizing differentials. Nurse practitioner and physician preceptors differed in their comparison of beginning student nurse practitioners to medical students in different years of training with physician preceptors viewing student nurse practitioners as comparable to first and second year medical students where as nurse practitioner preceptors viewed them as comparable to third and fourth year medical students. Conclusion: Remarkable similarity exists among nurse practitioner and physician preceptors around expectations for clinical skill development for their student nurse practitioner trainees. Some differences do exist around views of how student nurse practitioner trainees compare in the clinical setting to medical students in different years of medical school. Regarding faculty experience each group of preceptors values their precepting experience. Enhanced orientation and faculty development efforts may be of value in clarifying roles and responsibilities among nurse practitioner and physician preceptors when working with student nurse practitioners.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130276892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administering a Rural Longitudinal Integrated Clerkship Across 5 US States","authors":"Jay S. Erickson, T. Norris, D. Schaad","doi":"10.2174/1876519X01306010001","DOIUrl":"https://doi.org/10.2174/1876519X01306010001","url":null,"abstract":"This article illustrates the administrative structure that has evolved to support a multistate longitudinal inte- grated clinical clerkship (LICC) experience. In 1996 the University of Washington School of Medicine created the WWAMI Rural Integrated Training Experience (WRITE), a five-month rural continuity based LICC experience. WRITE students spend five months in a rural immersion experience with a primary care preceptor. During this time students form continuity based relationships with patients and preceptors, which allows students to develop skills and knowledge re- quired to treat the broad range of medical, surgical, and psychosocial problems found in rural communities. Administration of 21 rural sites across five states is based on a strong partnership between rural practice sites, regional clinical deans'offices, and the departments and dean's office in an academic medical center.We explore the key aspects of the multi-layered administration that has evolved to support the WRITE program. A review of the year-long calendar of the WRITE program illustrates the complexity, detail and components necessary for the administration of this successful program.Rural LICC experiences like WRITE offer a useful approach to meeting rural physician workforce needs. A brief review of the WRITE outcome data will be explored. Administration of a multistate LICC experience requires synchroni- zation of many components, especially a strong regional administrative presence that connects the rural practice sites with the academic medical center.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133860029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivational Consequences that Affect the Timeliness and Candidness of Resident Evaluations","authors":"Michael Fitzgerald, Daniel Schumacher","doi":"10.2174/1876519X01205010017","DOIUrl":"https://doi.org/10.2174/1876519X01205010017","url":null,"abstract":"Motivational factors that undermine the willingness of raters to be timely and candid in their evaluation of resi- dents has not been well studied. According to expectancy theory, this motivation stems from perceptions regarding the likelihood and desirability of various consequences associated with those actions.The aim of this initial investigation is to identify the range of positive andnegative consequences that might drive a rater's motivation toward - or away from - be- ing timely and candid when completing resident evaluations. Methods: This was an exploratory descriptive investigation using semi-structured interviews with nine physician faculty at Cincinnati Children's Hospital Medical Center. Faculty were asked to describe the potential consequences of being timely (or not) and being candid (or not) in their resident evaluations. The consequences described by respondents were analyzed using a thematic coding process. Results: A range of consequences were identified including personal-related (e.g., a sense of fulfilling one's role obliga- tions); resident-related (e.g., affecting self-confidence); and institution-related (e.g., chances of renewed accreditation). Conclusions: The range of potential consequences identified in this investigation shines a light on the motivational factors that should be considered with regards to rater timeliness and candidness and providesthe necessary information for the next step: the development of a tool for assessing raters' perceptions of the like lihood and desirability of each conse- quence in a specific rating context.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"244 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114091265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Study of ALSO ® Trained and Traditionally Trained OB-GYN and Family Medicine Residents in Shoulder Dystocia","authors":"P. Tullar, B. True, A. Stowe-Quain, R. Kauffman, K. Graves-Evenson","doi":"10.2174/1876519X01205010012","DOIUrl":"https://doi.org/10.2174/1876519X01205010012","url":null,"abstract":"Introduction: Obstetrics is a high risk specialty. The cephalic presentation vaginal delivery complicated by shoulder dystocia is a medical emergency commonly encountered. This study compares shoulder dystocia resolution edu- cational and manual skills of Obstetrics and Gynecology (OB-GYN) and Family Medicine (FM) residents following com- pletion of Advanced Life Support in Obstetrics (ALSO ® ) trained vs. a group of OB-GYN and FM residents untrained in ALSO but trained in traditional means in a traditional residency to manage shoulder dystocia. Materials and Methods: Shoulder dystocia resolution skills taught in simulation using pelvic and fetal manikins were tested in Family Medicine and OB-GYN residencies who were ALSO ® trained, and they were retested for the purpose of this study 6 months after their training. The same testing, using the same checklist, was done for traditionally trained OB- GYN and Family Medicine residents (who had not been exposed to the ALSO® training) by the same instructor, using the same checklist. Results: The mean score of all (FM & OB-GYN) who had taken the course six months before testing was statistically higher than those in traditional OB-GYN and FM training who had not (p < 0.0001). Discussion/Conclusions: Performance scores of simulation-trained Family Medicine and OB-GYN residents in resolving shoulder dystocia was higher 6 months after training compared to a group of OB-GYN and Family Medicine residents from traditional residencies not trained in shoulder dystocia resolution. This may have implications for patient safety.","PeriodicalId":304672,"journal":{"name":"The Open Medical Education Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124358116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}