The Student Grand Round: A Peer Teaching Initiative.

Introduction Oral presentation and public speaking skills are poorly emphasised in the medical school curriculum. The student grand round was created to tackle this deficiency by changing the way in which students are taught, from traditional lecture-based learning to interactive small-group peer-to-peer teaching. This approach encourages students to become responsible for their own learning, develop their public speaking and teaching skills, as well as identify and address gaps in their knowledge. Aims The primary aims of this study were to determine the understanding of students before and after peer teaching, including retention of concepts via quiz scores and confidence of students in giving SBAR (Situation, Background, Assessment, Recommendation) handovers. The secondary aim is to determine the place of student-led grand round teaching in the medical curriculum as a means of developing teaching skills and encouraging active learning. Methods A cohort of 21 third-year medical students from Leicester University attended a weekly peer teaching programme where students presented a case they had encountered during their clinical attachment. Peer teachers were required to research some background and pathophysiology regarding the topic and teach in an interactive manner and create discussion regarding the topic. The students then summarised the case and practised the skill of concise handovers using the SBAR format. Knowledge and understanding were assessed with an interactive quiz, and feedback via a survey was gathered before and after sessions. Each student engaged in case discussion and received input from a specialty registrar regarding their presentation skills, case knowledge, and SBAR handover. Results Individual and combined session analysis demonstrated a significant improvement in scores across understanding the topic and confidence in SBAR. Student recommendation for the session cumulatively was significant (p=0.02); however, comparison of medical student recommendations of individual sessions did not yield statistically significant results. There was a significant improvement in the overall quiz score (p=0.045), and average scores improved from 51% to 70% (p=0.043). There was a significant increase in the mean quiz result after the first two sessions (28-55% (p=0.002) and 56-85% (p=0.0001), respectively). Summary The student grand round is a promising teaching initiative that capitalises on peer teaching, a valuable learning theory that centres around students taking on the role of teachers to instruct their peers. Results from this study have shown that this method of collaborative teaching is effective in improving the understanding of medical topics, increases confidence in public speaking and precise handover skills, and therefore better prepares medical students for their career as future clinicians.

Benchtop fine needle aspirations: An untapped source of cytologic educational material.

Fine needle aspirations (FNAs) are a valuable tool for the diagnosis of a wide variety of lesions. However, obtaining proficiency in performing FNAs and finding simulated scenarios where one can practice specimen adequacy and slide smearing can all be challenging. Benchtop FNAs of fresh surgical specimens offer a novel training opportunity that addresses these needs. In this study, we describe the feasibility and practicality of benchtop FNAs of fresh surgical specimens as a training tool. We performed benchtop FNAs on multiple specimen types, although most were partial and radical nephrectomies. We documented this approach to cytology training and have provided examples of slides that were generated, along with the surgical pathology correlate. Our results suggest that benchtop FNAs of fresh surgical specimens can be a valuable training tool in the arsenal of today's cytopathologist. This technique offers several advantages over traditional training methods, including the ability to generate high-quality cytology slides, provide cyto-histo correlation, and practice almost immediate gross-microscopic correlation. However, there are also some disadvantages to this approach, including the need for immediate access to fresh surgical specimens and the potential for artifacts to be introduced. Overall, we believe that benchtop FNAs of fresh surgical specimens offer a promising new training tool that can maximize training opportunities, especially in institutions where the FNA volume is low.

Escape MD: Using an Escape Room as a Gamified Educational and Skill-Building Teaching Tool for Internal Medicine Residents.

Purpose To create an innovative medicine-themed escape room (EsR) and assess its feasibility as a learner-centered educational model for medical trainees. This platform could be used to teach and reinforce medical knowledge as well as enhance team-building skills. Materials and Methods We created an internal medicine (IM) themed EsR, in which participants are locked and instructed to solve a series of puzzles using both medical and nonmedical concepts to "escape" the room within a given set of time. The players must use their critical thinking and communication skills to solve puzzles consisting of complex activities (such as image identification and object matching or retrieval) linked in a nonlinear pattern. A pre-activity survey was used to collect basic demographic information and initial perceptions of the activity. A post-activity survey consisting of a modified Likert scale and free-response questions was used to assess perceived activity use and satisfaction. The activity was followed by a debriefing session with a faculty member to reflect on individual and team-based learning. This study was approved by the Institutional Review Board. Results Each week, a group of four to seven residents participated in a one-hour long EsR session, which was replicated 15 times over five weeks, for a total of 86 internal medicine residents. 76 of 86 residents completed the post-activity survey. Overall, residents expressed a high level of satisfaction with the session (x̄ = 4.89), found it fun to play (x̄ = 4.89), and felt immersed in medicine (x̄ = 3.95). Residents thought the activity was most suitable for reinforcing knowledge (x̄ = 4.26) and greatly tested their communication skills (x̄ = 4.48).  Conclusion The medical EsR experience was enjoyed by the vast majority of residents with very positive oral and survey feedback. Hence, we successfully created an active, learner-centered, gamified teaching tool that can be used for teaching/reinforcing medical concepts in a fun, competitive, and team-building format. The EsR, as a teaching tool, can be replicated with ease several times and requires very few resources to create.

When the Clinical Environment Is Closed to Students: The Harsh Reality of COVID-19 and Implications for Colleges of Osteopathic Medicine.

When the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a global health emergency, Colleges of Osteopathic Medicine (COMs) debated the role of medical students during this developing pandemic. Initially, the discussion included whether medical students were essential personnel contributing to meaningful patient care. Many questions arose regarding how COVID-19 would affect medical education and if the changes would be temporary or continue for a significant period of time. Due to the lack of availability of personal protective equipment (PPE) and a decreased focus on clinical education within many healthcare settings, in March the American Association of Colleges of Osteopathic Medicine (AACOM) declared that medical students were not essential personnel and recommended that COMs take a 'pause' and remove students from the clinical environment. This 'pause' would allow COMs time to assess where medical education could continue, to define the critical pieces of clinical education that required a clinical environment and to address how medical students could contribute during the pandemic. The AACOM Clinical Educators group began to meet on a weekly basis during this time so that Clinical Deans from Osteopathic medical schools across the country could collaborate, share ideas, discuss current challenges, and co-create a system to deliver medical education realizing the limitations of in-person clinical training.