Clinical resources to teach components of a new Family Medicine Clerkship Curriculum.

BACKGROUND AND OBJECTIVES: This retrospective study was designed to determine the capacity of a 6-week distributed Family Medicine Clerkship to provide student documented patient encounters that could facilitate instructions on the acute illness and chronic disease components of the new Family Medicine Clerkship Curriculum (FMCC). The FMCC was developed to standardize core clinical education experiences in Family Medicine Clerkships in US medical schools. METHODS: Three years (FY06--FY08) of patient encounters documented by students and compiled in a Family Medicine Clerkship patient encounter database at the Medical College of Georgia were examined to determine the presence of patient experiences consistent with the acute illness and chronic disease presentations objectives of the new FMCC. The study cohort consisted of 537 students encountering 78,770 patients in 21 learning sites. RESULTS: Fifty-five percent of the FMCC acute illness presentations objectives (n=20) were encountered at least once by >90% of the students while 81% of the chronic disease presentations objectives (n=16) were encountered at least once by >90% of the students. All students encountered patients with multiple chronic diseases, with an average of 32.29 and 13.6 student patient encounters containing two and three chronic diseases respectively. Patient volumes for the FMCC acute illness and chronic disease objectives ranged from means of 0.37 to 10.37 and 2.24 to 57.47 per student respectively. CONCLUSIONS: The study suggests that a 6-week Family Medicine Clerkship could provide patient experiences to facilitate student instructions on most of the acute illness and chronic disease presentations objectives of the new FMCC.

Teaching medical error apologies: development of a multi-component intervention.

BACKGROUND AND OBJECTIVES: Apologizing is an important component in addressing medical errors; yet, offering apologies continues to challenge physicians. To address limitations of prior educational interventions, a multi-faceted, apologies intervention was developed to provide medical students with increasingly applied learning opportunities. METHODS: First-year medical students taking a professionalism course at the authors' Southeastern medical school in 2008 or 2009 were eligible for the study. Data from their assigned activities and a post-intervention survey were analyzed. RESULTS: A total of 384 students contributed study data; 57.8% were male, 58.6% white, 10.9% Asian-Indian, 10.9% Asian-Other, and 7.6% African-American. Seventy-four percent of students considered tasks as useful or extremely useful. Student confidence in providing effective apologies increased as well as their comfort in disclosing errors to a faculty member or patient. Perceived importance of apology skills similarly increased. Apologies written by female authors were rated higher in effectiveness by peers than apologies written by male authors. Apology evaluators adopting patient perspective were more critical than evaluators adopting peer perspective. No race differences were found. CONCLUSIONS: This intervention was perceived useful by students and demonstrated medium to large effect size changes in importance, confidence, and comfort around apology errors. The higher evaluations of apologies written by female authors as well as the lower evaluations by evaluators adopting patient perspective warrant further consideration. Additional research is also warranted on streamlining and implementing the intervention for other institutions and ultimately how actual student apology behaviors are later affected.