Providing Information-Seeking Skills Feedback Within a Medical School Curriculum: A Partnership between Librarians and Education Specialists.

The Liaison Committee on Medical Education (LCME) revised their standards for MD program curricula with increased emphasis on the teaching and assessment of skills needed for life-long learning. This case study describes the collaboration between a team of librarians and a curriculum office to continuously improve information-seeking skills activities for medical students. This positive collaborative experience has firmly embedded librarians into the medical curriculum. Based on student feedback, the majority of students found the librarian-involved activities useful.

A Novel Approach to Assessing Professionalism in Preclinical Medical Students Using Multisource Feedback Through Paired Self- and Peer Evaluations.

Phenomenon: Professionalism is integral to the role of the physician. Most professionalism assessments in medical training are delayed until clinical rotations where multisource feedback is available. This leaves a gap in student assessment portfolios and potentially delays professional development. APPROACH: A total of 246 second-year medical students (2013-2015) completed self- and peer assessments of professional behaviors in 2 courses following a series of Team-Based Learning exercises. Correlation and regression analyses were used to examine the alignment or misalignment in the relationship between the 2 types of assessments. Four subgroups were formed based on observed patterns of initial self- and peer assessment alignment or misalignment, and subgroup membership stability over time was assessed. A missing data analysis examined differences between average peer assessment scores as a function of selective nonparticipation. FINDINGS: Spearman correlation demonstrated moderate to strong correlation between self-assessments completed alone (no simultaneous peer assessment) and self-assessments completed at the time of peer assessments (ρ = .59, p < .0001) but weak correlation between the two self-assessments and peer assessments (alone: ρ = .13, p < .013; at time of peer: ρ = .21, p < .0001). Generalized estimating equation models revealed that self-assessments done alone (p < .0001) were a significant predictor of self-assessments done at the time of peer. Course was also a significant predictor (p = .01) of self-assessment scores done at the time of peer. Peer assessment score was not a significant predictor. Bhapkar's test revealed subgroup membership based on the relationship between self- and peer ratings was relatively stable across Time 1 and Time 2 assessments (χ2 = 0.83, p = .84) for all but one subgroup; members of the subgroup with initially high self-assessment and low peer assessment were significantly more likely to move to a new classification at the second measurement. A missing data analysis revealed that students who completed all self-assessments had significantly higher average peer assessment ratings compared to students who completed one or no self-assessments with a difference of -0.32, 95% confidence interval [-0.48, -0.15]. Insights: Multiple measurements of simultaneous self- and peer assessment identified a subgroup of students who consistently rated themselves higher on professionalism attributes relative to the low ratings given by their peers. This subgroup of preclinical students, along with those who elected to not complete self-assessments, may be at risk for professionalism concerns. Use of this multisource feedback tool to measure perceptual stability of professionalism behaviors is a new approach that may assist with early identification of at-risk students during preclinical years.

Developing Professionalism via Multisource Feedback in Team-Based Learning.

UNLABELLED: CGEA 2015 CONFERENCE ABSTRACT (EDITED). A Novel Approach to Assessing Professionalism in Preclinical Medical Students Using Paired Self- and Peer Evaluations. Amanda R. Emke, Steven Cheng, and Carolyn Dufault. CONSTRUCT: This study sought to assess the professionalism of 2nd-year medical students in the context of team-based learning. BACKGROUND: Professionalism is an important attribute for physicians and a core competency throughout medical education. Preclinical training often focuses on individual knowledge acquisition with students working only indirectly with faculty assessors. As such, the assessment of professionalism in preclinical training continues to present challenges. We propose a novel approach to preclinical assessment of medical student professionalism to address these challenges. APPROACH: Second-year medical students completed self- and peer assessments of professionalism in two courses (Pediatrics and Renal/Genitourinary Diseases) following a series of team-based learning exercises. Assessments were composed of nearly identical 9-point rating scales. Correlational analysis and linear regression were used to examine the associations between self- and peer assessments and the effects of predictor variables. Four subgroups were formed based on deviation from the median ratings, and logistic regression was used to assess stability of subgroup membership over time. A missing data analysis was conducted to examine differences between average peer-assessment scores as a function of selective nonparticipation. RESULTS: There was a significant positive correlation (r = .62, p < .0001) between self-assessments completed alone and those completed at the time of peer assessment. There was also a significant positive correlation between average peer-assessment and self-assessment alone (r = .19, p < .0002) and self-assessment at the time of peer assessment (r = .27, p < .0001). Logistic regression revealed that subgroup membership was stable across measurement at two time points (T1 and T2) for all groups, except for members of the high self-assessment/low peer assessment at T1, who were significantly more likely to move to a new group at T2, χ(2)(3, N = 129) = 7.80, p < .05. Linear regression revealed that self-assessment alone and course were significant predictors of self-assessment at the time of peer assessment (Fself_alone = 144.74, p < .01 and Fcourse = 4.70, p < .05), whereas average peer rating, stage (T1, T2) and academic year (13-14, 14-15) were not. Linear regression also revealed that students who completed both self-assessments had significantly higher average peer assessment ratings (average peer rating in students with both self-assessments = 8.42, no self-assessments = 8.10, self_at_peer = 8.37, self_alone = 8.28) compared to students who completed one or no self-assessments (F = 5.34, p < .01). CONCLUSIONS: When used as a professionalism assessment within team-based learning, stand-alone and simultaneous peer and self-assessments are highly correlated within individuals across different courses. However, although self-assessment alone is a significant predictor of self-assessment made at the time of assessing one's peers, average peer assessment does not predict self-assessment. To explore this lack of predictive power, we classified students into four subgroups based on relative deviation from median peer and self-assessment scores. Group membership was found to be stable for all groups except for those initially sorted into the high self-assessment/low peer assessment subgroup. Members of this subgroup tended to move into the low self-assessment/low peer assessment group at T2, suggesting they became more accurate at self-assessing over time. A small group of individuals remained in the group that consistently rated themselves highly while their peers rated them poorly. Future studies will track these students to see if similar deviations from accurate professional self-assessment persist into the clinical years. In addition, given that students who fail to perform self-assessments had significantly lower peer assessment scores than their counterparts who completed self-assessments in this study, these students may also be at risk for similar professionalism concerns in the clinical years; follow-up studies will examine this possibility.

Curriculum renewal in the time of COVID-19: The Washington University School of Medicine Story.

Washington University School of Medicine began a curriculum renewal process in 2017 with a goal of implementing the Gateway Curriculum in 2020. In this article, we describe the vision of this curriculum and the infrastructure that was built to support it. We also describe the impact of COVID-19 on the legacy curriculum and the Gateway Curriculum as well as the lessons learned to date.

Physicians-in-training are not prepared to prescribe medical marijuana.

BACKGROUND: While medical marijuana use is legal in more than half of U.S. states, evidence is limited about the preparation of physicians-in-training to prescribe medical marijuana. We asked whether current medical school and graduate medical educational training prepare physicians to prescribe medical marijuana. METHODS: We conducted a national survey of U.S. medical school curriculum deans, a similar survey of residents and fellows at Washington University in St. Louis, and a query of the Association of American Medical Colleges (AAMC) Curriculum Inventory database for keywords associated with medical marijuana. RESULTS: Surveys were obtained from 101 curriculum deans, and 258 residents and fellows. 145 schools were included in the curriculum search. The majority of deans (66.7%) reported that their graduates were not at all prepared to prescribe medical marijuana, and 25.0% reported that their graduates were not at all prepared to answer questions about medical marijuana. The vast majority of residents and fellows (89.5%) felt not at all prepared to prescribe medical marijuana, while 35.3% felt not at all prepared to answer questions, and 84.9% reported receiving no education in medical school or residency on medical marijuana. Finally, only 9% of medical school curriculums document in the AAMC Curriculum Inventory database content on medical marijuana. CONCLUSIONS: Our study highlights a fundamental mismatch between the state-level legalization of medical marijuana and the lack of preparation of physicians-in-training to prescribe it. With even more states on the cusp of legalizing medical marijuana, physician training should adapt to encompass this new reality of medical practice.

Prospective Memory Training: Outlining a New Approach.

Prospective memory (PM) tasks are those that must be performed in the future (e.g., attend an appointment). While these everyday tasks can be especially relevant for older adults (i.e., medication adherence), and have been associated with age-related decline, PM has been virtually overlooked in the cognitive training domain. This article describes the first comprehensive PM training intervention. Older adults (age 55 to 75) who received training completed 8 weekly PM training sessions that consisted of variable PM training tasks, strategy-focused discussion, and homework assignments. Those assigned to a control group completed only the first and last training task. On both a real-world proxy PM transfer task and the training tasks detailed here, there was a positive impact of PM training, suggesting practical benefits of the current training package for older adults. Benefits may also extend to other special populations who experience PM impairments (e.g., traumatic brain injury [TBI], Parkinson's).

Effects of cognitive training with and without aerobic exercise on cognitively demanding everyday activities.

We investigated the potential benefits of a novel cognitive-training protocol and an aerobic exercise intervention, both individually and in concert, on older adults' performances in laboratory simulations of select real-world tasks. The cognitive training focused on a range of cognitive processes, including attentional coordination, prospective memory, and retrospective-memory retrieval, processes that are likely involved in many everyday tasks, and that decline with age. Primary outcome measures were 3 laboratory tasks that simulated everyday activities: Cooking Breakfast, Virtual Week, and Memory for Health Information. Two months of cognitive training improved older adults' performance on prospective-memory tasks embedded in Virtual Week. Cognitive training, either alone or in combination with 6 months of aerobic exercise, did not significantly improve Cooking Breakfast or Memory for Health Information. Although gains in aerobic power were comparable with previous reports, aerobic exercise did not produce improvements for the primary outcome measures. Discussion focuses on the possibility that cognitive-training programs that include explicit strategy instruction and varied practice contexts may confer gains to older adults for performance on cognitively challenging everyday tasks.