Interviewing Teen Parents: Simulated Patient Experience for Clinical Education and Outreach.

INTRODUCTION:  Many medical students' initial experience obtaining a history from a pediatric patient happens in their clerkship years. There is a shift in medical education to provide early clinical experiences to train physicians. To increase the exposure to pediatric history in the pre-clinical years, we developed this simulation-based session involving students in their second year of medical school. They are tasked with eliciting a history from a baby provided by a teenager who functions both as a standardized patient (SP) and the parent of the infant. Our goal was to have second-year medical students learn and practice interviewing an adolescent while obtaining history about an infant to assist in the transition to Year three Pediatric clerkship. APPROACH:  Collaborating with the Office of Diversity at our medical school, we recruited students registered in medical academies in public middle and high schools in our county and asked them to be part of this simulation-based activity. A majority of these medical academy students are underrepresented in medicine (URiM). The students functioned as SPs for pre-clerkship medical students while gaining exposure to a career in medicine and the medical school environment. The medical students obtained a history, with faculty providing formative feedback, followed by documentation of the encounter. OUTCOMES:  Medical students felt they gained skills to communicate with caregivers of pediatric patients. They also practiced the skill of eliciting a pediatric history from an infant whose parent is a teenager. The middle and high school students that functioned as SPs gained a better appreciation for the medical education system and felt that the experience was valuable for all parties involved. DISCUSSION:  This session exposed pre-clerkship medical students to the nuances of eliciting a pediatric history from pediatric caregivers while also engaging URiM from middle and high school in the medical education process. This session could be used at other institutions to expand diversity in the medical field while also providing pre-clerkship medical students with pediatric experiences.  This article was previously presented as an oral presentation at the AAMC Group on Education Affairs (GEA) Virtual Regional Spring Meeting on April 21, 2021.

Service-Learning Programs and Projects for Medical Students Engaged With the Community.

Introduction The medical school curriculum has changed from using the term "pedagogy" to framing adult learning theories with the goal of applying knowledge to a clinical situation or real-life experiences. Service-learning programs (SLPs) in medical schools illustrate one of several adult learning principles and practices now used in today's curriculum that better prepare medical students for working with a variety of patients.  Objective The researchers' aim was to assess medical students' learning experiences while participating with nonprofit organizations during a curricula-designed SLP. Method The authors analyzed 60 reflective essays over a three-year academic period from 192 medical students placed in teams of two to four. A qualitative study with a thematic analysis research design was employed in our study. This iterative approach allowed the researchers to identify themes and interpret meaning. The study was completed in 2020 using data from 2017-2020. Results Four major themes and one overarching theme emerged that reflect adult learning theories including: (1) transfer learning of one's skills and knowledge to community and practice; (2) articulate a variety of ways to communicate with multiple, diverse community audiences; (3) employ a creative process for quality improvement strategies; (4) create positive trusting and rewarding relationships that highlight an enhanced level of conduct and professionalism. An overarching theme found was: collaboration emerges almost without forethought. Medical educators may find that replicating this SLP into the curriculum infrastructure provides agency and student buy-in. We established an SLP as part of the medical school curriculum that brings privilege and reward to students and to the community. Reflection provides for meaningfulness from SLP and helps students identify how experiential learning affects their professional development as members of the community and future health care providers. Conclusion Implementing SLPs into any medical school curriculum strengthens the adult learning theoretical delivery approach. Disseminating projects and lessons learned to and from the community also showcases experiential learning opportunities for medical students and other professionals. Many aspects of awareness from the medical students' engagement during the SLP emerged. They learned about specific aspects of community engagement and found it a privilege to give and take many lessons from the experiences and opportunities.

Training Preclerkship Medical Students on History Taking in Transgender and Gender Nonconforming Patients.

The purpose of the study is to introduce a standardized patient (SP) activity focusing on communication with transgender and gender nonconforming (TGNC) individuals. Using an SP script, preclerkship medical students obtained medical histories from TGNC SPs, followed by a panel discussion. In total, 126 students participated in the SP encounter for a period of 2 years. After completion, 92.2% of students felt more confident using patient's pronouns and 95.4% indicated improved confidence with the overall experience of taking a history from a transgender patient. This study demonstrated that partnering with local LGBTQ+ community partners can create authentic simulated clinical experiences for preclerkship medical students, improving their confidence in communication and interpersonal skills with TGNC patients.

Complicated postoperative course secondary to kratom withdrawal: a case report.

We herein report a case of a 55-year-old female with an unusual case of post-operative kratom withdrawal. The patient's withdrawal symptoms subsequently contributed to complications and admission to the intensive care unit. Features of this case are discussed, alongside the management of kratom withdrawal and the implications of supplementation with unregulated herbal medications.