Effective Clinical Externships for International Medical Students: A Qualitative Study.

BACKGROUND: International student exchanges are a significant part of medical education, and experiences of North American and European medical students abroad have been extensively examined. By contrast, knowledge of visiting medical students in the United States (US) is limited largely to surveys of administrators and course directors. OBJECTIVE: To understand US attending physicians' thoughts on visiting international student clinical externships. DESIGN AND PARTICIPANTS: Three clinician-educator physician focus groups were conducted across two US medical schools with broad representation of training backgrounds, clinical disciplines, and career stages. Focus groups and constant comparison analysis of transcripts were performed iteratively to identify emerging themes. MAIN MEASURES: Qualitative themes and subthemes. KEY RESULTS: Two main themes emerged from the data: (1) administrative requirements for success: hosting international students requires careful planning and coordination, which is daunting amidst demanding faculty responsibilities. Externships must address experiences of the people directly involved in the clinical setting, leadership, communication, and institutional, financial, physical, and personnel resources. (2) Impact of student qualities: When working with international students, the importance of administrative details and student characteristics increases due to higher student variability overall, inconsistent language and cultural fluency, and the consequent recognition of the student as an ambassador for their home institution and country. CONCLUSIONS: Amidst already busy schedules, clinician educators identify the hosting of international medical students as a commitment resembling that for their own trainees. Linguistic and cultural distances, and the overall variability of international students amplify the importance of effective administration. The findings have influenced related processes at the University of Pittsburgh.

Exploring the Effects of Participation in a Shelter Medicine Externship on Student Knowledge and Self-Confidence.

With the recognition of shelter medicine as a sub-discipline of veterinary medicine, many veterinary programs are including clinical shelter experiences in their curricula. A concurrent mixed-methods study was designed with the aim to determine the effectiveness of a 4-week clinical shelter medicine program on students' perception of canine and feline surgical proficiency and shelter medicine knowledge as well as gain information on student attitudes toward shelter medicine and interest in pursuing this career path. Year 4 veterinary students at Western University of Health Sciences who were enrolled in a shelter medicine externship from 2014 to 2016 were invited to complete pre- and post-course online surveys. Of the 168 enrolled students, 77.4% were invited to participate, and 114 completed the survey. There was no statistically significant difference in student veterinary career interest before and after completing the externship. There was an overall increase in student rating of their ability to perform six shelter medicine tasks as well as ovariohysterectomy/ovariectomy (OVH/OE) and castration surgeries after completing their externship; all were statistically significant ( p < .001). There was a statistically significant difference in the proportion of students who were familiar with the Asilomar Accords and the Association of Shelter Veterinarians (ASV) Guidelines for Standards of Care in Animal Shelters after completion of their externship ( p < .001). Students largely supported pediatric spay and neuter, stating it was an effective means of population control. Based on the themes that emerged from the qualitative analysis, it appeared most students had an accurate understanding of the term no-kill.

An Ophthalmology Virtual Externship during the COVID-19 Pandemic: A Pilot Study.

Background The evolution of medical school curricula, characterized by truncated preclinical periods and reduced emphasis on ophthalmology, presents formidable obstacles to early exposure for aspiring medical students. The constraints imposed by the coronavirus disease 2019 pandemic further exacerbated the limitations on opportunities, compelling the implementation of innovative initiatives aimed at augmenting students' ophthalmology education through virtual means. Purpose This article assesses the impact of an Ophthalmology Virtual Externship (OVE) on medical students' knowledge, interest, confidence, and seeking mentorship in ophthalmology. Materials and Methods A total of 76 students voluntarily participated in the program. The OVE encompassed four virtual sessions, facilitated by 4th year medical students employing a near-peer mentorship framework. The initiative was tailored for 2nd and 3rd year medical students and was conducted under the supervision of a faculty member. All participating students completed both pre- and postexternship surveys utilizing a 7-point Likert scale to gauge their levels of interest, confidence, and inclination toward mentorship opportunities in the field of ophthalmology. Furthermore, assessments of ophthalmology knowledge were administered prior to and subsequent to the externship participation. The degree of satisfaction derived from the OVE experience was also evaluated. Results Participation in the OVE significantly elevated confidence in knowledge ( p < 0.001) and mentorship interest ( p = 0.029). Ophthalmology knowledge test scores also notably improved post-OVE across all participants, irrespective of prior experience ( p < 0.001), with the most significant increase observed among 2nd and 3rd year students ( p < 0.0001). After OVE participation, 73% of students expressed intent to pursue ophthalmology opportunities, including mentorship or research. The OVE received an average Likert score of 6.35 out of 7 for student satisfaction. Conclusion The OVE serves as a virtual learning instrument beneficial for 2nd and 3rd year students with a proclivity for ophthalmology, offering a means to circumvent curriculum-related constraints. Moreover, given the decline in formal ophthalmic education, our study contributes to future research assessing the effectiveness of an OVE in addressing ophthalmic knowledge gaps among all medical students.

Evaluations of Student's Satisfaction with Externship Education in the Academic Departments of the Medical School of Kermanshah University of Medical Sciences in July and August 2021.

OBJECTIVES: Determining the level of satisfaction in each field will help to examine and eliminate the existing problems and shortcomings. Using this information, students' satisfaction can be provided as much as possible while strengthening the positive factors and correcting the negative factors. The aim of this study was to evaluate the Student's Satisfaction with externship Education in the Academic Departments of the Medical School of Kermanshah University of Medical Sciences in 2021. METHODS: This descriptive cross-sectional study, was performed in the medical school of Kermanshah University of Medical Sciences. The statistical population was all externship students. The validity of the questionnaire's content was determined by consulting experts, and its reliability was obtained by Cronbach's alpha method based on a sample of 20 students. The questionnaires were completed virtually on the Google site using the Google Form. Data analysis was performed Stata V14.2 software using descriptive statistics, t-test, and chi-square, and the significant level was considered 0.05. RESULTS: The results showed that 55% of the participants were female and 45% were male. The level of students 'satisfaction with the quality of supervisors' education was moderate to high and in other cases was moderate to low. Students were more satisfied with teaching anesthesia than other departments and were dissatisfied with the infectious department. No statistically significant difference was found between people's satisfaction with the overall clinical education process in terms of age. CONCLUSION: The results of this study showed that students have moderate to poor satisfaction with externship education in educational groups.

What do dental students expect from oral and maxillofacial surgery externships?

INTRODUCTION: Limited information exists on the goals and expectations of dental students from oral and maxillofacial surgery (OMS) externships. This information is valuable to OMS residency programs. Dental students use externships to gain insight into various OMS residency programs.  The purpose of this project was to answer the following question: "what do dental students expect from OMS externships?" PURPOSE: The aim of this study was to report the expectations of dental students from OMS externships. MATERIALS AND METHODS: This cross-sectional study took place from June 2015 to September 2019. Every student completing an Emory OMS externship completed an anonymous survey. The survey consisted of questions regarding (1) demographics, (2) previous OMS experience, and (3) open-ended questions regarding expectations and sources of anxiety. Answers were grouped into categories with similar answers. Descriptive statistics summarized data. RESULTS: Of 116 externs who completed the survey, the majority were males (n = 80, 68.9%) with a mean age of 25 (range 21-30) years old in the 3rd/4th year of dental school. Most had previous OMS experience (n = 103, 89.6%) and plan to apply to OMS residency (n = 104, 90.4%). Most externs hoped to learn about life as a resident and the scope and culture of the program. Externs expressed the highest level of anxiety regarding their own experience and/or knowledge level. CONCLUSIONS: This project demonstrated that during the externship, externs expect to gain insight into the daily activities, scope, and culture of the OMS program they are visiting.

Otolaryngology externships and the match: Productive or futile?

OBJECTIVES/HYPOTHESIS: The objectives of this study were to summarize externship experiences among recent graduates and current residents in otolaryngology residency programs and determine whether externships affect the match process. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was distributed to otolaryngology residents in allopathic US residency programs and otolaryngology graduates from the past 5 years (2011-2015). There were 2,141 surveys distributed. RESULTS: There were 654 subjects who responded, for a 30.5% response rate. Most respondents were residents (n = 438, 67%). Of the residents, 85.6% had completed at least one externship compared to 75.9% of graduates (P = .002). The most common reasons for selecting a particular externship were geographic location (74.2%) and program reputation (71.1%), whereas the most common reason for not completing an externship was being advised not to (59.1%). Furthermore, 82.6% of respondents received at least one interview from their externships, 90% went to those interviews, and 89.1% reported that externship experiences affected their rank list. Respondents had a 32.7% match rate to the externship residency program if it was ranked versus a 48.8% match rate if the program was ranked first. Respondents who matched at the externship residency program matched higher on their rank list (P < .001). Of the respondents, 90.7% found externships to be valuable, and 74.5% recommended completing one. CONCLUSIONS: Externships are beneficial because they influence the rank list of applicants and are viewed as valuable experiences. Completing an externship is advisable for the experience, but applicants should weigh the benefits versus the possible risk of being judged more harshly during a month-long rotation. LEVEL OF EVIDENCE: NA Laryngoscope, 127:2242-2246, 2017.

Partnerships and new learning models to create the future perioperative nursing workforce.

To create new and sustainable approaches for development of the perioperative nursing workforce, perioperative nursing leaders at a hospital collaborated with administrators and faculty at a school of nursing to create an innovative learning model that reintroduces perioperative experiences to students in a nursing baccalaureate program. Key components of the initial approaches included an externship for nursing students and a revised internship for experienced nurses who wished to work in perioperative nursing. Project leaders then expanded the nursing student learning opportunity by adding two additional elective perioperative courses to the curriculum. Formation of perioperative clinical placement sites within the senior-level adult acute care course was an additional positive outcome of these initial initiatives. These initiatives resulted in decreased use of agency nurses at the clinical site where the externships take place and increased numbers of younger nurses working in the perioperative areas where they externed, with high levels of satisfaction reported by nurses involved in the program. Through this innovative collaboration, the perioperative nurse shortage at the hospital has abated, and the opportunity to continually recruit new colleagues into the practice of perioperative nursing has been established.

Benefits of externships with pediatric dentistry programs for potential residents: program directors' and current residents' perceptions.

This study's goal was to understand the extent, framework, and benefits of externships with prospective residency programs undertaken by predoctoral dental students or dentists interested in applying for a residency program. In 2012, a questionnaire was sent to all pediatric dentistry residents and program directors in the United States (63 percent and 74 percent return rate, respectively). Externships were offered by fifty-seven of the seventy-six programs. Most program directors (95 percent) agreed that externships are beneficial and compensate at least partially for the lack of numerical National Board Dental Examination scores or class rankings. Among the responding residents, 61 percent were female. The top reasons given by residents for choosing to extern with a certain program were its location and perceived reputation. Of the 249 respondents who did an externship, 47 percent externed with their current program. The acceptance rate into the number one choice of program was similar among those who did an externship vs. those who did not (73 percent vs. 75 percent). No relationship was found between gender and externships among the 341 respondents who were accepted into their top choice. Most of the residents (98.8 percent) felt that completing an externship was beneficial, and 88 percent got an increased understanding for the differences between university- and non-university-based residency programs.

An Innovative Model for Preclinical Exposure: West Virginia University Externship in Anesthesia.

BACKGROUND: Medical students often have limited opportunities for clinical exposure in the first and second years of training, especially in the operating room setting. We describe one approach designed to address this deficiency. The West Virginia University externship in anesthesia provides students with first-hand experience observing and performing common procedures. METHODS: Six externs worked with the anesthesia department for four weeks, learning the basics of anesthesia, anesthetic drugs, airway management, and intravenous line placement. The externs spent much of their time in the operating room, where they were exposed to a variety of cases. The externs evaluated the program before and after taking part. RESULTS: Student participants expressed satisfaction with the externship experience. It increased their self-reported knowledge of and comfort level with certain perioperative procedures and concepts. Post-survey responses showed higher scores compared to the pre-survey responses. CONCLUSIONS: An innovative model, the externship program promotes interest in anesthesia while introducing students to the operating room setting and training them to perform common clinical procedures.

Summer anesthesiology externship: Demonstrating the ability of early clinical involvement to educate and increase specialty interest.

BACKGROUND: We describe the influence of a 6-week "Summer Anesthesiology Externship" featuring didactic, procedure, and simulation education on formation of medical students' specialty choice. METHODS: Eighteen months after externship completion, externs were sent a questionnaire with Likert scale agreement ratings of subspecialties/simulations and yes/no questions about student career interests before/after the program, stipend importance, and procedural skill performance during/after the program. RESULTS: General anesthesiology had the highest subspecialty approval rating (9.0). Externs strongly agreed that simulations successfully progressed at first year student understanding levels (9.2 mean agreement rating), increased confidence in being part of a care team (9.4 mean agreement rating), and provided personal/interpersonal development. Externs unanimously agreed that the program introduced them to the breadth of anesthesiology, and that practicing clinical/procedural skills improved confidence when performing the procedures later in medical school. Four of 14 students applied for the externship with some focus on anesthesiology as a career choice. After the externship, a significantly higher number of students (12 of 14) were strongly considering applying to the field (p<0.0001). Eleven of 14 ultimately entered anesthesiology residencies, a significantly higher rate than our general medical student classes (p<0.0001). CONCLUSIONS: Both CA1 and CA3 resident post-test scores improved at the end of the ultrasound guided regional workshop. Our study showed a 68% improvement in test scores, which is larger than the 50% improvement previously reported. These results show that fast learning can occur in this type of setting. Furthermore, knowledge acquired during the workshop was retained when CA1 residents were re-tested one year after the workshop. The ultrasound-guided regional anesthesia workshop will become part of the didactic series for our CA1 residents and will be a required learning activity. Additional work still needs to be done to find out the best way to test knowledge and skill outcomes in residents learning new technology and techniques.