Medical School Clinical Trials Educational Intervention: Impact on Knowledge and Attitudes.

Medical student knowledge and opinions of clinical research have important ramifications for how likely they will be to refer patients into clinical trials as practicing physicians. This study examined students understanding, knowledge, and attitudes about clinical trials at the start of medical school and after completion of a multi-faceted intervention designed to increase medical students' confidence in understanding and explaining clinical trials during the pre-clinical and clinical years. Medical students were surveyed about their knowledge of and attitudes toward clinical trials in their first (N = 724) and third (N = 191) years of medical school. During the intervening years, students attend a lecture delivered by University of Hawai 'i Cancer Center faculty, were provided a resource manual from National Cancer Institute, participated in two problem-based learning clinical scenarios, and completed an optional practicum. After completing the comprehensive clinical trials education, there were significant increases in student understanding and knowledge and a decrease in student perception that clinical trials exploit participants. Most students agreed or strongly agreed that inclusion of clinical trials in the curriculum was important and would influence their future practice. Integration of clinical trials education into the medical school curriculum improved students' understanding of clinical research, their ability to communicate the clinical trials process, and confidence in conducting, referring to, and locating clinical trials. Medical students appreciate the importance of clinical trials in advancing medicine and medical education. Further integration of clinical trials education and opportunities to engage in research during medical school are warranted to address students' uncertainty about the benefits of participation for patients.

Introducing educational interventions for first year medical students in the area of cancer clinical trials: impact on attitudes and confidence.

BACKGROUND: This study tested the feasibility and efficacy of a multi-faceted educational intervention designed to increase medical students' confidence in discussing cancer clinical trials with patients. METHOD: First year students were provided with written resources, problem-based learning scenarios, and an optional practicum. RESULTS: Pre/Post results indicated significant increases in confidence levels; however, these results were tempered with declines in attitudes related to clinical trials. CONCLUSIONS: Integrating clinical trials education into existing medical school curriculum is both feasible and desirable. This intervention was successful in increasing students' confidence levels in discussing clinical trials with patients and deserves continued study.

The impact of curricular changes on the geriatrics knowledge, attitudes and skills of medical students.

We redesigned our medical school's Problem-Based Learning (PBL) curriculum to include a substantial increase in required geriatrics content. Innovations included new PBL health care problems and standardized patients (SPs) throughout the first three years and a new required four-week, fourth-year rotation. We used data from the AAMC Medical School Graduation Questionnaire, the UCLA Geriatrics Knowledge Test and Attitudes Survey and a Geriatrics SP Examination to measure self-efficacy, geriatrics specific knowledge, attitudes and clinical skills before and after these curricular changes. Positive effects on students' self-efficacy, knowledge and skills were demonstrated. Scores on the attitude scale were high before and after implementation. The demonstration of improved educational outcomes will help to validate our curricular changes and guide their future development.

The John A. Burns School of Medicine (JABSOM) graduation objectives.

JABSOM has defined its graduation objectives and shared it with students and faculty. They serve as an organizing principle for both curricular content, student evaluations, and program assessment. The school's Curriculum Committee monitors student achievement as a measure of program quality. Outcome data to date suggest that JABSOM students meet the objectives of the medical school and are prepared as life-long learners to undertake the challenges of their chosen profession as physicians.

Smoking cessation counseling training for pediatric residents in the continuity clinic setting.

OBJECTIVE: To determine the effectiveness of a clinic-based smoking cessation counseling curriculum on pediatric resident confidence, knowledge, counseling skills, and provision of counseling. METHODS: Twenty-six residents at a pediatric residency program completed a new smoking cessation counseling curriculum as part of continuity clinic training. We assigned residents to 2 groups (study group, n = 12 vs control group, n = 14) on the basis of clinic site. We used a quasi-experimental, crossover design with pre- and posttests for each group. Control-group residents served as an initial control before the intervention crossover. Residents were tested at baseline and at completion of each group's intervention. Standardized patients measured resident provision of counseling and quality of counseling during resident continuity clinic. Knowledge and confidence were measured by a written exam and self-administered survey. Analysis of variance with a mixed design assessed overall group differences and group performances over time. RESULTS: There were no baseline differences between groups. Across time, there were significant differences between study-group and control-group residents for confidence (F [2, 48] = 11.82; P <.01), knowledge (F [2, 48] = 6.24; P <.01), and provision of counseling (F [2, 48] = 3.60, P <.05) but not counseling skills (F [2, 48] = 2.44; P <.10). After each group's intervention, their confidence, knowledge, counseling skills, and inclusion of counseling increased significantly (P <.01 for all). CONCLUSIONS: Our findings suggest that a clinic-based curriculum in smoking cessation counseling can significantly increase knowledge, confidence, counseling skills, and provision of counseling. Future research should evaluate the long-term impact of such curricula on resident counseling behavior and patient outcomes.

USMLE performances in a predominantly Asian and Pacific Islander population of medical students in a problem-based learning curriculum.

PURPOSE: To compare the USMLE performances of students of various ethnicities, predominantly Pacific Islander and Asian, at one medical school and to examine the predictive validity of MCAT scores for USMLE performance. METHOD: A total of 258 students in the graduating classes of 1996-2000 at the University of Hawai'i School of Medicine were classified by ethnicity. Demographic and performance characteristics of the groups were examined, and MCAT scores with and without undergraduate science GPA were used to predict USMLE performance. Under- and over-prediction rates were computed for each ethnic group. RESULTS: Ethnic groups did not differ significantly by gender or undergraduate GPA. Chinese, Caucasian, and Other Asian students tended to have higher MCAT scores than Hawaiian/other Pacific Islander, and Filipino students. Ethnic groups did not differ significantly in prediction of USMLE Step 1 performance. For Step 2, MCAT scores significantly over-predicted performance of Filipino students and tended to under-predict performance of Caucasian students. CONCLUSION: Although MCAT scores and science GPA were good predictors of USMLE performance, ethnic differences were found in the degrees of their predictive validity. These findings both replicate and extend results of earlier studies, and again point to the importance of exploring additional predictor variables. The authors encourage future research on the effects of the following factors on success in medical school: reading and test-taking skills, socio-cultural and environmental influences on learning, communication styles, primary language use, family support, and family responsibilities.