Medical students learn over distance using virtual reality simulation.

INTRODUCTION: This article presents the results of a demonstration project that was designed with the goal to determine the feasibility and acceptability of medical students in using distance technology and virtual reality (VR) simulation within a problem-based learning (PBL). METHODS: This pilot project involved students from the Universities of New Mexico and Hawaii and compared (1) control groups consisting of medical students in a tutor-guided PBL session using a text-based case, (2) distance groups using the same text-based case but interacting over distance from multiple sites, (3) groups using a VR simulation scenario integrated into the case without interaction over distance, and (4) combination groups interacting over distance from multiple sites with integration of a VR simulation scenario. RESULTS: The study results suggest that it is possible to successfully conduct a PBL tutorial with medical students from two institutions with the integration VR and distributed distance interaction in combination or independently. The addition of these modalities did not interfere with learning dynamics when compared with traditional tutorial sessions. CONCLUSIONS: These findings suggest the feasibility and acceptability by students in the use of VR simulation integrated into a PBL learning session, as well as multipoint distance technologies that allowed interaction between students and tutors in different locations. The authors believe that these modalities can be applied where students and tutors from different institutions are in separate locations and can be used to support interactive experiential learning in a distributed network or on site and suggest areas for additional research.

Palliative medicine Death Rounds: small group learning on a vital subject.

BACKGROUND: The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. OBJECTIVE: To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. DESIGN: Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. CONCLUSIONS: The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

Improved patient notes from medical students during web-based teaching using faculty-calibrated peer review and self-assessment.

BACKGROUND: This study examines the effectiveness of Calibrated Peer Review (CPR), a Web-based writing development program, to teach and assess medical students' patient note-writing skills in a standardized fashion. METHOD: At the end of the clerkship year, 67 medical students were divided into three groups, introduced to CPR, and instructed in patient note-writing. Students then wrote notes for three clinical cases, presented in different order to each group. After training on faculty-calibrated standards, students evaluated their peers' notes and their own notes. Trained faculty, blinded to author, order, and group, also graded student notes. RESULTS: Faculty gave lower scores than students, but both groups found students' scores improved significantly from the first to the third note written. CONCLUSIONS: Student-written patient notes improved in quality while using CPR. The program uses approaches valued in medicine (accurate peer review and self-reflection) to enhance performance.

"Where have all the students gone?" Retaining medical school graduates through educational innovations.

CONTEXT: New Mexico is a sparsely populated rural state in the USA, with 20% of New Mexicans living in poverty. There is a need for physicians in the state, especially in primary care. New Mexico's only medical school, the University of New Mexico School of Medicine is state supported. New Mexico and its medical school have a vested interest in its graduates returning to the state to practice. OBJECTIVES: Evaluate the effects of early community preceptorships on graduating physicians' specialty choice and subsequent return to practice in the state where they attended medical school. STRATEGIES: A Primary Care Curriculum (PCC) was introduced into the medical school in 1979. Students expressing interest in this programme were considered. Twenty students per year were assigned to the PCC. The remainder went through the traditional curriculum. The PCC used a problem-based learning model. All PCC students participated in a 16-week, one-on-one community preceptorship (Phase 1B) in a small or rural community during their first year. Graduates from 1983-1996 were analysed for specialty and practice location. MAIN OUTCOMES: Of the 294 students doing Phase 1B, 99 (40%) returned to New Mexico to practice compared to 221 (32%) of traditional students. Fifty-eight (23%) of the Phase 1B students practice primary care compared to 112 (16%) of the traditional students. CONCLUSION: Self-selected students choosing and participating in early community-based clinical experiences coupled with problem-based learning are more likely to return to the state and to practice primary care.