Associations of medical student empathy with clinical competence.

OBJECTIVE: Empathy is a crucial skill for medical students that can be difficult to evaluate. We examined if self-reported empathy in medical students was associated with clinical competence. METHODS: This study combined cross-sectional data from four consecutive years of medical students (N=590) from the Boston University School of Medicine. We used regression analysis to evaluate if self-reported empathy (Jefferson Scale of Physician Empathy (JSPE)) predicted scores in clinical clerkships, United States Medical Licensing Examinations, and OBJECTIVE: Structured Clinical Examinations (OSCEs). We separately analyzed overall and OSCE communication scores based on interpersonal skills reported by standardized patients. We controlled for age, gender, debt, and specialty affinity. RESULTS: JSPE scores of medical students were positively associated with OSCE communication scores, and remained significant when controlling for demographics. We found that JSPE score was also predictive of overall OSCE scores, but this relationship was confounded by gender and age. JSPE scores were associated with performance in the Pediatrics clerkship, but not other clerkships or standardized tests. CONCLUSION: JSPE scores were positively associated with OSCE communication scores in medical students. PRACTICE IMPLICATIONS: This study supports that self-reported empathy may predict OSCE performance, but further research is needed to examine differences by gender and age.

A novel nutrition medicine education model: the Boston University experience.

Most deaths in the United States are preventable and related to nutrition. Although physicians are expected to counsel their patients about nutrition-related health conditions, a recent survey reported minimal improvements in nutrition medicine education in US medical schools in the past decade. Starting in 2006, we have developed an educational plan using a novel student-centered model of nutrition medicine education at Boston University School of Medicine that focuses on medical student-mentored extracurricular activities to develop, evaluate, and sustain nutrition medicine education. The medical school uses a team-based approach focusing on case-based learning in the classroom, practice-based learning in the clinical setting, extracurricular activities, and a virtual curriculum to improve medical students' knowledge, attitudes, and practice skills across their 4-y period of training. We have been using objectives from the NIH National Academy Awards guide and tools from the Association of American Medical Colleges to detect new areas of nutrition medicine taught at the medical school. Although we were only able to identify 20.5 h of teaching in the preclerkship years, we observed that most preclerkship nutrition medicine objectives were covered during the course of the 4-y teaching period, and extracurricular activities provided new opportunities for student leadership and partnership with other health professionals. These observations are very encouraging as new assessment tools are being developed. Future plans include further evaluation and dissemination of lessons learned using this model to improve public health wellness with support from academia, government, industry, and foundations.

Use of radiologic imaging to enhance physical diagnosis instruction in the preclinical curriculum.

RATIONALE AND OBJECTIVES: To expose students in the premedical years to imaging and its indications, to enhance their understanding of pathologic processes by allowing direct visualization, and to teach physical diagnosis through an integrated, multispecialty approach. MATERIALS AND METHODS: A total of 166 second-year medical students participated in a novel imaging session that accompanied the physical diagnosis course they were concurrently enrolled in. Students were provided a didactic orientation to imaging and taught how to use Picture Archiving and Communications System software. The students then participated in interactive imaging sessions in which they were able to scroll through entire imaging cases of real, anonymized patients with accompanying clinical scenarios and physical examination findings. RESULTS: Of 89 students responding to an online curricular feedback questionnaire, 41% believed that the imaging correlated with the other information taught in the course and 46% found it was helpful to their learning. The majority of students (64%) believed that the sessions helped challenge them to think about physical diagnosis in a different way. CONCLUSION: Physical diagnosis on the wards requires a multispecialty approach and the early introduction of this technique through the integrated mode of teaching we present will benefit students in their clinical years and future careers.