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1.
BMC Med Educ ; 21(1): 322, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090441

RESUMO

BACKGROUND: The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). METHODS: Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants' performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. RESULTS: The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters. CONCLUSIONS: Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.


Assuntos
Estágio Clínico , Competência Clínica , Feminino , Humanos , Japão , Exame Físico , Desempenho de Papéis
2.
Korean J Med Educ ; 33(2): 75-85, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34062639

RESUMO

PURPOSE: To compare differences in happiness and stress and related factors between pre-clinical and clinical year medical students during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A cross-sectional study was conducted in the Faculty of Medicine, Chiang Mai University, Thailand. All undergraduate medical students were requested to voluntarily respond to an electronic survey. Demographic data, related factors of happiness and stress, scores from the Thai version of the Oxford Happiness Questionnaire (Thai-OHQ), and Thai Stress Questionnaire (Thai-ST5) were collected. RESULTS: There were 369 responses, 64.8% from preclinical students and 35.2% responses from clinical students, and 53.9% were women. The mean age of the participants was 20.62±1.81 years. The most frequent platforms that the students used to track COVID-19 information were Facebook 43.9% and Twitter 43.4%. Both groups had a low level of stress. No difference was found in the Thai-OHQ score (p=0.323) and the Thai-ST5 score (p=0.278). With multivariable analysis, two factors significantly related to the happier students included higher health satisfaction scores (p<0.001) and maintaining an exercise program during the COVID-19 pandemic (p=0.015). CONCLUSION: There was no difference in the happiness and stress levels between the two groups during the first outbreak of COVID-19 in Thailand. To increase happiness, promoting awareness of health satisfaction and regularity of exercise for the medical students should be initiated. To direct the information during a disease outbreak such as the COVID-19 pandemic, Facebook, and Twitter are the primary platforms to use.


Assuntos
COVID-19/psicologia , Felicidade , Pandemias , Satisfação Pessoal , Estresse Psicológico , Estudantes de Medicina , Adolescente , Adulto , Conscientização , Estágio Clínico , Estudos Transversais , Surtos de Doenças , Educação de Graduação em Medicina , Exercício Físico/psicologia , Feminino , Humanos , Disseminação de Informação , Comportamento de Busca de Informação , Masculino , SARS-CoV-2 , Mídias Sociais , Inquéritos e Questionários , Tailândia , Universidades , Adulto Jovem
3.
Korean J Med Educ ; 33(2): 125-131, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34062644

RESUMO

PURPOSE: This study aims to analyze pre-clerkship medical students' learning strategies and perceptions in online classes during the coronavirus disease 2019 pandemic. METHODS: To develop the survey items, 20 pre-clerkship students were interviewed about their learning experiences in the first semester of 2020. A total of 425 pre-clerkship students have participated in the survey, which comprised four parts (general experience, learning strategies, important features, and overall satisfaction). RESULTS: Before classes began, students generally had "neutral expectations" about online classes (2.90 out of 5). At the end of the semester, overall satisfaction with the curriculum was moderate (3.04 out of 5). Premedical students reported lower scores in "daily study hours" and "regular lifestyle" and higher scores in "experience of playing recorded lectures solely for an attendance check" (p<0.001). In addition, first-year premedical students not only showed significantly lower utilization of learning strategies compared to other grades (p<0.001). CONCLUSION: Although pre-clerkship students mostly shared similar perceptions and behaviors in their learning regardless of grade level, some characteristics were either more prominent in premedical students on the whole or limited to first-year premedical students.


Assuntos
COVID-19 , Educação à Distância , Educação de Graduação em Medicina/métodos , Aprendizagem , Pandemias , Estudantes de Medicina , Adolescente , Adulto , Atitude , Estágio Clínico , Currículo , Feminino , Humanos , Masculino , Percepção , Satisfação Pessoal , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
4.
BMC Med Educ ; 21(1): 331, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103029

RESUMO

BACKGROUND: Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). METHODS: Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. RESULTS: 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. CONCLUSIONS: Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.


Assuntos
Estágio Clínico , Internato e Residência , Estudantes de Medicina , Criança , Currículo , Humanos , Smartphone , Ensino
5.
BMC Med Educ ; 21(1): 301, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34039327

RESUMO

BACKGROUND: Service learning (SL) is an educational methodology presumed to help medical students be more empathetic and compassionate. We longitudinally investigated the level of empathy in medical students and how preclinical SL experience was related to their level of empathy in their clinical clerkships. METHODS: Our cohort comprised fifth-year medical students engaged in clerkships as part of a 7-year medical programme at one medical school in Taiwan. Surveys were conducted at the beginning of the clerkship in September 2015 (T1) to collect data on the medical students' preclinical SL experience in curriculum-based service teams (CBSTs) and extracurricular service teams (ECSTs) and their SL self-efficacy, demographic characteristics, and empathy level. Subsequently, three follow-up surveys were conducted once every 3 months to determine the empathy level of the students during their clinical clerkships (T2-T4). Seventy students who returned the written informed consent and completed the baseline (T1) and two or more follow-up surveys (T2-T4) were included in our analysis with the response rate of 34%. In total, 247 responses across the 1-year clerkship were analysed. Descriptive statistics, paired t tests, and generalised estimating equations were employed. RESULTS: Our study revealed that changes in empathy level in the dimensions of perspective taking, compassionate care, and standing in patients' shoes in their clinical clerkships. Relative to that at T1, their empathy decreased in perspective taking and compassionate care at T2-T4 but increased in standing in patients' shoes at T3. Additionally, our study verified the positive effect of medical students' preclinical SL experience in CBSTs and ECSTs on empathy in terms of compassionate care and perspective taking, respectively, but not on that of standing in patients' shoes. CONCLUSIONS: Separate investigations into subconstructs of empathy, such as perspective taking, compassionate care, and standing in patients' shoes, in medical students may be necessary for exploring the various driving forces or barriers to developing empathy in medical students. Moreover, SL experience through both CBSTs and ECSTs at medical academies may have positive effects on medical students' empathy in their clinical clerkships and should be promoted at medical schools.


Assuntos
Estágio Clínico , Estudantes de Medicina , Currículo , Empatia , Humanos , Taiwan
6.
BMC Med Educ ; 21(1): 291, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020636

RESUMO

BACKGROUND: Medical school curricula are constantly evolving and change has potential positive and negative effects. At East Tennessee State University Quillen College of Medicine, a broader understanding of the effects of a curriculum change (reduction in clerkship length for one transitional year) was explored. METHODS: A broad, system-wide evaluation was used to evaluate impacts on all stakeholders. Curriculum management data, including qualitative and quantitative data and short-term and follow-up perspectives of stakeholders, were used for evaluation. RESULTS: Students evaluated the change positively. Academic performance in the transitional year was similar to the prior year. Differences in students' clerkship evaluations were not statistically significant. Clerkship directors were concerned that students' clinical experience suffered and noted that implementing changes was time consuming but recognized the benefits for students. Administrators dedicated a significant amount of time to planning the transitional year; however, the additional weeks at the beginning of fourth year made the scheduling process easier. CONCLUSION: This article demonstrates an overall positive result with this tool for curriculum change but also indicates the impacts differed across stakeholders. Knowledge gained from this experience can help other schools successfully anticipate challenges and prepare for a variety of outcomes in implementing necessary curriculum change.


Assuntos
Estágio Clínico , Estudantes de Medicina , Currículo , Humanos , Faculdades de Medicina , Tennessee , Universidades
7.
BMC Med Educ ; 21(1): 229, 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33882933

RESUMO

BACKGROUND: Medical students show varying clinical practical skills when entering their final year clinical clerkship, which is the final period to acquire and improve practical skills prior to their residency. We developed a one-on-one mentoring program to allow individually tailored teaching of clinical practical skills to support final year students with varying skill sets during their neurosurgical clinical clerkship. METHODS: Each participating student (n = 23) was paired with a mentor. At the beginning students were asked about their expectations, teaching preferences and surgical interest. Regular meetings and evaluations of clinical practical skills were scheduled every 2 weeks together with fixed rotations that could be individually adjusted. The one-on-one meetings and evaluations with the mentor gave each student the chance for individually tailored teaching. After completion of the program each student evaluated their experience. RESULTS: The mentoring program was well received by participating students and acquisition or improvement of clinical practical skills was achieved by most students. A varying practical skill level and interest in the field of surgery was seen. CONCLUSIONS: A neurosurgical one-on-one mentoring program is well received by final year medical students and allows for individually tailored learning of clinical practical skills.


Assuntos
Estágio Clínico , Tutoria , Mentores , Neurocirurgia/educação , Estudantes de Medicina/psicologia , Competência Clínica , Docentes de Medicina , Humanos , Faculdades de Medicina , Estados Unidos
9.
Med Educ Online ; 26(1): 1918609, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33886434

RESUMO

Introduction. The COVID-19 pandemic placed an unprecedented strain on academic healthcare systems necessitating a pause in medical student teaching in clinical care settings, including at Weill Cornell Medicine (WCM). WCM had a preexisting telemedicine curriculum, but limited opportunities for students to apply knowledge and skills related to direct virtual patient care. The authors describe the rapid implementation of real-time interactive telehealth experience (RITE) courses for clerkship students to allow for meaningful engagement in remote patient care and continuation of academic progress during the pause.Methods of Course Development. Medical school administration disseminated a request for proposals for RITE courses conforming to the WCM electives format with rapid turnaround time of 1 week or less. Requirements included remote care activities, goals and objectives, general logistics, supervision methods and standards of achievement. RITE courses were developed in outpatient medicine, inpatient medicine, psychiatry and women's health. A lottery process was developed to register students for the approved courses.Course Implementation and Evaluation. Using the technical platform and standard course registration process, students were assigned to 74 of 76 available RITE course slots. Students participated in supervised remote direct patient care and also provided critical support for frontline healthcare workers by performing remote clinical tasks. Online teaching and reflection sessions were incorporated into each RITE curricular offering. Student feedback was overall positive ranging from 3.33-4.57 out of 5.Discussion. The COVID-19 pandemic created a need to rapidly incorporate telehealth models in order to continue to deliver patient care and an opportunity to develop innovative remote educational experiences. We developed a framework for structured real-time interactive telehealth experiences to address COVID-19 related curricular needs that will be continued post-COVID-19. This expanded telehealth curriculum for our students will provide standardized training in telehealth logistics, communication techniques, and care delivery now essential for graduating medical students.


Assuntos
COVID-19 , Estágio Clínico , Currículo , Telemedicina , Atenção à Saúde , Educação de Graduação em Medicina/métodos , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2
10.
BMC Med Educ ; 21(1): 228, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33882913

RESUMO

BACKGROUND: The purpose of this study is to evaluate the mini-Clinical Evaluation Exercise (mini-CEX) as a formative assessment tool among undergraduate medical students, in terms of student perceptions, effects on direct observation and feedback, and educational impact. METHODS: Cluster randomised study of 38 fifth-year medical students during a 16-week clinical placement. Hospitals were randomised to provide a minimum of 8 mini-CEXs per student (intervention arm) or continue with ad-hoc feedback (control arm). After finishing their clinical placement, students completed an Objective Structured Clinical Examination (OSCE), a written test and a survey. RESULTS: All participants in the intervention group completed the pre-planned number of assessments, and 60% found them to be useful during their clinical placement. Overall, there were no statistically significant differences between groups in reported quantity or quality of direct observation and feedback. Observed mean scores were marginally higher on the OSCE and written test in the intervention group, but not statistically significant. CONCLUSIONS: There is considerable potential in assessing medical students during clinical placements and routine practice, but the educational impact of formative assessments remains mostly unknown. This study contributes with a robust study design, and may serve as a basis for future research.


Assuntos
Estágio Clínico , Estudantes de Medicina , Competência Clínica , Avaliação Educacional , Humanos , Exame Físico
11.
Fam Med ; 53(4): 282-284, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33887050

RESUMO

BACKGROUND AND OBJECTIVES: On March 17, 2020, the Association of American Medical Colleges recommended temporary suspension of all medical student clinical activities due to the COVID-19 pandemic, which required a rapid development of alternatives to traditional teaching methods. This study examines education changes spurred by COVID-19. METHODS: Data were collected via a Council of Academic Family Medicine Educational Research Alliance survey of family medicine clerkship directors. Participants answered questions about didactic and clinical changes made to clerkship teaching due to the COVID-19 pandemic, how positive the changes were, whether the changes would be made permanent, and how prepared clerkship directors were for the changes. RESULTS: The response rate was 64%. The most frequent change made to didactic teaching was increasing online resources. The most frequent change made to clinical teaching was adding clinical simulation. Greater changes were made to clinical teaching than to didactic teaching. Changes made to didactic teaching were perceived as more positive for student learning than the changes made to clinical teaching. Clerkship directors felt more prepared for changes to didactic teaching than for clinical teaching, and were more likely to make the didactic teaching changes permanent than the clinical teaching changes. CONCLUSIONS: The COVID-19 pandemic caused nearly all clerkship directors to make changes to clerkship teaching, but few felt prepared to make these changes, particularly changes to clinical teaching. Clerkship directors made fewer changes to didactic teaching than clinical teaching, however, didactic changes were perceived as more positive than clinical changes and were more likely to be adopted long term.


Assuntos
COVID-19 , Estágio Clínico/métodos , Educação à Distância/métodos , Educação de Graduação em Medicina/métodos , Medicina de Família e Comunidade/educação , Treinamento por Simulação/métodos , Controle de Doenças Transmissíveis , Humanos , SARS-CoV-2 , Inquéritos e Questionários , Telemedicina/métodos
12.
Harefuah ; 160(3): 181-185, 2021 03.
Artigo em Hebraico | MEDLINE | ID: mdl-33749182

RESUMO

INTRODUCTION: Elective clerkships in low income countries have been an integral part of the curriculum in the majority of medical schools worldwide. These programs expose students to global challenges, to a diversity of cultures and healthcare systems, and have been shown to improve medical knowledge, as well as clinical and communication skills. In 2018 and 2019, the Faculty of Medicine at the Technion, in cooperation with the Department for Infectious Diseases in the Rambam Health Care campus and the "Brit Olam" nonprofit organization, offered a clinical clerkship in Kiboga hospital, Uganda. The elective took place in a public governmental hospital located in one of the poorest districts of Uganda. During a three-week period, the students accompanied by Israeli and Uganda tutors, participated in clinical rounds and other clinical activities in various departments of the hospital. This manuscript, describes the students' experiences in Kiboga. During the short elective, students had a unique opportunity to observe a different culture, immerse in a completely different healthcare system, learn about how a detailed medical history and a thorough physical examination can lead to diagnosis (without extensive diagnostic tests), and closely observe ethical challenges and difficult clinical decisions. The elective helped students develop personally and professionally and solidify their commitment to medicine. Currently, in Israeli medical schools, there are a few programs which expose students to medicine in low-resource countries. We believe that expanding the understanding of Global Health through courses and overseas opportunities in long-term partnerships, can improve the students' medical education.


Assuntos
Estágio Clínico , Educação Médica , Estudantes de Medicina , Currículo , Humanos , Faculdades de Medicina , Uganda
14.
BMC Med Educ ; 21(1): 149, 2021 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-33685442

RESUMO

BACKGROUND: The COVID-19 pandemic has created a need for educational materials and methods that can replace clinical clerkships (CCs) for online simulated clinical practice (online-sCP). This study evaluates the impact of using simulated electronic health records (sEHR) for inpatients, and electronic problem-based learning (e-PBL) and online virtual medical interviews (online-VMI) for outpatients, for an online-sCP using a learning management system (LMS) and online meeting system facilitated by a supervising physician. METHODS: The sEHR was reviewed by medical students and subsequently discussed with a supervising physician using an online meeting system. In the e-PBL, medical students reviewed the simulated patients and discussed on the LMS. For the online-VMI, a faculty member acted as an outpatient and a student acted as the doctor. Small groups of students discussed the clinical reasoning process using the online meeting system. A mixed-method design was implemented. Medical students self-assessed their clinical competence before and after the online-sCP. They answered questionnaires and participated in semi-structured focus group interviews (FGIs) regarding the advantages and disadvantages of the practice. RESULTS: Forty-three students completed the online-sCP during May and June 2020. All students indicated significant improvement in all aspects of self-evaluation of clinical performance after the online-sCP. Students using sEHR reported significant improvement in writing daily medical records and medical summaries. Students using e-PBL and online-VMI reported significant improvement in medical interviews and counseling. Students also indicated CCs as more useful for learning associated with medical interviews, physical examinations, and humanistic qualities like professionalism than the online-sCP. Eight FGIs were conducted (n = 42). The advantages of online-sCP were segregated into five categories (learning environment, efficiency, accessibility, self-paced learning, and interactivity); meanwhile, the disadvantages of online-sCP were classified into seven categories (clinical practice experience, learning environment, interactivity, motivation, memory retention, accessibility, and extraneous cognitive load). CONCLUSIONS: Online-sCP with sEHR, e-PBL, and online-VMI could be useful in learning some of the clinical skills acquired through CC. These methods can be implemented with limited preparation and resources.


Assuntos
COVID-19/epidemiologia , Estágio Clínico , Competência Clínica , Educação à Distância , Pandemias , Aprendizagem Baseada em Problemas/métodos , Documentação , Registros Eletrônicos de Saúde , Estudos de Viabilidade , Grupos Focais , Humanos , Anamnese , Registros Médicos , Simulação de Paciente , SARS-CoV-2 , Autoavaliação (Psicologia)
15.
MedEdPORTAL ; 17: 11106, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33768143

RESUMO

Introduction: During the COVID-19 pandemic, third-year medical students were temporarily unable to participate in onsite clinical activities. We identified the curricular components of an internal medicine (IM) clerkship that would be compromised if students learned solely from online didactics, case studies, and simulations (i.e., prerounding, oral presentations, diagnostic reasoning, and medical management discussions). Using these guiding principles, we created a virtual rounds (VR) curriculum to provide IM clerkship students with clinical exposure during a virtual learning period. Methods: Held three times a week for 2 weeks, VR consisted of three curricular components. First, clerkship students prerounded on an assigned hospitalized patient by remotely accessing the electronic health record and calling into hospital rounds. Second, each student prepared an oral presentation on their assigned patient. Third, using videoconferencing, students delivered these oral presentations to telemedicine VR small groups consisting of three to four students and three tele-instructors. Tele-instructors then provided feedback on oral presentations and taught clinical concepts. We assessed the effectiveness of VR by anonymously surveying students and tele-instructors. Results: Twenty-nine students and 34 volunteer tele-instructors participated in VR over four blocks. A majority of students felt VR improved their prerounding abilities (86%), oral presentation abilities (93%), and clinical reasoning skills (62%). All students found small group to be useful. Discussion: VR allowed students to practice rounding skills in a supportive team-based setting. The lessons learned from its implementation could facilitate education during future pandemics and could also supplement in-person clerkship education.


Assuntos
COVID-19 , Estágio Clínico/métodos , Educação à Distância/métodos , Educação de Graduação em Medicina/métodos , Medicina Interna/educação , Visitas com Preceptor/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Competência Clínica , Currículo , Medicina Hospitalar/educação , Medicina Hospitalar/tendências , Humanos , Satisfação Pessoal , SARS-CoV-2 , Estudantes de Medicina/psicologia , Telemedicina/métodos
16.
BMC Med Educ ; 21(1): 153, 2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691688

RESUMO

BACKGROUND: Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students' clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients' perceptions of longitudinal relationships with the LIC students within Taiwan's Confucian cultural and social context. METHODS: We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients' descriptions of their experiences interacting with the LIC students. RESULTS: Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients' experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients' experience, feelings, and mood. CONCLUSION: In our study, Taiwanese patients' perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.


Assuntos
Estágio Clínico , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Percepção , Pesquisa Qualitativa , Taiwan
17.
Neurology ; 96(10): e1482-e1486, 2021 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-33686009

RESUMO

OBJECTIVE: To determine whether increased patient interaction, exposure to the neurologic examination, and access to positive neurology mentors increase interest in neurology for first-year medical students. METHODS: Neuro Day was a 2-part experience for first-year medical students. The first part consisted of a flipped classroom to teach the standard neurologic examination. The second part involved patient encounters modeled off of the traditional patient rounds. Students rotated from room to room, listening to patients' experiences with different neurologic diseases and eliciting pathologic neurologic examinations. Students were surveyed before and after Neuro Day. RESULTS: The result of the binomial test indicated that the proportion of medical students interested in neurology significantly increased from 78% to 85% (95% confidence interval [CI] 0.79-0.92; p = 0.034) after participating in Neuro Day. The proportion of students' knowledge of clinical neurology increased from 45% to 63.1% (95% CI 0.54-0.72; p < 0.0001), comfort with performing a neurologic examination increased from 30% to 78.4% (95% CI 0.70-0.86; p < 0.0001), and fear of studying neurology decreased from 46% to 26% (95% CI 0.17-0.34; p < 0.0001) following Neuro Day. One hundred percent of students indicated that they would recommend Neuro Day to their peers. CONCLUSION: Neuro Day is a feasible and effective model to incorporate into medical education. There was increased interest in and decreased fear of neurology. We anticipate that this paradigm can be used in the future to encourage students to consider a career in neurology.


Assuntos
Currículo , Internato e Residência , Neurologia/educação , Estudantes de Medicina , Escolha da Profissão , Estágio Clínico , Educação de Graduação em Medicina , Humanos , Mentores , Pacientes , Estudos Prospectivos , Inquéritos e Questionários
18.
Curr Sports Med Rep ; 20(2): 124-128, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33560037

RESUMO

ABSTRACT: Studies show that medical school curriculums do not prepare graduates to manage the most common musculoskeletal (MSK) injuries they will encounter in the outpatient setting. The authors proposed a new multiple-choice assessment to identify individual and program deficiencies for curriculum improvement. A multiple-choice MSK assessment tool was administered to learners at various stages of training. Students took the examination after completing their core clerkship year; residents took the examination near the beginning of their respective academic year. Outcome measures included average examination score, percent correct for each question, and overall examination reliability. Average examinees scores were 75.6% with higher scores based on training years. No statistical differences were found between MD/DO, male/female, or military/civilian examinees. The tool was found to be a statistically valid method of determining cognitive knowledge in basic MSK topics, identifying individual deficiencies, and highlighting gaps in training programs' MSK curriculums.


Assuntos
Estágio Clínico , Competência Clínica , Currículo , Avaliação Educacional , Internato e Residência , Sistema Musculoesquelético/lesões , Medicina de Família e Comunidade/educação , Feminino , Humanos , Masculino , Estados Unidos
20.
J Osteopath Med ; 121(2): 211-220, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33567082

RESUMO

Context: While the data generated by medical students at schools that require electronic patient encounter logs is primarily used to monitor their training progress, it can also be a great source of public health data. Specifically, it can be used for syndromic surveillance, a method used to analyze instantaneous health data for early detection of disease outbreaks. Objective: To analyze how the International Classification of Diseases, 10th Revision (ICD-10) codes input by medical students at the Edward Via College of Osteopathic Medicine into the Clinical Rotation Evaluation and Documentation Organizer (CREDO) patient encounter logging system could act as a new syndromic surveillance tool. Methods: A CREDO database query was conducted for ICD-10 codes entered between November 1, 2019 and March 13, 2020 using the World Health Organization's 2011 revised case definitions for Influenza Like Illness (ILI). During that period, medical students had an approximated mean of 3,000 patient encounters per day from over 1,500 clinical sites. A cumulative sum technique was applied to the data to generate alert thresholds. Breast cancer, a disease with a stable incidence during the specified timeframe, was used as a control. Results: Total ILI daily ICD-10 counts that exceeded alert thresholds represented unusual levels of disease occurred 11 times from November 20, 2020 through February 28, 2020. This analysis is consistent with the COVID-19 pandemic timeline. The first statistically significant ILI increase occurred nine days prior to the first laboratory confirmed case in the country. Conclusion: Syndromic surveillance can be timelier than traditional surveillance methods, which require laboratory testing to confirm disease. As a result of this study, we are installing a real-time alert for ILI into CREDO, so rates can be monitored continuously as an indicator of possible future new infectious disease outbreaks.


Assuntos
COVID-19/epidemiologia , Estágio Clínico , Vigilância de Evento Sentinela , Estudantes de Medicina , Surtos de Doenças , Feminino , Humanos , Influenza Humana/epidemiologia , Classificação Internacional de Doenças , Masculino , Vigilância da População/métodos , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Estados Unidos/epidemiologia
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