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1.
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
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 , Inquéritos e Questionários , Telemedicina/métodos
2.
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
Estágio Clínico/métodos , Educação à Distância/métodos , Educação de Graduação em Medicina/métodos , Medicina Interna/educação , Visitas com Preceptor/métodos , /epidemiologia , Competência Clínica , Currículo , Medicina Hospitalar/educação , Medicina Hospitalar/tendências , Humanos , Satisfação Pessoal , Estudantes de Medicina/psicologia , Telemedicina/métodos
4.
J Osteopath Med ; 121(1): 43-47, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33512395

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on both clinical practices and learning environments. On March 17th, 2020, the American Association of Colleges of Osteopathic Medicine and Commission on Osteopathic College Accreditation issued a statement recommending a "pause" in medical student participation in-person at clinical sites. In response, the Family Medicine Department at the Rowan University School of Osteopathic Medicine recognized the need to evolve the traditional curriculum and quickly transitioned to an online format, incorporating telemedicine into the clerkship. This new model enabled 44 third-year medical students to obtain high-quality, offsite, virtual education and learn new skills.


Assuntos
/epidemiologia , Estágio Clínico/métodos , Currículo/normas , Medicina Osteopática/educação , Faculdades de Medicina/normas , Estudantes de Medicina , Telemedicina/métodos , Competência Clínica , Humanos , Aprendizagem , Pandemias
6.
Med Educ Online ; 26(1): 1842660, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33121393

RESUMO

SUBSTANCE: We reviewed the effect of a hybrid remediation model combining co-regulated learning and deliberate practice on future exam performance of pre-clerkship medical students who had been unsuccessful on a previous clinic skills exam. With this remediation model, we aimed to strengthen students' self-regulated learning to improve future exam performance and support sustained and improved learning. Educational problem addressed: Observing that some students who initially performed well post remediation with deliberate practice, still struggled on future exams, we looked to address a method that could improve both short-and long-term clinical skills learning success with sustained performance. Intervention outcome: Comparing the remediated students' exam scores pre- and post-coaching to their cohort's performance, we observed the majority of students post remediation performed above their cohort's exam average. Lessons learned: Combining learning models resulted in improved learning outcomes.


Assuntos
Estágio Clínico , Competência Clínica , Avaliação Educacional , Tutoria , Logro , Estágio Clínico/métodos , Humanos , Aprendizagem , Modelos Educacionais , Estudantes de Medicina
10.
Int J Radiat Oncol Biol Phys ; 108(2): 444-451, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32890529

RESUMO

PURPOSE: We evaluated the impact of a virtual radiation oncology clerkship. METHODS AND MATERIALS: We developed a 2-week virtual radiation oncology clerkship that launched on April 27, 2020. Clerkship components included a virtual clinic with radiation oncology faculty and residents, didactic lectures, student talks, and supplemental sessions such as tumor boards and chart rounds. Medical students completed pre- and post-clerkship self-assessments. Faculty and resident participants also completed surveys on their experience with virtual lectures and clinics. Pre- and post-clerkship results were compared using a 2-sided paired t test. An analysis of variance model was used to analyze the clerkship components. RESULTS: Twenty-six medical students, including 4 visiting students, enrolled over 2 clerkship periods (4 weeks). All students completed the pre- and post-clerkship self-assessments and agreed that the clerkship improved their understanding of radiation oncology. Compared with 3 (11.5%) students who agreed that they understood the daily responsibilities of a radiation oncologist before the clerkship, 22 (84.6%) students agreed and 3 (11.5%) strongly agreed that they understood the daily responsibilities of a radiation oncologist after the clerkship (P < .0001). Although 15 students (57.7%) reported an increased interest in radiation oncology because of the clerkship, the mean level of interest in radiation oncology as a career remained the same, with pre- and post-clerkship scores of 3.0 (±0.9) and 3.0 (±1.1) on a 5-point scale, respectively (P = .7). Students found virtual clinic and didactic lectures to be the most valuable components of the clerkship. Most respondents agreed (30.8%) or strongly agreed (65.4%) to recommend the clerkship to their classmates. CONCLUSIONS: Our virtual clerkship was effective in increasing medical student interest in and knowledge about radiation oncology. These data will help optimize a new paradigm of virtual radiation oncology education for medical students during COVID-19 and beyond.


Assuntos
Estágio Clínico/métodos , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/educação , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Interface Usuário-Computador , Adulto Jovem
11.
Korean J Med Educ ; 32(3): 223-229, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32894923

RESUMO

PURPOSE: Clinical rotations of medical students across the world have inevitably been affected due to the coronavirus disease 2019 (COVID-19) pandemic. The aims of this study were to explore medical students' perception on the school's response and management of clinical rotation during the COVID-19 pandemic and on how it had affected the quality of their education. METHODS: An online questionnaire was distributed to third year medical students at one institution whose clinical rotations re-started during the pandemic. The questions asked about the students' satisfaction with the school's policy and feelings of safety, and the impact of COVID-19 on clinical learning. RESULTS: The students' perception on the school's response to the pandemic was mixed. Re-commencement of the clinical rotations and procurement of personal protective equipment was positive but a third of students still felt unsafe. The decreased number of hospital patients did not seem to have impacted their overall clinical education with praise on the role of the supervising physicians. Seventy-six-point seven percent of students conferred the positive educational opportunities on medical professionalism presented to them only as the clinical rotation during the ongoing pandemic. CONCLUSION: Our observations on the re-commencement of clerkship during this pandemic may help equip medical institutions on future public health crisis.


Assuntos
Atitude do Pessoal de Saúde , Betacoronavirus , Estágio Clínico/métodos , Infecções por Coronavirus/prevenção & controle , Educação de Graduação em Medicina/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Estudantes de Medicina/psicologia , Humanos , República da Coreia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
13.
Ann R Coll Surg Engl ; 102(9): 672-684, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32820649

RESUMO

INTRODUCTION: Since its inception, laparoscopic surgery has evolved and new techniques have been developed due to technological advances. This requires a different and more complex skill set in comparison with open surgery. Reduced working hours, less training time and patient safety factors demand that such skills need to be achieved outside the operating theatre environment. Several studies have been published and have determined the effectiveness of virtual reality training. We aimed to compare virtual reality training with the traditional apprenticeship method of training and determine whether it can supplement or replace the traditional apprenticeship model. We also aimed to perform a meta-analysis of the literature and develop conclusions with respect to the benefits achieved by adding virtual reality training on a regular basis to surgical training programmes. METHODS: A literature search was carried out on PubMed, MEDLINE, EMBASE and Google Scholar academic search engines using the MESH terms 'randomised controlled trials', 'virtual reality', 'laparoscopy', 'surgical education' and 'surgical training'. All randomised controlled trials published to January 2018 comparing virtual reality training to apprenticeship training were included. Data were collected on improved dexterity, operative performance and operating times. Each outcome was calculated with 95% confidence intervals and with intention-to-treat analysis; 24 randomised controlled trials were analysed. FINDINGS: Meta-analytical data were extracted for time, path length, instrument handling, tissue handling, error scores and objective structure assessment of technical skills scoring. There was significant improvement in individual trainee skill in all meta-analyses (p < 0.0002). CONCLUSION: This meta-analysis shows that virtual reality not only improves efficiency in the trainee's surgical practice but also improves quality with reduced error rates and improved tissue handling.


Assuntos
Estágio Clínico , Laparoscopia/educação , Realidade Virtual , Estágio Clínico/métodos , Humanos
14.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(3): 151-154, mayo-jun. 2020.
Artigo em Espanhol | IBECS | ID: ibc-193882

RESUMO

OBJETIVO: Conocer la opinión de los estudiantes de medicina que han realizado su rotación por el centro de salud en los últimos años, mediante el análisis de su opinión reflejada en la memoria de la estancia práctica que elaboran al final de su rotación en tercer y sexto curso. SUJETOS Y MÉTODOS: Se realizó un análisis documental de la opinión expresada por los estudiantes de medicina en la memoria de estancia práctica. Se analizaron un total de 15 memorias de estudiantes del Grado de Medicina de la Universidad Complutense de Madrid que han rotado por dos consultas de un centro de salud desde el año 2011 hasta 2019. RESULTADOS: Se han identificado seis categorías en las que se pueden agrupar las opiniones de los estudiantes de medicina sobre su rotación práctica en atención primaria: utilidad de la rotación para su formación, existencia de ideas preconcebidas sobre medicina de familia, grado de satisfacción de la rotación, duración de la rotación, aspectos positivos y negativos de la atención primaria y la medicina de familia, y relación con el tutor. CONCLUSIONES: La opinión del estudiante del grado de medicina sobre sus rotaciones en atención primaria es muy positiva sobre la utilidad y satisfacción con las rotaciones a pesar de su corta duración y la existencia de ideas preconcebidas negativas sobre la medicina de familia y la atención primaria. La rotación ha servido para conocer los aspectos conceptuales de la atención primaria y los valores de la medicina de familia


AIM: To know the opinion of medical students who have performed their rotation by the health center in recent years by analyzing their opinion reflected in the report of the practical stay they perform at the end of their rotation in third and sixth grades. SUBJECTS AND METHODS: A documentary analysis of the opinion expressed by medical students in the practical stay report was carried out. A total of 15 reports of Universidad Complutense de Madrid Medical Degree students who have rotated by two health primary care centers from 2011 to 2019. RESULTS: Six categories have been identified in which medical students' opinions on their practical rotation in primary care can be grouped: usefulness of rotation for their training; the existence of preconceived ideas on family medicine; the degree of rotation satisfaction; duration of rotation; positive and negative aspects of primary care and family medicine; and relationship with the tutor. CONCLUSION: The medical grade student's opinion of his or her rotations in primary care is very positive about the usefulness and satisfaction with rotations despite their short duration and the existence of negative preconceived ideas about the medicine of family and primary care. Rotation has served to understand the conceptual aspects of primary care and the values of family medicine


Assuntos
Humanos , Educação de Pós-Graduação em Medicina/métodos , Estágio Clínico/métodos , Atenção Primária à Saúde , Estágio Clínico/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Medicina de Família e Comunidade/educação
16.
J Surg Res ; 254: 49-57, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32408030

RESUMO

BACKGROUND: This study describes the relationship between medical student perception of surgery, frequency of positive surgery clerkship activities, and overall surgical clerkship experience. METHODS: Medical students at four academic hospitals completed pre- and post-clerkship surveys assessing 1) surgery clerkship activities/experiences and 2) perceptions of surgery during the 2017-2018 academic year. RESULTS: Ninety-one percent of students completed both a pre- and post-clerkship survey (n = 162 of 179). Student perception of surgery significantly improved across the clerkship overall (P < 0.0001) and for 7 of 21 specific items. Eighty-six percent of students agreed that the clerkship was a meaningful experience. Sixty-six percent agreed that the operating room was a positive learning environment. Multivariable logistic regression identified one-on-one mentoring from a resident (OR [95% CI] = 2.12 [1.11-4.04], P = 0.02) and establishing a meaningful relationship with a surgical patient (OR = 2.21 [1.12-4.37], P = 0.02) as activities predictive of student agreement that the surgical clerkship was meaningful. Making an incision (OR = 2.92 [1.54-5.56], P = 0.001) and assisting in dissection (OR = 1.67 [1.03-2.69], P = 0.035) were predictive of student agreement that the operating room was a positive learning environment. Positive student perception of surgery before the clerkship was associated with increased frequency of positive clerkship activities including operative involvement (r = 0.26, P = 0.001) and relationships with surgical attendings (r = 0.20, P = 0.01), residents (r = 0.41, P < 0.0001), and patients (r = 0.24, P = 0.003). CONCLUSIONS: Interventions to improve surgery clerkship quality should target enhancing student relationships with residents and surgical patients as well as providing opportunity for student operative involvement beyond just suturing. In addition, fostering positive perceptions of surgery in the preclinical period may increase meaningfulness and experience with the later surgery clerkship.


Assuntos
Estágio Clínico/métodos , Educação de Graduação em Medicina/métodos , Cirurgia Geral/educação , Estudantes de Medicina , Centros Médicos Acadêmicos , Adulto , Feminino , Humanos , Aprendizagem , Masculino , Mentores , Percepção , Cirurgiões/psicologia , Inquéritos e Questionários , Adulto Jovem
17.
Can J Surg ; 63(3): E257-E260, 2020 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-32400846

RESUMO

Summary: Surgeons are frequently perceived by medical students to be uncompassionate, resolute and individualistic. Surgical education often prioritizes teaching and learning approaches that perpetuate these perceptions. In other specialties, engaging patients in education has shown promise in refocusing attention from the technical and procedural aspects of care toward the humanistic and social aspects. Despite proven favourable outcomes for both patients and students in many clinical areas, a "patient as teacher" approach to surgical education has yet to be adopted widely in Canada. A patient as teacher program was developed for surgical clerks at the University of Toronto with the goal of emphasizing the humanity of the patient, the psychosocial impact of a surgical diagnosis of breast cancer on patients and their families, and the social and humanistic roles for surgeons in providing patient-centred care. We report on the program's development process and pilot session.


Assuntos
Estágio Clínico/métodos , Educação Médica/métodos , Cirurgia Geral/educação , Desenvolvimento de Programas , Estudantes de Medicina , Canadá , Humanos
20.
BMJ Open Qual ; 9(1)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32169862

RESUMO

BACKGROUND: In recent years, Rutgers New Jersey Medical School Department of Family Medicine has integrated a quality assurance (QA) project as a required component of their 5-week medical student clerkship. This project requires each student to conduct a QA study at an assigned family practice and discuss the results with their preceptor. The aim of this study was to determine if sequential medical student QA projects impact physician readiness to improve guideline adherence over time. METHODS: A retrospective analysis of student reports was conducted to determine if physician readiness to improve compliance improved post implementation of the QA project using James Prochaska's Transtheoretical Model of Behavioral Change. Fisher's exact test or the χ2 test were used as applicable to compare the change in results. RESULTS: In academic year 2015-2016, there were 11 (6%) instances where physicians were precontemplating on change, 43 (24%) instances where physicians were contemplating, 101 (57%) instances where physicians were preparing to make change, 18 (10%) instances where physicians were acting, and 4 (2%) of instances where a physician were maintaining previous changes. The following year, the numbers were: 15 (8%), 38 (21%), 82 (46%), 34 (19%) and 11 (6%), respectively. There were increases of physicians in stages of precontemplation (p=0.047), action (p=0.02) and maintenance (p=0.047), a decrease in physicians that were in the stage of preparation (p=0.05) and no significant change in the instances they were in a stage of contemplation (p=0.60). CONCLUSION: Student QA projects appear to leverage physician readiness to improve guideline adherence. Future studies will determine if raising awareness through these clerkship projects results in practice behavioural change.


Assuntos
Medicina de Família e Comunidade/educação , Garantia da Qualidade dos Cuidados de Saúde/métodos , Estudantes de Medicina/psicologia , Estágio Clínico/métodos , Estágio Clínico/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Medicina de Família e Comunidade/métodos , Humanos , New Jersey , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos , Melhoria de Qualidade , Estudos Retrospectivos , Estudantes de Medicina/estatística & dados numéricos
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