Assessing Physician Assistant Student Electronic Health Record Competency Using an Objective Structured Clinical Examination.

PURPOSE: Evaluate didactic year physician assistant (PA) student competency in electronic health record (EHR) communication and data management. METHODS: This study used an Objective Structured Clinical Examination (OSCE) to measure PA students' EHR patient communication and data skills. RESULTS: Most students demonstrated good EHR communication skills overall, while few students moved the computer to better facilitate the visit or verified the patient's identity. Additionally, few students demonstrated EHR data skills by reviewing patient history and medications. CONCLUSIONS: Utilizing an OSCE to assess EHR competence can highlight areas for curricular improvement in order to improve EHR skills.

Medical Student Teaching and Recruiting: 50 Years of Balancing Two Educational Aims.

BACKGROUND: Family medicine (FM) undergraduate medical educators have had two distinct missions, to increase the knowledge, skills, and attitudes of all students while also striving to attract students to the field of family medicine. A five decade literature search was conducted gathering FM curricular innovations and the parallel trends in FM medical student interest. Student interest in FM had a rapid first-decade rise to 14%, a second 1990's surge, followed by a drop to the current plateau of 8-9%. This falls far short of the 30-50% generalist benchmark needed to fill the country's health care needs. Curricular innovations fall into three periods: Charismatic Leaders & Clinical Exposures (1965-1978), Creation of Clerkships of FM (1979-1998) and Curricular Innovations (1998-present). There is good evidence that having a required third-year clerkship positively impacts student interest in the field, however there is little research regarding the recruitment impact of specific clerkship curricula. Other tools associated with student interest include programming geared towards primary care or rural training and extracurricular opportunities such as FM Interest Groups. Strategic plans to improve the primary care work force should focus funding and legislative efforts on effective methods such as: establishing and maintaining FM clerkships, admitting students with rural and underserved backgrounds or primary care interest, developing longitudinal primary care tracks, and supporting extracurricular FM activities. Rigorous research is needed to assess how best to utilize limited educational resources to ensure that all students graduate with a core set of FM competence as well as an increased FM matriculation.

Medical student perceptions of a behavioural and social science curriculum.

Background In 2006, Oregon Health & Science University began implementing changes to better integrate mental health and social science into the curriculum by addressing the Institute of Medicine's (IOM's) 2004 recommendation for the inclusion of six behavioural and social science (BSS) domains: health policy and economics, patient behaviour, physician-patient interaction, mind-body interactions, physician role and behaviour, and social and cultural issues.Methods We conducted three focus groups with a purposive sample of 23 fourth-year medical students who were exposed to 4 years of the new curriculum. Students were asked to reflect upon the adequacy of their BSS training specifically as it related to the six IOM domains. The 90-minute focus groups were recorded, transcribed and analysed.Results Students felt the MS1 and MS2 years of the curriculum presented a strong didactic orientation to behavioural and social science precepts. However, they reported that these principles were not well integrated into clinical care during the second two years. Students identified three opportunities to further the inclusion of BSS in their clinical training: presentation of BSS concepts prior to relevant clinical exposure, consistent BSS skills mentoring in the clinical setting, and improving cultural congruence between aspects of BSS and biomedicine.Conclusions Students exposed to the revised BSS curriculum tend to value its principles; however, modelling and practical training in the application of these principles during the second two years of medical school are needed to reinforce this learning and demonstrate methods of integrating BSS principles into practice.