Teaching history taking to medical students: a systematic review.

BACKGROUND: This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students' interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program's efficacy. METHODS: The databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students' history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: Seventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students' history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65). CONCLUSIONS: These findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping them to focus on interview skills and not being distracted by thinking about differential diagnoses or clinical management. The heterogeneity of outcome data and the varied ways of assessment strongly suggest the need for further research as many studies did not meet basic methodological criteria. Randomized controlled trials using external assessment methods, standardized measurement tools and reporting long-term data are recommended to evaluate the efficacy of courses on history taking.

College-level Baccalaureate-MD Student Perceptions of Research and Research-Oriented Careers.

PURPOSE: Concern about the decline in physician scientists has generated interest in promoting research participation among medical students. This study aimed to examine perceptions of research and research-oriented careers among college-level baccalaureate-MD (BA/MD) students at one institution in the United States. METHODS: A cross-sectional survey was distributed to a sample of 241 BA/MD students. Descriptive statistics were used to examine research perceptions of participants. RESULTS: The response rate was 52% (126/241). Most respondents conducted scientific research in high school and were interested in research-oriented careers. Most students participated in a research program (research course, faculty mentorship, or research grant), disseminated their research, and believed that research programs would be helpful for their research participation. The most common perceived barriers were a lack of time, interest, and prior research experience. CONCLUSIONS: College-level BA/MD students had positive perception of research-oriented careers and found student research programs helpful. However, addressing key barriers such as lack of time, interest and experience will help expand BA/MD student engagement in research.

Engaging College-Level Baccalaureate-MD Students in Clinical Research.

College students in baccalaureate-MD (BA/MD) programs are well situated to get involved with clinical research as a component of their scholarly enrichment. The authors review the educational and professional development benefits of BA/MD college research in the United States (US), the lack of evidence-based strategies to guide program innovation, lessons from non-US medical school research enrichment efforts, and teaching models that can help boost BA/MD research engagement at the college level. Collaboration on part of program directors, faculty and students can help strengthen the quality and accessibility of research opportunities with a focus on longitudinal skills building and professional mentorship.

The Association Between Premedical Curricular and Admission Requirements and Medical School Performance and Residency Placement: A Study of Two Admission Routes.

PURPOSE: The curricular elements of undergraduate premedical education are the subject of an ongoing debate. The Warren Alpert Medical School of Brown University (AMS) matriculates students via the traditional premedical route (TPM) and an eight-year baccalaureate/MD program-the Program in Liberal Medical Education (PLME)-which provides students with a broad and liberal education. Using the juxtaposition of these two admission routes, the authors aimed to determine whether there is an association between highly distinct premedical curricular and admission requirements and medical school performance and residency placement. METHOD: The cohorts studied included all of the PLME (n = 295) and TPM (n = 215) students who graduated from the AMS between 2010 and 2015. Outcome variables consisted of multiple measures of medical school performance, including standardized multiple-choice examination scores and honors grades, and residency placement. The authors employed unadjusted tests of averages and proportions (independent t tests and chi-square tests) to compare variables. RESULTS: The TPM students attained marginally, but statistically significantly, higher average scores on standardized multiple-choice examinations than their PLME counterparts. The number of undergraduate premedical science courses completed by PLME students accounted for less than 4% of the variance in key metrics of medical school performance. The residency placement record of the PLME and TPM cohorts proved comparable. CONCLUSIONS: These findings suggest that the association between medical school performance and residency placement and undergraduate premedical curricular and admission requirements is weak. Further study is needed to determine the optimal premedical preparation of students.