Diversity and consistency: a case study of regionalised clinical placements for medical students

2015 ◽  
Vol 39 (1) ◽  
pp. 95 ◽  
Author(s):  
Mavourneen G. Casey ◽  
Michael David ◽  
Diann Eley
Keyword(s):  
Academic Performance ◽  
Medical Students ◽  
Clinical Examination ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Clinical Settings ◽  
Clinical Placements ◽  
Clinical Rotations ◽  
Teaching Standards

Objective A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods A retrospective analysis of academic records for UQ medical students (n = 1514) completing clinical rotations (2009–2012) was performed using analysis of covariance (ANCOVA) for comparisons between clinical school cohorts and linear mixed-effects modelling (LEM) to assess predictors of academic performance. Results In all, 13 036 individual clinical rotations were completed between 2009 and 2012. ANCOVA found no significant differences in rotation grades between the clinical schools except that Rural Clinical School (RCS) cohorts achieved marginally higher results than non-RCSs in the general practice rotation (5.22 vs 5.10–5.18; P = 0.03) and on the final clinical examination (objective structured clinical examination; 5.27 vs 5.01–5.09; P < 0.01). LEM indicated that the strongest predictor of academic performance on clinical rotations was academic performance in the preclinical years of medical school (β = 0.38; 95% confidence interval 0.35–0.41; P < 0.001). Conclusions The decentralised UQ clinical schools deliver a consistent standard of clinical training for medical students in all core clinical rotations across a range of urban, regional and rural clinical settings. Further research is required to monitor the costs versus benefits of regionalised clinical schools for students, local communities and regional healthcare services. What is known about the topic? To help meet the demand of increasing numbers of students, Australian medical schools locate clinical training outside the traditional tertiary hospitals. However the viability of maintaining teaching standards across regional and rural locations is uncertain. What does this paper add? Maintaining teaching standards outside established urban teaching hospitals and across a diverse range of urban, regional and rural clinical settings is viable. What are the implications for practitioners? Decentralised clinical teaching networks provide consistent quality of clinical placements while diversifying exposure to different patient populations and clinical environments. These important outcomes may not only alleviate the strain on clinical teaching resources, but also help address the maldistribution of doctors in Australia.

scholarly journals Assessment of clinical teaching /training program in medicine among the medical students

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Aamir Shahzad ◽  
Tanvir Us Salam ◽  
Mohammad Ashraf Majrooh ◽  
Israr Ul Haque ◽  
Shamail Zafar ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Faculty Members ◽  
Senior Faculty ◽  
Clinical Rotations ◽  
Medical College ◽  
Teaching Standards ◽  
Teaching Curriculum ◽  
Very High

A student`s analysis of teaching / curriculum designing is important for proper educational planning. The study was conducted to evaluate the clinical training in subject of medicine with mutual collaboration of Foundation University Medical College Rawalpindi (FUMC) and Allama Iqbal Medical College (AIMC) Lahore. Total 151 students were interviewed out of those 74 were interview in FUMC Rawalpindi and 77 in AIMC Lahore. To get the feedback of clinical training in undergraduate students a simple questionnaire was distributed during the clinical attachments of final year students. The results showed 55% students were satisfied with duration of clinical rotation while 48.3% of the students thought, instead of rotation to all units, continuous stay in one unit would be a better idea; but marked variation in teaching standards and level of enthusiasm among teachers forces them to opt for the former to benefit from all teachers. Only 31 percent of students were satisfied with the level of commitment shown by senior faculty members and 21.8 percent thought that topics were adequately covered during clinical rotations. Ward tests were not rated very high as a reliable tool of their assessment and 60% felt it failed to assess them thoroughly.

The Clinician Directed Hierarchy: A Clinical Training Tool

2008 ◽  
Vol 11 (2) ◽  
pp. 56-60 ◽  
Author(s):  
Jill K. Duthie
Keyword(s):  
Clinical Supervision ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Settings ◽  
Specific Level ◽  
Problem Solving Skills ◽  
Training Tool ◽  
Target Behaviors ◽  
Intervention Process

Abstract Clinical supervisors in university based clinical settings are challenged by numerous tasks to promote the development of self-analysis and problem-solving skills of the clinical student (American Speech-Language-Hearing Association, ASHA, 1985). The Clinician Directed Hierarchy is a clinical training tool that assists the clinical teaching process by directing the student clinician’s focus to a specific level of intervention. At each of five levels of intervention, the clinician develops an understanding of the client’s speech/language target behaviors and matches clinical support accordingly. Additionally, principles and activities of generalization are highlighted for each intervention level. Preliminary findings suggest this is a useful training tool for university clinical settings. An essential goal of effective clinical supervision is the provision of support and guidance in the student clinician’s development of independent clinical skills (Larson, 2007). The student clinician is challenged with identifying client behaviors in the therapeutic process and learning to match his or her instructions, models, prompts, reinforcement, and use of stimuli appropriately according to the client’s needs. In addition, the student clinician must be aware of techniques in the intervention process that will promote generalization of new communication behaviors. Throughout the intervention process, clinicians are charged with identifying appropriate target behaviors, quantifying the progress of the client’s acquisition of the targets, and making adjustments within and between sessions as necessary. Central to the development of clinical skills is the feedback provided by the clinical supervisor (Brasseur, 1989; Moss, 2007). Particularly in the early stages of clinical skills development, the supervisor is challenged with addressing numerous aspects of clinical performance and awareness, while ensuring the client’s welfare (Moss). To address the management of clinician and client behaviors while developing an understanding of the clinical intervention process, the University of the Pacific has developed and begun to implement the Clinician Directed Hierarchy.

scholarly journals Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

2016 ◽  
Vol 10 (7-8) ◽  
pp. 281
Author(s):  
Kristen McAlpine ◽  
Stephen Steele
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Clinical Skills ◽  
Medical Schools ◽  
Clinical Settings ◽  
Undergraduate Medical Students ◽  
Canadian Medical School ◽  
Competency Based ◽  
English Speaking ◽  
And Training

<p><strong>Introduction:</strong> The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.</p><p><strong>Methods:</strong> This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.</p><p><strong>Results:</strong> A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.</p><p><strong>Conclusions:</strong> To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.</p>

scholarly journals Collaborating for Competency—A Model for Single Electronic Health Record Onboarding for Medical Students Rotating among Separate Health Systems

2018 ◽  
Vol 09 (01) ◽  
pp. 199-204 ◽  
Author(s):  
Anne Pereira ◽  
Michael Kim ◽  
Marcus Seywerd ◽  
Brooke Nesbitt ◽  
Michael Pitt ◽  
...  
Keyword(s):  
Medical Students ◽  
Electronic Health Record ◽  
Health Systems ◽  
Clinical Training ◽  
Single Type ◽  
Health Record ◽  
Clinical Rotations ◽  
Academic Medical ◽  
Competency Based ◽  
Electronic Health

Background Use of the electronic health record (EHR) is widespread in academic medical centers, and hands-on EHR experience in medical school is essential for new residents to be able to meaningfully contribute to patient care. As system-specific EHR training is not portable across institutions—even when the same EHR platform is used—students rotating across health systems are often required to spend time away from clinical training to complete each system's, often duplicative, EHR training regardless of their competency within the EHR. Methods We aimed to create a single competency-based Epic onboarding process that would be portable across all the institutions in which our medical students complete clinical rotations. In collaboration with six health systems, we created online EHR training modules using a systematic approach to curriculum development and created an assessment within the Epic practice environment. Results All six collaborating health systems accepted successful completion of the developed assessment in lieu of standard site-specific medical student EHR training. In the pilot year, 443 students (94%) completed the modules and assessment prior to their clinical training and successfully entered clinical rotations without time consuming, often repetitive onsite training, decreasing the cumulative time as student might be expected to engage in Epic onboarding as much as 20-fold. Conclusion Medical schools with multisystem training sites with a single type of EHR can adopt this approach to minimize training burden for their learners and to allow them more time in the clinical setting with optimized access to the EHR.

Comparative academic performance of medical students in rural and urban clinical settings

2006 ◽  
Vol 40 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Barb Waters ◽  
John Hughes ◽  
Kevin Forbes ◽  
David Wilkinson
Keyword(s):  
Academic Performance ◽  
Medical Students ◽  
Clinical Settings ◽  
Rural And Urban

scholarly journals A day in the life of third-year medical students: using an ethnographic method to understand information seeking and use

2017 ◽  
Vol 105 (1) ◽  
Author(s):  
Andrea B. Twiss-Brooks, MS, MLIS ◽  
Ricardo Andrade Jr., MLIS ◽  
Michelle B. Bass, PhD, MSI ◽  
Barbara Kern, MLIS ◽  
Jonna Peterson, MLIS ◽  
...  
Keyword(s):  
Medical Students ◽  
Time Management ◽  
Information Seeking ◽  
Information Resources ◽  
Clinical Settings ◽  
Structured Interviews ◽  
School Students ◽  
Desktop Computers ◽  
Available Technology

Objective: The authors undertook this project to learn how third-year medical students seek and use information in the course of daily activities, especially activities conducted in clinical settings in a variety of institutions.Methods: We recruited sixty-eight third-year undergraduate medical school students to create a mapping diary of a day that included clinical activities. We conducted semi-structured interviews based on the mapping diaries. Using content and thematic analyses of the resulting interview transcripts, we developed an ethnographic case study for each participant.Results: In the studied sample, we identified a broad range of information resources used for personal, clinical, and educational use. Participants relied heavily on technology throughout their day, including desktop computers, smart phones, handheld tablets, and laptops. Time management was a pervasive theme in the interviews, with participants squeezing in time to study for exams wherever and whenever they could. Selection of a particular information resource or technology to use was governed largely by the convenience of using that resource or technology. When obstacles were encountered, workarounds might be sought, but in many cases, the resource or technology would be abandoned in favor of a more convenient solution. Convenience was also a consideration in choosing spaces to use for clinical duties or for study, with specific considerations of available technology, proximity to clinical areas, and security for belongings contributing to choices made.Conclusions: Some of our results align with those of other recent studies of information use among medical students, residents, and practicing physicians. In particular, the fast-paced clinical setting favors use of information resources that are fast and easy to use. We demonstrated that the methods used are suitable to better understand clinicians’ discovery and use of information.

scholarly journals If you can’t make it, you're not tough enough to do medicine’: A qualitative study of Sydney-based medical students’ experiences of bullying and harassment in clinical settings

2019 ◽  
Author(s):  
Laura Colenbrander ◽  
Louise Causer ◽  
Bridget Haire
Keyword(s):  
Medical Students ◽  
Clinical Teaching ◽  
Medical Profession ◽  
Verbal Abuse ◽  
Clinical Settings ◽  
Negative Consequences ◽  
Academic Literature ◽  
Quality Patient Care ◽  
Depth Interviews ◽  
Bullying And Harassment

Abstract Background: Media exposés and academic literature reveal high rates of bullying and harassment of medical students, most commonly by consultant physicians and/or surgeons. Recent reports reveal the medical profession to be characterised by hierarchy, with verbal abuse a ‘rite of passage’, as well as sexist and racist behaviours. Methods : Semi-structured in-depth interviews were conducted with ten current or recently graduated medical students from Sydney-based medical schools. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Results : Hierarchy, and a culture of self-sacrifice, resilience and deference, were identified as problematic elements of the medical profession. In the minds of participants, these factors created barriers to reporting mistreatment, as participants felt reporting led to being labelled a ‘troublemaker’, affecting career progression. Additionally, participants stated that avenues of recourse were unclear and did not guarantee confidentiality or desired outcomes. Conclusions : Mistreatment is continuing in clinical teaching and has negative consequences on medical students’ mental health and learning. Structural change is needed to combat institutionalised mistreatment to ensure the wellbeing of future doctors and high quality patient care.

scholarly journals Medical students’ perceptions of stress factors affecting their academic performance, perceived stress and stress management techniques

2018 ◽  
Vol 5 (5) ◽  
pp. 1791 ◽  
Author(s):  
Violet N. Pinto ◽  
Sumit Wasnik ◽  
Sumedha M. Joshi ◽  
Deepa H. Velankar
Keyword(s):  
Academic Performance ◽  
Medical Students ◽  
Stress Management ◽  
Perceived Stress ◽  
Clinical Teaching ◽  
Mother Tongue ◽  
Stress Factors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Management Techniques

Background: Medical students during their training period to become competent physicians are themselves vulnerable to various stresses which can affect their health and academic performance. The objectives of the study were to study MBBS students perceptions of stress factors affecting their academic performance; to assess the perceived stress in the students; to identify the stress management techniques used by the students.Methods: A cross-sectional was conducted on 169 MBBS students in a private medical college in Navi Mumbai after taking their consent. Data collection was by pretested, pre-coded, semi-structured self-administered questionnaire. Statistical analysis was done by SPSS Version 20.0 and relevant tests for data analysis.Results: The mean PSS score in the students was 26.96 (SD=6.332). Moderate stress and severe stress were present in 37.3% and 1.1% students respectively. Perceived stress was significantly associated with female sex, mother tongue; vastness of curriculum, dissatisfaction with clinical teaching, competition with peers and high parental expectations. More than 50% students felt that they were not able to adequately manage their stress. The most commonly used stress management techniques were social media usage and engaging in hobbies/sports.Conclusions: There is an urgent need for conducting screening programmes for stress in medical students and implementing measures which will equip them with skills to manage their stress.

scholarly journals Attitudes of teaching faculty towards clinical teaching of medical students in an emergency department of a teaching institution in Singapore during the COVID-19 pandemic

2021 ◽  
Vol 6 (3) ◽  
pp. 67-74
Author(s):  
Tess Lin Teo ◽  
Jia Hao Lim ◽  
Choon Peng Jeremy Wee ◽  
Evelyn Wong
Keyword(s):  
Medical Students ◽  
Clinical Education ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Faculty Attitudes ◽  
Clinical Teachers ◽  
Risk Environments ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Teaching Faculty

Introduction: Singapore experienced the COVID-19 outbreak from January 2020 and Emergency Departments (ED) were at the forefront of healthcare activity during this time. Medical students who were attached to the EDs had their clinical training affected. Methods: We surveyed teaching faculty in a tertiary teaching hospital in Singapore to assess if they would consider delivering clinical teaching to medical students during the outbreak and conducted a thematic analysis of their responses. Results: 53.6% felt that medical students should not undergo clinical teaching in the ED and 60.7% did not wish to teach medical students during the outbreak. Three themes arose during the analysis of the data - Cognitive Overload of Clinical Teachers, Prioritisation of Clinical Staff Welfare versus Medical Students, and Risk of Viral Exposure versus Clinical Education. Conclusion(s): During a pandemic, a balance needs to be sought between clinical service and education, and faculty attitudes towards teaching in high-risk environments can shift their priorities in favour of providing the former over the latter.

scholarly journals Using medical reality television as a technology-enhanced learning strategy to provide authentic patient care experiences during clinical placements: a case study research investigation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Osborne ◽  
Miles Harrison ◽  
James Fisher ◽  
Belinda Bateman
Keyword(s):  
Medical Students ◽  
Patient Care ◽  
Learning Strategies ◽  
Reality Television ◽  
Case Study Research ◽  
Technology Enhanced Learning ◽  
Clinical Placements ◽  
Study Research ◽  
Enhanced Learning

Abstract Background Over the last decade, the use of technology-enhanced learning (TEL) has rapidly expanded and diversified. Since the COVID-19 pandemic, there is a growing demand for distance and online learning strategies to support and even replace learning experiences previously afforded by clinical placements and clerkships. An intriguing but under-researched modality is the use of medical reality television to provide authentic experiences of patient care. This strategy does not feature in published medical educational literature, though promising research is emerging from other disciplines. Methodology A programme of learning using medical reality television clips to facilitate case-based learning was developed according to the principles of ‘anchored instruction’, a technology-based educational theory. Clips were taken from the UK television show ’24 hours in A&E’. Medical students’ learning experiences were investigated using a qualitative approach addressing the following research questions: - What is the perceived emotional experience of medical students when watching reality television in an educational context? - How do medical students relate their experience of watching reality television in a formal educational setting to their perceived learning needs in the clinical environment? A case study research methodology was adopted within the interpretivist paradigm. Data were triangulated from semi-structured interviews with students and non-participant observation of the teaching session. Field notes and transcripts were analysed through an inductive thematic analysis. Results In response to the medical reality television, a diverse range of emotions were expressed including: excitement, amusement, concern, nervousness, sadness and joy. Students identified gaps in their clinical knowledge such as interpreting results, practical aspects of prescribing and end of life care. Key themes were increased student engagement and a promotion of holistic care practices. Discussion Students perceived reality television as a highly realistic and relatable medium and an enjoyable, memorable way to contextualise learning from the classroom to real life, a finding mirrored in previous studies in other fields. The high degree of emotion expressed may explain the improved subjective memorability of the cases. Conclusion Medical reality television offers a unique means of engaging students by providing authentic experiences of patient care and should be valued alongside other technology-enhanced learning strategies.

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