scholarly journals 83. ID Coaches Contribute to a Highly Effective Learning Experience for Third-Year Medical Students Rotating on the Infectious Diseases Consult Service

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S53-S54
Author(s):  
Erin Roberts ◽  
Rachel Sigler ◽  
Elliott Welford ◽  
Jocelyn Keehner ◽  
Darcy Wooten
Keyword(s):  
Medical Students ◽  
Infectious Diseases ◽  
Clinical Skills ◽  
Clinical Care ◽  
General Medicine ◽  
Consult Service ◽  
Medicine Clerkship ◽  
Highly Effective ◽  
Early Learners ◽  
The Impact

Abstract Background Education on infections in hospitalized patients, antimicrobial selection, and principles of antimicrobial stewardship are foundational to all clinicians. Incorporating early learners into Infectious Diseases (ID) consult services has the potential to build a strong fund of knowledge in these content domains, but also poses potential challenges. We evaluated the impact of a novel clinical rotation and supporting curriculum on third-year medical students rotating on the ID consult service for 2 weeks during their 12-week Internal Medicine clerkship at the University of California, San Diego. Methods Third-year medical students who selected to rotate on the ID consult service were given an hour-long orientation about the service and common infectious syndromes. They were provided with a checklist of clinical skills to complete during the rotation. In addition to daily rounds and clinical care, ID Coaches (ID faculty and senior ID fellows) met with students weekly for 1-2 hours to review ID topics, practice oral presentations, and/or conduct physical exam finding rounds. We surveyed medical students to assess the effectiveness of the rotation. Results Forty third-year medical students participated in the 2-week ID consult rotation between June 2020-May 2021; 31 (77%) completed the rotation evaluation. Seventy percent or more of students reported that the ID rotation facilitated their learning across 8 of 10 ID-content domains (Figure 1). More students reported that the ID Coach facilitated learning (71%) compared to the clinical skills checklist (42%). Students highlighted learning about antimicrobial selection, stewardship, and clinical reasoning on the rotation but reported that teaching was limited when the service census was high (Figure 2). Figure 1: Percent of Students Rating the ID Consult Rotation as Extremely or Very Effective in Facilitating Learning Across 10 Domains Figure 2: Students' Reflections on the Effectiveness of the ID Consult Rotation Conclusion Third-year medical students found that a 2-week rotation on the ID consult service was highly effective in teaching foundational ID content and general medicine skills. Incorporating early learners into a busy and complex subspecialty consult service can be facilitated through the use of supplemental curricular tools such as ID Coaches. Disclosures Darcy Wooten, MD, MS, Nothing to disclose

scholarly journals 1117. An HIV Primary Care Rotation Improved HIV and STI Knowledge, Enhanced Sexual History-Taking Skills, and Increased Interest in a Career in Infectious Diseases among Medical Students and Residents

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S589-S589
Author(s):  
Darcy Wooten ◽  
Austin Marshall
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Infectious Diseases ◽  
Clinical Care ◽  
Educational Experiences ◽  
Sexual History ◽  
Care Clinic ◽  
Clinical Rotations ◽  
Hiv Primary Care ◽  
The Impact

Abstract Background Clinical rotations in HIV primary care provide a unique opportunity to teach trainees about the management of HIV and other sexually transmitted infections (STI), and enhance trainees’ skills in obtaining a culturally-competent sexual history. Positive educational experiences in this setting may also influence trainees’ decisions to pursue a career in HIV Medicine and Infectious Diseases (ID). However, little is known about the impact of an HIV clinic rotation on trainees’ fund of knowledge regarding HIV and STI management, confidence in obtaining a sexual history, or interest in HIV and ID as a career choice. Methods Third year medical students and Internal Medicine residents rotate for two to four weeks in UCSD’s HIV primary care clinic. Over a six month period (September, 2019 - February, 2020) trainees were given a pre and post rotation survey to evaluate their fund of knowledge in managing patients with HIV and other STIs, their confidence in taking a sexual history, and their interest in pursuing a career in HIV and ID. Results Twenty-one of the 31 trainees completed both the pre- and post-rotation survey. Residents and medical students comprised 57% (12) and 43% (9) of the cohort, respectively. Fund of knowledge regarding antiretroviral management, HIV transmission, and STI diagnosis and treatment improved following the rotation (Figure. 1). Trainees’ confidence in their ability to manage patients with HIV and obtain a sexual history also improved (Figure. 2). Importantly, there was a substantial increase in the proportion of trainees interested in pursuing a career in HIV and ID after the rotation compared to beforehand (Figure. 2). Fund of Knowledge Pre and Post Rotation Self-Perceived Competency and Interest in HIV Clinical Care Conclusion Clinical rotations in HIV primary care provide valuable learning experiences for trainees by improving their fund of knowledge about HIV and STIs, and their self-efficacy in obtaining a sexual history. These clinical experiences may also be important in recruiting trainees to pursue a career in HIV and ID. Given the importance of these clinical skills and the need to increase the number of trainees entering the field, additional support for educational experiences in HIV primary care clinics is warranted. Disclosures All Authors: No reported disclosures

Structured Long Interview and Clinical Examination (SLICE) as Formative Assessment Tool in Clinical Clerkship: Medical Students Perspective

2021 ◽  
pp. 1-16
Author(s):  
Wajiha Shadab ◽  
Amna Ahmed Noor ◽  
Saira Waqqar ◽  
Gul Muhammad Shaikh
Keyword(s):  
Medical Students ◽  
Formative Assessment ◽  
Thematic Analysis ◽  
Assessment Tool ◽  
Clinical Skills ◽  
General Medicine ◽  
Sampling Technique ◽  
Clinical Clerkship ◽  
Primary Investigator ◽  
Skills Learning

Abstract Objective: This study aimed to assess the medical students’ opinions and views on undertaking SLICE as a formative assessment. Methods: This was a qualitative, exploratory study. Purposive sampling technique was used to select final year medical students who have undertaken a formative assessment through SLICE in their clerkship rotation. Total 32 students participated in this study .Four sets of focus group discussions (FGD) were conducted from medical students who had recently gone through their clinical clerkship modules for Pediatrics, General Medicine, General Surgery and Gynecology& Obstetrics. Each recorded FGD was transcribed verbatim. Thematic analysis was conducted manually. Themes were identified from the transcribed data, coded and analyzed. In order to achieve adequate coding and researcher reliability, investigator triangulation was performed. The initial thematic analysis was performed by the primary investigator. Thereafter, two more investigators independently analyzed the data. Before the data was finalized, all the three investigators reached a final consensus upon the themes that had emerged, ensuring triangulation of the analyzed data. Results: A four staged thematic analysis was conducted, in which five major themes and five sub-themes emerged. The main themes being: Purpose, Learning, Timing, Relevancy and Fairness of SLICE. Conclusion: The students generally thought that SLICE was effective in enhancing their clinical skills learning and should be conducted more frequently with minor adjustments. Continuous...

Undergraduate performance assessment

2017 ◽  
Vol 5 (9) ◽  
pp. 1-7
Author(s):  
Umayya Musharrafieh ◽  
Khalil Ashkar ◽  
Dima Dandashi ◽  
Maya Romani ◽  
Rana Houry ◽  
...  
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Faculty Evaluation ◽  
Multiple Choice Questions ◽  
Final Exam ◽  
Monthly Basis ◽  
Medicine Clerkship ◽  
Clinical Evaluations

Introduction: Objective Structured Clinical Examination (OSCE) is considered a useful method of assessing clinical skills besides Multiple Choice Questions (MCQs) and clinical evaluations. Aim: To explore the acceptance of medical students to this assessment tool in medical education and to determine whether the assessment results of MCQs and faculty clinical evaluations agree with the respective OSCE scores of 4th year medical students (Med IV). Methods: performance of a total of 223 Med IV students distributed on academic years 2006-2007, 2007-2008, and 2008-2009 in OSCE, MCQs and faculty evaluations were compared. Out of the total 93 students were asked randomly to fill a questionnaire about their attitudes and acceptance of this tool. The OSCE was conducted every two months for two different groups of medical students who had completed their family medicine rotation, while faculty evaluation based on observation by assessors was submitted on a monthly basis upon the completion of the rotation. The final exam for the family medicine clerkship was performed at the end of the 4thacademic year, and it consisted of MCQsResults: Students highly commended the OSCE as a tool of evaluation by faculty members as it provides a true measure of required clinical skills and communication skills compared to MCQs and faculty evaluation. The study showed a significant positive correlation between the OSCE scores and the clinical evaluation scores while there was no association between the OSCE score and the final exam scores.Conclusion: Student showed high appreciation and acceptance of this type of clinical skills testing. Despite the fact that OSCEs make them more stressed than other modalities of assessment, it remained the preferred one.

scholarly journals Patterns and Growth of a Dedicated Pediatric Coagulation Consult Service in a Freestanding Children's Hospital

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 33-34
Author(s):  
Shannon L Carpenter ◽  
Eryn Bilynsky ◽  
Dena Wideman ◽  
Kristina D'Agostino ◽  
Lauren E Amos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Board Of Directors ◽  
Research Funding ◽  
Tracking System ◽  
Clinical Care ◽  
Pediatric Hospital ◽  
Consult Service ◽  
Advisory Committees ◽  
Prophylactic Anticoagulation ◽  
The Impact

Introduction: At our freestanding pediatric hospital, a dedicated inpatient coagulation consult service has existed for 15 years. To our knowledge, this type of service is relatively unique in a pediatric hospital and provides an opportunity to objectively evaluate changes in coagulation consults in this patient population. Over the past decade, the increasing rate of thrombosis in hospitalized pediatric patients has been noted and more attention has been placed on preventing the occurrence of hospital-acquired venous thromboembolism. With concern over this increased incidence, more inpatients have been receiving prophylactic anticoagulation. Methods: This is a secondary use of existing clinical care data study, involving review of the patients receiving a consult from the inpatient coagulation consult service. Average daily census was documented via a clinical tracking system. Data collection ranged from May 2011 to May 2020. Since 2013, number of distinct new consults (not repeat patients), and indication for consult have also been documented. These data were analyzed for trends in average census number and indication for consult. Additionally, the service requesting the consult is also reported. Results: From May 2011 to May 2020, the average daily census for the coagulation consult service has increased from 4.5 to 34.4 patients. (Figure 1) The rate of consult request for prophylactic anticoagulation increased from 8 in 2013 to 82 in 2020, while thrombosis and bleeding referrals remained relatively stable. (Figure 2) Since 2013, the service with the most requests for prophylactic anticoagulation over the entire period was orthopedic surgery with 70, followed by the cardiovascular intensive care (31) and medical intensive care (28) units (ICU). There was an increase in the number of prophylactic anticoagulation consults from the ICUs over the course of the study. (Figure 3) In early 2020 a VTE risk stratification was instituted in the CVICU. Conclusions: In this single institution, retrospective study, we noted an increase in number of consults for the coagulation service overall, and a larger increase in requests for consults for prophylactic anticoagulation. Further studies should be done to determine whether this increase in use of prophylactic anticoagulation exists at other pediatric hospitals and the impact on subsequent VTE development. Disclosures Carpenter: CSL Behring: Research Funding; American Thrombosis and Hemostasis Network: Membership on an entity's Board of Directors or advisory committees; Genentech, Inc.: Honoraria; Kedrion: Honoraria; Novo Nordisk: Honoraria; Shire: Research Funding; Hemostasis & Thrombosis Research Society: Membership on an entity's Board of Directors or advisory committees; American Academy of Pediatrics: Other: PREP Heme/Onc editorial board.

scholarly journals Multiple Medical Students on a Clerkship Team: Do They Affect Each Others’ Grades?

2020 ◽  
Author(s):  
Krishan K. Sharma ◽  
Yuchiao Chang ◽  
Eli Michael Miloslavsky
Keyword(s):  
Internal Medicine ◽  
Medical Students ◽  
Student Performance ◽  
Student Perceptions ◽  
Response Rate ◽  
Medicine Clerkship ◽  
Internal Medicine Clerkship ◽  
Student Grades ◽  
Attending Physicians ◽  
The Impact

Abstract Background Medical students are often paired together on clinical teams during their clerkships, but the effect of this practice on student performance is unknown. The primary objectives of this study were (1) to retrospectively assess whether students paired together on a medical team during their Internal Medicine sub-internship affected each other’s grade and (2) to survey medical students’ perceptions on the impact of pairing on their evaluations. Methods We examined clerkship grades of 186 student-pairs at 3 sub-internship hospital sites of Harvard Medical School from 2013-2017. To evaluate student perceptions we administered a survey to the graduating class of 2018. Results There was no significant deviation between the expected and observed distribution of student grades (p=0.39) among 186 student pairs, suggesting that pairing had no meaningful effect on the sub-internship grade. We also saw no effect when controlling for prior internal medicine clerkship performance (p=0.53). We then surveyed students in the 2018 graduating class assessing student perceptions on pairing. Of the 99 respondents (59% response rate), 90% and 87% of respondents felt that being paired affected their evaluations by resident and attending physicians, respectively. Conclusions Our analysis suggests that paired medical students do not meaningfully affect each others’ grades, despite the majority of surveyed students believing that being paired affects their evaluations. Awareness of student perceptions regarding pairing can inform clerkship structure and be utilized to address student concerns.

scholarly journals CLASSROOM TEACHING IS BETTER THAN ONLINE TEACHING - A SURVEY REPORT IN MEDICAL COLLEGE MANDI H.P

2020 ◽  
Vol 8 (10) ◽  
pp. 1165-1170
Author(s):  
Soni Pankaj ◽  
◽  
Kapoor Kanchan ◽  
Rana Susheela ◽  
Bandana a ◽  
...  
Keyword(s):  
Medical Students ◽  
Online Teaching ◽  
Teaching And Learning ◽  
Clinical Care ◽  
Developed Countries ◽  
Online Classes ◽  
Survey Report ◽  
The Government ◽  
The Developed Countries ◽  
The Impact

Around the world even the developed countries are stunned by this pandemic causing extensive pain. India is no exception and the Government has imposed a nation – wide lockdown to help restrain the virus. At the onset of the pandemic, medical students in the midst of the session were suddenly pulled out of their studies and same for 3rd and 4th years medical students clerkships were abruptly pulled out of clinical care. Faculty scrambled to adjust learning experiences by switching to online cases and remote activities to prepare students for required exams and to build clinical reasoning skills without the face to face patient encounter. In such a situation, where educational institutions across the country have been closed, both teaching and learning have affected millions of students. As per the orders from the.Government, Universities the colleges have started offering online classes to students. The objective of these online classes is to make sure that students do not lose out on any teaching and learning activities during the lockdown. This paper examines the impact of lockdown on students of medical institutions, the challenges they are facing due to lockdown.

scholarly journals Improving medical students’ communication competencies to deal with intimate partner violence using clinical simulations in Mozambique

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
B. Manuel ◽  
M. Valcke ◽  
I. Keygnaert ◽  
K. Roelens
Keyword(s):  
Intimate Partner Violence ◽  
Medical Students ◽  
Student Perceptions ◽  
Partner Violence ◽  
Medical Training ◽  
Clinical Skills ◽  
Intimate Partner ◽  
Communication Competency ◽  
Post Test ◽  
The Impact

Abstract Background During their medical training, medical students aim to master communication skills and professionalism competencies to foster the best possible patient-physician relationship. This is especially evident when dealing with sensitive topics. This study describes and analyses the outcomes of a simulation-based training module on clinical communication competency through interacting with simulated intimate partner violence (IPV) survivors. The training was set up as part of a broader IPV module within a Gynaecology and Obstetrics Bachelor of Medicine and Bachelor of Surgery of Medicine (MBBS). Methods In total, 34 (59%) of all fourth-year medical students from one medical school in Mozambique were involved. A mixed-method approach was adopted. First, a quasi-experimental pre-test/post-test design was adopted to study the impact of the intervention to tackle critical IPV knowledge, skills, and attitudes, underlying a patient communication script. Second, a qualitative analysis of student perceptions was carried out. Results The results of the paired sample t-tests point at a significant and positive change in post-test values when looking at the general IPV self-efficacy (IPV SE) score and the subscales mainly in attitudes. Participants expressed a desire for additional IPV communication competency and suggested enhancements to the module. Conclusion We conclude that due to IPV being a sensitive issue, simulation activities are a good method to be used in a safe environment to develop clinical skills. The results of this study are a good complement of the analysis of the competencies learned by the medical students in Mozambique with the current curriculum.

scholarly journals Impact of Resident-Led Small-Group Learning Sessions on Preclinical Students' Perceptions of Ophthalmology

2021 ◽  
Vol 13 (01) ◽  
pp. e78-e81
Author(s):  
Priya Sorab ◽  
Andrew R. Benza ◽  
Ian T. Patterson ◽  
Lisa D. Kelly
Keyword(s):  
Medical Students ◽  
Small Group ◽  
Positive Impact ◽  
Clinical Skills ◽  
Positive Interactions ◽  
Area Of Interest ◽  
Positive Attitudes ◽  
Before And After ◽  
The Impact ◽  
Residents As Teachers

Abstract Introduction Resident physicians have a significant role in the education of medical students, and limited research has demonstrated that positive interactions with residents are linked with enhanced students’ perceptions of a specialty. Minimal research on residents as teachers has been done in ophthalmology, and no research has examined the impact of residents as teachers on the perceptions of preclinical students. This is an important area of interest because ophthalmology conducts an early match. The competitiveness of the field increases the importance of early involvement in research and clinical activities. This study aimed to assess the role of a resident-led workshops as a vehicle for exposing preclinical students to ophthalmology. Methods A 2-hour workshop on the Ophthalmology Clinical Skills was held at the University of Cincinnati College of Medicine in November 2018. The workshop was conducted by seven ophthalmology residents, and the learners were 15 first-year and 11 second-year medical students. The workshop format consisted of a 30-minute introductory lecture on the field of ophthalmology, followed by a 60-minute small-group clinical skills’ session focusing on direct ophthalmoscopy and slit lamp examination. Preworkshop and postworkshop surveys were administered to the medical students, and Student’s paired sample t-test was used to assess the differences in responses before and after the workshop. Results Students’ average interest in ophthalmology rose (p = 0.049) as did their likeliness to approach a resident for career advice (p = 4.65 × 10−6) and their likeliness to attend the Secrets of the Match Lunch talk, a yearly talk held by a student matched into ophthalmology (p = 0.002). Conclusion These results suggest that resident intervention can have a positive impact on preclinical students’ perceptions of ophthalmology and may be a good educational strategy to foster their positive attitudes toward the field.

scholarly journals Clinical application of cell-free next-generation sequencing for infectious diseases at a tertiary children’s hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julianne Wilke ◽  
Nanda Ramchandar ◽  
Christopher Cannavino ◽  
Alice Pong ◽  
Adriana Tremoulet ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Infectious Diseases ◽  
Clinical Application ◽  
Clinical Care ◽  
Next Generation ◽  
Children's Hospital ◽  
Percent Agreement ◽  
Children’S Hospital ◽  
The Impact ◽  
Generation Sequencing

Abstract Background Children affected by infectious diseases may not always have a detectable infectious etiology. Diagnostic uncertainty can lead to prolonged hospitalizations, inappropriately broad or extended courses of antibiotics, invasive diagnostic procedures, and difficulty predicting the clinical course and outcome. Cell-free plasma next-generation sequencing (cfNGS) can identify viral, bacterial, and fungal infections by detecting pathogen DNA in peripheral blood. This testing modality offers the ability to test for many organisms at once in a shotgun metagenomic approach with a rapid turnaround time. We sought to compare the results of cfNGS to conventional diagnostic test results and describe the impact of cfNGS on clinical care in a diverse pediatric population at a large academic children’s hospital. Methods We performed a retrospective chart review of hospitalized subjects at a tertiary pediatric hospital to determine the diagnostic yield of cfNGS and its impact on clinical care. Results We describe the clinical application of results from 142 cfNGS tests in the management of 110 subjects over an 8-month study period. In comparison to conventional testing as a reference standard, cfNGS was found to have a positive percent agreement of 89.6% and negative percent agreement of 52.3%. Furthermore, 32.4% of cfNGS results were directly applied to make a clinical change in management. Conclusions We demonstrate the clinically utility of cfNGS in the management of acutely ill children. Future studies, both retrospective and prospective, are needed to clarify the optimal indications for testing.

scholarly journals Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

2016 ◽  
Vol 13 ◽  
pp. 31 ◽  
Author(s):  
Catherine Gonsalves ◽  
Zareen Zaidi
Keyword(s):  
United States ◽  
Medical Students ◽  
Identity Formation ◽  
Social Role ◽  
Clinical Skills ◽  
Core Competencies ◽  
The United States ◽  
Competency Based Education ◽  
Competency Based ◽  
The Impact

Purpose: There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods: Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results: Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion: Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

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