A Multicenter Qualitative Analysis of Medical Student Narratives After a Palliative Care Elective

2020 ◽  
pp. 104990912097156
Author(s):  
Alana Sagin ◽  
Matthew S. Ellman ◽  
Ruhi R. Shariff ◽  
Christopher A. Jones ◽  
Kate Tindall ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Student ◽  
Medical Students ◽  
The United States ◽  
Lessons Learned ◽  
Clinical Experiences ◽  
Medical Centers ◽  
Academic Medical ◽  
Patient’S Experience ◽  
Fourth Year Medical Students

Background: The medical student experience of a clinical elective in palliative care (PC) remains understudied. Reflective narrative interventions can help students hone narrative competency skills, make sense of their clinical experiences and shed light on their perception of the rotation. Objectives: To evaluate medical student written reflections after a PC clinical elective. Design: Students were asked to write a short reflective essay after PC clinical electives using open-ended writing prompts. Setting: Essays were collected from third and fourth-year medical students after completion of a PC elective at three geographically diverse academic medical centers in the United States. Measurements: Essays were coded for themes using a conventional content qualitative method of analysis. Results: Thirty-four essays were analyzed and four major themes emerged: reflection on the mission of medicine or motivation for being in medicine, reflection on professional skills or lessons learned, reflection on patient’s experience and personal responses to PC rotation. Sub-themes were also identified. Conclusions: Themes underscore the utility of the PC clinical elective as a meaningful experience that imparts useful skills, builds empathy, reminds students of their own motivations for being in medicine and serves as a catalyst for reflection on their own lives and relationships with their patients. Awareness of medical students’ personal and emotional responses to a PC elective can help inform educators as they support their students and provide opportunities for reflection and education.

Issues in Developing the Medical Scientist, Part 2: Fostering Research among Medical Students (Interview with Michael John McPhaul, MD)

2004 ◽  
Vol 52 (5) ◽  
pp. 292-295 ◽  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Academic Medical Centers ◽  
Student Research ◽  
American Federation ◽  
Medical Student Research ◽  
Research Fellowship ◽  
Medical Centers ◽  
Associate Dean ◽  
Academic Medical

The American Federation for Medical Research (AFMR) continues its series of articles that address the challenges faced by academic medical centers and other institutions in developing medical scientists. The goal of this series is to assist leaders at academic medical centers in addressing the challenges for training the next generation of health care investigators. In addition, we hope to educate junior investigators and trainees on the many issues that their facilitators and mentors face in developing adequate programs for training and career development.Our second interview in this series is with Michael John McPhaul, MD, and it focuses on developing research interests among medical students. Dr. McPhaul is professor of medicine in the Department of Internal Medicine, Division of Endocrinology, at the University of Texas (UT) Southwestern Medical School in Dallas, Texas. He is associate dean for medical student research and the program leader of the UT Southwestern Doris Duke Clinical Research Fellowship for Medical Students. Dr. McPhaul has a productive research laboratory focused on the mechanisms of androgen action. His laboratory is well funded and quite productive because he has published over 100 articles. He has been successful in his endeavors in supporting and fostering medical student research interests over the last several years and has assisted in the development of some novel programs. We are happy to have the opportunity for Dr. McPhaul to give his thoughts on how research interests and skills can be developed in medical students.

scholarly journals Model Orthopaedic Surgical Skills Curriculum for Fourth Year Medical Students

2015 ◽  
Vol 5 (1) ◽  
pp. 1-5
Author(s):  
Benjamin Matthew Wooster ◽  
Samuel Evan Carstensen ◽  
James E Johnson ◽  
Allston Julius Stubbs
Keyword(s):  
United States ◽  
Medical Student ◽  
Medical Students ◽  
Orthopaedic Surgery ◽  
Skill Training ◽  
The United States ◽  
House Officer ◽  
Surgical Skills ◽  
Unique Challenge ◽  
Fourth Year Medical Students

ABSTRACT Musculoskeletal education in medical schools throughout the United States is inconsistent. Furthermore, formal surgical skill training in medical school is often lacking. Consequently, orthopaedic surgery residents in the United States are faced with a unique challenge as they transition from medical student to house officer in comparison to their peers pursuing more generalized specialties. In response, we designed and successfully implemented an innovative month long elective at Wake Forest University School of Medicine for fourth year medical students who were in the process of applying to ortho paedic surgery residency programs. This course provides medical students with an introduction to the basic skills and common surgical approaches that are commonly utilized early in orthopaedic surgery residency and beyond. While longi tudinal data are needed, we believe this novel month long elective will allow the transition from medical student to house officer to be a smoother and more seamless process. Wooster BM, Carstensen SE, Johnson JE, Stubbs AJ. Model Orthopaedic Surgical Skills Curriculum for Fourth Year Medical Students. The Duke Orthop J 2015;5(1):15. All other authors report no declarations of interest.

The Public Psychiatrist as Educator

2020 ◽  
pp. 149-168
Author(s):  
Sarah E. Baker ◽  
Adam Brenner
Keyword(s):  
United States ◽  
Medical Student ◽  
Medical Students ◽  
Public Sector ◽  
The United States ◽  
The Public ◽  
Academic Medical ◽  
The Many ◽  
Training Opportunities

Among the many important educator roles of the public psychiatrist is that of teacher for the medical students, residents, and fellows who rotate through her public sector clinic or hospital. Using a case study as its basis, this chapter describes how a public psychiatrist can engage with an academic medical center’s department of psychiatry in order to offer training opportunities in the public sector. It also describes the process for developing medical student clerkships and resident rotations and includes examples from clerkships and resident rotations from throughout the United States.

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

scholarly journals Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States

2021 ◽  
Author(s):  
Nathaniel J Rhodes ◽  
Atheer Dairem ◽  
William J Moore ◽  
Anooj Shah ◽  
Michael J Postelnick ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Drug Therapy ◽  
Supportive Care ◽  
The United States ◽  
Primary Objective ◽  
Point Prevalence ◽  
Medical Centers ◽  
Academic Medical ◽  
History Of ◽  
Secondary Objective

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.

scholarly journals Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

2021 ◽  
Vol 10 ◽  
pp. 216495612098848
Author(s):  
Elaine O Cheung ◽  
Ian Kwok ◽  
Allison B Ludwig ◽  
William Burton ◽  
Xinzi Wang ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Positive Psychology ◽  
Positive Emotion ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
Well Being ◽  
Preliminary Evidence ◽  
Lessons Learned ◽  
Psychology Program

Background Mental health tends to worsen over the course of medical school, with steep declines in well-being in students’ clerkship year (M3). Positive emotion promotes adaptive coping to stress and may help preserve medical student well-being. Objective This study describes the development of LAVENDER (Leveraging Affect and Valuing Empathy for Nurturing Doctors’ Emotional Resilience), a program aimed at increasing positive emotion to preserve well-being in medical students. Methods We conducted a single-arm pilot of LAVENDER, a positive psychology intervention developed for medical students delivered in an interactive classroom format to a cohort of 157 third-year medical students at the Albert Einstein College of Medicine. Our primary outcome was the acceptability of LAVENDER. We also examined preliminary efficacy using measures of emotion, stress and burnout collected at each intervention session. Results LAVENDER showed good acceptability: 76% of participants agreed that the LAVENDER skills were useful and 72% agreed that they would recommend the LAVENDER program to others. Qualitative feedback suggested that medical students enjoyed the program and found the skills to be useful for coping with stress, but also reported the following barriers to engagement: lack of time to practice the skills, resistance to the mandatory nature of the wellness sessions, and difficulty integrating the skills in daily life. We did not find support for the preliminary efficacy of LAVENDER for improving medical student well-being in students’ clerkship year. Participants showed decreases in positive emotion and increases in symptoms of burnout over the intervention period ( ps < .01). Conclusion The current paper describes the development and a single-arm pilot test of LAVENDER, a positive psychology program tailored for medical students. Although we found preliminary evidence for the acceptability of LAVENDER, we did not find support for the preliminary efficacy. Lessons learned and next steps for the program are discussed.

scholarly journals Implementing Resident Team Assistant Programs at Academic Medical Centers: Lessons Learned

2020 ◽  
Vol 12 (6) ◽  
pp. 769-772
Author(s):  
Ryosuke Takei ◽  
George Dalembert ◽  
Jeanine Ronan ◽  
Nicole Washington ◽  
Stuti Tank ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Clinical Care ◽  
Lessons Learned ◽  
Academic Medical Centers ◽  
Institutional Goals ◽  
Medical Centers ◽  
Academic Medical ◽  
Medical Teams ◽  
Administrative Task ◽  
Administrative Tasks

ABSTRACT Background Excessive inpatient administrative tasks can lead to adverse consequences for residents and their patients. Furthermore, this burden has been linked to depersonalization, a major component of physician burnout. Objective To describe the development, implementation, feasibility, acceptability, and early outcomes of Resident Team Assistant (RTA) programs. Methods Three large academic medical centers created RTA programs in which administrative assistants are incorporated into inpatient medical teams. First steps included a needs assessment and driver diagram creation to identify key issues and to solidify goals. Program directors were assigned, and RTAs were hired, trained, and incorporated into inpatient teams at each institution (2003, 2016, 2018). Program leadership and institutional stakeholders met regularly to discuss development and quality assurance. Surveys and direct interviews were performed to evaluate impact and acceptability. Institutional goals in accordance to RTAs tasks were also investigated. Results Resident surveys and interviews have shown acceptability with RTAs completing a large percentage of resident administrative tasks while promoting time spent in direct clinical care and job satisfaction. Hospital-specific improvements have included increase in referring physician communication rate and decrease in work hour violations. The programs have maintained high feasibility and sustainability with a relatively low time commitment from leadership and cost for the institutions. Conclusions The RTA programs at the 3 institutions have continued to be sustained over time with perceived improvements in administrative task burden and job satisfaction for the residents. They have maintained high acceptability and feasibility in terms of effort and costs for the hospitals.

Abstract 30: Sex Differences in Faculty Rank Among Academic Vascular Neurologists in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Lindsay A Bliss ◽  
Carol A Vitellas ◽  
Nayanika Challa ◽  
Vivien H Lee
Keyword(s):  
United States ◽  
Assistant Professor ◽  
The United States ◽  
Associate Professor ◽  
Academic Medical Centers ◽  
Full Professor ◽  
Academic Rank ◽  
Faculty Rank ◽  
Medical Centers ◽  
Academic Medical

Introduction: The lower proportion of women at the rank of full professor compared to men has been documented in nearly all specialties. Women are under-represented in academic stroke neurology, but there is limited data. Methods: We reviewed all 160 U.S. medical schools and the associated medical centers for vascular neurologists. An internet search of stroke team websites and neurology department websites was performed from August 1, 2020 to August 25, 2020. We included 117 academic medical centers that had at least 1 vascular neurologist on faculty. We included vascular neurology ABPN certified or board eligible (fellowship-trained) neurologists. Data was collected on sex, academic rank, and American Board of Psychiatry and Neurology (ABPN) certification status. ABPN board certification status was verified on the ABPN verify CERT website. Social medical women’s neurology groups were also queried for names of women full professor to cross check. Results: Among 540 academic ABPN vascular neurologists, 182 (33.8%) were women and 358 (66.3%) were men. Among academic ranks, women made up 108/269 (40.1%) of Assistant professors, 49/137 (35.8%) of Associate professors, and 25/134 (18.8%) of full professors. Twenty two academic centers had vascular neurology female professors on faculty, compared to 70 academic centers with male full professors on faculty. Twenty nine academic centers had multiple male professors on faculty compared to only 3 centers with multiple female full professors. Among women, 108 (59.3%) were assistant professor, 49 (26.7%) were associate professor, 25 (13.7%) were full professor. Among men, 161 (45.0%) were assistant professor, 88 (24.6%) were associate professor, and 109 (30.5%) were professor. There was a significant difference between academic rank based upon sex (p <0.0001). Conclusion: Among academic medical centers in the United States, significant sex differences were observed in academic faculty rank for ABPN vascular neurologists, with women less likely than men to be full professors. Further study is warranted to address the gender gap in the field of stroke.

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