scholarly journals Building a Successful, Socially-Distanced Family Medicine Clerkship in the COVID Crisis

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
John R. Hayes ◽  
Bryan Johnston ◽  
Rebecca Lundh
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Family Medicine ◽  
The United States ◽  
Learning Objectives ◽  
Direct Patient Care ◽  
Clinical Environment ◽  
Clinical Instruction ◽  
Medicine Clerkship ◽  
Illness Script

Introduction: In the wake of the COVID-19 pandemic, many family medicine clerkships across the United States are scrambling to provide meaningful medical education in a new clinical environment. Most medical schools have paused or severely limited the direct patient care that has been the core educational requirement of the clinical clerkships. The aim of this study was to develop and evaluate a curricular model that meets the family medicine clerkship learning objectives via telemedicine clinical instruction. Methods: We created a clerkship where all clinical encounters took place by phone or video visits. Students were required to have telemedicine encounters with at least 20 patients over a 4-week clerkship. We also created a telemedicine illness script-writing assignment to prepare students and faculty for these encounters. We evaluated our curriculum by surveying participating students and faculty members.   Results: Student surveys revealed that all learning objectives were met during the telemedicine clerkship experience. Students felt they made a difference during the COVID-19 pandemic. Faculty felt that the medical students were helpful and that they were able to provide meaningful clinical instruction. Conclusion: Our study reveals that a family medicine clerkship can be successfully delivered using telemedicine and remote learning techniques. Senior medical students are a valuable resource and can have a meaningful clinical impact while learning more about family medicine. If social distancing precautions continue, this model can be used by other clerkships to continue medical education and provide medical care. 

scholarly journals Institutional NIH Research Funding and a Culture of Support for Family Medicine—Their Relationship to Family Medicine Specialty Choice

2018 ◽  
Vol 50 (5) ◽  
pp. 369-371
Author(s):  
Arch G. Mainous ◽  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Alexander W. Chessman
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
School Environment ◽  
The United States ◽  
Specialty Choice ◽  
Medicine Clerkship ◽  
Educational Support ◽  
Negative Comments ◽  
Nih Funding

Background and Objectives: The United States suffers from a low proportion of medical students pursuing family medicine (FM). Our objective was to examine institutional characteristics consistent with a focus on National Institutes of Health (NIH) research, institutional support for FM education, and the proportion of medical students choosing FM. Methods: The 2015 CERA Survey of Family Medicine Clerkship Directors was merged with institutional NIH funding data from 2014 and medical student specialty choice in 2015. Institutional educational support was operationalized as (1) clerkship director’s perception of medical school environment toward FM, and (2) amount of negative comments about FM made by faculty in other departments. The outcome was the percentage of students selecting FM. Bivariate statistics were computed. Results: As NIH funding increases, the proportion of students entering FM decreases (r=-.22). Institutions with higher NIH funding had lower clerkship director perceptions of medical school support toward FM (r=-.38). Among private institutions, the negative correlation between NIH funding and the proportion of students entering FM strengthens to r=-.48, P=.001. As perceptions of support for FM increase, the proportion of students entering FM increase (r=.47). Among private schools, perceptions of support toward family medicine was strongly positively correlated with the proportion of students entering FM (r=.72, P=.001). Conclusions: Higher institutional NIH funding is associated with less support for FM and lower proportions of students choosing FM. These issues appear to be even more influential in private medical schools. Understanding how to integrate the goals of NIH-level research and increasing primary care workforce so that both can be achieved is the next challenge.

scholarly journals The impact of integrating environmental health into medical school curricula: a survey-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin Kligler ◽  
Genevieve Pinto Zipp ◽  
Carmela Rocchetti ◽  
Michelle Secic ◽  
Erin Speiser Ihde
Keyword(s):  
Climate Change ◽  
Medical Education ◽  
Medical Students ◽  
Medical School ◽  
Environmental Health ◽  
School Curriculum ◽  
Learning Objectives ◽  
Lead Contamination ◽  
Institute Of Medicine ◽  
The Impact

Abstract Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients’ environmental illnesses, nor speak to prevention. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students’ attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students’ perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives. Results 36 year 1 students completed both the pre and post EHMS surveys. McNemar’s test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling. When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted. Conclusions Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.

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 Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Two Student Perspectives on Clinical Medical Education During the COVID19 Pandemic

2021 ◽  
Author(s):  
Anne P. George ◽  
Elise E. Ewens
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Patient Care ◽  
Direct Patient Care ◽  
Rural And Urban ◽  
Hands On ◽  
Hands On Learning ◽  
Ultimate Question ◽  
To Come ◽  
The U.S

In the age of COVID19, the ultimate question in healthcare became who was essential and who was not. Basically, who could be cut from the roster in patient care? Unfortunately, as medical students, many of us did not make that cut, and as rotations were continually evolving and changing, students from even the same institution had varying experiences. Third-year clerkships are defined by the direct patient care and hands-on learning students get, but in the age of COVID19, “hands-on learning” has been a bit hard to come by. Hence, COVID has caused many changes in the way medicine is being taught and practiced. This article will detail the experiences of two medical students from the same institution, working in different locations for their third-year clerkships. We contrast our rural and urban experiences as students in the time of COVID and display the varying experiences students are having during this time. We touch on the potential ramifications for these wide varieties of experiences from students across the U.S. and how this will affect sub-internships and residency applications. 

scholarly journals Effect of Residents-as-Teachers in Rural Community-Based Medical Education on the Learning of Medical Students and Residents: A Thematic Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12410
Author(s):  
Nozomi Nishikura ◽  
Ryuichi Ohta ◽  
Chiaki Sano
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Family Medicine ◽  
Rural Community ◽  
Community Hospital ◽  
Community Based ◽  
Approach To Teaching ◽  
Medical Teams ◽  
The Impact ◽  
Residents As Teachers

Residents-as-teachers (RaT) is a theoretical framework emphasizing the significance of the similar learning background of teachers and learners. In Japan, community-based medical education (CBME) is a practical approach to teaching family medicine. This study aimed to investigate the impact and challenges of RaT on the learning of medical students and residents in CBME at a rural community hospital in Japan. Over the course of a year, the researchers conducted one-on-one interviews with three residents and ten medical students participating in family medicine training at the hospital. The interviews were recorded and transcribed verbatim. Grounded theory was used in the data analysis to clarify the findings. Three key themes emerged from the research: lack of educational experience with RaT, effectiveness of RaT, and challenges of RaT. Although participants were prejudiced against RaT, they felt its implementation could facilitate the establishment of beneficial relationships between learners and teachers. They were also able to participate in medical teams effectively. The findings suggest that the increased participation of senior doctors in RaT could strengthen its learning effects. RaT in rural CBME should be applied in various contexts, and its effectiveness should be further investigated both qualitatively and quantitatively.

scholarly journals Teaching Pediatric Otoscopy Skills to the Medical Student in the Clinical Setting: Preceptor Perspectives and Practice

2020 ◽  
Author(s):  
Caroline Rose Paul ◽  
Alanna Higgins Joyce ◽  
Gary Beck Dallaghan ◽  
Meg Keeley ◽  
Corinne Lehmann ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Survey ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Acute Otitis Media ◽  
The United States ◽  
Direct Patient Care ◽  
Barriers To Teaching

Abstract Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

scholarly journals FMAQ-S: Development of a Short Form of the Family Medicine Attitudes Questionnaire

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Hana Kang ◽  
Jacob Prunuske ◽  
Andrea L. Wendling ◽  
Jennifer Edwards-Johnson ◽  
Julie P. Phillips
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Student Attitudes ◽  
Short Form ◽  
Item Analysis ◽  
The United States ◽  
Criterion Validity ◽  
Specialty Choice ◽  
Supporting Evidence ◽  
Item Discrimination

Introduction: Identifying and training students who choose family medicine careers is essential to meeting primary care workforce needs in the United States. Medical students’ positive attitudes toward family medicine are associated with students’ choice of family medicine as a specialty. This study sought to refine a previously tested questionnaire assessing US medical students’ attitudes toward family medicine by shortening the questionnaire to make it more useful in educational practice and research settings. Methods: We refined our existing 14-item questionnaire by item analysis and validation. We conducted item analysis using a graded response model approach after identifying the unidimensionality of the original scale. We selected items based on their item discrimination parameters and item information levels, and calculated the correlation between specialty choice and family medicine attitudes score to evaluate criterion validity. Results: Exploratory factor analyses indicated the questionnaire is unidimensional. Among the original 14 items, 10 items had high item discrimination parameters and low standard error of measurement. These 10 items contribute the most to distinguishing individuals’ differences in family medicine attitudes and were selected for inclusion in the short-form questionnaire (FMAQ-S). The point-biserial correlation between the short-form scale and students’ choice of family medicine was 0.378, which provides supporting evidence for criterion validity. Conclusion: The FMAQ-S is a concise and validated measure for assessing medical student attitudes toward family medicine. This abbreviated questionnaire can be used by medical educators to identify students for specific programming or interventions intended to support family medicine specialty choice.

scholarly journals Expanding medical student interaction in neurology with a redesigned student interest group in neurology (sign) chapter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohit Gummi ◽  
Ross Smith ◽  
Raghav Govindarajan
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Interest Group ◽  
The United States ◽  
Student Interest ◽  
Post Intervention ◽  
Journal Clubs ◽  
Hands On ◽  
Neurology Clinic ◽  
Second Year

Abstract Background Student Interest Group in Neurology (SIGN) chapters across the medical schools in the United States provide opportunities for medical students to participate in clinical, research, and service activities in neurology. Despite these, applicants for the field of neurology have traditionally been low. Methods Following changes were introduced: an open board style SIGN chapter executive committee with greater active engagement of first and second year students. New activities included journal clubs, hands on workshops, celebration/cause events (example ALS walk). In addition, a free neurology clinic was introduced. Activities were planned in consultation with office of medical education, and were organized during ‘down times’. Data on student enrollment, activities successfully carried out, students interested in neurology residency, number of neurology-related research projects with student involvement were collected prior to changes and compared to values after changes were introduced. Results Post intervention, student engagement in neurology activities and projects increased significantly. However, a similar increase in applications to neurology residency was not yet observed. Conclusions An open chapter with early engagement and involvement of first and second year medical students, creating a variety of chapter activities with greater hands on involvement, planned in conjunction with office of medical education has reinvigorated our SIGN chapter.

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