scholarly journals Tracking Medical Students and Graduates from Hometown to Practice using Geographic Information Systems, 2011-2017

2018 ◽  
Vol 1 (3) ◽  
Author(s):  
Komal Kochhar ◽  
Laurie M Fancher ◽  
James J Brokaw ◽  
Jeffrey S Wilson ◽  
Peter M Nalin
Keyword(s):  
Medical Students ◽  
School Leadership ◽  
Geographic Information ◽  
Specialty Choice ◽  
Physician Workforce ◽  
Clinical Experiences ◽  
Major Step ◽  
Student Records ◽  
Academic Administration ◽  
Using Data

Background: Indiana University School of Medicine (IUSM) through its statewide system provides medical education and clinical experiences across Indiana for more than 1,450 medical students in nine regions, including Indianapolis and eight regional medical campuses (RMCs). The majority of medical students begin their education distributed among the RMCs, and some students continue clinical experiences at the RMCs for their third and fourth years. Methods: We used a Geographic Information System (GIS) to visualize and document the contribution of our RMCs in Indiana to the physician workforce pipeline. Using data from the 2011-2017 graduating classes, we created a geospatial database that linked key information from student records and public domain sources (e.g., hometown, campus assignment, PGY1 specialty, and practice) with their corresponding locational information. ArcGIS 10.5 GIS software was used to produce a series of maps to visualize patterns in student outcomes among the RMCs over time. Results: By using GIS to track medical trainees from hometown to practice, we can provide accurate visualization of extensive geographic data. The maps revealed similarities and differences among the RMCs not fully appreciated until visually mapped, including the specialty choice of students from different campuses and the proportion of graduates practicing in medically underserved areas of the state. Conclusions: GIS maps and their analyses can identify strengths and distinctions among the RMCs while providing accurate descriptions of the role of geography in the professional development journey of the physician workforce. This ongoing project is a major step toward integrating GIS as a familiar tool in academic administration and health workforce research to assist future decision-making by the school leadership.

Reliability and Validity of a Simulation-based Acute Care Skills Assessment for Medical Students and Residents

2003 ◽  
Vol 99 (6) ◽  
pp. 1270-1280 ◽  
Author(s):  
John R. Boulet ◽  
David Murray ◽  
Joe Kras ◽  
Julie Woodhouse ◽  
John McAllister ◽  
...  
Keyword(s):  
Medical Students ◽  
Acute Care ◽  
Reliability And Validity ◽  
Faculty Members ◽  
First Year ◽  
Clinical Experiences ◽  
Critical Events ◽  
Simulation Based ◽  
Broad Domain ◽  
Simulation Exercises

Background Medical students and residents are expected to be able to manage a variety of critical events after training, but many of these individuals have limited clinical experiences in the diagnosis and treatment of these conditions. Life-sized mannequins that model critical events can be used to evaluate the skills required to manage and treat acute medical conditions. The purpose of this study was to develop and test simulation exercises and associated scoring methods that could be used to evaluate the acute care skills of final-year medical students and first-year residents. Methods The authors developed and tested 10 simulated acute care situations that clinical faculty at a major medical school expects graduating physicians to be able to recognize and treat at the conclusion of training. Forty medical students and residents participated in the evaluation of the exercises. Four faculty members scored the students/residents. Results The reliability of the simulation scores was moderate and was most strongly influenced by the choice and number of simulated encounters. The validity of the simulation scores was supported through comparisons of students'/residents' performances in relation to their clinical backgrounds and experience. Conclusion Acute care skills can be validly and reliably measured using a simulation technology. However, multiple simulated encounters, covering a broad domain, are needed to effectively and accurately estimate student/resident abilities in acute care settings.

scholarly journals Moral judgement development during medical student clinical training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenny McDonald ◽  
Jane Graves ◽  
Neeshaan Abrahams ◽  
Ryan Thorneycroft ◽  
Iman Hegazi
Keyword(s):  
Medical Students ◽  
Moral Development ◽  
Clinical Training ◽  
Moral Judgement ◽  
Clinical Experiences ◽  
Cross Sectional ◽  
Moral Decisions ◽  
Moral Choices ◽  
Cognitive Maturity ◽  
Self Authorship

Abstract Background Whereas experience and cognitive maturity drives moral judgement development in most young adults, medical students show slowing, regression, or segmentation in moral development during their clinical years of training. The aim of this study was to explore the moral development of medical students during clinical training. Methods A cross-sectional sample of medical students from three clinical years of training were interviewed in groups or individually at an Australian medical school in 2018. Thematic analysis identified three themes which were then mapped against the stages and dimensions of Self-authorship Theory. Results Thirty five medical students from years 3–5 participated in 11 interviews and 6 focus groups. Students shared the impacts of their clinical experiences as they identified with their seniors and increasingly understood the clinical context. Their accounts revealed themes of early confusion followed by defensiveness characterised by desensitization and justification. As students approached graduation, some were planning how they would make moral choices in their future practice. These themes were mapped to the stages of self-authorship: External Formulas, Crossroads and Self-authorship. Conclusions Medical students recognise, reconcile and understand moral decisions within clinical settings to successfully reach or approach self-authorship. Curriculum and support during clinical training should match and support this progress.

Abstract P163: Accuracy to Diagnose Cardiac Arrest and Quickness to Start Chest Compression in Different BLS Algorithms; a Comparative Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tomoko Tamura ◽  
Koichi Tanigawa ◽  
Shinji Kusunoki ◽  
Takuma Sadamori ◽  
Tadatsugu Otani ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Health Care Providers ◽  
Chest Compression ◽  
Loss Of Consciousness ◽  
Care Providers ◽  
Clinical Experiences ◽  
European Resuscitation Council ◽  
The Subject ◽  
Erc Guidelines

Background; BLS algorithms for health care providers or experience personnel recommended by AHA, European Resuscitation Council (ERC), and Japanese Resuscitation Council (JPN) differ with respect to the sequence of assessment and procedures. The differences may affect accuracy to diagnose cardiac arrest and quickness to start chest compression. We compared BLS algorithms recommended by these organizations with respect to accuracy of respiratory/circulatory assessment, and quickness to start chest compression using a computed manikin model. Methods; Thirty three subjects (16 physicians and 17 medical students) were enrolled. The Sim-Man (Laerdal) was used to develop 2 scenarios (no pulse/no breathing, with pulse 60/min and breathing 10/min). The three algorithms and 2 scenarios were randomly assigned to the subject, and the accuracy to diagnose cardiac arrest and the time from confirmation of loss of consciousness to starting chest compression were evaluated. Results; The rates of incorrect assessment of respiratory/circulatory status were AHA;9.8% (13 out of 132), ERC;9.1%(12 out of 132) and JPN;6.8%(9 out of 132)(n.s. among algorithms). When the results were analyzed with respect to clinical experiences of the subjects, i.e. physicians vs. medical students, significant differences were found between the groups: AHA;17.2% (11 out of 64), ERC;15.6% (10 out of 64), JPN;12.5% (8 out of 64) in students, whereas AHA;2.9% (2 out of 68), ERC;2.9% (2 out of 68), JPN;1.5% (1 out of 68) in physicians* (* p<0.05 vs. students). The time to starting chest compression were AHA;27.8±5.1 sec, ERC;18.6±3.2** sec, JPN;23.7±4.2 sec (**p<0.05 vs. AHA and JPN), and no significant differences were found between physicians and students. Conclusions; No differences were found in accuracy of respiratory and circulatory assessment among the algorithms, although it may be influenced by clinical experiences of evaluators. The BLS algorithm starting CPR from chest compression such as ERC guidelines may reduce the time of no-flow status in cardiac arrest.

scholarly journals Validity Evidence for the Medical Student Core Physical Examination

2021 ◽  
Author(s):  
Todd Guth ◽  
Yoon Soo Park ◽  
Janice Hanson ◽  
Rachel Yudkowsky
Keyword(s):  
Medical Students ◽  
Clinical Skills ◽  
Validity Evidence ◽  
Clinical Experiences ◽  
Colorado School ◽  
The Core ◽  
University Of Colorado ◽  
School Of Medicine ◽  
Core Cluster ◽  
Cut Score

Abstract Background The Core Physical Exam (CPE) has been proposed as a set of key physical exam (PE) items for teaching and assessing PE skills in medical students, and as the basis of a Core + Cluster curriculum. Beyond the initial development of the CPE and proposal of the CPE and the Core + Cluster curriculum, no additional validity evidence has been presented for use of the CPE to teach or assess PE skills of medical students. As a result, a modified version of the CPE was developed by faculty at the University of Colorado School of Medicine (UCSOM) and implemented in the school’s clinical skills course in the context of an evolving Core + Cluster curriculum. Methods Validity evidence for the 25-item University of Colorado School of Medicine (UCSOM) CPE was analyzed using longitudinal assessment data from 366 medical students (Classes of 2019 and 2020), obtained from September 2015 through December 2019. Using Messick's unified validity framework, validity evidence specific to content, response process, internal structure, relationship to other variables, and consequences was gathered. Results Content and response process validity evidence included expert content review and rater training. For internal structure, a generalizability study phi coefficient of 0.258 suggests low reliability for a single assessment due to variability in learner performance by occasion and CPE items. Correlations of performance on the UCSOM CPE with other PE assessments were low, ranging from .00-.34. Consequences were explored through determination of a pass-fail cut score. Following a modified Angoff process, clinical skills course directors selected a consensus pass-fail cut score of 80% as a defensible and practical threshold for entry into precepted clinical experiences. Conclusions Validity evidence supports the use of the UCSOM CPE as an instructional strategy for teaching PE skills and as a formative assessment of readiness for precepted clinical experiences. The low generalizability coefficient suggests that inferences about PE skills based on the UCSOM CPE alone should be made with caution, and that the UCSOM CPE in isolation should be used primarily as a formative assessment.

scholarly journals Premedical Student Exposure to Pharmaceutical Marketing: Too Much, Too Soon?

2019 ◽  
Vol 51 (9) ◽  
pp. 722-727
Author(s):  
Toby Keys ◽  
Mark H. Ryan ◽  
Sharon Dobie ◽  
David Satin ◽  
David V. Evans
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Health Care Providers ◽  
Direct Marketing ◽  
Medical Schools ◽  
Pharmaceutical Marketing ◽  
Care Providers ◽  
Clinical Experiences ◽  
Premedical Students ◽  
Pharmaceutical Representatives

Background and Objectives: Direct pharmaceutical marketing to physicians by pharmaceutical representatives is effective in changing behavior of health care providers, resulting in less evidence-based prescribing. Although much has been written about pharmaceutical marketing exposures among medical students, less is known about direct marketing exposures before students matriculate. This study examined the types of pharmaceutical representative direct marketing exposures for premedical students and where they occurred. Methods: From June to August of 2017, researchers surveyed students who accepted admission to US public medical schools. These prematriculated students completed our survey just prior to matriculation. The survey inquired about whether the students were exposed to pharmaceutical marketing directly from pharmaceutical salespeople, the types of marketing they observed or received, and where these interactions occurred. Results: Survey participants included 911 prematriculated students from 14 of the 188 medical schools invited to participate. Seventy-one percent (646) of the participants received or observed someone receiving pharmaceutical marketing gifts, small meals or snacks, articles, or samples. The two most common contexts for direct pharmaceutical marketing exposures were during shadowing experiences (54%, 346) and during employment (50%, 323). Conclusions: The findings suggest that it may be common for medical students to have interacted directly with pharmaceutical salespeople or observed other health professionals in these interactions before they matriculate in medical school. Because many of these interactions occur during clinical experiences required by institutions for admission, medical schools and premedical associations should consider delivering conflict-of-interest education early in medical school education or before students matriculate.

scholarly journals Specialty choice determinants among Mexican medical students: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carlos Gutiérrez-Cirlos ◽  
J. Jesús Naveja ◽  
Manuel García-Minjares ◽  
Adrián Martínez-González ◽  
Melchor Sánchez-Mendiola
Keyword(s):  
Medical Students ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Specialty Choice ◽  
Three Dimensions ◽  
Chi Square ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Needs ◽  
Gynecology And Obstetrics

Abstract Background The choice of medical specialty is related to multiple factors, students’ values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students. Methods Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed. Results The questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach’s alpha was 0.8. The mean age was 24 ± 1 years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics. Conclusions Specialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).

scholarly journals BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students

2016 ◽  
Vol 40 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Ali Ajaz ◽  
Rhodri David ◽  
Damien Brown ◽  
Melanie Smuk ◽  
Ania Korszun
Keyword(s):  
Medical Students ◽  
Career Choice ◽  
Academic Staff ◽  
Medical Schools ◽  
Specialty Choice ◽  
Direct Result ◽  
Clinical Implications ◽  
Online Questionnaire ◽  
Medical Specialties ◽  
Negative Comments

Aims and methodWe used an online questionnaire to investigate medical students' perceptions of the apparent hierarchy between specialties, whether they have witnessed disparaging comments (‘badmouthing’ or ‘bashing’) against other specialists and whether this has had an effect on their career choice.ResultsIn total, 960 students from 13 medical schools completed the questionnaire; they ranked medical specialties according to the level of badmouthing and answered questions on their experience of specialty bashing. Psychiatry and general practice attracted the greatest number of negative comments, which were made by academic staff, doctors and students. Twenty-seven per cent of students had changed their career choice as a direct result of bashing and a further 25.5% stated they were more likely to change their specialty choice. Although 80.5% of students condemned badmouthing as unprofessional, 71.5% believed that it is a routine part of practising medicine.Clinical implicationsBashing of psychiatry represents another form of stigmatisation that needs to be challenged in medical schools. It not only has an impact on recruitment into the specialty, but also has the wider effect of stigmatising people with mental health disorders.

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