Neuroscience education of undergraduate medical students. Part II: outcome improvement

Object. Because of political and economic pressures, primary care physicians are now charged with greater responsibility for the care of patients with disease processes definitively managed by neurosurgeons. The goal of this study was to establish the feasibility and efficacy of a neurosurgical curriculum designed to teach future primary care physicians about these diseases.Methods. A compact, seven-lecture curriculum was developed to teach 3rd-year medical students about degenerative spine disease, stroke, tumor- and hydrocephalus-related raised intracranial pressure, head and spine injury, and subarachnoid hemorrhage. This curriculum was given as part of a 6-week pilot course that included neurology, neurosurgery, ophthalmology, and rehabilitation medicine components. This course was administered to two groups of 18 medical students, and an examination was administered at the end of the pilot course. The same examination was administered to an additional 19 students immediately after their completion of the neurology course currently required.Students enrolled in the pilot neuroscience course performed significantly better (p < 0.001) on the examination than those who had completed the standard neurology course. Striking improvements were noted in the recognition and management of head injury, hydrocephalus, and radiculopathy.Conclusions. Inclusion of a short neurosurgery-related curriculum in a combined neuroscience course significantly improved student performance on an examination focusing on the recognition and management of common neurosurgical disorders. Because primary care physicians are responsible for the initial recognition and management of these disorders, the knowledge gained may lead to improved patient care.

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Neuroscience education of undergraduate medical students. Part I: role of neurosurgeons as educators

Journal of Neurosurgery ◽

10.3171/jns.2000.92.4.0637 ◽

2000 ◽

Vol 92 (4) ◽

pp. 637-641 ◽

Cited By ~ 19

Author(s):

Daniel K. Resnick

Keyword(s):

Primary Care ◽

Medical Student ◽

Medical Students ◽

Primary Care Physicians ◽

Carotid Artery Disease ◽

Medical Student Education ◽

Low Back ◽

Content Type ◽

Artery Disease ◽

Fine Print

Object. Economic, demographic, and political pressures have mandated that medical schools increase the number of primary care physicians. The goal of this study was to determine the nature of the average medical student's exposure to neurosurgical issues.Methods. Surveys were sent to every neurosurgical program director in the United States and to the dean of every medical school in North America, querying the extent of neurosurgical involvement in medical student education. Specifically, the respondents were asked how medical students were educated about the management of low-back pain and radiculopathy, carotid artery disease, head and spine trauma, and headache.Survey results were obtained from 65 (67%) of 97 neurosurgery program directors and from 57 (40%) of 143 medical school deans. Only one program in North America reported having a required neurosurgical rotation for all medical students, and just over 50% (29 of 57 deans and 34 of 65 program directors) reported that neurosurgery was an option in a required neuroscience or surgical subspecialty course. Neurosurgeons were not listed among the top three sources for medical student education in the topics of low-back pain and radiculopathy or carotid artery disease. Neurosurgeons were the most frequently cited source of education regarding head and spinal injuries, despite the fact that the majority of medical schools do not have any required medical student exposure to neurosurgery.Conclusions. With rare exceptions, neurosurgeons are not significantly involved in the education of medical students concerning the management of common neurosurgical issues. As a result, most emerging primary care physicians are taught about these issues by other specialists or not at all. The implications of this situation are discussed.

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High frequency of otolaryngology/ENT encounters in Canadian primary care despite low medical undergraduate

Canadian Medical Education Journal ◽

10.36834/cmej.72328 ◽

2021 ◽

Author(s):

Brendan Sorichetti ◽

Julie Pauwels ◽

Thomas Jacobs ◽

Neil Chadha ◽

Emelie Kozak ◽

...

Keyword(s):

Primary Care ◽

Medical Students ◽

Primary Care Physicians ◽

Pediatric Population ◽

Adult Population ◽

Care Facility ◽

Symptom Presentation ◽

Undergraduate Medical Students ◽

Related Symptom ◽

Medical Undergraduate

Otolaryngology involves the treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. Many medical students in Canada have limited experiences in ENT and a vast majority of these students go on to pursue a career as primary care physicians. Physicians at a primary care facility classified patient’s visits as either being “ENT” related or not, to assess the amount of ENT related concerns they typically encounter. The data was collected separately in the summer and winter months to assess any seasonal variability. One in eight patient encounters presented with an ENT related concern. The percentage of ENT related symptom presentation visits in the pediatric population for both data collection periods (29%) was more than three times that of the adult population (9%). The rate of ENT symptom presentation in both adult and pediatric populations was not affected by seasonality. Primary care physicians will encounter new patients presenting with ENT related concerns quite frequently. This is especially true in the pediatric patient population. Increased ENT medical education is both necessary and essential for undergraduate medical students, residents, and primary care physicians.

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Neurosurgical manpower: the physician's viewpoint

Journal of Neurosurgery ◽

10.3171/jns.1982.56.5.0609 ◽

1982 ◽

Vol 56 (5) ◽

pp. 609-614

Author(s):

Clark Watts ◽

Robert C. Mendenhall ◽

Stephen E. Radecki ◽

Roger A. Girard

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

National Study ◽

Content Type ◽

Fine Print

✓ This paper reports a national study of physicians in 24 medical and surgical specialties, and reveals the opinions of neurosurgeons and their professional colleagues with regard to the adequacy of the supply of neurosurgical manpower. Among neurosurgeons, 30.4% believe the supply to be excessive, 60.1% think it is about right, 7.5% believe that there is a shortage, and 2.0% have no opinion. Neurologists' opinions do not differ significantly from those of neurosurgeons, but physicians and surgeons in 22 other specialties are significantly less likely to regard the supply as excessive, and are more likely to perceive a shortage. Primary care physicians, as a group, are most likely to perceive a shortage, and least likely to indicate an excess. Among the 24 specialties studied, 9.3% of physicians believe the supply of neurosurgeons to be excessive, 55.1% think it is about right, 22.9% believe that there is a shortage, and 12.8% have no opinion.

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Community diagnosis for a slum population under the field practice area of a government medical college, New Delhi: community-oriented primary care exercise for undergraduate students

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20184825 ◽

2018 ◽

Vol 5 (12) ◽

pp. 5404

Author(s):

P. Aravind Gandhi ◽

U. Venkatesh ◽

Poornima Tiwari ◽

Preety Doley

Keyword(s):

Primary Care ◽

Medical Students ◽

Urban Poor ◽

Unmet Need ◽

Drainage System ◽

Income Poverty ◽

New Delhi ◽

Undergraduate Medical Students ◽

Rapid Urbanization ◽

Awareness Campaigns

Background: Rapid urbanization has led to the increase in a group of people called ‘Urban poor’ dwelling as a community in ‘Slums’, worldwide. Slums manifest deprivation that transcends income poverty. Hence, we conducted this Community-oriented primary care (COPC) exercise, to give medical students a greater understanding of the situation of individual patients in the slum and to formulate a community diagnosis.Methods: The current study was done at Tyagaraj Nagar Jhuggi in the South district of New Delhi, during Community-oriented primary care (COPC) exercise of undergraduate medical students in their 4th semester over a period of 20 days, using a predesigned proforma for collecting data on health events and determinants of health, from families. 35 households were chosen by systematic random sampling.Results: Out of 179 community members studied, 33 (18.43%) were afflicted with morbidity, which consists of common cold with cough, generalized body pain and joint pain. The sex ratio was found to be 826, literacy rate was 76.9% in the study area, 44.11% of the households were having sanitary latrines owned by them, 68.6% had a closed drainage system 63% of the families used clean fuel for cooking and unmet need of contraception was 85% among eligible couples.Conclusions: Investments in women’s access to various contraceptive preferences are urgently needed to help increase the contraceptive prevalence rate. Health Education and awareness campaigns on prevention of potential mosquito, fly breeding sites, hand hygiene, avoidance of firewood as fuel, establishing smoke outlet and solid waste management should be arranged.

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Primary Care Tracks in Medical Schools

PRiMER ◽

10.22454/primer.2019.799272 ◽

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.

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Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm

PRiMER ◽

10.22454/primer.2021.304379 ◽

2021 ◽

Vol 5 ◽

Author(s):

Peggy R. Cyr ◽

Wendy Craig ◽

Hadjh Ahrns ◽

Kathryn Stevens ◽

Caroline Wight ◽

...

Keyword(s):

Primary Care ◽

Medical Students ◽

Skin Cancer ◽

Primary Care Physicians ◽

Survival Rates ◽

Family Physicians ◽

Skin Lesions ◽

Posttest Score ◽

Malignant Skin ◽

Attending Physicians

Introduction: Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. Methods: We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Results: Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P<.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant (P<.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. Conclusion: After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

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Physicians’ accounts of frontline tensions when implementing pilot projects to improve primary care

Journal of Health Organization and Management ◽

10.1108/jhom-01-2017-0013 ◽

2018 ◽

Vol 32 (1) ◽

pp. 39-55 ◽

Cited By ~ 3

Author(s):

Elizabeth Mansfield ◽

Onil Bhattacharyya ◽

Jennifer Christian ◽

Gary Naglie ◽

Vicky Steriopoulos ◽

...

Keyword(s):

Primary Care ◽

Health Services ◽

Primary Care Physicians ◽

Pilot Project ◽

Models Of Care ◽

Structured Interviews ◽

Pilot Projects ◽

Additional Time ◽

Content Type ◽

The Impact

Purpose Canada’s primary care system has been described as “a culture of pilot projects” with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

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