scholarly journals Effect of student-directed solicitation of evaluation forms on the timeliness of completion by preceptors in the United States

2019 ◽  
Vol 16 ◽  
pp. 32
Author(s):  
Conrad Krawiec ◽  
Vonn Walter ◽  
Abigail Kate Myers
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Clinical Performance ◽  
The United States ◽  
Summative Evaluation ◽  
Training Experience ◽  
Post Intervention ◽  
Improvement Project ◽  
Intervention Phase ◽  
Evaluation Form

Purpose: Summative evaluation forms assessing a student’s clinical performance are often completed by a faculty preceptor at the end of a clinical training experience. At our institution, despite the use of an electronic system, timeliness of completion has been suboptimal, potentially limiting our ability to monitor students’ progress. The aim of the present study was to determine whether a student-directed approach to summative evaluation form collection at the end of a pediatrics clerkship would enhance timeliness of completion for third-year medical students. Methods: This was a pre- and post-intervention educational quality improvement project focused on 156 (82 pre-intervention, 74 post-intervention) third-year medical students at Penn State College of Medicine completing their 4-week pediatric clerkship. Utilizing REDCap (Research Electronic Data Capture) informatics support, student-directed evaluation form solicitation was encouraged. The Wilcoxon rank-sum test was applied to compare the pre-intervention (May 1, 2017 to March 2, 2018) and post-intervention (April 2, 2018 to December 21, 2018) percentages of forms completed before the rotation midpoint.Results: In total, 740 evaluation forms were submitted during the pre-intervention phase and 517 during the post-intervention phase. The percentage of forms completed before the rotation midpoint increased after implementing student-directed solicitation (9.6% vs. 39.7%, P<0.05).Conclusion: Our clerkship relies on subjective summative evaluations to track students’ progress, deploy improvement strategies, and determine criteria for advancement; however, our preceptors struggled with timely submission. Allowing students to direct the solicitation of evaluation forms enhanced the timeliness of completion and should be considered in clerkships facing similar challenges.

scholarly journals A survey of syphilis knowledge among medical providers and students in Rhode Island

2020 ◽  
Vol 8 ◽  
pp. 205031212090259
Author(s):  
John Bonnewell ◽  
Sarah Magaziner ◽  
Joseph L Fava ◽  
Madeline C Montgomery ◽  
Alexi Almonte ◽  
...  
Keyword(s):  
Medical Students ◽  
Infectious Diseases ◽  
Rhode Island ◽  
Clinical Training ◽  
Medical Training ◽  
Clinical Signs ◽  
The United States ◽  
Basic Knowledge ◽  
Medical Providers ◽  
Training Experience

Background: In the United States, syphilis cases have increased dramatically over the last decade. Recognition and timely diagnosis by medical providers are essential to treating syphilis and preventing further transmission. Methods: From 2016 to 2017, a cross-sectional survey was performed among medical students, residents, fellows, and attending physicians in Rhode Island. Topics included demographics, level of medical training, experience diagnosing and treating syphilis, and familiarity with the reverse testing algorithm. Participants were asked 25 true/false questions to assess basic knowledge of syphilis, which covered five domains: epidemiology, transmission, clinical signs and symptoms, diagnosis, and treatment. Univariate and bivariate analyses were performed to determine knowledge levels across provider characteristics. Significance was defined as p < 0.05. Results: Of the 231 participants, 45% were medical students, 34% were residents or fellows, 11% were medicine attendings (non-infectious diseases), and 10% were infectious diseases attendings. The overall mean score was 9.79 (out of 25; range = 0–23, p ⩽ 0.001). Mean scores differed significantly ( p < 0.001) across groups, including 7.68 for students (range = 0–16), 10.61 for residents/fellows (range = 3–17), 10.41 for non-infectious diseases attendings (range = 4–18), and 16.38 for infectious diseases attendings (range = 6–23). Familiarity with the reverse sequence algorithm was low with only 22% having heard of it. Infectious diseases attendings were significantly more knowledgeable compared to other groups. Overall and across domains, infectious diseases attendings had significantly higher scores except when compared to non-infectious diseases attendings in the epidemiology domain and residents/fellows in the transmission domain. Conclusion: Overall syphilis knowledge among non-infectious diseases medical providers was low. Improved education and clinical training are needed to promote early diagnosis, treatment, and prevention efforts.

How an educational improvement project improved the summative evaluation of medical students

2009 ◽  
Vol 18 (4) ◽  
pp. 283-287 ◽  
Author(s):  
K G Hoffman ◽  
R M. A Brown ◽  
J W Gay ◽  
L A Headrick
Keyword(s):  
Medical Students ◽  
Summative Evaluation ◽  
Educational Improvement ◽  
Improvement Project

scholarly journals Crossmatch to Transfusion Ratios in the Operating Room with an Expanding Hospital Footprint

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S159-S159
Author(s):  
M S Virk
Keyword(s):  
Operating Room ◽  
Blood Product ◽  
Qualitative Interviews ◽  
The United States ◽  
Blood Bank ◽  
University Hospital ◽  
Post Intervention ◽  
Improvement Project ◽  
Surgical Subspecialty ◽  
Surgical Teams

Abstract Introduction/Objective The crossmatch to transfusion (CT) ratio is one of several metrics used to assess the efficiency of blood product utilization. A ratio of 2:1 has been suggested as a hospitalwide limit that indicates appropriate use of red blood cells (RBCs), and the Q Probe Study found that the average CT ratio for hospitals in the United States is 1.85:1. This ratio can vary widely from one patient location to another due to anticipatory or unknown needs within the operating room (OR) compared to laboratory or symptomatic based orders for patients on the floor. Following a recent hospital expansion at Stanford University Hospital that led to the creation of multiple adult OR locations and a move of our blood bank, we monitored the CT ratios of various OR locations and surgical subspecialties to assess the drivers of increased blood product utilization and interventions that could improve these metrics. Methods/Case Report This quality improvement project involved the collection of blood product order information through our LIS (SafeTrace) and clinical system (EPIC), creation of an on-demand report to provide constant updates to that data, qualitative interviews with OR staff, and process mapping for multiple subspecialties. Results (if a Case Study enter NA) Prior to our hospital expansion there was an appropriate CT ratio of 2.1:1 in our adult ORs. Post-expansion, this ratio has been between 3-5:1, depending on the OR location. This led us to focus our efforts on the OR locations that were furthest from the blood bank and existed prior to the hospital expansion. In discussions with our OR colleagues, we found that the major driver for this increased ratio was a longer travel path for blood products and delays in delivery which led to larger amounts of anticipatory orders. In addition, these concerns caused duplicative efforts in the OR with surgical teams and Anesthesiologists placing pre-operative orders for the same cases. To address this concern, remote blood product dispensing was implemented. To address duplicative ordering workflows, we partnered with Anesthesiology to determine the blood ordering workflow agreements with each surgical subspecialty to ensure appropriate division of roles and responsibilities. Evaluation of CT ratios after these interventions is ongoing, but early data suggests a significant reduction. Conclusion Post-intervention phase ongoing and will be updated with additional data & conclusions prior to conference.

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.

scholarly journals Feasibility of clinical performance assessment of medical students on a virtual sub-internship in the United States

2021 ◽  
Vol 18 ◽  
pp. 12
Author(s):  
John Woller ◽  
Sean Tackett ◽  
Ariella Apfel ◽  
Janet Record ◽  
Danelle Cayea ◽  
...  
Keyword(s):  
United States ◽  
Medical Students ◽  
Physical Examination ◽  
Performance Assessment ◽  
Clinical Performance ◽  
The United States ◽  
Clinical Performance Assessment ◽  
Assessment Measures

We aimed to determine whether it was feasible to assess medical students as they completed a virtual sub-internship. Six students (out of 31 who completed an in-person sub-internship) participated in a 2-week virtual sub-internship, caring for patients remotely. Residents and attendings assessed those 6 students in 15 domains using the same assessment measures from the in-person sub-internship. Raters marked “unable to assess” in 75/390 responses (19%) for the virtual sub-internship versus 88/3,405 (2.6%) for the in-person sub-internship (P=0.01), most frequently for the virtual sub-internship in the domains of the physical examination (21, 81%), rapport with patients (18, 69%), and compassion (11, 42%). Students received complete assessments in most areas. Scores were higher for the in-person than the virtual sub-internship (4.67 vs. 4.45, P<0.01) for students who completed both. Students uniformly rated the virtual clerkship positively. Students can be assessed in many domains in the context of a virtual sub-internship.

scholarly journals Peer Mentorship: Implementation of a Resident Registered Nurse Anesthetist Mentorship Program

2021 ◽  
pp. 1-5
Author(s):  
Thomas Pallaria ◽  
Chase Parrish ◽  
Alexandra Stillwell
Keyword(s):  
New England ◽  
Clinical Performance ◽  
The United States ◽  
Nurse Anesthesia ◽  
Improvement Project ◽  
Mentorship Program ◽  
Peer Mentorship ◽  
Action Point ◽  
Critical Action ◽  
Anesthesia Residents

Abstract Nurse anesthesia residents experience high levels of stress while being enrolled in a post-baccalaureate nurse anesthesia program. Elevated levels of stress have been proven to limit one’s ability to learn and commit new material to memory, all while inhibiting their academic and clinical performance. This study represents a quality improvement project that implements a Peer Mentorship Program (PMP) into a major University in the New England area of the United States. The study utilizes descriptive statistics to determine if implementation of a peer mentorship program can help to decrease nurse anesthesia resident’s stress, while simultaneously increasing academic and clinical performance. Data gathered by the investigators of this study was composed of a Critical Action Point Checklist (CAPC); a set of objectives that were meant to be completed by the participants in order to help run a successful mentorship program. Additional data was collected using a Peer Mentorship Reflection Questionnaire at the end of the study to receive feedback about the Peer Mentorship Program. 56% of participants agreed that the Peer Mentorship Program helped to decrease stress during the study and 83.4% of participants agreed that they would like to see the Peer Mentorship Program continue for future cohorts at their nurse anesthesia program. The findings of this study suggest that more Nurse Anesthesia Programs should work to incorporate a Peer Mentorship Program for their nurse anesthesia residents to help develop safe, high-quality anesthesia providers for the future.

scholarly journals Effects of the COVID-19 Pandemic on Medical Students: A Multicenter Quantitative Study

2020 ◽  
Author(s):  
Aaron Harries ◽  
Carmen Lee ◽  
Lee Jones ◽  
Robert M. Rodriguez ◽  
John Davis ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Clinical Training ◽  
The United States ◽  
Antibody Testing ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Rotations ◽  
Medical Education System ◽  
National Recommendation

Abstract Background: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy.Methods: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. Results: 741 (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved.Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). Conclusions: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.

scholarly journals Introduction of a Mandatory Pre-Block Safety Checklist into a Regional Anaesthesia Block Room Service: A Quality Improvement Project

2018 ◽  
Vol 46 (5) ◽  
pp. 504-509 ◽  
Author(s):  
E. J. McLellan ◽  
A. D. Hade ◽  
A. Pelecanos ◽  
S. Okano
Keyword(s):  
Regional Anaesthesia ◽  
High Rate ◽  
Complication Rates ◽  
Post Intervention ◽  
Improvement Project ◽  
Intervention Phase ◽  
Wrong Side ◽  
Block Time ◽  
Negative Effect ◽  
Mandatory Use

Wrong-side block is an uncommon yet potentially preventable complication of regional anaesthesia. One strategy for reducing the incidence of wrong-side block is to introduce an additional check into the pre-block workflow in the form of a block ‘time out’ or ‘stop before you block’. In the aftermath of a wrong-side block incident at our institution, the mandatory use of a pre-block safety checklist was successfully introduced into the workflow of the block room. Compliance with the checklist rose from 31% in the six-month pre-intervention phase to over 90% in the six-month post-intervention phase. This was achieved without any negative effect on block efficacy, theatre efficiency, complication rates or patient satisfaction. The high rate of checklist utilisation was associated with an increased rate of ultrasound video documentation. This suggests that there may be collateral benefit to using a pre-block safety checklist in addition to merely reducing the risk of wrong-side block.

Improvement in Herpes Zoster Vaccination in Patients with Rheumatoid Arthritis: A Quality Improvement Project

2016 ◽  
Vol 44 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Heena Sheth ◽  
Larry Moreland ◽  
Hilary Peterson ◽  
Rohit Aggarwal
Keyword(s):  
Rheumatoid Arthritis ◽  
Quality Improvement ◽  
Herpes Zoster ◽  
Immunosuppressive Therapy ◽  
Eligible Patient ◽  
Quality Improvement Project ◽  
Post Intervention ◽  
Improvement Project ◽  
Intervention Phase ◽  
Vaccination Rates

Objective.To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy.Methods.This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase. The electronic best practice alert (BPA) for HZ vaccination was developed; it appeared on electronic medical records during registration and medication reconciliation of the eligible patient by the medical assistant. The BPA was designed to electronically identify patient eligibility and to enable the physician to order the vaccine or to document refusal or deferral reason. Education regarding vaccine guidelines, BPA, vaccination process, and feedback were crucial components of the project interventions. The vaccination rates were compared using the chi-square test.Results.We evaluated 1823 and 1554 eligible patients with RA during the pre-intervention and post-intervention phases, respectively. The HZ vaccination rates, reported as patients vaccinated among all eligible patients, improved significantly from the pre-intervention period of 10.1% (184/1823) to 51.7% (804/1554) during the intervention phase (p < 0.0001). The documentation rates (vaccine received, vaccine ordered, patient refusal, and deferral reasons) increased from 28% (510/1823) to 72.9% (1133/1554; p < 0.0001). The HZ infection rates decreased significantly from 2% to 0.3% (p = 0.002).Conclusion.Electronic identification of vaccine eligibility and BPA significantly improved HZ vaccination rates. The process required minimal modification of clinic work flow and did not burden the physician’s time, and has the potential for self-sustainability and generalizability.

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