scholarly journals The Clerkship Pediatric Rotation: Does Setting Matter?

2010 ◽  
Vol 1 (1) ◽  
pp. e51-e55
Author(s):  
Natasha Bollegala ◽  
Hartley Garfield ◽  
Ian Scott ◽  
Bruce Wright ◽  
Fraser Brenneis ◽  
...  

ABSTRACTBackground: Medical student rotations in community practice settings are increasingly common within pediatric clerkship curricula yet little evidence exists to support the quality of the educational exposure. Purpose: To assess the impact of clerkship site (community setting vs. exposure to an Academic Health Sciences Center) on the following educational outcomes: 1. Clinical Performance; 2. Examination Performance; 3. Written Assignment Performance; and 4. Successful Matching to a Canadian Pediatric Residency Program.Methods: 340 medical students from the graduating classes of 2007 and 2008 at the University of Toronto, Canada were studied. Rotation performance (clinical assessment, examination mark, and written assignment mark) and acceptance into a Canadian pediatric residency program were assessed in relation to clerkship rotation site. These outcomes were assessed while controlling for the following potential confounders: 1) Pre-clerkship career preference and 2) Pre-rotation site preference as expressed by each medical student. Results: 172 medical students completed rotations that included exposure to an academic health sciences center, while 168 medical students had exclusive exposure to the community setting. Students who completed exclusively community-based pediatric rotations received slightly higher clinical evaluations (p=0.006), but not exam marks (p=0.812) nor written assignment marks (p=0.086). Students who had expressed an interest in paediatrics as a career prior to beginning their clerkship performed better during paediatric clerkship regardless of site (p= .0003) and were more likely to choose a clerkship setting that included exposure to an Academic Health Sciences Center (p=.052). Clerkship setting was not found to impact on successful matching to a Canadian pediatric residency program (p=0.171).Discussion: These results help support the decision of curriculum committees to incorporate the use of community practice settings and inform students and faculty as to the validity of distributed medical education within the field of pediatric medical education.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen Nolan ◽  
Katherine Owen

Abstract Background During the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel. Methods Individual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships. Results Interviews yielded data that broadly covered aspects of (1) Medical students’ experiences of clinical placement learning (2) Medical students’ experiences of working as medical student healthcare assistants (3) Learning resulting from working as a healthcare assistant (4) Hierarchies and professional barriers in the clinical environment (5) Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students’ interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice. Conclusions Changes to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.


2021 ◽  
Author(s):  
Grace Castelli ◽  
Dinah Diab ◽  
Alicia Scimeca ◽  
Chintan Mehta ◽  
Nicolette Payne ◽  
...  

Abstract Background: The full impact of the COVID-19 global pandemic has yet to be seen, yet medical education has already been critically disrupted. As U.S. hospitals were forced to aggressively limit non-essential care to preserve personal protective equipment and minimize COVID-19 exposure, in-person education and hands-on training was nearly eliminated for students. The objective of this study was to immediately and comprehensively investigate the impact of the COVID-19 pandemic on medical student education. Medical students in the U.S. were invited to complete an online survey about the impacts of the COVID-19 pandemic on their medical education experience. Students provided basic demographic information and answered questions about the impact of COVID-19 on their training/education, finances, and mental health. Results: Medical students reported nearly 18 fewer hours of patient care per week, an immediate switch to virtual learning (74%) along with grading changes (62%), and widespread cancellation of national exams. Additionally, 55% of fourth year students graduated early to provide direct clinical care. Students across years felt that changes from the pandemic would negatively affect their residency applications and that upcoming rotations would be impacted (p<0.001). Students reported that the pandemic had negatively affected their finances, increased their anxiety/stress, increased their feelings of burnout, and negatively impacted their work-life balance (p<0.001). Conclusion: Medical education has been critically impacted by COVID-19. Student perceptions and evaluation of experiences to date should be considered as educators prepare to ready students for academic and professional transitions in the context of continued COVID-19 disruptions and distanced learning.


2021 ◽  
Author(s):  
Helen Nolan ◽  
Katherine Owen

Abstract Background During the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel.Methods Individual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships.Results Interviews yielded data that broadly covered aspects of 1. Medical students’ experiences of clinical placement learning 2. Medical students’ experiences of working as medical student healthcare assistants 3. Learning resulting from working as a healthcare assistant 4. Hierarchies and professional barriers in the clinical environment 5. Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students’ interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice.Conclusion Changes to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin Kligler ◽  
Genevieve Pinto Zipp ◽  
Carmela Rocchetti ◽  
Michelle Secic ◽  
Erin Speiser Ihde

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.


2021 ◽  
pp. postgradmedj-2021-140032
Author(s):  
Michail Papapanou ◽  
Eleni Routsi ◽  
Konstantinos Tsamakis ◽  
Lampros Fotis ◽  
Georgios Marinos ◽  
...  

COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the ‘acting up’ of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more “evidence-based” approach.


2016 ◽  
Vol 21 (1) ◽  
pp. 30950 ◽  
Author(s):  
Orlaith McAuliffe ◽  
Mariam Lami ◽  
Tamara Lami

2019 ◽  
Vol 19 (2) ◽  
pp. 116-125 ◽  
Author(s):  
Aldrin Musiun ◽  
Khamisah Awang Lukman ◽  
Mohammad Saffree Jeffree ◽  
Fredie Robinson ◽  
Mohd Rohaizat Hassan ◽  
...  

Stress is accepted as the accumulation of unpleasant state of physical, mental and emotion on a person. Medical education has been known as one of the most stressful academic curriculum.  Hence, medical students may subjected to multiple psychological changes and challenges throughout the years of medical education.  The aim of this study was to determine the prevalence of stress and its associated factors among medical students. This cross sectional study was conducted from April to May 2018 in medical school in Sabah. It involved 396 medical students through universal sampling.  Self-administered questionnaires were used as an instrument for data collection. The questionnaires included were Sociodemographic Questionnaire, Depression, Anxiety and Stress Scales 21 (DASS-21) and Medical Student Stressors Questionnaire (MSSQ). Bivariate analysis (Chi Square test, Fisher’s Exact Test, Independent T test and Man-Whitney U test) were used to analyse the association. The response rate was 90.2%. The prevalence of stress among medical students were 33.3%.  Significant associated factors include financial support inadequacy (p=0.010) and all categories of medical student stressors. The mean score of the academic related stressors was found to be at 2.117 (±0.758) which was the highest mean score among medical student stressors assessed by MSSQ. The result of this study can be used as a basis for implementation of preventive measures such as provision of comprehensive, integrated and responsive mental health care services in university-based settings.


2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]


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