scholarly journals Transitioning From a Noon Conference to an Academic Half-Day Curriculum Model: Effect on Medical Knowledge Acquisition and Learning Satisfaction

2014 ◽  
Vol 6 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Duc Ha ◽  
Michael Faulx ◽  
Carlos Isada ◽  
Michael Kattan ◽  
Changhong Yu ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Knowledge Acquisition ◽  
Cleveland Clinic ◽  
Medical Knowledge ◽  
Learner Satisfaction ◽  
Learning Satisfaction ◽  
Medical Licensing ◽  
Sex Type ◽  
Multivariable Analyses ◽  
Resident Learning

Abstract Background The academic half-day (AHD) curriculum is an alternative to the traditional noon conference in graduate medical education, yet little is known regarding its effect on knowledge acquisition and resident satisfaction. Objective We investigated the association between the 2 approaches for delivering the curriculum and knowledge acquisition, as reflected by the Internal Medicine In-Training Examination (IM-ITE) scores and assessed resident learning satisfaction under both curricula. Methods The Cleveland Clinic Internal Medicine Residency Program transitioned from the noon conference to the AHD curriculum in 2011. Covariates for residents enrolled from 2004 to 2011 were age; sex; type of medical degree; United States Medical Licensing Examination Step 1, 2 Clinical Knowledge; and IM-ITE-1 scores. We performed univariable and multivariable linear regressions to investigate the association between covariates and IM-ITE-2 and IM-ITE-3 scores. Residents also were surveyed about their learning satisfaction in both curricula. Results Of 364 residents, 112 (31%) and 252 (69%) were exposed to the AHD and the noon conference curriculum, respectively. In multivariable analyses, the AHD curriculum was associated with higher IM-ITE-3 (regression coefficient, 4.8; 95% confidence interval 2.9–6.6) scores, and residents in the AHD curriculum had greater learning satisfaction compared with the noon conference cohort (Likert, 3.4 versus 3.0; P  =  .003). Conclusions The AHD curriculum was associated with improvement in resident medical knowledge acquisition and increased learner satisfaction.

scholarly journals Curriculum Transition From Lecture-Based to Team-Based Learning is Associated With Improved Performance on Internal Medicine In-Training Examination

2021 ◽  
Vol 13 (5) ◽  
pp. 691-698
Author(s):  
Gerald Schynoll ◽  
Justin Perog ◽  
Paul J. Feustel ◽  
Raymond Smith
Keyword(s):  
Internal Medicine ◽  
Standardized Testing ◽  
Knowledge Acquisition ◽  
Univariate Analysis ◽  
Medical Knowledge ◽  
Percent Correct ◽  
Team Based Learning ◽  
Traditional Lectures ◽  
Multivariable Regression ◽  
Improved Performance

ABSTRACT Background Team-based learning (TBL) is an alternative to traditional lectures in graduate medical education, but evidence is scarce regarding its impact on knowledge acquisition and standardized testing performance. Objective We examined the association between resident performance on the Internal Medicine In-Training Examination (IM-ITE) and these 2 educational methods. Methods In 2013, the internal medicine residency program at Albany Medical College transitioned from a lecture-based curriculum to TBL. Residents enrolled in academic years 2011–2012 and 2012–2013 comprised the lecture cohort, and those enrolled in 2015–2016 and 2016–2017 the TBL cohort. Covariates included the type of medical school attended, gender, and United States Medical Licensing Examination Step 2 Clinical Knowledge scores. We performed univariate analysis and multivariable regression to determine the association between covariates and ITE scores. Results Of 120 residents, 60 were in the lecture cohort and 60 in the TBL cohort. The IM-ITE percent correct scores were higher with TBL than lecture (PGY-1 61.0% vs 55.0%, P < .001; PGY-2 69.0% vs 59.7%, P < .001; PGY-3 73.2% vs 61.7%, P < .001). In a multivariable regression analysis of 3 PGYs combined, the transition from lecture to TBL resulted in an increase in IM-ITE Z-score of 0.415 (P < .001), equivalent to 0.415 SD, when including the effects of all covariates. Conclusions Compared to a lecture-based curriculum, TBL was associated with improved resident medical knowledge acquisition as evidenced by higher IM-ITE scores.

scholarly journals How do we assess resilience and grit among internal medicine residents at the Mayo Clinic? A longitudinal validity study including correlations with medical knowledge, professionalism and clinical performance

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040699
Author(s):  
Fares Alahdab ◽  
Andrew J Halvorsen ◽  
Jayawant N Mandrekar ◽  
Brianna E Vaa ◽  
Victor M Montori ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Internal Consistency ◽  
Test Performance ◽  
Mayo Clinic ◽  
Clinical Performance ◽  
Medical Knowledge ◽  
Internal Consistency Reliability ◽  
Validity Study ◽  
Training Environment ◽  
Conference Attendance

BackgroundThere has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.ObjectivesTo investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.MethodsWe evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).ResultsA total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=−3.4, 95% CI −6.2 to −0.5, p=0.02) and mini-CEX (β=−0.2, 95% CI −0.5 to −0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).ConclusionsThis study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.

scholarly journals Fourth-Year Medical School Course Load and Success as a Medical Intern

2017 ◽  
Vol 9 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Christopher J. Richards ◽  
Kenneth J. Mukamal ◽  
Nikki DeMelo ◽  
C. Christopher Smith
Keyword(s):  
Medical School ◽  
Medical Knowledge ◽  
Intensive Courses ◽  
Course Work ◽  
Increased Risk ◽  
Medical Licensing ◽  
Course Load ◽  
Usmle Step 1 ◽  
Intensive Course

ABSTRACT Background  The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished. Objective  To assess the relationship between fourth-year course load and success during internship. Methods  We reviewed transcripts of 78 internal medicine interns from 2011–2013 and compared the number of intensive courses (defined as subinternships, intensive care, surgical clerkships, and emergency medicine rotations) with multi-source performance evaluations from the internship. We assessed relative risk (RR) and 95% confidence interval (CI) of achieving excellent scores according to the number of intensive courses taken, using generalized estimating equations, adjusting for demographics, US Medical Licensing Examination (USMLE) Step 1 board scores, and other measures of medical school performance. Results  For each additional intensive course taken, the RR of obtaining an excellent score per intensive course was 1.05 (95% CI 1.03–1.07, P < .001), whereas the RR per nonintensive course taken was 0.99 (95% CI 0.98–1.00, P = .03). An association of intensive course work with increased risk of excellent performance was seen across multiple clinical competencies, including medical knowledge (RR 1.08, 95% CI 1.04–1.11); patient care (RR 1.07, 95% CI 1.04–1.10); and practice-based learning (RR 1.05, 95% CI 1.03–1.09). Conclusions  For this single institution's cohort of medical interns, increased exposure to intensive course work during the fourth year of medical school was associated with better clinical evaluations during internship.

Social media as a primary source of medical knowledge acquisition and dissemination

2016 ◽  
Vol 127 ◽  
pp. A1 ◽  
Author(s):  
Chieh-Chen Wu ◽  
Richard Lu ◽  
Hsuan-Chia Yang ◽  
Yu-Chuan (Jack) Li
Keyword(s):  
Social Media ◽  
Knowledge Acquisition ◽  
Medical Knowledge ◽  
Primary Source

Abstract 15353: Apixaban Failure in Prevention of Ischemic Cerebrovascular Accidents in Non-valvular Atrial Fibrillation Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mohammad Zmaili ◽  
Jafar Alzubi ◽  
Mohamed Gad ◽  
Ahmed Abu-Haniyeh ◽  
Walid I Saliba ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Low Dose ◽  
Carotid Artery Disease ◽  
Cleveland Clinic ◽  
Inappropriate Use ◽  
Multivariable Analyses ◽  
Artery Disease

Introduction: Apixaban has been increasingly used over the past decade for the prevention of ischemic strokes in atrial fibrillation (AF) patients. Nonetheless, some patients may experience ischemic strokes despite apixaban therapy. There is scarce information about factors underlying apixaban failure in AF patients. Methods: A system wide search was employed at the Cleveland Clinic Health System using electronic records. All patients 18 years of age or older, who were diagnosed with AF, and developed an ischemic stroke while being treated with apixaban (January 2013 through May 2019) were included. A matched controls series (no stroke on apixaban) was included accounting for antiplatelet and statin therapy, and carotid artery disease. Multivariable analyses were performed to assess for associations between clinical characteristics and stroke on apixaban. Results: A total of 137 patients with stroke while on apixaban were identified and matched to 137 controls. Cases and controls were comparable in a large number of clinical characteristics. There was an association between apixaban dosing and risk of stroke. About 40% of the lower (2.5 mg BID) dose of apixaban was prescribed for patients who would have qualified for full dose. Being on inappropriately low dose of apixaban was associated with a higher risk of ischemic strokes compared to appropriately prescribed doses with an adjusted OR 3.37 [1.37-8.32]. Among appropriately prescribed doses, the 5 mg BID dose showed a statistically nonsignificant lower risk of ischemic stroke compared to the 2.5 mg BID dose, adjusted OR 0.55 [0.21-1.41]. Compared to the inappropriate use of the 2.5 mg dose, the appropriate prescription of the 2.5 mg dose was associated with a lower risk of stroke adjusted OR 0.34 [0.07-1.64]. Conclusion: In this series, there was a statistically significant association between being on an inappropriately low dose of apixaban and the odds of stroke while on apixaban therapy.

Approach to the Internal Medicine Board Examination

2014 ◽  
pp. 1103-1107
Author(s):  
Stuart B. Mushlin
Keyword(s):  
Internal Medicine ◽  
Medical Knowledge ◽  
Core Knowledge ◽  
Self Assessment ◽  
Medical Specialties ◽  
The Core ◽  
Body Of Knowledge ◽  
The Subject ◽  
The 1960S ◽  
Core Body

This chapter is different from the others. Its intent is to concentrate your mind on the American Board of Internal Medicine (ABIM) examination, its purpose, and its likely test scenarios. The ABIM moved to a written rather than oral test in the 1960s. The testing has been extensively validated and is unlikely to change much in its character. Essentially, the ABIM wants to determine if you have the core knowledge in all the disciplines to be an effective and efficient physician. It further wants to discriminate between you and the other test takers so that you can see how you compare with others taking the examination. Many candidates, in their increasing anxiety over the subject matter, lose sight of these major objectives. To pass the examination it is not necessary to regurgitate in photographic detail one of the standard textbooks of medicine or the latest Medical Knowledge Self-Assessment Program (MKSAP) review; however, you should feel that you know the core body of knowledge in all the major medical specialties.

scholarly journals Evaluating Nonphysician Staff Members' Self-Perceived Ability to Provide Multisource Evaluations of Residents

2013 ◽  
Vol 5 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Susan Michelle Nikels ◽  
Gretchen Guiton ◽  
Danielle Loeb ◽  
Suzanne Brandenburg
Keyword(s):  
Internal Medicine ◽  
Health Care Professionals ◽  
Medical Knowledge ◽  
Evaluation Process ◽  
Professional Behaviors ◽  
Medical Assistants ◽  
Perceived Ability ◽  
Staff Members ◽  
Clinical Background ◽  
And Behavior

Abstract Background Multisource evaluations of residents offer valuable feedback, yet there is little evidence on the best way to collect these data from a range of health care professionals. Objective This study evaluated nonphysician staff members' ability to assess internal medicine residents' performance and behavior, and explored whether staff members differed in their perceived ability to participate in resident evaluations. Methods We distributed an anonymous survey to nurses, medical assistants, and administrative staff at 6 internal medicine residency continuity clinics. Differences between nurses and other staff members' perceived ability to evaluate resident behavior were examined using independent t tests. Results The survey response rate was 82% (61 of 74). A total of 55 respondents (90%) reported that it was important for them to evaluate residents. Participants reported being able to evaluate professional behaviors very well (62% [36 of 58] on the domain of respect to staff; 61% [36 of 59] on attire; and 54% [32 of 59] on communication). Individuals without a clinical background reported being uncomfortable evaluating medical knowledge (60%; 24 of 40) and judgment (55%; 22 of 40), whereas nurses reported being more comfortable evaluating these competencies. Respondents reported that the biggest barrier to evaluation was limited contact (86%; 48 of 56), and a significant amount of feedback was given verbally rather than on written evaluations. Conclusions Nonphysician staff members agree it is important to evaluate residents, and they are most comfortable providing feedback on professional behaviors. A significant amount of feedback is provided verbally but not necessarily captured in a formal written evaluation process.

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