MedEdPublish (2016)最新文献

Point of care ultrasound (POCUS) has increasingly been used by midwives worldwide. In 2018, the scope of midwifery care in Ontario was expanded to include POCUS to allow practitioners to provide more comprehensive care. In response to the scope expansion, a new continuing POCUS education course was created in collaboration with faculty and clinicians from obstetrics, midwifery, and medical radiation sciences. The continuing education sonography course focused on fostering the knowledge, skills and judgment Ontario midwives required to safely perform these new POCUS skills. The course included online modules, a two-day hands-on bootcamp workshop, and a clinical practicum under the supervision of a sonographer to confirm competency across the three trimesters of pregnancy. This paper outlines the process for POCUS curriculum development and implementation in pregnancy care following course completion. The first cohort of 17 learners completed the course in 2019. The new curriculum was well received by learners for learning and applying bedside sonography in clinical care. The indications to use POCUS most frequently reported by learners after course completion included assessment of pregnancy viability and fetal presentation. Challenges identified by participants with the course included learning new content such as physics and struggling to complete the clinical practicum due to the coronavirus pandemic. The success of this course is indicated by the completion of the objective structured clinical exams for all learners and meeting the competencies for beginning their practicum. The POCUS continuing education course plays an important role in providing the knowledge, skills and ability to perform point of care pregnancy scans among midwives.

Background: Communication and cultural differences predispose Deaf patients to suboptimal healthcare. Despite this disparity, health professionals have historically received little to no training in caring for Deaf patients. Patient panels are an effective tool in medical education to model communication strategies.

Objective: In this paper, we describe the design, implementation, and results of a virtual patient panel focused on communicating with Deaf patients in clinical contexts. We offer practical suggestions for incorporating similar educational interventions in health professions education to prepare trainees to effectively navigate these conversations with their patients.

Methods: The panel consisted of a one-hour question and answer discussion facilitated by the authors with Deaf patients and Certified Deaf Interpreters (CDI). The panel was presented to 271 second-year medical students at our institution in November of 2023. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using pile-sorting qualitative analysis to identify main themes.

Results: There were 73 respondents, with a response rate of 27%. After the panel, the most popular takeaway points from student reflections included communication ( n=56, 77%) and access to care ( n=47, 64%), followed by autonomy ( n=17, 23%), the doctor-patient relationship ( n=15, 21%), and culture ( n=11, 15%). Based on this initiative, we identified and offer twelve tips for developing similar exercises. These tips are thematically presented under three groupings: Virtual Panel Considerations, Curricular Considerations, and Special Considerations with Deaf Panelists.

Conclusion: This patient panel was the first of its kind in our medical school curriculum. Important considerations in panel design and implementation should focus on delivery time constraints with live-interpreting and further exploring the role of trust and communication in the physician-patient relationship.

Emergency medicine clerkships have become more prevalent in the third year of medical school, a time when students are immersed in the core clinical training of their undergraduate medical education. There is little guidance for clinician educators, however, on how to effectively scaffold learning for third-year medical students when rotating in the emergency department (ED) during core clerkships. The authors sought to provide best practices in teaching to leverage the rich learning environment of the ED - regardless of their specialty selections. Based on an extensive review of the literature spanning on-shift teaching, feedback, clinical medicine, and bedside teaching, the following twelve tips are offered to guide the instruction of the undifferentiated third-year medical student in the ED.

Introduction: Residents report limited end-of-life care training, resulting in negative socio-emotional impacts, burnout, and inadequate patient care. An academic urban county hospital adopted the Death Rounds (DR) conference for residents in the medical intensive care unit as a monthly free-form discussion to help residents cope with the emotional aspects of caring for dying patients. Our goal was to implement and evaluate a newly structured DR curriculum to help residents further reflect on experiences of caring for dying patients, reduce emotional burnout, and improve physician well-being.

Methods: Using a mixed-methods design, we conducted a qualitative needs assessment using interviews of residents. DR conference modifications based on the needs assessment include shorter, more frequent sessions; breakout groups; prompts for facilitating discussion; and multidisciplinary facilitators. A pre-post modification survey using the Likert scale was administered to all residents to assess the programmatic changes.

Results: Pre- and post-modification data were received from 30 and 50 of 116 residents, respectively. A greater proportion of post-test DR attendees reported that DR helped them feel less distressed when caring for dying patients (p=0.018). Among residents who did not attend DR, there was greater agreement in feeling emotionally supported by their team when caring for dying patients (p=0.046). Overall, 81% of post-test respondents agreed DR was worthwhile of their time, and almost all respondents agreed discussing the emotional impacts of patient death is important.

Conclusion: Death Rounds is a replicable and impactful curriculum that helps residents process the challenges of caring for dying patients and may improve emotional distress and team support.

Background: According to the Association of American Medical Colleges (AAMC) Year 2 questionnaire, the percentage of students using online medical education videos (Boards and Beyond®Sketchy Medical®, Youtube) at least once per week increased from 47.7% (2015) to 70.1% (2022). Transition to virtual learning in 2020 fostered a greater reliance on these online third-party resources (i.e., educational tools distinct from formal medical curriculum), yet existing literature have rarely evaluated their efficacy. As students in this landscape, we aimed to review the usage, efficacy, and drawbacks of third-party resources and their financial burden on students.

Methods: Four authors searched PubMed from June-July 2023 using the search terms "prevalence," "efficacy," and "disparities introduced by third-party board preparation resources." All peer-reviewed articles in English were evaluated. No inclusion or exclusion criteria were implemented. References were mined for additional results, per the discretion of each reviewer.

Results: 31 studies were examined for common themes and findings to provide a snapshot of the existing literature. Studies suggest third-party resources are used in a task-dependent manner with a supplemental role to lectures during the preclinical years and a primary role for United States Medical Licensing Examination (USMLE) preparation during clinical years. Medical students access these resources to perform well on board exams, prompted by studies demonstrating their efficacy in increasing USMLE Step 1 scores. Though certain resources have been frequently cited for improving board performance (e.g., First Aid, UWorld), students combine multiple third-party resources to best serve their preparation. Subscription-pricing of most third-party resources and 12-month access prices range from $100 to $479.

Conclusion: Third-party resource use may contribute to an increased financial strain on students. This, coupled with overwhelming medical student debt, may exacerbate socioeconomic disparities in medical education. Institutions should evaluate third-party resource use among students and consider provisions to increase access to them.

Despite the importance of case-based multiple-choice question (CBMCQ) exams, medical educators rarely discuss strategies to systematically approach these questions, and literature on the topic is limited. Through trial-and-error, many students develop more refined and efficient approaches to answering CBMCQs that help them maximize the application of their knowledge base. In this article we present a structured six-step approach to answering CBMCQs, grounded in dual process theory. We provide strategies for success on CBMCQ-based exams and approaches to challenging question types. We also present tips for helping neurodiverse students. Medical educators can use this structured approach and the related tips to coach students on improving performance on CBMCQ-based exams.

Objectives: The British Medical Association announced a successful vote towards industrial action to achieve 'pay restoration' on 20 February 2023; with 11 walkout periods occurring in the following months. During industrial action, concerns arose about the role medical students would play and the pressure placed upon them to 'act up'. The objective of this study was to assess the guidance issued by medical schools and local placement sites during industrial action.

Design setting and participants: This cross-sectional study collected online survey data between 7 March 2023 and 7 April 2023 from medical students across England.

Main outcome measures: Reports about guidance issued by medical schools and hospital placements.

Results: 62% of the medical schools issued guidance stating they were not cancelling clinical placements; of these, 10% said attendance was a personal choice. 17% of medical schools cancelled all clinical placements and 7% did not issue guidance. 52% of medical schools monitored attendance on strike days. 1 medical school and 3 clinical placement sites advertised paid work for students during the industrial action.

Conclusion: The impact industrial action has on medical students has not been examined. Our results show mixed guidance from medical schools that can contradict local placement guidance. This lack of guidance is mirrored in the existing, yet limited, literature. If students feel pressured to perform tasks outside their remit, with inadequate supervision, it can impact patient safety and their license to practice. For the safeguarding of patients, and students, further work is needed to produce standardised guidance during industrial action.

Purpose: Social interactions are fundamental to effective medical practice, yet assessing these complex dynamics in educational settings remains challenging. This review critically examines the emerging use of dual eye-tracking technology as a novel method to quantify, analyze, and enhance social interactions within medical education contexts.

Materials and methods: We performed a scoping review of the literature, focusing on studies that utilized dual eye-tracking within medical education contexts. Our search included multiple databases and journals. We extracted information on technical setups, areas of application, participant characteristics, dual eye-tracking metrics, and main findings.

Results: Ten studies published between 2012 and 2021 met the inclusion criteria, with 90% utilizing dual screen-based- and 10% dual mobile eye-tracking. All studies were conducted in the context of surgical training, primarily focusing on laparoscopic surgery. We identified two main applications of dual eye-tracking: (1) as an educational intervention to improve collaboration, (2) as a diagnostic tool to identify interaction pattern that were associated with learning. Key metrics included joint visual attention, gaze delay and joint mental effort.

Conclusion: Dual eye-tracking offers a promising technology for enhancing medical education by providing high-resolution, real-time data on social interactions. However, current research is limited by small sample sizes, outdated technology, and a narrow focus on surgical contexts. We discuss the broader implications and potential for medical education research and practice.

Social media has revolutionized how society receives and transmits information in the digital age, including healthcare. While the future of social media platforms remains uncertain, the benefits of social media for healthcare organizations, departments, and divisions are clear when compared to traditional communication methods, including improved recruitment efforts, increased promotion of faculty work, rapid dissemination of information and education innovations, and accelerated professional networking. Consequently, preferred platforms may shift but the benefits of social media likely cement it, in one form or another, in medical education and society at large. The strategic development of a social media presence at the department level can be opaque and overwhelming amidst varying mediums, yet the benefits of use have never been more important. Here, we present 12 tips for developing a successful social media presence as a healthcare department, addressing the creation of a purposeful social media strategy and crucial considerations for any platform, current or future, at all levels of development.

Disability is extremely common, and there is a need for high quality medical school curricula on working with persons with disabilities. The goal of disability training is to provide the proper knowledge and skills to address the unique needs of persons with disability (PWD), mitigate health disparities, and help shape more compassionate and informed physicians. This article presents 12 tips to incorporate disability training into undergraduate medical education. These tips emphasize the inclusion of PWD in all stages of the curriculum, interprofessional education, experiential learning, and exposure to a range of disability types. By leveraging these tips, educators will be able to create effective learning opportunities and improve the future healthcare of PWD.