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integrated clinical clerkships

Galina Gheihman, Tomi Jun, Grace J Young, Daniel Liebman, Krishan Sharma, Eileen Brandes, Barbara Ogur, David A Hirsh
BACKGROUND: Longitudinal clinical experiences are a common component of undergraduate medical curricula, yet these programs have not been systematically characterized in US medical schools. OBJECTIVE: Our study sought to identify and characterize longitudinal clinical programs (LCPs) in US medical schools and measure associations between programs' structures and goals. DESIGN: Using a mixed-methods approach, we conducted a secondary analysis of data from publicly available websites...
December 2018: Medical Education Online
Jochanan Benbassat
Undergraduate clinical education follows the "bedside" tradition that exposes students to inpatients. However, the hospital learning environment has two main limitations. First, most inpatients require acute care, and students may complete their training without seeing patients with frequent non-emergent and chronic diseases that are managed in outpatient settings. Second, students rarely cope with diagnostic problems, because most inpatients are diagnosed in the community or the emergency room. These limitations have led some medical schools to offer longitudinal integrated clerkships in community settings instead of hospital block clerkship rotations...
February 24, 2018: Advances in Health Sciences Education: Theory and Practice
Olle Ten Cate, Jan Borleffs, Marijke van Dijk, Tineke Westerveld
AIM: The aim of this report, written for the 40th anniversary issue of Medical Teacher, is to document 20 years of development of the Utrecht undergraduate medical curriculum, as both to exhibit accountability and to inform the community of the process and choices that can be made in long-term curriculum development. METHODS: We used the SPICES model, created by Medical Teacher's Editor Ronald Harden and colleagues in 1984. RESULTS: The Utrecht six-year program, now called "CRU+", has many distinct features that were introduced, most of which are well documented...
February 22, 2018: Medical Teacher
Olle Ten Cate, Lysanne Graafmans, Indra Posthumus, Lisanne Welink, Marijke van Dijk
AIM: As reports of the application of entrustable professional activities (EPAs) increase, not only for postgraduate but also for undergraduate medical education, there is a need for descriptions of what a UME curriculum with EPAs could look like. We provide such a description based on the experiences at University Medical Center Utrecht, the Netherlands, which can be used as an example by other curriculum developers. METHODS: In a three-year process, the UMC Utrecht Curriculum Committee developed a clinical workplace curriculum with an EPA structure, taking into account examples, such as the US Core EPAs for Entering Residency, and recommendations to integrate and increase the length of clerkships...
February 22, 2018: Medical Teacher
Jennifer L Biggs, Jamie S Sutherell, Rochelle Remus, Eric S Armbrecht, Marta A King
PROBLEM: Student-preceptor discontinuity during 3rd-year clerkships limits the quality and quantity of supervision, teaching, and feedback. Although longitudinal integrative clerkships increase continuity and are associated with improved student and preceptor experience, they require schoolwide curricular reform. Alternative innovations enhancing student-preceptor relationships within the constraints of a traditional block clerkship may demonstrate similar benefits. INTERVENTION: We piloted a continuity-enhanced general pediatric ambulatory schedule during 2 consecutive clerkship blocks in 2013...
January 24, 2018: Teaching and Learning in Medicine
Malcolm D Mattes, William Small, Neha Vapiwala
PURPOSE: To characterize radiation oncologist involvement in undergraduate medical education at US academic medical centers and to incorporate these findings into practical pathways for greater and broader integration of radiation oncology (RO) into medical curricula. METHODS: Chairpersons and residency program directors at RO departments directly affiliated with a medical school were asked to describe all the ways in which radiation oncologists in their department are involved in medical student education, excluding their elective clerkship...
January 2, 2018: Journal of the American College of Radiology: JACR
Judith K Ockene, Karen M Ashe, Rashelle B Hayes, Linda C Churchill, Sybil L Crawford, Alan C Geller, Denise Jolicoeur, Barbara C Olendzki, Maria Theresa Basco, Jyothi A Pendharkar, Kristi J Ferguson, Thomas P Guck, Katherine L Margo, Catherine A Okuliar, Monica A Shaw, Taraneh Soleymani, Diane D Stadler, Sarita S Warrier, Lori Pbert
Physicians have an important role addressing the obesity epidemic. Lack of adequate teaching to provide weight management counseling (WMC) is cited as a reason for limited treatment. National guidelines have not been translated into an evidence-supported, competency-based curriculum in medical schools. Weight Management Counseling in Medical Schools: A Randomized Controlled Trial (MSWeight) is designed to determine if a multi-modal theoretically-guided WMC educational intervention improves observed counseling skills and secondarily improve perceived skills and self-efficacy among medical students compared to traditional education (TE)...
November 8, 2017: Contemporary Clinical Trials
Wei Wei Lee, Maria L Alkureishi, Kristen E Wroblewski, Jeanne M Farnan, Vineet M Arora
BACKGROUND: Integrating electronic health records (EHRs) into clinical care can prevent physicians from focusing on patients. Despite rapid EHR adoption, few curricula teach communication skills and best practices for patient-centered EHR use. OBJECTIVE: We piloted a 'Patient-centered EHR use' curriculum, consisting of a lecture and group-observed structured clinical examination (GOSCE) for second-year students (MS2s). DESIGN: During the lecture, students watched a trigger tape video, engaged in a reflective observation exercise, and learned best practices...
2017: Medical Education Online
Elizabeth Curry, Tamara K Oser, Sean M Oser
BACKGROUND AND OBJECTIVES: Electronic Health Record (EHR) use in clinical practice has accelerated in recent years. While several aspects of EHR use have been extensively studied, there is little data on EHR impacts on medical student educators, especially those involved in outpatient family medicine. This study evaluated perceived impacts of EHR use on clinician teachers of outpatient family medicine. METHODS: The study used a mixed methods survey of clinicians who teach third-year medical students during the required family and community medicine outpatient clerkship at a Mid-Atlantic medical school...
October 2017: Family Medicine
Heather L Heiman, Celia L O'Brien, Raymond H Curry, Marianne M Green, James F Baker, Robert F Kushner, John X Thomas, Thomas C Corbridge, Julia F Corcoran, Joshua M Hauser, Patricia M Garcia
In 2012, the Northwestern University Feinberg School of Medicine launched a redesigned curriculum addressing the four primary recommendations in the 2010 Carnegie Foundation for the Advancement of Teaching report on reforming medical education. This new curriculum provides a more standardized evaluation of students' competency achievement through a robust portfolio review process coupled with standard evaluations of medical knowledge and clinical skills. It individualizes learning processes through curriculum flexibility, enabling students to take electives earlier and complete clerkships in their preferred order...
September 26, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Katrin Werwick, Anke Spura, Marc Gottschalk, Frank Meyer, Felix Walcher, Sarah König, Rüdiger Braun-Dullaeus, Philipp Stieger
Background/Aim Surgical and other disciplines have been noticing difficulties in recruiting junior staff for several years. In response to a decrease in interest within study courses, surgical associations recommend better supervision during undergraduate practical education as "clerkships" in order to increase the attractiveness of surgery. This clerkship has an initiation function, as students for the first time - albeit marginally - can act as physicians. The aim of this study was to investigate the impact of clerkships on the disciplinary orientations and preferences of undergraduates' perceptions of specialist training...
September 13, 2017: Zentralblatt Für Chirurgie
Rebecca J Hlavac, Rachel Klaus, Kourtney Betts, Shilo M Smith, Maureen E Stabio
Medical schools in the United States continue to undergo curricular change, reorganization, and reformation as more schools transition to an integrated curriculum. Anatomy educators must find novel approaches to teach in a way that will bridge multiple disciplines. The cadaveric extraction of the central nervous system (CNS) provides an opportunity to bridge gross anatomy, neuroanatomy, and clinical neurology. In this dissection, the brain, brainstem, spinal cord, cauda equina, optic nerve/tract, and eyes are removed in one piece so that the entire CNS and its gateway to the periphery through the spinal roots can be appreciated...
August 17, 2017: Anatomical Sciences Education
Imran H Yusuf, Edward Ridyard, Timothy H M Fung, Zuzana Sipkova, Chetan K Patel
OBJECTIVE: To describe the conception and evaluation of a novel educational intervention to teach direct ophthalmoscopy with retinal simulators using a peer-assessed group objective structured clinical examination (OSCE) format. DESIGN: Prospective, single-centre educational trial at Oxford University Medical School, Oxford, U.K. PARTICIPANTS: A total of 160 consecutive undergraduate fifth-year medical students participated in the study. METHODS: Students identified prior experience, teaching, examination, and feedback relevant to direct ophthalmoscopy...
August 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Grace Margaret Scott, Corliss Ann Elizabeth Best, Damian Christopher Micomonaco
BACKGROUND: Although 20-40% of primary care complaints are Otolaryngology-Head and Neck Surgery (OtoHNS) related, little emphasis is placed on OtoHNS instruction at the undergraduate medical education level. An OtoHNS clerkship rotation is not required at most Canadian medical schools. Furthermore, at institutions offering an OtoHNS rotation, less than 20% of students are able to complete a placement. Given that a large percentage of medical students in Canada will pursue primary care as a career, there remains a gap in providing OtoHNS clinical training...
July 10, 2017: Journal of Otolaryngology—Head & Neck Surgery
Elisa Cheng, David Hirsh, Elizabeth Gaufberg, Todd Griswold, J Wesley Boyd
OBJECTIVE: The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students' perceptions of and interest in psychiatry, as well as performance. METHODS: Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically...
June 23, 2017: Academic Psychiatry
Ting Dong, Christopher Zahn, Aaron Saguil, Kimberly A Swygert, Michelle Yoon, Jessica Servey, Steven Durning
Construct: We investigated the extent of the associations between medical students' clinical competency measured by performance in Objective Structured Clinical Examinations (OSCE) during Obstetrics/Gynecology and Family Medicine clerkships and later performance in both undergraduate and graduate medical education. BACKGROUND: There is a relative dearth of studies on the correlations between undergraduate OSCE scores and future exam performance within either undergraduate or graduate medical education and almost none on linking these simulated encounters to eventual patient care...
July 2017: Teaching and Learning in Medicine
Marcy E Rosenbaum
The purpose of this paper, based on a 2016 Heidelberg International Conference on Communication in Healthcare (ICCH) plenary presentation, is to examine a key problem in communication skills training for health professional learners. Studies have pointed to a decline in medical students' communication skills and attitudes as they proceed through their education, particularly during their clinical workplace training experiences. This paper explores some of the key factors in this disintegration, drawing on selected literature and highlighting some curriculum efforts and research conducted at the University of Iowa Carver College of Medicine as a case study of these issues...
November 2017: Patient Education and Counseling
Michelle Daniel, Amy Fleming, Colleen O'Conner Grochowski, Vicky Harnik, Sibel Klimstra, Gail Morrison, Arnyce Pock, Michael L Schwartz, Sally Santen
The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Calvin L Chou, Arianne Teherani
Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships...
July 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Erik E Langenau, Robert Lee, Marci Fults
CONTEXT: Traditional medical education is shifting to incorporate learning technologies and online educational activities with traditional face-to-face clinical instruction to engage students, especially at remote clinical training sites. OBJECTIVE: To describe and evaluate the effectiveness of the blended learning format (combining online and face-to-face instruction) for third-year osteopathic medical students during their pediatric rotation. METHODS: Third-year medical students who completed the 4-week clerkship in pediatrics during the 2014-2015 academic year were divided into a standard learning group and a blended learning group with online activities (discussion boards, blogs, virtual patient encounters, narrated video presentations, and online training modules)...
April 1, 2017: Journal of the American Osteopathic Association
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