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A Novel Medical Student Assistant Accommodation Model for a Medical Student With a Disability During a Required Clinical Clerkship.

ABSTRACT: Background:As efforts continue to diversify the physician workforce so that it better matches the patient population, the number of medical students with disabilities will increase. U.S. medical schools and emergency medicine (EM) clerkships should be prepared to provide full and meaningful access to learners with disabilities. Methods:We created a novel means of providing access to a senior medical student with a mobility disability (secondary to a cervical spinal cord injury) to participate in a fourth-year EM clerkship. We hired four second-year medical students as intermediaries to perform senior medical student-directed physical examination maneuvers, during his 15 required 8-hour emergency department shifts. The senior medical student dictated his documentation using Dragon Natural Speaking (Nuance Communications, 2015) voice recognition software. Results:The senior medical student successfully completed the required clinical clerkship and earned a honors grade for his work. Both the senior medical student and the second-year medical student intermediaries gave positive feedback about the experience. Conclusions:Given the significant prevalence of disability among medical students in U.S. medical schools, medical educators should provide greater access to students with disabilities and opportunities for advanced education for all learners by creating innovative clinical curriculum. The authors recommend the student intermediary model for senior medical students with physical disabilities in required clinical clerkships.

SUBMITTER: Jauregui J

PROVIDER: S-EPMC7369484 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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A Novel Medical Student Assistant Accommodation Model for a Medical Student With a Disability During a Required Clinical Clerkship.

Jauregui Joshua J Strote Jared J Addison Conrad C Robins Lynne L Shandro Jamie J

AEM education and training 20191219 3

<h4>Background</h4>As efforts continue to diversify the physician workforce so that it better matches the patient population, the number of medical students with disabilities will increase. U.S. medical schools and emergency medicine (EM) clerkships should be prepared to provide full and meaningful access to learners with disabilities.<h4>Methods</h4>We created a novel means of providing access to a senior medical student with a mobility disability (secondary to a cervical spinal cord injury) to ...[more]

PMID: 32704599

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Project description:PurposeStudents applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated.Methods and materialsAn anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content.ResultsThe survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank-sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43).ConclusionsBased on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These results support further development of structured didactic curricula for the radiation oncology clerkship.

Project description:PURPOSE:A structured didactic radiation oncology clerkship curriculum for medical students is in use at multiple academic medical centers. Objective evidence supporting this educational approach over the traditional clerkship model is lacking. This study evaluated the curriculum efficacy using an objective knowledge assessment. METHODS AND MATERIALS:Medical students received the Radiation Oncology Education Collaborative Study Group (ROECSG) curriculum consisting of 3 lectures (Overview of Radiation Oncology, Radiation Biology/Physics, and Practical Aspects of Simulation/Radiation Emergencies) and a radiation oncology treatment-planning workshop. A standardized 20-item multiple choice question (MCQ) knowledge assessment was completed pre- and post-curriculum and approximately 6 months after receiving the curriculum. RESULTS:One hundred forty-six students at 22 academic medical centers completed the ROECSG curriculum from July to November 2016. One hundred nine students completed pre- and post-clerkship MCQ knowledge assessments (response rate 74.7%). Twenty-four students reported a prior rotation at a ROECSG institution and were excluded from analysis. Mean assessment scores increased from pre- to post-curriculum (63.9% vs 80.2%, P < .01). Mean MCQ knowledge subdomain assessment scores all improved post-curriculum (t test, P values < .01). Post-scores for students rotating de novo at ROECSG institutions (n = 30) were higher compared with pre-scores for students with ≥1 prior rotations at non-ROECSG institutions (n = 55) (77.3% vs 68.8%, P = .01), with an effect size of 0.8. Students who completed rotations at ROECSG institutions continued to demonstrate a trend toward improved performance on the objective knowledge assessment at approximately 6 months after curriculum exposure (70.5% vs 65.6%, P = .11). CONCLUSIONS:Objective evaluation of a structured didactic curriculum for the radiation oncology clerkship at early and late time points demonstrated significant improvement in radiation oncology knowledge. Students who completed clerkships at ROECSG institutions performed objectively better than students who completed clerkships at non-ROECSG institutions. These results support including a structured didactic curriculum as a standard component of the radiation oncology clerkship.

Project description:BackgroundNo published reports of studies have provided aggregate data on visiting medical student (VMS) programs at allopathic medical schools.MethodsDuring 2006, a paper survey was mailed to all 129 allopathic medical schools in the United States and Puerto Rico using a list obtained from the Association of American Medical Colleges. Contents of the survey items were based on existing literature and expert opinion and addressed various topics related to VMS programs, including organizational aspects, program objectives, and practical issues. Responses to the survey items were yes-or-no, multiple-choice, fill-in-the-blank, and free-text responses. Data related to the survey responses were summarized using descriptive statistics.ResultsRepresentatives of 76 schools (59%) responded to the survey. Of these, 73 (96%) reported their schools had VMS programs. The most common reason for having a VMS program was "recruitment for residency programs" (90%). "Desire to do a residency at our institution" was ranked as the leading reason visiting medical students choose to do electives or clerkships. In descending order, the most popular rotations were in internal medicine, orthopedic surgery, emergency medicine, and pediatrics. All VMS programs allowed fourth-year medical students, and approximately half (58%) allowed international medical students. The most common eligibility requirements were documentation of immunizations (92%), previous clinical experience (85%), and successful completion of United States Medical Licensing Examination Step 1 (51%). Of the programs that required clinical experience, 82% required 33 weeks or more. Most institutions (96%) gave priority for electives and clerkships to their own students over visiting students, and a majority (78%) reported that visiting students were evaluated no differently than their own students. During academic year 2006-2007, the number of new resident physicians who were former visiting medical students ranged widely among the responding institutions (range, 0-76).ConclusionsMedical schools' leading reason for having VMS programs is recruitment into residency programs and the most commonly cited reason students participate in these programs is to secure residency positions. However, further research is needed regarding factors that determine the effectiveness of VMS programs in residency program recruitment and the development of more universal standards for VMS eligibility requirements and assessment.

Dataset Information

A Novel Medical Student Assistant Accommodation Model for a Medical Student With a Disability During a Required Clinical Clerkship.

Publications

A Novel Medical Student Assistant Accommodation Model for a Medical Student With a Disability During a Required Clinical Clerkship.

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