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Skill Session on Writing Patient Assessments for Pediatric Clerkship Students.

ABSTRACT: Introduction:Formulating written patient assessments requires the student to synthesize subjective and objective information and use clinical reasoning to reach a diagnosis. Medical students lack this skill, and clinical experience is not enough to acquire it. This session provides a structured process for learning how to formulate a patient assessment. Methods:Third-year medical students participated in a large-group interactive skill session at the beginning of their pediatrics clerkship. Instructors following a scripted model walked students through practice examples to ultimately formulate a complete written patient assessment. The session covered data synthesis, use of appropriate medical terminology, and differential diagnosis development. Students used an audience response system to practice these skills. Results:Over 1 academic year, 250 medical students participated in six sessions, with an average of 40-50 attendees per session. Over 90% of students completed pre- and postsession written patient assessments. These assessments were evaluated using portions of the Pediatric History and Physical Exam Evaluation grading rubric. The session had a positive effect on patient assessment formulation skills, with a significant increase in scores after the session. Discussion:The session improved students' skill in generating more complete written patient assessments. Almost all students found the session valuable regardless of prior clinical experience. Nearly 50% of students felt inadequately prepared to formulate a written patient assessment prior to the session, revealing a skills gap for learners and a curricular teaching gap. This skill session provided a structured method and active learning format for teaching this essential clinical skill.

SUBMITTER: Khera S

PROVIDER: S-EPMC7666838 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Skill Session on Writing Patient Assessments for Pediatric Clerkship Students.

Khera Sofia S Gavvala Sheela S Parlar-Chun Raymond R Huh Hanna H Hsu Jean J Ford Christine C

MedEdPORTAL : the journal of teaching and learning resources 20201109

<h4>Introduction</h4>Formulating written patient assessments requires the student to synthesize subjective and objective information and use clinical reasoning to reach a diagnosis. Medical students lack this skill, and clinical experience is not enough to acquire it. This session provides a structured process for learning how to formulate a patient assessment.<h4>Methods</h4>Third-year medical students participated in a large-group interactive skill session at the beginning of their pediatrics ...[more]

PMID: 33204844

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Project description:IntroductionAssessment of medical students' clinical skills (CS) remains a challenge. Little is known about early predictors of future CS performance. This study examines the relationship between students' pre-clerkship clinical skills (PCCS) performance and year 3 clerkship performance measures.MethodsThe authors performed a retrospective analysis of four medical student cohorts who matriculated between 2014 and 2017 and participated in a longitudinal pre-clerkship CS curriculum. A total of 440 students were included in the analyses. Students' clinical skills were assessed through a series of PCCS exams, each consisting of a single standardized patient encounter. First-year PCCS exams assessed history taking, physical examination, professionalism, and communication skills; second-year PCCS exams also assessed clinical documentation and clinical reasoning skills. Evaluators assigned a grade of "satisfactory," "borderline," or "unsatisfactory" for each skill set. Regression analyses compared year 3 performance outcomes between students with one or more "unsatisfactory" or "borderline" PCCS skill set grades and students assessed as "satisfactory" for all PCCS skill set assessments.ResultsThirty-two percent (n = 140) of the 440 students had at least one borderline or unsatisfactory (US) PCCS skill set grade. These students performed significantly worse on year 3 National Board of Medical Examiner subject exams, workplace-based clinical performance evaluations, and overall year 3 performance compared to students who passed all PCCS exam components. In addition, a higher percentage of students with PCCS performance deficiencies failed the United States Medical Licensing Examination Step 2 CS exam on the first attempt versus students who passed all PCCS exam components.ConclusionsPCCS exam performance at our institution aligned with future student performance on multiple year 3 clerkship outcome measures. This pre-clerkship performance data can be used to identify at-risk students who would benefit from additional resources to achieve competency in the clerkship environment and future medical training.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-022-01519-8.

Project description:IntroductionA disconnect appears to exist for medical students between learning drug facts in a basic science context and applying those facts in a clinical context when they begin working with authentic patients. In patients with kidney dysfunction, dosages of medications that are renally eliminated often need to be adjusted, due to potentially toxic accumulation in the body. To gain insight into the thought processes and gaps underlying student thinking, we developed this standardized patient (SP) case featuring a patient with drug-related renal dysfunction.MethodsThis activity was conducted in a simulation center, in a setting reminiscent of an emergency department. It took place over 2 days, with all 23 third-year medical students at our regional campus. After reporting to the simulation center at their assigned time, students completed four different medication scenarios. This specific case involved two parts. The first part, an SP-student encounter, was allotted 15 minutes, followed by 1 minute to walk to a computer station. For the second part, writing a SOAP (subjective, objective, assessment, and plan) note, 15 minutes were allotted. This was followed by 3 minutes for the SP to provide student feedback and 1 minute to rotate to the next station. In total, 35 minutes were allotted for each student to complete the case.ResultsAll third-year medical students at our regional campus completed this activity at the midpoint of their academic year. Students were well prepared to gather necessary background information from the standardized patient. However, few made the connection between the patient's symptoms and the way in which her medications were contributing. Nor did they recommend an appropriate course of action for medications that required adjustment.DiscussionFrom this activity, we gained insight into the student thought process with regard to medication management and have been able to develop new ways of revisiting basic science concepts in clinically relevant contexts to help bridge the gap between the basic and clinical components of pharmacology education.

Project description:BackgroundLongitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students' clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients' perceptions of longitudinal relationships with the LIC students within Taiwan's Confucian cultural and social context.MethodsWe invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients' descriptions of their experiences interacting with the LIC students.ResultsTwenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients' experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients' experience, feelings, and mood.ConclusionIn our study, Taiwanese patients' perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.

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Skill Session on Writing Patient Assessments for Pediatric Clerkship Students.

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Skill Session on Writing Patient Assessments for Pediatric Clerkship Students.

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