Dataset Information

An evaluation of cascading mentorship as advocacy training in undergraduate medical education.

ABSTRACT:

Background

Physicians are in a position of great influence to advocate for health equity. As such, it is important for physicians-in-training to develop the knowledge and skills necessary to fulfil this role. Although various undergraduate medical programs have implemented health advocacy training, they often lack experiential learning and physician involvement. These aspects are foundational to the Advocacy Mentorship Initiative (AMI) which utilizes cascading mentorship as a novel approach to advocacy training. Medical students develop advocacy competency as peer mentors to youth raised in at-risk environments, while also being mentored themselves by physician residents. We aim to determine whether there are specific advantages to utilizing cascading mentorship to facilitate the attainment of advocacy competencies in undergraduate medical education.

Methods

Medical students participating in AMI between 2017 to 2020 completed pre- and post-exposure questionnaires. Questionnaires assessed confidence in advocacy-related skills and knowledge of youth advocacy concepts, as well as learning goals, skills gained, benefits of AMI and resident mentors, and impact on future career. Sign tests were utilized to analyze quantitative results, and content analysis was used for open-ended responses. A triangulation protocol was also utilized.

Results

Fifty mentors participated, 24 (48%) of which completed both pre- and post-exposure questionnaires. Participants gained confidence in advocacy-related skills (p?ConclusionsAMI offers a unique method of advocacy training through cascading mentorship that engages medical students both as mentors to at-risk youth and mentees to resident physicians. Through cascading mentorship, medical students advance in their advocacy-related skills and understanding of social determinants of health.

SUBMITTER: Patel M

PROVIDER: S-EPMC7818733 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

An evaluation of cascading mentorship as advocacy training in undergraduate medical education.

Patel Mitesh M Aitken Devon D Xue Yunlin Y Sockalingam Sanjeev S Simpson Alexander A

BMC medical education 20210121 1

<h4>Background</h4>Physicians are in a position of great influence to advocate for health equity. As such, it is important for physicians-in-training to develop the knowledge and skills necessary to fulfil this role. Although various undergraduate medical programs have implemented health advocacy training, they often lack experiential learning and physician involvement. These aspects are foundational to the Advocacy Mentorship Initiative (AMI) which utilizes cascading mentorship as a novel appro ...[more]

PMID: 33478476

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Project description:BACKGROUND:Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of telemedicine training in undergraduate medical education. OBJECTIVE:The aim of this review was to collect and outline the current experiences and learnings that have been generated as medical schools have sought to implement telemedicine capacity-building into undergraduate medical education. METHODS:We performed a mixed-methods review, starting with a literature review via Scopus, tracking with Excel, and an email outreach effort utilizing telemedicine curriculum data gathered by the Liaison Committee on Medical Education. This outreach included 70 institutions and yielded 7 interviews, 4 peer-reviewed research papers, 6 online documents, and 3 completed survey responses. RESULTS:There is an emerging, rich international body of learning being generated in the field of telemedicine training in undergraduate medical education. The integration of telemedicine-based lessons, ethics case-studies, clinical rotations, and even teleassessments are being found to offer great value for medical schools and their students. Most medical students find such training to be a valuable component of their preclinical and clinical education for a variety of reasons, which include fostering greater familiarity with telemedicine and increased comfort with applying telemedical approaches in their future careers. CONCLUSIONS:These competencies are increasingly important in tackling the challenges facing health care in the 21st century, and further implementation of telemedicine curricula into undergraduate medical education is highly merited.

Project description:Objective: The objective of this article is a description of the longitudinal communication curriculum in the Model Medicine Curriculum (MSM) at Charité - Universitätsmedizin Berlin. The authors describe the planning and integration of the curriculum into the study program, outline how communicative competence is taught and evaluated in the MSM, and identify which challenges need to be mastered in the process. Project description: Starting with the introduction of the MSM in 2010, students have been spending 102 class hours, spread out over seven semesters, practicing social and communicative competences in the interactive small group format "Communication, Interaction & Teamwork (KIT)". The course contents are closely linked to the topics covered each semester and increase in complexity over the course of their studies. The contents are selected by the KIT planning group whose members continually check the curriculum's timeliness and determine any changes. Students as well as instructors have opportunities for evaluating KIT throughout, and their evaluations are taken into consideration as KIT continues to be updated. Instructors from different disciplines teach KIT courses. They participate in mandatory didactic trainings that prepare them to teach KIT. During their 4th and 9th semesters, respectively, students take summative exams that test their communicative competence. Results: According to the semester evaluations by students and instructors, students participating in KIT improved their conversation management skills (students: M=2.2, SD=1.1, instructors: M=1.9, SD=0.7, on a scale of 1-5). In addition, students and graduates rate KIT to be (very) relevant, consider the degree to which it is taught in the MSM to be (very) high, and consider KIT to be a meaningful part of the curriculum. Students taking the summative exams in their 4th and 9th semesters achieve a mean score of 75.9%, respectively 76.9%, in the purely communicative stations and 82.6%, respectively 83.3%, in the global evaluation of communicative competence in clinical-practical stations. Discussion: Survey and exam results alike indicate that the communication training is well accepted by students and instructors and that the training led to an improvement in general and specific communicative skills. Due to a lack of control groups or a pre-post design, it has thus far not been possible to unequivocally demonstrate a causal relationship between communicative competence trainings and good test results. Quality control measures, such as trainings for instructors and regular course evaluations, have been designed to address any challenges in the implementation of the communication curriculum at the faculty level. Conclusion: Building on the experience with the Charité's Reformed Medical Curriculum, a longitudinal, competence-based communication curriculum was integrated into the MSM's overall curriculum. This measure remedied a gap in the medical training that many graduates of regular study programs had previously bemoaned (Jansen 2010 [1]).

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Project description:BACKGROUND:Professionalism standards encourage physicians to participate in public advocacy on behalf of societal health and well-being. While the number of publications of advocacy curricula for GME-level trainees has increased, there has been no formal effort to catalog them. OBJECTIVE:To systematically review the existing literature on curricula for teaching advocacy to GME-level trainees and synthesize the results to provide a resource for programs interested in developing advocacy curricula. METHODS:A systematic literature review was conducted to identify articles published in English that describe advocacy curricula for graduate medical education trainees in the USA and Canada current to September 2017. Two reviewers independently screened titles, abstracts, and full texts to identify articles meeting our inclusion and exclusion criteria, with disagreements resolved by a third reviewer. We abstracted information and themes on curriculum development, implementation, and sustainability. Learning objectives, educational content, teaching methods, and evaluations for each curriculum were also extracted. RESULTS:After reviewing 884 articles, we identified 38 articles meeting our inclusion and exclusion criteria. Curricula were offered across a variety of specialties, with 84% offered in primary care specialties. There was considerable heterogeneity in the educational content of included advocacy curriculum, ranging from community partnership to legislative advocacy. Common facilitators of curriculum implementation included the American Council for Graduate Medical Education requirements, institutional support, and preexisting faculty experience. Common barriers were competing curricular demands, time constraints, and turnover in volunteer faculty and community partners. Formal evaluation revealed that advocacy curricula were acceptable to trainees and improved knowledge, attitudes, and reported self-efficacy around advocacy. DISCUSSION:Our systematic review of the medical education literature identified several advocacy curricula for graduate medical education trainees. These curricula provide templates for integrating advocacy education into GME-level training programs across specialties, but more work needs to be done to define standards and expectations around GME training for this professional activity.

Project description:IntroductionOver the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver.MethodsThis was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively.ResultsFifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001).ConclusionThe use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills.

Dataset Information

An evaluation of cascading mentorship as advocacy training in undergraduate medical education.

Background

Methods

Results

Publications

An evaluation of cascading mentorship as advocacy training in undergraduate medical education.

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