Peer assessment of professionalism: a five-year experience in medical clerkship.
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ABSTRACT:
SUBMITTER: Kovach RA
PROVIDER: S-EPMC2686767 | biostudies-other | 2009 Jun
REPOSITORIES: biostudies-other
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Project description:IntroductionProfessionalism is a core competency of medical education. It impacts one's ability to generate rapport with patients, foster patient satisfaction, and enhance the overall well-being of the medical professional. Unprofessional attitudes among medical students have been associated with higher rates of career dissatisfaction and burnout. A group of faculty and medical students at our institution have developed a series of peer facilitated modules addressing a set of common themes relevant to medical professionalism: professionalism in the clinical setting, professional electronic communication, teamwork and community, and work-life integration.MethodsStudent discussions on professionalism were facilitated by senior medical students. Using a 5-point Likert scale, electronic pre- and postsurveys assessed the impact of the workshop on first-year medical students' understanding of various professionalism topics.ResultsSeventy-seven percent of first-year medical students (n = 131) felt the modules contributed to their learning. Pre- and postsurveys showed significant improvements in understanding of and comfort with the majority of topics discussed. Students felt that their knowledge improved as well. Narrative comments expressed approval of the modules and suggested they addressed unmet needs in the medical curriculum.DiscussionThese modules were successfully incorporated into the first-year medical school curriculum and led to improved student understanding and comfort around these topics. Senior medical student facilitators also found the experience useful in their own career development. Although these modules were designed for medical students, they may also be useful for other professional students (e.g., dental, nursing, etc.) or for interprofessional educational experiences.
| S-EPMC6342056 | biostudies-literature
Project description:IntroductionData from the Association of American Medical Colleges' Medical School Graduation Questionnaire show persistent trends of medical student mistreatment nationwide. To reduce the barriers and increase actionable reporting of mistreatment, we integrated peer-facilitated learning environment sessions led by a group of trained third- and fourth-year medical students in all core clinical clerkships.MethodsDuring the 2018-2019 academic year, third-year medical students were recruited, oriented, and trained to act as facilitators of sessions on mistreatment. The sessions occurred once every clerkship block, using a standardized session introduction and guide. After a 6-month pilot, new medical students were recruited and worked as scribe/facilitator pairs, receiving an additional 1.5-hour training midyear, which was evaluated with a postworkshop survey.ResultsThirty-eight students implemented 43 peer-facilitated sessions and completed deidentified minutes of each session, which were shared with clerkship directors and the Medical Education Office for review. Survey data from midyear facilitator training indicated that facilitators highly agreed peer-led sessions were an important avenue for students to process experiences of mistreatment (3.9 out of 4), understood barriers to reporting (3.8 out of 4) and definitions of mistreatment (3.6 out of 4), and felt confident to facilitate these sessions (3.6 out of 4).DiscussionPeer-facilitated sessions offer a method to learn more about student experiences with mistreatment in real time and create a new avenue for communication between faculty and students. Assembling a stable core team of third- and fourth-year students trained in facilitation skills ensures the sustainability and relevance of the program.
| S-EPMC8473588 | biostudies-literature
Project description:ObjectivesIn 2016, a national consensus conference created the National Clinical Assessment Tool for Medical Students in Emergency Medicine (NCAT-EM), a standardized end-of-shift assessment tool. We report the first large-scale analysis of professionalism concerns collected from May 2017 through December 2018 by a multisite consortium using the NCAT-EM. Our primary objective was to characterize the nature and frequency of professionalism concerns. Our secondary objective was to identify characteristics associated with giving or receiving a professionalism flag.MethodsThe consortium database includes assessments for all students on EM clerkships at participating sites. This report presents descriptive statistics about the frequency of different flags, the distribution of flags among different student categories, assessor and student characteristics, and distribution of global assessment scores on assessments citing concerns. We used Fisher's exact test to look for associations between the frequency of professionalism flags and the sex of the students and assessors and across student categories. We used logistic regression to look for relationships between professionalism concerns and global assessment scores as well as intent to apply in EM.ResultsWe screened 6,768 assessments of 784 students by 719 assessors from 13 sites. After excluding assessments without flags and assessments with apparent data entry errors, we analyzed 57 (0.8%) assessments containing 79 flags. The most frequent flags were punctuality (25/79, 31.6%) and initiative (20/79, 25.3%). Few students received flags (42/784, 5.4%). Few assessors flagged concerns (41/719, 5.7%). We detected no correlation between the frequency of flags and whether a student was applying in EM or between the sex of students and assessors. Global scores of lower one-third appeared more often in assessments with a flag (30/57, 52.6% vs. 233/6,711, 3.5%).ConclusionsOnly 5.4% of students received flags. Punctuality and initiative accounted for a majority of citations. Professionalism flags correlated strongly with lower global assessment scores.
| S-EPMC8019228 | biostudies-literature
Project description:While the number of female medical students is increasing in Japan, gender differences in medical school performance have not been studied extensively. This study aimed to compare gender differences in repeat-year experience, Clinical Clerkship (CC) performance, and related examinations in Japanese medical students. We retrospectively analyzed the number of repeat-year students and years to graduation for male and female medical students, and assessed gender differences in performance on computer-based testing (CBT) before CC, CC as evaluated by clinical teachers, the CC integrative test, and the graduation examination in 2018-2020 graduates from our medical school. Subgroup analyses excluding repeat-year students were also performed. From 2018 to 2020, 328 medical students graduated from our medical school. There were significantly fewer repeat-year female students compared to male students (P = .010), and the average number of years to graduate was significantly higher for male students than female students (P < .001). Female students showed higher scores and performance in all integrative tests and CC (P < .05, each). In analysis excluding repeat-year students, there were no significant gender difference in performance on the CBT, and CC integrative test, although female students significantly outperformed male students on the CC and graduation examination. Female medical students had a fewer number of repeat-years and performed better in the CC and graduation examination compared to their male counterparts.
| S-EPMC9387990 | biostudies-literature
Project description:BackgroundProfessionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates' professionalism and communication skills from the patients' perspective and to examine its association with patients' socio-demographic variables.MethodsThis is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients' assessment was influenced by variables such as age, gender, education, at a level of significance, p ≤ 0.05.ResultsFemale patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36 ± 16. Patients' scoring of the graduate's skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the "patient involvement in decision-making" were assigned the minimum mean values, while items dealing with "establishing adequate communication with patient" assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p < 0.001). Patients with higher education reported much lower scores than those with lower education (p = 0.003). Patients' gender did not show any statistically significant influence on the rating level.ConclusionGenerally patients rated the medical graduates' professionalism and communication skills at a good level. Patients' age and educational level were significantly associated with the rating level.
| S-EPMC3923249 | biostudies-literature
Project description:BackgroundTo improve the medical professionalism of medical students, it is essential to understand the dilemmas they face in various situations. This study explored the types and distribution of dilemmas Korean medical students encounter during their clinical clerkships. It then compared these with previous dilemma frameworks and identified the types and distribution of "complexity dilemmas," wherein two dilemma themes emerge in a single clinical situation.MethodsThe researchers organized and recorded a group discussion with 106 third-year medical students who had completed their clinical clerkships. These students participated in the discussion as part of an assignment, focusing on the dilemmas they encountered during their clerkships. For data analysis and visualization, the researchers employed the MAXQDA software program and utilized the template analysis method, a qualitative research methodology.ResultsA total of seven dilemma themes and sixteen sub-themes were identified. The identity-related dilemma concerning student-doctors had the highest frequency. The themes "mismatch" and "Nun-chi" emerged as new additions not found in previous dilemma frameworks. The complexity dilemmas appeared in the sequence of "identity-dignity," "identity-abuse," and "identity-consent".ConclusionsTo navigate the unique dilemmas present within South Korea's clinical culture, several key issues need consideration: elevating the role of student-doctors, balancing the primary emphasis of educational hospitals on delivering medical services, and understanding interpersonal strategies, such as "Nun-chi".
| S-EPMC10870601 | biostudies-literature
Project description:BACKGROUND:Basic medical skills such as history taking and physical examination are essential components of clinical work profiles, but nevertheless have been neglected by conventional preclinical curricula. The near-peer-teaching program AaLplus [living anatomy plus] teaches basic medical skills, especially history taking, physical examination, and venepuncture, to preclinical students. It is a highly popular compulsory course in the first four semesters (320 students/year, 9h/semester) at Heidelberg University and ends with a formative Objective Structured Clinical Examination (OSCE) during which students receive structured in-depth feedback on their performance. AaLplus is part of the Department of General Practice's longitudinal curriculum for Family Medicine. OBJECTIVES:This study aims to assess whether the AaLplus program has positive effects on students' clinical skill development and subjective confidence in history taking, physical examination and venepuncture. METHODS:From 2015 to 2019, we asked all AaLplus participants to rate the program and self-assess their medical skills on 5-point Likert scales (min 1, max 5). In 4-station OSCEs, trained tutors rated the students' performance in all taught skills using standardized checklists. RESULTS:From 2015 to 2019 n = 1534 questionnaires returned (response rate = 98.6%, 52.7% females). After course completion, students felt able to take a patient's history (mean 3.97, SD = 0.75) and perform physical examinations (means range 3.82-4.36, SDs range 0.74-0.89) as well as venepuncture (mean 4.12, SD = 0.88). A large majority of students claimed they acquired these skills in the AaLplus program. During OSCE, 81.9% passed anamnesis, 93.1% passed physical examination, and 95.4% passed venepuncture (of n = 1556). Students mostly rated the feedback they received during the OSCE as "helpful" or "very helpful" (means for different stations 4.69-4.76, SDs 0.50-0.70). CONCLUSIONS:AaLplus is a positive example of a peer teaching program in the preclinical stage of medical studies. It successfully trains junior students in essential medical abilities and increases their confidence in their skills. A high percentage of students pass the formative OSCE and evaluate it positively. Consistently high ratings indicate the program's routine viability. Further studies are needed to analyze if programs like AaLplus could have an impact on the number of graduates choosing career in Family Medicine.
| S-EPMC7259978 | biostudies-literature
Project description:Medical professionalism is a basic competency in medical education. This study aimed to adapt the Professionalism Assessment Scale, which is used to evaluate the professionalism attitudes of medical students, into Turkish and to assess its validity and reliability. First, the scale's translation-back-translation was performed and piloted on 30 students. Then, the final scale was applied to medical students to ensure the scale's validity. The Penn State University College of Medicine Professionalism Questionnaire was used for external validation to assess criterion validity. Confirmatory factor analysis was performed for structure validity. Test-retest, item correlations, split-half analysis, and Cronbach's alpha coefficient were evaluated to determine the scale's reliability. SPSS 25.0 and AMOS 24.0 package programs were used for statistical analysis. The statistical significance level was accepted as P<0.05. The mean age of the participants was 21±2 years, and 50.5% (n = 166) were female. Three hundred thirty-five students were invited, and 329 participated in the study. The response rate was 98%. The mean total Professionalism Assessment Scale score was 96.36±12.04. The three-factor structure of the scale, "empathy and humanism," "professional relationship and development," and "responsibility," was confirmed. The Cronbach's alpha coefficient of the scale was 0.94, and both the Spearman-Brown and Guttman split-half coefficients were 0.89. The three-factor structure of the scale, consisting of 22 items, explained 59.1% of the total variance. The intraclass correlation coefficient between test-retest measurements was 0.81. Confirmatory factor analysis showed a model suitable for the original version of the scale (χ2/sd = 2.814, RMSEA = 0.074). The Turkish version of the Professionalism Assessment Scale is a valid and reliable tool to determine the professionalism attitudes of medical students in Turkey.
| S-EPMC9879428 | biostudies-literature
Project description:Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.The curriculum included these components: (1) four, once-weekly, 60-minute classroom sessions; (2) prerequisite reading assignments; (3) individual daily meditation practice and journaling; and (4) the development of a personalized wellness plan with the help of a mentor. The design was based on self-directed learning theory and focused on building relatedness, competence, and autonomy to help cultivate mindfulness.Thirty students participated in the curriculum; 20 were included in the final analysis. Each student completed surveys prior to, immediately after, and six months after participation in the curriculum. We found significant changes in the self-reported behaviors and attitudes of the students immediately following participation in the curriculum, which were sustained up to six months later.Although this was a pilot study, our pilot curriculum had a significantly sustained self-reported behavioral impact on our students. In the future, this intervention could easily be adapted for any four-week rotation during medical school to reduce burnout and increase physician wellness.
| S-EPMC6040904 | biostudies-other
Project description:BackgroundThe importance of medical professionalism and its assessment has been well documented in the literature. However, there is currently no culturally-adapted tool to assess medical professionalism in Singapore. This study sets out to find consensus on relevance of the items from the Professionalism Mini Evaluation Exercise (P-MEX) for assessing medical professionalism in Singapore.MethodsA two-round Delphi survey was completed by an expert panel consisting of program directors, associate designated institutional officials, and designated institutional official (n = 15) from residency programs in Singapore. Round 1 comprised of 23 items from the P-MEX rated on a 5-point scale (1 = Definitely include, 2 = Possibly include, 3 = Neutral, 4 = Possibly exclude, 5 = Definitely exclude). In round 2, the experts received feedback from the previous round, and were asked to re-rate the items which did not achieve consensus in the previous round. The threshold for consensus in the study was defined as 70% or greater agreement among experts.ResultsCompleted questionnaires for both rounds were received from all 15 experts. In round 1, 18 items (78%) achieved consensus to be included. In round 2, 1 (4%) item achieved consensus to be included. However, none of the remaining items achieved consensus to be removed, and they exhibited stability in responses. A list of 19 items covering four domains of medical professionalism (Doctor-patient relationship skills, Reflective skills, Time management and Inter-professional relationship skills) was obtained during the two-rounds of Delphi survey.ConclusionsNineteen items in the P-MEX had garnered consensus and is suitable for assessing medical professionalism in Singapore. The findings of this study can provide guidance for faculty and institutions who want to assess medical professionalism of their medical trainees.
| S-EPMC7362541 | biostudies-literature