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An Intervention to Improve Medical Student Perception of Observation and Feedback During an Anesthesiology Clerkship.

ABSTRACT: Background:Between 2011 and 2013, medical students at a large, tertiary academic hospital reported a lower-than-expected perception of direct observation and feedback during their third- and fourth-year clinical clerkships. The anesthesiology clerkship is a team-based care model that involves an anesthesiologist, resident or anesthetist, and student. This model allows for direct supervision of all patient interactions and procedures. Despite this structure, medical students reported an acceptable but lower-than-anticipated perception of direct observation and feedback taking place during a 2-week anesthesiology clerkship. Methods:Interventions were proposed to improve student awareness of the supervision, teaching, and feedback taking place. A skills checklist for intravenous (IV) line placement that an anesthesia provider completed while observing the student was chosen as a meaningful intervention to improve the students' perception of observation and feedback. This checklist required direct observation of the IV line placement clinical skill, and the evaluator was directed to give oral feedback to the student. Students were surveyed regarding their perceptions of direct observation and feedback during a 4-year period, 2 years prior to and 2 years after implementation of the IV checklist. Results:No statistically significant difference was noted between the preintervention and postintervention groups. Conclusion:While formal observation of and feedback on an IV placement did not change student perception, the intervention showed that a more in-depth analysis of the "educational alliance" desired during an anesthesiology clerkship is warranted, especially as medical education continues to evolve.

SUBMITTER: Trawicki MC

PROVIDER: S-EPMC6135281 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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An Intervention to Improve Medical Student Perception of Observation and Feedback During an Anesthesiology Clerkship.

Trawicki Michael C MC Zuegge Karin L KL Volz Lana M LM Abd-Elsayed Alaa A AA

Ochsner journal 20180101 2

<h4>Background</h4>Between 2011 and 2013, medical students at a large, tertiary academic hospital reported a lower-than-expected perception of direct observation and feedback during their third- and fourth-year clinical clerkships. The anesthesiology clerkship is a team-based care model that involves an anesthesiologist, resident or anesthetist, and student. This model allows for direct supervision of all patient interactions and procedures. Despite this structure, medical students reported an a ...[more]

PMID: 30258298

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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.

Project description:IntroductionVideoconferencing has been employed in numerous medical education settings ranging from remote supervision of medical trainees to conducting residency interviews. However, no studies have yet documented the utility of and student response to videoconference meetings for mid-clerkship feedback (MCF) sessions required by the Liaison Committee on Medical Education (LCME).MethodsFrom March 2017 to June 2018, third-year medical students rotating through the mandatory, four-week emergency medicine (EM) clerkship at a single medical school were randomly assigned either to a web-based videoconference meeting via Google Hangouts, or to a traditional in-person meeting for their MCF session. To compare students' MCF experiences we sent out an electronic survey afterward to assess the following using a 0-100 sliding scale: overall satisfaction with the meeting; the effectiveness of communication; the helpfulness of the meeting; their stress levels, and the convenience of their meeting location. The survey also collected data on these demographic variables: the name of the faculty member with whom the student met; student gender, age, and interest in EM; location prior to meeting; meeting-method preference; and number of EM shifts completed.ResultsDuring the study period, 133 third-year medical students responded to the survey. When comparing survey responses between individuals who met online and in person, we did not detect a difference in demographics with the exception of preferred meeting method (p=0.0225). We found no significant differences in the overall experience, helpfulness of the meeting, or stress levels of the meeting between those who met via videoconference vs. in-person (p=0.9909; p=0.8420; p=0.2352, respectively). However, individuals who met in-person with a faculty member rated effectiveness of communication higher than those who met via videoconference (p=0.0002), while those who met online rated convenience higher than those who met in-person (p<0.0001). Both effects remained significant after controlling for preferred meeting method (p<0.0001 and p=0.0003, respectively) and among EM-bound students (p=.0423 and p<0.0110, respectively).ConclusionOur results suggest that LCME-required MCF sessions can be successfully conducted via web-based programs such as Google Hangouts without jeopardizing overall meeting experience. While the convenience of the meetings was improved, it is also important for clerkship directors to note the perceived deficit in the effectiveness of communication with videoconferencing.

Dataset Information

An Intervention to Improve Medical Student Perception of Observation and Feedback During an Anesthesiology Clerkship.

Publications

An Intervention to Improve Medical Student Perception of Observation and Feedback During an Anesthesiology Clerkship.

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