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Steinhagen E, Khan SZ, Ofshteyn A, Terhune K, Selby L, Miller-Ocuin J, Stein SL, Ammori JB. Creation and Implementation of an Online Tool for Feedback on Resident Teaching: A Pilot Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:713-721. [PMID: 38580499 DOI: 10.1016/j.jsurg.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE There are few assessments of the competence and growth of surgical residents as educators. We developed and piloted an observation-based feedback tool (FT) to provide residents direct feedback during a specific teaching session, as perceived by medical students (MS). We hypothesized that residents' performance would improve with frequent, low stakes, observation-based feedback. SETTING This prospective study took place at an academic general surgery program. PARTICIPANTS Focus groups of MS, surgical residents, and faculty informed FT development. MS completed the FT regarding resident teaching. DESIGN The FT utilized 5 slider-bar ratings (0 to 100) about the teaching encounter and a checklist of 16 desirable teaching behaviors. QR codes and weekly email links were distributed for 12 months (6 clerkship blocks) to promote use. Residents were sent their results after each block. A survey after each block assessed motivation for use and gathered feedback on the FT. Descriptive statistics were used for analysis (medians, IQRs). Primary measures of performance were median of the slider-bar scores and the number of teaching behaviors. RESULTS The FT was used 111 times; 37 of 46 residents were rated by up to 65 MS. The median rating on the slider-bars was 100 and the median number of desirable teaching behaviors was 12; there were no differences based on gender or PGY level. 10 residents had 5 or more FT observations during the year. Four residents had evaluations completed in 4 or more blocks and 19 residents had evaluations completed in at least 2 blocks. Over time, 13 residents had consistent slider-bar scores, 1 resident had higher scores, and 5 residents had lower scores (defined as a more than 5-point change from initial rating). Frequency of use of the FT decreased over time (38, 32, 9, 21, 7, 5 uses per block). The post-use survey was completed by 24 MS and 19 residents. Most common reasons for usage were interest in improving surgical learning environment, giving positive feedback (MS), and improving teaching skills (residents). Most common reasons for lack of usage from residents were "I did not think I taught enough to ask for feedback," "I forgot it existed," and "I did not know it existed." CONCLUSIONS The FT did not lead to any meaningful improvement in resident scores over the course of the year. This may be due to overall high scores, suggesting that the components of the FT may require reevaluation. Additionally, decreased utilization of the instrument over time made it challenging to assess change in performance of specific residents, likely due to lack of awareness of the FT despite frequent reminders. Successful implementation of observation-based teaching assessments may require better integration with residency or clerkship objectives.
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Affiliation(s)
- Emily Steinhagen
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES).
| | - Saher-Zahra Khan
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - Asya Ofshteyn
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - Kyla Terhune
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Luke Selby
- University of Kansas Medical Center, Department of Surgery, Kansas City, Kansas
| | | | - Sharon L Stein
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - John B Ammori
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
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Joel M, Iosif L, Grenda T, Tholey R. A Mentorship-Based Surgery Clerkship: A Prospective Study Investigating Student Satisfaction. J Surg Res 2024; 295:41-46. [PMID: 37980827 DOI: 10.1016/j.jss.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/12/2023] [Accepted: 10/16/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Interest in general surgery has steadily decreased among medical students due to negative perceptions of surgeons, a lack of meaningful clerkship involvement, and inadequate mentorship. We implemented a novel mentorship-based surgery clerkship (MBSC) in which each student was matched with a resident mentor with the goals of enhancing student learning experience, meaningfulness, and interest in surgery. We hypothesized that students participating in the MBSC would report increased confidence in surgical competencies, exposure to surgical faculty, and positive perception of surgery, with no detriment to clerkship grades. METHODS Mentors were instructed to provide the following when asked by the student: (1) weekly feedback; (2) personalized goals; (3) daily cases; (4) specific videos; (5) presentation subjects; (6) operating room skills coaching. A 5-point Likert Scale survey was distributed to the students pre and post clerkship, and median differences in Likert Scale Score pre and post mentorship were compared between mentored and control groups using the unpaired Wilcoxon's test. This was a two-arm, nonrandomized trial comparing traditional curriculum with the mentored program. RESULTS The total sample size was n = 84. When comparing mentored to control, Wilcoxon's analysis showed greater post clerkship increases in confidence in operating room etiquette (P = 0.03), participating in rounds (P = 0.02), and suturing (P < 0.01). There were greater increases in perceived surgeon compassion (P = 0.04), respectfulness (P < 0.01), and teaching ability (P < 0.01). Median scores for meaningfulness overall (P = 0.01) and as measured as a feeling of positively impacting a patient (P = 0.02) were also increased when comparing mentored to control. More students were encouraged by a surgeon to pursue surgery (P = 0.01) and consider a surgery career themselves (P = 0.02). CONCLUSIONS An MBSC increases meaningfulness, confidence, skills, and exposure in various surgical competencies. Compared to nonmentored students, MBSC students have more positive perceptions of surgeons and are more likely to pursue surgery.
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Affiliation(s)
- Marisa Joel
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Leah Iosif
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Tyler Grenda
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Renee Tholey
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
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Thompson B, Brag K. Twelve tips for integrating medical students into specialty clinics. MEDICAL TEACHER 2024; 46:337-340. [PMID: 37917992 DOI: 10.1080/0142159x.2023.2274620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
The specialty clinic is an excellent educational environment for medical students. However, preceptors face several challenges as they seek to balance treating complex system-specific conditions with effective teaching, including time constraints, clinical tasks, engaging multi-level learners, and perhaps a lack of guidelines for or training in outpatient medical education. We thus propose twelve tips for integrating medical students into specialty clinics in a feasible and mutually fulfilling way. The first three tips focus on planning the session and setting expectations, the next seven tips detail specific, actionable strategies for enhancing learning while maximizing efficiency, and the final two tips discuss how to optimally close the session with feedback and debriefing.
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Affiliation(s)
| | - Katherine Brag
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Duffy TL, Ahmad Y, Lewis GJ, Brazendale K. Investing in the Future: A Premedical Surgical Elective for Undergraduate Students. Am Surg 2024; 90:231-237. [PMID: 37625383 DOI: 10.1177/00031348231198109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND Research has shown that providing surgical exposure and mentorship before clerkship can bolster interest and cultivate quality surgical residents. However, most studies have focused exclusively on programs for 1st and 2nd year medical students. The purpose of this study is to describe a novel undergraduate premedical surgical elective (PMSE) and the interests and perceptions of PMSE participants of the surgical field. METHODS Undergraduate students applied for a semester long PMSE that included surgical shadowing, mentorship, a research component, attendance at seminars, and hands-on workshops. Post-PMSE completion, participants were invited to complete an online survey about their perceptions of pursuing a career in surgery and their specialties of interest. RESULTS Thirty-six PMSE participants completed the survey (21 females and 15 males). More than half (57%) of female respondents expressed interest in a surgical career. Most respondents (78%) agreed or strongly agreed that they are confident in their ability to become a surgeon. A lower proportion of female respondents (33%) believed the atmosphere of the surgical field to be inclusive than males (53%). Males accumulated significantly more surgical shadowing hours than females (P < .05). DISCUSSION Findings from this study describe a novel PMSE at a large undergraduate institution. Survey data of PMSE participants revealed a high proportion of female respondents would like to pursue a career in surgery and reported confidence in achieving this. However, females perceived the field to be less inclusive than male respondents. Improving inclusivity may require increased focus and attention by PMSEs and surgical education programs.
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Affiliation(s)
- Taylor L Duffy
- Department of Health Sciences, College of Health Professions and Sciences University of Central Florida, Orlando, FL, USA
| | - Yaser Ahmad
- Department of Biomedical Sciences, College of Medicine University of Central Florida, Orlando, FL, USA
| | - Gideon J Lewis
- Department of Medical Education, College of Medicine University of Central Florida, Orlando, FL, USA
| | - Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences University of Central Florida, Orlando, FL, USA
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Murray C, Stauffer-Macdowell C, Shenvi C. Medical Student Learning Experience With Attending or Resident Preceptors in the Emergency Department. Cureus 2023; 15:e47285. [PMID: 38021862 PMCID: PMC10656126 DOI: 10.7759/cureus.47285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The emergency department (ED) provides a unique learning environment for medical students. However, environment, patient, and preceptor factors limit standardized teaching. We explored the most effective educational interactions for fourth-year medical students during an emergency medicine (EM) clerkship designed to allow clinical interaction with both residents and faculty. Methods This is an exploratory, prospective, needs assessment study of objective cards and surveys submitted by medical students as part of their month-long fourth-year clinical rotation at a tertiary care academic ED. Students marked which topics or procedures they had reviewed, and who had precepted them. In an exit survey, students were asked to rate how often they received individualized teaching and whether their educational goals were met when working with residents and attendings. Qualitative and quantitative data were collected anonymously with institutional review board (IRB) exemption. Results Shift card data was collected from 69 of the rotating students. Attendings tended to precept visual diagnostics while residents tended to teach technical procedures. Forty-four students completed the exit survey. Results showed that students felt they received individualized teaching from both attendings and residents (7.9 and 8.0 respectively, p = 0.059). Students felt their goals were met more when reporting to the residents than the attendings but not significantly so (8.6 and 8.0, respectively, p = 0.088). Additional themes were that students wanted more individualized experiences with the attendings and requested more dedicated teaching shifts. Conclusions Fourth-year medical students in the ED felt they received individualized teaching on most shifts. They reported their education goals were met as often when working with residents as with attendings; however, interactions feature different educational content. Clerkship curricula design would benefit from resident and attending-directed teaching experiences to optimize the educational experience in the ED.
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Affiliation(s)
- Collyn Murray
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | | | - Christina Shenvi
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
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6
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Granruth CB, Esantsi ME, Sommi CP, Stamm MA, Mulcahey MK. Mentoring on Orthopedic Surgery Clinical Rotations: A Survey of Mentor Effectiveness on Student Mentees Compared to an Unmentored Control Group. JOURNAL OF SURGICAL EDUCATION 2023; 80:697-705. [PMID: 36890044 DOI: 10.1016/j.jsurg.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/05/2022] [Accepted: 02/08/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Mentorship is an important aspect of medical education in providing students guidance and connections to new opportunities, ultimately leading to increased productivity and career satisfaction. The purpose of this study was to design and implement a formal mentoring program between medical students participating in their orthopedic surgery rotation and orthopedic residents to determine if this relationship improved students' experiences during their rotation compared to students who were not mentored. DESIGN Third- and fourth-year medical students rotating in orthopedic surgery and PGY2-PGY5 orthopedic residents at one institution were eligible to participate in a voluntary mentoring program between the months of July and February during 2016 to 2019. Students were either randomly paired with a resident mentor (experimental group) or not (unmentored control group). Anonymous surveys were distributed to participants at weeks 1 and 4 of their rotation. There were no minimum number of meetings required between mentors and mentees. RESULTS Twenty-seven students (18 mentored, 9 unmentored) and 12 residents completed surveys during week 1. Fifteen students (11 mentored, 4 unmentored) and 8 residents completed surveys during week 4. While both mentored and unmentored students experienced an increase in enjoyment, satisfaction, and level of comfort at week 4 compared to week 1, the unmentored group demonstrated a greater overall increase. However, from the perspective of the residents, excitement for the mentoring program and the perceived value of mentoring decreased and 1 (12.5%) resident felt that it detracted from their clinical responsibilities. CONCLUSION While formal mentoring enhanced the experience of medical students on orthopedic surgery rotations, it did not substantially improve medical student perceptions when compared to students who did not receive formal mentoring. The greater satisfaction and enjoyment observed in the unmentored group may be explained by informal mentoring that naturally occurs among students and residents with similar interests and goals.
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Affiliation(s)
- Caroline B Granruth
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Michael E Esantsi
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Corinne P Sommi
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Michaela A Stamm
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
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Jarvis-Selinger S, Armstrong A, Wisener K. The More Things Change, the More They Stay the Same: Residents Perspectives on Learning to Teach Over 7 Years. JB JS Open Access 2023; 8:JBJSOA-D-22-00133. [PMID: 37274129 PMCID: PMC10237712 DOI: 10.2106/jbjs.oa.22.00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Despite increasing emphasis on the development and implementation of Residents-as-Teachers programs, resident perspectives on their roles as teachers have rarely been explored. This paper explores trends across 7 years of data collected from resident leaders across North American orthopaedic residency programs. Methods Data were collected during the American Orthopaedic Association's resident-only engagement activity known as the C. McCollister Evarts Resident Leadership Forum (RLF). A total of 997 of 1,050 RLF participants responded from 2015 to 2021. Results Residents perceived themselves as having a strong influence on medical students' education more so than any other teacher. However, less than one third are provided with any formal instruction from their institutions to support their teaching, and nearly 3 quarters of participants felt there was room for improvement in their teaching effectiveness. For the most part, resident perspectives have stayed relatively consistent over time. Discussion Residents are keen and willing to invest time into developing their teaching effectiveness. There may be a need for improved advocacy to program directors to increase the presence and availability of formal Residents-as-Teachers programs to support residents in their roles as teachers. We offer suggestions for the composition of such programs for consideration.
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Affiliation(s)
| | - April Armstrong
- April Armstrong, Pennsylvania State Health, Hershey, Pennsylvania
| | - Katherine Wisener
- Sandra Jarvis-Selinger, University of British Columbia, Vancouver, Canada
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Coe TM, McKinley SK, Hamdi I, Sinyard RD, Jogerst KM, Pradarelli AA, Petrusa E, Moses J, Saillant N, Phitayakorn R. The Big Sibling program: Impact of a medical student-resident mentorship program during the surgery clerkship. Am J Surg 2023; 225:650-655. [PMID: 35871028 DOI: 10.1016/j.amjsurg.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/19/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND We created a Big Sibling mentorship program for medical students and studied the program effects. METHODS Between July 2019 to December 2020, students completing their surgery clerkship were paired with a Big Sibling surgical research resident. Participation in and perceptions of the program were assessed by survey. RESULTS 81 medical students and 25 residents participated with a 79% and 95% survey response rate, respectively. The most valuable topics discussed included ward skills, personal development and career advising. Students who interacted >2 times with their Big Sibling were more likely to perceive the operating room as a positive learning environment, view attendings as role models, and receive mentoring and feedback from residents and attendings (p = 0.03, 0.02, 0.01 respectively). 78% of residents thought the program was a positive experience and no residents found it burdensome. CONCLUSION The Big Siblings program enhances the surgery clerkship learning environment. Students who engaged with their Big Sibling had a more positive view of the clerkship and the mentorship provided by residents and attendings.
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Affiliation(s)
- Taylor M Coe
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Isra Hamdi
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Robert D Sinyard
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Kristen M Jogerst
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Joy Moses
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
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Hoyler MM, Pryor KO, Gotian R, Brumberger ED, Chan JM. Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review. Anesth Analg 2023; 136:270-281. [PMID: 36638511 DOI: 10.1213/ane.0000000000006243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.
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Affiliation(s)
- Marguerite M Hoyler
- From the Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York
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Tomei KL, Selby LV, Kirk LM, Bello JA, Nolan NS, Varma SK, Turner PL, Elliott VS, Brotherton SE. Beyond Training the Next Generation of Physicians: The Unmeasured Value Added by Residents to Teaching Hospitals and Communities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1592-1596. [PMID: 35731593 PMCID: PMC9592142 DOI: 10.1097/acm.0000000000004792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Following medical school, most newly graduated physicians enter residency training. This period of graduate medical education (GME) is critical to creating a physician workforce with the specialized skills needed to care for the population. Completing GME training is also a requirement for obtaining medical licensure in all 50 states. Yet, crucial federal and state funding for GME is capped, creating a bottleneck in training an adequate physician workforce to meet future patient care needs. Thus, additional GME funding is needed to train more physicians. When considering this additional GME funding, it is imperative to take into account not only the future physician workforce but also the value added by residents to teaching hospitals and communities during their training. Residents positively affect patient care and health care delivery, providing intrinsic and often unmeasured value to patients, the hospital, the local community, the research enterprise, and undergraduate medical education. This added value is often overlooked in decisions regarding GME funding allocation. In this article, the authors underscore the value provided by residents to their training institutions and communities, with a focus on current and recent events, including the global COVID-19 pandemic and teaching hospital closures.
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Affiliation(s)
- Krystal L. Tomei
- K.L. Tomei is associate professor of pediatric neurosurgery, Rainbow Babies & Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Luke V. Selby
- L.V. Selby is assistant professor of surgery, Department of Surgery, Division of Colorectal and Oncologic Surgery, University of Kansas Medical Center, Kansas City, Kansas; ORCID: https://orcid.org/0000-0002-0202-9646
| | - Lynne M. Kirk
- L.M. Kirk is chief of accreditation and recognition, Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Jacqueline A. Bello
- J.A. Bello is director of neuroradiology and professor of radiology and neurosurgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York
| | - Nathan S. Nolan
- N.S. Nolan is medical education fellow and infectious disease physician, Washington University Hospital, St. Louis, Missouri
| | - Surendra K. Varma
- S.K. Varma is executive associate dean for graduate medical education and resident affairs, university distinguished professor, and vice chair, Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas
| | - Patricia L. Turner
- P.L. Turner is executive director, American College of Surgeons, and clinical associate professor of surgery, University of Chicago Medicine, Chicago, Illinois
| | - Victoria Stagg Elliott
- V.S. Elliott is a technical writer, Medical Education Outcomes, American Medical Association, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-1223-0084
| | - Sarah E. Brotherton
- S.E. Brotherton is director, Data Acquisition Services, American Medical Association, Chicago, Illinois
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Katz SJ, Wang D. Comparing Entrustable Professional Activity Scores Given by Faculty Physicians and Senior Trainees to First-Year Residents. Cureus 2022; 14:e25798. [PMID: 35836450 PMCID: PMC9273189 DOI: 10.7759/cureus.25798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 11/05/2022] Open
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Rudasill S, Negrete Manriquez JA, Benharash P, Kim D, Yetasook A, Bowens N, de Virgilio C. Association between Participation in a Preclinical Surgery Elective and Future Match into Surgical Residency. Am Surg 2022:31348221074242. [PMID: 35099317 DOI: 10.1177/00031348221074242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since 2013, we have offered a robust "Introduction to Surgery" elective (ITS) for preclinical medical students. The present study investigates whether participants of the ITS elective were more likely to match into surgical residencies than non-ITS participants. METHODS This is a retrospective case-control study of medical students from two medical schools in Southern California who participated in the ITS elective and those who did not. Descriptive results and univariate analysis using STATA were utilized to analyze the de-identified data who matched between 2016 and 2021 were included. RESULTS Overall, 87 (8.9%) of the 982 matched students participated in the ITS elective, with an increase in participation from 1.2% in 2016 to 13.9% in 2021 (P < .001). Among ITS participants, 49.4% matched into a surgical specialty compared to only 22.9% for non-ITS students (P < .001). There was no difference between ITS and non-ITS students with regards to procedural specialty match (14.9% vs 12.6%, P = .537). CONCLUSION ITS participants were more than twice as likely to match into a surgical specialty than non-participants. Future qualitative research will help discern the relative impact of the ITS course versus a student's baseline predisposition to surgery.
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Affiliation(s)
- Sarah Rudasill
- Department of Surgery, 2348Massachusetts General Hospital, Boston, MA, USA
| | - Jose A Negrete Manriquez
- David Geffen School of Medicine, 5140University of California, Los Angeles, CA, USA.,College of Medicine, 21640Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, 12222University of California, Los Angeles, CA, USA
| | - Dennis Kim
- Department of Surgery, 21640Harbor UCLA Medical Center, Torrance, CA, USA
| | - Amy Yetasook
- Department of Surgery, 21640Harbor UCLA Medical Center, Torrance, CA, USA
| | - Nina Bowens
- Department of Surgery, 21640Harbor UCLA Medical Center, Torrance, CA, USA
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13
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Hao KA, Fu S, Islam S, Larson SD, Mustafa MM, Petroze RT, Taylor JA. Medical Student Career Choice: Who Is the Influencer? J Surg Res 2021; 272:9-16. [PMID: 34922268 DOI: 10.1016/j.jss.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND While many factors influence medical student career choice, interactions with attending and resident physicians during clinical rotations are particularly important. To evaluate the influence of attending and resident physicians on medical students' career choices, particularly for those pursuing surgical careers, we quantified their respective influence in the context of other known influences. METHODS Rising fourth-year medical students and new graduates were given an IRB-exempt, 14-item online survey. Descriptive statistics were performed on the demographic information. Chi-square analysis was used, as were Kruskal-Wallis and Mann-Whitney analyses on the Likert responses (α = 0.05). RESULTS Survey response was 24%. Students pursuing general surgery rated residents greater than or equal to attendings on 7 of 8 key mentoring characteristics. Of students choosing a different specialty than the one they intended to pursue upon entering medical school, the influence of residents was cited by 100% of the students pursuing general surgery, compared to 59% of the entire cohort. Identification of a role model and perceived personality fit were significantly more important than other factors (P < 0.0001). Students pursuing general surgery rated the importance of identifying a role model and perceived personality fit greater than their peers. CONCLUSIONS Residents have greater influences on medical students' career choice compared to attendings. Students pursuing a surgical specialty, particularly general surgery, considered the influence of role models and perceived personality fit to be the most important factors in their specialty decision. These findings provide valuable insights to improve student experiences and career recruitment in surgical specialties, particularly general surgery.
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Affiliation(s)
- Kevin A Hao
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Shengyi Fu
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Saleem Islam
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Shawn D Larson
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Moiz M Mustafa
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Robin T Petroze
- Department of Surgery, University of Florida, Gainesville, Florida
| | - Janice A Taylor
- Department of Surgery, University of Florida, Gainesville, Florida.
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Thomas C, Plumblee L, Dieffenbaugher S, Talley C. Teaching on Rounds and in Small Groups. Surg Clin North Am 2021; 101:555-563. [PMID: 34242599 DOI: 10.1016/j.suc.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bedside teaching plays a vital role the training future physicians, allowing for instruction in history taking, physical examination skills, differential diagnosis development, professionalism, teamwork integration, effective communication, and discussions of medical ethics. Due to changes in the health care system, accreditation bodies, and shortened admittance of patients, rates of bedside teaching have declined. Attending surgeons feel increased external pressures to meet performance metrics while resident physicians adhere to duty hour restrictions. This article highlights popular methods, including bedside rounds, near-peer teaching, and resident versus attending preceptors, and discusses how teaching on rounds has an impact on patients.
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Affiliation(s)
- Christopher Thomas
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Leah Plumblee
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Sean Dieffenbaugher
- Carolinas Medical Center, Atrium Health, Department of Surgery, 1000 Blythe Boulevard, MEB Office 601, Charlotte, NC 28203, USA
| | - Cynthia Talley
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
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Attracting the Best Students to a Surgical Career. Surg Clin North Am 2021; 101:653-665. [PMID: 34242607 DOI: 10.1016/j.suc.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The predicted shortage of surgeons in the future workforce is already occurring in rural areas and is expected to worsen. US allopathic medical school graduates have been losing interest in surgery for the past 40 years. The residency match remains unaffected because of foreign and osteopathic applicants. Negative myths regarding surgeon training, lifestyle, and personality persist among medical students, proving to be a powerful deterrent to students who might consider a surgical career. Proven strategies for making surgery more attractive to students are not always used and can be as simple as getting early exposure to students before clinical rotations.
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Sorab P, Benza AR, Patterson IT, Kelly LD. Impact of Resident-Led Small-Group Learning Sessions on Preclinical Students' Perceptions of Ophthalmology. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0040-1722742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Abstract
Introduction Resident physicians have a significant role in the education of medical students, and limited research has demonstrated that positive interactions with residents are linked with enhanced students’ perceptions of a specialty. Minimal research on residents as teachers has been done in ophthalmology, and no research has examined the impact of residents as teachers on the perceptions of preclinical students. This is an important area of interest because ophthalmology conducts an early match. The competitiveness of the field increases the importance of early involvement in research and clinical activities. This study aimed to assess the role of a resident-led workshops as a vehicle for exposing preclinical students to ophthalmology.
Methods A 2-hour workshop on the Ophthalmology Clinical Skills was held at the University of Cincinnati College of Medicine in November 2018. The workshop was conducted by seven ophthalmology residents, and the learners were 15 first-year and 11 second-year medical students. The workshop format consisted of a 30-minute introductory lecture on the field of ophthalmology, followed by a 60-minute small-group clinical skills’ session focusing on direct ophthalmoscopy and slit lamp examination. Preworkshop and postworkshop surveys were administered to the medical students, and Student’s paired sample t-test was used to assess the differences in responses before and after the workshop.
Results Students’ average interest in ophthalmology rose (p = 0.049) as did their likeliness to approach a resident for career advice (p = 4.65 × 10−6) and their likeliness to attend the Secrets of the Match Lunch talk, a yearly talk held by a student matched into ophthalmology (p = 0.002).
Conclusion These results suggest that resident intervention can have a positive impact on preclinical students’ perceptions of ophthalmology and may be a good educational strategy to foster their positive attitudes toward the field.
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Affiliation(s)
- Priya Sorab
- University of Cincinnati College of Medicine Department of Ophthalmology, Cincinnati, OH
| | - Andrew R. Benza
- University of Cincinnati College of Medicine Department of Ophthalmology, Cincinnati, OH
| | - Ian T. Patterson
- University of Cincinnati College of Medicine Department of Ophthalmology, Cincinnati, OH
| | - Lisa D. Kelly
- University of Cincinnati College of Medicine Department of Ophthalmology, Cincinnati, OH
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Zessis NR, Dube AR, Sadanand A, Cole JJ, Hrach CM, Daud YN. Teaching scripts via smartphone app facilitate resident-led teaching of medical students. BMC MEDICAL EDUCATION 2021; 21:331. [PMID: 34103029 PMCID: PMC8185492 DOI: 10.1186/s12909-021-02782-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). METHODS Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. RESULTS 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. CONCLUSIONS Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.
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Affiliation(s)
- Nicholas R Zessis
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 152, Chicago, IL, 60611, USA.
| | - Amanda R Dube
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Arhanti Sadanand
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jordan J Cole
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Christine M Hrach
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yasmeen N Daud
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
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Trinh LN, O'Rorke E, Mulcahey MK. Factors Influencing Female Medical Students' Decision to Pursue Surgical Specialties: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2021; 78:836-849. [PMID: 32933885 DOI: 10.1016/j.jsurg.2020.08.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/02/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Gender inequality within the medical field continues to be a prominent issue, particularly for surgical specialties. The purpose of this systematic review was to evaluate the factors that influence female medical students' decision to pursue a career in surgery, including general surgery and surgical subspecialties. METHODS A literature search was conducted by 2 independent researchers searching PubMed, Embase, Medline, Web of Science, and Science Direct databases, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Keywords included "female," "medical students," "surgery," "gender," "career," "surgical subspecialty," "plastic surgery," "otolaryngology," "neurosurgery," "orthopedics," and "urology." Studies evaluating factors that influenced female medical students' decision to pursuing surgical specialties were identified. RESULTS The initial search identified 2200 articles. Five hundred twenty-seven duplicates were removed, and 1993 studies were eliminated based on inclusion and exclusion criteria. Sixty-one articles underwent full-text review. Twenty-six additional studies were identified from references. A total of 14 articles were included in the review. Female medical students were positively influenced by mentorship, intellectual challenge, the rewarding nature of surgery, and specialty exposure. Gender discrimination, surgical lifestyle, and societal and cultural barriers were deterrents for female medical students. Compared to male, females minimized the importance of prestige and expected financial rewards. CONCLUSIONS This systematic review identifies mentorship, specialty exposure, nature of the surgical field, gender discrimination, and personal factors to be major determinants in female medical students' decisions to pursue a career in surgery. While factors such as inherent interest in surgery may not be easily modified, improvements in gender discrimination, access to mentorship, and specialty exposure can attract more female trainees to surgical specialties. Specifically, improving parental leave policies, reducing pregnancy-related stigma, eliminating gender-discrimination, matching medical students with role models early, and implementing outreach programs designed for women may increase students' interest in a surgical career.
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Affiliation(s)
- Lily N Trinh
- Tulane University School of Medicine, New Orleans, Louisiana.
| | - Erin O'Rorke
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
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Demetri L, Donnelley CA, MacKechnie MC, Toogood P. Comparison of Case-Based Learning and Traditional Lectures in an Orthopedic Residency Anatomy Course. JOURNAL OF SURGICAL EDUCATION 2021; 78:679-685. [PMID: 32888846 DOI: 10.1016/j.jsurg.2020.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/18/2020] [Accepted: 08/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The impact of new pedagogical methods such as case-based learning (CBL) rather than traditional lectures in graduate medical education is poorly defined. We hypothesized that using CBL in lieu of lectures in an orthopedic surgery residency anatomy course would lead to increased resident engagement, improved resident satisfaction, and similar knowledge acquisition. DESIGN A prospective, observational study design was used. CBL sessions were developed for an orthopedic surgery residency anatomy course. Content was delivered in 6 sessions (3 traditional lecture-based and 3 CBL) taught by the same attending surgeon. Engagement was measured every 10 minutes by 2 trained observers using a standardized protocol. Resident satisfaction was surveyed and knowledge acquisition tested. Data from the course were scored separately for CBL verses lectures and compared statistically. SETTING Orthopedic surgery residency program at the University of California, San Francisco. PARTICIPANTS Orthopedic surgery interns and residents (n = 35). RESULTS No significant differences were measured in resident engagement (83% vs 85%, p = 0.664) or in knowledge acquisition (84% vs 78%, p = 0.056) in CBL verses lecture sessions, respectively. CBL sessions were judged equally valuable compared to lectures with high satisfaction rates across all survey measures. CONCLUSIONS Residents demonstrated similar engagement and satisfaction with CBL compared to lectures with equivalent knowledge acquisition, suggesting both pedagogical methods are effective for a highly motivated group of learners.
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Affiliation(s)
- Leah Demetri
- Department of Orthopaedic Surgery, University of San Francisco, California, San Francisco, California
| | - Claire A Donnelley
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of San Francisco, San Francisco, California
| | - Madeline C MacKechnie
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of San Francisco, San Francisco, California
| | - Paul Toogood
- Department of Orthopaedic Surgery, University of San Francisco, California, San Francisco, California.
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Shin TH, Klingler M, Han A, Mocsiran JL, Vilchez V, Naples R, French J, Lipman JM, Rosenblatt S. Efficacy of Virtual Case-Based General Surgery Clerkship Curriculum During COVID-19 Distancing. MEDICAL SCIENCE EDUCATOR 2021; 31:101-108. [PMID: 33200037 PMCID: PMC7654350 DOI: 10.1007/s40670-020-01126-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The COVID-19 pandemic created a paradigm shift in medical education with a reliance upon alternative teaching methods to deliver meaningful surgery clerkship content. This study examines the efficacy of a novel, case-based virtual surgery clerkship curriculum to determine its impact on student experience during quarantine. STUDY DESIGN Sixteen third-year medical students enrolled in the General Surgery clerkship between April through June 2020 during COVID-19 distancing at a quaternary medical center (Cleveland Clinic, Cleveland, OH) participated in this study. Course surveys, including a 10-question curriculum-based multiple-choice assessment, were administered before and after the clerkship. Analyses include student self-perception of readiness to see a surgical consult independently, students' interest in pursuing a General Surgery residency, and improvement of surgical knowledge. RESULTS AND CONCLUSION On a 5-point Likert scale, students felt significantly more assured in their ability to independently assess a surgical consult by the end of the course. Five (31%) students reported an influence of the curriculum on their personal interest in a career in General Surgery. Mean scores on the curriculum-based knowledge assessment increased. These findings highlight that a virtual platform can be a reliable alternative adjunct that delivers surgical content and positively impacts student experience. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-020-01126-5.
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Affiliation(s)
- Thomas H. Shin
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Michael Klingler
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Amy Han
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Jennifer L. Mocsiran
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Valery Vilchez
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Robert Naples
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Judith French
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Jeremy M. Lipman
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
| | - Steven Rosenblatt
- Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH 44195 USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA
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The Influence of an Acting or Subintern on Third-Year Medical School Surgery Clerkship Students. J Surg Res 2020; 259:8-13. [PMID: 33278797 DOI: 10.1016/j.jss.2020.11.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/14/2020] [Accepted: 11/01/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous reports demonstrated a positive relationship between the surgical clerkship and student likelihood of pursuing a surgical career, but no studies have examined the influence a peer has on comfort during a surgical clerkship. We hypothesized that a fourth-year acting intern (AI) would positively impact third-year medical students' experience during their surgical clerkship. METHODS All third-year medical students at our institution who completed their surgical clerkship in 2019 were surveyed regarding the preclerkship and postclerkship perceptions. RESULTS Of the 110 students surveyed, 52 responded (47.3% response rate), and 25 students (48.1%) reported having an AI during their clerkship rotation, and 27 did not (51.9%). Presence of an AI had no significant effect on the postclerkship perception of surgery, likelihood of pursuing general surgery, or comfort in the OR. Analysis of all responses demonstrated the surgery clerkship had no significant impact on students' perception of surgery or likelihood of pursuing general surgery but did statistically increase students' comfort in the OR. CONCLUSIONS The results of this study suggest that AI presence did not significantly influence a student's clerkship experience or comfort in the OR. Further studies are needed to determine what, if any effect, an AI could have on third-year clerkship students.
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McKinley SK, Cassidy DJ, Sell NM, Mullen JT, Saillant N, Petrusa E, Phitayakorn R, Gee D. A qualitative study of the perceived value of participation in a new Department of Surgery Research Residents as teachers program. Am J Surg 2020; 220:1194-1200. [PMID: 32723491 DOI: 10.1016/j.amjsurg.2020.06.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/06/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aims to understand the perspectives of surgical residents who completed a Research Residents as Teachers Program (RRATP). METHODS Our RRATP included a 6 h workshop followed by formal teaching opportunities across one academic year. Resident teachers participated in semi-structured interviews, which were inductively analyzed for prominent themes. RESULTS Eight surgical research residents completed the RRATP workshop and taught 330 h (median = 26 h, range: 8-105). Interview participation rate was 100%; kappa was 0.81. Residents reported four themes: 1) increased knowledge of teaching principles with subsequent teaching changes, specific factors that contributed to their development as a teacher, numerous personal benefits to participation, and broad positive consequences for the surgical department including improved culture and patient care. CONCLUSION A RRATP can generate a significant number of formal teaching hours by surgical research residents, who perceive a high value of formal education training to themselves and their surgical residency program.
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Affiliation(s)
- Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Naomi M Sell
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
| | - Denise Gee
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, USA.
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Training-Module for Residents in Medical Educational Technologies (TRIM): Need and Operational Strategies. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-2000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McKinley SK, Cassidy DJ, Mansur A, Saillant N, Ghosh A, Evenson A, Askari R, Haynes A, Cho N, James BC, Olasky J, Rangel E, Petrusa E, Phitayakorn R. Identification of Specific Educational Targets to Improve the Student Surgical Clerkship Experience. J Surg Res 2020; 254:49-57. [PMID: 32408030 DOI: 10.1016/j.jss.2020.03.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/12/2020] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study describes the relationship between medical student perception of surgery, frequency of positive surgery clerkship activities, and overall surgical clerkship experience. METHODS Medical students at four academic hospitals completed pre- and post-clerkship surveys assessing 1) surgery clerkship activities/experiences and 2) perceptions of surgery during the 2017-2018 academic year. RESULTS Ninety-one percent of students completed both a pre- and post-clerkship survey (n = 162 of 179). Student perception of surgery significantly improved across the clerkship overall (P < 0.0001) and for 7 of 21 specific items. Eighty-six percent of students agreed that the clerkship was a meaningful experience. Sixty-six percent agreed that the operating room was a positive learning environment. Multivariable logistic regression identified one-on-one mentoring from a resident (OR [95% CI] = 2.12 [1.11-4.04], P = 0.02) and establishing a meaningful relationship with a surgical patient (OR = 2.21 [1.12-4.37], P = 0.02) as activities predictive of student agreement that the surgical clerkship was meaningful. Making an incision (OR = 2.92 [1.54-5.56], P = 0.001) and assisting in dissection (OR = 1.67 [1.03-2.69], P = 0.035) were predictive of student agreement that the operating room was a positive learning environment. Positive student perception of surgery before the clerkship was associated with increased frequency of positive clerkship activities including operative involvement (r = 0.26, P = 0.001) and relationships with surgical attendings (r = 0.20, P = 0.01), residents (r = 0.41, P < 0.0001), and patients (r = 0.24, P = 0.003). CONCLUSIONS Interventions to improve surgery clerkship quality should target enhancing student relationships with residents and surgical patients as well as providing opportunity for student operative involvement beyond just suturing. In addition, fostering positive perceptions of surgery in the preclinical period may increase meaningfulness and experience with the later surgery clerkship.
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Affiliation(s)
- Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arian Mansur
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Amy Evenson
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Reza Askari
- Harvard Medical School, Boston, Massachusetts
| | - Alex Haynes
- Department of Surgery, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts
| | - Nancy Cho
- Harvard Medical School, Boston, Massachusetts
| | - Benjamin C James
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Jaisa Olasky
- Department of Surgery, Dell Medical School, University of Texas, Austin, Texas
| | | | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Shah P, Zuckerman SP, Thompson C, Pantel AR, Rubinstein NA, Galperin-Aizenberg M, Scanlon MH, Nachiappan AC. First-Year Radiology Residents Teaching Anatomy to First-Year Medical Students: A Symbiotic Relationship. Curr Probl Diagn Radiol 2020; 49:157-160. [DOI: 10.1067/j.cpradiol.2019.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/26/2019] [Accepted: 02/06/2019] [Indexed: 11/22/2022]
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Ng CWQ, Syn NL, Hussein RBM, Ng M, Kow AWC. Push and pull factors, and the role of residents in nurturing medical students' interest in surgery as a career option in a multicultural Asian context: Results of a prospective national cohort study. Am J Surg 2020; 220:1549-1556. [PMID: 32591071 DOI: 10.1016/j.amjsurg.2020.04.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/12/2020] [Accepted: 04/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Studies in Caucasian populations suggest that interest among medical students in pursuing a surgical career is dwindling. We sought to investigate these trends and to evaluate the impact of resident teaching in a multiethnic Asian population. STUDY DESIGN Between 2015 and 2017, 1780 Singaporean third- and fifth-year medical students completed a structured anonymized questionnaire following the completion of an 8-week general surgery rotation. Medical students' impressions of their faculty and resident mentors were analyzed using hierarchical multilevel mixed-effects models. RESULTS Respondents' opinions of general surgery improved from 3.31 ± 0.91 points to 4.03 ± 0.83 points on a 5-point Likert scale (P < 0.0001). Medical students were more likely to regard their interaction with residents as a "pull" factor compared to their interaction with faculty members (74.7% vs 65.6%; P < 0.0001). Our analyses revealed 9 statistically-significant "pull" factors and 5 "push" factors which attract or deter Asian medical students from a career in surgery. Comparing the pedagogical qualities of resident and faculty mentors, we found that residents surpassed faculty mentors in 9 domains, had comparable appraisal scores on 3 domains, and fared worse than faculty on 8 domains. Importantly, residents fared better at promoting interest in a surgical career (P = 0.0006) and influencing the career aspirations of medical students (P < 0.0001) compared with faculty members. CONCLUSIONS To our knowledge, this is the largest study from a Southeast Asian country providing representative sample numbers. With this knowledge of pull and push factors, the surgical clerkship can be improved by emphasizing pull factors and preparing students to cope with the push factors. Finally, our findings suggest that roping in residents as mentors to medical students may improve the pipeline of students interested in pursuing surgery after medical school.
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Affiliation(s)
- Celene Wei Qi Ng
- Department of Surgery, University Surgical Cluster, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas L Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Maggie Ng
- Department of Surgery, University Surgical Cluster, National University Hospital, Singapore
| | - Alfred Wei Chieh Kow
- Department of Surgery, University Surgical Cluster, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Sansosti AA, Jacobs RC, Safonova A, Jani RH, Schumann J, Friedlander RM, Lunsford LD, McDowell MM, Sekula RF. Impact of a Hands-on Pre-Clinical Neurosurgery Elective Course on Second-Year Medical Student Interest and Attitudes. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520964852. [PMID: 33150209 PMCID: PMC7580150 DOI: 10.1177/2382120520964852] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Medical student involvement opportunities and educational experiences with surgical residents during medical school have been shown to increase the chance of students deciding to specialize in surgical specialties. This study aims to determine the effect of a neurosurgery elective during the second preclinical year on student interest and opinion of neurosurgery. METHODS Thirty-nine students completed opinion-based surveys and factual knowledge quizzes during a neurosurgical elective course over 3 iterations, which included lecture and skills lab instruction. Pre- and post-course surveys used the Likert scale, with a score of 1 corresponding to the most negative opinion and a score of 10 corresponding to the most positive opinion, in order to measure various aspects including interest in neurological surgery, understanding of the field, and perception of female inclusion in the field. Weekly pre- and post-lecture quizzes assessed practical knowledge of neurosurgical topics. RESULTS A higher percentage of students rated neurosurgery highly as a career possibility (⩾8/10 interest level) post-course (58.6%) compared to pre-course (45.7%). Post-course, students reported a significantly increased mean understanding of neurosurgery on the Likert scale compared to pre-course (6.1 ± 1.7 vs 4.4 ± 2.0; P = .001). Knowledge based-content assessment revealed a significant increase in overall correct answers after lectures (meanpre = 3.85, meanpost = 5.05, P = .001). Inclusion of female instructors in the second and third iteration of the course resulted in a significant increase in students' perception of female inclusion in the field of neurosurgery (7.6 compared to 5.6, P = .01). CONCLUSIONS Early exposure to subspecialties may assist in making important career decisions. The implementation of this neurosurgical elective improved medical students' perception of the field and enhanced knowledge of the lectures and procedures. This study can be used as a framework for implementation of this curriculum at other institutions.
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Affiliation(s)
| | | | | | | | | | - Robert M Friedlander
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - L Dade Lunsford
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Michael M McDowell
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Raymond F Sekula
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Alberti H, Rosenthal J, Kirtchuk L, Thampy H, Harrison M. Near peer teaching in general practice: option or expectation? EDUCATION FOR PRIMARY CARE 2019; 30:342-346. [PMID: 31496435 DOI: 10.1080/14739879.2019.1657363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
General Practice (GP) trainees who teach medical students do so as near peers with established educational benefits for all concerned. Through teaching, GP trainees consolidate their own knowledge and skills whilst students value the experience of learning from teachers closer in age and stage. Importantly, involving GP trainees as teachers increases primary care teaching capacity and promotes GP as a potential career option for undergraduates. However, whilst junior doctors are often to be found teaching on hospital wards and in clinics, GP trainees based in primary care appear to have fewer opportunities to teach. This article encourages the promotion of near peer teaching in primary care on several levels. We make practical suggestions of potential benefit to the individual GP trainee, trainer and practice. We also discuss ways in which key stakeholders, including medical schools and those organising post-graduate primary care training programmes, may promote near peer teaching in GP. We propose that all medical students should have experience of being taught by GP trainees, and that all future general practitioners should have training and experience of teaching undergraduate medical students.
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Affiliation(s)
- Hugh Alberti
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Joe Rosenthal
- Department of Primary Care and Population Health, University College London, London, UK
| | - Liza Kirtchuk
- School of Population Sciences and Health Services Research, King's College London School of Medicine, London, UK
| | - Harish Thampy
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Michael Harrison
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Dick ML, Henderson M, Wei Y, King D, Anderson K, Thistlethwaite J. A systematic review of the approaches to multi-level learning in the general practice context, using a realist synthesis approach: BEME Guide No. 55. MEDICAL TEACHER 2019; 41:862-876. [PMID: 31012386 DOI: 10.1080/0142159x.2019.1595554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Recent global increases in medical student numbers and shifts in medical education from teaching hospitals to community settings call for effective strategies to meet the demand for general practice teaching placements. It has been proposed that "multi-level learning" (MLL), in which learning and teaching are shared across different levels of learners, may provide teaching efficiencies and valuable experiences for learners and teachers. Aims: To identify, evaluate and synthesize the evidence related to the types, benefits, challenges, and facilitators of MLL in community-based general practice, and the underlying mechanisms and associated contexts to explain the reported outcomes. Method: A realist synthesis approach guided the systematic review. Results: Fifteen papers were identified, providing primary evaluation data predominantly from interviews with or surveys of key stakeholders. Generally, all levels of learners reported overall satisfaction with their MLL experiences. Medical students appreciated learning from prevocational doctors and registrars due to social and cognitive congruence. Mechanisms and contexts that supported our hypotheses regarding successful MLL outcomes were identified, with "a strong teaching culture" being a major mechanism. Conclusions: The findings can help inform practices considering the implementation or enhancement of MLL initiatives in general practice. Further research should include measuring defined learning outcomes.
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Affiliation(s)
- Marie-Louise Dick
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Margaret Henderson
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Yi Wei
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - David King
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Katrina Anderson
- Academic Unit of General Practice, Australian National University Medical School , Canberra , Australia
| | - Jill Thistlethwaite
- Faculty of Arts and Social Sciences, University of Technology Sydney , Australia
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Schuman AD, Heisel CJ, Black KM, Matusko N, Gilbert CM, James CL, Reddy RM. Student Factors That Influence Clerkship Grades and Matching Into a Surgical Residency. JOURNAL OF SURGICAL EDUCATION 2019; 76:393-400. [PMID: 30401615 DOI: 10.1016/j.jsurg.2018.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 07/23/2018] [Accepted: 08/23/2018] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Evaluate the relationship between medical school factors (including preclinical mentorship, order of clerkships, and clerkship grades) and matching into surgical specialties. DESIGN Clerkship information, match data, and data on structured preclinical research obtained from 2010 to 2015 for a single institution was obtained and analyzed using multivariate analysis. SETTING University of Michigan Medical School. PARTICIPANTS Seven hundred and forty-six students who took both the Internal Medicine and Surgery clerkships between 2010 and 2015 and have since participated in the match. RESULTS Among 740 students studied, 243 matched into a surgical field. Higher Shelf scores were associated with higher clerkship grades in Surgery and Internal Medicine. Honors or High Pass in Surgery were associated with matching into a surgical field. Structured preclinical research in Surgery and order of clerkship were not associated with matching into a surgical field. CONCLUSIONS Students who went into surgery were more likely to receive Honors or High Pass. Preclinical choices geared toward a surgical specialty (e.g., order of clerkship and structured research) were not associated with matching into a surgical field. These data may help guide school specific advice for students.
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Affiliation(s)
- Ari D Schuman
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | - Niki Matusko
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | - Rishindra M Reddy
- University of Michigan Medical School, Ann Arbor, Michigan; Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan.
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Laitman BM, Malbari A, Friedman S, Moerdler S, Kase S, Gibbs K. Preseason Pediatrics: an Interactive Preclinical Curriculum Enhances Knowledge and Skills in Medical Students. MEDICAL SCIENCE EDUCATOR 2019; 29:233-239. [PMID: 34457472 PMCID: PMC8368684 DOI: 10.1007/s40670-018-00676-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Medical students have limited preclinical exposure to pediatrics. We created an optional preclinical curriculum for first-year medical students called "Preseason Pediatrics" (PSP). This 6-month curriculum teaches pediatric-specific knowledge and clinical skills, consisting of monthly resident-led didactic sessions followed by complementary resident-mentored clinical experiences. METHODS Participants completed a survey before and after completion of PSP. Knowledge was assessed with multiple-choice questions pertaining to each topic covered in PSP and perceived skills, with a 5-point Likert scale ranging from not at all (1) to extremely (5) for skills taught. Skill maintenance was assessed with a newborn objective structured clinical exam (OSCE) 6 months after PSP completion in 2016. Students beginning their pediatric clerkship also completed a survey, comparing students who did and did not complete PSP. RESULTS From 2014 to 2017, 135 first-year medical students participated. Percent correct scores on pediatric knowledge increased in 4/5 topics covered, and students perceived increases in their pediatric skills in all course domains. 86.8% (n = 92/106) of students reported feeling more prepared for the pediatric clerkship. 94.3% (n = 100/106) would recommend the PSP experience to other students. Third-year students who participated in PSP reported higher comfort with pediatric patients prior to their clerkship. CONCLUSIONS PSP is a successful novel preclinical program introducing students to pediatrics. We demonstrated that didactics paired with resident-mentored clinical experiences improved pediatric knowledge, clinical-based skills, and perceived clerkship preparedness. Students may academically and professionally benefit from such earlier exposure to pediatrics.
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Affiliation(s)
- Benjamin M. Laitman
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - Alefiyah Malbari
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - Suzanne Friedman
- Department of Pediatrics, Columbia University Medical Center, 3959 Broadway, CHC 1-102, New York, NY 10032 USA
| | - Scott Moerdler
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, New Brunswick, NJ 08903 USA
| | - Samuel Kase
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 USA
| | - Kathleen Gibbs
- Pediatrics, Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Blvd., Philadelphia, PA 19104 USA
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McKinley SK, Kochis M, Cooper CM, Saillant N, Haynes AB, Petrusa E, Phitayakorn R. Medical students' perceptions and motivations prior to their surgery clerkship. Am J Surg 2019; 218:424-429. [PMID: 30732867 DOI: 10.1016/j.amjsurg.2019.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND This study aims to determine the effect of a pre-clerkship workshop on medical students' perceptions of surgery and surgeons and to describe their concerns and learning goals. METHODS Thirty-nine medical students completed surveys before and after a workshop preceding their surgery clerkship. Quantitative data and free responses that were inductively coded were used to assess effectiveness. RESULTS Perceptions from 38 students (response rate = 97.4%) significantly improved for 11 of 21 items. At pre-workshop, the most frequently cited learning goals were improving technical skills (58%), surgical knowledge (53%), and understanding surgical culture and work (53%). Students' top concerns were meeting clerkship demands (68%) and being evaluated (55%). After the workshop, student learning objectives and concerns remained largely unchanged. CONCLUSIONS A pre-clerkship workshop improved student perceptions of surgery and surgeons. Understanding students' intrinsic motivations may facilitate future clerkship curriculum improvement via better alignment of educator and student goals and objectives.
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Affiliation(s)
- Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Michael Kochis
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Cynthia M Cooper
- Department of Medicine, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Alex B Haynes
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States.
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Resident-as-teacher programs in general surgery residency - A review of published curricula. Am J Surg 2018; 217:209-213. [PMID: 30224071 DOI: 10.1016/j.amjsurg.2018.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/24/2018] [Accepted: 09/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The Liaison Committee on Medical Education (LCME) requires that residents are trained to fulfill their educational duties toward medical students. This study reviews the literature on resident-as-teacher programs (RATPs) aimed at surgical residents. METHODS Literature search with MeSH terms internship, residency, general surgery, teaching, education, and curriculum was performed using PubMed, Embase, Web of Science, and ERIC. Curriculum components and how curricula's success was measured were extracted for each study. Quality was scored using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS For the seven relevant publications the average MERSQI score was 9.9 (range 6.5-13.5). The RATPs were either lecture based (4/7) or content was distributed electronically (3/7). Change in attitude toward teaching was the most frequently assessed outcome. Highly rated curricular components were individualized feedback and iterative reminders to make teaching part of practice. CONCLUSIONS Few published RATPs in general surgery training exist. The literature suggests that pairing lectures with observation and feedback is successful. Distributing the content electronically is a feasible alternative to class-room based teaching in a busy surgical residency.
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Byrne R, Barbas B, Baumann BM, Patel SN. Medical Student Perception of Resident Versus Attending Contributions to Education on Co-Supervised Shifts During the Emergency Medicine Clerkship. AEM EDUCATION AND TRAINING 2018; 2:82-85. [PMID: 30051073 PMCID: PMC6001488 DOI: 10.1002/aet2.10091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The objective was to assess medical student perception of resident and attending contributions to nine Accreditation Council for Graduate Medical Education educational objectives during their emergency medicine (EM) clerkship. METHODS This was a prospective survey study of fourth-year medical students during their EM clerkship in a single academic emergency department. Students anonymously completed end-of-shift surveys if supervised by both resident and attending physicians. Students estimated the relative educational contribution from resident and attending on a 100-point visual analog scale (-50 to 50) with -50 = 100% resident contribution, +50 = 100% attending contribution, and 0 = equal contributions by resident and attendings. Nine educational objectives were surveyed: evidence-based medicine (EBM), clinical knowledge, chart documentation, bedside teaching, patient throughput, interpersonal communication, oral patient presentations, efficiency, and procedural instruction. RESULTS We collected 274 surveys from 65 students. Of the nine objectives, students perceived that residents contributed more than attendings in eight of nine (results reported as mean values with 95% confidence intervals): clinical knowledge -4.5 (-7.3 to -1.7), chart documentation -8.0 (-12.0 to -4.0), bedside teaching -8.6 (-12.0 to -5.2), throughput -13.0 (-16.4 to -9.6), oral presentations -14.2 (-17.3 to -11), efficiency -14.4 (-17.6 to -11.3), procedural instruction -20.2 (-24.0 to -16.5), and interpersonal communication -13.5 (-17.7 to -9.4). The sole outlier favoring attendings was EBM: 5.5 (1.9 to 9.1). CONCLUSIONS Medical students perceive resident physicians to contribute more than attendings for most of their EM educational objectives, with faculty providing the greatest contribution to their EBM training.
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Affiliation(s)
- Richard Byrne
- Department of Emergency MedicineCooper Medical School of Rowan UniversityCamdenNJ
| | - Brian Barbas
- Department of Emergency MedicineCooper Medical School of Rowan UniversityCamdenNJ
| | - Brigitte M. Baumann
- Department of Emergency MedicineCooper Medical School of Rowan UniversityCamdenNJ
| | - Sundip N. Patel
- Department of Emergency MedicineCooper Medical School of Rowan UniversityCamdenNJ
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Peel JK, Schlachta CM, Alkhamesi NA. A systematic review of the factors affecting choice of surgery as a career. Can J Surg 2018; 61:58-67. [PMID: 29368678 PMCID: PMC5785290 DOI: 10.1503/cjs.008217] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Interest in surgical careers among medical students has declined over the past decade. Multiple explanations have been offered for why top students are deterred or rejected from surgical programs, though no consensus has emerged. METHODS We conducted a review of the literature to better characterize what factors affect the pursuit of a surgical career. We searched PubMed and EMBASE and performed additional reference checks. Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Education scores were used to evaluate the included data. RESULTS Our search identified 122 full-text, primary articles. Analysis of this evidence identified 3 core concepts that impact surgical career decision-making: gender, features of surgical education, and student "fit" in the culture of surgery. CONCLUSION Real and perceived gender discrimination has deterred female medical students from entering surgical careers. In addition, limited exposure to surgery during medical school and differences between student and surgeon personality traits and values may deter students from entering surgical careers. We suggest that deliberate and visible effort to include women and early-career medical students in surgical settings may enhance their interest in carreers in surgery.
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Affiliation(s)
- John K. Peel
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
| | - Christopher M. Schlachta
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
| | - Nawar A. Alkhamesi
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
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Abstract
PURPOSE We set out to evaluate how residents in pediatric surgery learn and how they teach. We hypnotized that European residents learn as much from their peers and teach as much as their fellows worldwide, but that they receive comparably less educational training. METHODS An online questionnaire was distributed to the participants of the combined annual meeting for German, Swiss and Austrian residents in pediatric surgery. Participants were asked whom they learn from in different workplace environments (ward, operating room, emergency department), how, when and why they adopt the role of teacher and how they were prepared for this role. RESULTS Response rate was 48%. 65 questionnaires were analyzed. Residents stated that they predominantly learn from each other on wards and in the emergency department, less frequently in the operating room. They ranked fellow residents as first or second most important source of instruction. 53% of participants have never had any educational training, for another 33% the instruction was being done by fellow residents without any set curriculum. 93% of the participating residents had no or did not know about any resident as teacher training program available to them. Nevertheless, motivation to teach was stated to be high and interest in educational training was assured. CONCLUSIONS Our data delivers evidence that peer teaching during residency is the rule rather than the exception in Central Europe. Educational training however is scarce. Resident as teacher-training programs need to be introduced. Next to local initiatives, we strongly recommend national initiatives powered by regulatory authorities and surgical associations. TYPE OF STUDY Research paper. LEVEL OF EVIDENCE II.
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Affiliation(s)
- S Zundel
- Department of Pediatric Surgery, Children's Hospital Lucerne, Switzerland.
| | - M Stocker
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital Lucerne, Switzerland
| | - P Szavay
- Department of Pediatric Surgery, Children's Hospital Lucerne, Switzerland
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Watkins AA, Gondek SP, Lagisetty KH, Castillo-Angeles M, Gangadharan SP, Cahalane MJ, Kent TS. Weekly e-mailed teaching tips and reading material influence teaching among general surgery residents. Am J Surg 2017; 213:195-201.e3. [DOI: 10.1016/j.amjsurg.2016.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 03/19/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
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Landmann A, Havron WS, Patel A, Thompson BM, Lees JS. Medical student expectations from surgical education: A two-year institutional experience. Am J Surg 2016; 212:1265-1269. [PMID: 27889269 DOI: 10.1016/j.amjsurg.2016.09.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The third-year surgical rotation is the first exposure medical students have to the fundamentals of surgical education. It is known that medical students come to the surgical clerkship with preconceived ideas, many of them negative and based on prior student feedback and hearsay. METHODS An anonymous survey was conducted of third-year medical students while on the surgical clerkship. We sought to quantify student's experiences and expectations by assessing the students' confidence levels before and after the rotation. RESULTS Over a 26 month period from July 2013-August 2015, 250 surveys were conducted. In terms of confidence gained on the surgical rotation, students reported a statistically significant (p < 0.01) increase in confidence in fifteen different areas of interest. However, in terms of expectations, students reported discordance between anticipated experience and actual experience. Students' responses indicate that students felt confident with their knowledge of diseases; however, they desire more involvement in complex patient care and procedural skills. CONCLUSIONS The third-year clerkship is the first exposure to surgery for many medical students. Surgical educators are tasked with providing a foundation for clinical medicine; however, students have expressed an expectation to be more involved with complex patient care and management.
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Affiliation(s)
| | - William S Havron
- Orlando Regional Medical Center, Department of Surgical Education, USA
| | - Arpit Patel
- University of Oklahoma, College of Medicine, Department of Surgery, USA
| | - Britta M Thompson
- Penn State College of Medicine, Department of Medical Education, USA
| | - Jason S Lees
- University of Oklahoma, College of Medicine, Department of Surgery, USA
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Goh SH, Tan JHM, Cook S. Student’s perspective of Residents as educators following introduction of Accreditation Council for Graduate Medical Education-International (ACGME-I) in SingHealth Residency. PROCEEDINGS OF SINGAPORE HEALTHCARE 2016. [DOI: 10.1177/2010105816641971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Singapore’s postgraduate medical education underwent a transition in 2010, moving away from the House staff model to the American Residency model. Teaching was defined as a core competency for SingHealth Residency programs. This study sought to determine how this transition impacted medical students’ perception of Residents as teachers. Methods: A 19-item Likert-type questionnaire comprising three domains—(1) quality, (2) frequency and (3) engagement—was given to all Duke-NUS medical students at the end of each clerkship from the academic year (AY) 2009–10 through 2013–14. The first two academic years were classified as the pre-initiation stage of the Residency, and the latter three, the post-initiation stage. Students rated Residents they encountered in their most recent clerkship. Results: Student ratings have gradually improved, with the largest improvement occurring after the initiation of Residency, and after the introduction of Residents as Future Teachers courses. Student ratings in the post-initiation Residency years combined were significantly higher than the pre-initiation of Residency years combined, for all three domains. Analysis of individual items revealed significant improvement in student ratings on all items in all domains, except for the quality of teaching in performing procedural skills. Conclusion: Findings from this study indicate a positive shift in the teaching culture with the transition of Singapore’s postgraduate medical education from the House staff model to the Residency program.
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Affiliation(s)
- Sok Hong Goh
- Medical Education, Research and Evaluation Department, Duke-NUS Medical School
| | | | - Sandy Cook
- Medical Education, Research and Evaluation Department, Duke-NUS Medical School
- Academic Medicine Education Institute, Duke-NUS Medical School
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Ramani S, Mann K, Taylor D, Thampy H. Residents as teachers: Near peer learning in clinical work settings: AMEE Guide No. 106. MEDICAL TEACHER 2016; 38:642-55. [PMID: 27071739 DOI: 10.3109/0142159x.2016.1147540] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This AMEE Guide provides a framework to guide medical educators engaged in the design and implementation of "Resident as Teacher" programs. The suggested approaches are based on established models of program development: the Program Logic model to guide program design, the Dundee three-circle model to inform a systematic approach to planning educational content and the Kirkpatrick pyramid, which forms the backbone of program evaluation. The Guide provides an overview of Resident as Teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own program based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents, but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and program evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programs, encouragement of evidence-based approach to education and rewards for all levels of teachers.
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Affiliation(s)
- Subha Ramani
- a Department of Medicine , Brigham and Women's Hospital , Harvard Medical School, Boston , MA , USA
| | - Karen Mann
- b Division of Medical Education, Faculty of Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
| | - David Taylor
- c School of Medicine , University of Liverpool , Liverpool , UK
| | - Harish Thampy
- d Manchester Medical School, University of Manchester , Manchester , UK
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Schmidt LE, Cooper CA, Guo WA. Factors influencing US medical students' decision to pursue surgery. J Surg Res 2016; 203:64-74. [PMID: 27338536 DOI: 10.1016/j.jss.2016.03.054] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/09/2016] [Accepted: 03/22/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery. METHODS Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias. RESULTS We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2). CONCLUSIONS This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career.
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Abstract
BACKGROUND Medical student interest in neurosurgery is decreasing and resident attrition is trending upwards in favor of more lifestyle-friendly specialties that receive greater exposure during medical school. The University of Toronto began offering an annual two week comprehensive, focused surgical experience (Surgical Exploration and Discovery (SEAD) program) to 20 first year medical students increasing exposure to surgical careers. This study determines how SEAD affects students' views of a career in neurosurgery. METHODS Surveys were administered to 38 SEAD participants over two program cycles. Information was obtained regarding demographics, impacts of SEAD, and factors affecting career decision making. Subgroup analyses assessed for factors predicting pre- and post-intervention interest in neurosurgery. RESULTS Ninety-seven percent (n=37) of students completed the survey. Before SEAD, 25% were interested in neurosurgery but this decreased to 10% post-SEAD (p=0.001). However, post-SEAD interest increased from 10% to 38% if lifestyle factors were theoretically controlled across surgical specialties (p<0.005). A majority (81%) felt SEAD improved their understanding of neurosurgery, 62.2% felt that exposure to other surgical specialties reduced their interest in neurosurgery, and 21% felt SEAD increased their interest in neurosurgery. Nineteen percent intended to explore neurosurgery further with observerships and one student planned to organize neurosurgical research. CONCLUSIONS This surgical exposure intervention increased understanding about neurosurgery and reduced overall interest in neurosurgery as a career. However, those remaining interested were motivated to plan further neurosurgical clinical experiences. The SEAD program may, therefore, aid in early selection of students motivated to satisfy the demands of a neurosurgical career.
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Hampton BS, Craig LB, Abbott JF, Buery-Joyner SD, Dalrymple JL, Forstein DA, Hopkins L, McKenzie ML, Page-Ramsey SM, Pradhan A, Wolf A, Graziano SC. To the point: teaching the obstetrics and gynecology medical student in the operating room. Am J Obstet Gynecol 2015; 213:464-8. [PMID: 25857571 DOI: 10.1016/j.ajog.2015.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/27/2015] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of considerations for teaching the medical student in the operating room during the obstetrics/gynecology clerkship. The importance of the medical student operating room experience and barriers to learning in the operating room are discussed. Specific considerations for the improvement of medical student learning and operating room experience, which include the development of operating room objectives and specific curricula, an increasing awareness regarding role modeling, and faculty development, are reviewed.
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Cherry-Bukowiec JR, Machado-Aranda D, To K, Englesbe M, Ryszawa S, Napolitano LM. Improvement in acute care surgery medical student education and clerkships: use of feedback and loop closure. J Surg Res 2015; 199:15-22. [PMID: 26148827 DOI: 10.1016/j.jss.2015.05.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 05/27/2015] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The unpredictable and sometimes chaotic environment present in acute care surgery services (trauma, burn, surgical critical care, and nontrauma emergency surgery) can cause high levels of anxiety and stress that could impact a medical students' experience during their third year of medical school surgical clerkship. This negative perception perhaps is a determinant influence in diverting talented students into other medical subspecialties. We sought out to objectively identify potential areas of improvement through direct feedback and implement programmatic changes to address these areas. We hypothesized that as the changes were made, students' perception of the rotation would improve. MATERIALS AND METHODS Review of end of clerkship third year of medical school trauma burn surgery rotation evaluations and comments was performed for the 2010-2011 academic year. Trends in negative feedback were identified and categorized into five areas for improvement as follows: logistics, student expectations, communication, team integration, and feedback. A plan was designed and implemented for each category. Feedback on improvements to the rotation was monitored via surveys and during monthly end of rotation face-to-face student feedback sessions with the rotation faculty facilitator and surgery clerkship director. Data were compiled and reviewed. RESULTS Perceptions of the rotation markedly improved within the first month of the changes and continued to improve over the study time frame (2011-2013) in all five categories. We also observed an increase in the number of students selecting a surgical residency in the National Resident Matching Program match from a low of 8% in 2009-2010 before any interventions to 25% after full implementation of the improvement measures in 2011-2012. CONCLUSIONS A systematic approach using direct feedback from students to address service-specific issues improves perceptions of students on the educational value of a busy trauma-burn acute care surgery service and may have a positive influence on students considering surgical careers to pursue a surgical specialty.
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Affiliation(s)
- Jill R Cherry-Bukowiec
- Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
| | - David Machado-Aranda
- Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Kathleen To
- Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Michael Englesbe
- Section of Transplant Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Susan Ryszawa
- Division of Surgical Education, Department of Surgery, University of Michgian, Ann Arbor, Michigan
| | - Lena M Napolitano
- Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Wirth K, Malone B, Turner C, Schulze R, Widmann W, Sanni A. A structured teaching curriculum for medical students improves their performance on the National Board of Medical Examiners shelf examination in surgery. Am J Surg 2015; 209:765-70. [DOI: 10.1016/j.amjsurg.2014.09.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/27/2014] [Accepted: 09/08/2014] [Indexed: 11/28/2022]
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Moore J, Parsons C, Lomas S. A resident preceptor model improves the clerkship experience on general surgery. JOURNAL OF SURGICAL EDUCATION 2014; 71:e16-e18. [PMID: 25001063 DOI: 10.1016/j.jsurg.2014.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/16/2014] [Accepted: 05/26/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The frenetic pace of inpatient care on surgical services can create barriers to resident teaching of students. Students are often concerned that busy surgical residents will not be able to adequately evaluate their performance at the end of a clerkship. OBJECTIVE To determine whether the addition of a resident preceptor would increase the satisfaction of students rotating through the general surgery portion of the required third-year surgery clerkship. STUDY DESIGN Before implementing a resident preceptor model, third-year students rotating on general surgery were administered a 24-item web-based survey regarding their experience on the general surgery portion of the surgery clerkship. General surgery residents were similarly surveyed. A resident preceptor model was then introduced. Subsequent students and residents were surveyed. Presurveys and postsurveys were compared and mean responses analyzed. RESULTS The addition of a resident preceptor made students more comfortable with asking residents questions (p = 0.02), increased the time students felt was available for developing relationships with residents (p = 0.03), and improved the feeling that residents would be able to accurately evaluate the student's effectiveness as a team member (p = 0.05). The students felt resident teaching on afternoon rounds was increased with the resident preceptor model (p = 0.05). Residents reported spending more time teaching students on morning rounds (p = 0.03). CONCLUSIONS Implementation of a resident preceptor model resulted in significant improvement in medical students' perceptions of resident teaching effectiveness and ability to accurately evaluate a student's performance.
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Affiliation(s)
- Jesse Moore
- Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont.
| | - Charles Parsons
- Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont
| | - Sarah Lomas
- Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont
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Jagsi R, Griffith KA, DeCastro RA, Ubel P. Sex, role models, and specialty choices among graduates of US medical schools in 2006-2008. J Am Coll Surg 2014; 218:345-52. [PMID: 24468225 DOI: 10.1016/j.jamcollsurg.2013.11.012] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Undergraduate education studies have suggested instructor sex can influence female students to pursue a discipline. We sought to evaluate a similar hypothesis in medical students. STUDY DESIGN We obtained Association of American Medical Colleges (AAMC) data about the specialization of 2006-2008 graduates of US medical schools, the sex of their faculty and department chairs, and sex of residents in the residency programs in which they enrolled. We used logistic regression to examine associations between faculty and leadership sex and female students' pursuit of 5 surgical specialties along with 3 nonsurgical specialties for context. We used Wilcoxon rank-sum tests to evaluate whether women entered residency programs with a higher proportion of female residents. RESULTS In 2006-2008, US medical school graduates included 23,642 women. Women were substantially under-represented among residents in neurosurgery, orthopaedics, urology, otolaryngology, general surgery, and radiology; women constituted 47.4% of US graduates specializing in internal medicine and 74.9% in pediatrics. We found no significant associations between exposure to a female department chair and selection of that specialty and no consistent associations with the proportion of female full-time faculty. Compared with male students, female students entered residency programs in their chosen specialty that had significantly higher proportions of women residents in the year before their graduation. CONCLUSIONS Although we did not detect consistent significant associations between exposure to potential female faculty role models and specialty choice, we observed that female students were more likely than males to enter programs with higher proportions of female residents. Sex differences in students' specialization decisions merit additional investigation.
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Affiliation(s)
- Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
| | - Kent A Griffith
- Center for Cancer Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Rochelle A DeCastro
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Center for Bioethics and Social Science in Medicine, University of Michigan, Ann Arbor, MI
| | - Peter Ubel
- Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, NC
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Naeger DM, Wilcox C, Phelps A, Ordovas KG, Webb EM. Residents Teaching Medical Students: How Do They Compare With Attending Educators? J Am Coll Radiol 2014; 11:63-7. [DOI: 10.1016/j.jacr.2013.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/29/2013] [Indexed: 11/26/2022]
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