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Donohue K, Davis N, Farber D, Retener N, Dittmar P. An internal medicine residency preparatory curriculum for fourth-year medical students. CLINICAL TEACHER 2024; 21:e13703. [PMID: 38049309 DOI: 10.1111/tct.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/09/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Intern preparation courses are often broad in scope; there are few published specialty-specific programs outside of General Surgery and Obstetrics. We designed an internal medicine (IM) residency preparatory course at the University of Maryland School of Medicine, which aimed to prepare graduating medical students for the rigours of IM residency training, mapped to Entrustable Professional Activities (EPAs). METHODS Fourteen fourth-year medical students who were matriculating into IM residency programs enrolled in a 4-week long residency preparation course. The course was designed to teach skills using case-based learning modules, specialty topic seminars, simulation laboratories, procedure laboratories and clinical practice. Participants were surveyed before and after the course on their perceived knowledge and ability with the skills tested. RESULTS With the exception of 'giving signout to a colleague', there was a significant difference in the participant's perceived ability for each skill taught within the course (P < 0.03 for each), with mean pre-course scores of 1.4-3.7 (SD = 0.5-1.2) and mean post-course scores of 3.2-4.2 (SD = 0.5-1.3). A second survey on course evaluation and perceived impact, completed 3 months after starting intern year, resulted in all respondents reporting that the information learned during the course had directly affected their care of patients on a daily or weekly basis. The modified Ottawa scale was the primary assessment means for the EPAs, with participants approaching entrustment at the conclusion of the course. CONCLUSIONS Implementation of an IM-specific residency preparation course is a useful adjunct in the fourth year of medical school.
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Affiliation(s)
- Katelyn Donohue
- Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Natalie Davis
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Dara Farber
- Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Norman Retener
- Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Philip Dittmar
- Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Anand A, Jensen R, Korndorffer JR. More is not better: A scoping review of simulation in transition to residency programs. Surgery 2023; 174:1340-1348. [PMID: 37852830 DOI: 10.1016/j.surg.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/02/2023] [Accepted: 08/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Transition to residency programs frequently use simulation to promote clinical skills but place limited emphasis on non-clinical skills. We conducted a scoping review to determine how simulation is being used in transition to residency programs and the key non-clinical skills addressed by simulation activities and tools in these programs. METHODS We searched PubMed, Scopus, and Embase to identify articles addressing transition to residency, simulation, and non-clinical skills/attributes. Two authors independently screened all abstracts and full-text articles and identified non-clinical attributes elicited in each study. Using descriptive statistics, we characterized the simulation activities and tools and the number and type of non-clinical attributes captured in the programs. Using analysis of variance, we compared the number of non-clinical attributes elicited based on the number of simulation activities used and compared the number of non-clinical attributes elicited based on the number of simulation tools used. RESULTS We identified 38 articles that met the study criteria. We characterized simulation activities as mock paging (37%), case-based scenarios (74%), and/or procedural skills training (39%). We found that the most common simulation tools were standardized patients (64.8%), and the most elicited non-clinical attributes were communication skills, critical thinking, and teamwork. Using more simulation activity categories or simulation tools did not increase the number of non-clinical skills elicited. CONCLUSION Simulation is used broadly in transition to residency programs but provides training in a few of the non-clinical skills required for a successful transition. Incorporating more simulation activities or tools does not increase the number of non-clinical attributes elicited, illustrating the importance of developing more targeted simulation activities to promote non-clinical skills more effectively.
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Affiliation(s)
- Ananya Anand
- Department of Surgery, Stanford University, Stanford, CA.
| | - Rachel Jensen
- Department of Surgery, Stanford University, Stanford, CA. https://twitter.com/GSEC_Surgery
| | - James R Korndorffer
- Department of Surgery, Stanford University, Stanford, CA. https://twitter.com/StanfordSurgery
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Dennis D, Furness A, Brosky J, Owens J, Mackintosh S. Can student-peers teach using simulated-based learning as well as faculty: A non-equivalent posttest-only study. NURSE EDUCATION TODAY 2020; 91:104470. [PMID: 32454315 DOI: 10.1016/j.nedt.2020.104470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/19/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Peer-assisted learning has an important place in the delivery of health care education with benefits for both the learners and the peer teachers. Simulation-based learning (SBL) is evolving in healthcare professions training and academic programs as a modality that conveys realism and fidelity through immersion. OBJECTIVES The primary aim was to compare physiotherapy student's motivation to learn between a conventional faculty-led SBL activity and the same SBL activity delivered by trained final year physiotherapy peer tutors. METHODS Physiotherapy students from two Universities (n = 226) undertook a SBL learning activity (either faculty led or peer led) and completed the Instructional Materials Motivation Scale questionnaire to assess motivation to learn. RESULTS There was a high level of learner motivation in all learning groups, with significantly higher learner satisfaction (p < 0.001) and lower attention (p < 0.001) in student-led SBL than faculty-led SBL. CONCLUSIONS This study has highlighted the potential to incorporate peer-assisted and simulation-based learning together in the development of future educational activities in health care training.
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Affiliation(s)
- Diane Dennis
- Curtin University School of Physiotherapy and Exercise Science, Perth, Australia; Sir Charles Gairdner Hospital, Perth, Australia.
| | - Anne Furness
- Curtin University School of Physiotherapy and Exercise Science, Perth, Australia
| | - Joseph Brosky
- Bellarmine University, School of Movement and Rehabilitation Sciences, Louisville, KY, USA
| | - John Owens
- Curtin University School of Physiotherapy and Exercise Science, Perth, Australia
| | - Shylie Mackintosh
- University of South Australia, School of Health Sciences, Adelaide, Australia
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Servotte JC, Bragard I, Szyld D, Van Ngoc P, Scholtes B, Van Cauwenberge I, Dardenne N, Goosse M, Pilote B, Guillaume M, Ghuysen A. Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department. West J Emerg Med 2019. [DOI: 10.5811//westjem.2019.8.43441] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jean-Christophe Servotte
- University of Liège, Department of Public Health Sciences, Liège, Belgium University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
| | - Isabelle Bragard
- University of Liège, Department of Public Health Sciences, Liège, Belgium University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
| | - Demian Szyld
- Institute for Medical Simulation, Center for Medical Simulation, Brigham and Women’s Hospital, Harvard Medical School
| | - Pauline Van Ngoc
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Beatrice Scholtes
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | | | - Nadia Dardenne
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Manon Goosse
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Bruno Pilote
- Université Laval, Faculté des sciences infirmières, Québec, Canada
| | - Michele Guillaume
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Alexandre Ghuysen
- University of Liège, Department of Public Health Sciences, Liège, Belgium University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
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Servotte JC, Bragard I, Szyld D, Van Ngoc P, Scholtes B, Van Cauwenberge I, Donneau AF, Dardenne N, Goosse M, Pilote B, Guillaume M, Ghuysen A. Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department. West J Emerg Med 2019; 20:893-902. [PMID: 31738716 PMCID: PMC6860397 DOI: 10.5811/westjem.2019.8.43441] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/07/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Breaking bad news (BBN) in the emergency department (ED) represents a challenging and stressful situation for physicians. Many medical students and residents feel stressed and uncomfortable with such situations because of insufficient training. Our randomized controlled study aimed to assess the efficacy of a four-hour BBN simulation-based training on perceived self-efficacy, the BBN process, and communication skills. Methods Medical students and residents were randomized into a 160-hour ED clinical rotation without a formal BBN curriculum (control group [CG], n = 31) or a 156-hour ED clinical rotation and a four-hour BBN simulation-based training (training group [TG], n = 37). Both groups were assessed twice: once at the beginning of the rotation (pre-test) and again four weeks later. Assessments included a BBN evaluation via a simulation with two actors playing family members and the completion of a questionnaire on self-efficacy. Two blinded raters assessed the BBN process with the SPIKES (a delivery protocol for delivering bad news) competence form and communication skills with the modified BBN Assessment Schedule. Results Group-by-time effects adjusted by study year revealed a significant improvement in TG as compared with CG on self-efficacy (P < 0.001), the BBN process (P < 0.001), and communication skills (P < 0.001). TG showed a significant gain regarding the BBN process (+33.3%, P < 0.001). After the training, students with limited clinical experience prior to the rotation showed BBN performance skills equal to that of students in the CG who had greater clinical experience. Conclusion A short BBN simulation-based training can be added to standard clinical rotations. It has the potential to significantly improve self-efficacy, the BBN process, and communication skills.
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Affiliation(s)
- Jean-Christophe Servotte
- University of Liège, Department of Public Health Sciences, Liège, Belgium.,University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
| | - Isabelle Bragard
- University of Liège, Department of Public Health Sciences, Liège, Belgium.,University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
| | - Demian Szyld
- Institute for Medical Simulation, Center for Medical Simulation, Brigham and Women's Hospital, Harvard Medical School
| | - Pauline Van Ngoc
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Béatrice Scholtes
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | | | | | - Nadia Dardenne
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Manon Goosse
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Bruno Pilote
- Université Laval, Faculté des sciences infirmières, Québec, Canada
| | - Michèle Guillaume
- University of Liège, Department of Public Health Sciences, Liège, Belgium
| | - Alexandre Ghuysen
- University of Liège, Department of Public Health Sciences, Liège, Belgium.,University of Liege, Interdisciplinary Medical Simulation Center of Liège, Liège, Belgium
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