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Hoxha I, Hekman DJ, Schnapp B. Second- and third-year medical students' clinical encounters in the emergency department. AEM EDUCATION AND TRAINING 2024; 8:e10937. [PMID: 38504802 PMCID: PMC10950016 DOI: 10.1002/aet2.10937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/08/2023] [Accepted: 11/23/2023] [Indexed: 03/21/2024]
Abstract
Background Experiential learning theory suggests that direct clinical experiences facilitate learning. Previous literature has focused primarily on the experiences of fourth-year medical students. As more students gain early clinical exposure, it is important to understand the types of patients seen by junior students. Objectives This study aims to categorize the clinical experiences of early (M2 and M3) students in the emergency department (ED). Methods A retrospective review of the electronic health record of patients seen by M2s and M3s on a 2-week emergency medicine rotation at a single urban academic ED in the Midwest was performed. Data elements extracted included total number of patients seen, Emergency Severity Index (ESI), disposition, and chief complaint. Students were not mandated to see any particular patients. Results Medical students (248) saw 2994 total patients from 2018 to 2022. The median number of patients seen by each student was 12.0 (range 1-32). Pediatric patients made up 6.5% (n = 194) of total patients. Encounters were primarily ESI 2 or 3, which accounted for 89.4% of all patients (n = 2676). The most encountered complaints were abdominal pain, chest pain, and dyspnea, making up 15.6% (n = 467), 8.7% (n = 260), and 5.5% (n = 165), respectively, of total cases. Obstetrics/gynecology, hematologic, and environmental disorders were the least frequently encountered domains. No students saw all Clerkship Directors in Emergency Medicine (CDEM)-recommended complaints. Conclusions There is significant variability in the ED encounters of M2s and M3s, with wide ranges of patient volume and presentations. This study provides some evidence that early students may not be meeting CDEM recommendations.
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Affiliation(s)
- Ines Hoxha
- University of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Daniel J. Hekman
- Department of Emergency MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Benjamin Schnapp
- Department of Emergency MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
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Goldfine C, Lung D, Beauchamp G, O'Connor A, Stolbach A, Kao L, Judge B, Wax P, Patwari R, Kazzi Z. Consensus Development of a Core Content for a Standardized Medical Toxicology Curriculum for Medical Students. J Med Toxicol 2022; 18:139-144. [PMID: 35089533 PMCID: PMC8796743 DOI: 10.1007/s13181-021-00874-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background Currently, no standardized core content in medical toxicology exists for medical students. The goals of this study were to (1) assess the current state and needs of medical toxicology clerkships and (2) develop a consensus-derived list of core topics that should be covered during a medical toxicology clerkship. Methods We assembled a task force established by the American College of Medical Toxicology (ACMT) of nine experts in medical toxicology or emergency medicine. We developed a needs assessment survey that was sent to all medical student clerkship directors in medical toxicology. Based on their responses, we used a modified Delphi process to develop a consensus of core topics that should be covered during a medical student clerkship. Results Nineteen out of 42 (45%) clerkship directors completed the survey; 18 met inclusion criteria. The majority of clerkships were 4 weeks in duration with an average of 15 students/year. The three most common teaching methods used were bedside teaching (n = 17/18), classroom teaching (n = 17/18), and journal club (n = 14/18). All the clerkship directors (n = 18/18) reported they would use a standardized curriculum as well as educational content developed by ACMT. There was overwhelming consensus on the core topics which included, but were not limited to, pharmacology/toxicology; drugs; drugs of abuse; natural products; pharmacological basis of antidote use; toxicologic syndromes; vital sign abnormalities; initial management; supportive and other care; withdrawal syndrome management; industrial, household, and environmental toxins; differential diagnosis by clinical findings; and ABCs-resuscitation. Conclusion The ACMT task force developed a medical toxicology clerkship core content. The task force also identified a need for shared resources among clerkships.
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Affiliation(s)
- Charlotte Goldfine
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Derrick Lung
- Division of Clinical Pharmacology and Medical Toxicology, Department of Emergency Medicine, San Mateo Medical Center, San Mateo, CA, USA
| | - Gillian Beauchamp
- Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Lehigh Valley Health Network, University of South Florida Morsani College of Medicine, Allentown, PA, USA
| | - Ayrn O'Connor
- Banner - University Medical Center Phoenix, Phoenix, AZ, USA
| | - Andrew Stolbach
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Louise Kao
- Department of Emergency Medicine, Division of Medical Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bryan Judge
- Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Paul Wax
- Southwestern School of Medicine, University of Texas, Dallas, TX, USA
| | | | - Ziad Kazzi
- Georgia Poison Center, Emory University, Atlanta, GA, USA
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Hiller K, Jung J, Lawson L, Riddell R, Franzen D. Multi-institutional Implementation of the National Clinical Assessment Tool in Emergency Medicine: Data From the First Year of Use. AEM EDUCATION AND TRAINING 2021; 5:e10496. [PMID: 33842811 PMCID: PMC8019216 DOI: 10.1002/aet2.10496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Uniformly training physicians to provide safe, high-quality care requires reliable assessment tools to ensure learner competency. The consensus-derived National Clinical Assessment Tool in Emergency Medicine (NCAT-EM) has been adopted by clerkships across the country. Analysis of large-scale deidentified data from a consortium of users is reported. METHODS Thirteen sites entered data into a Web-based platform resulting in over 6,400 discrete NCAT-EM assessments from 748 students and 704 assessors. Reliability, internal consistency analysis, and factorial analysis of variance for hypothesis generation were performed. RESULTS All categories on the NCAT-EM rating scales and professionalism subdomains were used. Clinical rating scale and global assessment scores were positively skewed, similar to other assessments commonly used in emergency medicine (EM). Professionalism lapses were noted in <1% of assessments. Cronbach's alpha was >0.8 for each site; however, interinstitutional variability was significant. M4 students scored higher than M3 students, and EM-bound students scored higher than non-EM-bound students. There were site-specific differences based on number of prior EM rotations, but no overall association. There were differences in scores based on assessor faculty rank and resident training year, but not by years in practice. There were site-specific differences based on student sex, but overall no difference. CONCLUSIONS To our knowledge, this is the first large-scale multi-institutional implementation of a single clinical assessment tool. This study demonstrates the feasibility of a unified approach to clinical assessment across multiple diverse sites. Challenges remain in determining appropriate score distributions and improving consistency in scoring between sites.
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Affiliation(s)
- Katherine Hiller
- From theDepartment of Emergency MedicineUniversity of ArizonaTucsonAZUSA
| | - Julianna Jung
- theDepartment of Emergency MedicineJohns Hopkins UniversityBaltimoreMDUSA
| | - Luan Lawson
- theDepartment of Emergency MedicineEast Carolina UniversityGreenvilleNCUSA
| | - Rebecca Riddell
- theOffice of Assessment and EvaluationJohns Hopkins UniversityBaltimoreMDUSA
| | - Doug Franzen
- and theDepartment of Emergency MedicineUniversity of WashingtonSeattleWAUSA
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Yong SA, Chaou CH, Yu SR, Kuan JT, Lin CC, Liu HP, Chiu TF. Video Assisted Laryngoscope Facilitates Intubation Skill Learning in the Emergency Department. J Acute Med 2020; 10:60-69. [PMID: 32995157 DOI: 10.6705/j.jacme.202003_10(2).0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices. Methods This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices. Results We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both p < 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (p < 0.001). VL also improved the glottic view performance during post-course assessments. Conclusions VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
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Affiliation(s)
- Su Ann Yong
- Chang Gung Memorial Hospital Department of Emergency Medicine Linkou, Taoyuan Taiwan
| | - Chung-Hsien Chaou
- Chang Gung Memorial Hospital Department of Emergency Medicine Linkou, Taoyuan Taiwan.,Chang Gung Memorial Hospital Chang Gung Medical Education Research Centre Taoyuan Taiwan.,Chang Gung University College of Medicine Taoyuan Taiwan
| | - Shiuan-Ruey Yu
- Chang Gung Memorial Hospital Chang Gung Medical Education Research Centre Taoyuan Taiwan
| | - Jen-Tse Kuan
- Chang Gung Memorial Hospital Department of Emergency Medicine Linkou, Taoyuan Taiwan
| | - Chih-Chung Lin
- Chang Gung University College of Medicine Taoyuan Taiwan.,Chang Gung Memorial Hospital Department of Anesthesiology Linkou, Taoyuan Taiwan
| | - Hung-Pin Liu
- Chang Gung Memorial Hospital Department of Anesthesiology Linkou, Taoyuan Taiwan
| | - Te-Fa Chiu
- China Medical University Department of Emergency Medicine, China Medical University Hospital and School of Medicine Taichung Taiwan
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Guth TA, Overbeck MC, Roswell K, Vu TT, Williamson KM, Yi Y, Hilty W, Druck J. Impact of a Dedicated Teaching Attending Experience on a Required Emergency Medicine Clerkship. West J Emerg Med 2019; 21:58-64. [PMID: 31913820 PMCID: PMC6948705 DOI: 10.5811/westjem.2019.11.44399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/13/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction One published strategy for improving educational experiences for medical students in the emergency department (ED) while maintaining patient care has been the implementation of dedicated teaching attending shifts. To leverage the advantages of the ED as an exceptional clinical educational environment and to address the challenges posed by the rapid pace and high volume of the ED, our institution developed a clerkship curriculum that incorporates a dedicated clinical educator role – the teaching attending – to deliver quality bedside teaching experiences for students in a required third-year clerkship. The purpose of this educational innovation was to determine whether a dedicated teaching attending experience on a third-year required emergency medicine (EM) clerkship would improve student-reported clinical teaching evaluations and student-reported satisfaction with the overall quality of the EM clerkship. Methods Using a five-point Likert-type scale (1 - poor to 5 - excellent), student-reported evaluation ratings and the numbers of graduating students matching into EM were trended for 10 years retrospectively from the inception of the clerkship for the graduating class of 2009 through and including the graduating class of 2019. We used multinomial logistic regression to evaluate whether the presence of a teaching attending during the EM clerkship improved student-reported evaluation ratings for the EM clerkship. We used sample proportion tests to assess the differences between top-box (4 or 5 rating) proportions between years when the teaching attending experience was present and when it was not. Results For clinical teaching quality, when the teaching attending is present the estimated odds of receiving a rating of 5 is 77.2 times greater (p <0.001) than when the teaching attending is not present and a rating of 4 is 27.5 times greater (p =0.0017). For overall clerkship quality, when the teaching attending is present, the estimated odds of receiving a rating of 5 is 13 times greater (p <0.001) and a rating of 4 is 5.2 times greater (p=0.0086) than when the teaching attending is not present. Conclusion The use of a dedicated teaching attending shift is a successful educational innovation for improving student self-reported evaluation items in a third-year required EM clerkship.
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Affiliation(s)
- Todd A Guth
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Michael C Overbeck
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Kelley Roswell
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, Colorado
| | - Tien T Vu
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, Colorado
| | - Kayla M Williamson
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Yeonjoo Yi
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - William Hilty
- Saint Mary's Medical Center, Department of Emergency Medicine, Grand Junction, Colorado
| | - Jeff Druck
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
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Berger-Estilita J, Nabecker S, Greif R. A Delphi consensus study for teaching "Basic Trauma Management" to third-year medical students. Scand J Trauma Resusc Emerg Med 2019; 27:91. [PMID: 31623634 PMCID: PMC6798469 DOI: 10.1186/s13049-019-0675-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical students, it was necessary to revise the BTM content and re-align it. Our aim was to identify core competencies for the revised BTM course. Methods We applied a three-round step-wise Delphi consensus. First, we asked open-ended questions on what were the most important competencies to be taught for BTM; the second round used Likert scales to ensure agreement on the competencies; and the final round reached out for consensus on these BTM competencies. Stakeholders were selected based on their long-standing experience in teaching BTM and in managing trauma patients. Results Consensus was found on 29 competencies out of an initial 130 proposals. “Human Factors”, which had not been taught previously, scored relatively high, at 22%. The sole specific trauma skill agreed upon was the use of tourniquets. Conclusions This is an example of curricular revision of a clinical skills course after the introduction of a regulatory framework for undergraduate medical education. The revised course curriculum tailors the concepts and skills in trauma that fulfill stakeholder needs, and are in agreement with the new Swiss learning outcomes.
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Affiliation(s)
- Joana Berger-Estilita
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland.
| | - Sabine Nabecker
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland
| | - Robert Greif
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland
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Ben Mustapha S, Meijnders P, Jansen N, Lakosi F, Coucke P. The status of radiation oncology (RO) teaching to medical students in Europe. Clin Transl Radiat Oncol 2019; 17:40-46. [PMID: 31193619 PMCID: PMC6538841 DOI: 10.1016/j.ctro.2019.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/28/2022] Open
Abstract
RO teaching is underrepresented in the curriculum of medical students in Europe. RO is often taught and examined in modular courses. E-learning, computer-based examination and OSCE are used in few institutions. Clerkships and policies to enroll students in RO departments should be improved.
Aim To provide an overview of Radiation Oncology (RO) teaching to medical students around Europe. Materials and methods An electronic survey was sent to European academic teachers of RO. The survey focused on the teaching of RO to medical students throughout their undergraduate education. Results A total of 87 academic RO teachers from 29 countries were invited to participate in the electronic survey. Thirty-two surveys were completed by respondents from 19 European countries (response rate: 37%). The median number of hours devoted to RO teaching was 10 h (mean 16 h, range 2–60). The number of hours assigned to RO teaching was equal or inferior compared to medical oncology. In two institutions (6%) RO was delivered as a stand-alone course with an individual knowledge assessment. In 30 institutions (94%), the RO course was taught and/or assessed in a modular curriculum with other disciplines. Radiobiology, breast, lung, gastrointestinal, gynecologic malignancies, RO adverse events and palliative RO were taught in 80% of institutions. Pediatric RO, RO for benign conditions and economic topics were taught in less than 30% of institutions. In most institutions, classical written and oral examinations were used. Computer-based examinations and/or objective structured clinical examinations (OSCE) were seldom used. E-learning methods were available in less than 10% of institutions. A clerkship in RO department was available in 28 out of 32 institutions (87%), less than 5% of medical students were involved in research in RO during their undergraduate education. Strategies to encourage medical students to consider RO as a future career were offered in 53% of institutions. Conclusions RO teaching to medical students was not uniform in Europe. RO teaching during undergraduate education in Europe was undervalued, and its knowledge and learning tools could be broadened and updated in the core curricula of medical students
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Affiliation(s)
- Selma Ben Mustapha
- Department of Radiation Oncology, CHU de Liège, University of Liège, Liège Belgium
| | - Paul Meijnders
- Department of Radiation Oncology, Iridium Kankernetwerk, University of Antwerp, Antwerp, Belgium
| | - Nicolas Jansen
- Department of Radiation Oncology, CHU de Liège, University of Liège, Liège Belgium
| | - Ferenc Lakosi
- Institute of Diagnostic Imaging and Radiation Oncology, Health Center, Kaposvár University, Hungary
| | - Philippe Coucke
- Department of Radiation Oncology, CHU de Liège, University of Liège, Liège Belgium
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Tews MC, Ditz Wyte CM, Coltman M, Hiller K, Jung J, Oyama LC, Jubanyik K, Khandelwal S, Goldenberg W, Wald DA, Zun LS, Zinzuwadia S, Pandit K, An C, Ander DS. Implementing a third-year emergency medicine medical student curriculum. J Emerg Med 2015; 48:732-743.e8. [PMID: 25825161 DOI: 10.1016/j.jemermed.2014.12.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 11/05/2014] [Accepted: 12/22/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emergency medicine (EM) is commonly introduced in the fourth year of medical school because of a perceived need to have more experienced students in the complex and dynamic environment of the emergency department. However, there is no evidence supporting the optimal time or duration for an EM rotation, and a number of institutions offer third-year rotations. OBJECTIVE A recently published syllabus provides areas of knowledge, skills, and attitudes that third-year EM rotation directors can use to develop curricula. This article expands on that syllabus by providing a comprehensive curricular guide for the third-year medical student rotation with a focus on implementation. DISCUSSION Included are consensus-derived learning objectives, discussion of educational methods, considerations for implementation, and information on feedback and evaluation as proposed by the Clerkship Directors in Emergency Medicine Third-Year Curriculum Work Group. External validation results, derived from a survey of third-year rotation directors, are provided in the form of a content validity index for each content area. CONCLUSIONS This consensus-derived curricular guide can be used by faculty who are developing or revising a third-year EM medical student rotation and provide guidance for implementing this curriculum at their institution.
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Affiliation(s)
- Matthew C Tews
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Collette Marie Ditz Wyte
- Department of Emergency Medicine, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan
| | - Marion Coltman
- Department of Emergency Medicine, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan
| | - Kathy Hiller
- Department of Emergency Medicine, University of Arizona Health Network, Tucson, Arizona
| | - Julianna Jung
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Leslie C Oyama
- UCSD Emergency Medicine, University of California, San Diego, San Diego, California
| | - Karen Jubanyik
- Department of Emergency Medicine, Yale-New Haven Hospital, New Haven, Connecticut
| | - Sorabh Khandelwal
- Department of Emergency Medicine, The Ohio State University Medical Center, Columbus, Ohio
| | - William Goldenberg
- Department of Emergency Medicine, Naval Medical Center, San Diego, California
| | - David A Wald
- Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Leslie S Zun
- Department of Emergency Medicine, Mount Sinai Hospital, Chicago Medical School, Chicago, Illinois
| | - Shreni Zinzuwadia
- Department of Emergency Medicine, New Jersey Medical School-University Hospital, Newark, New Jersey
| | - Kiran Pandit
- Department of Emergency Medicine, Columbia University, New York, New York
| | - Charlene An
- Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Douglas S Ander
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
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Lareau SA, Caudell MJ, Pandit KB, Hiestand BC. Medical Student Electives in Wilderness Medicine: Curriculum Guidelines. Wilderness Environ Med 2014; 25:474-80. [DOI: 10.1016/j.wem.2014.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 03/28/2014] [Accepted: 04/26/2014] [Indexed: 11/29/2022]
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Askew KL, Weiner D, Murphy C, Duong M, Fox J, Fox S, O’Neill JC, Nadkarni M. Consensus development of a pediatric emergency medicine clerkship curriculum. West J Emerg Med 2014; 15:647-51. [PMID: 25247034 PMCID: PMC4162720 DOI: 10.5811/westjem.2014.4.20007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 03/11/2014] [Accepted: 04/15/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION As emergency medicine (EM) has become a more prominent feature in the clinical years of medical school training, national EM clerkship curricula have been published to address the need to standardize students' experiences in the field. However, current national student curricula in EM do not include core pediatric emergency medicine (PEM) concepts. METHODS A workgroup was formed by the Clerkship Directors in Emergency Medicine and the Pediatric Interest Group of the Society of Academic Emergency Medicine to develop a consensus on the content to be covered in EM and PEM student courses. RESULTS The consensus is presented with the goal of outlining principles of pediatric emergency care and prioritizing students' exposure to the most common and life-threatening illnesses and injuries. CONCLUSION This consensus curriculum can serve as a guide to directors of PEM and EM courses to optimize PEM knowledge and skills education.
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Affiliation(s)
- Kim L. Askew
- Wake Forest University School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Debra Weiner
- Boston Children’s Hospital, Division of Emergency Medicine, Boston, Massachusetts
| | - Charles Murphy
- Mount Sinai Medical Center, Department of Emergency Medicine, New York, New York
| | - Myto Duong
- Southern Illinois University, Department of Emergency Medicine, Carbondale, Illinois
| | - James Fox
- Duke University Medical Center, Department of Pediatrics, Durham, North Carolina
| | - Sean Fox
- Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina
| | - James C. O’Neill
- Wake Forest University School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Milan Nadkarni
- Wake Forest University School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
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Iyer MS, Mullan PB, Santen SA, Sikavitsas A, Christner JG. Deliberate apprenticeship in the Pediatric Emergency Department improves experience for third-year students. West J Emerg Med 2014; 15:424-9. [PMID: 25035748 PMCID: PMC4100848 DOI: 10.5811/westjem.2014.5.19647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/22/2014] [Accepted: 05/05/2014] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The Pediatric Emergency Department (PED) provides medical students with learning in a high-volume, fast-paced environment; characteristics that can be stressful for new students. Shadowing can improve transitioning, yet this alone does not facilitate students’ development of independent medical care competencies. This study evaluates if third-year medical students’ deliberate apprenticeship with senior residents increases students’ comfort and patient exposure in the PED. METHODS This study took place over the 2011–2012 academic year, and study participants were all third-year medical students during their pediatric clerkship rotation. This was a prospective educational intervention assigning students to randomized control blocks of deliberate apprenticeship (DA) intervention or control. DA students were paired with a senior resident who oriented and worked with the student, while control students were unpaired. All students completed a 20-question structured survey at shift end, which included questions about their perception of the learning environment, comfort with, and number of patient care responsibilities performed. We used independent Mann-Whitney and t-tests to compare experiences between the groups. Statistical significance was defined as p<0.05. We used the constant comparative method to qualitatively analyze students’ comments. RESULTS Response rate was 85% (145/169). Students also rated on 5-point Likert-scale their level of comfort with defined aspects of working in the PED. DA students (n=76) were significantly more comfortable obtaining histories (4.2 versus 3.8) and formulating differential diagnoses (3.9 versus 3.4). DA students also performed more physical exams (2.9 versus 2.4). We categorized themes from the qualitative analysis of the students’ comments about their PED experience. The titles for these themes are as follows: PED provides a good learning experience; uncertainty about the medical student’s role in the PED; third-year medical students compete with other learners for teaching attention; opportunities provided to medical students for inclusion in patient care; personal knowledge deficits limit the ability to participate in the PED; PED pace affects learning opportunities. CONCLUSION DA constitutes a feasible approach to the clinical learning environment that increases students’ patient care experiences and may ease transitioning for undergraduate medical students to new clinical environments.
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Affiliation(s)
- Maya Subbarao Iyer
- Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Department of Pediatrics, Division of Emergency Medicine, Pittsburgh, Pennsylvania
| | - Patricia B Mullan
- University of Michigan Medical School, Department of Medical Education, Ann Arbor, Michigan
| | - Sally A Santen
- University of Michigan, Department of Medical Education and Department of Emergency Medicine, Ann Arbor, Michigan
| | - Athina Sikavitsas
- University of Michigan, Department of Emergency Medicine and Department of Pediatrics, Ann Arbor, Michigan
| | - Jennifer G Christner
- State University of New York at Syracuse, Department of Medical Education and Department of Pediatrics, Syracuse, New York
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Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum. Int J Radiat Oncol Biol Phys 2014; 88:45-50. [DOI: 10.1016/j.ijrobp.2013.10.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/17/2013] [Accepted: 10/29/2013] [Indexed: 11/23/2022]
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Cox M, Chandra A. Undergraduate emergency medicine in an African medical school – Experiences from Botswana. Afr J Emerg Med 2013. [DOI: 10.1016/j.afjem.2013.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Senecal EL, Heitz C, Beeson MS. Creation and implementation of a national emergency medicine fourth-year student examination. J Emerg Med 2013; 45:924-34. [PMID: 23948604 DOI: 10.1016/j.jemermed.2013.05.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 02/11/2013] [Accepted: 05/01/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND A National Board of Medical Examiners examination does not exist for Emergency Medicine (EM) students. To fill this void, the Clerkship Directors in Emergency Medicine tasked a committee with development of an examination for 4th-year (M4) EM students, based on a published syllabus, and consisting of questions written according to published question-writing guidelines. STUDY OBJECTIVES Describe examination development and statistics at 9 months. METHODS The committee reviewed an existing EM student question database at www.saemtests.org for statistical performance, compliance with item-writing guidelines, and topic inclusion within the published EM M4 syllabus. For syllabus topics without existing questions, committee members wrote new items. LXR 6.0 software (Applied Measurement Professionals, Inc., Georgetown, SC) was used for examination administration. Data gathered included numbers of examinations completed, mean scores with SD, and point biserial correlation (rpb). RESULTS Of the 553 questions assessed, 157 questions met the stated criteria, and 37 were included in the examination. Thirteen new questions were written by committee members to cover all curriculum topics. The National EM M4 Examination was released online August 1, 2011. Nine months later, the examination had been completed 1642 times by students from 27 clerkships. Mean score was 79.69% (SD 3.89). Individual question difficulties ranged from 26% to 99%. Question rpbs ranged from 0.067 to 0.353, mean 0.213 (SD 0.066). CONCLUSIONS A national group of EM educators developed an examination to assess a published clerkship syllabus. The examination contains questions written according to published item-writing guidelines, and exhibits content validity, appropriate difficulty levels, and adequate question discriminatory ability.
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Affiliation(s)
- Emily L Senecal
- Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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