Medical Student Education

Background: Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty. Objectives: We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency. We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from ''strongly disagree'' to ''strongly agree,'' either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course. Results: Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students. Conclusions: Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency. [West J Emerg Med. 2011;12(4):543-550.]

Mental rehearsal, defined as the deliberate cognitive rehearsal of tasks without action, is an emerging approach to procedural skills learning in healthcare education. In particular, mental rehearsal has been associated with durable improvement of complex skills in various fields such as aviation, high performance sports and surgery. Despite this, mental rehearsal-based practices in healthcare are challenged with mainly informal and highly heterogeneous practice. Given this, the efficacy of mental rehearsal in medical education remains poorly characterised. Furthermore, there is currently no evidence-based approach to integrating mental rehearsal in the medical curriculum, nor frameworks to guide development of mental rehearsal skills for students. This narrative review explores mental rehearsal in medical education and evaluates the current principles of mental rehearsal and how these can be applied to improve procedural skills learning for medical students.

Background The global COVID-19 pandemic has had a major impact on medical student education. As the pandemic spread nationwide, numerous universities shut down with only days’ notice, and medical students were removed from all patient care settings and restricted from campuses. Yet, the need and curiosity of these future physicians to understand this new disease was great, including how to interpret and integrate rapidly evolving information on the underlying viral and immune mechanisms, pathophysiology, and epidemiology. Time students spent away from patient care settings presented an opportunity to rapidly develop and deliver new curriculum covering SARS-CoV-2 and COVID-19. Methods A team of students and faculty at Indiana University developed a Fundamentals of COVID-19 course that included up-to-date information on the virology, immunology, and pathophysiology of COVID-19. The course was delivered online, with both synchronous and asynchronous activities. Virology and immunology ...

Background: Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty. Objectives: We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency. We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from ''strongly disagree'' to ''strongly agree,'' either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course. Results: Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students. Conclusions: Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency. [West J Emerg Med. 2011;12(4):543-550.]

The effect of emergency department (ED) crowding has been recognized as a concern for more than 20 years; its effect on productivity, medical errors, and patient satisfaction has been studied extensively. Little research has reviewed the effect of ED crowding on medical education. Prior studies that have considered this effect have shown no correlation between ED crowding and resident perception of quality of medical education. Objective: To determine whether ED crowding, as measured by the National ED Overcrowding Scale (NEDOCS) score, has a quantifiable effect on medical student objective and subjective experiences during emergency medicine (EM) clerkship rotations. We collected end-of-rotation examinations and medical student evaluations for 21 EM rotation blocks between July 2010 and May 2012, with a total of 211 students. NEDOCS scores were calculated for each corresponding period. Weighted regression analyses examined the correlation between components of the medical student evaluation, student test scores, and the NEDOCS score for each period. Results: When all 21 rotations are included in the analysis, NEDOCS scores showed a negative correlation with medical student tests scores (regression coefficient= -0.16, p=0.04) and three elements of the rotation evaluation (attending teaching, communication, and systems-based practice; p<0.05). We excluded an outlying NEDOCS score from the analysis and obtained similar results. When the data were controlled for effect of month of the year, only student test score remained significantly correlated with NEDOCS score (p=0.011). No part of the medical student rotation evaluation attained significant correlation with the NEDOCS score (p≥0.34 in all cases). ED overcrowding does demonstrate a small but negative association with medical student performance on end-of-rotation examinations. Additional studies are recommended to further evaluate this effect. [

The effect of emergency department (ED) crowding has been recognized as a concern for more than 20 years; its effect on productivity, medical errors, and patient satisfaction has been studied extensively. Little research has reviewed the effect of ED crowding on medical education. Prior studies that have considered this effect have shown no correlation between ED crowding and resident perception of quality of medical education. Objective: To determine whether ED crowding, as measured by the National ED Overcrowding Scale (NEDOCS) score, has a quantifiable effect on medical student objective and subjective experiences during emergency medicine (EM) clerkship rotations. Methods: We collected end-of-rotation examinations and medical student evaluations for 21 EM rotation blocks between July 2010 and May 2012, with a total of 211 students. NEDOCS scores were calculated for each corresponding period. Weighted regression analyses examined the correlation between components of the medical student evaluation, student test scores, and the NEDOCS score for each period. Results: When all 21 rotations are included in the analysis, NEDOCS scores showed a negative correlation with medical student tests scores (regression coefficient=-0.16, p=0.04) and three elements of the rotation evaluation (attending teaching, communication, and systems-based practice; p<0.05). We excluded an outlying NEDOCS score from the analysis and obtained similar results. When the data were controlled for effect of month of the year, only student test score remained significantly correlated with NEDOCS score (p=0.011). No part of the medical student rotation evaluation attained significant correlation with the NEDOCS score (p≥0.34 in all cases). Conclusion: ED overcrowding does demonstrate a small but negative association with medical student performance on end-of-rotation examinations. Additional studies are recommended to further evaluate this effect. [West J Emerg Med. 2015;16(6):913-918.] * † 20 years. 1 Previous reports have noted crowding as a risk factor for patients leaving without being seen, increased inpatient mortality, increased frequency of medical errors, and increased

Figure 4-Choosing The Correct Antibiotic After PEST Teaching Conclusion. Our results showed fidelity in using the PEST approach to improve therapeutic reasoning after a teaching session, but the method did little to improve antibiotic selection. Perhaps antibiotic selection requires greater clinical experience in order to provide a narrower or more optimal spectrum of coverage. Interestingly, some interns used select "PEST" concepts prior to the intervention suggesting that the PEST approach may solidify prior knowledge or clinical reasoning skills. Continued incorporation of the PEST approach using a case-based framework may solidify conceptual and practical knowledge of antimicrobial selection. Disclosures.

Background: Knowledge of mental disorders is poor in developing countries and often has a negative impact on the ways the public relate to persons with mental disorders. The present study seeks to explore changes in knowledge and attitude of student nurses to mental disorders following an educational program. Materials / Method: The study involved first and second-year students from two schools of basic nursing: the State School of Nursing, Calabar (intervention group) and the University of Calabar Teaching Hospital's School of Nursing (control). A total of 191 students from both schools were assessed at different times (pre and post-intervention periods) using the modified World Psychiatric Association (WPA) questionnaire. The educational intervention was performed only on the students in the intervention group using the WPA semi-structured educational material. Results: The baseline results show that while a small proportion of the respondents (28.1% in the intervention group and 37.9% of control) attributed the cause of mental illness to witchcraft, majority had poor attitudes to mental disorders. One week post-intervention assessment shows some improvement in knowledge of the respondents in the intervention group. This improvement was significant for those that endorsed witchcraft (P=0.01) and God's punishment (P=0.01) as causes of mental disorders. This significant improvement was sustained at the one-month post-intervention assessment. Conclusion: The study shows that an educational program is capable of improving knowledge of aetiology of mental disorders and attitudes towards persons with such disorders.

To determine if there is any correlation between any of the 10 individual components of a global rating index on an emergency medicine (EM) student clerkship evaluation form. If there is correlation, to determine if a weighted average of highly correlated components loses predictive value for the final clerkship grade. Methods: This study reviewed medical student evaluations collected over two years of a required fourth-year rotation in EM. Evaluation cards, comprised of a detailed 10-part evaluation, were completed after each shift. We used a correlation matrix between evaluation category average scores, using Spearman's rho, to determine if there was any correlation of the grades between any of the 10 items on the evaluation form. Results: A total of 233 students completed the rotation over the two-year period of the study. There were strong correlations (>0.80) between assessment components of medical knowledge, history taking, physical exam, and differential diagnosis. There were also strong correlations between assessment components of team rapport, patient rapport, and motivation. When these highly correlated were combined to produce a four-component model, linear regression demonstrated similar predictive power in terms of final clerkship grade (R 2 =0.71, CI 95 =0.65-0.77 and R 2 =0.69, CI 95 =0.63-0.76 for the full and reduced models respectively). Conclusion: This study revealed that several components of the evaluation card had a high degree of correlation. Combining the correlated items, a reduced model containing four items (clinical skills, interpersonal skills, procedural skills, and documentation) was as predictive of the student's clinical grade as the full 10-item evaluation. Clerkship directors should be aware of the performance of their individual global rating scales when assessing medical student performance, especially if attempting to measure greater than four components. [

Background: Knowledge of mental disorders is poor in developing countries and often has a negative impact on the ways the public relate to persons with mental disorders. The present study seeks to explore changes in knowledge and attitude of student nurses to mental disorders following an educational program. Materials / Method: The study involved first and second-year students from two schools of basic nursing: the State School of Nursing, Calabar (intervention group) and the University of Calabar Teaching Hospital's School of Nursing (control). A total of 191 students from both schools were assessed at different times (pre and post-intervention periods) using the modified World Psychiatric Association (WPA) questionnaire. The educational intervention was performed only on the students in the intervention group using the WPA semi-structured educational material. Results: The baseline results show that while a small proportion of the respondents (28.1% in the intervention group and 37.9% of control) attributed the cause of mental illness to witchcraft, majority had poor attitudes to mental disorders. One week post-intervention assessment shows some improvement in knowledge of the respondents in the intervention group. This improvement was significant for those that endorsed witchcraft (P=0.01) and God's punishment (P=0.01) as causes of mental disorders. This significant improvement was sustained at the one-month post-intervention assessment. Conclusion: The study shows that an educational program is capable of improving knowledge of aetiology of mental disorders and attitudes towards persons with such disorders.

Despite the emphasis placed on physicians' lifelong learning, no psychometrically sound instrument has been developed to provide an operational measure of the concept and its components among physicians. The authors designed this study to develop a tool for measuring physician lifelong learning, to identify its underlying components and to assess its psychometric properties. A 37-item questionnaire was developed, based on a review of literature and the results of two pilot studies. Psychometric analyses of the responses of 160 physicians identified 19 items that were included in the Jefferson Scale of Physician Lifelong Learning. Factor analysis of the 19 items showed five meaningful factors that were consistent with the definition and major features of lifelong learning. They were 'need recognition', 'research endeavor', 'self-initiation', 'technical skills' and 'personal motivation'. The method of contrasted groups provided evidence in support of the validity of the five factors. The factors' reliability was assessed by coefficient alpha. It is concluded that lifelong learning is a multifaceted concept, and its operational measure is feasible for evaluating different educational programs and for studying group differences among physicians.

The emergency medicine (EM) clerkship curriculum at Los Angeles County + University of Southern California Medical Center includes monthly lectures on pediatric fever and shortness of breath (SOB). This educational innovation evaluated if learning could be enhanced by &quot;priming&quot; the students with educational online videos prior to an in-class session. Factors that impacted completion rates were also evaluated (planned specialty and time given for video viewing). Twenty-minute videos were to be viewed prior to the didactic session. Students were assigned to either the fever or SOB group and received links to those respective videos. All participating students took a pre-test prior to viewing the online lectures. For analysis, test scores were placed into concordant groups (test results on fever questions in the group assigned the fever video and test results on SOB questions in the group assigned the SOB video) and discordant groups (crossover between video assigned and topi...

Physicians must be competent communicators to ef-fectively practice medicine, and communication is one of six required competencies identified by the Accredi-tation Council on Graduate Medical Education (ACGME).1 Elements of competent communication are featured in four of the six ACGME competencies. The

This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.

Objective This study assessed beliefs about mental disorders and changes in those beliefs following an educational intervention for a convenience sample of Nigerian medical and nursing students. Methods A 43-item questionnaire was used to assess perceptions regarding mental disorders and attitudes toward people with mental illness before and after a 4-day educational intervention. Results Factor analysis identified four domains: (1) socializing with people with mental illness, (2) belief in witchcraft or curses as causes of mental illness, (3) favorable attitudes toward normalization of the lives of people with mental illness , and (4) biopsychosocial approaches to mental illness. The greatest changes were in attitudes favoring normalization of the lives of people with mental illness (p=0.0002), socializing with the mentally ill (p=0.01), and biopsychosocial perspectives on mental illness (p=0.01). Conclusion Brief educational interventions may alter some stigmatizing negative attitudes toward mental illness in healthcare trainees in low-and middle-income countries.