Medical education
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Randomized Controlled Trial
Clinical skills education: outcomes of relationships between junior medical students, senior peers and simulated patients.
Peer-assisted learning (PAL) has been reported to have educational benefits in cross-year, small-group teaching in other contexts. Accordingly, we explored whether senior medical students are effective tutors for their junior peers in clinical skills education, and how the participants in the learning triad (tutors, learners and simulated patients [SPs]) perceive the learning environment created in PAL. ⋯ With appropriate support, volunteer Year 6 student tutors are as effective as graduate doctors for small-group structured tutorials in clinical skills. Educational relationships were forged between all participants in the learning triad.
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Although lack of time has been frequently cited as a barrier to scholarship, there has been little inquiry into what specific factors medical faculty staff perceive as contributing to this dilemma. The purpose of the present study was to explore, in greater detail, lack of time as a barrier for faculty interested in pursuing education scholarship. ⋯ With respect to education scholarship, the dilemma caused by lack of time involves a complex, multi-faceted set of issues which extends beyond the number of hours available in a day. Personal interest and having background training in education do not appear to be sufficient to encourage involvement. Multiple institutional support mechanisms are necessary.
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Teaching and evaluating professionalism remain important issues in medical education. However, two factors hinder attempts to integrate curricular elements addressing professionalism into medical school training: there is no common definition of medical professionalism used across medical education, and there is no commonly accepted theoretical model upon which to integrate professionalism into the curriculum. ⋯ We offer a model based on the theory of planned behaviour (TPB), which describes the relationships of attitudes, social norms and perceived behavioural control with behaviour. It has been used to predict a wide range of behaviours, including doctor professional behaviours. Therefore, we propose an educational model that expands the TPB as an organisational framework that can integrate professionalism training into medical education. We conclude with a discussion about the implications of using this model to transform medical school curricula to develop positive professionalism attitudes, alter the professionalism social norms of the medical school and increase students' perceived control over their behaviours.
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Multicenter Study
Transition to clinical training: influence of pre-clinical knowledge and skills, and consequences for clinical performance.
Many students experience a tough transition from pre-clinical to clinical training and previous studies suggest that this may constrict students' progress. However, clear empirical evidence of this is lacking. The aim of this study was to determine: whether the perceived difficulty of transition influences student performance during the first 2 weeks of clerkships; whether it influences students' overall performance in their first clerkship, and the degree to which the difficulty of transition is influenced by students' pre-clinical knowledge and skills levels. ⋯ The negative effect of the transition period on student progress suggested in the literature was not found in this study. A possible explanation for the limited influence of students' knowledge and skills on performance during the transition period is that the workload in this period causes a cognitive overload, interfering with students' abilities to apply their pre-clinical knowledge and skills.
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Recent educational reform in US medical schools has created integrated curricular structures. This study investigated how stakeholders in a newly integrated curriculum - students, course directors and curriculum leaders - define integration and perceive its successes and challenges during its first year. ⋯ Integrating a curriculum is a complex process. It is differentially understood and experienced by students and faculty, and can refer to instructional method, content, faculty work or synthesis of knowledge in the minds of learners. It can occur at different rates and some subjects are integrated more easily than others. We point to some specific considerations as medical schools embark on curriculum reform.