Academic medicine : journal of the Association of American Medical Colleges
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Comparative Study
Development of an office-based curriculum of common pediatric primary care skills for residents.
Basic primary care skills-such as injections and hearing screening-are commonly absent from residency curricula, yet competence in these skills is required by residency accrediting organizations. To meet this need at our program, an office-based curriculum of common pediatric primary care skills was developed and piloted in a resident continuity practice. ⋯ This pilot demonstrated that it is feasible to teach primary care skills to residents in the office setting. In our pilot, the test group performed 61% better on a written test and 64% better on a practical test when compared with the control group (p <.0001). Residents who participated in the pilot felt the methods used were appropriate and effective and that the skills taught were important. Additionally, they found the pilot did not interfere with the operation of the continuity clinic. The procedure checklist proved to be an effective and simple method of instructing a psychomotor skill. Conducting the educational sessions at the beginning of clinic was difficult due to interruptions and tardiness. While other methods, such as noon conferences, may also be effective, instruction in the actual clinical setting appeared to better demonstrate the importance, practicality, and relevance of the skill. The residents were more enthusiastic during this office-based curriculum than a typical resident conference. We conclude that this model is an effective and practical method to teach primary care skills in a clinical setting. Our success with the pilot unit has been encouraging, and we plan to develop and test the remaining units of the curriculum.
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The objective of the Health Professions Partnership Initiative is to increase the number of underrepresented minority Georgia residents who become health care professionals by (1) creating a pipeline of well-qualified high school and college students interested in health care careers, (2) increasing the number of well-qualified applicants to medical and other health professions schools, and (3) increasing the number of underrepresented minority students at the Medical College of Georgia (MCG). ⋯ The ultimate solution to the paucity of underrepresented minority physicians resides largely in successful pipeline programs that expand the pool of well-qualified applicants, matriculants, and graduates from medical schools. Intermediate results of the HSLA support the success of the program. Since its creation in the 1996-1997 academic year, 203 students have participated in the HSLA and all 38 (from the original two schools) who completed the four-year program have enrolled in college. The mean SAT score for students who completed the HSLA program was 1,066, compared with a mean of 923 for all college-bound students in the participating schools. The mean increases in SAT scores for students who completed the four-year program were.5% (1,100 to 1,105) for students attending a magnet high school and 18% (929 to 1,130) for students attending the comprehensive high school. The mean overall increases in SAT scores for students in the two high schools were 1% (1,044 to 1,048) and 9.1% (765 to 834), respectively. The HSLA is accomplishing its goals and, while it is too early to know if these students will participate in MCAT preparatory programs and apply to medical and other health professions schools, their sustained commitment and enthusiasm bode well for continued success.
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Students often request a "study month" prior to taking the USMLE Step 2 to maximize their performance on the exam. This report questions the utility of this approach.
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Adolescents in the United States have high morbidity rates, which are attributable to injuries, behavioral disorders, sexually transmitted diseases, and unplanned pregnancies. This has led to a call to action for health care educators to better prepare future practitioners to meet adolescent health care needs. Although pediatrics residency programs have required one-month curricula dedicated to adolescent medicine, many internal medicine (IM) residency programs do not have such requirements despite an American College of Physicians position paper recognizing the importance of internists' providing health care to adolescents. Thus, an introductory curriculum in adolescent medicine was developed for a community hospital IM residency program. The curriculum was designed to train IM residents to effectively interview, provide preventive care for, and evaluate common medical problems of older adolescents (ages 16-21) in an outpatient setting. ⋯ Twenty-one of 40 residents participated in the pilot unit. Evaluations were overall very positive. Quiz scores confirmed that the residents achieved the desired learning objectives. Given these results from the pilot unit, the remaining two units of the curriculum have been integrated into the residency curriculum. Additional faculty members have been selected to deliver future sessions and support this important educational activity. The adolescent medicine curriculum can be used as an model by other IM residency programs for teaching adolescent health care, with an emphasis on both the knowledge base of adolescent issues and awareness of the unique skills necessary for the establishment of a physician-patient relationship between internists and older adolescents.
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The purpose of the migrant health initiative is to give medical students the opportunity to provide clinical services, at appropriate levels of training, to a population that reflects a different ethnic and economic background than medical students typically see in the clinical setting. This initiative integrates concepts of cultural competency with experiential learning. ⋯ The partnership between students, faculty, and the community provides the mechanism to thoughtfully develop and integrate cultural issues and experiences into the curriculum. Students have recently received a Caring for Community five-year grant from the Association of American Medical Colleges. Program expansions will continue into the third-year medicine clerkship and include a senior elective. The program expansions will result in a migrant health initiative that will be coordinated; comprehensive; and expand student knowledge, skills, and experiences in cultural health care.