Teaching and learning in medicine
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Most formal instruction in professionalism and communication occurs in the preclinical years of medical school, with an acknowledged need to fortify and apply these competencies during the clinical years. Role modeling provides a powerful way to teach professionalism, particularly when mentors identify specific learning goals and focus the learners' observations. ⋯ As educators seek methods for learners to attain greater competence in communication and interpersonal skills, the SCOOP provides an explicit framework to optimize modeling for the learning of professionalism.
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Physicians can expect to confront a variety of psychiatric emergencies during their careers. However, medical schools are not required to teach emergency psychiatry and little is known about the content of existing instruction. ⋯ Most schools provide emergency psychiatry instruction, but methods vary among institutions. Given its importance, medical schools should work to provide uniformity in the way emergency psychiatry is taught.
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Residency programs must prepare physicians to practice in the current health care environment. This mandate is reflected in 3 of the 6 competency domains now required by the Accreditation Council for Graduate Medical Education: systems-based practice, interpersonal skills and communication, and practice-based learning and improvement. ⋯ The use of several practical, scientifically sound, and specific methods for assessing residents' competency in care management are recommended. Assessment instruments will need to be flexible enough to adapt to the rapid changes in the health care delivery system and terminology.
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Review
What is the impact of commercial test preparation courses on medical examination performance?
Commercial test preparation courses are part of the fabric of U.S. medical education. They are also big business with 2,000 sales for 1 firm listed at nearly $250 million. This article systematically reviews and evaluates research published in peer-reviewed journals and in the "grey literature" that addresses the impact of commercial test preparation courses on standardized, undergraduate medical examinations. ⋯ The articles and unpublished reports reveal that current research lacks control and rigor; the incremental validity of the commercial courses on medical examination performance, if any, is extremely small; and evidence in support of the courses is weak or nonexistent; almost no details are given about the form and conduct of the commercial test preparation courses; studies are confined to courses in preparation for the Medical College Admission Test, the former National Board of Medical Examiners Part 1, and the United States Medical Licensing Examination Step 1, not tests of clinical science; and that cost-benefit analyses of the test preparation courses have not been done. It is concluded that the utility and value of commercial test preparation courses in medicine have not been demonstrated, and that evaluation apprehension in the medical profession and aggressive marketing practices are most likely responsible for commercial course prosperity.
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The factors medical students use to choose emergency medicine (EM) as a career path have not been well studied. The role of a 3rd year clerkship in EM in a student's choice of EM residency is not known. ⋯ This study did not demonstrate a correlation of a 3rd year rotation in EM with the number of students applying or matching in EM.