Browsing by Subject "Schools, Medical"

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Open Access
Development of an Interactive Global Surgery Course for Interdisciplinary Learners.
(Annals of global health, 2021-03) Fitzgerald, Tamara N; Muma, Nyagetuba JK; Gallis, John A; Reavis, Grey; Ukachukwu, Alvan; Smith, Emily R; Ogbuoji, Osondu; Rice, Henry E
Introduction
Global surgical care is increasingly recognized in the global health agenda and requires multidisciplinary engagement. Despite high interest among medical students, residents and other learners, many surgical faculty and health experts remain uniformed about global surgical care.
Methods
We have operated an interdisciplinary graduate-level course in Global Surgical Care based on didactics and interactive group learning. Students completed a pre- and post-course survey regarding their learning experiences and results were analyzed using the Wilcoxon signed-rank test.
Results
Fourteen students completed the pre-course survey, and 11 completed the post-course survey. Eleven students (79%) were enrolled in a Master's degree program in global health, with eight students (57%) planning to attend medical school. The median ranking of surgery on the global health agenda was fifth at the beginning of the course and third at the conclusion (p = 0.11). Non-infectious disease priorities tended to stay the same or increase in rank from pre- to post-course. Infectious disease priorities tended to decrease in rank (HIV/AIDS, p = 0.07; malaria, p = 0.02; neglected infectious disease, p = 0.3). Students reported that their understanding of global health (p = 0.03), global surgery (p = 0.001) and challenges faced by the underserved (p = 0.03) improved during the course. When asked if surgery was an indispensable part of healthcare, before the course 64% of students strongly agreed, while after the course 91% of students strongly agreed (p = 0.3). Students reported that the interactive nature of the course strengthened their skills in collaborative problem-solving.
Conclusions
We describe an interdisciplinary global surgery course that integrates didactics with team-based projects. Students appeared to learn core topics and held a different view of global surgery after the course. Similar courses in global surgery can educate clinicians and other stakeholders about strategies for building healthy surgical systems worldwide.
Open Access
History of Medicine in the Clerkships: A Novel Model for Integrating Medicine and History.
(Journal of the history of medicine and allied sciences, 2023-03) Barr, Justin; Ingold, Rachel; Baker, Jeffrey P
The history of medicine has only unevenly been integrated into medical education. Previous attempts to incorporate the subject have focused either on the first year, with its already over-subscribed curriculum, or the fourth year in the form of electives that reach a small minority of students. Duke University provides an alternative model for other universities to consider. At our institution we have overcome many of the curricular limitations by including history during the mandatory third year clerkships. Reaching 100% of the medical school class, these sessions align with clinical disciplines, providing students a longitudinal perspective on what they are seeing and doing on the hospital wards. They are taught in conjunction with a medical history librarian and rely heavily on the utilization and interpretation of physical artifacts and archival manuscripts. The surgery, obstetrics/gynecology, and pediatrics rotations now feature successful and popular history of medicine sessions. Describing our lesson plans and featuring a list of both physical and online resources, we provide a model others can implement to increase the use, the framing, and the accessibility of history in their medical schools.
Open Access
International crises and global health electives: lessons for faculty and institutions.
(Academic medicine : journal of the Association of American Medical Colleges, 2010-10) Steiner, Beat D; Carlough, Martha; Dent, Georgette; Peña, Rodolfo; Morgan, Douglas R
Student participation in global health electives and community service initiatives is associated with a number of favorable outcomes, and student interest in participating in such experiences is high. Increasingly, medical schools are facilitating and supervising global health opportunities. The inherent risks and uncertainties of global community service deserve careful consideration as schools engage more actively in this area. This article presents how one institution managed three crises in three electives in a single year. The H1N1 flu epidemic impacted a group of students bound for Mexico, a political upheaval affected a student group working in Honduras, and a hurricane threatened a student group in Nicaragua. This article outlines lessons learned from responding to these crises. Well-defined institutional travel policies, clear communication plans in the event of an emergency, a responsible administrative entity for global experiences, and formal predeparture training for students and faculty can help institutions better respond to unpredictable events. A comprehensive examination of these lessons and reflections on how to institutionalize the various components may help other institutions prepare for such events and lessen negative impact on student learning.
Open Access
Physician Assistant Program Policies to Assess and Address Student Reports of Mistreatment During Clinical Training.
(The journal of physician assistant education : the official journal of the Physician Assistant Education Association, 2022-09) Hudak, Nicholas M; Blazar, Melinda; Knudsen, Nancy W
Introduction
Many physician assistant (PA) students experience mistreatment in clinical learning environments, and accredited PA programs are required to define, publish, and make readily available policies and procedures for student reports of mistreatment. The purpose of this study is to describe the prevalence, content, and dissemination of program policies to address students' reports of mistreatment involving preceptors during supervised clinical experiences.
Methods
To conduct a national policy analysis, the investigators included 10 new survey items in the 2019 Physician Assistant Education Association annual program survey. Deidentified data were analyzed by using descriptive statistics.
Results
The program response rate to the survey items was 99% (232). Approximately 76% of PA programs reported having a learner mistreatment policy. Policy content across programs varied widely, and several student reporting mechanisms were available. Program directors, clinical faculty, and institutional leadership were most likely to be involved in the management of reports. A majority programs actively assessed for mistreatment and most did so through clinical course evaluations and at the end of each clinical phase course. Most programs disseminated information about policy to faculty, students, and preceptors at least once a year.
Discussion
The descriptions of policy content, procedures, and dissemination increase educators' understanding of current policies across PA programs in the context of renewed efforts to write or revise policy that is specific to mistreatment. The authors discuss key policy priorities to define mistreatment, offer a range of confidential reporting mechanisms, review the management of reports, and consider how to optimize dissemination strategies.
Open Access
Providing premedical students with quality clinical and research experience: the Tobacco Science Scholars Program.
(WMJ, 2013-10) Davis, James M; Anderson, Maggie C; Stankevitz, Kristin A; Manley, Alison R
Undergraduate premedical students face a formidable decision as they work to determine whether to pursue a profession in medicine. Exposure to clinical medicine and research is essential to inform students what it might be like to be a physician. Undergraduates, however, face a number of obstacles to obtaining the kind of quality clinical and research experience needed to make an informed decision. Growing regulations designed to protect patient confidentiality, though undeniably important, pose a barrier to students seeking patient contact. Traditional passive physician shadowing often does not provide ample opportunities for one-on-one patient interaction or problem solving. Finally, research opportunities available to students typically are not associated with clinical work and therefore do not provide an experiential model of how empirical evidence informs medical practice. This report describes the University of Wisconsin School of Medicine and Public Health's Tobacco Science Scholars Program, a pilot program designed to address some of these barriers. While fulfilling institutional requirements for patient contact, the program provides students with an active model of clinical patient interaction and problem solving, with a research experience integrated into these clinical experiences so that undergraduates better understand how research informs clinical medicine.
Open Access
Representation of Female Faculty at US Medical Schools and Success in Obtaining National Institutes of Health Funding, 2008-2018.
(JAMA network open, 2021-03) Malinzak, Elizabeth Burney; Weikel, Daniel; Swaminathan, Madhav
Open Access
Students with global experiences during medical school are more likely to work in settings that focus on the underserved: an observational study from a public U.S. institution.
(BMC medical education, 2021-10) Slifko, Shay E; Vielot, Nadja A; Becker-Dreps, Sylvia; Pathman, Donald E; Myers, Justin G; Carlough, Martha
Background
Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.), additionally considering students' interests and experiences prior to medical school. We also examined whether respondents perceived benefits gained from global electives.
Methods
We surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students' backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S.
Results
In the 5 to 8 years post-graduation, 78% of 161 respondents reported work, research, or teaching with a focus on global or underserved U.S.
Populations
Completing a global health elective during medical school (p = 0.0002) or during residency (p = 0.06) were positively associated with currently working with underserved populations in the U.S. and pre-medical school experiences were marginally associated (p = 0.1). Adjusting for pre-medical school experiences, completing a global health elective during medical school was associated with a 22% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings.
Conclusion
Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school. We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S. and abroad.
Open Access
Transformative Learning and Critical Consciousness: A Model for Preclerkship Medical School Substance Use Disorder Education.
(Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 2023-04) Muzyk, Andrew; Mantri, Sneha; Mitchell, Phillip; Velkey, J Matthew; Reisinger, Deborah; Andolsek, Kathryn
Objective
Preparing medical students to provide compassionate person-centered care for people with substance use disorders (SUD) requires a re-envisioning of preclerkship SUD education to allow for discussions on stigma, social determinants of health, systemic racism, and healthcare inequities. The authors created a curricular thread that fosters the development of preclerkship medical students' critical consciousness through discussion, personal reflection, and inclusion of lived experiences.
Methods
The authors used transformative learning theories to design and implement this thread in the 2021-2022 academic year in the Duke University School of Medicine preclerkship curriculum. Content included lectures, person-centered workshops, case-based learning, motivational interviewing of a standardized patient, and an opioid overdose simulation. Community advocates and people with SUD and an interdisciplinary faculty were involved in the thread design and delivery and modeled their lived experiences. Students wrote a 500-word critical reflection essay that examined their personal beliefs in the context of providing care for people with SUD.
Results
One hundred and twenty-two students submitted essays and 30 (25%) essays were randomly selected for a qualitative analysis. Seven major themes emerged: race/racism, systemic barriers, bias and stigma, personal growth/transformation, language or word usage, future plans for advocacy, and existing poor outcomes. Students were able to link material with prior knowledge and experiences, and their attitudes towards advocacy and goals for future practice were positively influenced.
Conclusion
By aligning the thread design with the principals of transformative learning, students developed their critical consciousness toward people with SUD and cultivated a holistic understanding of SUD.
Open Access
Use of seniors as mentors to medical students: a collaboration between the University of South Carolina School of Medicine and the Medical University of South Carolina.
(J S C Med Assoc, 2011-02) Wiley, M Kathleen; Granholm, Ann-Charlotte; Bachman, Dav; Wieland, Darryl; Roberts, Ellen; Hardin, Rebekah; Dever-Bumba, Maureen; Eleazer, G Paul
Open Access
When the library is located in prime real estate: a case study on the loss of space from the Duke University Medical Center Library and Archives.
(J Med Libr Assoc, 2010-01) Thibodeau, Patricia L
The Duke University Medical Center Library and Archives is located in the heart of the Duke Medicine campus, surrounded by Duke Hospital, ambulatory clinics, and numerous research facilities. Its location is considered prime real estate, given its adjacency to patient care, research, and educational activities. In 2005, the Duke University Library Space Planning Committee had recommended creating a learning center in the library that would support a variety of educational activities. However, the health system needed to convert the library's top floor into office space to make way for expansion of the hospital and cancer center. The library had only five months to plan the storage and consolidation of its journal and book collections, while working with the facilities design office and architect on the replacement of key user spaces on the top floor. Library staff worked together to develop plans for storing, weeding, and consolidating the collections and provided input into renovation plans for users spaces on its mezzanine level. The library lost 15,238 square feet (29%) of its net assignable square footage and a total of 16,897 (30%) gross square feet. This included 50% of the total space allotted to collections and over 15% of user spaces. The top-floor space now houses offices for Duke Medicine oncology faculty and staff. By storing a large portion of its collection off-site, the library was able to remove more stacks on the remaining stack level and convert them to user spaces, a long-term goal for the library. Additional space on the mezzanine level had to be converted to replace lost study and conference room spaces. While this project did not match the recommended space plans for the library, it underscored the need for the library to think creatively about the future of its facility and to work toward a more cohesive master plan.
Open Access
Why are medical students 'checking out' of active learning in a new curriculum?
(Medical education, 2014-03) White, Casey; Bradley, Elizabeth; Martindale, James; Roy, Paula; Patel, Kunal; Yoon, Michelle; Worden, Mary Kate
Objectives
The University of Virginia School of Medicine recently transformed its pre-clerkship medical education programme to emphasise student engagement and active learning in the classroom. As in other medical schools, many students are opting out of attending class and others are inattentive while in class. We sought to understand why, especially with a new student-centred curriculum, so many students were still opting to learn on their own outside of class or to disengage from educational activities while in class.
Methods
Focus groups were conducted with students from two classes who had participated in the new curriculum, which is designed to foster small-group and collaborative learning. The sessions were audio-recorded and then transcribed. The authors read through all of the transcripts and then reviewed them for themes. Quotes were analysed and organised by theme.
Results
Interview transcripts revealed candid responses to questions about learning and the learning environment. The semi-structured nature of the interviews enabled the interviewers to probe unanticipated issues (e.g. reasons for choosing to sit with friends although that diminishes learning and attention). A content analysis of these transcripts ultimately identified three major themes embracing multiple sub-themes: (i) learning studio physical space; (ii) interaction patterns among learners, and (iii) the quality of and engagement in learning in the space.
Conclusions
Students' reluctance to engage in class activities is not surprising if classroom exercises are passive and not consistently well designed or executed as active learning exercises that students perceive as enhancing their learning through collaboration. Students' comments also suggest that their reluctance to participate regularly in class may be because they have not yet achieved the developmental level compatible with adult and active learning, on which the curriculum is based. Challenges include helping students better understand the nature of deep learning and their own developmental progress as learners, and providing robust faculty development to ensure the consistent deployment of higher-order learning activities linked with higher-order assessments.

Browsing by Subject "Schools, Medical"

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