Browsing by Subject "Education, Medical, Undergraduate"

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Assessing the Need for and Developing a Standardized Patient Handover Curriculum for Undergraduate Medical Education
(2017-04-03) Gajera, Prakash; Reed, W. Gary; Greilich, Philip; Ambardekar, Aditee
BACKGROUND: Improving patient handoff communication is a national patient safety goal; however, few medical schools have standardized handoff training curricula for their medical students. Studies show that a large number of medical students perform handoffs and observe handoff errors during their clerkships [1,2]. This lack of formalized training has a negative impact on medical student perceptions of handoffs [3]. This project assessed the need for handoff education at our institution and developed a curriculum aimed at medical students. IMPLEMENTATION: Clerkship directors were interviewed & preclinical medical students were surveyed for a stakeholder analysis. Prior to starting core clerkships, 200 total students participated in four 1-hour workshops consisting of a 20-minute lecture and three 10-minute handoff scenarios. Trained residents performed the scenarios and led group discussions. Pre- and post-course engagement surveys were used to evaluate the workshop. EVALUATION & OUTCOMES: Clerkship directors desired handoff training before clerkships; however, there was concern that the curriculum would be too advanced. Survey of pre-clinical students showed 71% had heard of standardized patient handoffs, but 94% had no training. 75% believed training should be done prior to core clerkships, and 64% believed handoff simulations were the best method for learning. Students scored 10.7% higher on the post-engagement quiz and 98% of students believed they better understood the elements of a good handoff after the workshop. IMPACT & LESSONS LEARNED: Standardized patient handoff curriculum designed for preclinical medical students improved confidence and knowledge about the handoff process. Concerns about creating handoff curriculum for medical students were addressed by focusing on general concepts rather than specific handoff tools and by creating simple handoff evaluation scenarios. Further work will focus on evaluating the impact of this workshop on the handoff experience during clerkships.
Formative Feedback Passport: A Tool to Engage Students in Reflecting on and Incorporating Mid-Point Feedback
(2022-05) Postma, Heather Elizabeth; Abraham, Reeni; Collins, Sarah; Brinker, Stephanie
BACKGROUND: The importance of formative feedback in undergraduate medical education is widely appreciated; however, it is historically inadequate. The formative feedback passport (FF tool) was developed and implemented in the Internal Medicine (IM) clerkship at UT Southwestern to address these concerns. OBJECTIVE: This dissertation examines the FF tool's role in facilitating an optimal formative feedback process. METHODS: Initially, a pre-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2018-2019 IM clerkship were analyzed for content and quality of student reflection. Results revealed that student reflection on feedback was insufficient, with transformative, thoughtful reflection seldom occurring. In response to these findings, the FF tool's instructions were augmented with a module to encourage critical reflection. Subsequently, a post-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2020-2021 IM clerkship were analyzed in the same manner as the pre-intervention study. RESULTS: 149 feedback tips from 50 FF tools were included in the pre-intervention study, and 162 feedback tips from 54 FF tools were included in the post-intervention study for a total of 311 feedback tips from 104 FF tools analyzed. In both studies, most of the feedback tips aligned with established standards for resident and faculty evaluators. In addition, the mean scores for each REFLECT Rubric criterion were significantly higher in the post-intervention group than the pre-intervention group. CONCLUSION: The FF tool is an invaluable electronic feedback tool in the IM clerkship at UT Southwestern. It enables documentation of formative feedback and promotes critical student engagement, reflection upon feedback, and the development of plans to implement feedback for improvement. Study results demonstrate that students receive formative feedback from an attending, resident, or patient that is appropriate in content. Additionally, study results demonstrate that the intervention improved student engagement and quality of reflection on feedback using the FF tool.
Identifying Predictors of Performance on USMLE® Step 1
(2017-03-27) Shah, Sachin; Sendelbach, Dorothy; Mihalic, Angela; Sachs, Arlene
BACKGROUND: USMLE® Step 1 is considered by residency program directors to be one of the most important factors in selecting medical students for interviews, so it is important for both students and medical schools to maximize scores. However, despite its importance, very little has been studied to determine indicators of performance on the exam. OBJECTIVE: The goals of this study are: 1) to determine if data available prior to admission can predict Step 1 performance, 2) to evaluate if success in pre-clinical courses at UT Southwestern correlates to success on Step 1, 3) to analyze survey data and determine correlations between studying resources/strategies and Step 1 scores, and 4) to develop a mathematical model to flag students at risk of scoring poorly on Step 1. METHODS: This study utilized data from the UT Southwestern Medical School Class of 2018 (n=238). First, Undergraduate GPA, MCAT® scores, and demographic information were correlated with Step 1 scores and medical school grades to determine if pre-admissions factors could predict Step 1 or medical school performance. Second, medical school exam scores from the second pre-clinical year and NBME® Comprehensive Basic Science Self-Assessment (CBSSA) scores were analyzed to determine their correlation with Step 1 scores. Third, the class was surveyed during a dedicated six-week study period before the exam as well as after the exam, and results were analyzed to determine how students prepared. Each question from the surveys was correlated with exam scores to identify which factors led to higher test scores. Finally, the factors with the highest correlations to Step 1 scores were used to develop a mathematical model to predict Step 1 scores using multiple linear regression. This model was then tested to determine its effectiveness at identifying at-risk students. RESULTS: MCAT® biological and physical sciences scores and undergraduate GPA had moderate correlation with Step 1 scores (both R2 = 0.10) and weak correlation with medical school grades (R2 = 0.060 and 0.058, respectively). Of all factors studied, the initial CBSSA scores had the highest predictive value of Step 1 scores (R2 = 0.60). Cumulative medical school grades were also highly correlated with Step 1 scores (R2 = 0.52). The weekly pre-exam surveys indicate that each successive week of study produced smaller gains in points on Step 1, and most students did not see significant point increases after 6 weeks of study. The post-exam survey shows that students who answered greater than 4000 practice questions scored an average of 254 ± 5.3 (95% CI), whereas those who answered fewer than 1700 questions scored an average of 230 ± 10.6 (95% CI). There was no significant difference between those who studied 4 versus 7 dedicated weeks, or those who studied fewer than 250 hours versus more than 600 hours during the dedicated study time. However, students who started to study 6 months prior to the exam scored 252 ± 6.9 (95% CI), whereas students who waited until the dedicated preparation time scored 237 ± 3.6 (95% CI). A model incorporating a pre-admissions and medical school performance factors was developed that accounted for 64% of the score variability, with a standard error of ±8.87. When used to identify those at risk of scoring below 220, the model had a sensitivity of 81% and specificity of 86%. CONCLUSION: The study finds that MCAT® and undergraduate GPA are mediocre determinants of medical school and USMLE performance and should be used cautiously in the admissions process. Conversely, medical school grades and CBSSA scores are very accurate predictors of Step 1 scores, and students who do well on medical school exams generally do well on Step 1. Students should plan five to six weeks for dedicated study, but start reviewing material as early as possible and focus on question-based resources. The model developed from this data can be a useful tool to identify at-risk students for early intervention. This project demonstrates that objective data analysis can be used to guide students towards optimal preparation for Step 1, as well as identify those at risk of performing poorly on the exam.
[News]
(1976-07-27) Williams, Ann
Special to Brenham Banner Press
(1976-08-10) Williams, Ann
Student-Led Design of a Medical Education Track and Distinction: Providing an Opportunity for Medical Students to Transform into Knowledgeable Clinician Educators
(2017-03-31) Yoder Lepse, Ashley Nicole; Wick, Neda Evguenieva Mitkova; Barker, Blake; Sendelbach, Dorothy; Mihalic, Angela; Wagner, James
BACKGROUND: Throughout their careers, physicians at all stages of training and practice are charged with the responsibility of educating the next generation of physicians, peers and colleagues, as well as patients and their families. Despite the fact that a significant role of being a physician is being an educator, there is limited formal training for developing physicians as strong Clinician Educators. OBJECTIVE: Through the development and implementation of a Medical Education Track and Distinction, we aim to provide a platform for interested medical students to grow in their knowledge related to medical education, their teaching skillsets, and their ability to conduct sound medical education research. METHODS: The Medical Education Track and Distinction encompasses three Medical Education courses, scholarly activity in medical education, and an optional Distinction in Medical Education. The track's overall success, has been measured by student and faculty involvement. The Medical Education courses are evaluated by student surveys that utilize a five-point Likert scale and solicit student comments about the courses. RESULTS: There have been over forty student and twenty faculty participants to date. The majority of survey responses have been positive with most students strongly agreeing or agreeing that the courses have increased their knowledge about key topics in medical education and improved their teaching skills. Approximately 4.6% of the first class to complete the scholarly activity has expressed interest in the medical education track, and in the first year student are eligible to graduate with an M.D. with Distinction in Medical Education, three students have met the requirements. CONCLUSION: The development and implementation of the Medical Education Track and Distinction at UT Southwestern aims to fill a current gap in medical education that exists in teaching future physicians how to be effective educators. The positive interests and results from this curriculum demonstrate that medical students are interested in learning how to teach and that medical school provides a feasible platform for beginning the development of future physicians as strong clinician educators.