COLLABORATION AMONG CLINICAL AND BASIC SCIENCES FACULTY IN A SKILLS SESSION FOR SECOND YEAR MEDICAL STUDENTS THAT TAUGHT BEST PRACTICES FOR DIAGNOSING VAGINITIS
Michele Manting & Mary Johnson
Education Director for Obstetrics and Gynecology Department of Clinical Sciences
Assistant Dean for Faculty Development Professor of Microbiology
Department of Biomedical Sciences
Florida State University College of Medicine.
To teach second year medical students microscopy skills that are clinically relevant to the care of women.
A skills lab was begun 2 years ago to prepare students for a Clinical Learning Center Simulation of an Annual Well Woman Encounter. Clinical faculty had expressed concern over general discomfort and lack of skills in students when performing wet mounts associated with the work-up of vaginitis. Collaboration between microbiology, clinical sciences and the simulation center resulted in a process that enabled the institution to provide live microbiologic specimens, specifically T. vaginalis and C. Albicans for a structured experience in best practice performance techniques recommended by the CDC for diagnosing vaginitis. In addition basic microscopy skills, pH and whiff tests were performed.
120 second year medical students participated in the 40 minute session with successful completion of: basic review of microscopy; best practices preparation of wet mount studies; and identification of two unknown ‘vaginitis’ specimens through completion of a Vaginitis Differential Diagnosis grid based on microscopic findings pH and
whiff test results.
Collaboration among clinical and basic sciences resulted in an innovative approach to an educational deficit identified in student preparation for clinical practice environments. Although there is a movement away from using microscopes in medical school, it is used daily in the practice of the majority of general Obstetrician-Gynecologists in the United States. Since vaginitis is the most common presenting complaint in Women’s Medicine, facilitating students’ ability to make the correct diagnosis has the potential for benefitting large numbers of women when students enter practice.
MEDICAL STUDENT KNOWLEDGE AND COMFORT WITH LUMBAR PUNCTURE AND THE POWER OF A STANDARD TEACHING MODULE
Soby, Karin* & Blaya, Maike
Graduating Medical Student from Tulane University School of Medicine, May 2010
Associate Professor of Clinical Neurology
Tulane University School of Medicine New Orleans, LA
A standard method for teaching Lumbar Puncture (LP) skills is not described in the medical education literature, although LP is required in clinical practice (Wigton, 2007). We therefore created and implemented a Standardized LP skills Teaching Module (TeachLP) for medical students. The purpose of this study is to measure the impact of
TeachLP on student knowledge and comfort with the LP.
Twelve medical students, five fourth-year and seven third-year students, from Tulane University School of Medicine neurology clerkship were selected for the pilot group of this study. Each student completed a pre-training questionnaire about exposure and comfort with the procedure, and a pre-knowledge test. Students then completed TeachLP, which incorporates lecture and practical experience on an LP mannequin simulator. Participants were assessed using a procedure checklist, a knowledge post-test, and post-training questionnaire. De-identified data was uniformly analyzed with coding by one researcher. This study received IRB approval.
All 12 student responses were included in results. Before completing TeachLP, student-reported comfort in performing an LP was 1.9 on a 5 point Likert scale (median and mode of 1). 11/12 desired an opportunity to learn. Average pre-test knowledge score was 68%, with poor safety knowledge. After completing TeachLP, student-reported comfort in LP performance doubled to 3.9 (5 point scale; median and mode of four), and all stated the training was beneficial. Knowledge test scores also improved an average of 25%, from 13.58/20 pre-test to 18.65/20 post-test. Safety knowledge improved most. Procedure checklist also reflected competency.
This pilot study showed that most students are uncomfortable with, and largely uninformed about most aspects of the LP procedure. However, using TeachLP one can significantly improve students’ knowledge and confidence, while additionally acquiring LP procedural skills. A larger study is ongoing and may be helpful in generalizing these conclusions to other students.