AN INTERPROFESSIONAL STUDENT HEALTH CARE TEAM
Marshall Anderson*, Patrick Bankston & Susan Rouse
Gary, IN 46408
The purpose of this project was to form interprofessional student health care teams to educate students on the role of various health care professionals in patient care and management.
Interprofessional student heath care teams consisting of a MS1 medical student, a third year undergraduate nursing students, and a graduate social work student were formed within the College of Health and Human Services of Indiana University Northwest. Each team was assigned a patient at a nursing home/assisted living facility. The student health care team followed this patient for a period of two years, making periodic individual visits to see the patient, and meeting as a team either in person or online in a chat room to discuss the progress of the patient, the plan for patient care and to educate each other on their role as a team member. The medical student team member made two presentations on their patient to their peers and faculty. The first presentation was in the second semester of the MSI year and was a complete medical history on the patient. The second presentation was in the fall of the MSII year and consisted of a report on the physical exam of their patient. In the second semester of the second year, the team made a team presentation of their patient and discussed what they had learned from each other.
Students reported that this was a valuable educational experience and would help them to be better health care professionals and understand their and other health care professionals’ roles in the care and management of patients.
We plan to continue and expand this program with the inclusion of other health care students within the College of Health and Human Services.
THOUGHTS, FEELINGS AND DRAWINGS OF FIRST YEAR MEDICAL STUDENTS BEFORE THEY MEET THEIR FIRST PATIENT – THE CADAVRE
Bulent Coskun*, Ugur Cakir
For most of the first year medical students, anatomy lessons mean starting to learn “human body”, memorizing new “Latin words”, wearing “whites”, going through some “rituals” with specific smell of the labs, working with “bones and the cadavre”. Although real cadavre is no longer used in some medical schools, at a place where classical mysterious and fascinating atmosphere of anatomy labs are still valid, there is an orientation program for the students. The aim of this presentation is to share experiences and get views from the participants about this program.
Students are asked to write their thoughts and feelings about working with bones and body of a dead person and to draw what they imagine to see at the lab where they are going to meet the cadavre for the first time.
Together with faculty from Anatomy Department, the teacher of behavioral sciences, runs discussions with the students on topics like “respect for the cadavre and for the patients”, “importance of human dignity” and “awareness about thoughts and feelings of oneself”.
A qualitative analysis of the results of this orientation program for the last three years, with impressive examples of thoughts, feelings and drawings of the students are going to be presented during the session.
It has been observed that the program helps the students handle their anxiety before meeting the cadavre, helps them to be aware of their own thoughts and feelings and express themselves through a discussion as well as by their drawings.
RESIDENT BARRIERS TOWARDS PRACTICING EBM, A SYSTEMATIC REVIEW
N. van Dijk*, L. Hooft & M. Wieringa – de Waard
Amsterdam 1105 AZ
Physicians are expected to work according to the principles of evidence based medicine (EBM). Insufficient time and lack of skills are known barriers to this practice. Residents could have additional barriers, since their practice is strongly influenced by the educational system and clinical supervisors. Objective of this study was to systematically appraise and summarize the literature on the barriers of residents in the application of EBM in daily practice.
MEDLINE, EMBASE, the Cochrane Library, CINAHL and ERIC were searched. Additionally, the abstracts of relevant conferences were screened manually and experts in the field were contacted. Original studies on the barriers of residents in applying EBM in daily practice were included. Two reviewers independently applied the inclusion and exclusion criteria to select the relevant studies from the titles, abstracts or full test of the references retrieved by the literature search. Methodological quality was assessed and results were extracted by two reviewers using prespecified data-extraction forms.
The search resulted in 511 titles, 84 abstracts, and 3 studies suggested by experts of which 9 were included in this review. These studies were quantitative surveys (n = 4), quantitative interviews (n = 1) and a RCT (n = 1), and 3 were qualitative studies. The quality of the included studies was high. The most frequently mentioned barriers for residents were limited available time (28 – 85% of residents), attitude (moderate (positive) in 53%-70% of residents), and knowledge and skills. In four studies, specific barriers related to the position of residents, like influences from staff members, lack of experience in EBM and low possibilities to change conditions are described.
Residents experience specific barriers to practice EBM. These barriers should recognized and integrated in the EBM training program of residents.
CHALLENGES AND INNOVATIONS OF PERSONAL AND PROFESSIONAL DEVELOPMENT INTO MEDICAL EDUCATION
Jacqueline Goulbourne*, Tomlin Paul & Merinna Scarlett
University of the West Indies Mona
To describe the implementation of a Personal and Professional Development (PPD) theme in the five year undergraduate medical training programme at the University of the West Indies, Jamaica.
Two years ago a structured orientation program for medical students was introduced along with a concerted effort to ensure that the PPD themes are infused throughout each year of training. The aim of PPD is that all students from orientation to separation become critical thinkers with superior problem solving skills, effective and efficient as individuals and in teams, articulate, culturally sensitive, and committed to ethical behaviour. Workshops, role plays, skills laboratory, videos and didactic seminars are held for 2 hours per week in different semesters across the curriculum. Themes include communication and motivation theories, team building, and ethics. Students demonstrate learning through role play, group presentations and examinations.
350 students have participated in the new orientation program. Improvement in group work and better understanding of the role of other professionals in the inter-professional team approach to patient care has occurred. Students have also become more culturally aware and sensitive in their communication skills. New strategies for measuring and rewarding not just learning but development need to be developed. Appreciation of the program increases with clinical and community exposures and students are motivated by their own innovations.
Diverse teaching and learning strategies encourages team building and facilitates excellence in communications as one of the paramount approach to patient care.
THE DESIGN AND IMPLEMENTATION OF AN EARLY CAREER FACULTY DEVELOPMENT PROGRAM IN MEDICAL EDUCATION
Ariel Hirsch* & Gail March
Boston University School of Medicine
Boston MA 02118
The study identifies the needs of early career medical school faculty in order to implement faculty development programs in medical education.
The first phase of the research used an anonymous, online IRB-approved survey to ask early career faculty about their: (1) demographics, (2) teaching categories, (3) educational goals and obstacles, (4) selection of faculty development training topics and time, and (5) self-identification as Early Career Faculty.
As indicated by the survey results, the second phase of the study developed and implemented faculty development training. Data collected included the number of participants, their departments, and program evaluations.
Survey Responders (N=80) represent 86% of the medical school departments and teach 49% at the undergraduate level and 70% at the graduate level. Half of the survey population participates in clinical patient care and 21% in clinical research. The top topics for faculty development training were: mentoring, facilitating small groups, effective lecture strategies, evidence based medicine, presentation skills, and bedside teaching. Major barriers preventing faculty from achieving their educational goals are clinical responsibilities, lack of specific guidelines for academic advancement, and lack of formal training in education and educating adult learners.
The results indicate that while early career faculty express an interest in teaching, there is a sense of lack of time and incentive to pursue faculty development in medical education.
The third phase will investigate different ways that early career faculty can be awarded time and promotional points for attending faculty development programs in medical education.
TEACHING STYLE IN CLINICAL NURSING EDUCATION: IRANIAN NURSING TEACHERS’ EXPERIENCES
Hossein Karimi Moonaghi*, Fatemeh Dabbaghi, Seid Fatemeh Oskouie, Katri Vehviläinen-Julkunen, Tahereh Binaghi & Seyed Massoud Hosseini
Mashhad University of Medical Sciences
There are many studies about nursing clinical settings and their problems, but the teaching style as a whole has not been widely studied. Therefore, this study aimed to explore nursing teachers’ perceptions about teaching style in the clinical settings in Iran.
A grounded theory approach was used to conduct this study. Fifteen nursing teachers were interviewed individually, 2006-2007. The interviews were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using Strauss and Corbin’s method.
Three main and twelve sub themes emerged from data and these could explain the nature of the teaching style in clinical education of the Mashhad Faculty of Nursing and probably others in Iran. The main themes included: multiplicity in teaching style, nature of clinical teaching, and control and adaptation in education atmosphere. Multiplicity in teaching style was the dominant concept in this study. Each teacher had a personal and individualized style which was flexible according to the situation, type of the skill (course content), education environment and facilities, and level of the learner.
This study can guide nurse teachers to know more about teaching styles and use them appropriately in the clinical settings. The findings have developed knowledge in the field of teaching in clinical settings and revealed the nature of nursing clinical teaching style. Teachers, students, educational planners and stakeholders can use these findings to promote the quality of teaching and learning in clinical settings, nursing education and health care.
This study illustrates that clinical education is a personal and interpersonal experience with its rules and principles, and requires the active participation of both teachers and students. The teaching styles discovered in this study can be used in any kind of clinical education.
UNCOVERING THE POSITIVE INFLUENCES OF THE HIDDEN CURRICULUM
David Rudy*, Margaret Disselkamp, Erika Erlandson & Carol Hustedde
University of Kentucky
Lexington KY 40536
Much of medical student learning occurs through observation of both positive and negative clinical role models, i.e. the hidden curriculum. Instead of focusing on the negatives, we sought to identify positive experiences during clinical clerkships. By defining contributing themes of positive encounters and positive personal characteristics we hope to increase their frequency and build upon the current success of the informal curriculum.
Twenty third-year medical students at were interviewed Appreciative Inquiry. AI uses interviews to gather information about positive experiences. Students were asked to describe an experience where they witnessed or participated in excellent patient care and to identify the personal characteristics that of those involved. Transcripts of interviews were analyzed for thematic categories by two reviewers in an iterative process and coded for the presence or absence of the themes. Discrepancies were resolved via consensus.
Thirty seven percent of accounts described empathy, 32% concentrated on completeness of patient care, and 26% cited commitment of spending time with patients. Contributing personal attributes were dominated by compassion (53%) and humanistic attitude (37%).
CONCLUSIONS/ FUTURE DIRECTIONS
The majority of medical students in this study experienced excellent patient care as part of their hidden curriculum. These encounters revealed compassion, empathy, and humanism along with an unhurried, all-inclusive nature of care. Efforts should be made to identify, acknowledge, and reward persons exhibiting such traits as role models. Such a system would support continuation of such encounters and foster these attributes to become standard of care and medical education.