Brainwaves in your pager?

Abstract

Context and setting At our institution, Year 3 medical students are asked to carry text pagers. This makes it easier for their clinical teams to reach them and to demonstrate what is involved in wearing a pager. During the 5.5-week neurology block, students rotate through in-patient and out-patient settings and attend neurology lectures. In this context, we attempted to show the new educational potential of wearing a pager. Why the idea was necessary The neurology clerkship is medical students’ most extensive exposure to neurology. It attempts to offer a broad perspective on the subject on a tight schedule. We wondered how we could deliver some supplemental education and how we could enhance students’ neurological and historical knowledge. Could the text pager help to initiate or cement students’ relationships with the clinical team? Might it encourage students to embark on short, fact-finding expeditions? What was done We initiated a project designated ‘Brainwaves’. We compiled a list of relevant pearls of clinical information, questions and historical facts. Then, once-a-day, between three and five times a week throughout the course of the neurology clerkship, we sent short messages to students via group text-page. Evaluation of results and impact We electronically surveyed the students who had been through the neurology clerkship during the initial 2007–2008 school year. Our response rate was 61% (78 of 127). Those who responded said they had found Brainwaves useful for giving them a broader appreciation of neurology (42%), helping to enhance relationships with their team (19%), and preparing them to ask and answer questions on rounds (8%); it was less helpful for preparing students for examinations, lectures and patient care (5%, 4% and 1%, respectively). However, students made several surprising additional compliments on the Brainwave system in their free text comments. Brainwaves text-pages were seen as a great way of broadening students’ interest in neurology by the clerkship leadership. They also encouraged students to feel that the department was strongly committed to their learning. Students thought that the paged snippets were an effective way to ‘pepper’ or ‘add fun to’ their days by giving them pearls of knowledge about otherwise uncovered neurological territory. One student wrote that ‘…information about random diseases that I would have otherwise not [have] learned’ was subsequently asked in the national board examination. Criticisms pertained mainly to content and suggested that some of the Brainwaves were too obscure to be relevant to medical student neurology knowledge. This can easily be corrected by adapting the information sent and keeping the topics relevant to patient care; for example, medications used to treat stroke are relevant, but the historical facts behind their development are not directly relevant. (We had aimed to enhance the students’ historical perspective of their material.) However, 69% of students thought that this was a worthwhile programme to continue and 41% stated that other clerkships could benefit from a similar paging system. The system is easy to implement, but does require secretarial input to create the e-mail group and to send regular messages (using a copy−paste−send format). Ideally, the system could be set up and automated to send out some strong Brainwaves.