Clinical Rotations Research Articles

FORTIFYING GERIATRIC CARE AND RESEARCH: THE VHA ADVANCED FELLOWSHIP IN GERIATRICS

Abstract Geriatric care often involves addressing complex medical, social, and behavioral needs that require input from multiple disciplines. A robust workforce with geriatric specialties is essential to ensure that older adults receive the comprehensive care and support necessary for optimal aging. Despite the growing demand, there is a significant shortage of providers working in geriatric care, exacerbating the strain on existing resources. One way to address this shortage may be through the Advanced Fellowship in Geriatrics (AFiG), a Department of Veterans Affairs (VA) program overseen by the Office of Academic Affiliations (OAA). The AFiG is a 2-year, postgraduate (post-residency, post-doctoral, post-masters) training program, offered to clinicians and non-clinician scientists, that prepares leaders in geriatric research, education, and clinical innovation. Fellows are hosted in Geriatric Research, Education, and Clinical Centers (GRECC) in 20 VA medical centers across the country, providing a rich combination of clinical rotations, didactic education, and research opportunities. Fellows gain expertise in identifying and addressing the unique healthcare needs of older adults, particularly within the veteran population. This fellowship provides participants with a wealth of advanced training topics including management of multiple chronic conditions, population health and health promotion, models of care, policy initiatives, and interdisciplinary collaboration. This symposium features presentations from 1) AFiG leadership, 2) GRECC leadership, and 3) facilitated discussion with an interprofessional cohort of current/former Fellows to share the breadth of clinical and research experiences in the AFiG.

PREPARING THE NEXT GENERATION OF THE DEMENTIA CARE WORKFORCE VIA SERVICE LEARNING: A SCOPING REVIEW

Abstract The prevalence of Alzheimer’s Disease and Related Dementia’s (ADRD) is rising rapidly with the aging of the baby boomer generation. A large workforce gap in dementia providers is widening with education as a frequently cited barrier to entry into the ADRD workforce (Mayer et al, 2023). This scoping review aimed to explore the extant literature on the use of service learning (SL) pedagogy related to ADRD in higher education settings for students in health-related majors. A systematic search was conducted using seven databases. Sources were included if participants were undergraduate/graduate students in any health-related discipline and if SL was utilized in conjunction with specific instructional paradigms (e.g., coursework, on-site workshops). SL, though individually defined by authors of included studies, was required to include community engagement with adults with ADRD; studies specific to clinical rotations were excluded. Included sources (n=32) were systematically extracted for characteristics including student demographics, SL components (learning instruction methods/training, experiences, reflection), and outcomes. Analysis of training revealed most ADRD SL paradigms relied on setting-specific training (n=15) over didactic academic instruction (n=7) or a combination (n=7). SL experiences ranged in type with informal activities (n=13) and creative arts (n=9) most commonly utilized to engage participants. The reflection component most commonly included open-ended reflective journals (n=15). Analysis revealed variability in how SL is represented in the literature. Despite this variability, sources frequently report SL as a viable option for educating the next generation of dementia service providers, with observed improvements in student attitudes and knowledge related to ADRD.

CAN NOVICE LEARNERS BE CLINICAL CHANGE AGENTS FOR DEMENTIA CARE PRACTICE?

Abstract Intro Caregiver support is an essential component in dementia care and yet clinicians’ referrals to community-based support services are lacking. Direct Connect (DC) is a clinician-initiated referral process for dementia patients and caregivers, offered by the Alzheimer Association to make the process simple and efficient. Methods We created a brief educational intervention targeting medical, nursing, and pharmacy students to develop them into DC champions at clinical rotation sites in Wisconsin. Content focused on dementia detection, caregiver burden, available resources, and DC referrals. Delivery included online, in-person, and hybrid formats. Data was collected with a post-intervention survey and student interviews. At baseline (2021), 277 DC referrals were made by clinicians in Wisconsin. Results Following a 2-year rollout to students (N=375), the annual number of DC referrals received from clinicians increased (300 in 2022; 351 in 2023). However, review of referral data revealed the increase was primarily from licensed clinicians not at student champion sites. Follow-up interviews with students indicated they find it daunting to suggest changes in busy clinical settings where they lack experience and autonomy. Despite incorporating scripting and role playing into our educational session, students continued to lack confidence. Discussion Although student champions have proven effective in other clinical conditions, our results suggest different strategies are needed for dementia care. Based on these findings, we propose to refocus training efforts toward more senior learners such as medical residents who have more experience and clinical autonomy, and to embed the DC referral within the electronic health record to facilitate usage.

INTEGRATING AGE-FRIENDLY QUALITY IMPROVEMENT INTO RURAL CLINICAL ROTATION FOR MEDICAL STUDENTS

Abstract Early learning experiences in quality improvement (QI) prepare medical students for practice in complex health systems and for improving processes of care for older adult patients. We developed a curriculum using the Institute for Healthcare Improvement (IHI) Age-Friendly Health Systems 4Ms framework to train third-year medical students (n=75) in geriatrics-focused QI during a twelve-week family medicine clinical rotation in rural communities. Prior to the rotation, students completed asynchronous online training introducing QI models, Plan-Do-Study-Act (PDSA) cycles, and the Age-Friendly 4Ms framework. During the rotation, students met with their preceptor to identify a goal and conduct project activities to enhance Age-Friendly care for older adults within their practice setting. Students also collected information about the local community and patient outcome data related to CMS quality measures. Geriatrics faculty conducted weekly virtual meetings with students to discuss projects and challenges. A final written assignment summarizing their project results, clinical implications and next steps for the primary care setting in a standard abstract format that can be used for a poster presentation at a professional conference. Students (n=71) completed evaluation surveys to rate the usefulness of training and to self-assess knowledge and skills using five-point Likert-type items. Students (n=50) reported increased knowledge and skills in conducting QI activities and improved understanding of the importance of improving processes and patient care. Integrating the Age-Friendly Health Systems framework into QI training can support competency development in system-based practice while disseminating Age-Friendly practices and resources within a health care setting.

The Impact of Clinical Rotation in Addiction Treatment Centers (AMATEM) on Attitudes and Behaviors of Psychiatry Residents Toward Individuals with Addiction

Aim: Psychiatry residents often feel unprepared and may exhibit negative attitudes toward individuals with substance use disorders, which can undermine treatment access and outcomes. This study examined the impact of a three-month Alcohol and Drug Treatment Center (AMATEM) rotation on residents’ attitudes and explored factors influencing these attitudes. Material and Method: Ninety-one psychiatry residents who applied for a three-month rotation training on addictions at Ankara Training and Research Hospital AMATEM Clinic completed a personal information form and the Attitudes and Behaviors Toward Substance Users Scale at the start and end of the rotation. Results: Residents’ stigmatizing attitudes significantly decreased post-rotation. Those who felt unsafe before the rotation reported higher stigma scores, and residents who believed they needed more education had fewer negative attitudes initially. Paradoxically, participants who anticipated referring patients to AMATEM due to insufficient training showed increased stigma after completion of the rotation. Conclusion: Overall, structured, practical, and case-based training—delivered under experienced supervision—can reduce negative attitudes and help residents feel safer. Further research should clarify how specific training processes influence the knowledge, attitudes, and beliefs of future psychiatrists regarding substance use disorders.

Use of Debates in Team-Based Learning to Improve Critical Thinking Skill of Medical Students: A Mixed Method Study

This mixed qualitative and quantitative study was conducted to assess use of debates in team-based learning to improve critical thinking skill of medical students at Combined Military Hospital Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in the months of February and March, 2023. Non-probability, purposive sampling was done and 26 students of final year, Bachelor of Medicine, Bachelor of Surgery (MBBS) attending the Obstetrics and Gynecology ward for clinical rotation in the study period were included after informed consent. The team-based learning session with debates was conducted with pre and post-test to assess critical thinking of students. Results were compared using paired-t test, taking P values < .05 as statistically significant. Students’ reflection on their learning and notes of Teacher observation were obtained and thematic analysis was done. A total of 26 students, 14 girls and 12 boys, were included in our study. The mean score of pre-test was 3.8 ±1.7 and mean score of post-test was 5.3 ±1.4, generating a statistically significant p value. The three common themes identified in student reflection and teacher observation were 1) team work, 2) active learning and 3) critical thinking. The student reflections also identified the theme of ‘good learning environment’. The teacher observation identified two other themes 1) improved confidence and 2) student engagement. Debates improve student engagement, team work, communication and critical thinking skills of medical students.

Enhancing Prelicensure Nursing Student Clinical Experience through Post-Conference Discussions

Prelicensure nursing students are often anxious and cannot comprehend the situations they will be exposed to as they develop clinical judgement. Early clinical rotations help them familiarize themselves not only with the healthcare environment but with their own emotional adjustment to patient care.

Nursing students and role modeled behavior while caring for LGBTQ + people: a cross-sectional, descriptive study

BackgroundWhile efforts to improve the educational preparedness of nurses to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ +) people have increased, the influence of role-modeled behaviors by healthcare professionals working with nursing students and recent graduates is not well understood. The purpose of this study is to describe the role-modeled behaviors of healthcare professionals observed by nursing students and recent graduates caring for LGBTQ + patients in clinical settings.MethodsA cross-sectional, online survey was conducted. Recruitment of nursing students who had completed one or more clinical rotations or were recent graduates (≤ 2 years) was performed through university emails and social media. Items included measurement of stigmatizing attitudes, observed stigmatizing behaviors, and ability to provide inclusive/affirming care for LGBTQ + patients. Open-text items prompted participants to describe observed behaviors. Data were analyzed using descriptive statistics and Wilcoxon signed rank sum tests to evaluate differences between LGB (lesbian, gay, bisexual) and T + (transgender and gender diverse) subscales. Open-text responses were analyzed using thematic analysis to identify relevant themes.ResultsParticipants (N = 73) had a low level of stigmatizing attitudes toward LGBTQ + people (M = 1.8, SD = 0.4), although higher stigmatizing attitudes toward T + people were reported (M = 3.0, SD = 0.2; Z = -7.254, p < .001). Half of the participants reported that they observed LGBTQ + stigmatizing behaviors role-modeled by two + healthcare professional roles; approximately one-third of participants personally engaged in one + LGBTQ + stigmatizing behaviors, most commonly toward T + people. Themes from participants’ examples of observed stigmatizing behaviors included: cis-heteronormative bias, non-affirmation of chosen name/pronouns, outing patients, and rejected competency.ConclusionsThe majority of participants described observing stigmatizing behaviors toward LGBTQ + people in clinical settings. Poorer attitudes and a higher frequency of stigmatizing behaviors observed towards T + people point to deficits in healthcare provided to T + people in particular. Efforts to address LGBTQ + stigma in healthcare should be expanded to include clinical settings to address role-modeled behaviors and socialization of nurses.

Third-year medical students’ perceptions of confidence and readiness to perform EFAST after training

BackgroundAs Point-of-Care Ultrasound (POCUS) education is increasingly incorporated in undergraduate medical education (UME), evaluation of the effectiveness of various ultrasound-related curricula is a developing field. The Extended Focused Assessment with Sonography (EFAST) is a POCUS exam widely used in emergency medicine. This project examines third-year osteopathic medical (OMS III) students’ perceptions of the impact of a focused introduction to EFAST training curriculum on their performance ability and utilization of EFAST during third-year clinical rotations. Furthermore, we assessed student perceptions of barriers to the use of POCUS during third-year clinical rotations.MethodsThe introduction to EFAST curriculum was developed using competency-based backward design and was delivered in July 2022 to incoming OMS III students. The curriculum involved didactics, hands-on ultrasound practice with standardized patients, and a comprehensive OSCE assessment, where students performed the EFAST exam. In July/August 2023, curriculum participants were anonymously surveyed regarding the effectiveness of the EFAST curriculum and perceived barriers to EFAST and POCUS utilization during their third-year clerkships. Descriptive and thematic analyses were performed on quantitative and qualitative data.ResultsTwenty-one of 69 (30.4%) participants responded to the survey, with 17 (24.6%) participants completing the entire survey. Respondents reported increased knowledge and confidence in performing and interpreting EFAST, with 82.4% indicating increased likelihood of performing EFAST and POCUS in general. 76.4% performed EFAST at least once during third-year clerkships, with 11.8% performing it 15 times or more. Students reported valuing the safe simulated learning environment of the EFAST training, and identified lack of patients with indications for EFAST, time constraints, lack of ultrasound machine availability and clinician comfort level as barriers to EFAST utilization.ConclusionsThis study presents the implementation of a focused EFAST curriculum developed through competency-based deliberate backward design based on professional guidelines and the anticipated educational needs of our institution and community. Student perceptions provided valuable insight into access and barriers to EFAST and POCUS use in subsequent clinical clerkships, indicating student perception of POCUS curriculum effectiveness may provide insight to continual curriculum improvement.

Comparison of clinical independence level scores among predoctoral dental students between dental school clinic and community clinic rotation.

The aim of this study was to compare the difference in the level of clinical independence among predoctoral dental students during their community clinic rotation with their dental school clinic rotations. Descriptive statistics, assessment of sample normality, and T-tests were performed to present the difference in average independence scale scores for the participants in each of the clinical disciplines at dental school clinical rotations and community rotations. The relative impact of each community clinical site was assessed to compare scores assigned at varying locations by different faculty. This study analyzed 222 dental students, including 29 from International Dental Program (IDP) and 193 traditional Doctor of Dental Surgery (DDS) students. Community clinic scores showed greater variability, with significantly higher scores in diagnostics and operative dentistry compared to school clinics, where higher scores were noted in endodontics and oral surgery. IDP students scored lower than traditional DDS students in school clinics but outperformed them in community settings. Community clinic scores showed greater variation between 2023 and 2024 compared to the smaller changes observed in dental school clinic scores. This study highlights the impact of clinical setting, and duration on student procedural experience and performance, suggesting that varied clinical settings can enhance students' skills and readiness for practice. It reveals differences in DDS and IDP students' experiences due to prior training and potential evaluation biases. Study findings suggested lack of significant variance in the overall scores across different evaluators in community rotations. Future research should focus on refining evaluation metrics and better prepare students for practice.

Ultrasound education, competencies and expected future use among medical interns in Denmark: a national cross-sectional study

BackgroundPoint-of-care ultrasound is increasingly used across medical specialties, calling for timely and relevant ultrasound education in specialty training. To enable customizing such education, we aimed to explore medical interns’ received ultrasound education during medical school and internship, perceived scanning competencies, evaluation of received education, future expectations for using ultrasound, and tendencies for perceiving ultrasound competence.MethodsThis was a national cross-sectional study. We developed a questionnaire based on a theoretical conceptual model, individual interviews with medical interns and focus groups with medical students, followed by pilot testing. The questionnaire was distributed to all medical interns in Denmark (N = 1231). Data were summarized with descriptive statistics. Differences between universities and tendencies for perceiving ultrasound competence were analyzed with Fisher’s exact tests and modified Poisson regression, respectively.ResultsResponses from 420 (34.1%) interns were included. Although varying across medical schools, 95.7% received formal ultrasound training and 86.0% encountered ultrasound examinations through clinical rotation. During internship, 44.2% received formal training, while 68.5% had to pursue it independently. Ultrasound examinations during clinical work were observed by 73.2% and performed by 47.6%. Common ultrasound usage barriers were insufficient scanning routine, supervision, knowledge, confidence and mental surplus. Ultrasound competence gain from medical school and internship was reported by 75.2% and 55.3%, respectively, but mainly to lesser/some extent. Most desired more training, expected to use ultrasound in the future (71.0%) and considered it a core competence (73.0%). Perceived ultrasound competence was significantly associated with receiving practical (RR: 4.08) or both practical and theoretical education (RR: 4.34) in medical school, and practical training on patients (RR: 1.09), required number of performed scans (RR: 1.06), competence test(s) (RR: 1.07), and/or consulting books/encyclopedia (RR:1.07) during internship.ConclusionsUltrasound training is part of medical school curricula but varies in type and extent. While most encounter and many use ultrasound during internships, formal training is less integrated. Most desire more training and attitudes towards future ultrasound usage are positive. Filled curricula pose dilemmas for prioritization and several barriers prevail for using ultrasound, representing missed opportunities for competence development and maintenance. Training governance and scaffolding continuous learning may be needed.Trial registrationNone.

Assessment of Adherence to COVID-19 Diagnosis and Treatment Guidelines in Outpatient Settings: Perspectives of Medical Interns at Tabriz University of Medical Sciences

Background. The Ministry of Health had developed guidelines for the management of COVID-19 patients in outpatient settings. Despite the development of a national guideline and its importance, no study had been conducted on compliance with the guidelines for the diagnosis and treatment of COVID-19. Therefore, the aim of this study was to evaluate the extent to which these guidelines were followed in outpatient services, specifically from the perspective of interns at Tabriz University of Medical Sciences. Methods. This study was cross-sectional, involving all 100 interns who were completing their clinical rotations in COVID-19-related departments during February and March 2022. The data collection tool was a checklist, which was developed using the guideline for the diagnosis and treatment of COVID-19 published by the National Scientific Committee for COVID-19 Management in January 2022. The checklist comprised 29 items and was validated for both validity and reliability by relevant specialists. Results. This study included 100 medical interns from Tabriz University of Medical Sciences. Fifty interns completed their rotations in the emergency department, and the remaining 50 in outpatient clinics. The mean compliance scores with COVID-19 guidelines, as reported by emergency department and outpatient clinic interns, were 26.54 ± 3.34 and 26.73 ± 2.16, respectively (P = 0.124). The lowest compliance rate (37%) was observed for item 22 ("Azithromycin and other antibiotics should not be used without strong suspicion of concomitant bacterial infection"). However, the majority of checklist items (89.65%) demonstrated excellent compliance. Conclusion. Overall, interns reported good adherence to COVID-19 guidelines in both the outpatient clinic and emergency department settings. However, instances of inappropriate antibiotic and vitamin supplement prescription were observed. To mitigate unnecessary treatments, further efforts to improve staff awareness and adherence are needed.

Exploring the perception of nursing students facing burnout in clinical settings during COVID pandemic

Abstract Aim. The purpose of this study was to learn about the experience of the group of students who are at high risk for experiencing burnout and nursing shortage. This study seeks to reveal students’ perception of nursing burnout and nursing shortage observed during a clinical course. Material and methods. This study was conducted with a qualitative method using conventional content analysis approach. Data were collected by conducting in-depth semi-structured interviews. Results. Thematic analysis of the interview transcripts identified four core themes, with corresponding sub-themes: Sources of burnout, Uncertainty, Coping Strategies, Varying faculty support during clinical rotation. This study proves that nursing students experienced similar feelings of burnout and emotional strain during their clinical rotation during COVID. Evidence highlights the impact of psychological stress on nursing students in pandemic circumstances and additionally the stress of completing all required competencies to complete their degree. Conclusions. The findings of this study include sources of burnout such as working conditions, workload, dealing with suffering, death, and dying, and uncertainty in the present and future such as the evolving and changing understanding of COVID. Coping mechanisms involve staying positive and talking to family and friends. Finally, the varied opinions of the students regarding emotions and feelings of support from faculty.

Deconstructing imposter syndrome among BIPOC genetic counseling students: Insights from a longitudinal qualitative study.

"Imposter syndrome" is a term used to describe feelings of pervasive self-doubt despite evident success. It is the lay version of "imposter phenomenon," a concept that was proposed as an explanation for why highly accomplished (mostly white and middle- to upper-class) women persisted in believing that their success was due to luck or a mistake despite evidence to the contrary. However, the experience of imposter syndrome in genetic counseling, particularly among Black, Indigenous, and People of Color (BIPOC) individuals, remains underexplored. This study investigates the etiologies and impacts of imposter syndrome among BIPOC genetic counseling students with the aim of elucidating how the term is used and identifying potential interventions. We conducted semi-structured interviews with 26 participants who were part of a longitudinal constructivist grounded theory study investigating the training experiences of BIPOC genetic counseling students. Using reflexive thematic analysis, we constructed themes related to self-doubt, classroom and clinical performance, identity, and disclosing imposter syndrome feelings to others. Participants described imposter syndrome as arising from concerns that they were unprepared for their training program, less qualified than their peers, or admitted by accident or due to their BIPOC identity. Some participants attributed imposter syndrome to being a BIPOC student in a predominantly white profession. Comparisons to classmates and practicing genetic counselors, academic struggles, and anxiety about clinical rotations exacerbated imposter syndrome. Our findings underscore the multifaceted nature of imposter syndrome among BIPOC genetic counseling students and the need for a multipronged approach to mitigate its harmful effects. For BIPOC students, training programs should recognize that imposter syndrome is intertwined with racial inequities within the field that position them as imposters. We propose that supportive relationships with classmates, BIPOC mentors, and other BIPOC students can reduce imposter syndrome and enhance student well-being and academic success.

Veterinary anesthesia curricula beliefs and practices.

To document the anesthesia curricula in colleges of veterinary medicine and compare it with student clinical supervision and expectations of new graduates by anesthesia staff. Cross-sectional open survey study. American Veterinary Medical Association-accredited colleges of veterinary medicine (41 out of 49) and members of the American College of Veterinary Anesthesia-L (ACVA-L) listserv (88 of 128 responses). We created two separate surveys: one distributed to colleges and one distributed to individuals. Anesthesia faculty members of each college were encouraged to complete the survey together; only one survey was submitted for each accredited veterinary college. The college survey asked about current practices of teaching veterinary anesthesia. The individual survey was distributed to the ACVA-L listserv and asked members about tasks they permit students to perform on clinic rotations, knowledge, and skills they believe are Day One Competencies. Communicating with clients about anesthesia was a Day One Competency for 95% of respondents, but not taught in almost 50% of colleges. Students are not allowed to perform this duty on their clinical rotation by almost 60% of instructors. Cardiac arrest and resuscitation, euthanasia, patient safety/systems thinking, and professionalism were cited as Day One Competencies by 97% of participants but were not taught in the anesthesia core course in at least 25% of colleges. Use of simulations for education was mentioned as important but was rare as an instructional tool. Veterinary anesthesia curricula generally agree with each other and the content generally aligns with what are expected Day One Competencies, as judged by anesthetists. Some topics are taught in the core anesthesia course although they were rarely considered Day One Competencies. Removal of these topics may allow room in the curriculum for the content cited more commonly as Day One Competencies.

Exploring experiences of house officers in bridging gap in translation of knowledge into practice using different learning strategies in Prosthodontics: an in-depth qualitative approach

Objective: To explore the lived experiences of Prosthodontics house officers in bridging gap in translation of knowledge into practice using different learning strategies in Prosthodontics. Methodology: A qualitative study was conducted by using phenomenological approach; the individual face to face in depth interview was conducted at the workplace of the participants. Purposeful sampling was considered among the Prosthodontics House Officers who have successfully completed their clinical rotation in the department of Prosthodontics. Using NIVIVO software, a thematic analysis was done considering Braun and Clark (2006) thematic analysis. Results: Braun &amp; Clarke steps were used for the thematic analysis. Seven themes were identified: Theme 1: Observational learning strategy; Theme 2: Case-discussion as a learning strategy; Theme 3: Feedback enhances skills; Theme 4: Laboratories procedures play vital role; Theme 5: Early clinical exposure as a learning strategy; Theme 6: Record keeping as learning strategy; Theme 7: Visual aids improve clinical skills. The participants suggested some learning strategies that can help in the development of clinical skills during clinical rotations of house job tenure in Prosthodontics in bridging the gap. Conclusion: There are learning strategies that can bridge the gap in translation of knowledge into clinical practice during the clinical rotations in Prosthodontics. These learning strategies are observation, case discussion, laboratory practice, taking feedback, early exposure to clinics and video-based learning.

Prevalence of Language Barriers, Impacts, and Coping Strategies among Medical Students during their Clinical Rotation in Peshawar

Background: This study examines the Prevalence of Language Barriers, Impacts, and Coping Strategies among Medical Students during their Clinical Rotation in Peshawar, an area with a wide range of language diversity. Methods: A cross-sectional survey was conducted among 663 medical students from six medical colleges in Peshawar to assess the prevalence, frequency, and severity of language barriers, their impact on patient interactions, and the coping mechanisms employed by students. Results: The findings indicated that 39.1% of the students faced language barriers during clinical rotations; most of them were female and non-Pashto speakers. A vast proportion (69.1%) felt that these barriers negatively affected patient care due to difficulties in obtaining proper patient history and increased miscommunication. Moreover, students with language barriers reported anxiety and frustration during patient interaction. The primary coping strategy used by students was seeking support from colleagues at 80.7%. Figures showed that only 11.9% of students received formal training to overcome language barriers. Of course, students who received language barrier training were significantly more confident in clinical interactions. Conclusion: These results suggest extreme reforms in medical curricula, such as including many languages and cultural training programs to overcome language barriers; this would better prepare the students to work in a multilingual setting, dramatically reducing communication errors, improving patient care, and enriching the education experience in diverse areas.

Predicting Admission and Future Performance of Veterinary School Applicants: Evaluation of Scores of Self-Reported Animal Experience and Rural Versus Urban Background.

Admission to veterinary school is generally based on academic and nonacademic measures. Descriptions of animal or veterinary experience and rural versus urban background are often sought from applicants, but little is objectively known about their impact on admission success or future performance. We evaluated scores from written descriptions from 590 veterinary school applicants for the nature and extent of self-reported animal experience. For those admitted to the program, we compared animal experience and rural versus urban background to performance in discipline-based courses, professional skills courses, clinical rotations, and the North American Veterinary Licensing Exam (NAVLE). More than 98% of applicants reported animal experience, with small animal veterinary experience most reported. There was no difference in animal experience or background between successful and unsuccessful applicants, but rural and urban applicants reported different experiences. There was a small correlation between small animal experience and performance in clinical rotations (.21), a small negative correlation between rural background and NAVLE performance (-.23), but otherwise, no significant correlations between animal experience or background and future performance. These findings suggest that scores of self-reported animal experience do not provide predictive information on applicants, or, alternatively, that the nature and extent of animal experience, the methods used to score these experiences, and/or the measures assessed during veterinary school need to be explicitly defined to ensure that we are capturing the appropriate information. More investigation into the scoring and impact of animal experience and background on applicant performance in the DVM program and success in a veterinary career is warranted.

Medical students’ perspectives of reflection for their professional development

BackgroundReflection is a critical component of learning which plays a significant role in improving knowledge and skills. It is a metacognitive process that aims to create a deeper understanding of the situation. This study sought to explore the perspectives of medical students concerning the role of reflection in their professional development.MethodologyThis qualitative content analysis study was undertaken with 20 medical students across different year levels in 2023. Participants entered the study by purposive sampling. Data was collected through individual semi-structured interviews. Interviews were audio recorded and transcribed verbatim. Collected data was analyzed based on the steps proposed by Graneheim and Lundman. Data analysis was performed using MAXQDA-10 software.ResultsA total of 168 primary codes were extracted. After removing duplicate codes and merging similar codes, finally 54 codes were extracted, which were placed in 3 main themes and 7 subthemes. They encompassed: self-awareness (self-acceptance, metacognitive self-exploration, semantic perception); professional competence (self-directed learning, professional commitment); and reflection culture (organizational climate, educational structure).ConclusionsFindings revealed that the most important aspect of reflection is the recognition and acceptance of individual identity, along with the metacognitive awareness of how to know, especially in the early years, and understanding the meaning of behaviors and relationships over time. Students explained the undeniable impact of reflection on individual and self-directed learning and the development of professional commitment during their studies. The findings of this study, specifically major themes from reflection culture narratives, provide us with a better understanding of the lack of a positive organizational atmosphere, inappropriate educational structure and intensive clinical rotations, as well as lack of trust between students and medical teachers, which negatively impact on or hinder professional development. It seems that by faculty development initiatives, mentoring, group reflection sessions, reflective practices can turn into an opportunity to improve the quality of education.

Does Student and Staff Gender Affect Physician Associate Student Experience on Clinical Rotations?

Physician assistant/associate (PA) courses rely heavily on hands-on experience during clinical placement, and higher education institutes aim to provide students with an equitable experience. This article aims to understand how student gender and supervisor gender affect student experience on clinical placement at 2 PA courses in the United Kingdom, where PAs are known as physician associates. We found no evidence of pedagogical literature that focused on the gender differences in PA experience, so we aim to be the first to provide this research. To assess student experience, student feedback was collected through online qualitative surveys and stratified by student and supervisor gender. 95% confidence intervals were calculated for scaled questions. Qualitative feedback from students shows a clear difference in their clinical placement experiences. Male students report fewer opportunities to observe and assess female patients, while female students report fewer opportunities observe and assess male patients. The most significant difference is seen when male students are seeing female patients. The discrepancy becomes more pronounced when male students are supervised by male supervisors and when female students are supervised by female supervisors. In planning clinical placements for students, programs must understand and recognize the potential for differences in experience based on student and supervisor gender and should take action to ensure a more equitable experience for all students.