Clinical Clerkship Research Articles

Clinical clerkship at an oncology hospital based on the curriculum of a clinical pharmacy program from a university belonging to low-middle-income country: Insights from a pharmacy program experience.

Nepal, a low-middle-income country, is relatively new to clinical pharmacy. Although the program started in 2000 with several universities running it as of today, the effectiveness of this program has been under discussion since its inception regarding its syllabus, practical issues, clinical postings, and importance in hospital settings. In this commentary, we share our 14 days of experience of a clinical clerkship period carried out under a curriculum of a university constituent school in an oncology-based hospital with a clinical pharmacy department providing clinical pharmacy services.

Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis

BackgroundSocial determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students’ reports.MethodsStudy design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. Study participants: Students who completed the program during October 2018–June 2021. Analysis: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework.ResultsWe analyzed 118 reports from 2018–19, 101 reports from 2019–20, and 142 reports from 2020–21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively.ConclusionsStudents’ understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine.

GAMBARAN TINGKAT KECEMASAN PADA MAHASISWA KEPANITERAAN KLINIK DI ERA PANDEMI COVID-19 TAHUN 2022

The clinical clerkship is one part of basic medical education and is an advanced stage to complete the medical professional education program. In dealing with COVID-19, medical personnel are at the forefront. It is not an easy thing to organize clinical clerkship activities for Medical Professional Education Students while continuing to stay at the hospital during the COVID-19 pandemic. Clinical clerkship students will sacrifice time, thought, and energy to prevent the spread of COVID-19. This condition places clinical clerkship students under the threat of psychological disorders such as anxiety. The purpose of this study was to describe the level of anxiety in clinical clerkship students in the COVID-19 pandemic era in 2022. The method used was cross-sectional on clinical clerkship students, Faculty of Medicine, University of Pattimura, with a total sample of 114 respondents. The analysis used is univariate analysis. The questionnaire used in this study was the SAS/SRAS (Zung Self Rating Anxiety Scale) questionnaire. The results showed as many as 35.1% of students experienced moderate anxiety and 16.7% of students experienced severe anxiety. The results of the research based on gender found that male respondents had a mild level of anxiety, namely 19 people (16,7%), and female gender had an anxiety level in the moderate category, reason, 36 people (31,6%). The results also show that based on where they live with their parents, most of them have an anxiety level in the moderate category, as many as 31 people (27,2%) and those who live alone (not with their family) most of them have an anxiety level in the mild category, namely as many as 25 people (21,9%). Based on the location of the rotation, the respondents were located at RSUD Dr. M. Haulussy mostly has an anxiety level in the severe category, namely as many as 19 people (16,7%); at Regional Special Hospitals (RSKD) Maluku Province mostly has an anxiety level in the mild category, namely 4 people (3,5%); at Regional General Hospital dr. H. Ishak Umarella mostly has an anxiety level in the moderate category, namely as many as 5 people (4,4%); at Al-Fatah General Hospital mostly has an anxiety level in the mild category, namely 6 people (5,3%); at Level II General Hospital Prof. dr. J. A. Latumeten Ambon mostly has an anxiety level in the moderate category, namely 7 people (6,1%); as well as the respondents whose rotation locations is at Sumber Hidup-GPM Hospital, most of them had a moderate level of anxiety, namely as many as 8 people (7,0%).

The Effect of Providing Protected Time for Utilization of Video-Based Learning in the Pediatric Clerkship: A Randomized Trial

Online learning activities are used in medical school clinical clerkships, but studies report variable learner utilization. This study investigated the effect on lesson completion and knowledge gains when providing protected time and when making a video-based curriculum mandatory during the pediatric clerkship. From March 2019 to March 2020, a multicenter, prospective, randomized trial was conducted at seven medical schools. Students were randomized by clerkship block to receive or not receive protected time and to mandatory versus optional assignment of a six-video curriculum. Lesson completion, difference between pre- and post-clerkship knowledge tests, and student experience were assessed. One-hundred and sixty students completed the study. Students given protected time completed more lessons (mean=4.89 (SD=2.15) vs 2.7 (2.87); p<0.001) and were more likely to complete all six lessons as compared to students without protected time (79.2% vs 39.8%; p<0.001), with no difference in lesson completion observed between students in mandatory completion versus optional arms (p=0.250). There was no difference in knowledge gains across arms (p=0.957), but students who completed all six lessons had higher knowledge gains as compared to those who viewed fewer or none (p=0.002). Students appreciated protected time, although most did not complete lessons during protected time. Critics of protected time encouraged prioritization of patient-related clinical time and desired better integration into the clerkship. Protected time may improve utilization of supplemental learning activities, but should be integrated to avoid competition with patient care. Optimal provision of protected time warrants further study.

The mediating role of psychological flexibility in the association of autistic-like traits with burnout and depression in medical students during clinical clerkships in Japan: a university-based cross-sectional study

BackgroundBurnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported. The treatment aims to improve psychological flexibility, a concept indicating engagement in personal value-based behaviors without avoiding uncomfortable private experiences. This study examined whether ALTs were associated with burnout or depression among medical students during clinical clerkships in Japan, and then investigated what psychological flexibility processes might mediate these associations.MethodsA cross-sectional survey was administered to 284 medical students at Nagoya City University School of Medical Sciences who had been in clinical clerkships for 10 months or longer. Linear multiple regressions were performed with each burnout factor or depression as the outcome variable using validated tools measuring burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), ALT (Autism-Spectrum Quotient Japanese version-21), and psychological flexibility processes (Cognitive Fusion Questionnaire-7 and Valuing Questionnaire). Additionally, a mediation analysis was conducted using structural equation modeling.ResultsA linear multiple regression analysis that controlled for age and gender found that ALTs were significantly associated with lower personal accomplishment, a factor of burnout, and depression. Lower personal accomplishment was also associated with males and lower progress toward values of the psychological flexibility process. Depression was also associated with males and higher cognitive fusion, lower progress towards values, and higher obstruction to values of the psychological flexibility process. Surprisingly, emotional exhaustion and depersonalization were not significantly associated with ALTs. The mediation analysis revealed that the relationship between ALTs and personal accomplishment was partially mediated by a process of progress toward values, while the relationship between ALTs and depression was partially mediated by both processes of progress toward values and cognitive fusion.ConclusionsALTs were significantly associated with lower personal accomplishment of burnout and depression among medical students in clinical clerkships. Consideration should be given to the psychological flexibility processes that focus on interventions targeting psychological flexibility for medical students with ALTs to reduce burnout and depression.

Student Clinical Experiences in Cross-Cultural Education

Education in cultural competence is critical to training medical students to care for patients from all backgrounds, but it is unclear what experience students have in the clinical learning environment. We describe the medical student experience in directly observed cross-cultural encounters within two clinical clerkships, and we identify areas of need for further resident and faculty training in providing high-quality feedback following these encounters. We collected direct observation feedback forms from third-year medical students in the Internal Medicine and Pediatrics clerkships. The observed cross-cultural skill was categorized, and the quality of feedback given to students was quantified using a standardized model. Students were observed using an interpreter more frequently than any other skill. Positive feedback received the highest quality scores, averaging 3.34 out of 4 coded elements. Corrective feedback quality only averaged 2.3 out of 4 coded elements, and quality correlated with the frequency of cross-cultural skill observation. Significant variability exists in the quality of feedback provided to students following the direct observation of cross-cultural clinical skills. Faculty and resident training to improve feedback should focus on corrective feedback in less commonly observed cross-cultural skills.

Evaluasi Preseptor Lapangan Pada Kegiatan Kepaniteraan Klinik Mahasiswa Prodi Pendidikan Profesi Bidan FK UNAND

The Quality Control Group of Midwife Professional Study Program makes maximum efforts in carrying out its main tasks and functions as well as quality control in every lesson in the study program. The obstacle faced is the absence of clinical clerkship evaluation activities by field preceptors on the learning process carried out in study programs through relevant measuring instruments in the form of questionnaires. The purpose research is to create documented, can be analyzed and followed up As an effort to improve and improve sustainable quality. Type of research is cross-sectional approach. This study used total sampling with respondents from all field preceptors in the practice area of ​​the Health Center, Independent Midwife Practice and network hospitals in the Midwife Professional Education Study Program with a total of 21 respondents. The results of the validity test on the research questionnaire items were 0.001 so all questionnaire items were declared valid. The results of the questionnaire reliability test were &gt; 0.8 so the reliability was very good. The results of average value of the field preceptor on the assessment of the application of the theory are 84.69%, and the assessment of lecturer and student interactions is 78.91%. Furthermore, the assessment of the preparation for clinical clerkship activities was 88.10% the assessment of students regarding clinical clerkship activities was 75.89%. The results of the overall assessment are categorized as very good so that they can be used as a reference for improving the quality of learning.

Do clinical interview transcripts generated by speech recognition software improve clinical reasoning performance in mock patient encounters? A prospective observational study

BackgroundTo investigate whether speech recognition software for generating interview transcripts can provide more specific and precise feedback for evaluating medical interviews.MethodsThe effects of the two feedback methods on student performance in medical interviews were compared using a prospective observational trial. Seventy-nine medical students in a clinical clerkship were assigned to receive either speech-recognition feedback (n = 39; SRS feedback group) or voice-recording feedback (n = 40; IC recorder feedback group). All students’ medical interviewing skills during mock patient encounters were assessed twice, first using a mini-clinical evaluation exercise (mini-CEX) and then a checklist. Medical students then made the most appropriate diagnoses based on medical interviews. The diagnostic accuracy, mini-CEX, and checklist scores of the two groups were compared.ResultsAccording to the study results, the mean diagnostic accuracy rate (SRS feedback group:1st mock 51.3%, 2nd mock 89.7%; IC recorder feedback group, 57.5%–67.5%; F(1, 77) = 4.0; p = 0.049), mini-CEX scores for overall clinical competence (SRS feedback group: 1st mock 5.2 ± 1.1, 2nd mock 7.4 ± 0.9; IC recorder feedback group: 1st mock 5.6 ± 1.4, 2nd mock 6.1 ± 1.2; F(1, 77) = 35.7; p < 0.001), and checklist scores for clinical performance (SRS feedback group: 1st mock 12.2 ± 2.4, 2nd mock 16.1 ± 1.7; IC recorder feedback group: 1st mock 13.1 ± 2.5, 2nd mock 13.8 ± 2.6; F(1, 77) = 26.1; p < 0.001) were higher with speech recognition-based feedback.ConclusionsSpeech-recognition-based feedback leads to higher diagnostic accuracy rates and higher mini-CEX and checklist scores.Trial registrationThis study was registered in the Japan Registry of Clinical Trials on June 14, 2022. Due to our misunderstanding of the trial registration requirements, we registered the trial retrospectively. This study was registered in the Japan Registry of Clinical Trials on 7/7/2022 (Clinical trial registration number: jRCT1030220188).

Community medicine clerkship amidst COVID-19 pandemic: re-designing, implementation, and evaluation

Clerkship on primary care and family medicine is multi-elemental and very challenging in amidst the COVID-19 pandemic. Some medical students have postponed their graduation because the clerkship at the health center cannot be carried out in a pandemic situation. This article aims to describe the community medicine clerkship (CMC) module and how the implementation amidst the COVID-19 pandemic. This module was delivered by online and offline activities from 10th August to 13th September 2020. A total of forty students, twelve faculty mentors, and fifteen PHC preceptors from ten PHCs in Tangerang District, Indonesia were involved. Students could carry out activities and fulfill assignments given in the midst of a pandemic with a re-designing of the CMC module. One-sample t-tests were run to determine whether scores of students participating in CMC module during the COVID-19 pandemic differed from normal and showed that individual and group scores were significantly different from normal. The findings of the study clearly indicate that all clinical clerkship modules must be redesigned to suit the current conditions. Modifications and variations of various learning methods, guidance techniques, monitoring and coordination are factors that should be considered in its implementing.

Greater Objective and Perceived Competence for Clinics is Associated with Reduced Stress but No Change in Impostorism in Medical Students &lt;sup&gt;&lt;a class="tippyShow" data-tippy-arrow="true" data-tippy-content="A portion of this work was published in abstract form and presented at the 25&amp;lt;sup&amp;gt;th&lt;/sup&gt; annual meeting of the International Association of Medical Science Educators, June 12-17, 2021 [1]" data-tippy-interactive="true" data-tippy-theme="light-border" style="cursor:pointer"&gt;a&lt;/a&gt;&lt;/sup&gt;

Impostorism is prevalent in medical students and negatively impacts wellness, contributing to stress and burnout. Perceived competence is noted as one attribute underlying impostorism. A curricular change that resulted in improved United States Medical Licensing Examination (USMLE) Step 1 scores and student self-perceptions of preparedness for clinical training was used as a natural experiment to assess the effects higher competence/preparedness, based on an objective indicator and self-perceptions, on impostorism, stress, and burnout during early clinical training. Third-year medical students in the last class of the old “Legacy” curriculum and the first class of the revised “ACE” curriculum completed a voluntary, anonymous survey that included the Clance Impostor Phenomenon Scale, the Perceived Stress Scale, and the abbreviated Maslach Burnout Assessment. USLME Step 1 scores and data on students’ self-perception of their preparedness for clinics were collected as part of routine curricular monitoring. Both groups of students had highly similar entering demographics. Compared to Legacy students, ACE students had higher USMLE Step 1 scores (p &lt; 0.001) and perceived themselves to be better prepared for clinical clerkships (p &lt; 0.001). Stress scores were 15% lower in ACE students (p &lt; 0.05). However, impostor scores were nearly identical between these groups and the proportions of students endorsing burnout were not different. This suggests that impostorism and burnout during the transition to clinical training are not attenuated by improved competence and are not directly related to stress.

The relationship of online pre-recorded neurology mini-lectures to medical student assessment: a pilot study

IntroductioneLearning has become an essential part of medical education. However, there is a lack of published research on student engagement with online pre-recorded mini-lectures and its relation to assessment. The aim of this pilot study is to explore the relationship between newly introduced neurology pre-recorded mini-lectures and undergraduate medical students engagement and assessment. This may encourage the wider use of mini-lectures in undergraduate medical curricula.MethodsThe engagement of medical students with 48 online pre-recorded neurology mini-lectures was assessed through a Learning Management System. To measure engagement, data was stratified according to the number of watched/downloaded mini-lectures. A point system was used (out of 5): − 1 point = watching/downloading 0–10 mini-lectures, 2 points = watching/downloading 11–20 mini-lectures, 3 points = watching/downloading 21–30 mini-lectures, 4 points = watching/downloading 31–40 mini-lectures and, 5 points = watching/downloading 41–48 mini-lectures. The students’ engagement was correlated with their neurology assessments [Objective Structured Clinical Examination (OSCE), and knowledge-based assessment 10 Multiple Choice Questions (MCQs) and one 10-mark Short Answer Question, (SAQ)], internal medicine grade and annual grade point average (GPA) using the Pearson correlation coefficient.ResultsThe mean engagement of 34, Year 5, medical students is 3.9/5. There is a significant positive correlation between engagement and internal medicine grade (r = 0.35, p = 0.044). There is a moderate correlation between engagement and neurology OSCE (r = 0.23), annual Year 5 GPA (r = 0.23), neurology knowledge-based score (r = 0.22) and composite neurology knowledge/OSCE (r = 0.27). The knowledge-based assessment included SAQ and MCQs: there was a moderate correlation with SAQ (r = 0.30), but a weak negative correlation with the MCQs (r =-0.11). Sub-groups analysis comparing the top- and low- or non- engaging students made these weaker correlations stronger.ConclusionThis pilot study indicates a high rate of engagement with an online pre-recorded mini-lectures resource and evidence of moderate correlation between engagement and assessment. Online pre-recorded mini-lectures should be used more in delivering the curriculum contents of the clinical clerkships. Further studies are needed to evaluate the relation and the impact of the mini-lectures on assessment.

Cultivating patient-centered care competence through a telemedicine-based course: An explorative study of undergraduate medical students' self-reflective writing.

The COVID-19 pandemic has encouraged adaptations of learning methods in clinical clerkship. There have been limited reports on the merits of involving medical students in telemedicine. This study, therefore, aims to investigate students' reflection on what they learned and identify the challenges and benefits of doctor-patient interaction through their experience in a telemedicine-based course. A 4 week telemedicine-based course for medical students to participate in telemonitoring of COVID-19 patients undergoing self-isolation was conducted. This is a qualitative study using an interpretive phenomenology design to investigate students' self-reflection on their experiences in monitoring COVID-19 patients. Students were asked to reflect on their experience upon completion of the course through 750-1,000 words essays. A thematic analysis which considers units of meaning based on students' experiences was completed. Our study identified four main themes gathered from students' experiences related to the telemedicine-based course: communication and education, professionalism and professional identity formation, system-based practice, and patient-centered care. The course was part of an integrative effort involving multiple parties to tackle the burden on the nation's healthcare system during the pandemic. Telemedicine is part of future medical practice which supports the medical curriculum adaptability along with attempts to develop future-proof medical doctors through various clinical learning experiences.

An Elite Privilege: Top-Ranked Medical Schools Provide Fewer Comparative Performance Data on Their Students.

The objective of this study was to determine differences in the reporting of performance data on medical student performance evaluations (MSPEs) by medical school ranking. MSPEs from all US allopathic and osteopathic medical schools received by a single diagnostic radiology residency program during the 2021-2022 application cycle were retrospectively reviewed. Preclinical class and core clerkship grades were categorized as pass/fail or multitiered. Comparative summative assessments provided in the MSPEs were recorded. Medical schools were grouped by their US News & World Report rankings, and the proportion of reported performance metrics for each group was compared. Information from 95% of US allopathic medical schools (148 of 155) and 73% of osteopathic medical schools (27 of 37) was collected, on the basis of 1,046 applications received. For preclinical classes, multitiered grading was reported by no schools ranked in the top 10, 17% of schools ranked 11th to 50th, 52% of schools ranked 51st to 100th, and 59% of unranked schools (P < .001). For core clinical clerkships, multitiered grades were reported by 70% of the top 10 ranked schools, 90% of schools ranked 11th to 50th, 94% of those ranked 51st to 100th, and 94% of unranked schools (P= .0463). Comparative summative assessments were reported by none of the top 10 ranked schools, 56% of schools ranked 11th to 50th, 80% of those ranked 51th to 100th, and 81% of unranked schools (P < .001). Higher ranked medical schools are less likely to provide comparative assessment data on their MSPEs, which may disadvantage students from lower ranked medical schools.

Clinical Clerkships in General Medicine Enable Students to Acquire Basic Medical Competencies and Experience in Community-Based Integrated Care: A Descriptive Questionnaire-Based Study.

Background No previous research has targeted educators regarding educational practice and the achievements of students in terms of the learning objectives of clinical clerkships in university general medicine departments of Japan. We aimed to clarify the characteristics of clinical clerkships in Japanese general medicine departments using a questionnaire administered to chairpersons of university general medicine departments. Methods This was a descriptive questionnaire-based study using Google Forms (Google, Inc., Mountain View, CA, USA). We asked the chairpersons of general medicine departments in Japanese universities the following questions, with responses given on a 5-point Likert scale: Question 1: How well are primary symptoms in the national model core curriculum for undergraduate medical education taught in clinical clerkships in university general medicine departments? Question 2: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in general medicine departments of university hospitals? Question 3: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in other community clinics or hospitals?The results of the questionnaire responses are described as mean±standard deviation. Results Of the 71 Japanese universities with general medicine departments, 43 were included in the analysis. For Question 1, the symptoms and pathophysiologies with a mean score of 4 points or higher were fever, general malaise, anorexia, weight loss or gain, edema, abdominal pain, lymphadenopathy, and headache. All those symptoms require basic medical competencies. For Questions 2 and 3, the intramural clinical clerkship of general medicine departments had a higher mean score than the extramural clinical clerkship for diagnostic reasoning that emphasizes medical history and physical examination and a comprehensive approach to patients with multiple health problems.In contrast, the extramural clinical clerkship, in which medical students can build experience with community-integrated care, had a mean score of 3 points or higher for all items. Conclusions The clinical clerkship in general medicine departments of Japanese universities provides students with chances to acquire clinical competencies regarding primary symptoms and pathophysiologies. Additionally, the extramural clinical clerkship provides experience in community-based integrated care, including home medical care, collaboration, health and welfare, and long-term care.

A Guided Near-Peer Mentorship Program for Transitioning into Clinical Clerkships at a Regional Medical Campus

Background&#x0D; Transitioning from preclinical to clinical medical education is a significant milestone in medical training; however, it is associated with anxiety and uncertainty about adapting to a new work and learning environment. These feelings may be additionally heightened when students are also transitioning to a branch or regional campus for their clerkship training. A guided, near-peer mentorship program was designed at a regional medical campus in hopes of reducing anxiety associated with transitioning into clinical rotations, as well as teach clinical medical students how to effectively mentor a fellow student.&#x0D; Methods&#x0D; This curricular improvement program was developed and implemented at a regional campus of a US Midwestern medical school. A list of 14 topics for discussion was created from responses to reflection questions completed by students participating in the program. These topics were sorted into meeting guides that mentors could reference during three individual meetings with their mentee. Mentors attended a workshop prior to the start of the program to learn more about effective mentorship in medicine. Participants from the first two years of this program were asked to complete feedback surveys evaluating their experience in the program.&#x0D; Results&#x0D; Forty-one of 48 potential second-year students agreed to participate as mentees and 40 of 48 potential third-year students agreed to participate as mentors. Ninety-two percent of mentees agreed that participating in the program decreased their stress and anxiety about transitioning into clerkships and 96% reported they would recommend the program to other students. Among the mentors, 93% reported they would recommend the program to other students and 78% agreed that the mentorship skills they practiced during the program are useful in their professional and academic development.&#x0D; Discussion&#x0D; With the introduction of this guided, near-peer mentorship program, mentees reported feeling supported in their transition into clinical clerkships and mentors reported feeling prepared to effectively mentor a fellow student. Though such one-on-one programs can be somewhat time-intensive to establish and execute, the skills gained by mentors can serve them for the rest of their careers and the individualized advice given to mentees markedly decreases anxiety in a high-stress transition.

The effects of simple graphical and mental visualization of lung sounds in teaching lung auscultation during clinical clerkship: A preliminary study.

The study aimed to evaluate visualization-based training's effects on lung auscultation during clinical clerkship (CC) in the Department of Respiratory Medicine on student skills and confidence. The study period was December 2020-November 2021. Overall, 65 students attended a lecture on lung auscultation featuring a simulator (Mr. Lung™). Among them, 35 (visualization group) received additional training wherein they were asked to mentally visualize lung sounds using a graphical visualized lung sounds diagram as an example. All students answered questions on their self-efficacy regarding lung auscultation before and after four weeks of CC. They also took a lung auscultation test with the simulator at the beginning of CC (pre-test) and on the last day of the third week (post-test) (maximum score: 25). We compared the answers in the questionnaire and the test scores between the visualization group and students who only attended the lecture (control group, n = 30). The Wilcoxon signed-rank test and analysis of covariance were used to compare the answers to the questionnaire about confidence in lung auscultation and the scores of the lung auscultation tests before and after the training. Confidence in auscultation of lung sounds significantly increased in both groups (five-point Likert scale, visualization group: pre-questionnaire median 1 [Interquartile range 1] to post-questionnaire 3 [1], p<0.001; control group: 2 [1] to 3 [1], p<0.001) and was significantly higher in the visualization than in the control group. Test scores increased in both groups (visualization group: pre-test 11 [2] to post-test 15 [4], p<0.001; control group: 11 [5] to 14 [4], p<0.001). However, there were no differences between both groups' pre and post-tests scores (p = 0.623). Visualizing lung sounds may increase medical students' confidence in their lung auscultation skills; this may reduce their resistance to lung auscultation and encourage the repeated auscultation necessary to further improve their long-term auscultation abilities.

Anxiety level and functional dyspepsia incidence during COVID-19 pandemic

The adaptation process of the learning system, the hospital environment, and the high risk of COVID-19 infection can be stressors for anxiety in clinical clerkship. Through the brain-gut–axis, the interaction of psychological factors, such as anxiety, can trigger symptoms related to functional dyspepsia. This study aimed to determine the relationship between anxiety levels and functional dyspepsia during the COVID-19 pandemic among clinical clerkship students. This research was conducted on clinical clerkship students/young doctors in 2021. This was an observational analytic study with a cross-sectional approach and involved 131 respondents. The hamilton anxiety rating scale (HARS) questionnaire was utilized to quantify the level of anxiety, while functional dyspepsia was measured based on Rome IV criteria. The data were analyzed by the Lambda (λ) coefficient of correlation test. This study revealed a significant relationship between anxiety level and functional dyspepsia during the COVID-19 pandemic.

The 2021 Podiatric Residency Candidate and Program Virtual Interview Experience During COVID-19 with Multispecialty Reflections and Recommendations for a Successful Virtual Match.

The coronavirus disease of 2019 pandemic impacted all facets of health care in the United States, including the professional training for podiatry residents and students. In March of 2020, the Association of American Medical Colleges recommended pausing then modifying all clinical rotations. The podiatric community followed suit. In-person restrictions, cancellations of clerkships, limited clinical experiences, virtual didactic programs, and reduced surgical cases for students and residency programs occurred for many months during the ongoing pandemic. These adaptations impacted the ability of podiatric students to complete clinical rotations and clerkships, which are pivotal to their academic curriculum and residency program application and selection. A survey was conducted by the Council of Teaching Hospitals (COTH) and sent out by the American Association of Colleges of Podiatric Medicine. The 2021 postinterview surveys were sent out to all participants in the 2021 Centralized Application Service for Podiatric Residencies Web application and match cycle, both programs and candidates. The COTH presents results and comments from the 2021 virtual interview experience and residency match. Data and anecdotal comments from the 2021 postinterview survey conducted by COTH, sent out by American Association of Colleges of Podiatric Medicine, are presented here. Results from the surveys of program directors and candidates show a preference by both groups for in-person interviews despite the personal time demands and increased costs associated with travel.

Evaluation of the public health clinical rotation in medical school: a qualitative case study design.

Public health clinical rotation in the Faculty of Medicine, Universitas Islam Indonesia, was conducted in Puskesmas (community health center). This study aims to evaluate the public health clinical rotation in Puskesmas, part of the clinical clerkship of the Faculty of Medicine, Universitas Islam Indonesia. Several concerns have been highlighted regarding the implementation of clinical rotations in public health in Puskesmas. A briefing session before placement in the village must be coherent with a guidebook. The placement of students in the village was based on community health issues determined by the Puskesmas supervisor. Priority in the curriculum was given to converting the alertness village (Desa Siaga) into a Program Indonesia Sehat-Pendekatan Keluarga (Healthy Indonesia Program-Family Education) program throughout implementation. Moreover, scheduling after four major clinical programs was difficult, and the writing of reports served as a guide for establishing the correct format. Therefore, the objective of the evaluation was to assess knowledge, skill, and psychomotor, and the burden of assignment in Puskesmas was difficult to accomplish a primary task in the community.

Improvisation to combat sexual harassment on the wards.

In the spring of 2021, medical students at the University of Geneva, Switzerland, conducted a survey amongst their peers concerning sexual harassment during the clinical clerkships. The survey collected multiple testimonies of sexual harassment that occurred during their clinical rotations. These results inspired an awareness campaign against sexual harassment. Knowing that the impact of sexual harassment includes physical and psychological repercussions, burnout, career change and avoidance of learning opportunities, the medical school created a sexual harassment awareness course for medical students before beginning their clinical rotations. Due to the sensitive nature of the subject matter, we decided to use actual testimonies of the campaign as part of the teaching strategy. We sought to create an active learning exercise that would stimulate students to reflect deeply on prevention and response strategies with the purpose of removing students from the role of victim or passive witness. In collaboration with an improvisational theatre troupe, Impro-Impact, we created the course using the extended parallel process model (EPPM) as our conceptual framework.1 This model purports that if one believes that a threat is harmful and that they are at risk, while at the same time they believe in the effectiveness of solutions and have the confidence to practice them, they are more likely to take protective action to avoid or reduce the threat. The course was constructed in five parts: (1) a brief theoretical introduction, (2) a performance depicting the day in the life of a female medical student who experiences sexual harassment on the first day of her surgery clerkship, (3) students formed small groups to debrief the scenarios and to brainstorm potential responses as a victim and as a bystander, (4) the scenes were replayed by the actors using the suggestions of the students, and (5) the course concluded with a presentation of available resources. Feedback from the medical students showed that our initial objective of increasing awareness was attained, but in addition, we learned that this course was able to empower students to speak up about their own experiences, to question the status quo and to give students enough agency to react in these uncomfortable situations. In the first clinical rotation following the course, students in the surgery rotation were able to come forward about incidents of sexual harassment, allowing the medical school to intervene on their behalf. Students were also vocal about the necessity to train faculty in order to bring about a culture change. Two multiple-choice questions asking students to decide upon next steps in a sexual harassment vignette were included in the final exam. Surprisingly, responses to the questions showed that students did not identify medical school faculty as an important resource. Future work will need to focus on ways to increase student confidence in the medical school's response to sexual harassment. The course will occur annually and there are now plans to create similar courses for medical school faculty and other faculties associated with the university. Pauline Hämmerli, Lygia Pavitt and Nadia M. Bajwa designed, constructed, implemented and evaluated the project. Nadia M. Bajwa wrote the draft manuscript. Pauline Hämmerli and Lygia Pavitt revised the manuscript.