Clinical Experience Of Medical Students Research Articles

‘They never mentioned this in medical school!’ A qualitative analysis of medical students’ reflective writings from general practice

Objective The aim of the study was to identify final-year medical students’ experiences with thought-provoking and challenging situations in general practice. Design setting and subjects We conducted a qualitative analysis of 90 reflective essays written by one cohort of Norwegian final-year medical students during their internship in general practice in 2017. The students were asked to reflect upon a clinical encounter in general practice that had made a strong impression on them. A primary thematic content analysis was performed, followed by a secondary analysis of encounters that stood out as particularly challenging. Main outcome measures Clinical scenarios in general practice that make students feel professionally ‘caught off guard’. Results The analysis identified several themes of challenging student experiences. One of these was ‘disorienting encounters’ for which the students felt totally unprepared in the sense that they did not know how to think and act. Five different scenarios were identified: (1) patients with highly distracting appearances, (2) ‘ordinary consultations’ that suddenly took a dramatic turn, (3) patients who appeared unexpectedly confrontational or devaluating, (4) scornful rejection of the young doctor’s advice, and finally, (5) confusion related to massive contextual complexity. Conclusions Disorienting encounters stood out as particularly challenging clinical experiences for medical students in general practice. These scenarios evoked an acute feeling of incapacitation: not knowing what to think and do. Further curriculum development will focus on preparing the students to ‘know what to do when they don’t know what to do’.

Walking the Walk: A Review of Medical Students’ Perspective of a Surgical Theatre as the New Classroom

Medical school trains eligible students for a medical degree (MD). As part of the clinical years in the MD program, students attend surgical theatre sessions to learn medical concepts from hands-on experience in the theatre. This review aims to provide a comprehensive overview of the role surgical theatre plays in the learning process and clinical experience of medical students. Google Scholar, PubMed and NCBI databases were searched for articles from 1990 to March 2022 using the search terms ‘Operating Room’ or ‘Operating Theatre’ or ‘Surgical Theatre’ and ‘Learning’, ‘Medical Students’ and ‘Surgeons’. Only articles on medical students’ perceptions on their learning experience in the surgical theatre were included. Thirty-four articles were eligible for inclusion. Unpreparedness, anxiety, lack of clear learning outcomes, fear and intimidation were the most common reported experiences by students. These demotivate medical students from attending theatre, along with poor surgical field visibility, resulting in a negative learning experience. Positive experiences during theatre time were more likely to attract students to choose a future surgical career. Limitations include the inclusion of surgical residents’ perspectives and the exclusion of other surgical team members’ perspectives. Studies included students across different clinical years, and results were primarily based on subjective perceptions. Evidently, the surgical theatre is a great learning opportunity for medical students. However, for this learning environment to be beneficial, students need to be included during surgical discussions and procedures. Additionally, clear learning outcomes need to be present whilst adequately training students prior to their first surgical attendance.

Clinical experience of medical students in Children Emergency Room: A cross-sectional study at a University hospital in Nigeria

Background: The Children Emergency Room (CHER) is a high-volume, fast-paced environment where children present with acute illnesses. With the paradigm shift in educational models towards outcome-based education, teaching and assessment of students must be structured to attain intended learning outcome in every rotation.
 Objective: This study assessed the relationship between teaching methods and learners’ satisfaction. We also identified challenges to CHER posting and likely solutions.
 Methods: This is a descriptive cross-sectional study, using a semi-structured anonymous feedback form to elicit perception of learning objectives and adequacy of teaching methods in CHER. Adequacy of participation in emergency care was assessed on a 4-point Likert scale. Bivariate analysis for possible determinants of adequate CHER posting satisfaction on a visual analogue scale (VAS) was done. P-value < 0.05 was considered significant.
 Results: A total 112 medical students participated in this study; 51.8% of them knew their specific learning objectives on the first day in the unit. The participants’ grand mean score for learning satisfaction in CHER was adequate (2.65±0.24). Their preferred teaching method was Bedside Teaching/ Clerkship (3.01±0.78) but they were dissatisfied with simulations (2.29±0.91) and participation in emergency care (2.19±0.10). Participants in junior posting were more satisfied than those in senior posting (OR =3.45, 95% CI: 1.46- 8.15; p=0.005). A high workload was identified as a challenge.
 Conclusion: The overall clinical experience of medical student in CHER is satisfactory. Our study however, shows that there is inadequate simulation-based teaching, case presentation and participation in case management by the medical students. Curriculum reforms may be necessary to address these identified gaps and improve clinical experience of medical students in CHER.

Using the EPAs to Evaluate the Clinical Experience of Medical Students.

Although there are standardized assessments of medical students throughout medical school, the clinical experience of each student may vary widely. Currently, medical schools do not have a systematic method to ensure that students perform clinical skills during clinical clerkships. Our study used the Entrustable Professional Activities for Entering Residency (EPAs) framework to assess the ways in which medical students meaningfully participate in patient care at various clinical sites in each required clerkship and over time. Over the 2020-2021 academic year, 170 third-year medical students were asked to report the number of times they performed EPA-1 (gather history and perform physical examination), EPA-5 (document clinical encounter), and EPA-6 (provide oral presentation of clinical encounter) at the end of each required clinical rotation (emergency medicine, internal medicine, surgery, obstetrics/gynecology, pediatrics, neurology, psychiatry) at a single medical school. We used descriptive statistics and t tests to compare frequency of these EPAs by campus type, site type, clerkship, and time. One thousand, two hundred sixty-one surveys met inclusion criteria. Students performed EPA-5 more often at an academic medical center, and EPA-1 more frequently in the outpatient setting. Students performed EPA-1 and EPA-6 most often during emergency medicine and EPA-5 most often during internal medicine. Performance of all three EPAs increased over time. This reporting system produced a robust data set that allowed for EPA performance comparisons by campus, site type, clerkship, and time. EPA performance varied by rotation, site type, clerkship, and time.

A literature review for the introduction of psychiatric simulation to University of Liverpool Medical School

AimsThe aim of this review is to systematically investigate simulation in psychiatry to enable the evidence based introduction of psychiatry simulation into the undergraduate curriculum at the University of Liverpool.BackgroundTransformations in the structure of psychiatric delivery and reductions in funding to mental health care have limited the availability of direct patient clinical experiences for medical students. Experiential learning through simulation can be utilised as a powerful pedagogical tool and provide exposure to a broad range of psychopathology.Although psychiatric skills and knowledge are gained from the current University of Liverpool undergraduate curriculum, there is no specific well-designed psychiatry simulation.MethodThe author searched MEDLINE, EMBASE and PsycINFO databases for studies that met the inclusion criteria. Search terms included ‘simulation (psychiatry or ‘mental health’). Studies were also searched using snowballing via citation tracking within the databases.Inclusion criteria comprised studies of an educational intervention that involved simulation. The intervention had to be utilised within the field of psychiatric teaching.ResultThe literature review illustrated the dearth of studies analysing role-playing (RP) and/or simulated patients (SP) in psychiatry with it typically encountered as part of the more general communication skills curriculum. Studies analysing SP and RPs demonstrate how they build on the social context of learning alongside drawing on a range of educational theories, including experiential learning. However, studies show that well-designed simulation training should encompass more facets of learning to be transformative, specifically reflecting upon ones experiences alongside understanding and interpreting this new knowledge, allowing it to guide future actions and change practice.Studies analysing virtual-reality in psychiatry are limited but demonstrate significant improvements in students’ acquisition of key psychiatric skills and exposure to psychopathology. More studies are needed to evaluate the efficiency and cost-effectiveness of virtual-reality over more traditional methods.Despite the increase in simulation teaching within psychiatry, and the expansion of innovative simulation approaches in other specialties, there was limited use of novel approaches found within the studies analysing psychiatric simulation. There were studies evaluating novel approaches to psychiatry simulation outside of the undergraduate curriculum.ConclusionWhilst there are barriers to overcome in simulation training, these are primarily logistical and are clearly outweighed by the educational gain demonstrated throughout this review. Simulation training in psychiatry has often remained limited to traditional communication-oriented scenarios using RP or SP. A greater emphasis on furthering the advancement and integration of more innovative approaches into psychiatric undergraduate teaching is needed.

University of Missouri-Columbia School of Medicine.

University of Missouri-Columbia School of Medicine.

Loyola University Chicago Stritch School of Medicine.

Loyola University Chicago Stritch School of Medicine.

Florida State University College of Medicine.

Florida State University College of Medicine.

University of California, San Francisco School of Medicine

University of California, San Francisco School of Medicine

Hackensack Meridian School of Medicine at Seton Hall University.

Hackensack Meridian School of Medicine at Seton Hall University.

Texas Tech University Health Sciences Center School of Medicine, Lubbock.

Texas Tech University Health Sciences Center School of Medicine, Lubbock.

Texas A&M University College of Medicine.

Texas A&M University College of Medicine.

University of Arizona College of Medicine-Tucson.

University of Arizona College of Medicine-Tucson.

Remote Learning in the Time of COVID-19.

With the spread of SARS-CoV-2 in the U.S., medical schools across the nation have taken measures to protect the health and safety of their students. Notably, most schools have elected to suspend clinical experiences for medical students as the pandemic evolves. Many schools have demonstrated creativity and adaptability by developing online, non-clinical electives for their students to engage in.

Cultural sensitivity or professional acculturation in early clinical experience?

Aim: This study aimed to explore the early clinical experience of medical students following the adaptation of an Early Patient Contact curriculum from a European culture in Ireland to an Arab culture in Bahrain.Methods: Medical students in Bahrain took part in an Early Patient Contact module modelled on a similar module from a partner medical school in Ireland. We used a qualitative approach employing thematic analysis of 54 student reflective logbooks. Particular attention was placed on reflections of cultural influences of experience in the course.Results: Medical students undergoing this module received reported documented benefits of early clinical experience. However, students in Bahrain were exposed to cultural norms of the local Arab society including gender values, visiting the homes of strangers, language barriers and generous hospitality that led to additional challenges and learning for the medical students in acculturating to norms of the medical profession.Conclusion: Modules intended for curriculum adaptation between two cultures would be best served by a group of “core” learning outcomes with “secondary” outcomes culturally appropriate to each site. Within the context of the Arab culture, early clinical experience has the added benefit of allowing students to learn about both local and professional cultural norms, thereby facilitating integration of these two cultures.

To the point: obstetrics and gynecology global health experiences for medical students

This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an overview of considerations for obstetrics and gynecology global health experiences for the medical student. Options for integration of obstetrics and gynecology global health into undergraduate medical curricula are discussed. Specific considerations for global health clinical experiences for medical students, including choosing a clinical location, oversight and mentorship, goals and objectives, predeparture preparation, and evaluation, are reviewed.

Pre-clerkship Preparation from Live Patient Practice Pelvic Examinations

Our previous survey found students perceived live patient practice pelvic examinations (PPE) helpful for clinical rotations. Therefore, we wanted to follow up after Obstetrics and Gynecology (Ob/Gyn) rotations to determine if the experience was truly preparatory. This study tested the hypothesis that practice pelvic examinations on a live teaching patient during the pre-clinical medical school curriculum increases students’ knowledge, confidence and comfort during the clinical years Ob/Gyn clerkships. Questionnaires were emailed to third and fourth year medical students. Sixteen questions were asked related to demographics, pelvic examination experience, and perceptions regarding experience during Ob/Gyn clerkship. Data were collected and descriptive statistics generated. Ninety-seven students (28%) completed the survey (36 male, 61 female). As a result of the PPE experience with a live teaching patient, 96% students felt prepared for their first pelvic examination during rotations. During rotations, 91% students felt more confident/comfortable performing their first examination; 92% indicated knowing what (and how) to tell the patient about the examination; 92% knew how to hold a speculum; 91% knew how to bimanually locate the cervix. Additionally, 92% students would feel confident/capable performing a pelvic examination, without physician assistance. Furthermore, 95% students agreed/strongly agreed that the teaching patient pelvic examination experience during pre-clinical medical school curriculum helped prepare them for clinical rotations. Results indicate that PPEs, utilizing a live teaching patient, improve medical student confidence and comfort during this examination in clinical clerkships. By alleviating anxiety during sensitive examinations, this experience will improve the clinical experience of medical students, physicians, and patients.

The situation and enlightment of clinical experience of medical students in Northern America

This research mainly analysed the section of clinical experience in the reporl ofA panoramic snapshot of medical students'education at the beginning of the 21st centuryand gave a brief introduction to the mainstream medical education in No,hem Amercia according to the literature.At last,the enlightment from the report and reformation of our clinical practice were put forward. Key words: Northern America; Medical students; Clinical experience

Reflective Practice Enriches Clerkship Students’ Cross-Cultural Experiences

To describe a curriculum incorporating written reflection followed by reflective discussion with the goal of enhancing students' recognition and handling of cross-cultural and health disparity issues in different healthcare delivery settings. PROGRAM AND SETTING: This required curriculum was implemented within a 4-week family medicine clerkship (n = 188 students, 6 to 12 per rotation) in 23 successive rotations over 2 years. Electronic submission of a written assignment in response to structured questions was followed by in-class discussion in week 4. Outcomes were students' session evaluations, thematic analysis of student responses, and analysis of faculty facilitators' reflections about discussion sessions. Students' cultural knowledge about their patients' health beliefs around diabetes was assessed using multiple choice questions at the beginning and end of the clerkship. One hundred percent of students submitted narratives. Student evaluations demonstrated high acceptance, appreciation of sessions and faculty. Analyses of written assignments and in-class discussions identified recurring themes. Students achieved greater synthesis and more nuanced understanding of cross-cultural encounters after discussion. Self-rating of confidence in addressing cultural issues after the curriculum was high at 3.17 +/- SD 0.57 (1-4). Cultural knowledge scores improved significantly. Core components for success were clerkship director support, required participation, experienced faculty facilitators without evaluative roles, a structured assignment and formal forum for trigger question discussion. Written reflection followed by facilitated peer discussion adds value to simple 'exposure' to cross-cultural clinical experiences for medical students.

The clinical experience of medical students compared with that of residents

The clinical experience of medical students compared with that of residents