Clinical Teaching Of Medical Students Research Articles

Using instant messaging applications to promote clinical teaching of medical students.

The main purpose of this study was to evaluate the use of Telegram as an Instant messaging application in clinical teaching of medical students, especially clinical ward rounds. In this quasi-experimental study, Telegram as an Instant messaging application was employed. To do this, a Telegram group entitled as "Lavender" was created and then selected patients were divided between students and externs daily. After that, students and externs were asked to take medical histories, perform complete physical examinations, and then share their data in the Lavender group. Ultimately, to evaluate the effects of this intervention, two quantitative and qualitative approaches were used. From the students' point of view the highest average was associated with "Readiness for teaching round" (3.71 ± 1.34) and the lowest average was related to "Time-saving for studying about illnesses" (2.08 ± 1.44). In addition, medical trainees mentioned that reporting patients' daily medical histories and progress notes could create a reflective process. The suggestion made by many medical trainees was to select and discuss simpler cases who have more teaching points for them, while other trainees recommended focusing on common illnesses in the Lavender group. The use of messaging software applications such as Telegram in medical education has created a new paradigm, which could facilitate interpersonal interactions among trainees.

Attitudes of teaching faculty towards clinical teaching of medical students in an emergency department of a teaching institution in Singapore during the COVID-19 pandemic

Introduction: Singapore experienced the COVID-19 outbreak from January 2020 and Emergency Departments (ED) were at the forefront of healthcare activity during this time. Medical students who were attached to the EDs had their clinical training affected. Methods: We surveyed teaching faculty in a tertiary teaching hospital in Singapore to assess if they would consider delivering clinical teaching to medical students during the outbreak and conducted a thematic analysis of their responses. Results: 53.6% felt that medical students should not undergo clinical teaching in the ED and 60.7% did not wish to teach medical students during the outbreak. Three themes arose during the analysis of the data - Cognitive Overload of Clinical Teachers, Prioritisation of Clinical Staff Welfare versus Medical Students, and Risk of Viral Exposure versus Clinical Education. Conclusion(s): During a pandemic, a balance needs to be sought between clinical service and education, and faculty attitudes towards teaching in high-risk environments can shift their priorities in favour of providing the former over the latter.

Survey of faculty development in four Israeli medical schools: clinical faculty development is inadequate and clinical teaching is undervalued in Israeli faculties of medicine

BackgroundTeaching medical students is a central part of being a doctor, and is essential for the training of the next generation of physicians and for maintaining the quality of medicine. Our research reviews the training that physicians in Israel receive as teachers of clinical clerkships, and their thoughts regarding teaching students. The importance of faculty development cannot be overstated, for securing quality medicine and physician empowerment.MethodsThis study was based on a survey conducted among physicians teaching at Israeli medical schools. The survey was conducted using an online questionnaire sent to clinical teachers according to lists received from the teaching units of the faculties, department heads, and other clinical teachers. Participation in the study was anonymous.FindingsOf 433 invited physicians, 245 (56%) from three departments (internal medicine, paediatrics, obstetrics and gynaecology) of four faculties of medicine in Israel, out of five total, completed the questionnaire. Only 35% of the physicians reported having received training for their role as teachers, most of these participated in a short course of up to 2 days. There were significant differences between the Technion and the other schools. Technion teachers without academic appointment had higher rates of pedagogic training. The same was true in regard to Technion teachers, either residents or young specialist. Significant gaps were reported between the content covered in the training and the topics the doctors felt they would want to learn. The clinicians who participated in the survey expressed that clinical teaching was less valued and more poorly remunerated than research, and that improved compensation and perceived appreciation would likely improve the quality of clinical teaching.ConclusionsOf the one-third of the physicians surveyed who had received some training in clinical teaching, the training was perceived as inadequate and not aligned with their needs. There was a significant difference in rates of pedagogic training between the Technion and other medical schools. In addition, most clinical teachers surveyed felt that teaching students is inadequately valued. Due to its focus on just three disciplines, and higher relative number participants from the Technion faculty of medicine, our survey may not fully represent the activities of the faculties of medicine in Israel. Nevertheless, given the importance of clinical teaching of medical students, our findings argue for increasing faculty development and educational training of physicians in clinical settings, for recognizing the importance of teaching in academic and professional promotion processes.

A Model for Undergraduate Medical Student Education in Otolaryngology During the Post-COVID-19 Era.

The clinical learning environment is limited for undergraduate medical education in otolaryngology as the result of coronavirus disease 2019. In an effort to foster and rebuild the attending-medical student relationship, we have developed the R4 teaching model. This model encourages the student to read background information, respond to questions, and review online with faculty with the goal of realization of clinical decision making with gained knowledge. Within the R4 model, there are learning environment subtypes, including real patient cases, journal club, interactive quizzes, flipped classroom, and attending-lead discussions. In the absence of a multitude of "live" patients, our curricula reinstate the core of clinical teaching for medical students.

The Status of Clinical Teaching from Viewpoint of Faculty Members and Students in Guilan University of Medical Sciences

Background: One of the main tasks of the faculty of medical sciences is clinical training. Given the importance of clinical teaching for medical students, the study aim was to determine the clinical teaching status from the perspective of students and faculty members. Methods: The population of this cross-sectional study was all medical interns and final-year students of nursing and midwifery and faculty members of Guilan University of Medical Sciences in the 2015. The sampling was conducted by census method after obtaining the consent of the participants. The scale was a questionnaire consisting of 4 parts, including demographic data,phrases related to clinical teaching principles by faculty members, phrases related to the use of material and educational media by clinical faculty members and phrases related to educational activities by clinical faculty members. Data analysis was done by descriptive and inferential statistics (Mann-Whitney U test). Results: Based on the results, the mean score of clinical teaching status from the perspective of the faculty members was 62.88 ± 5.76 out of a score of 66, and the mean score was 52.11 ± 1.1 from the students’ perspective. Mann-Whitney U test results also showed a significant difference between faculty members’ and students’ perspective scores about clinical teaching status(P < 0.0001). Conclusion: According to the findings of this study, to improve the quality of clinical education,implementation strategies will be necessary. One of the most important parts of teaching in the field of medical science is clinical education as it is the first real experience students have with their future work environment and it has a significant impact on their occupational success.

Teaching mode exploration for eight-year program interns in the out-patient department of general internal

Clinical practice teaching in out-patient department is an important part of general internal clinical teaching for medical students. From 2010, eight-year program medical students in Huazhong University of Science and Technology began their clinical rotation practice in the out-patient department of general internal medicine. The one-on-one tutoring style was used in clinical teaching. We combined teacher demonstration teaching method with teacher supervision teaching method in clinical practice, and carried out periodical case discussion. At the end of each rotation stage, regular teaching evaluation and examination was taken. It has been proved that our teaching mode can not only help the students improve their professional and practical levels of clinical skills, and also help them gain the clinical working abilities and the professional spirits, which is worthy of further promotion. Key words: Eight-year program; Medical education; General internal; Clinic practice teaching

El residente como docente, Quo vadis?

Residents play an important role in the clinical teaching of medical students. Although this role is usually considered beneficial for both students and residents, it has rarely been evaluated and lacks academic recognition. Despite the fact that students value the teaching provided by residents positively, residents feel unprepared to teach. Some programs to improve resident teaching skills have been successfully developed. Association between hospitals and universities is essential to develop and provide with academic recognition these programs, whose funding should be shared. Internal Medicine should participate actively in clinical teaching and promote the figure of the resident as teacher by means of training activities adapted to the new times of our speciality.

Thinking about the status of faculty during clinical teaching of medical students

Cultivation of medical students' clinical practice is an important part of higher medical education.At present,the imbalance of teachers structure and the old and single teaching mode and method etc,have had a great impact on the clinical practice of medical students.Only by strengthening the construction of clinical teachers,establishing access and assessment system of clinical teachers,carring out diverse clinical education reform,such as Problem-Based Learning ( PBL )and Case-Based Learning ( CBL ),etc,and fully mobilizing the initiative of students and enthusiasm for learning to reach teaching and learning complement in virtuous circle.can we truly improve the quality of clinical practice. Key words: Medical students; Clinical teaching; Faculty

Refuting patients’ obligations to clinical training: a critical analysis of the arguments for an obligation of patients to participate in the clinical education of medical students

Context The clinical teaching of medical students is essential to the continuation of medicine, but it has a major impact on the patient’s health care and autonomy. Some people believe that there is a moral obligation for patients to participate in this training. Such an obligation, real or perceived, may endanger patients’ autonomy. Objectives The author makes a critical analysis of the main arguments he encounters supporting such an obligation. These arguments are: (1) the furthering of medical education; (2) compensation when uninsured or unable to pay; (3) an equitable return for the care received in a teaching hospital, and (4) fulfilment of a student’s need for (and some say right to) clinical training. Methods Related literature is reviewed in search of evidence and/or support for such arguments. Conclusions The review reveals that these arguments either cannot be verified or do not necessarily place any obligations on the patient. It is argued that, while a medical student may have a right to clinical education, the obligation to fulfil this right rests with the medical university and not on the patients of its teaching hospitals. Solutions Several proposals are made about how to satisfy this need without infringing on the patient’s right to refuse participation, explaining the patient’s rights and role in clinical teaching, and the use of standardized patients where necessary.

Teaching by Residents

This paper stresses the importance to students and residents of committed and competent teaching by residents who nationwide provide 20% to 70% of the clinical teaching for medical students. The obstacles to teaching effectiveness by residents are the lack of: (1) sufficient role modeling by faculty; (2) time (and money); (3) knowledge of the principles of adult learning and teaching techniques; (4) service-specific learning objectives; (5) recognition of teaching efforts; and (6) resident interest in teaching. Overcoming these obstacles will require increased faculty commitment to teaching, compensation for structured educational activities, more effective use of potential teaching moments, teaching workshops for residents, development of service-specific educational objectives, and recognition of exemplary teaching by residents and faculty.

'Sorry, it's my first time!' Will patients consent to medical students learning procedures?

The clinical teaching of medical students is essential to medicine; however, medical students often may not inform patients of their inexperience. Hence patients do not have the opportunity to consent specifically to the procedures being performed by medical students. The purpose of this study was to determine whether patients, when informed of the inexperience of a medical student, would still consent to the procedure. Adult emergency department patients (114) were enrolled if they required one of the following procedures: sutures, intravenous (i.v.) access or splinting. Patients were first surveyed about his or her perceptions of medical student performing procedures. The first-year medical student then informed the patient of their inexperience (the number of procedures they had performed successfully). Finally, the patient was asked to consent to the student performing the procedure (i.e. "this is my first/third time suturing, may I suture you?") The main outcome measure was patient consent to the student performing the procedure. Only 48% of participants knew they could be the first patient on whom a medical student might perform a procedure. A total of 66% thought they should be told if a student was performing his or her first procedure on them. The majority of patients (90%) consented (69/80 i.v., 20/20 splints, 13/14 sutures). For 7 of the 12 refusals, it was the student's first time performing the procedure. Most patients will allow medical students to perform minor procedures, even when informed of the student's inexperience.

Sir John Struthers MD FRCS Edin LLD Glasg: Anatomist, Zoologist and pioneer in medical education

Sir John Struthers (1823--1899), a past president of the Royal College of Surgeons of Edinburgh and Regius Professor of Anatomy at the University of Aberdeen, was an accomplished scientist and medical educator. Much of his career was spent in shaping the medical curriculum of the nineteenth century. He was a strong proponent of a sound basic science education as preparation for a career in medicine, but was also central in developing more formal clinical teaching for medical students. His interest in comparative anatomy and evolution has provided a rich legacy of human and zoological specimens that remain of value in everyday teaching. Much of his work on educational theory and the place of basic sciences in the medical curriculum remains relevant to this day, and is of particular interest given the ongoing debate regarding the place of the basic medical sciences in the undergraduate medical curriculum

Teaching Techniques in the Clinical Setting: the Emergency Medicine Perspective

AbstractThe emergency department (ED) provides a unique educational experience that is distinct from both inpatient and ambulatory care settings. Because of the high acuity, interesting pathology, and rapid patient turnover, the ED is an ideal location to train medical students. Numerous teaching opportunities exist within the domain of the ED. In the preclinical years, the ED setting provides medical students with an introduction to clinical medicine and may serve as a venue for teaching basic history and physical examination skills. In the clinical years, medical students are exposed to a wide range of undifferentiated patients. Besides common medical and surgical complaints, many medical students will encounter clinical scenarios that they otherwise would have little direct contact with. Encounters such as the acutely poisoned or intoxicated patient, environmental emergencies, interaction with out‐of‐hospital providers, and patients requiring emergency procedures are just a few situations that make emergency medicine a distinct clinical specialty. These and other student–patient encounters can provide the teaching physician an opportunity to focus case‐based teaching on a number of elements including complaint‐directed medical interviewing and physical examination skills, development of case‐specific differential diagnosis, diagnostic evaluation, implementation of patient management plans, and patient disposition. In this review article, the authors discuss various ways to approach and improve clinical teaching of medical students, including: opportunities for teaching in the ED, teaching procedural skills, student case presentations, clinical teaching styles, qualities of an effective clinical teacher, and barriers to effective clinical teaching.

Teaching Techniques in the Clinical Setting: the Emergency Medicine Perspective

AbstractThe emergency department (ED) provides a unique educational experience that is distinct from both inpatient and ambulatory care settings. Because of the high acuity, interesting pathology, and rapid patient turnover, the ED is an ideal location to train medical students. Numerous teaching opportunities exist within the domain of the ED. In the preclinical years, the ED setting provides medical students with an introduction to clinical medicine and may serve as a venue for teaching basic history and physical examination skills. In the clinical years, medical students are exposed to a wide range of undifferentiated patients. Besides common medical and surgical complaints, many medical students will encounter clinical scenarios that they otherwise would have little direct contact with. Encounters such as the acutely poisoned or intoxicated patient, environmental emergencies, interaction with out‐of‐hospital providers, and patients requiring emergency procedures are just a few situations that make emergency medicine a distinct clinical specialty. These and other student–patient encounters can provide the teaching physician an opportunity to focus case‐based teaching on a number of elements including complaint‐directed medical interviewing and physical examination skills, development of case‐specific differential diagnosis, diagnostic evaluation, implementation of patient management plans, and patient disposition. In this review article, the authors discuss various ways to approach and improve clinical teaching of medical students, including: opportunities for teaching in the ED, teaching procedural skills, student case presentations, clinical teaching styles, qualities of an effective clinical teacher, and barriers to effective clinical teaching.

Short CommunicationEvaluating a ‘service elective’ in clinical teaching for medical students

Many medical students wish to begin developing clinical teaching skills before residency. Faculty at the University of California, Irvine developed a 60-hour, longitudinal ‘service elective’ in teaching skills, which 50 third-year and fourth-year students have completed since 2001. Students learned to enact and rate eight stations of an objective structured teaching examination (OSTE) for generalist resident physicians, broadening this practical training with in-class exercises. To evaluate the elective, structured, written questionnaires were administered. Participating students gave the elective a mean rating of 5.24 on a seven-point Likert-type scale, which fell between ‘very good’ (5) and ‘excellent’ (6). Narrative comments showed that students believed the elective—and in particular the OSTE training—prepared them well for teaching as residents.

Differences in learning objectives during the labour ward clinical attachment between medical students and their midwifery preceptors.

Midwives have been actively involved in the clinical teaching of medical students for many years. However, this role has received little attention and limited research has been conducted into either its efficacy or the development of strategies to maximise the potential of such teaching opportunities. We examined medical student and midwifery preceptor attitudes towards students' learning objectives during the labour ward placement. A descriptive cross-sectional survey of midwifery preceptors and medical students was undertaken. The setting was an Australian teaching and tertiary referral hospital. The questionnaire contained questions about strategies to improve medical student involvement on the labour ward and opinions towards core competencies of the student curriculum. Of 94 questionnaires issued to midwifery preceptors, 63 were returned (response rate 67%). Of 130 questionnaires issued to medical students, 93 were returned (response rate 72%). Major differences in the expectations of students and midwifery preceptors were identified. Only 17% of midwives felt medical students should be involved in helping mothers with breastfeeding, and some no longer saw a role for students in delivering babies or performing well baby checks. These differences in opinions led to student dissatisfaction with their obstetric learning experience. Educators need to ensure that students and midwifery preceptors identify common learning objectives. Failure to address these differences may lead to poor interdisciplinary relationships.

Promoting Collaborative Teaching in Clinical Education

Background: Although the practice of medicine is increasingly a multidisciplinary effort, clinical teaching of medical students is accomplished primarily within a departmental structure. Purpose: The purpose of this study was to identify subject matter within the clinical curriculum that could serve as focus for multidisciplinary teaching. Methods: A questionnaire was sent to 13 clerkship directors (representing required clerkships) at a large Midwestern medical school in which they were asked to rate a list of 631 patient problems as critical (primary), important (secondary), or "nice to know," relevant to their respective clerkship objectives. Results: All clerkship directors completed the questionnaire. There were 523 items that were considered primary, and over 90% of these items were listed as either primary or secondary in more than 1 clerkship. Twelve topics were considered primary or secondary by at least 5 clerkship directors. Four clerkship directors identified 43 patient problems, and 3 clerkship directors identified 92 topics as primary or secondary clerkship objectives. Conclusions: In this study, listing of patient problems across clerkships demonstrated significant overlap of the clinical curriculum, suggesting multiple opportunities for faculty collaboration in clinical education.

Refuting patients' obligations to clinical training: a critical analysis of the arguments for an obligation of patients to participate in the clinical education of medical students

The clinical teaching of medical students is essential to the continuation of medicine, but it has a major impact on the patient's health care and autonomy. Some people believe that there is a moral obligation for patients to participate in this training. Such an obligation, real or perceived, may endanger patients' autonomy. The author makes a critical analysis of the main arguments he encounters supporting such an obligation. These arguments are: (1) the furthering of medical education; (2) compensation when uninsured or unable to pay; (3) an equitable return for the care received in a teaching hospital, and (4) fulfilment of a student's need for (and some say right to) clinical training. Related literature is reviewed in search of evidence and/or support for such arguments. The review reveals that these arguments either cannot be verified or do not necessarily place any obligations on the patient. It is argued that, while a medical student may have a right to clinical education, the obligation to fulfil this right rests with the medical university and not on the patients of its teaching hospitals. Several proposals are made about how to satisfy this need without infringing on the patient's right to refuse participation, explaining the patient's rights and role in clinical teaching, and the use of standardized patients where necessary.

Attitudes of elderly patients to medical students

The attitudes of elderly patients towards clinical teaching of medical students was assessed by a structured interview carried out by a doctor unknown to the patient immediately prior to discharge. One hundred and thirty alert patients were approached on three acute geriatric medicine wards in the Royal Liverpool (Teaching) Hospital. A total of 106 (81.5%) patients were suitable for inclusion in the study (mean age, 80.2 years). Twenty-nine per cent did not know what a medical student was despite having been interviewed and examined by one. Fifty-nine per cent of patients had no prior knowledge that clinical teaching occurred. Fourteen patients (13 women, 1 man, P < 0.05) objected to being examined. Nineteen women patients were examined by a man student without a chaperone. Students usually (95%) asked permission to interview and examine the patients whereas doctors only asked patients in the context of bedside teaching (33%). Elderly patients were sympathetic towards ('They have to learn') and positive about ('It's good to have them') medical students. However, 29% of patients were not aware that a medical student was going to be a doctor despite being interviewed and examined. We suggest that the term should be used either with explanation or abandoned in favour of 'student doctor'. The level of awareness of clinical teaching was poor and examination of women patients without a chaperone caused distress and should be rectified.

Proceedings of a conference on the role and training of the general internist.

American medicine is undergoing public scrutiny with an intensity never before experienced by a profession. The immediate cause for this scrutiny is the recent perception of a in the health care system. The factors that cumulatively contributed to this sense of crisis are multiple and interdependent and some are probably at least 100 years old. During the past century, medicine has changed from an empiric art toward a research-based, quantitative, technologically oriented, specialty-dominated scientific discipline. The 19th-century advances in microbiology and anesthesia, which transformed the disciplines of surgery and public health, were previews of the remarkable 20th-century achievements in physics, biochemistry, physiology, and pharmacology that were to transform the practice of clinical medicine. The Flexner report of 1910 encouraged the development of scientific medicine by integrating medical schools into universities and helped to effectively eliminate proprietary medical schools. In addition, Flexner urged that the clinical teaching of medical students