Council On Medical Student Education In Pediatrics Research Articles

Pediatric Intersession: An Upfront Flipped-Classroom Curriculum to Promote Pediatric Clerkship Readiness.

Best practices for content selection, mode of delivery, and timing of pediatric clerkship readiness curricula for medical students have, by and large, not been established. Capitalizing on changes in structure of the clinical clerkships during the COVID-19 pandemic, we created an upfront clerkship readiness curriculum, termed Pediatric Intersession (PI), to replace the existing weekly lecture-based clerkship didactics. Our goal was to develop an interactive curriculum with innovative instructional design methodology intended to promote broad foundational pediatric knowledge and clerkship preparedness using case-based learning. We first conducted a needs assessment and crafted curriculum content using guiding principles from the 2019 Council on Medical Student Education in Pediatrics (COMSEP) curriculum. We then organized material into four daily modules prior to the start of the clerkship and employed flipped classroom (FC) methodology. Sixty-six percent of students completed course evaluations, and >90% of the 100 respondents reported that the PI enhanced their clinical learning. Pre-/post-testing demonstrated some knowledge gain following the small-group sessions and there was no change on the National Board of Medical Examiners (NBME) Subject Exam mean scores compared to prior cohorts of students. The global pandemic provided an opportunity to re-envision our pediatric clerkship didactics content, while also incorporating instructional design methodology preferred by students. Our curriculum promotes a small group-based, interactive approach to clerkship readiness that fosters learning in the clinical environment that can be adapted for various settings. Our evaluation suggests that the transition to a FC readiness curriculum can be done successfully while effectively preparing students for their pediatric clerkship.

Disseminating evidence in medical education: journal club as a virtual community of practice

BackgroundThis study explores the impacts of the Council on Medical Student Education in Pediatrics (COMSEP) Journal Club, a unique means of providing monthly professional development for a large international community of pediatric undergraduate medical educators. In particular, we sought to establish member engagement with the Journal Club, identify factors impacting member contributions to the Journal Club, and determine perceived benefits of and barriers to participation as a Journal Club reviewer.MethodsUsing an established Annual Survey as a study instrument, six survey questions were distributed to members of COMSEP. Items were pilot tested prior to inclusion. Quantitative data were analyzed using descriptive statistics and chi-square analysis..ResultsOf 125 respondents who completed the survey, 38% reported reading the Journal Club most months or always. Level of engagement varied. Reasons for reading included a topic of interest, keeping up to date on medical education literature, gaining practical tips for teaching and implementing new curricula. Motivators for writing a review included keeping up to date, contributing to a professional organization, and developing skill in analyzing medical education literature, with a minority citing reasons of enhancing their educational portfolio or academic promotion. The most commonly cited barriers were lack of time and lack of confidence or training in ability to analyze medical education literature.ConclusionAs a strategy to disseminate the latest evidence in medical education to its membership, the COMSEP Journal Club is effective. Its format is ideally suited for busy educators and may help in members’ professional development and in the development of a community of practice.

Telehealth Curricula in the Pediatric Core Clerkship: Results From a Survey of Clerkship Directors.

Given the increasing prevalence of telehealth, medical students require dedicated instruction in the practice of high-quality telehealth. This study characterizes telehealth practices and curricula in pediatric core clerkships across the United States and Canada. We surveyed pediatric core clerkship directors and site directors through the 2020 Council on Medical StudentEducation in Pediatrics (COMSEP) annual member survey. We analyzed the results using descriptive statistics. Of 104 medical schools represented, 28 responded (26.9%). Directors reported students spent little time on telehealth during their pediatric core clerkships (average 8.2% of clerkship; SD 10.4). Only 10.7% (n=3) of clerkships had dedicated telehealth curricula. The instructional methods, content, and modes of evaluation varied across the clerkships' curricula. Barriers to implementation of telehealth curricula included lack of dedicated time in the existing curriculum (64.0%), lack of faculty time to teach (44.0%), lack of curricular materials (44.0%), students not participating in telehealth activities (40.0%) and lack of faculty expertise (36.0%). Most pediatric core clerkships do not include dedicated telehealth curricula, and the characteristics of existing curricula vary. Considering the rapid adoption of telemedicine, pediatric core clerkships merit additional support and guidance for the training of medical students in telehealth practice.

Exploring how national educational organizations can promote educational research amongst members: a survey-based study

BackgroundEngagement of academic faculty in research remains low. While barriers to research have been explored, there are no data on how national organizations can help overcome these barriers. Our study explored faculty satisfaction and motivational drivers for engagement with research opportunities offered by the Council on Medical Student Education in Pediatrics (COMSEP), an organization of pediatric medical educators, and characterize strategies perceived by faculty to promote the use of these opportunities.MethodsIn 2021, 5 survey questions were administered to faculty members of COMSEP to explore satisfaction with COMSEP’s research offerings, the perceived value of educational research, and the facilitators, barriers and potential opportunities for COMSEP to promote research. Clark’s Commitment and Necessary Effort model on motivation served as the theoretical framework for our study, which explores motivation, self-efficacy and contextual factors influencing an individual’s pursuit of goals. Chi-square analysis and Wilcoxon Signed Ranks Test were used to compare categorical and scaled variables among groups who did and did not avail of COMSEP’s research offerings.Results90 (25%) of 360 recipients responded. 61% expressed satisfaction with COMSEP’s research offerings. 68% indicated research was an expectation of their academic appointment, that education was their primary research focus (74%) and that they did not have other research opportunities that met their needs (58%). Of respondents, 75.7% of females had submitted a proposal compared to 60% of non-responders who were females. The comparison by gender was not statistically significant. Exploration by academic rank revealed that 35% of instructor/assistant professors had submitted a proposal compared to 65% of associate professors/professors (p =.05). Barriers leading to non-submission to any of the offerings included having too much other work, lack of enjoyment in writing and inability to find mentors. Respondents endorsed the importance of several strategies to promote engagement in research-skill building opportunities, personalized consultations and increased funding.ConclusionsFaculty educators value the importance of educational research and recognize that research opportunities offered by COMSEP address an unmet need, but express ambivalence in the enjoyment of writing (reflecting their mood), and endorse structural barriers, that are amenable to change, affecting their personal agency.

Essential yet Ill-defined: leadership roles to support fourth-year medical students in pediatrics

ABSTRACT Background: Few studies have been published about specialty-specific fourth-year medical student leadership in any discipline. This paper provides insight from pediatric educators about the current status and recommendations for pediatric-specific fourth-year leaders. Objective: To identify the prevalence of pediatric fourth-year medical student directors across the US and Canada and to compare current and ideal responsibilities for this role. Methods: Five multi-part questions were written and submitted for the 2019 Council on Medical Student Education in Pediatrics (COMSEP) Annual Survey and subsequently disseminated to all COMSEP member physicians. Anonymous responses were collected and results analyzed. The study was IRB exempt. Results: The program-level survey response rate was 79%. Of 115 respondent medical schools, 37% reported having a pediatric fourth-year director separate from the clerkship director, with an average of 9.8% full-time equivalent (FTE) protected time for the role. In contrast, individuals indicated 20% FTE would be ideal for fourth-year director responsibilities. The most common role identified for pediatric fourth-year directors was directing sub-internships. Respondents indicated it would be ideal for pediatric fourth-year directors to have an increased level of involvement in all areas queried in the survey, especially directing a pediatric residency preparatory course/boot camp, faculty development for educators of fourth-year students, and remediating fourth-year students. Conclusions: As specialty-specific experiences have grown in the fourth year of medical school, there is an increasing demand for faculty leadership separate from direction of the pediatric clerkship. In this national survey, pediatric educators expressed a need for additional protected time to lead fourth-year specific activities. Similar findings in other disciplines would support advocating for more protected time and expanded roles for specialty-specific fourth-year directors nationally.

Teaching pediatric otoscopy skills to the medical student in the clinical setting: preceptor perspectives and practice

BackgroundAcute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy.MethodsA 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey.ResultsSurvey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%).ConclusionsOur study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

Medical Student Participation in Patient- and Family-Centered Rounding: A National Survey of Pediatric Clerkships

ObjectivePediatrics rotations may be medical students’ only experience with patient- and family-centered rounding (PFCR). It is unclear how students participate in or are prepared for PFCR. We surveyed national pediatrics clerkships to determine the prevalence of PFCR and the proportion providing orientation in order to inform a needs assessment for PFCR orientation. MethodsA 5-item peer-reviewed survey was distributed to the Council on Medical Student Education in Pediatrics (COMSEP) membership as part of a larger survey in 2017. Institutional differences among programs performing PFCR were compared using chi-square and t-tests. Responses to 1 open-ended question were coded and grouped into broad categories using content analysis. ResultsThe full COMSEP survey received answers from 190 participants representing 103 medical schools. Our questions received 174 responses representing 94 schools (98 training sites) and had an 85% (83/98) prevalence of student PFCR participation. Although most (n = 108; 85%) reported that their students received PFCR orientation, half (n = 62; 49%) considered orientation “informal,” and only 2 reported using published curricula. After didactics, the most common orientation materials were handouts (n = 33; 26%), videos (n = 13; 10%), and role play (n = 7; 6%). Orientation was most commonly initiated at the start of clerkship (n = 62; 49%) by clerkship administration (n = 38; 30%), but 20% (n = 26) reported resident-led orientation. Qualitative responses (n = 98) were coded and organized into 4 themes; the greatest perceived challenges for medical students on PFCR were communication and anxiety. ConclusionsAlthough most students participate in and receive orientation to PFCR, there is wide variability in the content, timing, and administration of orientation. A nationally disseminated, evidence-based orientation curriculum may reduce educational variability and better prepare students for PFCR.

Interprofessional education in pediatric clerkships: A survey of pediatric educators in North America

Medical education organizations in the US and Canada recommend that interprofessional education (IPE) occur throughout health professions training. Prior studies have demonstrated few IPE activities in medical school clinical clerkship curricula. To determine the prevalence of IPE curricular activities in pediatric clerkships in North America. Through the Council on Medical Student Education in Pediatrics (COMSEP), faculty leaders in pediatric medical education were questioned about the prevalence of IPE activities in their pediatric clerkship, as well as their attitudes about IPE, including perceived barriers. Faculty leaders from 50% of all COMSEP member medical schools in the US and Canada responded. Overall, 29% (20/68) of clerkship directors or associate clerkship directors (CD's) stated that IPE activities existed in their medical school pediatric clerkship. Nearly 40% of these programs (8/18) did not offer IPE to all their students, owing to IPE activities being available only at certain times of the year or only at certain clerkship site locations. Among all IPE activities, nursing, pharmacy and physical therapy students participated most often with pediatrics medical students. CD's rated interprofessional communication competencies as the most important goal of the existing IPE programs. Barriers to IPE included insufficient faculty teaching time and poor alignment of academic calendars among health professions schools. Despite IPE being a national curricular priority, more than 70% of pediatric clerkships in the US and Canada do not have structured IPE activities. Numerous barriers to implementing IPE exist.

Developmental-Behavioral Pediatric Teaching of Medical Students: A National COMSEP Survey

Background: The Council on Medical Student Education in Pediatrics (COMSEP) pediatric clerkship curriculum is widely followed. To date, there are no known studies on clerkship instruction related to developmental-behavioral pediatric (DBP) curricular elements. Purposes: The goals of this study are to examine pediatric clerkships’ current DBP teaching methods and to identify barriers and solutions to recommended curriculum implementation. Methods: Electronic survey was conducted with COMSEP-member pediatric clerkship directors. Descriptive statistics and qualitative data analysis was conducted. Results: Response rate was 66%. General Pediatricians (87.1%) were mostly responsible for clerkship DBP teaching. Around 18% of directors reported not assessing DBP competencies. Most clerkship directors report time constraints (61.8%) as a barrier to implementing the curriculum, along with faculty availability and resources. Suggested solutions included DBP faculty collaboration and resources. Conclusions: General pediatricians should collaborate with DBP faculty for instructional content creation, and community-based observational opportunities and web-based shared resources could help clerkship directors achieve the COMSEP DBP curriculum competencies.

Pediatric Education Across the Continuum: What Continuum?

I greatly appreciate the opportunity to deliver the keynote address to this third biannual Pediatric Educational Excellence Across the Continuum meeting, sponsored by the Academic Pediatric Association, Association of Pediatric Program Directors (APPD), Council on Medical Student Education in Pediatrics (COMSEP), and Council of Pediatric Subspecialties (CoPS). I want to thank the planning committee members for this honor and commend them for the deliberate pairing of individuals from UME and GME to cofacilitate the workshops.

Use of Simulation-Based Education: A National Survey of Pediatric Clerkship Directors

ObjectiveTo document the prevalence of simulation-based education (SBE) for third- and fourth-year medical students; to determine the perceived importance of SBE; to characterize the barriers associated with establishing SBE. MethodsA 27-item survey regarding simulation was distributed to members of the Council on Medical Student Education in Pediatrics (COMSEP) as part of a larger survey in 2012. ResultsSeventy-one (48%) of 147 clerkship directors (CD) at COMSEP institutions responded to the survey questions regarding the use of SBE. Eighty-nine percent (63 of 71) of CDs reported use of SBE in some form: 27% of those programs (17 of 63) reported only the use of the online-based Computer-Assisted Learning in Pediatrics Program, and 73% (46 of 63) reported usage of other SBE modalities. Fifty-four percent of CDs (38 of 71) agreed that SBE is necessary to meet the requirements of the Liaison Committee on Medical Education (LCME). Multiple barriers were reported in initiating and implementing an SBE program. ConclusionsSBE is commonly used for instruction during pediatric undergraduate medical education in North American medical schools. Barriers to the use of SBE remain despite the perception that it is needed to meet requirements of the LCME.

Changes to Pediatric Clerkships' Nighttime Structure After Introduction of the 2011 ACGME Resident Duty Hour Standards

ObjectiveTo report changes in pediatric clerkship nighttime clinical structures before and after implementation of the 2011 Accreditation Council for Graduate Medical Education (ACGME) resident duty hour standards. MethodsAs part of the 2011 Council on Medical Student Education in Pediatrics (COMSEP) member annual survey, we surveyed leaders of pediatric undergraduate medical education on their medical school's current nighttime clinical structure, changes in nighttime structure between 2010 and 2011, and their school's student duty hour standards. ResultsFifty-six percent (n = 83) of Liaison Committee for Medical Education (LCME)-accredited medical schools responded to the survey. Of received responses, 98% of pediatric clerkships have some form of nighttime clinical experience; 49% of clerkships have medical students stay late, 24% of clerkships utilize night shifts, and 16% use a traditional call structure. Forty-five percent of clerkships report changing their nighttime clinical experience after implementation of the 2011 ACGME duty hour standards; 46% of clerkships that changed had previously used traditional call. Seventy-six percent of clerkships report having medical student duty hour standards at their medical school. ConclusionsThe majority of pediatric clerkships in our survey include nighttime clinical experiences in their curriculum, although variability exists in the type of structure. Additionally, the new ACGME duty hour standards appear to affect clerkships directors' choice of structure.

Key Elements of Highly Effective Teams

The Council on Medical Student Education in Pediatrics (COMSEP) is an organization that values — and appreciates the benefits of — teams. COMSEP's best work comes as a result of highly effective teamwork. A team is more than 1 person working together toward a common goal. Therefore, every physician is on multiple teams, ranging from a small team of himself or herself and a patient and family, to primary care medical home teams, to inpatient care teams with various levels of trainees and different professionals, to clinical and basic science research teams, to hospital boards, university committees, and organized community initiatives. Knowing the key elements of highly effective teams is relevant to every clinician, no matter where he or she practices. In health care, team communication failures contribute to health care errors.1 Effective teams decrease length of stay, result in fewer unanticipated admissions, improve coordination of care, decrease wait times, increase patient satisfaction, and improve health outcomes.2 The literature on teams is complex. A wide variety of conceptual frameworks3 have been developed independently, and as a result, they are not aligned with each other.4 In the health care literature specifically, a large number of team models have been proposed.5–7 In this article, we present a novel way to think about team effectiveness that is easy to remember and can be used to set your team up for success and resolve common barriers. Drawing on the business, … Address correspondence to Susan L. Bannister, MD, MEd, Department of Paediatrics, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary AB, T3B 6A8, Canada. E-mail: susan.bannister{at}albertahealthservices.ca

Further Dissemination of Medical Education Projects After Presentation at a Pediatric National Meeting (1998–2008)

Background: Further dissemination of medical education work presented at national meetings is limited. Purposes: The purpose of this study was to explore dissemination outcomes of scholarly work in pediatric medical education. Methods: Council on Medical Student Education in Pediatrics (COMSEP) members who presented at COMSEP national meetings from 1998 to 2008 received a questionnaire about scholarly dissemination outcomes. Descriptive statistics and chi-square analysis explored variables related to dissemination. Qualitative analysis of free text comments explored barriers to dissemination. Results: Outcomes were determined for 81% of presentations (138/171). The dissemination rate was 67% (92/138 presentations), with 47 publications (34%). Dissemination rates did not vary by presentation type (poster vs. oral) or project type. There was no relationship between presentation type, project type, and dissemination method. Barriers included perceived inadequate time, mentorship, and methodological skills for scholarly work. Conclusions: Most projects were further disseminated. Additional resources including mentoring and protected time for scholarly work are needed by educators to optimize dissemination.

Opting in to Online Professionalism: Social Media and Pediatrics

* Abbreviations: AMA — : American Medical Association The Council on Medical Student Education in Pediatrics (COMSEP) is committed to excellence in medical student education in pediatrics. This article continues our series on skills of, and strategies used by, great clinical teachers. Kind et al argue that the digital world provides a great opportunity for clinical educators to promote and enhance student education and model professionalism. They provide resources and tips to get started using this domain . —Susan Bannister, MD Editor-in-Chief, COMSEP Monthly Feature Social media can be described as a digital space for creating and sharing information with others, disseminating it widely and rapidly.1 It can extend real-life learning and relationships into a shared space to foster online connections and learning. Physicians and physicians-in-training are entering this digital environment with little guidance on best practices. Professionalism lapses online can have consequences not only for individuals but also for public trust in the medical profession.2 And yet, when used well , social media enriches the personal and professional lives of clinicians and learners. We’ll consider the risky (red) zone, the safe but go slow (yellow) zone, and the opt in to opportunity (green) zone to explain the challenges students may face and to outline how to teach and model professionalism in the use of social media. Several studies describe social media use by medical students,3,4 physicians,5,6 and medical educators.7 In 2012, 67% of online adults reported using Facebook, 20% LinkedIn, 16% Twitter, 15% Pinterest, 13% Instagram, and 6% Tumblr.8,9 These and other platforms allow users to connect through words, photos, audio, or videos in various ways: privately or publicly, synchronously or asynchronously, and uni- or multidirectionally. There are also less public avenues, such … Address correspondence to Terry Kind, MD, MPH, Children’s National Medical Center, 111 Michigan Ave, NW, Washington, DC 20010. E-mail: tkind{at}childrensnational.org; [@kind4kids][1] (Twitter) [1]: http://www.Twitter.com/kind4kids

Expectations for student oral case presentations: Do internal medicine and pediatric course directors see eye to eye?

In North American medical schools, internists agree on the most important attributes of a medical student's oral case presentation (OCP). We hypothesized that pediatric undergraduate medical education leaders would share opinions with internists. To test this, we surveyed North American pediatrician members of the Council on Medical Student Education in Pediatrics (COMSEP) regarding the relative importance of attributes of the medical student OCP in 2010. Eighteen items were identical to those posed to members of the Clerkship Directors in Internal Medicine (CDIM) in 2007, four were unique to pediatrics. Responses were compared using χ2 or t-tests as appropriate. Although COMSEP's response rate was 157 of 334 (47%) it included a respondent from 71% of US medical schools. CDIM received 82 of 110 surveys (75%). The same eight OCP attributes were rated as ‘very important’ by >50% of both internists and pediatricians. Only one pediatric-specific item was rated as ‘very important’ by >50% of pediatricians. Pediatricians, compared with internists, believed OCPs should be slightly shorter (6.8 ± 3.3 vs. 8.2 ± 4.2 minutes, P = 0.006). The shared common expectations for OCPs can be used to develop interdepartmental instruction in, and assessment of, OCPs.

Teaching and Evaluating Oral Presentations on Family-Centered Rounds Using the FREE TIPSS Tool

OPEN ACCESSSeptember 20, 2013Teaching and Evaluating Oral Presentations on Family-Centered Rounds Using the FREE TIPSS Tool Jared Austin, MD, Tracy Bumsted, Chad Brands Jared Austin, MD Oregon Health & Science University School of Medicine Google Scholar More articles by this author , Tracy Bumsted Oregon Health and Science University Google Scholar More articles by this author , Chad Brands All Children's Hospital, Johns Hopkins Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9553 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: Presentations on family-centered rounds (FCR) provide a critical forum for information exchange, decision-making and teaching at the bedside. However, great variation exists in how this is done. This variation can lead to inefficient oral presentations on rounds, and frustration amongst learners, attending physicians and families. This tool is intended to aid clinician educators in teaching and evaluating medical students, interns, and residents on giving succinct, standardized bedside presentations on FCR. Methods: This tool includes a facilitator's guide, a two-sided card featuring the FREE TIPSS mnemonic (Family/team introductions, Recap, Events overnight, Exam pertinents, Tests, Impressions, Problem-based plan, Staff input, Summary for family), scorecard assessment forms, and patient presentation examples. This tool is given to all pediatric interns and third-year medical students for use during their general inpatient pediatric rotations. This tool is also used individually with medical students and interns who struggle with oral presentations. Results: We have successfully used this tool in our institution for the past 2 years. Prior to the initiation of this tool, we conducted a survey of our residents concerning guidelines and expectations for oral presentations of rounds on the general inpatient pediatric service. Three months after initiating this tool, we repeated the survey. The percentage of residents who reported clear guidelines and expectations of oral presentations increased from 79% before implementation to 91% after implementation. Discussion: Since implementation, the FREE TIPSS tool has been used on our general inpatient pediatric service with positive feedback from residents, medical students, and faculty. While this module focuses on providing a standardized tool for oral presentations on rounds, it is important to allow some flexibility so that it may be adapted to the different needs of different rounding teams. Educational Objectives By the end of this resource, learners will be able to give accurate and efficient patient presentations on family-centered rounds. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: FREE TIPSS INPATIENT ROUNDING CARD- Side 1.docx FREE TIPSS INPATIENT ROUNDING CARD- Side 2.docx FREE TIPSS Patient Presentation Examples.doc Facilitator's Guide - FREE TIPSS Rounding Tool.docx SCORECARD-FREE TIPSS Rounding Tool Assessment Form-Established Patients.docx SCORECARD-FREE TIPSS Rounding Tool Assessment Form-New Patients.docx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2013 Austin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution license.KeywordsOral Patient PresentationsFamily-Centered RoundsMedical EducationBedside Presentations Disclosures None to report. Funding/Support None to report. Prior Presentations Austin JP, et al. A Novel Rounding Mnemonic for Family-Centered Rounds. Poster presented at: Council on Medical Student Education in Pediatrics (COMSEP) Annual Meeting; 2011; San Diego, CA. Loading ...

What’s the Story? Expectations for Oral Case Presentations

This article focuses on teaching and evaluating oral presentation skills as part of the ongoing Council on Medical Student Education in Pediatrics (COMSEP) series on skills and strategies used by superb clinical teachers. While oral presentations by students can be used to enhance diagnostic reasoning,1 we will focus this article on the characteristics of high-quality oral presentations by medical students, highlight several common pitfalls, and reinforce the connection between effective oral presentations and clinical reasoning. A model for evaluating student clinical performance, the RIME model, will be reviewed. Students often struggle with what is expected of them when asked to give an oral presentation of a patient encounter. Many preceptors have asked a student to present a case, only to be answered with the question, “What would you like to hear?” Students frequently perceive the oral presentation as “a rule-based, data-storage activity governed by order and structure.”2 Clinicians, however, view the oral presentation as a flexible form of communication, with content determined by the clinical context and audience. The first step in bridging this gap is to set explicit expectations. Students should be told early in the clinical experience the commonly accepted and expected style for oral presentations and the rationale for the organization. The ultimate goal of the presentation is to provide the justification for diagnostic and therapeutic decisions. Table 1 summarizes the elements of an effective oral presentation.3 View this table: TABLE 1 Oral Presentation Expectations Checklist3 ### Chief Complaint: Who Are We Talking About? Presenting information in an expected order makes it easier for listeners to process information. This begins with the chief complaint. Either a direct quote (eg, “My tummy hurts”) or an identifying statement (“A 6-year-old girl with fever and abdominal pain”) sets the context for this patient’s story from the first line (a different context than that … Address correspondence to Michael Dell, MD, Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children’s Hospital, 11100 Euclid Ave, Cleveland, OH 44122. E-mail: michael.dell{at}uhhospitals.org

Preparing Future Pediatricians: Making Time Count

At the 2011 annual meeting of the Pediatric Academic Societies participants debated whether the duration of pediatric residency should be extended. Those favoring a longer residency argued that there is more to learn now than 30 years ago and, because of regulations curtailing resident work hours, less time in which to learn it. Their opponents argued that the purpose of residency is basic competence, not mastery, and there is still sufficient time and flexibility for residents to achieve basic competence. Moreover, adding time to the residency would be prohibitively expensive. A proposal to extend residency is a simple (and simplistic) solution to complex issues. In addition to the increase in medical knowledge in recent decades, the scope of pediatrics has widened, and subspecialization has progressed; learners' exposure to various aspects of pediatrics is now occurring, if at all, in distinct and separate silos. Although setting basic competence, rather than mastery, as the outcome measure may seem reassuring, defining “basic competence” is challenging: does the term refer to a basic level of competence in the vast breadth of pediatrics or to competence in a narrow basic “core” of pediatrics? This is a fundamental distinction for educators, future pediatricians, and the public, and there are implications for length of medical school and residency training and breadth of experiences required or necessary during training. The Association of American Medical Colleges is undertaking a pediatrics redesign project for students interested in pediatrics that begins in the second year of medical school and progresses to the end of residency.1 Transition from medical school to residency and residency to practice will be based on competence rather than time. This effort is an exciting opportunity to create a true … Address correspondence to Kenneth B. Roberts, MD, 3005 Bramblewood Drive, Mebane, NC 27302. E-mail: kenrobertsmd{at}gmail.com

Using the Student Case Presentation to Enhance Diagnostic Reasoning

This article resumes the series by the Council on Medical Student Education in Pediatrics (COMSEP) examining the skills and strategies of great clinical teachers. So far we have reviewed what makes a clinical teacher great1 and the importance of orientation,2 observation,3 and feedback.4 In this article we discuss how best to use the time during or after a student case presentation to assess and strengthen student diagnostic reasoning skills. The development of good clinical reasoning skills is an essential component of medical school training and remains critical to clinical practice. Each of us has heard lengthy presentations from medical students on patients they have seen. The presentations tend to emphasize the facts of the case (the history and what others have done) but often do not include an assessment or any explanation of why the student has come to a particular conclusion. Using case presentations as a platform, we present 2 models for assessing diagnostic reasoning skills: one in which the student presents the case and drives the learning (SNAPPS)5 and one in which the preceptor directs the learning by asking 5 types of questions after listening to the case presentation (One-Minute Preceptor [OMP]).6 Both models are designed for use in a busy office setting with minimal time commitment by the preceptor. SNAPPS is a learner-driven model in which the student articulates both his or her diagnostic reasoning processes and uncertainties about the clinical case.7 SNAPPS stands for “summarize the history and physical findings,” “narrow down … Address correspondence to Susan L. Bannister, MD, Department of Pediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada T3B 6A8. E-mail: susan.bannister{at}albertahealthservices.ca