Early Clinical Exposure Research Articles

Role of clinical simulation in early clinical exposure

Role of clinical simulation in early clinical exposure

Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum

Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

Impact of a Comprehensive Early Clinical Exposure Program for Preclinical Year Medical Students

PurposeTo study the impact of an early clinical exposure program designed to provide a wide variety (cognitive, affective and psychomotor) of learning experiences for the preclinical year students. MethodOne hundred and fifty preclinical students were posted in small groups to selected departments – Transfusion medicine, Catheterization lab, Simulation lab, Radiology, Neurology, Nephrology, Respiratory medicine and General surgery. Each student had atleast ten hours of clinical exposure under this program. The program was evaluated through a series of pre and post-test questionnaires, which were designed based on the learning objectives of each session. Students who wished to participate in the program evaluation gave informed consent, took up the pre / post test and were also asked to give their written open comments about the program. ResultsThere was a significant increase in the post-test scores (ranging from 9.14±2.67 to 36.65±6.62) when compared to the pre-test scores (ranging from 7.94±2.31 to 28.69±6.11) for all the sessions (p value <0.001, n=144). Analysis of the open feedback showed that the program had significant impact on the cognitive, psychomotor and affective domains. “Application of basic sciences in clinical practice”, “motivation to learn”, “got familiar with various specialties”, “insight about what the patient undergoes” were the themes identified from the open comments. ConclusionThe innovative use of early clinical exposure program to teach/learn clinical skills like phlebotomy and Basic Life Support had been well appreciated by the students. The present design involving a variety of learning experiences has been successful in introducing the various dimensions of medical profession like scientific, ethical, interpersonal, professional and social to the new entrants in addition to enhancing their motivation to learn.

Poster Number: EI 55 - Early Clinical Exposure to Geriatric Psychiatry and Medical Students' Interest in Caring for Older Adults: A Randomized Controlled Trial—Preliminary Findings

Poster Number: EI 55 - Early Clinical Exposure to Geriatric Psychiatry and Medical Students' Interest in Caring for Older Adults: A Randomized Controlled Trial—Preliminary Findings

Impact of early clinical exposure on the learning experience of undergraduate dental students.

The aim of this research was to evaluate the impact of early clinical exposure on the learning experiences of undergraduate dental students. This study was based on mixed methods. The first phase involved administering a purposely designed questionnaire consisting of 16 items, grouped into three subscales. The second phase of the research was conducted using qualitative semi-structured interviews to explore the perceptions and experiences of stakeholders regarding early clinical exposure. In total, 134 undergraduate dental students and eight clinical supervisors responded to the questionnaire and reported positive perceptions regarding the learning experiences, professional relationship and learning environment. Qualitative interviews were conducted with 12 participants, and early clinical exposure was perceived to be useful in providing a context to theoretical learning and development of interpersonal skills. Curriculum overload and further need for consolidation were highlighted as the main challenges. This study provided insights into the clinical training model in an undergraduate dental programme and highlights the benefits and challenges of early clinical exposure in the study population. The study served as a vehicle for engagement with a range of stakeholders using a mixed methods approach to inform further development of the training model.

Early Clinical Exposure as a Learning Tool to Teach Neuroanatomy for First Year MBBS Students.

Context:Early clinical exposure (ECE) is one of the important tools to teach basic science to the MBBS students. It is one form of vertical integration between basic science and clinical subjects. This study is an effort at exploring the use of ECE as a motivational tool toward better learning in neuroanatomy for first year MBBS students.Aim:This study aims to make the students interested and motivated to study neuroanatomy by using ECE as learning tool in neuroanatomy and to make the students enable to retain the knowledge of neuroanatomy more efficiently and correlate the knowledge of neuroanatomy with neuromedicine.Settings and Design:This study was conducted in collaboration with the Departments of Anatomy, General Medicine and Medical Education Unit in the year 2016. This was cross-sectional study.Subjects and Methods:One hundred and fifty students of 1st Professional MBBS were subdivided into two groups. After preliminary classes on brain, brainstem, and spinal cord for both groups, conventional lecture classes were taken for Group A only on upper motor neuron (UMN) and lower motor neuron (LMN) paralysis, and only Group B visited General Medicine ward where HOD, General Medicine showed and examined patients of UMN paralysis and LMN paralysis, elicited different symptoms, and discussed different investigation. It was followed by assessment of all by problem-based multiple choice questions (MCQ) and short answer questions. Then, Group B attended lecture class on different cranial nerve palsy whereas Group A visited medicine ward. It was followed by assessment of both groups by problem-based MCQ and short answer questions. The performance was compared. Then, the feedback of the students on ECE was collected by means of reflection writing followed by administration of questionnaire. Then, the perception of teachers regarding ECE was recorded by focused group discussion.Statistical Analysis Used:Student's t-test was used to compare the performance of both batches. Reflection writing and focus group discussion were analyzed qualitatively.Results:There was a significant difference in Group A (P = 0.019) but no significant difference in Group B (P = 0.679). All the teachers opined that ECE was an efficient method but more time and interdepartmental collaboration were necessary.Conclusions:Group A improved performance due to ECE but Group B maintained the motivational effect of it. Therefore, ECE can be used as an effective learning tool.

Student Satisfaction with Early Clinical Exposure and E-learning in Learning Anatomy

Student Satisfaction with Early Clinical Exposure and E-learning in Learning Anatomy

Students’ Perspectives of Their Rotation in Nephrology during Early Clinical Exposure

Students’ Perspectives of Their Rotation in Nephrology during Early Clinical Exposure

Challenges in Learning Preclinical Prosthodontics: A Survey of Perceptions of Dental Undergraduates and Teaching Faculty at an Indian Dental School.

Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student's and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. The students and faculty expressed a "need" for early clinical exposure to enhance the learner's understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India.

A Study of Learning Style Preferences among First Year Undergraduate Medical Students Using VARK Model

Introduction: Medical students have a wide range of diversity in their learning preferences. This has been always a challenge for the teachers to meet the demands of all the medical students. VARK (Visual, Aural, Read/write and Kinaesthetic way of learning styles) is a learning inventory grouped under “instructional preference” model. Methods: This study analysed the learning style and approaches to learning among the first year undergraduate students in a tertiary care teaching hospital using VARK questionnaire version. Results: Our study revealed that, unimodal learning preference was among 48% of the students and multimodal learning styles being with 52% of students. Among the unimodal learning preferences, kinaesthetic and auditory learning styles were predominant (35% and 34% respectively). Among multimodal learning style preferences Kinaesthetic, Aural (KA) and Visual, Aural, Kinaesthetic (VAK) styles were predominant. There was no difference in the learning preferences among the sexes (p = 0.208). Conclusion: Since the most preferred learning styles were kinaesthetic and auditory, the strategies employed by students could be recordings of lectures, audio recordings of power point presentations, increased frequency of early clinical exposure to patients in wards and use of models and problem solving questionnaires. This will also help the teachers to act in accordance with students need and guide them in achieving their academic goals.

To study the perceptions of first year MBBS students towards “Early Clinical Exposure (ECE) in Anatomy”

To study the perceptions of first year MBBS students towards “Early Clinical Exposure (ECE) in Anatomy”

APEP – Anesthesiology Preceptorship Enrichment Program…A Popular Student Curriculum AND a Recruiting Tool?

APEP- Anesthesiology Preceptorship Enrichment Program, is a 7-month curriculum for MS1s and MS2s, providing early clinical exposure to anesthesiology. APEP students meet monthly with their anesthesiology preceptors in an intraoperative setting and review basic science lecture material with an anesthesia focus. APEP is a consistently popular annual curriculum, yet its effectiveness as a recruiting tool was unknown. This curriculum was evaluated for its effectiveness in attracting students into anesthesiology. Annual surveys were sent to APEP students querying if they were MORE or LESS interested in anesthesiology as a career choice after APEP participation. Because the survey was not anonymous, follow up data was obtained for each MS1 and MS2, confirming their match into anesthesiology. Non-survey data was also reviewed for students' APEP involvement, career choice and match results. Of the 77 APEP students surveyed from 2006-2010, 54/77 (70%) were MORE interested in anesthesiology as a career choice after participating in APEP and 23 of the 54 (43%) applied to/matched into anesthesiology. Collected data also reinforced APEP's supporting role in developing student interest into the field of anesthesiology. From 2008-2012, of the 45 students who matched into anesthesiology, 28 (62%) were involved with APEP. Since the launch of APEP, there has been a 57% increase in students from the previous five years matching into anesthesiology which is 18 percentage points higher than the national upward trend. APEP is an educational tool that is effective for attracting students into the field of anesthesiology.

Medical students' attitudes towards early clinical exposure in Iran.

ObjectivesThis study was carried out to investigate the medical students’ attitudes towards early clinical exposure at Tehran University of Medical Sciences.MethodsA cross-sectional study was conducted during 2012-2015. A convenience sample of 298 first- and second-year students, enrolled in the undergraduate medical curriculum, participated in an early clinical exposure program. To collect data from medical students, a questionnaire consisting of open-ended questions and structured questions, rated on a five-point Likert scale, was used to investigate students’ attitudes toward early clinical exposure. ResultsOf the 298 medical students, 216 (72%) completed the questionnaires. The results demonstrated that medical students had a positive attitude toward early clinical exposure. Most students (80.1%) stated that early clinical exposure could familiarize them with the role of basic sciences knowledge in medicine and how to apply this knowledge in clinical settings. Moreover, 84.5% of them believed that early clinical exposure increased their interest in medicine and encouraged them to read more. Furthermore, content analysis of the students’ responses uncovered three main themes of early clinical exposure, were considered helpful to improve learning: “integration of theory and practice”, “interaction with others and professional development” and “desire and motivation for learning medicine”. ConclusionsMedical students found their first experience with clinical setting valuable. Providing clinical exposure in the initial years of medical curricula and teaching the application of basic sciences knowledge in clinical practice can enhance students’ understanding of the role they will play in the future as a physician.

Stakeholders’ Perceptions About a Newly Established Dental School with a Problem‐Based, Student‐Led, Patient‐Centered Curriculum: A Qualitative Study

The aim of this study was to explore the perceptions of stakeholders regarding a newly established dental school with a problem-based, student-led, patient-centered curriculum in a community setting. Qualitative methods using 16 semistructured interviews and two focus groups were used to engage a range of stakeholders from students to faculty members to practitioners. Purposive sampling was employed with participants contacted through professional channels. Interview and focus group transcripts were transcribed verbatim. The data were analyzed thematically using an inductive approach. Themes related to preparedness of dental graduates were identified during data analyses. Early clinical exposure with patients in the first year of the course, holistic care using a patient-centered approach, and the acquisition of communication skills, professionalism, team-working skills, reflective practice, and evidence-informed clinical practice were perceived to be key strengths of the curriculum. The participants also expressed the need to strengthen teaching of life sciences and provide additional clinical experience in simulated general dental practice clinics. This study provides insight into the perceptions of a wide range of stakeholders and provides a deeper understanding of the merits and challenges of an innovative undergraduate dental curriculum.

Emergency Medical Technician Training for Medical Students: A Two-Year Experience

Background: New medical school educational curriculum encourages early clinical experiences along with clinical and biomedical integration. The University of South Carolina School of Medicine Greenville, one of the new expansion schools, was established in 2011 with the first class matriculating in 2012. To promote clinical skills early in the curriculum, emergency medical technician (EMT) training was included and begins in the first semester. Along with the early clinical exposure, the program introduces interprofessional health and teams and provides the opportunity for students to personally see and appreciate the wide variety of environments from which their future patients emanate. Objective: This report describes the EMT program and changes that were made after the first class that were designed to integrate EMT training with the biomedical sciences and to assess the value of these integrative changes using objective criteria. Methods: A two-year retrospective study was conducted that involved the first two classes of medical students. Baseline student data and pass rates from the psychomotor skill and written components of the State examination were used to determine if students performed better in the integrated, prolonged course. Results: There were 53 students in the first class and 54 in the second. Of the 51 students in the first class and 53 students in the second class completing the state psychomotor and written examination, 20 (39%) in the first class and 17 (32%) in the second passed on the initial psychomotor skill attempt; however, more students passed in the first three attempts in the second class than the first class, 51 (96%) versus 45 (88%) , respectively. All students passed by 5 attempts. For the written examination, 50 (98%) students in the first class and 51 (96%) in the second class passed on the first attempt. All students passed by the third attempt. Pass rates on both components of the State examination were not significantly different between classes. Conclusion: Medical students who received their EMT training in a 6-week, non-integrated format performed similarly on the EMT State certification examination to those who received their training in a prolonged, integrated structure.

Skill Learning Through Early Clinical Exposure: An Experience of Indian Medical School.

Indian Medical curriculum being discipline based, there is a line of demarcation between preclinical and clinical subjects. The challenges in medical education include the methods that would enhance the clinical education quality; one such method been Early Clinical Exposure (ECE). ECE can help to instill the skill component of medical education in the first year students helping to minimize the line of demarcation. Hence this study was undertaken to assess the skill learning of students through early clinical exposure and to collate the perception of them. In the present study, students of 1(st) MBBS were exposed to ECE as an adjunct teaching method with preset modules. They were evaluated by Objectively Structured Clinical Examination (OSCE). Feedback was obtained from 1(st) MBBS and also from the same students after passing the 1(st) MBBS in 4(th) semester. Significant differences in pre and post OSCE scores were noted (p<0.0001). Seventy six percent students rated ECE as an excellent tool. Second year students also perceived ECE held in 1(st) year was helpful to correlate topics and increasing confidence. ECE had an effective influence on learning as manifested in skills gained by the students and their perceptions of ECE being helpful prospectively in their routine clinical posting.

Basic life support through early clinical exposure: Students’ perspective

Background Preclinical students in Indian medical colleges, who are fresh from their secondary schooling, are required to accumulate facts in basic sciences without any practical reference. Growing awareness of the significance of early clinical exposure (ECE) has prompted many institutions worldwide to start programs to introduce preclinical students to clinical medicine early. Following the Medical Council of India (MCI), PSG Institute of Medical Sciences and Research (PSG IMSR), Coimbatore has introduced this program for first-year students.

Influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care: Pilot study between two colleges from Japan and India.

Objective:The objective of this study is to identify the influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care.Materials and Methods:We have selected two different colleges from Japan and India, namely, Tokyo Dental College (TDC), Tokyo, and Government Dental College (GDC), Nagpur, respectively. The GDC students exposed to patients in a 3rd year and TDC in the 5th year of course. Survey of 74 undergraduate students GDC and 95 of TDC was conducted. The questionnaire was developed based on to the 50 points undergraduate curriculum by European College of Gerodontology. The questionnaire categorized into four parts; Part I (15 questions) on aging and medicine, Part II (15 questions) on communication skills, Part III (15 questions) on diagnosis/treatment, and Part IV (5 questions) on need of more training in Gerodontology. Their own-perception on self-knowledge and competency was scored on 4 level scale as 3, 2, 1, and 0 for response yes, rather yes, rather no, and no, respectively. Average scores were calculated and presented.Results:The differences of the opinions as per students’ perception level were found to be slightly more affirmative in GDC students (1.9 for the 4th year and 2 for the 5th year) than TDC students (1.1 for 5th grade and 1.5 for 6th grade). Both clinical and didactic hours should be increased in curriculum according to the TDC (89%) and GDC (79%) students. Separate gerodontology subject is suggested from TDC (76%) to GDC (81%) students.Conclusion:Average scores about own-perception of knowledge and competency about aging, medicine, and communication skills were almost same in both GDC and TDC students. With early clinical exposure, GDC students appear have better self-perception regarding the different aspects of the geriatric dental care including subject knowledge, communications, diagnosis, and treatment planning than TDC students with late clinical exposure.

Study of impact of manual biochemistry practicals vs practicals using automation techniques in first-year MBBS students

Background: Biochemistry being considered as one of the fundamental science subjects taught during the first year of medical course, is proposed to be taught in the right perspective to medical students; since it forms the basic for General Medicine. Innovative curriculum with case-based learning is proven to develop the academic performance of biochemistry in medical students. Objective: To study the impact of manual and automated technique practicals on students’ knowledge, skills, and attitude and its perception by the students. Materials and Methods: The 150 voluntary participants were first-year MBBS students who consented to undergo study. They were asked to perform practical of estimation of urinary sugar using Uristik and using Benedict’s test (manual method). Knowledge was tested by questionnaire. Result: Statistically significant difference was found between automated method when compared with manual method. Conclusion: From this study, we found early clinical exposure to automated method was better than traditional manual method for medical students in Indian scenario. However, it was also noted that automated method requires extra efforts by the students to learn the accurate interpretation of the results. But, students were satisfied more by automated method.

Students’ Evaluation of an Outpatient Escort Practicum as Early Clinical Exposure for First-year Dental Students―A Comparison between Evaluations Immediately after the Outpatient Escort Practicum and after the Clinical Training Five Years Later―

Students’ Evaluation of an Outpatient Escort Practicum as Early Clinical Exposure for First-year Dental Students―A Comparison between Evaluations Immediately after the Outpatient Escort Practicum and after the Clinical Training Five Years Later―