Professional Medical Students Research Articles

Perceptions and suggestions of second year medical professional students of deemed health university about their teaching and learning process in pharmacology: an analytical study

Background: The teaching learning process in 2 nd year medical professional course is crucial. Learning in the 2 nd year medical students acts as a foundation on which a process of becoming a good professional is resting. Pharmacology is a medical science that forms a backbone of the medical profession as drugs form the corner stone of therapy in human diseases. So, in order to assess the strength of the pharmacology curriculum and students’ learning experience, collection of the students’ feedback is important so that necessary reforms can be implemented for the betterment of teaching/learning of the subject. Objective of this questionnaire based study was conducted to determine the perceptions of 2 nd year medical professional students about various aspects of their teaching and learning, in order to make teaching more effective and enable students to learn better. Methods: This was a questionnaire based analytical study. The first part of the questionnaire contains respondent’s general information. The second part of the questionnaire was in multiple choices format with a space for suggestions/remarks. The response was reviewed and analysis was done. Results: Out of total 180 students, 111 were able to complete the survey. Out of them 2 were not filled the first part of the questionnaire (respondent’s general information). Out of 109 duly filled questionnaires 43 were males and 66 females and the mean age of the students was 20 years. Majority of the students found Pharmacology to be the most relevant and useful subject in further profession and future. About teaching learning media in understanding the subject in theory class majority of students preferred combination of chalk and board as well as power point presentation (PPT). Regarding the reforms to be made in the curriculum, majority of the students opined that group discussions should be introduced. Regarding preparation for annual university exams most of students felt class tests were useful. Conclusions: This study has helped us in knowing the student preferences regarding pharmacology teaching and its outcomes would be helpful in modifying undergraduate pharmacology teaching pattern.

Internet Addiction and Estimation Procedure, Among Computer and Medical Professional Students: A Cross Sectional Study Odisha, India

This paper is about the Estimation of internet addiction of MCA Students & Medical Students of Hi-tech medical college & hospital at Utkal University, Bhubaneswar, Odisha. It has transformed academic landscape Research over the last decade has identified Internet addiction as a new and often unrecognized clinical disorder that impact a user’s ability to control online use to the extent that it can cause relational, occupational, and social problems. A total of 100 study participants were selected. Probability sampling technique of cluster sample of two cluster &a cross-sectional study of the students of Master in computer Application 50 Students & Hi-tech medical college & hospital 50 students were scored using a questionnaire to determine the number of hours they spend on the use of internet and also the purpose for which they use internet & its risk factors, estimation of future trends. From the result most of them are internet addicted 69.61% are mild addiction but most of MCA students are severe (75 out of 100 scores) addicted but most of Medical Students are mild addicted (63 out of 100 scores). Higher the score range the greater the level of internet addiction, risk factors are higher. Further it was observe through the advance statistical analysis pair t test for impact of internet addiction & Estimation procedure apply by linear Regression analysis for predict the future internet addiction show that a significant among MCA & Medical Students for internet addiction & are having high risk factors for health, family, friends, psychological, angry etc. have positive impact. The study showed that more than 70% of students are mild addiction out of which MCA students are severe risk than the medical students. For 47% of the students reason for surfing is nonacademic work i.e. personal out of which 9% are others like Porn & Online Purchasing, Online movies, etc. Thus it is essential to orient the students on using internet for their studies for better career and life.

A study to assess the knowledge, attitude, and practices about voluntary blood donation amongst the undergraduate medical students in Solan, North India

Background: Voluntary blood donation is considered as backbone of blood safety and safe transfusion practices. There is a serious need to improve the recruitment and retention of voluntary donor population to ensure a sustainable safe blood transfusion practice. Objectives: The objective of our study is to perceive various factors like knowledge, aptitude, and practices about voluntary blood donation among undergraduate medical students so that their doubts and misconceptions regarding blood donation can be removed and they can be inspired to become regular non-remunerated blood donors. Material and Methods: This study has been carried out among second professional medical students in M.M. Medical College and Hospital, Solan, Himachal Pradesh, North India. Pre-designed and pre-arranged questionnaires were used to evaluate the knowledge, attitude, and practices regarding blood donation among 150 medical students. Results: Most of the students 123 (82%) were aware about the suitable age group for blood donation and 114 (76%) stated that the minimum gap between donations should be 3 months. Voluntary donors were considered as the inimitable source of blood by 124 (82.67%). There were 85 respondents who had never donated blood and the chief reasons for not donating blood were fear of needle or sight of blood, perception that blood donation can leads to anemia, objection from family members, and never has been asked to donate blood. In total, 65 (43.4%) respondents had donated blood in the past and out of this, 44 (67.69%) respondent donates one time in a year, and 21 (32.31%) donates more than one time in a year. Out of 65 respondents who have previously donated blood, 25 (38.46%) had donated voluntarily whereas 40 (61.54%) had donated on replacement basis. Conclusion: Awareness sessions on voluntary blood donation should be held regularly to create positive attitude, and to remove misconceptions among the college students about voluntary blood donation.

Role of concept map in teaching general awareness and pharmacotherapy of HIV/AIDS among second professional medical students.

Objective:Medical students as future doctors will play an important role in caring for HIV-infected patients. This study assessed and evaluated the existing level of knowledge of MBBS students about HIV/AIDS given through lecture delivery methods and by use of concept map (CM).Materials and Methods:This study was carried out on 150 professional MBBS students of tertiary care hospital. A pretest was conducted by giving 10 multiple choice questions (MCQ) of general awareness and 15 questions regarding pharmacotherapy of HIV/AIDS. In between pre- and post-test, a session of 1-week integrated teaching module was organized. After completion of integrated teaching, 2 h session of CM on general awareness and pharmacotherapy of HIV/AIDS was taken. A posttest was conducted using MCQs and problem-based question (PBQ) to assess the effect of integrated teaching and CM on their knowledge about HIV/AIDS. Feedback was also taken from the students to regarding their views about CM.Results:There was a significant increase in student’s score in MCQ test after integrated teaching than pretest (P < 0.05). There was also significant improvement in PBQ score after CM than that of after integrated teaching (P < 0.05). Students’ perception about the effectiveness of CM was positive.Conclusion:CM can make a significant improvement in the knowledge of medical students and were motivated and developed interest in the subject.

Is the Empathy Level of Medical Students at KAU Changeable along their Study Years? What is behind this Change?

Although empathy is considered one of the essential attributes of professionalism for medical students, the empathy level of the Saudi medical students was not assessed till now while it was assessed worldwide. This study aimed to determine the level of empathy among medical students in different study years at Faculty of Medicine (FOM), King Abdulaziz University (KAU), Jeddah, and to explore in depth the factors that affect it. This comparative cross sectional study used a translated Arabic version of the Jefferson Scale of Physician Empathy-student version (JSPE-SV). It was distributed to all medical students in different study years at KAU during the academic year 2014-2015 and the response rate was 58.3 %. Data were collected and analyzed using the statistical package of Social sciences (SPSS) version 22. The mean empathy score was 106.55±19.16 and it was higher, but nonsignificant, in females than males. It increases along with the study year and its level among the 6th year students was significantly higher (p=0.004) than that of the 2nd year. Intact marital status of parents (p=0.012), satisfactory relationship with mother and father (p=0.009, p=0.012), having a patient in the family (p=0.002) were significantly associated with higher empathy level. Student’s empathy level was relatively low but it was increasing throughout the study years denoting the positive impact of the medical curriculum. More highlights on the patients physician relationship all through the medical curriculum is needed to emphasize and promote empathy of the student.

Developing a Curriculum to Promote Professionalism for Medical Students Using Social Media: Pilot of a Workshop and Blog-Based Intervention.

BackgroundAs the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior.ObjectiveTo develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students.MethodsThis project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism.ResultsA total of 72 medical students completed the survey (response rate 30%). Among the survey respondents, 71/72 (99%) reported visiting social networking sites, with 55/72 (76%) reporting daily visits. Privacy of personal information (62/72, 86%) and mixing of personal/professional identities (49/72, 68%) were the students’ most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion.ConclusionsMost medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students.

Developing Professionalism via Multisource Feedbackin Team-Based Learning

CGEA 2015 CONFERENCE ABSTRACT (EDITED) A Novel Approach to Assessing Professionalism in Preclinical Medical Students Using Paired Self- and Peer Evaluations. Amanda R. Emke, Steven Cheng, and Carolyn Dufault Construct: This study sought to assess the professionalism of 2nd-year medical students in the context of team-based learning. Background: Professionalism is an important attribute for physicians and a core competency throughout medical education. Preclinical training often focuses on individual knowledge acquisition with students working only indirectly with faculty assessors. As such, the assessment of professionalism in preclinical training continues to present challenges. We propose a novel approach to preclinical assessment of medical student professionalism to address these challenges. Approach: Second-year medical students completed self- and peer assessments of professionalism in two courses (Pediatrics and Renal/Genitourinary Diseases) following a series of team-based learning exercises. Assessments were composed of nearly identical 9-point rating scales. Correlational analysis and linear regression were used to examine the associations between self- and peer assessments and the effects of predictor variables. Four subgroups were formed based on deviation from the median ratings, and logistic regression was used to assess stability of subgroup membership over time. A missing data analysis was conducted to examine differences between average peer-assessment scores as a function of selective nonparticipation. Results: There was a significant positive correlation (r = .62, p < .0001) between self-assessments completed alone and those completed at the time of peer assessment. There was also a significant positive correlation between average peer-assessment and self-assessment alone (r = .19, p < .0002) and self-assessment at the time of peer assessment (r = .27, p < .0001). Logistic regression revealed that subgroup membership was stable across measurement at two time points (T1 and T2) for all groups, except for members of the high self-assessment/low peer assessment at T1, who were significantly more likely to move to a new group at T2, χ2(3, N = 129) = 7.80, p < .05. Linear regression revealed that self-assessment alone and course were significant predictors of self-assessment at the time of peer assessment (Fself_alone = 144.74, p < .01 and Fcourse = 4.70, p < .05), whereas average peer rating, stage (T1, T2) and academic year (13–14, 14–15) were not. Linear regression also revealed that students who completed both self-assessments had significantly higher average peer assessment ratings (average peer rating in students with both self-assessments = 8.42, no self-assessments = 8.10, self_at_peer = 8.37, self_alone = 8.28) compared to students who completed one or no self-assessments (F = 5.34, p < .01). Conclusions: When used as a professionalism assessment within team-based learning, stand-alone and simultaneous peer and self-assessments are highly correlated within individuals across different courses. However, although self-assessment alone is a significant predictor of self-assessment made at the time of assessing one's peers, average peer assessment does not predict self-assessment. To explore this lack of predictive power, we classified students into four subgroups based on relative deviation from median peer and self-assessment scores. Group membership was found to be stable for all groups except for those initially sorted into the high self-assessment/low peer assessment subgroup. Members of this subgroup tended to move into the low self-assessment/low peer assessment group at T2, suggesting they became more accurate at self-assessing over time. A small group of individuals remained in the group that consistently rated themselves highly while their peers rated them poorly. Future studies will track these students to see if similar deviations from accurate professional self-assessment persist into the clinical years. In addition, given that students who fail to perform self-assessments had significantly lower peer assessment scores than their counterparts who completed self-assessments in this study, these students may also be at risk for similar professionalism concerns in the clinical years; follow-up studies will examine this possibility.

The outlook of first professional medical students: do we need to guide them? a study from India

The outlook of first professional medical students: do we need to guide them? a study from India

Enlisting the power of the verb.

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A descriptive study of knowledge of Pharmacovigilance and adverse drug reactions among second professional undergraduate medical students in a teaching hospital

Background: Adverse drug reactions (ADRs) are adverse consequences of drug therapy being one of the leading causes of morbidity and represent a substantial burden of healthcare resources. Though Pharmacovigilance program was started in India in 1982, the awareness about it is much lower and underreporting of ADRs is a common problem with only 6-10% of all ADRs being reported. The objective of this study was to analyze the baseline knowledge of awareness regarding the ADRs and Pharmacovigilance activity in the undergraduate medical students who are future doctors of society so as to foster a culture of reporting ADRs, to fulfill various it is lacunaes and make adjustments of medical student’s curriculum in order to improve practice of reporting. Methods: A cross-sectional survey was conducted among second professional medical students in July 2015 to assess the knowledge of ADRs and Pharmacovigilance activities using a questionnaire to collect the information. Part “A” consisted of choosing the most appropriate answer and Part “B” included replying with “Yes” or “No.” Data were expressed as percentage proportions. Results: Out of the total of 150 enrolled students, 134 filled and returned the questionnaire with students having a mediocre knowledge about Pharmacovigilance and majority of them (94%) vouching that reporting of ADRs should be mandatory as it is going to benefit patients (99.2%). Conclusions: Our study revealed that there are gaps between knowledge regarding ADRs and Pharmacovigilance that needs to be addressed on priority basis for the success of the Pharmacovigilance program and better clinical management of patients in general.

To design and implement a prescription writing teaching module for second professional medical students.

Context:There is ample evidence to prove that medical graduates are not prescribing rationally and this can be improved by proper training.Aims:To design and implement a prescription writing teaching module for second professional medical students.Subjects and Methods:A module of 3 h duration consisting of didactic lecture, interactive audiovisual small group session, and evaluation method was framed for every disease and implemented. Completeness of the prescriptions was evaluated on a scale of 1–4. Appropriateness of the prescription, knowledge about the rationale behind the drugs used and adverse events related to the drugs used was judged in three categories, that is, appropriate and complete; appropriate but insufficient; and inappropriate.Results:One thousand six hundred and seven response sheets to 24 health problems were collected. Completeness score of 18% was 2, 59% was 3% and 24% was 4.41% prescriptions were appropriate and complete, 58% appropriate but insufficient and 1% inappropriate. The rationale behind the drugs used was appropriate and complete 24%, appropriate but insufficient 68%, inappropriate 8%. Documentation of adverse events was appropriate and complete 23%, appropriate but insufficient 49%, inappropriate 28%. All facilitators were satisfied with the duration, contents and conduct of the sessions.Conclusions:A module is an effective tool for teaching prescription writing to undergraduate students; modifications required in contents and strategy to emphasize the need of complete documentation.

A descriptive study of prevalence, pattern and attitude of self-medication among second professional medical students in a tertiary care center

Background: The implications of self-medication practices are increasingly recognized around the world as self-medication is a common practice worldwide and irrational use of drugs is a cause of concern more so among medical students as they are future medical practitioners. The objective was to determine the prevalence, attitude, and knowledge of self-medication among second professional medical students.Methods: A cross-sectional study was conducted among medical students in February-March 2015. Data were collected through self-administered questionnaire and expressed as percentage frequency.Results: Of the 138 students, only 122 filled and returned the questionnaire. The majority of the students self-medicated because of the illness being too trivial for consultation (63.1%) or had previous experience of same illness (63.1%), headache (77.8%), flu/cold and sore throat (58.1%), closely followed by fever (52.4%) were the main symptoms leading to self-medication. Commonly used medicines were analgesics (74.6%), headache relievers (71.3%), antibiotics (64%), and antipyretics (50.8%). A large proportion (42.6%) and 35% used every few months or 2-3 times per year, respectively.Conclusion: Our study showed that self-medication is widely practiced among students, easy availability of medicine probably being the cause. Educating the students regarding advantages and disadvantages of self-medication is necessary to create awareness.

Nurturing the Art of Professionalism in Japanese Medical Students at Okayama University Medical School

In simple words, professionalism means the skill, good judgement and polite behavior expected from a trained person in order to do the job well, namely good conduct.

Development and validation of a professionalism assessment scale for medical students

ObjectivesTo develop and validate a scale for the assess-ment of professionalism in medical students based on students' perceptions of and attitudes towards professional-ism in medicine.MethodsThis was a mixed methods study with under-graduate medical students. Two focus groups were carried out with 12 students, followed by a transcript analysis (grounded theory method with open coding). Then, a 3-round Delphi with 20 family medicine experts was carried out. A psychometric assessment of the scale was performed with a group of 449 students. The items of the Professional-ism Assessment Scale could be answered on a five-point Likert scale.ResultsAfter the focus groups, the first version of the PAS consisted of 56 items and after the Delphi study, 30 items remained. The final sample for quantitative study consisted of 122 students (27.2% response rate). There were 95 (77.9%) female students in the sample. The mean age of the sample was 22.1 ± 2.1 years. After the principal component analysis, we removed 8 items and produced the final version of the PAS (22 items). The Cronbach's alpha of the scale was 0.88. Factor analysis revealed three factors: empathy and humanism, professional relationships and development and responsibility.ConclusionsThe new Professionalism Assessment Scale proved to be valid and reliable. It can be used for the assessment of professionalism in undergraduate medical students.

A community-engaged cardiovascular health disparities research training curriculum: implementation and preliminary outcomes.

To overcome cardiovascular disease (CVD) disparities impacting high-risk populations, it is critical to train researchers and leaders in conducting community-engaged CVD disparities research. The authors summarize the key elements, implementation, and preliminary outcomes of the CVD Disparities Fellowship and Summer Internship Programs at the Johns Hopkins University Schools of Medicine, Nursing, and Bloomberg School of Public Health. In 2010, program faculty and coordinators established a transdisciplinary CVD disparities training and career development fellowship program for scientific investigators who desire to conduct community-engaged clinical and translational disparities research. The program was developed to enhance mentorship support and research training for faculty, postdoctoral fellows, and predoctoral students interested in conducting CVD disparities research. A CVD Disparities Summer Internship Program for undergraduate and preprofessional students was also created to provide a broad experience in public health and health disparities in Baltimore, Maryland, with a focus on CVD. Since 2010, 39 predoctoral, postdoctoral, and faculty fellows have completed the program. Participating fellows have published disparities-related research and given presentations both nationally and internationally. Five research grant awards have been received by faculty fellows. Eight undergraduates, one postbaccalaureate, and two medical professional students representing seven universities have participated in the summer undergraduate internship. Over half of the undergraduate students are applying to or have been accepted into medical or graduate school. The tailored CVD health disparities training curriculum has been successful at equipping varying levels of trainees (from undergraduate students to faculty) with clinical research and public health expertise to conducting community-engaged CVD disparities research.

Preserving third year medical students’ empathy and enhancing self-reflection using small group “virtual hangout” technology

Background: Medical student professionalism education is challenging in scope, purpose, and delivery, particularly in the clinical years when students in large universities are dispersed across multiple clinical sites. We initiated a faculty-facilitated, peer small group course for our third year students, creating virtual classrooms using social networking and online learning management system technologies. The course emphasized narrative self-reflection, group inquiry, and peer support.Methods: We conducted this study to analyze the effects of a professionalism course on third year medical students’ empathy and self-reflection (two elements of professionalism) and their perceptions about the course. Students completed the Groningen Reflection Ability Scale (GRAS) and the Jefferson Scale of Empathy (JSE) before and after the course and provided anonymous online feedback.Results: The results of the JSE before and after the course demonstrated preservation of empathy rather than its decline. In addition, there was a statistically significant increase in GRAS scores (p < 0.001), suggesting that the sharing of personal narratives may foster reflective ability and reflective practice among third year students.Conclusion: This study supports previous findings showing that students benefit from peer groups and discussion in a safe environment, which may include the use of a virtual group video platform.

An assessment of Pakistani pharmacy and medical students’ knowledge of black box warnings

Food and Drug Administration delivers the black box warnings (BBW) which should appear on the leaflets of medicines for patient awareness and the prescription of drugs indicating its highly fatal adverse effects to human body. The aim of this study was to assess the knowledge of Pakistani pharmacy and medical students about BBW. A questionnaire containing contents about BBW was given to the 1st, 2nd and 3rd professional year pharmacy and medical students from different pharmacy and medical institutes. A 76% survey response rate was observed. It was observed that student’s knowledge about BBW improves in association with the promotion in professional years of pharmacy and medical education. The results indicate that student’s knowledge about black box increases with the study level. Training in black box warnings should be implemented in pharmacy and medical institutions influencing the meaningful ways to educate and train pharmacy and medical students, and help these students to get recent knowledge about black box warnings so that, in future, they may perform an ethical practice in their respective fields.

Educational Environment at University Medical and Dental College, FSD

Abstract Aims and Objectives: To determine student's per-ception of learning environment at university Medical and Dental college, FSD. Study Type: Observational, cross sectional. Place of Study: University Medical and Dental Col-lege, FSD. Duration of Study: 6 months from Jan 2010 to June 2010. Methods: Dundee Ready Education Environment Measure (DREEM) was used to gather information about the teaching environment at University Medical and Dental College, FSD. It was administered to all five professional year medical students at UMDC, FSD. Data was collected and analyzed using SPSS version 15. Chi-square goodness of fit was used as test of statistical significance. P-value of < 0.05 was con-sidered significant. Results: The total mean score of DREEM at UMDC, FSD was 112/200 (56%). The total score of SPL domain was 30.02/48 (62.54%).The total score of SPT domain was 23.06/44 (52.40%), while that of SASP was 19.28/32 (68.85%). The total score of SPA domain was 27.54/48 (57.34%) and that of SSP was 12.46/28 (44.5%). For SPL, SPT, SASP, and SPA domains the score was ≥ 50%. However for SSSP domain the score was 44.5%. Conclusion: Total DREEM score at UMDC, FSD was 112/200, more positive than negative. It also hel-ped to identify certain issues which require further exploration such as support system for students who get stressed. Key words: Educational environment.

Curricular Journey on Ethics and Professionalism and its Impact on Students’ Attitudes

In traditional medical schools, patient contact is made through specialized clinical services that provide the students with a fragmented view of medicine, and ethical and professional issues are handled separately from clinical practice, in many cases as a theoretical debate unconnected to clinical reality. Under these conditions, it is difficult for future doctors to get a style of person-centered practice, combining both the scientific and humanistic aspects of the profession (relational and communication skills, professional attitudes and values, ethical criteria, etc).Currently there are no established guidelines on the most effective ways of supporting medical students to develop high standards of medical ethics and professionalism. Francisco de Vitoria University has developed its own curricular pathway to promote them. The curricular journey focuses on five main areas to support the development of ethics and professionalism in medical students: student selection, curriculum design, role modeling, new teaching and learning methods as well as assessment methods.The School of Medicine of Francisco de Vitoria University in Madrid, Spain, started its Medicine Degree in the the 2010-2011 academic year. The first cohort of 50 medical students, currently on the third academic year, has been following this medical ethics and professionalism pathway. Our experience confirms the idea of structuring a formal program in five main themes as a way of supporting the development of professionalism in medical students.

Online tool to promote medical student professionalism and moral decision making

Medical EducationVolume 48, Issue 5 p. 538-539 Really Good Stuff: Lessons learned through innovation in medical education Online tool to promote medical student professionalism and moral decision making Sigall K Bell, Corresponding Author Sigall K BellCorrespondence: Sigall K Bell, Department of Medicine, Beth Israel Deaconess Medical Center, 110 Francis Street, LMOB-GB, Boston, Massachusetts 02215, USA. Tel: 00 1 617 632 0760; E-mail: sbell1@bidmc.harvard.eduSearch for more papers by this authorB Price Kerfoot, B Price KerfootSearch for more papers by this authorElizabeth Gaufberg, Elizabeth GaufbergSearch for more papers by this author Sigall K Bell, Corresponding Author Sigall K BellCorrespondence: Sigall K Bell, Department of Medicine, Beth Israel Deaconess Medical Center, 110 Francis Street, LMOB-GB, Boston, Massachusetts 02215, USA. Tel: 00 1 617 632 0760; E-mail: sbell1@bidmc.harvard.eduSearch for more papers by this authorB Price Kerfoot, B Price KerfootSearch for more papers by this authorElizabeth Gaufberg, Elizabeth GaufbergSearch for more papers by this author First published: 09 April 2014 https://doi.org/10.1111/medu.12469Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume48, Issue5May 2014Pages 538-539 RelatedInformation