BACKGROUND AND OBJECTIVES Several factors have been linked to the decline in medical student choice of a career in primary care (eg, gender, race, family income, student debt), yet understanding remains limited regarding the availability of curricular and co-curricular experiences for medical students within family medicine that may play a role, particularly one-on-one opportunities such as faculty mentoring and advising. Our study sought to collect baseline data on family medicine learning experiences during predoctoral training. METHODS An online 21-question survey was sent to family medicine departments at US allopathic medical schools between January and March 2012 (84.6% response rate) to capture institutional representation and experiences within family medicine. RESULTS Most institutions reported offering family medicine interest groups (98.1%), electives (97.1%), and clerkships (90.4%). Career advising as an elective course component was available at 53.8% of schools and as ...

Background: Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries.

Medical Education 2010: 44: 387–395Context  Elective courses are a significant part of undergraduate medical education throughout the world, but the value provided by these courses and the reasons for choosing particular elective courses have not been studied extensively.Objectives  The aim of this study was to investigate medical and dental students’ experiences of elective courses in undergraduate medical education in Croatia and to gather students’ recommendations for the improvement of elective courses.Methods  Medical and dental students studying under the Bologna curriculum were given a questionnaire in which they were asked for their opinions of elective courses and their suggestions as to how they might be improved. Data on elective courses were obtained from medical schools’ administrative offices.Results  The survey response rate was 92% (834/903). Medical students gave elective courses an average grade of 3.44 out of 5, whereas dental students gave a lower average of 3.15. Students’ suggestions for change included introducing more practical work and recognising international student exchanges and attendance at conferences as elective options. A third of students indicated that teachers should be given additional training in leading elective courses. Analysis of the curriculum showed that elective courses in Croatian medical schools are very heterogeneous in terms of their content and the number of credits and assessment methods they involve, and are very conservative in that only structured courses are offered. Students cannot design their own courses or take more elective courses than represent 10% of their total number of credits.Conclusions  Student opinion should be consulted when medical schools venture into the elective curriculum so that students can feel that they are really benefiting from these subjects. Students would welcome new and personally designed strands. Elective courses are a significant part of medical education and therefore their quality and purpose need to be assessed regularly in order to ensure that they meet students’ needs.

performance was evaluated by an examiner who was not connected with the project. Evaluation of results and impact The low performers included 15 men and 6 women aged 19-20 years. All came from high socioeconomic backgrounds and had gained high scores in their entrance examinations. Non-academic causes of low performance were stress resulting from language problems (8 ⁄ 21 students), problems in adjusting to life away from home (6 ⁄ 21), lack of self-confidence (12 ⁄ 21), fear of failure (8 ⁄ 21) and worry about the future (10 ⁄ 21). Academic problems included difficulty in managing study time (17 ⁄ 21), lack of concentration (10 ⁄ 21), inability to retain what was studied (10 ⁄ 21), examination anxiety (8 ⁄ 21), inability to write examinations (5 ⁄ 21), etc. Analysis by paired t-test revealed a statistically significant improvement in the post-programme performance of the 16 students who participated in the sessions (P < 0.001). The pre-and post-programme performances of the 6 low performers who did not participate in the project showed no statistically significant difference (P ¼ 0.518, Wilcoxon signed rank test). A post-programme questionnaire was administered to assess the participants' response to the intervention. The response was positive and majority of them felt that the sessions had helped to improve their performance (average score 3.63 ⁄ 6.00), change their study behaviour (3.69 ⁄ 6.00) and change their attitude (3.50 ⁄ 6.00). They felt that the strong point of this programme was that it gave them more confidence and boosted their self-esteem. It was concluded that poor performers can benefit from individually tailored remedial programmes which include counselling and training in study skills, along with good mentor support.

Successful innovation and change in the way medical students are prepared are notoriously difficult. The relationship between the administrative structures of the medical school and its teaching hospitals, other responsibilities ofits teachers and administrators, and the intricacies of the curriculum as a system of interrelated components, mean that any real change has wide repercussions. An opportunity for evaluation of a curriculum undergoing change was presented at the University of New South Wales, when the Faculty of Medicine introduced a new 6-year medical curriculum in 1988. The change was made to address a number of problems experienced with the old 5-year curriculum. The Course Evaluation Committee was in a unique position to conduct an ongoing evaluation of the new curriculum, year by year, as it was being introduced. A method for obtaining feedback from both staff and students on a medical curriculum undergoing change, is described. While some sample results are presented, the paper concentrates on the advantages and disadvantages of, and our experiences with, this method. Advantages include the specificity and timing of the information collected, and the high response rate. One disadvantage was the repeated use of the same cohort of students. Some staff still perceived the evaluation process as a threat, or were sceptical about the value and validity of student feedback. Whether staff acknowledged ownership of the new curriculum also affected the use of feedback.

Since 1994, higher education policy has been committed to equity of access for all, irrespective of race and gender. We investigated progress towards these goals in the education of medical doctors, with an emphasis on gender. Databases from the Department of Education (DoE), Health Professions Council of South Africa (HPCSA) and University of Cape Town (UCT) Faculty of Health Sciences were used to explore undergraduate (MB ChB) trends at all eight medical schools and postgraduate (MMed) trends at UTC. Nationally women have outnumbered men in MBChB enrollments since 2000, figures ranging between 52% and 63% at seven of the eight medical schools in 2005. However, the rate of change in the medical profession lags behind and it will take more than two decades for female doctors to outnumber male doctors. A study of UCT postgraduate enrollments shows that females had increased to 42% of MMed enrollments in 2005. However, female postgraduate students were concentrated in disciplines such...

The aim of our study was to investigate the influence of gender, loss of academic year(s), confidence and attitudes of students on the clinical experience gained by undergraduate education. The survey was conducted during 2004 and 2005 in a sample of 182 students of the 5 th and the 6 th year at J.J.Strossmayer University School of Medicine in Osijek. The participants were grouped and matched according to their gender, regular studying, the number of time(s) student has performed certain practical medical procedure and the self-confidence arisen by performing one. Furthermore, participants were grouped and compared due to their own assessment of their own practical and theoretical medical knowledge, courses which provide them the least and oppositely -the most practical medical knowledge and their attitude toward current medical faculty curriculum on clinical courses as well as the possibilities of improving them. Fisher's exact test and c 2 -test were used to estimate statistical differences between the groups and the parameters in research, while coefficient of contingency was introduced with the aim of defining their correlation. The results showed statistically significant differences between male students who performed more practical medical procedures than female (p<0.001), nonrepeaters performed medical procedures more often than repeaters (p<0.001, C=0.658) while repeaters thought higher of their theoretical knowledge than non-repeaters (p<0.005). Data analysis showed statistically significant correlation between clinical experience and the level of confidence (C=0.944). This study confirmed influence of male gender, regular studying, better opinion about one's own practical skills and higher confidence in one's own work on greater number of clinical skills performed during undergraduate education.

Medical schools' curricular content ranges widely from precise basic science material to a heterogeneous mix of clinical presentations to diffuse social and life issues. The context within which this content is delivered is also variable, covering precisely designed laboratory settings, structured clinical ward settings, and uncontrolled community settings. Educators in medical schools, while able to cover curriculum content didactically, may find it challenging to adequately facilitate a wide and varied exposure to relevant learning issues. This challenge becomes greater when moving from the basic science laboratory to the community setting. The response of the student to community-oriented programmes is an important consideration in helping educators to assess possible learning outcomes beyond the stated learning objectives. This adds an important dimension to the restricted learning environment of the lecture room. It is in fact noted that some of the skills doctors require, can only be gained through planned practical learning experiences in a representative range of health problems encountered in their normal setting (World Health Organization, 1985).

Context Changes to the style of medical teaching will place a greater responsibility on individual medical students to manage their own learning, highlighting the need for students to develop good so-called`transferable' skills at an early stage in their undergraduate career.

Virtual microscopy is being introduced in medical education as an approach for learning how to interpret information in microscopic specimens. It is, however, far from evident how to incorporate its use into existing teaching practice. The aim of the study was to explore the consequences of introducing virtual microscopy tasks into an undergraduate pathology course in an attempt to render the instruction more process-oriented. The research questions were: 1) How is virtual microscopy perceived by students? 2) Does work on virtual microscopy tasks contribute to improvement in performance in microscopic pathology in comparison with attending assistant-led demonstrations only? During a one-week period, an experimental group completed three sets of virtual microscopy homework assignments in addition to attending demonstrations. A control group attended the demonstrations only. Performance in microscopic pathology was measured by a pre-test and a post-test. Student perceptions of regular...

identify the problems and to design, implement and Previous projects (Combell I & 11) to assess clinical skills were conducted in medical schools in Catalonia, in order to introduce a model of such an assessment using standardized patients (SP). The aim of this study (Combell 111) was to measure selected characteristics of our model. Seventy-three medical students in the final year at the Bellvitge teaching unit of the University of Barcelona participated in a clinical skills assessment (CSA) project that used 10 SP cases. The mean group scores for the four components of clinical skills for each day of testing were studied, and ratings for each student in the 10 sequential encounters were checked. The study also compared the clinical skills scores with their academic grades. The total case mean score (mean score of history-taking, physical examination and patient notes scores) was 51*9%, and the mean score for communication skills was 63.6%. The clinical skills scores over the 8 testing days showed no day-to-day differences. The study did not find differences among the sequential encounters for each student (training effect). There was a lack of correlation between clinical skill scores and academic grades. The project demonstrated the feasibility of the method for assessing clinical skills, confirmed its reliability, and showed that there is no correlation between scores with this method and academic examinations that mainly reflect knowledge.

Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi proc...

Since 1994, higher education policy has been committed to equity of access for all, irrespective of race and gender. We investigated progress towards these goals in the education of medical doctors, with an emphasis on gender. Databases from the Department of Education (DoE), Health Professions Council of South Africa (HPCSA) and University of Cape Town (UCT) Faculty of Health Sciences were used to explore undergraduate (MB ChB) trends at all eight medical schools and postgraduate (MMed) trends at UTC. Nationally women have outnumbered men in MBChB enrollments since 2000, figures ranging between 52% and 63% at seven of the eight medical schools in 2005. However, the rate of change in the medical profession lags behind and it will take more than two decades for female doctors to outnumber male doctors. A study of UCT postgraduate enrollments shows that females had increased to 42% of MMed enrollments in 2005. However, female postgraduate students were concentrated in disciplines such...

Nearly all veterinary and medical students (94 per cent) found it morally acceptable to use animals in research and believed it to be a necessity in order to treat human diseases. In contrast with the medical students a substantial proportion of veterinary students (40 per cent) considered themselves animal rights activists. Unlike the medical curriculum, the veterinary curriculum contains a two-week course in laboratory animal medicine, and a higher proportion of the students who had not been through this course was opposed to the use of animals in research than of the students who had completed the course. The course modified the views of half the students; more than 26 per cent of them became more positive towards animal use in research after the course, whereas 3 per cent became more negative.

A ~ummary. We instituted two thanatology seminars for medical students and residents which emphasized feelings more than objective data. The seminars began with students filling out a death certificate on themselves. Eighty-four per cent predicted that their own probable cause of death would be &om an acute illness. Discussion and reflection on this experience helped them realize how difficult it would be to deal with a chronic illness. By answering a question about what they were most grateful for, they became aware that they valued family and fiiends most highly. We believe that this experience legitimized feelings which form the basis of empathy.

The importance of properly evaluating students' potential before and upon entering medical school is obvious to all concerned with the admission process. Diversity considerations have led to a substantial increase in the admissions of underrepresented minorities (URMs) to medical schools in the late 1960s, but, as Kassebaum and Szenas demonstrate, this was followed by a wave of increases in attrition rates.! As the Association of American Medical Colleges (AAMC) statistics reveal, this has never been corrected to an acceptable degree.2

One of the biggest challenges that a physician will face is conveying difficult news (CDN) to a patient. The ability to provide this information may either strengthen or destroy the patient-physician relationship. Despite the importance of this skill, formal education for medical students has been limited. To improve upon skill building in the medical student experience, fourth year medical students (on their oncology clerkship) spent 3 hours partaking in a CDN session. During this session, each student had a videotaped encounter with a standardized patient, followed by a small group discussion and review of the tape with other students and a clinician. We evaluated the experience with pre-and post-questionnaires assessing overall knowledge, satisfaction, and specific components of the curriculum. The objective of this study was to review our institution's educational program focused on teaching techniques for CDN.

Prevalence of chronic disease is rising at unprecedented rates with associated costs that account for 84% of US health care spending. Physicians have the opportunity to guide patients to make lifestyle changes for preventing and self-managing chronic diseases. However, current medical education offers limited training opportunities in behavioral change counseling approaches. Motivational interviewing (MI) is an increasingly well-recognized intervention in the medical community that addresses both behavior change and self-management support. While evidence to support training in motivational interviewing for medical students is growing, more studies are needed. The purpose of this study is to evaluate changes in third-year medical students&#39; knowledge, skills, and attitudes as a result of a 4-hour MI training. The study utilized a quasi-experimental design with a pretest and posttest to evaluate the impact of a MI workshop. Fifty-three third-year medical students completed the 4-h...

AAIM is the largest academically focused specialty organization representing departments of internal medicine at medical schools and teaching hospitals in the United States and Canada. As a consortium of five organizations, AAIM represents department chairs and chiefs; clerkship, residency, and fellowship program directors; division chiefs; and academic and business administrators as well as other faculty and staff in departments of internal medicine and their divisions.

resulting in a pass rate of 51%. Scores ranged from 34.8% to 70.5%. Overall, 80% of students considered the OSCE to be a more objective clinical assessment tool, most appreciated the time-efficiency of the process, and all respondents were in favour of adopting the OSCE as a permanent tool. Future plans in the Department of Internal Medicine include the adoption of the OSCE in Years 4 and 6. In addition, the Departments of Psychiatry and Preventive Dentistry are investigating possible uses of the OSCE model.

Objectives In 1984 females made up 45% of medical undergraduates in Ireland. By 1996 this proportion had increased to 57%. This study examines gender differences in performance at ®nal medical examinations, with a view to ascertaining the impact of the change in proportion of females attending medical school.

The extent of surgical training given to undergraduates is variable and the decisions taken on the adequacy of the amount to be delivered are often made using little evidence. Therefore, these decisions are vulnerable to bias. Arbitrary coherence is a recently recognized behavior that can be induced by influencing subjects to anchor their answers to a series of questions to an unrelated anchor. We set out to assess the impact of arbitrary numerical anchors on answers given to questions concerning surgical training. DESIGN: Prospective Anchoring Study. SETTING: Nonclinical environment. PARTICIPANTS: A group of 41 fourth year medical students.

OBJECTIVES It is well recognised that medical training can be extremely stressful and that high stress is a risk factor for a wide range of psychological and health-related consequences. The primary aims of this study were to introduce the Medical Student Stress Profile (MSSP) and to demonstrate its psychometric quality as a specific device for auditing medical student stress. Secondary aims were to establish the reliability, construct and criterion validity of this instrument and to explore the relationships between stress, coping, personality, motivation and emotional intelligence in medical students.

Effective patient-centred communication requires physicians to respond &#39;in the moment&#39; to comments and questions. It is a valuable skill to be able to react to unexpected patient utterances with empathy and support, and these surprises may be most common in general practice where patients are encouraged to speak to their doctor about anything. We developed an elective for medical students to learn and practise improvisational skills that would optimise their communications with patients during medical encounters. Nineteen second-year medical students during two consecutive years (n =38) participated in a four-session elective that introduced and allowed them to practise the principles and skills of improvisation, and reflect on the role of those skills in their communication with patients. Specific skills that were practised and emphasised included listening, affirmation, vocal tone modulation, nonverbal communication, agreement, collaboration, acceptance and validation. In ...

Aim To test the stability of medical student communication skills over a period of 17 months as exhibited by performance in objective structured clinical examinations (OSCEs) and to determine the strength of prediction of these skills by initial levels of knowledge and understanding.

Universities need to ensure that clinical undergraduates are educated in the use of computers in medical, nursing, dental and veterinary practice. We surveyed 875 students at Glasgow University to determine their computer literacy and attitudes to the use of computers.

RESULTS Factor analyses suggest a 2-dimensional conceptualisation of professional competence: 1 factor represents Work Habits and the other factor represents Interpersonal Habits, including respect and trustworthiness. The Work Habits factor had moderate, yet statistically significant correlations ranging from 0.21 to 0.53 with all other performance measures that were part of a comprehensive assessment of professional competence. Approximately 6 peer raters were needed to achieve a generalisability coefficient of 0.70. CONCLUSIONS Our findings suggest that it is possible to introduce peer assessment for formative purposes in an undergraduate medical school programme that provides multiple opportunities to interact with and observe peers.

INTRODUCTION Inventories to quantify approaches to studying try to determine how students approach academic tasks. Medical curricula usually aim to promote a deep approach to studying, which is associated with academic success and which may predict desirable traits postqualification. AIMS This study aimed to validate a revised Approaches to Learning and Studying Inventory (ALSI) in medical students and to explore its relation to student characteristics and performance. METHODS Confirmatory factor analysis was used to validate the reported constructs in a sample of 128 Year 1 medical students. Models were developed to investigate the effect of age, graduate status and gender, and the relationships between approaches to studying and assessment outcomes. RESULTS The ALSI performed as anticipated in this population, thus validating its use in our sample, but a 4-factor solution had a better fit than the reported 5-factor one. Medical students scored highly on deep approach compared with other students in higher education. Graduate status and gender had significant effects on approach to studying and a deep approach was associated with higher academic scores. CONCLUSIONS The ALSI is valid for use in medical students and can uncover interesting relationships between approaches to studying and student characteristics. In addition, the ALSI has potential as a tool to predict student success, both academically and beyond qualification. KEYWORDS education, medical undergraduate ⁄ *methods; educational measurement ⁄ *standards; questionnaires; reproducibility of results.

The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. Methods. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). Results. The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. Conclusion. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

OBJECTIVES: To increase medical students' ability to detect contextual and emotional cues and to respond empathetically to patients. METHODS: a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerckships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. RESULTS: Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. CONCLUSIONS: The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10 minutes. PRACTICAL IMPLICATIONS: The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes.

Educating medical students is a core mission of academic radiology departments. In some programs, residents participate in student teaching. The aim of this study was to retrospectively compare medical student evaluations of radiology resident lectures with lecture evaluations of radiology faculty members. Methods: Numeric evaluations for lectures given by faculty members, fellows, and residents were collected over a 1-year period as part of routine course evaluations for a fourth-year medical student radiology elective. Faculty member, fellow, and resident lecture scores were compared, overall using analysis of variance and pairwise using Student's t test. A predefined low P-value threshold was used for the t tests to account for the multiple comparisons. To account for the inherent clustering of the data due to repeat lecturers, the data were reanalyzed on a "per lecturer" basis. Results: Three hundred seven individual lecture scores were collected. There was no statistical difference between the lecture scores received by attending faculty members (mean, 9.10 on a scale of 10) and residents (mean, 8.99) (P ϭ .08). Fellows, however, scored statistically significantly lower (mean, 8.45) than attending faculty members and residents (P Ͻ.001 for both comparisons). The per lecturer analysis yielded similar results. Conclusions: Lectures delivered by residents received similar evaluations as lectures delivered by faculty members. Given that teaching can be an educational experience for residents, involving radiology residents in medical student teaching may benefit students and residents alike.

Context Interest 1 in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skills, to prohibit decline of performance and to establish further improvements. Objective This review provides an overview of evaluation studies of communication skills training programmes for clinically experienced physicians who have ®nished their undergraduate medical education. The review focuses on the training objectives, the applied educational methods, the evaluation methodology and instruments, and training results. Methods CD-ROM searches were performed on Med-Line and Psychlit, with a focus on effect-studies dating from 1985. Results Fifteen papers on 14 evaluation studies were located. There appears to be some consistency in the aims and methods of the training programmes. Course effect measurements include physician self-ratings, independent behavioural observations and patient outcomes. Most of the studies used inadequate research designs. Overall, positive training effects on the physicians' communication behaviour are found on half or less of the observed behaviours. Studies with the most adequate 2 designs report the fewest positive training effects. Conclusion Several reasons are discussed to explain the limited ®ndings. Future research may bene®t from research methods which focus on factors that inhibit and facilitate the physicians' implementation of skills into actual behaviours in daily practice.