Copyright (c) 2009 All rights reserved. http://works.bepress.com/pugnairem Recent documents in Michele P Pugnaire en-us Sun, 31 May 2009 10:34:41 PDT 3600 http://works.bepress.com/pugnairem/19 http://works.bepress.com/pugnairem/19 Tue, 01 Apr 2008 10:06:36 PDT OBJECTIVE: Residents do a significant amount of teaching. Therefore, as medical students prepare for the clinical aspects of their residency, it is also important for them to prepare for their role of physician as teacher. With the goal of offering fourth-year students an opportunity to enhance their teaching skills, an elective was designed that presented them with an opportunity to expand their knowledge base in education, and then apply and practice this new set of knowledge. A week-long elective, Physician as Teacher, was designed to encompass core educational information such as needs assessment of learners, establishing goals and objectives, teaching methods, and evaluation and feedback. This core information was then applied and enriched during an end-of-course teaching presentation. Aside from this course, there is no forum during their undergraduate medical training for the students to acquire knowledge and skills about how to be teachers. DESCRIPTION: The course was developed with the appreciation that application of knowledge is a rich source of learning. The course began with interactive classroom teaching sessions designed to facilitate acquisition of core educational knowledge. Sessions topics included assessment of learner needs, methods of teaching, learning styles, microprecepting, and feedback. Also incorporated were sessions on facilitating small groups, and teaching and learning how to use technology. Those classroom sessions were then enhanced by a complement of sessions that asked the students to apply their new knowledge to clinical situations. Those more application-based sessions included observation and follow-up discussion of clinical teaching and small-group teaching sessions with the goal of developing the students' skills with respect to the teaching and learning process. An end-of-course teaching presentation by each student provided them with a capstone experience of applying the knowledge and skills learned throughout the week. The topic of the teaching presentation was of their choosing, and could incorporate technology. Each student's teaching presentation was videotaped, immediately viewed by the student, and discussed using a structured format of facilitated feedback. DISCUSSION: Students reported that the end-of-course teaching presentation was a rich source of their learning, and an important vehicle for helping them apply and synthesize the new knowledge. Fifteen percent of fourth-year students enrolled in and completed the elective. Seventy-one percent of those students "strongly agreed" and 29% "agreed" that the course provided useful knowledge and skills. Seventy-nine percent "strongly agreed" and 21% "agreed" that their teaching would be better because of the course. Based on comments, the students appeared to feel that the experience of presenting a teaching session at the end of the course was a rich source of their learning, and helped them to apply and synthesize the new knowledge. Students noted, "the teaching project was an excellent idea to see how much we have learned; I never realized what a responsibility we have as residents to teach our peers; I have been enlightened this past week and will now consciously make an effort to share what little information I currently have; I will be a better teacher because I have been given the appropriate tools." Susan J. Pasquale *Education, Medical, Undergraduate Students, Medical *Teaching http://works.bepress.com/pugnairem/18 http://works.bepress.com/pugnairem/18 Tue, 01 Apr 2008 10:06:34 PDT In 1995 as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative, the University of Massachusetts (UMass) Medical School developed the "standardized family" as a new model for teaching the essential elements of primary care in a core curriculum format outside of the clinical setting. Using this model, a hypothetical family unit (the "McQ Family") serves as the focus for case-based clinical problem solving. This paper describes the standardized family model and provides two years of evaluation outcomes such as curriculum assessments, student performance outcomes, and correlation with external measures of clinical performance to support the effectiveness of this educational model. It discusses the transferability of the standardized family model from UMass Medical School to Pennsylvania State University College of Medicine and uses Pennsylvania State's adaptation (the "Hershey-Penn Family") to illustrate how the standardized family can be customized to integrate a core curriculum into a three-year longitudinal primary care program. The authors suggest that the standardized family model has the potential to meet a broad range of primary care teaching needs at other institutions. Michele P. Pugnaire *Curriculum *Education, Medical, Undergraduate Family Practice Humans Massachusetts *Models, Educational Program Development Program Evaluation Schools, Medical http://works.bepress.com/pugnairem/17 http://works.bepress.com/pugnairem/17 Tue, 01 Apr 2008 10:06:30 PDT Although combined osteopathic and allopathic medical programs are well established for graduate medical education and continuing medical education, little has been published in the literature about such integration at the undergraduate level. The authors describe the preliminary efforts of a joint clinical clerkship program with students from regional osteopathic and allopathic medical schools at a major community teaching hospital in New England. Osteopathic principles and practice are consistently reinforced, exposing students from both medical backgrounds to them. It is hoped that this pilot program serves as a model for developing similar combined programs throughout the United States. Henry Tulgan *Clinical Clerkship *Education, Medical, Undergraduate Hospitals, Teaching Humans Massachusetts New England Osteopathic Medicine Pilot Projects Schools, Medical http://works.bepress.com/pugnairem/16 http://works.bepress.com/pugnairem/16 Tue, 01 Apr 2008 10:06:26 PDT BACKGROUND: This study examined the longitudinal stability of students' perceptions by comparing ratings on similar survey items in three sequential evaluations: end-of-clerkship (EOC), AAMC graduation questionnaire (GQ), and a postgraduate survey (PGY1). METHOD: For the classes of 2000 and 2001, ratings were compiled from EOC evaluations and comparable items from the GQ. For both cohorts, selected GQ items were included in the PGY1 survey and these ratings were compiled. Matched responses from EOC versus GQ and PGY1 versus GQ were compared. RESULTS: Proportions of "excellent" ratings were consistent across EOC and GQ surveys for all clerkships. Comparison of GQ and PGY1 ratings revealed significant differences in only seven of 31 items. CONCLUSION: Student perceptions as measured by GQ ratings are notably consistent across the clinical years and internship. This longitudinal stability supports the usefulness of the GQ in programmatic assessment and reinforces its value as a measure of student satisfaction. Michele P. Pugnaire *Attitude Clinical Clerkship Clinical Competence Cohort Studies Curriculum *Education, Medical, Undergraduate Humans Internship and Residency Longitudinal Studies Personal Satisfaction Questionnaires *Students, Medical Teaching Teaching Materials http://works.bepress.com/pugnairem/15 http://works.bepress.com/pugnairem/15 Tue, 01 Apr 2008 10:06:23 PDT Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula. Adina Kalet Clinical Clerkship *Clinical Competence *Communication Curriculum Educational Measurement Female Humans Male Physician-Patient Relations Schools, Medical Sensitivity and Specificity United States http://works.bepress.com/pugnairem/14 http://works.bepress.com/pugnairem/14 Tue, 01 Apr 2008 10:06:20 PDT INTRODUCTION: Professionalism is fundamental to the practice of medicine. Objective structured clinical examinations (OSCEs) have been proposed as appropriate for assessing some aspects of professionalism. This study investigated how raters assign professionalism ratings to medical students' performances in OSCE encounters. METHODS: Three standardised patients, 3 doctor preceptors, and 3 lay people viewed and rated 20 videotaped encounters between 3rd-year medical students and standardised patients. Raters recorded their thoughts while rating. Qualitative and quantitative analyses were conducted. Comments about observable behaviours were coded, and relative frequencies were computed. Correlations between counts of categorised comments and overall professionalism ratings were also computed. RESULTS: Raters varied in which behaviours they attended to, and how behaviours were evaluated. This was true within and between rater type. Raters also differed in the behaviours they consider when providing global evaluations of professionalism. CONCLUSIONS: This study highlights the complexity of the processes involved in assigning ratings to doctor-patient encounters. Greater emphasis on behavioural definitions of specific behaviours may not be a sufficient solution, as raters appear to vary in both attention to and evaluation of behaviours. Reliance on global ratings is also problematic, especially if relatively few raters are used, for similar reasons. We propose a model highlighting the multiple points where raters viewing the same encounter may diverge, resulting in different ratings of the same performance. Progress in assessment of professionalism will require further dialogue about what constitutes professional behaviour in the medical encounter, with input from multiple constituencies and multiple representatives within each constituency. Kathleen M. Mazor Clinical Competence Communication *Education, Medical, Undergraduate Humans Massachusetts Physician-Patient Relations Students, Medical http://works.bepress.com/pugnairem/13 http://works.bepress.com/pugnairem/13 Tue, 01 Apr 2008 10:06:17 PDT No abstract provided. Julie A. Jonassen Adult Child Clinical Clerkship Curriculum Domestic Violence *Education, Medical *Faculty, Medical Female Humans Male *Patient Care Team Program Evaluation Spouse Abuse http://works.bepress.com/pugnairem/12 http://works.bepress.com/pugnairem/12 Tue, 01 Apr 2008 10:06:15 PDT Since 1995, a three-generation "standardized family," the McQs, has been successfully implemented as a core curriculum in the third-year family medicine clerkship. In July 1999, the standardized family was expanded into two other clerkships (internal medicine and pediatrics), with the goal of creating an interdisciplinary core curriculum in primary care across three clerkships. Our experience supports that the standardized family curriculum can be implemented across clerkships and that it provides a model for developing a multidisciplinary and integrated core curriculum in primary care. The curriculum's effectiveness in attaining its primary care learning objectives will be assessed when analysis of data currently being gathered from multiple evaluation measures is completed. Michele P. Pugnaire Clinical Clerkship *Curriculum *Family Health Family Practice Humans *Models, Educational *Primary Health Care United States http://works.bepress.com/pugnairem/11 http://works.bepress.com/pugnairem/11 Tue, 01 Apr 2008 10:06:12 PDT No abstract provided. Julie A. Jonassen *Clinical Clerkship Curriculum *Education, Medical Humans *Spouse Abuse http://works.bepress.com/pugnairem/10 http://works.bepress.com/pugnairem/10 Tue, 01 Apr 2008 10:06:10 PDT No abstract provided. E. 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