Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Ottawa, ON

Poster Presentation:


Identifying and Addressing Missed Opportunities for Teaching the Pediatric Physical Exam: Is there a role for video podcasts?

Authors:
Julia C. Kendall,Weill Cornell Medical College,New York,NY,Thanakorn Jirasevijinda,Weill Cornell Medical College,New York,NY,Mary J. Ward,Weill Cornell Medical College,New York,NY

Title: Identifying and Addressing Missed Opportunities for Teaching the Pediatric Physical Exam: Is there a role for video podcasts?

 

Background:

Medical students lack training in pediatric physical exam (PPE) before the pediatric clerkship (Guiot , 2013). A robust PPE curriculum requires intensive resources including time and personnel. Instructional podcasts are a convenient and effective format to deliver curricular contents on a variety of topics. (Orientale, 2008; Schickedanz, 2009). However, student perception of the utility of podcasts for PPE remains unknown.

 

Objectives:

To assess 1) how students learn PPE; 2) gaps in existing curriculum on PPE; 3) medical student self-assessment of PPE skills; 4) perceived utility of PPE podcasts.

 

Methods:

A mixed-methods design was used to gather data. Third-year pediatric clerks were recruit to complete an anonymous survey and participate in focus groups. Survey and focus group questions assessed self-reported comfort and skills levels in PPE, approaches to learning PPE, gaps in existing PPE curriculum and utility of PPE podcasts, Focus groups were audiotaped and transcribed, then analyzed by two investigators using semi-structured content analysis. Disagreements were resolved by consensus and the list of codes revised in an iterative process.

 

Results:

A total of 121 (83%) students completed the survey and 35 participated in focus groups during the 2013-15 academic years. The majority (62%) reported “needs improvement” in their comfort/confidence level with PPE, while 46% reported “needs improvement” in skills level. Most (86%) reported that PPE podcasts would increase their comfort/confidence and skills in PPE. Students cited lack of prior experience, resources, opportunities to practice, and the culture of evaluation as challenges to learning PPE. Students recommended that PPE curriculum include the teaching of approaches to working with children in addition to specific techniques, hands-on bedside teaching, flipped classroom and observation with feedback. Students also recommended short, accessible PPE podcasts for just-in-time training.

 

Discussion:

Students reported feeling unprepared for PPE. Curriculum enhancement should include approaches to working with children, hands-on format, and integration of video podcasts.

 

References

  1. Guiot AB, Baker RC, Dewitt TG. When and how pediatric history and physical diagnosis are taught in medical school: a survey of pediatric clerkship directors. Hosp Pediatr. 2013 Apr; 3(2):139-43.
  2. Orientale E Jr, Kosowicz L, Alerte A, Pfeiffer C, Harrington K, Palley J, Brown S, Sapieha-Yanchak T. Using web-based video to enhance physical examination skills in medical students. Fam Med. 2008 Jul-Aug;40(7):471-6.
  3. Schickedanz AD, Kim JE, Chou CL. Near-peer videos for physical examination instruction.  Med Educ. 2009 Nov;43(11):1095-6.