Nancy . Liao,,Columbus,OH,Ashley . Shamansky,,Columbus,Ohio,Rena . Kasick,,Columbus,Ohio,Ramya . Keshavaram,,Columbus,Ohio
Pediatric histories and physicals require a specialized subset of skills which most medical students do not learn prior to their pediatric clerkship. This results in a delay in effective communication as it takes specialized instruction, time, and experience to foster this competency.
To evaluate the effectiveness of a web-based module in enhancing the written history and physical documentation skills of novice, third-year medical students in their pediatrics rotation.
This study is a case control study, nested within a larger randomized case crossover study involving early third-year medical students. A 15 minute, web-based Articulate module was developed, which instructed students on how to interview a pediatric patient and construct H&P. All students (n=54) assigned to the pediatric clerkship during August-December 2015 were asked to participate in the study via e-mail. 1/2 of the students viewed the module at the beginning of their rotation and the other half viewed the module in the middle of the rotation. Each student submitted 4 H&Ps as part of their routine assignments for the clerkship. The H&Ps were assessed utilizing the P-HAPEE tool, a validated pediatric H&P rubric.
38 H&Ps so far were reviewed, of which 20 H&Ps were part of the intervention group and 18 H&Ps were part of the control group. The average P-HAPEE scores of the two groups were compared. The intervention group’s mean overall score was 22.69 (95% CI 19.96-25.43) compared to the control group’s mean of 23.50 (95% CI 21.11-25.89). Three H&P sub-components: the history, physical exam and diagnostic studies, and information synthesis and clinical reasoning were compared. The intervention group’s mean score for the history was 7.28 (95% CI 6.42-8.14) compared to the control mean of 7.56 (95% CI 6.59-8.52). For physical exam and diagnostics, the intervention group’s mean score was 7.52 (95% CI 6.97-8.07) and the control mean was 7.13 (95% CI 6.43-7.83). For synthesis and clinical reasoning, the intervention group’s mean score was 8.80 (95% CI 7.74-9.56) and the control group mean was 8.63 (95% CI 7.52-9.74). No statistical significance was found between the two groups using a two-sample t-test (p-values 0.3924, 0.6618, 0.3675, 0.8190), respectively.
While no significant differences were found between the groups, web-based modules may still provide some utility in preparing medical students for their pediatric clerkship. The study is limited by small sample size. Further research will be aimed at examining improvement in students’ scores over time between the two groups.