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Independent Learning in the Emergency Department


Exploring Medical Student Learning Needs in the Pediatric Emergency Department: “What Do You Want to Learn Right Now?”  Pusic MV, Best R, Black JB, Mutnick A.  Pediatr Emerg Care 2016 Apr;32(4):217-21.  http://dx.doi.org/10.1097/PEC.0000000000000766

Reviewed by Anne-Marie Kaulfers

Tags: learning needs, independent study, emergency department

What was the study question?

What are the predominant learning needs of medical students during clinical encounters in a pediatric emergency department, and can those learning needs be addressed by independent study?

How was the study done?

82 third year students and 44 faculty preceptors were interviewed during their shifts in the pediatric emergency department. The students were asked what they thought their learning needs were immediately after interacting with a patient.  , Faculty were asked the same question about a student after the student presented a patient case.  Results were recorded, coded and analyzed for themes.  Pediatric educators then ranked these needs on whether or not they could be addressed by independent study.

What were the results?

Self-reported learning needs were grouped by ACGME Core Competencies.    56% of the needs were judged to be related to medical knowledge, 27% to interpersonal skills and communication (comforting a child, talking to parent), 18% to skill for patient care, and 1-2% to all other areas.  Preceptors were more likely to report a medical knowledge need, and students were more likely to report a skill need.  Pediatric educators reported that a substantial minority of these learning needs would be amenable to independent study, especially medical knowledge. 

What are the implications of these findings?

Studies have shown that medical knowledge is better learned in the context of seeing a patient.

The authors suggest one approach: a specific and brief point-of-care computer tutorial in the emergency department that the student can be directed toward after seeing a patient with a particular disease state.  Preceptors can then use their limited time with the student to address skill and communication needs.

Editor’s Note: It is noteworthy, and perhaps not surprising, that the students valued clinical skills over medical knowledge.  Today’s students, born in the information age, can find medical knowledge quickly and easily, but clinical skills are harder to come by.  (JG)

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