Council on Medical Student Education in Pediatrics

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COMSEP 2008 Atlanta Meeting

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Medical Student Evaluations of a Hospitalist Lecture Series During the Inpatient Pediatric Rotation

Authors:
April O. Buchanan
Warren Alpert Medical School of Brown University Rhode Island Hospital / Hasbro Childrens Hospital

OBJECTIVE: Medical student education in the inpatient setting presents an opportunity for teaching by hospitalists. At our institution the didactic sessions for clerkship students have been structured according to the COMSEP curriculum: fluids and electrolytes, nutrition, adolescent issues, etc. A hospitalist lecture series originally designed to educate pediatric house officers and devoted to common conditions confronted in the inpatient setting such as cellulitis, sepsis evaluation, bronchiolitis, etc., has become well attended by pediatric clerkship and sub-internship students. The purpose of this study was to evaluate third and fourth year medical students’ opinions of a hospitalist lecture series and its impact on their educational experience in pediatrics. 
METHODS: At the conclusion of the inpatient portion of the pediatric rotation, third and fourth year medical students were asked to evaluate a hospitalist lecture series using a 4-point likert scale. Students rated topics for the hospitalists lectures, quality of lecturers, quality of lectures, and overall contribution to the educational experience in pediatrics. All evaluations were anonymous.
RESULTS: A total of 60 students rotated through their inpatient clerkship or sub-internship during the study period of July 2007 to January 2008. Fifty-three students (88.3%) submitted an evaluation. Forty-six (86.8%) were clerkship students and 6 (11.3%) were sub-interns; 1 (1.9%) was unidentifiable. The topics for the hospitalist lectures received a rating of 3.38 (3.33 by clerkship students and 3.83 by sub-interns). The overall quality of the lecturers was 3.34 (3.26 by clerkship students and 4.00 by sub-interns). The overall quality of the lectures was 3.28 (3.22 by clerkship students and 3.83 by sub-interns). The overall contribution of the lectures to the educational experience in pediatrics was rated at 3.12 (3.10 by clerkship students and 3.33 by sub-interns). 
CONCLUSIONS: Hospitalists lectures were viewed positively by third and fourth year medical students during clerkships and sub-internships. Hospitalists as lecturers were also viewed favorably. Medical student education in pediatrics may be further enhanced by exposure to core inpatient topics during their inpatient rotations. It may be beneficial to utilize objective measures to determine if medical student knowledge is indeed improved as a result of these lectures.
 
30. Being a Reflective Practitioner: A Medical Student Curriculum to Enhance Learning and Reflective Thinking on a Pediatric Clerkship.
Maria Marquez, Margaret Plack, Maryanne Driscoll, Melanie Rahmanand Larrie Greenberg.
Georgetown University Hospital, George Washington University, Touro College, New York, New York,
 
Background: Reflection enables students to revisit and analyze their experiences for deeper understanding and for the clinical decision-making process. Reflective practice enables learners to develop critical thinking skills essential to clinical reasoning.
Objective: Determine the impact of peer-facilitated action learning sets on clinical reasoning learning.
Design/Methods: Twenty-four third-year medical students on a pediatric clerkship were randomly assigned to 2 morning report clinical training sets. Each set conducted 2 morning report sessions. The cases for morning report 1 and 2 were the similar, except that the presentation was conducted with different preceptor’s intervention. The first set of morning reports (control). The second set of morning reports was with a tutor trained in action learning, and reflection. The intervention group was introduced to different tools and theories about reflective practice. Student’s development of the cases were audio recorded and then compared features of the encounters.
Results: Four recorded morning report sessions were analyzed. First set (control): first morning report showed 79 Knowledge and comprehension inquiries. 3 in an intermediate level and 0 at the highest level of thinking. First set-second morning report 38 in the knowledge level, 9 at an intermediate and 0 at the highest thinking process. Second set (intervention) - first morning report 83 at the knowledge level, 44 at an intermediate level and 3 at a higher level of thinking process. Second session 51 at lower level, 24 at an intermediate and 3 at a higher level of thinking process. Knowledge base of the students was similar in both groups.
Conclusions: Reflective practice curriculum provides a baseline for a deeper thinking. It allows more questioning and in a deeper thinking level. It seems to improve the relevance of diagnostic hypotheses. It assists to analyze the challenges they face in the clinical setting.