Council on Medical Student Education in Pediatrics

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COMSEP 2011 San Diego Meeting with AMSPDC

Poster Presentation:


WHAT TO DO WITH ALL THOSE MEDICAL STUDENTS? ATTENDING-ONLY SERVICES CAN PROVIDE VALUABLE EDUCATIONAL EXPERIENCES

Authors:
Elizabeth B. Seelbach, MD, Howard University College of Medicine, Children's National Medical Center, Washington, DC; Jamilet Alegria, MD, Jennifer Maniscalco, MD, MPH, USC Keck School of Medicine, Children's Hospital Los Angeles, Los Angeles, CA; Terry Kind, MD, MPH, The George Washington University Medical Center, Children's National Medical Center, Washington, DC

Background: With more students entering medical school, finding meaningful inpatient educational experiences can be difficult. Further challenges have arisen with decreasing resident duty hours and the formation of more attending-only services (AOS). Prior studies revealed concerns about teaching quality and quantity under these restricted hours. To address these challenges, Children’s National Medical Center (CNMC) and Children’s Hospital Los Angeles (CHLA) created rotations for third year students on AOS. Literature has described fourth year student curriculums on AOS, but there are no reports related to third year pediatric clerkships. Purpose: To create a high value curriculum for third year medical students on inpatient AOS. Description: Using their respective pediatrics clerkship learning objectives, CNMC and CHLA created two models for student education on AOS. CNMC uses a general pediatric service while CHLA uses a subspecialty service. Primary objectives of both models include helping students develop presentation skills, age-specific exam skills, and appropriately complete differential diagnoses. On the AOS team at each site, a teaching attending responsible for a limited number of patients is available to provide extensive feedback and education during morning rounds, supervised bedside examinations, and in depth discussions of differential diagnoses. Afternoon teaching sessions involve core didactics, continued bedside teaching, direct observation and feedback on presentations, and exam skills and at CNMC simulation training. The afternoon sessions provide the opportunity for student reflection on the morning rounds and determination of additional learning needs in order to improve skills.  48 student evaluations were collected at CNMC from 2008-2010; “overall educational experience” was rated 4.6 on a 5-point Likert scale (5=Outstanding). Comments from students included “Great Teaching Attendings,” “Tremendous one-on-one teaching,” and “Love the Attending interaction.” The CHLA curriculum was implemented in the fall of 2010, and evaluation is ongoing. Conclusions:  Both institutions developed curricula for third year students, taking advantage of the unique qualities of AOS, while optimizing students’ learning experiences. Initial satisfaction scores of students are high. Future research could compare shelf exam scores, satisfaction, and specialty choices with students on traditional services