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COMSEP 2011 San Diego Meeting with AMSPDC

Poster Presentation:


THE 4TH YEAR MEDICAL STUDENT CAPSTONE COURSE IN PEDIATRICS -- ONE LAST CHANCE TO PREPARE OUR FUTURE RESIDENT PHYSICIANS

Authors:
Craig C. DeWolfe, MD, MEd, Children's National Medical Center, George Washington University School of Medicine, Washington, DC

Background & Objective: While recognizing the important role that sub-internships and electives provide in 4th year medical student education, George Washington University School of Medicine chose to teach, review and assess competencies required of all students prior to graduation in a month-long capstone course. The course included instruction within the specialty of the student’s choice. A pediatric curriculum of case-based and simulation experiences was drawn from the COMSEP/APPD Pediatric Subinternship Curriculum, a study of residency directors (Langdale LA, Acad Med, 2003), and faculty experience. A capstone course for students entering surgical residencies has been described (Naylor RA, Am J Surg, 2010), but no published data exists for a required or pediatric course. We hypothesized that upon completing the capstone course, students destined for pediatrics would be more knowledgeable and skilled in competencies necessary for internship. Methods: 31 hours of case based instruction and simulation were provided to 30 students in 2010. Pre- and post-knowledge tests, a retrospective self-assessment of competency and a satisfaction survey were completed by 26. Knowledge acquisition was analyzed using the Fisher test. Satisfaction and skill acquisition were measured using the paired t-test based on a 5 point Likert scale (5 being greatest level of satisfaction / comfort with a skill). Values reported are means ± SD. A two-tailed p value <0.05 was considered significant. Results:

Mean self-rating scores of confidence
 
Category
Pre-course
Post-course
p value
Assess pediatric patients in emergencies
2.3 ± 0.6
4 ± 0.3
< 0.0001
Stabilize pediatric patients in emergencies
1.9 ± 0.7
3.8 ± 0.5
< 0.0001

Mean satisfaction scores
Relevant to interns
4.8
Met expectations
4.5

 
 
 

 

% students who answered question correctly
Category
Pre-course
Post-course
P value
Interpret an ABG
45%
82%
< 0.0001
Order a fluid bolus
32%
77%
< 0.0001

 


Conclusions: 4th year medical students positively responded to a course using case-based instruction and simulation designed to prepare them for residency. They reported feeling more confident in their abilities and demonstrated important knowledge acquisition. More comparative data using standardized tests and skill assessments in addition to outcome measures during residency will further clarify its benefit.