Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Nashville

Poster Presentation:


SUB-I: STUDENTS UNDERGOING A BRIDGE TO INTERNSHIP: AN EDUCATIONAL MODEL

Authors:

Joshua D. Noe, MD, MD, Medical College of  Wisconsin, Milwaukee, WI, Kris H. Saudek, MD, Medical College of Wisconsin,  Milwaukee, WI, Angela Bier, MD, Medical College of Wisconsin, Wauwatosa, WI,  Jane Machi, MD, Medical College of Wisconsin, Milwaukee, WI, Jennifer McKanry,  Medical College of Wisconsin, Milwaukee, WI, Becky Buelow, MD, Medical College  of Wisconsin, Milwaukee, WI, Alecia Huettl, MD, Medical College of Wisconsin,  Milwaukee, WI, Stephen Malcom, MD, Medical College of Wisconsin, Milwaukee, WI,  Matthew Gray, MD, Medical College of Wisconsin, Milwaukee, WI, Laura Norton,  MD, Medical College of Wisconsin, Milwaukee, WI, Tan Wyllie, MD, Medical  College of Wisconsin, Milwaukee, WI, Katie Fee, MD, Medical College of  Wisconsin, Milwaukee, WI, Molly Kleiman, MD, Medical College of Wisconsin,  Milwaukee, WI, Erin Shaughnessy, MD, Medical College of Wisconsin, Milwaukee,  WI, Sarah G. Gaethke, MD, Medical College of Wisconsin, Milwaukee, WI, Sajani  Tipnis, MD, Medical College of Wisconsin, MIlwaukee, WI 


Background: The 4th year sub-internship (Sub-I) rotation is challenging for a student as they have responsibilities of an intern.  Traditionally there have been no additional preparations for medical students for their intern year beyond this.  Previous studies have shown lack of self-reflection & improvement, poor organizational skills, underdeveloped professionalism, and lack of medical knowledge as the most common struggles.1
Aims: (1) To design an effective curriculum to teach Sub-I’s intern-level organization skills, professionalism, communication across audiences, & presentation skills.  (2) To effectively use simulation to teach common procedures & early management of unstable patients.
Methods: A 3-step curriculum was created & given over 2 years.  (1) Prior to their Sub-I, students watched an on-line video on how to sign out a patient.  (2) During the first week of their Sub-I, students participated in 4 one-hour workshops teaching skills listed in Aim #1.  Before and after these workshops, students answer confidence surveys to determine if the workshops increased their confidence in these skills.  Paired t-test was performed if there was a statistically significant difference.  (3) During the last week of their Sub-I, students underwent 5 simulations: Signing out a patient, communication across audiences, calling a consultation, performing a lumbar puncture, & resuscitating an infant in respiratory distress.  After their Sub-I was complete, students completed an Likert evaluation of the curriculum.  Z-test was performed to see if there was a positive response defined as “greater than neutral” to the workshops’ aspects.
Results: There was a statistically significant improvement in the students’ confidence in all aspects of every workshop.  There was a positive response in all aspects of every simulation.
Conclusion: (1) Students’ confidence for intern-level skills increases with a supplemental Sub-I curriculum.  (2) Students value simulations as useful to their preparation to be an intern.
1 Lyss-Lerman, P, Teherani, A, and Aagaard,E. What training is needed in the fourth year of Medical School?  Veiws of Residency Program Directors. Academic Medicine. 2009 Jul;97):823-829.