Clerkship timing and disparity in performance of racial-ethnic minorities in the medicine clerkship.
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PURPOSE: To determine the effect of the timing of the medicine clerkship on academic performance in different racial-ethnic student groups. METHOD: Performance was measured by the average assessment of clinical preceptors, an OSCE (objective structured clinical examination), and the NBME (National Board of Medical Examiners) medicine subject examination. Outcomes were analyzed by student racial-ethnicity and clerkship sequence. RESULTS: Of the 650 students who took the clerkship over four years, 6.9% were African American, 34.6% were Asian-Pacific Islander, 9.1% were Hispanic and 49.4% were white. African American and Hispanic students were in the earliest clerkship sequence 46.7% and 30.5% of the time, respectively, compared to 20% of Asian-Pacific Islanders and 27.4% of white students. Academic performance improved with time and varied among the racial-ethnic groups. All groups achieved higher scores in the NBME medicine examination later in the year but scores of African American and Hispanic students increased to a greater degree than other students. CONCLUSION: Sometimes, a "few points" on the NBME medicine examination can affect students' final grades and alter their attractiveness to competitive residency training programs. All students, but African American and Hispanic students, in particular, can significantly improve their scores in the NBME medicine examination by taking the clerkship later in the year. Students should be counseled regarding the timing effect and methods to neutralize the disparity should be considered. (+info)
Validation of electronic student encounter logs in an emergency medicine clerkship.
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Handheld electronic patient encounter logs offer opportunities to understand and enhance medical students' clinical experiences. Before using the data, the reliability of log entries needs to be verified. We assessed the sensitivity and specificity of handheld patient encounter logs by comparing documented entries with reliable external data sources. During an Emergency Medicine clerkship, medical students voluntarily recorded their patients' diagnoses in an Electronic Student Encounter Log (E-SEL) on handheld computers. We used patient demographics to match anonymous log entries with medical charts. Most students recorded 60% or more of their patient encounters and on average 60% of their patients' medical problems in the log. The false positive rate was 26% for patient encounters and 19% for patient problems. In general, students recorded more diagnoses in more detail than was available in the patient's ED chart. Improvements in the log's interface and documentation incentives should enhance the log's accuracy and utility. (+info)
A comparison of student performance in a simulation clinic and a traditional laboratory environment: three-year results.
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With simulation clinics, dental schools have improved their preclinical laboratories to provide a more realistic clinical teaching environment. However, there is very little data to support the assumption that these facilities actually improve student performance of technical skills. This study compared the scores of two fixed preparations for full cast crowns by third-year dental students. One of the preparations was made in the simulation clinic manikin, and the other was prepared on the bench top. Three prosthodontic faculty members scored the preparations in the areas of occlusal reduction, axial reduction, resistance and retention, and margination. The study also compared the performance of three classes of dental students: one class with no experience in the simulation clinic, one with one year of experience, and one with two years of experience. The amount of time since completing the fixed prosthodontics course among the students was also evaluated. This was done because the third-year students at the University of Iowa rotate through a series often-week clerkships rather than a comprehensive care model. (Therefore, not all students start clinical prosthodontics at the same time.) In addition, all student participants completed a questionnaire that addressed their perception of their clinical readiness prior to treating their first fixed prosthodontic patient. When we compared the classes of years 1, 2, and 3 by average preparation score, we found a significant difference among the scores for teeth prepared on the bench top (p = 0.0001) but not for the teeth prepared in the mannequin (p = 0.1176). For Year 1 (no simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.57113 and 0.0661). For Year 2 (one year of simulation clinic experience), the elapsed time following completion of the fixed prosthodontic course was significant for the tooth prepared on the bench top (p = 0.0482), but it was not significant for the tooth prepared in the manikin (p = 0.2968). For Year 3 (two years of simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.7275 and 0.6007). The questionnaire revealed that, in general, the majority of the students perceived their clinical readiness as more than adequate. These results are mixed in that students with more bench top experience scored better on the bench top, and students with more manikin experience scored equally in both environments. (+info)
Perspectives on dental education in the Nordic countries.
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The object of this review is to discuss the state of dental education and describe current developments at dental schools in the Nordic countries. The main focus is the undergraduate dental education; however, the postgraduate system will also be addressed. The curriculum model for undergraduate dental education in the Nordic countries is based upon the odontological tradition. The influence of biomedicine on dental education is increasing at present due to scientific and medico-technological developments and the altered disease profiles of oral and systemic diseases. These circumstances create new possibilities for dental education, but at the same time they raise some problems. In the long-term, the strong biomedical influence on dental education will be an advantage to future dentists' function and tasks in health care systems in the Nordic countries. In the short term, it may result in an identity crisis for dental schools, students, and our profession, as we experience the evolution from the traditional odontological curriculum model to one significantly influenced by ongoing changes in the biomedical field. Continuing professional education and advanced training in clinical specialties are likely to play important roles in this evolution. (+info)
U.S. predoctoral education in pediatric dentistry: its impact on access to dental care.
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This study sought to identify faculty, organization, patient pool, and procedures taught in predoctoral pediatric dentistry programs using a questionnaire sent to all fifty-five U.S. dental schools in 2001. Forty-eight (87 percent) programs reported an average of 3.9 full-time and 2.1 part-time FTE faculty, resulting in a mean faculty to student ratio of 1:6.4. One-third employ general dentists to teach pediatric dentistry, and 36 percent report fewer faculty than five years ago. Two-thirds were stand-alone departments. Over half (55 percent) reported increases in patient pools, but also a lack of patients with restorative needs. Half of the programs supplemented school-based pools with special populations, and two-thirds sent students on external rotations, most often to treat high-caries children. Those not using external rotations cited lack of faculty. Accepted patients averaged about four years, with only 6 percent of the pool under three years. Low-income or Medicaid-covered children accounted for 88 percent of school patient pools. Half of the schools felt the pool inadequate to meet competencies, attributable to lack of patients' restorative needs or inadequate intake numbers. Fewer than half of the programs (48 percent) provided hands-on experience with disabled patients, and one-third afforded every student with this experience. Pediatric dentistry was mentioned in fewer than half of the competency documents. Results suggest that U.S. pediatric dentistry predoctoral programs have faculty and patient pool limitations that affect competency achievement and adversely affect training and practice. (+info)
Pocket tape measure for waist circumference: training medical students and residents on a simple assessment of body composition.
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Metabolic syndrome, the clustering of hyperglycemia, hypertension and dyslipidemia, increases the risk of coronary heart disease. Abdominal obesity is an important cue for the clinician to consider metabolic syndrome. Measurement of waist circumference is a simple means of identifying abdominal obesity. The development and distribution of pocket tape measures to medical students, residents and attending physicians were initiated to enhance identification and treatment of metabolic syndrome. Distribution of the tape measures was added to a cardiovascular nutrition component in a 4th-y medical school curriculum. The nutrition component continued to include computer-based cases and pocket reference cards. Limited data suggest that the addition of pocket tape measures to the nutrition component of an ambulatory care clerkship may increase the percentage of medical students who use waist circumference to identify patients at risk for metabolic syndrome. It is anticipated that student use will increase with role modeling by residents and attending physicians. (+info)
Cardiovascular risk factor self-assessment program: using the general clinical research center to provide a clinical experience for third-year medical students.
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An educational program at the University of Iowa has been designed to provide medical students with the opportunity to do a self-assessment of their personal risk factors for developing cardiovascular disease. The University of Iowa Hospital and Clinic's General Clinical Research Center (GCRC) provided the personnel and resources to work with students in small groups to allow them to experience the diagnostic testing that is a standard part of cardiovascular assessment procedures. This report presents preliminary data from the first 88 students to participate in the program. (+info)
The Trauma Evaluation and Management (TEAM) teaching module: its role for senior medical students in Canada.
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INTRODUCTION: The objective of this study was to report on the role of the Trauma Evaluation and Management (TEAM) module devised by the American College of Surgeons in the trauma education of senior medical students. METHODS: Twenty-nine medical students who completed their surgical clerkship at the University of Toronto were randomly divided into 2 groups: a control and a TEAM group. All students completed a 20-item multiple-choice questionnaire (MCQ) pre-test. The TEAM group(15 students) took a post-test after completing the TEAM program and the control group (14 students) took the same "post-test" without completing the TEAM program. Students in the control groupdid complete the TEAM program after taking the post-test, allowing all 29 students to complete a post-module evaluation questionnaire. Paired t-tests were used for within group comparisons and unpaired t-tests for between group comparisons. The results of the evaluation questionnaire were analyzed according to the percentage of response in each of 5 categories of 1 - strongly disagree to 5 = strongly agree, as well as according to the median, range and 95% confidence intervals. RESULTS: The students had similar mean (+/- standard deviation) scores on the MCQ pre-test (TEAM 46.3 [5.5], control 47.5 [9.9]), but the TEAM group showed a significant (p < 0. 05) improvement in their scores after they completed the TEAM program (TEAM 80.7 [11.5], control 44.6 [6.3]). Eight of the 15 students in the TEAM group reached the Advanced Trauma Life Support (ATLS) pass mark of 80%, whereas none in the control group achieved this mark. With respect to the evaluation questionnaire, a score of 4 or greater was assigned by 100% of the students when asked if the objectives were met, 100% when asked if trauma knowledge was improved, 62% when asked whether clinical trauma skills were improved, 100% for overall satisfaction and 100% in recommending that the module be made mandatory in the undergraduate curriculum. CONCLUSIONS: This study demonstrates the teaching effectiveness of the TEAM module. It also was very well accepted by the senior medical students who unanimously indicated that this module should be mandatory in the undergraduate medical curriculum. (+info)