Academic medicine : journal of the Association of American Medical Colleges
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The purpose of the migrant health initiative is to give medical students the opportunity to provide clinical services, at appropriate levels of training, to a population that reflects a different ethnic and economic background than medical students typically see in the clinical setting. This initiative integrates concepts of cultural competency with experiential learning. ⋯ The partnership between students, faculty, and the community provides the mechanism to thoughtfully develop and integrate cultural issues and experiences into the curriculum. Students have recently received a Caring for Community five-year grant from the Association of American Medical Colleges. Program expansions will continue into the third-year medicine clerkship and include a senior elective. The program expansions will result in a migrant health initiative that will be coordinated; comprehensive; and expand student knowledge, skills, and experiences in cultural health care.
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Comparative Study
Development of an office-based curriculum of common pediatric primary care skills for residents.
Basic primary care skills-such as injections and hearing screening-are commonly absent from residency curricula, yet competence in these skills is required by residency accrediting organizations. To meet this need at our program, an office-based curriculum of common pediatric primary care skills was developed and piloted in a resident continuity practice. ⋯ This pilot demonstrated that it is feasible to teach primary care skills to residents in the office setting. In our pilot, the test group performed 61% better on a written test and 64% better on a practical test when compared with the control group (p <.0001). Residents who participated in the pilot felt the methods used were appropriate and effective and that the skills taught were important. Additionally, they found the pilot did not interfere with the operation of the continuity clinic. The procedure checklist proved to be an effective and simple method of instructing a psychomotor skill. Conducting the educational sessions at the beginning of clinic was difficult due to interruptions and tardiness. While other methods, such as noon conferences, may also be effective, instruction in the actual clinical setting appeared to better demonstrate the importance, practicality, and relevance of the skill. The residents were more enthusiastic during this office-based curriculum than a typical resident conference. We conclude that this model is an effective and practical method to teach primary care skills in a clinical setting. Our success with the pilot unit has been encouraging, and we plan to develop and test the remaining units of the curriculum.
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To teach internal medicine residents to use evidence-based medicine (EBM) in their interactions with patients by creating curricula that integrate EBM into clinical topics in internal medicine. ⋯ The women's health curriculum was introduced in the spring of 2000; the anticoagulation curriculum was introduced in the spring of 2001. Both have been well received and seem to have impacted the ability of our housestaff to incorporate EBM into patient care. Currently under development in this series is a curriculum in addiction medicine for interns that will use a similar approach to provide an overview of EBM topics and their integration into the flow of patient care. We feel that these educational programs have helped EBM to bridge the gap between the classroom and the exam room.
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To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. ⋯ This fourth-year, urban community-based preceptorship is designed to provide students with an alternative fourth year that integrates skill development in clinical and community medicine, offers a continuity primary care experience, and showcases innovative urban health resources and role models. It is hoped that these students will pursue graduate medical education in Milwaukee, incorporate a population perspective in their practice, and choose to work in neighborhoods that are currently underserved.
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The Leadership Opportunities with Communities, the Underserved, and Special Populations (LOCUS) Program aims to improve medical students' leadership knowledge and skills, to improve self-awareness and motivation for community service, and to provide models for students to integrate community service into their medical careers. ⋯ This pilot program demonstrates that motivated students can develop leadership skills and address unmet community health needs while they progress through medical school. LOCUS students, staff, and physicians provide a social network that includes opportunities, encouragement, reflection, and problem solving. Student and mentor satisfaction with the program has been high. Future challenges include securing long-term funding, refining the core curriculum, assessing the impact of the program on participants, and improving the quality of projects through community partnerships. LOCUS strives to kindle the fires of altruism and community service so they are not extinguished as students progress through medical training.