Academic medicine : journal of the Association of American Medical Colleges
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Randomized Controlled Trial
Impact of increased authenticity in instructional format on preclerkship students' performance: a two-year, prospective, randomized study.
To address whether increasingly authentic instructional formats are more effective in improving preclerkship medical students' performance. ⋯ The authors could not demonstrate that increased authenticity of the instructional format resulted in improved learner performance. However, they believe that there may be some benefit to tailoring preclerkship clinical education based on students' ability.
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Multicenter Study Comparative Study
More is better: students describe successful and unsuccessful experiences with teachers differently in brief and longitudinal relationships.
Clerkship experiences that structure student-teacher continuity may promote learning differently than brief student-teacher relationships. The authors compared students' successful and unsuccessful teaching experiences in brief and longitudinal relationships. ⋯ Clerkship students in brief relationships learn to adapt to teachers' preferences and questioning to facilitate their participation and knowledge acquisition; longitudinal students experience collaborative interactions focused on their development as care providers. In longitudinal relationships, students gain confidence to influence their own learning and modify circumstances to meet their learning needs. These findings suggest that medical students' clinical experiences may be enhanced by deliberately structuring longitudinal attachments to supervisors.
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Diagnostic errors in medicine are common and costly. Cognitive bias causes are increasingly recognized contributors to diagnostic error but remain difficult targets for medical educators and patient safety experts. The authors explored the cognitive and contextual components of diagnostic errors described by internal medicine resident physicians through the use of an educational intervention. ⋯ Residents can easily recall diagnostic errors, analyze the errors for cognitive bias, and richly describe their context. The use of reflective writing and narrative discussion is an educational strategy to teach recognition, analysis, and cognitive-bias-avoidance strategies for diagnostic error in residency education.
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Controlled Clinical Trial
The effects of a mid-day nap on the neurocognitive performance of first-year medical residents: a controlled interventional pilot study.
Despite shorter duty hours, fatigue remains a problem among medical residents. The authors tested the effect of a short, mid-day nap on the cognitive functioning and alertness of first-year internal medicine (IM) residents during normal duty hours. ⋯ A short, mid-day nap can improve cognitive functioning and alertness among first-year IM residents.
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Although academic centers rely on assessments from medical trainees regarding the effectiveness of their faculty as teachers, little is known about how trainees conceptualize and approach their role as assessors of their clinical supervisors. ⋯ Individual and system-based factors conspire to influence postgraduate medical trainees' motivation for generating high-quality appraisals of clinical teaching. Academic centers need to address these factors if they want to maximize the usefulness of these assessments.