Teaching and learning in medicine
-
Randomized Controlled Trial
Impact of acute stress on resident performance during simulated resuscitation episodes: a prospective randomized cross-over study.
Medical trainees have identified stress as an important contributor to their medical errors in acute care environments. ⋯ Residents exposed to simulated resuscitation scenarios experienced significant stress responses irrespective of the presence of acute stressors during these scenarios. This anticipatory stressful response could impact on resident learning and performance and should be further explored.
-
A battery of various psychometric assessments has been conducted on script concordance tests (SCTs) that are purported to measure data interpretation, an essential component of clinical reasoning. Although the breadth of published SCT research is broad, best practice controversies and evidentiary gaps remain. ⋯ Of the 6 scoring methods, 5-point scoring solutions generated more reliable measures of data interpretation than 3-point scoring methods. Data interpretation abilities were a function of experience at every level of item difficulty. Items categorized by type exhibited discriminatory power providing modest evidence toward the construct validity of SCTs.
-
Medical student training and experience in cardiac arrest situations is limited. Traditional Advanced Cardiac Life Support (ACLS) teaching methods are largely unrealistic with rare personal experience as team leader. Yet Postgraduate Year 1 residents may perform this role shortly after graduation. ⋯ This course significantly improved knowledge and psychomotor skills. Critical actions required for resuscitation were much more common after training. ACLS training including high-fidelity simulation decreases time to CPR and DF and improves performance during resuscitation.
-
The integration of bedside ultrasound into medical school curricula is limited by the availability of skilled faculty instructors. Peer mentors have been utilized successfully to teach clinical and procedural skills and may serve as a valuable resource for potential ultrasound instructors. We describe a method to train senior medical students as peer instructors for a combined ultrasound/physical exam curriculum and assessed junior medical students' perceptions of peer instruction relative to faculty. ⋯ Students' perception of peer instructors' teaching competency was equivalent to faculty instructors for the majority of sessions. Senior students who have completed an elective ultrasound rotation may serve as a useful resource for circumstances where the availability of skilled instructors is limited. However, further research is required to evaluate their effectiveness.
-
The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions. ⋯ The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum.