Medical students as teachers and role models for their future colleagues

Medical schools seldom involve students in applicant recruitment. The authors describe the role of junior medical students in recruitment at the University of Ottawa, aiming to increase the Franco-Ontarian applicant pool for the French-language medical program. The students have designed workshops reflecting their study program and offered them, since 1997, to 719 Ontario French-language high school students and to 291 francophone undergraduate university students. The workshops emphasize role modeling by medical students who act as physician-teachers while attendees act as medical students. Evaluation measures include attendee surveys, medical student focus groups and faculty admissions statistics. Attendees give uniformly positive evaluations, highlighting the importance of role modeling. Medical students find teaching enjoyable and highly educational. Admissions statistics show that the Franco-Ontarian applicant pool has more than doubled in spite of an almost fourfold increase in tuition fees. This experience has shown that junior medical student involvement in recruitment activities can benefit both the trainees and their institution.     

Medical students as feedback assessors in a faculty development program: Implications for the future

Abstract

Background: Little is known about simulated students’ ability in assessing feedback received in Objective Structured Teaching Encounters (OSTEs). We aimed to assess to which extent students’ perceptions matched objective analysis regarding quality of received feedback, to explore what elements of feedback they emphasized and what they learned about feedback.

Methods: In this mixed-method study, 43 medical students participated as simulated residents in five OSTEs at Geneva University Hospitals. They assessed quality of feedback from faculty using a 15-item questionnaire and gave written/oral comments. Videotaped feedbacks were assessed using an 18-item feedback scale. During four focus groups, 25 students were asked about what they learned as feedback assessors.

Results: 453 students’ questionnaires and feedback scale were compared. Correlations were moderate for stimulating self-assessment (0.48), giving a balanced feedback (0.44), checking understanding (0.47) or planning (0.43). Students’ feedback emphasized elements such as faculty’s empathy or ability to give concrete advice. They reported that being a feedback assessor helped them to realize importance of making the learner active and that giving effective feedback required structure and skills.

Conclusion: Medical students may identify quality of feedback. Involving them in OSTEs could be interesting to train them to become valid raters of supervisors’ teaching skills.     

Twelve tips for the recruitment and retention of general practitioners as teachers of medical students

Background: Primary care physicians have become a fundamental aspect of teaching in modern medical school curricula worldwide with a significant proportion of undergraduate teaching taking place in primary care. There are calls for this to increase with more patient care occurring in the community but teaching capacity in primary care is a potential challenge. Medical schools, therefore, need strategies to be able to increase their primary care physician teaching workforce.

Methodology: We asked all Heads of General Practice Teaching in UK medical schools to share their three top tips for recruiting and retaining GPs to teach undergraduate students. The majority (two-thirds) of medical schools responded and we have summarized the answers into the following twelve tips.

Results: Although the twelve tips are varied and comprehensive, including broad topics such as finances and training, one clear theme running through the majority of tips is good communication and relationships between education teams and GPs.

Conclusions: The solutions to recruiting and retaining GPs to teach undergraduate medical students are clearly multifactorial and complex. We hope that by presenting suggestions from UK GP heads of teaching as these twelve tips provides some helpful, thought-provoking ideas and inspiration for both the UK and internationally.     

AMEE Medical Education Guide No. 24: Portfolios as a method of student assessment

This guide is intended to inform medical teachers about the use of portfolios for student assessment. It provides a background to the topic, reviews the range of assessment purposes for which portfolios have been used, identifies possible portfolio contents and outlines the advantages of portfolio assessment with particular focus on assessing professionalism. The experience of one medical school, the University of Dundee, is presented as a case study. The current state of understanding of the technical, psychometric issues relating to portfolio assessment is clarified. The final part of the paper provides a practical guide for those wishing to design and implement portfolio assessment in their own institutions. Five steps in the portfolio assessment process are identified: documentation, reflection, evaluation, defence and decision. It is concluded that portfolio assessment is an important addition to the assessor's toolkit. Reasons for using portfolios for assessment purposes include the impact that they have in driving student learning and their ability to measure outcomes such as professionalism that are difficult to assess using traditional methods.     

A Best Evidence in Medical Education systematic review to determine the most effective teaching methods that develop reflection in medical students: BEME Guide No. 51

Introduction: Reflection is thought to be an essential skill for physicians. Although much has been written about it, there is little concurrence about how to best teach reflection in medical education. The aim of this review was to determine: (i) which educational interventions are being used to develop reflection, (ii) how is reflection being assessed, and (iii) what are the most effective interventions.

Methods: Inclusion criteria comprised: (i) undergraduate medical students, (ii) a teaching intervention to develop reflection, and (iii) assessment of the intervention. A review protocol was developed and nine databases were searched. Screening, data extraction, and analysis procedures were performed in duplicate. Due to the heterogeneity of studies, a narrative synthesis approach was performed for the study analysis.

Results: Twenty-eight studies met the inclusion criteria. The interventions in these studies had at least of two of the following components related to reflection: (i) introduction, (ii) trigger, (iii) writing, (iv) guidelines, (v) small group discussion, (vi) tutor and (vii) feedback. Three validated rubrics were used to assess reflective writing in these studies.

Conclusions: The strongest evidence from studies in this review indicates that guidelines for, and feedback on, reflective writing improve student reflection.     

Medical students’ perception of behaviors in the clinical learning environment evolve with increasing clinical exposure as measured with situational video vignettes

Abstract

This cross-sectional study involved matriculating, mid-level and graduating medical students (n?=?723) who participated in specific transition courses in our medical school curriculum between August 2016 and March 2019. We used a mixed-methods approach (survey and analysis of narrative comments) to study the evolution in perception of the learning environment by medical students with increasing clinical exposure using four different video vignettes. Differences in student perceptions of mistreatment exists at various levels of training. Compared to graduating students, matriculating students were more likely to perceive reprimanding a student on being late as appropriate behavior (80.5% vs 53.3%, p?=?0.001), whereas a significantly higher proportion of the graduating students (15.3%, p?=?0.001) perceived it as mistreatment. A majority of the matriculating students (84%, p?=?0.001) considered the case of an eager student as mistreatment, while a significantly higher proportion of the graduating students (59.5%, p?=?0.001) did not think it was mistreatment. Qualitative analysis of comments from students at different stages of training displayed an increased appreciation of their professional responsibilities and nuanced appreciation of body language and tone as contributing factors in determining whether a situation represented inappropriate behavior. Our results demonstrate that students’ perceptions of inappropriate behaviors evolve with increased clinical exposure.     

Change in attitudes to psychiatry and intention to pursue psychiatry as a career in newly qualified doctors: a follow-up of two cohorts of medical students

This follow-up study of 234 doctors examined whether improvements in attitudes to psychiatry following an undergraduate psychiatry attachment were maintained after graduation, and explored the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career. Improvements in attitudes following undergraduate psychiatric attachment decayed over time but remained higher than pre-attachment levels. Attitudes of doctors who definitely intended to pursue psychiatry, however, increased at each stage. Attitudes of doctors were predicted by post-attachment attitudes, which in turn were predicted by encouragement from consultants and influences of specialist registrars during the attachment at medical school. There were no differences between a problem-based and a traditional psychiatry curriculum in attitude change. The findings suggest that encouragement during medical school from more senior doctors increases the numbers wanting to pursue psychiatry and may increase the number who subsequently pursue psychiatry as a career.