Standard ED-2 of the Liaison Committee on Medical Education (LCME) requires medical schools to specify the types of patients that students should encounter, the student's level of responsibility, and the appropriate setting for the encounter. The authors describe the process at Joan and Sanford I. Weill Medical College of Cornell University in New York City for meeting this standard through the development of a Web-based case log. The log permits the medical college to specify expectations for patient encounters and allows the students to record their encounters in an efficient, brief, and user-friendly manner. By downloading the student's reports directly into a database, the medical college can track successes and deficiencies in the student's clinical experiences. However, in response to a questionnaire administered in 2005, students generally expressed dissatisfaction with the case logs, which they described as intrusive busywork.
BackgroundThe neurologic examination is a challenging component of the physical examination for medical students. In response, primarily based on expert consensus, medical schools have supplemented their curricula with standardized patient (SP) sessions that are focused on the neurologic examination. Hypothesis-driven quantitative data are needed to justify the further use of this resource-intensive educational modality, specifically regarding whether using SPs to teach the neurological examination effects a long-term benefit on the application of neurological examination skills.MethodsThis study is a cross-sectional analysis of prospectively collected data from medical students at Weill Cornell Medical College. The control group (n=129) received the standard curriculum. The intervention group (n=58) received the standard curriculum and an additional SP session focused on the neurologic examination during the second year of medical school. Student performance on the neurologic examination was assessed in the control and intervention groups via an OSCE administered during the fourth year of medical school. A Neurologic Physical Exam (NPE) score of 0.0 to 6.0 was calculated for each student based on a neurologic examination checklist completed by the SPs during the OSCE. Composite NPE scores in the control and intervention groups were compared with the unpaired t-test.ResultsIn the fourth year OSCE, composite NPE scores in the intervention group (3.5±1.1) were statistically significantly greater than those in the control group (2.2±1.1) (p<0.0001).ConclusionsSP sessions are an effective tool for teaching the neurologic examination. We determined that a single, structured SP session conducted as an adjunct to our traditional lectures and small groups is associated with a statistically significant improvement in student performance measured 2 years after the session.
PurposeFirst-year students negotiate new professional culture with a certain amount of excitement and anxiety. There are different approaches for offering guidance. In this study, the authors present Weill Cornell Medical College's experience with an advising program for first- and second-year students.MethodsFifty faculty advisors were each assigned 1–3 first-year students who they would follow for 2 years. The responsibilities were outlined to both faculty and students. The program was evaluated using an anonymous questionnaire.ResultsFor the two classes surveyed (2011 and 2012), most students met their advisors once. For both classes, the most frequently discussed issues were general adjustment to medical school, academic life, and the professional life of the advisor. Summer research and career opportunities were also discussed. Most students were satisfied with the advising program. Satisfaction increased with an increase in visits. Most students who did not meet their advisors established an advisor relationship on their own.ConclusionsAn advising program was established at Weill Cornell Medical College that satisfied most of the students. It is important to evaluate its format regularly, from both student and advisor perspectives, in order to ensure its continued success.
Students and preceptors may not agree on students' achievement of course goals. Furthermore, despite students' high ratings of global satisfaction and learning, and despite their satisfactory performance of physical examination skills, their ratings of post-course performance may be affected by pre-course expectations. The authors suggest that questionnaires assessing students' and preceptors' perceptions of students' achievement of specific goals should be independently verified before making decisions to modify objectives and activities in these kinds of courses.
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