Differences in Self-expression Re ect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship

Abstract

IntroductionMedical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for emergency medicine (EM), but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student’s shift in an emergency department and that student’s clerkship performance.MethodsThe authors conducted a retrospective case series by analyzing the performance and reflective statements of 116 students from a single medical school who participated in a required EM clerkship at one or two of four clinical sites from 2013–14. After each shift, an attending emergency physician evaluated the student according to the RIME (Reporter-Interpreter-Manager-Educator) scheme. The authors developed software to extract the text from those comments, remove uninformative words and standardize the remaining words. The authors determined the most common words and two-word phrases that students used to describe their shift. The correlation between students’ final clerkship grades and the fraction of student comments with at least one content word was analyzed.ResultsOf the 145 possible students, 116 were included for analysis. The other 29 were excluded as they were visiting students who did not receive a final numeric grade. The correlation between final grade and the number of completed self-reflections was 0.32. The correlation between final grade and the average number of words in each self-reflection was 0.21. The first correlation is significantly greater than 0 (p=0.03, t-test), but the second correlation is not (p=0.16, t-test). The median final grade of those who wrote reflections on more than half of their shifts was significantly greater than those who wrote reflections half of the time, 83.675 versus 79.23 (p=0.05, 2-sample Kolmogorov-Smirnov test).ConclusionStudents who reflected more frequently received a higher grade in an EM clerkship for fourth-year medical students. The number of words in each reflection was not significantly correlated with grade performance. The most common words and phrases students wrote were associated with learning and managing patients.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016

“…Additionally, in the United States, CORD maintains a listserv of EM educators making the widespread administration of Internet‐based, education‐related surveys feasible. A small number of studies included in this review utilized qualitative methods, which is consistent with the critical appraisals from prior years, six in 2016, six in 2015, three in 2014, and seven in 2013.…”

“…Similar to prior years, the most common study populations were medical students (21/75; 28%) and residents (48/75; 64%) . Interestingly, this year only one study addressing medical students was highlighted for excellence, in contrast to prior years.…”

“…As the EM community has settled into the next accreditation system, there are likely fewer unanswered questions regarding this topic, which may account for this decline. In place of assessment we have seen the resurgence of studies evaluating teaching and learning methods, which comprised 36% of reviewed articles in 2014, was not seen in 2015 and now makes up 20% of the included articles in this year's review. Similarly, curriculum evaluation studies that made up 38% of studies in 2013 dropped to 10% in 2015 and have again risen to 20% in 2016.…”

An assessment of emotional intelligence in emergency medicine resident physicians

“…Medical education programs that encourage self-expression exist and typically approach learners through various artistic activities such as self-reflective exercises. 29 - 32 They have shown modest improvements in medical student EM clerkship performance. 32 …”