Educating Clerkship Students in the Era of Resident Duty Hour Restrictions

Nixon, L. James; Aiyer, Meenakshy; Durning, Steven J.; Gouveia, Chris; Kogan, Jennifer R.; Lang, Valerie J.; Cate, Olle ten; Hauer, Karen E.

doi:10.1016/j.amjmed.2011.03.019

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…However, students tended to entrust the organisation of learning processes in the clerkship to their teachers [ 32 , 33 ]. As a consequence, many learning processes are dependent on the time and resources physicians and other health care professionals allocated to their students [ 34 ] as well as their teaching behaviour [ 35 , 36 ]. Moreover, our findings acknowledge, that interprofessional learning experience fulfils an important role in the students’ clerkship experience, but these learning encounters were often not structured nor were clear learning objectives available [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reimer et al [37] reported on pre-clerkship students' perception of medical professionalism and how it changed over time. Thus our study concludes, that the medical clerkship can be seen as a social, institutional and professional arrangement: tors like ward organisation [4,8,34], the daily interaction with patients and other healthcare professionals, as well as the handling of different learning processes lead to the creation of an individual system of relationships and values shaping the students medical identity [8].…”

Section: Discussionmentioning

confidence: 99%

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Students’ perception and learning experience in the first medical clerkship

et al. 2022

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Background The German clerkship (“Famulatur”) is the first phase in medical education, in which students learn from a physician’s perspective. According to the German Licensing Regulations for Physicians, students shall “familiarise” with providing care. However, specific learning objectives for the clerkship are not defined, although the acquisition of different competencies is implicitly demanded. Therefore, an additional understanding of the clerkship students’ learning experience is needed. The goal of this study is to explore the student’s learning perspective and experiences in the clerkship. Methods Twelve guideline-based interviews were conducted with third year medical students. All participants completed their first clerkship. A qualitative content analysis was performed. The inductively identified categories were transferred into a quantitative questionnaire using a 5-point Likert-scale to explore their relevance in a validation cohort. The questionnaire was completed by 222 clinical students of the Otto-von-Guericke-Universität Magdeburg. Results The qualitative analysis led to 26 individual items assigned to 4 main categories that describe the clerkship experience: 1) “coping with insecurities”, 2) “the clerkship as a social arrangement”, 3) “the clerkship as a learning opportunity” and 4) “the clerkship as a teaching opportunity”. In the quantitative validation cohort, category one yielded a well-balanced result (median 3 = “neither agree nor disagree”; IQR 2–4), items addressed in categories 2–4 were generally supported by the students, predominantly selecting “strongly agree” or “agree” (Median 2; IQR 1–2 for each category). Students rated the role of the clinical team as especially important for their learning success and feared exclusion or negative reactions. Conclusions The medical clerkship provides an institutional, professional, and social framework, in which students are learning. Insecurities arose from curricular inconsistencies, a high dependency on the clinical team as well as the absence of specific learning objectives. Therefore, a better curricular integration regarding the semester structure and the learning objectives of the German clerkship is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Students’ perception and learning experience in the first medical clerkship

et al. 2022

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“…Residents provide more workforce hours, including less desirable night and weekend shifts, for a relatively low professional salary. 7 Residents are critical members of many hospital safety net programs 8,9 and teach junior residents and medical students, thereby relieving clinically productive faculty from some teaching duties. 10 In addition, GME programs provide a pipeline for faculty recruitment, which is particularly important in rural states.…”

Section: Introductionmentioning

confidence: 99%

Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests

Varaklis

Parker

Peck

et al. 2019

Journal of Graduate Medical Education

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Background In 2017, the Maine Medical Center Graduate Medical Education Committee received an unprecedented number of requests (n ¼ 18) to start new graduate medical education (GME) programs or expand existing programs. There was no process by which multiple programs could be prioritized to compete for scarce GME resources. Objective We developed a framework to strategically assess and prioritize GME program expansion requests to yield the greatest benefits for patients, learners, and the institution as well as to meet regional and societal priorities. Methods A systems engineering methodology called tradespace exploration was applied to a 6-step process to identify relevant categories and metrics. Programs' final scores were peer evaluated, and prioritization recommendations were made. Correlation analysis was used to evaluate the relevance of each category to final scores. Stakeholder feedback was solicited for process refinement. Results Five categories relevant to GME expansion were identified: institutional priorities, health care system priorities, regional and societal needs, program quality, and financial considerations. All categories, except program quality, correlated well with final scores (R 2 range 0.413-0.662). Three of 18 requested programs were recommended for funding. A stakeholder survey revealed that almost half of respondents (48%, 14 of 29) agreed that the process was unbiased and inclusive. Focus group feedback noted that the process had been rigorous and deliberate, although communication could have been improved. Conclusions Applying a systems engineering approach to develop institution-specific metrics for assessing GME expansion requests provided a reproducible framework, allowing consideration of institutional, health care system, and regional societal needs, as well as program quality and funding considerations.

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“…Duty-hour regulations have resulted in faculty and residents perceiving less time to teach students, reduced continuity of patient care, and decreased volume and variety of patient exposures for students. [8][9][10][11][12][13] Billing and medico-legal concerns have resulted in many institutions prohibiting students from using EHRs. 14 Medicine (APDIM) surveyed its members about the IM subinternship.…”

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confidence: 99%