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Background and Objectives: The Rural Physician Associate Program (RPAP) at the University of Minnesota Medical School (UMMS) is a 9-month rural longitudinal integrated clerkship (LIC) for third-year medical students built on a foundation of family medicine. The purpose of this study was to examine the relationships between participation in the RPAP program and the desired workforce outcomes of practice in Minnesota, primary care specialty (particularly family medicine), and rural practice.Methods: We analyzed workforce outcomes for UMMS graduates who completed postgraduate training between 1975 and 2017, comparing RPAP participants (n=1,217) to noparticipants (n=7,928). We identified graduates through internal UMMS databases linked to the American Medical Association (AMA) Physician Masterfile and the National Provider Identifier (NPI) registry. We identified workforce outcomes of rural practice, practice in Minnesota, primary care specialty, and family medicine specialty based on practice specialty and practice location data available through the AMA and NPI data sets.Results: Proportionally, more RPAP graduates practice in state (65.7% vs 54.4%, P<.01), in primary care (69.0% vs 33.4%, P<.01), in family medicine (61.1% vs 17.3%, P<.01), and rurally (41.2% vs 13.9%, P<.01) than non-RPAP graduates.Conclusions: We demonstrate a significant association between participation in RPAP and a career in family medicine, rural practice, and primary care, all outcomes that promote meeting urgent rural workforce needs. [ABSTRACT FROM AUTHOR]

Background: Diagnostic error is a major problem in health care, yet there are few medical school curricula focused on improving the diagnostic process and decreasing diagnostic errors. Effective strategies to teach medical students about diagnostic error and diagnostic safety have not been established. Methods: We designed, implemented and evaluated a virtual patient module featuring two linked cases involving diagnostic errors. Learning objectives developed by a consensus process among medical educators in the Society to Improve Diagnosis in Medicine (SIDM) were utilized. The module was piloted with internal medicine clerkship students at three institutions and with clerkship faculty members recruited from listservs. Participants completed surveys on their experience using the case and a qualitative analysis was performed. Results: Thirty-five medical students and 25 faculty members completed the survey. Most students found the module to be relevant and instructive. Faculty also found the module valuable for students but identified insufficient curricular time as a barrier to implementation. Conclusions: Medical students and faculty found a prototype virtual patient module about the diagnostic process and diagnostic error to be educational. [ABSTRACT FROM AUTHOR]

Background Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination ( HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Context First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. Innovation First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. Implications An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. [ABSTRACT FROM AUTHOR]

AbstractProblem: Misleading health information is detrimental to public health. Even physicians can be misled by biased health information; however, medical students and physicians are not taught some of the most effective techniques for identifying bias and misinformation online. Intervention: Using the stages of Kolb’s experiential learning cycle as a framework, we aimed to teach 117 third-year students at a United States medical school to apply a fact-checking technique for identifying bias and misinformation called “lateral reading” through a 50-minute learning cycle in a 90-minute class. Each student’s concrete experience was to independently read a biased article and rate its credibility, demonstrating their baseline skills at identifying bias. Students were given structured opportunities for reflective observation through individual and large group discussion. Students were guided through abstract conceptualization to determine techniques and frameworks utilized by fact checkers, specifically “lateral reading”—utilizing the internet to research the background of the author, organization, and citations using independent sources before exploring the article itself in depth. Students’ active experimentation included re-rating the credibility of the same article and discussing further implications with classmates and instructors. Context: In January 2020, sessions were offered to third-year medical students during their required, longitudinal transition-to-residency course. Impact: Compared to baseline, when using lateral reading, students deemed the article less credible. Students’ active experimentation changed whether they identified the organization and sources behind the article as credible. Notably, 86% (53/62) of students who viewed the organization positively pre-intervention did not describe the organization positively post intervention. Similarly, 66% (36/55) of students who cited the sources as positive pre-exercise changed their assessment after the exercise. While three students mentioned the author negatively pre-intervention, none of the 21 students who described the author in a negative fashion post-intervention described the author negatively pre-intervention. Positively describing the organization, author, or sources pre-intervention correlated with differences in credibility rating after the intervention. These findings indicate that teaching students to read laterally may increase their ability to detect bias in online medical information. Lessons Learned: Further research is needed to determine whether students who learned lateral reading via experiential learning will apply this skill in their education and career. Additionally, research should assess whether this skill helps future physicians counter bias and misinformation in ways that improve health. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Clerkship grades are a component of determining a residency candidate's competitiveness. In 2017, the University of Minnesota Medical School's pediatric clerkship transitioned its standardized multiple-choice exam, the Aquifer Pediatrics Examination, to pass/fail with eligibility for honors being determined by clinical performance, not exam performance. We assessed the effect this change had on Aquifer exam performance and evaluated for correlation between Aquifer exam performance and clinical evaluation scores in order to gather insight into the validity of each type of assessment with respect to one another. METHODS: We analyzed de-identified data from 750 medical students between the academic years of 2016 to 2017 and 2019 to 2020. Individual Aquifer exam scores were compared to individual clinical performance scores. Differences in exam performance before and after the transition to pass/fail were investigated with a two-sample t -test and Cohen's d for effect size. RESULTS: No correlation was found between Aquifer exam scores and clinical performance scores. The mean Aquifer exam score prior to the transition to pass/fail was 80.02 ± 7.51 while the mean after the exam was made pass/fail was 77.8 ± 7.42. This difference was statistically significant (P <.001) with a Cohen's d (effect size) of 0.297. CONCLUSIONS: A lack of correlation between the Aquifer exam scores and clinical performance scores was found. There was a small yet statistically significant decrease in Aquifer exam scores after the change to pass/fail; it is not clear if this represents a meaningful decrease in learning by students. [ABSTRACT FROM AUTHOR]

In this article, the author focuses on the teaching hospital in the U.S. He states that academic medical service provides students and house staff to present the subjective and objective data about their patients and they learn about the importance of clinical data. He mentions that one can learn diagnostic testing and other methods from the presentations showed during medical teaching. He further states that physicians use slow physical examination methods to know the exact problem with a patient and then suggest proper treatment methods according to the symptoms they have found in the patient.

OBJECTIVES: Medical students are increasingly using a spaced repetition software called Anki to study. There are limited studies evaluating the relationship between Anki and learner outcomes. In this study, we describe the history of Anki use in medical school and assess the potential relationships between use of Anki and medical student academic, extracurricular, and wellness outcomes. METHODS: We used cross-sectional data from a 50-item online survey and retrospective academic performance data from our institution's outcomes database. Participants were medical students. The survey assessed the frequency and timing of Anki use, student perceived stress, sleep quality, burnout risk, and involvement in extracurricular activities. Academic success was measured by USMLE Step 1 and Step 2 scores. RESULTS: 165 students responded survey. 92 (56%) identified as daily Anki users. Daily Anki use was correlated with increased Step 1 score (P =.039), but not Step 2 scores. There was an association between Anki use and increased sleep quality (P =.01), but no difference for other measurements of wellness or extracurricular involvement. CONCLUSION: The study demonstrates potential benefits of daily use of Anki but also confirms that a variety of study methods can be used to achieve similar medical school outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Many physicians care for patients whose primary spoken language is not English, and these interactions present challenges in physician-patient communication. These challenges contribute to the significant health disparities experienced by populations with limited English proficiency (LEP). Using trained medical interpreters is an important step in addressing this problem, as it improves communication outcomes. Despite this, many medical education programs have little formal instruction on how to work effectively with interpreters. Methods: To address this gap, we created an interactive workshop led by professional trained interpreters and faculty facilitators for medical students in their clinical years. Students were asked to evaluate the session based on relevance to their clinical experiences and helpfulness in preparing them for interactions with patients with LEP. Results: Immediately after the session, students reported that the clinical scenarios presented were similar those seen on their clinical clerkships. They also reported increased confidence in their ability to work with interpreters. On later follow-up, students reported that the instruction helped prepare them for subsequent patient interactions that involved interpreters. Conclusion: A workshop is an effective method for improving medical student comfort and confidence when working with interpreters for populations with LEP. [ABSTRACT FROM AUTHOR]