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Background:Entrustable professional activities (EPAs) were introduced as a principle for individualized physician assistant (PA) workplace curricula at the University of Applied Sciences (UAS) Utrecht in 2008. We studied how the focus on EPAs served the competency-based flexibility intention of the program. Methods:We analyzed data of those 119 students who enrolled in the program 2010 through 2013, and completed the program before April 2016. We analyzed the number of EPAs per student at start and end of the program, number changed during training and the reasons for change. Results:Data of 101 students were suitable for evaluation. Excluded were 16 students ending the program prematurely and two with study delay. Mean number of EPAs per student at the start was 6.8 (range 4–12) and at the end 6.6 (range 3–13). On average 1.5 EPAs were altered (range 0–13). Reasons included extension of the EPA package during training (n = 10), lack of proficiency at planned moments of summative entrustment decisions (n = 9) and procedures not being suitable for PAs at closer look (n = 6). All changes resulted in a curriculum meeting the school’s standards for graduation. Conclusions:The flexibility of the EPA concept enabled changes in the individualized curriculum of students, according to the intended competency-based nature of the educational program. [ABSTRACT FROM PUBLISHER]

The global population is ageing and consequently cognitive problems are increasingly prevalent. To ensure that the healthcare needs of this complex group are met, healthcare professionals must receive adequate training in this field. There are, however, a variety of reasons why this is not currently being achieved, including, but not limited to: ethical and logistical issues relating to the delivery of educational experiences involving cognitively impaired patients; a failure of curricula to keep pace with the changing demographic; societal and institutional ageism; and the inherent complexity of the conditions. This article highlights challenges associated with the delivery of such training to medical undergraduates and presents strategies to tackle these. Drawing on current evidence where available, the 12 tips below offer educators practical advice on how to maximize the value of medical undergraduates’ educational experiences with cognitively impaired patients. [ABSTRACT FROM PUBLISHER]

Educators frequently learn together in cross cultural settings such as at international conferences. Cultural differences should influence how educational programs are designed and delivered to effectively support learning; cultural sensitivity and the competence to deal with such differences are important skills for health professions educators. Teaching without this approach may lead to lost learning opportunities. This article provides twelve tips for educators to consider when planning and delivering formal presentations (e.g. lectures and workshops) in cross cultural settings. The tips were constructed based on a literature review, the authors’ experience, and interviews with international educators who frequently deliver and receive education in cross cultural settings. The tips are divided into three phases: (1) preparation for the session to optimize learners’ experience (2) interaction when delivering the session and (3) reflection on the experience. [ABSTRACT FROM PUBLISHER]

Background: Medical certificates influence the distribution of economic benefits in welfare states; however, the qualitative aspects of these texts remain largely unexplored. The present study is the first systematic investigation done of these texts. Our aim was to investigate how GPs select and mediate information about their patients' health and how they support their conclusions about illness, functioning and fitness for work in medical certificates. Methods: We performed a textual analysis of thirty-three medical certificates produced by general practitioners (GP) in Norway at the request of the Norwegian Labour and Welfare Administration (NAV).The certificates were subjected to critical reading using the combined analytic methods of narratology and linguistics. Results: Some of the medical information was unclear, ambiguous, and possibly misleading. Evaluations of functioning related to illness were scarce or absent, regardless of diagnosis, and, hence, the basis of working incapacity was unclear. Voices in the text frequently conflated, obscuring the source of speaker. In some documents, the expert's subtle use of language implied doubts about the claimant's credibility, but explicit advocacy also occurred. GPs show little insight into their patients' working lives, but rather than express uncertainty and incompetence, they may resort to making too absolute and too general statements about patients' working capacity, and fail to report thorough assessments. Conclusions: A number of the texts in our material may not function as sufficient or reliable sources for making decisions regarding social benefits. Certificates as these may be deficient for several reasons, and textual incompetence may be one of them. Physicians in Norway receive no systematic training in professional writing. High-quality medical certificates, we believe, might be economical in the long term: it might increase the efficiency with which NAV processes cases and save costs by eliminating the need for unnecessary and expensive specialist reports. Moreover, correct and coherent medical certificates can strengthen legal protection for claimants. Eventually, reducing advocacy in these documents may contribute to a fairer evaluation of whether claimants are eligible for disability benefits or not. Therefore, we believe that professional writing skills should be validated as an important part of medical practice and should be integrated in medical schools and in further education as a discipline in its own right, preferably involving humanities professors. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives The purpose of medical education is to produce competent and capable professional practitioners who can combine the art and science of medicine. Moreover, this process must prepare individuals to practise in a field in which knowledge is increasing and the contexts in which that knowledge is applied are changing in unpredictable ways. The 'basic sciences' are important in the training of a physician. The goal of basic science training is to learn it in a way that the material can be applied in practice. Much effort has been expended to integrate basic science and clinical training, while adding many other topics to the medical curriculum. This effort has been challenging. The aims of the paper are (1) to propose a unifying conceptual framework that facilitates knowledge integration among all levels of living systems from cell to society and (2) illustrate the organizing principles with two examples of the framework in action - cybernetic systems (with feedback) and distributed robustness. Methods Literature related to hierarchical and holarchical frameworks was reviewed. Results An organizing framework derived from living systems theory and spanning the range from molecular biology to health systems management was developed. The application of cybernetic systems to three levels (regulation of pancreatic beta cell production of insulin, physician adjustment of medication for glycaemic control and development and action of performance measures for diabetes care) was illustrated. Similarly distributed robustness was illustrated by the DNA damage response system and principles underlying patient safety. Conclusions Each of the illustrated organizing principles offers a means to facilitate the weaving of basic science and clinical medicine throughout the course of study. The use of such an approach may promote systems thinking, which is a core competency for effective and capable medical practice. [ABSTRACT FROM AUTHOR]

Background: The surprise question is a validated tool for identifying patients with increased risk of death within one year who could, therefore, benefit from palliative care. However, its utility in surgery is unknown. Objective: We sought to determine whether the surprise question predicted 12-month mortality in older emergency general surgery patients. Design: This was a prospective cohort study. Setting/Subjects: Emergency general surgery attendings and surgical residents in or beyond their third year of training at a single tertiary care academic hospital from January to July 2014. Measurements: Surgeons responded to the surprise question within 72 hours of evaluating patients, ≥65 years, hospitalized with an acute surgical condition. Patient data, including demographic and clinical characteristics, were extracted from the medical record. Mortality within 12 months of initial evaluation was determined by using Social Security death data. Results: Ten attending surgeons and 18 surgical residents provided 163 responses to the surprise question for 119 patients: 60% of responses were 'No, I would not be surprised' and 40% were 'Yes, I would be surprised.' A 'No' response was associated with increased odds of death within 12 months in binary logistic regression (OR 4.8 [95% CI 2.1-11.1]). Conclusions: The surprise question is a valuable tool for identifying older patients with higher risk of death, and it may be a useful screening criterion for older emergency general surgery patients who would benefit from palliative care evaluation. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that pediatricians in all stages of training are uncomfortable managing patients at end of life. Our goal was to create and test a portable reference card to improve pediatric resident education in comprehensive care for children nearing end of life. Methods: We evaluated the impact of the Pediatric End-of-Life Care Management Reference Card on residents' perceived comfort and knowledge through pre- and post-intervention surveys. The preintervention questionnaires and pocket cards were distributed to all first- and second-year residents, and then a follow-up survey was provided six months later. Based on Likert scales, questions focused on self-reported understanding of palliative care principles and knowledge regarding and comfort in performing end-of-life symptom management. Results: Twenty-six pediatric residents completed pre- and post-intervention surveys. Following receipt of the reference card, no significant changes were noted consistently across all groups of residents. The majority of improvements were noted when comparing second to third year residents, including knowledge and comfort related to pain management, comfort in managing secretions and nausea, and documentation following death. The first to second year residents demonstrated improvement in knowing what language to use to tell a family that their child has died. Conclusion: This study demonstrates that a portable reference card may be a convenient, simple, and useful component of education for pediatric residents in end-of-life care management. This reference card is a foundation from which to develop a standardized educational tool. Additional research is required to assess the impact of this type of intervention in pediatric palliative care education. [ABSTRACT FROM AUTHOR]

The article presents succinct summaries of selected medical education articles published in internal medicine journals including academic medicine, teaching and learning in medicine, and medical education.

Number of appearances in the bottom quartile of 1st-year medical school exams were used to represent the extent to which students were having academic difficulties. Medical educators have long expressed a desire to have indicators of medical student performance that have strong predictive validity. Predictors traditionally used fell into 4 general categories: demographic (e.g., gender), other background factors (e.g., college major), performance/aptitude (e.g., medical college admission test scores), and noncognitive factors (e.g., curiosity). These factors, however, have an inconsistent record of predicting student performance. In comparison to traditional predictive factors, we sought to determine the extent to which academic performance in the 1st-year of medical school, as measured by examination performance in the bottom quartile of the class in 7 required courses, predicted later performance on a variety of assessments, both knowledge based (e.g., United States Medical Licensing Examination Step 1 and Step IICK) and clinical skills based (e.g., clerkship grades and objective structured clinical exam performance). Of all predictors measured, number of appearances in the bottom quartile in Year 1 was the most strongly related to performance in knowledge-based assessments, as well as clinically related outcomes, and, for each outcome, bottom-quartile performance accounted for additional variance beyond that of the traditional predictors. Low academic performance in the 1st year of medical school is a meaningful risk factor with both predictive validity and predictive utility for low performance later in medical school. The question remains as to how we can incorporate this indicator into a system of formative assessment that effectively addresses the challenges of medical students once they have been identified. [ABSTRACT FROM PUBLISHER]

Theory: Although medical students are exposed to a variety of emotions, the impact of emotions on learning has received little attention so far. Shame-provoking intimate examinations are among the most memorable events for students. Their emotions, however, are rarely addressed during training, potentially leading to withdrawal and avoidance and, consequently, performance deficits. However, emotions of negative valance such as shame may be particularly valuable for learning, as they might prompt mental rehearsal. We investigated the effect of shame on learning from the perspective of cognitive load theory.Hypotheses: We hypothesized that (a) training modality determines state shame, (b) state shame directly affects the quality of a clinical breast examination as one example of a shame-provoking exam, and (c) students who experience shame during training outperform those who just discuss the emotion during subsequent performance assessments.Method: Forty-nine advanced medical students participated in a randomized controlled, single-blinded study. After a basic, low-fidelity breast examination training, students were randomized to further practice either on a high-fidelity mannequin including a discussion of their emotions or by examining a standardized patient's real breasts. Last, all students conducted a breast examination in a simulated doctor's office. Dependent variables were measures of outcome and process quality and of situational shame. Results: Students training with a standardized patient experienced more shame during training (p< .001,d= 2.19), spent more time with the patient (p= .005,d= 0.89), and documented more breast lumps (p= .026,d= 0.65) than those training on a mannequin. Shame interacted with training modality,F(1, 45) = 21.484,p< .001, η2= 0.323, and differences in performance positively correlated to decline in state shame (r= .335,p= .022).Conclusions: Students experiencing state shame during training do reenact their training and process germane load—in other words, learn. Furthermore, altering simulation modality offers a possibility for educators to adjust the affective component of training to their objectives. [ABSTRACT FROM AUTHOR]

Phenomenon. As one of the most common chronic disease affecting adults and children, obesity is a major contributor to noncommunicable diseases, both nationally and globally. Obesity adversely affects every organ system, and as such it is imperative that the United States Medical Licensing Examination (USMLE) adequately assesses students' knowledge about the science and practice of obesity management. The purpose of this study was to evaluate the coverage and distribution of obesity-related items on the three USMLE Step examinations.Approach. Examination items that included obesity-related keywords were identified by National Board of Medical Examiners (NBME) staff. A panel of 6 content experts evaluated all items and coded obesity-relevant items using the American Board of Obesity Medicine (ABOM) test outline rubric into 4 domains and 107 subdomains.Findings. There were 802 multiple-choice items containing obesity-related keywords identified by NBME, of which 289 (36%) were identified as being relevant to obesity and were coded into appropriate domains and subdomains. Among the individual domains, the Diagnosis & Evaluation domain comprised most of the items (174) for all 3 Step examinations. Fifty-eight percent of items were represented by 4 of 17 organ systems, and 80% of coded items were represented by 6 ABOM subdomains. The majority of obesity-coded items pertained to the diagnosis and management of obesity-related comorbid conditions rather than addressing the prevention, diagnosis, or management of obesity itself.Insights. The most important concepts of obesity prevention and treatment were not represented on the Step exams. Exam items primarily addressed the diagnosis and treatment of obesity-related comorbid conditions instead of obesity itself. The expert review panel identified numerous important obesity-related topics that were insufficiently addressed or entirely absent from the examinations. The reviewers recommend that the areas identified for improvement may promote a more balanced testing of knowledge in obesity. [ABSTRACT FROM PUBLISHER]

Phenomenon: There is growing concern over racial/ethnic bias in clinical care, yet how best to reduce bias remains challenging, in part because the sources of bias in medical education are poorly understood. One possible source is the routinized use of race/ethnicity in lectures, assessment, and preparatory materials, including question banks for licensing examinations. Because students worldwide use question banks to prepare for the United States Medical Licensing Examination, we examined how race/ethnicity was used in one of the most commonly recommended question banks.Approach: We analyzed the use of race/ethnicity in all 2,211 questions in a question bank for Step 1 of the United States Medical Licensing Examination for the following: the frequency of mentions of racial/ethnic groups, whether the use of race/ethnicity was merely descriptive or was central to any part of the question, and whether the question associated race/ethnicity with genetic difference.Findings.In sum, 455 of the 2,011 (20.6%) of the questions in the question bank referred to race/ethnicity in the question stem, answer, or educational objective. The frequency of mentions of racial/ethnicity was disproportionate to the U.S. population: 85.8% referred to White/Caucasians, 9.70% to Black/African Americans, 3.16% to Asian, 0.633% to Hispanics, and 0.633% to Native Americans. No cases referred to Native Hawaiians/Pacific Islanders. The proportion of mentions of race/ethnicity classified as either a routine descriptor or central to the case varied by racial/ethnic category. The association between genetics and disease in cases also varied by racial/ethnic category.Insights.The routinized use of race/ethnicity with no specific goal in preparation materials, such as question banks, risks contributing to racial bias. The implications of routinized use extend to assessment in medical education. Race/ethnicity should be used only when referring to social experiences of groups relevant to their health, not as a proxy for genetics, social class, or culture. [ABSTRACT FROM PUBLISHER]

Problem: Training the next generation of health professionals requires leaders, innovators, and scholars in education. Although many medical schools and residencies offer education electives or tracks focused on developing teaching skills, these programs often omit educational innovation, scholarship, and leadership and are narrowly targeted to one level of learner. Intervention: The University of California San Francisco created the Health Professions Education Pathway for medical students, residents, and fellows as well as learners from other health professional schools. The Pathway applies the theoretical framework of communities of practice in its curricular design to promote learner identity formation as future health professions educators. It employs the strategies ofengagement, imagination, andalignmentfor identity formation. Context: Through course requirements, learnersengageand work with members of the educator community of practice to develop the knowledge and skills required to participate in the community. Pathway instructors are faculty members who model a breadth of educator careers to help learnersimaginepersonal trajectories. Last, learners complete mentored education projects, adopting scholarly methods and ethics toalignwith the broader educator community of practice. Outcome: From 2009 to 2014, 117 learners participated in the Pathway. Program evaluations, graduate surveys, and web-based searches revealed positive impacts on learner career development. Learners gained knowledge and skills for continuedengagementwith the educator community of practice, confirmed their career aspirations (imagination), joined an educator-in-training community (engagement/imagination), and disseminated via scholarly meetings and peer-reviewed publications (alignment). Lessons Learned: Learners identifiedengagementwith the learner community as the most powerful aspect of the Pathway; it provided peer support forimaginingand navigating the development of their dual identities in the clinician and educator communities of practice. Also important for learner success wasalignmentof their projects with the goals of the local educator community of practice. Our community of practice approach to educator career development has shown promising early outcomes by nurturing learners' passion for teaching; expanding their interest in educational leadership, innovation, and scholarship; and focusing on their identity formation as future educators. [ABSTRACT FROM PUBLISHER]

Theory:Empathy is one component of medical student education that may be important to nurture, but there are many potential psychological barriers to empathy, such as student depression, burnout, and low quality of life or wellness behaviors. However, few studies have addressed how positive behaviors such as wellness and spirituality, in combination with these barriers, might affect empathy.Hypotheses:We hypothesized a negative relationship between psychological distress and empathy, and a positive relationship between empathy and wellness behaviors. We also hypothesized that openness to others' spirituality would moderate the effects of psychological distress on empathy in medical students.Method:This cross-sectional study included 106 medical students in a public medical school in the U.S. Midwest. Mailed questionnaires collected student information on specialty choice and sociodemographics, empathy, spirituality openness, religiosity, wellness, burnout, depression, anxiety, and stress. Hierarchical multiple regression analysis was conducted, with empathy as the dependent variable, psychological distress and all wellness behaviors as predictors, and spirituality openness as a moderator.Results:Specialty choice, burnout, wellness behaviors, spirituality openness, and religiosity were significant independent predictors of empathy. In addition, when added singly, one interaction was significant: Spirituality Openness × Depression. Spirituality openness was related to empathy only in nondepressed students. Empathy of students with higher levels of depression was generally lower and not affected by spirituality openness.Conclusions:Nondepressed students who reported lower openness to spirituality might benefit most from empathy training, because these students reported the lowest empathy. Highly depressed or disengaged students may require interventions before empathy can be addressed. In addition, burnout was related to lower levels of empathy and wellness was related to higher levels. These provide potential points of intervention for medical schools developing tools to increase medical trainees' empathy levels. [ABSTRACT FROM PUBLISHER]

Problem: Leadership is increasingly recognized as a core physician competency required for quality patient care, continual system improvement, and optimal healthcare team performance. Consequently, integration of leadership into medical school curriculum is becoming a priority. This raises the question of the appropriate context, timing, and pedagogy for conveying this competency to medical students.Intervention: Our program introduced a 1-week leadership course grounded in business pedagogy to Year 1 medical students. The curriculum centred on four themes: (a) Understanding Change, (b) Effective Teamwork, (c) Leading in Patient Safety, and (d) Leadership in Action. Post-curriculum qualitative student feedback was analyzed for insight into student satisfaction and attitude towards the leadership course content.Context: The Undergraduate Medical Education program of the Schulich School of Medicine & Dentistry, Western University, is delivered over 4 years across 2 campuses in London and Windsor, Ontario, Canada. Course structure moved from traditional passive lectures to established business pedagogy, which involves active engagement in modules, case-based discussions, insights from guest speakers, and personal reflection.Outcome: A student-led survey evaluated student opinion regarding the leadership course content. Students valued career development reading materials and insights from guest speakers working in healthcare teams. Students did not relate to messages from speakers in senior healthcare leadership positions. Course scheduling late in the second semester was viewed negatively. Overall student opinion suggested that the 1-week course was suboptimal for establishing leadership principles and translated business pedagogy was ineffective in this context.Lessons Learned: Leadership curriculum in Undergraduate Medical Education should be grounded in a healthcare context relevant to the student's stage of training. Student engagement may be better supported if leadership is framed as a competency throughout their career. Schools considering such innovations could draw lessons from other professional schools and utilize material and faculty that resonate with students. [ABSTRACT FROM PUBLISHER]

Introduction: A standardized team-training program for healthcare professionals in obstetric units was developed based on an analysis of common causes for adverse events found in claims registries. The interdisciplinary and interprofessional training concept included both technical and non-technical skill training. Evaluation of the program was carried out in hospitals with respect to the immediate personal learning of participants and also regarding changes in safety culture. Methods: Trainings in n = 7 hospitals including n = 270 participants was evaluated using questionnaires. These were administered at four points in time to staff from participating obstetric units: (1) 10 days ahead of the training (n = 308), (2) on training day before (n = 239), (3) right after training (n = 248), and (4) 6 months after (n = 188) the intervention. Questionnaires included several questions for technical and non-technical skills and the Hospital Survey on Patient Safety (HSOPS). Results: Strong effects were found in the participants' perception of their own competence regarding technical skills and handling of emergencies. Small effects could be observed in the scales of the HSOPS questionnaire. Most effects differed depending on professional groups and hospitals. Conclusions: Integrated technical and team management training can raise employees' confidence with complex emergency management skills and processes. Some indications for improvements on the patient safety culture level were detected. Furthermore, differences between professional groups and hospitals were found, indicating the need for more research on contributing factors for patient safety and for the success of crew resource management (CRM) trainings. [ABSTRACT FROM AUTHOR]

Stigma is defined as endorsing prejudicial attitudes about mental illness leading to discriminatory behaviors. It undermines the quality of medical care received by people with mental illness. Research suggests contact based interventions are effective in reducing stigma and increasing positive attitudes towards people with mental illness. This paper describes the development of a consumer led student-nurse mentoring program as part of nursing student education. People with lived mental health experience would mentor student nurses regarding the harmful effects of stigma and the beneficial outcomes of affirming attitudes. Seventy members of stakeholder groups (people with lived mental health experience and student nurses) participated in focus groups. Qualitative analyses revealed themes across stakeholder groups regarding: perceived mental health stigma from nurses, ways to reduce stigma, target message for the mentorship program, characteristics of mentors and logistics in developing such a program within the student nurse curricula. [ABSTRACT FROM AUTHOR]

Background: Urban Social Health Activists (USHAs) are the grass root health care workers of urban areas. There are 290 USHAs distributed in various Urban Health Centers (UHCs) of Rajkot city. Objectives: To compare the (i) effectiveness of the training received by the USHAs on their knowledge and counseling skills (ii) knowledge and counseling skills of USHAs on the awareness and utilization of Maternal and Child Health (MCH) care services by their beneficiaries. Methods: This cross-sectional study involved 32 USHAs and 416 beneficiaries served by the same USHAs. 32 USHAs serving in the same field practice area for more than two years were randomly selected. The beneficiaries were those mothers who had a child between 1-2 years age, and who had availed their antenatal and postnatal services in the same area. A scoring system was used to assess the knowledge and counseling skills of the USHAs and the knowledge and utilization of services by their beneficiaries. Results: The utilization of health services was significantly more in the beneficiaries who were serviced by USHAs having comparatively better knowledge (72.7% vs. 35.3%) and counseling skills (62.2% vs. 30.6%). The median score for knowledge (41 vs. 30) and counseling skills (20 vs. 16) of the USHAs was found to be more (P < 0.05) in those who had undertaken induction training. Conclusions: Induction training helped the USHAs to improve their knowledge and counseling skills. Utilization of MCH services was more in those areas served by USHAs having better knowledge and counseling skills. [ABSTRACT FROM AUTHOR]

Pain Medicine; Education; Curriculum; Medical Students Setting and subjects. University-affiliated medical school and its fourth-year medical students. Methods. Analysis of a detailed inventory of firstand second-year curricula. Survey of graduating medical students assessing attitudes, skills, and confidence. Construction of a fourth-year pain education elective and collaboration with enrollees to better integrate pain throughout the four-year curriculum. Results. This student-faculty collaboration produced an evidence-guided proposal to reorganize painrelated content across the longitudinal medical curriculum. An attitudes/skills/confidence survey of graduating medical students (104 respondents of 200 polled) found that 70% believed chances for successful outcomes treating chronic pain were low. Self-evaluated competency was high for evaluating (82%) and managing (69%) acute pain; for chronic pain, both were lower (evaluating538%; managing56%). Self-evaluated knowledge of pain physiology and neurobiology was poor (14%), fair (54%), or good (30%), but rarely excellent (2%). Conclusions. To meet graduating students' desire for increased competency in pain, pain-related curricula can and should be reorganized to include pain as a disease state and a widespread public health burden, not merely a symptom. [ABSTRACT FROM AUTHOR]

Objective. Inventory one medical school's first- and second-year pain-related curriculum in order to explore opportunities to teach about pain both as a social, population-based process and as a neuroncentered phenomenon. Design. Deconstruction of pain-related curricular content through a detailed content inventory and analysis by students and faculty. Setting and Subjects. University-affiliated US medical school. Methods. Detailed inventory and content analysis of first- and second-year curricular materials. Results. The inventory of pain content showed fragmentation, mostly presenting it as a symptom without an underlying framework. Conclusion. Analysis of one medical school's painrelated curricular materials reveals opportunities for a more unified perspective that includes pain as a widespread disease state (not merely a symptom) and to provide an emphasis in the curriculum consistent with pain's public health burden. [ABSTRACT FROM AUTHOR]

Context Learning to prescribe is challenging for junior doctors. Significant efforts have been made to improve prescribing education, especially in view of the high rates of prescribing errors made by junior doctors. However, considerations of educational options often overlook the fact that learning to prescribe and prescribing practices rely on practice-based interactions with informed practitioners, such as pharmacists and consultants. Pharmacists have long made important contributions to developing prescribing capacities. Objectives The present study examines the potential of everyday co-working between junior doctors and pharmacists, in conjunction with consultants, as an accessible means of developing effective prescribing practices. Methods A qualitative interview study was conducted in an Australian tertiary hospital using thematic analysis to explore junior doctors', pharmacists' and consultants' perspectives on how co-working supports learning to prescribe in an acute tertiary hospital setting. Participants included 34 practitioners, comprising junior doctors ( n = 11), consultants ( n = 10) and pharmacists ( n = 13). The thematic analysis was informed by workplace learning theory. Results Learning to prescribe was found to be a highly interdependent process. In particular, junior doctors were dependent on co-working with consultants and pharmacists. Three interrelated themes related to co-working and learning to prescribe in the workplace were identified: (i) prescribing readiness of junior doctors; (ii) need for guidance, and (iii) the challenges of pharmacists co-working as outsiders. Conclusions Co-working with pharmacists and consultants contributes positively to junior doctors' prescribing practices. However, co-working is complex and is influenced by differing understandings of prescribing practices. These insights assist in informing how co-working can be enacted routinely in hospital settings to promote safe and effective prescribing practices. Consideration should be given to when and how co-working between junior doctors and pharmacists is initiated, including during medical school. In clinical settings, strategies such as having pharmacists attend ward rounds and adopt a role of learning facilitation rather than error identification may augment everyday opportunities for co-working and learning. [ABSTRACT FROM AUTHOR]

Context Peer assessment of professional behaviour within problem-based learning ( PBL) groups can support learning and provide opportunities to identify and remediate problem behaviours. Objectives We investigated whether a peer assessment of learning behaviours in PBL is sufficiently valid to support decision making about student professional behaviours. Methods Data were available for two cohorts of students, in which each student was rated by all of their PBL group peers using a modified version of a previously validated scale. Following the provision of feedback to the students, their behaviours were again peer-assessed. A generalisability study was undertaken to calculate the students' professional behaviour scores, sources of error that impacted the reliability of the assessment, changes in student rating behaviour, and changes in mean scores after the delivery of feedback. Results Peer assessment of professional learning behaviour was highly reliable for within-group comparisons ( G = 0.81-0.87), but poor for across-group comparisons ( G = 0.47-0.53). Feedback increased the range of ratings given by assessors and brought their mean ratings into closer alignment. More of the increased variance was attributable to assessee performance than to assessor stringency and hence there was a slight improvement in reliability, especially for comparisons across groups. Mean professional behaviour scores were unchanged. Conclusions Peer assessment of professional learning behaviours may be unreliable for decision making outside a PBL group. Faculty members should not draw conclusions from peer assessment about a student's behaviour compared with that of their peers in the cohort, and such a tool may not be appropriate for summative assessment. Health professional educators interested in assessing student professional behaviours in PBL groups might focus on opportunities for the provision of formative peer feedback and its impact on learning. [ABSTRACT FROM AUTHOR]

Context Making a diagnosis can be difficult for learners as they must integrate multiple clinical variables. Diagnostic schemes can help learners with this complex task. A diagnostic scheme is an algorithm that organises possible diagnoses by assigning signs or symptoms (e.g. systolic murmur) to groups of similar diagnoses (e.g. aortic stenosis and aortic sclerosis) and provides distinguishing features to help discriminate between similar diagnoses (e.g. carotid pulse). The current literature does not identify whether scheme layouts should guide learners to reason one step at a time in a terminally branching scheme or weigh multiple variables simultaneously in a hybrid scheme. We compared diagnostic accuracy, perceptual errors and cognitive load using two scheme layouts for cardiac auscultation. Methods Focused on the task of identifying murmurs on Harvey, a cardiopulmonary simulator, 86 internal medicine residents used two scheme layouts. The terminally branching scheme organised the information into single variable decisions. The hybrid scheme combined single variable decisions with a chart integrating multiple distinguishing features. Using a crossover design, participants completed one set of murmurs (diastolic or systolic) with either the terminally branching or the hybrid scheme. The second set of murmurs was completed with the other scheme. A repeated measures manova was performed to compare diagnostic accuracy, perceptual errors and cognitive load between the scheme layouts. Results There was a main effect of the scheme layout (Wilks' λ = 0.841, F3,80 = 5.1, p = 0.003). Use of a terminally branching scheme was associated with increased diagnostic accuracy (65 versus 53%, p = 0.02), fewer perceptual errors (0.61 versus 0.98 errors, p = 0.001) and lower cognitive load (3.1 versus 3.5/7, p = 0.023). Conclusions The terminally branching scheme was associated with improved diagnostic accuracy, fewer perceptual errors and lower cognitive load, suggesting that terminally branching schemes are effective for improving diagnostic accuracy. These findings can inform the design of schemes and other clinical decision aids. [ABSTRACT FROM AUTHOR]

Background Workplace-based assessments ( WPBAs) are widely used in postgraduate training programmes internationally. WPBAs can function as both an assessment and an educational tool. Although some WPBAs are a mandatory requirement of approved curricula (as in the UK), little previous research has explored the extent to which such assessments are associated with adverse outcomes in postgraduate training. The present study examines whether the assessment element of Multisource Feedback, Patient Satisfaction Questionnaire and Educational Supervisors Review ratings can indicate if a trainee is likely to experience difficulty in successfully completing their planned training programme (i.e. fail one of their licensing assessments or need additional training time). Methods Data were collected for trainees undergoing a General Practice specialty training placement in Health Education East Midlands ( UK). Multivariate analyses were used to examine the predictive validity of the WPBAs and the outcome measures ( n = 327 to 329) and t-tests to calculate whether there were significant differences in performance between trainees who received low versus high WPBA ratings ( t = 4.03 to 10.27, p < 0.01). Results Multisource Feedback, Patient Satisfaction Questionnaire and Educational Supervisor's Review ratings were significantly correlated with subsequent performance in licensing exams ( r = 0.14 to 0.47, p < 0.01), and in addition explained significant variance in the likelihood of requiring additional training time (15.6% to 25.6%, p < 0.01). Conclusions Based on the findings, we assert that Multisource Feedback, Patient Satisfaction Questionnaire and Educational Supervisor's Review ratings have validity for predicting performance during training and are thus a useful tool for identifying trainees who are more likely to experience difficulty and could benefit from early additional support. [ABSTRACT FROM AUTHOR]

Context The use of point-of-care ultrasound ( POCUS) in clinical care is growing rapidly and advocates have recently proposed the integration of ultrasound into undergraduate medical education ( UME). The evidentiary basis for this integration has not been evaluated critically or systematically. Objectives We conducted a critical and systematic review framed by the rationales enumerated in academic publications by advocates of ultrasound in UME. Methods This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified from an archive of 403 academic publications using techniques from Foucauldian critical discourse analysis ( CDA). We then sought empirical evidence in support of these rationales, using a critical synthesis methodology also adapted from CDA. Results We identified four dominant discursive rationales with different levels of evidentiary support. The use of ultrasound was not demonstrated to improve students' understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent and rests on minimal evidence. With POCUS, students' diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve the quality of patient care was difficult to evaluate. Conclusions Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimises them and may preclude further primary research. As the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required. [ABSTRACT FROM AUTHOR]

Introduction: The use of natural products, that is, herbs for clinical and domestic purposes, is quite common in Saudi Arabia. Studies have reported an increasing use of complementary and alternative medicines (CAMs). This study aims to investigate the perception, attitude, and knowledge of the students regarding CAMs and their use. Materials and Methods: A quantitative, cross-sectional study targeting the students of the pharmacy and medical colleges at the University of Dammam, Saudi Arabia was conducted for a 6-month duration. It employed a survey questionnaire termed as CAMs inventory. Results: The majority of the respondents were females (N = 180, 60.8%), and a major segment (N = 170, 57.4%) belonged to the age group between 21 and 23 years. Nearly half of the students (N = 121, 40.9%) strongly agreed on the need for integration of CAMs-related courses in medical and allied health education, and a similar proportion (N = 129, 43.6%) of the target population acknowledged using CAMs, based on family recommendations (N = 134, 45.3%). Half of the students (N = 142, 48%) had no knowledge about CAMs. Some of the CAMs were more prevalent in males and vice versa (P value <0.05). Conclusion: A positive perception and attitude toward CAMs was observed. It is influenced by their traditional use and partly by the recent induction of CAMs-related education in pharmacy. The majority of the students agreed on integrating CAMs-related courses in their curriculum. It was also observed that the knowledge regarding the subject was inadequate. Lastly, gender has the potential to influence the use of particular CAMs. [ABSTRACT FROM AUTHOR]

Background: Public health faces the paradox of being increasingly emphasized by the key health and social care regulators and stakeholders, while remaining a largely under-represented discipline in the context of medical curricula. Enhancing medical student engagement in public health teaching is one way to address this concern. Methods: We discuss four key solutions to the challenges faced by public health educators in medical schools, and present five case studies which demonstrate innovative approaches to engaging medical students in our discipline. Results: Four different approaches have been piloted by members of the Public Health Educators in Medical Schools (PHEMS) network: (i) ensuring social accountability, (ii) demonstrating clinical relevance, (iii) mapping the core curriculum, and (iv) using technology enhanced learning. Preliminary student feedback suggests that these approaches can be used to position public health as an enabler of modern medical practice, and promote a more holistic understanding of medicine by linking patient-centred care to the population level. Conclusions: The zeitgeist in both academia and the healthcare system supports the teaching of public health within the medical curriculum; there is also consensus at the political and pedagogical level. The challenge of ensuring engagement now needs to be met at the student–teacher interface. [ABSTRACT FROM AUTHOR]

Introduction: Stress and burnout are highly prevalent among medical doctors, and are associated with negative consequences for doctors, patients, and organizations. The purpose of the current study was to examine the effectiveness of a mindfulness training intervention in reducing stress and burnout among medical practitioners, by means of a Randomised Controlled Trial design. Methods: Participants were 44 intern doctors completing an emergency department rotation in a major Australian hospital. Participants were randomly assigned to either an active control (one hour extra break per week) or the 10-week mindfulness training intervention. Measures of stress and burnout were taken pre-, mid- and post intervention. Results: Participants undergoing the 10-week mindfulness training program reported greater improvements in stress and burnout relative to participants in the control condition. Significant reduction in stress and burnout was observed for participants in the mindfulness condition. No such reductions were observed for participants in the control condition. Conclusions: Mindfulness interventions may provide medical practitioners with skills to effectively manage stress and burnout, thereby reducing their experience of these symptoms. It is likely that doctors would benefit from the inclusion of such a training program as a part of their general medical education. [ABSTRACT FROM AUTHOR]

Context:Little is known about best practices for teaching and learning leadership through Team-Based learning™ (TBL™) with medical students. We hypothesized that guided reflection and feedback would improve shared leadership and shared leadership capacity, and enhance team decision quality in TBL teams. We used the Kolb experiential learning theory as the theoretical framework. Method:The study was conducted at Tehran University of Medical Sciences. Three TBL sessions with 206 students (39 teams) participated in the study. Using a quasi-experimental design, one batch received guided reflection and feedback on their team leadership processes (n = 20 teams) and the other received only TBL (n = 19 teams). Observers measured shared leadership using a checklist. Shared leadership capacity was measured using a questionnaire. Scores on a team application exercise were used to assess quality of team decisions. Results:Evidence did not support our first hypothesis that reflection and feedback enhance shared leadership in TBL teams. Percentages of teams displaying shared leadership did not differ between intervention and control groups in sessions 1 (p = 0.6), 2 (p = 1) or 3 (p = 1). The results did not support the second hypothesis. We found no difference in quality of decision making between the intervention and control groups for sessions 1 (p = 0.77), 2 (p = 0.23), or 3 (p = 0.07). The third hypothesis that the reflection and feedback would have an effect on shared leadership capacity was supported (T = −8.55,p > 0.001 adjusted on baseline; T = −8.55,p > 0.001 adjusted on gender). Discussion and conclusion: We found that reflection and feedback improved shared leadership capacity but not shared leadership behaviors or team decision quality. We propose medical educators who apply TBL, should provide guided exercise in reflection and feedback so that students may better understand the benefits of working in teams as preparation for their future roles as leaders and members of health care teams. [ABSTRACT FROM PUBLISHER]

Background:The voice of the child is increasingly recognized as important, as summed up in the Department of Health report “No decision about me, without me”. In medical education, however, the child’s voice is little heard: often in a pediatric OSCE, the examiner assigns a mark for the child. Aim:To explore whether children can contribute meaningfully to summative scoring of student performance. Methods:We studied this in two phases: first we compared child scores (CSs) to examiner predictions of the child scores (EPCS), and other simulated patient (SP) scores within a single exam. Then we looked at CS over a further 4 exams. Results:The Pearson correlation between CS and EPCS was 0.40 (p < 0.001), therefore EPCS accounted for 16% of variation in CS. Across 4 exams, the mean CS was higher than the mean adult SP score: exploratory factor analysis indicated that both may be measuring the same characteristic. Cronbach’s alpha (0.66 to 0.76) did not significantly increase when SP scores (including CS) were removed. Conclusions:Although there was some correlation between CS and EPCS, pediatricians could not accurately predict CS. We conclude that the child’s voice can and should be heard within the OSCE marking process. [ABSTRACT FROM PUBLISHER]

Background:This study follows on from a study that investigated how to develop effective final year medical student assistantship placements, using multidisciplinary clinical teams in planning and delivery. Aims:This study assessed the effects on objective structured clinical examination (OSCE) performance of the in-course enhanced “super-assistantship” placement introduced to a randomly selected sample of 2013–14 final year medical students at Leeds medical school. Methods:Quantitative data analysis was used to compare the global grades of OSCE stations between students who undertook this placement against those who did not. Results:There was a small overall improvement in the “super-assistantship” student scores across the whole assessment (effect size = 0.085). “Pre-op Capacity”, “Admissions Prescribing” and “Hip Pain” stations had small-medium effect sizes (0.226, 0.215, and 0.214) in favor of the intervention group. Other stations had small effect sizes (0.107–0.191), mostly in favor of the intervention group. Conclusions:The “super-assistantship” experience characterized by increasing student responsibility on placement can help to improve competence and confidence in clinical decision-making “in a simulated environment”. The clinical environment and multidisciplinary team must be ready and supported to provide these opportunities effectively. Further in-course opportunities for increasing final year student responsibility should be developed. [ABSTRACT FROM PUBLISHER]

Background:Intellectual curiosity can be defined as a desire for knowledge that leads to exploratory behavior and consists of an inherent and stable trait (i.e. trait curiosity) and a variable context-dependent state (i.e. state curiosity). Although intellectual curiosity has been considered an important aspect of medical education and practice, its relationship to medical education has not been empirically investigated. The purpose of this exploratory study was to describe medical students’ intellectual curiosity across a four-year undergraduate program. Methods:We employed a cross-sectional design in which medical students, across a four-year undergraduate program at McGill University, completed the Melbourne Curiosity Inventory as a measure of their state and trait intellectual curiosity. A Mixed Models ANOVA was used to compare students across year of training. Results:Four hundred and two out of 751 students completed the inventory (53.5%). Trait curiosity was significantly higher than state curiosity (M = 64.5, SD = 8.5 versusM = 58.5, SD = 11.6) overall, and within each year of training. Conclusions:This study is the first to describe state and trait intellectual curiosity in undergraduate medical education. Findings suggest that medical students’ state curiosity may not be optimally supported and highlight avenues for further research. [ABSTRACT FROM PUBLISHER]

Background:In medical education, students need to acquire skills to self-direct(ed) learning (SDL), to enable their development into self-directing and reflective professionals. This study addressed the mentor perspective on how processes in the mentor–student interaction influenced development of SDL. Methods:n = 22 mentors of a graduate-entry medical school with a problem-based curriculum and longitudinal mentoring system were interviewed (n = 1 recording failed). Using activity theory (AT) as a theoretical framework, thematic analysis was applied to the interview data to identify important themes. Results:Four themes emerged: centered around the role of the portfolio, guiding of students’ SDL in the context of assessment procedures, mentor-role boundaries and longitudinal development of skills by both the mentor and mentee. Application of AT showed that in the interactions between themes tensions or supportive factors could emerge for activities in the mentoring process. Conclusion:The mentors’ perspective on coaching and development of reflection and SDL of medical students yielded important insights into factors that can hinder or support students’ SDL, during a longitudinal mentor–student interaction. Coaching skills of the mentor, the interaction with a portfolio and the context of a mentor community are important factors in a longitudinal mentor–student interaction that can translate to students’ SDL skills. [ABSTRACT FROM PUBLISHER]

Background Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service ( NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. Concept The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist ( RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine ( ACRRM) and the Regional Training Provider ( RTP). This approach enhanced the James Cook University ( JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Achievements Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Results Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, Conclusions Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. [ABSTRACT FROM AUTHOR]

In medical contexts around the world, supervising physicians continuously decide what degree of supervision to apply as trainees carry out professional activities. Although the implications for patients can be far-reaching, little is known about how these entrustment decisions are formed. The concept of 'Entrustable Professional Activities' has initiated interest and valuable research on factors that may influence the entrustment decision process. The aim of the current article is to link models of entrustment developed in the fields of occupational and organizational psychology and military psychology to medical education studies that have explored the factors influencing physicians' entrustment decisions. We provide a conceptual framework of the entrustment decision-making process, which we suggest will contribute to the understanding of how supervising physicians arrive at the decision to entrust a medical trainee with a professional activity. [ABSTRACT FROM AUTHOR]

Throughout their careers, doctors are likely to come across complex management and leadership scenarios that many would not have had prior training in. Expectations of doctors are rising and it is becoming increasingly necessary to be able to astutely handle a variety of situations. Medical curricula must reflect this change and adapt to include the teaching of key management and leadership skills. Despite budgeting pressures, the National Health Service continues to spend vast sums of money on external management consultants. The 2013 Francis Report stressed the need for better management skills and leadership, especially in doctors who were identified as the spearheads of change. This view is backed up by senior professionals who stress that by incorporating it into undergraduate curricula, doctors will be equipped with the skills to flourish in the future. The challenges of doing so must be highlighted, since the teaching of managerial and leadership concepts must effectively combine theoretical approaches with practical applications. Empowering students of today will enable them as tomorrow's doctors to tackle the challenges of modern medicine [ABSTRACT FROM AUTHOR]

Objectives In 2014, the primary trauma care curriculum was delivered at a national trauma center in San Salvador, El Salvador. A quantitative analysis demonstrated that subsequent incorporation of primary trauma care algorithms did not occur. The purpose of this qualitative analysis is to explore why the delivery of the primary trauma care curriculum did not have a measurable effect on provider observance of primary trauma care algorithms. Methods Key informant interviews of primary trauma care instructors and students, trauma care observers, and hospital administrators involved in the delivery of the primary trauma care curriculum were conducted in February 2015. Interview transcripts were analyzed qualitatively using a grounded-theory approach and thematic analysis for insights and common themes. Results Four common themes emerged to explain why adherence to primary trauma care algorithms did not improve: Primary Trauma Care course delivery problems, insufficient equipment, insufficient nurse training, and unsystematic team response. Conclusions Despite the delivery of the primary trauma care curriculum, adherence to the primary trauma care algorithms did not improve as a result of problems integral to the primary trauma care model—including the teach-the-teachers method of curriculum dissemination—as well as local conditions at this hospital. These findings suggest that an isolated educational intervention may not be successful unless the host institution is able to commit to the implementation of the educational material in an ongoing and comprehensive fashion. [ABSTRACT FROM AUTHOR]

One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners. Our method for reflective learning addresses and enables processing of the most pressing ethical issues that learners encounter in practice. [ABSTRACT FROM AUTHOR]

As technology becomes ubiquitous in designing and delivering medical school curricula, health sciences librarians can embrace emerging opportunities for participation in curriculum design. A new medical librarian at Michigan State University Libraries engaged her user base outside of established duties, learned new skills, and challenged preconceived notions about librarians’ roles. In the process, she became a partner in copyright education, amended license agreements for enhanced curricular multimedia use, and facilitated curriculum mapping through taxonomy building. These projects helped create the informational foundation for a novel hybrid medical education curriculum and introduced new curricular roles for the librarian. [ABSTRACT FROM PUBLISHER]

Adoption of new primary care models has been slow in academic teaching practices. We describe a common framework that academic learning collaboratives are using to transform primary care practice based on our analysis of 6 collaboratives nationally. We show that the work of the collaboratives could be divided into 3 phases and provide detail on the phases of work and a road map for those who seek to emulate this work. We found that learning collaboratives foster transformation, even in complex academic practices, but need specific support adapted to their unique challenges. [ABSTRACT FROM AUTHOR]

Health education, which also includes medicine education, promotes social sustainability in society. Through the context of Internet-based intervention, this study reports on fourth graders' (N = 51, aged 10-11 years) perspectives on medicines, their use with common diseases and medicine-related information sources. The study was qualitative by nature. Data was collected in spring 2010, by audio recording students' group discussions during the study process and group interviews. After intervention, students were well aware of the proper use of medicines and how to find information both on medicines and health issues. The main challenge was finding websites that provide reliable and confidential information. The results of this study raise awareness of a concrete pedagogical approach to health education. The pedagogical approach conducted in the intervention could, to some extent, be transferred to any school setting. This study underlies the promotion of Internet-based health literacy and criteria, for evaluating online health information in the primary school context. [ABSTRACT FROM AUTHOR]

The teaching and training of doctors-in-training in paediatrics has become increasingly challenging in recent times. All too often there is a perception that training must come second to service provision. In this article, the case of a child with community-acquired pneumonia is considered and used to illustrate how a culture of teaching can be embedded in everyday clinical practice. [ABSTRACT FROM AUTHOR]

Objectives. Lung ultrasonography (LUS) is a useful examination to identify lung problems. Unfortunately, there are currently no LUS educational programs for medical students. We designed a brief LUS training course for medical students during the ED rotation. The purpose of training was improving cognitive and psychomotor learning domains, knowledge of ultrasound, knowledge of LUS, image acquisition, and image interpretation. Methods. Forty students in their fourth year of medical school were enrolled in this study. Student achievement was evaluated through examinations of cognitive and psychomotor skills. A survey was administered following the training. Results. The average test result was 42.1 ± 13.7 before training and 82.6 ± 10.7 after training. With respect to the assessment of LUS performance, the acceptable rates for right and left anterior chest wall scanning and right and left posterolateral scanning were 95%, 97.5%, 92.5%, and 100%, respectively. The students felt a high level of confidence in their ability to administer LUS to patients after training and they agreed that inclusion of LUS training in the medical school curriculum is necessary. Conclusion. This study showed that, among the medical students without ultrasound experience, limited LUS education to improve their knowledge, image acquisition, and interpretation ability was successful. [ABSTRACT FROM AUTHOR]

Purpose. The implementation of an interprofessional clinical pharmacology selective (CPS) learning experience for pharmacy residents and medical students is described. Summary. The opportunity for pharmacy residents to provide didactic lectures at a college of pharmacy and to develop teaching and preceptor skills with experiential pharmacy students may be limited by institutionspecific affiliations and geographic location. In order to overcome these barriers, the Mayo Clinic Hospital postgraduate year 1 (PGY1) pharmacy residency program implemented an interprofessional learning experience in which pharmacy residents serve the role of preceptors for first- and second-year medical students on a CPS. Medical students at the Mayo Medical School (MMS) work alongside the PGY1 resident to develop patient-specific, medication problem lists and gain an appreciation for pharmacy-focused interventions. Medical students teach pharmacy residents diagnostic, pathophysiologic, and patient-assessment considerations related to the medical school's curriculum. The clinical rounds component of the CPS allows for resident achievement of ASHP competency area R4, which focuses on the design of an effective educational activity; selection of a preceptor role; employment of instruction, modeling, coaching, and facilitation; use of effective presentation skills; generation of objective-based learner assessment questions; and identification of areas for continuous improvement. Conclusion. The Mayo Clinic Hospital PGY1 pharmacy residency program and MMS successfully implemented an innovative learning experience to promote interprofessional education between pharmacy residents and medical students. The program establishes collaborative relationships early in students' professional careers and allows for attainment of the ASHP-required competency area R4 through delivery of a CPS to medical students. [ABSTRACT FROM AUTHOR]

The article discusses the responsibility of clinical teacher in the U.S. to teach pediatric high-value health care to medical students starting their medical rotations. Also cited are the concept of "too much care" like overdiagnosis, overtreatment and excessive testing, some accessible teaching tools like the Choosing Wisely lists, the Prepare, Process, Initiate (PPI), and the Subjective, Objective, Assessment, Plan, Value (SOAP-V), as well as the total health care expenses in the country.

Background:Following a Judicial review brought by the British Association of Physicians of Indian Origin, greater expectation is now being placed upon Health Education England Local Offices and Deaneries across Scotland, Wales and Northern Ireland to identify doctors who may go on to experience difficulties in general practice specialty training – and who may benefit from educational support at an early stage. NHS Education for Scotland West region has offered an enhanced induction programme for trainees who were identified as being at risk of difficulty in training.Aims:To capture the experience of an enhanced induction programme; exploring insight towards potential difficulties in training; and the feelings relating to being identified as a trainee at risk of difficulty.Method:Interviews with trainees who attended the enhanced induction programme. Transcripts were analysed by a basic thematic analysis approach.Results:All non-UK Doctors completed 17 interviews. The term ‘at risk’ was accepted and the intervention was well received. Participants showed insight into the common areas of difficulty in trainees. The workshops helped to develop understanding of cultural differences, use of the ePortfolio, and gave participants an opportunity to practice their communication skills.Conclusions:This enhanced induction programme has provided targeted training to a group of trainees identified at risk of difficulty. [ABSTRACT FROM AUTHOR]

The article discusses a study related to role of windows method as a fresh approach to video case discussion. It mentions that the method provides security to explore uncertainties and alternatives for group members providing a framework and a vocabulary of constructive commentary. It also mentions that relying on traditional feedback rules results in superficial discussions.