Damon H Sakai

Using standardized patients to assess the geriatrics medicine skills of medical students, internal medicine residents, and geriatrics medicine fellows.

Purpose. Medical schools and residency programs are placing additional emphasis on including clinical geriatrics competencies within their curricula. An eight-station, Geriatric Medicine Standardized Patient Examination (GSPX) was studied as a method to assess bedside geriatrics clinical skills over the continuum of medical education from medical school through residency and fellowship training. Method. The GSPX was administered to 39 medical students, 49 internal medicine residents, and 11 geriatrics medicine fellows in 2001–02. Reliability of standardized patient (SP) checklists and rating scales used to assess examinees’ performance was measured by Cronbachs alpha. Validity was measured by surveying the examinees’ assessment of fairness, individual case length, difficulty, and believability, and by faculty standard setting for each level of trainee. Results. Reliability was high (α = .89). All levels of examinees found the SPs to be believable, station lengths to be adequate, and rated the GSPX as a fair assessment. Students rated the cases as more difficult. Previous experience with similar real patients increased significantly with level of training (Pearson’s r = .48, p < .0001). Faculty set passing scores that increased from students to residents to fellows. However, GSPX scores decreased with level of training (r = −.25, p = .01). Conclusion. The GSPX is a reliable measure of geriatrics medicine skills with adequate face validity for examinees at all levels. However, GSPX scores did not increase with level of training, suggesting that a single form of the examination cannot be used across the continuum of training. Potential modifications to the GSPX that might provide more discrimination between levels of training are currently being explored.

University of Hawaii at Mãnoa John A. Burns School of Medicine.

The JABSOM Office of Medical Education (OME) was established in 1989 to support the medical student education program. Currently, the office supports 14 professionals. Most of the faculty members assigned to the office have split assignments between the OME and their home department. The role of the office is to oversee and coordinate the required courses in the first two years of the curriculum and selected (primarily interdepartmental) courses in the third and fourth years. The OME also supports the activities of the JABSOM curriculum committee and provides an array of faculty development opportunities for the school.

Medical education in paradise: another facet of Hawaii

Hawaii is synonymous with paradise in the minds of many. Few know that it is also an environment where high quality medical education is thriving. This paper outlines medical education initiatives beginning with native Hawaiian healers of centuries ago, and continuing to present-day efforts to support top-notch multicultural United States medical education across the continuum of training. The undergraduate medical education program has as its core community-based problem-based learning. The community basis of training is continued in graduate medical education, with resident doctors in the various programs rotating through different clinical experiences at various hospitals and clinics. Continuing medical education is provided by nationally accredited entities, within the local context. Educational outreach activities extend into primary and secondary schools, homeless shelters, neighbouring islands, and to countries throughout the Pacific. Challenges facing the medical education community in Hawaii are similar to those faced elsewhere and include incorporating more technology to improve efficiency, strengthening the vertical integration of the training continuum, better meeting the needs of the state, and paying for it all. Readers are invited to join in addressing these challenges to further the realisation of medical education in paradise as a paradise of medical education.

University of Hawaii John A. Burns School of Medicine.

Graduates of the University of Hawaii John A. Burns School of Medicine are life-long learners. They apply their knowledge of biological and clinical sciences, demonstrate a deep appreciation for their community, and communicate effectively in the care of their patients, particularly the peoples of Hawaii and the Pacific Basin. They practice medicine with the highest professional standards while maintaining their personal health and well-being. All medical students at JABSOM must demonstrate achievement of these objectives prior to graduation.