Karen Hughes Miller

Improving residents’ teaching skills: A program evaluation of residents as teachers course

Background: The role of residents as teachers is recognized as an important part of medical education. However, residents may not possess the practical skills needed to teach medical students effectively. Aim: In response to a Liaison Committee on Medical Education citation concerning surgery residents’ teaching skills, the University of Louisville School of Medicine instituted a campus-wide residents as teachers program based on the bringing education and service together curriculum. Methods: This evaluation plan is grounded on Kirkpatricks four levels model. Levels 1 and 2 data included post-session learner questionnaires (2007 and 2008) and open-ended facilitator questionnaires (2008). Levels 3 and 4 data included third year medical students’ responses to CourseEval® questions on residents as teachers (2005–2006 and 2007–2008) and data from third year medical student focus groups (2008). Results: Levels 1 and 2 data analysis showed statistically significant improvements from session to session in Year I and significant improvements between Years I and II. Levels 3 and 4 data analysis showed third year students’ perceptions of most residents as teachers remained high and improved significantly in the surgery clerkship. Conclusion: Short-term and long-term measures show this curriculum to be successful for an interdisciplinary group of residents.

The Responsible Use of Online Social Networking: Who Should Mentor Medical Students

Background: As medical students become more active in online social networking (OSN), there are increasing concerns regarding violations of patient privacy and a lack of professionalism. Purpose: Students need to be mentored, but who is best suited to the task? We hypothesized that residents are closer to students in usage and attitudes toward online communication than are faculty. If so, they would be more credible as mentors. Methods: We surveyed faculty (N = 16), 1st-year residents (N = 120), and 3rd-year medical students (N = 130) to compare attitudes about OSN and the online usage patterns. Results: We found residents to be more like students in usage patterns of personal electronic media and in their choice of the mentoring techniques that should be used. Conclusion: Residents say they were not prepared to mentor students without additional guidance but were more confident than faculty members that they had the knowledge to do so.

Addressing patient sexual orientation in the undergraduate medical education curriculum.

ObjectiveThis study aims to estimate the number of hours dedicated to lesbian, gay, bisexual, and transgender content in one medical school’s undergraduate curriculum, compare it to the national average, and identify barriers to addressing this content.MethodsCourse and clerkship directors were asked to estimate how many hours they spent on lesbian, gay, bisexual, and transgender content, how many hours would be ideal, and what barriers they perceived to teaching this content.ResultsFaculty members identified lack of instructional time, lack of relevance to their course content, and lack of professional development on this topic as major barriers. There was a significant negative correlation (rs=−0.47, p=0.047) between “number of hours dedicated” and “perceived barriers to teaching this content.”ConclusionCourse and clerkship directors who perceive more barriers to teaching lesbian, gay, bisexual, and transgender content report dedicating less time to its instruction, but the barriers they perceive can largely be mitigated through faculty development.

Assessing Medical Students’, Residents’, and the Public’s Perceptions of the Uses of Personal Digital Assistants

Although medical schools are encouraging the use of personal digital assistants (PDAs), there have been few investigations of attitudes toward their use by students or residents and only one investigation of the publics attitude toward their use by physicians. In 2006, the University of Louisville School of Medicine surveyed 121 third- and fourth-year medical students, 53 residents, and 51 members of the non-medical public about their attitudes toward PDAs. Students were using either the Palm i705 or the Dell Axim X50v; residents were using devices they selected themselves (referred to in the study generically as PDAs). Three survey instruments were designed to investigate attitudes of (a) third- and fourth-year medical students on clinical rotations, (b) Internal Medicine and Pediatrics residents, and (c) volunteer members of the public found in the waiting rooms of three university practice clinics. Both residents and medical students found their devices useful, with more residents (46.8%) than students (16.2%) (p < 0.001) rating PDAs “very useful.” While students and residents generally agreed that PDAs improved the quality of their learning, residents’ responses were significantly higher (p < 0.05) than students’. Residents also responded more positively than students that PDAs made them more effective as clinicians. Although members of the public were generally supportive of PDA use, they appeared to have some misconceptions about how and why physicians were using them. The next phase of research will be to refine the research questions and survey instruments in collaboration with another medical school.

Evaluating the Utility of Peer-Assisted Learning in Pediatrics

Peer-assisted learning (PAL) is the signature teaching/learning strategy for training young physicians. This study reports on a PAL program held during the third-year pediatric clerkship. Respondents felt PAL was useful. A senior elective incorporating PAL is now an official course. PAL is an effective adjunct to traditional teaching methods.

Building and executing a research agenda toward conducting implementation science in medical education

Background Implementation science (IS) is the study of methods that successfully integrate best evidence into practice. Although typically applied in healthcare settings to improve patient care and subsequent outcomes, IS also has immediate and practical applications to medical education toward improving physician training and educational outcomes. The objective of this article is to illustrate how to build a research agenda that focuses on applying IS principles in medical education. Approach We examined the literature to construct a rationale for using IS to improve medical education. We then used a generalizable scenario to step through a process for applying IS to improve team-based care. Perspectives IS provides a valuable approach to medical educators and researchers for making improvements in medical education and overcoming institution-based challenges. It encourages medical educators to systematically build upon the research outcomes of others to guide decision-making while evaluating the successes of best practices in individual environments and generate additional research questions and findings. Conclusions IS can act as both a driver and a model for educational research to ensure that best educational practices are easier and faster to implement widely.Background Implementation science (IS) is the study of methods that successfully integrate best evidence into practice. Although typically applied in healthcare settings to improve patient care and subsequent outcomes, IS also has immediate and practical applications to medical education toward improving physician training and educational outcomes. The objective of this article is to illustrate how to build a research agenda that focuses on applying IS principles in medical education. Approach We examined the literature to construct a rationale for using IS to improve medical education. We then used a generalizable scenario to step through a process for applying IS to improve team-based care. Perspectives IS provides a valuable approach to medical educators and researchers for making improvements in medical education and overcoming institution-based challenges. It encourages medical educators to systematically build upon the research outcomes of others to guide decision-making while evaluating the successes of best practices in individual environments and generate additional research questions and findings. Conclusions IS can act as both a driver and a model for educational research to ensure that best educational practices are easier and faster to implement widely.

An Evaluation of the University of Louisville School of Medicine Pediatric Summer Externship Program

BackgroundThe Pediatric Summer Externship Program began in 1997. It is a unique program designed to give preclinical medical students early exposure to pediatrics. Rotations are available with subspecialists, general pediatricians, and in rural pediatric offices across the state.PurposeA review of the program was undertaken to evaluate perceptions of the program among both students and faculty with the plan to disseminate a model of the program for use by other departments.MethodsA survey was sent to participants and faculty. Results were compared to a 2007 program review.ResultsThe externship was highly rated by both students and faculty. Both groups agreed the program prepared students for their clerkship years. Those rotating in rural locations stated they were more likely to consider rural medicine as a career.ConclusionsThis study suggests the pediatric externship program is a unique, replicable, well-established model that has provided a consistently positive experience over the past 15 years.