Michael A. Ainsworth

Medical student professionalism: are we measuring the right behaviors? A comparison of professional lapses by students and physicians.

Background Examining the relationship between unprofessional behaviors observed in medical students and those manifested by physicians is important in determining whether medical school faculty are observing and reporting behaviors relevant to medical practice. Method This study compares the relationship between unprofessional behaviors identified in students at our medical school through Early Concern Notes, and behaviors for which physicians were sanctioned by our state medical board. Results The majority of reports in both groups were related to lapses in professional responsibility and integrity, and the specific behaviors identified in the groups were similar. A smaller number of reports in both groups were related to pursuit of excellence or personal interactions. Conclusion There are common features to the professional shortcomings seen in students at our medical school and practicing physicians in our state. These similarities add credibility to our faculty’s observations, and reinforce the relevance of monitoring such behaviors in future physicians.

An innovative evaluation method in an internal medicine clerkship

No abstract available.

Do students do what they write and write what they do? The match between the patient encounter and patient note

Background Patient notes are used for a variety of purposes in health care. Medical students are taught the structure of patient notes early in training. Review of patient notes are then used to assess synthesis and integration of patient information. It is critical that the information in the note accurately and completely represents the student-patient encounter. Method The authors reviewed videotapes of students in three standardized-patient based scenarios and compared what occurred during the physical examination with the subsequent documentation in the patient note. Results In all, 207 encounter-note pairs were reviewed. Only 8 (4%) of the notes completely and accurately represented what occurred during the encounter. Problems with underdocumentation, overdocumentation, and inaccurate documentation of physical findings were seen for all three patient scenarios. Conclusions These findings highlight the need to teach and assess both data gathering skills and written documentation of findings in medical training.

Effects of comprehensive educational reforms on academic success in a diverse student body

Medical Education 2010: 44: 1232–1240

Student Perceptions of the Professional Behavior of Faculty Physicians

Abstract This study was conducted to obtain a baseline understanding of the professional behavior of clinical faculty physicians from the medical students’ perspective. Students completed a professionalism evaluation of supervising faculty at the end of each required third-year clerkship over a one year period. Results were analyzed by specific behaviors and across clerkships. Differences were noted in the frequency of the types of problems seen, and varied by clerkship discipline. The most common transgressions of professional behavior reported were the use of derogatory language towards other services or patients and the disrespectful treatment of others. Our study served to provide objective feedback to the faculty about student perceptions of faculty as role models for professionalism while on clinical rotations.

Investigating gender bias in preceptors' ratings of medical students

No abstract available.

Use of standardised patients with actual findings.

Overall, GEMS has positively affected participants’ delivery of emergency medicine (5.7 ⁄ 7) and willingness to continue rural emergency medicine (5.5 ⁄ 7). Feedback has initiated minor changes to facilitate participant follow-up and completion. GEMS can help rural doctors to not only learn and practise emergency medicine skills, but to do so with confidence. Interactive training can be delivered at the rural site.

Developing a presentation and problem-solving station in a multistation standardized-patient examination.

No abstract available.

An independent community-based ambulatory clerkship.

No abstract available.

Evolution of Student Assessment Following Implementation of an Integrated Medical Curriculum: Contribution to Improved Educational Outcomes

This paper describes the stimuli and rationale for and the nature of assessment changes implemented after embarking on a new student-centered, problem-based learning curriculum. In 1998, the University of Texas Medical Branch implemented the Integrated Medical Curriculum (IMC), a problem-based curriculum with sequential, interdepartmental, clinically relevant basic science courses and a concurrent Practice of Medicine course. The IMC’s aim was to improve educational quality by emphasizing knowledge application over rote memorization, student-directed learning, problem-solving skills development, basic science and clinical concepts integration, early acquisition of clinical skills, and professional teamwork. During the initial years of the IMC, students’ learning outcomes did not improve over those of the former curriculum because, in part, we did not initially modify student assessment (a driving force for student study habits) to align with the new curricular goals and philosophies. We subsequently took several steps to modify our assessment practices in order to improve student learning and understanding. These steps included (1) increasing the number and quality of higher -order exam questions, (2) sequestering examinations, (3) increasing the number of practice exam items in each course, (4) and emphasizing in-depth discussion in problem-based learning sessions by introducing small-group quiz exercises. Following the assessment modifications, our students’ USMLE Step 1 scores and our pass rate for first-time test takers rose from being consistently below the national Step 1 average to above the national average. This improvement has been sustained for the past seven years. We believe that implementing those assessment modifications within the framework of the newly devised student-centered, problem-based curriculum in an interdepartmental environment resulted in a critical mass of “local” changes. The changes, initiated and supported by students, faculty and administration, catalyzed, produced and sustained more “global” changes that improved students’ learning, thus better preparing them for the USMLE Step 1 examination.