Nicole Verbeck

The impact of lecture attendance and other variables on how medical students evaluate faculty in a preclinical program.

Purpose High-quality audiovisual recording technology enables medical students to listen to didactic lectures without actually attending them. The authors wondered whether in-person attendance affects how students evaluate lecturers. Method This is a retrospective review of faculty evaluations completed by first- and second-year medical students at the Ohio State University College of Medicine during 2009–2010. Lecture-capture technology was used to record all lectures. Attendance at lectures was optional; however, all students were required to complete lecturer evaluation forms. Students rated overall instruction using a five-option response scale. They also reported their attendance. The authors used analysis of variance to compare the lecturer ratings of attendees versus nonattendees. The authors included additional independent variables—year of student, student grade/rank in class, and lecturer degree—in the analysis. Results The authors analyzed 12,092 evaluations of 220 lecturers received from 358 students. The average number of evaluations per lecturer was 55. Seventy-four percent (n = 8,968 evaluations) of students attended the lectures they evaluated, whereas 26% (n = 3,124 evaluations) viewed them online. Mean lecturer ratings from attendees was 3.85 compared with 3.80 by nonattendees (P ⩽ .05; effect size: 0.055). Student’s class grade and year, plus lecturer degree, also affected students’ evaluations of lecturers (effect sizes: 0.055–0.3). Conclusions Students’ attendance at lectures, year, and class grade, as well as lecturer degree, affect students’ evaluation of lecturers. This finding has ramifications on how student evaluations should be collected, interpreted, and used in promotion and tenure decisions in this evolving medical education environment.

Virtual Alternative to the Oral Examination for Emergency Medicine Residents

Introduction The oral examination is a traditional method for assessing the developing physician’s medical knowledge, clinical reasoning and interpersonal skills. The typical oral examination is a face-to-face encounter in which examiners quiz examinees on how they would confront a patient case. The advantage of the oral exam is that the examiner can adapt questions to the examinee’s response. The disadvantage is the potential for examiner bias and intimidation. Computer-based virtual simulation technology has been widely used in the gaming industry. We wondered whether virtual simulation could serve as a practical format for delivery of an oral examination. For this project, we compared the attitudes and performance of emergency medicine (EM) residents who took our traditional oral exam to those who took the exam using virtual simulation. Methods EM residents (n=35) were randomized to a traditional oral examination format (n=17) or a simulated virtual examination format (n=18) conducted within an immersive learning environment, Second Life (SL). Proctors scored residents using the American Board of Emergency Medicine oral examination assessment instruments, which included execution of critical actions and ratings on eight competency categories (1–8 scale). Study participants were also surveyed about their oral examination experience. Results We observed no differences between virtual and traditional groups on critical action scores or scores on eight competency categories. However, we noted moderate effect sizes favoring the Second Life group on the clinical competence score. Examinees from both groups thought that their assessment was realistic, fair, objective, and efficient. Examinees from the virtual group reported a preference for the virtual format and felt that the format was less intimidating. Conclusion The virtual simulated oral examination was shown to be a feasible alternative to the traditional oral examination format for assessing EM residents. Virtual environments for oral examinations should continue to be explored, particularly since they offer an inexpensive, more comfortable, yet equally rigorous alternative.

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study

Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain.Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain.

Child Neurology Education for Pediatric Residents:: How Are We Doing?

The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education–accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students

ABSTRACT The ‘Millennial’ generation faces medical education learning environment challenges differently. We explore gender differences in burnout, perceived stress, and empathic concern in third-year medical students. A sample size of 654 third-year medical students completed an annual survey over 6 years. Survey items included: the Maslach Burnout Inventory-Student Scale (MBI-SS), Interpersonal Reactivity Index (IRI), and Perceived Stress Scale (PSS). We examined demographic differences using independent sample t-tests and performed a two-way ANOVA to test for potential interactions. Female students were more likely to have higher empathic concern compared to male students (IRI) (20.9±3.9 versus 19.1±4.1, p<0.001), and reported more personal distress (IRI) (9.0±4.4 versus 7.6±3.8, p<0.001), emotional exhaustion (MBI-SS) (15.6±5.9 versus 14.4±5.9, P<0.013), and perceived stress (PSS) (17.3±6.1 versus 15.2±6.7, p<0.001). Male students were more likely to have cynicism (MBI-SS) and lower professional efficacy (MBI-SS) scores. Results of multivariate analyses yielded no significant interactions between gender, age, and ethnicity. Self-reported experiences of burnout and stress differed in male and female third-year medical students. Burnout and perceived stress scores while statistically significant were small. These findings suggest that support services should be made broadly available to all medical students, but should be targeted to the specific needs of male and female students.