Toshiko Uchida

E-learning and deliberate practice for oral case presentation skills: A randomized trial

Background: Oral case presentations are critical for patient care and student assessment. The best method to prepare early medical students for oral presentations is unknown. Aim: We aimed to develop and evaluate a curriculum of on-line learning and deliberate practice to improve pre-clinical students’ case presentation skills. Methods: We developed a web-based, interactive curriculum emphasizing conciseness and clinical reasoning. Using a waitlist control design, we randomly assigned groups of second-year students to receive the curriculum in December 2010 or in April 2011. We evaluated their presentations at three time points. We also examined the performance of an untrained class of students as a historical comparison. Results: We evaluated 132 second-year medical students at three time points. After the curriculum, mean scores of the intervention students improved from 60.2% to 70.1%, while scores of the waitlist control students improved less, from 61.8% to 64.5% (p < 0.01 for between-group difference in improvement). Once all students had received the curriculum, mean scores for the intervention and waitlist control students rose to 77.8% and 78.4%, respectively, compared to 68.1% for the untrained comparison students (p < 0.0001 compared to all curriculum students). Conclusion: An on-line curriculum followed by deliberate practice improved students’ oral presentation skills.

Introduction to Safe Space Training: Interactive Module for Promoting a Safe Space Learning Environment for LGBT Medical Students

Introduction Lesbian, gay, bisexual, and transgender (LGBT) students face challenges in achieving their educational goals. By understanding concepts surrounding sexual orientation and gender identity, faculty, staff, and students can support LGBT community members and provide a safe educational space. In order to address this we created a condensed training resource that focused on skill building and is easily implemented institution-wide for students, residents, fellows, faculty, and staff. Methods This module serves as an introduction to concepts integral to the LGBT community. It is structured into two sections and takes approximately 30 minutes to complete, including pre-/postevaluations. The first section of the module focuses on presenting basic information about the LGBT world experience and basic terminology. The second section contains two real-world scenarios aimed at demonstrating skills used to create a safe educational learning space. Each scenario contains interactive questions that allow participants to practice applying their new skills. Results To date, 89 institutional community members at the Northwestern University Feinberg School of Medicine have completed the module. Survey results demonstrate that the module was well-received and effective at improving attitudes towards creating a safe space. Discussion While this module provides a foundation in terminology and phenomena relevant to the LGBT experience, it is just one part of creating a positive institutional climate for LGBT community members. Additional in-person skills-based training should also be considered to complement and enhance this modules contents.

In reply to Gowda et al and to Yudkowsky.

Academic Medicine, Vol. 89, No. 6 / June 2014 835 While We Advocate for Integrated Electronic Medical Records, Continue to Empower Patients and Families To the Editor: Medical students everywhere sympathize with, and likely can unanimously relate to, Mr. Ehrmann’s account of his recent futile attempts to obtain a transfer patient’s medical records that were critical to ongoing treatment. Disjointed systems and unavailable archives regularly drive frustration and delay patient care. With each failed attempt to obtain records, the cycle of redundant diagnostic medicine repeats, as it is currently the only way to serve our patients in real time. I into an HTT exam. However, it is our impression that if the Core + Clusters curriculum is learned, there would be no need for students to perform the HTT in clinical settings. The Core + Clusters curriculum is designed to allow students to identify and perform maneuvers relevant to their particular patient, without the rote learning that the HTT perpetuates. We agree with Dr. Yudkowsky that determining which of these approaches to learning the PE is most effective is testable, and we look forward to further contributions to this area of research.

Update in general internal medicine.

The aim of this update is to briefly summarize the research articles published in 2008 that we think have the most important implications for General Internal Medicine practice. The wide breadth of General Internal Medicine practice always makes selecting articles a challenging and somewhat subjective process. In selecting articles, we relied heavily on the internal process we routinely use to do this in the Division of General Internal Medicine at Northwestern University. Each month, faculty members review an array of journals and journal aggregators (e.g., ACP Journal Club and Journal Watch General Medicine) to identify potential articles for discussion. A subgroup of the faculty then selects articles that deserve in-depth review and discussion by the entire faculty at our monthly Journal Club. If an article is judged to be particularly important and practice-changing, we then try to use this as a springboard for quality improvement efforts. For this review, we concentrate on eight articles with findings that we think should guide our practice in the future.