Mentorship of US Medical Students: a Systematic Review.

BACKGROUND: Mentoring of medical students remains a core pillar of medical education, yet the changing landscape of medicine has called for new and innovative mentoring models to guide students in professional development, career placement, and overall student well-being. The objective of this review is to identify and describe models of mentorship for US medical students. METHODS: We searched PubMed, PsycINFO, Education Resources Information Center, and Cochrane Databases of Systematic Reviews following PRISMA guidelines. We included original, English-language studies of any research design including descriptive studies that described a mentorship program at a US medical school designed for medical students. RESULTS: Our search yielded 3743 unique citations. Thirty articles met our inclusion criteria. There was significant diversity of the identified programs with regard to program objectives and size. The traditional dyad model of mentorship was the most frequently cited model, with a combination of models (dyad and group mentorship) cited as the second most common. Outcome measures of the programs were largely survey based, with satisfaction being the most measured outcome. Overall, satisfaction was highly rated throughout all the measured mentoring programs. Seven programs provided objective outcomes measures, including improved residency match data and increased scholarly productivity. The programs with objective outcomes measures were smaller, and 6/7 of them focused on a specific clinical area. Five of these programs relied on the traditional dyad model of mentorship. Cost and faculty time were the most frequently cited barriers to these programs. DISCUSSION: Our review demonstrates that mentoring programs for medical students can positively improve medical school satisfaction and career development. These results underscore the need for continued innovative mentoring programs to foster optimal student development in the setting of the increasingly competitive residency match process, growing expectations about student research productivity, and the national focus for overall student wellness.

A Brief Communication Curriculum Improves Resident and Nurse Communication Skills and Patient Satisfaction.

BACKGROUND: Despite the ever-expanding role that the patient experience plays in healthcare, effective strategies proven to increase patient satisfaction ratings remain scarce. At the University of Pittsburgh Medical Center, we identified patient-doctor and patient-nurse communication as an area for intervention to improve suboptimal patient satisfaction among medicine inpatients. We posited that the likely reasons for underperformance in this area were a lack of adequate training in bedside communication skills. DESIGN: We developed and evaluated a curriculum for medicine residents and nurses focused on clear communication at the bedside. A total of 76 internal medicine residents and 85 medical service nurses participated in 2016. The curriculum utilized didactics, video demonstrations, and role play, and was evaluated using pre- and post-surveys of participants' health literacy knowledge, attitudes, and confidence. Communication skills were evaluated using pre- and post-direct observation at the bedside with a communication skills checklist. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores were compared 3 months before and after the curriculum to assess changes in patient satisfaction. KEY RESULTS: Knowledge and attitudes improved significantly for both residents and nurses. Residents' and nurses' observed clinical communication skills improved significantly in most domains, and there was moderate increase in communication-specific HCAHPS scores. CONCLUSION: A small investment of curricular time devoted to clear communication skills improved residents' and medical nurses' knowledge, attitudes, skills, and communication-specific HCAHPS scores. This curriculum, focused on improving bedside communication skills, could be implemented in a variety of settings to improve patient satisfaction and patient experience.

Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education.

BACKGROUND: The flipped classroom is designed to reinvigorate education and utilizes "at-home" time to learn concepts and "in-class" time for clinical application. While some studies have shown positive effects of the flipped classroom in undergraduate medical education, there is a paucity of data on its use in graduate medical education. OBJECTIVE: We hypothesized that a flipped classroom curriculum of Medical Knowledge Self-Assessment Program (MKSAP) content with group case discussions could improve resident knowledge and preparedness in cardiology. METHODS: Ninety-eight internal medicine residents who rotated on the inpatient cardiology service from March to October 2017 were quasi-randomized into control and intervention groups, with the intervention group assigned MKSAP readings and cases to review on their own, accompanied by weekly case discussion. Pre-post surveys evaluated for change in knowledge and preparedness, quantity of teaching received, and use of MKSAP. RESULTS: A total of 93 of 98 residents (95%) participated in the curriculum. There were 37 of 51 residents (73%) in the control group and 37 of 47 residents (79%) in the intervention group who responded to pre-post assessments. In paired analysis, knowledge score did not improve significantly between the groups, nor did self-reported preparedness, number of teaching sessions per week, or reported MKSAP use. However, all participants had positive perceptions of the curriculum, and the majority felt it should be continued. CONCLUSIONS: This flipped classroom curriculum did not affect knowledge, preparedness, or number of teaching sessions for internal medicine residents on a cardiology rotation when compared to usual teaching, although residents experiencing the new model expressed high satisfaction.

Health Literacy and Clear Bedside Communication: A Curricular Intervention for Internal Medicine Physicians and Medicine Nurses.

Introduction: Communication remains the backbone of patient-provider relationships, and many health outcomes have been directly attributed to both effective and ineffective communication. We developed an educational intervention to improve bedside communication and increase use of health literacy principles, in part as a response to suboptimal inpatient satisfaction scores. Methods: Our intervention consisted of a beside communication curriculum among 37 attending medicine physicians, 76 internal medicine residents, and 85 bedside nurses. The 1- to 1.5-hour curriculum included a didactic session to teach health literacy principles, video demonstrations, group discussion, and role-play. Attending physicians' health literacy knowledge, attitudes, and confidence were evaluated using pre- and postsurveys. Evaluation of the curriculum included Likert-type questions and free-text responses. Results: Attending physicians' knowledge and confidence improved (74% correct pre, 100% correct post, p < .001; 4.41 pre, 4.68 post, p = .002, respectively). Certain attitude domains also improved, including importance of team introductions and nurse contributions to bedside rounds (p < .001). Both residents and nurses found the curriculum valuable and planned to incorporate it into their bedside rounding. Discussion: A brief, low-cost curricular intervention focusing on clear communication skills and health literacy principles resulted in significant improvements in knowledge and attitudes of attending physicians and was readily incorporated by resident physicians and nurses. This curriculum can be easily implemented in a variety of settings to improve bedside patient-physician communication.