ABSTRACT
The Deans' Rural Primary Care Clerkship was developed through the collaborative efforts of South Carolina's two medical schools. The clerkship provides students an innovative learning experience in rural community medicine through the unique combination of learning opportunities with community-oriented primary care, continuous quality improvement, interdisciplinary health care teams, and cultural competency. Much of students' learning addresses current directives for population health training. The positive experience students are having in these rural, underserved South Carolina communities will help them better understand the rewards and challenges of rural, community-responsive health care.
Subject(s)
Clinical Clerkship , Rural Health , Clinical Competence , Humans , South CarolinaABSTRACT
This study examined medical students' use of the WHACS mnemonic during an occupational history objective structured clinical examination station. Students' performance on the 10 content-specific station items was calculated. Factor analysis of the items was conducted, and student demographic and academic characteristics associated with performance on the station were examined. A total of 205 students completed the station. The mean number of correct responses was 5 (SD, 1.6). Students performed well on some items and less well on others. Factor analysis supported the WHACS framework. There were no significant associations with student demographic or academic characteristics. Students were aware of the particular features of an occupational history but were deficient in other areas; this awareness was not related to demographic or academic characteristics. The WHACS mnemonic could be an effective tool to teach occupational history-taking skills.
Subject(s)
Family Practice/education , Medical History Taking , Occupational Medicine/education , Students, Medical , Adult , Clinical Clerkship , Factor Analysis, Statistical , Female , Humans , Male , Patient SimulationABSTRACT
PURPOSE: The authors evaluated the ability of a two-step admission process to predict clinical performance and patients' satisfaction on a third-year objective structured clinical examination (OSCE). METHOD: Subjects were three matriculating classes (1993, 1994, 1995) at one medical school. Data for the classes were analyzed separately. Independent variables were the Academic Profile (AP), an initial ranking of applicants based on grade-point ratio and MCAT scores, and the Selection Profile (SeP), an average of three interview scores. Interviews were offered based on AP rank, and admission was offered based on SeP rank. Dependent variables were total score on the faculty-graded portion of the OSCE and patients' satisfaction scores completed by the OSCE standardized patients. The authors evaluated the correlations between AP and OSCE performance and between SeP and OSCE performance. The authors also compared the OSCE performances of students whose ranks changed after interviews (SeP rank < AP rank or SeP rank > AP rank). The level of significance was adjusted for the number of comparisons (Bonferroni method). RESULTS: Complete data were available for 91% of eligible students (n = 222). No class showed a significant correlation between either AP or SeP rankings and OSCE performance (p > .01). Likewise, there was no difference in OSCE performance for students whose ranks changed after the interview. CONCLUSIONS: The admission ranking and interview process at this medical school did not predict clinical performance or patients' satisfaction on this OSCE.
Subject(s)
Clinical Competence , Educational Measurement/methods , Family Practice/education , Schools, Medical/organization & administration , Achievement , Evaluation Studies as Topic , Humans , Patient Satisfaction , School Admission CriteriaABSTRACT
BACKGROUND AND OBJECTIVES: Several experts have emphasized the need to respond to a patient's emotions as an essential component of effective medical interviewing. This study examined the relationship of faculty observers' scores of students' performance in standardized patient (SP) interviewing stations in a family medicine clerkship objective structured clinical examination (OSCE) with SP satisfaction measures. METHODS: The faculty observers scored students in the following performance domains: 1) interviewing skills, 2) negotiating the diagnosis or plan, 3) gathering case-specific content information, 4) responding to the patient's emotions, and 5) student's overall performance. Pearson Product-Moment correlations were calculated for each of these domains and the Standardized Patient Satisfaction Questionnaire (SPSQ) scores. RESULTS: There were moderate correlations between the SPSQ score and the overall OSCE score (.45) and the response to patient's emotions skill score (.36). The faculty observer's response to patient's emotion score correlated highly with the student's overall OSCE score (.75). CONCLUSIONS: A student's ability to respond to the patient's emotions appears to be an important skill for successful medical interviewing from both the faculty observer's perspective and the SP's perspective. Results also demonstrate that the SP's perspective is similar, but not identical, to the faculty observer's perspective, suggesting that SPs have an important evaluative role in student assessment.
Subject(s)
Emotions , Family Practice/education , Patient Satisfaction , Patients/psychology , Physician-Patient Relations , Family Practice/methods , Humans , Interviews as Topic , Perception , Quality of Health Care , Students, Medical , Surveys and QuestionnairesABSTRACT
Students bring fresh ideas, knowledge, and perspective to health care organizations. As students learn how to apply the principles and methods of continuous improvement, they help improve both the quality of health care and the organization's way of improving quality.
