Soliciting feedback on the wards: a peer-to-peer workshop.

BACKGROUND: For medical students, soliciting feedback is a critical but difficult skill that merits proper training. This skill may be taught effectively by peers who have experienced challenges with feedback on the wards. METHODS: Two medical students developed and taught a workshop on feedback skills. The workshop was presented to 248 third-year students. The workshop trained students in soliciting, receiving and responding to feedback through interactive discussions of case scenarios. Students were given pre- and post-surveys to assess changes in their confidence in and attitudes towards the feedback process. RESULTS: There were statistically significant increases in students' likeliness to solicit feedback and confidence in their ability to solicit feedback. Students' view on the importance of feedback did not change. The most commonly cited barriers to feedback were time constraints, fear of negative feedback, emotions and skills when asking for feedback, and student-mentor relationship. The content the students valued the most was management of internal triggers to negative feedback. Students noted that the peer-to-peer format, case scenarios, and interactive questions were strengths of the workshop. DISCUSSION: Although medical students recognise the importance of feedback, they often lack the confidence and skills to obtain quality feedback. A peer-to-peer workshop on soliciting, receiving, and responding to feedback can be an effective method to improve students' confidence and skills in this area. More research needs to be done to conclude if this workshop increases the instances of students soliciting high-quality feedback on the wards and improves clinical performance.

Longitudinal Continuity Learning Experiences and Primary Care Career Interest: Outcomes from an Innovative Medical School Curriculum.

BACKGROUND: Medical students in the USA have negative perceptions of primary care careers, which are exacerbated by the hidden curriculum and medical school culture. Longitudinal integrated clerkships (LICs) have shown promise in ameliorating this situation by promoting student/preceptor continuity relationships and helping students maintain empathy. AIM: The aim of this study is to describe the Student Continuity of Practice Experience (SCOPE) program and demonstrate program outcomes using evaluation data from residency match results, course evaluations, and student grades. SETTING: University of Texas Medical Branch, an academic health center in Galveston, Texas. PARTICIPANTS: Undergraduate medical students. PROGRAM DESCRIPTION: Learners participate in a longitudinal curriculum designed to enhance their skills as primary care physicians. They regularly attend continuity clinic, establishing a panel of patients by their third year. Students receive frequent feedback from a faculty mentor on assignments and clinical performance. PROGRAM EVALUATION: SCOPE students have high primary care residency match rates and experience patient continuity rates comparable to an intern. Their interest in primary care increases between years one and three, a departure from typical medical student trends. DISCUSSION: SCOPE appears to promote and maintain primary care career interest in participants and has transferability to other institutions.

Estimation of the compaction of the denatured state by a protein variant involved in a reverse hydrophobic effect.

Fluorescence resonance energy transfer methods have been used to evaluate changes in the dimension of the denatured state for position 73 variants of iso-1-cytochrome c that show a reverse hydrophobic effect [Herrmann et al. (1995)]. The experiments take advantage of the Trp 59/heme donor-acceptor pair in cytochrome c. Two large aliphatic variants, Ile 73 and Leu 73, were compared directly to the wild-type protein (lysine 73). The Leu 73 was an outlier in the original work and serves as an internal control. The data show that the volume of the denatured state is contracted by a small but significant degree, 4-6%, for the Ile 73 variant whereas the Leu 73, which does not conform to the reverse hydrophobic effect, shows no significant compaction. Given that position 73 is beyond Trp 59 in the sequence, the denatured state compaction appears to be a global effect.