Educational value of the operating room experience during a core surgical clerkship.

BACKGROUND: The amount and content of medical student teaching in the operating room and its alignment with clerkship goals was unknown. METHODS: A qualitative research design using field observations, followed by qualitative and quantitative data coding and analysis. RESULTS: A mean of 9.8% of the total case time (range 1.6%-20.2%) was spent teaching clerkship goals. Teaching strategies based on basic principles of learning were used during a mean of 66% of the total case time (range 30%-99%). The most common teaching strategy was active student participation (28%) followed by command (14%) and lecture (13%). Educational experience in the OR was rated 4.0 (out of 5) by faculty and 3.3 by students. No correlation existed between student satisfaction and time actively participating in the operation or time spent teaching to clerkship goals (P = .66, P = .95, respectively). CONCLUSION: Teaching in the OR is more focused on technical aspects of the operation than the goals of a core surgery clerkship.

Residents as teachers of the pelvic floor and perineal anatomy.

CONTEXT: : As much as 50% of teaching is conducted by residents with limited clinical experience, pedagogical acumen or knowledge of the subject they teach. OBJECTIVE: : The purpose was to develop a residents-as-teachers program that integrated a basic science curriculum of the pelvic floor and perineal anatomy with clinical correlations while instructing residents in certain clinical and pedagogical skills. DESIGN: : A resident-as-teacher curriculum that focused on both the pedagogy and content related to pelvic floor and perineal anatomy was designed and collaboratively implemented by an anatomist, obstetrics/gynecology clinicians and a professional educator. It was implemented 4 times, with each session offered as a 3-hour training. A mixed-methods research design was used to study the impact of the resident-as-teacher program on the residents. SETTING: : A medical school anatomy laboratory. PATIENTS OR PARTICIPANTS: : A total of 51 residents in the Brigham and Women's Hospital/Massachusetts General Hospital Integrated Residency Training Program in Obstetrics and Gynecology (PG-1, -2, -3 and -4) and 4 Harvard Medical School students. INTERVENTIONS: : Four 3-hour resident-as-teacher curricular sessions. MAIN OUTCOME MEASURES: : To understand the impact of an innovative resident-as-teacher curriculum on Obstetrics and Gynecology residents. RESULTS: : The intervention significantly affected the residents' knowledge of pelvic floor and perineal anatomy and significantly increased the residents' comfort level with teaching pelvic floor and perineal anatomy. All the residents agreed that learning how to teach using clinical correlations and integrating the laboratory experience were excellent and that it was beneficial to be taught by the combination of clinical, anatomical and educational faculty. CONCLUSIONS: : Teaching residents how to teach using a hands-on anatomical laboratory experience relevant to their daily work was overwhelmingly positive. The recommendation was to continue the program and implement the session at least biannually.

An innovative curriculum for primary care neonatology.

This article describes the design of an innovative curriculum for pediatric residency newborn nursery rotation. In 1989, the Accreditation Committee for Graduate Medical Education added the requirement of newborn care to pediatric residency training; in 1996, the Accreditation Committee for Graduate Medical Education expanded that requirement. Specifically, certification required 4 weeks of newborn care, separate from any neonatal intensive care experience, and with at least 2 weeks in a newborn nursery. In response, we designed a structured newborn nursery curriculum for our pediatric residency training program. Three areas of focus were identified, from which the content and the strategies for teaching were derived. The areas of focus were (1). primary care, (2). confluence of levels of care that arise in newborn care, and (3). limitations and advantages of the structure and the environment of the rotation. The curriculum was implemented on a pediatric level 1 (PL-1) rotation entitled "primary care neonatology."