A student-led clerkship primer: a near-peer orientation to clerkship.

The transition between pre-clerkship and clerkship can be difficult for medical students. Near-peer teaching may fill knowledge gaps within curricular clerkship orientation, leveraging recent, relatable, and up-to-date experiences from near-peers. These benefits have not been formally evaluated in the context of a clerkship orientation. We therefore created the Clerkship Primer, a near-peer teaching initiative that aimed to introduce incoming clerks to clerkship through a curricular session facilitated exclusively by senior clerkship students. Sessions had high satisfaction among students. This pilot project suggests that curricular near-peer teaching is a valuable component of clerkship orientation.

La transition entre le pré-externat et l'externat peut être difficile pour les étudiants en médecine. Un enseignement par les pairs a le potentiel de combler des lacunes dans les connaissances dans le cadre d'une orientation à l'externat, à partir d'expériences récentes et actualisées de pairs. Ces avantages n'ont pas été formellement évalués dans le contexte d'une orientation à l'externat. Nous avons donc créé le Clerkship Primer, une démarche d'enseignement par les pairs qui vise à présenter l'externat aux nouveaux externes dans le cadre d'une séance animée exclusivement par des externes séniors. Les séances ont été très appréciées par les étudiants. Ce projet pilote porte à croire qu'un enseignement par les pairs est une composante précieuse de l'orientation à l'externat.

Towards a better understanding of medical students' mentorship needs: a self-determination theory perspective.

INTRODUCTION: Mentorship programs are ubiquitous in medical education. However, few emphasize equal development for learners and mentors, or incorporate clinical skills, which may be important for promoting medical students' self-determination. Central to this consideration are the three basic psychological needs for autonomy, competence, and relatedness, described by Self-Determination Theory (SDT). Grounded in SDT, this study assesses the extent that meeting these needs, in a near-peer mentoring program, impacts learners' and mentors' motivation and perceived competence about learning and teaching of clinical knowledge, respectively. METHODS: Medical students from the University of Saskatchewan, who participated in its near-peer mentoring program (PULSE: Peers United in Leadership & Skills Enhancement), were invited to complete an anonymous survey. Regression was used to determine how the program's learning climate impacted learners' and mentors' psychological need satisfaction and perceived competence within their mentorship role. RESULTS: Learners and mentors both rated PULSE as highly needs-satisfying. In turn, this was associated with greater perceived competence about learning and teaching of the material. CONCLUSIONS: Findings from this study suggest that mentoring programs in medical education, which support learners' basic psychological needs, may promote their motivation and perceived competence-both about learning and also teaching of clinical skills. The implications of these results are discussed from an SDT perspective, with respect to mentoring programs in medical education.

INTRODUCTION: Les programmes de mentorat sont très répandus en éducation médicale. Ceux qui mettent l'accent sur un statut égal des apprenants et des mentors ou qui intègrent des compétences cliniques pouvant favoriser l'autodétermination des étudiants en médecine sont toutefois rares. Les trois besoins psychologiques fondamentaux décrits par la théorie de l'autodétermination (TAD), à savoir l'autonomie, la compétence et l'appartenance, sont au cœur de cette préoccupation. Fondée sur la théorie de l'autodétermination, la présente étude évalue dans quelle mesure la satisfaction de ces besoins, dans le cadre d'un programme de mentorat par les quasi-pairs, a un impact sur la motivation et la compétence perçue des apprenants et des mentors en matière d'apprentissage et d'enseignement des connaissances cliniques. MÉTHODES: Les étudiants en médecine de l'Université de Saskatchewan, qui ont participé au programme de mentorat par les quasi-pairs (PULSE: Peers United in Leadership & Skills Enhancement), ont été invités à remplir de façon anonyme un sondage. Des analyses de régression ont été réalisées pour déterminer l'impact du climat d'apprentissage dans le programme sur la satisfaction des besoins psychologiques des apprenants et des mentors et sur la compétence perçue de ces derniers dans leur rôle de mentors. RÉSULTATS: Les apprenants et les mentors ont estimé PULSE comme hautement satisfaisant pour leurs besoins. Cela a été associé à une plus grande compétence perçue en ce qui concerne l'apprentissage et l'enseignement des contenus. CONCLUSIONS: Les résultats de cette étude suggèrent que les programmes de mentorat en éducation médicale qui soutiennent les besoins psychologiques fondamentaux des apprenants peuvent renforcer leur motivation et leur compétence perçue, à la fois pour l'apprentissage et pour l'enseignement des compétences cliniques. Les incidences de ces résultats pour les programmes de mentorat par les pairs en éducation médicale sont analysées du point de vue de la TAD.

Diffusing the bilingual lexicon: Task-based and lexical components of language switch costs.

Bilingual speakers show a response time (RT) cost when switching between languages. These costs could reflect the organization of language in a shared bilingual lexicon (Grainger, Midgley, & Holcomb, 2010) or a domain general cognitive processing cost (Green & Abutalebi, 2013). To test these accounts, we analysed RT distributions of bilingual (Spanish-English) performance on generalized lexical decision (GLD) tasks using Ratcliff (1978) diffusion model. Experiment 1 revealed that language switches decrease the rate of evidence accumulation (drift rate) and slow the cognitive processes that occur prior to decision-making (non-decision time). Experiment 2 showed that the anticipation of language switches did not change these effects. The results suggest that language switch costs originate from a combination of at least two loci: lexical access and a task-specific decision process.

Disentangling the developmental trajectories of letter position and letter identity coding using masked priming.

Masked transposed-letter (TL) priming effects have been used to index letter position processing over the course of reading development. Whereas some studies have reported an increase in TL priming over development, others have reported a decrease. These findings have led to the development of 2 somewhat contradictory accounts of letter position development: the lexical tuning hypothesis and the multiple-route model. One factor that may be contributing to these discrepancies is the use of baseline primes that substitute letters in the target word, which may confound the effect of changes in letter position processing over development with those of letter identity. The present study included an identity prime (e.g., listen-LISTEN), in addition to the standard two-substituted-letter (2SL; e.g., lidfen-LISTEN) and all-letter-different (ALD; e.g., rodfup-LISTEN) baselines, to remove the potential confound between letter position and letter identity information in determining the effect of the TL prime. Priming effects were measured in a lexical decision task administered to children aged 7-12 and a group of university students. Using inverse transformed response times, targets preceded by a TL prime were responded to significantly faster than those preceded by 2SL and ALD primes, and priming remained stable across development. In contrast, targets preceded by a TL prime were responded to significantly slower than those preceded by an ID prime, and this reaction-time cost increased significantly over development, with adults showing the largest cost. These findings are consistent with a lexical tuning account of letter position development, and are inconsistent with the multiple-route model. (PsycINFO Database Record

Word and pseudoword superiority effects on letter position processing in developing and skilled readers.

Studies have shown that letter position processing changes as reading develops. Whether these changes are driven by the development of the orthographic lexicon is currently unclear. In this study, we administered a novel variant of the Reicher-Wheeler task to children aged 7-12 years (Experiment 1) and adults (Experiment 2) to clarify the role of the developing lexicon in letter position processing. The task required participants to report the identity of a letter at a specified position within 3 orthographic contexts: anagram words (e.g., slime - which has the anagram partner, smile), pseudowords (e.g., blire - brile), and illegal nonwords (e.g., bfgsv - bsgfv). The influence of a reader's whole-word orthographic representations was investigated by comparing the performance of words to pseudowords (word superiority effect or WSE), and the influence of their knowledge of orthotactic constraints was investigated by comparing pseudowords to illegal nonwords (pseudoword superiority effect or PSE). While the PSE increased with developing orthographic skills (as indexed by irregular word reading) in primary schoolchildren, the WSE emerged only in adult readers. Furthermore, the size of the WSE increased with orthographic skill in adults. The findings are discussed in regards to current models and theories of visual word recognition and reading development. (PsycINFO Database Record

The locus of impairment in English developmental letter position dyslexia.

Many children with reading difficulties display phonological deficits and struggle to acquire non-lexical reading skills. However, not all children with reading difficulties have these problems, such as children with selective letter position dyslexia (LPD), who make excessive migration errors (such as reading slime as "smile"). Previous research has explored three possible loci for the deficit - the phonological output buffer, the orthographic input lexicon, and the orthographic-visual analysis stage of reading. While there is compelling evidence against a phonological output buffer and orthographic input lexicon deficit account of English LPD, the evidence in support of an orthographic-visual analysis deficit is currently limited. In this multiple single-case study with three English-speaking children with developmental LPD, we aimed to both replicate and extend previous findings regarding the locus of impairment in English LPD. First, we ruled out a phonological output buffer and an orthographic input lexicon deficit by administering tasks that directly assess phonological processing and lexical guessing. We then went on to directly assess whether or not children with LPD have an orthographic-visual analysis deficit by modifying two tasks that have previously been used to localize processing at this level: a same-different decision task and a non-word reading task. The results from these tasks indicate that LPD is most likely caused by a deficit specific to the coding of letter positions at the orthographic-visual analysis stage of reading. These findings provide further evidence for the heterogeneity of dyslexia and its underlying causes.

A behavioral database for masked form priming.

Reading involves a process of matching an orthographic input with stored representations in lexical memory. The masked priming paradigm has become a standard tool for investigating this process. Use of existing results from this paradigm can be limited by the precision of the data and the need for cross-experiment comparisons that lack normal experimental controls. Here, we present a single, large, high-precision, multicondition experiment to address these problems. Over 1,000 participants from 14 sites responded to 840 trials involving 28 different types of orthographically related primes (e.g., castfe-CASTLE) in a lexical decision task, as well as completing measures of spelling and vocabulary. The data were indeed highly sensitive to differences between conditions: After correction for multiple comparisons, prime type condition differences of 2.90 ms and above reached significance at the 5% level. This article presents the method of data collection and preliminary findings from these data, which included replications of the most widely agreed-upon differences between prime types, further evidence for systematic individual differences in susceptibility to priming, and new evidence regarding lexical properties associated with a target word's susceptibility to priming. These analyses will form a basis for the use of these data in quantitative model fitting and evaluation and for future exploration of these data that will inform and motivate new experiments.

Student perceptions of the care of children: impacts of pre-clerkship pediatric and primary care clinical teaching.

BACKGROUND: Pediatric clinical skills teaching sessions provide an early opportunity for students to be exposed to the medical care of children. This report describes second and third year medical students' perceptions of and attitudes towards working with children before and after the pediatric clinical skills teaching sessions, and the experiences of those students precepted by pediatricians only compared to those students working with a combination of pediatricians and family physicians. METHOD: A 13 question survey was voluntarily completed before and after teaching sessions. Written reflective assignments were qualitatively analyzed for key themes. Response rate averaged 68% with class sizes of 84 and 85 students. RESULTS: Students' perceptions of the care of children were generally very positive. Some differences were found based on gender, phase of study and prior clinical exposure to pediatric care. Pre and post responses were similar, regardless of preceptor specialty. Students with family physician preceptors identified the themes of prevention, health promotion and multidisciplinary care in their reflections. CONCLUSIONS: Students had already formed positive attitudes toward the medical care of children and intended to care for children in their future practice. Further research is needed into the effects of pre-clerkship experiences in the care of children on choice of medical specialty.

Implementing an evidence-informed faculty development program.

OBJECTIVE: To establish an evidence-informed faculty development program. DESIGN: Survey derived from a needs-assessment tool. SETTING: Department of Academic Family Medicine at the University of Saskatchewan, which is geographically dispersed across the province. PARTICIPANTS: Full-time faculty members in the Department of Academic Family Medicine at the University of Saskatchewan. MAIN OUTCOME MEASURES: Creation of an evidence-informed faculty development program. RESULTS: The response rate was 77.3% (17 of 22). The data were stratified by 2 groups: faculty members with less than 5 years of experience and those with 5 or more years of experience. Those with less than 5 years of experience rated the following as their top priorities: teaching, developing scholarly activities, and career development. Those with 5 or more years of experience rated the following as their top priorities: administration and leadership, teaching, and information technology. Although there were differences in overall priorities, the 2 groups identified 17 out of 54 skills as important to faculty development. CONCLUSION: The results of the needs-assessment tool were used to shape a dynamic, evidence-informed faculty development program with full-time faculty in the Department of Academic Family Medicine at the University of Saskatchewan. Future programs will continue to be dynamic, faculty-centred, and evidence-informed.

The longitudinal elderly person shadowing program: outcomes from an interprofessional senior partner mentoring program.

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults. Existing literature on SMPs provides little information on the sustainability of attitudinal changes toward older adults or changes in interprofessional attitudes. LEPS students completed Polizzi's Aging Semantic Differential and the Interdisciplinary Education Perception Scale. Perceptions of older men and women improved significantly and changes were sustained after one year. However, few changes were seen in interprofessional attitudes.

Source monitoring and proneness to auditory-verbal hallucinations: a signal detection analysis.

INTRODUCTION: It has been suggested that a bias to misattribute self-generated thoughts to a nonself source underlies the experience of auditory-verbal hallucinations (AVH). We tested this hypothesis with healthy participants prone or not prone to AVH. METHOD: Participants (N=133) were presented with 96 words for subsequent recognition (half positively, half negatively valenced). For self-generated trials, participants generated a sentence containing the word. For other-generated trials, participants heard a prerecorded sentence containing the word. At test, studied words were re-presented visually, intermixed with 96 matched lures. Participants indicated the study status (old or new) and source (self or other) for each item. Sensitivity and bias measures were derived for item and source memory using signal detection theory. The 20 participants scoring highest on questions relating to AVH from the revised Launay-Slade Hallucination Scale formed the high-AVH group and the 20 scoring lowest formed the low-AVH group. RESULTS: ANOVAs revealed no significant differences between the two participant groups in sensitivity or bias of source memory, regardless of item valence. There was a trend for the sensitivity of item memory to be lower in the high-AVH group, compared with the low-AVH group. The bias of item memory was not significantly different between groups. CONCLUSIONS: Although we found no evidence that source-monitoring problems underlie the experience of AVHs in the general population, we recommend that signal detection measures be applied in future investigations of source monitoring in at-risk and clinical populations.

Hearing voices inside and outside the head: spatial source monitoring in participants prone to auditory hallucinations.

INTRODUCTION: Previous studies of source monitoring and auditory hallucinations (AH) have often conflated spatial source (internal-external) with source agency (self-other). Other studies have used suboptimal manipulations of auditory space (e.g., imagine saying vs. saying aloud). We avoided these problems by presenting experimenter-generated stimuli over headphones in the voice of another person so that the location of the voice sounded either internal or external to the participant's head. METHODS: Participants (N=121) studied 96 words and indicated for each whether it was presented internally or externally (online spatial source monitoring). At test, studied words were presented visually, intermixed randomly with 96 unstudied words. Participants indicated whether each item was old or new (item memory) and whether it was presented internally or externally during study (spatial source memory). Independent measures of memory accuracy and response bias were derived for online source monitoring, item memory and source memory using signal detection theory. Performance on these measures was compared between two groups of 30 participants who scored low or high on a measure of AH proneness. RESULTS: ANOVAs revealed no differences between the high- and low-AH groups in online spatial source monitoring, item memory, or spatial source memory. CONCLUSIONS: We found no evidence that proneness to AH in a sample of healthy volunteers was related to any of the measures of spatial source monitoring performance. We recommend that the methods introduced be applied to future investigations of spatial source monitoring with patient groups and with individuals at-risk for psychosis.

Cultivating interest in family medicine: family medicine interest group reaches undergraduate medical students.

PROBLEM ADDRESSED: Fewer medical students are choosing careers in family medicine across Canada. One way to cultivate student interest is through creation of family medicine interest groups. Students, residents, community-based family physicians, and academic faculty can all contribute to the success of such groups. OBJECTIVE OF PROGRAM: A family medicine interest group provides information about the challenging and rewarding career of family medicine through medical students' exposure to family physicians and residents. PROGRAM DESCRIPTION: A group of faculty and undergraduate students combined forces to form the Family Medicine Club. Development of this group and results of evaluation of its effectiveness to date are discussed. CONCLUSION: One mechanism to increase interest in primary care as a career is to initiate and foster a family medicine interest group that links students with family physicians.

Understandings of health and its determinants among clients and providers at an urban community health center.

The authors' aim was to explore clients' and health care providers' perceptions of health and its determinants in preparation for the development of a screening tool to assess client health determinants at a community health center through template and editing analyses of interviews with 6 health care providers and 7 clients. Participants defined health as a multidimensional state, with common themes including the ability to cope and to function according to expectations. They identified multiple interrelated factors that affect health. The findings support existing health determinant frameworks but provide greater detail about specific determinants within broad categories presented in these frameworks. The results create a foundation for the development of a screening tool to assess client health determinants.