Teaching brief motivational interviewing to medical students using a pedagogical framework.

OBJECTIVE: Medical schools are charged with assisting medical students to acquire the confidence, knowledge and skills for behavior change conversations in primary healthcare. The present study evaluated teaching brief motivational interviewing (MI) to pre-clinical medical students. METHODS: Forty-six students participated in an educational intervention premised on the Learn, See, Practice, Prove, Do, Maintain pedagogical framework, comprising 2 × 2-h lectures, a 2-h role-play triad session, and 3 × 2-h small group simulated patient encounters supported by scaffolding strategies. Measures of brief MI knowledge (MI Knowledge and Attitudes Test & Multiple-Choice Knowledge Test) and confidence (MI Confidence Scale) were taken at baseline, post-training, and 3-month follow-up, and skills (Behavior Change Counseling Index) were assessed at three intervals during simulated patient encounters. RESULTS: Students who received brief MI training improved in knowledge and confidence from baseline to post-training and gains remained at 3-months. Brief MI skills improved across the simulation sessions. CONCLUSION: Pre-clinical medical students can attain knowledge, confidence and skills in brief MI after participation in a short intervention and improvements are sustainable. PRACTICE IMPLICATIONS: Our results support the use of an evidence-based pedagogical framework for teaching brief MI in pre-clinical years of medical curricula and our scaffolding strategy affords promise.

A simulated emergency department for medical students.

BACKGROUND: During their training, medical students often undertake a rotation in an emergency department (ED), where they are exposed to a wide variety of patient presentations. Simulation can be an effective teaching strategy to help prepare learners for the realities of the clinical environment. Simulating an ED shift can provide students with the opportunity to perform a range of clinical activities, within their scope of practice, in a supervised and supportive learning environment. Medical students often undertake a rotation in an emergency department CONTEXT: There is limited literature describing the structure, syllabus, feasibility and perceived usefulness of simulating a typical ED for medical student training. INNOVATION: We developed a simulated ED (simED) teaching session for medical students at our university. Students were informed of the purpose and learning tasks of the session prior to attendance. At the start of their 2-hour simED shift students were allocated 'patients' by the Triage nurse. At the completion of their shift, students attended a debriefing discussion. Student feedback indicated that they felt that the simED: provided a good opportunity to practise skills and apply theory to practice; was realistic and challenging; highlighted the importance of teamwork; and enabled them to identify skills requiring further practise. Suggestions for improvements included a longer time spent in the simED and the opportunity to see more patients. IMPLICATION: The simED approach seemed to be well received and perceived by medical students as useful preparation for the ED. An overview of the structure, materials and resources used is provided to assist educators seeking to implement similar ED clinical scenarios in their curriculum.

Pre-clinical medical students' perceptions of their patient safety skills in a simulated emergency department.

OBJECTIVES: Patient safety has emerged as an important topic for inclusion in medical curricula. However, there is limited literature describing how medical students are taught, learn and self-assess patient safety skills. The present study aimed to seek pre-clinical medical students' perceptions of (i) their individual performance at a range of safety skills; and (ii) how they define patient safety in a simulated ED. METHODS: Data were collected in the form of questionnaire responses at the end of the Bond University Simulated ED activity in October 2014. The simulated ED is a session for pre-clinical medical students prior to their clinical rotations, aimed at preparing them for the clinical environment. Likert scale and short answer responses were used to describe students' perceptions of their safety skills and to identify themes related to patient safety. RESULTS: Seventy-eight out of 92 students completed the questionnaires (85% response rate). The majority of students thought their patients were safe from adverse events during their shift. However, students' perception of patient safety was wide-ranging and demonstrated a number of misconceptions. The most frequent strategies employed by students to ensure patient safety were asking for help from nursing staff or senior doctors, ensuring good communication with the patient and checking allergies before administering medication. CONCLUSION: Students had a favourable opinion of their own safety skills. However, answers to free text question revealed misconceptions about the nature of patient safety despite significant teaching on this topic.