Medical Students and the Drive for a Single Right Answer: Teaching Complexity and Uncertainty.

The arrival of Generation Z, the next generation of medical learners, has been accompanied by efforts to adapt teaching practices for this new group of students. Many have identified challenges associated with addressing the needs of modern medical learners. One particular trend we have observed is that medical students are increasingly requesting an "answer key" for all aspects of their medical education. Students often expect to have the correct answers readily available to them to ensure they have reached the correct conclusion and to determine the precise knowledge they need to master. Yet, for much of medicine, and particularly in the care of critically ill patients with multisystem disease in intensive care units, answers are uncertain, and the body of knowledge is ever-growing. Students' regular requests for solutions to be provided to them threaten to undermine their development into critically thinking, self-sufficient physicians. We outline three potential contributors to this multifactorial problem and offer corresponding pedagogical solutions. Specifically, we address how prioritizing outcomes over process, discomfort with uncertainty, and fear of faltering can cause students to seek excessive levels of support that may ultimately do more harm than good. Addressing students' concerns in these three key areas will not only serve students well during their undergraduate medical training but will also equip them with the skills needed to succeed in the clinical realm. To produce physicians capable of navigating an increasingly uncertain world, medical educators will need to help students appreciate that finding the answer is more complex than being provided an answer key.

'Educator with a capital E': Comparing medical education experiences of student-as-teacher elective participants and peers.

PURPOSE: Student-as-teacher electives are increasingly offered at medical schools, but little is known about how medical education experiences among enrolled students compare with those of their peers. The study's aim was to characterize medical students' education-related experiences, attitudes, knowledge, and skills based on their enrollment status in a student-as-teacher course. MATERIALS/METHODS: We conducted four focus groups at a medical school in the United States: two with graduating students in a student-as-teacher elective (n = 11) and two with unenrolled peers (n = 11). Transcripts were analyzed using the Framework Method to identify themes. RESULTS: Four themes emerged: interest in and attitudes towards medical education; medical education skills, knowledge, and frameworks; strategies for giving/receiving feedback; medical education training as part of medical school. Course participants demonstrated higher-level education-related knowledge and skills. Both groups endorsed teaching skills as important and identified opportunities to incorporate medical education training into medical school curricula. CONCLUSIONS: Medical education knowledge and teaching skills are self-reported as important learning outcomes for medical students, independent of enrollment status in a student-as-teacher course. The structure of such courses, best understood through a deliberate practice-based model, supports students' achievement of key learning outcomes. Certain course elements may warrant inclusion in standard medical school curricula.

Factors Associated With Family Experience in Pediatric Inpatient Care.

BACKGROUND: Hospitals are rapidly increasing efforts to improve the pediatric inpatient experience. However, hospitals often do not know what to target for improvement. To determine what matters most to families, we assessed which aspects of experience have the strongest relationships with parents' willingness to recommend a hospital. METHODS: Cross-sectional study of 17 727 surveys completed from November 2012 to January 2014 by parents of children hospitalized at 69 hospitals in 34 states using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. Hierarchical logistic regressions predicted the "top box" for willingness to recommend from measures of specific care dimensions (nurse-parent communication, doctor-parent communication, communication about medicines, keeping parents informed about the child's care, privacy with providers, preparing to leave the hospital, mistakes and concerns, child comfort, cleanliness, and quietness), adjusting for parent-child characteristics. Relative importance was assessed by using partially standardized adjusted odds ratios (aORs). RESULTS: Child comfort (aOR 1.50; 95% confidence interval 1.41-1.60) and nurse-parent communication (aOR 1.50; 95% confidence interval 1.42-1.58) showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. Privacy and quietness were not significantly associated with willingness to recommend in multivariate analysis. CONCLUSIONS: Our study uncovered highly valued dimensions that are distinct to pediatric care. Hospitals that care for children should consider using dedicated pediatric instruments to measure and track their performance. Improvement efforts should focus on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.