Education Research: A Qualitative Study on Student Perceptions of Neurology and Psychiatry Clerkship Integration.

OBJECTIVE: To explore student perceptions of the feasibility of neurology and psychiatry clerkship integration, including clinical education and competency evaluation, as there has been a call to improve undergraduate medical education integration of the disciplines to better develop physicians that can address nervous system disorders. METHOD: Via a constructivist grounded theory approach, we carried out 5 focus groups in 2016-2017 with 28 medical students who completed both independent clerkships. Investigator triangulation was used with iterative interpretation comparisons, and themes were identified using constant comparative analysis. RESULTS: Three major themes arose: (1) combining the clerkships was not favorable as students need sufficient time to delve deeper into each discipline; (2) students did not observe an integrated clinical approach by faculty; (3) there is positive value to making links between neurology and psychiatry for effective patient care. CONCLUSIONS: Students emphasized the importance of making stronger links between the 2 disciplines for their learning and to improve patient care; however, they did not observe this clinical approach in the workplace. Students perceived that integration of neurology and psychiatry clerkships should occur via increased affinity of the complementary discipline by trainees and faculty in each specialty.

Organizational consciousness.

PURPOSE: The purpose of this paper is to develop a conceptual understanding of organizational consciousness that expands the discussion of organizational analysis, and use a case study to apply it in the analysis of a merger between an academic health center and a regional medical center. DESIGN/METHODOLOGY/APPROACH: The paper draws on the experiences and insights of scholars who have been exploring complex organizational issues in relationship with consciousness. FINDINGS: Organizational consciousness is the organization's capacity for reflection; a centering point for the organization to "think" and find the degree of unity across systems; and a link to the organization's identity and self-referencing attributes. It operates at three stages: reflective, social, and collective consciousness. RESEARCH LIMITATIONS/IMPLICATIONS: Translating abstract concepts such as consciousness to an organizational model is complex and interpretive. For now, the idea of organizational consciousness remains mostly a theoretical concept. Empirical evidence is needed to support the theory. PRACTICAL IMPLICATIONS: Faced with complicated and compelling issues for patient care, health care organizations must look beyond the analysis of structure and function, and be vigilant in their decisions on where important issues sit on the ladder of competing priorities. Organizational consciousness keeps the organization's attention focused on purpose and unifies the collective will to succeed. ORIGINALITY/VALUE: If the paper can come to understand how consciousness operates in organizations, and learn how to apply it in organizational decisions, the pay-off could be big in terms of leading initiatives for change. The final goal is to use what is learned to improve organizational outcomes.