Pelvic examination skills training with genital teaching associates and a pelvic simulator: does sequence matter?

INTRODUCTION: Introducing the pelvic examination to novice learners has been a challenging task for medical educators. The purpose of this study was to evaluate an educational intervention adding the use of a pelvic examination simulator (SIM) to the use of genital teaching associates (GTAs) in a pelvic examination skills curriculum for second-year medical students. METHODS: Each student participated in a session with the pelvic simulator and with the GTA. Students were randomized to the training sequence. Outcome measures include the Fear of Pelvic Examination Scale (F-PEXS), blood pressure measurement, and instructor evaluation of learning performance. RESULTS: For students who learned with a GTA in the first session, the mean F-PEXS score decreased significantly, and the learning performance score was significantly higher from sessions 1 to 2. There was no significant change in either measure when the pelvic simulator was used first. For both learning sequences, men had a significantly higher F-PEXS score. CONCLUSIONS: When using simulation to teach the pelvic examination to novices, standardized patients seem to be the better initial training experience, reducing student anxiety and improving learner engagement with subsequent mechanical simulation practice of psychomotor skills.

Communication skills instruction: an analysis of self, peer-group, student instructors and faculty assessment.

OBJECTIVE: To explore the correlation of student and faculty assessments of, second-year dental students' (D2s) communicative skills during simulated patient interviews. METHODS: Eighty-two D2s, 14 student instructors and 8 faculty used a 5-point scale, (1=poor-5=excellent) to assess 12 specific communicative skills of D2s generating assessment sources of self, peer-group, student instructor, and faculty. Mean scores and comparisons between assessment sources were calculated. Spearman correlations evaluated relationships between specific skills and assessment sources. RESULTS: Mean assessment score and standard error for peer-group (4.14 ± 0.04), was higher than self (3.86 ± 0.06, p<0.05) yet slightly higher than student instructor (4.07 ± 0.04) and faculty (3.93±0.10). Regarding assessment sources, the degree of correlation from highest to lowest was peer-group and student instructor (ρ=0.46, p<0.0001), self and student instructor (ρ=0.35, p<0.002), self and peer-group (ρ=0.28, p<0.02). The correlations between student instructor and faculty, faculty and self, and faculty and peer-group were nonsignificant. CONCLUSION: Student assessments were different from faculty by mean score and correlation index. Future studies are needed to determine the nature of the differences found between student and faculty assessments. PRACTICE IMPLICATIONS: Peer, student instructor and faculty assessments of dental students' communicative skills are not necessarily interchangeable but may offer uniquely different and valuable feedback to students.

Communication skills instruction utilizing interdisciplinary peer teachers: program development and student perceptions.

Lack of curricular time, faculty time, and funding are potential limitations for communication skills training in dentistry. Interdisciplinary collaboration amongst health care faculties could address these limitations. This article describes the development, implementation, and student perceptions of a communication skills program in dentistry. The program has four components: Knowledge, Observation, Simulation, and Experience (KOSE) and spans over the second and third years of dental school. KOSE allows students to obtain knowledge of and observe effective communication skills and practice these skills in the simulated and nonsimulated environment. A key feature of KOSE is the utilization of fourth-year medical and dental students as peer teachers. Evaluation of KOSE was geared toward student perceptions. Cross-sectional data were gathered via written surveys from 143 learners (second- and third-year dental students) in 2006-07. Students perceived the ability to recognize effective communication, demonstrated awareness of their communication strengths and weaknesses, and reported that skills gained were transferable to actual patient care. Interdisciplinary collaboration was a feasible way to address the lack of resources in the development of a communications skills program, which was perceived to be worthwhile by learners.

The importance of "high valence" events in a successful program for teaching geriatrics to medical students.

Virginia Commonwealth University developed an enhanced medical student geriatric curriculum that includes required home visits and nursing home visits for second year students (180 per year), an annual Forum on Aging for all first and second year students, and small group exercises. We added 30 hours of basic science material to pre-clinical courses and increased clinical exposure to geriatricians in third and fourth years. Student satisfaction with individual experiences was high. Persistent effects of "high valence" required activities, where emotion played a role, was shown by post-pre survey techniques and focus groups. Fourth year AAMC exit questionnaire items in areas addressed by this curriculum improved markedly between 2002 and 2006, while an internal control changed much less.

Medical student evaluation of faculty in student-preceptor pairs.

BACKGROUND: Students' willingness to provide candid feedback about faculty in student-preceptor pairs is unknown. Strategies addressing this in U.S. medical schools have not been reported. This study describes student comfort in evaluating preceptors and how medical schools obtain/use evaluations of preceptors. METHOD: First- and second-year medical students at Virginia Commonwealth University completed a survey at midyear and year end. A Web-based survey of U.S. medical schools was conducted. RESULTS: Two hundred eighty-two (78%) students and 84 (70%) medical schools responded. Most students felt comfortable providing feedback to program faculty (95%), whereas fewer felt comfortable with the preceptor (77%). Students commented on both the importance and awkwardness of giving feedback. Approximately 75% of medical schools agreed that lack of anonymity limits student candor on preceptorship evaluations. CONCLUSIONS: Understanding the impact of one-to-one ratio on student evaluations of faculty may enable programs to develop more effective evaluation strategies.

Professional development in geriatrics for community-based generalist faculty.

Generalist physicians provide most primary care for older people. Increasingly, undergraduate clinical education occurs in community sites. Hence, community-based generalist faculty members need continuing education in geriatrics to support clinical practice and teaching. The Geriatrics Scholars Program provided continuing medical education (CME) in geriatrics over a 3-year period to 88 participants. Sixty physicians completed 30 or more hours of education and were designated Geriatrics Scholars. On an anonymous exit survey, Scholars reported being better equipped to care for elderly patients and to teach geriatrics and improved patient care in specific aspects of geriatrics, including medication use, cognition, and functional assessment. In summary, community-based generalist faculty who participated in a substantial, 3-year program of geriatrics CME reported that their care of older people and their teaching of geriatrics were enhanced.