A professional development course for the clinical clerkships: developing a student-centered curriculum.

INTRODUCTION: Although professional development is addressed throughout the medical school curriculum, it is particularly salient to third-year students as they become integral members of health care teams. AIM: We present a professional development curriculum for third-year medical students. SETTING: Urban medical school. PROGRAM DESCRIPTION: In 2005, our curriculum consisted of 3 large group panels, each followed by a small group, occurring after the first, third, and last clerkship. Before each small group, students prepared critical incident reports, which led to focused group reflection. The individual topics were, respectively: (1) transition to clerkship learning; (2) challenges to professional behavior; and (3) medical errors. In 2006, based on student feedback, we piloted a revised student-centered panel on professionalism that was based entirely on themes from students' critical incident reports. PROGRAM EVALUATION: Students rated the curriculum well overall. In 2005-2006, the small groups ranged from 3.95 to 3.98 (SD 0.88) on a 5-point Likert scale (1 = poor, 5 = excellent) and the panels ranged from 3.54 to 4.41 (SD 0.9). The pilot panel in 2006 was rated 4.38 (SD 0.80). The most common professionalism themes generated from 185 critical incident reports were communication, compassionate patient care, accountability, and team collaboration. DISCUSSION: A professional development curriculum, consisting of panels, small groups, and critical incident reports, can promote reflection among third-year medical students.

Complementary and alternative medicine for menopause: a qualitative analysis of women's decision making.

BACKGROUND: While almost half of women use complementary and alternative medicine (CAM) during their menopause, almost no literature explores why women choose CAM for menopausal symptoms. Clinician-patient conversations about CAM can be unsatisfactory, and exploration of women's choices may benefit communication. OBJECTIVE: The objective of this study was to describe women's choices to use CAM for menopausal health issues. DESIGN: This is a qualitative study utilizing semi-structured interviews. PARTICIPANTS: Convenience sample of 44 menopausal women ages 45 to 60 recruited in two primary care clinics. Both users and non-users of CAM were included. APPROACH: Transcripts of semi-structured interviews were analyzed for themes that were refined through comparison of labeled text. MAIN RESULTS: Four themes emerged in decisions to use CAM: (1) valuing CAM as "natural", although the meaning of "natural" varied greatly, (2) perceiving menopause as marking a change in life stage, (3) seeking information about menopause generated from personal intuition and other women's experiences, and (4) describing experiences before menopause of using CAM and allopathic medication in patterns similar to current use (patterned responses). CONCLUSION: Women's decisions about using CAM during menopause can be understood through their perspectives on menopause and overall health. Increased clinician awareness of these themes may promote supportive discussions about CAM during counseling for menopause.

Do required preclinical courses with family physicians encourage interest in family medicine?

BACKGROUND: Many medical schools, including the University of California, San Francisco (UCSF), added required preclinical course work with family physicians in the 1990s. We examined whether current UCSF students interested in family medicine noted more contact with family physicians and more faculty support of their interest than current Stanford students and 1993 UCSF students, neither of whom had required preclinical course work with family physicians. METHODS: A questionnaire was administered to students interested in family medicine at UCSF and Stanford in February 2001, with response rates of 84% and 90%, respectively. Previously published 1993 data from UCSF were also used for comparison. Data were analyzed using chi-square and t statistics as appropriate. RESULTS: UCSF students in 2001, despite exposure to required preclinical course work with family physicians, did not perceive greater contact with family physicians than Stanford students. Stanford students perceived greater encouragement from their family medicine faculty but less from faculty overall, compared with 2001 UCSF students. UCSF students in 2001 perceived no more overall faculty encouragement than did UCSF students in 1993. CONCLUSIONS: Required preclinical course work with family physicians was not consistently associated with greater student perception of faculty support for students' interest in family medicine, nor was it demonstrated to increase the amount or quality of interested students' interaction with family medicine faculty.