Teaching evidence-based medicine: Impact on students' literature use and inpatient clinical documentation.

BACKGROUND: Effective teaching of evidence-based medicine (EBM) to medical students is important for lifelong self-directed learning. AIMS: We implemented a brief workshop designed to teach literature searching skills to third-year medical students. We assessed its impact on students' utilization of EBM resources during their clinical rotation and the quality of EBM integration in inpatient notes. METHODS: We developed a physician-led, hands-on workshop to introduce EBM resources to all internal medicine clerks. Pre- and post-workshop measures included student's attitudes to EBM, citations of EBM resources in their clinical notes, and quality of the EBM component of the discussion in the note. Computer log analysis recorded students' online search attempts. RESULTS: After the workshop, students reported improved comfort using EBM and increased utilization of EBM resources. EBM integration into the discussion component of the notes also showed significant improvement. Computer log analysis of students' searches demonstrated increased utilization of EBM resources following the workshop. CONCLUSIONS: We describe the successful implementation of a workshop designed to teach third-year medical students how to perform an efficient EBM literature search. We demonstrated improvements in students' confidence regarding EBM, increased utilization of EBM resources, and improved integration of EBM into inpatient notes.

Improvements in medical school wellness and career counseling: A comparison of one-on-one advising to an Advisory College Program.

BACKGROUND: Medical students have unmet needs in the areas of career and wellness advising. AIMS: The goal of this study is to describe the development of an Advisory College Program (ACP) and assess its effectiveness compared to a traditional one-on-one faculty advisor system. METHODS: The ACP, consisting of four colleges co-led by Advisory College Directors and supported by key Faculty, was developed to provide structured career and wellness advising. The authors compared the ACP to the former Faculty Advisory Program (FAP) using two parallel questionnaires. RESULTS: Surveys were completed by 74% of first-year students, 60% of second-year students, and 88% of third-year students. Survey data demonstrated a significant increase in the number of students who could identify their advisor, the frequency of student-advisor contacts, and the perceived accessibility of advisors in the ACP compared to the FAP. While an ordinal logistic regression model did not demonstrate a significant effect of the new advising system on overall satisfaction, univariate analysis demonstrated a significant increase in student satisfaction with wellness and career counseling. CONCLUSIONS: The ACP was more effective in promoting student wellness and career counseling than the traditional one-on-one faculty advisor system. Similar college-based programs may be beneficial to students at other medical school programs.

Tracking medical students' clinical experiences using natural language processing.

Graduate medical students must demonstrate competency in clinical skills. Current tracking methods rely either on manual efforts or on simple electronic entry to record clinical experience. We evaluated automated methods to locate 10 institution-defined core clinical problems from three medical students' clinical notes (n=290). Each note was processed with section header identification algorithms and the KnowledgeMap concept identifier to locate Unified Medical Language System (UMLS) concepts. The best performing automated search strategies accurately classified documents containing primary discussions to the core clinical problems with area under receiver operator characteristic curve of 0.90-0.94. Recall and precision for UMLS concept identification was 0.91 and 0.92, respectively. Of the individual note section, concepts found within the chief complaint, history of present illness, and assessment and plan were the strongest predictors of relevance. This automated method of tracking can provide detailed, pertinent reports of clinical experience that does not require additional work from medical trainees. The coupling of section header identification and concept identification holds promise for other natural language processing tasks, such as clinical research or phenotype identification.