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INTRODUCTION: Near-peer teaching offered by residents is common in a medical students' educational career, so preparation of residents for their role as teachers is essential. Understanding resident perspectives on interactions with medical students may provide insight into this near-peer relationship and allow stakeholders to emphasize concepts that add value to this relationship when preparing residents to teach. This study presents the results from an inquiry focusing on a cohort of family medicine residents' experiences with medical students in their role as teachers. METHODS: Family medicine residents at a Southeastern US academic medical center participated in one of three focus groups to assess resident perceptions of their role in teaching students and approaches employed. We coded focus group transcripts for themes. RESULTS: Themes identified from questions on residents' perceptions of teaching role and employed teaching approaches focused on teaching interactions and methods. Six categories of major themes were derived from this qualitative analysis: (1) the learning environment, (2) stimulating learning, (3) supervising, (4) role modeling, (5) collaborating, and (6) transferring knowledge. Trends within these categories include creating a safe environment for clinical reasoning and inquiry, setting expectations, developing clinical reasoning skills through practical application of knowledge, providing appropriate student supervision and autonomy, and including students as part of the team. CONCLUSIONS: Residents adopted a variety of teaching approaches that assist medical students in their transition into and ability to function within a clinical environment. Findings from this study have implications for program directors and educators when preparing residents as teachers.
RESUMO
INTRODUCTION: While point of care ultrasound (POCUS) integration into clinical clerkships provides unique educational experiences for students, there are barriers to implementation, particularly in a distributed campus medical school model in clerkships where the faculty do not often perform POCUS, like family medicine (FM). The objective of this paper is to describe the implementation and evaluation of a POCUS curriculum in an FM core clinical clerkship in a state-wide medical school campus model. METHODS: Seventeen Philips Lumify Ultrasound Systems were used in 20 clerkship sites with the requirement that students obtain abdominal aortic and inferior vena cava (IVC) images on patients evaluated during their rotation. Images were de-identified, transmitted to a university cloud-based storage account, and scored by medical school ultrasound faculty. RESULTS: Students were able to obtain adequate images of the aorta and IVC without direct ultrasound-trained faculty at the performance site. Of the 183 students, 119 (65%) were able to successfully submit images for scoring with failure to upload to the cloud-based storage account as the most common reason students were unsuccessful (42%). The majority of students (62%) scored in the top quartile of image quality scoring with the percentage of those scoring in the top quartile improving during the academic year from 57% in the first four rotations to 67% in the last four rotations. CONCLUSION: Barriers to implementation of a POCUS curriculum into a FM clerkship in a distributed campus medical school model can be challenging due to equipment availability and issues around the successful transmission of images. These challenges can be overcome however with sufficient attention to implementation design that includes equipment sharing protocols and technical options that enhance the ease of image transmission.
