How to win an argument about the senior year of medical school.

Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.34). 08/2009; 84(7):815-6. DOI: 10.1097/ACM.0b013e3181ae1f13
Source: PubMed
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    ABSTRACT: To determine the emotional responses to patient care activities described by fourth year medical students. Qualitative content analysis for emerging themes in letters written by graduating medical students to patients during a Capstone Course. The patient need not be alive and the letter would never be sent. Six themes emerged from student letters: (1) Sorrow for the depths of patient suffering; (2) Gratitude towards patients and their families; (3) Personal responsibility for care provided to patients; (4) Regret for poor care provided by the student or student's team; (5) Shattered expectations about medicine and training; and (6) Anger towards patients. Students expressed sensitivity to vulnerable patients, including those who were alone, unable to communicate, or for whom care was biased. Students' expressed powerlessness (inability to cure, managing a work-life balance, and challenges with hierarchy) in some essays. At graduation, medical students describe strong emotions about previous patient care experiences, including difficulty witnessing suffering, disappointment with medicine, and gratitude to patients and their families PRACTICE IMPLICATIONS: Providing regular opportunities for writing throughout medical education would allow students to recognize their emotions, reflect upon them and promote wellness that would benefit students and their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Patient Education and Counseling 12/2014; 98(3). DOI:10.1016/j.pec.2014.11.023 · 2.60 Impact Factor
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    ABSTRACT: Little is known about the purpose and value of the fourth year of medical school from the perspective of medical students. In this study, the authors systematically explored the year's purpose and value as determined by students. In April 2011, the authors conducted semistructured focus groups with graduating fourth-year students at the University of Colorado School of Medicine to understand their perspectives on the purpose of the fourth year. Using results of a thematic analysis of the focus group data, the authors developed and administered a 10-item questionnaire to all graduating fourth-year medical students in May 2011. Questionnaire data were analyzed using descriptive statistics and exploratory factor analysis. A total of 17 students participated in two focus groups. Six themes related to the purpose of the fourth year emerged from the focus group data: career development and preparation, pursuing personal interests, career identification, exploration of diverse practice settings, influence of emotion, and flexibility and individualization. The questionnaire was completed by 134 of 148 students (91% response rate). Factor analysis of the questionnaire data identified five factors: strengthening one's residency application, developing skills, pursuing personal interests, exploring diverse practice settings, and identifying a career. Medical students uniformly identified the fourth year of medical school as having purpose and value, but their views on the fourth year's purpose differed. This finding underscores the importance of the individualization of the fourth year. Students' perspectives should inform any decisions made about modifying fourth-year curricula and structure.
    Academic medicine: journal of the Association of American Medical Colleges 02/2014; 89(4). DOI:10.1097/ACM.0000000000000183 · 2.34 Impact Factor
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    ABSTRACT: Objectives: To characterize junior residents' perspectives on the purpose, value, and potential improvement of the final year of medical school. Methods: Eighteen interviews were conducted with junior residents who graduated from nine different medical schools and who were in internal medicine, surgery, and psychiatry programs at one institution in the United States. Interview transcripts were coded and analyzed inductively for themes. Results: Participants' descriptions of the purpose of their recently completed final year of medical school contained three primary themes: residency-related purposes, interest-or need-based purposes, and transitional purposes. Partici-pants commented on the most valued aspects of the final year. Themes included opportunities to: prepare for resi-dency; assume a higher level of responsibility in patient care; pursue experiences of interest that added breadth of knowledge, skills and perspective; develop and/or clarify career plans; and enjoy a period of respite. Suggestions for improvement included enhancing the learning value of clinical electives, augmenting specific curricular content, and making the final year more purposeful and better aligned with career goals. Conclusions: The final year of medical school is a critical part of medical education for most learners, but careful attention is needed to ensure that the year is developmental-ly robust. Medical educators can facilitate this by creating structures to help students define personal and professional goals, identify opportunities to work toward these goals, and monitor progress so that the value of the final year is optimized and not exclusively focused on residency preparation.
    01/2012; 3. DOI:10.5116/ijme.5019.6b01