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: 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; · 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.
    International Journal of Medical Education. 01/2012; 3.
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    ABSTRACT: Background: The subinternship is an integral part of the 4th year of medical school. There is little description of innovations aimed at assessing the preparedness and confidence of graduating students as they move on the next step in their training. Description: An innovation including an Objective Structured Clinical Examination (OSCE) at the conclusion of the subinternship was designed. We focused on key themes of transitions of care, communication within the health care system, and communication with patients and providers. Evaluation: A pre- and postsurvey addressed student self-perceived skill, confidence, and overall perception of importance. Improvement (p < .05) was seen across all themes from pre- to postsurvey, with more favorable scores on the postsurvey. Conclusions: A subinternship innovation including an OSCE was feasible and had a positive effect on student assessment, perception and confidence. As the landscape of medical education evolves, assessing students' preparedness for residency will become increasingly imperative.
    Teaching and Learning in Medicine 07/2013; 25(3):242-248. · 1.12 Impact Factor