A short transitional course can help medical students prepare for clinical learning.

Department of Family Medicine, Kansas University Medical Center, Kansas City 66160, USA.
Family medicine (Impact Factor: 0.85). 37(7):496-501.
Source: PubMed

ABSTRACT Despite the move toward integrated 4-year medical school curricula, many medical schools still offer a "2+2" curriculum divided into preclinical and clinical phases. These phases represent distinct learning environments that require different learning skills. To prepare students for learning in the clinical environment of the second 2 years, many medical schools offer transitional experiences before the third-year clerkships. Few of these transitional courses have published evaluations, and there is no consensus on the ideal content. In this paper, we provide evaluation and content validity data on a 2-week intensive clinical transition course for beginning third-year medical students.
A multidisciplinary team designed, implemented, and evaluated a 2-week transition course. Students indicated through surveys how prepared they felt for 18 clinical skills. We analyzed pre- and post-survey data using a Wilcoxen rank sum test and compared current to prior students using a chi-square analysis.
Students felt more prepared for 16 of 18 skills after the transitional course and for 14 of 18 skills compared to historical controls.
A transitional course based on common skills is relevant to students' clerkship experiences and can increase students' self-reported preparedness for the clinical years of medical school.

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    • "They vary in factors including duration of course, whether the course is required, the level of required participation of students and the amount of clinical exposure and didactic experiences. Programs range in duration and some strongly encourage, students to take a course to refresh their clinical skills prior to re-entering the clerkship years but do not require it (Chumley et al. 2005; Chandavarkar Practice points A clinical refresher course can facilitate the transition from research phase of training to clinical training for MD–PhD students Multimodal teaching methods improve the learning experience Students are able to retrieve their basic clinical skills but require more practice to use these skills MD–PhD students demonstrate large gaps in basic science knowledge after returning from their research phase of training A standardized approach to evaluation and feedback is instructive in gauging MD–PhD students' clinical proficiency compared to medical student counterparts "
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    ABSTRACT: Abstract Introduction: MD-PhD students experience a prolonged hiatus away from clinical medicine during their laboratory research phase and some have experienced difficulty transitioning back to clinical medicine during clerkship years. We developed a clinical refresher program that serves to rebuild clinical skills prior to re-entering the clinical clerkship years. Methods: A nine-week program includes a combination of didactic and practical review in history, physical exam, presentation and clinical reasoning skills. The program uses multiple modalities from classroom-based activities to patient care encounters and includes a final assessment using standardized patients. Results: After seven years of experience, we have made modifications that result in our students scoring comparably well on a standardized patient exam to their second-year medical student colleagues. By the end of the course, all students reported feeling more comfortable completing a history and physical examination and some improvement in preclinical knowledge base. Review of clerkship scores showed a higher percentage of MD-PhD students scoring Honors in a clerkship in years after course implementation as compared to years prior to course implementation. Conclusion: We describe a clinical refresher course for successfully retraining MD-PhD students to re-enter clinical medical training. It is effective at restoring clinical skills to a level comparable to their medical student contemporaries and prepares them to rejoin the medical student class at the conclusion of their research phase.
    Medical Teacher 02/2014; 36(6). DOI:10.3109/0142159X.2014.886767 · 2.05 Impact Factor
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    • "For personal use only. Prince et al. 2000; Seabrook et al. 2000; Fernald et al. 2001; Coldicott et al. 2003; Stark 2003; van der Hem-Stokroos et al. 2003; Chumley et al. 2005; Jacobs et al. 2005; Prince et al. 2005; Dornan et al. 2006). However, the learning theory implicit in research hitherto has tended to assume a relatively simple relationship between teaching and learning whereas the relationship between clinician, patient and student has quite complex dynamics (Ratanawongsa et al. 2005). "
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    ABSTRACT: The dynamics of effective teaching consultations need to be better understood. Find from medical students, patients and doctors how to optimize learning in ambulatory consultations. Patients and students independently gave semi-structured exit interviews after 25 ambulatory teaching consultations during a clinical attachment set up experimentally to strengthen students' ambulatory learning. The results of an abbreviated grounded theory analysis were checked in three focus group discussions with teachers and students. Patients and students identified strongly with one another and benefited from teaching consultations in parallel ways yet defaulted to passive roles. Patients deferred to professional expertise whilst students were uncertain what was expected of them, feared harming patients and feared being showed up as ignorant. The educational value of consultations was determined by doctors' ability to promote student-patient interaction. In the most effective teaching consultations, doctors promoted a level of participation that realized patients' and students' mutual sense of responsibility by orientating them to one another, creating conditions for them to interact, promoting and regulating discourse, helping students to perform practical tasks and debriefing them afterwards. Those broad conclusions translate into 18 practical recommendations for supervising a medical student in an outpatient clinic or surgery.
    Medical Teacher 03/2009; 31(2):e24-31. DOI:10.1080/01421590802464445 · 2.05 Impact Factor
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    • "Training medical students to provide patient care requires that they gain competency in core clinical skills. These skills include proficiency in history taking and physical examination, oral and written communication, clinical procedures, basic radiology, evidenced-based medicine, and professionalism (Windish, 2000; Chumley et al, 2005). The foundation for these skills is provided "
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    ABSTRACT: The preclinical years of undergraduate medical education provide educational content in a structured learning environment whereas clerkships provide clinical training in a more experiential manner. Although early clinical skills training is emphasized in many medical schools, students still feel unprepared and anxious about starting their clerkships. This study identifies the skills medical students perceive as essential and those skill areas students are most anxious about prior to starting clerkship rotations. Open-ended questionnaires were administered to two cohorts of students, preclinical students (PCS) completing their second year and clinical students (CS) in the ninth month of the clinical training of their third year at a single urban US medical school. The following questions were addressed in the survey: which three clinical skills do they perceive are most essential for the clerkships; which skills are students most anxious about as they enter clerkships; and what additional skills training should be provided to students to ease the transition into clerkships. Response rate to the questionnaire was 84%. PCS (n=93) reported the three most essential skills to be prepared for clerkships are: history taking/physical examination (73%), proficiency in oral case presentations (56%), and generation of differential diagnosis (46%). CS (n=105) reported interpersonal skills (80%), history taking/physical examination (37%), and time management (26%) as most essential. PCS were most anxious about their oral case presentation skills (30%), but CS were most concerned about time management and self care (40%). This study identified the skills that students at one school regard as most important to have mastered before beginning clerkship training and the areas students find most anxiety provoking before and after they make the transition into clerkships. These results can inform medical educators about needed curriculum to facilitate this transition and decrease the anxiety of students entering the clinical realm.
    Education for Health Change in Learning & Practice 12/2008; 21(3):192.
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