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Scholars Collaboration Abstracts Archives 2002 - 2003 • 2003 - 2004 • 2004 - 2005 • 2005 - 2006 _______________________________________________________
Dr. David Kaelber * Dr. Mimi Lam * Dr. Anita Schwandt Dr. Scott Simpson * Dr. Peggy Stager * Dr. Peter Whitehouse _______________________________________________________
Cynthia Bearer, MD, PhD ABSTRACT Environmental Health Training to Medical Students 1) Authors: Cynthia F. Bearer, M.D., Ph.D. and Tom Graber, M.D. 2) Statement of the problem: There is a paucity of environmental health taught in U.S. medical schools. (Graber, Musham et al. 1995; Roberts and Reigart 2001; McCurdy, Roberts et al. 2004) Environmental Health is on the interface between medicine and public health, and could be used as an example of this interface. 3) Goals of the Project: The goals of this project are to develop the materials and methods to successfully have students learn about environmental health as well as the interface between medicine and public health. Methods will include standardized patients , have medical students learn the content of environmental health and be able to obtain an environmental health history and to act on the information thus gained both for the good of the patient and for the good of the community. 4) Description of the Project: The project will successfully develop materials, scenarios and hands on experiences designed to have medical students learn about environmental health across the lifespan. Materials will include reading lists, syllabus materials, preceptor “cheat sheets”, and videos. Scripts for standardized patients with environmental health problems will be developed (some based on the Case Studies developed by ATSDR), and collaborators will train to become the standardized patients. Such scripts will involve several different scenarios: 1) Health maintenance visit; 2) Rapid care visit; 3) Well baby visit; 4) Sick child visit; 5) Prenatal visit. Resources for demonstrating important physical diagnosis skills will be identified (i.e. wheezing, skin rash, parathesias, hyperactivity). A clinical rotation in the Swetland Environmental Health Clinic/Poison control center will be developed. In addition, 4 bus trips will organized for visits to key environments within Cleveland, such as an inner City neighborhood, the beryllium manufacturing plant on Euclid Avenue, a nearby daycare center, and a public school. We will have the students meet with public health officials with whom they might in the future collaborate to improve the environment. Evaluation tools will also be designed. For factual knowledge, posttests will be developed. For skills, direct observation or videotaped sessions will be evaluated by faculty and the student him/herself. Rubrics will be developed to “grade” skills acquisition. Students use of skills will be determined by chart review during their clinical rotations. 5) Evaluation of the Project. The project will be piloted within the School of Medicine . The project will be subjectively evaluated by the students and their preceptors. In addition, the project will be objectively evaluated by 1) post tests to participating students and 2) chart review of students rotating in clinical settings to assess whether environmental histories were taken, documented, and appropriate response was formulated. Finally skill acquisition will be measured by videotaping students interacting with the standardized patients. Student performance will reflect project performance. 6) Key lessons to be learned include how to develop a standardized patient, how to organize safe and informative bus trips, what signs and symptoms are available through virtual patient resources, how to use medical students to test educational techniques, and how to conduct chart reviews which will demonstrate students' abilities “in the field” to take environmental health histories, do a targeted physical exam, and interact both with the individual patient and the public health system to ensure a favorable outcome. 7) Questions to be explored : How to develop physical diagnosis skills for pediatric patients? How to develop a standardized patient? What is the best way of supporting small group preceptors for environmental health related topics? How to more fully expose students to the public health partners engaged in environmental health? _______________________________________________________Maryann Fitzmaurice, MD, PhD ABSTRACT Use of Interactive, Electronic, Pathology (PathologE) Crossword Puzzles Problem: Teaching of pathology as a subject in medical school has been somewhat unconventional at Case, due to its integration into the organ system approach, and has used more active learning and electronic resources than many subject areas. This project will build on this success through the use of interactive, electronic, pathology (PathologE) crossword puzzles. Goals: The goal of this project is to create PathologE crossword puzzles, posted on the medical school electronic curriculum, to test the students' fund of knowledge in both the basic principles of the pathogenesis of disease and organ specific pathology. These puzzles will be used: 1) as an active, independent study technique as an alternative to more passive and larger group formats for learning; 2) to provide students with alternatives to textbooks, syllabus, class notes, etc. for exam preparation; and 3) to provide students with alternatives to current online educational resources in pathology, such as e-textbooks, e-atlases and on-line quizzes in more conventional formats. Description: PathologE crossword puzzles will be created for each committee using pathology topic areas as themes. Existing online crossword puzzles will be used to learn about interactive electronic puzzles and get ideas for web site display. Crossword puzzle creator freeware available on the Internet will be used to help layout the puzzles and format the clues/answers. Puzzles can be created in different formats with different difficulty levels, ranging from simple matching type formats to more complex formats using crossword puzzle type clues. And they could be made interactive, with links to hints and/or additional information about the pathology topics in the clues/answers. Evaluation: Student usage and the quality and effectiveness of the puzzles will be assessed using online questionnaires, email feedback and student feedback meetings. Committee chairs and faculty will also be asked for their feedback. Lessons: I hope to learn whether or not students will use the crossword puzzles as educational tools and which formats/difficulty levels are the most effective. Questions: Overall, I would like to explore the educational value of crossword puzzles and other games, particularly electronic games that are more often viewed as entertainment, as applied to the field of pathology. _______________________________________________________Jennifer Hanrahan, DO ABSTRACT Learner-Centered Teaching in Infectious Disease Clinic Author : Jennifer Hanrahan, D.O. Problem : Current outpatient medicine is patient-focused rather than learner-centered, and students are incidental to the clinic. Students are exposed to teaching based on patients who happen to be scheduled on that day, and the material learned is unpredictable. The lack of longitudinal experience does not allow sufficient meaningful feedback to the students, and there is insufficient direct observation of students. Goals: 1) to design a clinic model centered on the learner, and to incorporate active learning into the clinic experience, 2) to allow time for direct observation of interview and physical diagnosis skills, 3) to allow a longitudinal experience and exposure to specific curricular material. Description : Two students would elect to participate in this weekly clinic during their current third-year Medicine clerkship for a 3 month period. Clinic would be specifically scheduled for students. Students would receive a curriculum at the beginning of the clerkship, and would meet to review a topic prior to each clinic session. Patients would then be seen in the clinic, and the topic reviewed that day would be incorporated into the patient evaluation. Students and preceptors would meet at the end of the clinic session to review how the material was used in that clinic session, and give feedback. Questions arising from that clinic day would be discussed at the following clinic session, along with the next topic. Project Evaluation : A pretest and post-test would be administered to evaluate knowledge of topics reviewed during the 3 month period. Students would give feedback following each clinic session and to the clerkship director. This feedback would be used to modify the clinic structure and the curriculum. Both students participating in the proposed clinic and students participating in the traditional students would be given a survey regarding satisfaction with the clinic experience, and the surveys between the two groups would be compared Key lessons : 1) how to incorporate active learning in the clinic experience, 2) how to improve teaching in the outpatient setting, 3) whether students prefer this approach to outpatient teaching over the traditional approach, and if so why. Questions : 1) which topics should be included in the curriculum, 2) how to assess learners, 3) how the students would like clinic to be structured to optimize learning. 4) how to structure the feedback sessions in order to make them useful, and how to give feedback to students following direct observation. _______________________________________________________ David Kaelber, MD, PhD ABSTRACT Developing a Medical Informatics Curriculum Statement of Problem: Medical informatics (using information technology to improve healthcare) is becoming an increasingly important part of our medical system, however, no formal curriculum exists within the Case School of Medicine. Goals of Project:
Description of Project: The Working Group Team will overview the major topic areas within the field of medical informatics. The team will then develop a survey to be distributed among medical students and curriculum development faculty to assess the learners' background and perceived needs in medical informatics. Based on the survey results and the team's understanding of medical informatics, the team will then develop a medical informatics curriculum geared towards Case medical school students, consisting of no more then several hours worth of learning experiences. Evaluation Plan: Once the model medical informatics curriculum is developed, we will hold one focus group meeting among the target medical student learner audience to receive feedback about the proposed curriculum. Lessons to Learn:
Questions to Explore:
Mimi Lam, MD ABSTRACT Quiet Learners in Medical School Many medical students and physicians are quiet, introspective people who find it difficult to speak out in group settings such as ward rounds or large classes. The goal of this project is to learn about the attitudes and practices of such “quiet learners” and to trace their development through the years of their medical education and beyond. A questionnaire will be designed to gather information about self-described introverted students, each of whom will be interviewed two to three times over the course of the year. Both preclinical and clinical students will be studied, as well as postgraduate physicians (interns, residents, or fellows) and fully-trained practicing physicians. The data, suggestions, and advice garnered from these interviews will be collected into an article or booklet that, it is hoped, will help quiet learners to develop their abilities effectively, and will help medical educators to be better teachers and mentors of quiet or introverted students. _______________________________________________________Anita Schwandt, MD ABSTRACT STATEMENT OF PROBLEM/QUESTION EDUCATIONAL CHANGE IS ADDRESSING: Women with physical and developmental disabilities have unique medical, psychological and social challenges which affect their health and health care. There is little formal, reliable experience for medical students to learn about the health care of women with disabilities. Integration of new areas of medical education should be done in conjunction with both student and teacher with the knowledge of medical content and in the context of medical education theory. What is the best way to educate medical students to tailor gynecological care to women with physical and developmental disabilities? GOALS OF PROJECT: 1 - To develop a curriculum for medical student education which teaches the biopsychosocial aspects for healthcare for women who have disabilities. 2 - To create the best teaching plan for this content with regards to format and respect for time. 3 - To review feedback and evaluate effectiveness of this teaching module via “focus groups” of medical students, teachers, and patients. DESCRIPTION OF PROJECT: The current level of knowledge and educational opportunities regarding the clinical care for women with disabilities will addressed by review of prior questionnaires, ACOG literature, video tapes, lecture syllabi, and powerpoint presentations. Interactive discussion regarding content, format and style will be major emphasis of this project. Input from “experts” in the field will be discussed by reviewing comments from attorneys, physicans, and social workers who work with women with disabilities. Patient input will be invited. An integrated educational module will be developed; and the groundwork for an interactive computer simulation program will be created. EVALUATION OF PROJECT TO SEE IF EFFECTIVE: The teaching module will be critiqued by “experts”, including medical students, patients, and physicians with questionnaire/checklist. Pre- and post- module questions will be compared to evaluate improvement in knowledge. KEY LESSONS: I anticipate that the creation of a learning module will be enhanced through interactive input from the learners (medical students), experts (physicians, social workers, etc), and patients. KEY QUESTIONS TO EXPLORE: 1) How to develop a curriculum which teaches the diverse scope of the unique gynecological needs of women with disabilities in a sensitive environment involving direct patient contact and care? 2) How to integrate this educational module in order to maximize high-impact learning and time-management issues? _______________________________________________________Scott Simpson, PhD ABSTRACT Scholars Collaboration: The CWRU School of Medicine is now engaged in a significant reorganization of its curriculum. Two factors have emerged as central in this reorganization: less passive learning and more clinical relevance ( e.g. , Dangerfield, et al., 2000). Consequently, this has led to a reorganization of the teaching schedule producing a significant reduction in contact time for human anatomy training. Simply ‘shrinking' the curriculum ( i.e. , cutting content) is not an option, thus novel approaches to teaching anatomy must be developed. The new anatomy program will focus on case-based or theme-based group-learning meetings and anatomy presentations. The goal of this project is to develop a series of multi-media learning modules that will provide an efficacious means of learning the topography and spatial relationships of human structure. Evaluation of the project will be possible once the program is initiated during the 2005-06 academic year by assessment of student performance through matched (pre- and post-implementation) formative exams. The central conceptual issue that will be addressed is: ‘can students learn as effectively the major elements of anatomy in a ‘learning modules' approach as from a traditional dissection approach'? The Scholars Collaboration brings together the ‘distributors' and ‘consumers' of content in a forum that will develop a more effective means of learning anatomy. _______________________________________________________Peggy Stager, MD ABSTRACT STATEMENT OF THE PROBLEM: It is well known that few, if any, medical students are directly observed performing histories, or physical exams while on clinical rotations. This lack of direct observation of clinical skills leaves medical educators assuming clinical competency of the student. Clinicians report limitations of time and patient care flow as a few of the barriers to direct observation of students. Furthermore, most preceptors lack training, either formal or informal, in direct observation and feedback. PROJECT GOALS: 1. To train a small cohort of clinicians in direct observation and feedback skills. 2. To provide a small cohort of students with 3-4 direct observations while on the Pediatric clinical rotation (to be converted to Block 2 in July 2006). 3. To create an interactive exchange between faculty and students regarding various aspects of direct observation and feedback. 4. To determine the feasibility of expanding the direct observation experience across the realm of clinical rotations. DESCRIPTION OF THE PROJECT: A select number of medical students on the Pediatric clerkship will be offered the opportunity to participate in the direct observation pilot project. In addition, 2-3 pediatric clinicians will be offered training in direct observation and feedback. This will consist of performance dimension training, behavioral observation training and rater error training. The project is designed to provide at least 4 direct observations (5–10 minutes in length) of the students in the following areas: medical interviewing, physical examination, and patient counseling/education. These direct observations may occur in either the inpatient or outpatient setting. Lastly, if resources allow, the project also aims to videotape one full direct observation encounter of students' performance and the clinicians' feedback. The videotapes could be used as a training tool for future faculty development in direct observation and feedback. EVALUATION OF THE PROJECT: The outcome measurement of the project will be to compare practice OSCE scores between the direct observation participants and matched controls from the same site rotation. A second evaluation measurement will be qualitative feedback from both the student participants and the trained clinicians. ANTICIPATED LESSONS LEARNED: Key elements anticipated to be learned from the pilot project is receptivity of both students and clinicians to direct observation and feedback, changes in clinicians' feedback practices, and the importance of student input in optimizing the direct observation and feedback experience. PROJECT QUESTIONS: 1. What is the best tool for the clinician to use on site to facilitate the direct observation and optimize the feedback? 2. What is the role of reflection for the student? 3. What is the utility of the e-portfolio as a means of documenting the direct observation and feedback? 4. Are there other methods of evaluation we have not identified? 5. Would the use of a standardized patient play a role in this project? _______________________________________________________Peter Whitehouse, MD, PhD
“Family and Public Health in The Intergenerational School”, Statement of the problem/question the project is addressing: During their training medical students need more exposure to public and environmental health issues in community. The project will develop educational experiences for medical and Master's in Public Health students based on learning to conduct environmental histories with families enrolled in The Intergenerational School (TIS), an innovative, nationally recognized, excellent community public school and to develop interventions to help those families and the school help address public health challenges, such as lead poisoning. Goals of the project: The project is designed to provide an experiential learning opportunity for Case students in a novel community site, the only public intergenerational school in the US . Each student will develop an individual project based on family environmental health assessment and designing a service-learning intervention. Opportunities for reflection through journaling and small group sharing will be offered. Description of the project: Medical students (along with some graduate students in the Masters of Public Health program) will collect environmental health information from families enrolled in TIS. The major focus will be on the exposure to lead and other toxins. The students will provide practical advice to these families as well as help the school develop community projects to enhance the visibility of this and other public health challenges. Plan for evaluating the project's effectiveness: The project will be evaluated through quality of the environmental history of the medical students' journals, the success of projects that are implemented in the community and the ability of TIS to contribute in the Greater Cleveland Lead Advisory Counsel (GCLAC) and other community groups enhancing the visibility of public health issues. Key Lessons: How can a public school be utilized as a site to teach medical students about environmental and public health? Can medical students facilitate individual and community health through developing intervention projects for families and the school? Questions to explore in the Scholars Collaboration: How can we create innovative sites for medical education? What is the value of narrative medicine and journaling to assess the effectiveness of educational interventions? How can the curriculum incorporate ideas that allow medical students to understand the social and behavioral context of health and to be active as leaders in their communities? |
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