Types of clinical reasoning in a summative clerkship oral examination.

Introduction: Dual-process theory characterizes clinical reasoning (CR) as Type 1 (intuitive) and Type 2 (analytical) thinking. This study examined CR on a summative clinical clerkship structured clinical oral examination (SCOE).

Methods And Subjects: 511 clinical clerks at the University of Toronto underwent SCOEs.

Unearthing Faculty and Trainee Perspectives of Feedback in Internal Medicine: the Oral Case Presentation as a Model.

Background: The case presentation is a fundamental activity used in both patient care and trainee education, partly due to feedback from supervisor to trainee. Although feedback in medical education is well studied, prior studies have not focused on the perceptions of feedback by Internal Medicine supervisors and trainees as it relates to clinical activities like the case presentation.

Methods: Semi-structured interviews were conducted with eight Internal Medicine physicians, and 18 Internal Medicine trainees (5 medical students, 13 residents) at the University of Toronto.

Web-based learning in inflammatory bowel diseases: General truths and current specifics.

In a field rapidly evolving over the past few years, the management of inflammatory bowel diseases (IBD), Crohn's disease and ulcerative colitis, is becoming increasingly complex, demanding and challenging. In the recent years, IBD quality measures aiming to improve patients' care have been developed, multiple new medical therapies have been approved, new treatment goals have been set with the "treat-to-target" concept and drug monitoring has been implemented into IBD clinical management. Moreover, patients are increasingly using Internet resources to obtain information about their health conditions.

Overshadowed by Assessment: Understanding Trainee and Supervisor Perspectives on the Oral Case Presentation in Internal Medicine Workplace-Based Assessment.

Purpose: The oral case presentation (OCP) is an essential part of daily clinical practice in internal medicine (IM) and a key competency in medical education. It is not known how supervisors and trainees perceive OCPs in workplace-based learning and assessment.

Method: Using a constructivist grounded theory approach, 26 semistructured interviews were held with trainees and supervisors (18 clinical clerks and first- through third-year postgraduate trainees, and 8 supervisors) on the IM clinical teaching unit at the University of Toronto, 2015-2016.

Does Making the Numerical Values of Verbal Anchors on a Rating Scale Available to Examiners Inflate Scores on a Long Case Examination?

Purpose: Rating scales are frequently used for scoring assessments in medical education. The effect of changing the structural elements of a rating scale on students' examination scores has received little attention in the medical education literature. This study assessed the impact of making the numerical values of verbal anchors on a rating scale available to examiners in a long case examination (LCE).

Impact of a formal mentoring program on academic promotion of Department of Medicine faculty: a comparative study.

Purpose: To evaluate the impact of a formal mentoring program on time to academic promotion and differences in gender-based outcomes.

Methods: Comparisons of time to promotion (i) before and after implementation of a formal mentoring program and (ii) between mentored and non-mentored faculty matched for covariates. Using paired-samples t-testing and mixed repeated measures ANCOVA, we explored the effect of mentor assignment and influence of gender on time to promotion.

Evaluation of standardized doctor's orders as an educational tool for undergraduate medical students: a prospective cohort study.

Background: Standardized doctor's orders are replacing traditional order writing in teaching hospitals. The impact of this shift in practice on medical education is unknown. It is possible that preprinted orders interfere with knowledge acquisition and retention by not requiring active decision-making.

Morning report blog: a web-based tool to enhance case-based learning.

Background: Morning report is an interactive case-based teaching session common to internal medicine training programs across North America.

Description: We report here on a morning report web log ("blog"), created and updated after morning report sessions by the Chief Medical Resident with pertinent clinical topics, links to journal articles, and medical images. Trainees on their internal medicine rotation were e-mailed a web link with each posting.

Role of clinical context in residents' physical examination diagnostic accuracy.

Context: Clinical context may act as both an aid to decision making and a source of bias contributing to medical error. The effect of clinical history, a form of clinical context, on the diagnostic accuracy of the physical examination is unknown.

Methods: We randomised internal medicine residents to receive either no history or a short stem suggestive of one of six cardiac valvular diagnoses prior to a 10-minute objective structured clinical examination station assessing cardiac examination skills using a high-fidelity simulator.