Responding to a changing nation: are faculty prepared for cross-cultural conversations and care?

Background And Objectives: The United States is becoming increasingly diverse. Health disparities continue with little improvement despite national policies and standards. Medical institutions are modifying their curricula; however, little is known about faculty attitudes and comfort in addressing cultural issues.

Bayes' theorem and the physical examination: probability assessment and diagnostic decision making.

Purpose: To determine how examination findings influence the probability assessment and diagnostic decision making of third- and fourth-year medical students, internal medicine residents, and academic general internists.

Method: In a 2008 cross-sectional, Web-based survey, participants from three medical schools were asked questions about their training and eight examination scenarios representing four conditions. Participants were given literature-derived preexamination probabilities for each condition and were asked to (1) estimate postexamination probabilities (post-EPs) and (2) select a diagnostic choice (report that condition is present, order more tests, or report that condition is absent).

Online "spaced education progress-testing" of students to confront two upcoming challenges to medical schools.

Purpose: U.S. medical students will soon complete only one licensure examination sequence, given near the end of medical school.

Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students.

Background: Recent data do not exist regarding fourth-year medical students' performance of and attitudes toward procedural and interpretive skills, and how these differ from third-year students'.

Method: Cross-sectional survey conducted in February 2006 of 122 fourth-year students from seven U.S.

Sharpening the eye of the OSCE with critical action analysis.

Purpose: When interpreting performance scores on an objective structured clinical examination (OSCE), are all checklist items created equal? Although assigning priority through checklist item weighting is often used to emphasize the clinical importance of selected checklist items, the authors propose the use of critical action analysis as an additional method for analyzing and discriminating clinical performance in clinical skill assessment exercises. A critical action is defined as an OSCE checklist item whose performance is critical to ensure an optimal patient outcome and avoid medical error. In this study, the authors analyzed a set of clerkship OSCE performance outcome data and compared the results of critical action analysis versus traditional checklist item performance scores.

When should students learn essential physical examination skills? Views of internal medicine clerkship directors in North America.

Purpose: To determine whether any consensus exists among internal medicine clerkship directors regarding when students should acquire proficiency in selected physical examination (PE) skills.

Method: In 2004, the annual survey of Clerkship Directors in Internal Medicine (CDIM) included a question about the timing of PE-skills proficiency. (CDIM members are from 123 U.

Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics.

Procedural and interpretive skills of medical students: experiences and attitudes of third-year students.

Background: Recent data do not exist on medical students' performance of and attitudes toward procedural and interpretive skills deemed important by medical educators.

Method: A total of 171 medical students at seven medical schools were surveyed regarding frequency of performance, self-confidence, and perceived importance of 21 procedural and interpretive skills.

Results: Of the 122 responding students (71% response rate), a majority had never performed lumbar puncture, thoracentesis, paracentesis, or blood culture, and students reported lowest self-confidence in these skills.

Effect of a second-year primary care preceptorship on medical students' career plans.

Background: Preceptorships with community physicians have been incorporated into medical curricula to foster interest in generalist careers. An evaluation of our preceptorship program was undertaken to determine this influence.

Methods: Students were asked about career interests before and after a second-year community preceptorship.