Medical Faculty and Medical Student Opinions on the Utility of Questions to Teach and Evaluate in the Clinical Environment.

Objectives: We sought to report medical student and faculty perceptions of the purpose and utility of questions on clinical rounds.

Methods: We developed and administered a survey to third and fourth-year medical students and teaching physicians. The survey elicited attitudes about using questions to teach on rounds in both benign and malignant learning environments.

Using focus groups to understand causes for morale decline after introducing change in an IM residency program.

Background: Although program evaluation is a core requirement of Internal Medicine residencies, little is reported in the literature regarding resident satisfaction with training. Most program evaluation consists of numerical rating scales from which it is often difficult to pinpoint exact sources of dissatisfaction.

Methods: Our goal in this work is to evaluate the utility of focus group methodology to uncover in detail the reasons for residents' deteriorating morale in an IM residency program, as well as to solicit suggestions for correction.

Education first: reforming the first-year curriculum of the internal medicine residency.

Many opinion leaders of the academic internal medicine community have expressed concern about the adequacy of internal medicine (IM) residency training to prepare residents for their careers and to attract medical students to IM residency programs. In response to those concerns, several core organizations have prepared reports and issued significant recommendations suggesting comprehensive reform and restructuring of IM training programs.The authors discuss their approach, strategy, and efforts to restructure the first year in the IM residency training program at the University of California, Irvine.

Teaching the art of doctoring: an innovative medical student elective.

The authors describe a longitudinal third- and fourth-year elective, 'The Art of Doctoring', introduced in an attempt to counteract perceived frustration and cynicism in medical students at their home institution during the clinical years. The course goals aimed at helping students to develop self-reflective skills; improve awareness of and ability to modify personal attitudes and behaviors that compromise patient care; increase altruism, empathy and compassion toward patients; and sustain commitment to patient care, service and personal well-being. These goals were accomplished through introduction and development of five skill sets: learning from role models and peers; on-site readings of works by medical student- and physician-authors; self- and other-observation; self-reflective techniques; and case-based problem-solving.

Point-of-view writing: A method for increasing medical students' empathy, identification and expression of emotion, and insight.

Context: Although interest exists among medical educators in using writing that reflects on clinical experience to enhance medical students' communication skills, empathy, and overall professionalism, little empirical research documents the value of this approach. This study explored whether students trained in one type of writing would first demonstrate increased awareness of emotional aspects of a clinical encounter in their writing; and second, be evaluated more positively in an OSCE situation by standardized patients.

Method: Ninety-two students were assigned to either a point-of-view writing or a clinical reasoning condition as part of a second year doctoring course.

Training the clinical eye and mind: using the arts to develop medical students' observational and pattern recognition skills.

Introduction: Observation, including identification of key pieces of data, pattern recognition, and interpretation of significance and meaning, is a key element in medical decision making. Clinical observation is taught primarily through preceptor modelling during the all-important clinical years. No single method exists for communicating these skills, and medical educators have periodically experimented with using arts-based training to hone observational acuity.

An innovative, longitudinal program to teach residents about end-of-life care.

At the University of California, Irvine Medical Center, an end-of-life curriculum was implemented in 2000 for an internal medicine residency utilizing a longitudinal approach that allowed residents to follow patients through their entire hospice experience. An elective home hospice rotation was developed for which third-year residents served as primary care physicians for patients at the end of life over a one-year period. Residents were supervised by faculty who were hospice medical directors.

Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine.

The Program in Medical Humanities & Arts at the University of California, Irvine, College of Medicine has been in existence for five years. The program was implemented to enhance aspects of professionalism including empathy, altruism, compassion, and caring toward patients, as well as to hone clinical communication and observational skills. It contains elective or required curriculum across all four years of medical school and required curriculum in two residency programs, organized according to structural principles of horizontal coherence, vertical complexity, and patient care applications.

A pilot randomized, controlled trial of a longitudinal residents-as-teachers curriculum.

Purpose: To determine whether a longitudinal residents-as-teachers curriculum improves generalist residents' teaching skills.

Method: From May 2001 to February 2002, 23 second-year generalist residents in four residencies affiliated with the University of California, Irvine, College of Medicine, completed a randomized, controlled trial of a longitudinal residents-as-teachers program. Thirteen intervention residents underwent a 13-hour curriculum during one-hour noon conferences twice monthly for six months, practicing teaching skills and receiving checklist-guided feedback.

Becoming a physician: students' creative projects in a third-year IM clerkship.

Purpose: Medical educators have only limited understanding of how integrating humanities-based components into standard curricula contributes to the medical students' professionalism. This study qualitatively analyzed how students used a creative-project assignment during their third-year internal medicine clerkships to explore various aspects of their professional development.

Method: A total of 277 students from three consecutive classes (1999-2002) at the University of California, Irvine, College of Medicine each completed a creative project reflecting on a particularly problematic or meaningful illness-related incident.

Using literature as the framework for a new course.

Objective: The award-winning book The Spirit Catches You and You Fall Down,(1) a true story of the collision between two cultures (American and Hmong) with heartrending consequences for the patient, the patient's family, and the medical professionals who care for them, has been favorably reviewed(2) and used to stimulate teaching of cultural diversity, ethics, and professionalism to students and residents. We used it as a required text for a new Patient Doctor Society (PDS) course for 184 first- and second-year medical students. This report describes the scope and contexts in which the book was used to meet specific course goals.

Reach out and teach someone: generalist residents' needs for teaching skills development.

Background And Objectives: Family practice residents and students receive substantial teaching from senior residents. Yet, we lack data about residents' needs for teaching skills development, particularly in generalist training. This multicenter, interdisciplinary study describes the learning needs of generalist residents for becoming more effective teachers.

Medical students' note-taking in a medical biochemistry course: an initial exploration.

Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurate transmission of information, while opponents counter that provided notes inhibit students' cognitive processing or even discourage students from attending lectures.