Beyond Competency: A Student Perspective on Growth Through Clerkship Feedback.

This article proposes a paradigm shift from the competency-based model of clerkship feedback using checklists to a coaching-based, action plan-oriented process that centers on individualized student-oriented goals. Using a student perspective, the authors examine the feedback literature and put forward a proposal to use an impact model whose emphasis is to improve the learning climate for students. Several techniques are reviewed which include goal generation and creation of dynamic action plans.

Predictors of medical students' ethical decision-making: A pilot study using the Theory of Interpersonal Behavior.

Objective: To understand medical students' (MS) ethical decision-making using the Theory of Interpersonal Behavior (TIB).

Methods: We conducted two rounds of focus groups to develop a TIB-based questionnaire by eliciting students' perspectives on an ethical dilemma they will encounter in a standardized patient (SP) station, in which an SP "surgeon" asked them to intubate a sedated patient whom the student knew had requested no student involvement. We administrated questionnaires to 241 third-year MS following this SP station, asking for their decisions in the SP station and if a surgeon made the same request in their clerkship.

Communication skills teaching in Brazilian medical schools: What lessons can be learned?

Objective: To assess current practices in communication skills (CS) teaching in Brazilian medical schools (MS), looking for similarities and differences with other countries.

Methods: This study was performed with 162 out of the 237 accredited Brazilian MS (68.35%).

Preserving third year medical students' empathy and enhancing self-reflection using small group "virtual hangout" technology.

Background: Medical student professionalism education is challenging in scope, purpose, and delivery, particularly in the clinical years when students in large universities are dispersed across multiple clinical sites. We initiated a faculty-facilitated, peer small group course for our third year students, creating virtual classrooms using social networking and online learning management system technologies. The course emphasized narrative self-reflection, group inquiry, and peer support.

Residents' and standardized patients' perspectives on empathy: issues of agreement.

Objective: We investigated correlations between residents' scores on the Jefferson Scale of Empathy (JSE), residents' perceptions of their empathy during standardized-patient encounters, and the perceptions of standardized patients.

Methods: Participants were 214 first-year residents in internal medicine or family medicine from 13 residency programs taking standardized patient-based clinical skills assessment in 2011. We analyzed correlations between residents' JSE scores; standardized patients' perspectives on residents' empathy during OSCE encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy; and residents' perspectives on their own empathy, using a modified version of this scale.

How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach.

Background: Implementation of the electronic health record (EHR) has changed the dynamics of doctor-patient communication. Physicians train to use EHRs from a technical standpoint, giving only minimal attention to integrating the human dimensions of the doctor-patient relationship into the computer-accompanied medical visit.

Description: This article reviews the literature and proposes a model to help clinicians, residents, and students improve physician-patient communication while using the EHR.