Unintended Consequences? Assessing the Impact of Curricular Change on Medical Student Participation in a Student-Run Free Clinic.

Introduction: In a prior qualitative study of the impact of a new (ACE) medical school curriculum, students and faculty reported decreased participation in the student-run free clinic (SRFC) attributed to more intensive scheduling and more frequent testing compared to the previous (Legacy) curriculum.

Materials And Methods: To verify and understand this perception formed during curriculum reform, we conducted a mixed method study to measure student participation in the SRFC before and after curricular change and assessed student beliefs and motivations about SRFC participation using focus groups.

Results: Overall SRFC participation did not decrease among students in the ACE cohort following curriculum change.

Burnout and Other Types of Emotional Distress Among Medical Students.

Background: The medical literature reports that many medical trainees experience burnout. The primary goal of this study was to determine how the prevalence of burnout and other forms of emotional distress among the University of Kansas School of Medicine (KUSM) medical students compared to the previously published data.

Methods: We conducted a cross-sectional survey of 379 medical students.

Exploring the Impact of Group Size on Medical Students' Perception of Learning and Professional Development During Clinical Rotations.

Introduction: Research assessing the size of learning groups in medical education and how that affects the learner's experience is limited. The main goals of the study were to (1) assess the effect of varying group size on medical students' subjective experiences during clinical years. We hypothesized that students in smaller groups were more likely to have better experiences during clinical rotation than those in larger groups, and (2) determine if medical students have desirable experiences working with other medical learners (fellows, residents, osteopathic students, physician assistants, and nurse practitioners) during clinical rotations.

Improving Interrater Reliability of Medical Student Assessment by Clinical Supervisors.

Introduction: Clinical clerkships that rely on community preceptors as faculty and assessors are challenged by the variability in their assessments of student performance. This workshop was designed to improve the interrater reliability of preceptors' assessment of student performance.

Methods: This workshop uses a series of videos showing standardized student interactions with standardized patients and a preceptor.

Does a Vacation Break Impact the Outcomes of Required Clinical Clerkships?

Background And Objectives: Our objective was to assess the impact of disruption by a new 2-week vacation break on outcomes of required third-year clerkships.

Methods: Mean scores on National Board of Medical Examiners (NBME) clerkship specific clinical science subject ("subject") examinations and overall student evaluations were compared for clerkships with the break and those over the previous 3 years without the break. Students were surveyed about the impact of the break on learning and the time spent studying during the break.

Nasolaryngoscopy.

Nasolaryngoscopy is a low-risk, quick means of making a specific diagnosis for voice complaints; it should be performed before empiric treatment based on history and general examination alone. The most common indications for nasolaryngoscopy are hoarseness, globus sensation, and chronic cough. The most common findings in a primary care setting include laryngopharyngeal reflux (43%), chronic rhinitis (32%), and vocal cord lesions (13%).

Laryngeal problems.

Laryngeal complaints are common reasons for patients to seek care. There is considerable overlap between patient symptoms and final diagnosis. This article begins with a general approach to laryngeal symptoms followed by individual consideration of both the common and serious conditions of the larynx.

Complete genome sequence of Thauera aminoaromatica strain MZ1T.

Thauera aminoaromatica strain MZ1T, an isolate belonging to genus Thauera, of the family Rhodocyclaceae and the class the Betaproteobacteria, has been characterized for its ability to produce abundant exopolysaccharide and degrade various aromatic compounds with nitrate as an electron acceptor. These properties, if fully understood at the genome-sequence level, can aid in environmental processing of organic matter in anaerobic cycles by short-circuiting a central anaerobic metabolite, acetate, from microbiological conversion to methane, a critical greenhouse gas. Strain MZ1T is the first strain from the genus Thauera with a completely sequenced genome.

Silicon photomultiplier (SPM) detection of low-level bioluminescence for the development of deployable whole-cell biosensors: possibilities and limitations.

Whole-cell bacterial bioreporters await miniaturized photon counting modules with high sensitivity and robust compatible hardware to fulfill their promise of versatile, on-site biosensor functionality. In this study, we explore the photon counting readout properties of the silicon photomultiplier (SPM) with a thermoelectric cooler and the possibilities of detecting low-level bioluminescent signals. Detection performance was evaluated through a simulated LED light source and the bioluminescence produced by the genetically engineered Pseudomonas fluorescens bacterial bioreporter 5RL.

Are students less likely to report pertinent negatives in post-encounter notes?

In completing post-encounter notes (PENs), students are believed to under-report about 30% of the important information obtained in the medical history. The resulting incomplete clinical notes can contribute to adverse patient care and medicolegal outcomes. We hypothesized that pertinent negative items would be more likely to be under-reported than positive items.

Do students falsify information in clinical notes?

If students report information in a post-encounter note that was allegedly not obtained from the patient, they may be suspected of serious professional misconduct, ie, deliberate falsification of patient data. Over-reporting during a clinical assessment may result in accusations of cheating and even lead to failure of a high-stakes examination. Despite these serious implications, the prevalence and reasons for over-reporting are not clear.

Student treatment on clerkships based on their specialty interests.

Background: Student clerkship experiences may suffer if teachers are not sympathetic to students' clinical interests.

Purpose: In this study, we quantified these experiences, compared reports of primary care and focused specialty students, and identified clerkships and teachers that posed special problems.

Methods: Students starting their 4th year at 6 schools completed a survey.

Which patients are most challenging for second-year medical students?

Background And Objectives: Fostering appropriate attitudes toward patients begins with recognition of the physician's personal biases and preferences about patients. We sought to assist second-year medical students to identify those patient attributes that may influence their clinical behavior, especially in difficult patient encounters. This study's objectives were (1) to identify the principal patient characteristics reported by students to evoke negative or positive affective reactions sufficient to compromise the quality of patient care and (2) to examine differences between male and female students on these patient characteristics.

The RAFT approach to academic detailing with preceptors.

We have adapted "academic detailing" as a method to deliver real-time faculty development to nearly all community preceptors, both rural and urban, using the RAFT technique (Rapport-building, Assessment, Focused preceptor development, Thanks/Trinkets). The method is expensive in terms of faculty time and can be difficult to schedule. However, it has proven to be a valuable, learner-centered method that reaches preceptors missed by traditional faculty development workshops.

Treatment of medical students during clerkships based on their stated career interests.

Background: Clerkship students often face questions from teachers about their career interests and may perceive that their responses change their clerkship experiences significantly.

Purpose: To explore student experiences with "career interest" inquiries and how responses may influence clerkship experiences.

Methods: A qualitative study of 4th-year medical students by use of focus groups, whose experienced facilitators used a structured interview protocol.