Medical Student Educational Experiences and Completion of Learning

Medical Student Educational Experiences and Completion of Learning Objectives CLICK TO GO in the Emergency Department BACK TO KIOSK Collyn Murray, MD, Christina Shenvi, MD, PhD Background The Emergency Department (ED) provides a unique learning environment in which medical students can gain experience with managing acute, undifferentiated patients. It allows for countless learning experiences across a patients medical story. However, the fast-paced nature of the ED and preceptor variation limits standardized teaching. Little is known about the effectiveness of teaching in the ED, particularly for students. Medical schools are however integrating ED clerkships given their academic potential 1,2. In order to optimize students educational experiences we sought to better understand with whom and where teaching occurs under our current clerkship design. Methods This is a prospective study of procedure cards and surveys submitted by medical students as part of their month-long 4th year clinical rotation in the ED between 05/2017 and 03/2018 at a tertiary care academic ED. Students marked which topics or procedures they had reviewed, and who had precepted them. In an exit survey, students were asked to rate how often they received individualized teaching and whether their educational goals were met when working with residents and attendings on a 10 point Likert scale. Qualitative and quantitative data were collected anonymously with IRB exemption. Results 35 30 30 25 Attending 25 20 Resident 20 Num berofStudents Numberof Students Shift card data was collected from 69 students. Attendings tended to precept visual diagnostics while

residents tended to teach technical procedures. Fortyfour students completed the exit survey. Results showed that students felt they received individualized teaching from both attendings and residents (7.9 and 8.0 respectively, p = 0.059). Students felt their goals were met more when reporting to the residents than attendings but not significantly so (8.6 and 8.0 respectively, p = 0.088). Themes noted in the openended portion of the survey were that students wanted more individualized experiences with the attendings, and requested more dedicated teaching shifts. Rating of Learning Goal Achievement on Shift with Attendings and Residents Rating of Individualized Teaching on Shift with Attendings and Residents 15 10 5 0 3-4 5-6 Likert Score 7-8 9-10 Attending Resident 15 10 5 0 5-6 7-8 MENU

Conclusion 4th Year medical students in the ED felt they received individualized teaching on most shifts. They reported their education goals were met as often when working with residents as with attendings. From this, we plan to foster additional resident-student interaction and further train residents in bedside teaching on par with that of faculty development. Integrated teaching shifts may also help to establish rapport and fundamentals of learning in the ED. Overall, a larger sample size as well as input from preceptors are needed to further optimize ED education. 9-10 Likert Score REFERENCES 1. Coates WC. (2004). An educators guide to teaching emergency medicine to medical students. Acad Emerg med, 11(3):300-306. 2. Wald DA, Lin M, Manthey DE, Rogers RL, Zun Ls, Christopher T. (2010). Emergency medicine in the medical school curriculum. Acad Emerg Med, 17 Supp:S26-30. Medical Student Educational Experiences and Completion of Learning Objectives in the Emergency Department Collyn Murray, MD, Christina Shenvi, MD, PhD Research Question In what clinical setting do MS4s have the best learning experience? Background The Emergency Department (ED) provides a unique learning environment in which medical students can gain experience with managing acute, undifferentiated patients. It allows for countless learning experiences across a patients medical story. However, the fast-paced nature of the ED and preceptor variation limits standardized teaching. Little is known about the effectiveness of teaching in the ED, particularly for students. Medical schools are however integrating ED clerkships given their

1,2 academic potential . In order to optimize students educational experiences we sought to better understand with whom and where teaching occurs under our current clerkship design. 1. Coates WC. (2004). An educators guide to teaching emergency medicine to medical students. Acad Emerg med, 11(3):300-306. 2. Wald DA, Lin M, Manthey DE, Rogers RL, Zun Ls, Christopher T. (2010). Emergency medicine in the medical school curriculum. Acad Emerg Med, 17 Supp:S26-30. Medical Student Educational Experiences and Completion of Learning Objectives in the Emergency Department Collyn Murray, MD, Christina Shenvi, MD, PhD Methods This is a prospective study of procedure cards and surveys submitted by medical students as part th of their month-long 4 year clinical rotation in the ED between 05/2017 and 03/2018 at a tertiary care academic ED. Students marked which topics or procedures they had reviewed, and who had precepted them. In an exit survey, students were asked to rate how often they received individualized teaching and whether their educational goals were met when working with residents and attendings on a 10 point Likert scale. Qualitative and quantitative data were collected anonymously with IRB exemption. Medical Student Educational Experiences and Completion of Learning Objectives in the Emergency Department Collyn Murray, MD, Christina Shenvi, MD, PhD Results Rating of Learning Goal Achievement on Shift with Attendings and Residents Rating of Individualized Teaching on Shift with Attendings and Residents 35 30 Attending Resident 25 25

20 20 Number of Students Number of Students 30 35 15 10 15 10 5 5 0 0 3-4 5-6 Likert Score 7-8 9-10 Attending Resident 5-6 7-8

Likert Score 9-10 Medical Student Educational Experiences and Completion of Learning Objectives in the Emergency Department Collyn Murray, MD, Christina Shenvi, MD, PhD Conclusions Fourth-year medical students in the ED felt they received individualized teaching on most shifts. They reported their education goals were met as often when working with residents as with attendings. From this, we plan to foster additional resident-student interaction and further train residents in bedside teaching on par with that of faculty development. Integrated teaching shifts may also help to establish rapport and fundamentals of learning in the ED. Overall, a larger sample size as well as input from preceptors are needed to further optimize ED education. Medical Student Educational Experiences and Completion of Learning Objectives in the Emergency Department Collyn Murray, MD, Christina Shenvi, MD, PhD Ranking of Practice Setting in Meeting Educational Goals 35 Number of Students 30 25 20 15 10 5 0 Acute Bays Minor Treatment Teaching Shift