Students today (Generation Me) differ from those in the past. They score higher on assertiveness, self-liking, narcissistic traits, high expectations, and some measures of stress, anxiety and poor mental health, and lower on self-reliance, suggests Jean Twenge (Medical Education 2009: 43; 398-405). Today’s students would benefit from a more structured but also a more interactive learning experience. Also, over-confidence of students may need to be tempered. Staff should give very specific instructions and frequent feedback and should explain the relevance of the material. Instruction should be arranged in shorter segments and incorporate more material delivered in media such as videos and interactive format.
Courtesy of Dr. K. Stobbe
Monday, September 28, 2009
Monday, September 21, 2009
PBL Pearl Vol 2(#4): Emotional Intelligence and Choice of Specialty
We often assume certain personality types go along with certain specialties. When students are making choices, we may try to guide them into specialties that suit their personality. Is there really a “surgical personality”? A “type of person who would make a good family doctor”?
This paper looks at 3 independent studies of “emotional intelligence” in medical students and linked this to their choice of specialty. Emotional intelligence refers to empathy and emotional connectedness, and there exist a number of validated measurement tools.
Across all 3 studies, using different measurement tools, in different medical schools, and dividing specialty choice in different w ays (primary care vs. specialty and technical-surgical specialties vs. others) no significant differences were found in emotional intelligence between students and their choice of specialty.
Bottom line for me: I’ll stop using student personality as a factor in coaching them toward certain specialties.
Borges, Stratton, Wagner, Elam in Medical Education 2009; 43: 565-572.
Dr. Karl Stobbe
This paper looks at 3 independent studies of “emotional intelligence” in medical students and linked this to their choice of specialty. Emotional intelligence refers to empathy and emotional connectedness, and there exist a number of validated measurement tools.
Across all 3 studies, using different measurement tools, in different medical schools, and dividing specialty choice in different w ays (primary care vs. specialty and technical-surgical specialties vs. others) no significant differences were found in emotional intelligence between students and their choice of specialty.
Bottom line for me: I’ll stop using student personality as a factor in coaching them toward certain specialties.
Borges, Stratton, Wagner, Elam in Medical Education 2009; 43: 565-572.
Dr. Karl Stobbe
Clinical Skills Pearl Vol 2 (#4): What’s the best way to teach suturing and other procedural skills?
This "pearl" (previously known as a "muse") was contributed by Dr. K. Stobbe. It comes from Brydges, Carnahan, Safir and Dubrowski in Medical Education 2009, 43: 507-515. NOTE: this approach is meant for early learners – those with very little or no experience.
___________
We want our students to learn efficiently – i.e. the most learning in the least amount of time. We also want them to learn in a way that will stick – to retain their skills over time. The literature cites factors which can optimize the students’ learning, for both efficiency and retention. Self-guided learning and the setting of performance goals by students are more efficient and result in greater skill retention than traditional teaching.
What exactly is self-guided learning? Students first observe an expert performing the procedure, then are able to practice on their own, while being able to refer back to the expert performance when they wish (e.g. using a video). This is efficient – they learn the skill more quickly than traditional skills instruction.
Students who set their own goals retain their skills longer than those whose learning goals are set by the teacher. However they need guidance in setting goals, such as a list of what constitutes good performance. There are 2 general types of goals: outcome goals and process goals. It turns out that students who set process goals show greater skill retention than those who set outcome goals.
Here’s an example. When teaching suturing, outcome and process goals would look something like this:
1. If a student has never seen the procedure performed, I’ll demonstrate it once, or tell them to view a video on-line.
2. Self-guided: I’ll ask the student what they want to focus on this time. I’ll restrict my feedback to the element the student’s interested in, unless they’re compromising patient care.
3. I’ll restrict my teaching comments to how they’re doing the procedure rather than the end result.
Dr. Karl Stobbe
___________
We want our students to learn efficiently – i.e. the most learning in the least amount of time. We also want them to learn in a way that will stick – to retain their skills over time. The literature cites factors which can optimize the students’ learning, for both efficiency and retention. Self-guided learning and the setting of performance goals by students are more efficient and result in greater skill retention than traditional teaching.
What exactly is self-guided learning? Students first observe an expert performing the procedure, then are able to practice on their own, while being able to refer back to the expert performance when they wish (e.g. using a video). This is efficient – they learn the skill more quickly than traditional skills instruction.
Students who set their own goals retain their skills longer than those whose learning goals are set by the teacher. However they need guidance in setting goals, such as a list of what constitutes good performance. There are 2 general types of goals: outcome goals and process goals. It turns out that students who set process goals show greater skill retention than those who set outcome goals.
Here’s an example. When teaching suturing, outcome and process goals would look something like this:
- Outcome goals: Complete each interrupted suture and knot tie in a timely manner. Be sure to equally space the sutures, evert the skin edges, and ensure that every knot is square.
- Process goals: Needle is loaded on the driver 2/3 along the length and enters tissue perpendicular to the skin. Concentrate on hand pronation and supination when passing the needle through the tissue. Take the same size bite on each side of the wound. Ensure each throw is down square, either by having the sutures crossed, or by crossing your hands. Maintain appropriate tension on the tie.
1. If a student has never seen the procedure performed, I’ll demonstrate it once, or tell them to view a video on-line.
2. Self-guided: I’ll ask the student what they want to focus on this time. I’ll restrict my feedback to the element the student’s interested in, unless they’re compromising patient care.
3. I’ll restrict my teaching comments to how they’re doing the procedure rather than the end result.
Dr. Karl Stobbe
Tuesday, September 15, 2009
Clinical skills and PBL Muse Vol 2 (#3): Listening Skills
A major complaint that patients have with doctors is that they do not listen. Efficiency in listening skills however, has attracted little attention in the medical curriculum. How can this skill best be inculcated in medical students?
Preparing medical students to be attentive listeners is the subject of a paper by Boudreau and colleagues in Medical Teacher (2009; 31: 22-29). The authors developed a set of eight core principals of attentive listening. These were then used to design specific teaching modules in the context of curriculum renewal at the Faculty of Medicine, McGill University.
Attentive listening . . .
Medical Teacher; Volume 31. Number 6 – June 2009 (2009; 31: 563-568)
Preparing medical students to be attentive listeners is the subject of a paper by Boudreau and colleagues in Medical Teacher (2009; 31: 22-29). The authors developed a set of eight core principals of attentive listening. These were then used to design specific teaching modules in the context of curriculum renewal at the Faculty of Medicine, McGill University.
Attentive listening . . .
- is a perceptual, cognitive and social act.
- is an active process.
- is triadic: the speaker, the utterance, and the listener.
- involves focusing on word choice, paralanguage and non verbal cues and signs.
- requires receptiveness, an understanding of how spoken language works, and the ability to move between open-mindedness and an awareness of inference.
- can accomplish the following: reveal the personhood and concerns of the speaker (i.e. the patient); produce diagnostically relevant data; assist in healing.
- is not a neutral act – it can have a positive and negative impact on the patient, physician and their relationship.
- necessitates the formation of new habits.
Medical Teacher; Volume 31. Number 6 – June 2009 (2009; 31: 563-568)
Tuesday, September 8, 2009
PBL Muse Vol 2 (#2): Your role as tutors
The particular way in which students are asked to learn has a strong influence on how well they will be able to recall and apply what they have learned in the real clinical world outside of medical school. The basic aim of the PBL curriculum is to have our students:
1) Reason their way through patient problems.
2) Recall and apply what they have been taught to the care of their patients.
3) Recognize when their skills and knowledge are not adequate to the clinical task they are confronting.
4) Acquire new information and skills as they need it, and, as medical research moves ahead, keeping contemporary in their knowledge and skills.
5) Work independently and yet support a team approach, a task so important to the practice of medicine today.
Your role as tutors is to support this way of learning.
Dr. Maynard Luterman
1) Reason their way through patient problems.
2) Recall and apply what they have been taught to the care of their patients.
3) Recognize when their skills and knowledge are not adequate to the clinical task they are confronting.
4) Acquire new information and skills as they need it, and, as medical research moves ahead, keeping contemporary in their knowledge and skills.
5) Work independently and yet support a team approach, a task so important to the practice of medicine today.
Your role as tutors is to support this way of learning.
Dr. Maynard Luterman
Clinical Skills Muse Vol 2 (#2): The Six Habits of Highly Respectful Physicians
Here is an article from the New York Times describing six steps to promoting "etiquette-based medicine".
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