2011 - UCSF School of Medicine - University of California, San ...

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UCSF Education Day 2011professional practice. Student focus groups (n=41)investigated student perceptions of medical educationand the learning environment at MUHAS.Results: MUHAS medical students and recentgraduates identified strengths of the curriculum inconferring medical knowledge. However, they identifiedsignificant gaps in their medical education with respectto practical clinical training. Surgical skills andambulatory outpatient care were highlighted as specificdeficiencies in clinical training. Both students and facultyfeel that clinical teaching is impeded by the large numberof students in clinical sessions, limited facilities toconduct clinical teaching, and limited faculty to supervisestudents.Discussion: Increased practical clinical skill training isneeded to improve graduates’ clinical competency,especially in the areas of surgical skills and outpatientambulatory care. Informed by student, graduate, andstakeholder perspectives, MUHAS is currentlyundergoing major curriculum revisions focused oncompetency-based medical education and improvingclinical training.Reflective critique: In partnership with UCSF, MUHASis implementing efforts to increase clinical exposure,surgical skills simulation training, ambulatory careprecepting, and faculty development about clinicalteaching methodologies to improve medical educationand the preparation of graduates who are betterequipped to address health needs in Tanzania.Impact of Student-Run Clinics onPreclinical Students’ Socioculturaland Interprofessional Attitudes: AProspective Cohort AnalysisLeslie C. Sheu, BA, UCSF, leslie.sheu@ucsf.edu; CindyLai, MD, UCSF, clai@medicine.ucsf.edu; Anabelle D.Coelho, MS, UCSF, anabelle.coelho@ucsf.edu; Lisa D.Lin, MS, UCSF, lisa.lin@ucsf.edu; Patricia Zheng, BS,UCSF, patricia.zheng@ucsf.edu; Patricia Hom, BA,UCSF, patricia.hom@ucsf.edu; Vanessa Diaz, BS,UCSF, Vanessa.diaz@ucsf.edu; Patricia S. O’Sullivan,UCSF, osullivanp@medsch.ucsf.eduBackground: Descriptive studies suggest that studentrunclinics (SRCs) positively impact participatingstudents. However, studies rarely include students frommultiple professions, validated instruments, and a controlgroup. At our health professions campus, first-yearstudents can participate in SRCs focusing on specificunderserved populations: Latino(a), Asian/PacificIslander, and urban homeless communities. In thisstudy, we used validated measures to explore the impactof these SRCs on preclinical students’ sociocultural andinterprofessional attitudes.Methods: Using a pre-post control group design, weconducted a prospective cohort study of first-yearmedical, nursing, and pharmacy students whoparticipated in SRCs and those who did not. At thebeginning and end of the year, they completed surveysconsisting of demographics, validated measures onsociocultural awareness (SAMI) and readiness forinterprofessional learning (RIPLS), and open-endedquestions.Results: Of all participating students, 77% (274 of 358)completed the post-survey, with 68% (n=182) havingmatching pre-post surveys. Students held positiveattitudes in sociocultural and interprofessional domains.After adjusting for baseline scores, attitudes did not differsignificantly between those who participated in SRCsand those who did not. In the qualitative analysis, 99%reported reinforced or increased commitment to workingwith the underserved. Forty percent reported that theirexperiences made a positive impact on theirinterprofessional attitudes.Discussion: In this study, we found no quantifiableeffect of SRC participation on sociocultural orinterprofessional attitudes. However, students perceivedbenefits in both domains, suggesting that the SAMI andRIPLS may not be sensitive enough for measuring theeffects of SRCs. Further studies are needed to assessthe long-term impact of preclinical SRCs.Reflective critique: We have incorporated extensivefeedback from advisors and ESCape, and havesubmitted the abstract to an education meeting.Areas abstract covers: UMEDomain(s) addressed: Cultural Competence, Diversity,Evaluation of Programs and Curricula, InterprofessionalEducationPurpose: To evaluate the impact of student-run clinics(SRCs) on sociocultural and interprofessional attitudesacross health professions.University of California, San Francisco • School of Medicine 33
UCSF Education Day 2011Integrating Multiple Levels ofLearners into an InterdisciplinaryTeam-Based Model ofAmbulatory CareKatherine Julian, MD, UCSF, kathy.julian@ucsf.edu;Bridget O'Brien, Ph.D., UCSF,ObrienB@medsch.ucsf.edu; Maria Wamsley, MD,UCSF, maria.wamsley@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Evaluation of Programs andCurricula, Health Systems, Interprofessional Education,Primary CarePurpose: Near-peer teaching may be more effectivethan expert teaching. This project describes theintegration of interns/PISCES students into internalmedicine (IM) resident continuity clinic teams to promotenear-peer teaching among multi-level learners.Background: One limitation of the PISCES clerkship isthe relative lack of interaction with residents. IMresidents and interns have little interaction in clinic dueto separate continuity clinic days. Increasing teachinginteractions among residents, interns, and medicalstudents is desirable to promote near-peer teaching.Methods: In 2008, IM PGY2/PGY3 continuity clinics atParnassus/Zion were reorganized to create a teambasedmodel of care. In 2009, we integrated 14 PISCESstudents and 26 interns into the teams. Each teamconsisted of one attending, 2-6 PGY2/3 residents, 2-3interns, one LVN and one administrative assistant. 9 of10 teams included PISCES students.Results: Interns/PGY2/PGY3 residents were surveyedregarding their satisfaction with the team model. PISCESstudents participated in focus groups. 36 of 70 residentsresponded. 51% reported improved informal peermentoring; 38% reported improved educationalenvironment; 70% reported seeking advice from residentpeers in clinic and 59% reported receiving qualityteaching from resident peers. 87% of residentrespondents supported student presence on the teamsbut only 29% felt that students were effectivelyintegrated into the team structure. Although PISCESstudents reported positive learning experiences in IMclinic and appreciated resident interactions, they didn’tstrongly identify as members of their clinic team.Discussion: Integrating interns/residents in continuityclinic improved informal peer mentoring, near-peerteaching, collegiality and the clinic educationalenvironment. Residents overwhelmingly supported thepresence of students on their clinic teams. However,most residents and students did not feel that studentswere effectively integrated into the team structure.Reflective critique: More work must be done to betterintegrate students into clinic teams and increase theinteraction with interns and residents.Learners' Perspectives onEffective MentorshipChristy Boscardin, PhD, UCSF,christy.boscardin@ucsf.edu; Renee Courey, PhD,UCSF, CoureyR@medsch.ucsf.edu; Louise Aronson,MD MFA, UCSF, aronsonl@medicine.ucsf.edu; AllisonChen, UCSF, ChenAM@medsch.ucsf.edu; Mark Lovett,UCSF, LovettM@medsch.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Evaluation of Programs andCurricula, MentoringPurpose: The purpose of the study was to identifycharacteristics of mentors that students considerimportant for effective mentorship in the Pathwaysprogram.Background: Mentorship can significantly influencepersonal development, career choice, and researchproductivity. The UCSF Pathways to Discovery programprovides in depth training for careers beyond the routinepractice of medicine. Program success depends oneffective mentoring currently delivered by a team ofproject mentors and program directors. Learnerscurrently identify project mentors based on contentexpertise and project interest.Methods: 10 randomly selected medical studentsparticipated in a focus group. The learners were asked aseries of structured, open-ended questions to describetheir experience working with project mentors. 35students also completed a survey item (4 point-scale)rating their overall experience with mentorship.Results: 30 (86%) students rated mentorship quality asvery good or excellent (3 to 4). Learners described aneffective mentor as someone who provided contentexpertise but was also a “good advocate” and offeredinsight into the student’s career interests.Discussion: Although learners select mentors based oncontent expertise, learners expect each mentor toprovide scholarly, career development, and psychosocialsupport. While many faculty met their role as projectmentors, learner expectations match program-widegoals rather than narrower project mentor roles. Tobetter align learner expectations and availablementoring, we are 1) creating materials that explain the34 The Haile T. Debas Academy of Medical Educators
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