Objective:To explore student perceptions of the feasibility of neurology and psychiatry clerkship integration, including clinical education and competency evaluation, as there has been a call to improve undergraduate medical education integration of the disciplines to better develop physicians that can address nervous system disorders.Method:Via a constructivist grounded theory approach, we carried out five focus groups in 2016-2017 with 28 medical students who completed both independent clerkships. Investigator triangulation was used with iterative interpretation comparisons, and themes were identified using constant comparative analysis.Results:Three major themes arose: 1) combining the clerkships was not favorable as students need sufficient time to delve deeper in each discipline; 2) students did not observe an integrated clinical approach by faculty; 3) positive value of making links between neurology and psychiatry for effective patient care.Conclusions:Students emphasized the importance of making stronger links between the two disciplines for their learning and to improve patient care; however, they did not observe this clinical approach in the workplace. Students perceived that integration of neurology and psychiatry clerkships should occur via increased affinity of the complementary discipline by trainees and faculty in each specialty.
Introduction: Direct observation assessments that provide both formative feedback and data for summative decisions can be difficult to achieve. The mini-clinical evaluation exercise (mini-CEX) is a widely used tool of direct observation that provides opportunities for feedback. We introduced a direct observation system with frequent mini-CEXs to increase clerkship student learning opportunities and to improve competency-based summative decisions. However, students may express resistance to assessments for learning with any summative impact as they may perceive the assessments as purely a series of summative evaluations.
Aims:We explored how frequent low-stakes mini-CEXs affect clerkship students' perception of learning and to understand student perceptions of these assessments supporting their end-of-rotation summative clinical performance evaluations.Methods: This qualitative study used a purposive sampling strategy of focus groups with students who completed multiple mini-CEXs during their four-week neurology clerkship at one of three sites. All eleven students chose to participate. Eight students completed eight mini-CEXs, two students completed seven, and one student completed four. Investigator triangulation was used with interpretation comparisons that included independent content analysis. The emerging themes were discussed and final theme consensus was reached.Results: Three major themes arose: perceived effects of frequent mini-CEXs for clerkship student learning by facilitating multiple opportunities for guided practice under low assessment anxiety; the importance of consistent, effective faculty feedback and engagement to maximize mini-CEXs for learning; and support for summative impact of frequent, mainly formative, low stakes mini-CEXs.
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