Objectives The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. Methods The authors recruited 203 senior nursing students and 235 fourth-year medical students (total N¼438) from two major universities for a 1-day interdisciplinary teamwork training course. All participants received a didactic lecture and then were randomly assigned to one of four educational methods: didactic (control), audience response didactic, role play and human patient simulation. Student performance was assessed for teamwork attitudes, knowledge and skills using: (a) a 36-item teamwork attitudes instrument (CHIRP), (b) a 12-item teamwork knowledge test, (c) a 10-item standardised patient (SP) evaluation of student teamwork skills performance and (d) a 20-item modification of items from the Mayo High Performance Teamwork Scale (MHPTS The TeamSTEPPS programme is designed to improve care and patient safety through improved teamwork training to enhance provider communication skills. While the 7 h multidisciplinary Team-STEPPS programme has proven very effective, questions remain regarding the most effective and cost-efficient approach to providing this content to learners at all stages of the health-education continuum.Various educational approaches have been used to address training in team coordination skills in healthcare. Methods such as crisis resource management training using high fidelity human patient simulation provide realism and interactivity.1e3 However, this training modality is both costly and time-consuming, with one instructor per five trainees costing as much as $5000 per day. 12Because of this, medical and nursing schools are implementing more traditional didactic approaches to teaching team coordination skills as well as computer-based instruction, small-group sessions, analysis of videotaped team coordination scenarios and workplace practice experiences.10 11 13 Questions remain about the effectiveness of any of these methods to achieve the necessary changes in student attitudes, knowledge and skills, and there is little evidence for selecting particular methods. Therefore, this study was designed and implemented to adapt the TeamSTEPPS content to pre-licensure nursing and medical students, and measure the effectiveness of four educational interventions at teaching this material. METHODS ProtocolWe conducted a full-day teamwork training and assessment exercise for 438 students composed of fourth-year medical students (N¼235) and finalsemester nursing students (N¼203) from four health-professional schools at two major universities: all students convened on the one campus where they were randomised to one of four educational intervention groups. Students were offered the option of not participating in the research project but could not decline the educational experience. Institutional review boards of both universities approved the proj...
Medical educators can play a critical role in decreasing LGBT healthcare disparities. The University of Louisville LGBT Health Certificate Program played an important first step in increasing medical students' knowledge and improving certain attitudes about LGBT patients.
The community forum discussion showed that local transgender care is overwhelmingly underdeveloped and unresponsive to the needs of the transgender community. The follow-up survey revealed that priorities to improve transgender care included a multidisciplinary clinic for lesbian, gay, bisexual, and transgender (LGBT) patients, an LGBT-friendly network of physicians, and more training for providers and support staff. This mutually constructive engagement experience influenced reform in undergraduate curricula and continuing education opportunities. Insights: Community engagement in healthcare disparities research can cultivate improbable discussions, yield innovative insight from marginalized populations, and build relationships with community members for future collaborations and interventions. Societal acceptance of transgender identities, which could be promoted through healthcare providers, could stimulate significant progress in transgender healthcare. Supplemental educational interventions for practicing physicians will improve the current conditions of transgender healthcare, but a comprehensive medical school curriculum specifically for transgender health that includes interactions between the transgender community and medical students could be particularly impactful.
The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients.
Background Compassionate health care is associated with positive patient outcomes. Educational interventions for medical students that develop compassion may also increase wellness, decrease burnout, and improve provider-patient relationships. Research on compassion training in medical education is needed to determine how students learn and apply these skills. The authors evaluated an elective course for medical students modeled after the Compassion Cultivation Training course developed by the Stanford Center for Compassion and Altruism Research and Education. The elective goals were to strengthen student compassion, kindness, and wellness through compassion training and mindfulness meditation training modeled by a faculty instructor. The research objectives were to understand students’ applications and perceptions of this training. Methods Over three years, 45 students participated in the elective at the University of Louisville School of Medicine. The course administered a pre/post Kentucky Inventory of Mindfulness Skills that measured observing, describing, acting with awareness, and accepting without judgment. Qualitative analyses of self-reported experiences were used to assess students’ perceptions of compassion training and their application of skills learned through the elective. Results The mindfulness inventory showed significant improvements in observing ( t = 3.62, p = 0.005) and accepting without judgment skills ( t = 2.87, p = 0.017) for some elective cohorts. Qualitative data indicated that students across all cohorts found the elective rewarding, and they used mindfulness, meditation, and compassion skills broadly outside the course. Students described how the training helped them address major stressors associated with personal, academic, and clinical responsibilities. Students also reported that the skills strengthened interpersonal interactions, including with patients. Conclusions These outcomes illuminate students’ attitudes toward compassion training and suggest that among receptive students, a brief, student-focused intervention can be enthusiastically received and positively influence students’ compassion toward oneself and others. To underscore the importance of interpersonal and cognitive skills such as compassion and mindfulness, faculty should consider purposefully modeling these skills to students. Modeling compassion cultivation and mindfulness skills in the context of patient interactions may address student empathy erosion more directly than stress management training alone. This pilot study shows compassion training could be an attractive, efficient option to address burnout by simultaneously promoting student wellness and enhanced patient interactions.
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