A simulated “Night-onCall” to assess and address the readiness-for-internship of transitioning medical students

Kalet, Adina; Zabar, Sondra; Szyld, Demian; Yavner, Steven D.; Song, Hyuksoon S.; Nick, Michael W.; Ng, Grace; Pusic, Martin; Denicola, Christine; Blum, Cary; Eliasz, Kinga L; Nicholson, Joey; Riles, Thomas S.

doi:10.1186/s41077-017-0046-1

Cited by 19 publications

(18 citation statements)

References 37 publications

(32 reference statements)

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“…Exposing learners to unfamiliar cases and problems, carefully chosen to challenge them within reason and to enable them to deliberately build problem-solving skills to deal with uncertainty, may serve to develop adaptive skills. Such approaches to capture, reinforce, and assess adaptive skills have been tried with some success (Wijnen-Meijer et al 2013;Kalet et al 2017). iv.…”

Section: Practice Pointsmentioning

confidence: 99%

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

et al. 2021

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The COVID-19 pandemic has disrupted many societal institutions, including health care and education. Although the pandemic's impact was initially assumed to be temporary, there is growing conviction that medical education might change more permanently. The International Competencybased Medical Education (ICBME) collaborators, scholars devoted to improving physician training, deliberated how the pandemic raises questions about medical competence. We formulated 12 broad-reaching issues for discussion, grouped into micro-, meso-, and macro-level questions. At the individual micro level, we ask questions about adaptability, coping with uncertainty, and the value and limitations of clinical courage. At the institutional meso level, we question whether curricula could include more than core entrustable professional activities (EPAs) and focus on individualized, dynamic, and adaptable portfolios of EPAs that, at any moment, reflect current competence and preparedness for disasters. At the regulatory and societal macro level, should conditions for licensing be reconsidered? Should rules of liability be adapted to match the need for rapid redeployment? We do not propose a blueprint for the future of medical training but rather aim to provoke discussions needed to build a workforce that is competent to cope with future health care crises.

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Section: Practice Pointsmentioning

confidence: 99%

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

et al. 2021

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“…While an assortment of informal orientation opportunities to the on-call role exist already (e.g., having a PGY 1 resident carry the SMR pager), programs should consider what programmatic efforts can be taken to ensure junior trainees are sufficiently prepared for the on-call SMR role. Existing interventions include participation in an on-call simulation, 25 introduction of a "buddy-system" overnight where a more experienced SMR is paired with a newly minted SMR, 26 or the use of additional "float" senior residents during the first couple of weeks of a junior resident's transition to the senior role. 27…”

Section: Discussionmentioning

confidence: 99%

“Doing it Right” Overnight: a Multi-perspective Qualitative Study Exploring Senior Medical Resident Overnight Call

2020

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BACKGROUND: Competency-based medical education (CBME) requires the development of workplace-based assessment tools that are grounded in authentic clinical work. Developing such tools, however, requires a deep understanding of the underlying facets of the competencies being assessed. Gaining this understanding remains challenging in contexts where performance is not readily visible to supervisors such as the senior medical resident (SMR) on-call role in internal medicine. OBJECTIVE: This study draws on the perspectives of healthcare professionals with whom the SMR interacts with overnight to generate insights into the different components of on-call SMR practice and the range of ways SMRs effectively and less effectively enact these. APPROACH: We used a constructivist grounded theory (CGT) approach to examine variation in how on-call SMRs carry out their role overnight. PARTICIPANTS: Six medical students, five junior residents, five internal medicine attending physicians, five emergency physicians, and three emergency nurses conducted observations of their on-call interactions with SMRs. Participants were then interviewed and asked to elaborate on their observations as well as provide comparative reflections on the practices of past SMRs they worked with. KEY RESULTS: Strong collaboration and organizational skills were identified as critical components to effectively being the on-call SMR. Perceived weaker SMRs, while potentially also having issues with clinical skills, stood out more when they could not effectively manage the realities of collaboration in a busy workplace. CONCLUSION: What consistently differentiated a perceived effective SMR from a less effective SMR was someone who was equipped to manage the realities of interprofessional collaboration in a busy workplace. Our study invites medical educators to consider what residents, particularly those in more complex roles, need to receive feedback on to support their development as physicians. It is our intention that the findings be used to inform the ways programs approach teaching, assessment, and the provision of feedback.

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“…Using the thirteen "Core Entrustable Professional Activities for Readiness for Residency" framework proposed by the Association of American Medical Colleges, Night-onCall was designed to assess and address the readiness for internship of medical students who are near to graduating. All activities of Night-onCall were designed around four clinical cases [14].…”

Section: Methodsmentioning

confidence: 99%

Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation

Nicholson

Kalet

Vleuten

et al. 2020

jmla

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Objective: Evidence-based medicine practices of medical students in clinical scenarios are not well understood. Optimal foraging theory (OFT) is one framework that could be useful in breaking apart information-seeking patterns to determine effectiveness and efficiency of different methods of information seeking. The aims of this study were to use OFT to determine the number and type of resources used in information seeking when medical students answer a clinical question, to describe common information-seeking patterns, and identify patterns associated with higher quality answers to a clinical question.Methods: Medical students were observed via screen recordings while they sought evidence related to a clinical question and provided a written response for what they would do for that patient based on the evidence that they found.Results: Half (51%) of study participants used only 1 source before answering the clinical question. While the participants were able to successfully and efficiently navigate point-of-care tools and search engines, searching PubMed was not favored, with only half (48%) of PubMed searches being successful. There were no associations between information-seeking patterns and the quality of answers to the clinical question.Conclusion: Clinically experienced medical students most frequently relied on point-of-care tools alone or in combination with PubMed to answer a clinical question. OFT can be used as a framework to understand the information-seeking practices of medical students in clinical scenarios. This has implications for both teaching and assessment of evidence-based medicine in medical students.

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A simulated “Night-onCall” to assess and address the readiness-for-internship of transitioning medical students

Cited by 19 publications

References 37 publications

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

“Doing it Right” Overnight: a Multi-perspective Qualitative Study Exploring Senior Medical Resident Overnight Call

Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation

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