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Year : 2013  |  Volume : 26  |  Issue : 3  |  Page : 188-191

Brief structured observation of medical student hospital visits

Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

Correspondence Address:
J Rush Pierce
Department of Internal Medicine, MSC 10 5550, 1 University of New Mexico, Albuquerque, NM, USA, 87131 0001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1357-6283.126003

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Introduction: Students' clinical, communication, and professionalism skills are best assessed when faculty directly observe clinical encounters with patients. Prior to 2009, third-year medical students at our institution had one observed clinical encounter by clinic-based faculty during a required internal medicine clerkship. These observations averaged 45 minutes, feedback was not standardized, and student and faculty satisfaction was low. Methods: Two hospital-based faculty members redesigned a shorter, standardized exercise during which a faculty member observed the student making rounds on a hospitalized patient that they were actively following. On a checklist, faculty recorded observations about communication (8 items), physical examination (5 items), and professionalism (4 items). Faculty provided immediate feedback. Results: Faculty's direct observation of medical students prerounding on hospitalized internal medicine patients averaged 27 minutes including the feedback to students. In one year, 67/71 (94%) students completed the exercise; records were available for 66 (99%) of these encounters. Time of observation averaged 13.5 minutes (range 3-26 minutes). Feedback averaged 13.4 minutes (range 8-25 minutes). Faculty provided feedback in the following areas (proportion of students): Communication (66/66, 100%); examination skills (63/66, 95%); and professionalism (65/66, 98%). Forty-three students (64%) completed an anonymous satisfaction survey. Thirty-nine of these (91%) found the exercise useful or very useful (average 5-point Likert score = 4.30) and 38 (88%) found it easy or very easy to schedule (average 5-point Likert score = 4.30). Discussion: Students found this exercise useful and easy to schedule. Faculty consistently provided feedback to students in areas of communication, physical examination, and professionalism.

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