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      Association of Shadowing Program for Undergraduate Premedical Students with Improvements in Understanding Medical Education and Training

      research-article
      1 , , 2 , 3 , 4 , 5 , 5 , 2
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      Cureus
      Cureus
      undergraduate medical education, shadowing

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          Abstract

          Objective: Physician shadowing has become ubiquitous to the premedical experience. However, students without connections to a medical professional are oftentimes forced to reach out to physicians independently from a program. Subsequently, these inquiries may go unanswered as they oftentimes appear unsolicited. The primary goals in the design and development of our program were to increase access to a clinical observership experience at our academic institution utilizing resident physicians as primary supervisors.

          Methods: In January 2017, the Educational Shadowing Program (ESP) was established at our institution wherein undergraduate students could shadow within the Pediatric Continuity Clinic (PCC) staffed by pediatric resident physicians. ESP undergraduates shadowed the residents as they performed their history taking and physical exams and as they presented their patients to the attending physicians. Between patient encounters, the students assisted the residents in their administrative work which was completed as needed. ESP students were surveyed at their first orientation meeting and during the final case conference.

          Results: The pre-participation survey showed that none of the student participants strongly agreed to having a good understanding of what the job of a resident physician entails. By the end of their 30 weeks, the proportion of participants with a strongly perceived understanding increased significantly. The proportion of student respondents that strongly agreed with their understanding of the physician-patient interaction also improved significantly over the study period, from 33% to 78%. Seventy-two percent of the residents surveyed agreed or strongly agreed that they enjoyed having the undergraduates in the clinic, affirming the positive effects of the program on the resident physicians. Forty-five percent of residents agreed or strongly agreed that the undergraduates improved their workflow in the clinic.

          Conclusion: This study demonstrates that establishing an undergraduate shadowing program in a busy academic pediatric clinic that involves resident physicians can be an overall positive experience for all participants. Fostering premedical student interest in pediatric care and primary care can possibly lead to more physician commitment to these fields, potentially helping to alleviate impending physicians in these specialties.

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          Most cited references15

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          First year medical student stress and coping in a problem-based learning medical curriculum.

          To examine the prevalence of psychological morbidity, sources of stress and coping mechanisms in first year students in a problem-based learning undergraduate medical curriculum. Longitudinal cohort questionnaire survey. Glasgow University Medical School. All first year students (n = 275) in the 1997-98 intake. Scores on the 12-item General Health Questionnaire (GHQ-12), sources of stress and coping strategies. The prevalence of psychological morbidity and mean GHQ-12 scores increased significantly between term 1 and term 3, with no significant gender differences. Principal stressors were related to medical training rather than to personal problems, in particular uncertainty about individual study behaviour, progress and aptitude, with specific concerns about assessment and the availability of learning materials. The group learning environment, including tutor performance, and interactions with peers and patients caused little stress. Students generally used active coping strategies. Both stressor group scoring and coping strategies showed some variation with gender and GHQ caseness. Increased student feedback and guidance about progress throughout the year and the provision of adequate learning resources may reduce student stress. Educational or pastoral intervention regarding effective coping strategies may also be beneficial. Continued follow-up of this cohort could provide information to inform further curriculum development and, if appropriate, aid the design of programmes for the prevention of stress-related problems.
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            Osler, Flexner, apprenticeship and 'the new medical education'.

            Tim Dornan (2005)
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              Patients as teachers: a qualitative study of patients' views on their role in a community-based undergraduate project.

              Patients have been used in clinical medical education for many years with, traditionally, a relatively passive role. Following the General Medical Council recommendations for curricular change and the development of more community-based teaching, 'ordinary patients' in the community are increasingly being partnered with undergraduate students for particular projects. Very little research has been undertaken on patients' perceptions of this role. Semi-structured interviews were carried out with 20 people to explore the views of patients taking part in a community-based undergraduate medical student project (the 'patient study') at Newcastle Medical School about their role as teachers of medical students, what they felt they had gained from participating, any problems or concerns and suggestions for change or improvement. Newcastle Medical School, UK. Second-year medical students. Two major themes emerged. First, patients saw themselves in active roles as teachers: as experts in their medical condition; as exemplars of their condition; and as facilitators of the development of students' professional skills and attitudes. Secondly, patients felt they had benefited from participation, through talking about their problems; learning more about themselves; the satisfaction of helping; and from receiving gifts. In addition, a number of other issues were identified including interpersonal dynamics, gender and ethnic differences, inadequate briefing of participants and whether such community-based patient involvement might, in some situations, be felt to be exploitative. The study has shown that patients see themselves clearly as having specific contributions to make to medical students' education and training. This has implications for the further development of community-based teaching.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                16 December 2019
                December 2019
                : 11
                : 12
                : e6396
                Affiliations
                [1 ] Pediatrics, University of California, Los Angeles, Los Angeles , USA
                [2 ] Pediatrics, University of California, Los Angeles, Los Angeles, USA
                [3 ] Neurosurgery, University of California, Los Angeles, Los Angeles, USA
                [4 ] Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, USA
                [5 ] Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, USA
                Author notes
                Article
                10.7759/cureus.6396
                6961790
                31942265
                7af267f8-76ed-4bff-90eb-4edea46b1601
                Copyright © 2019, Thang et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 August 2019
                : 15 December 2019
                Categories
                Medical Education

                undergraduate medical education,shadowing
                undergraduate medical education, shadowing

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