David Mallott | PubMed Health

PubMed2006

Interview, Dean's Letter, and Affective Domain Issues.

The evaluation of medical students consists, in part, of a transparent academic record of grades, awards, and any publications or special clinical activities. In addition, however, each student is evaluated through more opaque processes within a medical school that speak to the behavior, character, and developing professionalism observed throughout the 4 year curriculum. In the process of choosing a medical student for residency, these non-academic factors may play a significant role in determining the best match between student and program. Three aspects of the non-academic record of the student are presented: the Interview; the Dean's Letter; and other Affective Domain Issues showing the lack of systematic study of these variables and the degree of difficulty in ferreting out information germane to the residency selection process. Nevertheless, information can be gleaned from careful interviewing and examination of information provided by the medical school to more fully assess each student. The most challenging task is to distinguish between behavior associated with the process of maturation and that associated with significant psychopathology.

Clinical Competence↗

PubMed2005

A basis for electronic cognitive simulation: the heuristic patient.

Although medical trainees are expected to become expert quickly and safely, limited electronic methods are available to rehearse medical cognition for common outpatient and non-emergent inpatient problems. We conducted a series of formal observational sessions designed to determine what interaction requirements are desirable for student rehearsal of medical management by using an electronic patient. The studies utilized both manual and electronic methods for a student to evaluate and manage patients with medical and surgical problems. We observed the following major requirements for an effective simulation experience: the user must have a trial-and-error experience with the patient; the user must have unconstrained access to query and treat the patient; anatomic and physiologic values in the patient must change appropriately in response to user actions; and the user must be able to control certain time-related aspects of the simulation. When these requirements are implemented within a simulation, user-directed management of an electronic patient, by itself, becomes a strong aid to learning by trial- and-error techniques. We conclude that the heuristic patient is a practical and useful concept. Once fully developed, it would allow rehearsal of patient care decision making, intrinsically demonstrating trainee knowledge deficits, and resulting in self-directed learning.

Clinical Clerkship↗