Person: Pelletier, Stephen
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Pelletier
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Pelletier, Stephen
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Publication Innovative curriculum for second-year Harvard-MIT medical students: practicing communication skills with volunteer patients giving immediate feedback(Dove Medical Press, 2017) Ali, Nadaa; Pelletier, Stephen; Shields, HelenPurpose Medical students are expected to develop excellent communication skills. The purpose of our study was to create an innovative communication skills exercise using real volunteer patients and physician co-teachers for students to practice communication skills while receiving immediate feedback. Method This is a mixed methods study where second-year medical students participated in the communication skills exercise with real patients and physician co-teachers giving immediate feedback. Clinical scenarios reflected the patients’ actual experiences. Students acted out roles as physicians. Physicians co-taught with the patients and gave immediate feedback to students. Students completed an anonymous written survey at the end of the exercise. Qualitative and quantitative responses were recorded. Student feedback from the 2014 surveys was used to modify the teaching designs to increase active role play opportunities by having only two students in each group and doubling the number of stations with real patients. Results: Students rated the overall exercise and the utility of patient volunteers in learning how to communicate on a Likert scale of 1–5, where in this medical school traditionally 1 is excellent and 5 is poor. In 2014, the exercises were rated with a mean score of 1.47 (SD 0.621). In 2015, the exercises were rated with a mean score of 1.03 (SD 0.62). In 2016, the exercises were rated with a mean score of 1.27 (SD 0.52). ANOVA analysis (p=0.002) and Bonferroni corrections indicate a statistically significant difference between combined mean scores of the exercise in 2014 and 2015 (p=0.001). No difference was shown between 2014 and 2016 or 2015 and 2016. Conclusions: Medical students rated practicing communication skills with real patient volunteers and physician co-teachers giving immediate feedback in their preclinical years very highly. Student feedback indicated that they preferred active roles and increased opportunities to practice their communication skills.Publication An active learning curriculum improves fellows’ knowledge and faculty teaching skills(Dove Medical Press, 2017) Inra, Jennifer; Pelletier, Stephen; Kumar, Navin; Barnes, Edward L; Shields, HelenObjectives: Traditional didactic lectures are the mainstay of teaching for graduate medical education, although this method may not be the most effective way to transmit information. We created an active learning curriculum for Brigham and Women’s Hospital (BWH) gastroenterology fellows to maximize learning. We evaluated whether this new curriculum improved perceived knowledge acquisition and knowledge base. In addition, our study assessed whether coaching faculty members in specific methods to enhance active learning improved their perceived teaching and presentation skills. Methods: We compared the Gastroenterology Training Exam (GTE) scores before and after the implementation of this curriculum to assess whether an improved knowledge base was documented. In addition, fellows and faculty members were asked to complete anonymous evaluations regarding their learning and teaching experiences. Results: Fifteen fellows were invited to 12 lectures over a 2-year period. GTE scores improved in the areas of stomach (p<0.001), general gastroenterology (p=0.005), esophagus (p<0.001), and small bowel (p=0.001), and the total score (p=0.001) between pre- and postimplementation of the active learning curriculum. Scores in hepatology, as well as biliary and pancreatic study, showed a trend toward improvement (p>0.05). All fellows believed the lectures were helpful, felt more prepared to take the GTE, and preferred the interactive format to traditional didactic lectures. All lecturers agreed that they acquired new teaching skills, improved teaching and presentation skills, and learned new tools that could help them teach better in the future. Conclusion: An active learning curriculum is preferred by GI fellows and may be helpful for improving transmission of information in any specialty in medical education. Individualized faculty coaching sessions demonstrating new ways to transmit information may be important for an individual faculty member’s teaching excellence.Publication The Effect of Rubric-Guided, Focused, Personalized Coaching Sessions and Video-Recorded Presentations on Teaching Skills Among Fourth-Year Medical Students: A Pilot Study(Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins, 2017) Tchekmedyian, Vatche; Shields, Helen; Pelletier, Stephen; Pazo, ValeriaProblem As medical students become residents, teaching becomes an expected and integral responsibility. Yet, training-for-teaching opportunities are lacking. In 2014, the authors designed a pilot study using rubric-guided, focused, personalized coaching sessions and video-recorded presentations to improve student teaching skills among fourth-year students at Harvard Medical School. Approach In 2014–2015, the authors recruited students from an elective on how to tutor preclinical students for the pilot, which consisted of four phases: a precoaching teaching presentation, a 30- to 45-minute coaching session, a postcoaching teaching presentation, and blinded reviewer ratings. Students’ pre- and postcoaching presentations were video recorded. Using a scoring rubric for 15 teaching skills, students rated their pre- and postcoaching videos. Blinded reviewers also rated the pre- and postcoaching presentations using the same rubric with an additional category to gauge their overall impression. Outcomes Fourteen students completed all four phases of the pilot. Students’ ratings demonstrated statistically significant improvement in several teaching skills, including presentation content (P < .001), rate of speech (P = .001), and opening statement and learning objectives (P = .004). Blinded reviewers’ ratings demonstrated statistically significant improvements in several teaching skills, including opening statement and learning objectives (P < .001), overall impression (P = .001), and conclusion and summary of learning objectives (P = .004). Students provided largely positive comments on the interventions. Next Steps The authors will work toward addressing limitations in the rubric, using coaching in different teaching settings, addressing the interventions’ generalizability, training coaches, and performing additional evaluations.Publication Volunteer patients and small groups contribute to abdominal examination’s success(Dove Medical Press, 2017) Shields, Helen; Fernandez-Becker, Nielsen Q; Flier, Sarah; Vaughn, Byron P; Tukey, Melissa H; Pelletier, Stephen; Horst, DouglasBackground: Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its “Introduction to Physical Examination” session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Aim Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? Methods: A total of 43–46 patients and 43–46 faculty were recruited and 43–46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43–46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Results: Over the 5-year time period (2008–2012), the abdominal examination ranked first among all organ systems’ “Introductory Sessions”. The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element. Conclusion: We successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school’s selecting the abdominal examination methods as an “Advanced Examination” for the Pathways Curriculum.