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Background:
The Kent State University College of Podiatric Medicine is negotiating with the College of Business Administration at Kent State University to establish a dual Doctor of Podiatric Medicine (DPM)/Master of Business Administration (MBA) degree. Of the nine colleges of podiatric medicine in the nation, there are two schools that have a joint DPM/MBA program listed in their catalogue, but no joint program was operational at the time this survey was conducted. A telephone survey of the other eight podiatric medical colleges was conducted to obtain that information. This survey was used to assess further data for the exploration of a dual DPM/MBA program at Kent State University College of Podiatric Medicine.
Methods:
A survey was sent out to 38 individuals who possessed both a DPM and an MBA degree. They responded to questions about why they obtained the business degree, how they are using their business degree, what courses in the MBA program are most relevant, and whether they would recommend that DPM students pursue a dual degree.
Results:
The majority of respondents indicated that they obtained an MBA degrees to gain a better understanding of the marketplace, to increase their income, and to better manage a podiatric medical practice. The respondents were generally very happy to have obtained their MBA degree and would encourage a dual-degree option. They admitted that a minor or series of courses with a business focus may be helpful to a DPM student who did not opt for an MBA degree.
Conclusions:
The positive survey results from respondents encourage continued research into a dual-degree DPM/MBA program. During research for a DPM/MBA degree, we feel a DPM with an MBA degree will allow our students to be better prepared for leadership roles within their community and administrative positions and to have a deeper understanding of the business of health care.
Background:
The fourth year of podiatric medical school is an important period in the education of the podiatric medical student, a period that consists largely of month-long clerkships. Nonetheless, there has been limited formal study of the quality of learning experiences during this period. Furthermore, there is limited knowledge of how podiatric medical students evaluate residency programs during clerkships.
Methods:
An online survey was developed and distributed electronically to fourth-year podiatric medical school students. The focus of the survey was the quality of learning experiences during externships, and decision making in ranking residency programs.
Results:
The most valuable learning experiences during clerkships were interactions with attending physicians, interactions with residents, and general feedback in surgery. Students self-identified that they most improved in the following areas during clerkships: forefoot surgery, clinical podiatry skills, and rearfoot surgery. The areas in which students improved the least were research, pediatrics, and practice management. The three most important factors students considered as they created their rank list were hands-on resident participation in surgical training, the attitude and personality of the residents, and the attitude and personality of the attending physicians. A range of surgical interest was identified among students, and students lacking in surgical interest self-reported less improvement in various surgical topics.
Conclusions:
The perspectives of fourth-year podiatric medical students are currently an underused resource. Improved understanding can help residency programs improve the quality of associated learning experiences and can make their programs more appealing to potential residency candidates.
Background:
Scholarly activity among students, residents, and faculty provides the foundation for medical education. However, a decline in the number of physician-scientists has been acknowledged during the past few decades. As a result, institutions have attempted to increase research activity among students and residents through a variety of means. This study describes a replicative model for medical institutions to increase their research enterprises among medical students, residents, and faculty.
Methods:
Des Moines University College of Podiatric Medicine and Surgery (DMU-CPMS) developed a Strategic Research Plan (SRP) to increase scholarly activity in the college. The SRP outlined an innovative model to increase research activity, including creating a Director of Research position, modifying the existing curriculum toward an evidence-based focus, increasing extracurricular research opportunities, and fostering collaborative research efforts among students, residents, and faculty.
Results:
After SRP implementation, an increase in scholarly activity was observed. In the 6 years before implementing the SRP, DMU-CPMS published 11 manuscripts. In the 6 years after initiating the SRP, manuscript publications increased to 50. During this same period, podium presentations at scientific meetings increased from 6 to 40, and students listed as lead author increased from 0 to 16.
Conclusions:
The SRP provides a replicative model for medical institutions seeking to increase their research enterprises through collaboration among students, residents, and faculty. To our knowledge, this is the first study to demonstrate a research plan aimed at increasing scholarly activity among a comprehensive scope of individuals in medical education.
Background:
The increased use of external interventions to diagnose and treat podiatric medical pathologies has warranted a greater understanding of the lower extremity in the transverse plane. Films, prosections, and plastinated cross sections have long been used alongside traditional instruction to assist students in anatomical studies. These methods, however, often fail to provide the tactile component of anatomical dissection and may obscure or exclude the requisite structures for identification by medical students. Such teaching techniques prove costly, time sensitive, and dated compared with the relatively less expensive and customizable nature of three-dimensional (3-D) printing.
Methods:
Limb length was measured on a cadaveric specimen, and eight cross sections of equal width were excised. Manual sketches of these sections were then digitized and 3-D printed.
Results:
Three-dimensional printing provides a safe and reproducible means to construct customizable cross sections of the lower extremity. Moreover, this method proves to be relatively inexpensive.
Conclusions:
Advancing traditional didactic teaching with the use of cost-effective 3-D printing can facilitate the visuospatial comprehension of lower-extremity anatomy. The evolution of 3-D printing enhances the clinical skills essential for the interpretation of imaging studies as well as planning for surgical procedures such as external fixation application.
Background:
This study examined the differences between faculty and trained standardized patient (SP) evaluations on student professionalism during a second-year podiatric medicine standardized simulated patient encounter.
Methods:
Forty-nine second-year podiatric medicine students were evaluated for their professionalism behavior. Eleven SPs performed an assessment in real-time, and one faculty member performed a secondary assessment after observing a videotape of the encounter. Five domains were chosen for evaluation from a validated professionalism assessment tool.
Results:
Significant differences were identified in the professionalism domains of “build a relationship” (P = .008), “gather information” (P = .001), and share information (P = .002), where the faculty scored the students higher than the SP for 24.5%, 18.9%, and 26.5% of the cases, respectively. In addition, the faculty scores were higher than the SP scores in all of the “gather information” subdomains; however, the difference in scores was significant only in the “question appropriately” (P = .001) and “listen and clarify” (P = .003) subdomains.
Conclusions:
This study showed that professionalism scores for second-year podiatric medical students during a simulated patient encounter varied significantly between faculty and SPs. Further consideration needs to be given to determine the source of these differences.
Background:
A patient “handoff,” or the “sign-out” process, is an episode during which the responsibility of a patient transitions from one health-care provider to another. These are important events that affect patient safety, particularly because a significant proportion of adverse events have been associated with a relative lack of physician communication. The objective of this investigation was to survey podiatric surgical residency programs with respect to patient care handoff and sign-out practices.
Methods:
A survey was initially developed and subsequently administered to the chief residents of 40 Council on Podiatric Medical Education–approved podiatric surgical residency programs attempting to elucidate patient care handoff protocols and procedures and on-call practices.
Results:
Although it was most common for patient care handoffs to occur in person (60.0%), programs also reported that handoffs regularly occurred by telephone (52.5%) and with no direct personal communication whatsoever other than the electronic passing of information (50.0%). In fact, 27.5% of programs reported that their most common means of patient care handoff was without direct resident communication and was instead purely electronic. We observed that few residents reported receiving formal education or assessment/feedback (17.5%) regarding their handoff proficiency, and only 5.0% of programs reported that attending physicians regularly took part in the handoff/sign-out process. Although most programs felt that their sign-out practices were safe and effective, 67.5% also believed that their process could be improved.
Conclusions:
These results provide unique information on a potentially underappreciated aspect of podiatric medical education and might point to some common deficiencies regarding the development of interprofessional communication within our profession during residency training.
Teaching of Manual Clinical Skills in Podiatric Medicine
Theory and Recommendations
In the podiatric medicine profession, there are a variety of manual tasks that require precision and skill beyond what would be usually expected in everyday living. It is the expectation of employers, regulatory bodies, and the public that graduating podiatric physicians sufficiently meet certain minimum competencies for that profession, including those for manual skills. However, teaching and evaluation methods seem to be inconsistent between countries, institutions, and programs. This may be the consequence of uncertainty regarding the safest and most effective methods to do so. A review of available international literature pertaining to psychomotor learning across a range of health professions was undertaken. As a result of this broad review, we present herein the available evidence and make recommendations for the teaching of psychomotor skills in the podiatric medicine profession. Specific aspects considered important include methods of teaching, practice, and feedback.
Attrition from medical school remains a serious cause of concern for the medical education community. Thus, there is a need to improve our ability to select only those candidates who will succeed at medical school from many highly qualified and motivated applicants. This can be achieved, in part, by reducing the reliance on cognitive factors and increasing the use of noncognitive character traits in high-stakes admissions decisions. Herein we describe an analytic rubric that combines research-derived predictors of medical school success to generate a composite score for use in admissions decisions. The analytic rubric as described herein represents a significant step toward evidenced-based admissions that will facilitate a more consistent and transparent qualitative evaluation of medical school applicants beyond their grades and Medical College Admissions Test scores and contribute to a redesigned and improved admissions process.
Background: Student self-assessment is viewed as an important tool in medical education. We sought to identify the relationship between student academic performance and third-year clinical performance self-assessment. No such study exists in podiatric medical education.
Methods: Third-year podiatric medical students from the classes of 2012 through 2014 completed a self-assessment of their performance for each of five broad clinical podiatric medical domains (Professionalism, Medicine, Radiology, Surgery, and Biomechanics/Orthopedics). The assessment was completed after students finished the first 12 weeks of their third-year clinical rotations (PRE) and a second time at the conclusion of the third year (POST). The mean self-assessment score for PRE and POST surveys for all combined domains was determined for each student. This mean was compared with the student's 3-year cumulative grade point average (GPA). Students' clinical experiences for the year were essentially identical.
Results: No statistically significant correlation was identified between cumulative GPA and the PRE and POST clinical self-assessments or with the change between PRE and POST assessments based on the Pearson correlation test for each class separately or on the pooled data.
Conclusions: Published studies in allopathic medical education have shown that students with lower GPAs tend to rate their clinical performance higher in initial clinical performance self-assessment. Our results show that student academic performance was not correlated with clinical performance self-assessment. These findings may be due to the explicit description of successful clinical competency completion, the orientation students receive before the start of clinical training, and the continuous feedback received from clinical preceptors.
Background: Des Moines University College of Podiatric Medicine and Surgery (CPMS) is implementing a cultural competency program for third-year podiatric medical students. This study assessed the effectiveness of the new educational program on cultural competency at CPMS by comparing pretest and posttest scores of students from the CPMS graduating classes of 2013 and 2014.
Methods: Students from the class of 2013 completed a 10-week online course on cultural competency, and the class of 2014 students did not. A pretest and posttest survey was used to assess cultural competency. The questions were categorized to assess either knowledge acquisition or attitudinal change. The 2013 students completed the pretest before the course and a posttest after completing the course. Without taking the course, 2014 students completed the same pretest and posttest separated by 10 weeks. A repeated-measures analysis of variance was used to compare the knowledge acquisition scores and attitudinal change scores.
Results: The repeated-measures analysis of variance revealed a significant interaction effect of taking the attitudinal change course (F(1,77) = 15.2; P < .001). The course did not show a significant interaction on knowledge acquisition (F(1,77) = 0.72; P > .05).
Conclusions: The analysis showed a statistically significant improvement in attitudinal change scores. The study suggests that there needs to be a greater knowledge acquisition component to the cultural competency course at CPMS.
