Browsing by Author "Guillaud, Daniel"
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Item Development of a Hybrid Clinical & Academic Anesthesiology Elective(2021-09-18) Yu, Corinna; Guillaud, Daniel; Webb, Timothy; Sanborn, Belinda; Cartwright, Johnny F.; Mitchell, Sally A.Item Examining Visiting Student Evaluation Forms(2023-04-28) Rigueiro, Gabriel; Dammann, Erin; Guillaud, Daniel; Packiasabapathy, Senthil; Mitchell, Sally; Yu, CorinnaBackground: Each medical school has clinical evaluation forms with competencies that align with their institutional and course learning objectives. The differences between evaluation forms and the items being assessed presents a challenge for elective course directors to evaluate and complete forms for visiting students. The aim of this project was to compare common characteristics of visiting student evaluation forms presented to an elective course director on Anesthesiology & Perioperative Medicine (APM) in 2022-2023. Materials & Methods: Each medical school has clinical evaluation forms with competencies that align with their institutional and course learning objectives. The differences between evaluation forms and the items being assessed presents a challenge for elective course directors to evaluate and complete forms for visiting students. The aim of this project was to compare common characteristics of visiting student evaluation forms presented to an elective course director on Anesthesiology & Perioperative Medicine (APM) in 2022-2023. Results: Schools (n=33) included ACGME competencies for communication (94%, 31), professionalism (91%, 30), medical knowledge (79%, 26), practice-based improvement (79%, 26), patient care (76%, 25), and systems-based practice (61%, 20) in their evaluation forms. Clinical reasoning skills included history & physical (82%, 27), assessment & plan (79%, 26), differential diagnosis (64%, 21), and charting/note-taking (61%, 20). Additional categories included inter-professionalism (85%, 28), osteopathic principles and practices (64%, 21), self- awareness/receptiveness to feedback (48%, 16), and procedural skills (42%, 14). Formative and summative comments were requested from 94% (31) of schools. Discussion: While many competencies for visiting medical student evaluation forms align with IU School of Medicine evaluations, some subcategories of ACGME core competencies like charting/note-taking are not assessed in the APM elective. Visiting students do not obtain electronic medical record access due to time-prohibitive training requirements, and thus, do not chart during their rotation. Mock paper records for the preanesthetic evaluation history and physical, intraoperative anesthesia record, and postoperative notes and orders could be created as additional assignments to assess students in this skill. Formative/summative comments may or may not comment on the delivery of patient care. Comments frequently discuss teamwork, work ethic, and medical knowledge which are easily evaluated. The time-pressured environment of the OR can limit student opportunity to perform the preoperative anesthetic evaluation. A differential diagnosis during a preoperative history and physical is challenging on the APM elective because patients present to surgery after diagnostic workup. However, differential diagnoses for perioperative symptoms like tachycardia and hypertension could be assessed through Canvas case log discussions. Students currently share an abbreviated written patient presentation with a learning point. They could include perioperative differential diagnoses and treatment plans and share an article from the literature to demonstrate evidence-based learning with more specific questions about systems-based practice. The perioperative environment provides an excellent opportunity to evaluate students in their interprofessional and communication skills working with surgeons, nurses, technicians, assistants, and other learners. Additional questions could be included in the APM evaluation to capture these relationships more fully. Conclusion: Analyzing visiting student evaluations for competencies and skills provides insight into areas for improvement in the APM elective curriculum and clinical evaluation form.Item How do Characteristic Descriptors Relate to Medical Student Performance Ratings on an Anesthesiology Elective: Implications for Letters of Recommendation(2024-04-26) Yu, Corinna; Dijak, Frank; Dammann, Erin; Guillaud, Daniel; Packiasabapathy, SenthilItem Medical Student Concerns for Respiratory Protection on Anesthesiology Elective(2022-04-28) Yu, Corinna; Webb, Timothy; Guillaud, Daniel; Mitchell, SallyIntroduction: Anesthesiologists perform aerosolizing procedures including endotracheal intubation, necessitating the use of personal protective equipment (PPE) such as N95 masks during the Coronavirus Pandemic. Medical students rotating on anesthesiology electives are similarly exposed to potential viral transmission during these procedures. Objective: This study compares student responses to concerns about their respiratory protection in 2020 vs. 2021. Methods: Medical students rotating on the Adult Anesthesia Elective (2020) and the Anesthesiology & Perioperative Medicine Elective (2021) were assigned to read, “Respiratory Protection for Healthcare Workers” and answer “Do you have any concerns about your respiratory protection?” 61 students completed the assignment in 2020, and 74 students in 2021. These responses were analyzed and coded for themes. 10 themes emerged for students who were concerned with their respiratory protection, and 4 themes emerged for students who were not concerned. Basic percentages were calculated and the number of students expressing various themes in their responses was summed and compared between 2020 vs. 2021. Results: In 2020, 35% of students were concerned about their respiratory protection, decreasing to 28% in 2021. Reasons for students not being concerned include the availability of PPE, vaccination status, testing patients for COVID pre-operatively, and the option to avoid the risk. Reasons for concern included the aerosol-generating nature of intubation, N95 masks should be single use, patients not being tested for COVID properly and failed fit tests and mask seals (only in 2020), availability of PPE, fear of being a vector, and not doffing properly. Long-term COVID complications and ability to socially distance at work were also concerns in 2020. Conclusion: Student concern with respiratory protection decreased from 35% to 28% from 2020 to 2021. One of the primary differences is that students were vaccinated in 2021. Students not concerned displayed confidence in PPE availability and patients testing negative for COVID-19 prior to OR procedures. In addition, some students commented on their ability to avoid risk by not caring for COVID-positive patients, although one student commented this hindered their education. Student concerns included viral transmission during aerosolizing procedures and the observation of N95 mask reuse, which is not advised. Some students were not able to get a fit test due to PPE shortages or had failed their fit test in 2020. Facial hair and having a beard was a concern in both 2020 and 2021 for proper mask fit. Other students feared being an asymptomatic carrier and acting as a vector to their patients and loved ones. Similarly, they worried that the testing window for patients was too wide. Students in both 2020 and 2021 expressed concern about self-contamination from not doffing their PPE properly. A few students commented on the unknown long-term effects of COVID-19 and the inability to socially distance at work. Generally, students were not concerned with PPE availability and their personal safety in the clinical environment on their anesthesiology elective. As the pandemic continues to evolve, time will tell if we can continue to maintain PPE supplies, effective vaccines, and work to decrease student concerns.Item Medical Student Concerns For Respiratory Protection on Anesthesiology Electives(2022-09-17) Yu, Corinna J.; Webb, Timothy T.; Guillaud, Daniel; Mitchell, Sally A.