1 aamc final school report 2003 medical school graduation questionnaire dartmouth medical school...

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AAMC Final School Report2003

Medical School Graduation QuestionnaireDartmouth Medical School

Response rate: Dartmouth: 48%All Schools: %

2

Table of content

1. Demographics of Students 2. Program Information 3. Premed Courses 4. Preclinical Experience 5. Special Content Areas 6. Clinical Experiences 7. Geriatrics and Gerontology Education 8. Cultural Competency Issues 9. Training at VA Medical Facility

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Table of content

10. Electives or Volunteer Activities 11. Communications Skills 12. Technology Skills 13. Preparation for Residency 14. Summary - Overall Satisfaction 15. Future Plans 16. DMS Support Services 17. Mistreatment 18. Views of Profession 19. Average Debt of Students with Debt

4

1. Demographics of students

Underrepresented minority category

10%

16%

4%

10%

0%

10%

20%

Dartmouth 01 Dartmouth 02

Dartmouth 03 All Schools 03

5

2. Program Info

Mean age at graduation

Dartmouth All Schools

2002 29 28

2003 29 28Years between matriculation and graduation - %

Dartmouth 2001

Dartmouth 2002

Dartmouth 2003

All Schools 2003

4 Years 71.7 63.6 60.0 83.8

5 Years 20.8 24.2 28.0 10.1

6

3. Premedical Courses—Current Requirements How important were the following premedical courses in preparing you for medical school

(Scale: 0 = not important to 4 = very important)

3.1 3.1

1.8

1.5

2.82.6

1.8 1.9

2.72.9

1.6 1.6

0

1

2

3

4

Genetics Biochemistry OrganicChemistry

Physics

Dartmouth 02 Dartmouth 03 All Schools 03

7

4. Preclinical experiences 1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

Basic science courses were well organized

Basic science courses provided relevant preparation for clerkships

Basic science courses had sufficient illustrations of clinical relevance

2.3 2.2

2.52.4 2.5 2.62.4

2

2.3

1

2

3

4

5

Organization Preparationfor clerkships

Clinicalrelevance


All Schools 03

8

4. Preclinical experiences (continued)1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

Basic science content objectives were made clear to students

Basic science content were sufficiently integrated/coordinated

Basic science content objectives and examination content matched closely

2

2.5

2.22.1

2.4 2.3

1.9

2.22

1

2

3

4

5

Clearobjectives

Integration Examinations


All Schools 03

9

4. Preclinical experiences (continued) How well instruction in the basic science courses prepared you for clerkships?

(Scale: 1 = excellent to 4 = Poor)

2.5 2.5

2.12.2

2.3 2.32.2

2.32.5 2.5

1.8

2.3

1

2

3

4

Biochemistry Genetics GrossAnatomy

Microanatomy


10



1.6

2.2

2

1.61.6

2

2.7

1.81.8

2.2

21.8

1

2

3

4

Physiology Immunology Neuroscience ICM/Intro tothe patient


11



2.12

1.71.8

1.9

2.7

1.81.7

2.6

2

1.7

2

1

2

3

4

BiostatsEpidemiology

Microbiology Pathology Pharmacology


12

5. Special content areasWas the time devoted to your instruction in the following areas

inadequate, appropriate, or excessive?

0% 20% 40% 60% 80% 100%

All schools

Biomedical Ethics-D

All schools

Clinical Epidemiology-D

All schools

Community Health-D

All schools

Geriatrics-D

All schools

Health Care Systems-D

Inadequate Appropriate Excessive

13

5. Special content areas (continued)Was the time devoted to your instruction in the following areas

inadequate, appropriate, or excessive?

0% 20% 40% 60% 80% 100%

All schools

Helath Promotion &Disease Promotion-D

All schools

Medical Economics-D

All schools

Professionalism-D

All schools

Cultural Competency-D


14

5. Special content areas (continued)Was the time devoted to your instruction in the following areas inadequate,

appropriate, or excessive?

0% 20% 40% 60% 80% 100%

All schools

Literature reviews/critiques - D

All schools

Interp. of clinical data and research - D

All schools

EBM in general - D

All schools

Teamwork w/ other health professionals - D

All schools

Primary Care - D


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5. Special content areas (continued)

0% 20% 40% 60% 80% 100%

All schools

Complementary andalternative medicine - D

All schools

Taking genetic familyhistory

All schools

Human sexuality

All schools

Palliative care - D


Was the time devoted to your instruction in the following areas inadequate, appropriate, or excessive?

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6. Clinical Experiences Rate the quality of your educational experience in the following clerkships.

1.5

1.8 1.8 1.8

1.61.7

1.61.7

1.6

1.92

1.9

1

2

3

4

Internal Med Family Med Psychiatry Surgery


Scale: 1 = Excellent to 4 = Poor

17

6. Clinical Experiences Rate the quality of your educational experience in the following clerkships. (continued)

2.3 2.3

1.7

22.1

22.1

2.3

1.9

1

2

3

4

Obstetrics &

Gynecology

Neurology Pediatrics


Scale: 1 = Excellent to 4 = Poor

18

I received clear learning objectives for the clerkship

My performance was assessed against the learning objectives

I had an opportunity to follow a variety of different patients (with different medical conditions)

1.61.8

1.6

22.2

1.8

1

2

3

4

5

Learning

Objectives

Assessment Patient Variety


6. Clinical Experiences Family Medicine Clerkship

1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

19

My attending faculty members:

Were adequately involved in teaching

Observed me performing physical examinations

Provided me with sufficient feedback on my performance

Provided me with feedback in a timely manner

1.3

1.7 1.71.6

1.8

2.22.1 2.1

1

2

3

4

5

FacultyInvolvement

Observed PE SufficientFeedback

TimelyFeedback




20


The clerkship employed an OSCE to evaluate my clinical skills

Residents and fellow provided effective teaching

The teaching from residents enhanced the educational value of the clerkship 1.7

2.4 2.4

2.82.6 2.5

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



21

6. Clinical Experiences Internal Medicine Clerkship




1.81.9

1.71.8

2

1.5

1

2

3

4

5

Objectives Assessment Variety Dx



22






2

2.32.2 2.1

1.7

2.22

2.1

1

2

3

4

5

Attendings

involved

Observed

PE

Sufficient

Feedback

Timely

Feedback




23




The teaching from residents enhanced the educational value of the clerkship

1.81.6

1.4

2.9

1.7 1.6

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



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6. Clinical Experiences OB/Gyn Medicine Clerkship




2.22.4

2.32.1

2.3

2

1

2

3

4

5

Objectives Assessment Variety Dx



25






2.4 2.42.5 2.5

2.3

2.62.7 2.7

1

2

3

4

5

Attendings

involved

Observed

PE

Sufficient

Feedback

Timely

Feedback




26





1.9

2.5 2.4

3.2

2.3 2.3

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



27

6. Clinical Experiences Pediatrics Clerkship




1.71.9

21.8

21.8

1

2

3

4

5

Objectives Performance Variety Dx



28






22.1

2 21.8

2.32.1 2.1

1

2

3

4

5

Faculty

involved

Observed

PE

Sufficient

Feedback

Timely

Feedback




29





2.1 2.2 2.1

3.1

1.9 1.9

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



30

6. Clinical Experiences Psychiatry Clerkship



I had an opportunity to follow a variety of different patients (with different medical conditions) 1.8 1.9 1.9

2 2 2

1

2

3

4

5




31






1.7 1.6 1.6 1.6

22.2 2.1 2.2

1

2

3

4

5

Faculty

Involved

Observed

PE

Sufficient

Feedback

Timely

Feedback




32





2 21.9

3.1

2.4 2.4

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



33

6. Clinical Experiences Surgery Clerkship




1.61.8 1.8

22.2

1.8

1

2

3

4

5




34






1.7

32.8 2.7

2.2

2.82.6 2.6

1

2

3

4

5

Faculty

Involved

Observed

PE

Sufficient

Feedback

Timely

Feedback




35





1.82

1.9

3.2

21.9

1

2

3

4

5

OSCE Residents

Effective

Resident

Teaching



36

6. Clinical ExperiencesMethods used to evaluate clinical skills - Final evaluation

0%

20%

40%

60%

80%

100%

MCexamination

Oral exam Observation byfaculty

OSCE CaseSimulation

Observed byResident

Dartmouth 03 All schools 03

Family Medicine

37


0%

20%

40%

60%

80%

100%

MCexamination


OSCE CaseSimulation

Observed byResident


Internal Medicine

38


0%

20%

40%

60%

80%

100%

MCexamination


OSCE CaseSimulation

Observed byResident


OB/GYN

39


0%

20%

40%

60%

80%

100%

MCexamination


OSCE CaseSimulation

Observed byResident


Pediatrics

40


0%

20%

40%

60%

80%

100%

MCexamination


OSCE CaseSimulation

Observed byResident


Psychiatry

41


0%

20%

40%

60%

80%

100%

MCexamination


OSCE CaseSimulation

Observed byResident


Surgery

42

7. Geriatrics and Gerontology Education 1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

I learned about the health care needs of healthy older adults during my medical training

I was exposed to expert geriatric care by the attending faculty of my medical program

I am well prepared to care for: older adult patients in

ambulatory settings older adult patients in long-

term health care settings

2.3 2.3 2.4

2.12.3

2.5 2.42.2

1

2

3

4

5

Healthy

older

patients

Geriatrics

exposure

Acute

settings

Ambulatory

settings


43

8. Cultural Competency Issues1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

The perspective of individuals from racial and ethnic groups different than your own were often brought into your medical training

My knowledge or opinion was influenced or changed by becoming aware of a different perspective

2.2 2.3

2.62.4

1

2

3

4

5

Diverse perspectivespresent in training

Diverse perspectivesinfluence on opinion


44

8. Cultural Competency Issues (continued)

Percentage of students who have participated in the following activities during medical school on an elective or volunteer basis:

Seminar in minority health Course/workshop on cultural

awareness Project with a community-

based multicultural group

10%

26%

19%

28%

36%

12%

0%

20%

40%

Seminar Course/workshop

Project


45

8. Cultural Competency Issues (continued)

0% 20% 40% 60% 80% 100%

All schools

Culturally appropriate care fordiverse populations-D

All schools

Cultural differences and healthrelated behaviors/customs-D

All schools

Health issues for underservedpopulations-D


Was the time devoted to your instruction in the following areas inadequate, appropriate, or excessive?

46

9. Training at VA Medical Facility 1 to 5 scale, 1 = Excellent 5 = Poor

Have you ever had a clinical training experience during medical school at a VA?

Dartmouth: 100% All schools: 69%

How would you rate the value of your VA clinical training experience?

1.44

2.06

1

2

3

4

5

Value of VA Clinical Training


47

9. Training at VA Medical Facility (continued) 1 to 5 scale, 5 = Excellent 1 = Poor

How would you compare your overall VA clinical training experiences to other non VA clinical training experiences you have had at the same or equivalent level?

48

10. Electives or Volunteer Activities Percentage of Dartmouth students participating in 2001, 2002, 2003

26

4549

77

70

2127

45

76

67

32

44

32

6064

0

20

40

60

80

100

Field experience inNursing home care

Field experience inhome care

Field experience incommunity health

Providing healtheducation

Delivering healthservices to underserved

populations

2001 2002 2003

49

10. Electives or Volunteer Activities (continued) Percentage of Dartmouth students participating in 2000, 2001, 2002

41.535.8

28.3

66

52.848.5

24.2

48.5

60.6

39.4

28

40

52

80

48

0

20

40

60

80

100

Educating studentsabout health careers

International healthexperiences

Authorship of a researchpaper submitted for

publication

Research project withfaculty member

Independent studyproject for credit

2001 2002 2003

50

11. Communication Skills1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

I am confident I have appropriate knowledge and skills to:

Discuss a prescription error I made with the patient

Discuss treatment options with a woman with late-stage breast cancer

Initiate discussion of DNR orders with a patient or family member

Assess the health practices of a patient using alternative therapies

2

2.3

2

2.4

1.92.1

1.9

2.4

1

2

3

4

5

Prescription

error

Breast

cancer

DNR orders Alternative

therapies


51

11. Communication Skills

0

20

40

60

80

100

120

1. Dartmouth 1. All schools 2. Dartmouth 2. All schools 3. Dartmouth 3. All schools

Pre-Clinical Clinical Preceptorship Role Modeling Not addressed

Where in your medical education were the following issues emphasized? (select one)

1. Advocating the interest of one’s patient over one’s own interests

2. Advocating for access to health care for members of underserved populations

3. Engaging in lifelong learning to stay abreast of relevant scientific advances

52

12. Technology SkillsI’m confident that I have the appropriate knowledge and skills to:

Carry out sophisticated searches of medical information databases

Critically review a published research report

Use a computer-based clinical record keeping program

Use a personal digital assistant (PDA) for clinical purposes

1.31.5 1.5

1.61.7

2.1

1.71.9

1

2

3

4

5

Search Review Records Use PDA


1 = Strongly Agree 5 = Strongly Disagree

53

13. Preparation for Residency 1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

I am confident that I have acquired the clinical skills required to begin a residency program

I have the fundamental understanding of basic disease mechanisms, clinical presentation, and principles of diagnosis and management the common conditions

I have the communication skills necessary to interact w/ patients and health professionals

1.7 1.7

1.4

1.7 1.7

1.4

1

2

3

4

5

Acquired ClinicalSkills

GeneralPathophysiology

Communication skills


54

13. Preparation for Residency1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

I have basic skills in clinical decision making and the application of evidence based information to medical practice

I have a fundamental understanding of the issues in social sciences of medicine (e.g. ethics, humanism, professionalism)

I have the ethical and professional values that are expected of the profession

1.71.8

1.4

1.7 1.7

1.4

1

2

3

4

5

EBM Social Sciences Professionalism


55

13. Preparation for Residency1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

I received appropriate faculty guidance in the selection of fourth year elective experiences

At my school, elective time in the fourth year should have been reduced

Additional required activities or selectives (e.g. course, sessions, clerkships, etc. should be added to the 4th year at my medical school

2.7

4.24

2.5

4 3.9

1

2

3

4

5

Faculty

Guidance

Reduce

Elective Time

Additional

Activities


56

14. Summary - Overall Satisfaction 1 to 5 scale, 1 = Strongly Agree 5 = Strongly Disagree

Overall, I’m satisfied with the quality of my medical education.

1.8

1.5

1.8

1

2

3

4

5

Overall Satisfaction


All Schools 03

57

15. Future Plans Type of Practice

44%

32%

4%

20%

30%

45%

7%

16%

0%

20%

40%

60%

80%

100%

University

Faculty

Clinical

Practice

Other Undecided


58

15. Future Plans

To what degree did your level of educational debt influence your specialty choice?

To what degree did career planning activities at your medical school influence your specialty choice?

59

15. Future Plans Where do you plan to practice?

9.1%

18.2%

0.0%

4.0%

16.0%

8.0%

0.5% 0.2% 0.4%

0%

5%

10%

15%

20%

Maine New Hampshire Vermont


(NNE: 28% vs 1.1%)

60

15. Future PlansDo you plan to locate your practice in an underserved area? If yes, where? (Percentage of students)

24%

63%

25%20%

40% 40%

21%

38%

52%

0%

20%

40%

60%

80%

100%

Yes Rural Community Inner-city

community


61

16. Various DMS Support Services Indicate your level of satisfaction with the following:

1 = very satisfied 5 = very dissatisfied

62



63



1.51.6

2.12

1.9

2.3

1

2

3

4

5

Library Computer resource center Student study space


64

17. Mistreatment Have you personally been mistreated during Medical School?

28% 30%

12% 15%

0%

20%

40%

60%

80%

100%

% of students mistreated



For 2003, 3 Dartmouth students cited clinical faculty and/or patients as source of mistreatment

65

18. Views of Profession Indicate your level of agreement with the following:


1.7

1.4

1.7 1.81.8 1.8 1.7

2.6

1

2

3

4

5

Access Entitlement Health

promotion

Advances in

science


Access to medical care continues to be a major problem in the United States

Everyone is entitled to receive adequate medical care regardless of his or her ability to pay

Physicians have an opportunity to exercise greater influence on health promotion and disease prevention

Advances in the biomedical sciences will make the practice of medicine more challenging and rewarding

66

18. Views of Profession (continued) Indicate your level of agreement with the following:


3.6

2.5

1.5

3.3

2.2

1.5

1

2

3

4

5

Cure of

Disease

Relief of

Patient

Suffering

Patients'

background


Cure of disease is the most important purpose of medicine

Relief of patient suffering is the most important pursuit of medicine

I am prepared to care for individuals from racial and ethnic backgrounds different from my own

67

19. Average debt of all students with debt

$100,060

$18,546

$102,452

$22,095

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

Premedical Debt Medical School Debt


1 aamc final school report 2003 medical school graduation questionnaire dartmouth medical school...

Documents

poor slide

important slide

debt slide

continued scale

preclinical experiences

following areas inadequate

following clerkships

special content areas