To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy. Multi-institutional, cross-sectional survey. All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care). A total of 1,098 medical students. Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life). Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores. Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.

How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study

BACKGROUND
While resident distress and its potential to negatively effect patient care have been well documented, little is known bout resident well-being or its potential to enhance care.

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Relationship between increased personal well-being and enhanced empathy among internal medicine residents

BACKGROUND: While resident distress and its potential to negatively effect patient care have been well documented, little is known about resident well-being or its potential to enhance care.

Relationship between increased personal well-being and enhanced empathy among

Context Case-based teaching is regarded as a superior instructional method compared with lectures in promoting a learner's critical thinking skills. While much is known about the role a discussion facilitator plays in case-based teaching, the debate on the influence of the format and structure of cases on learning is controversial.

Objectives  We sought to identify strategies for constructing cases based on studies from multiple disciplines, which report the development and use of cases in teaching and learning. The purpose was to offer the medical and other educational communities a conceptual framework that can be examined in future research.

Results  Based on a review of 100 studies, we synthesised 17 strategies around 5 core attributes of cases: relevant (level of learner, goals and objectives, setting of case narrative); realistic (authenticity, distractors, gradual disclosure of content); engaging (rich content, multiple perspectives, branching of content); challenging (difficulty, unusual cases, case structure, multiple cases), and instructional (build upon prior knowledge, assessment, feedback, and teaching aids).

Discussion  Despite the wide use of cases in disparate disciplines, there has been no overarching study that synthesises strategies of case development or tests these strategies in research settings. The framework we developed can serve as a menu of case development options that educators and researchers can pilot and evaluate in their local settings.

A conceptual framework for developing teaching cases: a review and synthesis of the literature across disciplines

Background: Research training is essential in a modern undergraduate medical curriculum. Our evaluation aimed to (a) gauge students’ awareness of research activities, (b) compare students’ perceptions of their transferable and research-specific skills competencies, (c) determine students’ motivation for research and (d) obtain students’ personal views on doing research. Methods: Undergraduate medical students (N=317) completed a research skills questionnaire developed by the Centre for Excellence in Teaching and Learning in Applied Undergraduate Research Skills (CETLAURS) at Reading University. The questionnaire assessed students’ transferable skills, research-specific skills (e.g., study design, data collection and data analysis), research experience and attitude and motivation towards doing research. Results: The majority of students are motivated to pursue research. Graduate entrants and male students appear to be the most confident regarding their research skills competencies. Although all students recognise the role of research in medical practice, many are unaware of the medical research activities or successes within their university. Of those who report no interest in a career incorporating research, a common perception was that researchers are isolated from patients and clinical practice. Discussion: Students have a narrow definition of research and what it entails. An explanation for why research competence does not align more closely with research motivation is derived from students’ lack of understanding of the concept of translational research, as well as a lack of awareness of the research activity being undertaken by their teachers and mentors. We plan to address this with specific research awareness initiatives. Keywords: undergraduate; research skills; translational research; training; scholarly activity programmes (Published: 10 September 2010) Citation: Medical Education Online 2010, 15: 5212 - DOI: 10.3402/meo.v15i0.5212

Undergraduate medical research: the student perspective.

This article describes a novel course that was designed to bridge the gap between the basic science years and clinical experiences in medical school by using information science and computer technology as major components of problem-based learning (PBL) sessions. The course, Integrated Case Studies and Medical Decision Making, was first given to second-year students at the University of Pittsburgh School of Medicine in the spring of 1994. It consists of 13 PBL exercises, each of which explores a clinical case. The cases, including images and gated access to information, are housed on a computer. Using one of 16 networked terminals in specially designed small-group rooms, groups of nine students progress through the cases with a faculty facilitator. The responses of students and faculty to the initial year of the course were favorable. In comparison with traditional PBL sessions, enhanced quality of and access to images and accountability for accessing case information in sequential fashion were cited as major strengths of the course. Juxtaposition of basic science and clinical material and utility in reviewing for the United States Medical Licensing Examination were also cited as strengths. The diversity of the basic science material involved in completing the cases drew overwhelming enthusiasm from students and facilitators alike. In conclusion, the course successfully employs computer and information science technology, which will be of increasing importance to future physicians. The course also serves as an effective bridge to the clinical years of medical school and as a study adjunct for the USMLE.

Integrated Case Studies and Medical Decision Making: A Novel, Computer-Assisted Bridge from the Basic Sciences to the Clinics

PURPOSE: To determine whether it is possible for faculty to arrive at consistent, non-idiosyncratic grades in a problem-based learning (PBL) course. METHOD: Integrated Case Studies and Medical Decision Making (ICS) is the final course of the second year at the University of Pittsburgh School of Medicine. In ICS, 16 groups of nine students work in a PBL format over seven weeks. Each group is led by three faculty facilitators who, at the end of the course, independently give each student ratings for overall performance in the course and for each of seven performance categories. In 1993-94 and 1994-95, concordance in grades among the facilitators was determined by computing the intraclass correlation coefficients [ICC (3,1)] for the overall scores, the seven performance category scores, and all eight scores in aggregate. An ICC (3,1) of > or = .1 was considered indicative of statistically significant interrater concordance. An ICC (3,1) of > or = .7 was considered indicative of concordance of practical significance. RESULTS: Because the facilitators occasionally did not rate every student in every performance category, complete information was not available for all 32 groups. Statistically significant concordance was achieved in the aggregate scores in 100% of 23 groups, and in the overall scores in 90% of 18 groups. In six of the seven performance categories, concordance was achieved in at least 75% of the groups (n = 16-20). Practically significant concordance was achieved in the aggregate scores in 83% of 23 groups. CONCLUSION: The study results show that, given specific criteria by which to judge students' performances, it is possible to arrive at consistent, non-idiosyncratic grades for students in PBL courses.

Interrater Concordance for Faculty Grading of Student Performances in a Problem-Based Learning Course.

An increasing number of medical schools have implemented or are considering implementing scholarly activity programs as part of their undergraduate medical curricula. The goal of these programs is to foster students' analytical skills, enhance their self-directed learning and their oral and written communication skills, and ultimately to train better physicians. In this article, the authors describe the approach to implementing scholarly activities at a school that requires this activity and at a school where it is elective. Both programs have dealt with significant challenges including orienting students to a complex activity that is fundamentally different than traditional medical school courses and clerkships, helping both students and their mentors understand how to "stay on track" and complete work, especially during the third and fourth years, and educating students and mentors about the responsible conduct of research, especially involving human participants. Both schools have found the implementation process to be evolutionary, requiring experience before faculty could significantly improve processes. A required scholarly activity has highlighted the need for information technology (IT) support, including Web-based document storage and student updates, as well as automatic e-mails alerting supervisory individuals to student activity. Directors of the elective program have found difficulty with both ensuring uniform outcomes across different areas of study and leadership changes in a process that has been largely student-driven. Both programs have found that teamwork, regular meetings, and close communication have helped with implementation. Schools considering the establishment of a scholarly activity should consider these factors when designing programs.

Implementation of a longitudinal mentored scholarly project: an approach at two medical schools.

Many U.S. medical schools offer students the opportunity to undertake laboratory or clinical research or another form of scholarly project over the summer months, yet few require this as a prerequisite for graduation, and even fewer provide comprehensive didactic material in preparation for

The Scholarly Project Initiative: introducing scholarship in medicine through a longitudinal, mentored curricular program.

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Integrated Case Studies and Medical Decision Making: A Novel, Computer-Assisted Bridge from the Basic Sciences to the Clinics

Interrater Concordance for Faculty Grading of Student Performances in a Problem-Based Learning Course.

Implementation of a longitudinal mentored scholarly project: an approach at two medical schools.

The Scholarly Project Initiative: introducing scholarship in medicine through a longitudinal, mentored curricular program.