Wednesday, October 18, 2006

Artificial Hearts, PBL, Class Meeting, and Clinical Skills

Today was absolutely jam-packed and non-stop from 8 to 5. The morning began with a visit to a lab in the LRI where they are working on developing artificial hearts. The work was really interesting, and we talked some more about pressure-volume loops to describe heart activity and how these loops are generated also. The textbook mentions them, but the seminar went into a lot more detail about why they change the way they do under certain circumstances, and I think that almost everyone found it to be really useful. The artificial heart work is also really neat. There are already some in clinical trials, which I didn't realize before, but they still have a long way to go before they will be available to the general public.

In PBL, we are continuing with the case of the girl who faints. My group is still having some issues with getting all of the objectives presented in a timely manner. I'm not sure what the best solution is for this problem. On one hand, I think that it's important to avoid stifling discussion of topics if people are interested or have questions. On the other hand, we need to keep moving so that we finish on time. PBL can be frustrating at times when you have eight people arguing over minutiae like whether a particular topic should be one objective or divided into two, but overall I still am enjoying it, and I feel like I am learning a lot from it. Both preparing my own objectives as well as listening to other people's presentations are really helpful.

Right after PBL, we had a class meeting. There were several topics discussed, but one that was of special interest to me is that the SAQs will not be used like quizzes. The powers that be basically want us to beta-test the questions, and they can't get enough feedback unless everyone does them because our class is so small. They are going to keep the data anonymous, and they are not going to break the code or report the scores to our PAs as a general rule unless they see that someone is consistently totally bombing the questions over the course of the entire block. I felt a lot better after hearing that, although I still don't think that they should make the questions required. But I understand that they need feedback, and if they don't require them, probably a lot of people will choose not to do them. I also understand that they want to be able to watch in case any students are falling through the cracks. I just think that there are better methods of doing this besides multiple choice quizzes. For example, I think that the CAPPs, which are essays, are a lot more useful for assessing student knowledge than the SAQs, because with the CAPPs the students can show what they know without it having to be all or nothing. This week's CAPPs are particularly good.

Our clinical skills class was all afternoon right after the class meeting. We spend half the time doing actual clinical skills, and the other half doing practice interviews with standardized patients. (Standardized patients are actors who get paid to pretend to have some problem, and we practice interviewing or checking them.) We are in groups of four for both halves of the class. I have clinical skills first. We learned how to take blood pressure, pulse rate, respiration rate, and generally observe the patient. Our standardized patient was very relaxed, and toward the end while we were talking with the preceptor who was training us, he actually fell asleep! In the second part, I did the practice interview. It's very interesting how different an interview with the same patient can be depending on who performs it. For example, my patient was initially less friendly and open with me compared to how he was with the other student in my group who interviewed him, but once I got him to start talking, it was hard for me to get him to stop!

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