Faculty Bibliography

BACKGROUND: Major changes in health care delivery and financing have negatively impacted students' experience during the surgery clerkship, particularly their exposure to physicians' decision-making processes and to the continuity of patient care. In response to these dilemmas in surgical education, we have developed the Web Initiative for Surgical Education (WISE-MD), a comprehensive surgery clerkship curriculum delivered through multimedia teaching modules and designed to enhance exposure to surgical disease and clinical reasoning. METHODS: As part of the process of creating WISE-MD, we conducted preliminary studies to assess the impact of this computer-assisted approach on students' knowledge, clinical reasoning, and satisfaction. RESULTS: Compared to students who did not view the modules, early data show a trend toward improved knowledge and an improvement in clinical reasoning for students who used the WISE-MD modules. This effect was specific to the clinical content area addressed in the module seen by the students. Most students felt the module was superior to traditional teaching methods and enhanced their understanding of surgical technique and anatomy. CONCLUSIONS: WISE-MD, a theory-driven example of a concerted technology-based approach to surgical education, has the potential to address the myriad problems of today's clinical learning environment.

Medical educators strive to promote the development of a sound professional identity in learners, yet it is challenging to design, implement, and sustain fair and meaningful assessments of professionalism to accomplish this goal. The authors developed and implemented a program built around a Web-based Professional Development Portfolio (PDP) to assess and document professional development in medical students at New York University School of Medicine. This program requires students to regularly document their professional development through written reflections on curricular activities spanning preclinical and clinical years. Students post reflections, along with other documents that chronicle their professional growth, to their online PDP. Students meet annually with a faculty mentor to review their portfolios, assess their professional development based on predetermined criteria, and establish goals for the coming year. In this article, the authors describe the development of the PDP and share four years of experience with its implementation. We describe the experiences and attitudes of the first students to participate in this program as reported in an annual student survey. Students' experiences of and satisfaction with the PDP was varied. The PDP has been a catalyst for honest and lively debate concerning the meaning and behavioral manifestations of professionalism. A Web-based PDP promoted self-regulation on an individual level because it facilitated narrative reflection, self-assessment, and goal setting, and it structured mentorship. Therefore, the PDP may prepare students for the self-regulation of the medical profession--a privilege and obligation under the physician's social contract with society