Clinical Focus

  • Family Medicine
  • Preventive Health Care
  • Women's Health

Academic Appointments

Administrative Appointments

  • Distinguished Member, Stanford Medicine Teaching and Mentoring Academy, Stanford University School of Medicine (2019 - Present)
  • Executive Director, Patient and Family Engaged Medical Education @ Stanford (2019 - Present)
  • Section Chief for Medical Education, Division of Primary Care and Population Health, Stanford University School of Medicine (2015 - Present)
  • Director, SHIELD (Stanford Healthcare Innovations and Experiential Learning Directive), Stanford University School of Medicine (2014 - Present)
  • Director, Predoctoral Education, Family Medicine, Stanford University School of Medicine (2009 - 2019)
  • Director, Core Clerkship in Family and Community Medicine, Stanford University School of Medicine (2006 - 2010)
  • Associate Course Director, Practice of Medicine, Stanford University (2005 - 2014)

Honors & Awards

  • Award for Excellence in Promotion of Humanism, Stanford University School of Medicine (2019)
  • Teaching and Mentoring Academy Innovation Grant, Stanford University School of Medicine (2017)
  • The Franklin G. Ebaugh, Jr. Award for Advising Medical Students, Stanford University School of Medicine (2017)
  • Award for Excellence in Promotion of Learning Environment and Student Wellness, Stanford Medicine (2016)
  • Program of Excellence Award for Promotion of Primary Care, American Academy of Family Physicians (2016)
  • Henry J. Kaiser Family Foundation Award for Outstanding & Innovative Contributions to Medical Educ, Stanford University School of Medicine (2015)
  • Program of Excellence Award in Exposure to Family Medicine and Family Physicians, American Academy of Family Physicians (2015)
  • STFM National Innovative Program Award for OSLER (O'Connor Stanford Leaders in Education Residency), Stanford Medical School and O'Connor Family Medicine Residency (2014)
  • The Lawrence H. Mathers Award for Commitment to Medical Education, Stanford Medical School (2013)
  • The Franklin G. Ebaugh, Jr. Award for Advising Medical Students, Stanford University School of Medicine (2012)
  • General Medical Disciplines Division Teaching Award, Stanford University School of Medicine (2011)
  • Leadership Development Program, Stanford University School of Medicine (2010)
  • Educator for CARE (Compassion, Advocacy, Responsibility, Empathy), Stanford Medical School (2008)
  • The Kaiser Award for Excellence in Clinical Teaching, Stanford University School of Medicine (2008)
  • The Arthur L. Bloomfield Award for Excellence in Teaching Clinical Medicine, Stanford University School of Medicine (2006)
  • General Internal Medicine Division Teaching Award, Family and Community Medicine at Stanford (2002)
  • The Arthur L. Bloomfield Award for Excellence in Teaching Clinical Medicine, Stanford University School of Medicine (2002)

Professional Education

  • Internship: UCSF Medical Center (1995) CA
  • Fellowship: UCSF Medical Center (2001) CA
  • Residency: UCSF Medical Center (1997) CA
  • Board Certification: American Board of Family Medicine, Family Medicine (1997)
  • Medical Education: Stanford University School of Medicine (1994) CA
  • M.D., Stanford University, Medicine (1994)
  • B.A., Harvard University, History and Literature (1986)

Community and International Work

  • Santa Clotilde, Peru service work


    Care of families

    Populations Served




    Ongoing Project


    Opportunities for Student Involvement


  • Families at the Border, Tijuana


    Care of migrant families

    Populations Served

    Migrant children and adults



    Ongoing Project


    Opportunities for Student Involvement


Current Research and Scholarly Interests

My academic passion is patient-engaged medical education, including doctor-patient communication, professionalism, physical examination and clinical reasoning. My focus has been primarily on curriculum design and innovation, having helped to develop, and then directed the Continuity of Care Clerkship, an interdisciplinary longitudinal elective for clinical students. I have been instrumental in designing and implementing Stanford's curriculum focusing on clinical skills for pre-clerkship students, as Associate Director of the Practice of Medicine course. I have created a number of teaching modules and Standardized Patient assessments for the Family Medicine core clerkship and Continuity Clerkship, and have been involved in faculty development for residents and faculty preceptors. Most recently, as Director of SHIELD, the Stanford Healthcare Innovations and Experiential Learning Directive I have the opportunity to introduce early medical students to meaningful, immersive clinical experiences in their first year. Patients are equal partners in the educational experience. Students add value to the interdisciplinary team while, learning to be compassionate change leaders, and patients help reinforce empathy and guide all of our learning.

My research focus is on medical student professionalism, interpersonal communication and clinical skills.

All Publications

  • Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment. JMIR aging Mao, A., Tam, L., Xu, A., Osborn, K., Sheffrin, M., Gould, C., Schillinger, E., Martin, M., Mesias, M. 2022; 5 (2): e34326


    Despite the increasing availability of telemedicine video visits during the COVID-19 pandemic, older adults have greater challenges in getting care through telemedicine.We aim to better understand the barriers to telemedicine in community-dwelling older adults to improve the access to and experience of virtual visits.We conducted a mixed methods needs assessment of older adults at two independent living facilities (sites A and B) in Northern California between September 2020 and March 2021. Voluntary surveys were distributed. Semistructured interviews were then conducted with participants who provided contact information. Surveys ascertained participants' preferred devices as well as comfort level, support, and top barriers regarding telephonic and video visits. Qualitative analysis of transcribed interviews identified key themes.Survey respondents' (N=249) average age was 84.6 (SD 6.6) years, and 76.7% (n=191) of the participants were female. At site A, 88.9% (111/125) had a bachelor's degree or beyond, and 99.2% (124/125) listed English as their preferred language. At site B, 42.9% (51/119) had a bachelor's degree or beyond, and 13.4% (16/119) preferred English, while 73.1% (87/119) preferred Mandarin. Regarding video visits, 36.5% (91/249) of all participants felt comfortable connecting with their health care team through video visits. Regarding top barriers, participants at site A reported not knowing how to connect to the platform (30/125, 24%), not being familiar with the technology (28/125, 22.4%), and having difficulty hearing (19/125, 15.2%), whereas for site B, the top barriers were not being able to speak English well (65/119, 54.6%), lack of familiarity with technology and the internet (44/119, 36.9%), and lack of interest in seeing providers outside of the clinic (42/119, 35.3%). Three key themes emerged from the follow-up interviews (n=15): (1) the perceived limitations of video visits, (2) the overwhelming process of learning the technology for telemedicine, and (3) the desire for in-person or on-demand help with telemedicine.Substantial barriers exist for older adults in connecting with their health care team through telemedicine, particularly through video visits. The largest barriers include difficulty with technology or using the video visit platform, hearing difficulty, language barriers, and lack of desire to see providers virtually. Efforts to improve telemedicine access for older adults should take into account patient perspectives.

    View details for DOI 10.2196/34326

    View details for PubMedID 35438648

  • Implementing Value-Added Medical Education: Lessons Learned From the Student-Initiated "Stanford Frontline" COVID-19 Consult Service. Academic medicine : journal of the Association of American Medical Colleges Zhou, B., Calkins, C., Jayaraman, T., Cassells, S., Rotto, T., Vaughan, L., Srinivasan, M., Schillinger, E. 2021


    PROBLEM: Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused a mass transition to online learning, removed students from clinical settings, and underscored students' desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions.APPROACH: The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students, but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer-review process. After two months, the authors expanded the service to local community clinicians.OUTCOMES: The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions.NEXT STEPS: The SFCS is a novel, student-initiated VAME curriculum focused on increasing students' meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning.

    View details for DOI 10.1097/ACM.0000000000004160

    View details for PubMedID 33983140

  • Hands Off Yet All In: A Virtual Clerkship Pilot in the Ambulatory Setting During the COVID-19 Pandemic. Academic medicine : journal of the Association of American Medical Colleges Rydel, T. A., Bajra, R., Schillinger, E. 2021


    PROBLEM: There is a paucity of guidance regarding implementation of telemedicine curricula at the clerkship level, particularly with students actively engaged in video and telephone encounters. The COVID-19 pandemic caused rapid shifts in the delivery of medical education to clerkship-level students. This article describes the successful pilot of a direct patient care, virtual health curriculum at the clerkship level and discusses lessons learned.APPROACH: All 18 preceptors and 5 students at Stanford University School of Medicine, California, enrolled in the required 4-week family medicine clerkship in April 2020 were connected as virtual partners via a commercial video platform. The combined use of both this video program and Epic electronic health record (EHR) software as modes for teaching and patient care led to technical challenges and logistical hurdles. As part of an iterative process, clerkship leadership identified problems via preceptor and student interviews and integrated that feedback in order to create a model for delivering high-quality, clerkship-level clinical instruction during the COVID-19 shelter in place order.OUTCOMES: Of those who completed an evaluation, the majority of preceptors (n = 16; 89%) and students (n = 4; 100%, 1 student did not respond) expressed satisfaction with the virtual, remote teaching model conducted over 37 clinic visits. A detailed 14-step process list resulted from identifying and addressing both audio and video technical challenges and is provided for use by other institutions that wish to implement this workflow.NEXT STEPS: Future directions include assessing patient perspectives on the involvement of students in virtual visits, soliciting patient input for a more robust patient-physician-student virtual experience, and integrating a multi-party platform, when available, via the EHR to afford greater student autonomy.

    View details for DOI 10.1097/ACM.0000000000004127

    View details for PubMedID 33883401

  • Balancing Forces: Medical Students' Reflections on Professionalism Challenges and Professional Identity Formation. Family medicine Maitra, A. n., Lin, S. n., Rydel, T. A., Schillinger, E. n. 2021; 53 (3): 200–206


    Professionalism is essential in medical education, yet how it is embodied through medical students' lived experiences remains elusive. Little research exists on how students perceive professionalism and the barriers they encounter. This study examines attitudes toward professionalism through students' written reflections.Family medicine clerkship students at Stanford University School of Medicine answered the following prompt: "Log a patient encounter in which you experienced a professionalism challenge or improvement opportunity." We collected and analyzed free-text responses for content and themes using a grounded theory approach.One hundred responses from 106 students generated a total of 168 codes; 13 themes emerged across four domains: challenging patients, interpersonal interactions, self-awareness, and health care team dynamics. The three most frequently occurring themes were interacting with emotional patients, managing expectations in the encounter, and navigating the trainee role.Medical students view professionalism as a balance of forces. While many students conceived of professionalism in relation to patient encounters, they also described how professionalism manifests in inner qualities as well as in health systems. Interpersonal challenges related to communication and agenda-setting are predominant. Systems challenges include not being seen as the "real doctor" and being shaped by team behaviors through the hidden curriculum. Our findings highlight salient professionalism challenges and identity conflicts for medical students and suggest potential educational strategies such as intentional coaching and role-modeling by faculty. Overall, students' reflections broaden our understanding of professional identity formation in medical training.

    View details for DOI 10.22454/FamMed.2021.128713

    View details for PubMedID 33723818

  • Entice With Procedures, Inspire With Primary Care: A Preclerkship Pipeline Course. PRiMER (Leawood, Kan.) Lin, C., Zheng, J., Shivakumar, V., Schillinger, E., Rydel, T. A., Montacute, T. 2021; 5: 22


    Background and Objectives: The growing demand for primary care clinicians in the United States continues to outstrip their dwindling supply. Many allopathic medical schools, including Stanford University School of Medicine, are not adequately meeting this shortage. We sought to develop a preclerkship elective to increase the visibility and desirability of primary care at our institution.Methods: A novel 9-week preclerkship elective titled "Primary Care Defined: Perspectives and Procedures," was designed as a series of procedural workshops followed by interactive sessions with local primary care clinicians. A total of 36 medical and physician assistant students were enrolled. We administered a questionnaire pre- and postcourse to evaluate the impact of the elective on learner interest and attitudes toward primary care.Results: Twenty-four enrolled and 10 nonenrolled learners completed the questionnaire both pre- and postcourse. A one-way analysis of covariance controlling for gender, program (medical doctor versus physician assistant), and precourse responses demonstrated that enrollees had a significantly increased interest in primary care compared to nonenrollees after the course (F 1,32=9.22, P=.005). Enrollees also more positively rated their attitudes toward compensation, scope of practice, and job fulfillment than nonenrollees. Both groups had high levels of agreement on statements concerning patient-physician interactions and the importance of primary care to the health care system.Conclusion: The design and content of this elective offers a framework for other institutions looking to promote the value of primary care specialties, particularly family medicine. Creating opportunities for experiential learning and early student-faculty engagement may encourage preclerkship learners to consider a career in primary care.

    View details for DOI 10.22454/PRiMER.2021.782026

    View details for PubMedID 34286225

  • "Making It Work": A Preliminary Mixed Methods Study of Rural Trauma Care Access and Resources in New Mexico. Cureus Carroll, A. L., Garcia, D., Cassells, S. J., Bruce, J. S., Bereknyei Merrell, S., Schillinger, E. 2020; 12 (10): e11143


    Introduction Patients in the rural western United States face challenges accessing trauma and surgical services and are more likely to succumb to their injuries. New Mexico, a rural and medically underresourced state, is a salient space to study these disparities. We examine how travel distance from trauma centers impacts injured patient outcomes and describe care delivery obstacles. Materials and Methods We conducted an explanatory mixed methods study by creating geospatial maps of New Mexico's trauma data, incorporating linear regression analyses on patient outcomes as a function of estimated travel distance from trauma centers. We also conducted qualitative semi-structured interviews with trauma providers to illuminate and provide context for the geospatial findings utilizing a systematic, collaborative, iterative transcript analysis process. We constructed a conceptual framework describing rural trauma care delivery obstacles. Results Geospatial analyses revealed that most New Mexicans face long travel times to trauma centers. Comparing regression analyses using different data sources suggests that solely hospital-derived data may undercount rural trauma deaths. Interviews with 10 providers suggest that elements that may contribute to these findings include on-the-ground resource-based challenges and those related to broader healthcare systems-based issues. Our conceptual framework denotes how these elements collectively may impact rural trauma outcomes and proposes potential solutions. Conclusions In addressing rural patients' needs, healthcare policy decision-makers should ensure that their datasets are comprehensive and inclusive. They must also take into account the particular challenges of underserved rural patients and providers who care for them by eliciting their perspectives, as presented in our conceptual framework.

    View details for DOI 10.7759/cureus.11143

    View details for PubMedID 33251053

    View details for PubMedCentralID PMC7685818

  • Interprofessional Collaboration: A Qualitative Study of Non-Physician Perspectives on Resident Competency JOURNAL OF GENERAL INTERNAL MEDICINE Garth, M., Millet, A., Shearer, E., Stafford, S., Merrell, S., Bruce, J., Schillinger, E., Aaronson, A., Svec, D. 2018; 33 (4): 487–92


    The Association of American Medical Colleges (AAMC) includes the ability to collaborate in an interprofessional team as a core professional activity that trainees should be able to complete on day 1 of residency (Med Sci Educ. 26:797-800, 2016). The training that medical students require in order to achieve this competency, however, is not well established (Med Sci Educ. 26:457-61, 2016), and few studies have examined non-physician healthcare professionals' perspectives regarding resident physicians' interprofessional skills.This study aims to describe non-physicians' views on barriers to collaboration with physicians, as well as factors that contribute to good collaborative relationships.Nurses, social workers, case managers, dietitians, rehabilitation therapists, and pharmacists at one academic medical center, largely working in the inpatient setting.A qualitative study design was employed. Data were collected from individual interviews and focus groups comprising non-physician healthcare professionals.Knowledge gaps identified as impeding interprofessional collaboration included inadequate understanding of current roles, potential roles, and processes for non-physician healthcare professionals. Specific physician behaviors that were identified as contributing to good collaborative relationships included mutual support such as backing up other team members and prioritizing multidisciplinary rounds, and communication including keeping team members informed, asking for their input, physicians explaining their rationale, and practicing joint problem-solving with non-physicians.Discussion of how physician trainees can best learn to collaborate as members of an interprofessional team must include non-physician perspectives. Training designed to provide medical students and residents with a better understanding of non-physician roles and to enhance mutual support and communication skills may be critical in achieving the AAMC's goals of making physicians effective members of interprofessional teams, and thus improving patient-centered care. We hope that medical educators will include these areas identified as important by non-physicians in targeted team training for their learners.

    View details for PubMedID 29204972

    View details for PubMedCentralID PMC5880757

  • Rethinking empathy decline: results from an OSCE. The clinical teacher Teng, V. C., Nguyen, C., Hall, K. T., Rydel, T., Sattler, A., Schillinger, E., Weinlander, E., Lin, S. 2017


    The phenomenon of empathy decline among medical students during training is widely accepted, with evidence based largely on studies using self-administered instruments. Recently, researchers have called into question this phenomenon, in light of new findings that suggest a discrepancy between self-administered empathy scores and observed empathic behaviours: for example, during objective structured clinical examinations (OSCEs). Our objective was to compare observed empathy among medical students in different clerkship years using an OSCE.Participants were medical students in their first or second year of clinical clerkships, enrolled in a required family medicine clerkship at Stanford University. Participants completed an OSCE that was directly observed by trained faculty staff, who used the Measure of Patient-Centered Communication (MPCC) instrument to measure empathic behaviours. Statistics were used to determine correlations between observed empathy and the students' year of clerkship, gender, and specialty preference.A total of 129 medical students, evenly divided by gender and clerkship year, participated. There was a possible trend towards higher MPCC scores among students in their second clerkship year compared with students in their first year (p = 0.09), which became more significant when adjusted for outlier effects (p = 0.05). There was no difference in performance by gender. Students interested in a 'people-oriented' specialty scored higher in 'handling the patient's frustration' compared with those who are interested in a 'technology-oriented' specialty.In our study, observed empathic behaviours were not lower in the second compared with the first year of clerkship training. More research is warranted to investigate the apparent discrepancy between self-administered empathy scores and observed empathic behaviours. New findings suggest a discrepancy between self-administered empathy scores and observed empathic behaviours.

    View details for DOI 10.1111/tct.12608

    View details for PubMedID 28164429

  • Patient-Centered Care Challenges and Surprises: Through the Clerkship Students' Eyes. Family medicine Boggiano, V. L., Wu, Y., Bruce, J. S., Merrell, S. B., Schillinger, E. 2017; 49 (1): 57-61


    The patient-centered care model for health care delivery encourages medical providers to respect patients' preferences and give patients more autonomy over their health care decisions. This approach has gained importance within US medical school curricula. Yet, little is known about student perspectives on both patient-centered care and the benefits and challenges that lie therein. This manuscript explores the greatest impediments to, as well as the benefits from, student engagement in patient-centered care from the perspectives of students participating in their family medicine outpatient clerkship.Clerkship students on their core family medicine clerkship at Stanford University School of Medicine were provided the following open-ended prompt: "Describe a patient-centered care challenge or surprise in the family medicine core clerkship." Free-text responses were collected and analyzed using content and thematic analysis.A total of 326 responses from 216 students were analyzed for frequency and patient-centered themes. Nine final themes emerged and were grouped into three domains: student definitions of patient-centered care, patient-centered care impact on patients, and patient-centered care impact on medical professionals.Our study suggests that students find the patient-centered care model for health care delivery to be challenging but worthwhile. We highlight that students find communication with patients in a patient-centered manner challenging and discuss the need for improved medical education about patient-centered care in order to better prepare students to implement the model in a variety of psychosocial and medical contexts.

    View details for PubMedID 28166582

  • An Academic Achievement Calculator for Clinician-Educators in Primary Care. Family medicine Lin, S. n., Mahoney, M. n., Singh, B. n., Schillinger, E. n. 2017; 49 (8): 640–43


    Academic medical centers need better ways to quantify the diverse academic contributions of primary care clinician-educators. We examined the feasibility and acceptability of an "academic achievement calculator" that quantifies academic activities using a point system.A cohort of 16 clinician-educators at a single academic medical center volunteered to assess the calculator using a questionnaire. Key measures included time needed to complete the calculator, how well it reflected participants' academic activities, whether it increased their awareness of academic opportunities, whether they intend to pursue more academic work, and their overall satisfaction with the calculator.Most participants (69%) completed the calculator in less than 20 minutes. Three-quarters (75%) reported that the calculator reflected the breadth of their academic work either "very well" or "extremely well". The majority (81%) stated that it increased their awareness of opportunities for academic engagement, and that they intend to pursue more academic activities. Overall, three-quarters (75%) were "very satisfied" or "extremely satisfied" with the calculator.To our knowledge, this is the first report of a tool designed to quantify the diverse academic activities of primary care clinician-educators. In this pilot study, we found that the use of an academic achievement calculator may be feasible and acceptable. This tool, if paired with an annual bonus plan, could help incentivize and reward academic contributions among primary care clinician-educators, and assist department leaders with the promotion process.

    View details for PubMedID 28953298

  • Actual and Standardized Patient Evaluations of Medical Students' Skills. Family medicine Sattler, A. L., Merrell, S. B., Lin, S. Y., Schillinger, E. n. 2017; 49 (7): 548–52


    Physicians must communicate effectively with patients. Actual patients (APs) rarely evaluate medical students' clinical skills; instead, standardized patients (SPs) provide proxy ratings. It is unclear how well SP ratings mirror AP experiences. The aim of this study was to compare AP and SP assessments of medical students' communication skills and professionalism. We hypothesized that their perspectives would be similar, but distinct, and offer insight about how to more reliably include the patient's voice in medical education.Using a mixed methods design, data were gathered from both APs and SPs using a modified SEGUE (Set the stage, Elicit information, Give information, Understand the patient's perspective, End the encounter) framework. Authors analyzed Likert-scale surveys using Spearman's rho (ρ) correlations, and qualitatively analyzed open-ended comments about students' interpersonal skills and professionalism.For APs, the domains of "trusted the student," "discussed treatment," and "reviewed next steps" were positively correlated with whether they would recommend the student to others (ρ.89, ρ.89, ρ.88, respectively, all P<.001). For SPs, feeling like they "trusted the student," "student appeared professionally competent," and "made personal connection" were most highly correlated with recommending the student to others (ρ.86, ρ.86, ρ.76, respectively, all P<.001).Feedback from APs provides unique perspectives, complementing those of SPs, and prompts insights into incorporating patients' voices and values into training. Students may benefit from learning experiences focused on sharing and clarifying information. Providing opportunities for deliberate practice and feedback during both AP and SP encounters may enhance mastery of these skills.

    View details for PubMedID 28724153

  • Creating the medical school of the future through incremental curricular transformation: the Stanford Healthcare Innovations and Experiential Learning Directive (SHIELD) EDUCATION FOR PRIMARY CARE Lin, S., Osborn, K., Sattler, A., Nelligan, I., Svec, D., Aaronson, A., Schillinger, E. 2017; 28 (3): 180–84
  • Creating the medical school of the future through incremental curricular transformation: the Stanford Healthcare Innovations and Experiential Learning Directive (SHIELD). Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors Lin, S., Osborn, K., Sattler, A., Nelligan, I., Svec, D., Aaronson, A., Schillinger, E. 2016: 1-5

    View details for PubMedID 27892817

  • Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic FAMILY MEDICINE Braverman, G., Merrell, S. B., Bruce, J. S., Makoul, G., Schillinger, E. 2016; 48 (10): 775-783


    Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development.Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis.We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter.Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

    View details for Web of Science ID 000387121300004

    View details for PubMedID 27875600

  • Qualities of Resident Teachers Valued by Medical Students FAMILY MEDICINE Montacute, T., Teng, V. C., Yu, G. C., Schillinger, E., Lin, S. 2016; 48 (5): 381-384


    Medical students often see residents as the most important teachers on the wards. However, there is a relative lack of data on the qualities that medical students value in their resident teachers. We conducted a qualitative study to determine the teaching behaviors that medical students value in their resident teachers.Over a 1-year period, 28 medical students completed 115 open-ended written reflections about their educational experiences with residents at a single, university-affiliated, community-based family medicine residency program in San Jose, CA. Qualitative data were analyzed using the constant comparative method associated with grounded theory. Ten recurring themes were identified after triangulation with published literature.When given the opportunity to make open-ended written reflections about the teaching abilities of their resident teachers, medical students most often commented on topics relevant to a "safe learning environment." More than one in four reflections were associated with this theme, and all were characterized as positive, suggesting that the ability to set a safe learning environment is a quality that medical students value in their resident teachers. In contrast, the least frequently occurring theme was "knowledge," suggesting that residents' fund of knowledge may not be as important as other qualities in the eyes of medical students.Our study adds to a growing body of literature suggesting that, from the medical students' perspective, a resident's fund of medical knowledge may not be as important as his/her ability to establish a supportive, safe, and nonthreatening environment to learn and practice medicine.

    View details for Web of Science ID 000376224100009

    View details for PubMedID 27159098

  • Dermatology resident physician training and readiness to identify and manage elder mistreatment Chang, J., Danesh, M., Endo, J., Osterberg, L., Millsop, J., Aughenbaugh, W., Schillinger, E., Singh, B., Sussman, R., Chang, A. S. MOSBY-ELSEVIER. 2016: AB25
  • Next big thing: integrating medical scribes into academic medical centres. BMJ simulation & technology enhanced learning Lin, S., Khoo, J., Schillinger, E. 2016; 2 (2): 27-29

    View details for DOI 10.1136/bmjstel-2015-000054

    View details for PubMedID 35518194

    View details for PubMedCentralID PMC8936598

  • Training Future Clinician-Educators: A Track for Family Medicine Residents. Family medicine Lin, S., Sattler, A., Chen Yu, G., Basaviah, P., Schillinger, E. 2016; 48 (3): 212-216


    Despite a growing demand for skilled clinician-educators, residents today rarely receive formal training in clinical teaching, curriculum development, administration, leadership, or educational scholarship. The authors describe the development, implementation, and preliminary evaluation of the O'Connor Stanford Leaders in Education Residency (OSLER) track, a novel clinician-educator track within the family medicine residency program affiliated with Stanford University School of Medicine.In 2010, the OSLER track was introduced at O'Connor Hospital, a community hospital that houses an 8-8-8 family medicine residency program. Residents who are in good standing can apply to the track at the midpoint of their first postgraduate year. Residents are immersed in a flexible, experience-based, 2.5-year-long curriculum with hands-on teaching activities at its core. To foster skills in educational scholarship, track residents are required to design and complete a scholarly project.A comprehensive evaluation plan is currently in progress. Preliminary data indicates high levels of satisfaction with the track's overall value, impact on core teaching skills, and effect on career trajectory. Residents gained more confidence in core teaching skills as they progressed through the track. Scholarly work output by residents has increased significantly since the track was implemented. The residency program has seen an increased interest from applicants since the track was started, with data suggesting that applicant quality has increased from the pre-track to post-track years.More research is needed to assess the effectiveness and reproducibility of this clinician-educator track. If proven, this model may be replicated at other academic medical centers.

    View details for PubMedID 26950910

  • Training Future Clinician-Educators: A Track for Family Medicine Residents. Family medicine Lin, S., Sattler, A., Chen Yu, G., Basaviah, P., Schillinger, E. 2016; 48 (3): 212-216

    View details for PubMedID 26950910

  • Value-added medical education: engaging future doctors to transform health care delivery today. Journal of general internal medicine Lin, S. Y., Schillinger, E., Irby, D. M. 2015; 30 (2): 150-151

    View details for DOI 10.1007/s11606-014-3018-3

    View details for PubMedID 25217209

  • Beyond Knowledge, Toward Linguistic Competency: An Experiential Curriculum JOURNAL OF GENERAL INTERNAL MEDICINE Bereknyei, S., Nevins, A., Schillinger, E., Garcia, R. D., Stuart, A. E., Braddock, C. H. 2010; 25: S155-S159


    Training is essential for future health care providers to effectively communicate with limited English proficient (LEP) patients during interpreted encounters. Our aim is to describe an innovative skill-based medical school linguistic competency curriculum and its impact on knowledge and skills.At Stanford University School of Medicine, we incorporated a linguistic competency curriculum into a 2-year Practice of Medicine preclinical doctoring course and pediatrics clerkship over three cohorts.First year students participated in extensive interpreter-related training including: a knowledge-based online module, interactive role-play exercises, and didactic skill-building sessions. Students in the pediatrics clerkship participated in interpreted training exercises with facilitated feedback.Knowledge and skills were evaluated in the first and fourth years. First year students' knowledge scores increased (pre-test = 0.62, post-test = 0.89, P < 0.001), and they demonstrated good skill attainment during an end-year performance assessment. One cohort of students participated in the entire curriculum and maintained performance into the fourth year.Our curriculum increased knowledge and led to skill attainment, each of which showed good durability for a cohort of students evaluated 3 years later. With a growing LEP population, these skills are essential to foster in future health care providers to effectively communicate with LEP patients and reduce health disparities.

    View details for DOI 10.1007/s11606-010-1271-7

    View details for Web of Science ID 000277270300016

    View details for PubMedID 20352511

    View details for PubMedCentralID PMC2847115

  • Teaching clinical students to teach FAMILY MEDICINE LeBaron, S., SCHILLINGER, E. 2004; 36 (2): 87-88

    View details for Web of Science ID 000220020600008

    View details for PubMedID 14872351

  • Teaching family medicine medical students about sleep disorders FAMILY MEDICINE Schillinger, E., Kushida, C., Fahrenbach, R., Dement, W., LeBaron, S. 2003; 35 (8): 547-549


    A 3.5-hour workshop was developed to teach family medicine medical students about sleep disorders.This family medicine clerkship requirement engages students in role-plays and provides them with didactic information about common sleep problems.Fifty-one students completed questionnaires assessing their knowledge prior to the workshop, 2 weeks and 6 months after the workshop, and their clinical behavior after the workshop.A role-play-based workshop is an effective, fun way to improve students' sleep knowledge and skills. Students retain that information over a 6-month period and are able to apply it during their clinical clerkships.

    View details for Web of Science ID 000185309100009

    View details for PubMedID 12947515

  • Do required preclinical courses with family physicians encourage interest in family medicine? FAMILY MEDICINE Hill-Sakurai, L. E., SCHILLINGER, E., Rittenhouse, D. R., Fahrenbach, R., Hudes, E. S., LeBaron, S., Shore, W. B., Hearst, N. 2003; 35 (8): 579-584


    Many medical schools, including the University of California, San Francisco (UCSF), added required preclinical course work with family physicians in the 1990s. We examined whether current UCSF students interested in family medicine noted more contact with family physicians and more faculty support of their interest than current Stanford students and 1993 UCSF students, neither of whom had required preclinical course work with family physicians.A questionnaire was administered to students interested in family medicine at UCSF and Stanford in February 2001, with response rates of 84% and 90%, respectively. Previously published 1993 data from UCSF were also used for comparison. Data were analyzed using chi-square and t statistics as appropriate.UCSF students in 2001, despite exposure to required preclinical course work with family physicians, did not perceive greater contact with family physicians than Stanford students. Stanford students perceived greater encouragement from their family medicine faculty but less from faculty overall, compared with 2001 UCSF students. UCSF students in 2001 perceived no more overall faculty encouragement than did UCSF students in 1993.Required preclinical course work with family physicians was not consistently associated with greater student perception of faculty support for students' interest in family medicine, nor was it demonstrated to increase the amount or quality of interested students' interaction with family medicine faculty.

    View details for Web of Science ID 000185309100015

    View details for PubMedID 12947521

  • The multiple mini-SOAP format for student presentations of complex patients FAMILY MEDICINE SCHILLINGER, E., LeBaron, S. 2003; 35 (1): 13-14

    View details for Web of Science ID 000180366900006

    View details for PubMedID 12564856

  • Including the patient in student presentations FAMILY MEDICINE LeBaron, S., SCHILLINGER, E. 2000; 32 (2): 87-88

    View details for Web of Science ID 000086669100008

    View details for PubMedID 10697765

  • Acupuncture: its use in medicine WESTERN JOURNAL OF MEDICINE Pearl, D., SCHILLINGER, E. 1999; 171 (3): 176-180

    View details for Web of Science ID 000083289400017

    View details for PubMedID 10560293