Shimon Amar, Elena Chernin, Gabriel Schreiber, Michael Friger, Angel Porgador
Objectives: To evaluate the association between the achievements of medical students and whether they were admitted via the pre-medical track or the regular direct track.
Methods: We performed a comparative retrospective data study using data from a three-year experimental cohort in a six-year medical school. We analyzed the academic achievements of all students admitted at one Israeli medical school between 2013-2015, either directly to the six-year program or via a pre-medical track. We compared averages of both yearly final grades and final medical examinations grades between the two groups. Descriptive statistics were calculated and differences between groups were evaluated using multivariate analysis.
Results: Of the 324 students included in the study, 65 (20.1%) were enrolled in all three cohorts of the pre-medical track. Age and Gender distribution were nearly similar for both tracks. For the first two cohorts, the average final grades of year one of pre-medical students were significantly higher than those of regular direct track (F=(3,167) 6.10, p=0.001), but the opposite was true for the third cohort (F=(3,110)2.38, p=0.073). No further statistically significant differences were found neither between the groups in their final exams grades nor between choosing a MD/PhD optional track and admission pathway.
Conclusions: Our results suggest promising achievements with the pre-medical admission pathway. This should encourage further discussion about the significant potential human resources lost by current admission processes and may question the effectiveness of six-year programs in medical schools.
{"title":"Comparing achievements of medical graduates in an alternative unique pre-medical track vs regular medical track.","authors":"Shimon Amar, Elena Chernin, Gabriel Schreiber, Michael Friger, Angel Porgador","doi":"10.5116/ijme.62f6.10b6","DOIUrl":"https://doi.org/10.5116/ijme.62f6.10b6","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between the achievements of medical students and whether they were admitted via the pre-medical track or the regular direct track.</p><p><strong>Methods: </strong>We performed a comparative retrospective data study using data from a three-year experimental cohort in a six-year medical school. We analyzed the academic achievements of all students admitted at one Israeli medical school between 2013-2015, either directly to the six-year program or via a pre-medical track. We compared averages of both yearly final grades and final medical examinations grades between the two groups. Descriptive statistics were calculated and differences between groups were evaluated using multivariate analysis.</p><p><strong>Results: </strong>Of the 324 students included in the study, 65 (20.1%) were enrolled in all three cohorts of the pre-medical track. Age and Gender distribution were nearly similar for both tracks. For the first two cohorts, the average final grades of year one of pre-medical students were significantly higher than those of regular direct track (F=<sub>(3,167)</sub> 6.10, p=0.001), but the opposite was true for the third cohort (F=<sub>(3,110)</sub>2.38, p=0.073). No further statistically significant differences were found neither between the groups in their final exams grades nor between choosing a MD/PhD optional track and admission pathway.</p><p><strong>Conclusions: </strong>Our results suggest promising achievements with the pre-medical admission pathway. This should encourage further discussion about the significant potential human resources lost by current admission processes and may question the effectiveness of six-year programs in medical schools.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"249-255"},"PeriodicalIF":3.1,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10717570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Umphrey, Nora Lenhard, Suet Kam Lam, Nathaniel E Hayward, Shaina Hecht, Priya Agrawal, Amy Chambliss, Jessica Evert, Heather Haq, Stephanie M Lauden, George Paasi, Mary Schleicher, Megan Song McHenry
Objectives: To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators.
Methods: We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation.
Results: Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps.
Conclusions: This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.
目的:综合最近针对医学研究生的虚拟全球健康教育活动,记录文献中的空白,提出未来的研究建议,并为全球健康教育者提供最佳实践建议。方法:通过检索MEDLINE、EMBASE、Cochrane Library、ERIC、Scopus、Web of Science和ProQuest dissert&theses A&I,系统回顾了2012-2021年间发表的关于虚拟全球健康教育活动的文章。我们对会议和组织网站进行了参考文献审查和搜索。我们收录了主要针对卫生专业受训人员的虚拟活动的文章。我们收集并定性分析了有关活动类型、评估、受众和驱动因素或障碍的描述性数据。纳入文章的异质性不利于正式的质量评估。结果:40篇描述69个虚拟活动的文章符合纳入标准。55%的活动主办国为高收入国家。大多数活动针对学生(57%),大多数(53%)针对中低收入和高收入环境中的受训人员。常见的活动驱动因素是课程内容、组织、同伴互动和在线灵活性。常见的挑战包括学生参与、技术、互联网、时区和日程安排。文章报道了活动的意想不到的好处,包括广泛的影响;现实世界的影响;改善合作关系;确定全球卫生实践差距。结论:本文首次综述了针对医学研究生的虚拟全球健康教育活动。我们的综述确定了这些活动的重要驱动因素和挑战,未来研究活动偏好的必要性,以及中低收入国家学习者和教育工作者的考虑因素。这些发现可以指导全球卫生教育工作者规划和实施虚拟活动。
{"title":"Virtual global health in graduate medical education: a systematic review.","authors":"Lisa Umphrey, Nora Lenhard, Suet Kam Lam, Nathaniel E Hayward, Shaina Hecht, Priya Agrawal, Amy Chambliss, Jessica Evert, Heather Haq, Stephanie M Lauden, George Paasi, Mary Schleicher, Megan Song McHenry","doi":"10.5116/ijme.62eb.94fa","DOIUrl":"https://doi.org/10.5116/ijme.62eb.94fa","url":null,"abstract":"<p><strong>Objectives: </strong>To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators.</p><p><strong>Methods: </strong>We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation.</p><p><strong>Results: </strong>Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps.</p><p><strong>Conclusions: </strong>This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"230-248"},"PeriodicalIF":3.1,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josefin Ivarson, André Hermansson, Björn Meister, Hugo Zeberg, Klara Bolander Laksov, Wilhelmina Ekström
Objectives: This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty.
Methods: Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments.
Results: A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course.
Conclusions: This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.
{"title":"Transfer of anatomy during surgical clerkships: an exploratory study of a student-staff partnership.","authors":"Josefin Ivarson, André Hermansson, Björn Meister, Hugo Zeberg, Klara Bolander Laksov, Wilhelmina Ekström","doi":"10.5116/ijme.62eb.850a","DOIUrl":"https://doi.org/10.5116/ijme.62eb.850a","url":null,"abstract":"<p><strong>Objectives: </strong>This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty.</p><p><strong>Methods: </strong>Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments.</p><p><strong>Results: </strong>A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course.</p><p><strong>Conclusions: </strong> This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"221-229"},"PeriodicalIF":3.1,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10701456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The COVID-19 pandemic caused medical education to shift unprecedentedly, leading medical schools to switch to virtual platforms and modify student-patient interactions. On top of educational changes, medical students adapted to their support network, finances, and mental and physical health changes. Objective: To understand the holistic impact of COVID-19 on medical students and medical education and identify how to distribute resources during future educational disruptions in a large medical university in the United States. Methods: An anonymous online survey was distributed to medical students at Sidney Kimmel Medical College, Philadelphia, in February 2021. Participants self-reported the impact of the COVID-19 pandemic on their medical education, family life, financial burden, mental health, and physical health. Results: 168 out of 1088 students at Sidney Kimmel Medical College completed the survey, with 58% (98/168) of the respondents identifying as female. The class breakdown was as follows: 38% (63/168) first years, 18% (31/168) second years, 21% (36/168) third years, 20% (34/168) fourth years, and 2% (4/168) were considered “other” (including research year, Master’s program). A total of 28% of respondents reported developing new mental illness, with second years having the highest incidence at 39%. In total, 42% said the pandemic affected a previous mental health condition. Further, 96% of third and fourth years reported COVID-19 affected their clinical rotations. In total, 68% of first years reported their entrance to medical school was severely affected. Moreover, 13% reported losing a family member due to COVID-19, and 7% reported personal sickness due to COVID-19. Additionally, 16% reported incurring a financial burden due to the pandemic. Conclusion: COVID-19 impacted the well-being of students by affecting their mental health and financial burdens. Clinical rotations and medical school entrance were the most problematic aspects. In the future setting of major educational disruptions, this study provides a starting point for where to focus resources, mental health support, financial support, and academic flexibility.
{"title":"Effect of COVID-19 Pandemic on Medical Students—A Single Center Study","authors":"Maria Poluch, R. Ries, Monjur Ahmed","doi":"10.3390/ime1010004","DOIUrl":"https://doi.org/10.3390/ime1010004","url":null,"abstract":"Background: The COVID-19 pandemic caused medical education to shift unprecedentedly, leading medical schools to switch to virtual platforms and modify student-patient interactions. On top of educational changes, medical students adapted to their support network, finances, and mental and physical health changes. Objective: To understand the holistic impact of COVID-19 on medical students and medical education and identify how to distribute resources during future educational disruptions in a large medical university in the United States. Methods: An anonymous online survey was distributed to medical students at Sidney Kimmel Medical College, Philadelphia, in February 2021. Participants self-reported the impact of the COVID-19 pandemic on their medical education, family life, financial burden, mental health, and physical health. Results: 168 out of 1088 students at Sidney Kimmel Medical College completed the survey, with 58% (98/168) of the respondents identifying as female. The class breakdown was as follows: 38% (63/168) first years, 18% (31/168) second years, 21% (36/168) third years, 20% (34/168) fourth years, and 2% (4/168) were considered “other” (including research year, Master’s program). A total of 28% of respondents reported developing new mental illness, with second years having the highest incidence at 39%. In total, 42% said the pandemic affected a previous mental health condition. Further, 96% of third and fourth years reported COVID-19 affected their clinical rotations. In total, 68% of first years reported their entrance to medical school was severely affected. Moreover, 13% reported losing a family member due to COVID-19, and 7% reported personal sickness due to COVID-19. Additionally, 16% reported incurring a financial burden due to the pandemic. Conclusion: COVID-19 impacted the well-being of students by affecting their mental health and financial burdens. Clinical rotations and medical school entrance were the most problematic aspects. In the future setting of major educational disruptions, this study provides a starting point for where to focus resources, mental health support, financial support, and academic flexibility.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"33 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88147072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students.
Methods: We conducted a qualitative study based on individual semi-structured interviews. Participants were physicians working at universities, teaching hospitals, or clinics who teach EBM to medical students. Purposive sampling was used to recruit participants via email through the researchers' acquaintances. Six physicians agreed to participate in the study and were interviewed individually from October 2019 to January 2020. The interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students, and what they felt was needed to improve current undergraduate EBM education. Interviews were recorded. Transcripts were analysed using thematic analysis.
Results: Thematic analysis extracted five themes: finding foreground questions, observing role models, active learning, understanding patient backgrounds, and understanding the reason for learning EBM. To promote EBM education for medical students, it is first necessary for students to actively participate in clinical practice and identify foreground questions by observing their supervisors practicing EBM. In addition to acquiring skills in information retrieval and critical appraisal, understanding a patient's background leads to understanding the significance of learning EBM, which improves students' motivation to learn EBM.
Conclusions: This study identified five themes that promote undergraduate EBM education. Curriculum development incorporating these elements would improve EBM education in Japan and other countries.
{"title":"A qualitative study of factors promoting EBM learning among medical students in Japan.","authors":"Yoshihiro Kataoka, Takami Maeno, Takashi Inaba, Sayaka Ninn, Masatsune Suzuki, Tetsuhiro Maeno","doi":"10.5116/ijme.62eb.7c19","DOIUrl":"https://doi.org/10.5116/ijme.62eb.7c19","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students.</p><p><strong>Methods: </strong>We conducted a qualitative study based on individual semi-structured interviews. Participants were physicians working at universities, teaching hospitals, or clinics who teach EBM to medical students. Purposive sampling was used to recruit participants via email through the researchers' acquaintances. Six physicians agreed to participate in the study and were interviewed individually from October 2019 to January 2020. The interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students, and what they felt was needed to improve current undergraduate EBM education. Interviews were recorded. Transcripts were analysed using thematic analysis.</p><p><strong>Results: </strong>Thematic analysis extracted five themes: finding foreground questions, observing role models, active learning, understanding patient backgrounds, and understanding the reason for learning EBM. To promote EBM education for medical students, it is first necessary for students to actively participate in clinical practice and identify foreground questions by observing their supervisors practicing EBM. In addition to acquiring skills in information retrieval and critical appraisal, understanding a patient's background leads to understanding the significance of learning EBM, which improves students' motivation to learn EBM.</p><p><strong>Conclusions: </strong>This study identified five themes that promote undergraduate EBM education. Curriculum development incorporating these elements would improve EBM education in Japan and other countries.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"215-220"},"PeriodicalIF":3.1,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10717569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeanne L Jacoby, Amy B Smith, Robert D Barraco, Marna Rayl Greenberg, Elaine A Donoghue, Bryan G Kane, Jennifer E Macfarlan, Lauren M Crowley, Kevin R Weaver, Joann Farrell Quinn
Objectives: To determine whether Empathy, Emotional Intelligence, and Burnout scores differ by specialty in incoming residents.
Methods: This is a single-site, prospective, cross-sectional study. Three validated survey instruments, the Jefferson Scale of Physician Empathy, Maslach Burnout Inventory, and Emotional and Social Competency Inventory, were written into a survey platform as a single 125-question Qualtrics survey. Over three academic years, 2015-2017, 229 incoming residents across all specialties were emailed the survey link during orientation. Residents were grouped by incoming specialty with anonymity assured. A total of 229 responses were included, with 121 (52.8%) identifying as female. Statistical analysis was performed using the Analysis of Variance or Kruskal-Wallis test, Chi-Square or Fisher's Exact test, and Independent Samples t-test or Mann Whitney U test. A Bonferroni correction was applied for pairwise comparisons.
Results: Family Medicine had a higher median Jefferson Scale of Physician Empathy score (127) compared to Emergency Medicine (115), (U=767.7, p=0.0330). Maslach Burnout Inventory depersonalization and personal accomplishment subcategory scores showed a significant difference between specialties when omnibus tests were performed, but pairwise comparisons with emergency medicine residents showed no differences. Differences were found in the Maslach Burnout Inventory categories of Depersonalization (χ2(8, N=229) =15.93, p=0.0434) and Personal Accomplishment level (χ2(8, N=229) =20.80, p=0.0077) between specialties.
Conclusions: Differences in measures of well-being exist across specialties, even prior to the start of residency training. The implication for educators of residency training is that some incoming residents, regardless of specialty, already exhibit troublesome features of burnout, and resources to effectively deal with these residents should be developed and utilized.
{"title":"Do incoming residents vary in measures of emotional status even prior to residency training?","authors":"Jeanne L Jacoby, Amy B Smith, Robert D Barraco, Marna Rayl Greenberg, Elaine A Donoghue, Bryan G Kane, Jennifer E Macfarlan, Lauren M Crowley, Kevin R Weaver, Joann Farrell Quinn","doi":"10.5116/ijme.62cb.f308","DOIUrl":"https://doi.org/10.5116/ijme.62cb.f308","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether Empathy, Emotional Intelligence, and Burnout scores differ by specialty in incoming residents.</p><p><strong>Methods: </strong>This is a single-site, prospective, cross-sectional study. Three validated survey instruments, the Jefferson Scale of Physician Empathy, Maslach Burnout Inventory, and Emotional and Social Competency Inventory, were written into a survey platform as a single 125-question Qualtrics survey. Over three academic years, 2015-2017, 229 incoming residents across all specialties were emailed the survey link during orientation. Residents were grouped by incoming specialty with anonymity assured. A total of 229 responses were included, with 121 (52.8%) identifying as female. Statistical analysis was performed using the Analysis of Variance or Kruskal-Wallis test, Chi-Square or Fisher's Exact test, and Independent Samples t-test or Mann Whitney U test. A Bonferroni correction was applied for pairwise comparisons.</p><p><strong>Results: </strong>Family Medicine had a higher median Jefferson Scale of Physician Empathy score (127) compared to Emergency Medicine (115), (U=767.7, p=0.0330). Maslach Burnout Inventory depersonalization and personal accomplishment subcategory scores showed a significant difference between specialties when omnibus tests were performed, but pairwise comparisons with emergency medicine residents showed no differences. Differences were found in the Maslach Burnout Inventory categories of Depersonalization (χ<sup>2</sup><sub>(8, N=229)</sub> =15.93, p=0.0434) and Personal Accomplishment level (χ<sup>2</sup><sub>(8, N=229)</sub> =20.80, p=0.0077) between specialties.</p><p><strong>Conclusions: </strong>Differences in measures of well-being exist across specialties, even prior to the start of residency training. The implication for educators of residency training is that some incoming residents, regardless of specialty, already exhibit troublesome features of burnout, and resources to effectively deal with these residents should be developed and utilized.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"198-204"},"PeriodicalIF":3.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9279248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the reliability and construct validity of a French version of the Jefferson Scale of Empathy-Students.
Methods: A cross-sectional study was performed among undergraduate medical students in Tunisia. A total of 833 students completed a French version of the JSE-S using convenience sampling. To identify the internal consistency aspect of the reliability, Cronbach's alpha coefficient was computed. Moreover, to assess the construct validity, the sample was randomly divided into two groups. Data from the first group (n=415) were subjected to exploratory factor analysis (EFA), with principal axing factoring (PAF) and oblimin rotation, to re-examine the underlying factor structure of the scale. Data from the second group (n=419) were used for confirmatory factor analysis (CFA) to confirm its latent variable structure. Some goodness-of-fit indices were used to assess the hypothesized model. Gender groups were compared using a t-test to check the known-group validity.
Results: Reliability analysis reported an acceptable level of internal consistency, with an overall Cronbach's alpha of 0.78 (95% CI [0.75,0.80]). EFA identified a two-factor structure, accounting for 27.4% of the total variance. The two-factor model produced good fit indices when item correlated errors were considered (χ2/df = 1.95, GFI = 0.92, CFI = 0.90, PCFI = 0.79, PGFI = 0.73 and RMSEA = 0.04). Female students had a statistically significant higher empathy scores than male students (t (830) = - 4.16, p < .001).
Conclusions: The findings support the construct validity and reliability of a French version of the JSE for medical students. This instrument appears to be useful for investigating empathy among French-speaking populations.
{"title":"Psychometric properties of a French version of the Jefferson Scale of Empathy.","authors":"Mariem Ghardallou, Chekib Zedini, Jihene Sahli, Thouraya Ajmi, Hedi Khairi, Ali Mtiraoui","doi":"10.5116/ijme.62d2.8497","DOIUrl":"https://doi.org/10.5116/ijme.62d2.8497","url":null,"abstract":"<p><strong>Objective: </strong>To assess the reliability and construct validity of a French version of the Jefferson Scale of Empathy-Students.</p><p><strong>Methods: </strong>A cross-sectional study was performed among undergraduate medical students in Tunisia. A total of 833 students completed a French version of the JSE-S using convenience sampling. To identify the internal consistency aspect of the reliability, Cronbach's alpha coefficient was computed. Moreover, to assess the construct validity, the sample was randomly divided into two groups. Data from the first group (n=415) were subjected to exploratory factor analysis (EFA), with principal axing factoring (PAF) and oblimin rotation, to re-examine the underlying factor structure of the scale. Data from the second group (n=419) were used for confirmatory factor analysis (CFA) to confirm its latent variable structure. Some goodness-of-fit indices were used to assess the hypothesized model. Gender groups were compared using a t-test to check the known-group validity.</p><p><strong>Results: </strong>Reliability analysis reported an acceptable level of internal consistency, with an overall Cronbach's alpha of 0.78 (95% CI [0.75,0.80]). EFA identified a two-factor structure, accounting for 27.4% of the total variance. The two-factor model produced good fit indices when item correlated errors were considered (χ<sup>2</sup>/df = 1.95, GFI = 0.92, CFI = 0.90, PCFI = 0.79, PGFI = 0.73 and RMSEA = 0.04). Female students had a statistically significant higher empathy scores than male students (t <sub>(830)</sub> = - 4.16, p < .001).</p><p><strong>Conclusions: </strong>The findings support the construct validity and reliability of a French version of the JSE for medical students. This instrument appears to be useful for investigating empathy among French-speaking populations.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"205-214"},"PeriodicalIF":3.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To explore factors associated with prescribing confidence and competence of final-year medical students for prescribing antiplatelet and fibrinolytic agents in ST-segment elevation myocardial infarction (STEMI).
Methods: The study was conducted among final-year medical students with a triangular convergent mixed-methods approach. First, an online survey was conducted using a voluntary sampling method with concurrent in-depth interviews performed. The survey data was analysed using descriptive statistics and paired t-tests, while survey factors were compared using the chi-squared or Fisher's exact test. The interview data were coded and analysed thematically. The relations between the qualitative and quantitative findings were finally described.
Results: Totally 92 validly replied to the questionnaire, and 20 participated in the interviews. The quantitative analysis indicated that they had high competence in the diagnosis of STEMI and prescribing antiplatelet and fibrinolytic agents. The mean confidence score of prescribing for both was medium and was significantly lower in fibrinolytic agents. (M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t(91)=5.39, p<0.01). Their experience, knowledge, and mentoring were accounted for, considering the prescribing confidence factors in both approaches. Besides, providing guidelines and standing orders were derived from the interview data.
Conclusions: This study has demonstrated that final-year medical students have a high ability to diagnose and prescribe essential medications in STEMI but tend to have low confidence in prescribing fibrinolytic agents. Experiential learning, mentorship and providing guidelines can help them, especially in emergency settings to prescribe confidently and safely. Further multicenter studies on undergraduate and graduate medical students' confidence and perspective of prescribing are required, especially for high-alert medications.
目的探讨与应届医学生在 ST 段抬高型心肌梗死(STEMI)中开具抗血小板和纤溶药物处方的信心和能力相关的因素:本研究采用三角聚合混合方法在医学专业毕业班学生中开展。首先,采用自愿抽样法进行在线调查,同时进行深度访谈。调查数据采用描述性统计和配对 t 检验进行分析,调查因素则采用卡方检验或费雪精确检验进行比较。对访谈数据进行了编码和专题分析。最后描述了定性和定量结果之间的关系:共有 92 人有效回答了问卷,20 人参加了访谈。定量分析显示,他们在诊断 STEMI 和开具抗血小板及纤维蛋白溶解药物处方方面具有很高的能力。开具抗血小板药物和纤维蛋白溶解药物处方的平均信心分数为中等,而开具纤维蛋白溶解药物处方的平均信心分数明显较低。(M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t(91)=5.39, p结论:本研究表明,应届医学生诊断和处方 STEMI 必要药物的能力较高,但对处方纤溶药物的信心不足。经验学习、导师指导和提供指南可以帮助他们,尤其是在急诊环境中自信、安全地开药。需要进一步开展多中心研究,了解医科本科生和研究生对处方的信心和看法,尤其是对高警戒药物的处方。
{"title":"Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study.","authors":"Teeranan Angkananard, Panida Issarasenarak, Pawita Teerawattananon, Maneekarn Kosulawath, Varunrut Samrejphol, Kamolnetr Okanurak","doi":"10.5116/ijme.62c2.c33c","DOIUrl":"10.5116/ijme.62c2.c33c","url":null,"abstract":"<p><strong>Objectives: </strong>To explore factors associated with prescribing confidence and competence of final-year medical students for prescribing antiplatelet and fibrinolytic agents in ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>The study was conducted among final-year medical students with a triangular convergent mixed-methods approach. First, an online survey was conducted using a voluntary sampling method with concurrent in-depth interviews performed. The survey data was analysed using descriptive statistics and paired t-tests, while survey factors were compared using the chi-squared or Fisher's exact test. The interview data were coded and analysed thematically. The relations between the qualitative and quantitative findings were finally described.</p><p><strong>Results: </strong>Totally 92 validly replied to the questionnaire, and 20 participated in the interviews. The quantitative analysis indicated that they had high competence in the diagnosis of STEMI and prescribing antiplatelet and fibrinolytic agents. The mean confidence score of prescribing for both was medium and was significantly lower in fibrinolytic agents. (M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t<sub>(91)</sub>=5.39, p<0.01). Their experience, knowledge, and mentoring were accounted for, considering the prescribing confidence factors in both approaches. Besides, providing guidelines and standing orders were derived from the interview data.</p><p><strong>Conclusions: </strong>This study has demonstrated that final-year medical students have a high ability to diagnose and prescribe essential medications in STEMI but tend to have low confidence in prescribing fibrinolytic agents. Experiential learning, mentorship and providing guidelines can help them, especially in emergency settings to prescribe confidently and safely. Further multicenter studies on undergraduate and graduate medical students' confidence and perspective of prescribing are required, especially for high-alert medications.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"187-197"},"PeriodicalIF":1.6,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10789879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lena Engqvist Boman, Kay Sundberg, Lena-Marie Petersson, Malin Backman, Charlotte Silén
Objectives: To design, apply, evaluate, and analyse a pedagogical model to enhance nurses' ability to create pedagogical encounters to support patients' learning.
Methods: The study relies on an educational design research approach. A pedagogical model based on learning theories was designed, applied, evaluated, and analysed in a specialist nursing programme in cancer care. All students (n=28) who attended the programme accepted to participate in the evaluation of the model. Their perception of the learning activities was evaluated in a questionnaire, and 16 (57%) students responded. The students' learning was assessed in written assignments, including all students. Descriptive statistics, content analysis and theoretical reasoning, were used to analyse data and interpret the usefulness and shortcomings of the model.
Results: The most appreciated learning activities were to study learning theories, observe pedagogical encounters, act as a critical friend, and document one's own pedagogical encounters. The written assignments about observing and performing their own pedagogical encounters with patients showed students' increased awareness of how to support patients' learning. The clinical supervisors' lack of pedagogical knowledge inhibited the feedback on students' performances.
Conclusions: The theoretical analysis of the evaluation identified strengths and needs for further development. The strengths tend to be the ongoing learning process created by learning activities supporting students to continuously study, experience, and apply their knowledge. Nurse supervisors and other stakeholders at the clinics are suggested to be involved in improving the design and require pedagogical competence. Further research should include observational and interview studies related to students' performance in pedagogical encounters.
{"title":"A pedagogical model to enhance nurses' ability to support patient learning: an educational design research study.","authors":"Lena Engqvist Boman, Kay Sundberg, Lena-Marie Petersson, Malin Backman, Charlotte Silén","doi":"10.5116/ijme.62c2.b9c4","DOIUrl":"https://doi.org/10.5116/ijme.62c2.b9c4","url":null,"abstract":"<p><strong>Objectives: </strong>To design, apply, evaluate, and analyse a pedagogical model to enhance nurses' ability to create pedagogical encounters to support patients' learning.</p><p><strong>Methods: </strong>The study relies on an educational design research approach. A pedagogical model based on learning theories was designed, applied, evaluated, and analysed in a specialist nursing programme in cancer care. All students (n=28) who attended the programme accepted to participate in the evaluation of the model. Their perception of the learning activities was evaluated in a questionnaire, and 16 (57%) students responded. The students' learning was assessed in written assignments, including all students. Descriptive statistics, content analysis and theoretical reasoning, were used to analyse data and interpret the usefulness and shortcomings of the model.</p><p><strong>Results: </strong>The most appreciated learning activities were to study learning theories, observe pedagogical encounters, act as a critical friend, and document one's own pedagogical encounters. The written assignments about observing and performing their own pedagogical encounters with patients showed students' increased awareness of how to support patients' learning. The clinical supervisors' lack of pedagogical knowledge inhibited the feedback on students' performances.</p><p><strong>Conclusions: </strong>The theoretical analysis of the evaluation identified strengths and needs for further development. The strengths tend to be the ongoing learning process created by learning activities supporting students to continuously study, experience, and apply their knowledge. Nurse supervisors and other stakeholders at the clinics are suggested to be involved in improving the design and require pedagogical competence. Further research should include observational and interview studies related to students' performance in pedagogical encounters.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"13 ","pages":"176-186"},"PeriodicalIF":3.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10789878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Hierlmeier, A. Prem, Suwarna Anand, A. Lerant, Galina Ostrovsky
Objectives: Demonstrate the feasibility and effectiveness of using the AirSim® Bronchi airway simulator to teach anesthesia residents how to successfully troubleshoot and manage malpositioned double-lumen endotracheal tubes used for single-lung ventilation. Design: Prospective observational study. Setting: Simulation lab in a university-based anesthesiology residency training program. Participants: CA1 (PGY2) anesthesiology residents. Interventions: Each resident was initially tasked with troubleshooting a malpositioned double-lumen tube (DLT) on an AirSim® Bronchi (Trucorp, Craigavon, UK) airway simulator in one of the three positions and was timed on their performance. This first simulation was followed by completion of a survey that assessed the resident’s level of confidence in repositioning a malpositioned DLT. Following the initial simulation, a didactic presentation was given to the residents on the management of malpositioned DLTs using a protocol, followed by a practice session. Two months later, each resident repeated the simulation exercise. A follow-up survey was conducted after each simulation, assessing the quality of the curriculum and subsequent level of confidence in performing the same tasks using a five-point Likert scale. Measurements and Main Results: Ten residents at the University of Mississippi Medical Center completed the simulation exercises and curriculum. The average time it took to troubleshoot the malpositioned DLT during the first simulation was 139 s, with only 30% of the residents correctly identifying the specific malposition and 40% correctly repositioning the DLT after initial malposition. The repeat simulation after two months showed significant improvement in efficiency, with the average time to complete the task decreasing from 139 s to 56 s. During the second simulation exercise, all 10 residents were able to correctly identify the DLT malposition and correctly reposition the DLT to the correct position. Additionally, residents’ confidence levels in managing a malpositioned DLT improved significantly. Initially, 70% of the residents reported a lack of confidence in identifying and correcting a malpositioned DLT, but after the didactic curriculum and simulation training, 100% of the residents reported confidence in completing the task. Conclusions: The AirSim® Bronchi (Trucorp, Craigavon, UK) simulator can be used to effectively teach and evaluate residents on correctly identifying and repositioning a malpositioned DLT. The residents’ performance and level of confidence were evaluated before and after the simulation curriculum. The results reveal that simulation-based training is an effective educational tool for improving clinical performance and confidence in identifying and appropriately managing a malpositioned DLT.
{"title":"Management of Malpositioned Double-Lumen Tubes: A Simulation-Based Training Exercise for Anesthesiology Residents","authors":"B. Hierlmeier, A. Prem, Suwarna Anand, A. Lerant, Galina Ostrovsky","doi":"10.3390/ime1010003","DOIUrl":"https://doi.org/10.3390/ime1010003","url":null,"abstract":"Objectives: Demonstrate the feasibility and effectiveness of using the AirSim® Bronchi airway simulator to teach anesthesia residents how to successfully troubleshoot and manage malpositioned double-lumen endotracheal tubes used for single-lung ventilation. Design: Prospective observational study. Setting: Simulation lab in a university-based anesthesiology residency training program. Participants: CA1 (PGY2) anesthesiology residents. Interventions: Each resident was initially tasked with troubleshooting a malpositioned double-lumen tube (DLT) on an AirSim® Bronchi (Trucorp, Craigavon, UK) airway simulator in one of the three positions and was timed on their performance. This first simulation was followed by completion of a survey that assessed the resident’s level of confidence in repositioning a malpositioned DLT. Following the initial simulation, a didactic presentation was given to the residents on the management of malpositioned DLTs using a protocol, followed by a practice session. Two months later, each resident repeated the simulation exercise. A follow-up survey was conducted after each simulation, assessing the quality of the curriculum and subsequent level of confidence in performing the same tasks using a five-point Likert scale. Measurements and Main Results: Ten residents at the University of Mississippi Medical Center completed the simulation exercises and curriculum. The average time it took to troubleshoot the malpositioned DLT during the first simulation was 139 s, with only 30% of the residents correctly identifying the specific malposition and 40% correctly repositioning the DLT after initial malposition. The repeat simulation after two months showed significant improvement in efficiency, with the average time to complete the task decreasing from 139 s to 56 s. During the second simulation exercise, all 10 residents were able to correctly identify the DLT malposition and correctly reposition the DLT to the correct position. Additionally, residents’ confidence levels in managing a malpositioned DLT improved significantly. Initially, 70% of the residents reported a lack of confidence in identifying and correcting a malpositioned DLT, but after the didactic curriculum and simulation training, 100% of the residents reported confidence in completing the task. Conclusions: The AirSim® Bronchi (Trucorp, Craigavon, UK) simulator can be used to effectively teach and evaluate residents on correctly identifying and repositioning a malpositioned DLT. The residents’ performance and level of confidence were evaluated before and after the simulation curriculum. The results reveal that simulation-based training is an effective educational tool for improving clinical performance and confidence in identifying and appropriately managing a malpositioned DLT.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"39 3 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76064740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}