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Leadership Training in Undergraduate Medical Education: A Systematic Review 本科医学教育中的领导能力培养:系统回顾
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1717
Mallory Evans, E. James, Misa Mi
Background: This review seeks to characterize existing curricular interventions implemented to develop leadership skills in undergraduate medical students at LCME-accredited medical schools and elucidate best practices for leadership curriculum development.Methods: PRISMA guidelines were used to guide the review. Comprehensive literature searches of five databases retrieved peer-reviewed journal articles with empirical data published in English. Two phases of screening were conducted to identify studies describing leadership development curricular interventions, followed by data extraction and synthesis.Results: Comprehensive literature searching and hand searching identified 977 articles potentially eligible for inclusion, with a final set of 16 articles selected for the review. A majority of the leadership development programs targeted preclinical students, while others spanned the entire curriculum. "Mixed settings," including both classroom and clinical and community components were common. There was a wide range of cohort sizes spanning from over 100 students to fewer than 10. Using the competencies defined by Mangrulkar et al, we determined that all of the programs described leadership skills development, including conflict management and emotional intelligence. Out of the 16 selected studies, curricula that emphasized the development of skills were evidence-based medicine and practice, and 6 curricula targeted interprofessionalism.Conclusions: Leadership development needs to be standardized in undergraduate medical education, ideally using a competency-based framework to develop these standards. Longitudinal programs that had a didactic and project-based component received consistently high quality and effectiveness scores, as did programs with smaller cohort sizes that received more consistent mentorship and monetary investment from institutions.
背景:本综述旨在描述lcme认可的医学院为培养本科医学生领导技能而实施的现有课程干预措施,并阐明领导力课程开发的最佳实践。方法:采用PRISMA指南进行综述。综合文献检索五个数据库检索同行评议的期刊文章与经验数据发表在英文。筛选进行了两个阶段,以确定描述领导力发展课程干预的研究,随后是数据提取和综合。结果:综合文献检索和人工检索确定了977篇可能符合纳入条件的文章,最终选择了16篇文章进行综述。大多数领导力发展项目针对临床前学生,而其他项目则涵盖整个课程。“混合环境”,包括课堂、临床和社区组成部分是很常见的。学员人数从100人以上到不足10人不等。使用Mangrulkar等人定义的能力,我们确定所有的项目都描述了领导技能的发展,包括冲突管理和情商。在16个选定的研究中,强调技能发展的课程是循证医学和实践,6个课程是针对专业间性的。结论:领导力发展需要在本科医学教育中标准化,理想情况下使用基于能力的框架来制定这些标准。具有教学和基于项目的组成部分的纵向项目获得了一致的高质量和有效性得分,同样,较小的队列规模的项目也获得了来自机构的更一致的指导和资金投资。
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引用次数: 2
Contamination of Clinical White Coats with Potential Pathogens and their Antibiotic Resistant Phenotypes Among a Group of Sri Lankan Medical Students 在一组斯里兰卡医科学生中,临床白大褂与潜在病原体的污染及其抗生素耐药表型
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1856
Harshana Daraniyagala, Omesh Dahanayake, Amila Dasanayake, Pramod Dayarathna, Sevwandi Dayarathna, Kusal Dayasiri, Devmini De Silva, Sachie De Silva, Nipuni De Silva, Dinushi De Silva, D. De Zoysa, Rasadani Dissanayake, A. Ekanayake, G. Vidanapathirana, V. Liyanapathirana
Background: Clinical white coats worn by the medical students can be contaminated at hospitals and act as a potential reservoir for pathogens including antibiotic-resistant bacteria. This study aimed to identify the contamination rates of clinical white coats worn by medical students with selected potential pathogens and their antibiotic resistant phenotypes.Methods: A cross-sectional study was done among 151 4th year medical students of Faculty of Medicine, University of Peradeniya, Sri Lanka in September 2020. The participants belonged to two batches undergoing clinical training at two settings. Swabs from pockets and sleeves of the clinical white coats were taken. Potential pathogens and their resistant phenotypes were identified with routine tests.Results: Fifty-three participants (35.1%) had coats contaminated with Staphylococcus aureus; 15 (9.9%) had coats contaminated with Methicillin-Resistant S.aureus (MRSA).  One Enterobacterales (0.7%) was an AmpC producer.  Enterococcus species were isolated from 19 (12.6%) coats and 2 (1.3%) had coats contaminated with vancomycin resistant enterococci.  Molecular testing on the MRSA isolates identified that 5(20%) of the MRSA isolates were PVL positive while all were mecA positive. Sex, type of clinical appointment, and frequency of washing white coats were not associated with contamination. The “batch” was significantly associated with contamination with S.aureus and Enterococcus species. Conclusions: We found that clinical white coats worn by medical students recruited for the study were contaminated with S.aureus, MRSA and Enterococcus species. There was a notably high-rate of contamination with S. aureus.  All MRSA isolates were mecA positive while the rate of PVL positivity was low.
背景:医学生所穿的临床白大褂可能在医院被污染,并成为包括耐药细菌在内的病原体的潜在储存库。本研究旨在确定医学生穿着的临床白大褂与选定的潜在病原体及其抗生素耐药表型的污染率。方法:于2020年9月对斯里兰卡Peradeniya大学医学院151名四年级医学生进行横断面研究。参与者分两批在两种环境下接受临床培训。从临床白大褂的口袋和袖子中取出棉签。通过常规检测确定潜在病原体及其耐药表型。结果:53人(35.1%)大衣感染金黄色葡萄球菌;15例(9.9%)感染耐甲氧西林金黄色葡萄球菌(MRSA)。1个肠杆菌(0.7%)是AmpC产生菌。19例(12.6%)被检出肠球菌,2例(1.3%)被万古霉素耐药肠球菌污染。分子检测结果显示,5株(20%)MRSA分离株PVL阳性,全部为mecA阳性。性别、临床预约类型和洗白大褂的频率与污染无关。“批次”与金黄色葡萄球菌和肠球菌污染显著相关。结论:我们发现参与研究的医学生所穿的临床白大褂被金黄色葡萄球菌、MRSA和肠球菌污染。金黄色葡萄球菌的污染率明显很高。所有MRSA分离株均为mecA阳性,PVL阳性率低。
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引用次数: 1
Women in Science: A Student Workshop at a University in Mexico 科学中的女性:墨西哥一所大学的学生研讨会
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1435
Daniela C. González Cruz, Sofía Jezzini Martínez, Paloma Calafia Leyva Camacho, Ilse Janeth De la Rosa-Rodríguez, Andrea Flores Rodríguez, Karina Raygoza Cortez, Mariana García Leal
Women have participated in science since the earliest of times. However, their valuable contributions are not as widely acknowledged throughout our history and women still face several barriers throughout their professional career. We developed and hosted a half-day Women in Science seminar organized by students, for students. The main goal was to promote ways to involve more women in research activities and to strengthen the scientific community within our medical school. The workshop consisted of three main sections, where we shared relevant statistics, resources, and strategies among a community of students interested in science. At the end of the workshop, participants shared their insights proving the necessity and utility of such events to strengthen the development of science as an inclusive field.
自古以来,妇女就参与了科学研究。然而,她们的宝贵贡献在我们的整个历史中并没有得到广泛承认,女性在整个职业生涯中仍然面临着一些障碍。我们开发并举办了一个由学生组织的为期半天的女性参与科学研讨会。主要目标是促进让更多妇女参与研究活动的方式,并加强我们医学院内的科学界。研讨会由三个主要部分组成,我们在对科学感兴趣的学生社区中分享相关的统计数据、资源和策略。在研讨会结束时,与会者分享了他们的见解,证明了这些活动对加强科学作为一个包容性领域的发展的必要性和实用性。
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引用次数: 1
“Passengers, May I Have Your Attention Please...” – The Airport Diaries of Young COVID-19 Warriors “乘客们,请注意……——《COVID-19年轻勇士机场日记》
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1627
Shweta Gajare, Alhad Mulkalwar
This article summarizes the novel experiences of a team of medical interns posted at Chhatrapati Shivaji Maharaj International Airport, Mumbai in the midst of the COVID-19 Pandemic. The authors describe the protocols, guidelines, duties and procedures that were to be followed while deputed to screen the incoming international passengers for possible exposure and symptoms of coronavirus. For the young healthcare workers, in the early days of their internship, being a part of this team was no less than a roller coaster ride. From anxiety and excitement to fatigue and crippling exhaustion, the authors narrate their ordeal as young COVID warriors on duty. 
本文总结了2019冠状病毒病大流行期间,在孟买贾特拉帕蒂·希瓦吉·马哈拉杰国际机场工作的医疗实习生团队的新奇经历。作者描述了在筛选入境国际旅客可能接触冠状病毒和出现冠状病毒症状时应遵循的协议、指导方针、职责和程序。对于年轻的医护人员来说,在他们实习的早期,作为这个团队的一员,不亚于乘坐过山车。从焦虑和兴奋到疲劳和极度疲惫,作者讲述了他们作为值班的年轻COVID战士的磨难。
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引用次数: 1
Hypercoagulability and Cavernous Sinus Thrombosis due to Protein C Deficiency. A Case Report 蛋白C缺乏引起的高凝和海绵窦血栓形成。病例报告
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1660
Wilson S. Peñafiel-Pallares, Camila Brito-Balanzátegui, Jaime David Acosta-España
Background: Thrombophilia due to Protein C deficiency is a rare condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to life-threatening superinfections. Case: A 51-year-old woman presented with pressing frontal headache accompanied with left periorbital edema, fever, diplopia, and disorientation. Laboratory findings showed low protein C levels. Computed tomography demonstrated sphenoidal rhinosinusitis. Magnetic resonance venography revealed cavernous sinus thrombosis. The patient was started on empiric antibiotic treatment (vancomycin, ceftriaxone, and metronidazole) and anticoagulants. Conclusion: This case report emphasizes the importance of early diagnosis and appropriate management of patients with protein C deficiency complicated by septic cavernous sinus thrombosis. Background: Thrombophilia due to Protein C deficiency is a rare condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to life-threatening superinfections. Case: A 51-year-old woman presented with pressing frontal headache accompanied with left periorbital edema, fever, diplopia, and disorientation. Laboratory findings showed low protein C levels. Computed tomography demonstrated sphenoidal rhinosinusitis. Magnetic resonance venography revealed cavernous sinus thrombosis. The patient was started on empiric antibiotic treatment (vancomycin, ceftriaxone, and metronidazole) and anticoagulants. Conclusion: This case report emphasizes the importance of early diagnosis and appropriate management of patients with protein C deficiency complicated by septic cavernous sinus thrombosis.
背景:蛋白C缺乏引起的血栓形成是一种罕见的疾病,约占总人口的0.2%。成人脑静脉血栓的发病率为百万分之3-4例。两者的结合是非常罕见的。患有这些疾病的患者容易发生危及生命的重复感染。病例:一名51岁女性,表现为紧张性额部头痛,并伴有左眶周水肿、发热、复视和定向障碍。实验室结果显示蛋白C水平较低。计算机断层扫描显示蝶窦性鼻窦炎。磁共振静脉造影显示海绵窦血栓形成。患者开始经验性抗生素治疗(万古霉素、头孢曲松和甲硝唑)和抗凝血药物。结论:本病例报告强调了蛋白C缺乏合并脓毒性海绵窦血栓形成的早期诊断和适当处理的重要性。背景:蛋白C缺乏引起的血栓形成是一种罕见的疾病,约占总人口的0.2%。成人脑静脉血栓的发病率为百万分之3-4例。两者的结合是非常罕见的。患有这些疾病的患者容易发生危及生命的重复感染。病例:一名51岁女性,表现为紧张性额部头痛,并伴有左眶周水肿、发热、复视和定向障碍。实验室结果显示蛋白C水平较低。计算机断层扫描显示蝶窦性鼻窦炎。磁共振静脉造影显示海绵窦血栓形成。患者开始经验性抗生素治疗(万古霉素、头孢曲松和甲硝唑)和抗凝血药物。结论:本病例报告强调了蛋白C缺乏合并脓毒性海绵窦血栓形成的早期诊断和适当处理的重要性。
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引用次数: 0
De-Epithelialization Protocol with Tapered Sodium Dodecyl Sulfate Concentrations Enhances Short-Term Chondrocyte Survival in Porcine Chimeric Tracheal Allografts 锥形十二烷基硫酸钠去上皮化方案可提高猪嵌合气管同种异体移植软骨细胞的短期存活
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1437
K. X. Zhou, F. Aoki, Alba Marin, G. Karoubi, S. Haykal, Thomas K. Waddell
Background: Tracheal transplantation is indicated in cases where injury exceeds 50% of the organ in adults and 30% in children. However, transplantation is not yet considered a viable treatment option partly due to high morbidity and mortality associated with graft rejection. Recently, decellularization (decell) has been explored as a technique for creating bioengineered tracheal grafts. However, risk of post-operative stenosis increases due to the death of chondrocytes, which are critical to maintain the biochemical and mechanical integrity of tracheal cartilage. In this project, we propose a new de-epithelialization protocol that adequately removes epithelial, mucosal, and submucosal cells while maintaining a greater proportion of viable chondrocytes.Methods: The trachea of adult male outbred Yorkshire pigs were extracted, decontaminated, and decellularized according to the original and new protocols before incubation at 37 °C in DMEM for 10 days. Chondrocyte viability was quantified immediately following post-decellularization and on days 1, 4, 7, and 10. Histology was performed pre-decellularization, post-decellularization, and post-incubation.Results: The new protocol showed a significant (p < 0.05) increase in chondrocyte viability up to four days after de-ep when compared to the original protocol. We also found that the new protocol preserves ECM composition to a similar degree as the original protocol. When scaffolds created using the new protocol were re-epithelialized, cell growth curves were near identical to published data from the original protocol.Conclusion: While not without limitations, our new protocol may be used to engineer chimeric tracheal allografts without the need for cartilage regeneration.
背景:气管移植适用于成人器官损伤超过50%和儿童器官损伤超过30%的病例。然而,移植尚未被认为是一种可行的治疗选择,部分原因是与移植排斥相关的高发病率和死亡率。近年来,脱细胞(decell)已被探索作为一种技术来创建生物工程气管移植物。然而,由于软骨细胞的死亡,术后狭窄的风险增加,而软骨细胞对于维持气管软骨的生化和机械完整性至关重要。在这个项目中,我们提出了一种新的去上皮化方案,充分去除上皮、粘膜和粘膜下细胞,同时保持更大比例的活软骨细胞。方法:取成年公杂种约克郡猪气管,按原方案和新方案进行净化和脱细胞处理,37℃DMEM孵育10 d。在脱细胞后和第1、4、7和10天立即定量软骨细胞活力。分别进行脱细胞前、脱细胞后和孵育后的组织学观察。结果:与原始方案相比,新方案显示软骨细胞活力在deep -ep后4天显著(p < 0.05)增加。我们还发现,新协议保留了与原始协议相似的ECM组成。当使用新方案创建的支架被重新上皮化时,细胞生长曲线与原始方案发表的数据几乎相同。结论:虽然并非没有局限性,但我们的新方案可用于设计嵌合气管同种异体移植物,而无需软骨再生。
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引用次数: 1
Navigating Research Enthusiasm in Medical Students Towards Clinically Impactful Articles 引导医学生对临床影响文章的研究热情
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1668
Muhammad Abdul-Qadeer, Danish Ramesh, Samar Mahmood
Learning medical research is an integral part of the development of a holistic physician. Though, not all physicians become clinician-scientists, those who do become enjoy significant privileges over their clinician-only counterparts, mainly in terms of faster career progression and higher employability. Though, to produce more well-rounded clinician-scientists, academic physicians and medical scientists need to make themselves available and be willing to work with and mentor medical students. Besides, a curriculum reform is warranted where students should be encouraged to start learning and conducting research in their first year of medical school. To make the process even easier and help scale these ideas, students should be encouraged to replicate previous highly cited studies, as they can provide a walkthrough for students to follow, thereby necessitating lesser supervision while maintaining the clinical impact that can be made with their time and effort.
学习医学研究是一个整体医生发展的一个组成部分。虽然不是所有的医生都能成为临床科学家,但那些成为临床科学家的人比那些只做临床医生的同行享有更大的特权,主要是在更快的职业发展和更高的就业能力方面。尽管如此,为了培养出更全面的临床科学家,学术医师和医学科学家需要让他们自己愿意与医学生一起工作和指导医学生。此外,有必要进行课程改革,鼓励学生在医学院的第一年开始学习和进行研究。为了使这个过程更容易,并帮助扩展这些想法,应该鼓励学生重复以前高引用的研究,因为他们可以为学生提供一个演练,从而需要较少的监督,同时保持他们的时间和努力可以产生的临床影响。
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引用次数: 1
Global Needs and Barriers for Medical Research Education: Initiatives to Solve the Physician-Scientist Shortage. 医学研究教育的全球需求与障碍:解决医生-科学家短缺问题的倡议。
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.2011
Marc R Schneider, Abdelrahman M Makram, Esther Bassey, Mihnea-Alexandru Găman, Ciara Egan, Juan C Puyana, Francisco J Bonilla-Escobar
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引用次数: 0
Medical Students’ Attitudes and Influential Factors Towards Conducting Medical Research 医学生对医学研究的态度及影响因素
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1667
Bassam AlRajhi, Ibrahim Omer, Reema Abualnaja, Faisal Alqahtani, Alqassem Y. Hakami
Background: Medical research has become an essential part of medical students’ curricula at several medical colleges in Saudi Arabia. This study aimed to assess medical students' attitudes and identify factors influencing their willingness to conduct medical research. Methods: This cross-sectional study was conducted between December 2021 and April 2022 using the students' attitudes towards research and the students’ perceived influential factors toward participating in research activities questionnaires. A 5-Likert scale to calculate the average of the students’ responses, where 5 indicated ‘strongly agree’ and 1 indicated ‘strongly disagree’. The survey was distributed to medical students at the College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia. Results: A total of 500 responses were collected from the students (67.2% male and 32.8% female). Most students agreed with the following statement: ‘Research is important for identifying and investigating problems in a subject matter’ (N=399, 79.8%). More than half of the students agreed with the following statement: ‘I am very interested in participating in research activities at the undergraduate level’ (N=318, 63.6%). The top three influential factors for conducting medical research were ‘to facilitate entry into competitive residency programs’, followed by ‘interest in specific research fields or medical topics’ and ‘to improve curriculum vitae (CV).’ Conclusion: The majority of the surveyed students showed a positive attitude towards conducting medical research in King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia. Most students conduct research to gain a competitive edge and explore specialties of interest.
背景:医学研究已成为沙特阿拉伯几所医学院医学生课程的重要组成部分。本研究旨在评估医学生对医学研究的态度,并找出影响医学生进行医学研究意愿的因素。方法:在2021年12月至2022年4月期间,采用学生对研究的态度和学生对参与研究活动的感知影响因素问卷进行横断面研究。用5-李克特量表计算学生回答的平均值,其中5表示“非常同意”,1表示“非常不同意”。该调查已分发给沙特阿拉伯沙特国王本阿卜杜勒阿齐兹健康科学大学医学院(ksauu - hs)的医科学生。结果:共收集问卷500份,男生占67.2%,女生占32.8%。大多数学生同意以下说法:“研究对于确定和调查主题中的问题很重要”(N=399, 79.8%)。超过一半的学生同意以下陈述:“我对参与本科阶段的研究活动非常感兴趣”(N=318, 63.6%)。进行医学研究的前三大影响因素是“便于进入有竞争力的住院医师项目”,其次是“对特定研究领域或医学主题的兴趣”和“改善简历”。结论:大多数被调查的学生对在沙特阿拉伯国王本阿卜杜勒阿齐兹健康科学大学进行医学研究持积极态度。大多数学生进行研究是为了获得竞争优势和探索感兴趣的专业。
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引用次数: 0
Beck’s Depression Inventory II Suicidal Ideation in Medical Students – Prevalence and Associated Factors 贝克抑郁量表II医学生自杀意念-患病率及相关因素
Pub Date : 2023-03-31 DOI: 10.5195/ijms.2023.1434
Lea Keuch, L. Pukas, Nadja Rabkow, E. Ehring, Tordis Kindt, C. Rehnisch, Angelina Pelzer, Patricia Lamlé, S. Watzke
Background: Suicide is the second leading cause of death in 15- to 29-year-olds in Germany. Studies have shown that compared to the general population students are more affected by suicidal ideation, as one major indicator of an attempted suicide. This effect is observed all over the world, interestingly, it is also true for physicians. Therefore, we investigated whether medical students are at an even higher risk than their peers to develop suicidal ideation.Methods: N=1,103 medical students at a German university completed a self-reporting survey investigating socio-demographic, potential risk, and protective factors. The Beck’s Depression Inventory (BDI)-II Item 9 “Suicidality“ served as the dependent variable.Results: N=130 students (11.8% of the total sample) reported suicidal ideation within the last two weeks. Stepwise computed logistic regression models including all potential risk factors resulted in 40% explained variance. The most significant independent risk factors were the BDI-score, usage of tranquilizers, feeling lonely, insufficient time for hobbies and prior personal mental health issues, whereas focus enhancing drugs showed to be the only independent protective predictor. The BDI-II score correlated positively with the number of students suffering from suicidal ideation.Conclusion: The prevalence of suicidal ideation in our sample medical student population exceeds that of the general population greatly, confirming existing data and emphasizing the need to raise awareness and establish prevention programs.
背景:自杀是德国15- 29岁人群死亡的第二大原因。研究表明,与一般人群相比,学生更容易受到自杀意念的影响,这是企图自杀的一个主要指标。这种效应在世界各地都能观察到,有趣的是,对医生来说也是如此。因此,我们调查医学生是否比他们的同龄人有更高的产生自杀意念的风险。方法:德国一所大学的1103名医学生完成了一项自我报告调查,调查了社会人口统计学、潜在风险和保护因素。贝克抑郁量表(BDI)-II第9项“自杀倾向”为因变量。结果:N=130名学生(占总样本的11.8%)在最近两周内有自杀意念。逐步计算的逻辑回归模型包括所有潜在的危险因素,导致40%的解释方差。最显著的独立危险因素是bdi评分、使用镇定剂、感到孤独、没有足够的时间从事业余爱好和先前的个人心理健康问题,而注意力增强药物是唯一的独立保护预测因子。BDI-II得分与有自杀意念的学生人数呈正相关。结论:在我们的样本医学生人群中,自杀意念的患病率大大超过一般人群,证实了现有数据,并强调了提高认识和建立预防方案的必要性。
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引用次数: 1
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International journal of medical students
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