scholarly journals Teaching diagnostic reasoning: using simulation and mixed practice to build competence

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 142-145 ◽  
Author(s):  
Heather Murray ◽  
Tyson Savage ◽  
Louise Rang ◽  
David Messenger
Keyword(s):  
Medical Students ◽  
Ad Hoc ◽  
Vital Signs ◽  
Diagnostic Reasoning ◽  
Emergency Physicians ◽  
Immediate Feedback ◽  
Clinical Encounters ◽  
The Impact ◽  
Mixed Practice

ABSTRACTThe acquisition of competence in diagnostic reasoning is essential for medical trainees. Exposure to a variety of patient presentations helps develop the skills of diagnostic reasoning, but reliance on ad hoc clinical encounters is inefficient and does not guarantee timely exposure for all trainees. We present a novel teaching series led by emergency physicians that builds upon the existing medical education literature to teach diagnostic reasoning to preclinical (2nd year) medical students. The series used emergency department simulations involving patient actors and simulated vital signs to provide students with exposure to three acute care presentations: chest pain, abdominal pain, and headache. Emergency physicians coached and provided immediate feedback to the students as they actively worked through diagnostic reasoning. The participating medical students reported benefit from these sessions immediately following the sessions and in an 18-month follow-up survey where the students could consider the impact of the sessions on their clinical clerkship. Students felt that the sessions had assisted them in recognizing the key features of relevant diagnoses during clerkship as well as providing a helpful adjunct to their in-class learning.

scholarly journals Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10164
Author(s):  
Ilango Saraswathi ◽  
Jayakumar Saikarthik ◽  
K. Senthil Kumar ◽  
Kumar Madhan Srinivasan ◽  
M. Ardhanaari ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Sleep Quality ◽  
Undergraduate Medical Students ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Self Administered Questionnaire

Background The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.

scholarly journals Anti-stigma training for medical students: The Education Not Discrimination project

2013 ◽  
Vol 202 (s55) ◽  
pp. s89-s94 ◽  
Author(s):  
Bettina Friedrich ◽  
Sara Evans-Lacko ◽  
Jillian London ◽  
Danielle Rhydderch ◽  
Claire Henderson ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Curriculum ◽  
Intervention Group ◽  
Mental Health Stigma ◽  
Control Group ◽  
Short Term ◽  
Study Intervention ◽  
The Impact ◽  
Intended Behaviour

BackgroundEducation Not Discrimination (END) is the component of the Time to Change programme intended to reduce mental health stigma among professionals and professional trainees.AimsTo investigate the impact of the END anti-stigma programme on medical students immediately and after 6 months with regard to knowledge, attitudes, behaviour and empathy.MethodA total of 1452 medical students participated in the study (intervention group n = 1066, control group n = 386).Participants completed questionnaires at baseline, and at immediate and 6-month follow-up. Groups were compared for changes in stigma outcomes.ResultsAll measures improved in both groups, particularly among students with less knowledge and more stigmatising attitudes and intended behaviour at baseline. At immediate follow-up the intervention group demonstrated significantly greater improvements in stigma-related knowledge and reductions in stigma-related attitudes and intended behaviour, relative to the control group. At 6 months' follow-up, however, only one attitude item remained significantly better.ConclusionsAlthough the intervention produced short-term advantage there was little evidence for its persistent effect, suggesting a need for greater integration of ongoing measures to reduce stigma into the medical curriculum.

scholarly journals Transforming Health Experience and Action through Shifting the Narrative on Obesity in Primary Care Encounters

2019 ◽  
Vol 30 (5) ◽  
pp. 730-744
Author(s):  
Thea Luig ◽  
Louanne Keenan ◽  
Denise L. Campbell-Scherer
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Everyday Life ◽  
Significant Role ◽  
Clinical Encounters ◽  
Narrative Perspective ◽  
The Impact

We sought to understand the impact of primary care conversations about obesity on people’s everyday life health experience and practices. Using a dialogic narrative perspective, we examined key moments in three very different clinical encounters, the patients’ journals, and follow-up interviews over several weeks. We trace how people living with obesity negotiate narrative alternatives that are offered during clinical dialogue to transform their own narrative and experience of obesity and self. Findings provide pragmatic insights into how providers can play a significant role in shifting narratives about obesity and self and how such co-constructed narratives translate into change and tangible health outcomes in people’s lives.

scholarly journals 21 Suture School: A Socially Distanced Surgical Education

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Galloway ◽  
H Amar ◽  
V Panchalingham
Keyword(s):  
Medical Students ◽  
Small Group ◽  
Surgical Skills ◽  
Small Group Teaching ◽  
Knot Tying ◽  
Innovative Teaching ◽  
Informal Assessment ◽  
Surgical Career ◽  
The Impact

Abstract Introduction Limited theatre exposure, cancelled practical teaching and placements abandoned due to COVID-19, has potential to damage the learning opportunities and experiences of medical students within surgery. We aimed to create and deliver an emergency small group teaching programme throughout the pandemic, targeted at increasing medical student confidence in basic surgical skills and inspiring interest in surgery. Method Multiple small-group teaching sessions were delivered to a cohort of 14 medical students recruited for work during the pandemic, whilst adhering to social distancing and sanitary measures. On completion of the programme and informal assessment of 11 surgical competencies, participants completed a follow up questionnaire to assess their improvement. Results 70% reported improvement in 10 competencies and 30% across all 11 competencies. The greatest improvements were in abscess drainage and knot tying. 30% relayed increased interest in pursuing a surgical career. 80% were ‘more likely’ to attend theatres in future. Conclusions The teaching series facilitated increase in self-perceived confidence of students in basic surgical skills, whilst inspiring surgical interests. During challenging times, we must support learners to undertake activity that drives improvement in training for the wider benefit of health services. Innovative teaching programmes may reduce the impact of similar adversity in the future.

scholarly journals Chinese medical students’ disposition for critical thinking: a mixed methods exploration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Huang ◽  
Angela Pei-Chen Fan ◽  
Na Su ◽  
Jessica Thai ◽  
Russell Olive Kosik ◽  
...  
Keyword(s):  
Medical Education ◽  
Critical Thinking ◽  
Longitudinal Study ◽  
Medical Students ◽  
Medical Training ◽  
Cross Sectional ◽  
Chinese Medical Students ◽  
One Year ◽  
The Impact

Abstract Background Critical thinking (CT) is an essential competency for medical students. This study’s aim was to evaluate Chinese medical students’ disposition for CT and to explore the impact of current trends in medical education on students’ CT development. Methods We used multistage stratified cluster sampling to recruit a total of 1241 medical students among five different years of training and from three medical institutions in China. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and self-reported information were used to collect cross-sectional data. Based on the data from the CTDI-CV, 112 medical students in clinical course training from a single institution continued one-year follow-up. Their one-year CTDI-CV score changes were collected regarding various medical education variables. Results The mean CTDI-CV score of the 1241 medical students was 287.04 with 729 (58.7%) students receiving a score of 280 or higher. There were statistically significant differences in schools attended(F = 3.84, P < 0.05), year of school attended(F = 10.32, P < 0.001), GPA(F = 6.32, P < 0.01), weekly time spent learning after class(F = 14.14, P < 0.001), attitude toward medicine(F = 28.93, P < 0.001), desire to be a doctor after graduation(t = − 3.35, P < 0.001), familiarity with CT(F = 20.40, P < 0.001), and perception of importance of CT(F = 22.25, P < 0.001). The participants scored the highest on the CTDI-CV subscales of “inquisitiveness” and the lowest on “truth seeking.” The 112 students in the longitudinal study had significantly lower total CT scores after one academic year follow-up. Conclusions Chinese medical students generally exhibited positive CT dispositions. The cross-sectional survey and one-year longitudinal study indicated that students’ CT disposition diminished as they progressed through traditional medical training. Our study contributes to understanding the status of Chinese medical education of and influential factors on medical students’ CT disposition.

scholarly journals One size doesn’t fit all: framework and resources for individualized interventions for struggling medical students

MedEdPublish ◽  
2021 ◽  
Vol 11 ◽  
pp. 4
Author(s):  
Karina R. Clemmons ◽  
Jasna Vuk ◽  
Nicole Sullivan
Keyword(s):  
Academic Success ◽  
Medical Students ◽  
Medical School ◽  
Academic Support ◽  
Support Strategies ◽  
School Faculty ◽  
The Impact ◽  
Life Career

When helping struggling medical students, a “one size fits all” approach is often ineffective, as many different factors affect academic success. In our experience, these factors may overlap or be distinct for each student, and thus require individualized interventions based on student needs. We recommend an individualized model of academic support includes an intake interview, assessment, individualized interventions, and follow up to assess progress. This paper provides a recommended framework of resources for medical school faculty and staff who work with struggling students. Different issues that lead students to struggle are categorized in the main domains of Bloom’s taxonomy: cognitive, affective, and psychomotor. A discussion of the impact of the factors in each domain includes detailed tables with corresponding manifestations, assessments, and support strategies literature for each issue. An application of a proposed framework is presented on a case example. Individualized approaches to improving medical student success are presented to address the complex and interrelated areas of academic success, wellbeing, quality of life, career potential, and satisfaction with medical school.

scholarly journals Neonatal appendicitis: a survival case study

2017 ◽  
Vol 70 (6) ◽  
pp. 1296-1300 ◽  
Author(s):  
Izabela Linha Secco ◽  
Taine Costa ◽  
Etiene Letícia Leone de Moraes ◽  
Márcia Helena de Souza Freire ◽  
Mitzy Tannia Reichembach Danski ◽  
...  
Keyword(s):  
Medical Records ◽  
Vital Signs ◽  
Human Beings ◽  
Neonatal Appendicitis ◽  
Clinical Surveillance ◽  
The Impact ◽  
Early Surgical Intervention ◽  
Survival Case

ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

Supporting Medical Students To Support Peers: A Qualitative Interview Study

2021 ◽  
Author(s):  
Jane Graves ◽  
Eleanor Flynn ◽  
Robyn Woodward-Kron ◽  
Wendy C.Y. Hu
Keyword(s):  
Medical Students ◽  
Peer Support ◽  
Ad Hoc ◽  
Support Programs ◽  
Future Research ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Role Boundaries ◽  
Support Relationships ◽  
The Impact

Abstract BackgroundStudents may be the first to recognise and respond to psychological distress in other students. Peer support could overcome medical student reluctance to seek help despite their high rates of mental ill-health. Yet, despite the adoption of peer support programs, there is little evidence of impact on students. Peer support programs may assume that medical students accept and view peer support positively. We explored these assumptions by asking students about their experiences and views on peer support. MethodsQualitative semi-structured interviews exploring peer support experiences and views on peer support were conducted with ten medical students at two contrasting medical schools. Informed by a constructivist stance, interview transcripts underwent thematic analysis. ResultsThree groups of themes were identified: participants’ experiences of peer support encounters, concerns about providing support, and views on students’ roles in peer support. Participants readily recalled signs of peer distress. Encounters were ad hoc, informal, and occurred within relationships based on friendship or by being co-located in the same classes or placements. Concerns about initiating and offering support included lack of expertise, maintaining confidentiality, stigma from a mental health diagnosis, and unclear role boundaries, with implications for acceptance of student roles in peer support. Conclusions: Our study emphasised the centrality of social relationships in enabling or discouraging peer support. Relationships developed during medical studies may anticipate the collegial relationships between medical professionals. Nevertheless, only some students are willing to undertake peer support roles. We suggest different strategies for promoting informal peer support that can be offered by any student, to those promoting formal support roles for selected students. Future research focusing on the impact for both the students who receive, and on the students who provide peer support is called for.

scholarly journals Hand Hygiene Practices in Medical Students: A Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sajad Ahmad Salati ◽  
Azzam Al Kadi
Keyword(s):  
Medical Students ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
World Health ◽  
Improve Hand Hygiene ◽  
Follow Up Study ◽  
Hygiene Practices ◽  
Hygiene Compliance ◽  
The Impact

Objective. The study was conducted to study the impact of various measures instituted to improve hand hygiene practices of the medical students after having documented poor hand hygiene awareness and compliance in a study conducted in 2012. Methods. A self-designed questionnaire based on World Health Organization’s concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications of hand hygiene. Compliance was observed during Objective Structured Clinical Examination (OSCE) sessions. Fifty-one students participated voluntarily in the study. Results. The awareness and compliance of hand hygiene among the medical students in 2014 had shown statistically significant improvement (P<0.005) as compared to figures of the study conducted in 2012. Conclusion. Dedicated multifaceted intervention can improve the hand hygiene practices in medical students.

scholarly journals Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial

2021 ◽  
Vol 41 (3) ◽  
pp. 329-339
Author(s):  
Antonius Schneider ◽  
Markus Bühner ◽  
Therese Herzog ◽  
Siona Laverty ◽  
Stefanie Ziehfreund ◽  
...  
Keyword(s):  
Family Medicine ◽  
Educational Intervention ◽  
Diagnostic Tests ◽  
Controlled Trial ◽  
Diagnostic Reasoning ◽  
Significant Group ◽  
Significant Group Difference ◽  
The Impact ◽  
Family Medicine Residents

Objective Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents’ (FMRs’) intention to request diagnostic tests and their attitudes toward uncertainty. Methods Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive “dealing with uncertainty” seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians’ Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. Results In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( P = 0.006). The Diagnostic Reasoning scale increased significantly ( P = 0.025) without a significant group difference ( P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( P = 0.029) without a significant group difference ( P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. Conclusion The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.

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