Palliative care in medical practice: medical students' expectations

ObjectivesDuring their careers, all doctors will be involved in the care of the dying, and this is likely to increase with current demographic trends. Future doctors need to be well-prepared for this. Little is known about medical students’ expectations about providing palliative care. Our aim was to investigate how satisfying students expect palliative care to be, and any attitudes towards palliative care associated with a negative expectation.MethodsFifteen UK medical schools participated in the study, with 1898 first and final year students completing an online questionnaire which investigated how satisfying they expect providing palliative care to be and their attitudes towards palliative care.ResultsAt both the beginning and end of their training, a significant proportion of students expect palliative care to be less satisfying than other care (19.3% first year, 16% final year). Students expecting palliative care to be less satisfying were more likely to be men, and their attitudes suggest that while they understand the importance of providing palliative care they are concerned about the potential impact of this kind of work on them personally.ConclusionsMedical student education needs to address why palliative care is important and how to deliver it effectively, and the strategies for dealing positively with the impact of this work on future clinicians.

Download Full-text

Replicating Anatomical Teaching Specimens using 3D Modelling Embedded within a Multimodal E-Learning Course: A Pre/Post Study Exploring the Impact on Medical Education during COVID-19 (Preprint)

10.2196/preprints.30533 ◽

2021 ◽

Author(s):

Chelsea Stunden ◽

Sima Zakani ◽

Avery Martin ◽

Shreya Moodley ◽

John Jacob

Keyword(s):

Medical Students ◽

Learning Outcomes ◽

Test Scores ◽

Student Attitudes ◽

Congenital Heart ◽

Secondary Outcome ◽

First Year ◽

Undergraduate Medical Students ◽

E Learning ◽

The Impact

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal way of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects. OBJECTIVE To assess if a multimodal e-learning course contributed to learning outcomes in a cohort of first year undergraduate medical students study congenital heart diseases. Secondarily, we assess student attitudes and experiences associated with multimodal e-learning. METHODS The pre/post study design involved 290 first year undergraduate medical students. Recruitment was conducted through the course instructors. Data were collected before using the course and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcome included attitudes and experiences, as well as time to complete the modules, and browser metadata. RESULTS A total of 141 students were included in the final analysis (N=141). Students’ knowledge significantly improved by an average of 44.6% when using the course (SD 1.73, Z = -10.287, p < 0.001). 88.26% of students were highly motivated to learn with the course and 93.5% of students reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs = 0.687, p<0.001, N = 122). There were no relationships found between change test scores and attitudes or experiences (p>0.05). Students most frequently completed the e-learning course with Chrome (77.3%), and on Apple MacOS (61.0%) or Windows 10 (36.9%). Most students had devices with high-definition screens (83.0%). Most students (58.9%) completed the course in under 3 hours. CONCLUSIONS Multi-modal e-learning could be a viable solution to improving learning outcomes and experiences for undergraduate medical students, who do not have access to cadavers. Future research should focus on validating long-term learning outcomes. CLINICALTRIAL n/a

Download Full-text

Student engagement and higher order skill proficiency: a comparison of traditional didactic and renewed integrated active learning curricula

AJP Advances in Physiology Education ◽

10.1152/advan.00149.2018 ◽

2018 ◽

Vol 42 (4) ◽

pp. 685-692 ◽

Cited By ~ 1

Author(s):

Mari K. Hopper ◽

Daniela A. Brake

Keyword(s):

Student Engagement ◽

Medical Students ◽

Active Learning ◽

Medical School ◽

Curriculum Reform ◽

Higher Order ◽

Poor Correlation ◽

First Year ◽

Cohort Groups ◽

The Impact

A large, multicampus, public medical school underwent curricular renewal, emphasizing a student-centered approach with 50% of all course contact time devoted to active learning. Determining the impact of active learning on student engagement and higher order skill (HOS) proficiency was the primary aim of this study. Following Institutional Review Board approval, two cohort groups of first-year medical students were enrolled. The first cohort ( n = 54) included students before curriculum reform in the legacy curriculum (LC). The second cohort ( n = 73) included students completing studies in the renewed curriculum (RC). Near the end of the first year of medical school, both cohorts completed a validated survey of student engagement, and a proctored problem-based assessment of HOS proficiency [Collegiate Learning Assessment (CLA+)]. Results indicated RC students perceived greater levels of engagement than LC (39.5+5.8 vs. 33.3+5.6), and greater reliance on HOS, including analysis, synthesis, and application. However, there were no significant differences between cohorts in proficiency of HOS when assessed by the CLA+ (LC = 1,878 ± 161 vs. RC = 1,900 ± 157). Additionally, poor correlation between engagement and HOS for both LC and RC indicated more engaged students do not necessarily possess greater HOS proficiency. Ceiling effect may explain results as medical students enter medical school as highly skilled learners with potentially little room for improvement. It will be informative to continue to track engagement and HOS of both cohort groups as they continue their medical studies.

Download Full-text

First year medical students’ perceptions of the impact of wearing scrubs on professional identity: a narrative analysis in the United Arab Emirates

BMJ Open ◽

10.1136/bmjopen-2020-039357 ◽

2020 ◽

Vol 10 (11) ◽

pp. e039357

Author(s):

Sara Sorrell ◽

Halah Ibrahim

Keyword(s):

Medical Students ◽

Qualitative Analysis ◽

Medical School ◽

Professional Identity ◽

United Arab Emirates ◽

Medical Curriculum ◽

First Year ◽

Written Narratives ◽

First Year Medical Students ◽

The Impact

ObjectivesMedical school serves as a critical developmental period for future physicians, during which students begin to form a professional identity. Just as personal appearance, particularly clothing, is an important external expression of one’s personal identity, ‘uniforms’ in healthcare, including white coats and scrubs, symbolise status and a group identity. There are, however, limited studies on the impact of physician attire on medical students’ formation of professional identity. Accordingly, through qualitative analysis of written narratives, we sought to analyse medical students’ experiences of wearing professional physician attire, namely scrubs, and how the uniform impacted their confidence level, performance and behaviours, as well as their identity as future physicians.DesignQualitative analysis of medical student’s written narratives.SettingKhalifa University College of Medicine and Health Sciences (KU CMHS) is a new medical school in the United Arab Emirates, with an inaugural class of 30 students admitted in August 2019. It is the only medical school in the city of Abu Dhabi, and the only school in the country that follows a postgraduate medical curriculum.ParticipantsAll first year medical students at KU CMHS were purposively sampled.MethodsStudents completed a voluntary online anonymous questionnaire. We employed a social identity approach to data analysis. Thematic content analysis was conducted on their narratives to identify themes.ResultsWe identified three major themes, namely (1) emotions, (2) logistics and (3) interpersonal relationships.ConclusionsMedical students form early perceptions regarding physician attire and its impact on their professional identity. Engaging in conversations regarding professional attire with educators or mentors could provide an important opportunity for students to discuss and explore professional identity early in training.

Download Full-text

11 Filling the void: preparing future junior doctors for challenging conversations

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-mariecurie.11 ◽

2018 ◽

Vol 8 (3) ◽

pp. 363.3-364

Author(s):

Hannah Costelloe ◽

Alice Copley ◽

Andrew Greenhalgh ◽

Andrew Foster ◽

Pratik Solanki

Keyword(s):

Palliative Care ◽

Medical Education ◽

Medical Students ◽

Small Group ◽

End Of Life ◽

Communication Skills ◽

Skills Training ◽

Junior Doctors ◽

List Type ◽

The Impact

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

Download Full-text

Research knowledge in undergraduate school in Brazil: a comparison between medical and law students

Einstein (São Paulo) ◽

10.1590/s1679-45082010ao1702 ◽

2010 ◽

Vol 8 (3) ◽

pp. 273-280 ◽

Cited By ~ 2

Author(s):

Antonio José Souza Reis Filho ◽

Bruno Bezerril Andrade ◽

Vitor Rosa Ramos de Mendonça ◽

Manoel Barral-Netto

Keyword(s):

Medical Students ◽

Educational Institution ◽

Law School ◽

Law Students ◽

First Year ◽

Research Experience ◽

Research Knowledge ◽

First Year Students ◽

Research Activities ◽

The Impact

ABSTRACT Objective: Exposure to science education during college may affect a student's profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. Methods: A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Results: Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Conclusion: Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students’ participation in more scientific activities.

Download Full-text

The impact of library instruction: do first-year medical students use library resources specifically highlighted during instructional sessions?

Journal of the Medical Library Association JMLA ◽

10.3163/1536-5050.101.3.011 ◽

2013 ◽

Vol 101 (3) ◽

pp. 213-217 ◽

Cited By ~ 6

Author(s):

Ryan S. Rafferty

Keyword(s):

Medical Students ◽

First Year ◽

Library Instruction ◽

Library Resources ◽

First Year Medical Students ◽

The Impact

Download Full-text

The Impact of Transfer from Hemodialysis on Peritoneal Dialysis Technique Survival

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00147 ◽

2015 ◽

Vol 35 (3) ◽

pp. 297-305 ◽

Cited By ~ 16

Author(s):

Sharon J. Nessim ◽

Joanne M. Bargman ◽

S. Vanita Jassal ◽

Matthew J. Oliver ◽

Yingbo Na ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Initial Period ◽

Significant Proportion ◽

Secondary Analysis ◽

First Year ◽

Technique Survival ◽

The Impact ◽

Organ Replacement

BackgroundA significant proportion of peritoneal dialysis (PD) patients receive an initial period of hemodialysis (HD) before transitioning to PD (“PD-switch”). We sought to better understand the risks of PD technique failure (TF) and mortality for those patients compared with patients starting with PD as their first dialysis modality (“PD-first”).MethodsUsing Canadian Organ Replacement Register data, we compared the risk of PD TF between PD-first and PD-switch patients within the first year after HD initiation. In a secondary analysis, the PD-switch patients were stratified into three groups based on timing of the switch from initial HD to PD as follows: 0 – 90 days, 91 – 180 days, and 181 – 365 days. Each group was compared with PD-first patients for risk of PD TF and death.ResultsBetween 2001 and 2010, 9404 patients initiated PD as their first renal replacement therapy, and 3757 switched from HD to PD. After multivariable adjustment, the risk of PD TF was higher among PD-switch patients than among PD-first patients [adjusted hazard ratio (AHR): 1.37; 95% confidence interval (CI): 1.26 to 1.49], particularly within the first year after the switch from HD to PD (AHR: 1.51; 95% CI: 1.36 to 1.68). There was no association between time on HD within the first year and subsequent risk of PD TF. For all the stratified PD-switch groups, death rates were higher than those for PD-first patients.ConclusionsCompared with patients who start renal replacement therapy with PD, those who transfer from HD to PD within the first year on dialysis experience higher rates of PD TF and death, with the highest risk being observed in the initial year after the switch to PD.

Download Full-text

Medical Student Perspectives on LGBTQ Health

PRiMER ◽

10.22454/primer.2019.288724 ◽

2019 ◽

Vol 3 ◽

Author(s):

Julie A. Christensen ◽

Travis Hunt ◽

Steven A. Elsesser ◽

Christine Jerpbak

Keyword(s):

Health Care ◽

Medical Student ◽

Medical Students ◽

Student Attitudes ◽

Life Experience ◽

Response Rate ◽

Gender And Sexuality ◽

First Year ◽

Sex And Gender ◽

The Impact

Introduction: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) community members experience adverse health outcomes at higher rates than non-LGBTQ individuals. We examined the impact of student demographics as well as gender and sexuality didactic instruction on the attitudes of first-year medical students toward LGBTQ patients. Methods: In January 2017, 255 first-year students at an urban allopathic medical school participated in a gender and sexuality health curriculum. We assessed student attitudes regarding LGBTQ patients using anonymous pre- and postintervention surveys. Each item was measured on a 5-point Likert scale. Results: Of 255 possible respondents, we received 244 responses to the preintervention survey (95.7% response rate) and 253 to the postintervention survey (99.2% response rate). Participants were predominantly white (66.8%), heterosexual (94.7%), and cisgender (100%). Respondents who identified as LGBQ were significantly (P<.05) more likely than heterosexual students to agree with the following preintervention statements, among others: (1) Discordance between birth sex and gender is a natural human phenomenon, (2) When meeting a patient for the first time, I feel comfortable asking what pronoun they use, (3) I am able to empathize with the life experience of an LGB/T patient, (4) I am motivated to seek out opportunities to learn more about LGBTQ-specific health care issues. Statistically significant changes in attitudes between time points are seen in 4 out of 15 items. Conclusion: A focused gender and sexuality curriculum appears to impact medical student attitudes regarding LGBTQ patients. Furthermore, recruitment of LGBTQ-identifying medical students may translate into improved workforce motivation to provide health care for LGBTQ patients.

Download Full-text

Nutrition education on obesity and diabetes to medical students

AJP Advances in Physiology Education ◽

10.1152/advan.00193.2020 ◽

2021 ◽

Vol 45 (2) ◽

pp. 217-223

Author(s):

Patricia Pérez-Cornejo ◽

Nancy E. Corral-Fernandez ◽

Maria Luisa Guzman-Hernandez ◽

Chaya Gopalan

Keyword(s):

Blood Glucose ◽

Medical Students ◽

Nutrition Education ◽

First Year ◽

Teaching Intervention ◽

Laboratory Exercise ◽

Obesity And Diabetes ◽

First Year Medical Students ◽

Blood Glucose Concentrations ◽

The Impact

First-year medical students learned about the impact of nutrition on obesity and diabetes through lectures and a laboratory exercise where they tested how carbohydrates of varying glycemic indexes changed blood glucose concentrations. Pre- and posttests were conducted to assess this teaching intervention. The posttest ranks were significantly higher compared with the pretest ranks (Z = −6.6, P < 0.001), suggesting the intervention was beneficial to students.

Download Full-text

Khat chewing practice and associated factors among medical students in university of Gondar, Ethiopia, 2019: a cross-sectional study

10.21203/rs.3.rs-19242/v1 ◽

2020 ◽

Author(s):

Tsegaye Adane Birhan ◽

Walelegn Worku ◽

Jember Azanaw ◽

Lamrot Yohannes

Keyword(s):

Medical Students ◽

Associated Factors ◽

Significant Proportion ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sectional Study ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Khat Chewing ◽

The Impact

Abstract Background: Globally, khat chewing practice becoming an alarming and common among the youth generation especially in higher educational institutions. It may also leads to frequent misbehavior, poor academic performance and memory impairment among students. This study aimed to determine the prevalence of khat chewing and associated factors among medical students in University of Gondar, Northwest Ethiopia, 2019.Method: An institution-based cross-sectional study was employed on 422 medical students. Data were collected using a self-administered questionnaire and analyzed using SPSS 20 software. Stratified followed by random sampling was employed to select the samples. Multivariable logistic regression model was fitted to identify the predictors. P ≤ 0.05 was used to select statistically significant factors.Result: The current prevalence of khat chewing among medical students was 21.5%. The odds of khat chewing was higher among males [AOR=3.353; 95%CI (1.460-7.701)], Muslims [AOR=6.390; 95%CI (1.903-21.460)], fifth and six year students [AOR= 3.391; 95%CI (1.354-8.488)], smokers [AOR=5.081; 95%CI (1.898-13.601)], alcohol users [AOR=4.872; 95%CI (2.094-11.332)], students who had khat chewer close friends [AOR=30.645; 95%CI (12.261-76.589)].Conclusion: Since a significant proportion of students chew khat, continuous awareness creation on the impact of khat chewing and counseling services are recommended.

Download Full-text