scholarly journals Education around medication review and deprescribing: a survey of medical and pharmacy students’ perspectives

2020 ◽  
Vol 11 ◽  
pp. 204209862090961
Author(s):  
Alan J. Poots ◽  
Barry Jubraj ◽  
Emily Ward ◽  
Amante Wycoco ◽  
Nina Barnett

Research into the practice of medication review is developing across the world in response to the ever-increasing burden of inappropriate polypharmacy. Education, training and support of undergraduates and novice practitioners to equip them to participate in the medication review process could lead to long-term shifts in practice. The purpose of this study was to explore the awareness of pharmacy and medical undergraduates about medication review, deprescribing and polypharmacy, in order to inform improvement strategies. In November 2016, all final-year medical and pharmacy students at a London (UK) university were invited to complete a short questionnaire survey. Qualitative analysis inductively themed free-text comments and quantitative analysis used descriptive statistics to summarize responses, with chi-square tests used to indicate differences between the groups. The overall response rate was 34% (171/500). The terms ‘medication review’ and ‘polypharmacy’ were known to the students, whilst the term ‘deprescribing’ was unfamiliar with no difference between the groups. The term ‘medication review’ meant different things to the groups: pharmacy students suggested a focus on adherence and patient understanding, whilst medical students focused on interactions and whether medicines were still indicated. The groups differed in their perceptions of who they thought undertook reviews, who identifies potentially inappropriate medicines, who makes the final decision to deprescribe and the frequency of medication reviews. Both groups reported that on qualification they would not be comfortable stopping a medicine without discussion with a senior colleague, but would be comfortable prompting a senior colleague to review. Both groups had some awareness of medication review tools. The meaning of the term ‘medication review’ differed between the student groups. While medical students focused on clinical aspects, pharmacy students emphasized patient experience. Both groups anticipated a lack of confidence in deprescribing without senior support, highlighting the need for alignment between education and professional development syllabi in a way that combines the variety of professional perspectives. Prompts by juniors could lead to more medication reviews within existing practice, and may give them invaluable experience in reviewing medicines in their future careers as seniors.

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711293
Author(s):  
Sarah Garnett ◽  
Hajira Dambha-Miller ◽  
Beth Stuart

BackgroundEmpathy is a key health care concept and refers to care that incorporates understanding of patient perspective’s, shared decision making, and consideration of the broader context in which illness is experience. Evidence suggests experiences of doctor empathy correlate with improved health outcomes and patient satisfaction. It has also been linked to job satisfaction, and mental wellbeing for doctors. To date, there is a paucity of evidence on empathy levels among medical students. This is critical to understand given that it is a key point at which perceptions and practices of empathy in the longer term might be formed.AimTo quantify the level of empathy among UK undergraduate medical studentsMethodAn anonymised cross-sectional online survey was distributed to medical students across three universities. The previously validated Davis’s Interpersonal Reactivity Index was used to quantify empathy. The survey also collected information on age, sex, ethnicity, year of medical school training and included a free-text box for ‘any other comments’.ResultsData analysis is currently underway with high response rates. Mean empathy scores by age, sex, year of study and ethnic group are presented. A correlation analysis will examine associations between age and year of study, and mean empathy sores.ConclusionThese data will help to provide a better understanding of empathy levels to inform the provision of future empathy training and medical school curriculum design. Given previous evidence linking experiences of empathy to better health outcomes, the findings may also be significant to future patient care


Author(s):  
Dur-e- Nishat

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Razan Nour ◽  
Kerry Jobling ◽  
Alasdair Mayer ◽  
Salma Babikir

Abstract Background Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors’ ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students’ interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices. Methods One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students’ motivation for entering the prize exam and the students’ baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students’ opinion of the project and whether participation was beneficial. Results Sixteen students participated in the exam. There was a statistically significant increase in the students’ knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions. Conclusions This pilot project was a useful intervention in increasing medical students’ knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision.


2021 ◽  
Author(s):  
Veronica M Burns ◽  
Fritz M Castillo ◽  
Rodney L Coldren ◽  
Trisha Prosser ◽  
Renee L Howell ◽  
...  

ABSTRACT Introduction Influenza is a globally occurring viral respiratory infection that can lead to hospitalizations and death. An influenza outbreak can interfere with combat readiness in a military setting, as the infection can incapacitate soldiers. Vaccination remains the most effective tool to prevent and mitigate seasonal influenza. Although influenza vaccinations for U.S. Army soldiers can be monitored through military health systems, those systems cannot capture DoD civilians and Army dependents who may not use military health services. This study aims to gauge flu vaccine uptake and perceptions in U.S. Army civilians and dependents. Materials and Methods An online survey was e-mailed to civilian and dependent enrollees of Landstuhl Regional Medical Center. The survey contained 24 questions pertaining to demographics, vaccine history, history of the flu, and beliefs toward vaccines. Chi-square tests, t-tests, and logistic regressions were performed to investigate the association between demographic, behavior, and belief factors with vaccine uptake. Free-text answers were coded and categorized by themes. Results Over 70% of respondents were vaccinated for the flu. There were differences between vaccinated and unvaccinated respondents regarding their perceptions of barriers to vaccination, benefits of the flu vaccine, severity of flu symptoms, and personal risk of getting ill with the flu. After controlling for confounders, flu vaccination in the previous season and healthcare worker status were associated with increased vaccine uptake, while perceived barriers to influenza vaccination were associated with decreased vaccine uptake. Conclusions Flu vaccine uptake may be increased by increasing access to vaccination, promoting vaccination and addressing concerns at the provider level, and engaging positively framed public messaging. Increasing flu vaccine uptake is of particular importance as the flu season approaches during the COVID-19 (Coronavirus disease 2019) pandemic.


Author(s):  
AA Toubasi ◽  
BR Khraisat ◽  
RB AbuAnzeh ◽  
HM Kalbouneh

Objective Medicine is considered one if not the most stressful educational field. Thus, the aim of this study is to investigate the prevalence of stress and poor sleeping quality among medical students and the association between them. Method This cross-sectional study was conducted at the University of Jordan on second- and third-year medical students. The questionnaire consisted of: 1) Demographics; 2) The assessment tools which were Pittsburgh Quality of Sleep Index (PSQI) and Kessler Psychological Distress Status (K10). Binary logistic regression, chi-square and linear regression were used to investigate the association between PSQI, K10, and their determinants. Results The mean for PSQI score was 6.76 ± 3.32. PSQI scores interpretation revealed that 61.7% of the 282 participants of this study were poor sleepers. Logistic regression results showed that only the category of not napping at all from the napping hours variable was significantly associated with sleeping quality. Furthermore, the mean of K10 scores was 24.5 ± 8.5. K10 scores revealed that 66.3% of the participants were stressed. Logistic regression results showed that gender and regular exercise were significantly associated with psychological distress. Additionally, chi-square test, logistic regression and linear regression showed that PSQI was significantly associated with K10 (P <0.01). Conclusions Stress and poor sleeping quality in medical students at the University of Jordan were highly prevalent and strongly associated. What determined PSQI was daytime napping, and for K10 were regular exercise and gender. Further investigations into stress and sleep quality in the Arabian region are needed.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Pritesh Mistry ◽  
James Bateman ◽  
Helen Foss ◽  
Muhamad Jasim

Abstract Background/Aims  Medical students need to gain patient contact to develop their skills in history taking and examinations. In year three, undergraduate students typically rotate across various hospitals and specialties and are expected to have dedicated rheumatology exposure for history and examination competencies. Rheumatology as an out-patient specialty can limit opportunities for medical students to have broad exposure to rheumatological conditions. Methods  In January 2018, we designed an annual rheumatology half-day teaching workshop (‘Rheumatology Carousel’) using a combination of lecture-based teaching and small group based guided clinical history and examination stations, aimed at third-year medical students from the University of Birmingham. This covered key presentations in rheumatology: axial spondyloarthropathy, rheumatoid arthritis, systemic sclerosis (connective tissue disease), osteoarthritis, and vasculitis. Each station required a Clinical Teaching Fellow or Rheumatology ST trainee, overseen by one consultant facilitator. We designed patient proforma’s incorporating consent, demographics, key clinical history, therapy, and examination findings. We produced a written patient guide, and consultants invited appropriate patients to volunteer for the day. We designed a one-hour lecture-based tutorial. A lesson plan and schedule were created outlining faculty requirements; including time, roles, and faculty numbers. We invited five to six patients to each session, with a plan of four to five focussed examinations. We designed the carousel to accommodate up to 40 students, split into two groups running over a day. Focussed examinations involved students in groups of four, with each student being a lead examiner in at least one station, each station lasting 20 minutes. Best practice examination techniques for each condition were assessed and emphasised. Following a debrief, we collected feedback from students, faculty, and patients (online and written feedback), using Likert scores for teaching content, and quality of the session delivery. Results  The carousel ran in February 2018, 19, and 20. The sessions were positively evaluated by students, faculty, and patients. In total, 93 students attended, 89/93 completed feedback. Satisfaction scores (mean; SD; range) were high (1-strongly disagree, 5-strongly agree) for content (4.8; 0.49, range 3-5) and quality of delivery (4.7; 0.54; 3-5). All patients who participated volunteered to return for future teaching sessions, with several patients attending all three years. Free text feedback indicated students valued structured exposure to core conditions and called for more sessions of this nature. Conclusion  This sustainable reproducible intervention ensures students have structured exposure to important rheumatological conditions. The methodology allows reproducible sessions that are positively evaluated despite rotating clinical teaching staff. We have made all our teaching materials, logistical plan, and scheduling tools available as open access resources under a Creative Commons license for free re-use and adaptation by any healthcare professional, via a web link. We plan to record an electronic version to distribute post the COVID-19 pandemic. Disclosure  P. Mistry: None. J. Bateman: None. H. Foss: None. M. Jasim: None.


2009 ◽  
Vol 31 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Clóvis Alexandrino-Silva ◽  
Maira Lazarini Guimarães Pereira ◽  
Carlos Bustamante ◽  
André Corrêa de Toledo Ferraz ◽  
Sergio Baldassin ◽  
...  

Objective: We aimed to assess the presence of suicidal ideation, depressive symptoms and symptoms of hopelessness in three healthcare training programs. Method: The study's population comprised all students enrolled at the Medical School of the Fundação do ABC, Brazil, from 2006 to 2007 compared to students enrolled in nursing and pharmacy programs. We applied the Beck Scale for Suicidal Ideation, the Beck Depression Inventory and the Beck Hopeless Scale to assess psychiatric symptomatology. The general response rates of the medical, nursing, and pharmacy students were 56%, 56% and 61%, respectively. Results: There was no difference regarding the presence of suicidal ideation among medical, nursing and pharmacy students. There was also no difference regarding the presence of either depression or hopelessness in medical students in comparison to nursing and pharmacy students. In comparison to nursing and pharmacy students, significantly higher severity rates in terms of hopelessness were observed only among medical students. Conclusion: Although we did not observe significant differences regarding suicidal ideation and depression among the three healthcare programs, our findings suggest that the presence of suicidal ideation is indeed a source of concern. Early identification of these symptoms is crucial in order to offer appropriate support and treatment and prevent deaths by suicide.


2018 ◽  
Vol 08 (04) ◽  
pp. 221-225
Author(s):  
Beenish Fatima Alam ◽  
Hira Raza ◽  
Shizma junejo ◽  
Marium Azfar ◽  
Tuba Saleem ◽  
...  

Objective: To determine the differences of self-perception of halitosis and oral hygiene practices among the medical and dental undergraduate students. Methodology: A cross-sectional study conducted over duration of 9 months amongst the medical and dental undergraduate students of Bahria University Medical and Dental College. The questionnaires were distributed to 298 students. Questionnaire employed for this study was adopted and modified from the study conducted by Khalid Almas et al. Descriptive statistics were checked by means of percentages and frequency for all variables. Chi-square test was applied to check significant difference among the responses given by the medical and dental undergraduate students. Results: The response rate for the survey was about 85%. 55% of dental and 17 % of medical students were able to smell their breath. About having examination by dentist about 73% of medical students agreed as compared to 53% of dental students. Both medical and dental students preferred having examination done by the dentist. For management of halitosis, dentist was preferred by 62% of the dental students, while 97% of the medical students did not agree. 62% of the dental students preferred using traditional medications, while 82% of the medical students preferred using self-medications for treatment. Conclusion: The results suggest that there is not a high level of agreement among dental and medical students concerning the detection and management of halitosis. Although large percent of the respondents claimed to be aware of dentistry, our findings revealed low level of knowledge and attitude to Dentistry by the medical undergraduate students. Efforts should be made towards closing this knowledge gap to attain effective oral health.


2020 ◽  
Vol 10 (3) ◽  
pp. 49-56
Author(s):  
Türkan SEZEN ERHAMZA ◽  
Kübra A ARSLAN ÇARPAR

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.


Author(s):  
Chetanjit Baruah ◽  
Alpana P. Rabha ◽  
Hiranya Saikia

Background: Oral health is an integral part of general health and wellbeing of an individual at every stage of life. Good oral health knowledge is a requisite criterion for good oral health related behavior. So, this study was done to assess knowledge and practice about oral health and whether there is any difference of knowledge and practice about it among nursing and pharmacy students.Methods: A cross sectional study was done among 110 nursing and 90 pharmacy students in June 2019 by stratified random sampling method using a self-administered predesigned structured questionnaire. Descriptive statistics and chi-square test were applied using SPSS software.Results: Knowledge and practice of pharmacy students was found to be better than nursing students.Conclusions: Knowledge and practice of the students should be improved through health education.


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