scholarly journals “More than just a medical student”: a mixed methods exploration of a structured volunteering programme for undergraduate medical students

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Kerry Badger ◽  
Rory Morrice ◽  
Olivia Buckeldee ◽  
Natalia Cotton ◽  
Dilshani Hunukumbure ◽  
...  

Abstract Background As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to explore the relationship between the processes, context, participant experiences and impacts of the programme so that lessons can be learned for future emergencies and service-learning programmes. Methods Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This explored differences in experience across demographics and contextual factors, correlations between aspects of induction, supervision and overall experience, and reviewed the impacts of the programme. Quantitative responses were statistically analysed and qualitative reflections were thematically coded to triangulate and explain quantitative findings. Follow up interviews were carried out to check back findings and co-create conclusions. Results We received responses from 61 students and 17 supervisors. Student participants described predominantly altruistic motivations and transformational changes to their professional identity driven by feeling included, having responsibility, and engaging in authentic workplace-based learning afforded by freedom from the assessed curriculum. They reported new perspectives on their future professional role within the multidisciplinary team and the value of workplace-based learning. They reported increases in wellbeing and self-esteem related to feeling included and valued, and positively contributing to service provision at a time of need. Significantly higher overall satisfaction was associated with a personalised induction, active supervision, earlier stage of training, and male gender. Gender-related differences were not explained through our data but have been reported elsewhere and warrant further study. The duration, intensity and type of role that volunteers performed was similar across demographics and did not appear to modulate their overall experience. Conclusions Whilst acknowledging the uniqueness of emergency volunteering and the survey response rate of 15% of volunteers, we suggest the features of a successful service-learning programme include: a learner-centred induction, regular contact with engaged and appreciative supervisors, and roles where students feel valued. Programmes in similar settings may find that service learning is most impactful earlier in medical students’ training and that students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments.

Author(s):  
Monica Rose Arebalos ◽  
Faun Lee Botor ◽  
Edward Simanton ◽  
Jennifer Young

AbstractAlthough medical students enter medicine with altruistic motives and seek to serve indigent populations, studies show that medical students’ attitudes towards the undeserved tend to worsen significantly as they go through their medical education. This finding emphasizes the need for medical educators to implement activities such as service-learning that may help mitigate this negative trend.All students at the University of Nevada Las Vegas (UNLV) School of Medicine are required to participate in longitudinal service-learning throughout medical school, and a majority of students interact with the underserved at their service-learning sites. Using the previously validated Medical Student Attitudes Towards the Underserved (MSATU), independent sample T-tests showed that students who interact with underserved populations at their sites scored with significantly better attitudes towards the underserved at the end of their preclinical phase. Subjects included 58 medical students with 100% taking the MSATU. This result indicates that longitudinal service-learning, particularly when it includes interaction with the underserved, can be one method to combat the worsening of medical students’ attitudes as they complete their medical education.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041810
Author(s):  
José Manuel Blanco ◽  
Fernando Caballero ◽  
Santiago Álvarez ◽  
Mercedes Plans ◽  
Diana Monge

ObjectiveTo analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine.DesignLongitudinal, prospective 5-year study, between October 2014 and June 2019.SettingStudents from a Spanish university of medicine.ParticipantsTwo voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias.Primary outcome measureThe Jefferson Scale of Empathy (JSE).ResultsThe cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease.ConclusionsThe empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.


2021 ◽  
Vol 71 (5) ◽  
pp. 1791-96
Author(s):  
Syed Muslim Abbas ◽  
Abid Ashar

Objective: To explore medical undergraduate students’ perceptions pertaining to the key domains of leadership and highlight strategies to enhance leadership skills in undergraduate studies. Study Design: Mixed methods study. Place and Duration of Study: Fatima Memorial Hospital College of Medicine & Dentistry, Lahore, from Sep to Oct 2019. Methodology: A total of 207 medical students were recruited from the first and final year by purposive sampling to fill out a structured questionnaire. Three focus group discussions were conducted comprising of twelve students in each group. All focus groups were audio-recorded, anonymized and transcribed verbatim before the analysis by framework analysis technique. Results: Total fifty percent of the first-year students were of the view that ensuring patient safety was an important component of the leadership domain of improving services whereas only 11% responded as critically evaluating as a component of this domain. The themes that emerged pertaining to the strategies to enhance leadership skills included increasing awareness, role models depicting change, cultural challenges, and supplementing existing practices. Conclusions: The validated essential domains of leadership and its associated competencies should be streamlined strategically and prioritized in accordance with the level of training of the undergraduate medical students. A multicentre study is suggested to gather data at the national level which could inform further development of inclusion of leadership domains within undergraduate MBBS curriculum.


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10164
Author(s):  
Ilango Saraswathi ◽  
Jayakumar Saikarthik ◽  
K. Senthil Kumar ◽  
Kumar Madhan Srinivasan ◽  
M. Ardhanaari ◽  
...  

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.


2019 ◽  
Vol 6 ◽  
pp. 238212051986920 ◽  
Author(s):  
María Lorena Aguilera ◽  
Sergio Martínez Siekavizza ◽  
Francis Barchi

Objective: This case study describes a faculty initiative to create a curriculum in applied medical ethics for undergraduate medical students at the Universidad Francisco Marroquin (UFM) in Guatemala City, Guatemala. Methods: The new ethics curriculum (PRACTICE) incorporates ethics short-courses into the university’s system of nontraditional, credit-bearing electives offered to students as part of their 6-year undergraduate medical education and complements existing didactic courses in normative ethics. Structured case-based activities allow for flexibility in design and scheduling, do not compete with core requirements of the existing curriculum, and enable students to develop critical reasoning approaches to ethical situations they will encounter in medical practice. Two preliminary workshops provided teaching opportunities for the faculty, stimulated student interest in future ethics courses, and provided an evidence base to guide the development of a formal curriculum. Results: The elective currently includes six 2-hour modules, each of which is a stand-alone unit with learning goals and objectives, brief didactic lecture, assigned readings, discussion case, and assessment. To date, more than 110 students have participated in the workshops and courses. Student feedback and evaluations are being used to refine pedagogical approaches and drive future course content. Conclusions: The PRACTICE course format offers a transformative model for ethics education in Guatemala that can be used in medical education throughout the country and region.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035690
Author(s):  
Xiong Ye ◽  
Haiying Guo ◽  
Zhou Xu ◽  
Hui Xiao

ObjectivesEmpathy education is very important for medical students. There is little research on the influence of early clinical practice on the development of empathy and other aspects of professionalism in medical students. The aim of this study was to compare the self-reported empathy levels of first-year and second-year undergraduate medical students before and after their early clinical contact curriculum.SettingThe study was conducted at the Shanghai University of Medicine & Health Sciences, Shanghai, China.ParticipantsA total of 257 undergraduate medical students participated in the study. The 154 first-year students were studying in 10 community-based teaching hospitals, and the 103 second-year students were studying in 3 university-affiliated hospitals.Primary and secondary outcome measuresPrimary measures: the Jefferson Scale of Empathy—Student version (JSE-S) was compared between students of different sexes and in different academic years before their early clinical contact course. Secondary measures: comparisons were made after they finished the curriculum 3 weeks later.ResultsA total of 219 of 257 students responded (85.21% response rate), and 214 answers could be analysed (135 first-year and 79 second-year students; 120 female and 94 male individuals). No significant differences in the empathy scores before early clinical contact were observed between students of different sexes and in different academic years. After early clinical contact, the mean JSE-S score of the participants was significantly higher than the mean score at the beginning of the curriculum.ConclusionsEmpathy-focused training during early clinical contact can improve the empathetic capacity of undergraduate medical students. Fostering empathetic attitudes among undergraduate medical students is necessary for the early stage of their medical education. Further research is needed on the long-term effects of empathy-focused education in entry-level medical students.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Sheng Yang ◽  
Pei-Chin Liu ◽  
Yung Kai Lin ◽  
Chia-Der Lin ◽  
Der-Yuan Chen ◽  
...  

Abstract Background Service learning (SL) is an educational methodology presumed to help medical students be more empathetic and compassionate. We longitudinally investigated the level of empathy in medical students and how preclinical SL experience was related to their level of empathy in their clinical clerkships. Methods Our cohort comprised fifth-year medical students engaged in clerkships as part of a 7-year medical programme at one medical school in Taiwan. Surveys were conducted at the beginning of the clerkship in September 2015 (T1) to collect data on the medical students’ preclinical SL experience in curriculum-based service teams (CBSTs) and extracurricular service teams (ECSTs) and their SL self-efficacy, demographic characteristics, and empathy level. Subsequently, three follow-up surveys were conducted once every 3 months to determine the empathy level of the students during their clinical clerkships (T2–T4). Seventy students who returned the written informed consent and completed the baseline (T1) and two or more follow-up surveys (T2–T4) were included in our analysis with the response rate of 34%. In total, 247 responses across the 1-year clerkship were analysed. Descriptive statistics, paired t tests, and generalised estimating equations were employed. Results Our study revealed that changes in empathy level in the dimensions of perspective taking, compassionate care, and standing in patients’ shoes in their clinical clerkships. Relative to that at T1, their empathy decreased in perspective taking and compassionate care at T2–T4 but increased in standing in patients’ shoes at T3. Additionally, our study verified the positive effect of medical students’ preclinical SL experience in CBSTs and ECSTs on empathy in terms of compassionate care and perspective taking, respectively, but not on that of standing in patients’ shoes. Conclusions Separate investigations into subconstructs of empathy, such as perspective taking, compassionate care, and standing in patients’ shoes, in medical students may be necessary for exploring the various driving forces or barriers to developing empathy in medical students. Moreover, SL experience through both CBSTs and ECSTs at medical academies may have positive effects on medical students’ empathy in their clinical clerkships and should be promoted at medical schools.


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