Anxiety, PTSD, and stressors in medical students during the initial peak of the COVID-19 pandemic

Purpose To assess psychological effects of the initial peak phase of the COVID-19 pandemic on United States (US) medical students in clinical training to anticipate sequelae and prepare for future outbreaks. Methods Authors emailed a cross-sectional survey in April-May, 2020 to students in clinical training years at six US medical schools which included validated General Anxiety Disorder (GAD-7) and Primary Care-PTSD (PC-PTSD-5) screening tools, and asked students about pandemic-related stress and specific concerns. Authors used quantitative and thematic analysis to present results. Results Of 2511 eligible students, 741 responded (29.5%). Most students (84.1%) reported at least “somewhat” increased levels of stress and anxiety related to the pandemic. On the GAD-7, 34.3% showed mild, 16.1% moderate, and 9.5% severe anxiety symptoms, with 39.6% demonstrating no/minimal symptoms. One quarter (25.4%) screened positive for PTSD risk symptoms. Top concerns of students chosen from a pre-populated list included inadequate COVID-19 testing, undiagnosed or asymptomatic spread and racial or other disparities in the pandemic. In thematic analysis, students’ reactions to removal from clinical learning included: understanding the need to conserve PPE (32.2%), a desire to help (27.7%), worry over infectious risk to others (25.4%) and self (21.2%), and lost learning opportunities (22.5%). Female students were significantly more likely to report anxiety and PTSD risk symptoms. Asian students had a greater risk of moderate anxiety and those underrepresented in medicine (UIM) had greater risk of moderate and severe anxiety symptoms compared to white students. Conclusions During the initial peak phase of COVID-19, over 60% of US medical students screened positive for pandemic-related anxiety and one quarter were at risk for PTSD. Female and UIM students were significantly more affected. Medical schools should consider broad support of students, and targeted outreach to female and UIM students.

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Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽

10.3390/medicina49060045 ◽

2013 ◽

Vol 49 (6) ◽

pp. 45

Author(s):

Kamila Faizullina ◽

Galina Kausova ◽

Zhanna Kalmataeva ◽

Ardak Nurbakyt ◽

Saule Buzdaeva

Keyword(s):

Medical Students ◽

Human Resources ◽

Rural Areas ◽

Urban Areas ◽

Human Resources For Health ◽

Medical Schools ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Unequal Distribution ◽

Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

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Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

Canadian Urological Association Journal ◽

10.5489/cuaj.3679 ◽

2016 ◽

Vol 10 (7-8) ◽

pp. 281

Author(s):

Kristen McAlpine ◽

Stephen Steele

Keyword(s):

Medical Students ◽

Clinical Training ◽

Clinical Skills ◽

Medical Schools ◽

Clinical Settings ◽

Undergraduate Medical Students ◽

Canadian Medical School ◽

Competency Based ◽

English Speaking ◽

And Training

Introduction: The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.Methods: This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.Results: A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.Conclusions: To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.

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Medical Students in Russia evaluate the training during the COVID-19 Pandemic

10.31219/osf.io/bmhsk ◽

2021 ◽

Author(s):

Arina Ziganshina

Keyword(s):

Online Learning ◽

Medical Students ◽

Clinical Training ◽

Learning Experience ◽

Medical Schools ◽

Knowledge Assessment ◽

Instruction Time ◽

Medical Undergraduates ◽

Level Of Knowledge ◽

Self Instruction

Introduction: The aim of the study was to obtain feedback from medical students in Russia regarding online learning experience during COVID-19 Pandemic. Methods: 130 040 students from 46 Medical Schools of Russia have completed an original evaluation form validated by 6 experts. Criterion and construct validity were determined in a pilot study (n = 46). The study design was based on the use of Google forms. Visual Analog Scale from 1 to 10 was used by the participants to assess the level of knowledge acquired. Results: 95.31% of the medical schools in Russia switched to online learning during the Pandemic. 39.8% of the students stated that the time to prepare for the class has doubled. For 19.9% of them it increased by one third, 26.6% - did not report on changes. 38,4% of the participants were happy with particular elements of online learning, 27.5% - like such a format, 22.9% - do not like it, and 11.2% - could not answer the question. The average scores for the knowledge assessment were 5.9 for the humanities, 6.1 for fundamental science, and 6.0 for clinical training. Discussion: Remote learning was described by the medical undergraduates in Russia as the increased self-instruction time and perception of decreased level of knowledge gained. Only particular components of the “new normal” can be considered for use beyond the pandemic.

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Medical Students’ Attitudes Towards Cardiothoracic Surgery in the United Kingdom: A Cross-Sectional Survey of 1675 Students

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211072722 ◽

2022 ◽

Vol 9 ◽

pp. 238212052110727

Author(s):

Samiullah Dost ◽

Lana Al-Nusair ◽

Mai Shehab ◽

Arwa Hagana ◽

Aleena Hossain ◽

...

Keyword(s):

Medical Students ◽

Extracurricular Activities ◽

Online Survey ◽

Negative Relationship ◽

Medical Schools ◽

Cardiothoracic Surgery ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Students Attitudes ◽

Survey Responses

Objectives The objectives of this study were the following: (i) assess interest levels in cardiothoracic surgery (CTS) among UK-based medical students, (ii) identify potential motivators and barriers to pursuing CTS training, (iii) explore the influence of gender on interest in CTS in greater depth. Methods Medical students from all year groups across UK medical schools were invited to participate in a cross-sectional, national online survey. Responses were collected from 02/12/2019 to 08/12/2019. Results 1675 medical students from 31 UK medical schools responded, with an estimated 5.3% response rate. Of the respondents, 33.7% respondents reported having exposure to CTS, primarily through their medical school or through extracurricular activities (48.4% and 38.8%, respectively). When assessing interest in CTS, 31.4% were interested in undertaking a career in CTS, with a larger proportion of students expressing interest with no exposure to CTS than those with exposure. However, interest in pursuing CTS decreased with exposure as medical students transitioned from pre-clinical to clinical stages. Additionally, male participants were more interested in seeking a CTS post than their female counterparts (38% vs. 27.6%). The length of training ( p = 0.0009) and competitive nature ( p < 0.0001) of gaining a CTS post were the primary deterring factor for female participants, compared to their male counterparts. Conclusions This study shows the importance of quality of exposure and its impact on students’ interests in pursuing a career in CTS. The negative relationship between exposure and interest in CTS can be associated with the realisation of the challenges that come with pursuing CTS.

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Attitudes of Israeli Medical Students Towards the Medical Treatment of Uninsured Migrants

10.21203/rs.2.12590/v1 ◽

2019 ◽

Author(s):

Zohar Mor ◽

Adam Cadesky ◽

Ran Halleluyan ◽

Rivka Sheffer

Keyword(s):

Medical Students ◽

Clinical Training ◽

Medical Training ◽

Medical Schools ◽

Developed Countries ◽

Cross Sectional Study ◽

Cross Sectional ◽

Professional Responsibilities ◽

Students Attitudes ◽

Societal Expectations

Abstract Background: Undocumented migration to developed countries poses practical concerns, as migrants are not medically insured. This cross-sectional study aims to appraise the attitudes of Israeli medical students towards the uninsured migrant population. Methods: Participants from five medical schools in Israel completed anonymous questionnaires in Hebrew, based on the "Medical Students’ Attitudes Toward the Underserved" (MSATU), which assessed students' attitudes regarding the professional responsibility and societal expectations towards the migrants. It also evaluated students' views of the migrants as eligible for expensive medical procedures. Results: A total of 891 students completed the survey with a median age of 28 years. The majority were Jews (N=816, 91.6%) and singles (N=681, 68.5%). Participants in the pre-clinical years were likely to be female and unmarried compared to those in clinical training. They also demonstrated higher scores on professional responsibilities and societal expectations than students in clinical training, but no significant differences were found in their views on expensive medical services. Students of minorities (non-Jews and migrants) scored higher on professional responsibilities and societal expectations. The scores for professional responsibilities and societal expectations decreased as students progressed in their medical training (Spearman coefficient p=0.04 and p=0.01, respectively). This trend was more apparent in males rather than females. Conclusion: MSATU scores declined as students progressed through medical school, with females maintaining more favorable attitudes than males. Medical schools should attempt to maintain the enthusiasm and idealism that students possess as they enter medical training and provide clinical experience with migrant populations that allows for cross-cultural communication.

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Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

10.1101/2021.07.06.21260058 ◽

2021 ◽

Author(s):

Matthew H V Byrne ◽

James Ashcroft ◽

Jonathan C M Wan ◽

Laith Alexander ◽

Anna Harvey ◽

...

Keyword(s):

Medical Students ◽

Prosocial Behavior ◽

Medical Schools ◽

Final Decision ◽

Educational Strategies ◽

Healthcare Provision ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Decision Making Processes ◽

Primary Focus

Introduction: COVID-19 has caused major disruptions to healthcare, with voluntary opportunities offered to medical students to provide clinical support. We used the conceptual framework of prosocial behavior during an emergency - behaviors whose primary focus is benefiting others - to examine volunteering during COVID-19. Methods: We conducted an in-depth, mixed-methods cross-sectional survey, from 2nd May to 15th June 2020, of medical students studying at UK medical schools. Data analysis was informed by Latane and Darley's theory of prosocial behavior during an emergency and aimed to understand students' decision-making processes. Results: A total of 1145 medical students from 36 medical schools completed the survey. While 947 (82.7%) of students were willing to volunteer, only 391 (34.3%) had volunteered. The majority (92.7%) of students understood that they may be asked to volunteer; however, we found that deciding one's responsibility to volunteer was mitigated by a complex interaction between the interests of others and self-interest. Further, concerns revolving around professional role boundaries influenced students' decisions over whether they had the required skills and knowledge to volunteer. Deciding to volunteer depended not only on possession of necessary skills, but also seniority and identification with the nature of volunteering roles offered. Conclusions: We propose two additional domains to Latane and Darley's theory of prosocial behavior during an emergency that students consider before making their final decision to volunteer. These are 'logistics' - whether it is logistically feasible to volunteer - and 'safety' - whether it is safe to volunteer. This study highlights a number of modifiable barriers to prosocial behavior that medical students encounter and provides suggestions regarding how Latane and Darley's theory of prosocial behavior can be operationalized within educational strategies to address these barriers. Optimizing the process of volunteering can aid healthcare provision and may facilitate a safer volunteering process for all.

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RE-AIMing COVID-19 online learning for medical students: a massive open online course evaluation

BMC Medical Education ◽

10.1186/s12909-021-02751-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yusuf Yilmaz ◽

Ozlem Sarikaya ◽

Yesim Senol ◽

Zeynep Baykan ◽

Ozan Karaca ◽

...

Keyword(s):

Public Health ◽

Medical Students ◽

Clinical Training ◽

Medical Schools ◽

Course Evaluation ◽

Online Course ◽

Accurate Information ◽

Free Text ◽

Massive Open Online ◽

Massive Open Online Course

Abstract Background Clinical training during the COVID-19 pandemic is high risk for medical students. Medical schools in low- and middle-income countries (LMIC) have limited capacity to develop resources in the face of rapidly developing health emergencies. Here, a free Massive Open Online Course (MOOC) was developed as a COVID-19 resource for medical students working in these settings, and its effectiveness was evaluated. Methods The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework was utilized to evaluate the effectiveness of MOOC in teaching medical students about COVID-19. The data sources included the student registration forms, metrics quantifying their interactions within the modules, students’ course feedback, and free-text responses. The data were collected from the Moodle learning management system and Google analytics from May 9 to September 15, 2020. The research team analyzed the quantitative data descriptively and the qualitative data thematically. Results Among the 16,237 unique visitors who accessed the course, only 6031 medical students from 71 medical schools registered, and about 4993 (83% of registrants) completed the course, indicating high levels of satisfaction (M = 8.17, SD = 1.49) on a 10-point scale. The mean scores of each assessment modules were > 90%. The free-text responses from 987 unique students revealed a total of 17 themes (e.g., knowing the general information on COVID-19, process management of the pandemic in public health, online platform use, and instructional design) across the elements of the RE-AIM framework. Mainly, the students characterized the MOOC as well-organized and effective. Conclusions Medical students learned about COVID-19 using a self-paced and unmonitored MOOC. MOOCs could play a vital role in the dissemination of accurate information to medical students in LMIC in future public health emergencies. The students were interested in using similar MOOCs in the future.

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Attitudes of Israeli Medical Students Towards the Medical Treatment of Uninsured Migrants

10.21203/rs.2.12590/v2 ◽

2020 ◽

Author(s):

Zohar Mor ◽

Adam Cadesky ◽

Ran Halleluyan ◽

Rivka Sheffer

Keyword(s):

Medical Students ◽

Clinical Training ◽

Medical Training ◽

Medical Schools ◽

Developed Countries ◽

Cross Sectional Study ◽

Cross Sectional ◽

Professional Responsibilities ◽

Students Attitudes ◽

Societal Expectations

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Effects of the COVID-19 Pandemic on Medical Students: A Multicenter Quantitative Study

10.21203/rs.3.rs-49481/v2 ◽

2020 ◽

Author(s):

Aaron Harries ◽

Carmen Lee ◽

Lee Jones ◽

Robert M. Rodriguez ◽

John Davis ◽

...

Keyword(s):

Medical Education ◽

Medical Students ◽

Clinical Training ◽

The United States ◽

Antibody Testing ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Clinical Rotations ◽

Medical Education System ◽

National Recommendation

Abstract Background: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy.Methods: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. Results: 741 (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved.Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). Conclusions: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.

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Role models and teachers: medical students perception of teaching-learning methods in clinical settings, a qualitative study from Sri Lanka.

10.32920/14753898 ◽

2021 ◽

Author(s):

Vathsala Jayasuriya-Illesinghe ◽

Ishra Nazeer ◽

Lathika Athauda ◽

Jennifer Perera

Keyword(s):

Medical Students ◽

Sri Lanka ◽

Role Models ◽

Clinical Training ◽

Learning Experiences ◽

Medical Schools ◽

Role Modeling ◽

Clinical Settings ◽

Clinical Teachers ◽

Teaching Learning

Background Medical education research in general, and those focusing on clinical settings in particular, have been a low priority in South Asia. This explorative study from 3 medical schools in Sri Lanka, a South Asian country, describes undergraduate medical students’ experiences during their final year clinical training with the aim of understanding the teaching-learning experiences. Methods Using qualitative methods we conducted an exploratory study. Twenty eight graduates from 3 medical schools participated in individual interviews. Interview recordings were transcribed verbatim and analyzed using qualitative content analysis method. Results Emergent themes revealed 2 types of teaching-learning experiences, role modeling, and purposive teaching. In role modelling, students were expected to observe teachers while they conduct their clinical work, however, this method failed to create positive learning experiences. The clinical teachers who predominantly used this method appeared to be ‘figurative’ role models and were not perceived as modelling professional behaviors. In contrast, purposeful teaching allowed dedicated time for teacher-student interactions and teachers who created these learning experiences were more likely to be seen as ‘true’ role models. Students’ responses and reciprocations to these interactions were influenced by their perception of teachers’ behaviors, attitudes, and the type of teaching-learning situations created for them. Conclusions Making a distinction between role modeling and purposeful teaching is important for students in clinical training settings. Clinical teachers’ awareness of their own manifest professional characterizes, attitudes, and behaviors, could help create better teaching-learning experiences. Moreover, broader systemic reforms are needed to address the prevailing culture of teaching by humiliation and subordination.

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