scholarly journals The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: A study of clerkship training effects.

2020 ◽  
Author(s):  
Silvio Ndoja ◽  
Saad Chahine ◽  
Donald H. Saklofske ◽  
Brent Lanting
Keyword(s):  
Psychological Factors ◽  
Medical Training ◽  
Short Form ◽  
Inverse Correlation ◽  
Educational Interventions ◽  
Ambiguity Tolerance ◽  
Clinical Experiences ◽  
Demographic Information ◽  
Tolerance Of Ambiguity ◽  
Moderate Inverse Correlation

Abstract Background : Medicine is a field that is simultaneously factual and ambiguous. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with other psychological factors such as perfectionism is unknown. Methods: This was a single cohort study:174 Students in the first (pre) and last (post) 12 weeks of their 3 rd year comprising of 6 core rotations were invited to participate in an online anonymous survey. The survey included demographic information along with published and validated TOA and perfectionism scales. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons and correlations were used to detect the effect of clerkship on TOA, perfectionism and their relationship. Results: 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a decrease TOA (p<0.00) with pre-TOA scores at m=59.57 and post TOA at m=43.8. There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Clerkship was not significantly associated with levels of perfectionism (P>0.05). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre clerkship than those choosing other specialties, this difference was not found post clerkship. Conclusion: Clerkship does appear to influence student’s tolerance of ambiguity. However, perfectionism remained unchanged. Further work needs to be done exploring tailoring educational interventions to extremes of TOA and perfectionism.

scholarly journals The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate medical training: results from multiple samplings of a single cohort

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Silvio Ndoja ◽  
Saad Chahine ◽  
Donald H. Saklofske ◽  
Brent Lanting
Keyword(s):  
Medical Students ◽  
Medical Training ◽  
Short Form ◽  
Inverse Correlation ◽  
Full Time ◽  
Clinical Clerkship ◽  
Clinical Experiences ◽  
Clinical Exposure ◽  
Tolerance Of Ambiguity ◽  
Single Cohort

Abstract Background Medicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students. Methods This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results From a cohort of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p < 0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p > 0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r = 0.32) that increased slightly after clerkship (r = 0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship. Conclusion Exposure to clerkship decreased TOA while perfectionism remained stable in medical students. These results were not expected as exposure has been previously shown to increase TOA. The frequency of rotation changes maintaining a cycle of anxiety may be an underlying factor accounting for these results. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.

scholarly journals The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: Results from multiple samplings of a single cohort.

2020 ◽  
Author(s):  
Silvio Ndoja ◽  
Saad Chahine ◽  
Donald H. Saklofske ◽  
Brent Lanting
Keyword(s):  
Medical Students ◽  
Medical Training ◽  
Short Form ◽  
Inverse Correlation ◽  
Full Time ◽  
Clinical Clerkship ◽  
Clinical Experiences ◽  
Clinical Exposure ◽  
Tolerance Of Ambiguity ◽  
Single Cohort

Abstract Background: Medicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students.Methods: This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results: From a cohort of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p<0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p>0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship. Conclusion: Exposure to clerkship decreased TOA while perfectionism remained stable in medical students. These results were not expected as exposure has been previously shown to increase TOA. The frequency of rotation changes maintaining a cycle of anxiety may be an underlying factor accounting for these results. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.

scholarly journals The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: A study of clerkship training effects.

2020 ◽  
Author(s):  
Silvio Ndoja ◽  
Saad Chahine ◽  
Donald H. Saklofske ◽  
Brent Lanting
Keyword(s):  
Primary Care ◽  
Medical Training ◽  
Short Form ◽  
Inverse Correlation ◽  
First Year ◽  
Clinical Clerkship ◽  
Clinical Experiences ◽  
Clinical Exposure ◽  
Tolerance Of Ambiguity

Abstract Background: Medicine is a field that is simultaneously factual and ambiguous. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. Methods: This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results: From a total possible sample of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p=0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p>0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship. Conclusion: We hypothesize that the decrease in TOA seen in this study may reflect an underlying anxiety cycle related to frequent rotation changes. Implications of the role of perfectionism and primary care is discussed. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.

scholarly journals The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: Results from multiple samplings of a single cohort.

2020 ◽  
Author(s):  
Silvio Ndoja ◽  
Saad Chahine ◽  
Donald H. Saklofske ◽  
Brent Lanting
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Medical Training ◽  
Short Form ◽  
Inverse Correlation ◽  
Full Time ◽  
Clinical Clerkship ◽  
Tolerance Of Ambiguity ◽  
Single Cohort

Abstract Background: Medicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students.Methods: This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results: From a total possible sample of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p<0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p>0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship.Conclusion: Exposure to clerkship decreased TOA while perfectionism remained stable in medical students. We discuss these findings in the context of an underlying anxiety cycle related to frequent rotation changes. Implications of the role of perfectionism and primary care is discussed. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.

scholarly journals Ambiguity Tolerance and Prospective Specialty Choice Among Third-Year Medical Students

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Oksana Babenko ◽  
Delane Linkiewich ◽  
Kalee Lodewyk ◽  
Ann Lee
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Online Survey ◽  
Clinical Decision Making ◽  
Medical Training ◽  
Specialty Choice ◽  
Ambiguity Tolerance ◽  
Older Students ◽  
Tolerance Of Ambiguity ◽  
Significant Difference

Introduction: Poor tolerance of ambiguity is consequential in clinical practice, and has been linked to avoidance of family medicine, in which there is inherently more ambiguity. This study aimed to investigate the relationship between tolerance of ambiguity and prospective specialty choice of medical students in their third year of medical school. This stage of medical training is of particular importance as students develop clinical reasoning skills and encounter clinical ambiguity. Methods: This was a cross-sectional study using an online survey. Sixty-one third-year medical students (62% response rate) from a large Canadian university completed the survey with a validated measure of ambiguity tolerance (the 29-item Tolerance of Ambiguity in Medical Students and Doctors scale) and their top three specialty choices. Specialty choices were subsequently grouped into two categories: family medicine (FM) and non-family medicine (non-FM) specialties. Results: There was no significant mean difference in tolerance of ambiguity between students who reported interest in FM and students interested in non-FM specialties. Similarly, we observed no significant difference in tolerance of ambiguity between female and male students. Older students reported higher levels of ambiguity tolerance. Older students were also more likely to report FM as one of their top three specialty choices. Conclusion: Qualitative studies are needed to explore possible reasons for the observed results, including the effects of digital information resources and clinical decision-making tools on medical students’ ambiguity tolerance. Medical educators should be aware that some students may require explicit training in how to respond to ambiguity.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

scholarly journals Correlates of Neutralizing/SARS-CoV-2-S1-binding Antibody Response with Adverse Effects and Immune Kinetics in BNT162b2-Vaccinated Individuals

2021 ◽  
Author(s):  
Kenji Maeda ◽  
Masayuki Amano ◽  
Yukari Uemura ◽  
Kiyoto Tsuchiya ◽  
Tomoko Matsushima ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Inverse Correlation ◽  
Significant Rise ◽  
Neutralization Titer ◽  
Symptomatic Infection ◽  
Protective Measures ◽  
Neutralizing Activity ◽  
Pain Scores ◽  
Binding Antibody ◽  
Moderate Inverse Correlation

Abstract While mRNA vaccines against SARS-CoV-2 are exceedingly effective in preventing symptomatic infection, their immune response features remain to be clarified. In the present prospective study, 225 healthy individuals in Japan, who received two BNT162b2 doses, were enrolled. Correlates of BNT162b2-elicited SARS-CoV-2-neutralizing activity (50% neutralization titer: NT50; assessed using infectious virions) with various determinants were examined and the potency of serums against variants of concerns was determined. Significant rise in NT50s was seen in serums on day 28 post-1st dose. A moderate inverse correlation was seen between NT50s and ages, but no correlation seen between NT50s and adverse effects. NT50s and SARS-CoV-2-S1-binding-IgG levels on day 28 post-1st dose and pain scores following the 2nd shot were greater in women than in men. The average half-life of NT50s was ~ 68 days and the estimated average time length till the total disappearance of neutralizing activity was ~ 198 days. While serums from elite-responders (NT50s > 1,500-fold: the top 4% among the participants) potently to moderately blocked all variants of concerns examined, some serums with low NT50s failed to block the B.1.351-beta strain. Since BNT162b2-elicited immunity against SARS-CoV-2 is short, an additional vaccine or other protective measures are needed.

scholarly journals What Are the Characteristics of Fourth-Year Medical Students With Higher Levels of Resilience?

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Sey Park ◽  
Maribeth Porter ◽  
Ki Park ◽  
Lauren Bielick ◽  
Benjamin J. Rooks ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Medical Training ◽  
Personal Characteristics ◽  
After School ◽  
Demographic Information ◽  
Personal Time ◽  
Resilience Scale ◽  
Fourth Year Medical Students ◽  
Race Ethnicity

Introduction: Burnout during medical training, including medical school, has gained attention in recent years. Resiliency may be an important characteristic for medical students to have or obtain. The aim of this study was to examine the level of resiliency in fourth-year medical students and whether certain characteristics were associated with students who have higher levels of resiliency. Methods: Subjects were fourth-year medical students who completed a survey during a required end-of-year rotation. The survey collected subjects’ demographic information including age, gender, race, ethnicity, marital status, and chosen specialty. They were also asked to complete the Brief Resilience Scale (BRS) and answer questions that assessed personal characteristics. Results: The response rate was 92.4%. Most respondents had personal time for themselves after school (92.6%), exercise or participate in physical activity for at least 30 minutes most days of the week (67.2%), were able to stop thinking about medical school after leaving for the day (58.2%), and had current financial stress (51.6%). No differences were noted in demographic information among students across specialty categories. A higher BRS score was associated with being male and having the ability to stop thinking about school. Conclusions: BRS scores in medical students are associated with specific demographic characteristics and the ability to stop thinking about school. Addressing the modifiable activities may assist students with increasing their resiliency and potentially decreasing their risk of burnout.

scholarly journals Does Routine Pain Assessment Result in Better Care?

2009 ◽  
Vol 14 (3) ◽  
pp. 211-216 ◽  
Author(s):  
Thomas Hadjistavropoulos ◽  
Ying C MacNab ◽  
Amanda Lints-Martindale ◽  
Ronald Martin ◽  
Heather Hadjistavropoulos
Keyword(s):  
Pain Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Educational Interventions ◽  
Geriatric Depression ◽  
Clinical Practices ◽  
Medical Problems ◽  
Medical Practitioners ◽  
Over Time

BACKGROUND: Although a variety of national organizations such as the Canadian Pain Society, the American Pain Society and the Joint Commission on Accreditation of Health Care Organizations have advanced the idea that pain should be assessed on a routine basis, there is little evidence that systematic pain assessment information is used routinely by clinicians even when it is readily available.OBJECTIVE: To determine whether systematic pain assessment information alters medical practitioners’ clinical practices.METHODS: A population of seniors with complex medical problems who were evaluated by case coordinators was studied. Case coordinators were assigned to either an experimental or control patient assessment condition. Control condition patients were assessed as usual. In the experimental condition, a psychometrically valid pain assessment battery as well as the Geriatric Depression Scale – Short Form (because depression and chronic pain are frequently comorbid) were integrated into the routine case coordination assessment. A summary of the results of the depression and pain assessments was subsequently sent to physicians via mail and fax. Patients were also given copies of the assessment summaries and were asked to discuss these with their physicians. Physicians’ medication prescriptions were monitored over time through the database of the provincial ministry of health.RESULTS: At the end of the study, no significant differences between experimental and control patients were found with respect to medications prescribed or patient self-reports of pain. Nonetheless, there was a significant relationship between Geriatric Depression Scale – Short Form scores and pain medications prescribed for patients in the experimental condition. Moreover, indexes of overall pain intensity did not change significantly over time.CONCLUSIONS: The findings do not support the idea that the availability of systematic pain assessment information leads to change in clinician’s medication practices. As such, educational interventions and public policy initiatives are needed to ensure that treatment providers do not only gather but also use pain assessment information.

Exercise Partner Preferences, Social Physique Anxiety, and Social Discomfort in Exercise Settings among Women University Wellness Center Patrons

2001 ◽  
Vol 10 (1) ◽  
pp. 89-101 ◽  
Author(s):  
Nancy S. Diehl ◽  
Britton W. Brewer ◽  
Judy L. Van Raalte ◽  
Darlene Shaw ◽  
Patricia L. Fiero ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Social Physique Anxiety ◽  
Partner Preference ◽  
Demographic Information ◽  
Social Psychological ◽  
Chi Square ◽  
Lower Odds ◽  
Partner Preferences ◽  
Social Discomfort ◽  
University Wellness

In a study examining the relationships between two social psychological factors and exercise partner preferences, 97 women (mean age 32.42; SD = 9.85 years) provided demographic information, indicated their exercise partner preference, and completed measures of social physique anxiety (SPA) and perceived social discomfort (PSD) in exercise settings. Chi-square analyses on PSD and exercise partner preferences revealed significant effects, X2 (4) = 34.53, p < .001. Logistic regression revealed an effect for the SPA X PSD interaction, LR = 0.97, p < .01. When PSD was low, SPA had little impact on the odds of selecting a partner. When PSD and SPA were high, there were far lower odds of selecting an exercise partner. Overall, based upon the results, the number of exercise partners may be an important issue for women and women with high SPA may use an exercise partner to help moderate their anxiety, thereby increasing the palatability of the exercise setting.

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