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 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: 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 Magyar Imre orvosprofesszor mint abszolút pedagógus

2020 ◽  
Vol 10 (21) ◽  
pp. 36-46
Author(s):  
Árpád Hudra
Keyword(s):  
Internal Medicine ◽  
Medical Students ◽  
Medical Training ◽  
Vital Role ◽  
Inaugural Address ◽  
Training And Education ◽  
Big Picture ◽  
Internal Medicine Clinic ◽  
The University

Imre Magyar, the last great representative of the Korányi School, who was appointed as the director and professor of the Internal Medicine Clinic I of the Budapest University of Medicine in 1965, emphasised in his inaugural address that from the three closely intertwined functions of the university clinic, i.e. patient care, research and medical training and education, he considers the latter the most important. The study intends to present that Imre Magyar, as an absolute educator, pursued this objective until his retirement in 1980. In his inaugural address he regarded lectures given by teachers of higher calibre with the intention to teach students medical thinking as one of the most important components of education. He even looked at lectures rather as seminars, never forgetting to make presentations on patients. Textbooks were meant for home education. Magyar, however, also “provided assistance” with this for medical students. His functional holistic thinking made it possible that medicine as specialised sciences be once again summarised as a uniform internal medicine dealing with the whole individual in his textbooks co-written by Petrányi and used in medical training for decades. Making a concrete connection with the patient, appropriate verbal and metacommunications, empathy, understanding and showing appropriate medical behaviour were, in his view, prerequisites for becoming a doctor. That is why he was concerned about the function of the doctor’s character in healing, and conducted investigations also described in this study on several occasions in relation with the cultivation of medical students. That is why Imre Magyar, who saw the big picture of education, emphasised the vital role of literature, arts and music in a doctor’s life.

Modal Personality and Values of Medical Students

1986 ◽  
Vol 58 (1) ◽  
pp. 33-34 ◽  
Author(s):  
Gordon J. Di Renzo
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Medical Training ◽  
Career Attitudes ◽  
The Third ◽  
D 20

30 men and 12 women in the third year of medical training completed the D-20 version of Rokeach's Dogmatism Scale, the Rokeach Scales for Terminal and Introductory Values, and items on career attitudes and background. Scores suggested these students are congenial to primary-care and patient-oriented medicine.

scholarly journals Effects of Implementing an Interactive Substance Use Disorders Workshop on a Family Medicine Clerkship

2021 ◽  
Vol 53 (4) ◽  
pp. 295-299
Author(s):  
Rebecca E. Cantone ◽  
Nonda S. Hanneman ◽  
Matthew G. Chan ◽  
Rebecca Rdesinski
Keyword(s):  
Substance Use ◽  
Medical Students ◽  
Family Medicine ◽  
Pacific Northwest ◽  
Substance Use Disorders ◽  
Medical Training ◽  
Medicine Clerkship ◽  
Health Crisis ◽  
Drug Problems

Background and Objectives: Substance use disorders (SUD) remain a public health crisis and training has been insufficient to provide the skills necessary to combat this crisis. We aimed to create and study an interactive, destigmatizing, skills-based workshop for medical students to evaluate if this changes students’ self-reported knowledge, skills, and attitudes toward patients with SUD. Methods: We surveyed students on a required family medicine outpatient rotation at a Pacific Northwest medical school during clerkship orientation on their views regarding SUDs utilizing the validated Drug and Drug Problems Perceptions Questionnaire containing a 7-point Likert scale. After attending a substance use disorder workshop, they repeated the survey. We calculated differences between the paired pre- to postsurveys. Results: We collected the pre- and postdata for 118 students who attended the workshop and showed statistically significant positive differences on all items. Conclusions: The positive change in the medical students’ reported attitudes suggests both necessity and feasibility in teaching SUD skills in a destigmatizing way in medical training. Positive changes also suggest a role of exposing students to family medicine and/or primary care as a strategy to learn competent care for patients with substance use disorders.

A Clinic to Improve Care of Patients with Sickle Cell Disease and the Role of Medical Students in Quality Improvement

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5586-5586
Author(s):  
Annie Press ◽  
Robert Lucito ◽  
Ilene Friedman ◽  
Samara Ginzburg
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Medical Students ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cell Disease ◽  
Improvement Project ◽  
Clinical Microsystems ◽  
One Year

Abstract Background: At Hofstra-North Shore LIJ School of Medicine, we have opportunities for our medical students to participate in experiential quality improvement projects. As part of this initiative, some students participate on health-care improvement teams using a Clinical Microsystems approach. This approach is a conceptual framework that has been applied to various departments in the North Shore-LIJ Health System in order to improve quality and patient safety. The basis of Clinical Microsystems is to identify a need in the hospital that may be targeted in order to improve the efficacy of healthcare quality and delivery. Once the objective for healthcare improvement is determined, a multidisciplinary team is created spanning one or more microsystems to target the specific barrier. One of the multidisciplinary teams focuses on the care of patients with sickle cell disease. LIJ Hospital admits between 150 and 200 patients with sickle cell disease a year primarily due to recurrent pain crises. The initial sickle cell multidisciplinary improvement team included physicians, patients, nurses, social workers and two medical students. The role of the students on this team included literature searches and survey administration. The team's initial analysis found that a lack of consistent outpatient follow up was resulting in frequent readmissions for this population to acute care facilities for pain control. To address this, the team was instrumental in establishing a primary care outpatient clinic focused exclusively on caring for patients with sickle cell disease, run by a primary care physician, in 2012. The current study was conducted by a medical student, and her mentor, who were original members of the sickle cell improvement team. The study tested the hypothesis that enrolling patients with sickle cell disease in an outpatient clinic with a dedicated physician focused on sickle cell disease management and pain control would decrease the number of admissions this population has for acute care at LIJ. The study also highlights the opportunity to involve medical students in a meaningful way in hands-on quality improvement projects in the early stages of training. Methods: This was a retrospective study of all adults with sickle cell disease, 21 years or older, who were seen at the primary care outpatient sickle cell clinic. We compared the rates of hospital admissions and length of stay in the one-year prior and one-year after their establishment of care at the clinic. All data was identified through manual and automated searches of the Electronic Health Record. Results: Since the opening of the clinic in 2012, 107 adults established care at the clinic. Within the first year that a patient began being cared for by the clinic, their admission rate dropped 27%, from an average of 3.775 to 2.75 admissions per year (p=0.0003). There were a total of 151 admissions one-year pre-intervention and 110 admissions one-year post-intervention. Conclusion: This project supports the value of a dedicated primary care outpatient sickle cell clinic on decreasing the admission rates for patients with sickle cell disease. Within one year of establishing care at the clinic, admissions rates decreased significantly, emphasizing the role of dedicated outpatient primary care in the management of patients with sickle cell disease. This study also highlights the importance and feasibility of integrating medical students into a quality improvement project early on during medical school. There are opportunities for students to have meaningful roles on hospital based improvement projects and learn quality improvement methodologies. An important component to this success is faculty mentoring to support a student's involvement in the project. The student involved in this study experientially participated in multidisciplinary team-based rapid cycles of change, process mapping, data collection and analysis. Similar projects could offer students an opportunity to participate during medical school in a longitudinal quality improvement project to develop skills they will need as physicians to identify, participate and measure the effects of improvement efforts. Disclosures No relevant conflicts of interest to declare.

scholarly journals P73 LEARN: uroLogical tEAching in bRitish medical schools Nationally - a national retrospective multi-centre audit of urology teaching across British medical schools

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
A Ng ◽  
W A Cambridge ◽  
K Jayaraajan ◽  
C M Lam ◽  
A Light ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Medical Training ◽  
Medical Schools ◽  
School Curriculum ◽  
Primary Objective ◽  
Targeted Advertising ◽  
The United Kingdom

Abstract Introduction Urological conditions account for approximately 25% of acute surgical referrals and 10-15% of general practitioner appointments. In 2012, the British Association of Urological Surgeons (BAUS) produced ‘An Undergraduate Syllabus for Urology’, advising on common clinical areas of urology that must be covered during undergraduate medical training. However, its uptake nationally remains unknown. This project aims to assess undergraduate urology teaching across UK medical schools. Methods A targeted advertising drive using social media, medical school societies, websites and newsletters was performed over 4 weeks. Collaborators are responsible for recruiting survey respondents (year 2 medical students to foundation year 1 (FY1) doctors). Survey respondents will complete a REDCap survey retrospectively assessing their urology teaching to date. The primary objective is to compare current urology teaching in medical schools across the United Kingdom with the BAUS undergraduate syllabus. Results Currently, 522 collaborators have registered from 36 medical schools nationally. Of these collaborators, 6.32% (33/522) are FY1s and 93.68% (489/522) are medical students. Each collaborator will be responsible for recruiting at least 15 survey respondents to be eligible for PubMed-indexed collaborator authorship. Conclusion LEARN has recruited successfully to date, with all collaborators from the medical student and FY1 cohort. With the role of collaborators to further recruit survey respondents, LEARN will provide the most representative and thorough evaluation of UK undergraduate urological teaching to date. It will provide evidence to support changes in the medical school curriculum, and allow re-evaluation of the current national undergraduate BAUS syllabus.

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