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: 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):  
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: 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 729 “I Don’t Feel Like I’m Learning How to Be A Doctor:” The Impact of Disruptions Due to Covid-19 On Professional Identity Formation in UK Medical Students

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Harvey ◽  
M E L Brown ◽  
M H V Byrne ◽  
J Ashcroft ◽  
J C M Wan ◽  
...  
Keyword(s):  
Medical Students ◽  
Professional Identity ◽  
Identity Formation ◽  
Medical Training ◽  
Professional Identity Formation ◽  
Clinical Environment ◽  
Clinical Exposure ◽  
Open Questions ◽  
Qualitative Responses ◽  
The Impact

Abstract Introduction Professional identity formation (PIF) is a priority of medical training. Covid-19 caused disruption to medical education. We ask how this disruption impacted PIF through the lens of the activities performed – or not performed – by medical students during the first wave of the covid-19 pandemic, and perceptions of conflicts between activities. Method A pragmatic survey was distributed in spring 2020. Thematic analysis was performed of qualitative responses to two open questions. A social constructivist approach linked participants’ comments to PIF theory. Results We analysed 928 responses. Three themes surrounding students’ activities during covid-19 and their impact on identity were constructed: Conflict arose at the intersections between these themes. Students noted lack of clinical exposure was detrimental, implicitly recognising that aspects of PIF require the clinical environment. Participants were keen to volunteer but struggled with balancing academic work. Participants worried about risk to their households and the wider community and wanted their skills to add value in the clinical environment. Volunteers felt frustrated when they were unable to perform tasks aligning with their identity as a future doctor. An exception was participants who worked as interim FY1s, aligned with the role of an FY1. Conclusions Medical students feel a duty to help during crises. Conflict arises when different aspects of their identity demand different actions. Care must be taken to nurture PIF during periods of disruption.

Medical students positions regarding resource allocation in times of crisis

2021 ◽  
pp. 147775092110572
Author(s):  
Daniel Minkin Levy ◽  
Iftach Sagy ◽  
Margaret Johansson Lipinski Lubianiker ◽  
Alan Jotkowitz
Keyword(s):  
Medical Students ◽  
Medical Training ◽  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
Clinical Phase ◽  
Ethical Decisions ◽  
Preclinical Phase ◽  
Phase Group

Objective To compare the perspectives of medical students in the preclinical and clinical phases of medical training on the issue of rationing scarce medical resources in times of crisis. Methods Questionnaire-based cross-sectional study. Results A total of 201 participants took part in the study, with 100 participants in the preclinical phase group, and 101 in the clinical phase group. A multivariable analysis found that just 14.9% (n = 34) of the clinical phase students were willing to give a short-supplied blood unit to the first-arrived patient to the emergency department when more patients are expected compared to 63.9% in the preclinical group (n = 62) ( p < 0.001, OR = 0.75 95% CI: 0.029−0.192). Seventy-four percent (n = 74) of the clinical phase students were found to be willing to remove a patient from a respirator to allocate it to an ill child compared to 35.7% (n = 35) in the preclinical phase group ( p < 0.001, OR = 4.168 95% CI: 1.931−8.998). Of the clinical phase group, 46.6% (n = 41) were willing to allocate a short supplied flu medicine to a patient with poor prognosis compared to 57.7% (n = 56) in the preclinical phase group ( p = 0.04, OR = 0.457 95% CI: 0.216−0.966). Conclusion Clinical exposure during training may affect the way medical students make ethical decisions, independent of age, sex, as well as marital and parental status.

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.

scholarly journals Attitude of Gratitude: Evaluation of a Wellness Program to Improve Dispositional Gratitude Among Medical Students

2020 ◽  
Vol 2 (2) ◽  
pp. 1-5
Author(s):  
Amelia Phillips ◽  
◽  
Farina Klocksieben ◽  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Medical Training ◽  
Short Form ◽  
Well Being ◽  
South Florida ◽  
Wellness Program ◽  
Intervention Participant ◽  
Dispositional Gratitude ◽  
The Impact

Introduction: Medical students face significant mental health challenges as they matriculate through medical training. Research has emphasized the need for more interventions that promote physician trainee well-being and resilience during the early stages of training. Recent interventions have shown to be effective in promoting mental health and well-being; however, no interventions have examined the impact that daily gratitude practice, which is linked to increased well-being, may have on dispositional gratitude levels among medical students. Methods: In Spring 2019, medical students at the University of South Florida were invited to participate in a gratitude program. Participants logged three good things that happened to them each day, for a period of 30 days. Their dispositional gratitude levels were assessed using the short-form Gratitude Resentment and Application Test (GRAT) before and after the 30-day intervention. Participant demographics and changes in GRAT scores from baseline to follow-up were examined. Results: Forty-six medical students volunteered to participate in a short-term, gratitude-focused wellness program. Overall levels of dispositional gratitude increased significantly among medical students (p<.001). While a significant increase in GRAT score was found among the thirty-five female participants (p<.001), no significant change was found among the eleven male participants (p=.154). GRAT scores increased significantly among both first- and second-year medical students (p=.001). However, no significant increases were reported among third- and fourth-year students (p=.109). GRAT scores increased significantly regardless of whether students used a tool to practice gratitude at baseline. Conclusion: Our results demonstrate that a 30-day gratitude practice program can improve dispositional gratitude among medical students, particularly among female students and pre-clinical students in years one and two.

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

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