scholarly journals A qualitative evaluation of a 'covid responder' scheme for medical students

Author(s):  
Ciaran Grafton-Clarke ◽  
Hussein Uraiby ◽  
Shalin Abraham ◽  
Ayushi Ramjee ◽  
Jennifer Kent ◽  
...  

Abstract Background The first UK wave of COVID-19 led to the temporary suspension of medical school placements. Medical students were offered paid employment through a COVID Responder Scheme (CRS). We aimed to qualitatively assess the experience of those who participated in this scheme in comparison to traditional clinical attachments. Summary of work A bespoke questionnaire was designed to explore key themes identified through theme selection, literature review and consensus. Following piloting and validation, the questionnaire was circulated to students recruited to the CRS. A grounded theory analytic framework was used to analyse data. A modified-Delphi consensus process was used to reach a consensus on ‘what makes you feel most valued as a medical student’. Summary of results 36 students (46.2% response rate) responded. 86.1% of respondents felt their contribution was worthwhile. 65% reported being significantly more integrated into a team than in their university attachments. Concerns prior to starting CRS work included availability of PPE and the ability to contribute effectively, but refreshingly these concerns did not present as challenges. The steep learning curve of experiential learning alongside virtual teaching commitments proved difficult to juggle when facing physical, mental and emotional fatigue from long hours working busy clinical shifts. Respondents cited the educational benefit of the CRS throughout the survey. Recognition and commendation were highly effective in providing a sense of value ahead of renumeration. 44.4% of respondents were concerned about their future training and a reduction in clinical exposure. Discussion The majority of respondents reported CRS work as worthwhile, with reasons including increased responsibility for patient care and a sense of contribution to the clinical team. This in turn led to autonomous practice and task accountability, which further integrated them into the team and developed their clinical confidence. A student’s sense of value was strongly linked to being identified in emotional responses from colleagues and patients ahead of financial renumeration, suggesting scope for improvement within unpaid attachments / rotations. Conclusion There is an opportunity to take value from the COVID-19 medical student experience to improve undergraduate medical education through and beyond the pandemic.

2019 ◽  
Vol 29 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Marisa Gasparini ◽  
Shruti Jayakumar ◽  
Sarah Ayton ◽  
Marco N Nardini ◽  
Joel D Dunning

Abstract OBJECTIVES There has been declining interest in cardiothoracic surgery amongst medical graduates. This survey examines the exposure of British medical students to cardiothoracic surgery in various settings and its relationship with students’ interest in the speciality. METHODS A questionnaire composed of 14 quantitative and qualitative items was distributed amongst 162 medical students. The survey included questions on demographics, interest in cardiothoracic surgery, mechanisms of exposure to the speciality and desire to pursue a career in cardiothoracic surgery before and after exposure. RESULTS Amongst the surveyed students, 71.0% reported exposure to cardiothoracic surgery as part of their medical school curricula and 24.7% reported extracurricular exposure. Of the students, 46.7% reported clinical exposure. Overall, 27.1% of students reported interest in a career in cardiothoracic surgery, which was higher amongst students who had curricular (29.6%), clinical (35.5%) or extracurricular exposure (50.0%). Amongst interested students, 43.2% engaged in extracurricular cardiothoracic activities compared with 16.1% of students not interested in pursuing the speciality. Confidence in career choice after exposure increased more in interested students (20.4%) than not interested students (1.6%). Students rated exposure and mentorship as the most important factor in promoting a career in cardiothoracic surgery. CONCLUSIONS Medical students with an interest in cardiothoracic surgery are more likely to organize independent attachments in the speciality and attend extracurricular events; however, many students might fail to identify cardiothoracic surgery as an area of interest because of the lack of exposure at medical school.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023890 ◽  
Author(s):  
Madalina Toma ◽  
Tobias Dreischulte ◽  
Nicola M Gray ◽  
Bruce Guthrie

ObjectivesHealthcare is a complex system, so quality improvement will commonly lead to unintended consequences which are rarely evaluated. In previous qualitative work, we proposed a framework for considering the range of these potential consequences, in terms of their desirability and the extent to which they were predictable or expected during planning. This paper elaborates on the previous findings, using consensus methods to examine what consequences should be identified, why and how to prioritise, evaluate and interpret all identified consequences, and what stakeholders should be involved throughout this process.DesignTwo-round modified Delphi consensus study.Setting and participantsBoth rounds were completed by 60 panellists from an academic, clinical or management background and experience in designing, implementing or evaluating quality improvement programmes.ResultsPanellists agreed that trade-offs (expected undesirable consequences) and unpleasant surprises (unexpected undesirable consequences) should be actively considered. Measurement of harmful consequences for patients, and those with high workload or financial impact was prioritised, and their evaluation could also involve the use of qualitative methods. Clinical teams were agreed as important to involve at all stages, from identifying potential consequences, prioritising which of those to systematically evaluate, undertaking appropriate evaluation and interpreting the findings. Patients were necessary in identifying consequences, managers in identifying and prioritising, and improvement advisors in interpreting the data.ConclusionThere was consensus that a balanced approach to considering all the consequences of improvement can be achieved by carefully considering predictable trade-offs from the outset and deliberately pausing after implementation to identify any unexpected surprises and make an informed decision as to whether quantitative or qualitative evaluation is needed and feasible. Stakeholders’ roles in in the process of identifying, prioritising, evaluating and interpreting potential consequences should be explicitly addressed within planning and revisited during and after implementation.


2019 ◽  
Vol 8 (3) ◽  
pp. e000610 ◽  
Author(s):  
Allison Brown ◽  
Seamus Sreenan ◽  
Alice McGarvey

The alarming prevalence of medical error and adverse events in the health system raises a call to action to ensure that doctors in training receive adequate training in quality improvement (QI). Training medical students in QI remains a challenge given time constraints, lack of clinical exposure, and already saturated curricula. In some instances, QI training may be delivered during clerkship through didactic, and in some instances, and experiential learning. Preclinical years of medical school remain focused on introducing students to scientific and clinical concepts, rarely do they learn about QI. The Program for Innovation in Scholarship and Medicine (PRISM) is a programme that introduces first-year medical students to the fundamentals of QI using their experience as a medical student as the context. PRISM is a condensed QI curriculum that is delivered through an international partnership, based on a previously piloted programme at a Canadian medical school. Following an introductory workshop, medical students work in teams to develop QI proposals (project charters) which detail how QI principles and tools can generate small-scale improvements within their educational programme. Project charters are assessed by a team of faculty and upper year students, who have previously participated. On completion of the programme, students demonstrated increased knowledge, skills, and attitudes towards QI. Programme participants were satisfied with the structure and expectations of PRISM and expressed a newfound interest in QI. Nearly all participants would recommend PRISM to another medical student. In conclusion, PRISM serves as a resourceful, efficient educational approach for preclerkship students that provides an introduction to the concepts of QI in order for early trainees to build on baseline knowledge and skills throughout their training.


Author(s):  
Sarah E. Myers ◽  
Nicholas R. Bender ◽  
Marina A. Seidel ◽  
Ruth S. Weinstock

Abstract Background Traditional medical student curricula limit substantial clinical experiences until the third and fourth years of medical school. This delay in valuable experiences hinders the ability of some medical students to choose a specialty to pursue, delays the formation of meaningful longitudinal mentorship relationships, and limits the development of important clinical acumen. Furthermore, the use of medical students in preclinical years may help to improve patient care and outcomes. Approach The novel preclinical Diabetes SPECIAL (Students Providing Education on Chronic Illness and Lifestyle) elective was designed to introduce first year medical students to the field of endocrinology, promote the development of a professional identity, improve medical student communication skills, and raise awareness of the complexities of managing patients living with diabetes mellitus. Furthermore, and novel to this experience, was to measure the impact of this elective on patient outcomes. Evaluation Students attended patient appointments, communicated with their assigned patients regularly, relayed important health information to the attending endocrinologist, and attended monthly didactic sessions. The elective outcomes were evaluated via completed surveys by patients, students, and attending physicians as well as medical record review for pre- and post-elective hemoglobin A1C levels. Reflection Students, faculty, and patients who participated in this elective generally reported having a positive experience. Seven out of 10 patients had a reduction in their hemoglobin A1C levels. The outcomes from the pilot of this novel preclinical elective support the importance of early clinical exposure in medical student training and highlight potential positive impacts on both medical student education and patient outcomes.


2017 ◽  
Author(s):  
Jennifer S Mascaro ◽  
Sean Kelley ◽  
Alana Darcher ◽  
Lobsang Negi ◽  
Carol Worthman ◽  
...  

Increasing data suggest that for medical school students the stress of academic and psychologicaldemands can impair social emotions that are a core aspect of compassion and ultimately physiciancompetence. Few interventions have proven successful for enhancing physician compassion inways that persist in the face of suffering and that enable sustained caretaker well-being. To addressthis issue, the current study was designed to (1) investigate the feasibility of cognitively-basedcompassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreasesdepression, enhances compassion, and improves daily functioning in medical students. Comparedto the wait-list group, students randomized to CBCT reported increased compassion, and decreasedloneliness and depression. Changes in compassion were most robust in individuals reporting highlevels of depression at baseline, suggesting that CBCT may benefit those most in need by breakingthe link between personal suffering and a concomitant drop in compassion


2020 ◽  
Vol 133 (3) ◽  
pp. 848-854 ◽  
Author(s):  
Daniel Lubelski ◽  
Roy Xiao ◽  
Debraj Mukherjee ◽  
William W. Ashley ◽  
Timothy Witham ◽  
...  

OBJECTIVENeurosurgery seeks to attract the best and brightest medical students; however, there is often a lack of early exposure to the field, among other possible barriers. The authors sought to identify successful practices that can be implemented to improve medical student recruitment to neurosurgery.METHODSUnited States neurosurgery residency program directors were surveyed to determine the number of medical student rotators and medical students matching into a neurosurgery residency from their programs between 2010 and 2016. Program directors were asked about the ways their respective institutions integrated medical students into departmental clinical and research activities.RESULTSComplete responses were received from 30/110 institutions. Fifty-two percent of the institutions had neurosurgery didactic lectures for 1st- and 2nd-year medical students (MS1/2), and 87% had didactics for MS3/4. Seventy-seven percent of departments had a neurosurgery interest group, which was the most common method used to integrate medical students into the department. Other forms of outreach included formal mentorship programs (53%), lecture series (57%), and neurosurgery anatomy labs (40%). Seventy-three percent of programs provided research opportunities to medical students, and 57% indicated that the schools had a formal research requirement. On average, 3 medical students did a rotation in each neurosurgery department and 1 matched into neurosurgery each year. However, there was substantial variability among programs. Over the 2010–2016 period, the responding institutions matched as many as 4% of the graduating class into neurosurgery per year, whereas others matched 0%–1%. Departments that matched a greater (≥ 1% per year) number of medical students into neurosurgery were significantly more likely to have a neurosurgery interest group and formal research requirements. A greater percentage of high-matching programs had neurosurgery mentorship programs, lecture series, and cadaver training opportunities compared to the other institutions.CONCLUSIONSIn recent decades, the number of applicants to neurosurgery has decreased. A major deterrent may be the delayed exposure of medical students to neurosurgery. Institutions with early preclinical exposure, active neurosurgery interest groups, research opportunities, and strong mentorship recruit and match more students into neurosurgery. Implementing such initiatives on a national level may increase the number of highly qualified medical students pursuing neurosurgery.


e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Daniel Alberth Lallo ◽  
L. F. Joyce Kandou ◽  
Herdy Munayang

Abstrak: Kecemasan dialami oleh hampir semua orang di dunia, termasuk mahasiswa baru kedokteran. Mahasiswa baru kedokteran memiliki banyak stressor termasuk ujian yang menimbulkan kecemasan dan dapat mempengaruhi hasil ujian mereka. Sampai saat ini, hanya sedikit penyelidikan yang ditemukan menyelidiki fenomena ini. Di Fakultas Kedokteran Universitas Sam Ratulangi, tidak ada yang meneliti fenomena tersebut. Penelitian ini bertujuan untuk menilai hubungan antara kecemasan dan hasil ujian semester 1 (UAS-1) mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi. Ini merupakan penelitian analitik potong lintang dengan metode survei dan sensus sebagai cara dalam pengambilan sampel. Sampel penelitian yang telah memenuhi kriteria inklusi dan ekslusi didapatkan berjumlah 298 orang dari 319 mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi. Populasi tersebut kemudian diberi informed consent, kuesioner data sosiodemografi, dan dinilai kecemasannya menggunakan Hamilton Anxiety Rating Scale (HARS). Tidak ada hubungan yang signifikan antara kecemasan dan hasil UAS-1 (p=0,602>0,05). Ada hubungan yang signifikan antara jenis kelamin dan kecemasan (p=0,005<0,05) with odds ratio 2,91. 267 dari 298 mahasiswa (89,6%) mengalami kecemasan dengan kecemasan ringan sebagai tingkat kecemasan yang paling banyak ditemukan, berjumlah 177 orang (59,4%). Semua mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi mengalami kecemasan, terutama kecemasan ringan. Tidak terdapat hubungan antara kecemasan dengan hasil UAS-1 mereka, tetapi terdapat hubungan antara jenis kelamin dan kecemasan dengan kecenderuang hampir 3 kali bagi mahasiswa baru perempuan untuk mengalami kecemasan dibandingkan dengan mahasiswa baru laki-laki. Dibutuhkan penelitian lebih lanjut terkait coping strategies dan defense mechanism yang dilakukan mahasiswa untuk menganggulangi kecemasan mereka. Kata Kunci: Kecemasan, Ujian, Mahasiswa kedokteran.   Abstract: Anxiety is experienced by almost all people around the world including new medical students. New medical student experiences a lot of stressor include examination which cause anxiety to occur and may affect their exam results. Somehow, there are a few study found to date that has investigate this phenomenon. In Sam Ratulangi University, which is the nearest medical faculty, there is no research for such phenomenon. This study aims to investigate the relationship between anxiety and new medical student’s achievement on their last exam in Medical Faculty of Sam Ratulangi University. This is an analytic research using a survey method with census as the option of sampling. However, the research samples are who meet inclusion category and not in the exclusion category. The nearest samples are in Sam Ratulangi University who are given questioners to measure their anxiety by using Hamilton Anxiety Rating Scale (HARS) before their exam and to collect their sosiodemograpic data as well. There is no significant relationship between anxiety and their last exam results (p=0,602>0,05), but there is a significant relationship between gender and anxiety (p=0,005<0,05) with odds ratio 2,91. According to anxiety test results, 267 of 298 grade-1 medical students (89,6%) present an anxiety and the most prevalence anxiety level is mild anxiety with total 177 people (59,4%). In conclusion, almost all grade-1 new medical students in Medical Faculty of Sam Ratulangi University experienced anxiety with mild anxiety as the most prevalence anxiety level. There is no significant relationship between anxiety and their last exam results, but there is a significant relationship between gender and anxiety with almost 3 times for new female medical students experiencing anxiety than new male medical students. Further research is needed to investigate coping strategies and defense mechanisms which may be used to cope with their anxiety. Keywords: Anxiety, Exam, Medical Student


2021 ◽  
pp. 155982762110217
Author(s):  
Christopher R. D’Adamo ◽  
Kayli Workman ◽  
Christine Barnabic ◽  
Norman Retener ◽  
Bernadette Siaton ◽  
...  

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.


2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Carlo Fusco ◽  
◽  
Vincenzo Leuzzi ◽  
Pasquale Striano ◽  
Roberta Battini ◽  
...  

Abstract Background Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare and underdiagnosed neurometabolic disorder resulting in a complex neurological and non-neurological phenotype, posing diagnostic challenges resulting in diagnostic delay. Due to the low number of patients, gathering high-quality scientific evidence on diagnosis and treatment is difficult. Additionally, based on the estimated prevalence, the number of undiagnosed patients is likely to be high. Methods Italian experts in AADC deficiency formed a steering committee to engage clinicians in a modified Delphi consensus to promote discussion, and support research, dissemination and awareness on this disorder. Five experts in the field elaborated six main topics, each subdivided into 4 statements and invited 13 clinicians to give their anonymous feedback. Results 100% of the statements were answered and a consensus was reached at the first round. This enabled the steering committee to acknowledge high rates of agreement between experts on clinical presentation, phenotypes, diagnostic work-up and treatment strategies. A research gap was identified in the lack of standardized cognitive and motor outcome data. The need for setting up an Italian working group and a patients’ association, together with the dissemination of knowledge inside and outside scientific societies in multiple medical disciplines were recognized as critical lines of intervention. Conclusions The panel expressed consensus with high rates of agreement on a series of statements paving the way to disseminate clear messages concerning disease presentation, diagnosis and treatment and strategic interventions to disseminate knowledge at different levels. Future lines of research were also identified.


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