Introduction of the Modified Neuroanatomy Motivation Questionnaire and Its Role in Comparing Medical Student Attitudes Towards Learning Neuroanatomy Between Neuro-enthusiasts and Standard Students

Background Neurophobia has been identified as a potential barrier to adequate knowledge of neurology in the medical community, and therefore to patient safety. There is a drive to identify the source of neurophobia, in the hope of tackling it. Comparing the learning motivations of standard medical students with those who enjoy neuroanatomy may be a way of doing this. Methods The science motivation questionnaire (SMQ) was modified for neuroanatomy. It was distributed to three cohorts of second year medical students and students attending the extracurricular National Undergraduate Neuroanatomy Competition (NUNC). Cohen’s D test for effect size was used to compare standard medical students and those attending the NUNC. Results Five hundred ninety-seven questionnaires were completed by second year students, and 320 by NUNC attendees. The differences in motivation to learn neuroanatomy between the 2 groups mainly fell into themes of career motivation, personal relevance, intrinsic motivation and assessment anxiety. Conclusion This study has demonstrated the use of the SMQ in neuroanatomy, and found differences in motivators to learn neuroanatomy between self-selecting “neurophiles” and standard medical students, mainly relating to intrinsic motivation and its role in their lives. More research is needed to further explore these differences and how they might apply to interventions in medical school curricula.

Stigma in Psychiatry: Impact of a Virtual and Traditional Psychiatry Clerkship on Medical Student Attitudes

Objective The objective of the study was to assess the change in medical students’ attitudes towards psychiatry following a virtual clerkship experience compared to a traditional clerkship experience. Method Ninety-seven medical students from the University of Ottawa were assessed pre- and post-clerkship on the ATP-30 (Attitudes Towards Psychiatry-30) measure. Cohorts of students were categorized as pre-COVID or during-COVID depending on when and how they experienced their clerkship (traditional or virtual). The total student response rate was approximately 48%. A quasi-experimental design was implemented, and non-parametric statistics were used to analyze the data. Results Medical students’ overall attitudes towards psychiatry improved from pre- to post-clerkship, with the type of clerkship experience (traditional or virtual) having no significant impact on the magnitude to which attitudes improved. Conclusion Implementation of a virtual clerkship in psychiatry did not deteriorate medical student attitudes towards psychiatry as a specialty, with both the traditional and virtual clerkship program enhancing students’ attitudes towards psychiatry favorably.

Measuring the Efficacy of Pathology Career Recruitment Strategies in US Medical Students

Context.— Multiple articles and surveys in the literature suggest that medical students find a career in pathology undesirable and believe it is disproportionately focused primarily on the autopsy. Objective.— To measure the effect of applied interventions on medical student attitudes about the field of pathology. Design.— This prospective study involving medical students from first through fourth year was conducted as a pilot study in 2 medical schools in the United States. A 2-part anonymous survey regarding interest in pathology as a career and familiarity with the specialty using a 10-point scale was given to first- and second-year medical students before and after they listened to a 10-minute pathology career presentation. The same survey was given to third- and fourth-year medical students before and after a 4-week pathology elective. Results.— A total of 121 and 83 students responded to the survey before and after the intervention, respectively. Of the 121 students who responded to the survey before the intervention, 106 (87.6%) had not spent significant time in a pathology laboratory before the intervention. The majority of responses in interest in career, job responsibilities, and features of pathologists before and after the intervention demonstrated a statistically significant difference (P < .001). We compared survey scores of presentation versus 4-week rotation groups before and after the intervention. Students who experienced the presentation did not differ from students who experienced the rotation in the majority of questions related to interest in career, job responsibilities, and features of pathologists. Conclusions.— Our study suggests that pathology exposure strategies can have a beneficial effect on student perceptions of the field and consideration of a career in pathology. Overall, the presentation intervention on the first- and second-year students seemed to have the greatest effect.

Required Longitudinal Service-Learning and Its Effects on Medical Students’ Attitudes Toward the Underserved

Although medical students enter medicine with altruistic motives and seek to serve indigent populations, studies show that medical students’ attitudes towards the undeserved tend to worsen significantly as they go through their medical education. This finding emphasizes the need for medical educators to implement activities such as service-learning that may help mitigate this negative trend.All students at the University of Nevada Las Vegas (UNLV) School of Medicine are required to participate in longitudinal service-learning throughout medical school, and a majority of students interact with the underserved at their service-learning sites. Using the previously validated Medical Student Attitudes Towards the Underserved (MSATU), independent sample T-tests showed that students who interact with underserved populations at their sites scored with significantly better attitudes towards the underserved at the end of their preclinical phase. Subjects included 58 medical students with 100% taking the MSATU. This result indicates that longitudinal service-learning, particularly when it includes interaction with the underserved, can be one method to combat the worsening of medical students’ attitudes as they complete their medical education.

Validity evidence for a novel instrument assessing medical student attitudes toward instruction in implicit bias recognition and management

Background Implicit bias instruction is becoming more prevalent in health professions education, with calls for skills-based curricula moving from awareness and recognition to management of implicit bias. Evidence suggests that health professionals and students learning about implicit bias (“learners”) have varying attitudes about instruction in implicit bias, including the concept of implicit bias itself. Assessing learner attitudes could inform curriculum development and enable instructional designs that optimize learner engagement. To date, there are no instruments with evidence for construct validity that assess learner attitudes about implicit bias instruction and its relevance to clinical care. Methods The authors developed a novel instrument, the Attitude Towards Implicit Bias Instrument (ATIBI) and gathered evidence for three types of construct validity- content, internal consistency, and relationship to other variables. Results Authors utilized a modified Delphi technique with an interprofessional team of experts, as well as cognitive interviews with medical students leading to item refinement to improve content validity. Seven cohorts of medical students, N = 1072 completed the ATIBI. Psychometric analysis demonstrated high internal consistency (α = 0.90). Exploratory factor analysis resulted in five factors. Analysis of a subset of 100 medical students demonstrated a moderate correlation with similar instruments, the Integrative Medicine Attitude Questionnaire (r = 0.63, 95% CI: [0.59, 0.66]) and the Internal Motivation to Respond Without Prejudice Scale (r = 0.36, 95% CI: [0.32, 0.40]), providing evidence for convergent validity. Scores on our instrument had low correlation to the External Motivation to Respond Without Prejudice Scale (r = 0.15, 95% CI: [0.09, 0.19]) and the Groningen Reflection Ability Scale (r = 0.12, 95% CI: [0.06, 0.17]) providing evidence for discriminant validity. Analysis resulted in eighteen items in the final instrument; it is easy to administer, both on paper form and online. Conclusion The Attitudes Toward Implicit Bias Instrument is a novel instrument that produces reliable and valid scores and may be used to measure medical student attitudes related to implicit bias recognition and management, including attitudes toward acceptance of bias in oneself, implicit bias instruction, and its relevance to clinical care.