Awareness and perspectives on patients' rights: a survey of health profession students at a Ugandan University

Efforts to address inequities in medical education are centered on a dialogue of deficits that highlight negative underrepresented in medicine (UIM) learner experiences and lower performance outcomes. An alternative narrative explores perspectives on achievement and equity in assessment. This study sought to understand UIM learner perceptions of successes and equitable assessment practices. Using narrative research, investigators selected a purposeful sample of self-identified UIM fourth-year medical students and senior-level residents and conducted semistructured interviews. Questions elicited personal stories of achievement during clinical training, clinical assessment practices that captured achievement, and equity in clinical assessment. Using re-storying and thematic analysis, investigators coded transcripts and synthesized data into themes and representative stories. Twenty UIM learners (6 medical students and 14 residents) were interviewed. Learners often thought about equity during clinical training and provided personal definitions of equity in assessment. Learners shared stories that reflected their achievements in patient care, favorable assessment outcomes, and growth throughout clinical training. Sound assessments that captured achievements included frequent observations with real-time feedback on predefined expectations by supportive, longitudinal clinical supervisors. Finally, equitable assessment systems were characterized as sound assessment systems that also avoided comparison to peers, used narrative assessment, assessed patient care and growth, trained supervisors to avoid bias, and acknowledged learner identity. UIM learners characterized equitable and sound assessment systems that captured achievements during clinical training. These findings guide future efforts to create an inclusive, fair, and equitable clinical assessment experience.

BackgroundUnderstanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria.MethodsA cross-sectional study was conducted among 102 health professional students (age = 19–34 years old, 43.1% women) of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics.ResultsThe students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time) and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time). Sedentary time was higher among older than younger students (P<0.038) and among medical laboratory science students than physiotherapy and nursing students (P = 0.046). Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041). Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity.ConclusionsPrevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health professional students in Nigeria. These findings provide preliminary evidence that could be used to inform the needs to develop interventions to improve and support active lifestyle behaviour among students in Nigerian universities.

BackgroundBurnout is a well-recognized phenomenon that may manifest with feelings of stress, fatigue, or exhaustion. It is a common and emerging problem among healthcare workers. Medical students may be at increased risk of burnout given the rigorous nature of their training. However, there is a paucity of data on the burden of burnout among medical students in Africa.AimThis study aimed to determine the prevalence of burnout, as assessed using the Maslach Burnout Inventory – Student Survey (MBI-SS) as well as factors associated with the development of burnout among students pursuing Bachelor of Medicine and Bachelor of Surgery (MBChB) degrees at Mbarara University of Science and Technology (MUST), Uganda.MethodsA single-centre, cross-sectional, online survey was conducted among MBChB students of MUST. Burnout was assessed using the Maslach Burnout Inventory – Student Survey (MBI-SS) tool. Bivariate analysis and backward stepwise logistic regression analysis were performed to assess possible associations between variables related to participants’ demography, socioeconomic, personal, learning environment, outside school environment aspects and burnout prevalence scores.ResultsA total of 145 medical students, 102 (70.3%) male, with a median (range) age of 23 (18–40) years were studied. A total of 135 students (93.1%) presented with high levels of emotional exhaustion, 90 (62.1%) students had low levels of professional efficacy scores and 141 (97.2%) of the medical students had high levels of cynicism. Overall, 79 (54.5%) students had burnout, as defined by the MBI-SS tool. Choosing MBChB willingly appears to be an independent predictor of burnout (Adjusted odds ratio: 7.2; 95% CI: 1.4–36.9; p=0.018).ConclusionMore than one-half of medical students questioned at MUST do experience a degree of burnout. Preventative and interventional measures should be considered in the development of the medical curriculum.

The World Health Organization's Action Framework for tuberculosis elimination in low-tuberculosis incidence countries includes the screening for active and latent tuberculosis in selected high-risk groups, including health care workers. In this context, medical and health profession students, exposed to nosocomial tuberculosis transmission during training and clinical rotations, are target populations for tuberculosis screening. No updated data are available on tuberculosis screening practice and knowledge of medical and health profession students in Italy. Within the activities Italian Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health, we carried out a multicentre cross-sectional study to assess knowledge, attitude and practices on tuberculosis prevention and control among Medical, Dentistry, Nursing and other health professions' students. Students were enrolled in the study on a voluntary basis and were administered a previously piloted structured questionnaire. Logistic regression models were applied to explore knowledge on tuberculosis prevention by selected socio-demographic variables and University-based tuberculosis prevention practice. Students of seventeen Universities across Italy participated in the study, and 58.2% of them received compulsory tuberculin skin test either at enrollment or while attending clinical practice. A total of 5,209 students filled the questionnaire. 37.7% were medicine and dentistry students (Group 1), 44.9% were nursing students (Group 2) and 17.4% were other health professions' students (Group 3). Age and gender had different distributions by groups, as well as knowledge and practice on tuberculin skin test. 84.4% of the study population (95% CI = 83.3-85.3) was aware of the existence of the tuberculin skin test, 74.4% (95% CI = 73.2-75.6) knew what is the first-level screening test for latent tuberculosis and only 22.5% (95% CI = 21.4-23.6) knew how to proceed after a positive tuberculin skin test result. Overall, knowledge on tuberculosis prevention was higher in Group 2 and lower Group 3, as compared to Group 1. In Italy, the knowledge on tuberculosis screening among University students is generally good. To reduce some of the criticalities found among the different study courses, it would be appropriate to harmonize both the regulations on tuberculosis screening practices for admission to University courses, and the educational activities on the topic of tuberculosis, to be extended to all workers involved in health care setting.

BACKGROUND:The psychological state of medical students gaining concern on the part of medical institutions in several countries. Numerous studies are being conducted to study stress, burnout, and depression in medical students in India and globally. However, little is known about medical student resilience, particularly in India. The objectives of this study were to study the resilience, self-perceptions of stress coping skills, and burnout among medical students in clinical training in a tertiary care health center, to study factors associated with resilience among medical students in clinical training in a tertiary care health center and to study the relationship between resilience and self-perceptions of stress coping skills and symptoms of burnout.MATERIALS AND METHODS:This cross-sectional study was conducted in a tertiary healthcare hospital in district Guntur, Andhra Pradesh from November 2020 to December 2020, among 186 adult male and female medical students, aged more than 20 years, enrolled in the regular degree course and part of patient care or at least last three months. Participants were randomly selected and a structured questionnaire with Connor Davidson Resilience Scale 10 was used for interviewing. Descriptive and inferential statistics were conducted to measure associations between outcome and explanatory variables. We used multiple linear regression to examine the association between dependent and independent variables. A P value less than. 05 was considered significant.RESULTS:In the present study, 109 (58.0%) were females. The mean age of the study participants was 25.4 years (standard deviation 2.78). The mean score resilience score of the study participants using Connor Davidson Resilience Scale 10 was 25.1 (standard deviation 7.97). Of the total 44 (23.7%) of the study, participants reported the presence of burnout. A significant positive correlation was between resilience and self-perceptions of stress-coping skills with a Pearson Correlation coefficient of 0.393. Among the study participants, the mean resilience score was higher among those not having any symptoms of burnout. In the hierarchical stepwise multiple linear regression analysis, male gender (P value = .014), financial independence (P value = .044), and absence of burnout symptoms (P value = .004) were significantly associated with higher resilience scores. Psychiatric medicine usage was significantly associated with a lower resilience score with P < .05.CONCLUSION:Our study samples had higher resilience and lower burnout prevalence compared to the West. The stressful clinical event experienced by medical students demands training and innovative strategies to foster communication and teamwork skills among medical teams.

Recreational use of opioids is a growing problem in the United States, particularly in the Midwest. Educators have called for inclusion of pain- and opioid-specific courses in health professional school curricula, yet more research is needed to address future prescribers' beliefs, experiences, and postgraduate plans related to opioids. To examine health professional students' perceived severity of the opioid crisis and opioid-related beliefs, experiences, and postgraduate plans. Using a descriptive, cross-sectional design, researchers evaluated health professional students from 3 academic programs (nurse practitioner [NP], physician assistant [PA], and doctor of osteopathic medicine [DO]) using a 25-item survey that assessed perceived opioid crisis severity and opioid-related beliefs, experiences, and postgraduate plans. Demographics of respondents were assessed using descriptive statistics and frequencies. Responses were compared between academic programs with 1-way analysis of variance or Kruskal-Wallis tests, and relationships between students' experiences and postgraduate plans were assessed. A total of 491 students (mean [SD] age, 27.2 [5.4] years; 62.7% female; 68.2% DO students) participated in the survey (response rate, 40.4%). The opioid crisis was perceived to be severely impacting the health care system (mean [SD] score, 79.7 [16.8] out of 100), and most respondents (415 [84.5%]) reported that opioid use affected their communities. Clinical experience varied by program, with NP students (75 [81.5%]) reporting the most experience treating acute overdose. Most respondents (317 [64.6%]) agreed that their postgraduate practice would involve caring for patients addicted to opioids; however, only 232 students (47.3%) felt confident in their ability to treat patients with addiction. Experiences managing acute overdose and handling drug-seeking behavior were positively associated with a belief that postgraduate work would involve working with patients with addiction (U=38,275.5, Z=5.92, P<.001; U=25,346.0, Z=4.94, P<.001) and confidence in treating patients with opioid addictions (U=36,806.5, Z=4.96, P<.001; U=23,765.5, Z=3.66, P<.001). Although health professional students had similar beliefs and perceptions regarding the opioid crisis, there were notable differences between academic programs. Students with clinical opioid experiences were more likely to plan on working with patients addicted to opioids and be confident in treating these patients. Thus, the inclusion of experiential learning in the medical curricula may be beneficial for both students and their future patients.

The past decade witnessed momentum toward redesigning the U.S. health care system with the intent to improve quality of care. To achieve and sustain this change, health professions education must likewise reform to prepare future practitioners to optimize their ability to participate in the new paradigm of health care delivery. Recognizing that interprofessional education (IPE) is gaining momentum as a crucial aspect of health care professions training, this article provides an introduction to IPE programs from three different academic health centers, which were developed and implemented to train health care practitioners who provide patient-centered, collaborative care. The three participating programs are briefly described, as well as the processes and some lessons learned that were critical in the process of adopting IPE programs in their respective institutions. Critical aspects of each program are described to allow comparison of the critical building blocks for developing an IPE program. Among those building blocks, the authors present information on the planning processes of the different institutions, the competencies that each program aims to instill in the graduates, the snapshot of the three curricular models, and the assessment strategies used by each institution. The authors conclude by providing details that may provide insight for academic institutions considering implementation of IPE programs.

Medical schools are known to be stressful environments with never-ending academic demands to be reached with limited time and energy. Such high demands can lead to burnout and stress among health professional students. The objective of this research is to study the prevalence of and the relationship between perceived stress, optimism, and burnout among medical (MBBS), dental (BDS), and ayurvedic (BAMS) students. The difference in perceived stress, optimism, and burnout among health professional students was also studied in this study. A total of 104 samples were conveniently selected to participate in the study. The variables (Perceived stress, optimism, and burnout) were measured using “The Perceived Stress Scale (PSS)”, “The revised Life Orientation Test (LOT-R)”, and “Oldenburg Burnout Inventory (OLBI)” respectively. Descriptive statistics, Pearson’s correlation, and one-way ANOVA were used to analyze the data. The analysis of the results indicated a moderate to a high prevalence of perceived stress, low prevalence of optimism, and moderate prevalence of burnout among health professional students. A significant correlation between perceived stress, optimism, and OLBI burnout was found in this study. Interestingly, no significant correlation was seen between optimism and disengagement (OLBI component). Dental students were found to be more optimistic than medical students. The study implies that cultivating the skill of optimistic thinking, along with interventions to enhance the college environment, can help reduce burnout and stress while increasing academic achievement among health professional students.

The experiences of pre-licensure or pre-registration health professional students and their educators in working with intra-professional teams: a systematic review of qualitative evidence protocol

The Gastroenterology Core Curriculum, Third Edition

The AAMC has provided a resource to medical schools for implementing curricular change in lesbian, gay, bisexual, and transgender (LGBT) health education. However, studies have identified that many health professionals who do not feel comfortable in their ability to provide quality care for LGBT patients do not perform complete sexual histories routinely and/or harbor bias towards these patients or their sexual practices. This situation underscores the continued need for further education on this topic. Based on a needs assessment survey of medical students and faculty, we developed a 1-hour didactic lecture to provide instruction on how social determinants of health impact the care of LGBT patients. Students were not required to have any prerequisite knowledge for the session. A content expert in LGBT health taught the lecture using Microsoft PowerPoint in a traditional medical school lecture hall. The lecture was given to 180 third-year medical students. A total of 63 students (35%) responded to the retrospective pre- and postlecture survey. After the didactic lecture, students reported a statistically significant change in their knowledge of the lecture objectives. The didactic lecture was able to increase students' knowledge of how social determinants impact the health of LGBT patients. The lecture can be incorporated into a longitudinal curriculum on LGBT health. Additional work and research are needed on increasing comfort in faculty teaching.

ObjectivesChronic pain, particularly when undiagnosed, is often misunderstood by clinicians due to its invisible and subjective nature. This study aimed to design and evaluate a narrative-driven Virtual Reality (VR) experience that immerses medical students in the fragmented reality of a patient living with undiagnosed chronic pain. The project seeks to bridge the empathy gap in clinical training for medical students and healthcare professionals while enhancing understanding of patient experiences.MethodsWe developed a 4-minute immersive VR experience. Seventy undergraduate medical and health professional students with prior clinical exposure to chronic pain patients participated in the study. Following the experience, participants completed two questionnaires: one assessed the usability and validity of the VR application, while the other evaluated the medical students’ empathy and learning outcomes through a comparative analysis of post-experience surveys.ResultsThe SUS score was 70.13 ± 7.38, suggesting an above-average evaluation of the system’s usability and maturity. VR-experienced participants showed significantly better comprehension of chronic pain’s daily impacts and stronger emotional resonance with patient suffering. Additionally, the students in VR-experienced group rated the tool higher for its effectiveness in fostering empathy and improving knowledge retention.ConclusionOverall, the VR experience achieved the expected outcomes, with students identifying it as an immersive and impactful educational tool. It holds promise for enhancing empathy in clinical training, such as regarding undiagnosed chronic pain, potentially improving diagnosis and treatment approaches. While the results underscore VR’s potential to humanize chronic pain education, future studies should include longitudinal assessments, expanded narratives that reflect diverse patient experiences, and opportunities for users to engage with multiple scenarios, thereby better representing the full spectrum of challenges in many diseases.

BackgroundDuring the recent Coronavirus pandemic, many universities realized that the traditional delivery of educational content was not adequate in the context of imposed restrictions. Adoption of e-learning was one obvious way to foster continuity of learning. Despite its rapid implementation during the lockdown in Uganda, it was not known whether health professional students were willing to adopt e-learning as a way to foster continuity of learning. We, therefore, adopted a Technology Acceptance Model to determine the predictors for the adoption of e-learning using learner and information technology variables.MethodsA cross-sectional study among 109 health professional students ≥18 years of age at Clarke International University was conducted. Adoption of e-learning was measured as a self-report. Data were obtained using a smart survey and descriptively summarized. The differences in the study outcome were compared using the chi-square test. The factors that independently influenced the adoption of e-learning were determined using binary logistic regression and reported as adjusted odds ratios (aORs) with a 95% confidence interval (CI).ResultsOf the 109 respondents, 71 (65.1%) adopted e-learning. Our data showed low odds of adoption of e-learning among participants in first year (aOR, 0.34: 95%CI, 0.14–0.79), low e-learning expectations (aOR, 0.01: 95%CI, 0.01–0.34), no confidence in using IT devices (aOR, 0.16: 95%CI, 0.00–0.77), no prior experience in e-learning (aOR, 0.11: 95%CI, 0.02–0.68), not considering e-learning flexible (aOR, 0.25:95%CI, 0.08–0.86) and high cost of internet (aOR, 0.13: 95%CI, 0.02–0.84).ConclusionWe identified predictors of e-learning adoption which include having completed at least 1 year of study, high e-learning expectations, confidence in using IT devices, prior experience in e-learning, considering e-learning to be flexible and internet access. This information can be used by universities to enhance infrastructure and prepare potential e-learners.

Modern medicine necessitates evidence-based interdisciplinary patient care. Research is at the centre of fostering an evidence-based mindset in healthcare teams. Studies have demonstrated that exposing students to research translates into better patient care. Studies investing the perceptions of students towards research have focused on the views of medical students, leaving the perceptions of allied health professional (AHP) students unaccounted for. A mixed-methods, anonymous online questionnaire was distributed to 837 AHP students studying at the University of Malta, across five different courses. The collected data was then statistically analysed through descriptive statistics and chi-square testing. Qualitative results were coded, triangulated and subsequently analysed. An overall response rate of 28.43% was achieved. Only 2.49% of respondents managed to publish research, despite many participants stating that research is important for their future careers. Career progression and lack of opportunity were identified as the major motivating and stumbling factors, respectively. Students pursuing research-focused degrees considered their curriculum to sufficiently equip them with research skills, compared to students studying clinically oriented degrees (p < 0.01). The results obtained from this study indicate that the perceptions of AHP students towards research are on par with the already established medical students. AHP students face the same stumbling blocks, are driven by the same motivating factors and experience a similar disparity between interest in research and research being produced, as medical students. Thus, a joint effort, between stakeholders in medical and AHP students' education, should be taken to address the factors limiting undergraduate students from conducting research. This will enable the implementation of an evidence-based mindset in the clinic, ultimately resulting in better patient care. The online version contains supplementary material available at 10.1007/s40670-022-01715-6.

BackgroundThe prevalence of burnout and anxiety is constantly increasing among health profession students worldwide. This study evaluates the prevalence of burnout and its relationship to anxiety and empathy during the COVID-19 pandemic among health profession students in the main governmental institution in Doha, Qatar using validated instruments.MethodsA cross-sectional survey of health profession students using validated instruments was employed. The Maslach Burnout Inventory-General Students Survey (MBI-GS(S)) to measure burnout; The Generalized Anxiety Disorder (GAD-7) to measure anxiety; and Interpersonal Reactivity Index (IRI) to measure empathy were utilized. Descriptive statistics and multivariable linear regression were used.ResultsOf the 1268 eligible students, 272 (21.5%) completed the online survey. Burnout was found to be prevalent amongst the students. The mean scores for the MBI-GS(S) subscales of emotional exhaustion, cynicism, and professional efficacy were 4.07, 2.63, and 3.97, respectively. Anxiety was found to be a strong predictor for burnout and burnout was positively associated with empathy.ConclusionsFindings from this study demonstrated relationships between health profession students’ burnout, anxiety, and empathy. These findings might have an impact on the development of curriculum interventions to enhance student well-being. More burnout awareness and management programs that cater to the specific needs of health profession students are needed. Furthermore, findings of this study may have implications for future educational interventions during times of crisis or how this can be used to improve student experiences in normal times.