Australian Medical Students Research Articles

Epworth Sleepiness Scale results in medical students. A preliminary study

Introduction Sleep disorders, especially insomnia and excessive daytime sleepiness, are common complaints. They are associated with an increased prevalence of various somatic diseases and/or psychiatric disorders as well as psychosocial problems. Previous general population studies have estimated that the prevalence of sleep disorders ranges between 15 and 42%. Objectives and aim Studying sleepiness in younger medical students, that is, in the carrier initial or lower grades. Methods The Epworth Sleepiness Scale was administered to a 135 (mean age 19.90 y.o.) (76% female/33% male) voluntary agreeing sample of first cycle medical students in Tenerife during 2014–2015. EES measures daytime sleepiness. The Statistical Package for Social Science was applied. Results and discussion 1. Age is about the same than that of a Brazilian medical students sample (20.16). 2. Just over 50% (68 out of 135) had daytime sleepiness, higher than the Brazilian's and much higher than that observed in an Australian medical students sample. Curiously, 29 percent of our students with diurnal sleepiness had reported a good quality sleep in the previous month. 3. This figure (>50%) is really higher than the recorded proportion in adult general population. 4. No intersex differences were noticed ( P >0.05). Conclusions Our study points out that complaints about sleepiness are very common in younger medical students. The question remains whether adjustment, personality traits, high tasks and curricula burdens associated with fatigue may have a causal link with sleepiness in a very demanding carrier. Moreover, we should highlight that sleepiness, as a subjective variable, could be confounded with fatigue.

Resourcing the clinical complementary medicine information needs of Australian medical students: Results of a grounded theory study.

The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines.

Medical students' epistemological beliefs: Implications for curriculum.

Epistemological beliefs have a pervasive influence on learning and practice. Understanding these beliefs and how they develop, could play an important role in medical student training and shape later clinical practice. The epistemological beliefs of first-year medical students from an Australian and Malaysian university were explored using a domain-specific instrument. There were significant differences between the disciplinary epistemological beliefs of Australian and Malaysian medical students across many items, and two specific factors (Certainty of Knowledge and Justification for Knowing). These findings have potential implications for teaching in biomedical disciplines and adaptation of Western curriculum innovations in Eastern educational contexts. Further work is needed to confirm and understand any epistemological differences and subsequent implications for learning and teaching in medicine.

Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience

ObjectivesTo investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or...

Unhealthy imbalance; decreased exercise and poor knowledge of exercise as medicine in Australian Medical Students the MEDx study

Unhealthy imbalance; decreased exercise and poor knowledge of exercise as medicine in Australian Medical Students the MEDx study

Australian medical students’ perceptions towards the introduction of MD courses in medical education

Introduction: There is an increasing trend away from undergraduate-entry to postgraduate-entry Doctor of Medicine (MD) courses of medical education. To date, data is lacking on the perceptions of the consumers of medical education, medical students, towards this trend. The following research aims to fill that gap to inform course developers, administrators and policy-makers. The objective was to explore the perceptions of Australian medical students towards the introduction of postgraduate- entry Doctor of Medicine (MD) programs. Methods: Between September and October 2012, medical students across all medical courses and year levels in Australia were invited to participate in a survey to determine their perceptions of MD programs. Responses were received from 1,291 students (35.5%). The main outcome measures were mean scores on six items regarding the impact on professional practice of respondents and two items regarding the impact on future medical school places across three categories of medical course types. Results: MD students were more positive about the impact of the MD program than both MBBS students at universities that also offer the MD program and MBBS students at universities without the MD program ( p <0.001) for all six professional practice items. MBBS students at universities without the MD program were more positive than MBBS students at universities with the MD program for two professional practice items (interactions with other medical professionals, p =0.007; qualifications recognised overseas, p <0.001). MBBS students at universities without the MD program were more concerned than MD students regarding MD programs allowing domestic full-fee medical places ( p <0.01). Average ratings for the possibility of MD programs allowing unregulated medical student numbers were similar across groups ( p =0.178). Conclusions: While the introduction of MD courses to Australia has its benefits, potential disadvantages include decreased quality of medical education, decreased availability of post-graduate training, decreased diversity of the medical workforce, increased competition for educational resources and community misperceptions regarding MD graduates. These concerns may be addressed by governmental regulation, provision of additional resources and further research on community perceptions regarding MD graduates.

Factors affecting Australian medical students' attitudes to interprofessional education; validity of the Readiness for Inter-professional Learning Scale-Med

Abstract Objectives To examine the attitudes of undergraduate pre-professional medical students toward involvement in interprofessional learning, using the Readiness for Interprofessional Learning Scale. Methods A cross sectional survey of 478 Australian medical students in the clinical years (3, 4 and 5). Results Positive attitudes (mean: 72%), varied significantly across course years 3, 4 and 5 ( p ≤ .05). More negative attitudes to IPL in the middle (second) year of clinical placement (course year 4) compared with the prior year. A three-factor explanatory model was adopted: Shared Learning (11 items) (Cronbach alpha .92), Professional Identity (5 items) ( α = .75) and Teamwork/Collaboration (2 items) ( α = .51) components. Conclusions Medical students' attitudes suggest that interprofessional education should be offered early in the medical course. This study confirms the Readiness for Interprofessional Learning Scale-Med as reliable tool when used with undergraduate/pre-professional medical students.

The influence of international medical electives on career preference for primary care and rural practice.

BackgroundPrevious studies have demonstrated a correlation between medical students who undertake international medical electives (IMEs) in resource poor settings and their reported career preference for primary care in underserved areas such as rural practice. This study examines whether a similar correlation exists in the Australian medical school context.MethodsData was extracted from the Medical Schools Outcomes Database (MSOD) of Australian medical students that completed commencing student and exit questionnaires between 2006 and 2011. Student responses were categorized according to preferred training program and preferred region of practice at commencement. The reported preferences at exit of students completing IMEs in low and middle income countries (LMIC) were compared to those completing electives in high income countries (HIC).ResultsThe effect of elective experience for students expressing a preference for primary care at commencement was non-significant, with 40.32 % of LMIC and 42.11 % of HIC students maintaining a preference for primary care. Similarly there were no significant changes following LMIC electives for students expressing a preference for specialist training at commencement with 11.81 % of LMIC and 10.23 % of HIC students preferring primary care at exit. The effect of elective experience for students expressing a preference for rural practice at commencement was non-significant, with 41.51 % of LMIC and 49.09 % of HIC students preferring rural practice at exit. Similarly there were no significant changes following LMIC electives for students expressing a preference for urban practice at commencement, with 7.84 % of LMIC and 6.70 % of HIC students preferring rural practice at exit.ConclusionsThis study did not demonstrate an association between elective experience in resource poor settings and a preference for primary care or rural practice. This suggests that the previously observed correlation between LMIC electives and interest in primary care in disadvantaged communities is likely dependent on student and elective program characteristics and supports the need for further research and critical examination of elective programs at Australian medical schools.

Medical studies and Nazi medicine: Nazi medicine as perceived by Austrian medical students.

Austrian medical universities have not covered the topic of Nazi medicine in their curricula to any satisfactory degree to date. In the context of medical-ethical education and on-going medical ethics debates, it seems indispensable to be confronted also with the dark chapters of medical history, and especially Nazi medicine. Students should learn to understand controversial discussions, e.g. about euthanasia, in a historical context. The purpose of this study was to investigate whether students had, during their studies, been confronted with Nazi medical crime and whether they considered such a confrontation as important. The survey also focused on extant knowledge about this topic. From late 2012 to May 2013, 341 late semester students of the medical universities in Vienna, Graz, and Innsbruck were questioned about the coverage of Nazi medicine during their courses, using multiple choice questionnaires. The data were evaluated using a descriptive-statistical approach. The study has shown a low level of knowledge of students about Nazi medicine in the three universities. Only a third of the students had ever heard about "Aktion T4". About 65% of the participants found it important to be comprehensively informed about Nazi medicine during their studies, e.g. with a view to their future career. On average across the three universities, only 43% of the students had been confronted with this topic. The study found a clear wish for more information about Nazi medicine. Universities should, therefore, offer students various opportunities and ways of discussing this issue in the university context.

Prudentia: A medical school's solution to curriculum mapping and curriculum management

The School of Medicine (SoM) at the University of Notre Dame Australia has developed a curriculum mapping system called Prudentia. This web-based application allows users to explore curriculum across all four years of the MBBS to determine what and when students are expected to learn, and if there are any anomalies evident within this data. A five-level hierarchical, outcomes-based curriculum framework underpins Prudentia, ranging from the macro Australian Medical Council's Student Outcomes Statements to the micro daily learning objectives. Data in all five levels of the framework can be mapped and constructive alignment between the outcomes, instructional and assessment methods can also be investigated. While Prudentia is a user-friendly application, it is only as good as the curriculum framework which underpins it. This paper discusses the critical questions that were pivotal in developing the SoM’s curriculum framework, upon which a robust curriculum mapping system was eventually built. This journal article is available in Journal of University Teaching & Learning Practice: http://ro.uow.edu.au/jutlp/vol12/iss4/9

Prudentia: A medical school’s solution to curriculum mapping and curriculum management

The School of Medicine (SoM) at the University of Notre Dame Australia has developed a curriculum mapping system called Prudentia. This web-based application allows users to explore curriculum across all four years of the MBBS to determine what and when students are expected to learn, and if there are any anomalies evident within this data. A five-level hierarchical, outcomes-based curriculum framework underpins Prudentia, ranging from the macro Australian Medical Council's Student Outcomes Statements to the micro daily learning objectives. Data in all five levels of the framework can be mapped and constructive alignment between the outcomes, instructional and assessment methods can also be investigated. While Prudentia is a user-friendly application, it is only as good as the curriculum framework which underpins it. This paper discusses the critical questions that were pivotal in developing the SoM’s curriculum framework, upon which a robust curriculum mapping system was eventually built.

Bullying and harassment of trainees: an unspoken emergency?

Bullying and harassment of trainees: an unspoken emergency?

Are Future Doctors Taught to Respond to Intimate Partner Violence? A Study of Australian Medical Schools.

Intimate partner violence (IPV) is a leading cause of morbidity and mortality among women of childbearing age. This study aimed to describe delivery of IPV education in Australian pre-vocational medical degrees, and barriers and facilitators influencing this delivery. Eighteen Australian medical schools offering pre-vocational medical degrees were identified. Two were excluded as they had not finalized new curricula. One declined to participate. At least one staff member from each of the remaining 15 schools completed a telephone survey. Main outcome measures included whether IPV education was delivered within the degree, at what stage, and whether it was compulsory; mode and number of hours of delivery; and barriers and facilitators to delivery. Twelve of the medical schools delivered IPV education (median time spent per course = 2 hr). IPV content was typically included as part of Obstetrics and Gynecology or General Practice curriculum. Barriers included time constraints and lack of faculty commitment, resources, and funding. The two schools that successfully implemented a comprehensive IPV curriculum used an integrated, advocacy-based approach, with careful forward planning. Most Australian pre-vocational medical students receive little or no IPV education. The need remains for a more consistent, comprehensive approach to IPV education in medical degrees.

Exploring the approaches used to teach concepts of hand hygiene to Australian medical students.

Recent audit data has revealed that the hand hygiene (HH) rates of Australian medical students is suboptimal. It has been suggested that new approaches are needed to teach students about infection control. As a first step, we undertook a study to determine the current educational approaches used to teach Australian medical students about HH. Secondly, this study aimed to explore the perceived barriers and to explore what other teaching approaches could be used to improve the levels of knowledge and compliance. A self-administered questionnaire was sent to the Dean of Medical Education at each of the medical schools in late 2012. Of the 19 medical schools in Australia, 17 agreed to participate. The most commonly reported approaches currently used to teach students about HH are skills stations (17/17) and case scenarios/lectures (15/17). Clinical practical exams (15/17) and competency checks (11/17) are mostly used to assess the HH practices of medical students. Participants nominated the following as barriers to improving HH compliance: negative role modelling by senior doctors, and negative attitudes of students. Practical exercises (15/17), online teaching (12/17) and reflection (12/17) were suggested as other useful approaches that could be used to teach these concepts. Practical laboratory-based approaches were suggested as the most useful teaching and learning approach. Given the trend towards blended learning, universities may want to consider new HH teaching approaches that combine campus-based learning with online components and reflection. Early exposure and the continued reinforcement of HH concepts through the student's medical degree are essential.

Ian Anderson: transforming Indigenous medicine and education

Ian Anderson: transforming Indigenous medicine and education

Student identification of the need for complementary medicine education in Australian medical curricula: A constructivist grounded theory approach

Across the Western world, including Australia, growing popularity of complementary medicines (CMs) mandates their implementation into medical education (ME). Medical students in international contexts have expressed a need to learn about CMs. In Australia, little is known about the student-specific need for CM education. The objective of this paper was to assess the self-reported need for CM education among Australian medical students. Thirty second-year to final-year medical students participated in semi-structured interviews. A constructivist grounded theory methodological approach was used to generate, construct and analyse data. Medical school education faculties in Australian universities. Medical students generally held favourable attitudes toward CMs but had knowledge deficits and did not feel adept at counselling patients about CMs. All students were supportive of CM education in ME, noting its importance in relation to the doctor-patient encounter, specifically with regard to interactions with medical management. As future practitioners, students recognised the need to be able to effectively communicate about CMs and advise patients regarding safe and effective CM use. Australian medical students expressed interest in, and the need for, CM education in ME regardless of their opinion of it, and were supportive of evidence-based CMs being part of their armamentarium. However, current levels of CM education in medical schools do not adequately enable this. This level of receptivity suggests the need for CM education with firm recommendations and competencies to assist CM education development required. Identifying this need may help medical educators to respond more effectively.

The Australian Medical Schools Assessment Collaboration: benchmarking the preclinical performance of medical students.

To report the level of participation of medical schools in the Australian Medical Schools Assessment Collaboration (AMSAC); and to measure differences in student performance related to medical school characteristics and implementation methods. Retrospective analysis of data using the Rasch statistical model to correct for missing data and variability in item difficulty. Linear model analysis of variance was used to assess differences in student performance. 6401 preclinical students from 13 medical schools that participated in AMSAC from 2011 to 2013. Rasch estimates of preclinical basic and clinical science knowledge. Representation of Australian medical schools and students in AMSAC more than doubled between 2009 and 2013. In 2013 it included 12 of 19 medical schools and 68% of medical students. Graduate-entry students scored higher than students entering straight from school. Students at large schools scored higher than students at small schools. Although the significance level was high (P<0.001), the main effect sizes were small (4.5% and 2.3%, respectively). The time allowed per multiple choice question was not significantly associated with student performance. The effect on performance of multiple assessments compared with the test items as part of a single end-of-year examination was negligible. The variables investigated explain only 12% of the total variation in student performance. An increasing number of medical schools are participating in AMSAC to monitor student performance in preclinical sciences against an external benchmark. Medical school characteristics account for only a small part of overall variation in student performance. Student performance was not affected by the different methods of administering test items.

Complementary medicines in medicine: Conceptualising terminology among Australian medical students using a constructivist grounded theory approach

Terminology around the use of complementary medicines (CM) within medical discourse is ambiguous. Clear collective discourse within the medical context is required. This study reports the findings of a Constructivist Grounded Theory Method study used to explore medical students’ conceptualisation of terminology and associated value components around CMs as evidenced within their discourse community. The results show that terminology surrounding CMs within medicine is politically charged and fraught with value judgements. Terms used to describe CMs were considered, many of which were deemed problematic. Categorisation of specific medicines was also deemed inappropriate in certain contexts. Conceptualisation of CM terminology, categorisation and value implications, discriminated between levels of evidence for CMs and provided insights into the social change of medicine towards emergence of an evidence-based integrative approach. The results show that terminology surrounding CM is a social construct consistent with fluid conceptualisation and operationalisation in different social contexts.

The relationships among self-care, dispositional mindfulness, and psychological distress in medical students

BackgroundPast research suggests that medical students experience high levels of psychological distress.ObjectiveThe aim of the current study was to investigate the relationships among engagement in self-care behaviours, dispositional mindfulness, and psychological distress.MethodsThe sample consisted of 139 female and 68 male Australian medical students (N=207) aged 17–41 years (M=21.82, SD=3.62) across the 5 years of the Monash University medical course. Participants completed an online survey comprising a demographics questionnaire, the Five Facet Mindfulness Questionnaire, the Health-Promoting Lifestyle Profile II, and the Depression, Anxiety, and Stress Scales.ResultsResults revealed significant and interpretable multivariate correlations between distress and both mindfulness and self-care. Furthermore, the dispositional mindfulness observation subscale was found to be a significant moderator of the relationship between several dimensions of self-care and psychological distress.ConclusionsThe present study points to the potential of self-care and mindfulness to decrease medical student distress and enhance well-being.

Medical leadership is the new black: or is it?

Considerable resources are being invested in healthcare leadership development programs and there is a new requirement for leadership teaching for Australian medical students. The new attention to medical leadership may be a reaction to loss of medical status and power. There is little evidence for return on investment from such programs. It is simply not clear what kind of leadership training is needed for collaborative work to improve healthcare nor what kind of organisational structures enable productive exercise of medical leadership skills. Caution is recommended.