Brazilian Medical Students Research Articles

Is it possible to teach Geriatric Medicine in a stimulating way? Measuring the effect of active learning activities in Brazilian medical students.

To describe the experience of a Brazilian medical school in implementing different active methods to teach Geriatric Medicine, reporting the students' opinions and satisfaction with the classes and comparing pre- and postcourse measurements of knowledge, attitudes and skills. A total of 166 third-year medical students received different active theoretical-practical activities for teaching Geriatric Medicine and their knowledge, attitudes, clinical skills and satisfaction were investigated. All activities had good acceptance among students ranging from 8.54 in the activity "Walking aids" to 9.81 in the activity "Nursing Home visit" (ranging 0-10). After the course, students had better attitudes towards older persons (r=0.55-0.81, P<0.001), better knowledge (r=0.84, P<0.001), greater empathy (r=0.51, P<0.001) and better clinical skills (r=0.86, P<0.001). Finally, the course was evaluated positively by the students. New active Geriatric Medicine learning activities resulted in improvement in medical students knowledge, attitudes and skills.

Brazilian version of the Fresno test of competence in Evidence-Based Medicine: a validation study

AIMS: To validate the Brazilian version of the Fresno test of competence in Evidence-Based Medicine.METHODS: This is a cross-sectional, validation study. Phase 1: translation of the Fresno instrument. Phase 2: validation of the translated version, which was tested in 70 undergraduate medical students. The psychometric properties evaluated were validity, internal consistency, and sensitivity to change.RESULTS: Overall, validity was adequate; most items showed a moderate to strong and significant correlation with the total score; there was an important and significant difference between both groups, with and without previous contact with Evidence-Based Medicine (median, 55 [IQ25-75, 45.2-61.7] vs. median, 18.5 [IQ25-75, 6.0-29.7]) (p &lt;0.001). Internal consistency was also adequate (α-C 0.718), and sensitivity to change showed a considerable and significant difference between pre and post-test (median, 18.5 [IQ25-75, 6.0-29.7] vs. median, 44 [IQ25-75, 34.0-60.0]) (p &lt;0.001).CONCLUSIONS: The Brazilian version of the Fresno test showed satisfactory psychometric properties, and it can now be used as a tool to assess the knowledge and skills of Evidence-Based Medicine in Brazilian medical students.

Alcohol abuse and dependence among Brazilian medical students: Association to sociodemographic variables, anxiety and depression

ABSTRACTBackground: Few data are available regarding the prevalence of alcohol abuse (AB) and alcohol dependence (AD) and their association with sociodemographic variables, anxiety and depression in medical students.Objectives: Estimate the prevalence of AB and AD and investigate their relation with sociodemographic variables, depression and anxiety in medical students.Methods: Structured questionnaires regarding alcohol use (AUDIT), depression (PHQ-9) and anxiety (GAD-7) were given to 659 medical students. Data were analyzed using descriptive statistics and logistic regression analyses.Results: The prevalence of AB and AD was, respectively, 28.4% and 15.6%. Multivariate analysis showed statistically significant higher rates of both conditions in men (AB: OR 2.54. AD: OR 2.32) and lower prevalence of these conditions among those in a relationship (AB: OR 0.55. AD: OR 0.43). AB was higher among those living with friends or in a university dorm (OR: 1.65). Prevalence was lower among those currently attending the second (AB: OR 0.48. AD: OR 0.36) and fourth (AB only: OR 0.35) years of medical school. A significant correlation between AD and depression (OR 1.74) was identified.Conclusions: The findings highlight the high prevalence of AB and AD in medical students and identify variables associated with these conditions.

Which Cholecystectomy do Medical Students Prefer?

Introduction:This study was undertaken to identify which minimally invasive technique medical students prefer for cholecystectomy and what factors determine their decision.Methods:Brazilian medical students watched a video reviewing the advantages and disadvantages of six different surgical approaches to cholecystectomy: open surgery, conventional laparoscopy, mini-laparoscopy (MINI), single-incision laparoscopic surgery, natural-orifice transluminal endoscopic surgery, and robotic surgery. Respondents then answered questions about hypothetical situations in which the participants would be submitted to elective cholecystectomy.Results:One hundred eleven medical students completed the survey, 60 females (54%) and 51 males (46%). Most students were 19–26 years old. When asked whether they would consider an open cholecystectomy if minimally invasive surgery (MIS) techniques were available, only 9% answered yes. Senior medical students were the least willing to consider open surgery (P = .036). When asked if they would prefer conventional laparoscopy, MINI, or robotic surgery for their cholecystectomy, 85% of the women and 63% of the men chose MINI (P = .025). When asked if they would consider a single-incision laparoscopic surgery or natural-orifice transluminal endoscopic surgery approach, 94 respondents (84%) answered no. When asked to rank which factors they consider the most important when choosing a surgical technique, they ranked safety of the procedure first (58%) and surgeon experience second (30%).Conclusion:When Brazilian medical students were asked to select a surgical approach for cholecystectomy, most chose MINI. The preference for MINI was strongest amongst female medical students. Both female and male medical students ranked safety as the most important factor.

Formative online quiz on hemotherapy from blood physiology to transfusion medicine: a pilot study conducted with Brazilian medical students.

Formative online quiz on hemotherapy from blood physiology to transfusion medicine: a pilot study conducted with Brazilian medical students.

Low back pain in Brazilian medical students: a cross-sectional study in 629 individuals.

Low back pain (LBP) is a common problem in the general population. Medical students may be at risk of LBP because of demanding curricula. To study the prevalence of LBP in Brazilian medical students and the associated factors. Six hundred twenty-nine medical students (72.8% females, mean age of 23years old) answered a questionnaire containing epidemiological data; data on presence and frequency of LBP, use of painkillers, and LBP interference in daily activities; number of sitting and exercising hours/day, posture habits. They also filled a VAS (or visual analogic scale) on the own perception of anxiety, depression, fatigue, and the Roland Morris functional questionnaire for LBP. In this sample, 81.7% had periods of recurrent LBP that was more common in females (77.6% vs 51.3%; p < 0.0001) and associated with bad posture habits (p < 0.0001). Number of sitting hours, exercising, and study period at school could not be associated with LBP. The mean Roland Morris result was 4.0; IQR = 2-7 and its value showed a modest correlation with VAS of anxiety (rho = 0.21) and depression (rho = 0.33). LBP interfered with social activities in 20.5%, with physical activities in 33.1%, and in school activities in 29.2%. There is a high prevalence of LBP in medical students, mainly females, associated with bad posture habits. Physical dysfunction for LBP showed correlation with anxiety and depression.

Subjective well-being, religiosity and anxiety: a cross-sectional study applied to a sample of Brazilian medical students.

To assess associations between subjective well-being (SWB), religiosity, anxiety and other factors in a sample of Brazilian medical students from a public university in northeastern Brazil. The present study followed a cross-sectional, observational, analytical approach. Data were collected by administering a self-applicable questionnaire composed of questions focused on sociodemographic data and based on the Satisfaction With Life Scale (SWL), Positive Affect and Negative Affect Scale (PANAS), Penn State Worry Questionnaire (PSWQ), and the Duke Religiosity Index (DUREL). The sample comprised 417 medical school students (73.54% of all the enrolled students). The medical students assessed presented a medium level of satisfaction with life, low mean positive emotion levels and high anxiety/uneasiness levels. Surprisingly, lower anxiety and intrinsic religiosity (IR) scores were associated with higher scores in the two SWB parameters (positive emotions and satisfaction with life). Furthermore, the factors leisure activities, good sleep quality, financial support, age, and gender were associated with the highest SWB scores (with emotional and cognitive components, or with only one of these two components). Data in the current study corroborated the negative association between SWB and anxiety; however, in opposition to the literature, they also evidenced a negative association between SWB and IR. In addition, the present research signaled the need for creating preventive intervention programs to increase SWB through positive psychological techniques and/or to decrease anxiety by applying, for instance, cognitive-behavioral therapy paradigms and/or mindfulness techniques to medical students.

Was there a change in perception of medical students of what good doctors are and what it would take to train them across a 14-year span? A mixed methods panel

ABSTRACT Background Although overall cultural differences exist between individuals from the X and Y generations, to our knowledge few previous studies have contrasted their expectations regarding what good doctors are, and their perceptions on the training processes they undergo. Aims To conduct a study exploring perceptions on what good doctors are and their perceptions about training among a sample of Brazilian medical students at the University of Sao Paulo Medical School, comparing groups from 2000 and 2014. We aimed to provide information that can be used to guide curriculum development in medical schools. Methods We conducted a mixed methods study of a series of open questions asked to medical students from the University of São Paulo, Brazil, in 2000 and 2014. This qualitative analysis focused on uncovering emerging themes related to students’ perceptions regarding what good doctors are and how they see their training process. A subsequent quantitative analysis through Natural Language Processing was undertaken. Results Gender distribution was balanced between the 2000 and 2014 groups, with most students being in the early 20s. Our main emerging concepts involved four themes: Skills and qualities of a good doctor, positive and negative aspects of the curriculum, as well as expectations related to students’ future career. From a qualitative perspective, the 2014 group focused their criticisms on the School of Medicine itself and the study overload, while the 2000 group focused its criticism on the faculty and competition. Therefore, the 2014 group experienced more criticism and less idealization in relation to the School and the medical training process. There were no statistically significant differences between the 2000 and 2014 groups, as well as across genders. Discussion Students in this sample have demonstrated little change over time in relation to their characterization of what good doctors are and how they should be trained. Their preferences for a practical, patient-centered education should guide future curriculum development in medical schools.

Burnout Prevalence and Associated Factors Among Brazilian Medical Students.

Objectives:This study aims to identify the prevalence of burnout and associated factors in Brazilian medical students.Methods:In the largest medical school from Central Brazil, the Maslach Burnout Inventory-Student Survey and a socio-demographic questionnaire were adopted in this cross-sectional study. Correlations among the three dimensions of burnout were verified.Results:The evaluation of 399 students revealed a frequency of 12.0% of burnout. Women had a higher rate of burnout (8.0%) than men (4.0%). The fifth period had the higher frequency of burnout (27.1%), while the seventh grade had the lower frequency (2.1%). The students showed high scores only in emotional exhaustion (63.2%). Between the dimensions “emotional exhaustion” and “disbelief” found a significant correlation.Conclusion:The fifth period of the Medicine course and the female gender are the most affected by burnout syndrome and therefore, the preventive actions to reduce stress among medical students should be directed mainly at these higher risk categories. The low burnout rate found in our study can attest that the PBL methodology and medical schools strategically located to meet regional demand may represent strategies for the prevention of burnout among medical students.

The use of drugs and medical students: a literature review.

The consumption and abuse of alcohol and other drugs are increasingly present in the lives of university students and may already be considered a public health problem because of the direct impacts on the physical and mental health of these individuals. The requirements of the medical program play a vital role in the increasing rate of drug users. To carry out a systematic review of the literature on the use of drugs, licit or not, in Brazilian medical students. A descriptive-exploratory study, in which the SciELO and MEDLINE databases were used. A total of 99 articles were found, of which 16 were selected for this review. Alcohol and tobacco were the most frequently used licit drugs among medical students. The most consumed illicit drugs were marijuana, solvents, "lança-perfume" (ether spray), and anxiolytics. The male genre presented a tendency of consuming more significant amounts of all kinds of drugs, with the exception of tranquilizers. It was found an increasing prevalence of drug consumption in medical students, as the program progressed, which may result from the intrinsic stress from medical school activities. Students who do not use psychoactive drugs are more likely to live with their parents, to disapprove drugs consumption, to practice religious beliefs and to be employed. The prevalence of licit and illicit drug use among medical students is high, even though they understand the injuries it may cause.

Neurophobia in Brazil: Detecting and Preventing a Global Issue

ABSTRACT Neurophobia is a global issue known as a fear of Neurology and Neurosciences by medical students and physicians, and it may contribute to a reduced number of trained neurologists and a global misunderstanding of neurological diseases among physicians. To date, there are no studies that address the issue of Neurophobia in Brazil. The present study aimed to evaluate the perception of Neurology and Neurosciences among Brazilian medical students. Students from four medical schools in the state of Pará, in the second (pre-clinical phase), fourth (clinical phase) and sixth (internship) years of the course, were submitted to a self-administered and written questionnaire divided into two sections: the first section included questions assessing their perceived level of interest, level of knowledge, degree of difficulty, confidence in examining patients, quality of teaching in medical school and likelihood of pursuing the career, concerning different clinical specialties (Cardiology, Endocrinology, Gastroenterology, Nephrology, Neurology, Respiratory Medicine and Rheumatology). In the second section, there were questions about possible reasons why Neurology was perceived as a difficult subject and possible ways to improve neurological education. A total of 486 questionnaires were completed. Neurology was perceived as the most difficult clinical specialty (mean score 4.00; p &lt; 0.001), in which students feel least confident about conducting physical examinations (mean score 2.97; p &lt; 0.001), and with the worst quality of teaching (mean score 3.12; p &lt; 0.001). The main cause of Neurophobia was the need to know neuroanatomy and neurophysiology (very important reason for 39.4% of students), and the most frequently suggested method to improve neurological education was through more and better bedside tutorials (very important factor — 53.3%). Students developing extracurricular activities, women and older students had more unfavorable opinions about Neurology. Neurophobia is also present in Brazil, and new educational approaches must be proposed to improve the misperception of Neurology by medical students. The Medical Education Commission of the Brazilian Academy of Neurology should propose guidelines on Neurology teaching at undergraduate level.

A smoking prevention photoageing intervention for secondary schools in Brazil delivered by medical students: protocol for a randomised trial

IntroductionMost smokers start smoking during their early adolescence, often with the idea that smoking is glamorous; the dramatic health consequences are too far in the future to fathom. We recently...

Cross-cultural Differences in Mental Health, Quality of Life, Empathy, and Burnout between US and Brazilian Medical Students.

This study aimed to compare mental health, quality of life, empathy, and burnout in medical students from a medical institution in the USA and another one in Brazil. This cross-cultural study included students enrolled in the first and second years of their undergraduate medical training. We evaluated depression, anxiety, and stress (DASS 21), empathy, openness to spirituality, and wellness (ESWIM), burnout (Oldenburg), and quality of life (WHOQOL-Bref) and compared them between schools. A total of 138 Brazilian and 73 US medical students were included. The comparison between all US medical students and all Brazilian medical students revealed that Brazilians reported more depression and stress and US students reported greater wellness, less exhaustion, and greater environmental quality of life. In order to address a possible response bias favoring respondents with better mental health, we also compared all US medical students with the 50% of Brazilian medical students who reported better mental health. In this comparison, we found Brazilian medical students had higher physical quality of life and US students again reported greater environmental quality of life. Cultural, social, infrastructural, and curricular differences were compared between institutions. Some noted differences were that students at the US institution were older and were exposed to smaller class sizes, earlier patient encounters, problem-based learning, and psychological support. We found important differences between Brazilian and US medical students, particularly in mental health and wellness. These findings could be explained by a complex interaction between several factors, highlighting the importance of considering cultural and school-level influences on well-being.

Mental health problems among medical students in Brazil: a systematic review and meta-analysis.

Objective:To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors.Methods:We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP.Results:We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs.Conclusion:Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.

Medical Student Oncology Congress: Designed and Implemented by Brazilian Medical Students.

Oncology is an essential field of medicine; however, its teaching is occasionally underemphasized and uncoordinated during medical school. An alternative method of providing additional oncological information to medical students is through extracurricular activities, such as congresses and medical student associations. The aim of this paper is to describe a Medical Student Oncology Congress entirely designed and organized by medical students. Three medical students from oncology study and research groups identified the gap in oncology training at universities and decided to organize a congress for students. They selected representatives from 26 universities in Brazil for onsite registration and created a website for online registration and promotion of the congress. To determine the topics of the lectures, they searched the medical literature for the most commonly occurring cancers in adults and children. Extrapolating the academic content of oncology, they organized lectures by non-governmental organizations (NGOs), talks on career guidance and research in this field as well as a role-playing workshop to train future doctors on how to deliver news to patients. There were a total of 609 attendees, with 590 students from 26 different universities in Brazil. Approximately 82% were medical students, and among the participants there were also 15 medical educators. A total of 80.75% of the participants were extremely satisfied with the congress, and 99.17% would recommend it to a colleague. Most of the overall cost of the congress, 96%, was covered by registration fees. There was a 6% positive net balance, which was donated to the NGOs participating in the congress. This successful experience proves that it is possible to have a congress fully designed, organized and managed by students. It demonstrates how students can be active participants in their own education, as opposed to a classic approach through which only professors are responsible for instruction.

Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents and emergency physicians

OBJECTIVE:To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings.METHODS:A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil. The questionnaire’s self-assessment items for knowledge were transformed into scores.RESULTS:The average score among all participants was 21% (0-100%). Of the total, 85% respondents felt they did not receive sufficient information about mechanical ventilation during medical training. Additionally, 77% of the group reported that they would not know when to start noninvasive ventilation in a patient, and 81%, 81%, and 89% would not know how to start volume control, pressure control and pressure support ventilation modes, respectively. Furthermore, 86.4% and 94% of the participants believed they would not identify the basic principles of mechanical ventilation in patients with obstructive pulmonary disease and acute respiratory distress syndrome, respectively, and would feel insecure beginning ventilation. Finally, 77% said they would fear for the safety of a patient requiring invasive mechanical ventilation under their care.CONCLUSION:Self-assessment of knowledge and self-perception of safety for managing mechanical ventilation were deficient among residents, students and emergency physicians from a sample in Brazil.

Versão brasileira do Attribution Questionnaire – Adaptação transcultural e validação de propriedades psicométricas

RESUMO Objetivo Realizar a adaptação transcultural do Attribution Questionnaire – AQ27 para o português falado no Brasil a partir da versão de Portugal e validar as propriedades psicométricas da escala por meio da análise fatorial exploratória. Métodos Após a adaptação semântica e cultural, o questionário foi aplicado a 431 alunos do 1º ao 6º ano do Curso de Medicina Unifenas-BH, Brasil, e, em seguida, conduziu-se análise fatorial exploratória pelo método de extração de componentes principais e rotação Varimax. Resultados A versão final brasileira do Questionário de Atribuição (AQ-26B) apresentou um fator a menos que a versão original em inglês e a portuguesa devido à fusão dos fatores Medo e Percepção de Perigo, o que gerou a supressão da questão 11 do questionário brasileiro por não apresentar valores psicométricos adequados. Dificuldades linguísticas relacionadas à interpretação da questão 11 e sua maior complexidade de significado latente parecem ter contribuído com esse resultado. Conclusões O questionário brasileiro (AQ-26B) manteve parâmetros de validade e confiabilidade adequados observando-se coerência com o modelo teórico original. Além disso, mostrou-se de fácil aplicação, demonstrando ser um instrumento útil para avaliar o estigma relacionado à doença mental entre alunos de medicina de escolas médicas brasileiras.

Empathy is Associated with Meaning of Life and Mental Health Treatment but not Religiosity Among Brazilian Medical Students.

The purpose of this study was to investigate the influence of spirituality, religiosity, personal beliefs, and previous contact with health issues on the level of empathy in medical students. Jefferson Scale of Empathy-Student Version, WHOQOL-Spirituality, Religiousness and Personal Beliefs, and Duke University Religion Index were applied to 285 Brazilian medical students. The findings suggest that meaning of life and previous mental health treatment but not Religiosity were positively related to empathy. We suggest that more attention should be given for prevention and treatment of mental health issues, and further studies are needed to understand and replicate these findings.

Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis.

BackgroundTuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure.ObjectiveTo estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries.MethodsDatabases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity.ResultsA total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa.ConclusionThe findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings.

Knowledge of Guidelines for Cardiopulmonary Resuscitation among Brazilian Medical Students

ABSTRACT Introduction Sudden death is a substantial public health problem, representing a major cause of mortality worldwide. Suitable initial care is essential for a good prognosis of these patients. Objectives To assess the knowledge of the 2010 guidelines for cardiopulmonary resuscitation (CPR) among medical students in their final year of undergraduate training. Methods This was a cross-sectional study with a sample of 217 medical students enrolled in the sixth year of accredited medical schools in Brazil. A structured questionnaire with 27 items was used to record the sociodemographic characteristics of the participants and to assess their knowledge base of the 2010 ILCOR guidelines for CPR. Results Only fifty (23.04%) out of 217 students achieved results considered as satisfactory in the written evaluation. The average score obtained was 56.74% correct answers. Seventeen percent of the students had never performed CPR maneuvers and 83.80% had never performed cardioversion or defibrillation. Conclusions The knowledge base of medical students regarding cardiopulmonary resuscitation is low. Considering these medical students are in their final year of medical school, this study reveals a worrisome scenario.