Fifth Year Of Medical School Research Articles

The Level of Knowledge and Attitudes Toward Dementia Among Senior Medical Students in Recife, Brazil.

Aging is no longer a phenomenon for society; it has become a reality in all countries, leading to a notable increase in the prevalence of dementia, a common condition among the elderly population. This situation highlights the importance of adequately preparing future healthcare professionals with the necessary knowledge and attitudes to effectively care for dementia patients. This study aims to describe the knowledge and attitudes towarddementia among fifth- and sixth-year medical students at a prestigious medical school in Recife, Brazil. A descriptive, analytical cross-sectional study was conducted in which participants answered questionnaires related to epidemiological and educational data of the involved students, the assessment of the sample's knowledge regarding dementia, and addressing attitudetoward a patient with dementia. Data collection took place online, targeting fifth- and sixth-year medical students at the Faculdade Pernambucana de Saúde (FPS). A total of 111 students participated in the study, with a majority of females (73.9%), most of them in the fifth year of medical school (79.3%). While the majority of the students received training during their undergraduate studies on cognitive changes related to dementia (58.6%), this knowledge was mostly theoretical (64%), and only a few students took extracurricular courses on the subject (7.2%). Regarding the questionnaire evaluating students' knowledge, the overall mean was 6.69 points (on a scale of 0-14). Notably, there was no significant difference in correct answers among the tested areas of epidemiology, diagnosis, and management, with percentages of correct answersof 49.8%, 45.27%, and 52.53%, respectively. As for their attitudes towarddementia, the majority of students responded in a manner consistent with current literature and best practices for managing patients with functional dependence and cognitive changes. The results indicate that despite the notable rise in dementia cases across the world, the study revealed that the participants lacked essential knowledge about dementia. However, most of them demonstrated attitudes aligned with the best practices for managing dementia patients and their families. These data may suggest the need for greater attention in the teaching-learning process on the part of the medical school, as well as the promotion of extracurricular activities on this topic, in addition to enhancing the promotion of practical activities in geriatrics.

Causes that induce self-medication in first and fifth year students of the USFX School of Medicine

Introduction: We live in a society that encourages self-medication and one reason is the availability of drugs that do not require a prescription and are easily accessible, the abuse of these have important implications for the health of the general population; being the most commonly used drugs: analgesics, antibiotics, antihistamines and others. Objective: Determine the causes that induce self-medication in freshmen and fifth year of the Faculty of Medicine of the Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca - Bolivia, 2012. Methodology: Quantitative and descriptive cross-sectional approach. A sample of 284 students which they apply structural survey was obtained. Results.A high percentage of students who are self-medicating themselves without.medical.supervision. Conclusions: We can say that self-medication on freshmen and fifth year of medical school at the University Of San Francisco Xavier De Chuquisaca is induced by influence of social circle (friends and parents), advertising of certain medications, access to internet and lack of time.

Are clinical medical students confident about their head and neck anatomy knowledge?

Anatomy is a pillar of medical knowledge and essential for safe medical and surgical practice. The literature highlights concerns regarding anatomy knowledge, and knowledge of the head and neck in particular, in medical students and newly qualified doctors. We investigated medical students’ confidence to be assessed on head and neck anatomy, the amount of teaching they received, and its mode of delivery, through an online survey completed by 185 medical students across two English Universities (122 (66%) students from University A and 63 (34%) from University B). Students were in their third to fifth year of medical school. A total of 126 (68%) had received two to four sessions on head and neck anatomy, and 56 (30%) had received one or two sessions. A total of 113 (61%) had received prosection teaching, and 44 (24%) had received computer/virtual anatomy teaching. In total, 140 (76%) did not feel confident to be assessed on head and neck anatomy, and 137 (74%) did not feel they had received an adequate amount of head and neck anatomy teaching. Despite formal head and neck anatomy teaching most of our cohort did not feel confident to be assessed on the topic. Further work is required to integrate anatomy into the clinical years and to devise a national undergraduate curriculum to enhance an interest in head and surgery as a career.

Case presentation methods: arandomized controlled trial of the one-minute preceptor versus SNAPPS in acontrolled setting.

IntroductionOne-minute preceptor (OMP) and SNAPPS (a mnemonic for Summarize history and findings; Narrow the differential; Analyze the differential; Probe the preceptor about uncertainties; Plan management; and Select case-related issues for self-study) are educational techniques developed to promote learners’ expression of clinical reasoning during the case presentation in the workplace. The aim of this present study was to compare the content of the case presentation between the SNAPPS and the OMP methods.MethodsThis was a randomized controlled trial comparing SNAPPS and OMP in 60 medical students at the beginning of their fifth year of medical school. After an introduction session, students presented and discussed two cases based on real patients and provided in written format. All case presentations were recorded and evaluated by two researchers. The assessed elements of the case presentations were divided into three subgroups related to expression of clinical reasoning, time and initiative to guide the presentation.ResultsThere were 30 participants in each group. There was no difference in the expression of clinical reasoning between OMP and SNAPPS groups (number of differential diagnoses, justification of most likely diagnosis and differential diagnosis, expression of comparing and contrasting hypotheses). However, students in the SNAPPS group expressed significantly more questions and uncertainties (p < 0.001), and more often took the initiative to present and justify the most likely diagnosis, differential diagnosis and management plan than students in the OMP group, both in simple and complex cases (all p values <0.001) without extending the length of the teaching session.ConclusionOMP and SNAPPS equally promote medical students’ expression of clinical reasoning. The SNAPPS technique was more effective than the OMP technique in helping students to take on an active role during case presentation. We propose SNAPPS as an effective learning tool, engaging students and promoting the expression of their clinical reasoning as part of a case presentation.

Research of the impact of urinary infection teaching methods on the learning process

IntroductionThe classical teaching methodology was based on passive transmission-based learning. The model has changed toward an orientation based on student-centered learning. ObjectiveThe objective of the study has been to evaluate the students’ perception when learning about urinary tract infections, and their perspective about the teaching imparted on this pathology in the various subjects that include ITU in their syllabus. MethodsA cross-sectional analytical study of the responses to an anonymous survey entitled: “Methodology on urine infections. Teaching aspects” issued by 228 students at their fifth year of Medical School, from two promotions. They referred to the following subjects: Pharmacy, Pathophisiology, Gynecology and Obstetrics, Infectious diseases, Microbiology, Nephrology, Pediatrics and Urology. ResultsThe following variables have been analyzed: teaching content, teaching basic aspects of the disease, consideration of teaching methodology and improvement suggestions. Descriptive and inferential statistics were used. ConclusionThe study has concluded that teaching urinary tract infection is perceived in specific subjects related to microorganism (Microbiology), the target organ (Infectious diseases, Urology), affected patients (Pediatrics, Gynecology and Obstetrics) rather than transversal subjects such as Pathophysiology or Pharmacy. The teaching methodology has been considered appropriate by more than 50% of the students in five from the 8 subjects that teach the concept of urinary tract infection. The students suggest convenient changes in current teaching methodology in several subjects that impart the urinary tract infection concept.

Investigación de la repercusión en el proceso de aprendizaje según la metodología docente en la infección urinaria

IntroductionThe classical teaching methodology was based on passive transmission-based learning. The model has changed towards an orientation based on student-centred learning. ObjectiveThe objective of the study has been to evaluate the students’ perception when learning about urinary tract infections, and their perspective about the teaching imparted on this pathology in the various subjects that include ITU in their syllabus. MethodsA cross-sectional analytical study of the responses to an anonymous survey entitled: “Methodology on urine infections. Teaching aspects “issued by 228 students at their fifth year of Medical School, from two promotions. They referred to the following subjects: Pharmacy, Pathophisiology, Gynecology and Obstetrics, Infectious diseases, Microbiology, Nephrology, Pediatrics and Urology. ResultsThe following variables have been analysed: teaching content, teaching basic aspects of the disease, consideration of teaching methodology and improvement suggestions. Descriptive and inferential statistics were used. ConclusionThe study has concluded that teaching urinary tract infection is perceived in specific subjects related to microorganism (Microbiology), the target organ (Infectious diseases, Urology), affected patients (Pediatrics, Gynecology and Obstetrics) rather than transversal subjects such as Pathophysiology or Pharmacy. The teaching methodology has been considered appropriate by more than 50% of the students in five from the 8 subjects that teach the concept of urinary tract infection. The students suggest convenient changes in current teaching methodology in several subjects that impart the urinary tract infection concept.

The Process of Clinical Reasoning among Medical Students

ABSTRACT Introduction: Research in the field of medical reasoning has shed light on the reasoning process used by medical students. The strategies in this process are related to the analytical [hypothetical-deductive (HD)] and nonanalytic [scheme-inductive) (SI)] systems, and pattern recognition (PR)]. Objective: To explore the clinical reasoning process of students from the fifth year of medical school at the end of the clinical cycle of medical internship, and to identify the strategies used in preparing diagnostic hypotheses, knowledge organization and content. Method: Qualitative research conducted in 2014 at a Brazilian public university with medical interns. Following Stamm's method, a case in internal medicine (IM) was built based on the theory of prototypes (Group 1 = 47 interns), in which the interns listed, according to their own perceptions, the signs, symptoms, syndromes, and diseases typical of internal medicine. This case was used for evaluating the clinical reasoning process of Group 2 (30 students = simple random sample) obtained with the "think aloud" process. The verbalizations were transcribed and evaluated by Bardin's thematic analysis. The content analysis were approved by two experts at the beginning and at the end of the analysis process. Results: The interns developed 164 primary and secondary hypotheses when solving the case. The SI strategy prevailed with 48.8%, followed by PR (35.4%), HD (12.2%), and mixed (1.8 % each: SI + HD and HD + PR). The students built 146 distinct semantic axes, resulting in an average of 4.8/ participant. During the analysis, 438 interpretation processes were executed (average of 14.6/participant), and 124 combination processes (average of 4.1/participant). Conclusions: The nonanalytic strategies prevailed with the PR being the most used in the development of primary hypotheses (46.8%) and the SI in secondary hypotheses (93%). The interns showed a strong semantic network and did three and a half times more interpretation than combination processes, reflecting less deep organization and content of knowledge when compared with experienced physicians.

Confidence in palliative care issues by medical students and internal medicine residents

BackgroundPalliative care (PC) is a relatively new field in Brazil, but this knowledge is of great importance in medical practice.ObjectiveTo evaluate the degree of confidence among medical students and first-year...

Prevalence and characteristics of impulse control disorders in a group of medical students

Objective: To determine the prevalence of impulse control disorders (ICDs) among medical students and evaluate the related socio-demographic and clinical features. Methods: A total of 277 students in the fourth and fifth year of medical school were included in the study. The study was conducted between September 2011 and June 2012 in Cukurova University Medical School, Adana, Turkey. A demographic data form has been completed. The Structured Clinical Interview for DSM-IV (SCID-I) was used to determine axis I psychiatric disorders. The prevalence rates of ICDs were investigated by using the modified version of the Minnesota Impulse Disorders Interview. All patients completed Barratt Impulsiveness Scale Version 11 (BIS-11) and Symptom Check List-90. Results: The lifetime prevalence of at least one ICD in our sample was 11.2% (n=31). When the participants with the diagnosis of ICDs not otherwise specified were excluded the prevalence rate decreased to 7.9%. The most common ICD was intermittent explosive disorder (6.1%), followed by trichotillomania (2.5%). History of suicide attempts was significantly higher in the group with ICD. There was statistically significant difference between comorbidity of other Axis I psychiatric disorders and a significant difference was observed in terms of total impulsivity, non-planning activity, and motor impulsivity scores as determined by BIS-11 between groups with or without ICDs. Conclusion: ICDs might be underdiagnosed in young adult populations. ICDs affect the quality of life, the course and outcome of comorbid disorders so it is important to ask for these disorders in regular psychiatric interviews and treating them in an appropriate and specific way.

Standardized and quality-assured video-recorded examination in undergraduate education: informed consent prior to surgery

BackgroundCommunication skills combined with specialized knowledge are fundamental to the doctor–patient relationship in surgery. During a single-station video-recorded objective structured clinical examination (VOSCE), students were tasked with obtaining informed consent. Our aim was to develop a standardized and quality-assured assessment method in undergraduate education. MethodsOne hundred fifty-five students in their fifth year of medical school (78 videos) participated in a summative VOSCE within the framework of the teaching module “Operative Medicine.” They prepared for three clinical scenarios and the surgical procedures involved. The examination comprised participants having to obtain informed consent from simulated patients, video recording their performance. Students were assessed by two independent raters, the background of one of whom was nonsurgical. Results were statistically tested using SPSS. ResultsStudents' scores were all beyond the pass mark of 70%, averaging 91.0% (±4.0%), 88.4% (±4.4%), and 87.0% (±4.7%) for the appendectomy, cholecystectomy, and inguinal hernia repair checklist, respectively. Most items (68%–89% of the checklists) were found to have fair to excellent discrimination values. Cronbach's α values ranged between 0.565 and 0.605 for the individual checklists. Interrater agreement was strong (Pearson correlation coefficient = 0.80, P < 0.01; intraclass correlation coefficient 2.1 = 0.78). ConclusionsThe VOSCE is both feasible and reliable as a method of assessing student communication skills and the application of clinical knowledge while obtaining informed consent in surgery. This method is efficient (flexible rating outside normal working hours possible with reductions in administrative load) and may be used for high-stakes evaluation of student performance.

A experiência da Universidade São Francisco com o internato médico de psiquiatria utilizando a metodologia da aprendizagem baseada em problemas

Nos últimos anos, o ensino médico vem sofrendo modificações pedagógicas e curriculares, visando promover a formação de um novo profissional de saúde. Uma das alternativas pedagógicas propostas é a educação problematizadora, que trabalha essencialmente com a construção de conhecimentos a partir da vivência de experiências significativas. Tal modelo de aprendizagem tem viabilizado mudanças curriculares, em que a psiquiatria vem conquistando espaço significativo para o desenvolvimento de uma prática médica mais humanística e integral. O artigo se propõe a discutir a experiência do Curso de Medicina da Universidade São Francisco, em Bragança Paulista (SP) referente à implantação do internato de psiquiatria pela metodologia da aprendizagem baseada em problemas, desde 2003. O internato de psiquiatria ocorre no quinto ano do Curso de Medicina, com carga horária de 320 horas, correspondendo a 8 semanas de 40 horas. As atividades são desenvolvidas no hospital-dia e no ambulatório, e a interconsultoria é realizada no hospital geral. Observa-se significativa evolução no conhecimento adquirido dos alunos, que conseguem, ao término do internato, desenvolver raciocínio clínico e sedimentação de conceitos e práticas psiquiátricas adequadas à formação médica generalista, compatíveis ao que o curso de graduação propõe. A experiência relatada pode servir de modelo para a implantação de uma proposta de aprendizagem em saúde mental inserida nos preceitos da reforma psiquiátrica no Brasil, buscando-se implementar o desenvolvimento de práticas comunitárias e interdisciplinares.

Undergraduate medical students’ experience in general practice

Increasingly, undergraduate medical education is becoming community-based. Logbooks are a useful tool in documenting the range of clinical exposure and learning opportunities available to students during clinical training, particularly where the role of new clinical settings for training medical students is being explored. To describe the clinical experience of medical students during an undergraduate programme in general practice at an Irish University. Medical students in the fifth year of medical school were asked to record data from 20 consecutive consultations during a clinical attachment in general practice. A total of 186 students (82% of total) recorded data on 3,710 consultations. The patient population encountered was similar in demography and morbidity profile to other general practice populations, with hypertension, preventive immunisation and cough the most frequently encountered diagnostic labels. Respiratory illness and circulatory illness were the most frequently encountered primary and secondary presentations, respectively. An active role was adopted by students in almost half of all consultations. This paper provides evidence that general practice in Ireland is a setting in which medical students can both encounter a wide range of clinical problems and engage in active learning processes.

Conhecimento dos métodos para diagnóstico do câncer de mama entre estudantes de medicina

Objetivos: avaliar o nivel de conhecimento de nocoes basicas do diagnostico do câncer de mama entre os alunos de medicina; promover a discussao entre eles e avaliar o aproveitamento dos alunos do 5o ano medico, apos cursar a Disciplina de Ginecologia. Metodos: por meio de questionarios aplicados a 348 alunos do total de 550 alunos, do 1o ao 5o ano do curso medico, buscaram-se informacoes a respeito do conhecimento basico do diagnostico do câncer de mama. Dos 348 questionarios aplicados, 55 (16%) foram respondidos por estudantes do 5o ano que haviam cursado a Disciplina de Ginecologia. Destes, 43% eram mulheres, 62% tinham familiares medicos e 17% historia familiar de câncer de mama. Resultados: em relacao ao conhecimento dos metodos diagnosticos, 84% dos alunos acertaram o sinal mais frequente do câncer de mama; 34%, o melhor metodo de rastreio; 49%, quando indicar a mamografia em mulheres assintomaticas; 37%, a periodicidade preconizada da mamografia apos 50 anos e 24%, quando associar o ultra-som a mamografia para deteccao do câncer de mama. Os alunos do 5o ano apresentaram um indice de acerto para todas as perguntas significativamente maior que os demais. O sexo so apresentou diferenca em relacao ao maior conhecimento pelas mulheres quanto ao melhor periodo para o auto-exame e quando indicar a associacao do ultra-som a mamografia. A presenca de familiares medicos e a historia familiar de câncer de mama nao influenciaram as respostas. Conclusao: mesmo entre academicos de medicina ainda e grande a desinformacao a respeito do diagnostico do câncer de mama. Nao obstante, apos cursar a disciplina, esse conhecimento aumenta significativamente.

An Indian dilemma

Raj, a 4-day-old baby, has not urinated since birth. Dr Jha gently refers his distraught mother to a paediatrician. Nina is 21 years old and has a breast abscess. Dr Jha tells her he will operate on the abscess in the morning, notices her blanched look, rightly guesses her fear, and reassures her that it is not cancer. I suddenly notice an old schoolfriend sitting across the room from me. She unwraps her scarf to reveal a large dressing on her neck. A recently drained tuberculous abscess discharges pus. While Dr Jha examines her wound, our eyes meet. I am embarrassed to meet her under such conditions and leave the room. On returning, I ask Dr Jha whether clean and well-nourished people can get tuberculosis; the sight of a schoolfriend with tuberculosis has shaken me, as if I expected all those who I know to be free from disease. He replies that tuberculosis is very common throughout India and no one is spared. One of the theatre staff arrives to tell Dr Jha that the theatre is ready for Mr Lal’s cholecystectomy. The rest of the throng outside must wait, most of whom have travelled long distances, many on foot, to seek treatment here. Word has spread far about Dr Jha, who, after finishing at the top of his medical class, went to the UK for specialist training and then returned to India. He cares for his own people. At least half the waiting patients will have a non-surgical complaint, but in India there is no medical system to channel patients to appropriate specialists. Dr Jha is first a general practitioner and then a surgeon, as well as physician, paediatrician, obstetrician, and gynaecologist when needed. Dr Jha rolls up his trousers and shirt sleeves, discards his tie, scrubs up, dons a sterile gown and gloves, and walks into theatre. There is a combination of clean and unclean, qualified and unqualified in the theatre. Although the surgeon wears a sterile gown and uses autoclaved equipment, there are six other people present in civilian clothing. The ward is next to the theatre and the attendants walk freely between the two areas. The theatre door is wide open and one of the ubiquitous houseflies finds its way in; someone reaches quickly for the Baygon spray, filling the room with its intolerable smell. The anaesthetist has been working in this clinic for the past 3 years. Before his arrival, a man with no medical background, personally trained by Dr Jha, carried out all anaesthetic duties, and he still assists when the anaesthetist is unavailable. The other attendants, all without medical training, are familiar with different antibiotic regimens, the various intravenous solutions used, and the general care of patients. This clinic works 365 days a year. Thousands of patients go through its doors, and they share between them just three medically qualified practitioners. Bhagalpur, Bihar, India 2200 h, Dec 4, 1996 I stand by the bedside, holding his hand as he writhes in pain. In the dim candle-light, I notice his bare feet, hardened by years of walking unprotected through sun and rain, his hands callused, scarred, and capped by black nails, his dirty torn kurta, and old khaki pants. I take in the agonised look on his face, the trickle of blood at the corner of his mouth where he has just bitten his lip. I am in the private clinic of Dr Jha, on an elective in India at the end of my fifth year of medical school at Monash University, Melbourne, Australia. Dr Jha is still working in his office so we sit down for a chat. That is when Mr Lal is carried in by his wife and brother. In whispered conversation with his wife, she tells me how Mr Lal was pulling his rickshaw when he suddenly felt a pain in his abdomen. Fortunately, he had been close enough to return home, where he collapsed. His brother and wife had taken him by rickshaw to the local hospital, only to find that the power supply had been cut off, there was a shortage of medications and equipment, and at that time of night help was unavailable. It is now 3 hours since the pain began. Dr Jha diagnoses acute cholecystitits, prescribes analgesia, and admits Mr Lal to the clinic for a cholecystectomy.

Smoking habits of future physicians: a survey among medical students of a south German university.

Physicians can play a key role in promoting abstinence from tobacco. In many European countries, however, a large proportion of physicians are still smoking themselves. To assess smoking habits of future physicians, a cross-sectional study was conducted in 1992/1993 among 817 students enrolled in the first, third, and fifth years of medical school at the university of Ulm, Germany, using a self-administered questionnaire. The overall participation rate was 85.2%. Prevalence of current smoking was 17.6% among female participants and 29.2% among male participants. Among male students, smoking prevalence varied between 22.9% in the first year and 34.6% in the fifth year of medical school. Among female students, there were only minor differences in smoking prevalence between the first, third and fifth years at medical school. Most of the smokers had started to smoke prior to entry into medical school. Among third and fifth year students, slightly more students quit smoking than started to smoke during medical school, and smokers in the fifth year of medical school were more frequently willing to quit than smokers in the first and third year. Factors associated with regular smoking of medical students, after adjustment for potential confounders in multivariable analysis, were age, sex, and maternal smoking. While smoking prevalence was somewhat lower in the present study than in previous studies from Germany, further efforts are needed to reduce smoking among future physicians in this country.