First Semester Of Medical School Research Articles

First-year Medical Students’ Varying Vulnerability to Developing Depressive Symptoms and Its Predictors: a Latent Profile Analysis

ObjectivePrevious meta-analytic data have demonstrated the propensity for mental morbidity among medical students (Rotenstein et al. JAMA. 2016;316(21):2214–36). However, there is a lack of research on medical students’ varying depression vulnerabilities and predictive factors. The present study aims to gain a better understanding of the development of mental health morbidity and its predictive factors among first-semester medical students.MethodsIn November 2020 and January 2021, 184 first-semester students from two medical schools were surveyed regarding depression (PHQ-9), self-efficacy, resilience, and cognitive self-regulation. Using latent profile analysis, we identified distinct depression development profiles. We applied a multinomial logistic regression analysis to determine how self-efficacy, resilience, and cognitive self-regulation and their changes predicted profile membership.ResultsFive profiles of depression development were identified: profile 1, no depression (53.8%); profile 2, mild depression (26.1%); profile 3, depression increase I (9.2%); profile 4, depression increase II (9.8%); and profile 5, persistent depression (1.1%). Students with initially high self-efficacy, resilience, and cognitive self-regulation levels were more likely to belong to the no depression profile. A decrease in self-efficacy and cognitive self-regulation was associated with both depression increase profiles (profiles 3 and 4), and a decrease in resilience was found to be a predictor of profile 4.ConclusionStudents who enter medical school have varying states of mental health, and they differ in their vulnerability to developing depressive symptoms. The promotion of resilience, self-efficacy, and cognitive self-regulation strategies may be key in preventing students’ depression in the first semester of medical school.

Pathology Encountered During Cadaver Dissection Provides an Opportunity for Case‐based Learning

Dissection based anatomy education engages medical students in building several skills, including professionalism, problem solving, and critical thinking. During the first semester of medical school at Oakland University William Beaumont (OUWB) School of Medicine, students spend a significant amount of time dissecting and learning anatomy regionally. In addition to viewing typical structures throughout the body, cadaveric dissection also allows for the opportunity to discover and learn from pathology that may be encountered. In this case, students observed a malignant tumor (adenocarcinoma) in the right lung, accompanied by severe fibrosis of the right diaphragmatic parietal pleura. The superior, middle, and inferior lobes of the right lung were significantly reduced in size within the thoracic cavity compared with the left lung. Additionally, several gross malformations in the pulmonary tissue and cavity were observed, likely due to the malignancy. As part of this analysis, histopathology and radiology for the malignant lung tumor will be compared and reviewed against normal lung tissue and mechanisms for adenocarcinoma will be discussed. These will be used to develop a case study to facilitate peer teaching. This case provides a valuable opportunity for medical students at OUWB to connect basic anatomy to clinical presentation and develop a deeper understanding of pathophysiology of disease prior to clinical rotations.

Active Learning and Competency Preconditioning Strengthen Osteopathic Medical Student Performance, Physician Attributes, and Competency Assessments

Background: Medical education has been reliant on didactic lectures, which are predominantly teacher-centered learning. Competency-based education was introduced in North America and with this came a paradigm shift in how schools conceptualize curricula and measure learning outcomes. This modern approach started a change away from traditional lecture-based and teacher-centered curricula to a more student-centric approach using various tools. Competency based education is widely regarded as an outcome-based approach to design, implement and evaluate the curriculum using widely accepted competencies. Authorities recommend seven core competencies which have various indicators to address student performance. The main purpose of this research is to utilize active learning tools to enhance this approach and then assess competencies in the first year of medical school to improve academic outcomes as well as exposing students to competency domains on which they will be assessed and to ultimately create a complete physician. Methods: The study was conducted at a medical school during the first semester of medical school and included 145 students. Various active learning tools, such as modified case-based learning, quizzes, and case discussions, were used to assess competency in a biochemistry and genetics course, and these were compared to questions based on concepts delivered by the traditional lecture method. Results: Student performance on high-stakes examinations after active learning sessions on content and concepts had statistically higher average percentages on the second, third and fourth examinations. The average Diff (p) for the second, third, and fourth examination to the questions being considered for the study were (Diff p= 0.84, 0.83, and 0.92) with a positive moderate correlation for the second examination (r= 0.535) and strong positive correlation for the third and fourth examination (r=0.745 and r=0.856) for their final biochemistry grades. Conclusion: The study shows some positive and significant results that active learning methods are a useful and meaningful way to deliver a curriculum for a competency-based education system, and may be better suited than traditional lectures for providing content and assessing competencies which are necessary to become a complete physician.

Training Medical Student Facilitators of Peer-Assisted Study Sessions Using an Objective Standardized Teaching Exercise.

IntroductionPeer-assisted study sessions (P.A.S.S.) are medical student–facilitated small-group sessions that aim to improve students’ knowledge and performance in preclinical courses. Peer teaching has been shown to have a positive impact on academic performance of both learners and peer teachers. For peer teaching to be more effective, there is a need for training of peer teachers. We developed a facilitator training workshop to help to improve medical students’ confidence in serving as P.A.S.S. facilitators.MethodsParticipants were first-year medical students who were approved to become P.A.S.S. facilitators. We recruited facilitators to attend a training workshop and provided them with a training manual to use during the training session and as a resource after the session. We recruited five standardized students to participate in an objective standardized teaching exercise (OSTE). We asked facilitators to complete pre/post surveys before and after the workshop to indicate their level of confidence in facilitating the sessions and provide feedback on the workshop.ResultsNine P.A.S.S. facilitators participated in the training session. Analysis of pre- and postworkshop survey data showed a statistically significant increase in student confidence (p ≤ .02).DiscussionDeveloping and implementing a formalized P.A.S.S. facilitator training manual and workshop with an OSTE helped improve students’ confidence in facilitating an organized, effective, and interactive peer teaching session. Students’ positive feedback on the OSTE suggests that OSTEs can be useful tools to help peer teachers learn skills to cope with challenging situations with students.

GenerationY in surgery-the competition battle for talent in times of talent shortage

HintergrundChirurgische Fachdisziplinen kämpfen mit einem kritischen und sich zuspitzenden Nachwuchsproblem. Potenzielle Berufsanfänger zählen zur Generation Y, die Chefärzte und Personalabteilungen regelmäßig vor große Herausforderungen stellt. Ziel dieser Arbeit ist die Analyse verschiedener Maßnahmen der Personalakquise unter Berücksichtigung erhobener Motivationsfaktoren junger Medizinstudenten.Material und MethodenUmfrage unter Medizinstudenten des 1. und 9. Fachsemesters (FS) einer medizinischen Fakultät zu individuellen Motivationsfaktoren, der angestrebten Facharztweiterbildung und der gesammelten Berufserfahrung in der Chirurgie.ErgebnisseErgebnisse von 179 der 269 befragten Medizinstudenten (66,5 %) konnten ausgewertet werden. Das Interesse an einer chirurgischen Facharztweiterbildung ist im 1. FS hoch (21 %) – fällt jedoch bis zum 9. FS deutlich ab (13 %; p = 0,23). Medizinstudenten, die im 9. FS „Aufstieg und Anerkennung“ gegenüber „flexible Arbeitszeiten“ präferieren, zeigen ein signifikant höheres Interesse an einer chirurgischen Weiterbildung (p = 0,022). Erworbene chirurgische Berufserfahrung wird mit einer durchschnittlichen Schulnote von 2+ bewertet.SchlussfolgerungDas hohe Grundinteresse an einer chirurgischen Facharztweiterbildung zu Studienbeginn ist ein Wettbewerbsvorteil der Chirurgie. Die vielfältigen Rekrutierungsanstrengungen setzen jedoch oft erst gegen Ende des Studiums an. Zur langfristigen Nachwuchsbindung haben sich insbesondere frühzeitige Programme mit „Hands-on“-Charakter im chirurgischen Kernarbeitsbereich – dem Operationssaal – als erfolgreich erwiesen.

Contact and role modeling predict bias against lesbian and gay individuals among early-career physicians: A longitudinal study

RationalePhysician bias against sexual minorities can hinder the delivery of high-quality health care and thus contribute to the disproportionate prevalence of negative health outcomes within this population. Medical students' interpersonal experiences within the context of medical school may contribute to this bias. ObjectiveThe goal of the current research was to examine the relationship between these interpersonal experiences, reported by heterosexual, cisgender medical students, and explicit and implicit bias against lesbians and gay individuals, reported two years later during second year of medical residency. MethodData were collected by surveying students (n = 2940) from a stratified sample of U.S. medical schools in fall 2010 (first semester of medical school), spring 2014 (final semester of medical school), and spring 2016 (second year of medical residency). ResultsAmount and favorability of contact with LGBT individuals, reported during the final semester of medical school, predicted lower levels of explicit bias against lesbian and gay individuals during second year of medical residency. Additionally, exposure to negative role modeling, also reported during the final semester of medical school, predicted higher levels of explicit bias against lesbian and gay individuals during second year of medical residency. Amount of contact with LGBT individuals – and in particular, with LGBT medical students – predicted lower levels of implicit bias against lesbian and gay individuals during second year of medical residency. Neither favorability of contact with LGBT individuals nor exposure to negative role modeling predicted implicit bias against lesbian and gay individuals during second year of medical residency. ConclusionThese results suggest that interpersonal experiences during medical school can systematically shape heterosexual, cisgender physicians' subsequent explicit and implicit bias against lesbian and gay individuals.

Kaleidoscope heart

I am an enthusiastic amateur photographer, taking great pleasure in capturing landscapes but also dabbling in portrait and still life photography. This image was inspired by my daily bicycle commute to and from UBC's Point Grey campus during my first semester of medical school in the fall of 2016. Every day, I cycled through the ever-changing landscape of Vancouver. While we were studying cardiology, in my mind’s eye, the colourful leaves falling from the trees formed the chambers and vessels of a heart. This playful fantasy reminded me of the importance of maintaining an open mind in recognizing patterns when diagnosing patients in medicine.

What millennial medical students say about flipped learning.

Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements.

Outcomes of a rotational dissection system in gross anatomy

At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to attend ICM or study independently. For the next laboratory, the assignments were reversed. At the start of the session, the team that had dissected previously spent 30 minutes teaching the other team. In 2012, the students were given three traditional practical examinations with 50 questions drawn equally from each laboratory. Students also completed three mid-course evaluations. There were no significant differences in overall performance between the two teams. Nevertheless, we wanted to determine how well individual students identified structures they had dissected compared with those they had not. For dissected structures, the mean percent correct was 80.0 ± 13.0 (mean ± standard deviation), and for undissected structures, it was 78.3 ± 14.1. The difference was small, but statistically significant (P = 0.0007). Although this result validated the concerns expressed by some students, it did not appear that a change in the system was justified. Students were generally enthusiastic about the opportunity to learn clinical skills in the first semester of medical school, and 91-96% of the students agreed that learning anatomy at the same time helped them understand the physical examination exercises in ICM.

Medical Skills in a Clinical Presentation-Based Curriculum – Approach to the Patient With Acute Fever

Abstract Introduction During the first semester of medical school, most medical students have their first precepted clinical experiences. For medical students to participate effectively in these ex...

University of New Mexico School of Medicine

University of New Mexico School of Medicine

Person-Oriented Versus Technique-Oriented Specialties: Early Preferences and Eventual Choice

Background:Students’ selection of a specialty is an important decision in their career as a physician. While distinguishing primary care physicians from non-primary care specialists has served a purpose for how medicine is practiced and managed, considering alternative ways of grouping specialties is appropriate when exploring specialty decisions.Purpose:This study explored how early specialty preferences correspond to eventual specialty choice using the person-oriented versus technique-oriented taxonomy.Method:Participants were 349 students who completed a career plan survey during the first semester of medical school and later graduated.Results:Chi-square analysis showed a statistically significant difference between students’ early preference for a person-oriented or technique-oriented specialty and the specialty they chose for their residency.Conclusion:Students with an early preference for person-oriented specialties were more likely to choose a person-oriented specialty, whereas students with an early preference for technique-oriented specialties were less likely to enter a technique-oriented specialty.

Using gross anatomy to teach and assess professionalism in the first year of medical school

The public is uneasy about the lack of professionalism in physicians chronicled in the different news media. Since professionalism is a set of values developed over a period of time, it is imperative that the evaluation of medical students in regard to these values begins early in their medical school education. In the Gross Anatomy laboratory there are opportunities for students to display such aspects of professionalism as responsibility/accountability for actions, working with others (teamwork), respect for patients, and social responsibility. Because students spend a significant time in the Gross Anatomy laboratory with the faculty, this setting can provide the forum for faculty to assess the expression of principles of professionalism by the students. This requires faculty who are committed to evaluating the progress of students in this regard. Faculty can monitor work ethic, interpersonal relationships, and overall attitude of these students throughout the course. Thus, aspects of professionalism can be introduced, monitored, and evaluated as early as the first semester of medical school.

Experience and attitudes towards information technology among first-year medical students in Denmark: longitudinal questionnaire survey.

BackgroundAs more and more information technology (IT) resources become available both for support of campus- based medical education and for Web-based learning, it becomes increasingly interesting to map the information technology resources available to medical students and the attitudes students have towards their use.ObjectiveTo determine how extensively and effectively information handling skills are being taught in the medical curriculum, the study investigated Internet and computer availability and usage, and attitudes towards information technology among first-year medical students in Aarhus, Denmark, during a five-year period.MethodsIn the period from 1998 to 2002, students beginning the first semester of medical school were given courses on effective use of IT in their studies. As a part of the tutorials, the students were asked to complete a web-based questionnaire which included questions related to IT readiness and attitudes towards using IT in studies.ResultsA total of 1159 students (78%) responded. Overall, 71.7% of the respondents indicating they had access to a computer at home, a number that did not change significantly during the study period. Over time, the power of students' computers and the use of e-mail and Internet did increase significantly. By fall 2002, approximately 90% of students used e-mail regularly, 80% used the Internet regularly, and 60% had access to the Internet from home. Significantly more males than females had access to a computer at home, and males had a more positive attitude towards the use of computers in their medical studies. A fairly constant number of students (3-7%) stated that they would prefer not to have to use computers in their studies.ConclusionsTaken together with our experience from classroom teaching, these results indicate optional teaching of basic information technology still needs to be integrated into medical studies, and that this need does not seem likely to disappear in the near future.

A Primary Care Preceptorship for First-year Medical Students Coordinated by an Area Health Education Center Program

In 1991, the University of Florida College of Medicine established a required primary care preceptorship coordinated by the Area Health Education Center (AHEC) Program for all students in the first semester of medical school. Six years' experience with this course, which is entirely community-based and taught by community physicians, provides evidence of the success of the preceptorship. Over the first six years, 97% of students and 92% of preceptors felt strongly that this was an appropriate and valuable experience for students in the first semester of medical school. All believed that the students were capable of interacting with patients in a meaningful fashion and that the course allowed students to gain confidence as health care providers. The course also reinforced the importance of the basic science curriculum and initiated the process of professional development by affirming students' decisions to pursue a career in medicine. The use of content analysis to further evaluate attitudes and behaviors indicated that the students were highly satisfied with their experience and were active participants in the preceptors' practices. Students' approach to patients as people, rather than cases, was positive, and increased from the first to the last day of the preceptorship. After six years, this preceptorship has been demonstrated to have a positive and meaningful impact on medical student education and development.

University of New Mexico School of Medicine.

University of New Mexico School of Medicine.

A three-week primary care preceptorship in the first semester of medical school.

A three-week primary care preceptorship in the first semester of medical school.

Perceived stress, sleep, and natural killer cell function during the first semester of medical school : Steven E. Keller, Ph.D., David F. Dinges, Ph.D., Emily Carota Orne, Nancy Bauer-Manley, M.S.S., Wayne G. Whitehouse, Ph.D., Page Morahan, Ph.D., Peter B. Bloom, M.D., Martin T. Orne, M.D., Ph.D. UMDNJ, New Jersey Medical School, Newark, NJ 07103, Institute of Pennsylvania Hospital and University

Perceived stress, sleep, and natural killer cell function during the first semester of medical school : Steven E. Keller, Ph.D., David F. Dinges, Ph.D., Emily Carota Orne, Nancy Bauer-Manley, M.S.S., Wayne G. Whitehouse, Ph.D., Page Morahan, Ph.D., Peter B. Bloom, M.D., Martin T. Orne, M.D., Ph.D. UMDNJ, New Jersey Medical School, Newark, NJ 07103, Institute of Pennsylvania Hospital and University