First-year Medicine Research Articles

Discoveries or doubts: a qualitative study of the transformative potential of portfolio meetings.

To adapt to medical school, students need to change their approaches to learning and study. Transformative learning through critical reflection on disorienting learning experiences supports perspective change to direct new activity. We explored how portfolio meetings support changes in students' perspectives towards learning and study during the transition to studying medicine. This qualitative mixed methods study explored changes in medical students' perspectives before and after two portfolio meetings with a mentor during the first year of medicine. Adopting a constructionist approach, we analyzed interview transcripts and written reflections from a diverse sample of students using reflexive thematic analysis. The findings were integrated during analysis. Transformative learning theory was our interpretive lens. Our analysis revealed five themes. Two themes represented students' initial apprehension about portfolio meetings: The Disclosure Dilemma and A Question of Priorities. The theme "Seeing the Big Picture" described new perspectives from reflection on learning while preparing for meetings. Clarity from Dialogue described changed perspectives to learning and study after meetings. In the theme Dialogue Disappointment, meetings perceived as unhelpful led to persisting doubts about the value of portfolio meetings. Transformative learning was evident when students described new insights into their learning leading to goal-setting and new study strategies. When initial meetings were helpful, doubts about portfolio meetings were dispelled, enhancing student engagement in future meetings. Not all meetings were transformative, highlighting the importance of student and mentor preparation and training. Further research is needed to determine whether early portfolio experiences shape later engagement in clinical contexts.

Online Problem-Based Learning (PBL) during COVID-19 Pandemic: Trial at the Libyan International Medical University

Background Online courses that utilize problem-based learning (PBL) are widely recognized as an effective educational method that blends self-directed learning with collaborative problem-solving. Aim The aim of this study was to evaluate the satisfaction of students from the Faculty of Basic Medical Sciences (BMS) at Libyan International Medical University (LIMU) with an online PBL course during the coronavirus disease 2019 (COVID-19) pandemic in 2020. Method This is a cross-sectional study performed during the COVID-19 pandemic in 2020, involving a total of 293 students from four different classes of Faculty of BMS. Each online PBL session ran for 2 hours and was arranged independently for each year group. Students had access to a seven-closed-question questionnaire for a few hours after the end of the session. The questions were of three different categories. The first category was related to the online organization of the session, tutor control, and instructions provided in the applied Modular Object-Oriented Dynamic Learning Environment (Moodle). The second category involves questions related to online communication problems, the facility of the Google Hangouts application used, and the time allocated for the session. The third category was the cooperation of the PBL group. The student was asked to answer agree or disagree for each question. If the student did not choose one of the answers, his response was recorded as (no response). The scores of (agree), (disagree), or (no response) for each student were transferred to a Microsoft Office (2021) Excel file and were displayed as frequency and percentages. A two-way analysis of variance without replication was performed to analyze the differences in student responses across various groups using Excel statistics. The proportion test was utilized to determine whether the proportion of positive responses (agree) in any group significantly differed from a specified level of 0.75 (75%). The acceptable proportion of no response was set at 0.2 (20%). The significant level was set at p-value less than 0.05. Results For the first category, the highest level of student satisfaction (79.9%) was associated with Moodle instructions, followed by tutor control (79.5%), and online organization (72%). However, students in the third year of medicine demonstrated significantly lower satisfaction with online organizations compared with other groups (62.3%, p < 0.05). For the second category, all groups, except first-year medicine students, reported significantly low satisfaction with online access (58% p < 0.05). All groups expressed satisfaction with the time allotted for the session (74%) and the online Google Hangouts application used (71%), except for third-year medicine students, who exhibited a notable level of dissatisfaction with the use of online Google Hangouts application (7%, p < 0.05). Lastly, the third category focused on group cooperation and reflected an overall student satisfaction rate of 80%. Conclusion BMS students responded positively regarding their first online PBL session during the COVID-19 pandemic. The study displayed that the availability of online communication, the clarity of instructions, good session organization, and control are important factors that will determine the effectiveness of online PBL.

Integration of Gross Anatomy, Histology, and Pathology in a Pre-matriculation Curriculum: A Triple-Discipline Approach.

In recent years, many schools have cut back on their teaching and laboratory hours, and courses in the anatomical sciences are more integrated into the horizontal and longitudinal curriculums. Traditionally, teaching in anatomical science classes consists of lectures and laboratory sessions. Usually, gross anatomy and histology are the two main courses in pre-matriculation programs. The summer pre-matriculation program at the University of Mississippi Medical Center (UMMC) was designed to better prepare students for success in their first year of medicine and dentistry. The course provided these students with an opportunity to study gross anatomy and histology ahead of time and develop their learning skills for the coming academic year. Historically, gross anatomy and histology courses have been taught separately with a different emphasis. We have designed a new approach to implement gross anatomy, histology, and pathology-all three disciplines-in a single lecture in the organ section of the histology course. This triple-discipline (triple lecture) approach allows three professors in anatomy, histology, and pathology to work together in a two-and-a-half-hour review lecture. This approach allows students to develop their critical thinking skills and better prepares them to transfer basic anatomic knowledge into their future clinical practice. Students indicated this was their first experience with the triple-discipline approach, and they remarked that it helped them integrate anatomy and histology as well as demonstrate the clinical importance of the structures and organs. This approach can be used at different stages of medical education and helps faculty and students better integrate various disciplines and is more suitable in the modern curriculum. A similar approach was used in our fourth year course in medical histology.

A shared decision-making communications workshop improves internal medicine resident skill, risk-benefit education, and counseling attitude

ObjectiveWe assessed the impact of a workshop on first-year medicine residents (PGY1) shared decision-making (SDM) communication skill, risk-benefit education, and attitude. MethodsA SDM skills-focused workshop was integrated into an academic medical center PGY1 ambulatory rotation in 2016–2017. Pre/post recordings of virtual Objective Structured Clinical Examinations (OSCEs) with standardized patients sharing decisions were scored using OPTION5. Risk-benefit education, including decision aid use, was measured. Pre/post surveys assessed SDM practice attitudes and perceived barriers. Results31 of 48 (65%) PGY1 workshop attendees completed pre/post OSCEs yielding 62 videos. OPTION5 scores improved from 27/100 pre to 56/100 post (p < 0.001). Pre/post increases in integration of qualitative (15/31 vs 31/31, p < 0.001) and quantitative (3/31 vs 31/31, p < 0.001) risk measures, and decision aids (1/3 vs 31/31, p < 0.001) were observed. Pro-SDM attitude of decisional neutrality increased 16.6% pre to 71.9% post-survey (P < 0.001). Barriers to SDM remain. ConclusionThis PGY1 workshop with virtual OSCEs improved SDM communication skills, the ability to find and provide risk-benefit education, and SDM-facilitating attitude. Practice implicationsResidency programs can improve SDM skills, risk-benefit education, and attitudes with a workshop intervention. Perceived time constraints and cognitive biases regarding risk-benefit estimates should be addressed to ensure quality SDM in practice.

Evaluating In‐person and Remote Delivery of Human Anatomy Laboratory Education Among Medicine and Dentistry Students

As remote teaching has become the forefront of education during the COVID-19 pandemic, anatomy curricula have been forced to adapt to provide quality education for core competencies. In particular, in-person laboratory components have been largely reduced or removed from anatomy teaching to comply with social distancing guidelines. While this has compromised typical learning environments, it offers a unique opportunity to implement remote teaching practices in anatomy and assess their impact on students’ learning. The Faculty of Medicine and Health Sciences at McGill University has initiated a hybrid teaching strategy for the anatomy laboratory curriculum that combines limited hands-on cadaveric dissection with remote laboratory-adjacent activities using a 3-D software application (Complete Anatomy 2021). During the Fall 2020 semester, first-year medicine and dentistry students had the opportunity to experience both teaching formats while learning respiratory and cardiovascular anatomy. Our study aimed to evaluate the efficacy of this hybrid curriculum delivery format by comparing in-person versus digital teaching approaches implemented within the same cohort on the following outcomes: (i) student and instructor experiences, (ii) students’ approach to learning (SAL) and performance, and (iii) faculty time, resources, and cost considerations. Given that hands-on cadaver-based learning is considered the gold standard in anatomy education, we hypothesized that the in-person teaching format would be associated with higher deep and lower surface learning scores, higher grades, and higher resource requirements. The qualitative feedback revealed greater student preference for in-person dissection learning. Comparisons of SAL between in-person and remote delivery formats revealed no significant differences in students’ deep or surface approach scores between in-person and remote delivery formats during the respiratory (deep: p = 0.63; surface: p = 0.84) or cardiovascular (deep: p = 0.18; surface: p = 0.22) anatomy laboratory sessions. Further, no significant differences were noted in mean grades on the laboratory exam when correlated with the respective in-person vs. remote learning format for both respiratory (p = 0.65) and cardiovascular (p = 0.18) blocks. Together, these findings suggest that irrespective of the teaching method utilized, students adopted similar approaches to learning anatomy and performed equally well in summative assessments. Pending a thematic analysis of instructors’ experiences, resource use, and cost considerations, findings from this study will help guide educational policy revisions aimed at maintaining student-centered learning during current and future disruptions to in-person teaching.

The contribution of plastinates to teaching complex anatomy of the heart

Objectives: The use of plastination can minimize health risks and cost in anatomy laboratories. Plastinates are easy to handle and can facilitate the learning of complex anatomical structures. Therefore, we aimed to evaluate the contribution of plastinates to teaching complex anatomy of the heart. Methods: Standard S10 technique was used for heart plastination by fixation, dehydration, impregnation and curing stages. Ninety volunteer first-year medicine students at Akdeniz University, who did not take cardiovascular system anatomy lectures yet, were included. Formalin-fixed heart specimens were used in the lecture of group 1; both formalin-fixed heart specimens and heart plastinates were used in the lecture of group 2. After the lecture, a 10-question exam was administered. Statistical significance between the scores of the two groups was tested with one sample t-test, and post hoc Tukey test was used for multiple comparisons. Results: The pre-test scores of the groups were compared with the scores obtained after the 2 hours of lecture (p=0.002, p&lt;0.05). The test scores of both groups increased significantly after the lecture (p&lt;0.05). The post-test scores of group 2 were significantly higher than group 1 (p= 0.047, p&lt;0.05). The average test scores of those trained with formalin-fixed specimens increased from 23.78±1.94 to 48.22±3.19 (p&lt;0.05). Students gave positive feedback about heart plastinates, and they stated that their rising interest in the anatomy lecture due to the odourless, disinfected and reusable materials. Conclusion: In conclusion, besides being cost-effective, healthy, long lasting and easy to maintain materials, plastinates are useful tools to teach complex anatomical structures.

Factors influencing choice of career: A comparative study among medical, dental and pharmacy students in a private university in Malaysia

Background: Students choose their careers based on many factors, which vary for every country. Recent advancements in healthcare systems have made pharmacy one of the most pursued professions. Aim: To study the factors that influence students in Malaysia to choose pharmacy as their career. Methods: A cross-sectional study was conducted among first-year medicine, dentistry and pharmacy students in a private university in Malaysia. One-way analysis of variance followed by Tukey’s post-hoc test was used to determine the factors that influenced students’ career choices. Results: There were significant differences among medicine, dentistry and pharmacy students in the mean scores for the dimensions ‘economic status’, ‘personal background’, and ‘work-life balance’ which influenced their career choice. Conclusions: Economic status, personal background and work-life balance were the factors that significantly influenced students to choose pharmacy compared with students’ choice of dentistry and medicine.

Teaching Evidence-Based Medicine to Medical Students Using Wikipedia as a Platform.

While ideal curricular structures for effective teaching of evidence-based medicine (EBM) have not been definitively determined, optimal strategies ensure that EBM teaching is interactive and clinically based, aligns with major trends in education and health care, and uses longitudinally integrated, whole-task activities. The authors developed a longitudinal, semester-long project, embedded in a first-year medicine course, through which they taught EBM using Wikipedia as a platform. Students worked individually and in small groups to choose a medicine-related Wikipedia article, identify information gaps, search for high-quality resources, appraise the sources, and incorporate the new information into the article (i.e., by editing Wikipedia). Students also applied their new appraisal skills to critique a second article. The authors used an online tool to track and record student editing, and they obtained qualitative data on student perceptions of the project via survey. Duplicate marking of a sample of assignments was performed using the Valid Assessment of Learning in Undergraduate Education critical thinking rubric developed by Finley and Rhodes. In fall 2017, 101 students made over 1,000 unique edits to 16 online Wikipedia articles, adding over 10,000 words. Through thematic analysis of qualitative data, the authors highlighted several aspects of the project that students appreciated, as well as barriers related to completing their projects. Correlation of the 17 consenting students' final assignments with the critical thinking rubric supports the assignment structure as a tool for assessing critical thinking. This authentic task adheres to the principles of high-quality EBM instruction and could be implemented by a variety of health care educational programs. Modifications to the delivery model are underway to address challenges identified.

First-year French medical students consume antidepressants and anxiolytics while second-years consume non-medical drugs.

Background: First year exams are a major source of stress amongst first-year medical students. Objective: To explore antidepressant and anxiolytic consumption and addictive behavior of medical students before and after exams. Methods: Medical students of the 35 French medical schools were recruited through mailing lists and social networks between December 2016 and May 2017 and completed online Internet anonymized questionnaires. Results: Overall, 4345 medical students were included (3051 first year vs. 1294 second year). In multivariate analyses, compared to those in the first year of medicine, second year students were found to have lower anxiolytic (adjusted odd ratio (aOR)=0.56, p = 0.01) and antidepressant consumption (aOR=0.21, p<0.0001) but higher psychiatric follow-up (aOR=1.95, p<0.0001) after adjustment for age, gender and relationship status. Whilst second year students reported slightly higher quality of life (especially for mental health), they also reported more daily tobacco smoking (aOR=1.78, p<0.0001), more cannabis use disorders (aOR=2.37, p<0.0001), hazardous drinking (aOR=3.61, p<0.0001), and alcohol dependence (aOR=3.66, p<0.0001). Second year medical students reported fewer difficulties relating to studying in comparison to first year students (aOR=0.60, p<0.0001) yet they reported a higher rate of recreational drugs use with a variety of reasons including self-treatment of anxiety; disinhibition and to copy their peers (all p<0.05). Limits: These results should be confirmed by longitudinal studies. Conclusion: First year medical students who are faced with challenges relating to studying consume more antidepressants and anxiolytics, whilst second year students have a higher consumption of recreational drugs for a range of reasons. This suggests that the first two years at medical school are an important contributor to adverse mental health and therefore present a window of opportunity for preventative intervention.

Integrated virtual and cadaveric dissection laboratories enhance first year medical students\u2019 anatomy experience: a pilot study

BackgroundRadiology integration into medical anatomy courses is well established, but there is a paucity of literature on integrating virtual dissection into cadaveric dissection laboratories. Virtual dissection is the digital dissection of medical images on touchscreen anatomy visualization tables. The purpose of this pilot study was to investigate the feasibility of integrating virtual dissection into a first-year medical cadaver-based anatomy course and to assess students’ overall attitude towards this new technology.MethodsAll students in first-year medicine at a single medical school participated in this study (n = 292). Six virtual dissection laboratories, which focused on normal anatomy, were developed and integrated into a cadaver-based anatomy course. The virtual dissection table (VDT) was also integrated into the final anatomy spot exam. Following the course, students completed a short evidence-informed survey which was developed using a theoretical framework for curriculum evaluation. Numerical data were tabulated, and qualitative content analysis was performed on students’ unstructured comments.ResultsThe survey response rate was 69.2% (n = 202/292). Most (78.7%) students reported that virtual dissection enhanced their understanding of the cadaveric anatomy and the clinical applications of anatomy. Most (73.8%) students also felt that the VDT was an effective use of the laboratory time. Thirteen narrative comments were collected, most of which (61.5%) identified strengths of the curriculum.ConclusionsIn this pilot study, students perceived that their learning was enhanced when virtual dissection was combined with a cadaver-based anatomy laboratory. This study demonstrates that there is potential for virtual dissection to augment cadaveric dissection in medical education.

Oral health knowledge and behaviour in the field of oral health among freshman medical students

Abstract Introduction: Students of medical faculties are the backbone of a well-educated medical team. First-year medicine students in the field of oral health have knowledge and pro-health behaviors acquired before the beginning of academic education. The level however does not always match scientific views. It is important that during studies they should systematically deepen and model. It is expected that appropriate, reliable and professional knowledge about oral health obtained during the academic training has modulated their own pro-health behaviors concerning the oral health of future doctors and their patients. The aim of the study was to assess the level of knowledge and pro-health behaviors concerning the oral cavity of first-year students of medicine. Materials and methods: The study covered 60 first-year medical students of the Faculty of Medicine and Health Sciences at the University of Zielona Góra. Students anonymously filled out a questionnaire containing questions about health knowledge and behaviors as well as a self-assessment of oral health. Results: Only 13.3% of the medical students knew that tooth decay is an infectious disease. At the same time, 95% indicated acid bacteria and carbohydrates as a cause of caries. When assessing the level of their own health-oriented knowledge in the field of dentistry, the vast majority considered it sufficient (over 61%) or too low (14%). It is worrying to submit responsibility for the oral health of the unit to the dentist – 96.7% of respondents considered it. As many as 33.3% of respondents believed that the responsibility for removing plaque is borne by the dentist. The vast majority determined their oral hygiene as good, and only 3.4% as bad. Among students 65% recognized the need to change the toothbrush every month, and 90% when needed. Most students, 93.3%, knew that toothpaste with fluoride prevents the development of caries and that one of the hygienic procedures is cleansing the tongue. In the assessment of oral health, the vast majority indicated the range of 1–3 teeth treated for dental caries. At the same time, almost 70% admitted that they never had an endodontically treated tooth, with almost 80% stating that they had not had any tooth removed. Almost 18% of respondents did not report any signs of periodontal inflammation. The largest number of respondents after the analysis of their teeth would change the color – 64%, slightly less the teeth position 21.5%, and for a change in the shape of the teeth indicated 6.1%. The most common source of pro-health knowledge was a dentist for the students and then mass media. Conclusions: The level of knowledge regarding oral health and healthy behaviors of first-year medical students requires raising thorough academic training. Attention should be paid to building systematic and cause–and–effect knowledge based on tooth and periodontal anatomy, bacterial etiology of caries, formation of odontogenic inflammatory foci and their impact on the development of focal diseases. Research has shown no causal relationship between the level of knowledge and pro-health behavior. The undergraduate education of future doctors should include shaping the correct dietetic and hygienic regimes. Developed attitudes based on professional knowledge will allow future physicians to promote proper health behaviors in the oral cavity of their friends and patients.

What Should a Spanish Graduate in Medicine in the European Higher Education System Know About Biochemistry and Molecular Biology? A Personal Reflection

For over 40 years of working in the area of biochemistry and molecular biology, 30 of which have been spent teaching at the University of Malaga, I have been involved in the theoretical and practical teaching of the subject initially called biochemistry and now called biochemistry and molecular biology (BMB). The expansion of this scientific discipline and the renewed interest in research have led to such a large accumulation of knowledge (knowledge base) that the elaboration of a BMB program requires applying notable doses of synthesis; otherwise, it would be impossible to cover all this subject within the strict confines of the bi-semestral term. Advances in medicine and BMB are inseparable, and much of modern medicine would not be practiced as it is if it were not for our understanding of how hereditary, pathogenic, and environmental factors affect the human body at the molecular level. The importance, therefore, of teaching medical students biochemistry is evident. BMB is a subject that corresponds to the area of biomedicine and is taught during the first year of medicine. The main aim is to study the basics of chemical structures from the molecular viewpoint, with special emphasis on regulating and integrating aspects, necessary to understand such disciplines as physiology, pharmacology, or pathology. Thus, based on many years of experience teaching BMB to medical undergraduates, my aim is to define what it is that a graduate in medicine should know about the subject.

Louie Mary Mangar

Louie Mary Mangar was born in Norwich, the only child and daughter of a headmistress and shoe business owner. she had a happy—albeit lonely—childhood, excelled academically at school, and in...

A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents.

Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

Wilderness First Responder: Are Skills Soon Forgotten?

Wilderness first responders are trained to provide competent medical care in wilderness settings or until evacuation for more advanced treatment can be obtained. In light of the isolated environments in which they are called upon to respond to illnesses and injuries, their ability to effectively apply their training is crucial. Despite the responsibility assigned to them, there is an absence of research assessing the skill and knowledge retention of wilderness first responders, creating a gap in understanding whether a deficit in their ability to perform exists between certifications. Without such research, it is important to review knowledge and skill retention in related responder groups. The literature over the past 4 decades documents the loss over time of skills and knowledge across an array of trained responders, both professional and laypeople. Although the findings reviewed suggest that WFRs will exhibit a similar pattern of increasing skill loss beginning shortly after certification and a slower, but concurrent, decrease in knowledge, research is needed to document or refute this assumption.

Ultrasound approach as integration of gross anatomy educational path for medical students

For physicians, the human body is the focus of investigation and intervention on a daily basis. It follows that the study of anatomy will continue to be essential to safe medical practice [1]. Anatomical education represents the cultural path that includes the best coexistence of old techniques, and avant-garde. Thus teachers forming future physicians are imposed to find new strategies for the acquisition of adequate professional competences [2]. The gross anatomy course attended by medical students was integrated by ultrasound training. Students were trained either in palpating and recognizing surface body-landmarks, or in the detection of different viscera. Their abilities were then evaluated. For three academic years (since 2009-10 to 2011-12), all the 262 students enrolled in the first year of Medicine and Surgery degree (“San Paolo” Hospital, Universita degli Studi di Milano, Italy) participated. Of them, 16 volunteered in 2009-10, and 17 in each of the next two years, to preliminarily attend ultrasound training that their fellows would attend later. After this preliminary training, volunteers tutored their course fellows as peer tutors. All participants were either models or users. Each training presented three modules: 1) information about ultrasound scanning; 2) musculoskeletal system, major arterial and venous vessels, major nervous trunks, thyroid gland; 3) most thoracic, abdominal and pelvic viscera. Modules 2 and 3 were attended by small groups (6 students, assisted by 2 peer tutors). In module 2, topographical anatomy and subsequent recognition and palpation of surface bodylandmarks were also taught. The study of musculoskeletal system, major vessels and nerve trunks, and thyroid gland was supported by a multi-frequency probe equipped ultrasound machine. Thoracic, abdominal, and pelvic viscera were explored by a new generation pocket-sized ultrasound machine. Acquired skills were verified. The levels of expertise obtained by peer tutors and students were generally satisfactory. Students understood the importance of operative knowledge in human anatomical context. Anatomists found a valid method to consolidate the professionalizing quality of the topic.

Current Tropical Medicine Reports: A Path Forward to Highlight Research and Clinical Advances, New Trends and Innovations

Welcome to the first edition of Current Tropical Medicine Reports! This is an exciting time in tropical medicine; the ongoing advancements in basic and applied science to clinical research have now positioned the discipline beyond what the giants in our field may have expected in their wildest dreams. Manson, Gorgas, and Kean would be impressed with the audacious milestones that the scientific community has completed: from having complete sequences of nematode genomes to new innovations for the development of vaccines and drugs against pathogens that have plagued mankind for eons. The goal of this journal is to enhance the understanding of tropical medicine by delving into the latest advances in the wide expanse of the world of biosciences. This journal seeks to access a varied audience of readers, from the established principal investigators wanting to gain new ideas for basic or applied research to the first-year medicine resident or fellow wanting to learn more about these global diseases and apply that knowledge to the care of their patients. New issues will be released on a quarterly basis, and will focus on current highlights, hot topics, and a review of recent advances in the study of pathogens that affect morbidity and mortality worldwide. The topics will include virology, bacteriology, parasitology, mycology, entomology, immunology, cellular and molecular biology, epidemiology, and more; the journal will address the latest in diagnostics, treatment, and prevention of these global diseases and pathogens. To add variety, the quarterly selections will include one or more organisms from a pathogenesis group and describe the latest preventive and therapeutic strategies, evolving trends, and important developments in their burden of disease, the geographical distribution, and advances in research & development, all the way to clinical trials and clinical management. The articles will focus on work from the past three years and the advancements that are shaping the way we study and practice medicine. The section editors and authors have been selected from a cadre of scientists and physicians who are leaders in their field. They bring years of accumulated knowledge and research, but also their expert opinion and personal experience in their field. In addition the journal has compiled a diverse group of global leaders to participate as the editorial board. This inaugural edition covers viral tropical medicine with a focus onDengue virus, from emergence in the Americas to the regulation of its replication. Also included is a review of the helminth Toxocara, from development of molecular assays to clinical presentations of toxocariasis. As recently assessed in the Global Burden of Disease Study 2010, tropical diseases continue to have huge contributions towards the world’s morbidity (1). Furthermore, the notion that tropical medicine is limited to tropical climates or resource-limited areas in developing countries is now changing. Active transmission of these R. Mejia :M. E. Bottazzi (*) Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, National School of TropicalMedicine, Baylor College of Medicine, Houston, TX, USA e-mail: Bottazzi@bcm.edu

Residency schedule, burnout and patient care among first-year residents

BackgroundThe 2011 US Accreditation Council for Graduate Medical Education (ACGME) mandates reaffirm the need to design residency schedules to augment patient safety and minimise resident fatigue.ObjectivesTo evaluate which elements of...

Réforme pédagogique et « e-learning » pour le concours de première année à la faculté de médecine de Grenoble : satisfaction des étudiants et des enseignants

Before 2005, at Grenoble, the teaching of the first year of medicine satisfied neither the students, nor the teachers anxious to exempt a correctly targeted effective teaching. By 2006, the Grenoble-native teaching method was reformed in-depth with the introduction of information and communication technology (ICT) in education. Each sequence was over 4 weeks connecting: self- learning using multi-media resources, questions submitted online, meetings with teaching staff for interactive question-answer sessions in the presence of the teacher,) tutorials animated by older students for Multiple Choice Question (MCQ) training in preparation for the exams. The whole health formation was structured in 12 cycles of this same structured sequence. Since 2010, this method was extended from the faculty of medicine to the faculty of pharmacy and maieutic. Each year, more than 1600 students, 40 teachers and 140 tutors are concerned. The ICT laboratory was responsible for the production of the multi-media support, of the management of the questions online, the collection and the treatment of the evaluations of the lesson by the students. It also took part in the preparation of the MCQ trainings and after each sequence, delivered to students their personal ranking. Staffs between teachers and students are organized for the 12 cycles. The teachers' and students' opinions were analyzed to evaluate the reforms and allow teaching methods to be adapted accordingly. The expressed satisfaction' rate vary from 85% with more than 91% by students and teachers. The intensive use of new information and communication technologies is well accepted, by both sides: teachers and students. After each tutorial, students had their results and their rank, which are linked with the contest result. The mean of the 12 notes obtained during the tutorials is correlated with the note with the contest (R of Spearman=0.75). Student profiles at registration and success in the exams following the reform are described. The keys to success (e.g. social background, high school specialization) seem to be modified by the reform providing greater equality of opportunity between students. Since 2006, the teachers have adopted this teaching reform. All the returns from the students but also the staff and the teachers, allowed us to improve teachings quality. This teaching reform modified the profiles and the characteristics of the students received with the contest as well as the nature of the factors of this success.

The Longitudinal Elderly Person Shadowing Program: Outcomes From an Interprofessional Senior Partner Mentoring Program

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults. Existing literature on SMPs provides little information on the sustainability of attitudinal changes toward older adults or changes in interprofessional attitudes. LEPS students completed Polizzi's Aging Semantic Differential and the Interdisciplinary Education Perception Scale. Perceptions of older men and women improved significantly and changes were sustained after one year. However, few changes were seen in interprofessional attitudes.