Groups Of Final Year Medical Students Research Articles

Representación del riesgo suicida y su exploración en una simulación realizada por estudiantes de Medicina

IntroductionExploring suicide risk is a fundamental skill for medical professionals. However, university medical education typically does not include enough formal training in this area. Simulation has been used as a method for learning this skill, although most studies using this pedagogic tool focus on analysing changes in self-perceived capabilities and attitudes after receiving specific training on suicide. MethodsA formative assessment task was carried out, consisting of recording a video in which groups of final-year medical students conducted a general psychiatric assessment with a simulated patient. The patient's diagnosis, suicide risk assessment, and exploratory questions were chosen by the students. Videos recorded over one term were studied. The chosen suicide risk assessment and exploratory questions regarding suicide risk were analysed independently and in relation to the chosen diagnosis. ResultsOut of 34 videos recorded, in 70% of those where suicide risk was explored, there was no suicidal ideation, and none had active suicidal ideation. Suicide risk was explored in 88% of the videos, but only 23.5% directly asked about the presence of suicidal ideation. ConclusionsThe task helped students integrate the importance of exploring suicide risk. The proportion of suicidal risk represented, and the exploratory questions, highlight the need to implement additional training interventions that focus on knowledge and stigma towards suicide.

Medical students value-adding to general practice.

Medical students can make valuable contributions to patient care during clinical placements. The aim of this study was to investigate student perceptions of the value of general practice placements for their learning, and their sense of contribution during their placements. The study used a qualitative design to gather in-depth student perspectives on learning and contributions, using focus groups of final-year medical students on general practice placement. Thirteen students participated in one of three focus groups. Students reported valuable learning affordances in general practice and identified contributions to improved workflow, rapport-building, patient education, encouraging clinician reflection and shared learning between general practitioner and student. Student perspectives of value-adding on general practice placements, and a deeper understanding of these learning environments, may enable general practice supervisors to facilitate placements that maximise these benefits.

Using log diaries to examine the activities of final-year medical students at decentralised training platforms of four South African universities

Background. An important strategy in the transformation and scaling up of medical education is the inclusion and utilisation of decentralised training platforms (DTPs). Objective. In light of the dearth of research on the activities of medical students at DTPs, the purpose of this study was to determine how final-year medical students spent their time during the integrated primary care (IPC) rotation at a DTP. Methods. The study was conducted at Sefako Makgatho Health Sciences University (SMU), the University of KwaZulu-Natal (UKZN), the University of the Witwatersrand (Wits) and Walter Sisulu University (WSU). At each of the participating universities, a voluntary group of final-year medical students completed a log diary by entering all activities for a period of 1 week during the IPC rotation. The log diary contained five activity codes: clinical time teaching time, skill time, community time and free time, with each subdivided into additional categories. The data were analysed for students at each university separately, using frequencies and proportions. Results. A total of 60 students volunteered to complete the diaries: at WSU n=21; UKZN n=11; Wits n=18; and SMU n=10. At each university, students reported that they spent large amounts of time on clinical activities: WSU=46.0%; UKZN=33.8%; Wits=29.6%; and SMU=44.1%. They reported low amounts of time spent on community-based activities: WSU 0.8%; UKZN 7.6%; Wits 6.8%; and SMU 0.0%. Conclusion. Students reported that they spent a sizeable proportion of their time on clinical activities, while reported time spent on community-based activities was negligible. The transformation potential of DTPs will only be realised when students spend more time on community-based activities.

Knowledge and Confidence of Final-Year Medical Students Regarding Critical Care Core-Concepts, a Comparison between Problem-Based Learning and a Traditional Curriculum.

Background:Medical undergraduates should be prepared to recognize life threating critical conditions. Undergraduate medical curriculum development to incorporate more critical care education is an essential requirement. Problem Based Learning curriculum has a potential advantage in providing more focused critical care education to medical undergraduate.Objectives:We aimed to evaluate the final year medical students’ knowledge and confidence in key critical care concepts in Problem Based Learning (PBL) curriculum compared to those in Traditional (Lecture) Based Learning curriculum. We also aimed to evaluate undergraduate’s level of satisfaction with the exposure to critical care education during medical education and training.Materials and methods:This is a cross-sectional anonymous self-administered survey questionnaire completed by two groups of final-year medical students (PBL and TBL) from three Saudi medical schools to assess the degree of undergraduate exposure to critical care and their knowledge of key critical care assessment parameters.Results:The responses of 279 final year medical students was analyzed (70% response rate). The majority (53%) was male and the mean age 23.9 ± 1.4 years. Only 13% of students felt confident to manage hypovolemic shock and 15% could recognize the signs of a threatened airway. One third of the students (29%) correctly identified the critical level of lactic acid in shock and less than 2% of the sample responded correctly to all the questions related to the formal assessment of critically ill patients. Lectures were the main source of information in acute care. More than two-thirds (46%) of the sample indicated that they received tuition in critical care, however the total duration spent in a critical care rotation or teaching was 1 day or less. The medical students, who completed their training with a Problem-Based Learning curriculum, had a higher knowledge base and were more confident in many critical care concepts. Only 6.5% choose critical care as their likely future career.Conclusion:Medical undergraduates in PBL have an overall better knowledge on key concepts and assessment tools applicable to evaluating and managing critically ill patients compared to students in TBL. However the gap in knowledge and confidence in assessing ill patients in both groups is evident. Critical care was not chosen as a preferred future career in all surveyed students. There is a need for institutional support and endorsement of undergraduate critical care exposure and education in Saudi Universities both to better prepare medical students for their imminent post-graduates exposure to ill patients and to help in closing the gap in critical care physicians through promoting the specialty.

Lessons Learned from a Study of the Integration of a Point-of-Care Ultrasound Course into the Undergraduate Medical School Curriculum

BackgroundPoint-of-care ultrasound (POCUS) diagnosis, performed by a physician at the patient bedside, is routinely used in emergency medicine and critical care. Although training in ultrasonography has become part of the medical school curriculum, POCUS can be challenging for medical students. This study aimed to assess the effectiveness of a one-day POCUS course in a group of final-year medical students by pre-course and post-course assessment of both diagnostic ability and changes in student confidence levels in making a diagnosis.Material/MethodsA prospective study recruited 57 final-year medical students who participated in a one-day POCUS course. Improvement in making decisions and levels of confidence were evaluated before and two weeks after the course, using image-based testing and a self- evaluation questionnaire.ResultsAll 57 final-year medical students attended the course and completed the tests and surveys. The pre-training and post-training test scores of medical students improved from 41.78±12% to 58±13%. Student confidence scores in the post-training assessment significantly increased. The post-training confidence scores were significantly increased compared with the pre-training scores regardless of whether or not the questions were answered correctly (p<0.001). The Dunning-Kruger effect, or cognitive bias, might partially explain this phenomenon.ConclusionsOne day of POCUS training integrated into anesthesia curriculum for final-year medical students improved performance in the post-training test scores and improved their confidence scores. Further studies are needed to evaluate this effect and to develop adequate tools to assess medical students.

Evaluation of national guidelines for bronchiolitis: AGREEments and controversies

Bronchiolitis is a common respiratory illness and is a leading cause of hospitalisation in infancy. We aimed to appraise three recent national bronchiolitis guidelines produced by the Australasian Paediatric Research in Emergency Departments International Collaborative, the National Institute for Health and Care Excellence in the UK and the American Academy of Pediatrics. A group of final-year medical students and one senior clinician used the AGREE II tool to appraise each guideline in two stages. First, two students appraised each guideline independently and presented their results. Second, two self-selected students met with the senior clinicians to review all scores to ensure completeness of the appraisal and consistency of AGREE II application. The guidelines scored well overall, with particular strengths in the domains of clarity of presentation, scope and purpose and rigour of development. Comparison of the recommendations across each guideline demonstrated a high degree of consistency. Notable differences included recommendations for the role of palivizumab in prevention of bronchiolitis, the use of continuous pulse oximetry monitoring in the hospitalised patient and the value of respiratory virus testing. Our appraisal of bronchiolitis guidelines from three high-income countries demonstrated that they were of high quality, with substantial areas of agreement. Most aspects of clinical practice should be uniform for this common paediatric condition. Areas of guideline weakness were in the domains of applicability and editorial independence. We identified three areas of controversy where further research is needed to support stronger evidence-based recommendations.

Association of professional identity, gender, team understanding, anxiety and workplace learning alignment with burnout in junior doctors: a longitudinal cohort study

ObjectivesTo examine how burnout across medical student to junior doctor transition relates to: measures of professional identity, team understanding, anxiety, gender, age and workplace learning (assistantship) alignment to first post.DesignA...

Is it Time for a Specific Undergraduate Interventional Radiology Curriculum?

Interventional radiology (IR) is traditionally underrepresented in undergraduate medical curricula. Final-year medical students ought to be familiar with some common IR procedures in order to make adequate referrals and work-up patients appropriately. We evaluated the knowledge of final-year medical students on common IR procedures and compared it with their knowledgeof other specialties. A fourteen-question, single-best-answer questionnaire assessing the knowledge of IR procedures and other minimally invasive non-IR procedures was administered to a group of final-year medical students. Paired two-tailed student's t test was used to compare knowledge across specialties. Fifty-one questionnaires were administered and returned. No student answered all questions correctly. The median score was 5/11. The best-answered question was on coronary intervention followed by neurosurgical procedures. The average score for IR procedures was 38% versus 57% for non-IR procedures (P<0.0005). While most students had come across IR previously, 70% would like further exposure. We also accessed the undergraduate curricula of five London Medical Schools; all five have a radiology curriculum, but only one has a dedicated IR section. Medical students' lack of IR exposure translates into a lack of appreciation of the role of the specialty. We propose the introduction of a specific undergraduate IR curriculum to bridge this knowledge gap.

Junior doctor-led practical prescribing course

Several authors have studied the transition from medical student to junior doctor. There have been several problems identified, one being prescribing. Junior doctors have been found to be the cause of most of the prescription errors in hospitals. These authors suggest improvements in prescribing teaching, and several describe their own innovations seeking to correct these problems. As junior doctors in a district general hospital in the UK we had the opportunity to provide teaching to small groups of final-year medical students. We had recently begun working as Foundation Year 1 doctors, and had fresh experience of the transition from medical student and the problems that we had encountered with prescribing. We were acutely aware of the commonly made mistakes. We have designed a short, five-session course covering the practical aspects of prescribing. Assuming that theory had been covered elsewhere, we focused on encouraging the students to prescribe on real drugs charts using information available to junior doctors on the wards. We measured the efficacy of the course by asking the students to rate their own confidence in prescribing in each of the scenarios before and after the session. The intention was to design and deliver a course that would bridge the gap between pharmacological theory and prescribing in practice. Existing prescribing courses are often taught by senior doctors or pharmacists. We believe that the major strength of this course was that it was designed and delivered by junior doctors, under the supervision of a senior doctor.

A comparison of clinical communication skills between two groups of final-year medical students with different levels of communication skills training

AbstractBackgroundTraining in communication skills is prominent in many undergraduate medical programmes. In South Africa, training in this highly complex skill is developing rapidly, especially against the backdrop of a multilingual and multicultural society. Little work has been done locally to evaluate which training works best in our context. In 1999, the Stellenbosch University Faculty of Health Sciences introduced a new curriculum that included considerably more communication skills training. The aim of this study was to assess and compare the communication skills used in the consultations of two groups of final-year medical students who had different levels of communication skills training in order to make recommendations on appropriate changes in this training.MethodsStandardised doctor-patient interviews performed by students during the final-year examinations in 2003 and 2004 were videotaped. These were assessed by two independent, blinded evaluators using an abbreviated version of the Calgary- ...

Comparison of student learning in the out-patient clinic and ward round

In undergraduate medical education there is a trend away from ward-based teaching towards out-patient and community-based teaching. To study the potential effects of this altered emphasis on student learning, a pilot group of final-year medical students at the University of Dundee was asked to keep individual structured log-books. These contained details of patients seen during their 3-week orthopaedic attachment in both a ward and out-patient setting. A comparison of perceived learning in the two settings showed that students learned more from attending an out-patient clinic than a ward round, but did not make full use of the learning potential of either. The setting did not particularly influence the balance of learning as categorized here but only the ward round supplied experience of surgical complications. The amount of learning taking place in an out-patient clinic was influenced by student ability, measured by examination performance, but not by clinic work-load. The implications of increased use of out-patient clinics and the advantages and disadvantages of the approach employed are discussed. It is concluded that in the situation studied student learning in the outpatient setting is as good as or superior to the ward setting but should not totally replace it.