International Medical Students Research Articles

Sociocultural adjustment and social support as predictors for international medical sciences students’ anxiety during COVID-19

BackgroundThe prevalence of anxiety is high among international medical sciences students and it increased even more during the COVID-19 pandemic due to different restrictions and social isolation. Successful sociocultural adjustment and social support could be important factors in overcoming those challenges, however, there is a lack of studies which would investigate the role of those factors among inter- national medical students. This study aimed to assess the role of sociocultural adjustment and social support as predictors for international medical students’ anxiety during COVID-19.MethodsTwo measurements were conducted via self-reported questionnaires which consisted of three scales - SCAS, MSPSS and GAD-7. In total, 82 international medical students participated in both measurements in this longitudinal study.ResultsThe findings indicated that 37% of international students had symptoms of moderate or severe anxiety during their first year of studies at university. In the second year, during the COVID-19 pandemic and an official lockdown, 35% of international students had symptoms of moderate or severe anxiety. In addition, this study showed that gender and sociocultural adjustment did not play a role as predictors of students’ anxiety during the second year of studies. However, this study revealed that social support provided by family during the first year of studies, as well as having friends or family members who had been ill with COVID-19 predicted higher levels of anxiety at second measurement, while sociocultural adjustment was an even stronger predictor of anxiety in the second year of studies of international medical students.ConclusionsThis knowledge can help to better understand how international medical students felt during the COVID-19 pandemic and what role the above- mentioned factors played in the students’ anxiety. As the anxiety level is quite high among international medical students, universities and mental health service providers should take it into consideration and help them to overcome those challenges.

A qualitative study of career decision making among African and Asian international medical students in China: process, challenges, and strategies.

China hosts around 68,000 international medical students (IMSs) primarily from lower income countries in Africa and Asia, who have the potential to contribute to international medical services. Understanding how these IMSs make career decisions can help better address the issue of global medical workforce shortage. However, such research is limited. Our study aims to explore the career decision-making process of China-educated IMSs, the challenges they experienced and the strategies they employed.In this exploratory qualitative study, we conducted semi-structured interviews with IMSs educated in China in 2022 using purposeful sampling. Twenty virtual one-on-one interviews were conducted, and data were analysed through directed qualitative content analysis. Cognitive Information Processing (CIP) theory was applied as the guiding framework for organising and analysing the data.The career decision-making process of the participants generally followed the stages of decision-making cycle in CIP theory, with a combination of urgent migration decisions and specialisation considerations adding layers of complexity to their career trajectories. Identified challenges encompassed lack of knowledge about oneself and career options, lack of decision-making skills, concerns of contextual complexities that limited the career decision-making process, low motivation and negative thoughts. Specific challenges due to their role as IMSs arose, which were related to career information access, self-capability evaluation, degree accreditation, employment competitiveness and mental states. Participants' proposed strategies were categorised into personal and institutional aspects, providing insights into addressing these challenges.This study substantiates and expands the application of the CIP theory within the sphere of the particular cultural and educational context of IMSs educated in China. It highlights the significance of integrating migration decision-making into career guidance for IMSs, and contributes to the literature by proposing an evidence-based tiered career intervention programme for IMSs.

DISTANCE LEARNING METHODS FOR INTERNATIONAL MEDICAL STUDENTS

In response to contemporary challenges and the imperative to adapt medical education to a distance learning format, particularly for international students, there arises a pressing need to develop and implement effective teaching methodologies. This article is aimed at investigating and discussing modern approaches to distance learning tailored for medical students, especially those from abroad. The highlights recent literature sources exploring current teaching methods in distance education for international medical students and outlining the most promising strategies for ensuring high-quality medical education through online platforms. For this analysis, a variety of sources including scientific articles, pedagogical reports, and personal experiences in teaching medical disciplines such as general surgery, nursing practice in surgery, and patient care with a surgical focus in an online format were consulted. It is imperative to underscore that the success of distance education for medical professionals hinges not only on the utilization of technology but also on the cultivation of interactive medical communities. Collaborative problem-solving of clinical tasks and case discussions foster the development of professional identity. The analysis indicates that employing interactive virtual lectures, online simulation workshops, and virtual clinical cases enables medical students to acquire practical skills in real-time. Based on this analysis, it can be inferred that effective distance education for foreign medical practitioners demands a comprehensive approach. Interactive methodologies, teacher support, and the integration of virtual tools facilitate not only the assimilation of theoretical knowledge but also the development of practical skills essential for future medical professionals. The conclusions of this work can be used for the further development of distance medical education, ensuring the high quality of training of specialists in the field of medicine.

NEW CHALLENGES OF DISTANCE TEACHING AT THE INTERNATIONAL MEDICAL FACULTY DURING THE WAR AND CORONAVIRUS PANDEMIC IN UKRAINE

The aim of this work is to address specific challenges related to the organization and future prospects of distance teaching in medical higher education institutions, especially pertinent amidst the current military situation in Ukraine. Materials and methods. In our analysis, we reviewed relevant experiences and documentation, considering the participation of medical students in higher education. The data analysis on student’s performance and engagement in online courses to assess the effectiveness of current distance teaching methods was performed. Results and discussion. The education of medical professionals at international faculties holds significant national importance, contributing to addressing various societal challenges and enhancing Ukraine's educational reputation. However, recent events such as the COVID-19 pandemic and martial law have posed new challenges for distance teaching practices in pedagogy. Ii is crucial for educators who work with international medical students to possess high levels of professionalism and moral integrity. Across the globe, simulation technologies are increasingly employed in medical training, offering innovative methods for preparing highly skilled medical personnel. One such technology is the "virtual patient," which allows learners to engage in realistic clinical scenarios, make diagnostic and treatment decisions, and understand the consequences of their actions without compromising patient safety. The development of communication and language skills among future medical professionals remains a pressing concern within higher education institutions. Utilizing technological storytelling methods to illustrate the journeys of successful specialists can provide valuable insights and inspiration for students. In the context of distance learning, maintaining prompt feedback channels between students and departmental teachers is essential for effective learning outcomes. Conclusion. Practical application of innovative methodological approaches provide with opportunity for teachers of medical higher education institutions to implement and improve the novel methods of work, to increase the effectiveness of the educational process and the level of knowledge of students of the international faculty. Innovative distance learning technologies stimulate the teacher's work, increase his/her professional level, since the organization of the educational process requires preparation for each class, constant pedagogical research, development and use of additional new materials, study of innovative technologies.

The Anxiety and Depression of International Medical Students during COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic has inflicted physical harm and exacerbated a significant mental health crisis, warranting greater attention. This study investigated the prevalence of anxiety and depression among international medical students (IMSs) during the pandemic and explored its correlation with demographic factors. Participants completed a comprehensive questionnaire encompassing demographic details, the Zung self-rating anxiety scale, and the Zung self-rating depression scale. The findings revealed that 23.27% of IMSs reported anxiety, while 48.52% experienced symptoms of depression. Multivariate logistic regression analysis identified poor health conditions and limited access to the family as independent risk factors for anxiety. At the same time, depression was associated with both compromised health and notable financial burdens. This study provides crucial insights for policymakers, college administrators, and government authorities, urging proactive measures to support and manage the wellbeing of IMSs during pandemic situations.

Factors related to university teaching that influence academic success of international medical students in China

Background Academic success is extremely important for international medical students enrolled in Chinese universities, as it affects their performance in their licence exams and future work opportunities. However, insufficient research has been conducted on university academic staff’s awareness of teaching-related factors that affect their students’ academic success. Methods A purposive sampling approach was taken in the study to recruit academics teaching in medical universities in China. The selection of informants was based on the subject they taught and their gender, experience of teaching international medical students, educational background and career stage. Semi-structured interviews were conducted with academics (N = 36) between November 2020 and January 2021 at two medical universities in China. Each interview lasted between 30 and 70 minutes and was audiotaped, transcribed verbatim and thematically analysed. Results The teaching factors that academics perceived to have an important influence on the success of students were (i) pedagogy and content alignment; (ii) language barriers; (iii) resource management and the learning environment; and (iv) educator attributes and guidance. Conclusions University faculties and departments involved in teaching international medical students should ensure that their academic staff are supported in their ongoing professional development and provided with resources to enhance their teaching quality. The four factors (and their sub-factors) listed above should be prioritised in such staff training.

Chronotype, sleep and mental health of International Medical Students in Georgia

Chronotype, sleep and mental health of International Medical Students in Georgia

High- and low-achieving international medical students’ perceptions of the factors influencing their academic performance at Chinese universities

ABSTRACT China has become an attractive destination for international medical students, particularly those from developing countries in Asia and Africa. These students are known to face difficulties in adapting to Chinese medical universities and they tend to score poorly on subsequent examinations to enter the medical profession in their home or in a third country. To date, limited research concerning the factors that affect the academic performance of this group of students in China has been conducted. In particular, there have been very few comparisons between high and low achievers to identify the factors that high- and low-achieving international medical students in all years of study perceive as affecting their academic performance. A qualitative research approach was implemented at two medical universities. Semi-structured interviews were conducted with 18 high achievers and 22 low achievers in their second, third, fourth, fifth, sixth, and post-graduation years. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.A few key overlapping factors were identified: social support, learning motivation and interest, exam preparation and strategies, time management, and coping. The high achievers manipulated these strategies successfully while the low achievers did not. The high achievers demonstrated efficient learning methods (efficient use of class time, good note-taking habits, preview and review strategies, expanded learning, self-study and group learning, deep learning, choosing an appropriate study location, and focusing on basics and concepts). They also achieved a good balance between studying and leisure. The low achievers mentioned learning challenges, health issues, English language barriers, and problems with online classes. This study allowed us to identify important factors that international medical students at Chinese institutions perceive to influence their performance. The findings contribute to the literature on the topic and provide a solid basis for practice and policy development.

Challenges and Expectations of First Year International Medical Students in Egypt

Challenges and Expectations of First Year International Medical Students in Egypt

Comprehensive Cardiopulmonary Resuscitation Training for Foreign Medical Students

The purpose of this study was to assess acquired knowledge and practical skills in foreign medical students (FMS) after theoretical and practical training in cardiopulmonary resuscitation.Material and methods. We conducted a prospective randomized trial «Simulation-based CPR training among international medical students: perspectives for medical education» envolving students undergoing training in the 31.05.01 specialty — General Medicine in English. Sealed envelope randomization was used to assign the participants (N=71) to 3 groups. European Resuscitation Council (ECR) educational Guidelines for Resuscitation was studied by students of all 3 groups. Group 1 (N=21) students did not receive additional training materials and practices. Group 2 (N=25) students were additionally provided with a link to a video lesson on CPR on the ECR Youtube channel. Students from Group 3 (N=25) were additionally involved in developing 3 mind maps: on the anatomy and physiology of the heart and CPR algorithm. All participants underwent theoretical training at the 1st stage, and «Basic Cardiopulmonary Resuscitation and Automated External Defibrillation (AED)» simulation training at the second stage. At the end of the course, students’ practical skill in performing continuous chest compressions were examined.Results. The majority of examinees passed the ECR platform test on the first or second attempt. The participants of the simulation course demonstrated high learning efficiency: there were no statistically significant differences between the groups in the number and average frequency of compressions performed. Almost all participants correctly performed hand placement in the center of the chest for chest compression. Decompression phase efficiency reached 71–77% (P=0.811) in all groups. The majority of examinees performed chest compressions to the required depth and with the recommended frequency (P=0.62).Conclusion. The educational project initiated by foreign students yielded positive results: acquired knowledge of CPR algorithm, gained essential techniques of performing chest compressions and giving rescue breaths, retained skills in using automated external defibrillator, as well as teamwork skills.

International Medical Students’ Adaptation to University Life in Egypt: A Qualitative Study

International Medical Students’ Adaptation to University Life in Egypt: A Qualitative Study

Effect of Stress Management Training on the Mental Health of Medical Students and Interns Training Centers During the Pandemic: An Intervention Study

Background: Medical students, as a part of the first line of combating COVID-19, have been exposed to harm caused by mental disorders. Objectives: This study investigated how stress management training affects the mental health of medical students and interns during the COVID-19 pandemic.
 Methods: sixteen training and internship students of Birjand University of Medical Sciences from 2020-2021 were included in this intervention study. The intervention group completed the stress management training course in 6 sessions. Mental health dimensions were collected with the SCL90 questionnaire before and after intervention in both groups. SPSS 22 software and Mann-Whitney U-test, Wilcoxon, Chi-square, and Fisher’s exact test were utilized for data analysis.
 Results: The basic data showed no significant differences between groups (P > 0.05). After the intervention, the mean scores of physical complaint, obsessive-compulsive, interpersonal relations, depression, anxiety, aggression, fear, paranoid and psychotic dimensions in the intervention group significantly decreased (P < 0.05). In controls, the obsessive-compulsive, depression, anxiety, and aggression dimensions significantly decreased (P < 0.05). However, in controls, there was no significant difference in the mean score of other dimensions before and after intervention (P > 0.05). Before the intervention, the frequency distribution of various levels of sensitivity to interpersonal relationships in the two studied groups was the same (P > 0.05); after the intervention, these levels were significantly different between groups (P < 0.05). After intervention, the control group had a higher frequency distribution of individuals with degrees of depression (P < 0.05).
 Conclusions: The mental health of medical internship students during a crisis can be improved by stress management training, which reduces anxiety and depression. Therefore, stress management courses are recommended in stressful situations.

Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status – a cross-sectional study in Hungary

BackgroundMedical students are more likely to have various physical and psychological issues, but less information is available about the healthcare-seeking behaviour for physical and mental health issues. The aim of this study is to determine the factors affecting medical students’ healthcare-seeking when visiting a general practitioner (GP) and/or psychologist.Methods688 medical students (326 International and 362 Hungarian,) participated in a cross-sectional study. The information was gathered using a self-administered online questionnaire and covered socio-demographic background, health behaviour, general and mental health status and healthcare-seeking. For analysing adjusted associations, multivariable logistic regression models were used.ResultsOverall, 56.8% of medical students visit the GP; and 17.2%, the psychologist. Hungarian medical students visited the GP with chronic diseases, International medical students were more likely to visit a GP when they encountered sexual activity and had chronic diseases. Moreover, there was a significant correlation between sex, alcohol consumption, and perceived stress in the total sample of psychologist visits. When Hungarian medical students were in their clinical years and had a poor self-rated mental health, they were more likely to visit a psychologist. Whereas female international medical students and those who had poor self-rated mental health were more likely to seek psychological help.ConclusionStudents visit a GP and/or psychologist is associated with a variety of factors, including socio-demographic background, health behaviours, and health issues. Medical schools should encourage help-seeking behaviours and early disclosure of medical students. Their ability to grasp healthcare attitudes and designing treatments will be important for both their academic success and future profession.

Exploring medical students’ perceptions and understanding of the health impacts of climate change: a qualitative content analysis

BackgroundClimate change has been identified as the greatest threat to global health in the twenty-first century, with its unfavorable health consequences being among its impacts on humans. Exploring the perspectives and understanding of healthcare professionals and service providers concerning climate change becomes imperative. The aim of this study is to investigate the perceptions and understanding of final-year medical students regarding the health impacts of climate change on individuals and the healthcare system using a qualitative content analysis.MethodsThis study employed a qualitative content analysis approach. Face-to-face interviews were conducted with the aid of an interview guide to explore the students' awareness, understanding, and attitudes towards the impacts of climate change on public health and the healthcare system. The collected interview data were subsequently organized into codes, categories, and subcategories based on the students' perspectives and attitudes towards climate change.ResultsFifteen medical intern students were interviewed for this study, and the qualitative findings were categorized into 3 categories, 23 subcategories, and 229 codes. The study's findings revealed various health impacts of climate change, which were classified into three main categories, including environmental effects with 8 subcategories, socio-economic effects with 8 subcategories, and health effects with 7 subcategories. The study's findings revealed medical students' perceptions of various health impacts of climate change and These findings suggest that medical student understand that climate change has significant impacts on individuals' health and society, mainly through environmental degradation, increased risks, and climate-related disasters, which ultimately lead to adverse health outcomes.ConclusionsThe perspectives of medical students in this study indicate that climate change may not have a direct and immediate impact on the health of individuals and communities. However, it can significantly influence their health and socio-economic well-being by exacerbating or causing environmental problems, increasing the risk of weather-related events and natural disasters, ultimately leading to adverse health outcomes. While the medical students' perspectives on the health impacts of climate change are indeed broad, incorporating scientific knowledge about this topic into the medical curriculum and educating students on how to deal with patients affected by these consequences can have a significant impact on health management. This proactive approach, despite the students' already comprehensive understanding, can enhance their preparedness to address the health effects of climate change and contribute to strengthening the healthcare system's resilience in the face of climate-related challenges.

O.1.1-10 Determinants of mental health: do body mass index, perceived stress and acculturation impact the mental health of international medical students?

Abstract Background International medical students are more likely to experience mental health issues. In addition to the acculturation challenges, people living with obesity often struggle with mood and anxiety disorders. The aim of this study was to investigate the association between mental health and nutritional status of international medical students, focusing on body mass index (BMI), perceived stress and acculturation. Methods This was a cross-sectional study among international medical students at the University of Szeged, Hungary between April and October 2021. A self-administered survey was used to obtain the data. Questionnaires were asked regarding the perceived stress scale (PSS), the modified Stephenson multigroup acculturation scale (SMAS), BMI, and sociodemographic characteristics. The data were analysed using SPSS 28.0 with a multiple logistic regression model. Results A total of 326 international medical students participated in the study. 49.7% of the students reported poor mental health and 5.2% were underweight and 10.1% were obese. We have found that perceived stress and acculturation were associated with poor mental health after adjusting for covariates. Higher perceived stress was likely to increase poor mental health (OR = 8.50; 95% CI = 3.82 – 8.93, P < 0.001), similar to acculturation where marginalization was more likely to have poor mental health (OR = 6.42; 95% CI = 2.39 – 9.03, P = 0.011). Meanwhile, the association between poor mental health and BMI in total was not significant, but underweight students were less likely to have poor mental health in the multivariable analysis (OR = 0.23; 95% CI = 0.06 – 0.86, P = 0.029). Conclusions The results of the study can be used to advise academic institutions to help international students integrate into the local students and local communities. The arts and other free time activities, and sports could help to alleviate mental conditions including anxiety, depression, and burnout.

Application of bilingual simulated patients in the medical history collection for international medical students in China

BackgroundIn all international medical student (IMS) programs in China, language barriers between IMSs and Chinese patients greatly reduced the learning in clinical practice and brought great challenges to IMSs in their transition from preclinical to clinical practice. This study aimed to investigate the role of bilingual simulated patients (B-SPs) in IMSs learning of medical history collection in China.Methods48 IMSs of grade 4 between October 2020 to Jan 2021 were enrolled in this study. During the training of medical history collection, students were randomly arranged into two groups trained with either B-SPs (B-SP group) or English-speaking SP (E-SP group). All SPs in Objective Structured Clinical Exam station (OSCE) were trained in the Affiliated Hospital of Wuhan University. Clinical skills in medical history collection were assessed by instructors during pre-clinical, post-clinical OSCE and clinical rotations.ResultsThe scores of IMSs in each group were analyzed in terms of medical history collection including the ability to effectively consult for information and key communication skills related to patient care. Our results indicated that IMS in B-SP group obtained similar scores in preclinical training for history collection (67.3 ± 8.46 vs 67.69 ± 8.86, P < 0.05) compared to E-SP group, while obtaining significantly higher score improvements between pre- and post-OSCE (17.22 (95% CI 12.74 to 21.70) vs 10.84 (95% CI 3.53 to 18.15), P = 0.0007).ConclusionB-SPs are more conducive to doctor-patient communication and actually improve IMSs learning in medical history collection in China.

Value of a UK medical degree for international students (VISION): a cross-sectional study

ObjectivesIt is estimated that NHS staff consist of over 200 different nationalities, with a reported 30.7% of doctors holding a nationality other than British. Despite this, international medical students represent...

COVID-19: Falling Apart and Bouncing Back. A Collective Autoethnography Focused on Bioethics Education

The COVID-19 pandemic disrupted academic life worldwide for students as well as educators. The purpose of this study is to shed light on the collective adversity experienced by international medical students and bioethics educators caused by the COVID-19 pandemic in relation to both personal and academic life. The authors wrote their subjective memoirs and then analyzed them using a collective autoethnography method in order to find the similarities and differences between their experiences. The results reveal some consistent patterns in experience that are captured in two metaphors: Falling apart and Bouncing back. “Falling apart” involves the breakdown of daily lives during the initial stages of the pandemic, shown through subjective quotes contextualized through the authors’ commentary. The consensus is that returning home and the transition to remote education were the two main reasons for the breakdown. “Bouncing back” encompasses the authors’ recovery after the initial breakdown, achieved by acquiring new information about the virus, discovering how to continue their hobbies at home, such as working out or dancing, and learning to adjust exam expectations. At the educational level, the bioethics course, which guided students through the ethical dilemmas of the pandemic, played an important role in the recovery/bouncing back process. For that reason, we report on how it was to learn about and teach this subject during the pandemic, and how bioethics knowledge was applied for better understanding and coping with some of the moral dilemmas related to the pandemic. The study testifies to the importance of bioethics education during a pandemic and explains how this can contribute to shaping the moral resilience of future medical practitioners.

Improved Understanding of Learning Characteristics among International Students in Post-Baccalaureate Medical Education for Sustainable Development

Ensuring the success of medical students in post-baccalaureate training is crucial for providing sustainable, high-quality healthcare worldwide. However, international medical students encounter unique sustainability challenges that may affect their ability to learn and excel in medical schools. Therefore, this study aimed to investigate and assess the key attributes of learning styles and attitudes among first- and second-year medical students from a university in Southern Taiwan using the Attitudes Toward Thinking and Learning Survey (ATTLS). In November 2022, a cross-sectional survey and purposive sampling were used to recruit all 43 international medical students. Factor analysis was employed to identify and simplify complex personality traits associated with learning styles and attitudes. The resulting four-factor solution, which accounted for 70.364% of the total variance, was labeled as follows: Factor 1 “Understanding, Interaction Insights, and Empathy”, Factor 2 “Respect, Trust, and an Objective and Rational Vision of Multicultural Diversity”, Factor 3 “Comment, Debate, and Declare One’s Position”, and Factor 4 “Critical Thinking, Logical and Rational Problem Solving, and Rigorous Inference”. This study highlights the significance of connected knowers, who possess both Factor 1 and Factor 2, in providing holistic empathy and multicultural insight for future pedagogy. The four factors identified in this research can serve as a guide for developing teaching strategies that consider students’ diverse learning preferences and needs. By cultivating connected knowers, this research contributes to the sustainable improvement of pedagogical quality and the reduction of non-intellectual challenges in the classroom.

Abstracts of the 6th Edition International Medical Students’ Congress of Bucharest (IMSCB)

Abstracts of the 6th Edition International Medical Students’ Congress of Bucharest (IMSCB)