Medical Degree Program Research Articles

Vaccine-preventable diseases: evaluating immune response in a sample of Italian healthcare students

Abstract Background Healthcare university students are exposed to a range of risk factors during their hospital practical training, particularly in relation to biological hazards. Despite being students, they must be paid the same attention as health professionals in relation to the same possibility of transmitting infections to fellow colleagues, patients, and the wider community.The primary aim of this study is to investigate the seroprevalence characteristics of IgG antibodies against main infectious diseases in students enrolled in medical and health-related degree programs in an Italian university. Methods We conducted a retrospective epidemiological study of health professions students of a university hospital in Rome, collecting sociodemographic information and serology of antibody titers under study (hepatitis B, measles, mumps, rubella and varicella) from 2013 to 2023. After initial description of the study population, bivariate and multivariate analyses were performed to study the association between presence of antibodies with relevant variables. Results Our study sample included 2523 students (68.5% females; mean age 22.2, SD 3.8), of which 44.4% were protected against HBV, 87.3% against measles, 85.5% against mumps, 94.6% rubella and 95.2% against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), with the exception of mumps. Surprisingly, the prevalence of HBV antibody titer below the seropositivity cut-off appeared to have an inverse correlation with older age (1998-99 OR 0.75 CI 0.61-0.93, 2000-01 OR 0.50 CI 0.41-0.62, 2002-04 OR 0.40 CI 0.31-0.52). Conclusions Despite several recommendations and campaigns to promote vaccinations, the goal of achieving high immunization rates among healthcare workers still represents a challenge. Public health policies should focus on improving prevention strategies, including serological screening and workplace vaccination for non-immune individuals, especially for Hepatitis B. Key messages • Improving prevention strategies, including serological screening and vaccination, is crucial to achieve high immunization rates among healthcare students, especially for Hepatitis B. • Health profession students are at risk of exposure to infectious diseases during hospital practical training, and the prevalence of immunity varies among different age groups.

Assessment of the Knowledge and Opinions of Undergraduate Health Care Students Concerning Influenza Vaccination in Saudi Arabia: A Cross-Sectional Study.

Influenza remains a significant global public health challenge, causing substantial morbidity and mortality worldwide. Despite the availability of influenza vaccines, challenges related to vaccine hesitancy and healthcare professionals' attitudes persist. Furthermore, there is a need to understand the knowledge and opinions of undergraduate healthcare students regarding influenza vaccinations. Therefore, we aimed to assess and compare the knowledge and opinions of undergraduate healthcare students about influenza vaccinations, addressing the existing knowledge gap in this area. We employed a cross-sectional study design to assess the opinions and knowledge of undergraduate healthcare students in Saudi Arabia regarding influenza vaccination. A total of 137 healthcare programs were invited to participate via filled-out the survey online. Data analysis was performed using SPSS, with descriptive statistics for the demographic profile and Chi-Square and independent t-tests for examining associations and differences in opinions and knowledge, respectively. A total of 429 undergraduate students completed the survey and were included. Significant associations were found between the students' major and their beliefs regarding the effectiveness of the vaccine in preventing influenza (p=0.017) and the inclusion of influenza vaccines in medical practice (p=0.016). The majority of students agreed with seven out of nine knowledge statements, with agreement percentages ranging from 42.9% to 44.8%. When comparing knowledge scores, students majoring in medicine had a significantly higher mean knowledge score (3.91) compared to students studying other medical sciences (3.72) (p=0.019). Our study suggests that a comprehensive approach involving education, awareness initiatives, and policy changes is needed to enhance knowledge about influenza vaccination among Saudi Arabian undergraduate students in Medical School allied medical sciences and medical degree programs. By implementing these strategies, we can promote a positive attitude towards flu vaccination and ultimately increase its uptake.

Analytics-Informed Design: Exploring Visualization of Learning Management Systems Recorded Data for Learning Design

One apparent challenge associated with learning analytics (LA) has been to promote adoption by university educators. Researchers suggest that a visualization dashboard could serve to help educators use LA to improve learning design (LD) practice. We therefore used an educational design approach to develop a pedagogically useful and easy-to-use LA visualization solution to support data-informed LD. We interviewed four staff in a medical degree program at a New Zealand university, designed and piloted a dashboard, and evaluated it through interviews. As a proof-of-concept project, our study showed that educational design research could be meaningfully used to develop a visualization dashboard that is easy-to-use and useful. In particular, the preliminary design principles identified provide implications for practitioners who are seeking to use LA to inform LD. Finally, we reflect on the purpose of visualization dashboards in relation to the literature and identify areas for future developments.

Walking the Walk: A Review of Medical Students’ Perspective of a Surgical Theatre as the New Classroom

Medical school trains eligible students for a medical degree (MD). As part of the clinical years in the MD program, students attend surgical theatre sessions to learn medical concepts from hands-on experience in the theatre. This review aims to provide a comprehensive overview of the role surgical theatre plays in the learning process and clinical experience of medical students. Google Scholar, PubMed and NCBI databases were searched for articles from 1990 to March 2022 using the search terms ‘Operating Room’ or ‘Operating Theatre’ or ‘Surgical Theatre’ and ‘Learning’, ‘Medical Students’ and ‘Surgeons’. Only articles on medical students’ perceptions on their learning experience in the surgical theatre were included. Thirty-four articles were eligible for inclusion. Unpreparedness, anxiety, lack of clear learning outcomes, fear and intimidation were the most common reported experiences by students. These demotivate medical students from attending theatre, along with poor surgical field visibility, resulting in a negative learning experience. Positive experiences during theatre time were more likely to attract students to choose a future surgical career. Limitations include the inclusion of surgical residents’ perspectives and the exclusion of other surgical team members’ perspectives. Studies included students across different clinical years, and results were primarily based on subjective perceptions. Evidently, the surgical theatre is a great learning opportunity for medical students. However, for this learning environment to be beneficial, students need to be included during surgical discussions and procedures. Additionally, clear learning outcomes need to be present whilst adequately training students prior to their first surgical attendance.

Integrating Foundational and Clinical Science Remotely by Combining Team-Based Learning and Simulation

Integrating foundational and clinical science in medical and other professional healthcare degree programs has been well established as a means to enhance learning. However, implementation remains challenging, and a significant gap exists in guidance for non-professional degree programs to effectively accomplish both types of integration. Additionally, many modalities described in the literature are resource-intensive, scale poorly to larger groups, and are widely inaccessible. We present an online modality combining team-based learning and a simulation-based learning experience that fosters vertical and horizontal integration of physiology, pharmacology, and clinical science. The tools utilized include a vital sign simulator, video conferencing software, and a document-sharing platform. The activity demonstrated improved knowledge comparing pre- and posttests and evidence that the activity helped students integrate physiology, pharmacology, and clinical medicine. The novel structure is effective and accessible, uses open-source software and standard equipment available to most undergraduate and graduate faculty, and is adaptable to in-person, hybrid-remote, and fully remote delivery.

The Importance of Teaching English for Medical Students in Kurdistan: A Critical Review

The significance of English in Kurdistan medical education for gathering information, pursuing information, and presenting research efforts to international audiences necessitates that programmes for teaching and learning English pay particular attention to the significance of English. This is required because of the importance of English is essential for the accumulation of knowledge, the pursuit of information, and the presentation of research efforts to international audiences. This is necessary because the importance of English cannot be overstated when it comes to the accumulation of knowledge, the quest for information, and the presentation of research efforts to audiences from across the world. Students interested in learning English as a second language will benefit from this review article since it explains several fundamental topics associated with teaching English for medical reasons and is thus recommended reading for such students. Reading this post benefits students interested in learning English as a second language and will help them in their studies. Some of the academic variables that have an impact include the promotion of instructors' understanding, the periodic updating of the English medical curriculum, and the value of reviewing the material, analyzing the needs of students, and evaluating the relevance of assessing the requirements of students. Other relevant elements are as follows: The research is brought to a close by the presentation of several recommendations that instructors of English as a foreign language (EFL) and other members of the Kurdish educational system might put into action to improve the level of English as EFL instruction that is provided within medical degree programmes in the region.

Curricular course for medical students at a hematology and oncology specialty practice, 2010-2022.

Aim: For several years now, medical students have also been taught general practice at academic medical teaching practices. Specialty practices have not yet been included in the curricular education. Since 1998, we have conducted a block seminar in hematology twice per semester for eighth-semester medical students. This block seminar was offered from 1998-2001 to students at the Philipps University in Marburg and since 2001 to students at the Johannes Gutenberg University in Mainz. Since 2010 our block seminar has been part of the curriculum at the Johannes Gutenberg University.Method: Standardized course evaluation by students who had attended our block seminar between January 2010 and March 2022. Courses that were held virtually due to corona were not included in the analysis. The questionnaire used to evaluate courses in the medical degree program at the Johannes Gutenberg University served as the evaluation instrument.Results: Since 1998 more than 1,000 students have attended our seminar. The systematic evaluation of the course by 500 students who participated in the curricular, classroom-based seminar sessions since 2010 shows that the highest ratings possible are given for practical relevance, learning atmosphere, teaching and effectiveness.Conclusion: High quality in teaching curricular courses to medical students at a specialty practice is possible. Insights into the possibilities connected with working in the outpatient setting at a medical practice broadens students’ experience. This teaching format facilitates external university instructors in terms of teaching and, at the same time, relieves the university in terms of staff and financial budget.

Determinants of peer selection for collaborative group work of third-year bachelor students in a medical degree programme with learning communities

ABSTRACT The social capital theory reveals the importance of peer relationships on students’ learning. However, it is unclear how students select their collaborators under the influence of their previous collaborations and backgrounds. This study explores to what extent students’ free selection choices for collaborators among their peers are based on previous collaboration in formally structured groups (i.e., learning communities (LCs)) and based on different students’ background characteristics. A parallel program was studied where students studied in one of four LCs for two years and after that, they have to find their own group members within or across LCs to finish their bachelor thesis in the third year. In total, 1152 students’ selections of their peers were analyzed. This paper presents the percentages of students choosing group members within or across LCs. It also considered the influence of students’ backgrounds, like sex, nationality, and academic performances on their peerchoices by logistic regression analysis. More than half of the students chose group members within their own LC, regardless of which LC they were in. Although the majority of the students chose collaborators within their own LC, still around 40% of students were willing to collaborate with others from different LCs with whom they had never collaborated before in the formal curriculum. Students’ backgrounds (i.e., sex, and academic performance) were also associated with their decisions. A high frequency of collaboration within formally structured groups enhances the students’ preference of group members from the same groups, but also informal peer relationships are crucial in students’ choices for collaboration. Students’ sex and academic performance influence their free choice of group members while nationality does not. Students with different academic levels have a higher chance to become group members when they collaborated before in formally structured groups than those students who had not had such a collaboration experience.

Understanding the Experiences of American Indian and Alaska Native Students Enrolled in Allopathic and Osteopathic Medical Degree Programs.

Despite a growing population, American Indian and Alaska Native (AI/AN) students have seen no meaningful increase in representation in allopathic and osteopathic medical degree programs. While AI/AN medical students are more likely to practice in underserved areas, they face financial and sociocultural obstacles towards doing so. This underscores the need to understand the experiences of these trainees, and identify barriers and facilitators to the successful recruitment, retention, and advancement of AI/AN trainees. A survey was administered to members of the Association of Native American Medical Students (ANAMS), an organization representing self-identified Native medical students. This survey elicited demographic information, opinions of institutional climate, and aspects of academic and social experiences during medical school. There were n = 39 complete responses. Over fifty percent of respondents (n = 21) identified as AI/AN alone and not in combination with another racial or ethnic group. Overall, respondents were: Generally, not satisfied with their school's engagement with Native communities and AI/AN health curricula. Likely to report barriers towards their timely advancement in training, namely being a first-generation or low income student, and feelings of imposter syndrome. Likely to report an interest to work in primary care fields and serve AI/AN communities in the future. This survey identified several barriers to successful AI/AN medical trainee advancement, highlighting opportunities for institutions to foster inclusion of AI/AN trainees and grow the number of Native physicians.

International student perceptions of online medical education during the COVID-19 epidemic.

This study aimed to investigate how international students enrolled on medical and surgical bachelor's degree programs (MBBS) in China perceived online medical education course, compared to native Chinese students during the Covid‐19 pandemic. The perceptions of 38 MBBS and 31 Chinese sophomores were surveyed using the Chaoxing platform. The international student group's mean satisfaction with online teaching was 2.737 on a 5‐point scale, much lower than the Chinese students' mean score of 4.355 (p < 0.05). Similarly, the international students expressed less satisfaction than the Chinese learners with other aspects of the course, including the teacher's level, at 3.964 ± 0.818 versus 4.445 ± 0.548 (p < 0.05); curriculum organization, at 3.651 ± 0.848 versus 4.333 ± 0.568 (p < 0.05); and self‐learning level, at 3.634 ± 0.996 versus 3.686 ± 0.949 (p > 0.05), respectively. There were also noteworthy differences between the progress made by the international students in Chinese language learning, which was positively correlated with satisfaction with teaching on the online medical education (p < 0.05). The results suggest that, while online teaching was a necessary response to the Covid‐19 pandemic, satisfaction with this mode of education is lower among international students than their Chinese counterparts.

Medical students' views on the value of trigger warnings in education: A qualitative study.

BackgroundTrigger warnings—advance notification of content so recipients may prepare for ensuing distress—feature in discussions in higher education. Students' expectations for warnings in some circumstances are recognised, and some educators and institutions have adopted use. Medical education necessitates engagement with potentially distressing topics. Little is known about medical students' expectations regarding warnings in education.MethodsAll students from a 4‐year graduate‐entry UK medical degree programme were contacted via digital message outlining study details and were openly sampled. Qualitative methodology was chosen to explore participant expectations, experiences and meanings derived from experiences. Students participated in semi‐structured interviews exploring perspectives on functions, benefits and drawbacks of trigger warnings in classroom‐based medical education. We analysed interview transcripts using thematic analysis.ResultsThirteen semi‐structured, qualitative interviews were undertaken. Themes in the following areas were identified: (1) students' experiences influence understanding of trauma and trigger warnings, (2) warnings as mediators of learning experiences, (3) professional responsibilities in learning, (4) exposure to content, (5) professional ethos in medical education and (6) how to issue trigger warnings. Students recognised the term ‘trigger warning’, and that warnings are an accommodation for those affected by trauma. Students' conceptualisation of warnings was influenced by personal experiences and peer interactions both within and outside education. Students expressed both support and concerns about use of warnings and their ability to influence learning, assuming of responsibility and professional development.DiscussionDiverse student opinions regarding warnings were identified. Most students suggested that warnings be used prior to topics concerning recognised traumas. Incremental exposure to distressing content was recommended. Students should be supported in managing own vulnerabilities and needs, while also experiencing sufficient formative exposure to develop resilience. Greater understanding of trauma prevalence and impacts and underpinnings of warnings amongst students and educators are recommended to optimise education environments and professional development.

Final-year medical student Psychiatry and Addiction Medicine synchronous summative tele-assessments during a COVID-19 Delta-variant stay-at-home lockdown.

ObjectiveWe describe the planning, process and evaluation of final-year Psychiatry and Addiction Medicine summative assessments in a four-year graduate medical degree program, during a COVID-19 Delta-variant public health stay-at-home lockdown.ConclusionsWe conducted separate written and clinical synchronous (real-time simultaneous) tele-assessments. We used online assessment technology with students, examiners and simulated patients, all in different physical locations. Medical students’ examination performance showed a good range. This was comparable to other discipline stations, and performance in previous years. There was no differential performance of students through the day of the assessments.

Quality assurance and curricular development of medical faculties using graduate surveys: Challenges - proposal of a core questionnaire - implementation guide.

Graduate surveys provide valuable information to further improve and develop an academic study program. The aim of this project report is to point out the relevance of these surveys for medical schools and to offer guidance on planning and implementing such surveys so that comparable evaluations of medical degree programs are possible.The authors of this project report were asked by the MFT working subgroup on Quality Assurance in Education to generate quality recommendations for surveying medical graduates. To accomplish this, the questionnaires used by the medical schools to survey graduates were closely inspected and analyzed. A questionnaire containing core and optional questions was created as part of this project. A comprehensive matrix was also developed listing all of the procedural elements of graduate surveys.

The place of disease prevention and health promotion in the fourth-year medical degree program in Morocco

The place of disease prevention and health promotion in the fourth-year medical degree program in Morocco

Use of Established Guidelines When Reporting on Interprofessional Team-Based Learning in Health Professions Student Education: A Systematic Review.

Team-based learning (TBL) has gained popularity across the health professions, including in interprofessional contexts. The authors conducted this systematic review to summarize the published evidence regarding the extent, design, and practice of interprofessional TBL within health professions (including medical) degree programs to inform interprofessional education (IPE) educators and curricula designers. In June 2020, the authors searched PubMed Central, CINAHL, Web of Science, and ERIC for original research articles describing TBL programs with student representation from multiple health professions degree programs that were published between January 2010 and June 2020. Included articles underwent data extraction for study characteristics (e.g., country of origin, topics covered, class descriptors) and the 7 core design elements of TBL: team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the 4 Ss (significant problem, same problem, specific choice, and simultaneous reporting), incentive structure, and peer review. Twelve articles were included. Significant variability was noted in the application and reporting of the 7 core design elements of TBL, which highlighted challenges to the implementation of interprofessional TBL. Although the structured format of TBL provides a suitable pedagogy for IPE, this review identified challenges associated with the effective integration of IPE into TBL, including: the unequal distribution of students to teams as a result of there being multiple disciplines from different programs; varied levels of student experience with the pedagogy of TBL; a lack of resources required for large groups of students; timetabling requirements for multiple disciplines from different programs; inability to provide more than 1 TBL session; design of patient cases that suit multiple disciplines; alignment of topics within the curricula of multiple disciplines, programs, and universities; inequities in grading for different students within the same TBL program; and limited opportunity for peer review.

Assessing the predictive validity of the UCAT—A systematic review and narrative synthesis

Background The University Clinical Aptitude Test (UCAT) is an admissions assessment used by a consortium of universities across the UK, Australia, and New Zealand, to aid the selection of applicants to medical and dental degree programmes. The UCAT aims to measure the mental aptitude and professional behaviours required to become successful doctors and dentists. We conducted a systematic review to establish the predictive value of the UCAT across measures of performance at undergraduate and post-graduate levels. Methods A literature search was conducted in April 2020 using eight electronic databases: MEDLINE, APA PsycInfo, SCOPUS, Web of Science, EThOS, OpenGrey, PROSPERO, and the UCAT website. Data were extracted from selected studies and tabulated as results matrices. A narrative synthesis was performed. Results Twenty-four studies satisfied our inclusion criteria, 23 of which were deemed to be of good quality (using the Newcastle-Ottawa Scale). For over 70% of univariate data points, the UCAT exerted no statistically significant predictive validity; for the remainder, predictive power was weak. The cognitive total and verbal reasoning subtests had the largest evidence base as weakly positive predictors of academic performance. The SJT subtest was a weak predictor of professional behaviour during medical school. Studies specific to dental schools demonstrated variable findings across the five studies. Only 1 study looked at post-graduate outcome measures and demonstrated that the UCAT was not a predictor of health- or conduct-related fitness to practice declarations at GMC registration. Conclusions These data provide some support for the use of cognitive total and verbal reasoning subtests as part of medical school selection. Further research is needed to investigate outcomes beyond professional registration and for dental students.

Online lessons of human anatomy: Experiences during the COVID-19 pandemic.

The social distancing measures necessitated by the COVID‐19 pandemic have resulted in the migration of human anatomy lessons to virtual platforms. Even student communities have had to relocate online. The virtual replacement of visual–spatial and social elements, essential for studying anatomy, has posed particular challenges for educators. Our department used Microsoft Teams, an online communication platform, in conjunction with Visible Body, a 3D anatomical modeling program, EdiErmes online resources, and Leica Acquire for teaching microscopic anatomy. We delivered about 160 h of both synchronous and asynchronous lessons for students on the medical degree program per academic year. In this study, we compare face‐to‐face and distance teaching in order to define these different approaches better and to evaluate the final student scores. The aim is to debate the relevance of distance learning pedagogy to the design of new online anatomy teaching courses and the development of online learning. Analysis of the final scores showed that anatomy examinations after the online course had a statistically significantly higher average value than those obtained at the end of the face‐to‐face course. The experience at the University of Genoa shows that distance learning in the teaching of human anatomy was perceived by most students as useful and positive. Distance learning can be an effective support for anatomy teaching, facilitating a different mode of learning in which lessons and study are more sensitive to the individual's schedule and needs. Of course, we should not and cannot exclude face‐to‐face teaching.

Enhancing research and scholarly experiences based on students' awareness and perception of the research-teaching nexus: A student-centred approach.

ObjectivesResearch is a core competency of a modern-day doctor and evidence-based practice underpins a career in medicine. Early exposure encourages graduates to embed research in their medical career and improves graduate attributes and student experience. However, there is wide variability of research and scholarly experiences offered in medicals schools, many developed with a significant degree of pragmatism based on resources and financial and time constraints. We examined undergraduate medical students’ awareness and experience of research throughout their degree to provide recommendations for implementation and improvement of research and scholarly experiences.MethodFocus groups were conducted with medical students at all five stages of the medical degree programme. Data was coded to facilitate qualitative analysis for identification of important themes from each stage.ResultsStudents reported positive impacts of research on undergraduate experience, future career and society in general. Two important themes emerged from the data, the opportunity for research and timing of research experiences. Early-stage students were concerned by their lack of experience and opportunity, whereas later-stage students identified the importance of research to employability, personal development and good medical practice, but ironically suggested it should be integrated in early stages of the course due to limitations of time.ConclusionsStudents provided feedback for improving research and scholarly experiences, ideally involving early exposure, a clear programme overview, with equality of access and a longitudinal approach. An emerging framework is proposed summarising the important issues identified by students and the positive impacts research experiences provide for them. These recommendations can be applied to both existing and new research programmes to provide a student-centred approach designed to augment the students’ critical analysis, inspire life-long learning, enhance the student experience and inevitably train better physicians.

Insights into Delivering Cross-Cultural Medical Education in the UK and Malaysia

Newcastle University UK operates an international campus, NUMed, in Malaysia. NUMed delivers the same medical degree programme as in the UK, within a different cultural context. In this paper, medical education faculty and NUMed graduates with experience working in both the UK and Malaysia provide insights into cross-cultural diversity in approaches to learning. Observations from small and large group teaching and approaches to assessment are discussed in relation to students’ cultural backgrounds including previous learning experiences and English language abilities. We provide practice points for educators preparing a diverse range of students to work in global healthcare settings.

Medical educators' views and experiences of trigger warnings in teaching sensitive content.

Trigger warnings-prior notification of topics so recipients may prepare for ensuing distress-are encountered widely in contemporary culture. Students at some universities have expressed expectations for trigger warnings. Medical education routinely exposes students to numerous potentially distressing topics. However, this topic remains understudied in medical education. Little is understood about educators' views or practice relating to warnings in the context of medical education. Twenty medical educators from a medical degree programme in the UK participated in a semi-structured qualitative interview study, exploring medical educators' views and experiences of managing distressing situations and, specifically, their use of warnings. We analysed interview transcripts by thematic coding and identified themes. Analysis identified themes relating to educators' conceptualisation of trigger warnings and rationale for use, concerns about the use of warnings and the critical purpose of medical school in ensuring preparedness for clinical practice. Participants shared that warnings were given to empower students in approaching distressing topics and to enable engagement with learning. Warnings acknowledged that some experiences would be distressing and normalised and signalled acceptability of emotional responses. Decisions to use warnings were influenced by the nature of content and, reactively, in response to experiences of student distress. Terminology regarding trigger warnings was interpreted varyingly by participants. A broad variety of topics were identified as potentially sensitive. A number of concerns were noted regarding the use of warnings. Warnings alone did not fulfil educators' responsibility in supporting students' professional development, but may be a useful adjunct, signalling that self-care is valued and should be prioritised. Despite frequent use of warnings, individual educator practice was shaped by varying rationale. A framework that addresses competing tensions of preventing distress and supporting professional development is needed as part of a trauma-informed approach to medical education.