Medical Student Population Research Articles

Two Years into Digital Transformation: The Lived Experience of a Middle Eastern Medical Student Population in a Problem-Based Learning Curriculum

Two Years into Digital Transformation: The Lived Experience of a Middle Eastern Medical Student Population in a Problem-Based Learning Curriculum

Anthropometric Profile and Nutritional Intake in a Tunisian Population of Medical Students

Young students, in particular those in the medical field, seem to have poor eating habits and therefore inadequate nutritional intake. We aimed to study the anthropometric and nutritional profile of a Tunisian population of medical students. We conducted a descriptive cross-sectional study at the Medical University of Tunis between November 2019 and May 2020. It included 250 students. Each student benefited from a dietary survey and anthropometric measurements. A female predominance was noted in 71.2% of cases. The mean BMI was 23.28 [16.01-35.67] kg/m2. Abdominal obesity was present in 30% of cases. More than a third of the students had a hypocaloric (38.4%) or hypoglucidic (41.2%) intake. The majority (82.4%) had a high protein intake and 51.6% had a high fat intake. Regarding micronutrients, iron deficiency was noted in more than half of the cases (55.8%). Insufficient vitamin D intake was found in two-thirds of the cases (68.8%). Dietary fiber intake was insufficient in most students (84.4%). These results justify the need for providing nutritional education among medical students in order to preserve the physical and mental health of future caregivers.

A scoping review to identify and organize literature trends of bias research within medical student and resident education

BackgroundPhysician bias refers to the unconscious negative perceptions that physicians have of patients or their conditions. Medical schools and residency programs often incorporate training to reduce biases among their trainees. In order to assess trends and organize available literature, we conducted a scoping review with a goal to categorize different biases that are studied within medical student (MS), resident (Res) and mixed populations (MS and Res). We also characterized these studies based on their research goal as either documenting evidence of bias (EOB), bias intervention (BI) or both. These findings will provide data which can be used to identify gaps and inform future work across these criteria.MethodsOnline databases (PubMed, PsycINFO, WebofScience) were searched for articles published between 1980 and 2021. All references were imported into Covidence for independent screening against inclusion criteria. Conflicts were resolved by deliberation. Studies were sorted by goal: ‘evidence of bias’ and/or ‘bias intervention’, and by population (MS or Res or mixed) andinto descriptive categories of bias.ResultsOf the initial 806 unique papers identified, a total of 139 articles fit the inclusion criteria for data extraction. The included studies were sorted into 11 categories of bias and showed that bias against race/ethnicity, specific diseases/conditions, and weight were the most researched topics. Of the studies included, there was a higher ratio of EOB:BI studies at the MS level. While at the Res level, a lower ratio of EOB:BI was found.ConclusionsThis study will be of interest to institutions, program directors and medical educators who wish to specifically address a category of bias and identify where there is a dearth of research. This study also underscores the need to introduce bias interventions at the MS level.

Post-traumatic stress disorder in a Canadian population of medical students, residents, and physicians.

Physicians encounter stressors with potential long-term psychological consequences. However, a comprehensive picture of post-traumatic stress disorder (PTSD) prevalence and symptomatic work-related event occurrence across practice stages is lacking. To evaluate PTSD prevalence and the occurrence of work-related symptomatic events among physicians and medical learners. In 2017, we surveyed 3,036 physicians, residents, and students within the province of Saskatchewan, Canada. Participants completed the Life Events Checklist (LEC) for DSM 4 and the PTSD Checklist for DSM 4-Civilian version (PCL-C). They also reported work-related events that triggered PTSD-like symptoms. The prevalence of a positive PTSD screen (PCL-C ≥ 36) and the proportion identifying a symptomatic work event were determined. The t-test, Chi-square test, and multiple regression were used to evaluate associations between respondent characteristics and these outcomes. Among 565 respondents, 21.2% screened positively, with similarity across career stages. Thirty-nine percent reported a symptom-inducing work event, with many training-related. Although independent PTSD predictors were not identified, partnered residents and surgical residents were more likely to identify a work-related event. Internationally trained practicing physicians were less likely to identify an event. Both symptom-inducing work events and PTSD are frequent, broadly based concerns requiring better preventive strategies across career stages.

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Prevalence of Contributing Factors Leading to the Development of Insulin Resistance Among Male Medical Students at a Private College in Saudi Arabia.

Background Insulin resistance can result from various genetic and lifestyle factors. Initially, symptoms of insulin resistance may not be readily noticeable, but as the condition progresses, individuals may start experiencing symptoms. This study aimed to investigate the factors contributing to the development of insulin resistance among medical students at a private college in Saudi Arabia. Methodology We conducted a cross-sectional study using a convenient non-probability sampling technique, with a sample size of 241 participants. We employed validated questionnaires to gather information on physical activity, sleep, dietary habits, and stress. Specifically, we used the International Physical Activity Questionnaire (IPAQ)-Short Form for assessing physical activity, the Single-Item Sleep Quality Scale (SQS) for evaluating sleep quality, the Healthy Eating Quiz (HEQ) to gauge dietary patterns, and the stress questionnaire designed by the International Stress Management Association (ISMA) to measure stress levels. Additionally, we collected anthropometric measurements, as well as systolic and diastolic blood pressure readings. We calculated prevalence using percentages and employed the chi-square test to analyze variables, with a significance level set at p-values <0.05. Results This study investigated risk factors associated with lifestyle, focusing on waist circumference as an indicator of insulin resistance. Our findings revealed that a majority of individuals with high waist circumference were physically inactive and more susceptible to stress, and this difference was statistically significant when compared to those with normal waist circumference. Additionally, we observed that sleep deprivation and poor nutrition were more prevalent among individuals with high waist circumference, although these differences were not statistically significant. Conclusions This study highlights a high prevalence of elevated waist circumference, indicating insulin resistance, among medical students. Furthermore, it underscores the significant presence of well-known risk factors associated with insulin resistance within this population of medical students.

The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis.

Medical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students. The purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included. A comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics. Mindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239-0.501, p < .001) and one-arm pre-post studies (d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127-0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress. This study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.

Prevalence of Persons with Disability Enrolled in Undergraduate Medical Schools in Brazil, 2019.

The affirmative policies in Brazil guarantee the provision of undergraduate medical education to People with Disability (PWD). The objective was to estimate the prevalence of PWD undergraduate medical students in Brazil in 2019. This is an exploratory, descriptive study that used census data from the total population of the undergraduate medical students (N=183,646) who were enrolled at the Brazilian medical schools, in 2019. The data are secondary, unidentified and accessed online, and were originally collected by the Higher Education Census conducted by Anísio Teixeira National Institute of Educational Studies and Research (INEP), which used a questionnaire designed to capture information from students and medical courses. The descriptive analysis was based on absolute and relative frequencies. The prevalence of medical students that were PWD was 0.80% (1,460/183,646), and this includes both Brazilian and foreign students. The latter includes people from 76 different countries. Foreign students who are PWD came from eight different countries: Bolivia, Burundi, Cabo Verde, Republic of Congo, Paraguay, Philippines, Singapore and Spain. Most of the PWD were male (51.37%), aged 20 to 24 years (46.78%) and of non-white ethnicity (52.26%). Most students were enrolled in public medical schools (73.97%). A fraction of PWD students (6.51%) was enrolled in medical schools with no specific resource or assistance for PWD. The highest prevalence was the physical disability (39.11%), followed by low vision accuracy (24.45%), intellectual (15.41%), low hearing (14.11%), blindness (3.97%), multiple disabilities (2.47%) and deafness (1.51%). The prevalence of PWD medical students in Brazil is low, and is dominated by students with physical and sensory disabilities but lacks the deaf-blind. Despite the existence of legal regulations favoring PWD to study medicine, some medical schools have not done adequate adjustments to accommodate them. This suggests that affirmative policies for the inclusion of PWD in higher education, particularly in medicine, still need improvement.

Fatigue and the psychological characteristics of medical students.

The present study examined the relationship between medical student fatigue with psychological variables: emotional intelligence (EI), sense of coherence (SoC) (comprehensibility, manageability, and meaningfulness), quality of life (QoL), stress, and satisfaction with studying medicine. The sample consisted of 566 medical students from the Medical University of Gdańsk, Poland. The instruments used were the Chalder Fatigue Scale, Schutte Self Report Emotional Intelligence Test, Sense of Coherence Questionnaire, and a questionnaire designed by the authors, comprised questions relating to the quality of life, stress levels, and satisfaction with studying medicine. The results show that fatigue was negatively related to the ability to use emotions effectively in the management of one's activities (EI), 1 aspect of SoC - a level of comprehensibility, QoL, and satisfaction with studying medicine. Fatigue is positively related to the ability to recognize, understand, and control emotions (EI) and stress connected with studying medicine. The outcomes of the study afford a better understanding of the relation- ship between selected variables in the field of individual differences in the context of fatigue in the medical student population. It may help medical educators and authorities to have a better understanding of the phenomenon of building resilience and increasing abilities to cope with the negative effects of chronic stress such as fatigue in the population of medical students. Early recognition of specific psychological features in medical stu- dents, such as misunderstanding emotions and their perception of environments as unstructured, would make it possible to prepare early support and development programmes. Int J Occup Med Environ Health. 2023;36(4):517-25.

Knowledge and Barriers to a Healthy Lifestyle in Medical Students

Across the US, chronic illnesses, including cancer and cardiovascular disease, largely result from poor lifestyle decisions such as diet, tobacco/alcohol use, and physical inactivity. Medical students' healthy lifestyle habits drastically decline during medical school, which can result in severe medical conditions, future poor patient outcomes, and burnout. However, little evidence exists on what perceived barriers medical students hold on lifestyle behaviors or how well they understand the relationship between specific lifestyle behaviors and their impact on health. This study included data from a self-selected sample of 127 medical students aged 22-41 years. Measures included the perceived health impact of 14 different lifestyle and dietary behaviors, self-reported barriers to lifestyle behaviors, and basic demographic questions. Results showed an average correlation of −.004 between participants' perceived impact and the actual impact of the behaviors on health (SD = .25; CI = −.047 - .039). Results also identified perceived barriers across behaviors that impact health. Data suggests that medical students have insufficient knowledge of the impact of lifestyle behaviors on health. Interventions targeting a medical student population should include information on how to overcome perceived barriers and the impact of lifestyle behaviors on health. Incorporating such information will bolster future interventions' effectiveness.

Is Medical Student Well-being Related to the Overall “Happiness” of a Country?

Previous research has repeatedly shown poor mental health, high rates of substance misuse, and burnout in medical students across many countries. The annual World Happiness Report provides insight into how “happy” countries are and how happiness is measured. Our review aims to identify whether whole population “happiness” across different countries correlates with data looking specifically at burnout in medical students. We found a moderate negative correlation between medical student burnout (disengagement type) and population average life evaluations. There appears, therefore, to be some association between rates of medical student burnout in a country and the overall population average life evaluations. The overall happiness of a country obviously reflects on the whole population, but medical students are, especially under pressure and subject to unusual stressors. In this study, we note various factors which may need further exploration in future studies.

SP11.13 A Systematic Review on the Effectiveness of Augmented Reality for Medical Students’ Surgical Training

Abstract Aims Interest in augmented reality (AR) technologies within an educational setting has surged in recent years. However, few studies evaluate the use of AR in a primarily medical student population. This systematic review with meta-analysis was conducted to evaluate the existing literature on this topic. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to during this review. Using relevant synonyms for the terms “augmented reality”, “medical students” and “surgery”, the databases Embase, Medline and Scopus were searched. Data was extracted for outcome measures such as errors/fails, attempts/retries, time for task completion, motion sickness/nausea and focus shifts. Results 826 records were initially retrieved; 19 studies were included in the final review, with a total of 485 participants. The AR group performed better than the comparator group in 84% of the statistically significant main outcomes. The groups showed no statistically significant difference in likelihood of failing assessment, with a pooled odds ratio of 1.76 (95% CI:0.06-51.71, p=0.74, I2=81%). One study reported 57% fewer critical errors in the AR group than the comparator group. Two studies reported nausea/motion sickness as an outcome (12% (n=3) and mean Likert-scale score of 3 (out of 10) in the AR groups). Conclusions AR can be an effective surgical teaching and training tool for medical students. However, the limitations of AR, including visually induced motion sickness, have not been explored extensively by primary studies. Gradual integration of AR is therefore proposed until further studies elucidating benefits and risks can be undertaken.

The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey.

The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence. To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students. An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed. Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002). Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.

Career intentions of medical students in the UK: a national, cross-sectional study (AIMS study)

ObjectiveTo determine current UK medical students’ career intentions after graduation and on completing the Foundation Programme (FP), and to ascertain the motivations behind these intentions.DesignCross-sectional, mixed-methods survey of UK medical...

Validation and reliability for the updated REAP-S dietary screener, (Rapid Eating Assessment of Participants, Short Version, v.2)

BackgroundThe American Heart Association (AHA) chose the REAP-S dietary screener in 2020 as one of three US dietary screeners recommended for integrating dietary assessment into clinical care. The REAP-S v.2 is an updated version that is aligned with the 2020–2025 US Dietary Guidelines and is easily incorporated into electronic medical records and taught to medical students.MethodsThe University of New England, Institutional Review Board, approved the study protocol. We evaluated the reliability and validity of the REAP-S v.2 scale by having first-year medical students (n = 167) complete both the REAP-S v.2 and a three-day food record and then analyzing their data with the following statistical techniques: Internal consistency was measured using Cronbach's alpha. Construct validity was assessed with exploratory factor analysis. Criterion validity was evaluated using analysis of variance (ANOVA) that explored the associations between REAP-S v.2 scale item responses and selected nutrient estimates from the food record analyses. The hierarchical cluster analysis classified healthy and unhealthy diet grouping under each subscale. Further using these groupings, cut points for "good" and "bad" diets for each of the three main REAP-S v.2 subscales (Food Sufficiency/Food Insufficiency; Healthy Eating Pattern and Low Nutrient Density Foods) were calculated using receiver operating characteristics (ROC) analysis. Students analyzed their three-day food intake records using an online USDA application called SuperTracker.ResultsThe Cronbach’s alpha measuring internal consistency was acceptable for the overall scale at 0.71. The exploratory factor analysis extracted three factors that roughly paralleled the three main subscales, suggesting construct validity. Most selected food record-derived nutrient values were significantly associated with scale items confirming criterion validity. The score cut points suggest that dietary counseling might be needed at ≤ 8, ≤ 10, and ≤ 16 for the above subscales.ConclusionThe REAP-S v.2 is intended for clinicians to use as a brief dietary screener with their patients. Tested in a population of first-year medical students, the REAP-S v.2 brief dietary screener showed acceptable internal consistency, criterion, and construct validity. It is easily scored and incorporated into the electronic medical record.

Multiple choice question writing and medical students: a systematic literature review

Background: Multiple-choice question (MCQ) tests have been the standard for ensuring fairness and ease of grading within school curricula for several years. Students, teachers, and researchers alike have developed methods and materials to improve performance on MCQ tests. One practice of interest to the research team is students writing their own multiple-choice questions as a learning methodology. This study intends to review the current literature to assess the validity of student-written MCQs as a study technique. Methods: This literature review was performed following the PRISMA guidelines. Relevant articles were pulled via a systematic search of various databases (Google Scholar, Cochrane, and PubMed) performed on 7.17.2022. Forty-seven non-duplicated articles were extracted. These were then limited, following full text evaluation, to a total of five articles. Results: In three out of the five articles there were positive subjective views of the use of MCQ writing as a method for studying, and one article showed that the students did not feel that the process helped them or provided value. In two of the five articles, data was collected on how MCQ writing worked in comparison with students that were not writing MCQs, and results demonstrated that those students who wrote MCQs more frequently demonstrated better exam scores as compared to those who did not use MCQ writing as a study method or utilized it infrequently. Conclusions: This literature review demonstrated some of the preliminary work that has been done thus far on the utility of MCQ writing as a learning tool in medical education. While still limited in overall understanding of the effects of the use of this method, there remains much promise for its use in the medical student population. It is the hope of the authors that further work be done on this question for the benefits of the students.

Comparison of Musculoskeletal Symptoms of Neck and Shoulder among Different Types of Hand Held Device Users

Introduction: Prolonged and forceful utilization of hand-held devices has contributed to a global increase in upper extremity and cervical musculoskeletal disorders. These pathologies are directly associated with the excessive use of mobile phones, tablets, and similar devices. Objectives: The study aimed to evaluate the impact of diverse hand-held devices on musculoskeletal (MSK) symptoms in the neck and shoulder and investigate the relation between usage duration and MSK symptoms in the neck and shoulder region. Materials and Methods: This study utilized an observational design with a self-structured questionnaire approved by the Department of Physical Therapy at Sargodha Medical College. The sample consisted of 300 young adults aged 21 to 28 years, selected through convenient sampling across different academic years. Data collection involved the distribution of a comprehensive questionnaire, ensuring meticulous responses and privacy. Inclusive criteria included 2nd to final year students, while exclusions maintained homogeneity. Rigorous standards were followed, enhancing reliability and validity, and facilitating a comprehensive exploration of musculoskeletal health in the medical college student population. Results: Among the 300 participants, 76% experienced musculoskeletal discomfort in the neck and shoulder regions, while 24% were asymptomatic. Specifically, 57% reported pain, 16% had numbness, 5% experienced cramping, and 22% felt stiffness. Moreover, 55% of the total population reported some level of pain on the Visual Analog Scale, while 45% were pain-free. Conclusion: Excessive utilization of handheld devices is intricately associated with cervico-brachial discomfort, revealing correlations between device typology, duration of usage, postural alignments, and musculoskeletal symptoms. Keywords: hand-held devices, musculoskeletal symptoms, neck and shoulder discomfort

Association Between Mobile Phone Usage and Neck Pain in Medical Students of Islamabad Pakistan: A Cross Sectional Study

Introduction: Neck pain has become a common issue among today's students, affecting their studies and daily activities. Prolonged use of laptops and cell phones, leading to incorrect head and cervical spine posture, is considered a major contributing factor. This study aimed to determine the frequency of neck pain among medical students who use these devices and identify the specific areas of discomfort and the duration of device usage that causes pain. Additionally, the study aimed to identify risk factors associated with symptoms during device use, particularly in sitting postures, and explore the occurrence of neck and shoulder problems along with potential risk factors. Methodology: The study involved an observational cross-sectional design conducted on a population of medical students. A self-administered, closed-ended questionnaire was used to collect data. The questionnaire focused on variables such as duration of device usage, positions adopted while using the devices, affected areas of discomfort, and the impact of smartphone use on sleep. Convenience sampling was employed to select participants, and statistical analysis was conducted using SPSS software, presenting the results in the form of graphs and tables. Results: A total of 500 students participated in the study. The findings revealed that 76% of the students experienced neck, shoulder, or hand pain. Among them, 39.5% reported symptoms appearing after 3-4 hours of device use, while 56% experienced discomfort lasting less than 30 minutes. Furthermore, 65.5% stated that their discomfort did not interfere with their sleep, and 59.5% reported recurring neck pain. Conclusion: This study demonstrates that neck discomfort is a prevalent issue among college students, with risk factors such as poor posture and inadequate body ergonomics. Managing these risk factors through posture adjustment and avoiding behaviors that exacerbate neck pain can help alleviate the issue.

Ascertaining the Career Intentions of Medical Students (AIMS) in the United Kingdom Post Graduation: Protocol for a Mixed Methods Study.

Among doctors in the United Kingdom, there is growing sentiment regarding delaying specialist training, emigrating to practice medicine abroad, or leaving the profession altogether. This trend may have substantial implications for the future of the profession in the United Kingdom. The extent to which this sentiment is also present in the medical student population is not well understood. Our primary outcome is to determine current medical students' career intentions after graduation and upon completing the foundation program and to establish the motivations behind these intentions. Secondary outcomes include determining which, if any, demographic factors alter the propensity to pursue different career paths available to a medical graduate, determining which specialties medical students plan on pursuing, and understanding current views on the prospect of working in the National Health Service (NHS). The Ascertaining the Career Intentions of Medical Students (AIMS) study is a national, multi-institution, and cross-sectional study in which all medical students at all medical schools in the United Kingdom are eligible to participate. It was administered via a novel, mixed methods, and web-based questionnaire and disseminated through a collaborative network of approximately 200 students recruited for this purpose. Both quantitative and thematic analyses will be performed. The study was launched nationally on January 16, 2023. Data collection was closed on March 27, 2023, and data analysis has commenced. The results are expected to be available later in the year. Doctors' career satisfaction within the NHS is a well-researched topic; however, there is a shortage of high-powered studies that are able to offer insight into medical students' outlook on their future careers. It is anticipated that the results of this study will bring clarity to this issue. Identified areas of improvement in medical training or within the NHS could be targeted to improve doctors' working conditions and help retain medical graduates. Results may also aid future workforce-planning efforts. DERR1-10.2196/45992.

German Physicians and Medical Students Do Not Represent the Population They Serve.

Medical professionals who represent the communities they serve are in a better position to understand patients' social circumstances and communicate in a more patient-centered way. International studies show limited diversity and underrepresentation of certain social groups in the population of physicians and medical students. We designed an observational study to investigate the cultural and socio-economic diversity of physicians and medical applicants in comparison to the general population in Germany. We invited 15,195 physicians in Hamburg and 11,287 medical applicants in Germany to participate in an online survey between June and August 2022. The lower three quintiles of objective socio-economic background (SEB) were vastly underrepresented in all subsamples of the study and in particular amongst applicants and students admitted in Hamburg: 57.9% of physicians and 73.8% of medical students in Hamburg originate from the top quintile of SEB. The Turkish and Polish communities were particularly underrepresented in the group of physicians from Hamburg and medical applicants and students in Germany (p = 0.02; p < 0.001). In line with existing evidence, the vast majority of physicians and medical students come from the most affluent households when entering medical school. Widening participation strategies are needed to facilitate fairer access to the study of medicine in Germany.