Medical Students In Australia Research Articles

Gender bias in generative artificial intelligence text-to-image depiction of medical students

Introduction: In Australia, 54.3% of medical students are women yet they remain under-represented in stereotypical perspectives of medicine. While potentially transformative, generative artificial intelligence (genAI) has the potential for errors, misrepresentations and bias. GenAI text-to-image production could reinforce gender biases making it important to evaluate DALL-E 3 (the text-to-image genAI supported through ChatGPT) representations of Australian medical students. Method: In March 2024, DALL-E 3 was utilised via GPT-4 to generate a series of individual and group images of medical students, specifically Australian undergraduate medical students to eliminate potential confounders. Multiple iterations of images were generated using a variety of prompts. Collectively, 47 images were produced for evaluation of which 33 were individual characters and the remaining 14 images were comprised of multiple (5 to 67) characters. All images were independently analysed by three reviewers for apparent gender and skin tone. Consequently, 33 feature individuals were evaluated and a further 417 characters in groups were evaluated ( N = 448). Discrepancies in responses were resolved by consensus. Results: Collectively (individual and group images), 58.8% ( N = 258) of medical students were depicted as men, 39.9% ( N = 175) as women, 92.0% ( N = 404) with a light skin tone, 7.7% ( N = 34) with mid skin tone and 0% with dark skin tone. The gender distribution was a statistically significant variation from that of actual Australian medical students for individual images, for group images and for collective images. Among the images of individual medical students ( N = 25), DALL-E 3 generated 92% ( N = 23) as men and 100% were of light skin tone ( N = 25). Conclusion: This evaluation reveals the gender associated with genAI text-to-image generation using DALL-E 3 among Australian undergraduate medical students. Generated images included a disproportionately high proportion of white male medical students which is not representative of the diversity of medical students in Australia. The use of DALL-E 3 to produce depictions of medical students for education or promotion purposes should be done with caution.

Pre-service medical education course completion and drop-out rates

IntroductionThe “Global strategy on human resources for health: Workforce 2030” was adopted by the 69th World Health Assembly. Among its objectives is the strengthening of data on human resources for health, to inform evidence-based policy decisions. These data include the course completion and drop-out rates, to inform mechanisms that support recruitment and retention.ObjectiveThis paper sought to evaluate trends in course completion and drop-out rates of health workforce students. However, original data were only obtained for pre-service medical students, but no other health worker occupational groups.MethodsA mixed method approach was employed to obtain data presented in this paper. A structured questionnaire was sent out to targeted medical training institutions, regulatory bodies, and National Medical Associations, supplemented by a web and literature search for existing studies or data reports. Data were analyzed using IBM SPSS Statistics version 21.0 (Chicago, IL, USA) and Microsoft Excel 2010.ResultsEight previously published studies were identified originating from six countries, with course completion rates ranging from 84% in Pakistan to 98.6% in the United States of America, while the drop-out rates ranged from 1.4% in the United States of America to 16% in Pakistan. An analysis of pre-service medical students in Australia and New Zealand, revealed average course completion rates of 93.3% and 96.9%, respectively, and average drop-out rates of 6.7% and 3.1%, respectively. An analysis of pre-service medical students from Nigeria, revealed an average course completion rate of 88.3%, and an average drop-out rate of 11.7%. Data were not readily available for most countries targeted during the research, either because of lack of existing mechanisms for collation of required data or restrictions making such data publicly unavailable and inaccessible.ConclusionsDrop-out rate for pre-service medical students varies across countries with some countries recording higher drop-out rates, which raise significant concerns about the capacity of such countries to scale up production of human resources for health. Data that monitor both course completion and drop-out rates, and seek to provide insight into reasons for observed numbers, can inform mechanisms to address the causes of course drop-out and support student retention.

Core procedural skills competencies and the maintenance of procedural skills for medical students: a Delphi study

BackgroundIt is well recognised that medical students need to acquire certain procedural skills during their medical training, however, agreement on the level and acquisition of competency to be achieved in these skills is under debate. Further, the maintenance of competency of procedural skills across medical curricula is often not considered. The purpose of this study was to identify core procedural skills competencies for Australian medical students and to establish the importance of the maintenance of such skills.MethodsA three-round, online Delphi method was used to identify consensus on competencies of procedural skills for graduating medical students in Australia. In Round 1, an initial structured questionnaire was developed using content identified from the literature. Respondents were thirty-six experts representing medical education and multidisciplinary clinicians involved with medical students undertaking procedural skills, invited to rate their agreement on the inclusion of teaching 74 procedural skills and 11 suggested additional procedures. In Round 2, experts re-appraised the importance of 85 skills and rated the importance of maintenance of competency (i.e., Not at all important to Extremely important). In Round 3, experts rated the level of maintenance of competence (i.e., Observer, Novice, Competent, Proficient) in 46 procedures achieving consensus.ResultsConsensus, defined as > 80% agreement, was established with 46 procedural skills across ten categories: cardiovascular, diagnostic/measurement, gastrointestinal, injections/intravenous, ophthalmic/ENT, respiratory, surgical, trauma, women’s health and urogenital procedures. The procedural skills that established consensus with the highest level of agreement included cardiopulmonary resuscitation, airway management, asepsis and surgical scrub, gown and gloving. The importance for medical students to demonstrate maintenance of competency in all procedural skills was assessed on the 6-point Likert scale with a mean of 5.03.ConclusionsThe findings from the Delphi study provide critical information about procedural skills for the Clinical Practice domain of Australian medical curricula. The inclusion of experts from medical faculty and clinicians enabled opportunities to capture a range of experience independent of medical speciality. These findings demonstrate the importance of maintenance of competency of procedural skills and provides the groundwork for further investigations into monitoring medical students’ skills prior to graduation.

Impacts of the COVID-19 pandemic on medical students in Australia.

ANZ Journal of SurgeryVolume 90, Issue 7-8 p. 1244-1245 SPECIAL ARTICLE Impacts of the COVID-19 pandemic on medical students in Australia Nicholas Savage, Nicholas Savage orcid.org/0000-0003-1035-0090 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, AustraliaSearch for more papers by this authorAnshini Jain MBBS, FRACS, Anshini Jain MBBS, FRACS orcid.org/0000-0002-8395-7355 Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia Discipline of Surgery, University of Sydney, Sydney, New South Wales, AustraliaSearch for more papers by this authorSuat Chin Ng MSc, FRACS, Suat Chin Ng MSc, FRACS orcid.org/0000-0002-6291-8306 Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, AustraliaSearch for more papers by this author Nicholas Savage, Nicholas Savage orcid.org/0000-0003-1035-0090 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, AustraliaSearch for more papers by this authorAnshini Jain MBBS, FRACS, Anshini Jain MBBS, FRACS orcid.org/0000-0002-8395-7355 Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia Discipline of Surgery, University of Sydney, Sydney, New South Wales, AustraliaSearch for more papers by this authorSuat Chin Ng MSc, FRACS, Suat Chin Ng MSc, FRACS orcid.org/0000-0002-6291-8306 Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, AustraliaSearch for more papers by this author First published: 14 June 2020 https://doi.org/10.1111/ans.16103Citations: 4 N. Savage; A. Jain MBBS, FRACS; S. C. Ng MSc, FRACS. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume90, Issue7-8July/August 2020Pages 1244-1245 RelatedInformation

Oncology and Radiation Oncology Awareness in Final Year Medical Students in Australia and New Zealand.

This study aimed to determine final year students' core oncology and radiation oncology knowledge and attitudes about the quality of teaching in medical programmes delivered in Australia and New Zealand. Does the modern medical programme provide core oncology skills in this leading global cause of mortality and morbidity? An online survey was distributed between April and June 2018 and completed by 316 final year students across all 21 medical schools with final year cohorts in Australia and New Zealand. The survey examined teaching and clinical exposure, attitudes and core knowledge for oncology and radiation oncology. Several questions from a survey done of graduates in 2001 were repeated for comparison. We found that clinical exposure to oncology and its disciplines is low. Students rated oncology and haematology the worst taught medical specialties at medical school. Students reported the most confidence identifying when surgical management of cancer may be indicated and much lower levels of confidence identifying when systemic therapy and radiation therapy may be helpful. The majority of students had no formal course content on radiation therapy and more than one third of final year students erroneously believed that external beam radiation therapy turned patients radioactive. Exposure to oncology practice and the teaching of core oncology knowledge remains low for medical students in Australia and New Zealand. Many areas of oncology teaching and knowledge have worsened for medical students in Australia and New Zealand over the past 20years. Well-established gaps in the core oncology knowledge of medical graduates must be urgently addressed given the increasing incidence of cancer and ongoing underutilisation of radiation therapy in particular.

Medical students as interpreters in health care situations: "… it's a grey area".

To examine the extent to which medical students in Australia are acting as interpreters in medical settings, and their perceptions of this activity. Anonymous online survey of final year students in the graduate medical program of the University of Melbourne, undertaken in 2014. Numbers of students who had acted or who had been asked to act as ad hoc interpreters in health care situations during their clinical rotations and outside the medical education context. 146 of 319 final year medical students completed the survey (46% response). 106 students (73%) reported they could speak at least one language in addition to English; none had formal interpreting qualifications, but 40 (36%) had been asked to interpret during clinical rotations, and 36 (34%) had done so. The students described a diverse range of experiences, including complex interactions regarding informed consent and the breaking of bad news. Medical students frequently acted as interpreters during their clinical training. Most did not feel appropriately qualified to interpret in clinical situations, and some felt pressured to do so, but many found the experience positive. Our study highlights the lack of clear guidelines regarding medical student interpreters in Australian health care settings.

Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania but most left for specialty training. All 15 interview participants intended to remain in Australia for at least their intern year, although at enrolment only six had planned to remain. Factors influencing workplace location decisions were (1) 'professional': greater appeal of Australian medical workplaces, intention to pursue a speciality, and to complete this at an Australian metropolitan hospital; (2) 'social': proximity to family/partner or opportunity to meet a prospective partner, family obligations, positive rural experiences; and (3) 'location': direct travel access to family. IFP graduates from the Tasmanian medical program make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context. Most IFPs do not choose to work rurally. Rurally focused medical programs need to consider how they place IFP students to meet both the learning and career needs of IFP students and the goal of the rural medical programs in developing a rural workforce.

Antimicrobial knowledge and confidence amongst final year medical students in Australia.

IntroductionInappropriate use of antimicrobials is one of the major modifiable contributors to antimicrobial resistance. There is currently no validated survey tool available to assess knowledge and confidence of medical students in infectious diseases (ID) compared to other diseases states, and little is known about this topic.Materials and methodsA cross-sectional survey of final year medical students attending universities around Australia was conducted between August and September, 2015. A survey unique from other published studies was developed to survey satisfaction in education, confidence and knowledge in ID, and how this compared to these factors in cardiovascular diseases.ResultsReliability and validity was demonstrated in the survey tool used. Students were more likely to rate university education as sufficient for cardiovascular diseases (91.3%) compared to ID (72.5%), and were more confident in their knowledge of cardiovascular diseases compared to ID (74.38% vs. 53.76%). Students tended to answer more cardiovascular disease related clinical questions correctly (mean score 78%), compared to questions on antimicrobial use (mean score 45%).ConclusionsPoor knowledge and confidence amongst final year medical students in Australia were observed in ID. Antimicrobial stewardship agenda should include the provision of additional training in antimicrobial prescribing to the future medical workforce.

Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia

BackgroundThere is limited research to inform effective pedagogies for teaching global health to undergraduate medical students. Theoretically, using a combination of teaching pedagogies typically used in ‘international classrooms’ may prove to be an effective way of learning global health. This pilot study aimed to explore the experiences of medical students in Australia and Indonesia who participated in a reciprocal intercultural participatory peer e-learning activity (RIPPLE) in global health.MethodsSeventy-one third year medical students (49 from Australia and 22 from Indonesia) from the University of Tasmania (Australia) and the University of Nusa Cendana (Indonesia) participated in the RIPPLE activity. Participants were randomly distributed into 11 intercultural ‘virtual’ groups. The groups collaborated online over two weeks to study a global health topic of their choice, and each group produced a structured research abstract. Pre— and post-RIPPLE questionnaires were used to capture students’ experiences of the activity. Descriptive quantitative data were analysed with Microsoft Excel and qualitative data were thematically analysed.ResultsStudents’ motivation to volunteer for this activity included: curiosity about the innovative approach to learning; wanting to expand knowledge of global health; hoping to build personal and professional relationships; and a desire to be part of an intercultural experience. Afer completing the RIPPLE program, participants reported on global health knowledge acquisition, the development of peer relationships, and insight into another culture. Barriers to achieving the learning outcomes associated with RIPPLE included problems with establishing consistent online communication, and effectively managing time to simultaneously complete RIPPLE and other curricula activities.ConclusionsMedical students from both countries found benefits in working together in small virtual groups to complement existing teaching in global health. However, our pilot study demonstrated that while intercultural collaborative peer learning activities like RIPPLE are feasible, they require robust logistical support and an awareness of the need to manage curriculum alignment in ways that facilitate more effective student engagement.

Emergency Medicine in China- An Australian Medical Student’s First-Hand Experience

Medical students in Australia often participate in overseas electives as a part of their medical education. There are different views as to the value of these experiences, particularly in developing countries. The Chinese health care system has undergone repeated rapid transformations and presents unique learning opportunities for Australian medical students. Emergency Department cases observed first-hand at a Chinese tertiary hospital in December 2012 demonstrate some of the differences in health care systems including the privatization and change to hospitals becoming profit-driven, the tensions in the doctor-patient relationship and the differences in the use of analgesia. Thus, an overseas experience in a country such as China provides learning not only in clinical practice, but also in managing health care systems in a different environment.

"Teaching by humiliation" and mistreatment of medical students in clinical rotations: a pilot study.

To generate a contemporary understanding of "teaching by humiliation" as experienced by medical students in Australia. In this pilot study, we surveyed final-stage medical students from two Australian medical schools about their experiences of teaching by humiliation during their adult and paediatric clinical rotations. The students were invited to complete the anonymous survey at the end of their paediatric rotation in Semester 2 of 2013. We used descriptive statistics to analyse quantitative data, and a grounded theory approach to analyse qualitative data. Student reports of experiencing or witnessing teaching by humiliation during their adult and paediatric clinical rotations. Of 151 students invited to participate, 146 (96.7%) completed the survey. Most students reported experiencing (108; 74.0%) or witnessing (118; 83.1%) teaching by humiliation during adult clinical rotations. Smaller but still sizeable proportions had experienced (42; 28.8%) or witnessed (64; 45.1%) it during their paediatric clinical rotation. The humiliating and intimidating behaviours students experienced were mostly more subtle than overt and included aggressive and abusive questioning techniques. The students' responses to these practices ranged from disgust and regret about entering the medical profession to endorsement of teachers' public exposure of a student's poor knowledge. Practices associated with humiliating medical students persist in contemporary medical education. These practices need to be eradicated, given the evidence that they affect students' learning and mental health and are dissonant with formal professionalism curricula. Interventions are needed to interrupt the transgenerational legacy and culture in which teaching by humiliation is perpetuated.

Ian Anderson: transforming Indigenous medicine and education

Ian Anderson: transforming Indigenous medicine and education

Full medical program fees and medical student career intention.

To explore the future career preferences of Commonwealth-supported place (CSP) and full-fee paying (FFP) medical students in Australia. Data from the Medical Schools Outcomes Database and Longitudinal Tracking (MSOD) Project exit questionnaire for CSP and FFP students who graduated between 2008 and 2011 were analysed using logistic regression. The influence of age, sex, marital status, rural background and fee-paying status on future career preference were explored. Future career preference (location and specialty) at graduation. Compared with CSP students, domestic FFP students were more likely to nominate as their first preference both urban locations (odds ratio [OR], 5.58; 95% CI, 2.04-15.26; P < 0.001) and higher-income specialties (OR, 1.37; 95% CI, 1.07-1.75; P < 0.05), and less likely to nominate as their first preference in-need specialties (OR, 0.72; 95% CI, 0.52-1.00; P < 0.05), specifically general practice (OR, 0.71; 95% CI, 0.52-0.99; P < 0.05). There was a significant domestic FFP student by marital status interaction effect, such that domestic FFP students who were married or partnered on exit from medical school were more likely to prefer a rural location (OR, 0.64; 95% CI, 0.44-0.95; P < 0.05). Also, students who were married or partnered were less likely to select a one of the higher-income specialties as their first preference (OR, 0.77; 95% CI, 0.64-0.92; P < 0.01). A rural background increased preferences for rural location (OR, 0.18; 95% CI, 0.15-0.22; P < 0.001) and in-need specialties (OR, 1.28; 95% CI, 1.04-1.57; P < 0.05), and being older on entry to medical school also increased preferences for rural location (OR, 0.96; 95% CI, 0.95-0.98; P < 0.001) and in-need specialties (OR, 1.03; 95% CI, 1.01-1.04; P < 0.01). International FFP students were more likely to prefer urban practice (OR, 1.79; 95% CI, 1.19-2.72; P < 0.01). Domestic FFP graduates are less likely to prefer careers in rural locations and in lower-paid and in-need specialties, particularly general practice. Current workforce implications might be minor, but if fees for CSP students increase or more FFP places become available, potential impacts on workforce distribution will need to be considered.

Bogan bias: Addressing class-based prejudice in physician-patient interactions

There is a widespread belief in the ‘classlessness’ of Australian society, despite strong evidence demonstrating the impacts of socioeconomic status (SES) on individuals’ educational attainment, health, and mortality. Disparities in health care are also prevalent. The quality of communication between physicians and patients is associated with health outcomes and patient satisfaction, and we argue that this communication can be influenced by socioeconomic bias and prejudice. The majority of medical students in Australia are from backgrounds of high SES, and this is likely to influence their communication as physicians with patients from lower SES communities. In particular, mediatised representations of the Australian working-class as ‘the bogan,’ and the acceptability of derogatory humour towards those perceived to be ‘bogans’ – in the absence of lived experience and understanding of lower SES life – can influence the attitudes, expectations, and behaviour of physicians working in low SES communities. To begin to address these biases, we recommend expanding cultural competence training to reflect a multidimensional understanding of culture that includes SES, and going beyond cultural competence to promote self-reflexivity and critical awareness of personal socio-cultural backgrounds, assumptions, and biases, in staff induction programs.

Bogan bias: Addressing class-based prejudice in physician-patient interactions

There is a widespread belief in the ‘classlessness’ of Australian society, despite strong evidence demonstrating the impacts of socioeconomic status (SES) on individuals’ educational attainment, health, and mortality. Disparities in health care are also prevalent. The quality of communication between physicians and patients is associated with health outcomes and patient satisfaction, and we argue that this communication can be influenced by socioeconomic bias and prejudice. The majority of medical students in Australia are from backgrounds of high SES, and this is likely to influence their communication as physicians with patients from lower SES communities. In particular, mediatised representations of the Australian working-class as ‘the bogan,’ and the acceptability of derogatory humour towards those perceived to be ‘bogans’ – in the absence of lived experience and understanding of lower SES life – can influence the attitudes, expectations, and behaviour of physicians working in low SES communities. To begin to address these biases, we recommend expanding cultural competence training to reflect a multidimensional understanding of culture that includes SES, and going beyond cultural competence to promote self-reflexivity and critical awareness of personal socio-cultural backgrounds, assumptions, and biases, in staff induction programs.

Same admissions tools, different outcomes: a critical perspective on predictive validity in three undergraduate medical schools.

BackgroundAdmission to medical school is one of the most highly competitive entry points in higher education. Considerable investment is made by universities to develop selection processes that aim to identify the most appropriate candidates for their medical programs. This paper explores data from three undergraduate medical schools to offer a critical perspective of predictive validity in medical admissions.MethodsThis study examined 650 undergraduate medical students from three Australian universities as they progressed through the initial years of medical school (accounting for approximately 25 per cent of all commencing undergraduate medical students in Australia in 2006 and 2007). Admissions criteria (aptitude test score based on UMAT, school result and interview score) were correlated with GPA over four years of study. Standard regression of each of the three admissions variables on GPA, for each institution at each year level was also conducted.ResultsOverall, the data found positive correlations between performance in medical school, school achievement and UMAT, but not interview. However, there were substantial differences between schools, across year levels, and within sections of UMAT exposed. Despite this, each admission variable was shown to add towards explaining course performance, net of other variables.ConclusionThe findings suggest the strength of multiple admissions tools in predicting outcomes of medical students. However, they also highlight the large differences in outcomes achieved by different schools, thus emphasising the pitfalls of generalising results from predictive validity studies without recognising the diverse ways in which they are designed and the variation in the institutional contexts in which they are administered. The assumption that high-positive correlations are desirable (or even expected) in these studies is also problematised.

The Undergraduate Medical and Health Sciences Admissions Test: What is it measuring?

Background: The Undergraduate Medical and Health Sciences Admissions Test (UMAT) is used to select medical students in Australia and New Zealand but empirical evidence of its construct validity has never been reported.Aims: To identify the underlying constructs assessed in each of the three sections of the UMAT. Based on conclusions from an early qualitative study (Mercer & Chiavaroli 2006), it was expected that Section 1 scores would correlate with scores obtained from standard measures of cognitive ability (verbal and numeric reasoning), Section 2 scores would correlate with emotional intelligence, and Section 3 scores would be most strongly related to abstract or non-verbal reasoning ability.Method: Final year high school students (n = 432) completed tests of numerical, verbal, and non-verbal cognitive ability, and emotional intelligence. Correlations and multiple regressions assessed the relationship of these tests with scores on each section of the UMAT.Results: UMAT Section 1 was significantly related to verbal, non-verbal, and numerical reasoning tests. Section 2 was significantly related to emotional intelligence and verbal reasoning, but the majority of variance in this section's scores remained unexplained. Section 3 scores significantly correlated with non-verbal and numerical reasoning.Conclusions: The UMAT Sections 1 and 3 appear to be tests of cognitive abilities. Further research is required to identify the constructs being measured by Section 2.

Multi-site videoconference tutorials for medical students in Australia

About two-thirds of medical students are distributed among the major metropolitan tertiary teaching hospitals in Queensland, while the remainder are sent to regional hospitals up to 500 km away. The aim of this study was to investigate the feasibility and effectiveness of conducting surgical tutorials via videoconferencing (VC) for medical students undertaking at remote hospitals. Surgical tutorials were offered to final-year medical students at the Royal Children's Hospital (RCH) in Brisbane and shared by VC to students undertaking clinical placement at nine remotely located hospitals in Queensland. We have conducted a retrospective review of service activity, student satisfaction and subject scores from 2008 to 2010. The main outcome measures were VC activity, medical students' satisfaction and student exam results pre- and post-introduction of the surgical tutorial programme. Between March 2009 and November 2010, a total of 57 VC tutorials were conducted during nine rotations for a total of 669 students. Approximately, 35% of students (236) attended tutorials face-to-face at the RCH while the remainder (including those at the Mater Children's Hospital in Brisbane and eight regional sites) participated via VC. A snapshot survey to measure satisfaction of both groups of students showed that overall satisfaction was very high. A total of 299 students completed the paediatrics and child health multiple-station assessment task exam in 2008, 326 in 2009 and 382 in 2010. The pre-intervention (tutorials not delivered by VC) median scores (interquartile range) of surgical and non-surgical questions were 5 (4-6) and 23 (21-25). Post-intervention, surgical scores increased significantly to 6 (5-7) (P < 0.001), while non-surgical scores remained similar at 23 (21-25) (P = 0.64). Our study demonstrates that VC is a feasible and effective method of engaging medical students regardless of their location. VC provides equitable access to medical teaching for medical students undertaking remote clinical placements.

Complementary and alternative medicine and medical students in Australia: Where do we stand?

Complementary and alternative medicine and medical students in Australia: Where do we stand?

Complementary and alternative medicine and medical students in Australia:Where do we stand?

What is ‘CAM’? Complementary and alternative medicine (CAM) encompasses a diverse group of therapies that fall outside the paradigm of conventional medical practice, and are often used in conjunction with or alongside such practices. Generally speaking, CAM may be thought of as a group of therapies that offer more holistic approaches to medical ailments, compared to exclusively conventional therapies which may only “view the body mechanistically”.1 Many examples of CAM have originated from non-Western societies and are built upon the well-established culture of those societies.2 The World Health Organization (WHO) reports that about 75% of the world's population relies on medical practices that have originated from indigenous or traditional systems.3 Patients consult CAM practitioners for a number of reasons; often due to a chronic problem where they have received unsatisfactory outcomes from conventional therapies or encounters.4 However, many continue to use both systems concurrently and this is to perhaps to achieve a balanced, synergistically-driven therapy.4 In Australia, approximately half of the population uses or has used CAM, with an estimated 70 billion visits to CAM practitioners a year. Surprisingly, this is the same number of visits to medical practitioners.5,6 As a nation, Australia spends well over $4 billion on CAM annually and this figure is rising as the prevalence and integration of these therapies into conventional medicine increases.6,7 The National Institutes of Health (NIH) classifies CAM into seven broad categories:8 Natural therapies. Mind-body therapies. Body manipulation. Movement therapies. Traditional healers. Energy field-based therapies. Whole medical systems. In Australia, chiropractic, natural therapy and acupuncture remain three of the top most sought-after CAM.5,9,10 These are the CAM modalities in which Australian practitioners and medical students may find themselves encountering and hence will be explored in further detail.