Medical Student Reflections Research Articles

Chicken Over Rice: A Medical Student's Reflection on a Rotation in Palliative Care.

Chicken Over Rice: A Medical Student's Reflection on a Rotation in Palliative Care.

A Qualitative Analysis of Medical Student Reflections Following Participation in a Canadian Radiation Oncology Studentship.

Exposure to radiation oncology in medical school curricula is limited; thus, mentorship and research opportunities like the Dr. Pamela Catton SummerStudentship Program attempt to bridge this gap and stimulate interest in the specialty. In 2021, the studentship was redesigned as virtual research, mentorship, and case-based discussions due to the COVID-19 pandemic. This study explores the impact of COVID-19 on the studentship, on students' perceptions of the program, and on medical training and career choice. Fifteen studentship completion essays during 2021-2022 were obtained and anonymized. Thematic analysis was performed to interpret the essays with NVivo. Two independent reviewers coded the essays. Themes were established by identifying connections between coded excerpts. Consensus was achieved through multiple rounds of discussion and iteratively reviewing each theme. Representative quotes were used to illustrate the themes. The themes confirmed the studentship was feasible during the pandemic. Perceived benefits of the program included mentorship and networking opportunities; gaining practical and fundamental knowledge in radiation oncology; developing clinical and research skills; and creating positive attitudes towards radiation oncology and the humanistic aspect of the field. The studentship supported medical specialty selection by helping define student values, shaping perceptions of the specialty, and promoting self-reflection upon students' personal needs. This study informs future iterations of the studentship to promote radiation oncology in Canadian medical school curricula. It serves as a model for studentships in other specialties that have limited exposure and similar challenges with medical student recruitment.

Pre- and post-examination reflections of first-year medical students in an integrated medical anatomy course.

Due to the rigor and pace of undergraduate medical anatomy courses, it is not uncommon for students to struggle and fail initially. However, repetition of coursework places an additional burden on the student, instructor, and institution. The purpose of this study was to compare the exam preparation strategies of repeating and non-repeating students to identify areas where struggling students can be supported prior to course failure. As part of their integrated anatomy course, first-year medical students at Indiana University completed a metacognitive Practice-Based Learning and Improvement (PBLI) assignment prior to and after their first exam. In the PBLIs, students were asked to reflect on their exam preparation strategies, confidence, and satisfaction, as well as their predicted and actual exam performance. PBLI responses from non-repeating and repeating students were then analyzed quantitatively and qualitatively. A total of 1802 medical students were included in this study, including 1751 non-repeating and 51 repeating students. Based on their PBLI responses, non-repeating students were appropriately confident, somewhat satisfied, and more accurate when predicting their exam performance. Repeating students were overconfident, dissatisfied, and inaccurate when predicting their first exam performance on their initial, unsuccessful attempt but were more successful on their second, repeat attempt. Qualitative analysis revealed that repeating students aimed to improve their studying by modifying their existing study strategies and managing their time more effectively. In conjunction with other known risk factors, these insights into repeater and non-repeater exam preparation practices can help anatomy educators better identify and support potential struggling students.

134 A Qualitative Analysis of Medical Student Reflections Following Participation in a Canadian Radiation Oncology Studentship

134 A Qualitative Analysis of Medical Student Reflections Following Participation in a Canadian Radiation Oncology Studentship

Learning Harmony: Medical Student Reflections on the Intersection of the Arts & Humanities and Medicine, A Mixed Methods Study

Learning Harmony: Medical Student Reflections on the Intersection of the Arts & Humanities and Medicine, A Mixed Methods Study

Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies

Introduction Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals. Methods A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis. Results Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development. Discussion Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.

Duty Hours on Surgery Clerkship: From Compliance Nightmare to Leadership and Professional Development Opportunity

To evaluate the impact of an innovative leadership development initiative in the core surgery clerkship that addressed duty hours compliance and time-off requests. A combination of deductive and inductive analysis of medical student reflections written after rotating on Acute Care Surgery over 2 academic years (2019-2020 and 2020-2021) was performed. Reflections were part of criteria to receive honors and a prompt was given to discuss their experience in creating their own call schedules. We utilized a combined deductive and inductive process to identify predominant themes within the reflections. Once established, we quantitatively identified frequency and density of themes cited, along with qualitative analysis to determine barriers and lessons learned. Dell Seton Medical Center, Dell Medical School at The University of Texas at Austin, a tertiary academic facility. There were 96 students who rotated on Acute Care Surgery during the study period, 64 (66.7%) of whom completed the reflection piece. We identified 10 predominant themes through the combined deductive and inductive processes. Barriers were cited by most students (n = 58, 91%), with communication being the most commonly discussed theme when cited with a mean 1.96 references per student. Learned leadership skills included: communication, independence, teamwork, negotiating skills, reflection of best practices by residents, and realizing the importance of duty hours. Transferring duty hour scheduling responsibilities to medical students resulted in multiple professional development opportunities while decreasing administrative burden and improving adherence to duty hour requirements. This approach requires further validation, but may be considered at other institutions seeking to improve the leadership and communication skills of its students, while improving adherence to duty hour restrictions.

Perception and reflections of second year medical students on attitude, ethics, and communication skills module on patient autonomy and decision making in a tertiary care teaching hospital

Perception and reflections of second year medical students on attitude, ethics, and communication skills module on patient autonomy and decision making in a tertiary care teaching hospital

Enhancing patient-centered care for limited English proficiency patients through Tell Me More®: A student-driven initiative to explore the patient as a person and develop students’ communication skills

Tell Me More® (TMM) is a medical student-driven initiative to build rapport between patients, students, and the healthcare team through patient interviews and collaboratively created posters. Patients with limited English proficiency (LEP) often experience impaired communication with providers. TMM has the potential to address the loss of patient-centered dialogue in interpreter-mediated communications. In this exploratory pilot study, we aimed to include LEP patients in TMM by using medical interpreter phones (MIPs) at Long Island Jewish Medical Center, Northwell Health. Our objectives were to: (1) evaluate the feasibility of this approach, (2) compare TMM engagement between LEP and English-speaking (ES) patients, and (3) document the impact of this initiative on the medical student. Following the standardized TMM interview structure, the student used the MIP to interview LEP patients about who they are as people beyond their illnesses. This expanded social history was transcribed to bedside posters to enhance patient connection with the healthcare team. At the end of interviews, patients rated TMM’s impact on their hospital stay. Additionally, medical student reflections were recorded weekly. Our quantitative results from 12 LEP and 49 ES patients support significantly higher TMM participation for LEP compared to ES patients. Qualitative examination of student reflections suggests that TMM enriches medical education by promoting understanding of the LEP patient experience. Our results demonstrate that MIP-supported TMM is a feasible approach to enhance patient-centered care for LEP populations. Further research is needed to explore inclusion of LEP patients in patient-centered care initiatives such as TMM.

Revisiting the Exhibits-Medical Student Reflections on Changes to the Institutional Portraiture at a US Medical School.

Yale School of Medicine's (YSM) Sterling Hall of Medicine (SHM) has historically been lined with large oil paintings of mostly White men, despite over a century of Black and female enrollment. These spaces can be seen as exclusionary to students underrepresented in medicine, and may result in decreased well-being and adversely affect academic performance. Student-led activism has resulted in recent changes to these walls, including the addition of images of women faculty, and artwork by students, faculty, and staff. We aimed to evaluate how recent changes to longstanding historical portraiture in SHM affected students' reflections on being in that space. This was a qualitative study based on semi-structured interviews conducted virtually. Second- to fourth-year YSM medical students were interviewed. Qualitative interviews were used to gauge students' impressions of how they perceived both the original and updated artwork and portraiture, as well as the overall physical environment. Nine interviews were conducted, with interviewees describing the portraiture as reflective of YSM's institutional values. They related this to other aspects of an exclusionary environment, and noted that they created belonging at YSM within smaller communities. Students recognized and expressed appreciation for the changes to the portraiture, particularly the increase in diverse representation, and they noted stark contrasts to the prior space. While they describe positive attitudes regarding changes in SHM's exhibited portraiture and art, they also expressed skepticism about whether these changes were performative or whether they reflected true commitment to reform. This study depicts how the portraiture and physical environment of a medical school affects medical students, and that interventions to reform institutional portraiture can have considerable impact on students' attitudes regarding their medical school experiences.

Medical student reflections after a skilled nursing experience-Words to grow on.

Medical student reflections after a skilled nursing experience-Words to grow on.

Identity and uncertainty: art-mediated medical student reflections in a time of transition

ABSTRACT Medical education comprises intense periods of transition, which can significantly impact student well-being, as well as personal and professional development. In 2020, medical students navigating transitions from pre-clinical to clinical roles were also experiencing the historic forces of the COVID-19 pandemic and ongoing societal reckoning with systemic injustice and racism, likely heightening the usual challenges associated with these transitions. Reflection has been suggested as a tool for facilitating such transitions, and arts-mediated approaches hold promise in inspiring authentic reflection, yet they are rarely used to prompt medical student reflection. This article describes common themes in medical students’ reflections on a specific period of transition during a unique moment in history, via qualitative analysis of their narrative responses to visual arts-mediated reflective prompts. The authors used a visual arts-based activity to explore medical students’ hopes and concerns as they transitioned to clinical clerkships between the 2019–2020 and 2020–2021 academic years at one academic institution. Qualitative analysis using an exploratory constructivist approach revealed that students’ reflections often focused on identity within three main themes: the personal self, the professional self, and the social self. Within these categories, subthemes included uncertainty and concerns focusing on medical training and knowledge, the sense of hope and value inherent to their social connections, critiques of the culture of medical education, and reflections on complicity and responsibility in racial injustice. This article not only provides a cross-sectional snapshot of the experiences of medical students during a historic moment, but also provides themes to guide discussions on training transitions and describes a low-cost, adaptable approach to facilitating deep exploration and reflection on tumultuous moments in training.

Learning of empathy among first-year medical students

Empathy is one of the core competencies that doctors must possess. Teaching empathy is carried out since students are in undergraduate medical education. One of the learning activities that can be used to improve empathy skills is reflection. Many studies have reported on the empathic abilities of medical students. In addition, there have also been many scientific articles discussing the factors that affect the ability of empathy. However, how medical students learn empathy is still unclear, especially for first-year students who have just been exposed to medical science after graduating from high school. This study aimed to understand how first-year medical students learn empathy. A qualitative study with a phenomenological approach was carried out. We selected randomly, a total of 30 medical student reflection journals were analyzed using content analysis techniques. There are three themes, namely stimulus, process, and effect. Medical students learn empathy driven by internal and external stimuli so that a thinking process occurs through several learning activities. The existence of this stimulus and process influences both the self and the patient/client. The whole process of empathy learning can show how early-year students learn and the factors that influence student empathy learning. This study supports other research that discusses the learning process and factors that affect medical students' empathy. This result can encourage curriculum planners to design appropriate empathy learning for students.

Right Brain: A Medical Student's Reflections on Creating Space for Dementia Discussions.

The following narrative describes the experiences and reflections of a fourth-year medical student who longitudinally cared for a patient with dementia in an outpatient geriatric psychiatry clinic and inpatient medicine unit. The student, through these experiences, emphasizes the importance of creating space for honest and realistic discussions, balanced with empathic support, when discussing dementia diagnoses with patients and families. In addition, she recognizes the importance of engaging families in these discussions to promote proactive care planning and reminding patients and families that they are not at fault for their disease.

Early introduction of the multi-disciplinary team through student Schwartz Rounds: a mixed methodology study

BackgroundMedical education has changed continually throughout the covid-19 pandemic, creating additional stress for medical students. Personal reflection can empower an individual to adapt to new challenges, and reflection has gradually become incorporated into medical student training. Schwartz Rounds (SR) offer a compassionate group reflective forum for healthcare staff. SRs have been extensively introduced throughout the NHS, however medical student rounds are yet to be widely adopted. Entirely unresearched is how the multi-disciplinary team impacts a medical student SR.This study aims to compare medical student experience of a single-discipline and a multi-discipline SR using mixed methodology.MethodsTwo virtual SRs were run at an NHS district general hospital, using the existing structure of the Trust’s rounds. The first round included only medical students on placement at the hospital, whereas the second round also involved other student health disciplines. Following each round Likert scale questionnaires were collected, and focus groups were held with a small number of participants. Quantitative analysis used median averages as well direct comparison of scores for each round. Qualitative data from the focus groups underwent thematic analysis.ResultsThe quantitative data showed a positive response to both styles of student SRs, with over 87% of participants at both rounds stating they intended to attend further rounds. Direct comparison between the two rounds showed higher feedback scores for the single-discipline round. Qualitative analysis showed strong student interest in further group reflection, noting the value of SRs in improving workplace culture and inter-professional relationships. The analysis also highlighted frustrations with the existing SR structure, namely large group sizes and scripted panellists.ConclusionsBoth data sets showed a strong positive response to SRs, and a desire to attend again. There is some evidence to suggest the addition of multiple student disciplines at SRs impaired medical student reflection. Changes to the format of the round could result in even greater success in student rounds.

Humanity. A medical student's reflections on the healer role

Detailing the moving story of his interactions with a patient and her significant other, Ahmed Imcaoudene's Goodwin Prize-winning essay on the Healer Role was selected for presentation in McGill University's Physicianship curriculum. It was also read at the 4th International Congress on Whole Person Care on October 22nd, 2021, introducing profound discussions on compassion in healthcare.

Using vlogging to facilitate medical student reflection

ABSTRACT Reflection is a critical skill for medical professionals, however medical students often find it difficult to grasp and engage with. During a special choice module on yoga and mindfulness, students practised mindfulness at home and posted their reflections on the activities in text and vlogs in a closed WhatsApp group. Semi-structured focus groups investigated student perspectives on the acceptability and impact of v-logging on their reflective practice. We thematically analysed transcripts of the WhatsApp conversations and two focus groups.Students felt v-logging was more engaging and convenient than written reflections. V-logging was found to enhance emotional content that is commonly lacking in written reflection, which is has importance as emotional recognition promotes a higher quality of reflection. Although some students were concerned about their appearance in videos, they appeared to overcome this, finding v-logging facilitated deeper reflection compared with traditional written reflections due to accessibility and ease of expression. Furthermore, there was additional learning through watching other students’ emotive vlogs which fits with the phenomenon of reflective vicarious learning.Sharing vlogs within a WhatsApp group appeared to be an accessible way for facilitating greater engagement with affective and expressive aspects of reflection.

Discovering the Roots: A Qualitative Analysis of Medical Students Exploring Their Unconscious Obesity Bias

Phenomenon: Bias against individuals with obesity in medical settings has negative implications for patients, including stigmatization, poor health outcomes, and reduced healthcare utilization. This study explored reflections of medical students when confronted with their own implicit obesity bias. Approach: A group of 188 pre-clinical second-year medical students from George Washington University School of Medicine and Health Sciences completed the Weight Implicit Association Test (IAT) in 2020 and were instructed to write a reflective response based on their results. Participants reflected upon their preferences (“fat” vs. “thin”) and described the factors that influenced their perceptions of obesity. Inductive coding techniques were used to generate themes from medical students’ responses using Dedoose Version 8.3.35 (SocioCultural Research Consultants LLC, Los Angeles, California). Findings: Regarding IAT results, 7% of medical students preferred “fat over thin,” 14% had no preference, and 78% preferred “thin over fat.” Reflection themes highlighted medical students’ difficulty accepting IAT results, perspectives on the origins of obesity in individuals, personal and family challenges with obesity and body image, medical training’s perceived influence on bias, reservations about discussing obesity with patients, and desires to change current and future practices. Insights: Many medical students expressed a desire to provide optimal care for patients of all weight classes despite demonstrating a strong unconscious bias against individuals with obesity on the IAT. Medical school should provide targeted opportunities to acknowledge and mitigate obesity bias by expanding on medical students’ pre-established and often harmful understandings of obesity and highlighting the complexities of this disease. Such training would better equip medical students to facilitate successful interactions with patients as future physicians.

“Rhythm of the Night”: Medical student reflections on overnight trauma call

IntroductionOn their surgical clerkship, students reflected on their experience on a traditional overnight call. We explored whether perceived learning experiences differ between students who identify surgical specialties as their career compared to those who do not. MethodsMedical students participated in traditional call at a Level 1 Trauma Center and submitted guided reflections. Reflections were coded using thematic analysis. We used Epistemic Network Analysis to compare codes based on matched specialty. Results418 students submitted reflections between 2016 and 2019.95% learned something on call they could not have during daily services. Students who matched in surgical specialties connected more call learning experiences to formation of student agency through individualized teaching experiences and awareness of stamina. ConclusionsMost students found participation in overnight call valuable, and professed increased awareness of their skills and future residency duties. Results indicate students who matched in surgical specialties had more formative experiences on call.

Social Factors of Health Care: a Thematic Analysis of First and Second Year Medical Student Reflections.

Addressing health disparities is necessary to ensure appropriate care for patients. This study examined the impact of Clinical Week experiences on students' recognition of social determinants of health early in their medical education. A 5-day experience each of the first three semesters of medical school provided direct patient care experiences. Two Clinical Weeks were spent in outpatient clinics located primarily in rural areas. Students completed a reflective writing assignment about their experiences after each 5-day experience. Ninety-two reflections during AY 2018-2019 included discussions about social determinants of health. Two investigators analyzed these essays independently using narrative inquiry techniques. After inductive coding was complete, researchers discussed themes and their broader meaning. Themes emerged related to health disparities experienced by rural communities, minority populations, and both uninsured and underinsured patients. Reflections emphasized a lack of public accommodations in rural settings, such as public transportation and access to healthy food. Students noted how ethnic, cultural, and linguistic identity affect a patient's experience with healthcare. Other themes involved the challenges patients face affording treatment plans and conversely how health status can impact economic stability. Finally, students emphasized the importance of physician advocacy in overcoming such barriers to quality health care. Although not the emphasis of Clinical Week, students' reflections identified critical social issues impacting the health of patients they encountered. This experience could be adapted at other institutions.