Preclinical Medical Students Research Articles

Reliability and validity study of the Thai adaptation of the Maslach Burnout Inventory-Student Survey among preclinical medical students at a medical school in Thailand.

Burnout syndrome is characterized by emotional exhaustion, cynicism, and lack of professional efficacy. A considerable proportion of medical students experience burnout syndrome during their educational training. Therefore, this issue has become a major concern in the medical education community. The Maslach Burnout Inventory-Student Survey (MBI-SS) is the most widely used assessment of burnout syndrome among college students, including preclinical medical students. Therefore, our objective was to culturally modify and validate the MBI-SS in a Thai context for use with preclinical medical students. The MBI-SS comprises 16 items, including five items for emotional exhaustion, five items for cynicism, and six items for academic efficacy. Four hundred and twenty-six preclinical medical students participated in this study. We randomly divided the samples into two equivalent subsamples of 213 participants. The first subsample was used to calculate McDonald's omega coefficients to assess internal consistency and to perform exploratory factor analysis. McDonald's omega coefficients for exhaustion, cynicism, and academic efficacy were 0.877, 0.844, and 0.846, respectively. The scree plot from the unweighted least squares estimation and a direct oblimin rotation, supplemented with Horn's parallel analysis and the Hull method, revealed three major factors of the Thai MBI-SS. Due to the violation of the multivariate normality assumption in the second subsample, we performed a confirmatory factor analysis with the unweighted least squares with a mean and variance adjusted estimation approach. The results of the confirmatory factor analysis showed favorable goodness-of-fit indices. Data from 187 out of 426 participants (43.9%), who completed a second questionnaire, were utilized to evaluate test-retest reliability. The correlation coefficients for test-retest reliability with a three-week period between tests were 0.724, 0.760, and 0.769 for the exhaustion, cynicism, and academic efficacy domains, respectively (all p < 0.05). This indicates that the Thai MBI-SS is a valid and reliable instrument to assess burnout syndrome in our Thai preclinical medical student population.

SIMBA for Students - teaching endocrinology to pre-clinical medical and pharmacy students through online simulation- a pilot study

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Wright table of the cardiac cycle: Expanding application to clinical settings

Purpose: Introduce a clinical variant of the Wright table both to teach at the upper undergraduate/graduate level and to model pathologies at the graduate/residency level of clinical training. Introduction:The cardiac cycle is taught in cardiovascular units and used by health professionals. The original Wright table (1) models this process’ events using four flow phases and four compartments. Its use of pressures in each compartment to drive blood from veins to arteries, with valve openings, closings, and heart sounds, was applied at the preclinical level. Improvements in the Wright table (2) include those for a right heart, a left heart with pulmonary wedge pressures, and some comparisons (e.g., right-vs-left heart). Preclinical medical students used these to model valvular pathologies (3). We hypothesized that if the Wright table included isovolumetric phases, it could be a clinical instrument to be used by cardiologists to help solidify key concepts necessary to understand pathology. Methods:A variant of this table was developed using five columns of “compartments” to model the cardiac cycle in the left heart: pulmonary veins, left atrium, left ventricle, aorta, and a pulmonary wedges concept that illustrates when blood backs up into pulmonary capillaries. The right heart’s includes a jugular venous compartment. This variant was pilot-demonstrated via zoom to a group of cardiologists to explore its potential use as an instrument to model pathologies. Results:The clinical variant of the Wright table displays all seven phases of the cardiac cycle typically depicted in the Wiggers diagram. The first phase, 1) rapid ventricular filling, begins when the A-V valve opens. This is followed by 2) slow ventricular filling [a.k.a. diastasis], 3) active ventricular filling during atrial systole, 4) isovolumetric contraction, 5) rapid ventricular ejection, 6) slow ventricular ejection [and protodiastole], and 7) isovolumetric relaxation. Each phase occupies one row from 1) top to 7) bottom, resulting in a 5-compartment, 7-phase (5x7) table of the cardiac cycle. The clinical variant of the Wright table puts all three ventricular filling phases together at the top prior to ventricular emptying. It introduces a system for pathophysiological modeling for both clinical professionals and advanced medical students. The model is constructed in a way that allows for a variety of comparisons including right-vs-left heart; physiological vs. pathological; early vs. late progression of a pathological condition; and earlier-to-later times. It also can display atrial and/or septal defects and their pathological effects within the heart. Conclusion:We present a clinical variant of the Wright table that was successfully tested with cardiologists. This all-phase variant shows its potential as a tool to deepen physiological and pathophysiological insight on the cardiac cycle to both advanced medical students and clinical professionals in a cardiology context. Funding: None This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Exploring relationships between sleep-wake patterns, wellness, burnout, self-efficacy, and academic performance in medical students

Purpose: Morningness and eveningness are terms related to an individual’s sleep-wake pattern. Individuals with a morningness chronotype tend to wake up earlier, are more productive in the daytime, and go to bed earlier while individuals with an eveningness chronotype tend to wake up later, are more productive in the evening hours, and go to sleep later in the night. The purpose of this study was to see if medical students’ sleep-wake patterns correlated to their wellbeing and academic performance. We hypothesized that individuals with morningness chronotypes would report better wellbeing and higher GPAs than individuals with an eveningness chronotype. Another objective of the study was to determine if there were any differences between preclinical (M1) and clinical medical students (M3) in chronotype, levels of burnout, wellness, self-efficacy, and academic performance. We hypothesized that M3 students would have an increased preference for morningness and better overall wellness and academic outcomes compared to the M1 students.[JK1] Methods: Data were collected using an anonymous online survey. The M1 students were administered a 51-question survey in May of their first year while M3 students were administered a 62-question survey in May of their third year consisting of question subsets from multiple validated surveys. Chronotype was determined using the Composite Scale of Morningness (CSM) survey. Wellness metrics were measured using the CDC Healthy Days Measure, School Burnout Inventory, and Epworth Sleepiness Scale (ESS). M1 students completed a self-efficacy instrument about academic work and M3 students completed items about self-efficacy for clinical work. Academic performance was measured using cumulative GPA for M1 students and third year GPA for M3 students. The study was exempted by the UCF IRB. Data: Forty M1 students and 25 M3 students completed the survey, totaling 65 total participants. There was no statistically significant difference between M1 and M3 regarding morningness or eveningness chronotypes, allowing us to combine M1 and M3 data to run correlations of chronotype with wellness and academic metrics for all students. Morningness was associated with an increased number of healthy days (p=0.041, R2= 0.254) and a decreased amount of daytime sleepiness (p=0.017, R2= -0.296). Eveningness was correlated with a lower overall GPA (p=0.044, R2=-0.250). The other correlations did not demonstrate any association between chronotypes and the wellness/academic metrics. Conclusion: Morningness chronotypes were associated with an increase in health-related quality of life and a decrease in excessive sleepiness, while eveningness chronotypes were associated with lower GPAs, indicating that morningness may improve certain wellness and academic metrics. No significant associations between chronotypes and burnout or self-efficacy were found. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Linked CT and Cadaver Images Facilitate Radiographic Anatomy Learning in Pilot Study of Pre-Clinical Medical Students

Linked CT and Cadaver Images Facilitate Radiographic Anatomy Learning in Pilot Study of Pre-Clinical Medical Students

Practical wisdom in medicine through the eyes of medical students and physicians.

Practical wisdom is considered a multidimensional virtue of enduring relevance to medicine. Though it has received increasing attention in recent years, proposed frameworks for practical wisdom can differ, and little is known about how medical students and physicians describe its dimensions and relevance. We used structured interviews, employing open-ended and closed-ended questions, to describe how medical students and physicians understand practical wisdom and identify the kinds of clinical situations they believe require practical wisdom. We interviewed 102 participants at two US medical schools in 2021, comprising a voluntary response sample of 40 pre-clinical medical students and 40 clinical medical students and a purposive sample of 22 nominated physicians. Interviews were conducted by videoconference using a structured interview guide. Open-ended responses were coded using qualitative content analysis (directed and conventional) and tabulated; closed-ended responses were tabulated. Quotations provided qualitative illustrations, and frequencies were used for summative results. Participants considered practical wisdom clinically meaningful, broadly relevant and multidimensional. Most described it as deliberative, goal-directed, context-sensitive, integrated with ethics and marked by integrity and motivation to act. Many described it as experience-based, person-centred or problem-solving. Participants also selected an average of 15.6 (SD = 4.9) additional virtues as being essential for practical wisdom in medicine and described a broad range of clinical situations that require practical wisdom in medicine. Participants described practical wisdom as a multidimensional capacity that entails deliberation, depends on a constellation of other virtues and is broadly applicable to medicine. Most agreed it is goal-directed and context-sensitive and involves ethics, integrity and motivation. Efforts to teach practical wisdom in medical education should clarify its dimensions and highlight its relationship to virtue ethics, professionalism, clinical judgement and the individualised care of patients as persons.

Prescription Writing Skill among Intern Doctors of Birat Medical College Teaching Hospital, Nepal

Introduction: A prescription is a written order to a pharmacist by a doctor, which should contain all its components so that a patient can get precise and fruitful outcomes of disease treatment. Preclinical undergraduate medical students are taught and trained to develop good prescription skills. Thus, we aimed to appraise prescription writing skills among intern doctors of Birat Medical College Teaching Hospital, Nepal.&#x0D; Methods: This observational cross-sectional study enrolled 63 interns of Birat Medical College Teaching Hospital. Nineteen components of a prescription according to the World Health Organization were included in this study. They were name, address, degree, registration number, telephone number, sign of the prescriber, date, diagnosis, dosage form, correct dose, the correct route, correct quantity, and correct instruction of the drug, name, address, sex, and age of the patient. Then four groups; Group A (Poor), Group B (Fair), Group C (Good), and Group D (Excellent) were divided according to the number of components included in the prescription.&#x0D; Results: According to the study scoring system, the maximum prescriptions were from group C (65.08%) followed by group B (34.92%). None of them were group A and group D. Components such as prescriber’s name, drug’s name, dose, route, quantity, and instruction were found in all the prescriptions whereas, components such as prescriber’s address, degree, and contact number were not found in any of the prescriptions.&#x0D; Conclusions: The prescription writing skills of interns of Birat Medical College Teaching Hospital is not up to the mark. There are lots of missing components in their prescriptions.

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.

Use of Sociodemographic Information in Clinical Vignettes of Multiple-Choice Questions for Preclinical Medical Students.

This paper aims to characterize the use of demographic data in multiple-choice questions from a commercial preclinical question bank and determine if there is appropriate use of different distractors. Multiple-choice questions for medical students often include vignettes describing a patient's presentation to help guide students to a diagnosis, but overall patterns of usage between different types of nonmedical patient information in question stems have yet to be determined. Three hundred eighty of 453 randomly selected questions were included for analysis after determining they contained a clinical vignette and required a diagnosis. The vignettes and following explanations were then examined for the presence/absence of 11 types of demographic information, including age, sex/gender, and socioeconomic status. We compared both the usage frequency and relevance between the 11 information types. Most information types were present in less than 10% of clinical vignettes, but age and sex/gender were present in over 95% of question stems. Over 50% of questions included irrelevant information about age and sex/gender, but 75% of questions did not include any irrelevant information of other types. Patient weight and environmental exposures were significantly more likely to be relevant than age or sex/gender. Students using the questions in this study will frequently gain practice incorporating age and sex/gender into their clinical reasoning while receiving little exposure to other demographic information. Based on our findings, we posit that questions could include more irrelevant information, outside age and sex/gender, to better approximate real clinical scenarios and ensure students do not overvalue certain demographic data. The online version contains supplementary material available at 10.1007/s40670-023-01778-z.

Time to Flip? Feedback from UNIMAS Medical Students Towards Implementation of Flipped Pathology Classroom

This study aimed to explore the perception of year two preclinical medical students towards flipped classroom over conventional teaching method through qualitative and quantitative approaches. The study involved 110 year two preclinical medical students at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak from October 2020 to January 2021. Five one-hour pathology lectures were divided into two parts covering different topics of the lecture. The first half hour used conventional teaching, while the second half hour used flipped classroom. Student feedback was collected through a 19-item, self-administered questionnaire comprising 15 quantitative questions in three structured instruments and four qualitative open-ended questions. The score for mean perception of flipped classroom was significantly different according to place of residence while the mean knowledge acquisition score was significantly different among students using different internet sources. In addition, for examination preparation, slightly more than one third preferred traditional classroom. Six aspects of improvement on flipped classroom were identified: learning materials; teaching methods; quality of resource materials; class activity and interaction; choices of topics for flipped classroom; and time, pace, and atmosphere of lessons. Three aspects of significance of flipped classroom were captured, which included facilitating understanding and revision; flexible time, ability to ask and answer; and ability to share, focus and identify mistakes. A flipped classroom shows much potential in medical education. Future studies on feedback from students are needed to improve the flipped classroom to suit the Malaysian context.

Learning abnormal physical examination signs: an introductory course.

The acquisition of clinical skills is an essential part of the osteopathic medical school curriculum. Preclinical medical students, especially at osteopathic medical schools, have limited exposure to abnormal physical examination (PE) findings that are not typically seen in a student's peers or in a standardized patient (SP). The early exposure of first-year medical students (MS1s) to normal and abnormal findings in the simulation settings better equips them to identify abnormalities when they encounter them in a clinical setting. The aim of this project was to develop and implement the introductory course on learning abnormal PE signs and pathophysiology of abnormal clinical findings to address the educational needs of MS1s. The didactic part of the course consisted of PowerPoint presentations and lecture on the topics related to the simulation. The practical skill session was 60min, during which time students first practiced PE signs and then were assessed on their ability to accurately identify abnormal PE signs on a high-fidelity (HF) mannequin. Faculty instructors guided students through clinical cases and challenged them with probing questions in clinically relevant content. Before- and after-simulation evaluations were created to assess students' skills and confidence. Student satisfaction levels after the training course were also assessed. This study demonstrated significant improvements in five PE skills (p<0.0001) after the introductory course of abnormal PE clinical signs. The average score for five clinical skills increased from 63.1 to 88.74% (before to after simulation). The confidence of students in performing clinical skills and their understanding of the pathophysiology of abnormal clinical findings also increased significantly (p<0.0001) after simulation activity and educational instruction. The average confidence score increased from 3.3 to 4.5% (before to after simulation) on a 5-point Likert scale. Survey results demonstrated high satisfaction with the course among learners with mean satisfaction score 4.7±0.4 on 5-point Likert scale. The introductory course was well received by MS1s and they left positive feedback. This introductory course offered MS1s with novice PE skills the ability to learn a variety of abnormal PE signs, including heart murmurs and rhythms, lung sounds, measurement of blood pressure (BP), and palpation of the femoral pulse. This course also allowed abnormal PE findings to be taught in a time-efficient and faculty-resource-efficient manner.

Professionalism in small group learning between face-to-face and virtual settings: a mixed-methods study.

To explore whether and how preclinical medical students changed perceptions and behaviors related to professionalism in small group learning activities from face-to-face to virtual during the pandemic. The study used a mixed-methods sequential research design. We first retrospectively examined quantitative data from 101 medical students who completed mandatory peer evaluation surveys assessing professional behaviors of small group members in two courses (one face-to-face, the other online). Differences between student perceptions in two settings were compared using the Wilcoxon signed-rank test. Findings from the quantitative stage were probed further using focus groups at the qualitative stage. Six focus groups (n = 27) were conducted using purposeful sampling. Interviews were transcribed and inductive thematic coding was used to identify emerging themes. We found a significant decrease in perceptions of punctuality and attendance in the virtual setting compared to face-to-face learning (Z=-6.211, p<.001), despite lower expectations of their peers in online learning. Five major themes emerged from the qualitative data: punctuality/participation, camera usage, dress code/conversational style, multitasking, and engagement/accountability. Participants showed sensitivity when conceptualizing professional conduct, indicating the dynamic process of professional identity formation at the early stage of their career. Results show that students' perceptions of professionalism become contextualized, significantly influenced by the background of the virtual learning environment. Intentional communication about professionalism within specific sociocultural and educational contexts is vital for individual professional identity formation. These findings support of the importance of considering context when educational programs develop curricula and establish expectations related to professionalism.

Wearable point-of-view live streaming technology in a virtual airway management workshop for medical students

Background: Trauma resuscitation skills are an essential part of medical training. Airway management skills are often learned via simulation-based training, but physical distancing restrictions have forced medical schools to transition their preclinical curricula to a virtual format. A wearable, point-of-view (POV), live streaming tool was piloted in a virtual airway management workshop to preclinical medical students to address limitations in the standard online curriculum. Methods: An anesthesiologist instructor donned a chest-mounted smartphone that captured POV video as it was connected to a Zoom video conference call. Simultaneously, a second camera view from a different angle was streamed from a laptop webcam. Preclinical medical student attendees watched the facilitator demonstrate airway management and resuscitation skills on a simulation mannequin. Student perceptions of the workshop were assessed via standardised course evaluations administered through the online student portal and a questionnaire distributed by the course representative. Results: Qualitative and quantitative course evaluation data showed that although this platform may not completely substitute in-person learning, students appreciated the alternative teaching style, particularly the use of POV video and multiple camera views. Generally, students believed that the learning objectives were achieved. Camera stability, camera positioning, and the distracting nature of the virtual student-instructor interactions were identified as areas for improvement. Conclusions: Moving forward, this innovative workshop format can act as a valuable framework for other institutions that wish to bridge gaps in current virtual education methods and enhance technical skills training in medical learners.

Association Between Sleep Quality and Quality of Life Among Medical Students in Chiang Mai University

Objective: To explore and compare the sleep quality between pre-clinical and clinical medical students. The present study also assessed the influence of sleep quality on the quality of life in four domains, physical, psychological, social relationships, and environment. Materials and Methods: A cross-sectional study was conducted among 261 second-year students and 241 fourth-year students from the Faculty of Medicine, Chiang Mai University as the representatives of preclinical and clinical medical students. Participants completed questionnaires consisting of the Pittsburgh Sleep Quality Index (PSQI) Thai version and WHOQOL-BREF-THAI to assess sleep quality and quality of life. The sleep quality was examined by chi-square test for the comparison between the two groups. Linear regression was used to evaluate the overall influence of sleep quality on each domain of the quality of life after adjusting for other covariates. Results: Two hundred sixty-one participants or 46.7% had poor sleep quality with a PSQI of 6.5 or more. The sleep quality compared between the academic years had significantly worse results (p&lt;0.001) in the preclinical students. Sleep latency and sleep disturbance were the two components of sleep quality that were statistically poorer in the preclinical students (p&lt;0.001). Poor sleep was significantly associated with a poor quality of life in all domains (p&lt;0.001). Each score increased in the global PSQI score, 2.924 score of total WHOQOL-BREF-THAI would be diminished, resulting in an impaired quality of life (p&lt;0.001). Conclusion: The prevalence of poor sleep quality was significantly higher in the preclinical year. As poorer sleep is statistically associated with the poorer quality of life, the curriculum and schedule should give consideration and provision for good sleep quality, especially in preclinical students for the improvement of medical student’s well-being. Keywords: Sleep quality; Quality of life; Medical students

Attitude and Perception of Undergraduate Medical and Dental Students towards Problem-Based Learning in Karachi

Objective: The goal of this study is to assess students' attitudes and perceptions of problem-based learning sessions. Methods: A cross-sectional survey study was conducted at Medical College of Karachi from February to May 2022 with preclinical medical and dental students. Students' attitudes towards and perceptions of problem-based learning sessions were examined using an electronic questionnaire.. SPSS 21 was used to analyze the data. Results: Overall, the students had a positive attitude towards all of the items, including self-directed learning, critical thinking, integrating basic concepts into clinical science, identifying knowledge gaps, and improved problem-solving skills. Despite the fact that PBL took a lot of time, the majority of students found PBL interesting. Conclusion: Most of the preclinical students favored PBL and believe it should be included in the curriculum alongside other teaching methods. Keywords: Problem-based learning (PBL), Medical students, Dental students, Perception, Attitude

EFFECTS OF RAMADAN FASTING TOWARD STRESS USING THE DASS-42 SCORING SYSTEM

Problems in college faced by students can cause stress. Ramadan fasting is beneficial for physical, psychic, and emotional health, among which it can reduce stress. This study aimed to understand the effect of Ramadan fasting on stress of preclinical medical students at UIN Syarif Hidayatullah Jakarta. The design of this study was prospective cohort analytic with a cross-sectional approach with a one group pre-test and post-test design. The consecutive sampling method was used for 242 respondents. To collect the data, the DASS-42 questionnaires are used. The Wilcoxon test were used to analyse the data. We found that 52 (21.5%) were experiencing stress while 190 (78.5%) were normal. The findings revealed that the stress scores fell during the pre-to post-Ramadan period for all subjects (p=0.000) either stress (p=0.000) or normal students (p=0.000). Based on the results, we found that Ramadan fasting can affect the stress scores of preclinical medical students in both normal and stressful students.

Fit for Health? Levels of Physical Activity Among Preclinical and Clinical Medical Students.

Physical, mental, and emotional wellness are just some avenues to maintain a person's overall well-being. These components of wellness influence each other; mental wellness is known to be affected by physical wellness. Physical wellness in the form of regular exercise stands as a method to mitigate the high rates of depression and burnout among medical students. This study examines the levels of physical activity among preclinical and clinical medical students. This is an observational, non-randomized study with data collection over one month. Fifty-nine percent of students surveyed met the CDC recommendation for exercise. The major reason to exercise was to improve mental health, with 37% of respondents citing this as a motivator. For those who did not meet the physical activity recommendation, lack of time was cited in 75% of respondents. Greater knowledge of prevention methods, risk factors, and outcomes of chronic health conditions may contribute to higher physical activity levels among medical students compared to the general population. Emphasizing exercise and physical wellness campaigns may be a solution for medical schools to improve the overall wellness of their students.

How much is too much? Medical students’ perceptions of evaluation and research requests, and suggestions for practice

A combination of institutional requirements and research activity means health profession students receive many requests to complete evaluations or participate in research. This study aimed to understand pre-clinical medical students’ perceptions and attitudes towards these requests. A prospective audit of evaluation and research requests to students during 2022 was undertaken to identify the volume and frequency of requests, and inform survey development. The online survey included questions about request frequency, volume, and timing. Two student cohorts received 42 and 34 evaluation plus 8 and 10 research requests, respectively. Responses (n = 167, aggregated response rate 28%) showed 70% felt they received too many evaluation requests, 76% indicated evaluation request volume should be limited, and 30% indicated receiving evaluation requests was ‘a little stressful’. Students indicated reasonable evaluation and research request frequency was 1–2 per month, with yearly maximums of 10–19 evaluation and 10 research requests. Students preferred receiving requests at the start of semesters; examination and holiday times were least preferred. Findings indicate students feel over-evaluated with the current evaluation schedule; students suggested the Medical School should regulate requests. The current research schedule was viewed as reasonable. Outcomes may guide institutional practice around request delivery.

Comparison of Stress Levels and Factors Inducing It Between Polish Medical and Dental Students in the Pre-Clinical Years of Their Training

Introduction: Stress has become an integral part of modern life. In the short-term, stress can be beneficial, but however, experiencing it long-term is increasingly common and can lead to multiple disorders, such as cardiovascular disease, diabetes and memory disabilities. Medical and dental undergraduates experience both stress related to their medical training and such associated with existence in general.Aims: The primary aim of this study was to determine stress level among medical and dental students in the pre-clinical years of their training and find out which factors induce stress the most. The second objective was to discover which pre-clinical students are most susceptible to stress: medical or dental.Materials and methods: A total of 599 pre-clinical students from both dental and medical undergraduate studies at Jagiellonian University Medical College were enrolled in the study, of which 491 were medical and 108 were dental students. To assess stress levels and the factors that induce it, we used 2 validated surveys: the Perceived Stress Scale (PSS-10) and the Perceived Medical School Stress (PMSS) instrument.Results: We observed that dental pre-clinical students obtained significantly higher scores on the PSS 10 (23.49 6.18) and PMSS (37.34 8.08) than their medical colleagues: PSS-10 (21.58 6.89) and PMSS (35.33 8.15). However, both medical and dental students demonstrated high stress levels.Conclusions: Both pre-clinical Polish medical and dental students experience high levels of stress. The later achieved significantly higher scores regarding level of stress than their medical peers. Both medical and dental students most strongly agree with statements indicating that training takes over their life and leaves too little time for other activities. These findings allow to suggest that support services should be made widely-available to all preclinical medical and dental students. Such services should be targeted to the specific needs of both groups. It also seems necessary to conduct similar research in other groups of medical students whose programme also comprises clinical classes (with patients) - including students of physical therapy, nursing, occupational therapy as well as emergency services. Students of these faculties often spend more time directly beside the patient's bed, dealing with his/her care or rehabilitation.

Time to Effective Ventilation in Neonatal Manikins with a Supraglottic Airway vs. a Facemask: A Randomized Controlled Trial

(1) Background: Timely and effective positive pressure ventilation (PPV) is the most important component of neonatal resuscitation. Emerging data supports the use of supraglottic airways such as the laryngeal mask airway (LMA) as a first-line interface for PPV during neonatal resuscitation. LMA use reduces the need for intubation compared to facemask use in systematic reviews, but there is no difference in the incidence of death or moderate-to-severe hypoxic ischemic encephalopathy (HIE). Time to effective ventilation during simulation with manikin models by providers with limited neonatal airway experience may add to the current evidence that compares the LMA to the neonatal facemask as the first-line ventilation interface during neonatal resuscitation.; (2) Methods: Thirty-two pre-clinical medical students were recruited and randomized to learning and performing ventilation with either the LMA or neonatal facemask on a neonatal manikin. Tidal volume was measured by breath-by-breath analysis to assess adequacy and consistency of PPV in 10 consecutive breaths. Perceived confidence was measured by pre- and post-intervention surveys that utilized a Likert scale from 1 to 5.; (3) Results: Median time to achieve effective ventilation was shorter with a neonatal facemask compared to the LMA (43 (30, 112) seconds vs. 82 (61, 264) seconds, p < 0.01). Participants reported higher perceived confidence post-intervention with use of a facemask when compared to use of the LMA (5 (4, 5) vs. 4 (4, 4), p = 0.03).; (4) Conclusions: Pre-clinical medical students demonstrated a shorter time to effective ventilation and reported higher confidence scores after learning and demonstrating PPV using the facemask when compared to LMA in a neonatal manikin. Further studies are warranted to evaluate the use of supraglottic airways in providers with limited experience with airway management of neonates, as well as in ways to better promote proficiency and confidence in the use of the LMA.