Preparation Of Medical Students Research Articles

Osler Apprenticeship Program: Impact of peer advising on medical student preparedness and experience in the Neurology Clerkship (P2.9-028)

Osler Apprenticeship Program: Impact of peer advising on medical student preparedness and experience in the Neurology Clerkship (P2.9-028)

Flipping Radiologic Anatomy – An Assessment of Effectiveness in a Condensed Medical Gross Anatomy and Embryology Course

Recent trends in medical education suggest that condensing pre‐clinical curricula allows medical students more time to develop clinical skills. This trend challenges faculty to reshape content delivery. To meet this challenge, faculty have traded passive lecture‐based instruction for active‐learning strategies—such as flipped classroom—that promote deeper thinking through application. Radiologic anatomy content fits well into this model, as it provides learners with clinically relevant material framed within the construct of a medical gross anatomy and embryology (GAE) course. At the Brody School of Medicine (BSOM), radiologic anatomy was traditionally taught in a clinician‐led lecture series that complimented GAE content. In 2016, BSOM transitioned to a condensed pre‐clinical curriculum, and it became evident that the radiology lecture‐series was no longer an effective mode of delivery. In 2017, radiology lectures were shifted to clinician‐facilitated flipped classroom sessions, with the objective to improve medical student baseline knowledge of radiologic anatomy and promote retention for USMLE exams and clerkships. This study seeks to evaluate the effectiveness of this shift through two specific aims: 1. Assessment of student performance on radiology questions in a first‐year GAE course from 2016–2018; 2. Assessment of student perception of radiology flipped classroom sessions. Significant improvements in learner performance following the implementation of the radiology flipped classroom sessions and that learner perception will be highly favorable (>80% agree/strongly agree) were predicted. To investigate aim 1, de‐identified student performance (%) on radiology questions from GAE computer and laboratory examinations were compared between cohorts (t‐test; p<0.05) across four exam sections (1‐back/upper limb; 2‐head/neck; 3‐thorax/abdomen; 4‐pelvis/lower limb). Analyses revealed significant improvements in student performance on computer and laboratory radiology questions in 2017 (n=91) and 2018 (n=87) when compared to 2016 (n=84) for exam 1. While 2017 and 2018 cohorts significantly outperformed 2016 on computer exam 3, no difference was noted on lab exam 3 performance across groups. Surprisingly, the 2016 cohort significantly outperformed 2017 and 2018 on lab exam 2. These data suggest that flipped classroom sessions were most effective early, likely by establishing clear learning objectives and expectations, and that early active exposure to content improved performance on both computer and lab exams. To assess aim 2, a voluntary end‐of‐course survey was sent to cohort 2017 (98.8% response) to assess student perception of sessions. Survey data revealed 91.9% of respondents agreed/strongly agreed that sessions were engaging and offered clear objectives. Additionally, 89.7% and 93.1% agreed/strongly agreed that sessions enhanced understanding of gross and clinical anatomy content, respectively. Collectively, results support the use of flipped classroom as an instructional method that enhances early student engagement, perception and knowledge of radiologic anatomy content. Future directions include evaluation of medical student preparedness for USMLE Step‐1 and clerkships as related to radiologic anatomy.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

MEDICAL STUDENTS’ ATTITUDE TO CREATING SCIENTIFIC WORK

Introduction: Scientific studies and their publication have always been messengers for future advances in medicine, as the primary tool for technological and scholarly advances in the field. They are an integral part of the professional life of specialists working in a university. Creating your own scientific publication of any kind is often an undervalued activity whose procedural stages and significance remain insufficiently known. The path to the final publication can be a monotonous and extensive process. While the road to a final draft could be tortuous and monotonous, the pace and mood of walking it are heavily determined by the researcher’s motivation. Postgraduate scientific work in academia is an area less preferred to a clinical career, and not favorite for medical graduation students. The main goal of higher education is to prepare students for work, so the introduction to scientific thinking is an important factor for better results in the professional field. During their studies, students must learn how to properly work with scientific literature and create their own scientific work. Training students in the principles of creation and assessment of academic projects is an important factor for better science. Our aim is to explore the preparedness of medical students for scientific work. We can use this information to identifying strategies for the promotion of research skills among them. Materials and Methods: We gathered the opinions of 278 Bulgarian and English medical students in the second and fourth year of study, using a multiple-choice questionnaire, specifically designed and approbated to correspond to our research mission. Data was processed with the predictive analytics software IBM SPSS Statistics, v. 25. Results: Almost all students have had a certain level of previous experience with scientific work. They have mostly done presentations and essays; 94% of them have used scientific literature. The students generally exhibit consciousness of its importance and follow the requirement to properly cite used sources. The year of education is a factor in predicting a student‘s assessment of the level of importance. Even though 90% admit that it is important to learn how to create scientific work, only 76% are of the opinion that their own knowledge is lacking, and thus would potentially opt for a module on scientific writing. Discussion: Students' experience factored by their year of medical education and completed degree of previous studies is a factor that changes their opinions towards a greater understanding of the meaning of scientific work and the need for further training. Students agree that they need further training in research methodology to be able to develop valid and efficient skills to undertake scientific work.

A Simplified Mass Casualty Incident Training for Medical Students

Background: Medical students have the ability to play an important role in institutional response to a mass casualty incident (MCI). However, while previous studies have shown a strong desire among students to take part in MCI response, a lack of training has left them unprepared to confidently respond to such an event. Currently, simpler models are needed to increase the prevalence of MCI response training in medical school curricula. Our goal was to develop a sustainable curriculum to prepare medical students to respond in MCIs by combining didactic instruction and interactive simulationbased training. Methods: In 2017, a group of first-through-fourth year medical students designed and carried out a one-day MCI curriculum involving a one-hour didactic lecture on emergency management and triage as well as one hour of scenario-based exercises involving two mock mass casualty incidents. In order to analyze the impact of this event, students were asked to fill out pre- and post-training surveys. Results: Out of 45 participating medical students from all levels of training, 37 filled out the pre- and post-event surveys. Prior to the event, 17% (n=35) of the attendees reported that they were aware of the University of Michigan’s Mass Casualty Incident Protocol (MCIP), and 51% (n=35) reported they would be ‘likely’ or ‘very likely’ to respond to an MCI. After the event, 74% (n=35) of the students reported awareness of the MCIP, while 74% (n=35) also stated they would be likely or very likely to respond to an MCI. Of these participants, 85% (n=34) ‘agreed’ or ‘strongly agreed’ that the simulation environment was conducive to learning, and 91% (n=35) similarly agreed or strongly agreed that the simulations improved understanding of the MCIP and triage principles presented during the lectureportion of the training. Conclusion: Combined didactic- and scenario-based training is a simple tool to promote medical student preparedness for an MCI. In order to train a group of self-selected medical students to be involved in MCI response, future efforts to refine this training model should focus on the promotion of interprofessional involvement. Keywords: MASS CASUALTY INCIDENT RESPONSE, MEDICAL STUDENT, TRIAGE, TRAINING, SIMULATION, CURRICULUM

Re-boot: Simulation Elective for Medical Students as Preparation Bootcamp for Obstetrics and Gynecology Residency.

Objective: To evaluate the impact of a simulation-based elective on medical student preparedness for obstetrics and gynecology (OB/GYN) residency.Methods: A two-week, simulation-based elective course for post-clerkship medical students was developed, and 10 students participated at a single academic institution in 2016 and 2017. Using standardized patients and team-based training, students practiced procedural and surgical skills, as well as the diagnosis, management, and work-up of commonly seen problems. Close coaching with a low student-faculty ratio was employed for each session, allowing for individualized feedback in real time. Prior to and after completing the elective, student knowledge was evaluated using the Preparation for Residency Knowledge Assessment tool (PrepForRes). Written course evaluations were also completed by students at the end of the course.Results: Mean scores on the PrepForRes exam increased from 63.6% to 75.3% (p=0.0136). Notably, the average post-course score improved to a passing level, and all but one student achieved a passing score on the post-course test. Course evaluations and student feedback showed high satisfaction rates with the course.Conclusions: This study demonstrates that a simulation-based elective course is an effective tool for helping medical students transition to OB/GYN residency. As medical schools work to facilitate the transition from undergraduate to graduate medical education, simulation can bridge gaps during this transition in order for students to meet entry-level residency requirements.

Self-directed learning readiness of Indian medical students: a mixed method study

BackgroundSelf-directed learning (SDL) is defined as learning on one’s own initiative, with the learner having primary responsibility for planning, implementing, and evaluating the effort. Medical education institutions promote SDL, since physicians need to be self-directed learners to maintain lifelong learning in the ever-changing world of medicine and to obtain essential knowledge for professional growth. The purpose of the study was to measure the self-directed learning readiness of medical students across the training years, to determine the perceptions of students and faculty on factors that promote and deter SDL and to identify the role of culture and curriculum on SDL at the Christian Medical College, Vellore, India.MethodsGuglielmino’s SDL Readiness Scale (SDLRS) was administered in 2015 to six student cohorts (452 students) at admission, end of 1st, 2nd, 3rd and 4th year of training, and at the beginning of internship in the undergraduate medicine (MBBS) program. Analysis of variance (ANOVA) was used to compare SDL scores between years of training. 5 student focus groups and 7 interviews with instructors captured perceptions of self-direction. Transcripts were coded and analyzed thematically.ResultsThe overall mean SDLRS score was 212.91. There was no significant effect of gender and age on SDLR scores. There was a significant drop in SDLRS scores on comparing students at admission with students at subsequent years of training. Qualitative analysis showed the prominent role of culture and curriculum on SDL readiness.ConclusionsGiven the importance of SDL in medicine, the current curriculum may require an increase in learning activities that promote SDL. Strategies to change the learning environment that facilitates SDL have to be considered.

International medical electives in selected African countries: a phenomenological study on host experience.

ObjectivesTo explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives. MethodsA descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international medical electives. ResultsSix main themes emerged from the thematic analysis of interview data: international medical student contribution to host hospitals, host professional and personal fulfiment, barriers to student learning experience, international medical student preparedness, hope for reciprocity and barriers to cultural immersion and patient care. ConclusionsStudy participants described the experience of hosting international medical elective students as overwhelmingly positive. However, they highlighted issues such as barriers to students’ learning experience and the lack of reciprocity between host and sending institutions as areas which could be addressed to optimize the experience for both hosts and international medical students. An understanding of the host experience provides stakeholders with a clearer idea of what is important in preparation, organisation and evaluation of the elective experience. This study provides the impetus for further research to examine the effectiveness of introducing appropriate pre-departure training and post-elective debriefing to students embarking on international medical electives.

Determining attitude and readiness of Medical students in Kerman University of Medical Sciences concerning acceptance of Decision Support Systems for Electronic Prescription in 2017

Introduction: Clinical Decision Support Systems (CDSS) are any computer program designed to assist health care professionals in making clinical decisions, especially at the moment of action. These information systems are flexible and interactive, helping people by making use of models and rules of a comprehensive database, or on the basis of clinical guidelines, to make applicable decisions, especially solving difficult problems with common scientific methods. Therefore, these systems support complex medical decisions, increase their effectiveness, and can lead to a reduction in the types of medical errors, such as medication errors. However, knowledge and attitude of the future physicians in the country about these systems is unclear. The purpose of this study was Determining attitude and readiness of Medical students concerning acceptance of Decision Support Systems for Electronic Prescription.
 Methods: This research is descriptive-analytic. The research population included general medical students of Kerman University of Medical Sciences in 2017. Out of these students, a sample of 226 people was selected by proportional sampling. Data collection was done using a standard questionnaire. The questionnaire was first translated into Persian and then its validity was confirmed by three medical informatics specialists. Data analysis was done descriptively-analytically using SPSS 19.
 Results: The findings of this study showed that 17% of students (n=36) knew about this system and how to use it, and 83% of them (n=177) were willing to learn and use this system to practice their profession in the future. More than half of them (n=121) believed that using this system would Reduce errors in prescribing. 80% of them (n=170) lacked a strategic plan to implement a decision support system for electronic prescription and a lack of standard and acceptable software, and about 60% (n=128) lack of financial incentives and lack of sufficient evidence Concerned about the usefulness of using it as a potential obstacle to the implementation of this system. There was no significant difference between the age, sex and term of the students with their familiarity with this system (P>0.05).
 Conclusion: The results of this study showed that while many students lack sufficient knowledge about the clinical decision support system, they are interested in learning and using it, especially in the field of prescribing drugs. This result indicates that the system is likely to be admitted if it is implemented and educated to medical students and doctors.

Assessing the Nutrition Curriculum at Boston University School of Medicine

BackgroundFor the past several years, there has been a national charge to increase inter‐professional nutrition education in the medical school curricula. The Nutrition Vertical Integration Group (VIG) at Boston University School of Medicine (BUSM) has facilitated the integration of medical nutrition in the 4‐year medical school curriculum. However, the quality and quantity of instruction has been difficult to evaluate.Objectives1) To determine how many of the nutrition knowledge objectives set forth by the Nutrition VIG at BUSM are taught and tested on in the 4‐year curriculum. 2) To determine course directors’ opinions on the desirability of each nutrition knowledge objective in the curriculum.MethodsThe Nutrition VIG at BUSM developed a list of 80 medical student nutrition knowledge objectives to be taught in the 4‐year curriculum. Seventy‐seven of objectives were based off of the 146 nutrition learning knowledge objectives for medical students set forth by the National Academic Award (NAA) Program's Nutrition Curriculum Guide for Training Physicians and 3 original objectives on food security were also added. The Nutrition VIG conducted a survey of BUSM course directors to determine which objectives were currently being taught and on which students were being tested. The survey also assessed course directors’ opinions toward the desirability to integrate nutrition topics into the BUSM curriculum. The survey was administered during pre‐clerkship and clerkship subcommittee meetings and was available online for those who were not able to complete it during meetings.ResultsEighteen of 26 (69%) of the course directors responded to the survey. They reported teaching 63 of the 80 (78%) objectives but were only testing students on 48 of 80 (60%) objectives. Fourteen of the 18 (78%) course directors answered questions about the desirability of the objectives in the curriculum. For each of the 80 objectives, at least 92% of respondents reported that the objective was either a desired or necessary part of the curriculum.DiscussionThe results of this survey show that that the majority of BUSM nutrition knowledge objectives were covered in the BUSM curriculum. These findings are surprising, especially given that BUSM students indicate that they do not feel prepared to counsel their patients about nutrition. This gap raises question to the effectiveness of these nutrition knowledge objectives in the curriculum.ConclusionFurther studies are needed to determine whether current nutrition objectives improve medical student preparedness to assess and counsel patients about nutrition.Support or Funding InformationWith support from the Allen Foundation and New Balance Foundation

Perceptions of preparedness for the first medical clerkship: a systematic review and synthesis.

BackgroundThe transition from university-based to clerkship-based education can be challenging. Medical schools have introduced strategies to ease the transition, but there has been no systematic review synthesizing the evidence on the perceptions of preparedness of medical students for their first clerkship to support these interventions. This study therefore aimed to (1) identify and synthesize the published evidence on medical students’ perceptions of preparedness for their first clerkship, and (2) identify factors that may impact on preparedness for clerkship, to better inform interventions aimed at easing this transition.MethodsElectronic databases (Medline, Journals@Ovid, CINAHL, ERIC, Web of Science, Embase) were searched without restriction and secondary searching of reference lists of included studies was also conducted. Included studies used quantitative or qualitative methodologies, involved medical students and addressed student/supervisor perceptions of preparedness for first clerkship. The first clerkship was defined as the first truly immersive educational experience during which the majority of learning was vocational and self-directed, as per the MeSH term ‘clinical clerkship’ and associated definition. Using an inductive thematic synthesis approach, 2 researchers independently extracted data, coded text (from results and discussion sections), and identified themes related to preparedness. Any disagreements were resolved by discussion and findings were then narratively synthesized.ResultsThe initial search identified 1214 papers. After removing duplicates and assessing abstracts and full articles against the inclusion criteria, 8 articles were included in the review. In general, the body of evidence was of sound methodological quality. Ten themes relating to perceptions of preparedness of medical students for their first clerkship were identified; competence, disconnection, links to the future, uncertainty, part of the team, time/workload, adjustment, curriculum, prior life experiences and learning.ConclusionsEight of the ten themes related to perceptions of preparedness are potentially amenable to curricula strategies to improve the transition experience. The evidence supports clinical skills refreshers, clarification of roles and expectations, demystification of healthcare hierarchy and assessment processes and student-student handovers. Evidence also supports preclinical educational strategies such as enhancing content contextualization, further opportunities for the application of knowledge and skills, and constructive alignment of assessment tasks and pedagogical aims.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0615-3) contains supplementary material, which is available to authorized users.

Medical student preparedness for an era of personalized medicine: findings from one US medical school.

The objective of this research was to assess medical student preparedness for the use of personalized medicine. A survey instrument measuring attitude toward personalized medicine, perceived knowledge of genomic testing concepts and perceived ability to apply genomics to clinical care was distributed to students in medical school (MS) years 1-4. Of 212 participants, 79% felt that it was important to learn about personalized medicine, but only 6% thought that their medical education had adequately prepared them to practice personalized medicine. Attitude did not vary across years; knowledge and ability increased after MS1, but not after MS2. While medical students support the use of personalized medicine, they do not feel prepared to apply genomics to clinical care.

Development and validation of an instrument to assess the prescribing readiness of medical students in Malaysia.

BackgroundPrescribing incompetence is an important factor that contributes to prescribing error, and this is often due to inadequate training during medical schools. We therefore aimed to develop and validate an instrument to assess the prescribing readiness of medical students (PROMS) in Malaysia.MethodsThe PROMS comprised of 26 items with four domains: undergraduate learning opportunities; hands-on clinical skills practice; information gathering behaviour; and factors affecting the learning of prescribing skills. The first three domains were adapted from an existing questionnaire, while items from the last domain were formulated based on findings from a nominal group discussion. Face and content validity was determined by an expert panel, pilot tested in a class of final year (Year 5) medical students, and assessed using the Flesch reading ease. To assess the reliability of the PROMS, the internal consistency and test-retest (at baseline and 2 weeks later) were assessed using the Wilcoxon Signed Ranks test and Spearman’s rho. The discriminative validity of the PROMS was assessed using the Mann–Whitney U-test (to assess if the PROMS could discriminate between final year medical students from a public and a private university).ResultsA total of 119 medical students were recruited. Flesch reading ease was 46.9, indicating that the instrument was suitable for use in participants undergoing tertiary education. The overall Cronbach alpha value of the PROMS was 0.695, which was satisfactory. Test-retest showed no difference for 25/26 items, indicating that our instrument was reliable. Responses from the public and private university final year medical students were significantly different in 10/26 items, indicating that the PROMS was able to discriminate between these two groups. Medical students from the private university reported fewer learning opportunities and hands-on practice compared to those from the public university. On the other hand, medical students from the private university reported more frequent use of both web based and non-web-based resources compared to their public university counterparts.ConclusionsThe PROMS instrument was found to be a reliable and valid tool for assessing medical students’ readiness to prescribe in Malaysia. It may also inform on the adequacy of medical programmes in training prescribing skills.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0433-z) contains supplementary material, which is available to authorized users.

Improving preparedness of medical students and junior doctors to manage patients with diabetes

ObjectiveNew medical graduates are the front-line staff in many hospital settings and manage patients with diabetes frequently. Prescribing is an area of concern for junior doctors, however, with insulin prescribing...

Validity Evidence for Medical School OSCEs: Associations With USMLE® Step Assessments

Background: Recently, there has been a surge in the use of objective structured clinical examinations (OSCEs) at medical schools around the world, and with this growth has come the concomitant need to validate such assessments. Purposes: The current study examined the associations between student performance on several school-level clinical skills and knowledge assessments, including two OSCEs, the National Board of Medical Examiners® (NBME) Subject Examinations, and the United States Medical Licensing Examination® (USMLE) Step 2 Clinical Skills (CS) and Step 3 assessments. Methods: The sample consisted of 806 medical students from the Uniformed Services University of the Health Sciences. We conducted Pearson correlation analysis as well as stepwise multiple linear regression modeling to examine the strength of associations between students’ performance on 2nd- and 3rd-year OSCEs and their two Step 2 CS component scores and Step 3 scores. Results: Positive associations were found between the OSCE variables and the USMLE scores; in particular, student performance on both the 2nd- and 3rd-year OSCEs was more strongly associated with the two Step 2 CS component scores than with Step 3 scores. Conclusions: These findings, although preliminary, provide some predictive validity evidence for the use of OSCEs in determining readiness of medical students for clinical practice and licensure.

Understanding Student Experiences in a Near-Peer Resident Shadowing Program

Introduction. The preparation of medical students for clerkship has been criticized, both in terms of students’ ability to understand their new role as clinical trainees and in their ability to carry out that role. To begin to address this gap, this paper reports the experiences of students in a shadowing program aimed at enhancing the preparedness of medical students for clinical training. The study examined a novel program, the Resident-Medical Student Shadowing Program, in which first-year medical students at the University of Alberta shadowed a first-year resident during clinical duties over the course of eight months. Methods. A study was conducted to assess the experiences of 83 first-year medical student participants who shadowed a first-year resident intermittently for one year. Student and resident participants’ experiences were explored using semistructured interviews. Results. Students and residents experiences indicate that participation increased students’ understanding of the clinical environment and their role within it and introduced them to skills and knowledge needed to perform that role. Students reported that a close relationship with their resident enhanced their learning experience. Conclusion. This study demonstrates that a low-cost program in which first-year students shadow residents may be a useful tool for helping prepare students for clerkship.

Current practices in library/informatics instruction in academic libraries serving medical schools in the western United States: a three-phase action research study

BackgroundTo conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools.MethodsAction research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews.ResultsPublicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and teaching skills, and that they need to continually adapt to changes in curricula.ConclusionsThis study offers a long overdue, systematic view of current practices of library/informatics training at Western U.S. medical schools. Medical educators, particularly curricular leaders, will find opportunities in this study's results for more productive collaborations with the librarians responsible for library and informatics training at their medical schools.

Synchronous Videoconferencing: Impact on Achievement of Medical Students

Background: Medical schools are expanding their enrollment, and synchronous lecture broadcast is being used more frequently to deliver instruction across multiple sites. Purpose: To assess whether the videoconferencing lecture-delivery method is associated with differences in medical student performance on national licensing examinations at lecture site-of-origin versus lecture receiving sites. Methods: The academic preparedness of medical students at the time of admission and performance on a national licensing examination were compared for students predominantly receiving live lectures and those receiving synchronous videoconferencing lectures. External metrics were analyzed to establish baseline preparedness (Medical College Admission Test scores) and to determine academic achievement (national licensing examination scores). Results: The authors found no statistically significant differences between site-of-origin and receiving sites in medical student preparedness or academic achievement. Conclusions: Medical students that receive the majority of their lectures through synchronous videoconferencing perform no differently on national licensing examinations than students that attend live lectures at the site-of-origin.

Junior doctors' and medical students' commitment to working in areas of workforce shortage

Australian Government initiatives promote rural training placements, supported medical school places, and incentives that attract doctors to areas of need. The purpose of this study was to report on the preparedness of medical students and junior doctors to commit to working in areas of workforce shortage. Medical students and junior doctors across all Australian states and territories completed a web-based survey assessing career attitudes and intentions. Participants were asked to indicate their level of preparedness to commit to working in an area of need. Completed surveys were received from 760 medical students and 264 junior doctors. A substantial proportion of this sample were prepared to make some form of commitment to providing medical services in a rural area. The greatest proportion (38.3%) was prepared to make a small commitment equal to an irregular locum service of 1 week or 1 month per year. Government policies and incentives may be having an effect on medical students' and junior doctors' preparedness to work in rural and remote areas. Medical educators should encourage students and junior doctors to take up short-term placements/opportunities and to maintain links with rural communities. Practice opportunities that offer varying lengths of commitment should be advertised widely so junior doctors are aware of them and can apply.

Use of Simulated Pages to Prepare Medical Students for Internship and Improve Patient Safety

During the transition from medical school to internship, trainees experience high levels of stress related to pages on the inpatient wards. The steep learning curve during this period may also affect patient safety. The authors piloted the use of simulated pages to improve medical student preparedness, decrease stress related to pages, and familiarize medical students with common patient problems. A multidisciplinary team at Southern Illinois University School of Medicine developed simulated pages that were tested among senior medical students. Sixteen medical students were presented with 11 common patient scenarios. Data on assessment, management, and global performance were collected. Mean confidence levels were evaluated pre- and postintervention. Students were also surveyed on how the simulated pages program influenced their perceived comfort in managing patient care needs and the usefulness of the exercise in preparing them to handle inpatient pages. Mean scores on the assessment and management portions of the scenarios varied widely depending on the scenario (range -15.6 ± 41.6 to 95.7 ± 9.5). Pass rates based on global performance ranged from 12% to 93%. Interrater agreement was high (mean kappa = 0.88). Students' confidence ratings on a six-point scale increased from 1.87 preintervention to 3.53 postintervention (P < .0001). Simulated pages engage medical students and may foster medical student preparedness for internship. Students valued the opportunity to simulate "on call" responsibilities, and exposure to simulated pages significantly increased their confidence levels. Further studies are needed to determine effects on patient safety outcomes.

Assessment of awareness regarding climate change and its health hazards among the medical students

Background:Climate change has emerged as one of the most devastating environmental threat and there is overwhelming evidence of wide range of implications for human health. To mitigate this, well-prepared medical man power is required.Objectives:The objectives of this study were (1) to assess the awareness regarding climate change and its health hazards among the medical students and (2) to recommend the awareness campaigns regarding climate change and its health hazards for students based on the results.Settings and Design:This observational study was conducted at the Medical College in Pune city.Materials and Methods:Medical students from all years of M.B.B.S. (Bachelor of Medicine and Bachelor of Surgery) who had given the written consent were included in this study. A self-administered, pre-tested, questionnaire was used. Responses were evaluated.Statistical Analysis Used:Proportions, percentage, and Chi-square test.Results:A total of 250 medical students were included in this study. In all, 246 (98.40%) students commented that global climate is changing, while 245 (98%) students opined that human activities are contributing to climate change. The commonest source of information about climate change was newspaper and magazines (78.20%). Majority commented that deforestation and industrial and vehicular pollution contribute most to climate change. According to 47.50% of the students, health-related issues are priority for climate change prevention strategy. According to 65.10% students, direct physical hazards of extreme climatic events are most important health-related impact of climate change, followed by natural disaster-related health hazards (43.50%), waterborne diseases (27.60%), vector-borne diseases (17.60%), and malnutrition (10%). There was statistically significant difference found between year of MBBS of the students and the awareness regarding United Nations Federation on Climate Change, Kyoto protocol (χ2 = 7.85, P = 0.02), and Intergovernmental Panel on Climate Change (χ2 = 12.77, P = 0.002). A significant difference was found between the awareness about health impact of climate change at different places (χ2 = 11.25, P = 0.001).Conclusion:Students had awareness regarding health hazards of the climate change, but improvement for mitigation is required. It is suggested that a large nation-wide awareness survey regarding climate change and its health hazards is necessary to determine the preparedness of medical students and also to suggest any changes in the current curriculum.