Resident Students Research Articles

Outcomes of an Advanced Ultrasound Elective: Preparing Medical Students for Residency and Practice.

Many medical specialties have adopted the use of ultrasound, creating demands for higher-quality ultrasound training at all levels of medical education. Little is known about the long-term benefit of integrating ultrasound training during undergraduate medical education. This study evaluated the effect of a longitudinal fourth-year undergraduate medical education elective in ultrasound and its impact on the future use of ultrasound in clinical practice. A cross-sectional survey of medical graduates from The Ohio State University College of Medicine (2006-2011) was done, comparing those who participated and those who did not participate in a rigorous ultrasound program for fourth-year medical students. A 38-item questionnaire queried graduates concerning ultrasound education in residency, their proficiency, and their current use of ultrasound in clinical practice. Surveys were completed by 116 respondents, for a return rate of 40.8% (116 of 284). The participants of the undergraduate medical education ultrasound elective (n = 61) reported more hours of ultrasound training after graduation (hands-on training, bedside scanning, and number of scans performed; P < .001), higher ultrasound proficiency (proficiency in using ultrasound for clinical decision making, use in emergency settings, and use of novel techniques; P< .001), and higher rates of ultrasound use in clinical practice (P < .001). The longitudinal undergraduate medical education ultrasound elective produced physicians who were more likely to seek additional training in residency, evaluate themselves as more proficient, and use ultrasound in their clinical practice. Early training in bedside ultrasound during undergraduate medical education yields physicians who are better prepared for integration of ultrasound into clinical practice.

Involving Students in Residence Halls in Hong Kong

This article reports a study based on A. W. Astin’s (1984) involvement theory applied in residence halls at a public university in Hong Kong, China. The resident students who were involved as participants or student leaders in this study were found to be better developed in terms of leadership, career development, multicultural experience, community involvement, and ethical personal values. Implications for student affairs practice, considerations of cultural differences, involvement theory, future research, and study limitations are discussed.

Social determinants of health behaviors in primary school children: A cross-sectional study of both migrant and resident children in Beijing, China.

Childhood risky behaviors always result in adverse health outcomes. These behaviors are greatly affected by social environment and individual factors. However, few studies explored the social determinants of schoolchildren's health behaviors. In this cross-sectional study, the social determinants of health behaviors were examined among both migrant and resident students in Beijing, China. Data of 967 children from six urban and suburban primary schools were analyzed using multiple linear regression analysis. The results showed that less than 60% of children performed some healthy behaviors, although their health knowledge was generally good. Children's health behavior scores were greatly determined by school characteristics, health knowledge, demographic characteristics, and family context. Therefore, improving health education and conditions in primary schools is the priority to promote children's healthy behaviors, especially for disadvantaged children.

A suggested emergency medicine boot camp curriculum for medical students based on the mapping of Core Entrustable Professional Activities to Emergency Medicine Level 1 milestones.

BackgroundAn increasing number of students rank Emergency Medicine (EM) as a top specialty choice, requiring medical schools to provide adequate exposure to EM. The Core Entrustable Professional Activities (EPAs) for Entering Residency by the Association of American Medical Colleges combined with the Milestone Project for EM residency training has attempted to standardize the undergraduate and graduate medical education goals. However, it remains unclear as to how the EPAs correlate to the milestones, and who owns the process of ensuring that an entering EM resident has competency at a certain minimum level. Recent trends establishing specialty-specific boot camps prepare students for residency and address the variability of skills of students coming from different medical schools.ObjectiveOur project’s goal was therefore to perform a needs assessment to inform the design of an EM boot camp curriculum. Toward this goal, we 1) mapped the core EPAs for graduating medical students to the EM residency Level 1 milestones in order to identify the possible gaps/needs and 2) conducted a pilot procedure workshop that was designed to address some of the identified gaps/needs in procedural skills.MethodsIn order to inform the curriculum of an EM boot camp, we used a systematic approach to 1) identify gaps between the EPAs and EM milestones (Level 1) and 2) determine what essential and supplemental competencies/skills an incoming EM resident should ideally possess. We then piloted a 1-day, three-station advanced ABCs procedure workshop based on the identified needs. A pre-workshop test and survey assessed knowledge, preparedness, confidence, and perceived competence. A post-workshop survey evaluated the program, and a posttest combined with psychomotor skills test using three simulation cases assessed students’ skills.ResultsStudents (n=9) reported increased confidence in the following procedures: intubation (1.5–2.1), thoracostomy (1.1–1.9), and central venous catheterization (1.3–2) (a three-point Likert-type scale, with 1= not yet confident/able to perform with supervision to 3= confident/able to perform without supervision). Psychomotor skills testing showed on average, 26% of students required verbal prompting with performance errors, 48% with minor performance errors, and 26% worked independently without performance errors. All participants reported: 1) increased knowledge and confidence in covered topics and 2) overall satisfaction with simulation experience.ConclusionMapping the Core EPAs for Entering Residency to the EM milestones at Level 1 identifies educational gaps for graduating medical students seeking a career in EM. Educators designing EM boot camps for medical students should consider these identified gaps, procedures, and clinical conditions during the development of a core standardized curriculum.

Assessment of a course of realistic surgical training during medical education as a tool for pre-residential surgical training.

BackgroundIn recent years the focus on practical skills in the German curriculum of medical school has increased greatly. In this study we evaluate the value of a practical surgery course for medical students as a tool for surgical education, as a way of enhancing interest in surgical fields, and as a method of influencing medical students to subsequently choose a surgical career.MethodsThe “Feel like a surgeon”-course is an optional practical surgery course in which topographical anatomy and realistic surgical training using fresh human cadavers are combined for medical students of the RWTH Aachen University. Between 2010 and 2015 every student completed a survey before starting and after completing our course, and in 2015 a follow-up was performed. Using a standardized questionnaire, course quality, learning success and impact on post-instructional career and choice of profession was evaluated.ResultsIn total, 82 students attended our course between 2010 and 2015 and took part in the evaluation. Evaluation of the course was positive overall, with an average grade of 1.4° ± °0.50. Significant improvement of basic, as well as more complex surgical skills and theoretical knowledge was noted. Furthermore, self-confidence for patient related assignments improved as well. In the follow-up evaluation, a high level of recommendation for surgical residents was seen, as was a high influence of the course on our students’ career choice, although no significant change in career plans before and after taking the course was noted.ConclusionsOur results indicate that a practical surgical course can be a valuable tool to prepare students for a surgical residency and to improve their practical skills generally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0568-6) contains supplementary material, which is available to authorized users.

THE SATISFACTION OF FOREIGN STUDENTS WITH SOCIAL CULTURAL SUPPORT IN THE MEDICAL UNIVERSITY OF THE REPUBLIC OF KAZAKHSTAN

During education in medical university, foreign students are to adapt both to educational and social cultural environments. The study was organized to investigate satisfaction of foreign students with complex of activities concerning social cultural support in one of medical university of the Republic of Kazakhstan. The study was carried out in the state medical university of city of Semeii of the Republic of Kazakhstan. The sampling of questionnaire survey consisted of 225 students of medical faculty and 87 out of them were foreign students. The statistical processing of data was implemented using SPSS v.20.0 software. The work of supervising professor became the most useful measure of social cultural support from point of view of both foreign and resident students (93.1 and 77.4% correspondingly). The round-table discussion related to struggle with religious extremism and terrorism was considered as the least useful measure of such kind of support (24.1% and 28.5% correspondingly). Out of planned measures of social cultural support, 81.6% of foreign and 30.7% of resident students showed preference to additional courses of Kazakh and/or Russian languages. The usefulness of such supposed measure as establishment and maintenance of contact with parents was supported by 81.6% of foreign and 30.7% of resident students. The social cultural support provided to foreign students in one of medical university of the Republic of Kazakhstan is in general satisfactory though requires certain development. the university is to re- consider plan of activities implemented with purpose of social cultural support by renouncing of the least called-for and focusing on the most required instead.

The comparison of physical fitness in secondary male students in altitude and coastal areas

The aim of this research is the comparison of physical fitness in secondary male students in altitude and coastal areas and difference between the physical fitness on based AAHPERD test. The samples consist of 450 subjects of 1017 subjects in altitude (Shahrekord) and coastal area (Mahmood Abad) in Iran in years of 2013 which were selected cluster- randomly sampling by Morgan Table. We investigated the effect of high altitude on the tests of physical fitness resident students near sea level (-5 m) and in Altitude (2100 m). The tests of physical fitness include: Pull-ups test, Sit-ups test, Agility test (4 x 9), 45 Sprint test, 1600m running, Long jump and Flexibility test. For determining of different between physical fitness of altitude and coastal area students was used t- test. The result of this research shows that there is no significant difference between the average of Pull-ups test (t=0.965; p=0.385), Flexibility (t=1.722; p=0.089), Agility (4 x 9 m) test (t=1.765; p=0.084) and 45 sprint (t=1.24; p=0.221) of students in coastal area and altitude. There is significant difference between the average of Sit-ups (t=2.29; p=0.016), 1600m running (t=11.132; p=0.001) and Long jump (t=3.18; p=0.004) in altitude. The students of altitude have higher power and cardio-respiratory endurance rather than coastal area. But the students of coastal area have stronger abdominal muscles rather than altitude. High altitude reduces the distance covered by youth athlete students during tests. Neither acclimatization nor lifelong residence at high altitude protects against detrimental effects of altitude on tests activity profile.

The Relevance of Physical Library: A Case of Non- Resident Students in Universiti Teknologi Mara, Johor

The Relevance of Physical Library: A Case of Non- Resident Students in Universiti Teknologi Mara, Johor

The Case for Humanities Training: A Woman of Color Teaching Social Justice in a Predominantly White Institution

My entrance into instruction began as a graduate assistant at a tiny state university. I was thrown in head-first as teacher-of-record for a 20-student Composition and Rhetoric course, which served primarily as a freshman service course. The college campus is situated in the third most populous town in a state that is over 90% white, and most resident students come from smaller towns around the state. When I was receiving teacher training for my Composition and Rhetoric course, I was warned that many of my students would come from conservative backgrounds, and would resent and resist any intrusions that had the look or feel of liberal ideology. My training prepared me to temper any politicized discussion topics with a redirection towards the content of the evidence, and the structure of the argument. This training, I realized, was suggested as a self-preserving measure, and was meant to insure against student resistance and, thus, obstacles to effective teaching.THEORYWhen I received the chance to teach for the Women's Studies department, with a course entitled Justice in the 21st Century, I was prepared to eschew the politics-avoidance that had made up my composition teaching experience. Surely, the students who would sign up for such a course would be prepared to tackle all the attendant issues and discomforts surrounding the topic of social justice. I structured the course with ambitious feminist pedagogical strategies, such as group work, self-directed response papers, service-learning, and a review of course material through class discussion rather than lecture. Facilitating a dynamic and engaging classroom discussion was something I planned to rely heavily on, since it was one of the strongest skills I had developed as a beginning instructor. My classroom manner in composition classes had a highly-charged and fast-paced style of delivery, and it tended to produce a similar student response, indicative of excitement and idea production about the topic at hand. While there were shyer students who preferred to remain quiet in class, it seemed that I was almost always able to achieve a majority participation when discussing reading material and class concepts. I wanted to maintain this participation yield in my Social Justice course, but with added concern for the underrepresented voices in the classroom. My goal for teaching the class was to enable discussion-led knowledge-production in a space that was limited in prejudice, resistance, or unconscious bias that may harm those at the receiving end of stereotypes.When faced with my students on the first day of class, I found that I had greatly mis-prepared in my areas of pedagogical theory and praxis. That my course had been cross-listed in five different departments (African-American Studies, American Indian Studies, American Studies, Chicano Studies, and Women's Studies) led me to expect a greater diversity in students than I had experienced in my composition class. I was excitedly anxious to see what kind of voices would contribute to the narrative of the class and respond to the concepts introduced by the course material. I wanted to maintain awareness of classroom dynamics, and foster a special atmosphere inside the classroom that would transcend into the students' lives outside of the classroom. When I met the eyes of each student when taking attendance on the first day of class, I felt my preconceptions about teaching the class being shattered student by student. Despite being geared towards freshmen, the class was only about half freshmen, and when answering my first-day-of-class questionnaire, most students answered that they were placed in the class by advisors looking to fulfill a diversity requirement. My image of a classroom filled with nascent critics of social issues was replaced by the reality of thirty students who needed to fill a gap in their schedules. Not only did a majority of the students lack a pre-existing interest in social justice, most were completely uninitiated in the fundamental concepts at the heart of social justice. …

The politics of student housing: Student activism and representation in the determination of the user-price of a public–private partnership residence on a public university campus in South Africa

South African universities have been facing a critical shortage in the provision of studenthousing for several years now, and the establishment of public–private partnerships(PPPs) is seen as part of the solution to address the shortage (Rensburg, 2011). Thisarticle investigates the effectiveness of the Students’ Representative Council (SRC) ofthe University of the Western Cape (UWC) in representing student interests during itsnegotiations with university management to reduce the user-price per student for the newKovacs Residence, a PPP student housing complex on the UWC campus. It thus highlightssome of the complexities involved in public–private collaborations on student housingprovision, including the tension between profitability, affordability and equity in the face oforganised student power.The article shows that, considering the various initiatives taken by the SRC to engageuniversity management, and the resulting reduction of the user-price per annum, students’interests were effectively represented by the SRC, even if this view does not correspondwith the perceptions of students. Our analysis uncovers many deficiencies in studentrepresentation processes both within student structures and university management. It issupported by data from in-depth interviews and a focus group discussion. Interviews wereconducted with SRC members and university management, and a focus group discussionwas facilitated with students in residences.

Can a teaching assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents?

The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their teaching assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first assistant students offered by the School of Health Sciences at Mayo Clinic. Development of teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency.

A large temperature fluctuation may trigger an epidemic erythromelalgia outbreak in China.

Although erythromelalgia (EM) has been documented in the literature for almost 150 years, it is still poorly understood. To overcome this limitation, we examined the spatial distribution of epidemic EM, and explored the association between temperature fluctuation and epidemic EM outbreaks in China. We searched all peer-reviewed literature on primary epidemic EM outbreaks in China. A two-stage model was used to characterize the relationship between temperature fluctuation and epidemic EM outbreaks. We observed that epidemic EM outbreaks were reported from 13 provinces during 1960–2014 and they mainly occurred between February and March in southern China. The majority of EM cases were middle school students, with a higher incidence rate in female and resident students. The major clinical characteristics of EM cases included burning, sharp, tingling and/or stinging pain in toes, soles and/or dorsum of feet, fever, erythema and swelling. A large “V”-shaped fluctuation of daily average temperature (TM) observed during the epidemic EM outbreaks was significantly associated with the number of daily EM cases (β = 1.22, 95%CI: 0.66 ~ 1.79), which indicated that this “V”-shaped fluctuation of TM probably triggered the epidemic EM outbreaks.

PHYSICIANS' KNOWLEDGE, ATTITUDES AND PRACTICE ABOUT THE TREATMENT OF HIGH BLOOD PRESSURE ACCORDING TO THE SEVENTH REPORT OF THE JOINT NATIONAL COMMITTEE (JNC VII)

Hypertension is one of the most frequently encounter ed chronic medical conditions in almost all societies. The Seventh Report of the Joint National Committee (JNC - 7), published in 2003 is an important tool on Detection, Evaluation, and Treatment of High Blood Pressure. The present study was designed to asse ss the Knowledge, Attitude and Practice (KAP) of physicians towards JNC - 7 hypertension guideline. In this cross sectional study, we used a predesigned questionnaire to evaluate knowledge, attitude and practice of a group of physicians with JNC - 7 guideline. Two hundred physicians and residents in two different cities (Zabol and Mashhad) participated in this study. The majority of our study population had poor knowled ge about 6 key concepts of JNC 7 guideline. General practitioners had the lowest knowledge in comparison to specialist and residency students (P: 0.014). Most of participants performed best at choosing an initial agent for the treatment of hypertensive patients and worst at identifying appropriate disease specific blood pressure lowering goals. Mo st of study population refer to American Heart Association (AHA) guideline as the most reliable and useful guideline in hyperten sion management. Considering the importance of evidence based medicine and its benefits, we suggest revision of the teaching cur ricula in medical schools regarding evidence based guidelines and regular Continuous Medical Education programs after graduation as potential solutions.

Remote and resident students’ final grades and ratings of teaching effectiveness in an undergraduate psychology course.

Remote and resident students’ final grades and ratings of teaching effectiveness in an undergraduate psychology course.

Influence of a publication rotation in a neurology residency program in a developing country

Aptitude in research is a prerequisite for anyone pursuing a residency in neurology or, in fact, any specialty. Many world-class centers recruit students for residency or doctoral training based on their research ability. In developing countries, clinical research publication records have often been dismal primarily due to heavy patient loads and a lack of dedicated research time being available to most physicians, even in academic settings.1 The situation is worse in countries with fewer resources.1 The authors thank Dr. Sudesh Prabhakar, Professor and Head, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, for including the publication rotation in the neurology residency program.

Effectiveness of supervised oral health maintenance in hearing impaired and mute children- A parallel randomized controlled trial.

Context:Individuals with special needs may have great limitations in oral hygiene performance due to their potential motor, sensory, and intellectual disabilities. Thus, oral health care utilization is low among the disabled people. Hearing disorders affect the general behavior and impair the level of social functioning.Objectives:The present study was conducted to assess the dental health outcomes following supervised tooth brushing among institutionalized hearing impaired and mute children in Jaipur, Rajasthan.Materials and Methods:The study followed a single-blind, parallel, and randomized controlled design. A total of 315 students were divided into three groups of 105 children each. Group A included resident students, who underwent supervised tooth brushing under the supervision of their parents. The non-resident students were further divided into two groups: Group B and Group C. Group B children were under the supervision of a caregiver and Group C children were under the supervision of both investigator and caregiver.Results:There was an average reduction in plaque score during the subsequent second follow-up conducted 3 weeks after the start of the study and in the final follow-up conducted at 6 weeks. There was also a marked reduction in the gingival index scores in all the three groups.Conclusion:The program of teacher and parent supervised toothbrushing with fluoride toothpaste can be safely targeted to socially deprived communities and can enable a significant reduction in plaque and gingival scores. Thus, an important principle of oral health education is the active involvement of parents and caregivers.

Experience in teaching a biopsy-section course in Belarus

The paper deals with the improvement of teaching a biopsy-section course (BSC). The authors have analyzed the most frequent errors in the interaction of clinicians with a pathology service and summed up the experience of the Pathological Anatomy Department in practical work and teaching the BSC. The differentiated approach to teaching the BSC to resident students of different specialties is proposed.

Validation of Final Residency Tests Based on the Classical Model in Medical University of Mashhad (A Case Study Improving Dermatology, Ophthalmology, Obstetrics and Gynecology)

Background: Evaluation of students’ educational progress is one of the main goals of universities. One of the most important means to this end is the final test. In this study, the results of the final residency tests for dermatology, ophthalmology and Gynecology and Obstetrics of Medical University of Mashhad in (Tir 1391) have been examined. Methods: in this applied study, the population consisted of the answer sheets of residency students of dermatology, ophthalmology and Gynecology and Obstetrics of Medical University of Mashhad. The analysis of 113 answer sheets was performed through the classic model, which includes the credibility, level of difficulty and the coefficient of question determination; by the level of difficulty we mean the ratio of correct answers and by the coefficient of question determination, the two-point correlation of the question with the total score. More often than not, the questions included in the final test are the ones with a satisfactory level of difficulty, compatible with the target group and a remarkable coefficient of determination. The exams which lead to issuing the residency certificate are called summative tests. Such tests depend on questions at either extremes, on the one hand, and the discriminant index of questions, on the other, in the classic model. Results: the questions at either extremes were introduced. The vague questions or the ones lacking the discriminant index as well as other incompatible questions were excluded; the rest of the questions were regarded as the basis for decision-making and ranking of the test takers. Conclusions: 1) the ranking of test takers, being influenced by group changes was studied 2) All the questions of each test are compatible regarding both form and content so that all of them share a common feature 3) The questions were screened out through certain formulae and the final test questions were determined 4) The questions are chosen so as to make the test taker produce an answer rather than to pick an alternative from among others 5) Those questions which were left in the final test reflect a general scientific progress rather than a certain course belonging to that particular science.

Prevalence of Smoking among the Students resided at Dormitories in Golestan University of Medical Sciences, Iran

Introduction: Cigarette smoking leads to harmful physical and emotional problems and also is a predisposed factor for the addiction. The aim of this study was an attempt to determine the rate of prevalence and causes of smoking among the students of Golestan University of Medical Sciences who resided in the dormitories. Material &amp; Methods: A cross-sectional analytical study conducted among the resident students of dormitories in 2010. The sample size consisted of all the university dormitory students. The data gathered using a validated and reliable questionnaire. The data analyzed using SPSS software and statistical tests including Chi-square, Logistic regression and Independent t-test. Results: Of 669 students, 538 (80%) of them filled out the questionnaires completely. 67.3% (362 subjects) were female. 6.1% (33 students) were smoker and 83.5% of them had experiences of cigarette smoking. The most important reasons for the smoking tendency were “having a smoker friend in 33%, a personal interest 27% and as hobby in 24% of the cases”. There were significant relation between “age, sex, region and year of education” with smoking (P&lt;0.05). However, we couldn’t find any significant relation between major and marital status with cigarette smoking (P&gt;0.05).Conclusion: The results indicated low prevalence of cigarette smoking among the students. However, preventive measures should be taken to conduit youth toward healthier behaviors. It seems parental control and monitoring children’s friend finding are crucial issue.DOI: http://dx.doi.org/10.3329/bjms.v13i4.16727 Bangladesh Journal of Medical Science Vol.13(4) 2014 p.460-465

Analyzing the Quality Gap of Clinical Educational Services in Hospitals Affiliated with Kerman University of Medical Sciences Using SERVQUAL Method

Background:Students are the main customers of the universities. Thus, their perceptions and expectations of the educational quality is of great importance in planning for quality improvement. This study is aimed on evaluating the quality of clinical education in hospitals affiliated with Kerman University of Medical Sciences. Methods: This is a descriptive-analytical study. Three hundred and three externship, internship and residency students were participated. After validity and reliability tests, the adapted SERVQUAL questionnaire was used for data gathering. The descriptive tests, Kruskal-Wallis test, and paired t-test were used for data analysis in SPSS 18.0. Results: A negative gap in service quality was observed in all five dimensions. Among externship students, minimum and maximum mean of the quality gap were in assurance (-1) and empathy (-1.28) dimensions, respectively. Among internship students, minimum quality gap was observed in reliability and tangibles dimensions together (-1.09) and maximum quality gap was in responsiveness dimension (-1.36). Among residency students, minimum and maximum quality gap was in tangibles (-1.48) and responsiveness (-2.04), respectively. No significant difference was observed regarding the quality gap among different teaching hospitals (P>0.001). However, there was a significant difference among all students in all dimensions (P<0.001). Conclusions: Considering the negative gap in all dimensions of educational services, it is recommended to hold courses educating employees on how to better provide education services and effectively communicate with students. Using new educational methods, counselling skills and communicating with students must be considered in workshops for faculty members.