Rural Medical Students Research Articles

Developing a digital anatomy lab for rural medical students

This paper follows the genesis and development of a digital anatomy lab for geographically isolated students in a postgraduate Doctor of Medicine programme in rural New South Wales and represents a work in progress. Students studying their degree at the rural clinical school do so without an in-situ cadaver-centred anatomy laboratory. This represents a pivotal shift away from the fundamental learning pedagogies implicit in academic Medicine, and therefore a challenge for situating the digital anatomy lab; its contents and explicit pedagogical needs, inside an already saturated curriculum. The Digital Anatomy space under development represents an intersection of scholarship on whether nascent digital tools (VR/AR) can develop fast enough to provide haptic and spatial feedback, how such digital spaces sit pedagogically amidst the accepted didactic teaching frameworks of Medicine, and whether creating virtual spaces improves student learning of Anatomy. This work-in-progress reflects the conference themes of people, partnerships and pedagogies.

Employment intentions among rural order-oriented medical students in inner mongolia autonomous region, China.

The program of the "Free Training of Chinese Rural Order-Oriented Medical Students" is a plan to train general practitioners who can work at rural medical institutions. However, many students have been unwilling to fulfill their commitments and actually work in their assigned locations. This study aimed to provide some explanation by exploring factors influencing the employment intentions of rural order-oriented medical students in Inner Mongolia Autonomous Region of China to provide a basis for formulating relevant supporting policies to help increase the fulfillment rate of medical students. We conducted a cross-sectional study with a stratified cluster sampling method at four medical universities in Inner Mongolia using a survey questionnaire. Multivariate logistic regression was used to identify factors that were significantly associated with employment intentions. Approximately 67% of students were willing to work in rural areas, whereas 33% were not. Order-oriented medical students who were dissatisfied with, or indifferent to, training, were unclear about policy, were of Han ethnicity, or came from an urban area, had lower intentions to accept employment in rural areas. The training satisfaction in particular had the greatest predictive effect. The implementation of the program "Free Training of Chinese Rural Order-Oriented Medical Students" has been affected by the low actual employment intentions. This study may provide a useful basis on which medical educators and health policy makers can formulate relevant supporting policies and develop strategies to increase the number of order-oriented medical students who working in rural areas where they are most needed.

Analisis Uji Beda Gaya Hidup Mahasiswa Urban dan Rural Terhadap Perubahan Perilaku di Fakultas Kedokteran Universitas Prima Indonesia

This research aims to examine the influence of urban and rural backgrounds on the lifestyle choices and behavioral changes among medical students. The study addresses the question of how different backgrounds shape the students' lifestyles and behavioral patterns. A quantitative approach was employed, involving a sample of 100 medical students (50 from urban areas and 50 from rural areas). Data were collected through a questionnaire and analyzed using a t-test to compare the differences between the two groups. The findings indicate significant variations in lifestyle choices and behavioral changes between urban and rural medical students, with rural students exhibiting higher levels of consumerism and more pronounced behavioral shifts. The study concludes that the students' urban or rural backgrounds play a crucial role in shaping their lifestyles and behaviors, emphasizing the need for contextual considerations in educational interventions and support systems.

Australian rural medical students' perceived readiness for work as a junior doctor: A cross-sectional national survey.

To report self-perceived readiness for work as a junior doctor in a national cohort of rural clinical school students. Cross-sectional study using a self-report questionnaire. Independent variables included 14 individual readiness items related to clinical and professional tasks, sociodemographic data and reported experience of rural clinical school (RCS) training. Participants were 668 medical students (55.3% females) completing a full academic year in rural Australia. Multivariable analysis explored factors associated with overall readiness for work as a junior doctor. 86% agreed that RCS experience prepared them to undertake the roles and responsibilities of a junior doctor. Self-ratings for specific clinical and professional tasks varied from a mean score of 5.9-8.0 out of 10, and 13 of the 14 items were associated with the outcome (p-value <0.001, except for performing spirometry). Lowest readiness scores were seen for some aspects including raising concerns about a colleague (mean score 6.1) or responding to workplace bullying (mean score 6.0). Aspects of the RCS experience that were strongly associated with overall readiness included: feeling a valued team-member (OR 9.28, 95%CI 2.43-35.39), feeling well-supported academically (OR 6.64, 95%CI 3.39-13.00), having opportunity for unsupervised but supported clinical practice (OR 4.67, 95%CI 1.45-15.00), having a rural mentor (OR 3.38, 95%CI 1.89-6.06) and having a previous health professional qualification (OR 2.7, 95%CI 1.32-5.54). Most RCS students felt ready for work as a junior doctor. Important aspects of RCS experience are likely to include students feeling integrated within the clinical team and having opportunities for authentic clinical roles. There remains a significant challenge for medical school curricula to address professional areas where graduates felt less prepared.

THE RELATIONSHIP OF MOTIVATION ON THE INTEREST OF THE COMMUNITY VISITING THE DENTIST DURING THE COVID-19 PANDEMIC IN SUNGAI MIAI VILLAGE

THE RELATIONSHIP OF MOTIVATION ON THE INTEREST OF THE COMMUNITY VISITING THE DENTIST DURING THE COVID-19 PANDEMIC IN SUNGAI MIAI VILLAGE

Adapting Simulation Education for Rural Medical Students During COVID-19

The outbreak of the COVID-19 pandemic changed everything about the world we lived in in 2020. It has had obvious impacts on the way we teach and the way we learn. Monash University provides clinical health education to around 130 third, fourth and fifth year medical students each year in a rural setting. By mid-March 2020 it was clear that substantial changes in delivery methods would be required to ensure the continuation of both placements and clinical education. In particular, there was a need to provide continuity of education for the final year students who needed to be ready to graduate as Interns by the end of the year. A key component of the final year is a capstone unit in clinical skills which has a strong emphasis on simulation-based scenario teaching. This unit was already in the process of adapting to changes in the curriculum when the COVID-19 pandemic hit, presenting clinical educators with the additional challenge of teaching a new curriculum in new ways. What began as a reaction to an unforeseen disruptor resulted in innovations that ultimately were extremely well-received by the students and will likely become new ways of teaching final year students into the future. Additionally, these innovations offer important alternatives for how to ensure continuity of clinical education during systemic disruption caused by pandemic.

Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis

BackgroundThe prevalence of depression symptoms among medical students is particularly high, and it has increased during the COVID-19 epidemic. Sleep quality and state-trait anxiety are risk factors for depression, but no study has yet investigated the mediating role of state-trait anxiety in the relationship between poor sleep quality and depression symptoms in medical students. This study aims to investigate the relationship among depression symptoms, sleep quality and state-trait anxiety in medical university students in Anhui Province.MethodsThis was a cross-sectional survey of 1227 students’ online questionnaires collected from four medical universities in Anhui Province using a convenience sampling method. We measured respondents’ sleep quality, state-trait anxiety, and depression symptoms using three scales: the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Anxiety Inventory (STAI) and the Self-rating Depression Scale (SDS). We analysed the mediating role of STAI scores on the association between PSQI scores and SDS scores through the Sobel-Goodman Mediation Test while controlling for covariates. P < 0.05 was considered statistically significant.ResultsA total of 74.33% (912) and 41.40% (518) of the respondents reported suffering from poor sleep quality and depression symptoms. Sleep quality, state-trait anxiety, and depression symptoms were positively associated with each other (β = 0.381 ~ 0.775, P < 0.001). State-trait anxiety partially mediated the association between sleep quality and depression symptoms (Sobel test Z = 15.090, P < 0.001), and this mediating variable accounted for 83.79% of the association when adjusting for potential confounders. Subgroup analysis further revealed that STAI scores partially mediated the association between PSQI scores and SDS scores in females and rural students and fully mediated the association between PSQI scores and SDS scores in males and urban students.ConclusionsThis study found that sleep quality and state-trait anxiety have a significant predictive effect on depression symptoms. State-trait anxiety mediated the relationship between sleep quality and depression symptoms, with a more complex mechanism observed among rural and female medical students. Multiple pathways of intervention should be adopted, such as encouraging students to self-adjust, providing professional psychological intervention and timely monitoring, enriching extracurricular activities, and making changes in policies regarding long shifts and working hours.

Medical English anxiety patterns among medical students in Sichuan, China.

This study adapts a Medical English Language Anxiety Scale (MELAS) based on Horwitz’s Foreign Language Classroom Anxiety Scale (FLCAS) and examines students’ anxiety in medical English vocabulary, listening and speaking, communication, literature reading, and academic paper writing. The biographical factors related to medical English language anxiety (MELA) were also tested. The questionnaire sets including five dimensions were distributed to the students from a medical university in Sichuan, China, and were statistically analyzed by using SPSS 22.0 and AMOS 21.0. By employing the adapted MELAS, it was found that 85.2% of the medical students surveyed suffered moderate and higher anxiety. Among all dimensions, students with listening and speaking anxiety recorded the highest (89.3%), followed by literature reading anxiety (86.6%), English academic writing anxiety (85.9%), communication anxiety (81.9%), and vocabulary learning anxiety (81.2%). We also found that the anxiety of rural medical students in each dimension was higher than that of urban medical students. This study suggests that English teachers should be fully aware of their students’ language anxiety situation, design interesting class activities, and create a relaxed English learning atmosphere in classroom teaching to make students less nervous when learning medical English in class.

Reply by Authors.

No AccessUrology PracticeSpecialty1 Sep 2022Reply by Authorsis a reply to letterEditorial Commentary Tullika Garg, William D. Meeks, R. Matthew Coward, Suzanne B. Merrill, William C. Huang, and Arthur L. Burnett Tullika GargTullika Garg *Correspondence: Department of Urology, Geisinger, 100 N. Academy Ave., Mail Code 01-27, Danville, Pennsylvania 17822 telephone: 570-271-6328; FAX: 570-217-6955; email address: E-mail Address: [email protected] https://orcid.org/0000-0003-2679-7460 Departments of Urology and Population Health Sciences, Geisinger, Danville, Pennsylvania Current institution: Department of Urology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania. More articles by this author , William D. MeeksWilliam D. Meeks Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland More articles by this author , R. Matthew CowardR. Matthew Coward Department of Urology, University of North Carolina, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author , Suzanne B. MerrillSuzanne B. Merrill Colorado Urology, United Urology Group Affiliate, Denver, Colorado More articles by this author , William C. HuangWilliam C. Huang Departments of Urology and Radiology, NYU Grossman School of Medicine, New York, New York More articles by this author , and Arthur L. BurnettArthur L. Burnett Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000311.02AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Reply by Authors." Urology Practice, 9(5), p. 490 Reference 1. : The decline in rural medical students: a growing gap in geographic diversity threatens the rural physician workforce. Health Aff (Millwood) 2019; 38: 2011. Google Scholar © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesUrology Practice1 Jun 2022Editorial Commentary Volume 9Issue 5September 2022Page: 490-490 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tullika Garg Departments of Urology and Population Health Sciences, Geisinger, Danville, Pennsylvania *Correspondence: Department of Urology, Geisinger, 100 N. Academy Ave., Mail Code 01-27, Danville, Pennsylvania 17822 telephone: 570-271-6328; FAX: 570-217-6955; email address: E-mail Address: [email protected] Current institution: Department of Urology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania. More articles by this author William D. Meeks Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland More articles by this author R. Matthew Coward Department of Urology, University of North Carolina, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author Suzanne B. Merrill Colorado Urology, United Urology Group Affiliate, Denver, Colorado More articles by this author William C. Huang Departments of Urology and Radiology, NYU Grossman School of Medicine, New York, New York More articles by this author Arthur L. Burnett Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...

Factors Associated with Motivation for General Medicine among Rural Medical Students: A Cross-Sectional Study.

General medicine, as the Japanese version of primary care or family medicine, is critical for healthcare in aging societies. Medical students’ perceptions of general medicine and education might be associated with changes in the number of general physicians. This study aimed to clarify the association between these perceptions and students’ preferences for general medicine. A cross-sectional survey was conducted among Japanese medical students using a questionnaire on their perceptions regarding general medicine, background, and preferences for general medicine (knowledge, interest, motivation, and intention). The response rate was 70.3% (490/697). There was a large percentage gap between interest and motivation; therefore, a logistic regression analysis was performed to investigate the cause of this difference. The perceptions that general medicine meets the needs of society and the lack of general medicine educators were positively associated with motivation to become a general physician. In contrast, perceptions of lack of exposure to general medicine beyond the curriculum and inaccessibility were negatively associated with motivation. Medical students’ motivation to pursue general medicine may increase with improvements in flexible general medicine education and accessibility. Future research should investigate the relationship between students’ perceptions of general medicine and their motivation to become general physicians through longitudinal studies.

Reconstruction of teaching mode of Human Parasitology among rural order-oriented medical students in the context of curriculum ideology and politics

To set the cultivation goal with adaptation to rural order-oriented medical students, the teaching mode of Human Parasitology was reformed in the context of curriculum ideological and political education. The new teaching mode not only enables students to harvest medical knowledge during the school education stage, but also plays a guiding role in cultivation of humanistic qualities and professional spirit, which provides a basis for cultivating general practitioners serving for grassroots healthcare.

Brief online mindfulness training for medical students: a randomized control study

BACKGROUNDMedical students experience high levels of stress during their training. Literature suggests that mindfulness can reduce stress and increase self-compassion levels in medical students. However, most mindfulness training programs are delivered face-to-face and require significant time commitments, which can be challenging for rurally-based students with heavy academic workloads and limited support networks. PURPOSETo evaluate the feasibility and efficacy of a brief online Mindfulness training program for medical students based in rural areas, with regards to reducing stress, increasing self-compassion, mindfulness and study engagement. METHODSThis is a non-registered randomised control trial. Participants included both urban and rural medical students from UWA, University of Notre Dame and the RCSWA from 2018-2020. Participants were randomised to the intervention group, an 8-week online mindfulness training program, or the control group. Using quantitative-qualitative mixed-methods approach, we measured the frequency, duration and quality of the participants mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion, mindfulness and study engagement levels. Further, the intervention group recorded a weekly reflective journal documenting their experience of the program. RESULTS114 participants were recruited to the study. 61 were randomised to the intervention, and 53 to the control. Quantitative analysis of the frequency, duration and quality of mindfulness meditation practice and changes in stress, self-compassion, mindfulness and study engagement is currently being conducted. Preliminary qualitative results reveal that participants experienced increased self-awareness, more mindfulness of their day-to-day activities, improved emotional regulation and increased productivity, while also facing difficulties with making time for their mindfulness practice. CONCLUSIONWe anticipate that this study will demonstrate that an online mindfulness training program tailored to reach rurally located medical students is feasible and effective in modifying their stress levels and psychological wellbeing.

The Perception of Rural Medical Students Regarding the Future of General Medicine: A Thematic Analysis.

Although the demand for general physicians has increased in Japan because of its aging population, medical universities primarily provide organ-based education; thus, medical students do not receive sufficient general medical education. The number of residents focusing on general medicine remains low; therefore, to understand the present situation regarding general medicine education, we attempted to clarify the views of medical students and the factors influencing them. In this qualitative study, semi-structured interviews were conducted in 12 medical students at Shimane University, and the results were analyzed through thematic analysis. The results indicated the emergence of three themes and 14 concepts. The three overarching themes were as follows: hopes for the field of general medicine, gaps between ideal and reality of general medicine, and factors affecting students’ motivation for specialization in general medicine. Medical students had a positive impression of general medicine and believed that it has potential for further development; however, they felt a gap between their ideals and reality (i.e., unclear expertise). Factors creating this gap included poorly developed education and medical policies. We need to restructure general medicine education based on the participants’ perceptions by establishing collaborative curricula between universities and community hospitals and by increasing students’ exposure to general medicine.

Under the Background of "Internet +", Mixed Teaching Mode of Science in the Reform of Rural Medical Majors

With the construction of the network online course platform under the background of “Internet +”, the mixed teaching [1] based on the background of “Internet +” came into being, and has been widely used in the daily teaching of full-time students, and proved its existence advantages. Rural medical majors have limited education degree, age gap, fixed time and other factors, so that students’ teaching methods and full-time undergraduate students cannot be rigid. As one of the most important clinical medical courses for rural doctors, science not only requires students to master theoretical knowledge, but also requires proficiency in basic clinical operation skills. Therefore, for this kind of students, we by building “Internet +” science online open course platform, to provide high quality science teaching resources, at the same time using online learning + offline flip classroom mixed teaching model, the “tailored” for rural medical students, build in line with their learning ability level and receive knowledge ability of new teaching mode[2].

Rural medical students' self-reported perceptions of preparedness to practice in the Aboriginal and Torres Strait Islander Health Context.

Rural medical students' self-reported perceptions of preparedness to practice in the Aboriginal and Torres Strait Islander Health Context.

Study on the dynamic impact of population characteristics on health costs – Empirical study based on the panel smooth transformation model

In order to study the dynamic influence mechanism of population characteristics on health expenses, the panel data of 31 provinces, autonomous regions and municipalities directly under the Central Government (excluding Hong Kong, Macao and Taiwan) from 2009 to 2016 were used to construct panel smooth transformation model with population characteristics as heterogeneous variables for empirical analysis. The results show that the population number, population structure and population distribution have significant nonlinear effects on per capita health expenses, and the threshold values of population number, population structure and population distribution are 24.6686 million people, 6.9928%, 40.707%. When the threshold is crossed, The effect of population size on per capita health costs is reduced smoothly, The effect of population structure and population distribution on per capita health cost changed from inhibition to promotion.Therefore, according to the relationship between current population characteristics and health expenses, all regions should optimize the structure of health expenses expenditure, improve the level of health services, especially expand the scale of education and training of targeted rural medical students, strengthen the education and training of rural doctors, in order to narrow the difference between urban and rural diagnosis and treatment level.

Medical students on long-term rural clinical placements and their perceptions of urban and rural internships: a qualitative study

BackgroundThere is some anecdotal evidence that anxiety about the responsibility of an intern influences rural future intentions. Additionally, research has shown that urban interns have reported that they are worried about being ‘forced’ to work in non-metropolitan hospitals in their first year after graduation. This study sought to explore rural medical students’ perceptions and expectations of a rural internship and how local health services and/or their medical school can prepare them best for a rural intern position.MethodsFour focus groups were conducted with 62 final-year medical students upon completion of a 12-month rural clinical school placement. Focus groups were audio-recorded and transcribed verbatim for thematic analysis to identify key themes.ResultsMost students have high levels of anxiety around starting work but they acknowledge that this may be exaggerated. They believe that in rural areas they get higher quality supervisory support than in urban hospitals as people know you better, whereas in the city you are more anonymous. However, the level of responsibility placed on rural interns was considered to be a double-edged sword. While rural interns were allowed to do more than be a ‘paper-pusher’ this level of responsibility means they are more accountable. The majority felt that doing your first training years in a metropolitan hospital can be crucial to getting on a training program in your chosen speciality.ConclusionsThere appears to be a relatively high level of anxiety about rural internships amongst final-year medical students. Students need more targeted information around specialisation, particularly around regional training hubs, if we want to achieve higher levels of interns choosing a rural career path.

Determining the feasibility and effectiveness of brief online mindfulness training for rural medical students: a pilot study

BackgroundWe sought to determine the feasibility and effectiveness of a mindfulness training program, delivered online to medical students at a Rural Clinical School.MethodsAn 8-week online training program was delivered to penultimate-year medical students at an Australian Rural Clinical School during 2016. Using a mixed methods approach, we measured the frequency and duration of participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.ResultsForty-seven participants were recruited to the study. 50% of participants were practising mindfulness meditation at least weekly by the end of the 8-week program, and 32% reported practising at least weekly 4 months following completion of the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 4-month follow-up. Participants reported insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.ConclusionsThe results provide preliminary evidence that online training in mindfulness meditation can be associated with reduced stress and increased self-compassion in rural medical students. More rigorous research is required to establish concrete measures of feasibility of a mindfulness meditation program.

Lessons from rural medical training for physics education in Botswana

Despite being classified as an upper middle-income nation by the World Bank, Botswana’s economy is undiversified and heavily reliant on resources and commodities. Efforts are underway to drive the economy towards a knowledge- and technology-based one. In support of these efforts the Botswana International University of Science and Technology (BIUST) was recently established. It is foreseen that a future part of the BIUST undergraduate physics curriculum would be an internship placement for final year students. This article aims to provide a framework for the design of such an internship, based on the established practices of the final year internship of (rural) medical students in South Africa.

The Decline In Rural Medical Students: A Growing Gap In Geographic Diversity Threatens The Rural Physician Workforce.

Growing up in a rural setting is a strong predictor of future rural practice for physicians. This study reports on the fifteen-year decline in the number of rural medical students, culminating in rural students' representing less than 5percent of all incoming medical students in 2017. Furthermore, students from underrepresented racial/ethnic minority groups in medicine (URM) with rural backgrounds made up less than 0.5percent of new medical students in 2017. Both URM and non-URM students with rural backgrounds are substantially and increasingly underrepresented in medical school. If the number of rural students entering medical school were to become proportional to the share of rural residents in the US population, the number would have to quadruple. To date, medical schools' efforts to recognize and value a rural background have been insufficient to stem the decline in the number of rural medical students. Policy makers and other stakeholders should recognize the exacerbated risk to rural access created by this trend. Efforts to reinforce the rural pipeline into medicine warrant further investment and ongoing evaluation.