Undergraduate Medical Interns Research Articles

Culture on organ and tissue donation in the community of Medical School, Veracruz Region

Abstract Introduction Organ donation is a life-saving activity, yet there is a disparity between the high number of recipients and the minimal number of donors. Objetives To determine the level of organ and tissue donation culture for transplant purposes among faculty members and undergraduate medical interns at a Medical School Methods A cross-sectional and prospective study was conducted from January 2023 to 2024, including faculty members and undergraduate medical interns from the Medical School at the University of Veracruz - Veracruz Region. The main study variable was the culture of organ and tissue donation for transplant purposes, quantified through three dimensions: knowledge, attitude, and training, assessed using a validated instrument (Cronbach’s alpha: 0.6). The entire described population was included, and they were approached in different areas to invite them to participate in this research. Results 225 subjects (55 faculty members) agreed to participate. 97% of participants expressed support for organ donation. Among those not in favor of donation, 33% feared receiving poor medical care as donors, and 17% viewed donation as a business. Organ donation culture was deemed sufficient in 10.98% and outstanding in 71.76% of participants. The most common level of knowledge was outstanding (52%), 70% of the studied population showed a ‘very positive’ attitude towards organ and tissue donation. Training history was evaluated as an associated factor with knowledge about organ donation (OR/CI95%), identifying an association between lack of training and levels of sufficient knowledge (2.5/1.2-4.9) and outstanding knowledge (0.3/0.1-0.7), as well as with sufficient culture (9.6/1.2-73.0) and outstanding culture (0.1/0.04-0.4) (p < 0.05) Conclusions It is imperative to strengthen training programs for faculty and undergraduate personnel, as quality training enhances knowledge and culture within this essential area of healthcare personnel formation. Key messages • University professors should have accurate information on organ donation and sensitize future physicians on the subject, as this could be a crucial step for future interactions in favor of donation. • It is necessary to eradicate misinformation about organ donation in teachers and students of medical schools, since they are the basis for education and awareness on this issue in the population.

Risk of positive screening for anorexia nervosa, bulimia nervosa and night eating syndrome and associated risk factors in medical fellows in Northeastern Mexico: a multicenter study

BackgroundEating disorders and food ingestion (EDs) are serious mental illnesses with a higher prevalence in young adults, with difficult diagnoses that cause serious morbidity and mortality problems. There is not much information about the risk of positive screening for EDs, specifically, anorexia nervosa (AN) and bulimia nervosa (BN) and night eating syndrome (NES) in undergraduate medical interns (UMI) and medical residents (MR) in Mexico.AimTo determine the risk of AN, BN and NES and to determine the risk factors of such conditions such as age, body mass index (BMI) and gender of MR and UMI with AN/BN and NES at four private hospitals in northeastern Mexico.MethodsA cross-sectional, descriptive, non-randomized survey in MR and UMI in four hospitals in Northeastern Mexico was conducted using an electronic questionnaire that included: informed consent signature, SCOFF questionnaire for AN and BN screening, NES questionnaire. Also, a survey on general sociodemographic data of each participant was included. Chi-square test and a logistic regression model were computed for analyses.ResultsThe population included a total of 129 MR and UMI. It was observed that 48.8% were positive for AN or BN and 32.6% were positive for the NES. There was no difference between age, sex, BMI, or medical specialty (if they were MR); however, MR from the first year had a higher risk of AN or BN (OR 23.7, 95% CI 1.181–475.266).ConclusionsThere was a higher risk of positive screening for AN or BN and NES in UMI and MR in our population. In the case of MR, those in first year have a higher risk of AN and BN. Timely diagnosis and treatment are mandatory in this population.

Presentation of Clinical Cases by Undergraduate Physicians During the On-call Handover, Ethnographic Study

Objective: to describe an on-call handover and presentation of clinical cases in the pediatrics service and its impact on learning in undergraduate medical interns. Methods: qualitative study with ethnographic approach, with the participation of undergraduate medical interns who rotated through the pediatrics service, during the bimonthly March-April 2019, and attending physicians who participated in the on-call handover. Observations, video recordings and interviews were carried out, subsequently an ethnographic analysis was performed. Results: during the on-call period, the presentation of clinical cases was identified as a formative activity; the intern physicians presented medical histories and admission notes prepared during the on-call period; the attending physicians participated actively through questions, comments, recommendations, and explanations that served as a guide for the students to achieve greater learning in professional competencies. Conclusion: the presentation of clinical cases during the on-call handover was a key formative activity in the development of two professional competencies in medical practice, diagnosis and treatment.

Study on the undergraduate interns of a medical college in eastern India: the knowledge, attitude and practice regarding COVID-19 pandemic preparation

Background: With the rapid propagation of the SARS-COV-2 or COVID-19 pandemic, the healthcare facility around the world has been stretched a large extent. To keep the green supply chain to the healthcare resources ready for the battle, sufficient knowledge, proper attitude and adequate practices are of paramount necessity. Aims and Objectives: The study was done to the knowledge, practice and attitudes towards COVID-19 pandemic preparedness among the undergraduate medical interns of a tertiary care teaching center in Eastern India. Materials and Methods: Semi-structured proforma for socio-demographic details and KAP Questionnaire for COVID-19 preparedness were circulated among the Interns. Interaction among the subsets of the KAP scale as well as their association with different socio-demographic variables were studied. Results: Out of the 138 subjects participated in the study the KAP parameters were not significantly different based on the socio-demographic factors barring presence of better practices among the female interns and less score on knowledge and attitude in presence of Psychiatric illness. It was seen that better practice was significantly correlated with knowledge mean score. Conclusion: The study implied that training on the updated knowledge along with exposure to simulated environment with scheduled supervision to reflect the behavior of the interns was of great importance so that in extreme situation, the less experienced resources could also come handy into utilization if needed.

Severe Acute Respiratory Syndrome Coronavirus-2-Associated Perceived Stress and Anxiety among Indian Medical Students

Introduction: The spread of coronavirus disease (COVID-19) is a new public health concern that has shaken the whole world and possesses a challenge to the mental health of the public. This study aimed to investigate the impact of COVID-19 pandemic on the perceived stress, anxiety level, and mental health of medical students as well as to explore the knowledge of COVID-19 among Indian medical students. Methods: A web-based cross-sectional survey was conducted among the undergraduate medical interns and postgraduate medical residents using the online data collection form. The form consisted of five domains (sociodemographic details, knowledge assessment, perceived stress assessment, generalized anxiety disorder-7 assessment, and assessment of the perceived level of change in social habits and personal hygiene related to COVID-19 outbreak). The statistical analysis of the responses was carried out by the Mann–Whitney U-test and Kruskal–Wallis tests. Results: Two hundred participants filled the distributed survey, 61% (n = 122) were males. The mean knowledge score of 200 participants was 4.27 ± 1.45. The participant had a mean perceived stress score of 18.35 ± 6.28, and the females had a significantly higher perceived stress level than the male (P = 0.037). About 10% (n = 20) of the participants reported high perceived stress level (27–40), and moderate stress (score 14–26) was reported in 69% (n = 138) of the participants. However, only 21% (n = 42) of the participants reported low stress (0–13). While only moderate anxiety (score 10–14) was reported in 16% (n = 32) of the participant and 4% (n = 8) of the participants reported severe anxiety (score >14). Conclusion: There is an increased stress and anxiety in Indian medical students due to overburdened responsibilities and lack of adequate resources.

Elección de especialidad y actitud de médicos internos de pregrado hacia la Medicina Familiar

<p><span><strong>Objetivo:</strong> analizar la elección de especialidad y actitud de los médicos internos de pregrado (mip) hacia la Medicina Familiar (mf) después de cursar un nuevo modelo educativo con enfoque en el primer nivel de atención. <strong>Métodos:</strong> estudio transversal analítico realizado de diciembre de 2018 a febrero de 2019; participaron 141 mip del Hospital General Regional No.1 Vicente Guerrero del Instituto Mexicano de Seguro Social. Posterior a un año de que se implementara una nueva modalidad de internado médico enfocado al primer nivel, en el que se incrementó el tiempo de rotación por Medicina Familiar de dos a cuatro meses, se aplicó el Cuestionario de Actitud hacia la Medicina Familiar (camf) que explora la actitud hacia la mf, opinión de la rotación y su elección como especialidad y factores asociados. Se realizó análisis univariado y multivariado. <strong>Resultados:</strong> 98.6% presentó buena actitud hacia la mf (n=139), 34.5% la eligió como posible opción de especialidad (n=38), solo 3.5% la eligió como primera opción (n=5); la causa principal para elegirla es que brinda atención integral (22.6%, n=32) y para no elegirla es porque no les gusta (18.4%, n=26). La nueva rotación fue percibida como buena por 48 % (n=54); mediante análisis de regresión logística se encontró que al alumno que le gustó la rotación o prácticas por consulta de Medicina Familiar tiene 6.7 veces la probabilidad de seleccionar Medicina Familiar como opción de especialidad (ic 95%: 1.45-31.2). <strong>Conclusiones:</strong> a un año de la implementación del nuevo modelo con enfoque al primer nivel, la mayoría de los mip tienen buena actitud hacia la mf, sin embargo, no representa su primera elección como especialidad; las cualidades de la especialidad son los principales motivos para elegirla, el tiempo de internado no influyó su elección.</span></p>

Síndrome de burnout en médicos internos de pregrado

<p><strong>Objetivo:</strong> estimar la prevalencia e identificar los factores asociados al síndrome de burnout en médicos internos de pregrado (mip). <strong>Métodos: </strong>estudio transversal analítico, realizado entre los meses de diciembre de 2016 y enero 2017. Participaron 108 mip del Hospital General Regional (hgr) no. 1 Vicente Guerrero del Instituto Mexicano del Seguro Social (imss), en Acapulco, Guerrero, México. Se aplicó una cédula sociodemográfica y el instrumento Maslach Burnout Inventory, el cual evalúa tres dimensiones: desgaste emocional, despersonalización y baja realización personal. Se realizó análisis de frecuencias simples y análisis bivariado. <strong>Resultados:</strong> la prevalencia global de burnout fue de 17.5% (n= 19), no se encontró ningún caso entre los internos de nuevo ingreso, en 42 mip con antigüedad de seis meses el hallazgo fue de 17% (n= 7) y en 28 mip con doce meses de servicio el síndrome de burnout se diagnosticó en 43% (n= 12). El principal factor de riesgo asociado fue rotar por el servicio de urgencias (or: 5.4). <strong>Conclusiones: </strong>conforme avanza el tiempo en la prestación de servicio aumenta la prevalencia del síndrome de burnout en mip. Se requiere establecer estrategias que atenúen la problemática señalada.</p>

Indicators of vulnerability associated with less healthy circadian rhythms in undergraduate medical interns

ABSTRACTTo evaluate the association between circadian health parameters and psychological and biological vulnerability, a cross-sectional study was conducted with 15 undergraduate medical interns using the Brief Resilience Scale, the Mini International Neuropsychiatric Interview, and an ambulatory circadian monitoring device. Circadian Health construct was confirmed by factor analysis. Vulnerability factors (history of depression and low resilience) were associated to lower circadian health of motor activity and temperature rhythms. The findings suggest that not only being depressed but also having had depressive episodes in the past, as well as having low resilience, are associated with chronodisruption, and may increase the risk for developing new episodes of depression.

Effect of integration of humanistic concern into problem-based learning in the teaching of anorectal surgery

Objective To investigate the feasibility and practical value of the integration of humanistic concern into clinical problem-based learning (PBL) teaching. Methods A total of 112 undergraduate medical interns in Department of Colorectal Surgery were enrolled and randomly divided into experimental group receiving PBL teaching integrated with humanistic concern and control group receiving PBL teaching alone. Theoretical examination, operation examination, and patient satisfaction survey were performed after practice training to evaluate the teaching effect of the two groups. GraphPad Prism 6 software was used for statistical analysis of data, and the t-test was used for comparison of continuous data between the two groups. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection (22.57±2.63 vs 20.87±3.08, t=3.124, P=0.002) and operation skills (31.42±2.89 vs 29.87±4.72, t=2.107, P=0.037), but there were no significant differences between the two groups in the scores of theoretical examination (90.60±3.19 vs 90.52±3.38, t=0.129, P=0.898) and medical record writing (20.78±2.79 vs 20.65±3.51, t=0.215, P=0.830). Compared with the control group, the experimental group had a significantly higher degree of patient satisfaction with service attitude (3.94± 1.07 vs 3.22±1.09, t=3.256, P=0.002), trust (3.85±1.16 vs 3.22±1.05, t=2.759, P=0.007), and communication skills (3.92±1.03 vs 3.16±1.03, t=3.652, P=0.000), but there were no significant differences between the two groups in the scores of operating skills (3.60±1.09 vs 3.67±1.10, t=0.281, P=0.779) and arrangement of medical procedures (2.74±1.10 vs 3.02±1.02, t=1.312, P=0.193). Conclusion The integration of humanistic concern into PBL teaching of anorectal surgery can improve students’ clinical operation ability and degree of patient satisfaction. Key words: Problem-based learning; Humanistic concern; Anorectal surgery; Teaching method

Competency Based Learning of Interns in Spirometry

Objectives: To establish the knowledge and skill of performing and learning the interpretation of spirometry so that the Indian medical graduate is able to perform and integrate the knowledge of spirometry. Methods: The study involved undergraduate medical interns posted in the department of medicine in our institution. In this study interns were given competency based training of spirometry. For the learning they were given 1 hour theory as well as practical class demonstrating spirometry. After the class the students performed spirometry and the procedural skills were assessed by directly observed procedural skills (DOPS). After the Performance of the test the interns were given Post-test Questionnaire in which there was significant improvement in their knowledge about spirometry and interpretation of its results. Result: Highly significant improvement in learning and demonstration of skill of performing and interpretation of the result of spirometry was seen. Hence signifying the need of competency based training in internship. Conclusion: Learning of spirometry and its interpretation helped the intern to demonstrate adequate skills of performing spirometry and acquire knowledge regarding the utility of spirometer in diagnosing and management of respiratory disorders. These competency based trainings show the effectiveness of hands on training to interns to acquire the desired skills.

Knowledge, attitude and practice of medical ethics among medical intern students in a Medical College in Kathmandu

This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee.

Effect of Advanced Trauma Life Support program on medical interns’ performance in simulated trauma patient management

ObjectiveSince appropriate and timetable methods in trauma care have an important impact on patients’ outcome we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns’ performance in simulated trauma patient management MethodsA descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed interns’ clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, preand post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. ResultsOur findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns’ clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P<0.001, P=0.016 and P=0.01 respectively). ConclusionATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

The Comparison between two Methods of Basic Life Support Instruction: Video Self-Instruction versus Traditional Method

Introduction Medical education is changing and evolving. Teachers need to re-evaluate their medical teaching practice to enhance student learning. The data about the ideal training method of Basic Life Support (BLS) is lacking. The goal of this study was to analyse the use and performance of video self-instruction (VSI) method in BLS, in order to develop an efficient BLS training method. Methods Eighty-one undergraduate medical interns were enrolled in a prospective clinical study in 2011. They were divided into VSI group and traditional group. We provided the first group with a DVD containing a 20-minute training video while the second group took part in a 4-hour training class of BLS. Subjects participated in a pre-test and post-test based on 2010 American Heart Association Resuscitation guideline. Results The average scores of VSI group and the traditional group before training were 8.85±2.42 and 8.57±2.22 respectively (p=0.592). After training, the average scores of the VSI and the traditional group were 20.24±0.83 and 18.05±1.86 respectively. VSI group achieved slightly better scores compared with the traditional group (p&lt;0.001). Conclusions Training through VSI achieves more satisfying results than the traditional lecture method. VSI method can be considered a useful technique in undergraduate educational programs. Developing VSI can increase significantly the access to the BLS training. (Hong Kong j.emerg.med. 2015;22:291-296)

Evaluación por competencias de un modelo novedoso de gestión de calidad en médicos internos de pregrado

IntroductionThe global health problems require competent doctors who promote health in a humanitarian way and with ethical commitment. To contribute to this social demand, we have implemented a quality management model (QMM) oriented to the integral formation of physician competencies. ObjectiveTo assess the implications of this model evaluated through the objective structured clinical evaluation (OSCE). MethodA descriptive-transverse correlational study with the application of OSCE to 46 undergraduate medical interns (UMI) to assess humanist performance by competencies with stan-dardized patients (SPs) through four levels of performance: receptive, resolving, autonomous and strategic. A questionnaire was applied to measure the relationship between training projects of the quality management model and the competences of UMI. The results were analyzed with a significance level of p<0.01 and with a 1-10 scale in performance. ResultsThe UMI achieved an autonomous performance level (8-9) in the competences of: communication, socio cultural interrelationships and diagnosis and management of diseases. However the UMI showed a receptive level (5-6) and resolving (6-7 in the competence of culture in health and troubleshooting, they require support from the clinical tutor. Significant relationship was observed between the preparation of the tutor and the display a friendly, respectful, cordial attitude of the MIP to explore their patient (0.28). ConclusionsThe QMM through evaluation OSCE favors the development humanist competences: socio-cultural, communication and diagnosis and management of diseases.

7026 Deriving prostate alpha-beta ratio using carefully matched groups, long follow-up and the Phoenix definition of biochemical failure

Since appropriate and timetable methods in trauma care have an important impact on patients’ outcome we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns’ performance in simulated trauma patient managementA descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed interns’ clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, preand post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant.Our findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns’ clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P < 0.001, P = 0.016 and P = 0.01 respectively).ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.