Year Of Medical Studies Research Articles

The coping strategies during medical education predict style of success in medical career: a 10-year longitudinal study.

BackgroundThe stress associated with the physician’s work is generally acknowledged and is related to well-being and life satisfaction. The presented study was designed to extract the role of coping strategies in identifying differentiated styles of success in a medical career during medical education.MethodsThe participants were examined when they applied to medical school and each subsequent academic year. The final study took place four years after graduation. The baseline questionnaire measured coping strategies. The follow-up questionnaire consisted of measures of: quality of life, work stress and burnout, satisfaction with medicine as a career, and professional competency.ResultsBased on coping strategies assessed during admission and preclinical years of medical study, some aspects of success in the participants’ future medical career can be predicted. Students who take action and deal directly with a problem, neither accept resignation, nor reduce tension by expressing feelings would most probably resist future burnout. However, despite the fact that they obtain the highest quality of life or earn the highest income they would be, at the same time, the least satisfied with chosen career, as well as being more likely to be characterised by a low level of competence.ConclusionsAssessment of coping strategies at the beginning of medical education could be taken into consideration as an instrument to diagnose a specific trend in physicians’ career development.

Decision Making in Different Care Settings: Do Undergraduate Students Already Care?

PurposeThe process of decision making in medical practice has been studied extensively. However, the influence of different care settings on that process has not been examined to date. Do undergraduate medical students already adjust their decisions to the varying conditions of two different care settings? MethodsStarting on August 12th until September 23rd 2015 a complete semester cohort of students in their 5th year of medical studies attending a practical course in primary care at the University of Muenster was asked to answer questions about 6 paper cases on usual patient encounters. All students received the same cases. However, half of them should imagine they had to deal with the cases in a tertiary-care context, whereas the other half should picture to be confronted with the cases in a primary care context. ResultsDifferences between the two groups were found concerning decisions made with respect to the management of the cases. Those differences indicate that undergraduate students already include differences in care settings in their decision making processes. DiscussionAs decision making in medical care is an essential part of a physicians׳ daily routine and has tremendous impact on all parties involved, the results stress the need for addressing the different care settings as an influencing factor in undergraduate and continuing medical education.

An Examination of the Process of Professional Socialization of Medical Students

The purpose of this study is to examine the process through which medical students develop the professional expertise required to be a doctor. To achieve this end, various factors affecting specialization were broadly analyzed to develop diagnostic measures to examine the process of professional socialization. These measures consist of 24 analytic factors, 13 being profession-specific, 6 concerning self-management and 5 related to sociability with others. In all they prove to be highly reliable diagnostic measures. The confidence level of profession-specific factors is measured at 0.909 while those of self-management factors and sociability with others are computed at 0.725 and 0.830 respectively. The results from examining the process of professional socialization of medical students indicate that the respective year of medical study affects the profession-specific factors the most. It was also found that life satisfaction level as a medical student exerted the greatest influence on self-management factors. As for sociability factors, the year in medical school was notably the most significant variable. The more senior the students were, the more Received (February 10, 2016), Review Result (February 24, 2016) Accepted (March 3, 2016), Published (April 30, 2016) 42472 Dept. Medical education school of medicine, Catholic Univ. of Daegu, Daemyung-dong, Nam-gu, Daegu, Korea email: aramo@cu.ac.kr An Examination of the Process of Professional Socialization of Medical Students Copyright c 2016 HSST 252 likely they displayed leadership. More junior students, on the other hand, showed qualities of compassion, peer support and willingness to serve others. We expect that the findings of our study will help identify pressing issues and needs in facilitating specialization of medical students. In turn, it is hoped that a curriculum can be developed through which students are able to find their special skills at an opportune moment.

Formation des externes à l’examen gynécologique : intérêt de l’enseignement sur modèles anatomiques

To evaluate the benefits of training sessions for pelvic examination using anatomic models. The medical students (MS) registered in their 5th year of medical studies at Angers University Hospital had to complete two anonymous questionnaires; one at the beginning of the workshop and one at the end. Every procedure which included pelvic exam (PE), vaginal sample (VS), smear test (ST), insertion of a speculum and insertion of intra-uterine device (IUD) was evaluated. Seventy-one MS answered both questionnaires. They were very satisfied or satisfied with the outcomes of the workshop in 91% of the cases. At the beginning of the workshop, 28%, 52%, 30%, 25% and 3% reported a low level of difficulty to carry out, respectively, a PE, VS, ST, insertion of a speculum, insertion of an IUD. At the end of the session, there were respectively 55%, 83%, 76%, 66% and 16% of MS to report a low level of difficulty of these same procedures. For all of these procedures, there were a significant (P<0.05) number of MS who estimated the procedure's level of difficulty as being low at the end of the session. The level of technical difficulty of all procedures was significantly decreased at the end of the workshop.

Peer-led Stress Prevention Seminars in the First Year of Medical School--A Project Report.

Introduction: From the beginning of the first year of medical studies, increased psychological stress and elevated burnout prevalence rates can be registered compared to sample populations. Characterized by learning “on an equal footing”, the principle of peer-assisted learning (PAL) is widely used in medical education. This report aims to showcase the development and evaluation of peer-led stress prevention seminars for first year medical students after one year of implementation.Project description: With each of the three sessions lasting 90 min., the stress prevention seminars took place in small groups (6-10 students) in the period from November 2013 to January 2014 and from November 2014 to December 2014 at the Medical Faculty of Heidelberg. Led by trained peers, the seminar content ranged from psycho-educational elements, i.e. time management strategy development and test anxiety assistance, to relaxation techniques. All seminar sessions were evaluated via questionnaire. All questions were answered on a Likert scale ranging from 1 to 7 (1=strongly agree; 7=strongly disagree).Results: 75 students consented to participate in seminars (65% female; aged 20.5±3.3 years). The series of seminars was averagely given the school grade of 1.2±0.4 (1=very good to 6=unsatisfactory) in WS 2013/14 and 1.5±0.5 in the following year and the peer tutors’ competence was evaluated as very high (1.4 to 1.5 approval rate on the Likert scale).Discussion: The seminar sessions’ importance to the students is underlined by their very positive evaluations. This offer seems to have benefited students especially during the demanding transitional phase at the start of their studies. Both the implementation of the preventive measure at an early stage as well as the use of PAL seem to have proven effective.Conclusion: PAL seems to be effective in the field of stress prevention. However, specific efficacy studies are still lacking.

Épreuves informatisées de type ECNi : retour d’expérience sur un test multiuniversité

BackgroundThe year 2016 will be pivotal for the evaluation of French medical students with the introduction of the first computerized National Ranking Test (ECNi). The SIDES, online electronic system for medical student evaluation, was created for this purpose. All the universities have already organized faculty exams but few a joint computerized ranking test at several universities simultaneously. We report our experience on the organization of a mock ECNi by universities Paris Descartes, Paris Diderot and Paris 13. MethodsDocimological, administrative and technical working groups were created to organize this ECNi. Students in their fifth year of medical studies, who will be the first students to sit for the official ECNi in 2016, were invited to attend this mock exam that represented more than 50% of what will be proposed in 2016. A final electronic questionnaire allowed a docimological and organizational evaluation by students. An analysis of ratings and rankings and their distribution on a 1000-point scale were performed. ResultsSixty-four percent of enrolled students (i.e., 654) attended the three half-day exams. No difference in total score and ranking between the three universities was observed. Students’ feedback was extremely positive. Normalized over 1000 points, 99% of students were scored on 300 points only. Progressive clinical cases were the most discriminating test. ConclusionThe organization of a mock ECNi involving multiple universities was a docimological and technical success but required an important administrative, technical and teaching investment.

Medical Students’ Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey

There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.

Perception regarding AYUSH and integrative medicine among medical undergraduate students: a cross-sectional study

Background: Promotion of AYUSH by government of India and the increasing utilization of AYUSH concurrently with allopathic medicine by patient population can lead to unfavourable outcomes. Sensitising medical students to AYUSH will equip them in better management of patients. The objective of this study was to determine the prevalence of AYUSH use among medical students and their perception regarding AYUSH and its possible integration in medical curriculum.Methods: A Questionnaire based study was conducted on 450 medical undergraduate students of Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India from March 2015 to April 2015. Data obtained was analysed and presented as counts and percentages.Results: Among the 380 respondents, it was found that 96 (25.2%) students utilized AYUSH therapies; the most common indication for using them was for allergic disorders. Only 10% of the students believed that it caused less adverse effects. AYUSH utilization significantly increased in final year of medical studies. 71% of the students believed that AYUSH was useful; however they felt that scientifically unproven AYUSH therapies should be discouraged. 60% of the students opined that integrated medicine is a better approach than using either system alone. Among 266 (70%) students interested in learning AYUSH, 151 (40%) students favoured AYUSH integration in medical curriculum as an elective subject.Conclusions: Medical student’s perception towards AYUSH and integrative medicine is positive. Students were in favour of learning AYUSH as an elective subject in medical curriculum.

Aspectos académicos del internado

En resumen podemos concluir: 1.- En general, según los últimos seminarios de Educación Médica, el Internado actual cumple a medias, con los objetivos establecidos, por las recomendaciones de Seminarios Nacionales e Internacionales. 2.- Teniendo en cuenta las necesidades de la comunidad y los recursos del país, es de recomendar, que los comités encargados de revisar los programas de estudios en los distintos Programas de Ciencias Médicas del país, contemplar la posibilidad de suprimirlo, o de imprimirle cambios sustanciales, ya que como se viene realizando proporciona sólo una visión reducida de las situaciones con las cuales el futuro médico tendrá que enfrentarse con el ejercicio de su profesión. 3.-La supervisión del trabajo de los Internos en los hospitales docentes encuentra poca objeción. En cambio en otros tipos de hospitales deja mucho que desear debido a que no están cumpliendo los requisitos mínimos exigidos por la Comisión Intersectorial; precisamente por no contar ésta con mecanismos adecuados y operantes para su evaluación y supervisión. Como contribución a que los requisitos establecidos tengan pleno cumplimiento es de esperar que dichos hospitales se adscriban o afilien a los Programas de Ciencias Médicas, de su respectiva influencia. Esto entre otras cosas, mejora el nivel científico de los hospitales no universitarios. 4.- La participación de los Internos en Servicios comunitarios se acepta como una necesidad que debe estimularse, teniendo en cuenta las múltiples posibilidades existentes. En relación con las áreas en las cuales puede llevarse a cabo esta participación, las más recomendables son aquellas que por su ubicación geográfica, permitan una adecuada supervisión. 5.- Se deja claramente establecido que el Internado, por ser obligatorio, no debe ser aprovechado para solucionar la prestación de servicios asistenciales, y 6.- Que el Interno es un alumno del último año de estudios médicos, y, por lo tanto, no puede ser asalariado de ninguna institución hospitalaria. Esto sin embargo, no es un impedimento para que reciba un auxilio económico (no a título de sueldo sino de beca o ayuda pecuniaria) etc., de su propio Programa de Ciencias Médicas o del Hospital respectivo. Para evitar que la cuantía económica se convierta en un incentivo que desvíe al estudiante del interés puramente académico, se recomienda la unificación de dicha asignación a nivel nacional.

Perception of Palliative Care among Medical Students in a Teaching Hospital

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. Palliative care must be a part of every medical personnel's practice. But still medical education curriculums have not included palliative care in its syllabus, sufficiently due to which most of the health professional are not aware about this specialty. The purpose of this study is to find out the perception of the medical students in palliative care in a teaching hospital. A descriptive study was done among 270 undergraduate medical students studying in Institute of Medicine using a self structured pretested questionnaire. Data was entered in Microsoft Excel and analyzed by using SPSS 21. Of the total 270 undergraduate medical students only 152 has heard the word "palliative care". Only 84 students know, palliative care can be provided early in the life threatening illness. Total 80 students know it doesn't intend to postpone and hasten death. Though only 49 students didn't know PC is not included in our curriculum, 227 are interested to learn about it if given any opportunity. The perception of palliative care medicine is low in first couple of year of medical study. It is increased in clinically exposed students but is surprisingly more in fourth year than final year undergraduate medical students. However, it should be included in undergraduate medical study.

Technical Knowledge, Prosocial Knowledge, and Clinical Performance of Indian Medical Students

We cross‐culturally replicated and extended findings reported by Kell, Motowidlo, Martin, Stotts, and Moreno that technical knowledge and prosocial knowledge have independent effects on performance. In a sample of 196 Indian medical students, we found that prosocial knowledge explains variance in students' clinical performance beyond the variance explained by technical knowledge and technical knowledge explains variance in clinical performance beyond the variance explained by prosocial knowledge. Contrary to findings that American medical students' prosocial inclinations, as reflected in measures of empathy, seem to decline over the course of their medical training (e.g., Hojat, Vergare, Maxwell, Brainard, Herrine, and Isenberg), we found that Indian medical students' prosocial knowledge steadily increased from their third to fifth years of medical study.

Student Opinions on Factors Influencing Tutorials at Walter Sisulu University, South Africa.

INTRODUCTION Problem-based learning harmonized with education in and for the community is the cornerstone of the curriculum for the undergraduate medical degree at Walter Sisulu University, Mthatha, South Africa. In tutorials, students construct knowledge and learn to work collaboratively while interacting with one another in their search for solutions to a pedagogically modeled health issue based on a patient. Problems cover students' needs defined by the learning cycle of the second year medical curriculum, organized into four learning blocks. OBJECTIVES Determine student perspectives on which factors affect tutorial group functioning and detect the reported presence of these factors in the four learning blocks comprising the second year of medical studies at Walter Sisulu University. METHODS Twenty second-year medical students were chosen by stratified random sampling and assigned to two focus groups. One group discussed factors that foster smooth functioning of the tutorial group; the other focused on factors hindering effective group work. Later, in a joint session, 17 items previously identified by both groups were selected and included in a survey given to all 97 students at the end of second year. The survey assessed presence of each item in 0, 1, 2, 3 or 4 of the learning blocks. RESULTS Survey response was 93.8%. Mean reported presence of factors that influenced tutorials in the four learning blocks was 2.71 (SD 0.31) for the social dimension, 3.02 for motivational (SD 0.02), 3.00 for cognitive (SD 0.42), and 2.22 for self-directed learning (SD 0.79). CONCLUSIONS Tutorial group performance at Walter Sisulu University is positively influenced more by motivational and cognitive factors than by social and self-directed learning factors. Social dimensions should be prioritized when training tutors and self-directed learning stressed for students. The poor productivity of extra-tutorial group discussions suggests the need for a critical evaluation of this activity. KEYWORDS Problem-based learning, problem-based curriculum, active learning, medical education, tutorial groups, South Africa.

Numerus clausus et démographie médicale en France

In France, the number of students admitted to the second year of medical studies is limited (numerus clausus) by law. In 1971 this limit was first based according to hospital training capacity and subsequently 1979 it has been based on demographic trends. An objective of 250 physicians per 100 000 inhabitants seemed reasonable and required 6 000 students to be trained each year. In 1979, it was decided to restrict the number of students temporarily because of a likely demographic slump after the year 2000. These steps were introduced progressively, in order not to unfairly treat a particular student class. The numerus clausus is also modulated geographically to take into account differences in medical density, as most students set up in the region where they did their medical studies. It is logical to practice preselection for admission to medical school, yet in France every baccalaureat holder can enrol any medical school, and students are totally opposed to preselection. This is why selection takes place at the end of the first year. In the late 1980s, the numerus clausus should have been increased by the health and education ministries, but this was in fact done only ten years later. Estimates of medical demography are complicated by three factors. First, many physicians from European Union member states (mainly Belgium and Romania) practice in France. Second, some students not admitted to the second year of medical studies go to learn medicine in aforeign country before returning to sit the French national examination at the end of the sixth year. Third, public hospitals hire foreign physicians from outside the EU (mainly Algeria and Morocco), who then stay in France permanently. Thus, EU-level decisions are needed to harmonize the medical numerus clausus across member states. The hiring of physicians from non EU countries by French hospitals should be more tightly controlled.

(265) Perception of palliative care among medical students in a teaching hospital

Palliative care is an approach that improves the quality of life of patients and families facing the problem associated with life-threatening illness. Palliative care must be the part of every medical personnel's practice. But still medical education curriculums have not included palliative care in its syllabus, sufficiently due to which must of the health professional are not aware about this specialty. The propose of this study is to find out the perception of medical students in palliative care in a teaching hospital.A descriptive study was done among 270 undergraduate medical students studying in Institute of Medicine (IOM) using a self-structured pretested questionnaire. Data were entered in Microsoft Excel and analysed by using SPSS 21. Of the total 270 undergraduate medical students, only 152 has heard the word "palliative care". The perception of palliative care is 6.11%, 8.2%, 42.35%, 64.42%, 50.75% respectively from first year to final year. 210 (77.78%) don't know if palliative care is included in curriculum of IOM. However 227 are interested to learn about palliative care if they got any opportunity. The perception of palliative care is low in first couple of year of medical study. It is increased in clinically exposed students but is surprisingly more in fourth year than final year undergraduate medical students. However, it should be included in undergraduate medical study. Palliative care is an approach that improves the quality of life of patients and families facing the problem associated with life-threatening illness. Palliative care must be the part of every medical personnel's practice. But still medical education curriculums have not included palliative care in its syllabus, sufficiently due to which must of the health professional are not aware about this specialty. The propose of this study is to find out the perception of medical students in palliative care in a teaching hospital.A descriptive study was done among 270 undergraduate medical students studying in Institute of Medicine (IOM) using a self-structured pretested questionnaire. Data were entered in Microsoft Excel and analysed by using SPSS 21. Of the total 270 undergraduate medical students, only 152 has heard the word "palliative care". The perception of palliative care is 6.11%, 8.2%, 42.35%, 64.42%, 50.75% respectively from first year to final year. 210 (77.78%) don't know if palliative care is included in curriculum of IOM. However 227 are interested to learn about palliative care if they got any opportunity. The perception of palliative care is low in first couple of year of medical study. It is increased in clinically exposed students but is surprisingly more in fourth year than final year undergraduate medical students. However, it should be included in undergraduate medical study.

Encouraging an environment to nurture lifelong learning: An Asian experience

Introduction: Within an Asian context, this study examines the effect of changing from traditional course grades to a distinction/pass/fail (D/P/F) grading system on medical student self-perceived stress levels and on student exam performance.Methods: At the end of the 2010–2011 academic year, the Perceived Stress Scale-10 (PSS-10) was administered to the cohort of students finishing their first year of medical studies. For the academic year 2011–2012, the grading system was changed to D/P/F for the first year of medical school. The PSS-10 was also administered to the subsequent cohort of first-year medical students at the same point in the academic year as previous. Qualitative comments were collected for both cohorts.Results: Stress as measured by the PSS-10 was significantly lower in the cohort that went through the year with the D/P/F grading system in place. Thematic analysis of qualitative responses showed a shift in sources of student stress away from peer-competition. There were no significant differences in overall exam performance.Discussion: Within an Asian context, switching to a D/P/F grading system can alleviate stress and peer competition without compromising knowledge. This may help foster a “learning orientation” rather than an “exam orientation,” and contribute to inculcating lifelong learning skills.

Effect of diagnostic labeling and causal explanations on medical students' views about treatments for psychosis and the need to share information with service users

This study examines whether medical students' views of treatments for ‘schizophrenia’ and of patients' rights to be informed about their condition and their medication were influenced by diagnostic labeling and causal explanations and whether they differed over medical training. Three hundred and eighty-one Italian students attending their first or fifth/sixth year of medical studies read a vignette portraying someone who met diagnostic criteria for ‘schizophrenia’ and completed a self-report questionnaire. The study found that labeling the case as ‘schizophrenia’ and naming heredity among its causes were associated with confidence in psychiatrists and psychiatric drugs. Naming psychological traumas among the causes was associated with confidence in psychologists and greater acknowledgment of users' right to be informed about drugs. Compared to first year students, those at their fifth/sixth-year of studies more strongly endorsed drugs, had less confidence in psychologists and family support, and were less keen to share information on drugs with patients. These findings highlight that students' beliefs vary during training and are significantly related to diagnostic labeling and belief in a biogenetic causal model. Psychiatric curricula for medical students should include greater integration of psychological and medical aspects in clinical management of ‘schizophrenia’; more information on the psychosocial causes of mental health problems.

Physician and nurse supply in Serbia using time-series data.

BackgroundUnemployment among health professionals in Serbia has risen in the recent past and continues to increase. This highlights the need to understand how to change policies to meet real and projected needs. This study identified variables that were significantly related to physician and nurse employment rates in the public healthcare sector in Serbia from 1961 to 2008 and used these to develop parameters to model physician and nurse supply in the public healthcare sector through to 2015.MethodsThe relationships among six variables used for planning physician and nurse employment in public healthcare sector in Serbia were identified for two periods: 1961 to 1982 and 1983 to 2008. Those variables included: the annual total national population; gross domestic product adjusted to 1994 prices; inpatient care discharges; outpatient care visits; students enrolled in the first year of medical studies at public universities; and the annual number of graduated physicians. Based on historic trends, physician supply and nurse supply in the public healthcare sector by 2015 (with corresponding 95% confidence level) have been modeled using Autoregressive Integrated Moving Average (ARIMA) / Transfer function (TF) models.ResultsThe ARIMA/TF modeling yielded stable and significant forecasts of physician supply (stationary R2 squared = 0.71) and nurse supply (stationary R2 squared = 0.92) in the public healthcare sector in Serbia through to 2015. The most significant predictors for physician employment were the population and GDP. The supply of nursing staff was, in turn, related to the number of physicians. Physician and nurse rates per 100,000 population increased by 13%. The model predicts a seven-year mismatch between the supply of graduates and vacancies in the public healthcare sector is forecasted at 8,698 physicians - a net surplus.ConclusionThe ARIMA model can be used to project trends, especially those that identify significant mismatches between forecasted supply of physicians and vacancies and can be used to guide decision-making for enrollment planning for the medical schools in Serbia. Serbia needs an inter-sectoral strategy for HRH development that is more coherent with healthcare objectives and more accountable in terms of professional mobility.

Factors Influencing Lebanese Medical Students' Decisions to Train Abroad: Evaluation of a Conceptual Framework

Objective: To evaluate a conceptual framework portraying the factors underlying the intentions of medical stu- dents to train abroad. Methods: Eligible subjects were students in the pre-final and final years of medical studies in Lebanon. A survey ques- tionnaire based on the conceptual framework inquired about demographic and educational characteristics, influencing fac- tors, and intentions to train abroad. We assessed each of the factors for its frequency, distribution, and association with the intention to train abroad. Results: Of 576 eligible students, 425 (74%) participated. The frequency of the framework factors varied from 16% to 94% and was the highest for factors related to training and professional career. The factors independently associated with the intention to train abroad related to residency training, concern with professional career and political conditions. The intention to train abroad was also associated with thinking that the general public considers doctors trained abroad as more qualified (OR=6.3; 95% CI=1.2-33.2); receiving information about abroad training from doctors trained or training abroad (OR= 9.7; 95% CI=1.7-56.6); having relatives or friends living abroad (OR=6.9; 95% CI=1.4-35.7); and witnessing resi- dents traveling to retrain abroad (OR=22.2; 95% CI=4.5-111.1).

Implementation of the interdisciplinary curriculum Teaching and Assessing Communicative Competence in the fourth academic year of medical studies (CoMeD).

Introduction: Implementation of a longitudinal curriculum for training in advanced communications skills represents an unmet need in most German medical faculties, especially in the 4rth and 5th years of medical studies. The CoMeD project (communication in medical education Düsseldorf) attempted to establish an interdisciplinary program to teach and to assess communicative competence in the 4th academic year. In this paper, we describe the development of the project and report results of its evaluation by medical students.Methods: Teaching objectives and lesson formats were developed in a multistage process. A teaching program for simulated patients (SP) was built up and continuous lecturer trainings were estabilshed. Several clinical disciplines co-operated for the purpose of integrating the communication training into the pre-existing clinical teaching curriculum. The CoMeD project was evaluated using feedback-forms after each course.Results: Until now, six training units for especially challenging communication tasks like “dealing with aggression” or “breaking bad news” were implemented, each unit connected with a preliminary tutorial or e-learning course. An OSCE (objective structured clinical examination) with 4 stations was introduced. The students’ evaluation of the six CoMeD training units showed the top or second-best rating in more than 80% of the answers. Discussion: Introducing an interdisciplinary communication training and a corresponding OSCE into the 4th year medical curriculum is feasible. Embedding communication teaching in a clinical context and involvement of clinicians as lecturers seem to be important factors for ensuring practical relevance and achieving high acceptance by medical students.

Factors affecting the performance of undergraduate medical students: A perspective

Context:Performance of medical students in developing nations like India is perceived to have largely declined.Aims:We attempted to assess the reasons behind such trends.Settings and Design:Students in their third year of medical study were given a predesigned, pretested structured and validated questionnaire that they filled in anonymously. The key areas assessed were concentration, interest and understanding of the subject and other perceived causes of poor performance. Tests for descriptive statistics were applied for evaluation.Results and Conclusions:One hundred and fifty students participated in the study. Fifty-five (36.66%) students performed poorly. Male gender, inability to clear the previous professional examination at the first attempt, difficulty in understanding medium of instruction, self-assessed depression, sleep disorders and perceived parental and peer pressure and dissatisfaction with career choice were significantly linked with poor performance (P<0.05 for each factor). Socioeconomic status and regularity in class were not linked to academic performance.