Involving Medical Students in Providing Patient Education for Real Patients: A Scoping Review

Rho-Kinase Inhibitors as Emerging Targets for Glaucoma Therapy

Glaucoma, the leading cause of irreversible blindness worldwide, is a chronic and progressive optic neuropathy characterized by damage to the optic and retinal nerve fiber layers, which can lead to permanent loss of peripheral or central vision. Reduction of intraocular pressure (IOP) is the only known modifiable risk factor for preventing and treating glaucoma. Rho kinase (ROCK) inhibitors are a new class of glaucoma drugs with a novel mechanism of action and good safety profile. They exert neuroprotective effects, act on the trabecular tissue, increase the outflow of aqueous humor, and reduce intraocular pressure. However, they also cause local adverse reactions, including common conjunctival congestion and subconjunctival bleeding; however, most are self-limiting and temporary. Netarsudil (0.02%), a ROCK inhibitor, relaxes the trabecular meshwork, increases the outflow of aqueous humor, reduces scleral venous pressure, and directly decreases IOP. Conjunctival congestion can be reduced if netarsudil is administered at night. The combination of these medications is always more effective than the single drug. Ripasudil (0.4%), another ROCK inhibitor, also lowers IOP; however, conjunctival hyperemia is the most common adverse drug reaction. The purpose of this review is to summarize the effects and adverse reactions of ROCK inhibitors in the experimental trial stage and in clinical treatment in recent years, providing suggestions for future clinical drug use, and research and development to reduce the side effects of these drugs, maximize the potential for reducing IOP, and improve the therapeutic effect.

Influencing factors of sense of responsibility among undergraduate nursing students: A cross-sectional study

BACKGROUND

Nursing students are critical in responding to public health emergencies like the COVID-19 pandemic. Their ability to fulfill their responsibilities is influenced by their sense of responsibility, which holds profound cultural significance, particularly in traditional Chinese culture. However, limited research has specifically explored the sense of responsibility among undergraduate nursing students in China and globally.

OBJECTIVES

This study aimed to determine the sense of responsibility among undergraduate nursing students and identify potential factors associated with it.

DESIGN, SETTING & PARTICIPANTS

We conducted a cross-sectional study and recruited 526 nursing students from June to July 2022 in Guizhou province in southwest China.

METHODS

Participants completed the General Information Questionnaire, Sense of Responsibility, and Self-esteem Scale. We analyzed the relationship between a sense of responsibility and self-esteem using Spearman correlation analysis. Then we determined factors that affect undergraduate nursing students' sense of responsibility using multiple linear stepwise regression.

RESULTS

Nursing students' total sense of responsibility scores were 96(84,106). The study found a positive association between self-esteem and a sense of responsibility (r = 0.433, P < 0.001) and its four dimensions: altruism (r = 0.381, P < 0.001), self-control (r = 0.378, P < 0.001), courage (r = 0.300, p < 0.001), and commitment (r = 0.361, P < 0.001). Self-esteem (β = 1.532, p < 0.001), personality (extroverted personality β = 7.263, P < 0.001; neutral personality β = 3.221, P = 0.029), and social practice experience (β = -3.156, P = 0.010) significantly influenced undergraduate nursing students' sense of responsibility (R2 = 0.268, F = 17.065, P < 0.001).

CONCLUSIONS

The study highlights the importance of nursing students' sense of responsibility and suggests room for improvement in its level. Higher self-esteem was associated with a stronger sense of responsibility. Additionally, self-esteem, personality, and social practice experience emerged as significant influencing factors. Nursing educators should prioritize students' sense of responsibility and explore targeted interventions, such as social practice activities, particularly for students with low self-esteem and introversion.

How Are We Doing? A Scoping Review of Published Patient-Centered Outcomes Research in United States Student-Run Free Clinics

Phenomenon: Student-run free clinics (SRFCs) serve an integral role in most United States (US) medical schools and contribute substantially to literature on the quality of care to uninsured persons. There has been substantial growth over the past decade of scholarly work produced by SRFCs as they have increased in size and number. Research on patient care outcomes informs better care structures for patients, however there is no current synthesis of patient care outcomes research among SRFCs. This article provides an overview of SRFC research on patient outcomes to understand current research domains and to identify gaps in the literature. Approach: We completed a scoping review by searching Scopus, PubMed, and Journal of Student Run Clinics in June 2021. All peer-reviewed, English-language articles focused on patient-centered outcomes at SRFCs in the US were included. Two independent reviewers performed title, abstract, and full-text screening of relevant works, and eight reviewers conducted data extraction. Descriptive data analysis was performed along with relevant content analysis of patient-centered outcomes. Findings: The search strategy identified 784 studies, of which 87 met inclusion criteria. Most studies were published within the last six years (81.6%), located in California, New York, or Florida (43.7%), and intervention based (33.3%). Many studies (46.0%) had a specific disease of focus of which diabetes was the most researched(19.5%). Patient-centered studies were the leading focus of the study aims (40.2%), where key findings demonstrated primarily improved outcomes in clinic metrics post-intervention (36.8%) or equivalent/better clinical performance than national metrics (20.7%). Insights: This review brings to light gaps in the literature reporting research in SRFCs and can be applied to other low-resource settings. Future efforts to expand SRFC outcomes research should focus on community relationship building, understanding institutional support, and ensuring education on best practices for research within SRFCs. Doing so informs patient care improvement as SRFCs continue to operate as safety net clinics for marginalized populations.

"They were an advocate for me": A Qualitative Study Exploring Medical Student Longitudinal Relationships and Patient Well-Being

BACKGROUND

Patient navigators, community health workers, and care management teams improve patient experience and health outcomes. Medical student involvement in these roles is limited. Evaluation of these programs focuses on the student experience with less attention to patient participants.

OBJECTIVES

We sought (1) to understand the experience of being a participant in a medical education program; (2) to explore the patient-medical student relationship; and (3) to describe the impact of this relationship on patient health and well-being.

DESIGN

This was a qualitative study that utilized in-depth semi-structured interviews.

PARTICIPANTS

Participants were selected based on enrollment in a preceptorship program at an urban academic medical center between 2017 and 2020. Participants worked with a medical student during an 18-month period in which the medical student was embedded in a primary care medical home, serving as a health systems navigator for 1-2 medically and socially complex patients.

APPROACH

Nine participants completed 1-h compensated phone interviews. This study was deemed IRB exempt.

KEY RESULTS

Three themes and eight subthemes were identified, including Navigators Were Key to Accessing the System, Interpersonal Partnerships Improved Health, and Fulfillment in Teaching of Lived Experience. Navigators eased the burden of chronic illness by being a point of contact in the health system, which improved participants' overall experience. Participants also described the relationship as therapeutic, citing improvement and stability in both mental and physical health. Lastly, participants found meaning in chronic illness by teaching their students empathy.

CONCLUSIONS

Longitudinal patient-medical student relationships may provide stability and health benefits. These partnerships have the possibility of adding value to patients' healthcare experiences. This study complements current literature highlighting the value of these relationships for pre-clinical medical students. As such, additional opportunities for and additional research regarding the value of longitudinal patient connection should be incorporated in undergraduate medical education.

Assessing the current and desired levels of training and applied experiences in chronic disease prevention of students during medical school

INTRODUCTION

Chronic diseases account for approximately 70% of deaths in the U.S. annually. Though physicians are uniquely positioned to provide behavior change counseling for chronic disease prevention, they often lack the necessary training and self-efficacy. This study examined medical student interest in receiving chronic disease prevention training as a formal part of their education as part of an effort to enhance their ability to provide guidance to patients in the future.

METHODS

A 23-question, online survey was sent to all undergraduate medical students enrolled in a large medical education program. The survey assessed medical student interest in receiving training related to chronic disease prevention. Survey topics included student awareness of primary prevention programs, perceived importance of receiving training and applied experience in chronic disease prevention, and preferences for how and when to receive this training.

RESULTS

Of 793 eligible medical students, 432 completed the survey (54.5%). Overall, 92.4% of students reported receiving formal training in physical activity, public health, nutrition, obesity, smoking cessation, and chronic diseases was of "very high" or "high" importance. Despite this level of importance, students most frequently reported receiving no or 1-5 h of formal training in a number of topics, including physical activity (35.4% and 47.0%, respectively) and nutrition (16.9% and 56.3%, respectively). The level of importance given to public health training was significantly greater across degree type (p = 0.0001) and future specialty (p = 0.03) for MD/MPH students and those interested in primary care, respectively.

CONCLUSIONS

While medical students perceive chronic disease prevention as an important topic, most reported receiving little to no formal training. To address the growing prevalence of chronic disease across our society, programs schools should place greater emphasis on integrating training in physical activity, nutrition, and obesity-related content into the medical education curriculum.

Twelve tips for patient involvement in health professions education

Moving towards person-centered care, with equal partnership between healthcare professionals and patients, requires a solid role for the patient in the education of students and professionals. Patients can be involved as teachers, assessors, curriculum developers, and policy-makers. Yet, many of the initiatives with patients are isolated, small events for targeted groups and there is a lack of patient involvement at the institutional level. To support educators in involving patients, both at the institutional level and at single educational encounters, we offer twelve practical tips. This paper came about through an innovative collaboration between healthcare professionals, educators, teachers, and patients. These tips can be used as a tool to start or reinforce patient involvement in health professions education and provide guidance on how to make it a sustainable part of the curriculum. The article involves organizational conditions for success, tips for sustainable partnerships, ideas for curriculum design and proposes concrete teaching strategies. Finally, besides practical tips, we stress that involving patients in education is not business as usual, and paradoxically this needs to be acknowledged before it can become business as usual.

Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators

BACKGROUND

Amid concerns about the decline of empathy during the clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential alone cannot, however, guarantee the success of educational innovations to introduce empathy to the medical curriculum. This research aims to identify the barriers and facilitators of the implementation of a specific clinical initiative to enhance the empathy skills of clerks, namely the training of clerks to act as a 'MedGezel' or 'medical coach'.

METHOD

We conducted an explorative qualitative study based on interview data collected and analyzed using reflexive thematic analysis and the readiness for change theory. We conducted semi-structured interviews with relevant stakeholders in this particular qualitative study. Thematic analysis was based on open and axial coding using ATLAS.ti 9, which facilitated the emergence of common themes of interest and meaning for the study.

RESULTS

A total of 13 relevant stakeholders participated as interviewees in our study. The data was collected from April to June 2021. Our analysis generated 6 main themes which can provide insights into why the implementation of the MedGezel educational innovation failed so far. The following themes emerged: the case for change: why change?; practical necessity; leadership; management and resources; staff culture; and alignment with the corporate strategy.

DISCUSSION

The implementation failure can be partially explained as resulting from the personal attitudes and choices of participants, who struggled to reconcile a vision that they liked with side effects that they feared. While participants repeatedly mentioned management and leadership issues, these organizational issues seemed less important as they could be easily resolved in practice. What was more important and fatal for the initiative was its lack of alignment with staff culture, despite its alignment with corporate strategy.

CONCLUSION

This investigation into the barriers and facilitators influencing the implementation of the MedGezel program identified 6 explanatory themes, the most impactful one being staff culture.

Making knowledge clips with patients: What learning mechanisms are triggered in medical students?

OBJECTIVE

To prepare medical students for a rapidly changing healthcare landscape, where new means of communication emerge, innovative teaching methods are needed. We developed a project-based learning course in which medical students design audiovisual patient information in collaboration with patients and with students in Communication and Information Sciences (CIS). We studied what learning mechanisms are triggered in medical students by elements of a project-based-learning course.

METHODS

In this qualitative study, twelve sixth year medical students that participated in the course were individually interviewed. Data were analyzed according to the principles of qualitative template analysis.

RESULTS

We identified four learning mechanisms: Challenging assumptions about patients' information needs; Becoming aware of the origin of patients' information needs; Taking a patient's perspective; Analyzing language to adapt to patients' needs. These learning mechanisms were activated by making a knowledge clip, collaborating with patients, and collaborating with CIS students.

CONCLUSION

Collaborating with patients helped students to recognize and understand patients' perspectives. Working on a tangible product in partnership with patients and CIS students, triggered students to apply their understanding in conveying information back to patients.

PRACTICE IMPLICATION

Based on our findings we encourage educators to involve patients as collaborators in authentic assignments for students so they can apply what they learned from taking patients' perspectives.

Building the foundation of health-related knowledge via near-peer education for children with sickle cell disease

Health education for children with chronic illnesses (i.e., sickle cell disease [SCD]) has focused on educating adult caregivers with minimal consideration to educating the pediatric patients. We introduce a pediatric-focused educational paradigm, health-related knowledge (HRK), teaching pediatric patients developmentally appropriate general health literacy, and disease-specific knowledge. Using science, technology, engineering, and mathematics (STEM) education concepts, pediatric-specific HRK interactive activities address educational gaps: (a) general STEM education; and (b) general health and disease-specific knowledge to improve clinical outcomes. Total 144 pediatric SCD patients completed HRK activities, revealing overwhelmingly positive feedback (87%). Seventy-five percent of participants in 6th grade and above demonstrated thorough understanding of the STEM/HRK topics taught.

Enhancing the learning and transfer of preprocedural communication skills during clerkship using audio-visual material: a prospective case-controlled study over 2 years

OBJECTIVE/DESIGN/SETTING

This study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module.

TRAINEES

Between October 2018 and July 2021, 96 medical clerks were enrolled and randomly divided into regular and intervention groups. Another 48 trainees whose did not join the framework-based training but complete self-assessments were enrolled as the control group.

INTERVENTIONS

In the intervention training module, the key steps of preprocedural communication-specific skills were structuralised into a framework using the acronym of OSCAR.

PRIMARY AND SECONDARY OUTCOME MEASURES

This study compared the acceptability of trainees for two modules by measuring the degree of increase in the end-of-rotation and follow up (4 weeks later) competency from baseline by trainees' self-assessments and physician assessments after serial trainings.

RESULTS

In comparison with regular group trainees, greater degree of improvements (framework-1 statement: 111%±13% vs 27%±5%, p<0.001; framework-2 statement: 77%±9% vs 48%±2%, p<0.05; skill-1 statement: 105%±9% vs 48%±3%, p<0.001); skill-2 statement: 71%±11% vs 50%±9%, p<0.05) were noted in the framework-related and skill-related statement 1-2 (the familiarity and confidence to use the framework and skills) than those of intervention group. At the end-of-rotation stage, the trainees ability to use the 'A-step: using audiovisual materials' of the OSCAR was significantly improved (229%±13%, p<0.001), compared with other steps. In the intervention group, the degree of improvement of the end-of-rotation data of trainees' self-assessment from baseline was significantly correlated with the degree of the improvement in physicians' assessment data in the aspects of skills, framework and steps in framework (R=0.872, p<0.01; R=0.813, p<0.001; R=0.914, p<0.001).

CONCLUSIONS

The OSCAR framework-based intervention module is well accepted by medical clerks and motivates them to integrate the acquired skills in clinical practice, which leads to trainees' primary care patients being satisfied with their preprocedural communication.

Digital Tools in Behavior Change Support Education in Health and Other Students: A Systematic Review

Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students’ knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.

Medical Education and the Ethics of Self-Care: A Survey of Medical Students Regarding Professional Challenges and Expectations for Living Healthy Lifestyles

OBJECTIVES

Little is known about medical students' attitudes regarding the healthy lifestyle habits they are taught to recommend to patients and whether they believe they have a professional responsibility to live a healthy lifestyle. Understanding students' attitudes and practices regarding healthy lifestyles may provide insights into the personal and professional challenges that students face as they navigate the ethical tension between obligations to care for others (altruism) and for themselves (self-care).

METHODS

The authors conducted a cross-sectional, anonymous, online survey of all medical students at the University of Iowa Carver College of Medicine in fall 2019, using descriptive statistics for analysis.

RESULTS

A total of 351 students participated (response rate, 52.0%). Most agreed that physicians (85.5%) and medical students (77.8%) have a responsibility to try to live a healthy lifestyle; that physicians who practice healthy behaviors are more confident in counseling patients (94.0%), more likely to counsel patients (88.3%), and more likely to have their advice followed (86.9%); that as students they are more likely to counsel patients if they practice the healthy behavior (90.0%); and that their medical school workload resulted in exercise (69.7%), sleeping (69.4%), and eating (60.2%) practices that were less healthy than they should be.

CONCLUSIONS

Most medical students support the professional responsibility to live a healthy lifestyle and believe doing so increases their effectiveness in counseling patients about healthy lifestyle habits. The medical school workload may limit some students' ability to live healthy lifestyles, however. Medical students need educational opportunities in ethics and professionalism to discuss challenges and expectations for living healthy lifestyles, with an eye toward practical approaches to living the life of a medical student that are professionally responsible and personally realistic.

The impact of longitudinal integrated clerkships on patient care: a qualitative systematic review

BACKGROUND

Longitudinal Integrated Clerkships (LIC) are a relatively novel type of clinical placement model within medical education, particularly within the UK. The research on LICs primarily focuses on the impact of the model on students, tutors, communities, and organisations. The impact of LICs on patients has not yet been adequately synthesised. This systematic review aims to fill this gap by examining empirical evidence regarding the impact of LICs on patient care using quality-of-care measures, namely, health process measures and outcome measures.

METHODS

A systematic search was conducted in MEDLINE, PsycINFO, Academic Search Premier, Education Research Complete, CINAHL Complete, ERIC, Web of Science, and Scopus. Two reviewers independently conducted the screening process for study selection. Results across studies were analysed and summarised by thematic analysis.

RESULTS

The reviewers screened 1632 records. Seven studies met the inclusion criteria following a full-text review, from which four themes were created. Three themes describe health process measures, including: 1) Advocacy within healthcare system, 2) Provision of supplementary and personalised care, and 3) Providing companionship with care. One theme described a health outcome measure: Therapeutic Alliance.

CONCLUSION

Current evidence demonstrates an overall beneficial impact of LICs on patient health processes and outcome measures. However, the available evidence is weak and limited. Further research is required to illuminate the true impact of LICs on patient health.

Using the health belief model to assess the impact of student pharmacist-led health outreach events

INTRODUCTION

This study sought to assess the impact student pharmacist-led health outreach events had on participants in the Health Belief Model domains of perceived severity of disease, perceived barriers, perceived benefits, and self-efficacy.

METHODS

This study was an observational pre-/post-survey design conducted between January and December 2019 at student pharmacist-led community health outreach events in the Salt Lake City, Utah metropolitan area. The survey was developed partially based on the Health Belief Model and consisted of seven items with a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). The survey was completed by participants before and immediately after engaging in the outreach event.

RESULTS

A total of 31 participants across a variety of demographics and educational backgrounds completed the study. The surveys from the outreach events showed statistically significant increases in the participants' perceived severity of disease, perceived barriers, and self-efficacy. Perceived benefits was not significantly changed.

CONCLUSIONS

Student pharmacist-led community health outreach events significantly increase participants' perceived severity of disease, perceived barriers, and self-efficacy, which may indicate increased willingness to adopt the recommended health behavior.

Early longitudinal experiences increase medical student self-efficacy

This article was migrated. The article was marked as recommended. Background: The purpose of this study was to investigate the impact of early longitudinal preceptorship experiences on the evolution of general self-efficacy and patient-centeredness self-efficacy through medical school. Methods:Validated surveys for general self-efficacy and patient-centeredness self-efficacy were administered in an allopathic medical school at three timepoints. These data were stratified by traditional and longitudinal preceptorship groups and analyzed using Generalized Estimating Equations. Qualitative analysis of narrative medicine essays by the same cohort during their preceptorship experiences was also performed. Results: While general self-efficacy remained largely unchanged over time, patient-centeredness self-efficacy measures increased throughout medical school in the whole cohort (N=157). The longitudinal preceptorship group had higher gains in patient-centeredness self-efficacy, especially in the domain of exploring patient perspectives (p<0.05). The qualitative analysis of narrative medicine essays showed those in longitudinal preceptorships were more likely to discuss health care systems issues, consider psychosocial factors, and perceive themselves as active members of the care team. Discussion:Our study indicates greater patient-centeredness attitudes over time among students who have early longitudinal experiences, perhaps due to the self-efficacy building nature of these experiences. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students.

Women Leading Healthy Change: A Reciprocal Learning Experience for Women in the Sex Trade and Medical Students

INTRODUCTION

Service learning can teach medical students about the social determinants of health and prepare them to better serve marginalized populations, while people in the sex trade can serve as effective educators for their peers and health professions trainees. However, service-learning projects involving medical students and people in the sex trade are currently rare.

METHODS

We modified a curriculum from an author's prior institution to provide a unique service-learning experience for medical students and peer health education for women in the sex trade in a new city and new context. Medical students partnered with a local community organization to implement a 10-week course on physical and mental health for women in the sex trade. Coled by a medical student and a woman who had utilized the community partner's services, the course's instructional methods included in-class demonstrations, group discussion, games, and worksheets.

RESULTS

Ten women participated in the course, and six medical students facilitated its implementation. The participants demonstrated increased knowledge in physical and mental health topics and reported being more comfortable speaking with health care providers. The coleaders developed skills and confidence to pursue additional leadership opportunities. The medical student coleader gained a better understanding of addiction and was more prepared to work with patients with substance use disorders.

DISCUSSION

This mutual learning experience was a valuable health education opportunity for a local underserved community and helped medical students understand the barriers women in the sex trade face when seeking health care and how physicians can better meet their needs.

Teaching with Disruptive Technology: The Use of Augmented, Virtual, and Mixed Reality (HoloLens) for Disease Education

Modern technologies are often utilised in schools or universities with a variety of educational goals in mind. Of particular interest is the enhanced interactivity and engagement offered by mixed reality devices such as the HoloLens, as well as the ability to explore anatomical models of disease using augmented and virtual realities. As the students are required to learn an ever-increasing number of diseases within a university health science or medical degree, it is crucial to consider which technologies provide value to educators and students. This chapter explores the opportunities for using modern disruptive technologies to teach a curriculum surrounding disease. For relevant examples, a focus will be placed on asthma as a respiratory disease which is increasing in prevalence, and stroke as a neurological and cardiovascular disease. The complexities of creating effective educational curricula around these diseases will be explored, along with the benefits of using augmented reality and mixed reality as viable teaching technologies in a range of use cases.

Developing health promotional skills among medical undergraduates for tuberculosis patients: An innovative way to benefit students as well as patients

BACKGROUND

Involving medical undergraduate students in patients' health education will not only help in improving students' learning as well as professional and communication skills but also plays an important role in achieving better health outcome of patients. The aim of the study was to assess the impact of students led educational intervention regarding tuberculosis (TB) on their learning and on the patients' knowledge and attitude towards the disease.

MATERIALS AND METHODS

One hundred medical undergraduates were included in the study. An integrated lecture on TB was given to all participants followed by preintervention test on TB. One group was then subjected to interactive traditional lecture. Whereas the videos reflecting the experiences of TB patients were shown to the other group and was given an assignment to prepare educational leaflets for TB patients followed by postintervention test for both groups. The patients' satisfaction level with the information given via educational leaflet and the overall perceived benefits of this activity by the students were assessed. Data analysis done using SPSS version 23.0. Independent and paired t-test were used to calculate difference of means for quantitative variables.

RESULTS

Two groups were comparable preintervention however postintervention there was significant improvement in knowledge in the study group (P0.000). Overall 74.2% of the patients were satisfied with the information provided through leaflets. Students' feedback highlighted that majority of the them felt benefitted from this activity.

CONCLUSION

It can be concluded that such type of educational interventions have dual benefits, i.e., learning for the students as well as providing health education to patients which in turn will improve their clinical outcome.

Virtual reality informative aids increase residents' atrial fibrillation ablation procedures-related knowledge and patients' satisfaction

BACKGROUND

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and increasing numbers of patients receive AF ablation nowadays. Therefore, in the cardiology division, residents need to be familiar with the AF ablation procedure-related knowledge for primary care. This study evaluated the baseline residents and patients' self-efficacy to the AF ablation procedure-related knowledge, developed the specific virtual reality (VR) informative aids, and evaluated the effects of VR training and resident-led VR aids-based patient education on their self-efficacy, in the aspects of familiarity, confidence and anxiety, and satisfaction.

METHODS

From 2019, April to 2020, April, this 1-year prospective prestudy and poststudy was undergone in the cardiology division. Between 2019, April and 2019, December, the experienced physicians were invited to develop VR informative aids for AF ablation procedure-related knowledge. Between January 2020 and April 2020, newly developed VR informative aids were implemented in the educational program of training rotated residents for giving patient education.

RESULT

A total of 20 residents and 32 patients were enrolled. The baseline self-reported self-efficacy and knowledge scores were relatively low among rotated residents and their patients. In addition to the high level of satisfaction, self-efficacy and knowledge scores of residents and their patients were increased after VR aids-based training and resident-led patient education. Higher degree of improvement in self-efficacy was noted among patients with depression/anxiety history than those without history. The follow-up assessments among residents showed that the positive effects of VR aids were sustained until 2 weeks later.

CONCLUSION

Overall, residents and patients reported that the VR aids increase the effectiveness of patient education, achieve the purpose of a paperless environment, and motivate them to recommend it to others. The implementation of resident-to-patient education has a positive impact on trainees and patients understanding about AF ablation procedures-related knowledge.

When Doctor Means Teacher: An Interactive Workshop on Patient-Centered Education

INTRODUCTION

Increasingly, health care is delivered through a patient-centered model, and patients engage in shared decision-making with their medical providers. As a result, medical educators are placing more emphasis on patient-centered communication skills. However, few published curricula currently offer a comprehensive discussion of skills for providing patient-centered education (PCE), a key component of shared decision-making. We developed an interactive, two-session workshop aiming to improve students' abilities to provide PCE.

METHODS

Our workshop included didactic instruction, group discussion, and interactive simulations. The workshop was delivered to 50 clinical clerkship medical students. The first session concentrated on educating patients about their diagnoses, while the second session focused on providing patients with information about medications and other treatments. We used detailed and realistic role-play exercises as a core tool for student practice and demonstration of confidence. To evaluate the workshop, we used pre- and postsurveys.

RESULTS

The sessions were well received by students, who strongly agreed both before and after the workshop that PCE was an important skill. Students also strongly agreed that the role-play exercises were an effective tool for learning PCE. They demonstrated significant improvements in their confidence to name important elements of PCE and to deliver PCE in the future.

DISCUSSION

This workshop fills a curricular gap in offering a comprehensive and interactive curriculum for improving students' abilities to provide critical PCE. The format and content should be easily adaptable to various disciplines, learners, and teaching modalities.

Knowledge of diabetic foot care management among medical students at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

OBJECTIVES

To evaluate medical students' knowledge of diabetic foot care management and its related factors.

METHODS

This was a cross-sectional, descriptive study of 303 students studying at King Abdulaziz University Hospital, Jeddah, Saudi Arabia conducted from June to July 2019. Data were collected using a two-part questionnaire. The first one captured student information; the second assessed student knowledge. It consists of 68 true and false questions divided into 4 subscales (risk factors, foot examination, foot complications and footwear selection). The higher the total score is, the higher the students' knowledge.

RESULTS

The total average knowledge score was 55.5±5.5 out of 68. While the mean score was 14.11/16 for risk factors, 9.24/10 for foot examination, 24.21/32 for foot complications, and 7.88/10 for footwear selection subscales. Only 56.4% of students educated diabetic patients about diabetic foot risks;concurrently, only 63% performed foot examinations in diabetes patients. Students who educated diabetic patients, preformed foot exam, or attended extra elective clinical rotation in a diabetic foot team, had a significantly higher knowledge level. Conclusion: Students were found to have high level of knowledge regarding diabetic foot management. Students who educated patients about diabetic foot risk, performed foot examination on patients and students who took elective rotations in a diabetic foot care team had a higher knowledge level.

Oral Health Attitudes among Preclinical and Clinical Dental Students in Germany

Oral health care providers are expected to show good examples of oral health behaviours and attitudes to their community. Previous studies displayed the constructive effect of dental education on oral hygiene manners of undergraduate students. The aim of this survey was to assess and compare aspects of oral health attitudes and behaviours between preclinical and clinical dental students in German universities. The German-language version of the HU-DBI was distributed to preclinical and clinical students from different German universities. Dichotomized (agree/disagree) responses to 20 HU-DBI items were provided in this study, with a maximum possible score of 19. A quantitative estimate of oral health attitudes and behaviours was provided by the total of appropriate answers given to every statement by each group. Data were analysed statistically. The overall mean score of answers favouring good oral hygiene was marginally higher in preclinical (14.62) than clinical students (14.31) but showed no statistical significance. Similarly, the analysis of each item individually displayed no statistically significant differences between preclinical and clinical participants, except in a single item of the survey. This study showed no effective differences in oral hygiene attitudes and behaviour between preclinical and clinical students in German universities. This reveals a weak effect of dental education on improving students' oral health attitudes in Germany and might demand the introduction of more courses emphasizing the importance of correct oral health behaviour of health care providers.

Prospective Physician Awareness of the Associations Between Social Media and Mental Health

OBJECTIVE

Recently, studies have cited negative, positive, and an absence of impact on mental health with social media use. However, there has been little studied regarding the level of awareness and training of clinicians in screening and identifying for these associations. For this reason, the authors designed a study to assess the awareness of prospective physicians, or current medical students, on the associations between mental health and social media.

METHODS

The study was in the form of a 12-question survey. The questions aimed at assessing the awareness through past experiences with social media, education of its use and potential impacts, and self-reported ability to screen, identify, and counsel patients on these associations. The survey was sent to a total of 634 medical students and included all classes from MS1-MS4. A total of 148 students completed this survey (23.3% response rate).

RESULTS

The majority of medical students reported first social media use between the ages of 13 and 18, with the most common occurrence of bullying identified in this age group as well. The majority percentage of students believed there could be both positive and negative effects of social media on mental health; however, only a small percentage of students reported being aware of specific patterns of social media use that are associated with mental health. Moreover, only a few students reported feeling adequate in their ability to screen, educate, and counsel patients on these associations.

CONCLUSIONS

Findings from this study suggest the need for educational resources to train future physicians in screening, identifying, and counseling patients on associations between social media and mental health. The small numbers in this study are a limiting factor for the validity of result interpretation.

Enhancing student-pharmacists' professional development through community outreach with dementia population

INTRODUCTION

Misinterpreted or minimized sensations related to progressive neuronal loss are predictive of the prominent behavioral and psychological symptoms (BPSD) observed in dementia. Guidelines recommend nonpharmacologic interventions via sensory engagement be included in the standard of patient care. To facilitate implementation, collaboration with health care students equipped with nonpharmacologic strategies to manage BPSD should be encouraged. The aim of this study was to determine the impact of outreach participation on student-pharmacists' comfort levels and perceived communication ability when interacting with patients with dementia.

METHODS

During the sensory stimulation outreach, pharmacy students were paired with a patient with dementia to encourage fidget blanket use through patient-specific directions and demonstration. A single-group, pretest-posttest design was utilized to assess changes in students' comfort level and perceived communication ability prior to and immediately following outreach participation.

RESULTS

Twenty-six students attended between 1 and 5 outreaches. Students reported a statistically significant increase in comfort level while interacting with patients with dementia after attending their first (n = 26, Z = 2.754, P = .006), second (n = 16, Z = 2.124, P = .034), and third outreach (n = 12, Z = 2.449, P = .014). Students' weighted composite communication scores showed a statistically significant increase after their first (n = 26, Z = 3.309, P = .001) and third outreach experiences (n = 12, Z = 2.375, P = .018).

DISCUSSION

Participation in this sensory stimulation outreach improved students' comfort level and ability to communicate while interacting with patients with dementia. Greater exposure to the population through continued outreach participation was associated with a further increase in comfort level and perceived communication ability.

Wanting more: A look at preclinical students' desires for increased clinical experiences and interest in mentoring young adults with chronic illness

A growing population of children with chronic illness must transition from pediatric to adult healthcare. Medical students receive little formal training about the needs of these young patients. Strategies for educating students about how to address medical and psychosocial consequences of these conditions are needed. Interventions pairing medical students as mentors for young adults with chronic illness may provide dual benefit for both patient and student. To establish the feasibility of developing this type of program, we surveyed 165 medical students about their extra-curricular and clinical experiences as well their interest in and expectations for a patient mentoring experience.

Perceptions of Patient-Centered Care among First-Year Medical Students

Phenomenon: Teaching patient-centered care (PCC) is a key component of undergraduate medical curricula. Prior frameworks of PCC describe multiple domains of patient-centeredness, ranging from interpersonal encounters to systems-level issues. Medical students' perceptions of PCC are thought to erode as they progress through school, but little is known about how students view PCC toward the beginning of training. This study explores the perceptions of PCC among 1st-year medical students to inform curricular development and evaluation. Approach: Medical students participated in semistructured, in-person interviews within 4 months of starting medical school as part of a longitudinal study. Transcripts were analyzed using a grounded theory approach and the constant comparative method to describe responses and characterize emergent themes. Transcripts were reviewed to compare codes and compile a final codebook. Findings: Thirty-eight students completed interviews. Students provided heterogeneous definitions of PCC, including perceptions that PCC is implicit and obvious. Many students were unable to provide a concrete definition of PCC, juxtaposing PCC with other priorities such as profit- or physician-centered care, whereas others thought the term was jargon. Some participants defined PCC as upholding patient values using hypothetical examples centered around physician behavior. Insights: Although students appeared to enter medical school with a range of perceptions about PCC, many of their descriptions were limited and only scratch the surface of existing frameworks. Rather than their perceptions of PCC eroding during medical school, students may never fully develop a foundational understanding of PCC. Our findings reinforce the need for authentic, clinically experiential learning opportunities that promote PCC from the earliest stages of medical education.

THE ROLE OF GROUP EDUCATIONAL PROGRAMS IN MODIFICATION OF THE CARDIOVASCULAR RISK MAIN FACTORS

Aim – to study the influence of Healthy Schools "Healthy Lifestyle Basis" education on modifying of cardiovascular risk main factors. Materials and methods. 57 patients with cardiovascular diseases were examined. General clinical examination, anthropometric examinations (body weight, height, body mass index, and body composition), blood pressure measurement, and cholesterol determination, as well as its fractions in blood, were carried out before and after training course. The educational cycle included 9 lessons. Results. It was found that Healthy Schools education contributes to better both systolic and diastolic blood pressure monitoring. Thus, initially target blood pressure levels (<140/90 mmHg for patients without diabetes mellitus and <140/85 mmHg in case of diabetes) were observed in 49 % of patients, at the end of the training cycle – in 67 %. At the same time, the patients’ anthropometric parameters (BMI, fat and muscle tissue content, visceral fat) as well as cholesterol and its atherogenic serum fractions, did not change significantly. The patients’ education did not affect motivation level for their lifestyle improvement. So the number of patients consuming less than5 grams of table salt per day and over400 grams of vegetables and fruit did not change significantly. The level of physical activity between the examined patients did not change. Conclusion. The training course “Healthy Schools: Healthy Lifestyle Basis" contributes to improvement of blood pressure level monitoring, but does not significantly affect behavioral risk factors and does not lead to improvement of lipid metabolism monitoring in patients with cardiovascular disease. It is necessary to search for new more effective preventive care models for patients with high cardiovascular risk.

Medical students as health coaches, and more: adding value to both education and patient care

New ways of thinking about medicine and health care demand new methods in medical education. Over the past two decades, as both the practice and the study of medicine have become increasingly concerned with demonstrable outcomes, medical schools have developed new curricula in health systems science and are increasingly emphasizing students’ development and demonstration of skills essential to a systems-based, outcomes-oriented practice environment.

Polak and colleagues recently reported the development in Israel of one such curriculum, in lifestyle medicine, that includes opportunities for students to adopt the role of health coach. This commentary describes additional recent curricular developments elsewhere with similar goals, but utilizing more ambitious approaches that embed students in medical practices and provide meaningful, ongoing responsibility for assisting in the care of patients. These emerging new models for ambulatory care education, through a construct known as “value added education,” can simultaneously benefit both educational and patient care outcomes.