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Malvitz M, Khan N, Morgenstern LB. College preparation for a medical career in the United States. PLoS One 2024; 19:e0298203. [PMID: 38349896 PMCID: PMC10863898 DOI: 10.1371/journal.pone.0298203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE A college degree is required to enter medical school in the United States. A remarkably high percentage of students entering college have pre-medical aspirations but relatively few end up as medical students. As an "applied science", education about medicine is usually thought to be beyond the purview of a liberal arts curriculum. Students therefore receive little education about a medical career, or information about the many alternative careers in health science. Instead, they take courses for Medical College Admission Test (MCAT) preparation and medical school application prerequisites in biology, chemistry, physics, and math. These classes give them little insight into a real medical career. The current report considers this mismatch between student needs in health science and available resources in colleges across the United States. METHODS A Collective Case Series framework was used to obtain qualitative data. Key informant interviews were requested from a convenience sample of representatives from 20 colleges, with six colleges providing extensive data. Three institutions collected data specifically on students who matriculated college interested in a career as a physician. RESULTS At these schools, one-half to one-quarter of students who said they were interested in medicine at the beginning of college ended up not applying to medical school. At each of the six schools, we saw a wide range of generally sparse academic and professional advising involvement and a very limited number of classes that discussed concepts directly related to careers in health science. CONCLUSIONS Looking at this data, we provide a novel conceptual model as a potential testable solution to the problem of an underexposed and unprepared student population interested in medicine. This includes a brief series of courses intended to inform students about what a career in medicine would fully entail to help foster core competencies of empathy, compassion and resilience.
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Affiliation(s)
- Madelyn Malvitz
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
| | - Noreen Khan
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
| | - Lewis B. Morgenstern
- University of Michigan Medical School Department of Neurology, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
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Taylor JS, Wendland CL, Kulasegaram KM, Hafferty FW. Admitting privileges: A construction ecology perspective on the unintended consequences of medical school admissions. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1347-1360. [PMID: 36856902 PMCID: PMC9976670 DOI: 10.1007/s10459-023-10210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Medical-school applicants learn from many sources that they must stand out to fit in. Many construct self-presentations intended to appeal to medical-school admissions committees from the raw materials of work and volunteer experiences, in order to demonstrate that they will succeed in a demanding profession to which access is tightly controlled. Borrowing from the field of architecture the lens of construction ecology, which considers buildings in relation to the global effects of the resources required for their construction, we reframe medical-school admissions as a social phenomenon that has far-reaching harmful unintended consequences, not just for medicine but for the broader world. Illustrating with discussion of three common pathways to experiences that applicants widely believe will help them gain admission, we describe how the construction ecology of medical school admissions can recast privilege as merit, reinforce colonizing narratives, and lead to exploitation of people who are already disadvantaged.
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Affiliation(s)
- Janelle S Taylor
- Department of Anthropology, University of Toronto, Toronto, ON, Canada
| | - Claire L Wendland
- Department of Anthropology, Department of Obstetrics & Gynecology, University of Wisconsin-Madison, 5436 Sewell Social Sciences Building 1180 Observatory Drive, 53708, Madison, WI, USA.
| | - Kulamakan Mahan Kulasegaram
- Department of Family and Community Medicine, Wilson Centre for Research in Education, University of Toronto, Toronto, ON, Canada
| | - Frederic W Hafferty
- Division of General Internal Medicine and Program in Professionalism and Values, Mayo Clinic, Rochester, MN, USA
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Foo YY, Xin X, Rao J, Tan NCK, Cheng Q, Lum E, Ong HK, Lim SM, Freeman KJ, Tan K. Measuring Interprofessional Collaboration's Impact on Healthcare Services Using the Quadruple Aim Framework: A Protocol Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095704. [PMID: 37174222 PMCID: PMC10178681 DOI: 10.3390/ijerph20095704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/13/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
Despite decades of research on the impact of interprofessional collaboration (IPC), we still lack definitive proof that team-based care can lead to a tangible effect on healthcare outcomes. Without return on investment (ROI) evidence, healthcare leaders cannot justifiably throw their weight behind IPC, and the institutional push for healthcare manpower reforms crucial for facilitating IPC will remain variable and fragmentary. The lack of proof for the ROI of IPC is likely due to a lack of a unifying conceptual framework and the over-reliance on the single-method study design. To address the gaps, this paper describes a protocol which uses as a framework the Quadruple Aim which examines the ROI of IPC using four dimensions: patient outcomes, patient experience, provider well-being, and cost of care. A multimethod approach is proposed whereby patient outcomes are measured using quantitative methods, and patient experience and provider well-being are assessed using qualitative methods. Healthcare costs will be calculated using the time-driven activity-based costing methodology. The study is set in a Singapore-based national and regional center that takes care of patients with neurological issues.
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Affiliation(s)
- Yang Yann Foo
- Department of Technology Enhanced Learning and Innovation, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore 169608, Singapore
| | - Jai Rao
- Department of Neurosurgery, National Neuroscience Institute, Singapore 308433, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Nigel C K Tan
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore
| | - Qianhui Cheng
- Department of Neuroradiology, National Neuroscience Institute, Singapore 308433, Singapore
| | - Elaine Lum
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Hwee Kuan Ong
- Department of Physiotherapy, Singapore General Hospital, Singapore 169608, Singapore
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Sok Mui Lim
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Kirsty J Freeman
- Office of Education, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Kevin Tan
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore
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Mafinejad MK, Sarani H, Sayarifard A, Rostami D, Shahbazi F, Gruppen L. Insights on my future job: implementing near-peer shadowing program for operating room freshmen. BMC MEDICAL EDUCATION 2022; 22:72. [PMID: 35093038 PMCID: PMC8801118 DOI: 10.1186/s12909-021-03071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND As a main challenge in paramedical faculties of medical sciences, freshmen lose interest in their academic field of study and then job motivation. Lack of developed knowledge about their academic field and unfamiliarity with their future job's tasks and roles contribute to freshmen's job motivation loss. Various interventional programs have been implemented to improve students' job motivation by familiarizing them with their future job's duties and responsibilities. METHODS This was one-group pretest-posttest design study in 2019-2020. Students grouped into pairs of a freshman (shadowee) with a senior (shadower) in a clinical setting during shadowing program. This program helps freshmen to comprehend and discover realities of their academic field and can help them change their perspectives regarding their future job's duties and responsibilities. The shadowees' main task was reflective observation on operating room events and interactions and to be active in the program, several tasks e.g., how to wear gloves, guns, and disinfect equipment were assigned to them exclusively under the supervision of senior students. The Hackman and Oldham's Job Diagnostic Survey (JDS) questionnaire and a novel Job Motivation Survey (JMS) questionnaire were distributed among participants. RESULTS Fifty freshmen majoring in operating room participated in the shadowing program from November 2019 to January 2020. Before and after the program, they completed Hackman and Oldham's job diagnostic survey and researcher-made job motivation survey questionnaires. Results were indicative of a significant difference in job diagnostic survey questionnaire score, where overall pre-test and post-test scores before and after the intervention were 57.78 (±9.78) and 68.58 (±5.02), respectively; the score difference was statistically significant (P < 0.001). Moreover, the overall pre-test and post-test scores of the job motivation survey questionnaire were 25.16 (± 9.75) and 39.80 (±5.18), respectively; this score difference was statistically significant (P < 0.001). CONCLUSION Shadowing program improved freshmen's realistic perception of their future job's duties and responsibility, and hence enhancing their job motivation and job recognition. As future work, in various disciplines, further studies need to evaluate the impact of such interventional programs in providing early insights for freshmen as well as in providing guidance on their plans for education, and future job.
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Affiliation(s)
- Mahboobeh Khabaz Mafinejad
- Health Professions Education Research Center, Education Development Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Sarani
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Azadeh Sayarifard
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Daryoush Rostami
- Department of Anesthesiology, Faculty of Paramedicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Fatemeh Shahbazi
- Department of Community Medicine, School of Medicine Zahedan University of Medical Sciences, Dr. Hesabi Square - Medical Sciences Campus, Zahedan, Iran
- Education Development Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Larry Gruppen
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI USA
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Villalona S. Insights from the shadows: exploring deservingness of care in the emergency department and language as a social determinant of health. MEDICAL HUMANITIES 2021; 47:e5. [PMID: 33127616 DOI: 10.1136/medhum-2019-011669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
This study addresses the existing gap in literature that ethnographically examines the experiences of Spanish-speaking patients with limited English proficiency in clinical spaces. All of the participants in this study presented to the emergency department (ED) for evaluation of non-urgent health conditions. Patient shadowing was employed to explore the challenges that this population face in unique clinical settings like the ED. This relatively new methodology facilitates obtaining nuanced understandings of clinical contexts under study in ways that quantitative approaches and survey research do not. Drawing from the field of medical anthropology and approach of narrative medicine, the collected data are presented through the use of clinical ethnographic vignettes and thick description. The conceptual framework of health-related deservingness guided the analysis undertaken in this study. Structural stigma was used as a complementary framework in analysing the emergent themes in the data collected. The results and analysis from this study were used to develop an argument for the consideration of language as a distinct social determinant of health.
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Affiliation(s)
- Seiichi Villalona
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
- Anthropology, University of South Florida College of Arts and Sciences, Tampa, Florida, USA
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Brekalo Prso I, Mocny-Pachońska K, Trzcionka A, Pezelj-Ribaric S, Paljevic E, Tanasiewicz M, Persic Bukmir R. Empathy amongst dental students: An institutional cross-sectional survey in Poland and Croatia. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:687-694. [PMID: 33462930 DOI: 10.1111/eje.12557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/21/2020] [Accepted: 05/29/2020] [Indexed: 06/12/2023]
Abstract
AIM To determine and compare levels of empathy and its dimensions in Polish and Croatian dental students. METHODS Fourth- and fifth-year dental students (N = 193) at the University of Rijeka and University of Silesia completed questionnaires to determine levels of overall empathy and its dimensions: compassionate care (CC), perspective taking (PT) and ability to stand in someone else's shoes (ASSES). Total empathy and its dimensions were analysed depending on the country of origin, year of study and gender of the participants. The HPS version of the Jefferson Scale of Physician Empathy was used to conduct the research. Statistical analysis was performed using the Mann-Whitney U test. RESULTS The analysis showed no significant differences in total empathy level between Polish and Croatian students (P = .838). However, separate analysis of empathy items showed significant differences between the two groups. Croatian students obtained significantly higher average PT values (P = .021), whilst Polish students had significantly higher CC scores (P < .001). Analysis of Croatian respondents revealed significantly higher ASSES scores in the fourth- and fifth-year students (P = .047). Analysis in the Polish group demonstrated an increase in PT scores from the fourth to the fifth year of study (P = .008). CONCLUSION Croatian students scored higher on items associated with cognitive empathy, whilst Polish students displayed higher values in the aspect of emotional empathy. The present results demonstrated an increase in cognitive empathy level in Polish students, whilst in their Croatian colleagues, the level of cognitive empathy decreased with the progression of the academic programme.
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Affiliation(s)
- Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
- University of Osijek, Osijek, Croatia
| | - Katarzyna Mocny-Pachońska
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Agata Trzcionka
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Sonja Pezelj-Ribaric
- University of Osijek, Osijek, Croatia
- Department of Oral Medicine and Periodontology, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
| | - Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
| | - Marta Tanasiewicz
- Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Bytom, Poland
| | - Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental medicine, University of Rijeka, Rijeka, Croatia
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