Is it intelligent to intercalate? A two centre cross-sectional study exploring the value of intercalated degrees, and the possible effects of the recent tuition fee rise in England

Evaluating the publication practices of medical students: A mixed-methods study

PURPOSE

Engagement in research and publication helps medical students develop the skills to improve healthcare through evidence-based medicine. The qualitative evidence-base for the medical student experience of publishing is limited. This study aims to explore medical students' publication practices and understand their experiences of research and publication.

METHODS

The study is based on a mixed-methods convergent design. A survey questionnaire was distributed to medical students in UK medical schools by social media and email communication. We recruited volunteer participants through the survey and interviewed a sample whilst the survey was open. We purposively selected the sample to ensure representation from research-intensive and other universities.

RESULTS

Survey results indicated that 21.3% (27/127) of respondents had a publication. The most common publication type was a conference abstract. The main motivation to publish was career progression and the main barriers were lack of opportunity or support to submit an article. There was no significant association between attending a research-intensive university and submitting an article. The interviews revealed that contributing to academic advancement was also a motivation to publish. Participants expressed receiving differing levels of support from supervisors and their institutions.

CONCLUSIONS

Data from the interviews suggested that the most commonly perceived barriers identified in the survey (lack of opportunity and support to conduct and publish research) may vary in prevalence between different medical schools. Further research is required to explore how different types of support offered by medical schools affect student engagement in publishing research.

Cross-sectional Survey of Medical student perceptions of And desires for Research and Training pathways (SMART): an analysis of prospective cohort study of UK medical students

OBJECTIVE

Clinician-scientists are critical to medical innovation and research. However, the number of clinician scientists in the UK has been declining steadily over the last decade. One of the cited reasons is poor student recruitment to academic training pathways. The SMART study aims to assess current student perceptions on research and identify key factors influencing whether a student is interested in research.

DESIGN

We conducted a cross-sectional survey study between January and May 2022.

SETTING

This was a multi-centre national study with data collected across 40 universities offering medical courses in the UK.

PARTICIPANTS

Participants were UK medical students enrolled in medicine for 21/22 academic year.

MAIN OUTCOME AND MEASURE

The main outcomes were related to participant perceptions on research and whether they were interested in engaging with research in their future career. These measures were correlated with demographic and non-demographic details using regression analyses.

RESULTS

One thousand seven hundred seventy-four individuals participated in the SMART survey from 40 medical schools. Nearly half the participants felt there were barriers preventing them from doing research (46.67%) and almost three-quarters felt it was at least somewhat difficult to combine research with medical school (73.49%). Of the options available, most commonly students did not want to pursue an academic career (43.11%) or training pathway (42.49%). However, most participants felt it was useful to do research at medical school (59.54%) and were also interested in doing more research in the future (69.16%). Regression analysis identified many factors influencing student's perceptions of research including year of study, gender, socioeconomic status, family background, research exposure at medical school, ethnicity, and country of pre-university education.

CONCLUSIONS

The SMART study is the first of its kind in the UK, shedding light on medical student perceptions. While some express strong interest in academic careers, a larger proportion show a broader interest in research. Demographic factors like gender, parental occupation, and socioeconomic status play a role. Further exploration is needed for specific groups to address barriers, promote research, and boost academic pathway recruitment.

Impact of the increase in tuition fees and demographic factors on medical student intercalation rates between 2006 and 2020

Introduction

No quantitative research has assessed the trends in English medical student intercalation. In addition, the impacts of the increase in tuition fees, introduced in 2012, and demographic factors on intercalation rates are unknown.

Methods

Freedom of information requests were sent to all UK universities. Regression analysis compared intercalation rates before (2006-2012) and after (2012-2020) the tuition fee increase. Student's t-tests compared demographics of medical students who intercalated. Questionnaires were sent to all UK universities to explore reasons for intercalating.

Results

In total, 101,085 students from seven universities responded. The intercalation rate increased from 4.70% to 10.53% (mean percentage difference (MPD) 5.84; 95% confidence interval (CI) 2.94-8.73). Intercalating students were more likely to be <25 years of age (MPD 33.36%; 95%CI 28.34-38.39), without a previous degree (MPD 8.56%; 95% CI 7.00-10.11) and without a disability (MPD 3.15%; 95% CI 0.88-5.42). In total, 389 completed questionnaires were received from 10 universities. Medical students believed an intercalated degree made them a better doctor.

Discussion

The proportion of students who intercalated was greater following the increase in tuition fees. This might be explained by the value medical that students placed on the skills and opportunities that accompany an intercalated degree.

Can Research Training be Improved in Health Professional Student Curricula? A Qualitative Descriptive Study of Health Students' Experiences with an Integrated Research Training Platform

INTRODUCTION

Project-based learning is currently the status quo for research training for health professional students; however, it alone is not sufficient for holistic development of research skills. One promising style of intervention that can complement project-based research training is a centralised hub of e-learning resources. Therefore, we explored the perception of health professionals in tertiary education, towards the E-learning hub named 'Health and Medical Sciences Research Modules'. Specifically, we explored (1) the role the Modules can play in supporting students in their research training courses, (2) the perception of the selection of topics and content quality and (3) student engagement with content.

METHODS

Semi-structured interviews were conducted via the online platform Zoom for University of Western Australia 3rd- and 4th-year Dental doctoral students, and 2nd-year Master of Pharmacy students. Interview transcripts were analysed using the framework method, to identify manifest and latent level themes.

RESULTS

Eleven participants completed the interview, including five dentistry and six pharmacy students. The analysis yielded numerous manifest level themes including selection and depth of topics, and four latent level themes: content volume and balance, relevance of content to project, alignment and sequencing, and interactivity.

DISCUSSION

The present study suggests the Modules content and the online platform were well received as a complementary intervention to project-based learning. However, issues such as content oversaturation emerged as topics which can be addressed to improve the learning experience. These topics should be considered when considering further implementation of e-learning hubs to complement project-based learning, across Australia and worldwide.

Impact of Intercalated Degree on Post-graduate Career Progression and Academic Development in the UK: A Rapid Review of the Literature

An intercalated degree offers medical students an avenue to explore their interests and become competent in scientific literacy. Although intercalating can pose a financial burden and time commitment, they do provide competitive academic and speciality training applications. The aim of this review was to explore academic development and subsequent outcomes of career progression. Medline and EMBASE were systematically searched using keywords. After the removal of duplicates, the studies were screened against the inclusion criteria. For the five studies included in this review, a narrative synthesis was performed. The two main themes were academic development and career progression. All studies showed a plethora of academic achievements during and after intercalation. Two studies showed that students are more likely to enter a career in academic medicine. A further two studies have shown that the transferable skills of academia have allowed alumni to make more competitive applications for foundation year and speciality training. The results have shown a correlation between academic achievements and an increase in competitiveness in foundation programmes and speciality applications. There are clear discrepancies in the success of academic careers depending on the institution and type of intercalated degree. Current literature suggests a master’s degree results in more academic success compared to a bachelor’s degree. Due to the sheer diversity of intercalated degrees offered to medical students in the UK, there is limited literature on post-graduate career progression. More research should be undertaken to look at the implications of intercalation on post-graduate career progression.

Curriculum initiatives to enhance research skills acquisition by medical students: a scoping review

BACKGROUND

Although it is accepted that providing medical students with opportunities to engage in research activity is beneficial, little data has been collated on how medical degree curricula may address this issue. This review aims to address this knowledge gap by conducting a scoping review examining curriculum initiatives that seek to enhance research experience for medical students.

METHODS

This review looks to specifically look at 'doing research' as defined by the MEDINE 2 consensus rather than 'using research' for the bachelor component of the Bologna Cycle. The framework developed by Arksey & O'Malley was utilised and a consultation with stakeholders was incorporated to clarify and enhance the framework.

RESULTS

A total of 120 articles were included in this scoping review; 26 related to intercalated degree options and 94 to non-intercalated degree options. Research initiatives from the United States were most common (53/120 articles). For non-intercalated research options, mandatory and elective research projects predominated. The included studies were heterogeneous in their methodology. The main outcomes reported were student research output, description of curriculum initiative(s) and self-reported research skills acquisition. For intercalated degree options, the three main findings were descriptions of more 'novel' intercalated degree options than the traditional BSc, student perspectives on intercalating and the effect of intercalating on medical student performance and careers.

CONCLUSIONS

There are several options available to faculty involved in planning medical degree programmes but further research is needed to determine whether research activity should be optional or mandatory. For now, flexibility is probably appropriate depending on a medical school's resources, curriculum, educational culture and population needs.

The impact of research intercalation during medical school on post-graduate career progression

BACKGROUND

Medical students at The University of Manchester have the option of research intercalation on the Master of Research programme. There is a paucity of evidence for the benefits of research intercalation. However, we hypothesised that research intercalation would accelerate post-graduate career progression and aimed to objectively measure the career enhancing impact, quantify the benefits and determine the alumni perception of research intercalation.

METHODS

Data was collected retrospectively by electronic questionnaire (in 2018) from those commencing research intercalation between 2005 and 2012.

RESULTS

Participants (n=52) returned questionnaires (68% response), demonstrating that the cohort had completed 67 postgraduate qualifications, published 304 manuscripts (median 3 publications per person (PP); range: 0-53) and made 430 presentations (median 7 PP; range: 0-37). Alumni had been awarded 49 research grants; funding disclosed on 43% totalled £823,000. Career progression of 73% of alumni had taken the minimum number of years; 27% took longer due to time spent working abroad or to gain additional experience prior to specialty training. Fifty-five publications and 71 presentations were directly related to MRes projects.

CONCLUSION

Research intercalation provides graduates with an opportunity to learn valuable transferrable skills, contribute to translational research, and objectively enhances medical career progression.

Creating the Next Generation of Evidence-Based Veterinary Practitioners and Researchers: What are the Options for Globally Diverse Veterinary Curricula?

Veterinary educators strive to prepare graduates for a variety of career options with the skills and knowledge to use and contribute to research as part of their lifelong practice of evidence-based veterinary medicine (EBVM). In the veterinary curriculum, students should receive a grounding in research and EBVM, as well as have the opportunity to consider research as a career. Seeing a lack of a cohesive body of information that identified the options and the challenges inherent to embedding such training in veterinary curricula, an international group was formed with the goal of synthesizing evidence to help curriculum designers, course leaders, and teachers implement educational approaches that will inspire future researchers and produce evidence-based practitioners. This article presents a literature review of the rationale, issues, and options for research and EBVM in veterinary curricula. Additionally, semi-structured interviews were conducted with 11 key stakeholders across the eight Council for International Veterinary Medical Education (CIVME) regions. Emergent themes from the literature and interviews for including research and EBVM skills into the curriculum included societal need, career development, and skills important to clinical professional life. Approaches included compulsory as well as optional learning opportunities. Barriers to incorporating these skills into the curriculum were grouped into student and faculty-/staff-related issues, time constraints in the curriculum, and financial barriers. Having motivated faculty and contextualizing the teaching were considered important to engage students. The information has been summarized in an online "toolbox" that is freely available for educators to inform curriculum development.

A 5-year retrospective evaluation of undergraduate dental research projects in a Nigerian University: Graduates' perceptions of their learning experiences

INTRODUCTION

Undergraduate research projects have never been evaluated despite six decades of dental training in Nigeria. This study evaluated dental graduates' perceptions of the research project from 2013 to 2017.

METHODS

A cohort of 93 graduates from a Nigerian University was investigated through the use of self-administered questionnaires on a Google form platform. Analysis was done using descriptive and analytical statistics on SPSS version 16. Statistical significant level was set at P < .05.

RESULTS

The cohort showed a very good understanding of research project objectives during their undergraduate training with more male and older students independently choosing their research topics (P > .05). Students' research topics were changed by supervisors in about one-quarter and one-tenth of the male and female students, respectively. About one-third of the students met set deadlines with no significant differences amongst gender and age groups (P > .05). However, only two-thirds of the students submitted their projects before the deadline due to other contending academic works. More males and older age group sought assistance from other academic staff for information on their projects. About one-half of the students reportedly acquired additional knowledge as a direct benefit from the project. Of all the variables associated with the research project, only the level of preparedness to undertake the project was highly statistically significant (P < .05) and this varied significantly amongst gender and age group (P < .05).

CONCLUSION

The students demonstrated a good understanding of research project. The perceived level of preparedness to undertake the project was low but significantly higher in male and older age groups.

What difference can a year make? Findings from a survey exploring student, alumni and supervisor experiences of an intercalated degree in emergency care

BACKGROUND

One third of UK medical students undertake an intercalated degree, typically in traditional academic disciplines. It is less usual for students to undertake intercalated degrees that are directly aligned to a clinical speciality with longitudinal placements. This cross sectional survey aims to explore the self-reported experiences of students, alumni and supervisors associated with a clinically oriented intercalated degree in emergency care featuring a longitudinal placement in a hospital emergency department over a 9-month academic year. Themes for exploration include student clinical and academic development, effect on career choice, supervisor experience and the effect on host institutions.

METHODS

Current students, previous alumni, and clinical placement supervisors associated with a single intercalated degree programme in urgent and emergency care since 2005 were identified from records and using social media. Separate online surveys were then developed and distributed to current students/ previous alumni and consultant physician supervisors, between May and August 2016. Results are presented using basic descriptive statistics and selected free text comments.

RESULTS

Responses were obtained from 37 out of 46 contactable students, and 14 out of 24 supervisors (80 and 63%, respectively). Students self-reported increased confidence in across a range of clinical and procedural competencies. Supervisors rated student competence in clinical, inter-professional and academic writing skills to be commensurate with, or in many cases exceeding, the level expected of a final year medical student. Supervisors reported a range of benefits to their own professional and personal development from supervising students, which included improved teaching and mentoring skills, providing intellectual challenge, and helping with the completion of audits and service improvement projects.

CONCLUSIONS

Students report the acquisition of a range of clinical, academic, and inter-professional skills following their intercalated BSc year. A positive experience was reported by supervisors, extending to host institutions. Students reported feeling more enthusiastic about emergency medicine careers on completion. However, as students embarking on this degree naturally bring pre-existing interest in the area, it is not possible to attribute causation to these associations. Further investigation is also required to determine the longer term effect of clinically oriented intercalated degrees on career choice.

An Analysis of Medical Students' Attitude and Motivation in Pursuing an Intercalated MSc in Clinical Anatomy

OBJECTIVES

This study aimed to explore what factors influence and motivate medical students to undergo an intercalated degree and why they prefer to choose an intercalated MSc in Clinical Anatomy.

METHODS

The study consisted of 54 medical students enrolled in Queen's University Belfast which offers a range of intercalated degrees, including an iBSc in Medical Science and an iMSc in Clinical Anatomy. Five-point Likert scale survey was used to collect data, designed to discover what the influencing factors were in deciding to take an intercalating degree and if they have a desire to gain research experience. It measured the motivational features of their chosen courses.

RESULTS

In recent years, more students (68.5%, n = 54) opted for the iMSc rather than the iBSc. This difference in number of students was statistically significant (chi-square = 33.4, P < 0.0001). It was theorized that this was due to an interest in future surgical specialization; however, this study has shown that the prime reason 72.2% of students opt to take a year out of their medical degree to carry out an intercalated degree is simply to gain an extra qualification whilst 61.1% thought it would enhance their competitiveness in the job market. Ninety-four percent of the iMSc students recommended the intercalated degree to junior students in comparison to only 34.8% of the iBSc students. This difference in percentage was statistically significant (t = 2.78, P = 0.009).

CONCLUSION

The study shows no significant link to a desire to gain research experience in determining which intercalated programme to undertake. Students favoured iMSc more because they believed it will enhance their employability.

The influence of early research experience in medical school on the decision to intercalate and future career in clinical academia: a questionnaire study

BACKGROUND

Currently, only one in three UK medical students undertake an intercalated degree. This has often been implicated as a result of financial obstacles or a lack of interest in research due to inadequate exposure to academic medicine. The aims of this study were to determine whether exposure to research early in medical school, through the initiation of an early years clinical academic training programme has a positive influence on the decision-making related to intercalating and a career long interest in research. This study also aims to evaluate the perceived views of the recipients of such a scholarship programme.

METHODS

All previous recipients of the Aberdeen Summer Research Scholarship (ASRS) (n = 117) since its inception in 2010 until 2015 were invited via email in June 2016, to take part in the survey. Data were analysed using SPSS for quantitative data and a thematic approach was used to derive themes from free text.

RESULTS

The overall response rate was 56% (66/117). Of the respondents, seven received the scholarship twice. Seventy-three percent were still at medical school and 26% were foundation doctors. One respondent indicated that they were currently not in training. Seventy percent of respondents have continued to be involved in research since completing the scholarship. Fifty percent embarked on an intercalated degree following the ASRS. Furthermore, two thirds of the respondents who were undecided about undertaking an intercalated degree before the scholarship, chose to intercalate after completing the programme. ASRS was generally thought of as a positive, influential programme, yet the success of individual ASRS projects was dependent on the allocated supervisors and the resources available for specific projects.

CONCLUSIONS

Our findings indicate that early research exposure in medical school can provide students with a positive influence on involvement in research and allows students to make an informed decision about embarking on an intercalated degree. We therefore recommend the encouragement of similar programmes in medical schools to promote clinical academia at an early stage for medical students.

Student experiences and perceptions of compulsory research projects: a veterinary perspective

Background

Although research underpins clinical work, many students training to be clinicians are not inherently interested in developing research skills.

Aim

To characterise and understand veterinary student experiences and perceptions of compulsory research projects.

Methods

This was an explanatory sequential mixed-methods study, with a questionnaire survey of an entire cohort informing purposive selection for focus group discussions. Student views were triangulated with staff questionnaire data.

Results

About a third of the cohort felt that the project had not been worthwhile or had not fostered useful skills. Focus group data analysis identified fragility of motivation and lack of clear schemata for the research process as key themes. Students were easily demotivated by typical research challenges and lack of schemata contributed to a poor understanding of the rationale for the project, encouraging highly extrinsic forms of motivation. Triangulation with staff questionnaire data indicated that staff understood students’ challenges, but were more likely than students to consider it to be a valuable learning experience.

Conclusions

Findings support ongoing curriculum development and emphasise that, to optimise motivation, engagement and learning, students training to be clinicians need a clear rationale for research, based on development of critical inquiry skills as a core clinical competency.

Why apply for an intercalated research degree?

Intercalated degrees are commonly undertaken as part of the medical undergraduate course. In this article, we discuss the advantages and disadvantages of intercalation, along with alternatives that could be considered.

Should an intercalated degree be compulsory for undergraduate medical students?

Undertaking an intercalated year whilst at medical school involves taking time out of the medicine undergraduate programme in order to pursue a separate but related degree. It is widely seen as a challenging but rewarding experience, with much to be gained from the independent project or research component of most additional degrees. However, whilst intercalating is encouraged at many universities and is incorporated into some undergraduate curricula, it is by no means compulsory for all students. The literature would suggest that those who have intercalated tend to do better academically, both for the remainder of medical school and after graduating. Despite this, the issue of making intercalation mandatory is one of considerable debate, with counter-arguments ranging from the detrimental effect time taken out of the course can have to the lack of options available to cater for all students. Nonetheless, the research skills developed during an intercalated year are invaluable and help students prepare for taking a critical evidence-based approach to medicine. If intercalated degrees were made compulsory for undergraduates, it would be a step in the right direction. It would mean the doctors of tomorrow would be better equipped to practise medicine in disciplines that are constantly evolving.

Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis

IMPORTANCE

Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research.

OBJECTIVE

To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue.

EVIDENCE REVIEW

We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed.

FINDINGS AND CONCLUSIONS

Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD) before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may help in standardizing research education during medical school.

Application of Formalised Developmental Feedback for Feed-Forward to Foster Student Ownership of the Learning Process

There has been considerable criticism of assessment methods because of inconsistencies across modules and a focus on the measurement of learning rather than assessment for learning. The aim of the current study was to formalise the process of assessment feedback to feed-forward, and assess the impact on student learning. A cohort of undergraduate students ( N = 33) took part in a test-retest study on coursework assessment across 2 consecutive modules. They were assessed using generic academic criteria and instructed to use the grid from the previous feedback as a checklist to inform any amendments to their work. Findings demonstrated statistically significant improvements across 4 out of 5 domains of generic criteria, which improved the overall quality of the work. Active use of a consistent generic marking grid across modules enabled students to learn from feedback and apply that learning appropriately.

Impact of an intercalated BSc on medical student performance and careers: a BEME systematic review: BEME Guide No. 28

INTRODUCTION

Intercalated BScs (iBScs) are an optional part of undergraduate (UG) medicine courses in UK, Eire, Australia, New Zealand, the West Indies, Hong Kong, South Africa and Canada, consisting of advanced study into a particular field of medicine, often combined with research. They potentially improve students' skills and allow exploration of specific areas of interest. They are, however, expensive for institutions and students and delay workforce entry. There is conflicting evidence about their impact.

METHODS

A mixed-method systematic review (meta-analysis and critical interpretive synthesis) of the biomedical and educational literature, focusing on the impact of iBScs on UG performance, skills, and career choice, and to explore students' and other stakeholders' opinions about iBScs.

RESULTS

In the meta-analytic part of this review, we identified five studies which met our predetermined quality criteria. For UG performance, two studies using different methodologies report an improvement in UG performance; one study reported an Odds Ratio [OR] of 3.58 [95% CI 1.47-8.83] and the second reported a significant improvement in finals scores (1.27 points advantage 95% CI 0.52-2.02). One study reported a mixed result, while two studies showed no improvement. Regarding skills and attitudes, one paper suggested iBScs lead to the development of deeper learning styles. With regard to subsequent careers, two studies suggested that for those students undertaking an iBSc there is an increased chance following an academic career [ORs of 3.6 (2.3-5.8) to 5.94 (3.6-11.5)]. Seven of eight studies (with broader selection criteria) reported that iBSc students were less likely to pursue GP careers (ORs no effect to 0.17 [0.07-0.36]). Meta-analysis of the data was not possible. In the critical interpretative synthesis analysis, we identified 46 articles, from which three themes emerged; firstly, the decision to undertake an iBSc, with students receiving conflicting advice; secondly, the educational experience, with intellectual growth balanced against financial costs; finally, the ramifications of the iBSc, including some suggestion of improved employment prospects and the potential to nurture qualities that make "better" doctors.

CONCLUSION

Intercalated BScs may improve UG performance and increase the likelihood of pursuing academic careers, and are associated with a reduced likelihood of following a GP career. They help students to develop reflexivity and key skills, such as a better understanding of critical appraisal and research. The decision to undertake an iBSc is contentious; students feel ill-informed about the benefits. These findings could have implications for a variety of international enrichment programmes.