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Hamadeh RR, Abuelaish I, Yousufzai SJ, AlShammari YA, Ahmed YE, Jahrami HA. Knowledge and attitudes of medical students toward death: a cross-sectional comparative study between an Arab and a Western University. BMC Psychol 2024; 12:133. [PMID: 38459586 PMCID: PMC10924328 DOI: 10.1186/s40359-024-01616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/21/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Cultural factors influence attitudes toward death, and gender disparities are evident. Prior studies show that medical students have limited knowledge about death and are uncomfortable with it. Moreover, there is limited research that has examined factors that influence medical students' knowledge and attitudes toward death. OBJECTIVES The objectives of the study were to compare cultural and gender differences in relation to knowledge and attitudes toward loss and grief and to screen for complicated grief among medical students at the Arabian Gulf University and the University of Toronto. METHODS A cross-sectional study was disseminated to medical students at both universities in 2022. The variables in the survey included four parts: demographic characteristics of the participants, religious observance, history of encountering loss of a loved one, grief following loss, attitude toward death, and learning about how to deal with grief and death during medical school. The brief grief questionnaire and the death attitude profile-revised scales were used. RESULTS The study sample consisted of 168 medical students, with 74.1% being female. Complicated grief scores were higher among Arabian Gulf University students (3.87 ± 2.39) than among University of Toronto students (2.00 ± 1.93) and were higher for participants with a higher degree of religious observance in both schools (p < 0.05). Death avoidance (p = 0.003), approach acceptance (p < 0.001), and escape acceptance (p = 0.038) domains were significantly higher among Arabian Gulf University students than among University of Toronto students. Almost three-quarters of University of Toronto students reported not being taught about grief, compared to 54% of Arabian Gulf University students. CONCLUSIONS Arabian Gulf University medical students scored higher on complicated grief, most likely due to cultural and religious factors. Females at both institutions as well as those who indicated a higher level of religious observance reported higher scores of complicated grief. The study highlights how cultural and religious beliefs influence medical students' attitudes toward death and bereavement. It provides valuable insight into the knowledge and attitudes of medical students toward loss.
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Affiliation(s)
- Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, P.O. Box: 26671, Bahrain.
| | - Izzeldin Abuelaish
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Susan J Yousufzai
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Yousef At AlShammari
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, P.O. Box: 26671, Bahrain
| | - Yomna E Ahmed
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Haitham A Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, P.O. Box: 26671, Bahrain
- Government Hospitals, Manama, Bahrain
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Moroni M, Díaz Crescitelli ME, Capuccini J, Pedroni C, Bianco M, Montanari L, Ghirotto L. 'Now I can train myself to be with death': a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy. BMJ Open 2023; 13:e065458. [PMID: 37041055 PMCID: PMC10105916 DOI: 10.1136/bmjopen-2022-065458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE During the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with COVID-19 in care homes (CHs). The local palliative care (PC) unit decided to offer consultations and support to them. This study aimed to comprehend the experience of young doctors who asked for consultations when facing, during their first early years of practice, complex situations. DESIGN We conducted a qualitative study employing a phenomenological approach and in-depth interviews. PARTICIPANTS We involved 10 young doctors who worked in Italian SUCC during the pandemic and used a PC consultation support service. RESULTS What describes our participants' experience is related to four main themes: (1) reducing distances, (2) perceiving medical futility and improvising, (3) being supported to learn how to be with death and (4) narrowed timing to humanise care. The pandemic was, for our participants, a moment of reflection and critique on the skills acquired during the university course. It was a strong experience of human and professional growth that helped them reshape and deepen their role and skills, incorporating the approach of PC into their professional identity. CONCLUSIONS Integration between specialists and young doctors with an early entry into the workforce during the pandemic in CHs set out a 'shift' to a proactive and creative approach through a new awareness of professional and personal roles in doctor-patient relations. The continuity of care models should be rethought by integrating CHs and PC. Adequate PC training for young doctors (at pregraduate and postgraduate levels) can change doctors' vision and daily practice in assisting patients at the end of life.
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Affiliation(s)
- Matteo Moroni
- S.S.D. Cure Palliative, AUSL della Romagna, Ravenna, Italy
| | | | | | | | - Mattia Bianco
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Luca Ghirotto
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Campbell F, Rogers H. Through the looking glass: a review of the literature surrounding reflective practice in dentistry. Br Dent J 2022; 232:729-734. [PMID: 35624264 PMCID: PMC9137255 DOI: 10.1038/s41415-022-3993-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022]
Abstract
Reflection is an essential component of the learning process that helps to elicit deeper learning. In healthcare, this uses experiential activities to produce knowledge that compels the clinician to change their practice. Deep reflection allows one to explore emotions associated with challenging learning experiences, empowering reinterpretation of these experiences and removing barriers to further learning. Reflection is a key requirement of dental education at all stages. This paper aims to explore the existing literature on reflective practice in dentistry and identify areas for further research to improve reflective practice within dentistry. Traditional methods of reflecting through written means are not facilitating the deep reflection which is desired. A systematic overhaul of reflective practice is suggested, involving a shift away from structured written reflections. There is little evidence to inform the most appropriate format for reflective practice in dental education. There is a need for further research to determine the effectiveness of reflective practice in dental education, particularly as a move away from structured written reflection to more creative reflective opportunities are encouraged. Greater exploration of barriers to reflection in dentistry is indicated, with consideration to how these may be overcome and a need to engage regulatory bodies in system-wide changes. Reflection is an essential aspect of the learning process, with deep reflection eliciting deeper learning. Deep reflection is desirable for learners at all stages, from undergraduate students to experienced clinicians, as it allows exploration of the emotions associated with the learning experience, removing barriers to learning and supporting wellbeing. Further research to explore the barriers and facilitators to deep reflection in dentistry is indicated in order to support the planning and implementation of a systematic overhaul of current and often ineffective methods of reflection.
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Affiliation(s)
- Faith Campbell
- Glasgow Dental Hospital and School; Glasgow, UK; Honorary Clinical Teacher in Paediatric Dentistry, Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, UK.
| | - Helen Rogers
- School of Dental Sciences, Newcastle University, UK
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Yakov G, Riskin A, Flugelman AA. Mechanisms involved in the formation of professional identity by medical students. MEDICAL TEACHER 2021; 43:428-438. [PMID: 33290660 DOI: 10.1080/0142159x.2020.1854706] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite in-depth discussions regarding professional identity of doctors, there is still a gap in our understanding of how this professional identity actually evolves. OBJECTIVE To outline some major mechanisms involved in formation of medical students' professional identity. METHODS A qualitative study based on thematic analysis. 296 diary entries, written by eight medical students as part of the three-year course 'Becoming a Physician,' were reviewed. The course, conducted in small groups, gradually exposes students to the clinical field, and emphasizes awareness to marginalized populations, and interpersonal communication skills. RESULTS Following the social constructivist learning theory, where learners individually and socially construct meaning attributed to their experiences, we identified three major mechanisms based on students' written reflections. These include linking current experiences to past; comparing different types or aspects of knowledge, doctors or medicine; and future perspective taking. CONCLUSIONS This study sheds light on the possible mechanisms used by medical students in forming their professional identity prior to their clinical training. Knowing these mechanisms can help medical educators better understand and support their students in formation of their professional identities. Conducting reflective writing could serve as an effective tool for learners to comprehend the meanings of their experiences.
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Affiliation(s)
- Gila Yakov
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- Center for the Advancement of Teaching, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Arieh Riskin
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- Department of Neonatology, Bnai Zion Medical Center, Haifa, Israel
| | - Anath A Flugelman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
- BRCA Gene Carrier Clinic, Rambam Healthcare Campus, Haifa, Israel
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Costa-Drolon E, Verneuil L, Manolios E, Revah-Levy A, Sibeoni J. Medical Students' Perspectives on Empathy: A Systematic Review and Metasynthesis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:142-154. [PMID: 32769475 DOI: 10.1097/acm.0000000000003655] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Some evidence indicates that physician empathy declines during medical training, which has made it the subject of much research. Qualitative studies are relevant in this context, focusing as they do on how students themselves conceive and understand empathy during medical school. The aim of this study was to explore medical students' perspectives on empathy by conducting a metasynthesis, including a systematic review of the literature and analysis of included studies. METHOD The authors systematically searched 4 databases through June 17, 2019, for qualitative studies reporting medical students' perspectives on empathy in medical school. They assessed article quality using the Critical Appraisal Skills Program, and they applied thematic analysis to identify key themes and synthesize them. RESULTS The authors included 35 articles from 18 countries in their analysis. Four main themes emerged: (1) Defining empathy, with a lack of understanding of the concept; (2) Teaching empathy, with a focus on the hidden curriculum and clinical supervisors; (3) Willingness to be an empathetic doctor, with ambivalence expressed by some study participants; and (4) Evolution of empathy during medical school, specifically its decline. CONCLUSIONS Medical students are beset by theoretical confusion regarding the concept of empathy, and they express doubts about its utility and relevance. Instruction should focus on simpler concepts such as listening, and schools should leverage clinical supervisors' strong influence on students' empathy. Prioritizing certain types of knowledge (clinical facts) during medical education has a globally negative effect on medical students' empathy.
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Affiliation(s)
- Emmanuel Costa-Drolon
- E. Costa-Drolon is physician, Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Laurence Verneuil
- L. Verneuil is professor of medicine, Centre of Research in Epidemiology and Statistics, ECSTRRA Team UMR-1153, Institut national de la santé et de la recherche médicale, Université de Paris, Paris, France
| | - Emilie Manolios
- E. Manolios is psychologist, Centre of Research in Epidemiology and Statistics, ECSTRRA Team UMR-1153, Institut national de la santé et de la recherche médicale, Université de Paris, and Department of Psychiatry, European Georges-Pompidou Hospital, Paris, France
| | - Anne Revah-Levy
- A. Revah-Levy is professor of medicine, Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, and Centre of Research in Epidemiology and Statistics, ECSTRRA Team UMR-1153, Institut national de la santé et de la recherche médicale, Université de Paris, Paris, France
| | - Jordan Sibeoni
- J. Sibeoni is physician, Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, and Centre of Research in Epidemiology and Statistics, ECSTRRA Team UMR-1153, Institut national de la santé et de la recherche médicale, Université de Paris, Paris, France; ORCID: https://orcid.org/0000-0001-9613-5513
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Ho CY, Kow CS, Chia CHJ, Low JY, Lai YHM, Lauw SK, How AEH, Tan LHE, Ngiam XLL, Chan NPX, Kuek TYJ, Kamal NHA, Chia JL, Abdurrahman ABHM, Chiam M, Ong YT, Chin AMC, Toh YP, Mason S, Krishna LKR. The impact of death and dying on the personhood of medical students: a systematic scoping review. BMC MEDICAL EDUCATION 2020; 20:516. [PMID: 33371878 PMCID: PMC7768997 DOI: 10.1186/s12909-020-02411-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 12/02/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to best support them. METHODS We adopt Krishna's Systematic Evidence Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on the impact of death and dying on medical students. This structured search process and concurrent use of thematic and directed content analysis of data from six databases (Split Approach) enhances the transparency and reproducibility of this review. RESULTS Seven thousand six hundred nineteen were identified, 149 articles reviewed and 52 articles included. The Split Approach revealed similar themes and categories that correspond to the Innate, Individual, Relational and Societal domains in the Ring Theory of Personhood. CONCLUSION Facing death and dying amongst their patients affect how medical students envisage their personhood. This underlines the need for timely, holistic and longitudinal support systems to ensure that problems faced are addressed early. To do so, there must be effective training and a structured support mechanism.
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Affiliation(s)
- Chong Yao Ho
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Cheryl Shumin Kow
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Chin Howe Joshua Chia
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Jia Ying Low
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Yong Hao Melvin Lai
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Sarah-Kei Lauw
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Ashley Ern Hui How
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Dr, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Lorraine Hui En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Xin Ling Lisa Ngiam
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Natalie Pei Xin Chan
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Tze Yin Joshua Kuek
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Nur Haidah Ahmad Kamal
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Jeng Long Chia
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, Blk MD6, Centre, 14 Medical Dr, #05-01 for Translational Medicine, Singapore, 117599 Singapore
| | - Ying Pin Toh
- Star PALS (Paediatric Advanced Life Support), HCA Hospice Care, Kwong Wai Shiu Hospital Singapore, 705 Serangoon Road, Block A #03-01, Singapore, 328127 Singapore
- Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Level 4, 11 Hospital Crescent, Singapore, 169610 Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA UK
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
- Centre of Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597 Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436 Singapore
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Elhadi M, Buzreg A, Bouhuwaish A, Khaled A, Alhadi A, Msherghi A, Alsoufi A, Alameen H, Biala M, Elgherwi A, Elkhafeefi F, Elmabrouk A, Abdulmalik A, Alhaddad S, Elgzairi M, Khaled A. Psychological Impact of the Civil War and COVID-19 on Libyan Medical Students: A Cross-Sectional Study. Front Psychol 2020; 11:570435. [PMID: 33192858 PMCID: PMC7649391 DOI: 10.3389/fpsyg.2020.570435] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022] Open
Abstract
Objective We aim to determine the psychological status of medical students during the COVID-19 outbreak and civil war in Libya. Methods A cross-sectional study was conducted among medical students from 15 medical schools between April 20 and May 1, 2020. The demographic characteristics, generalized anxiety disorder 7-item (GAD-7) scale, and patient health questionnaire (PHQ-9) results were collected. Results Of the 3,500 students, 2,430 completed the survey. The mean (± SD) score of anxiety symptoms determined by the GAD-7 was 7.2 (5.1). A total of 268 (11%) students had a GAD-7 score of ≥15, which is indicative of moderate to severe anxiety. A total of 1,568 (64.5%) students showed different degrees of anxiety: mild, 910 (37.5%); moderate, 390 (16%); and severe, 268 (11%). Anxiety was significantly associated with living status and internal displacement (P < 0.05). The mean (+ SD) score of depressive symptoms determined by the PHQ-9 was 9.7 (6.3). A total of 525 (21.6%) students had a PHQ-9 score of ≥15, which is indicative of moderate to severe depression. A total of 1,896 (88%) students were diagnosed with mild (PHQ ≥ 5) depression. Suicidal ideation was present in 552 patients (22.7%). Depression was only statistically associated with the year of study (P = 0.009). Conclusion These data highlight that medical students in Libya are at risk for depression, especially under the current stressful environment of the civil war and the COVID-19 outbreak.
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Affiliation(s)
| | - Anis Buzreg
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | - Ala Khaled
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | - Ahmed Msherghi
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Ahmed Alsoufi
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Hind Alameen
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Marwa Biala
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | | | - Amna Elmabrouk
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | - Sarah Alhaddad
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | - Ahmed Khaled
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
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Reflections of an Integrated Maternal-Child Health Medical Student Assignment. Matern Child Health J 2020; 24:679-686. [PMID: 32277385 DOI: 10.1007/s10995-020-02907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Clinical experiences expose learners to the patient perspective, which can have a lasting impact on students' professional identity. However, in busy clinical settings where opportunities for reflection may be limited, listening to patients' stories is often neglected. We used a reflection assignment to augment a new maternal-child health integrated curriculum. METHODS Medical students completed a brief assignment from their session in the neonatal intensive care unit (NICU), which included reflective writing, between fall 2016 and summer 2017. The Depth of Reflection rubric was used to score reflections on a scale: "Knowledge and Comprehension" (Level I), "Analysis" (Level II), and "Synthesis and Evaluation" (Level III). A constant comparison method based on grounded theory elicited prenatal and postnatal themes from medical students' reflective writing. RESULTS All students completed narratives (n = 166); 70% (n = 116) achieved a Depth of Reflection of Level II or III. Six overarching themes emerged: (1) Conception, Pregnancy, and Delivery Experiences; (2) Positive Support Structures; (3) Barriers and Stressors to Care; (4) Future Plans; (5) Unexpected Complications; and (6) Student Career and Professional Considerations. DISCUSSION Reflections from a novel and brief integrated maternal-child health experience demonstrated high levels on the Depth of Reflection scale. This experience exposed students to core themes central to a family's pregnancy and perinatal experience. Professional identity formation also emerged as a theme. Reflective writing assignments in a busy NICU can facilitate exploration of medical students' knowledge of maternal-child health patient experiences.
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Boland JW, Barclay S, Gibbins J. Twelve tips for developing palliative care teaching in an undergraduate curriculum for medical students. MEDICAL TEACHER 2019; 41:1359-1365. [PMID: 30689479 DOI: 10.1080/0142159x.2018.1533243] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Palliative care is the holistic care of patients with advanced, progressive incurable illness. Palliative care is well recognized as an essential component of medical student curricula. However, teaching is variable within medical schools. Using current literature, these tips aim to highlight key points necessary to facilitate the development and delivery of palliative care teaching to medical students. The key practice points include: clinical exposure to patients with palliative care needs and those that are dying, being compulsory (and integrated) across the course, summative and formative assessments to encourage learning, support from within the university for curricular time and development, visits to a hospice/inpatient palliative care facility, emphasis on clinically based learning later in the course, teaching by specialists in palliative care as well as specialists in other areas including Family Doctors/General Practitioners, innovative teaching methods and inter-professional learning to develop teaching.
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Affiliation(s)
- Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jane Gibbins
- St Julia's Hospice, Cornwall Hospice Care, Hayle, UK
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Krishnasamy C, Ong SY, Loo ME, Thistlethwaite J. How does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57. MEDICAL TEACHER 2019; 41:1220-1231. [PMID: 31389720 DOI: 10.1080/0142159x.2019.1630731] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Background: Empathy and compassion are important in healthcare delivery, and are necessary qualities in medical students. Aims: To explore medical students', patients' and educators' perceptions of what affects empathy and the expression of compassion; and to address gaps in knowledge, attitudes and skills on how education affects empathy and the expression of compassion in medical students. Methods: The seven steps by Noblit and Hare were used for this meta-ethnography. Databases were searched for studies in English, published from 2007 to 2017 with outcomes of empathy and compassion. Key themes and concepts were identified, and accounts from the studies were used to build interpretations. Findings: Thirty-three qualitative studies were included and four main themes were derived: seeing the patient as a person; appreciating the elements of empathy and compassion; navigating in the training environment; and being guided by ideals. Interactions between the patient, the medical student and training environment which affect the development of empathy and compassion are illustrated in a conceptual model. Conclusions: This meta-ethnography extends our understanding of how medical education affects the expression of empathy and compassion in medical students. The results provide important considerations for medical educators and faculty developers in further developing and improving medical curricula.
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Affiliation(s)
| | - Sik Yin Ong
- HOMER, NHG Education, National Healthcare Group , Singapore , Singapore
| | - May Eng Loo
- HOMER, NHG Education, National Healthcare Group , Singapore , Singapore
| | - Jill Thistlethwaite
- NPS MedicineWise , Sydney , Australia
- FASS (Faculty of Social Sciences), University of Technology Sydney , Ultimo , Australia
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Redman M, Pearce J, Gajebasia S, Johnson M, Finn G. Care of the dying: a qualitative exploration of Foundation Year doctors' experiences. MEDICAL EDUCATION 2017; 51:1025-1036. [PMID: 28744956 DOI: 10.1111/medu.13358] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 11/21/2016] [Accepted: 04/18/2017] [Indexed: 05/26/2023]
Abstract
CONTEXT Foundation Year doctors (FYs), who are newly qualified, are expected to provide care for dying patients. Experiences at this early mandatory stage of training may form the foundation for future encounters, but little is documented about what these experiences involve. The aim of this research was to explore the experiences of FYs in caring for the dying, using the recently published Priorities for Care of the Dying Person as a conceptual framework, to identify areas for improvement in education and clinical practice. METHODS Semi-structured group and individual interviews were conducted to explore the experiences of FYs and how these relate to the five aspects of Priorities for Care of the Dying Person: 'recognise', 'communicate', 'involve', 'support' and 'plan and do'. All FYs in the North Yorkshire and East Coast Foundation School (n=335) were invited to participate and 47 FYs were recruited from five sites through convenience sampling and snowballing. Recordings were transcribed verbatim and a framework analysis approach was used with the published Priorities for Care of the Dying Person guidelines as a conceptual framework. RESULTS Five main themes and 13 subthemes emerged from the data. The five main themes, which mapped to the conceptual framework, were: recognition that the patient is dying; communication with the patient, family and other staff; involvement of the patient and family in their care; support for the dying person and their family; and planning and carrying out good care of the dying. Examples of when things are done poorly or done well were shared, giving context to experience. CONCLUSIONS Areas for improvement were identified around all five main themes. These will be useful for informing those involved in undergraduate and foundation training on how to improve the experiences of Foundation Year doctors and thereby improve patient care.
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Affiliation(s)
- Melody Redman
- Centre for Educational Development, Hull York Medical School, York, UK
| | - Jessica Pearce
- Centre for Educational Development, Hull York Medical School, York, UK
| | - Sareena Gajebasia
- Centre for Educational Development, Hull York Medical School, York, UK
| | - Miriam Johnson
- Centre for Educational Development, Hull York Medical School, York, UK
| | - Gabrielle Finn
- Centre for Educational Development, Hull York Medical School, York, UK
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Río AÁD, Marván ML, Gómez Avalos J. Facing Death in Medical Training. OMEGA-JOURNAL OF DEATH AND DYING 2017; 80:340-354. [DOI: 10.1177/0030222817729611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study explores how medical students feel about caring for terminally ill patients as well as how their medical courses prepare them for addressing end-of-life (EOL) issues with patients. Four hundred and five Mexican medical students were surveyed through the Student Views on Death questionnaire. The vast majority of students (94%) felt that physicians should inform patients of their impending death. Most students said they felt comfortable talking with (61%) or examining (76%) terminally ill patients. However, only half the students actually talked with patients about death. Participants in our study were interested in learning about EOL medical attention, yet most considered themselves poorly prepared to offer this type of care to terminally ill patients. The study provides objective data on a topic that has scarcely been explored in Mexico, data that will be useful in designing educational activities to improve EOL medical training.
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Affiliation(s)
- Asunción Álvarez-del Río
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ma. Luisa Marván
- Instituto de Investigaciones Psicológicas, Universidad Veracruzana, Xalapa, Mexico
| | - Julieta Gómez Avalos
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Gadoud A, Lu WH, Strano-Paul L, Lane S, Boland JW. A pilot study of interprofessional palliative care education of medical students in the UK and USA. BMJ Support Palliat Care 2017. [DOI: 10.1136/bmjspcare-2016-001267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundEducating medical students to care for patients at the end-of-life is increasingly recognised as an essential component of training. Traditionally, medical student programmes are run by doctors, but patient care is delivered by an interprofessional team. Our programmes in the UK and USA independently developed a teaching experience led by an interprofessional team of palliative care health professionals.ObjectivesThis study explores the palliative care health professionals’ perceptions, regarding their unique role in medical student palliative care education.MethodsThis is the first study to ascertain views of an interprofessional team delivering palliative care education to medical students. Focus groups enable interaction between members of the group as well as the generation of consensus of comments among group members.ResultsTwo major themes were identified: perceived benefits and value of the experience, and the challenges and lessons learnt from the experiences.ConclusionsDespite different structures and settings, this experiential learning in palliative care provided a rewarding interprofessional experience that has historically been difficult to achieve.
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