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Teo MYK, Ibrahim H, Lin CKR, Hamid NABA, Govindasamy R, Somasundaram N, Lim C, Goh JL, Zhou Y, Tay KT, Ong RRS, Tan V, Toh Y, Pisupati A, Raveendran V, Chua KZY, Quah ELY, Sivakumar J, Senthilkumar SD, Suresh K, Loo WTW, Wong RSM, Pei Y, Sng JH, Quek SQM, Owyong JLJ, Yeoh TT, Ong EK, Phua GLG, Mason S, Hill R, Chowdhury AR, Ong SYK, Krishna LKR. Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education. BMC MEDICAL EDUCATION 2024; 24:726. [PMID: 38970020 PMCID: PMC11225364 DOI: 10.1186/s12909-024-05707-5] [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: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS). METHODS A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion. RESULTS Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes. CONCLUSION Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
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Affiliation(s)
- Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Casper Keegan Ronggui Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nur Amira Binte Abdul Hamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Medical Social Services, Singapore General Hospital, Block 3, Singapore, 169854, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yi Zhou
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ryan Rui Song Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vanessa Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Youru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jeevasuba Sivakumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Samyuktha Dhanalakshmi Senthilkumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keerthana Suresh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Wesley Teck Wee Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yiying Pei
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Julia Huina Sng
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Simone Qian Min Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ting Ting Yeoh
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Road, Singapore, 574627, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Ruaraidh Hill
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Anupama Roy Chowdhury
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Department of Geriatric Medicine, Singapore General Hospital, Academia, Level 3, College Road, Singapore, 169608, Singapore
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK.
- 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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Ramanathan V, Pushpanathan P, Bodhare T, Bele S. Perceptions on Medical Professionalism Among Future Healthcare Professionals: A Mixed Method Study. Cureus 2024; 16:e57573. [PMID: 38707144 PMCID: PMC11069035 DOI: 10.7759/cureus.57573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background Accreditation councils across the world constantly examine policies and practices in professionalism in their medical curriculum. The National Medical Commission (NMC) in India has recognized the pressing need to reform and include professionalism in its undergraduate curriculum. Objectives The objective of this study was to explore the perspectives of medical and nursing students on professional behavior, suitable teaching-learning methods, and assessment strategies for curriculum integration. Methodology The study utilized a concurrent triangulation mixed method design, collecting both qualitative and quantitative data simultaneously to gain a comprehensive understanding of medical and nursing students' perceptions of professionalism. It included 83 final-year undergraduate medical students and 42 final-year undergraduate nursing students. The approval of the Institutional Review Board of Meenakshi Medical College Hospital & Research Institute was obtained. A semi-structured questionnaire consisting of demographic characteristics and opinions regarding academic professional behavior, teaching-learning, and evaluation of professionalism was used. Perceptions regarding the meaning of professionalism, behavior of professionalism to be emphasized in teaching, and pressing challenges of professionalism were explored. Students were also asked to rank the best behavior associated with professionalism. Frequency and percentages were used for descriptive statistics. Means and standard deviations were calculated for continuous variables. An unpaired t-test was used to determine a statistically significant difference between the means in the two groups. The quantitative data was analyzed with R programming and content analysis was performed for the qualitative data using ATLAS.ti qualitative data analysis software. Results Unexplained/unauthorized absence from academic activities (2.39 ± 1.553), not following the timeline (2.41 ± 1.560), making fun of patients and peers (2.16 ± 1.619), cheating in the exams (2.37 ± 1.651), and inebriation (2.39 ± 1.666) were unacceptable behaviors by undergraduate medical students compared with nursing students. Clinical experience (1.54 ± 0.857) and role models (1.74 ± 0.935) were the highly acceptable methods of teaching professionalism and interprofessional interactions (1.58 ± 0.650) and awards (1.98 ± 1.100) were the most common suggestions to improve the course curriculum by both groups. Community/field activity (1.78 ± 0.860) and clinical examination (1.89 ±1.123) were the most preferred methods of evaluation of professionalism. According to the students, dedication, honesty, respect, and self-improvement were identified as the best behaviors associated with professionalism. Conclusions The study revealed that students had a wide range of perspectives about professionalism. Different unprofessional acts were acceptable to students. The causes of these perspectives need to be explored and resolved to promote professionalism. Students identified the need for strong positive role models and frequent clinical experiences, along with improved interprofessional interactions and awards to improve teaching and learning professionalism. Community/field activity was the preferred assessment method proposed by the students. Medical institutions must promote these components in curriculum, faculty development, and clinical settings to foster the development of professionalism among students.
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Affiliation(s)
- Vijaya Ramanathan
- Anatomy, All India Institute of Medical Sciences, Madurai, IND
- Anatomy, Meenakshi Medical College Hospital & Research Institute, Meenakshi Academy of Higher Education & Research (Deemed to be University), Kanchipuram, IND
| | - Punita Pushpanathan
- Physiology, Meenakshi Medical College Hospital & Research Institute, Meenakshi Academy of Higher Education & Research (Deemed to be University), Kanchipuram, IND
| | - Trupti Bodhare
- Community & Family Medicine, All India Institute of Medical Sciences, Madurai, IND
| | - Samir Bele
- Community Medicine, Velammal Medical College Hospital & Research Institute, Madurai, IND
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Amin S, Ambreen S, Ul-Ain N, Murad T, Sajwani K, Qaiser A. Professionalism Program Evaluation and Its Impact on Undergraduate Medical Students. Cureus 2024; 16:e53051. [PMID: 38410301 PMCID: PMC10896135 DOI: 10.7759/cureus.53051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
Objective The study aims to evaluate the effectiveness of a professionalism program by conducting focus group discussions (FGDs). The research focuses on understanding how the program influences the development of professionalism skills among medical students, as well as their perceptions and experiences regarding the program. The study's objectives revolve around identifying the strengths and weaknesses of the program from the perspective of the students. Methods This was a qualitative study done after obtaining approval from the Institutional Review Committee, Islamic International Medical College. Students of 4th year Bachelor of Medicine and Bachelor of Surgery (MBBS; 56 students) were selected for the study. A convenience sampling technique was used to select the participants for FGDs. Seven separate FGDs were conducted, with eight participants in each group. All the FGDs were audiotaped. Data were transcribed and translated. Data were analyzed using the thematic analysis on Atlas. Both obvious and hidden content were analyzed. Codes and themes were identified, which were then finalized with consensus. Codes were then categorized into sub-themes, and finally, themes were generated. Results Participants identified the problems associated with applying professionalism during FGDs. These challenges encompassed hefty workloads and a perceived disparity between theoretical knowledge and practical implementation. The students highlighted the importance of practical teaching methods, the cultivation of role models, the alignment of curriculum with real-world experiences, and the revision of assessment methods. This study analyzes the obstacles and potential advantages associated with professionalism education and presents significant perspectives on improving it for upcoming healthcare practitioners. Conclusion Professionalism is a crucial component, and each graduate of a medical school should be fully qualified as a professional after graduation. As we want our future doctors to be skilled at both professional qualities and diagnosis, it is crucial that medical institutions teach professionalism.
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Affiliation(s)
- Sarah Amin
- Medical Education, National University of Sciences and Technology (NUST) School of Health Sciences, Islamabad, PAK
| | - Sundus Ambreen
- Forensic Medicine, Islamic International Medical College Trust, Rawalpindi, PAK
| | - Noor Ul-Ain
- Medical Education, Islamic International Medical College Trust, Rawalpindi, PAK
| | - Tasneem Murad
- Forensic Medicine, Islamic International Medical College Trust, Rawalpindi, PAK
| | - Khadeejah Sajwani
- Anatomy, National University of Sciences and Technology (NUST) School of Health Sciences, Islamabad, PAK
| | - Aasma Qaiser
- Medical Education, CMH (Combined Military Hospital) Kharian Medical College, Kharian, PAK
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Lönn A, Weurlander M, Seeberger A, Hult H, Thornberg R, Wernerson A. The impact of emotionally challenging situations on medical students' professional identity formation. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1557-1578. [PMID: 37184676 PMCID: PMC10184105 DOI: 10.1007/s10459-023-10229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/09/2023] [Indexed: 05/16/2023]
Abstract
In their interactions with patients and health care professionals during work-based learning, medical students are known to experience emotionally challenging situations that can evoke negative feelings. Students have to manage these emotions. Students learn and develop their professional identity formation through interactions with patients and members of the healthcare teams. Earlier studies have highlighted the issues involved with processing emotionally challenging situations, although studies concerning learning and professional identity formation in response to these experiences are rare. In this study, we explored medical students' experiences of emotionally challenging situations in work-based learning, and the impact these experiences had on forming medical students' professional identities. We conducted an analysis of narrative data (n = 85), using a constructivist grounded theory approach. The narratives were made up of medical students' reflective essays at the end of their education (tenth term). The analysis showed that students' main concern when facing emotionally challenging situations during their work-based education was the struggle to achieve and maintain a professional approach. They reported different strategies for managing their feelings and how these strategies led to diverse consequences. In the process, students also described arriving at insights into their own personal needs and shortcomings. We consider this development of self-awareness and resulting self-knowledge to be an important part of the continuously ongoing socialization process of forming a professional identity. Thus, experiencing emotionally challenging situations can be considered a unique and invaluable opportunity, as well as a catalyst for students' development. We believe that highlighting the impact of emotions in medical education can constitute an important contribution to knowledge about the process of professional identity formation. This knowledge can enable faculty to provide students with more effective and sufficient support, facilitating their journey in becoming physicians.
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Affiliation(s)
- Annalena Lönn
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden.
| | - Maria Weurlander
- Department of Education, Stockholm University, Stockholm, Sweden
| | - Astrid Seeberger
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Håkan Hult
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Robert Thornberg
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Annika Wernerson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
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Sebastian T, Prade A, Keis O, Schramm A, Öchsner W. Student experiences of professionalism and role models in an oral and maxillofacial surgery internship: A qualitative study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:849-858. [PMID: 36458891 DOI: 10.1111/eje.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Dental students have a clear concept of professionalism and the importance of role models. Our aim was to determine how dental students experience their first oral and maxillofacial surgery internship in terms of their concept of professionalism and their perception of role models. METHODS From June to August 2020, semi-structured telephone interviews were conducted with 22 dental students in their eighth and ninth semesters at the Medical Faculty of the University of Ulm. The interviews were transcribed and evaluated by qualitative content analysis according to Mayring. RESULTS The students' concept of dental professionalism was shaped by the elements of a good approach to patients, professional competence, and manual skills. This perception was not changed by the internship. Having a role model was seen as an important learning strategy, and role models were perceived in both positive and negative ways. Role models were perceived as positive if they corresponded to the student's concept of professionalism and as negative if they did not correspond to this concept, especially with regard to social interaction or the approach to patients. Students' reactions to discrepancies between their own moral values and the role models' behaviour were characterised by passivity and withdrawal. With regard to potential future careers, positive internship experiences supported student goals, whereas negative experiences raised doubts about them. CONCLUSION Supervising dentists may still underestimate the considerable impact of internships, and their awareness of this impact needs to be increased. Students' reactions to conflicts between reality and their own values do not appear to be constructive. One approach to solving this problem may be to include discussions of professional development in curricula.
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Affiliation(s)
- Tim Sebastian
- Medical Faculty of the University of Ulm, School of Dentistry, Ulm, Germany
| | - Amelie Prade
- Medical Faculty of the University of Ulm, Medical School, Ulm, Germany
| | - Oliver Keis
- Section on Teaching and Learning, Medical Faculty of the University of Ulm, Ulm, Germany
| | - Alexander Schramm
- Department of Oral and Maxillofacial Surgery, University of Ulm, Ulm, Germany
| | - Wolfgang Öchsner
- Department of Anesthesiology and Intensive Care Medicine, University of Ulm, Ulm, Germany
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Henick D, Italiano T, Person H, Keefer L. Medical students' knowledge and perception of irritable bowel syndrome in comparison to inflammatory bowel disease. Neurogastroenterol Motil 2023; 35:e14576. [PMID: 37018414 DOI: 10.1111/nmo.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 02/25/2023] [Accepted: 03/14/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Gastroenterologists may hold less positive attitudes toward disorders of gut-brain interaction (DGBI) like irritable bowel syndrome (IBS) compared with organic GI disorders like inflammatory bowel disease (IBD). This contributes to worse health outcomes in patients with DGBI and decreased patient satisfaction. Medical student knowledge and perception of these two disorders have not been directly studied. METHODS A cohort of medical students (n = 106) completed a survey where they read clinical vignettes about patients with IBS and IBD and answered questions regarding their knowledge of and attitudes toward these two diseases. KEY RESULTS IBS was perceived as a less real and a more exaggerated disorder when compared to IBD, and patients with IBS were seen as more difficult to treat. With more clinical exposure across 4 years of training, students were more likely to perceive IBS as a "less real" illness, though they held fewer negative attitudes toward patients with IBS. Greater familiarity with both IBS and IBD was associated with fewer negative attitudes. CONCLUSIONS & INFERENCES Biases observed in gastroenterologists toward patients with IBS originate as early as the beginning of medical school, including seeing IBS as a "less real" disease and more difficult to treat. Earlier educational interventions may be helpful in identifying and addressing these biases.
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Affiliation(s)
- Daniel Henick
- Department of Medical Education, Yale School of Medicine, New Haven, CT, USA
| | - Tyler Italiano
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hannibal Person
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Laurie Keefer
- Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wang YY, Chang C, Shi W, Huang XM, Jiao Y. Chinese medical students reflections on medical professionalism: A qualitative thematic analysis. Medicine (Baltimore) 2023; 102:e34640. [PMID: 37565906 PMCID: PMC10419547 DOI: 10.1097/md.0000000000034640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
There is no common medical professionalism framework in China, mandating work to conceptualize professionalism from various perspectives. Studies on students viewpoints about medical professionalism are limited. Therefore, this study aimed to investigate how Chinese medical students perceive professionalism to provide a reference for future medical education reform and policy development. Fifty-four written reflections on medical professionalism were collected from first-year students of China 4 + 4 medical education program enrolled in 2020 to 2021 academic years. Essays were subjected to thematic analysis using NVivo 12. Three main themes emerged: inter-personal, intra-personal, and public professionalism. Students emphasized the importance of physician-patient relationships, proficiency of medical knowledge, and enthusiasm for promoting health-related issues. By contrast, teamwork and confidentiality were not considered essential aspects of professionalism. The medical professionalism framework articulated by students in China was roughly the same as in other countries. Where there were differences, these may have been due to the unique sociocultural environment. Future medical professionalism education should be adjusted according to students understanding of professionalism.
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Affiliation(s)
- You-Yang Wang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chuheng Chang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wen Shi
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Ming Huang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Jiao
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Li C, Ye X, Yu C, Wu H. The effect of an information intervention on the career commitment of medical students: evidence from a randomized experiment. Front Med (Lausanne) 2023; 10:1101993. [PMID: 37283628 PMCID: PMC10239797 DOI: 10.3389/fmed.2023.1101993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/26/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction The needs-based shortage of healthcare workers is severe worldwide and it would be exacerbated if many medical students switch to other careers after graduation. Maintaining and improving the career commitment of medical students, which could be a feasible, effective, and scalable way to reduce the attrition rate, is essential in medical education. We designed a randomized experiment to test whether an information intervention based on role modeling could enhance medical students' career commitment. Methods In the randomized experiment, the sample (N = 36,482) was divided into the treatment group (N = 18,070) and the control group (N = 18,412). The intervention information consisted of image-text messages on Zhong Nanshan, who is an inspiring role model for he went to the frontline of COVID-19 in the most critical circumstances and received praise and affirmation from the public. Α difference-in-differences model was employed to identify the effect of the information intervention. Heterogeneous treatment effects were identified using sub-sample analyses. Results The results showed that the information intervention statistically significantly reduced medical students' dropout intention by 2.7 percentage points (95% CI: -0.037 to -0.016, t = -4.95, p < 0.001), equivalent to 14.6% of the control group mean. This estimate indicates that the information intervention could significantly increase the career commitment of medical students. Finally, male and senior students were influenced more than their female and junior counterparts, which can be explained by their relatively high dropout intention. Conclusion Role model-based information intervention improves the career commitment of medical students. The underlying behavioral model is that, when students use a role model as their reference point, they consider dropout as a substantial welfare loss. Role modeling is an effective way to improve the career commitment of medical students, especially for males and senior students.
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Affiliation(s)
- Chunqing Li
- Institute of Medical Education/National Center for Health Professions Education Development, Peking University, Beijing, China
| | - Xiaoyang Ye
- Annenberg Institute for School Reform, Brown University, Providence, RI, United States
| | - Chen Yu
- Institute of Medical Education/National Center for Health Professions Education Development, Peking University, Beijing, China
| | - Hongbin Wu
- Institute of Medical Education/National Center for Health Professions Education Development, Peking University, Beijing, China
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Koh EYH, Koh KK, Renganathan Y, Krishna L. Role modelling in professional identity formation: a systematic scoping review. BMC MEDICAL EDUCATION 2023; 23:194. [PMID: 36991373 PMCID: PMC10052869 DOI: 10.1186/s12909-023-04144-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP). METHODS A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices. RESULTS 12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences. CONCLUSION Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.
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Affiliation(s)
- Eugene Yong Hian Koh
- Singapore Armed Forces, 303 Gombak Drive, Singapore, 669645, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Kai Kee Koh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Yaazhini Renganathan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Lalit Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Duke-NUS Medical School, National University of Singapore, College Rd, Singapore, 169857, Singapore.
- Centre of Biomedical Ethics, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore.
- The Palliative Care Centre for Excellence in Research and Education, PalC, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Tabatabaei ZS, Mirzazadeh A, Amini H, Mafinejad MK. What we think about professional and unprofessional behaviors: differences between the perception of clinical faculty members and medical students. BMC MEDICAL EDUCATION 2022; 22:866. [PMID: 36517813 PMCID: PMC9749347 DOI: 10.1186/s12909-022-03874-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/08/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Differences in the viewpoints of clinical faculty members and medical students about prioritizing professional norms accepted by the professional community and lack of alignment of these views can lead to distortion of understanding, problems in learning and assessment of professionalism, and failure in students' professional identity formation. This study aimed to identify the differences in viewpoints of clinical faculty members and medical students about prioritizing the importance and prevalence of professional and unprofessional behaviors among undergraduate medical students. METHODS A multi-stage qualitative study was conducted at Tehran University of Medical Sciences during 2020-2021. At first, a systematic search was conducted to identify professional and unprofessional behaviors using the directional content analysis method. A panel of experts was formed to check the codes obtained from reviewing the literature and to evaluate its compliance with the context. Then, the modified nominal group technique sessions were held with clinical faculty members and medical students to strengthen the codes extracted from the studies and systematically integrate their views to achieve a comprehensive list of professional and unprofessional behaviors in accordance with the context. Finally, a consensus was made among them about prioritizing the importance and prevalence of these behaviors in undergraduate medical students. RESULTS A total of 490 codes of professional behaviors and 595 unprofessional behavior codes were identified in the literature review. In the following sessions of the modified nominal group, 13 clinical faculty members listed 105 codes of professional and unprofessional behaviors, and 51 medical students also listed 313 codes. The results of the modified nominal group technique showed that the faculty members reported the importance of unprofessional behaviors higher than professional ones. At the same time, students rated the importance of professional behaviors higher than unprofessional ones. Both faculty members and students rate the prevalence of professional behaviors as high and the prevalence of unprofessional behaviors as low. CONCLUSION The results showed a difference of views between clinical faculty members and medical students about prioritizing professional and unprofessional behaviors. It is essential to align their viewpoints to understand, learn and value professionalism to develop a professional identity.
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Affiliation(s)
- Zahra Sadat Tabatabaei
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Education Development Office, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azim Mirzazadeh
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Amini
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Khabaz Mafinejad
- Health Professions Education Research Center, Education Development Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
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Trenholm-Jensen EA, Burns L, Trenholm JE, Hand CJ. Beyond tingles: An exploratory qualitative study of the Autonomous Sensory Meridian Response (ASMR). PLoS One 2022; 17:e0277962. [PMID: 36454810 PMCID: PMC9714747 DOI: 10.1371/journal.pone.0277962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
This qualitative exploratory study investigated the embodied experiences and the meanings of Autonomous Sensory Meridian Response (ASMR) from the viewer's perspective. ASMR research has been sparse and largely quantitative, assuming it to be a predominantly fixed physiological response of "tingles", despite the acronym being rooted in pseudoscience. A qualitative research design was adopted to facilitate the exploratory nature of the study in this under-researched area. In contrast to the mostly survey-based research on ASMR, this study employed semi-structured interviews as a means to understand the lived experience of ASMR and to promote participant agency. Six self-identifying ASMR consumers were recruited using a mixture of snowball and opportunity sampling. Semi-structured interviews were conducted both in person and using Skype to facilitate transnational data collection. Interview transcripts were analysed using an inductive, data-driven approach to thematic analysis. The analysis suggests that ASMR is felt to provide a social environment of comfort rather than a solely physiological-based experience. Three key themes emerged: who and what defines ASMR? (reflecting the variety of what was classed as ASMR and what content was consumed to produce the response); "real" intimacy tailored to me (reflecting the idiosyncratic perception of intimacy made possible through ASMR); and emotional relief on my terms (reflecting the role of ASMR in self-soothing). The present data reflect a rich, complex experience of the ASMR consumer, pointing to potential wider applications and informing further research.
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Affiliation(s)
| | - Lindsey Burns
- Department of Psychology, Heriot-Watt University, Edinburgh, United Kingdom
| | - Jill Ellen Trenholm
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Chaudhuri JD. An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students. ANATOMICAL SCIENCES EDUCATION 2022; 15:910-927. [PMID: 34143562 DOI: 10.1002/ase.2112] [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: 02/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.
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Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine, USA
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Abstract
OBJECTIVE To determine whether trauma patients managed by an admitting or consulting service with a high proportion of physicians exhibiting patterns of unprofessional behaviors are at greater risk of complications or death. SUMMARY BACKGROUND DATA Trauma care requires high-functioning interdisciplinary teams where professionalism, particularly modeling respect and communicating effectively, is essential. METHODS This retrospective cohort study used data from nine level I trauma centers that participated in a national trauma registry linked with data from a national database of unsolicited patient complaints. The cohort included trauma patients admitted January 1, 2012 through December 31, 2017. The exposure of interest was care by one or more high-risk services, defined as teams with a greater proportion of physicians with high numbers of patient complaints. The study outcome was death or complications within 30 days. RESULTS Among the 71,046 patients in the cohort, 9,553 (13.4%) experienced the primary outcome of complications or death, including 1,875 of 16,107 patients (11.6%) with 0 high-risk services, 3,788 of 28,085 patients (13.5%) with one high-risk service, and 3,890 of 26,854 patients (14.5%) with 2+ high-risk services (p < .001). In logistic regression models adjusting for relevant patient, injury, and site characteristics, patients who received care from one or more high-risk services were at 24.1% (95% CI 17.2% to 31.3%; P < 0.001) greater risk of experiencing the primary study outcome. CONCLUSIONS Trauma patients who received care from at least one service with a high proportion of physicians modeling unprofessional behavior were at an increased risk of death or complications.
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Heydari S, Adibi P, Omid A, Yamani N. Diamond goals not graphite! A triangulation approach to clinical teachers' needs assessment. Med J Islam Repub Iran 2021; 35:96. [PMID: 34956942 PMCID: PMC8683781 DOI: 10.47176/mjiri.35.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Indexed: 11/09/2022] Open
Abstract
Background: Clinical faculty development plays a significant role in the professional empowerment of future physicians. Identification of educational needs is an important step in planning faculty development. This study identified the educational needs of medical faculties in the clinical setting.
Methods: This cross-sectional needs assessment study was conducted in Iranian medical universities during 2016-2018 using a triangulation paradigm. A total of 384 medical clinical faculties, 54 medical education specialists, and 194 faculty evaluation forms completed by medical residents participated in the study using a convenient randomized sampling method. The data were gleaned with a researcher-made questionnaire with 14 areas developed on the basis of clinical education goals and contexts and were analyzed with SPSS16 using descriptive statistic indices such as mean, standard deviation, and frequency percentile. Analytical tests including independent t-test, chi-square and Cramer's V were also applied (p<0.05). The content validity, face validity, and reliability were approved.
Results: The response rate was %59 (227) for clinical faculties, %77 (42) for medical education specialists, and %58 (110) for residents. Professionalism was the first priority of needs from the viewpoint of clinical faculties and faculty development planners. The clinical teachers' highest level skills, in their own perspective and also students’ perspective, were procedure training and grand round, whereas their lowest level skills were emotional intelligence and morning report. The greatest gap existed between the current skill and the need is management and leadership in the clinical setting. Cramer’s index ranged between 0.18 and 0.34 (p<0.05); hence, there was a correlation between the current status and the announced needs in all subjects.
Conclusion: Designers of faculty development programs ought to pay due attention to areas of professionalism, management, and leadership and carry out accurate and comprehensive planning to enable students to become competent future physicians in the roles of therapist, manager, teacher, supporter, and researcher.
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Affiliation(s)
- Sara Heydari
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Athar Omid
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nikoo Yamani
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Oerlemans AJM, Knippenberg ML, Olthuis GJ. Learning shared decision-making in clinical practice. PATIENT EDUCATION AND COUNSELING 2021; 104:1206-1212. [PMID: 33041158 DOI: 10.1016/j.pec.2020.09.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore how shared decision-making (SDM) is learned in clinical practice according to professionals and patients. METHODS Focus group and individual interviews with interns (n = 9), residents (n = 12), senior physicians (n = 13), and (former) patients and relatives (n = 13) in fertility care and intensive care. RESULTS Patients and professionals identified barriers and drivers for SDM related to patient, caregiver, and context. Participants agreed: the nuances of SDM are learned in practice, not during undergraduate medical education. Through observing and copying from other professionals, interns and residents describe building their personal "repertoire" of SDM skills, knowledge, and attitude. Professionals indicated it was helpful to see many different examples - both good and bad - of physicians in action. CONCLUSION Learning SDM is a complicated task for both students and professionals in healthcare. Relevant factors are the involvement of patients, the role of informal learning processes and role models, and the importance of reflective practice. PRACTICE IMPLICATIONS Learning SDM in practice requires 1) measures to lessen pressures on a meso and macro level that hinder SDM in practice, 2) inventive and precise training and education and paying explicit attention to informal learning processes in clinical practice and learning through role models.
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Affiliation(s)
- Anke J M Oerlemans
- IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101 (114 IQ), 6500 HB, Nijmegen, the Netherlands.
| | - Marjan L Knippenberg
- IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101 (114 IQ), 6500 HB, Nijmegen, the Netherlands
| | - Gert J Olthuis
- IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101 (114 IQ), 6500 HB, Nijmegen, the Netherlands
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Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context. Pak J Med Sci 2021; 37:1221-1229. [PMID: 34290812 PMCID: PMC8281152 DOI: 10.12669/pjms.37.4.4004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/15/2020] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature. Methods: We searched PubMed and Scopus for attributes of MP, using terms, “Professionalism,” “Medical Students,” and “Undergraduate Medical Education”. We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included. Results: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1)Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted “respect” as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, “communication” 5 (45.45 %) studies and “honesty” and “integrity” 4 (36.36%). (2)Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine’s elements of MP, viz, “altruism, accountability, excellence, duty, honor and integrity, respect for others.” Conclusions: Themes exemplified MP’s most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.
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Affiliation(s)
- Kamran Sattar
- Kamran Sattar, MBBS AcadMEd AoME (UK), MMedEd UoD (UK), PhD Scholar. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Muhamad Saiful Bahri Yusoff, MD, MSc, PhD. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Wan Nor Arifin
- Wan Nor Arifin: MBBS, MSc. Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Mohd Azhar Mohd Yasin: MD, MMed (Psy). Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Mohd Zarawi Mat Nor: PhD. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Al-Rawajfah OM, Al-Mugeed KA, Alaloul F, Al-Rajaibi HM, Al Omari O. COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman. Nurse Educ Pract 2021; 52:103041. [PMID: 33866236 PMCID: PMC7993640 DOI: 10.1016/j.nepr.2021.103041] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 02/23/2021] [Accepted: 03/22/2021] [Indexed: 12/16/2022]
Abstract
Assessing knowledge, attitude, and practices of healthcare students regarding any infectious outbreak became a fundamental step to set an effective plan related to their preparedness. The purpose of this study was to assess COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman. Data were collected using the Web-based survey method. The sample was recruited from the largest college of Medicine in Oman, while the nursing sample was recruited from two different nursing colleges in Oman. The study tool was developed based on the most recent advisory COVID-19 recommendations from the WHO and the CDC. A total of 222 students filled the survey, of which 55% were medical students and 59.9% were females. The mean knowledge score was 16.5 (SD = 4.2), which represents 66% of the highest possible score, with 25.7% were classified as ‘excellent knowledge’. Participants reported a high level of public precautionary practices (M = 44.1, SD = 5.0), which represents 84.6% of the highest score, with 61.3% were classified as ‘high compliance. The mean attitude score was 40.3 (SD = 5.9), which represents 67% of the highest possible score. According to the classification categories, most students (81%, n = 180) expressed a positive attitude toward COVID-19. More efforts should be done toward preparing the healthcare students to deal with the outbreak. Preparing healthcare students with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety. Healthcare students can play a major role in increasing public awareness about COVID-19 precautionary practices.
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Affiliation(s)
- Omar M Al-Rawajfah
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khod, 123 Muscat, Oman; Al al-Bayt University/Faculty of Nursing, P.O. Box 130040, Mafraq, 25113, Jordan.
| | | | - Fawwaz Alaloul
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khod, 123 Muscat, Oman
| | | | - Omar Al Omari
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khod, 123 Muscat, Oman
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Sattar K, Akram A, Ahmad T, Bashir U. Professionalism development of undergraduate medical students: Effect of time and transition. Medicine (Baltimore) 2021; 100:e23580. [PMID: 33655905 PMCID: PMC7939229 DOI: 10.1097/md.0000000000023580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/06/2020] [Indexed: 01/04/2023] Open
Abstract
Changeover phases are essential and inevitable times in professional life, which let the learners adapt and grasp emerging opportunities for learning based on the past experiences with the catering of novel creativity as required in the present as well as emerging time. This study was carried out to examine the effectiveness of a professionalism course, during the transition from a non-clinical to clinical setting, within the context of undergraduate medical education.This observational study was conducted during 2019 to 2020, with pre- and post-professionalism course evaluation. We used the Dundee Poly-professionalism inventory-1: Academic Integrity, among the undergraduate medical students.Our results are based on the medical student's professional progress with the transition from 2nd year to 3rd year. During the 1st phase of the study, the participants at their Pre-Professionalism Course (PrPC) level in their 2nd medical year (only attended the introductory lectures for professionalism), showed a good understanding of professionalism. For the 2nd phase, when the same students, at their Post-Professionalism Course (PoPC) level, in their 3rd year (completed professionalism course) filled the same survey and it was found that there was no decline in their understanding of the topic, even after more than a year. They were even more aware of the significance of professionalism in their clinical settings.Despite a year gap, the understanding of professionalism among students was stable. Results helped us infer that time laps did not affect the professionalism concept learned earlier; rather during clinical settings, students become more aware of professionalism.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Ashfaq Akram
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tauseef Ahmad
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Computer Science and Information Technology, NIMS University, Jaipur, Rajasthan, India
| | - Ulfat Bashir
- Department of Medical Education, Riphah International University, Islamabad, Pakistan
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Palmer EG, Reddy RK, Laughey W. Teaching Professionalism to Medical Students Using Dissection-Based Anatomy Education: a Practical Guide. MEDICAL SCIENCE EDUCATOR 2021; 31:203-213. [PMID: 33163287 PMCID: PMC7598239 DOI: 10.1007/s40670-020-01137-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
Professionalism is a core competency for all healthcare professionals and is a subject of great interest within the academic community due to its vital importance in delivering the highest quality patient care. Despite this, professionalism remains difficult to define, teach and assess. The potential use of anatomy education in teaching professionalism has been increasingly highlighted within the literature, but still remains an underutilised tool in medical education. Therefore, this practical guide offers evidence-based practical points for successfully incorporating professionalism within a dissection-based anatomy course delivered to undergraduate medical students.
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Affiliation(s)
- Emilia G. Palmer
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
| | - Rohin K. Reddy
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
| | - William Laughey
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
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Hernandez FE, Ouabo T, Long J, Fox D, Nguyen TH, Yee C, Rajagopalan V, Schulte M, Doroudgar S. Comparing perceptions of professionalism by pharmacy students, faculty, and staff during didactic education. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:127-133. [PMID: 33454068 DOI: 10.1016/j.cptl.2020.09.003] [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] [Received: 01/10/2020] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The objectives were to describe pharmacy students' perceptions of professionalism and to compare students and faculty/staff perceptions of professionalism during the didactic years at Touro University California College of Pharmacy in California (TUC COP). METHODS A two-part online survey was administered to the TUC COP faculty/staff and first-year (P1) and second-professional year (P2) students in May 2016. The first part of the survey collected demographic information, assessment of faculty/staff and students' overall opinions on behavior and conduct displayed by P1 and P2 students, students' responses about the average of missed lectures per month, and the average number of days of late arrival to lecture per week. The second part assessed professionalism perceptions responses to 20 scenarios using a 4-point Likert rating. RESULTS The study included 37 (88.4%) faculty/staff and 181 (96.4%) P1 and P2 students, for a 98% response rate. Of the faculty/staff, 59.5% perceived the students' overall behaviors and conduct as acceptable whereas 35.3% of students perceived the overall behavior of P1 and P2 students as acceptable, with the majority of students self-reporting missing on average fewer than five lectures per month (65.2%) and arriving late to lecture fewer than one day each week (71.8%). There were statistically significant differences between faculty/staff and students' responses in 9 of the 20 scenarios. CONCLUSIONS Differences in responses between faculty/staff and students regarding what is considered professional suggest that there is a gap in professionalism perceptions that should be addressed during didactic years.
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Affiliation(s)
| | - Tatiana Ouabo
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Jacob Long
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Danielle Fox
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Tran Huynh Nguyen
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Christopher Yee
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | | | - Margaret Schulte
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Shadi Doroudgar
- Touro University California College of Pharmacy, Vallejo, CA, United States; Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
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DE Gagne JC, Koppel PD, Kim SS, Park HK, Rushton S. Pedagogical foundations of cybercivility in health professions education: a scoping review. BMC MEDICAL EDUCATION 2021; 21:79. [PMID: 33516204 PMCID: PMC7847571 DOI: 10.1186/s12909-021-02507-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Teaching cybercivility requires thoughtful attention to curriculum development and content delivery. Theories, models, and conceptual and theoretical frameworks (hereafter "tools") provide useful foundations for integrating new knowledge and skills into existing professional practice and education. We conducted this scoping review to identify tools used for teaching cybercivility in health professions education. METHODS Using Arksey and O'Malley's scoping review framework, we searched six biomedical and educational databases and three grey literature databases for articles available in English published between January 1, 2000 and March 31, 2020. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we screened and extracted relevant data, and reported the results of the search. RESULTS The search resulted in 2272 articles, with 8 articles included in this review after inclusion criteria were applied. Four articles (50%) were peer-reviewed journal papers while the other 4 (50%) were dissertations. Eleven unique tools were identified by this review: (1) Transpersonal Caring Theory, (2) Theory of Workplace Incivility, (3) Conceptualization of Incivility, (4) Media Ecology Theory, (5) Principlism, (6) Salmon's Five Stage Model of Online Learning, (7) Learner-Centered Educational Theory, (8) Gallant and Drinan's 4-Stage Model of Institutionalization of Academic Integrity, (9) Theory of Planned Behavior, (10) Communication Privacy Management Theory, and (11) Moral Development Theory. Based on the tools analyzed in our scoping review, we determined three features of cybercivility pedagogy to which the tools provided a guide: (1) behavioral manifestations, (2) academic integrity, and (3) digital professionalism. CONCLUSIONS The reviewed tools provide a pedagogical foundation and guidance for teaching various properties of cybercivility. Future studies should be expanded to include a broader literature body and non-English literature to provide the global perspective and global skills needed by a diverse population of learners.
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Affiliation(s)
| | | | - Sang Suk Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
| | - Hyeyoung K Park
- College of Nursing, University of Massachusetts Amherst, Amherst, USA
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DeFoor MT, Moses MM, Flowers WJ, Sams RW. Medical student reflections: Chaplain shadowing as a model for compassionate care training. MEDICAL TEACHER 2021; 43:101-107. [PMID: 32981408 DOI: 10.1080/0142159x.2020.1817880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Training of compassionate and empathetic physicians requires commitment by educators to make it a priority. Chaplains typically have time and training to effectively demonstrate compassionate care in the clinical setting. This qualitative study aims to explore perceived benefits among medical students from pastoral care shadowing in integrating compassion and spirituality into education curricula. METHODS Sixty-four written reflections from first- and second-year medical students were collected from December 2018 to January 2020 after shadowing with hospital chaplains. Unprompted reflections were analyzed using coding networks. RESULTS Four major themes identified included (1) learned values within pastoral care, (2) learned roles of pastoral care in the healthcare setting, (3) practiced spiritual assessment tools and resource identification, and (4) reflected personal impact on future career. Within each major theme, three to four sub-themes were further identified. CONCLUSIONS Reflections support chaplain shadowing as a model for emphasizing spiritual and compassionate care through role-modeling, hands-on learning and reflective practices.
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Affiliation(s)
- Mikalyn T DeFoor
- School of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Center for Bioethics and Health Policy, Augusta University Health Systems, Augusta, GA, USA
| | - Mary M Moses
- School of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Center for Bioethics and Health Policy, Augusta University Health Systems, Augusta, GA, USA
| | - W Jeffery Flowers
- Center for Bioethics and Health Policy, Augusta University Health Systems, Augusta, GA, USA
- Department of Pastoral Care, Augusta University Health System, Augusta, GA, USA
| | - Richard W Sams
- Center for Bioethics and Health Policy, Augusta University Health Systems, Augusta, GA, USA
- Department of Family Medicine, Augusta University Health Systems, Augusta, GA, USA
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Al-Khalifa KS, Nazir MA. Evaluation of dental students’ responses to roleplay videos in a professionalism course. J Taibah Univ Med Sci 2020; 15:471-478. [PMID: 33318738 PMCID: PMC7715449 DOI: 10.1016/j.jtumed.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022] Open
Abstract
Objective This study aimed to evaluate dental students’ perceptions of roleplay videos used in a professionalism course that was conducted over three years. Methods All third-year dental students (N = 310) who participated in a professionalism course over three years (2016/17–2018/19) were included in this cross-sectional study. Miller's framework for clinical competence was used for the student-generated videos, which included 1) knowledge, 2) observation, 3) simulation, and 4) experience. Every year, at the end of the course, the students provided their responses to the roleplay videos using a 25-item self-administered questionnaire. The questionnaire was divided into four sections: 1) student preparations for video production, 2) skills developed through video production, 3) benefits of watching the videos, and 4) general aspects of the activity. Results Most students agreed that video production led to them working as a team (76%) and understanding professional communication with colleagues (70%) and patients (66%). An improvement in problem-solving skills (67%) and project management skills (65%) was recognised by a majority of the students. Nearly three quarters of the students acknowledged that watching videos improved their professional behaviour towards the patients. Female students and those with high grades showed greater mean scores for most items (22 and 11 out of 25 items, respectively) with significant differences (p < 0.05). Conclusion In our study, the impact of roleplay videos was recognised by a majority of the students. Female students and those with high grades highly rated learning through this method of teaching. Video assignments should be a part of professionalism courses in dentistry to improve students’ communication skills and professional behaviours with colleagues and patients.
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Le‐Bucklin K, Youm J, Wiechmann W, McRae D, Boysen‐Osborn M, Vega C, Park S. #
MD
sToo: A student mistreatment prevention curriculum for faculty members and residents. CLINICAL TEACHER 2020; 17:700-704. [DOI: 10.1111/tct.13211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Julie Youm
- University of California Irvine School of Medicine Irvine California USA
| | - Warren Wiechmann
- University of California Irvine School of Medicine Irvine California USA
| | - Deena McRae
- University of California Irvine School of Medicine Irvine California USA
| | | | - Charles Vega
- University of California Irvine School of Medicine Irvine California USA
| | - Sharon Park
- Sharon Park Johns Hopkins University School of Education Baltimore Maryland USA
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Berger M, Wollsching-Strobel M, Majorski D, Magnet FS, Windisch W, Schwarz SB. [Day/Night Variability of Coughing Events in Interstitial Lung Disease]. Pneumologie 2020; 75:337-343. [PMID: 33147638 DOI: 10.1055/a-1266-6408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Besides dyspnea a dry cough is one of the main symptoms in patients with pulmonary fibrosis. Little is known about the 24-hour-variability of this symptom. Moreover, it is unclear if other auscultation phenomena occur. METHODS A long-term auscultation for 24-hours was performed in patients with fibrotic lung diseases (LEOSound, Löwenstein Medical GmbH & Co. KG, Medical-Electronics, Bad Ems, Germany). Coughing and wheezing sounds were recorded. For the following analysis the 24-hour period was divided into two intervals of 12 hours each (daytime and nighttime). Events were registered in epochs (at least one event in 30 seconds). RESULTS 20 patients were included (6 with nonspecific interstitial pneumonia and 14 with idiopathic pulmonary fibrosis). On average 166 coughing epochs were recorded in a 24-hour-period (day/night 116/50; P < 0.001). Moreover, 203 wheezing epochs were registered (day/night 84/119; P = 0.273). Auscultation phenomena did not correlate with spirometric and bodyplethymographic data, nor with data of diffusion capacity. DISCUSSION The study is showing the clinical potential of long-term auscultation in patients with fibrotic lung diseases. Especially the findings concerning the coughing symptoms were remarkable. It could be shown that there was a decrease of coughing during nighttime in comparison to daytime. In contrast to this, wheezing sounds were increasing at nighttime. The clinical relevance of this finding is yet to be assessed. Finally, there was no correlation between the severity of the disease measured by functional diagnostics and the amount of coughing.
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Affiliation(s)
- M Berger
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - M Wollsching-Strobel
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - D Majorski
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - F S Magnet
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - W Windisch
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - S B Schwarz
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
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Kochis M, Jogerst K, McKinley SK, Sandler M, Petrusa ER, Phitayakorn R. "Fighting an uphill battle": A mixed methods exploration of surgeon involvement in medical schools' preclinical curricula. Am J Surg 2020; 221:315-322. [PMID: 33158493 DOI: 10.1016/j.amjsurg.2020.10.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/07/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Limited exposure to surgeons early on in medical school may adversely impact students' clerkship experiences and professional development. This explanatory sequential mixed methods study investigates a perceived discrepancy between surgical and nonsurgical instructors in our institution's preclinical curriculum. METHODS The demographics of preclinical faculty were assessed before and after a curricular reform. Semi-structured interviews with 13 surgical faculty explored barriers and facilitators to surgeon involvement. Responses were inductively coded and thematically analyzed. RESULTS Surgeons' contributions to preclinical instruction fell from 10% to 5% across the curriculum reform. Barriers both leading to and reinforced by surgeons' limited involvement relate to surgeon, medical school, and student factors. Participants proposed three solutions to barriers in each domain. CONCLUSIONS Surgeons provide a minority of our preclinical instruction and may be disproportionately impacted by reform efforts. Deliberate efforts are necessary to increase opportunities for surgeons to engage with preclinical medical students.
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Affiliation(s)
- Michael Kochis
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Kristen Jogerst
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | | | - Matthew Sandler
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Emil R Petrusa
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Roy Phitayakorn
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
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Keshet Y, Popper-Giveon A. Experiences of Jewish and Arab Healthcare Practitioners Treating Terrorists in Israel. VIOLENCE AND VICTIMS 2020; 35:674-689. [PMID: 33060250 DOI: 10.1891/vv-d-19-00098] [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] [Indexed: 06/11/2023]
Abstract
The growing number of terror attacks worldwide draws attention to the difficulties that healthcare practitioners experience when they treat terrorists or suspected terrorists. Research literature on the challenges faced by healthcare practitioners treating terrorists in conflict areas is limited. In-depth interviews were conducted during 2016-2017 with 50 Jewish and Arab healthcare practitioners (managers, physicians, and nurses) employed in 11 public hospitals in Israel, who treat Palestinian terrorists and security prisoners, in the context of a prolonged and violent national conflict. Jewish practitioners find it emotionally difficult to treat terrorists and security prisoners. They face an ethical dilemma when called upon to save the lives of those who took life and find themselves identifying with the victims. Arab practitioners identify with both sides of the conflict. Three coping strategies were described: maintaining a humanistic standpoint; adherence to a standard of detached professionalism; and refusal to treat terrorists and security prisoners.
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Affiliation(s)
- Yael Keshet
- Western Galilee Academic College, Akko, Israel
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A comparison of undergraduate teaching of psychiatry across medical schools in the Republic of Ireland. Ir J Psychol Med 2020; 37:77-88. [PMID: 32638671 DOI: 10.1017/ipm.2016.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine the delivery and assessment of psychiatry at undergraduate level in the six medical schools in the Republic of Ireland offering a medical degree programme. METHODS A narrative description of the delivery and assessment of psychiatry at undergraduate level by collaborative senior faculty members from all six universities in Ireland. RESULTS Psychiatry is integrated to varying degrees across all medical schools. Clinical experience in general adult psychiatry and sub-specialities is provided by each medical school; however, the duration of clinical attachment varies, and the provision of some sub-specialities (i.e. forensic psychiatry) is dependent on locally available resources. Five medical schools provide 'live' large group teaching sessions (lectures), and all medical schools provide an array of small group teaching sessions. Continuous assessment encompasses 10-35% of the total assessment marks, depending on the medical school. Only one medical school does not provide a clinical examination in the form of an Objective Structured Clinical Examination with viva examinations occurring at three medical schools. CONCLUSIONS Many similarities exist in relation to the delivery of psychiatry at undergraduate level in Ireland. Significant variability exists in relation to assessment with differences in continuous assessment, written and clinical exams and the use of vivas noted. The use of e-learning platforms has increased significantly in recent years, with their role envisaged to include cross-disciplinary teaching sessions and analysis of examinations and individual components within examinations which will help refine future examinations and enable greater sharing of resources between medical schools.
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Abdalla ME, Dash NR, Shorbagi S, Ahmed MH. Preclerkship medical students' perceptions of medical professionalism in the College of Medicine-University of Sharjah: A vision to sustain success in medical education. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:119. [PMID: 32642475 PMCID: PMC7325759 DOI: 10.4103/jehp.jehp_556_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Professionalism is an essential theme in both undergraduate and postgraduate medical education. The current study aimed to assess the preclerkship medical students' perception on medical professionalism. METHODS A cross-sectional qualitative study using the critical incident technique was conducted at the University of Sharjah in the United Arab Emirates (UAE). An online survey was sent to 300 medical students (years 1-3). Participants were asked to describe an official doctor-patient encounter that they have experienced in a health-care setting and to highlight the professional behaviors in that encounter. They were then requested to list the top five characteristics of a professional doctor. Thirty (10%) medical students responded to the study; only 13 reported real incidents. The responses were independently reviewed by the authors. The descriptions of the professional attitudes were grouped according to the six domains of professionalism defined by the American Board of Internal Medicine (ABIM) Physicians Charter and then plotted against the nine domains of medical professionalism published in the UAE Consensus Statement. RESULTS The most common professional behaviors reported were patience, honesty, respect, and patient care. The participants addressed all six domains of professionalism described by the ABIM physicians charter (altruism, accountability, duty , excellence, honor and integrity, and respect for others) and all the domains of medical professionalism published in the UAE Consensus Statement, except for "commitment to advocacy" and "commitment to education" domains. CONCLUSION Preclerkship medical students had an insight about the professional behaviors needed from doctors before formal teaching about professionalism in the curriculum.
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Affiliation(s)
- Mohamed Elhassan Abdalla
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Medical Education Center, University of Sharjah, Sharjah, United Arab Emirates
| | - Nihar Ranjan Dash
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sarra Shorbagi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed H. Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK
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Alipour F, Shahvari Z, Asghari F, Samadi S, Amini H. Personal factors affecting medical professionalism: a qualitative study in Iran. J Med Ethics Hist Med 2020; 13:3. [PMID: 33088430 PMCID: PMC7569534 DOI: 10.18502/jmehm.v13i3.2842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/05/2020] [Indexed: 11/24/2022] Open
Abstract
Professional behavior with patients and interactions with colleagues, the institution and professional bodies are influenced by many factors. The purpose of this manuscript is to clarify those personal factors affecting medical professionalism in clinical settings affiliated with Tehran University of Medical Sciences. For this purpose, a qualitative study was carried out. One hundred and eighty-two participants were recruited through purposive sampling of clinical staff, physicians, and medical students in Tehran. Data were collected through 22 focus group discussions, and conventional content analysis was used to analyze the data. The results were reported in five categories to present the participants' views. Categories were extracted from 103 codes and consisted of 1) people's belief in professionalism, 2) personality traits, 3) problems in family, 4) mental or physical health status, and 5) communication skills. The results showed that despite the facilitator roles of some personal factors, others act as barriers to professional behaviors. In order to control their impact, it is crucial to pay attention to them at the time of student/staff selection. Strengthening support systems in the organization is also essential for decreasing the effect of family problems or physical and mental health problems.
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Affiliation(s)
- Fateme Alipour
- Associate Professor, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shahvari
- Assistant Professor, Department of Nursing and Midwifery, Islamic Azad University of Ghachsaran, Ghachsaran, Iran
| | - Fariba Asghari
- Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Samadi
- Associate Professor, Department of Anesthesia and Intensive Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Amini
- Professor, Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Stratulat SI, Candel OS, Tăbîrţă A, Checheriţă LE, Costan VV. The perception of the educational environment in multinational students from a dental medicine faculty in Romania. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:193-198. [PMID: 31765081 DOI: 10.1111/eje.12484] [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] [Received: 04/05/2019] [Revised: 10/20/2019] [Accepted: 11/22/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Dental education comes with important challenges for the faculties as well as for the students. Its evolving nature leads to the constant adoption of new practices and techniques. Thus, the learning environment is in continuous development. This study aimed to describe a sample of senior undergraduate student's perceptions of their learning environment. METHODS Students (both Romanian and international) enrolled in the 6th year at the Faculty of Dental Medicine from a Romanian University completed the Dundee Ready Education Environment Measure (DREEM). The scale measures students' perceptions of the education environment using five domains: Learning, Teaching, Academic self-perception, Atmosphere and Social self-perception. Data were analysed using descriptive statistics, non-parametric and univariate statistics for group comparison. RESULTS Participants (N = 259, Romanian = 111, International = 148) had a good perception of their learning environment, with a total DREEM score of 117.82 out of 200. Still, they had a lower score in the areas of Academic and Social self-perception. The international students had more negative perceptions of the learning environment compared to the Romanian ones. The French-speaking students had the lowest scores on most of the areas. CONCLUSIONS Although the perception of medical dentistry education is generally good, international students are not as satisfied with the learning environment. The students' experiences could be improved by providing them with more social support. Also, it is important to address the needs of international students in order to create a more satisfying environment for them.
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Affiliation(s)
- Sorin I Stratulat
- Faculty of Medicine/Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania
- Rehabilitation Department, Clinic Hospital C.F., Iaşi, Romania
| | - Octav S Candel
- Department of Psychology, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University of Iaşi, Iaşi, Romania
| | - Alisa Tăbîrţă
- Department of Medical Rehabilitation, Physical Medicine and Manual Therapy, University of Medicine and Pharmacy "Nicolae Testemiţanu", Chişinău, Moldova
| | - Laura E Checheriţă
- Faculty of Medicine/Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania
| | - Victor V Costan
- Faculty of Medicine/Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania
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Lindberg O. Gender and role models in the education of medical doctors: a qualitative exploration of gendered ways of thinking. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:31-36. [PMID: 32007950 PMCID: PMC7246110 DOI: 10.5116/ijme.5e08.b95b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/29/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To examine how 'gendered ways of thinking' relate to role models in medical education. METHODS This study employed an explorative, qualitative, and cross-sectional design. A total of 57 interviews were held with medical students (28 interviews) and with faculty members (29 interviews) at a Swedish medical school. Participants were asked to describe their role models and the attributes that made certain individuals role models. Data were analysed using an inductive approach in three separate steps that explored the relationship between role models and gender. RESULTS Males do not generally consider female doctors as role models, and male role models are generally viewed as more admirable than female role models. This was shown in all steps of the analysis and most prominently in how male role models were described as qualitatively more admirable than female role models. Male role models are thus more common (for male and female students) and described as more admirable. The results point to the persistence of 'gendered ways of thinking' that subtly shape medical students. CONCLUSIONS Gendering role models is disadvantageous to female doctors in several ways, so the results have implications for women's career paths and opportunities. The results can thus form a basis for discussing and teaching the importance of gender in role modelling and in medical education in general.
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Affiliation(s)
- Ola Lindberg
- Department of Education, Umeå University, Umeå, Sweden
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Torralba KD, Jose D, Byrne J. Psychological safety, the hidden curriculum, and ambiguity in medicine. Clin Rheumatol 2020; 39:667-671. [PMID: 31902031 DOI: 10.1007/s10067-019-04889-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/04/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
Psychological safety is a feeling that individuals are comfortable expressing and being themselves, as well as comfortable sharing concerns and mistakes without fear of embarrassment, shame, ridicule, or retribution. It has long been recognized as part of successful patient safety and quality improvement processes. However, in the realm of medical education, psychological safety is a relatively unknown concept to many educators and learners alike. Learners, whether students or postgraduate trainees, are in a phase of cognitive apprenticeship whereby they learn not only skills and knowledge from teachers as part of an explicit and formal curriculum. At the same time, a hidden curriculum is also part of the learning environment in the form of norms, values, and behaviors exhibited by teachers. These norms, values, and behaviors become part of the culture of the clinical learning environment. The vulnerability of learners in this environment is magnified by the hierarchal nature of medicine, and the complexity, uncertainty, and the ambiguity inherent to medical conditions. This is especially true of cognitive specialties such as rheumatology. Educators who engage in unprofessional behaviors that result in learner humiliation and shame may serve to dampen productive discourse and scientific dialog. Therefore, educators must embrace psychological safety to foster learning and facilitate high-performing teams in the clinical learning environment.Key Points• Psychological safety improves communication and teamwork by allowing individuals to be comfortable expressing and being themselves, as well as comfortable sharing concerns and mistakes without fear of embarrassment, shame, ridicule, or retribution.• Commonly studied in the context of patient safety and quality improvement, psychological safety should extend towards medical education particularly in the context of allowing medical students and postgraduate trainees to be able to voice clinical reasoning in the face of ambiguity.• Educators take on a leadership role when having learners under their supervision; as leaders, educators are the prime movers of psychological safety• Learners in the process of developing their self-identity in the context of their chosen profession adopt not only knowledge and skills within the framework of an explicit and formal curriculum but also norms and values from daily behavior and language educators present in the clinical learning environment of learners; these norms and values are collectively part of the hidden curriculum.
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Affiliation(s)
- Karina D Torralba
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA.
| | - Donna Jose
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA
| | - John Byrne
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA.,Loma Linda Health Care System, Loma Linda, CA, USA
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Sullivan BT, DeFoor MT, Hwang B, Flowers WJ, Strong W. A Novel Peer-Directed Curriculum to Enhance Medical Ethics Training for Medical Students: A Single-Institution Experience. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120519899148. [PMID: 32030354 PMCID: PMC6977198 DOI: 10.1177/2382120519899148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The best pedagogical approach to teaching medical ethics is unknown and widely variable across medical school curricula in the United States. Active learning, reflective practice, informal discourse, and peer-led teaching methods have been widely supported as recent advances in medical education. Using a bottom-up teaching approach builds on medical trainees' own moral thinking and emotion to promote awareness and shared decision-making in navigating everyday ethical considerations confronted in the clinical setting. OBJECTIVE Our study objective was to outline our methodology of grassroots efforts in developing an innovative, student-derived longitudinal program to enhance teaching in medical ethics for interested medical students. METHODS Through the development of a 4-year interactive medical ethics curriculum, interested medical students were provided the opportunity to enhance their own moral and ethical identities in the clinical setting through a peer-derived longitudinal curriculum including the following components: lunch-and-learn didactic sessions, peer-facilitated ethics presentations, faculty-student mentorship sessions, student ethics committee discussions, hospital ethics committee and pastoral care shadowing, and an ethics capstone scholarly project. The curriculum places emphasis on small group narrative discussion and collaboration with peers and faculty mentors about ethical considerations in everyday clinical decision-making and provides an intellectual space to self-reflect, explore moral and professional values, and mature one's own professional communication skills. RESULTS The Leadership through Ethics (LTE) program is now in its fourth year with 14 faculty-clinician ethics facilitators and 65 active student participants on track for a distinction in medical ethics upon graduation. Early student narrative feedback showed recurrent themes on positive curricular components including (1) clinician mentorship is key, (2) peer discussion and reflection relatable to the wards is effective, and (3) hands-on and interactive clinical training adds value. As a result of the peer-driven initiative, the program has been awarded recognition as a graduate-level certification for sustainable expansion of the grassroots curriculum for trainees in the clinical setting. CONCLUSIONS Grassroots medical ethics education emphasizes experiential learning and peer-to-peer informal discourse of everyday ethical considerations in the health care setting. Student engagement in curricular development, reflective practice in clinical settings, and peer-assisted learning are strategies to enhance clinical ethics education. The Leadership through Ethics program augments and has the potential to transform traditional teaching methodology in bioethics education for motivated students by offering protected small group discussion time, a safe environment, and guidance from ethics facilitators to reflect on shared experiences in clinical ethics and to gain more robust, hands-on ethics training in the clinical setting.
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Affiliation(s)
- Brian T Sullivan
- Department of Orthopaedics, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mikalyn T DeFoor
- School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Center for Bioethics and Health Policy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Brice Hwang
- School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Department of Ophthalmology, School of Medicine, Georgetown University, Washington, DC, USA
| | - W Jeffrey Flowers
- Center for Bioethics and Health Policy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - William Strong
- Center for Bioethics and Health Policy, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Yavari N, Asghari F, Shahvari Z, Nedjat S, Larijani B. Obstacles of professional behavior among medical trainees: A qualitative study from Iran (2018). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:193. [PMID: 31807585 PMCID: PMC6852278 DOI: 10.4103/jehp.jehp_272_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Despite all efforts that have been made to promote professional behavior among medical trainees, unfortunately, reports from medical schools around the world confirm the prevalence of nonprofessional behaviors by medical students. Experts in the field of medical ethics and medical education in different countries have suggested several reasons for failing to minimize unprofessional performance among medical students. MATERIALS AND METHODS This qualitative study aimed to promote our understanding from the challenges faced by Iranian medical students in providing professional behavior. The study was first conducted in the form of a semi-structured face-to-face interview with medical students and then completed with a focus group discussion (FGD) session. Forty-nine medical students participated in the interviews and 11 students participated in the FGD session. Qualitative conventional content analysis was used for examining the data. RESULTS The participants classified the obstacles of professional behavior into the following three main categories: problems related to educational system, problems related to the society, and problems related to students themselves. CONCLUSION Regarding the impact of various personal, social, and educational factors on the creation and expansion of unprofessional behaviors among medical students, it is essential to have a comprehensive approach for solving the problem.
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Affiliation(s)
- Neda Yavari
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medical Ethics, School of Medicine, University of Medical Sciences, Tehran, Iran
| | - Fariba Asghari
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shahvari
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hee JM, Yap HW, Ong ZX, Quek SQM, Toh YP, Mason S, Krishna LKR. Understanding the Mentoring Environment Through Thematic Analysis of the Learning Environment in Medical Education: a Systematic Review. J Gen Intern Med 2019; 34:2190-2199. [PMID: 31011975 PMCID: PMC6816739 DOI: 10.1007/s11606-019-05000-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 11/13/2018] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Mentoring's success has been attributed to individualised matching, holistic mentoring relationships (MRs) and personalised mentoring environments (MEs). Whilst there is growing data on matching and MRs, a dearth of ME data has hindered development of mentoring programme. Inspired by studies likening MEs to learning environments (LEs) and data highlighting common characteristics between the two, this systematic review scrutinises reports on LEs to extrapolate the findings to the ME context to provide a better understanding of ME and their role in the mentoring process. METHODS Using identical search strategies, 6 reviewers carried out independent literature reviews of LEs in clinical medicine published between 1 January 2000 and 31 December 2015 using PubMed, ERIC, Cochrane Database of Systematic Reviews, Google Scholar and Scopus databases. Braun and Clarke's (2006) approach to thematic analysis was adopted to circumnavigate LE's evolving, context-specific, goal-sensitive, learner-tutor relationally dependent nature. RESULTS A total of 4574 abstracts were identified, 90 articles were reviewed, and 58 full-text articles were thematically analysed. The two themes identified were LE structure and LE culture. LE structure regards the framework that guides interactions within the LE. LE culture concerns the values and practices influencing learner-tutor-host organisation interactions. DISCUSSION LE is the product of culture and structure that influence and are influenced by the tutor-learner-host organisation relationship. LE structure guides the evolving tutor-learner-host organisation relationship whilst the LE culture nurtures it and oversees the LE structure. Similarities between LEs and MEs allow LE data to inform programme designers of ME's role in mentoring's success.
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Affiliation(s)
- Jia Min Hee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National Cancer Centre Singapore, Singapore, Singapore
| | - Hong Wei Yap
- National Cancer Centre Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Singapore, Singapore
| | - Zheng Xuan Ong
- National Cancer Centre Singapore, Singapore, Singapore
- Singapore General Hospital, Singapore, Singapore
| | - Simone Qian Min Quek
- National Cancer Centre Singapore, Singapore, Singapore
- Changi General Hospital, Singapore, Singapore
| | - Ying Pin Toh
- National Cancer Centre Singapore, Singapore, Singapore.
- Department of Family Medicine, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | | | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National Cancer Centre Singapore, Singapore, Singapore
- University of Liverpool, Liverpool, UK
- Duke-NUS Medical School, Singapore, Singapore
- Centre of Biomedical Ethics, National University of Singapore, Singapore, Singapore
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Bazrafkan L, Hayat AA, Tabei SZ, Amirsalari L. Clinical teachers as positive and negative role models: an explanatory sequential mixed method design. J Med Ethics Hist Med 2019; 12:11. [PMID: 32328224 PMCID: PMC7166239 DOI: 10.18502/jmehm.v12i11.1448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/07/2019] [Indexed: 11/24/2022] Open
Abstract
Today, role modeling is an essential component of medical education that facilitates the students' learning and affects their attitudes and behaviors. Hence, this study aimed to examine the characteristics of positive and negative role models using a mixed method approach. In the quantitative part, data were collected using a questionnaire with 24 items. The research population included medical students who were in their clinical period between May 2017 and December 2018 at Shiraz University of Medical Sciences (n = 750). A total of 282 questionnaires were completed by these students, and in the qualitative part, 26 semi-structured interviews were conducted with them. The most important components of role modeling for students included: individual characteristics, clinical skills and competence, teaching skills and professionalism, in that order. The qualitative analysis confirmed the results of the quantitative analysis. The findings showed that the characteristics of a negative role model can also be classified in four main components. The results demonstrated that 46.8% of the students identified one or more medical teachers as negative models. Students paid attention to not only the positive characteristics of their teachers, but also their negative features, stating that they had been influenced by both. Therefore, it can be concluded that clinical teachers should improve their performance as positive role models through reducing these negative effects and reinforcing positive characteristics.
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Affiliation(s)
- Leila Bazrafkan
- Assistant Professor, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asghar Hayat
- Assistant Professor, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ziaaddin Tabei
- Professor, Department of Medical Ethics and Philosophy in Health Care, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Amirsalari
- Researcher, Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Re-thinking How We Teach Quality Improvement: Adding Meaning to an ACGME Requirement. J Gen Intern Med 2019; 34:1662-1667. [PMID: 31197728 PMCID: PMC6667725 DOI: 10.1007/s11606-019-05059-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 12/13/2018] [Accepted: 03/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Many residency programs have struggled to meaningfully meet the ACGME quality improvement (QI) requirements. Similarly, our residents were receiving limited QI education, and their longitudinal projects were ineffective. AIM Create an integrated didactic and experiential learning environment that equips residents to become leaders of QI. SETTING AND PARTICIPANTS Internal medicine (IM) residency program of 45 residents in a large community hospital. PROGRAM DESCRIPTION This curriculum included eight content areas. Games, real-life application, and project celebrations cultivated engagement. Sessions occurred during residents' 2-week outpatient rotations. Project development was standardized. PROGRAM EVALUATION The QI Knowledge Application Tool-Revised (QIKAT-R) and separate surveys were used before and after the curriculum's implementation to evaluate resident QI knowledge and confidence, respectively. We also tracked QI scholarship and faculty engagement. Mean QIKAT-R scores improved significantly from 7.0 (SD 2.9) at baseline to 16.6 (SD 4.7) post-curriculum (n = 37 pairs, p = 0.043). Residents' adverse event reporting increased from 44% (19/43) at baseline to 90% (28/31) post-curriculum. Seven presentations were accepted for local, regional, and national conferences, compared with one presentation the preceding year. DISCUSSION A QI curriculum can be successfully integrated in a "4 + 2" program.
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Selic P, Cerne A, Klemenc-Ketis Z, Petek D, Svab I. Attitudes toward professionalism in medical students and its associations with personal characteristics and values: a national multicentre study from Slovenia raising the question of the need to rethink professionalism. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2019; 10:437-446. [PMID: 31417330 PMCID: PMC6593685 DOI: 10.2147/amep.s197185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/20/2019] [Indexed: 06/10/2023]
Abstract
Background: Professionalism is becoming one of the main competencies that all medical students should develop during their education. The attitudes of medical students to professionalism in the study process can change, depending on the curriculum and methods of teaching. Factors associated with attitudes to professionalism can be divided into the characteristics of the physician and the context, eg, education about professionalism and the health system; however other student characteristics are also important. This study focused on the factors associated with attitudes toward professionalism and took into account student demographic characteristics, personality and their personal values. Methods: A convenience sampling method was employed in the academic year 2015-2016 in the fourth and final year medical students at the two Medical Faculties in Slovenia. The instrument consisted of questionnaires examining the Big Five personality traits questionairre (BFQ), the scale of personal values and demographic and family background data. The outcome measure was the validated professionalism attitude scale (PAS). Results: A total of 323 students participated, of which 101 (31.3%) were men and 222 (68.7%) were women. The samples of the two faculties did not differ in any demographic characteristics and were analyzed together. Of the personal values, partner/love, profession/work and sport activity were significantly associated with the total score of the PAS (β=0.22, p=0.033; β=0.24, p=0.003; β=0.17, p=0.040, respectively). After the adjustments for the BFQ dimensions, only profession/work kept significance (β=0.19, p=0.016). Women scored significantly higher on attitudes toward professionalism (total PAS score: Mw=93.4±5.1, Mm=89.1±9.8, p=0.001), and this significance remained in multivariate modeling (β=-0.20, p=0.001). Of the hereditary traits, only acceptability was associated with attitudes toward professionalism (β=0.25, p<0.001). Conclusions: It seems that personal characteristics and values are important in students` concept of their future professional behavior. Further research will show whether these patterns are prerequisites for enrollment in the study process.
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Affiliation(s)
- Polona Selic
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana1000, Slovenia
| | - Anja Cerne
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana1000, Slovenia
| | - Zalika Klemenc-Ketis
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana1000, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor2000, Slovenia
- Department of Family Medicine, Community Health Centre Ljubljana, Ljubljana1000, Slovenia
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana1000, Slovenia
| | - Igor Svab
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana1000, Slovenia
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Keis O, Schneider A, Heindl F, Huber-Lang M, Öchsner W, Grab-Kroll C. How do German medical students perceive role models during clinical placements ("Famulatur")? An empirical study. BMC MEDICAL EDUCATION 2019; 19:184. [PMID: 31159794 PMCID: PMC6547468 DOI: 10.1186/s12909-019-1624-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 05/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND Studies have demonstrated the importance of role models in medical education. Medical students in Germany participate in clinical placements ("Famulatur") that last 4 months in total and represent the first real-world setting where students encounter possible role models in their clinical education. These placements are an extracurricular activity, however, and regarded as the "black box" of medical education. This study aimed to evaluate whether and how students experience role models during clinical placements, the qualities associated with potential role models and whether role model-related learning gains are relevant. METHODS We recruited 96 students (mean age: 23.83 years; 75% female) in their 5th to 9th semesters at the Faculty of Medicine at the University of Ulm, Germany, who were participating in a clinical placement between July and October 2015. Participants completed a questionnaire at the beginning of a 5-day working week to record sociodemographic and other information and another one at the end of the week to assess various aspects of their experiences. On each of the 5 days, they completed a structured questionnaire to record their perceived role models and self-assessed learning gains. RESULTS Role models and role modelling play an important role in clinical placements. The positive function of medical staff as role models predominated (88.4%) across all specialties. Junior doctors were the most frequently perceived role models (28.5%), followed by consultants (25.1%) and nursing staff (22.4%). The most commonly perceived positive quality was the interaction with students (16.5%), followed by team behaviour (13.6%), interaction with patients (13.6%) and professional expertise (13.4%). Students also had various kinds of learning gains such as knowledge or skills. CONCLUSIONS Although these clinical placements are extracurricular activities in Germany and their content is not regulated, they are home to a relevant amount of role modelling. Students experience the various medical professions in different roles and in a range of tasks and interactions. Defining basic learning objectives could help to increase the relevance of these placements for the medical curriculum in Germany and transfer the associated learning gains from the hidden to the open curriculum.
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Affiliation(s)
- Oliver Keis
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Achim Schneider
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Felix Heindl
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Markus Huber-Lang
- Institute for Clinical and Experimental Trauma Immunology, Ulm University Medical Center, Helmholtzstr. 8/2, 89081 Ulm, Germany
| | - Wolfgang Öchsner
- Center for Surgery / Department for Cardiac Anesthesiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Claudia Grab-Kroll
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
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Cusimano MC, Ting DK, Kwong JL, Van Melle E, MacDonald SE, Cline C. Medical Students Learn Professionalism in Near-Peer Led, Discussion-Based Small Groups. TEACHING AND LEARNING IN MEDICINE 2019; 31:307-318. [PMID: 30554529 DOI: 10.1080/10401334.2018.1516555] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Problem: Medical educators recognize that professionalism is difficult to teach to students in lecture-based or faculty-led settings. An underused but potentially valuable alternative is to enroll near-peers to teach professionalism. Intervention: We describe a novel near-peer curriculum on professionalism developed at Queen's University School of Medicine. Senior medical students considered role models by their classmates were nominated to facilitate small-group seminars with junior students on topics in professionalism. Each session was preceded by brief pre-readings or prompts and engaged students in semistructured, open-ended discussion. Three 2-hour sessions have occurred annually. Context: The near-peer sessions are a required component (6 hours; 20%) of the 1st-year professionalism course at Queen's University (30 hours), which otherwise includes faculty-led seminars, lectures, and online modules. Senior facilitators are selected through a peer nomination process during their 3rd year of medical school. This format was chosen to create a highly regarded position to which students could aspire by demonstrating positive professionalism. Outcome: We performed a qualitative descriptive evaluation of the near-peer curriculum. Fifty-six medical students participated in 11 focus group interviews, which were coded and analyzed for themes inductively and deductively. Quantitative reviews of student feedback forms and a third-party thematic analysis were performed to triangulate results. Medical students preferred the near-peer-led discussion-based curriculum to faculty-led seminars and didactic or online formats. Junior students could describe specific examples of how the curriculum had influenced their behavior in academic, clinical, and personal settings. They cited senior near-peer facilitators as the strongest aspect of the curriculum for their social and cognitive congruence. Senior students who had facilitated sessions regarded the peer teaching experience as formative to their own understanding of professionalism. Lessons Learned: Formal medical curricula on professionalism should emphasize near-peer-led small-group discussion as it fosters a nuanced understanding of professionalism for both early level students and senior students acting as teachers.
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Affiliation(s)
- Maria C Cusimano
- a Department of Obstetrics and Gynecology , University of Toronto , Toronto , Ontario , Canada
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
| | - Daniel K Ting
- b Department of Emergency Medicine , University of British Columbia , Kelowna , British Columbia , Canada
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
| | - Jonathan L Kwong
- c MD Program , University of Toronto , Toronto , Ontario , Canada
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
| | - Elaine Van Melle
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
| | - Susan E MacDonald
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
| | - Cheryl Cline
- d Undergraduate Medical Education , Queen's University , Kingston , Ontario , Canada
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Duma N, Maingi S, Tap WD, Weekes CD, Thomas CR. Establishing a Mutually Respectful Environment in the Workplace: A Toolbox for Performance Excellence. Am Soc Clin Oncol Educ Book 2019; 39:e219-e226. [PMID: 31099664 DOI: 10.1200/edbk_249529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Most health care professionals spend a substantial amount of their time at the workplace. Our interactions with team members can define our daily experiences, impact our work performance, and influence our overall job satisfaction. Over the last years, how we interact with colleagues and patients has changed with the introduction of social media, a tenser political climate, and an evolving health care system. In oncology, a team can be composed of medical students, clinicians, and support and administrative staff within a heavy emotional environment where some of our patients are facing the risk of early mortality and most are dealing with the unmeasurable burden of cancer. Many of these factors can increase the risk for professionalism lapses. We discuss common challenges faced in the practice of cancer care, including the generational gap between medical trainees and senior members, gender disparities, and microaggressions. Microaggressions represent verbal, behavioral, and environmental indignities that communicate hostile, derogatory, and negative slights that insult a target person or group. Microaggressions should not be accepted as the norm in the workplace. It is essential to recognize these negative behaviors and manage them effectively to reduce or even prevent the long-term toxicities that these behaviors can bring to the workplace environment. Ultimately, we must acknowledge that these issues exist and remember that education and collaboration are the pillars of an inclusive workplace. We owe such efforts to our patients who deserve good care, to our partners in the care of patients so that they feel supported and included, and to ourselves.
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Affiliation(s)
- Narjust Duma
- 1 Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | - Shail Maingi
- 2 Department of Hematology, Oncology, and Palliative Care, Saint Peters Health Partners, Troy, NY
| | - William D Tap
- 3 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Colin D Weekes
- 4 Division of Hematology/Medical Oncology, Massachusetts General Hospital, Boston, MA
| | - Charles R Thomas
- 5 Department of Radiation Medicine, Oregon Health & Science University, Portland, OR
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Manzoor A, Baig LA, Aly SM. Attitudes of faculty and residents of surgical specialties towards professionalism at a tertiary care hospital of Islamabad. Pak J Med Sci 2019; 35:371-376. [PMID: 31086517 PMCID: PMC6500805 DOI: 10.12669/pjms.35.2.387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: To determine the attitudes of faculty and residents of surgical specialties towards professionalism and to test the validity and reliability of a tool developed in USA for Pakistan. Methods: An exploratory validation study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad from 01-Aug-2016 to 31-Jan-2017. Penn State College of Medicine Professionalism Questionnaire (PSCOM) was used, being a reliable and valid survey tools. Exploratory Factor Analysis of the inter-correlations of responses for 36 items was done using SPPS v 21 to give a factor solution to reflect the perceptions regarding attitudinal elements. Results: There were 209 respondents including 172 residents and 37 faculty members. Response rate was 81.32%. Exploratory Factor Analyses of responses gave a seven factor solution of professionalism: accountability, honour and integrity, excellence, duty, altruism, equity and respect. Six of the factors that emerged reflect the six elements of professionalism reported by American Board of Internal Medicine (ABIM), except for ‘equity’, which was the new factor that emerged. Cronbach’s alpha (Internal Consistency Reliability) for each element of professionalism was between 0.88-0.98. Conclusion: PSCOM is a valid, reliable, feasible and acceptable tool to assess attitudes of faculty and residents towards professionalism in Pakistan. ‘Equity’ emerged as a new factor which needs to be studied further.
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Affiliation(s)
- Arifa Manzoor
- Dr. Arifa Manzoor, MBBS, FCPS, MRCS, MHPE. Assistant Professor, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | - Syed Moyn Aly
- Dean APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
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Kadar GE, Thompson HG. Obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care institution: A cross-sectional study. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:8-15. [PMID: 30044139 PMCID: PMC6417871 DOI: 10.7899/jce-17-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/15/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE: The purpose of this study was to assess the prevalence of obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care academic institution. METHODS: This was a cross-sectional quantitative, single-method survey with group comparison using the Beliefs About Obese Persons scale (BAOP) and the Attitudes Toward Obese Persons scale. Both instruments were administered as a single 28 question survey via email to 450 students and 46 faculty members in a doctor of chiropractic (DC) program. Differences were determined by 2 tailed t tests. RESULTS: The response rate for faculty and students was 31% and 65%, respectively. One hundred forty-three DC students, preclinical ( n = 65) and clinical ( n = 78), and 30 DC faculty, preclinical ( n = 15) and clinical ( n = 15) completed the survey. Both students and faculty harbored antiobesity attitudes and moderate antiobesity beliefs. Students demonstrated slightly more positive attitudes toward obese persons than did preclinical faculty. Although preclinical faculty did not demonstrate more biased attitudes than did preclinical students ( p = .057), they were more biased than clinical students ( p = .26). On the BAOP, preclinical faculty scored significantly lower than both preclinical students and clinical students ( p = .013 and .017, respectively). CONCLUSION: Obesity bias was common among clinical and preclinical chiropractic students and faculty at our institution. A cultural shift that reduces bias may require changes in both the curriculum and cocurriculum.
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Kumar Ghosh S, Kumar A. Building Professionalism in Human Dissection Room as a Component of Hidden Curriculum Delivery: A Systematic Review of Good Practices. ANATOMICAL SCIENCES EDUCATION 2019; 12:210-221. [PMID: 30376608 DOI: 10.1002/ase.1836] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/05/2023]
Abstract
The core values in medical practice which are essential for the humane outlook of a physician are clubbed within the domain of medical professionalism. Professionalism along with other discipline-independent skills (human skills) is propagated implicitly in medical schools as components of a "hidden curriculum." Evidence suggests a strong association between "hidden curriculum" delivery and development of professionalism in the human dissection room. In this review article, the authors have tried to highlight a few exclusive practices adopted by medical schools which enhance the implementation of the "hidden curriculum" within the practice of human dissection and successfully inculcate the key components of professionalism such as integrity, respect, and compassion among students. These distinctive concepts are aimed at humanizing the experience of anatomical dissection by revealing the identity of the donors along with their personal details either through display of video clips of donor interviews, interactions with the family members of the donor over a meal or recognition of the donor as a mentor and organizing memorial services in honor of donors after conclusion of the dissection in the presence of their family members. The resounding success of these good practices in building professionalism among medical students from the onset of the academic curriculum has signaled a new chapter in anatomical sciences education. It has become imperative to recognize the visionary efforts of a select few medical educators and begin incorporating these recent trends into the delivery of the "hidden curriculum" within the evolving gross anatomy education model.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Ashutosh Kumar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
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Wald HS, Anthony D, White J, Reis S, Esquibel A. Interactive reflective writing-enhanced reflection and professional identity formation in medical education - in reply to (1) Hichem Bouayed, Samiullah Dost, and Tanzeel Hussian and (2) Alexander Morgan, James Moore and Alexander Duff. MEDICAL TEACHER 2019; 41:236-237. [PMID: 30663478 DOI: 10.1080/0142159x.2018.1543861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Hedy S Wald
- a Family Medicine, Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - David Anthony
- a Family Medicine, Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Jordan White
- b Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Shmuel Reis
- c Medical Education , Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Angela Esquibel
- d Mayo Clinic Health System Franciscan Healthcare in La Crosse Family Medicine , La Crosse , WI , USA
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Mullikin TC, Shahi V, Grbic D, Pawlina W, Hafferty FW. First Year Medical Student Peer Nominations of Professionalism: A Methodological Detective Story about Making Sense of Non-Sense. ANATOMICAL SCIENCES EDUCATION 2019; 12:20-31. [PMID: 29569347 DOI: 10.1002/ase.1782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/17/2018] [Accepted: 02/21/2018] [Indexed: 06/08/2023]
Abstract
This article explores the assessment of professionalism within a cohort of medical students during a sequential 13-week medical school histology and anatomy course. Across seven data points, students were asked to identify a professionalism role model from amongst their peers and to score Likert-structured rationales for their decision. Based on density scores, an initial social network analysis identified six peer-nomination "stars." However, analysis of these stars revealed considerable variability and random-like "noise" in both the nomination and explanation data sets. Subsequent analyses of both data sets explored the possibility of underlying patterns in this noise using tests of reliability, principal components factor analysis, and fixed-effects regression analysis. These explorations revealed the presence of two dimensions (professional vs. supportive) in how students sought to explain their nomination decisions. Although data variability remained quite high, significantly less variability was present in the professional than in the supportive dimension, suggesting that academic helpfulness rationales are both empirically distinct and more mutable than rationales grounded in professionalism-related factors. In addition, data showed that the greater the stability in one's choice of a professionalism role model nomination over the T1-T7 data periods, the more stable one's reasons for that nomination-both for professionalism and supportive dimensions. Results indicate that while peer assessment of professionalism by first-year medical students may not be very reliable, students can differentiate between more personal and professional factors, even at this early stage in their professional development. Formal instruction within the pre-clinical curriculum should recognize and address this distinction. Anat Sci Educ. © 2018 American Association of Anatomists.
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Affiliation(s)
- Trey C Mullikin
- Department of Radiation Oncology Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
| | - Varun Shahi
- Department of Emergency Medicine, University of California Los Angeles Medical Center, Los Angeles, California
| | - Douglas Grbic
- Association of American Medical Colleges, District of Columbia, Washington
| | - Wojciech Pawlina
- Department of Anatomy Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
- Program in Professionalism and Values, Mayo Clinic, Rochester, Minnesota
| | - Frederic W Hafferty
- Program in Professionalism and Values, Mayo Clinic, Rochester, Minnesota
- Department of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Ranauta A, Freeth D, Davenport E. Developing understanding and enactment of professionalism: undergraduate dental students' perceptions of influential experiences in this process. Br Dent J 2018; 225:sj.bdj.2018.813. [PMID: 30287964 DOI: 10.1038/sj.bdj.2018.813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 11/09/2022]
Affiliation(s)
- A Ranauta
- Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary, University of London, Turner Street, London, E1 2AD
| | - D Freeth
- Royal College of Physicians, 11 St Andrews Place, London, NW1 4LE
| | - E Davenport
- Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary, University of London, Turner Street, London, E1 2AD
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Ding N, Yan D, Li H, Ma Y, Wen D. Chinese medical students' agreement with and fulfillment of the Physician Charter. BMC MEDICAL EDUCATION 2018; 18:212. [PMID: 30223813 PMCID: PMC6142398 DOI: 10.1186/s12909-018-1324-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 09/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Although it has been nearly 15 years since the Medical Professionalism in the New Millennium: A Physician Charter (the Physician Charter) was proposed to reaffirm medical professionalism in response to the new challenges in healthcare delivery in the new century, the manner in which Chinese medical students agree with and fulfill the principles and responsibilities of professionalism defined in the Physician Charter still remains unknown. METHODS In March 2016, 748 fifth-year medical students from China Medical University (CMU) participated in a survey in which they indicated their rate of agreement with and manner of fulfillment of the principles and responsibilities defined in the Physician Charter using a 10-point Likert scale. The data were then analyzed by t-tests, exploratory factor analysis, and multiple linear regressions. RESULTS The total score of agreement with the Physician Charter was significantly higher than that of fulfillment (p < 0.001). The largest difference between agreement and fulfillment scores were with the principle of social justice (P3), commitments to improving access to care (R6), and a just distribution of finite resources (R7). Exploratory factor analysis distinguished two principles - primacy of patient welfare (P1) and patient autonomy (P2) - from the others in terms of the gap between agreement and fulfillment. This is partially because the proportion of students who rated agreement lower than fulfillment of P1 or P2 was much higher than it was for any other principle or responsibility. Additionally, multiple linear regressions show that students who are enrolled in a five-year program or who was registered as a rural resident (i.e. holding a rural Hukou) had significantly higher scores of agreement, but not fulfillment. CONCLUSIONS Chinese medical students endorsed the Physician Charter and its core values of medical professionalism, although they felt difficult to fulfill in practice. Medical educators and the health authority should act together to support and foster professional values.
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Affiliation(s)
- Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Dan Yan
- School of Public Health, Dalian Medical University, Dalian, Liaoning China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Yuan Ma
- Office of Student Affairs, China Medical University, Shenyang, Liaoning China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
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The Professional Online: Stranger in a Strange Land. Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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