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Mohanraj PS, Das A, Rajendran V, Gopal N, Saravanan K, Balan Y. Evaluating the Effectiveness of Online Assessments and Their Parameters as Predictors of Academic Performance in Undergraduate Medical Education. Cureus 2024; 16:e62129. [PMID: 38993421 PMCID: PMC11238035 DOI: 10.7759/cureus.62129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
Background and objectives Considering the increasing utilization of online educational tools in medical education, it is essential to evaluate the reliability and validity of online assessments to accurately assess student proficiency and predict academic success. This study investigated the predictive efficacy of different online assessment methods in comparison to standard offline methods within the medical educational setting. Methods This study utilized a mixed-methods crossover design, involving 125 first-year medical students who were randomly assigned to either online or traditional examinations. The students then crossed over to the other type of assessment. The assessments consisted of multiple-choice questions (MCQs), viva voce, objective structured clinical examinations, and written theory examinations. Quantitative data on results, finishing times, and academic metrics were analyzed, along with qualitative data from student interviews exploring perceptions of each format. Results The online MCQs had the highest average scores and a moderately positive correlation with performance on the theory examination (r=0.326). Regression models indicated that online and offline MCQs were moderate positive predictors of theoretical marks (R2=0.106 and 0.107, respectively). Qualitative responses emphasized advantages such as flexibility and accessibility for online examinations but also concerns regarding technological challenges, interaction, and integrity compared to traditional formats. Conclusions Online MCQ assessments showed promise as indicators of medical student academic performance. However, additional online forms require improvement to match conventional assessments reliably. As medical education involves digital technologies, cautious implementation of online evaluations substantiated by further research is needed to preserve educational quality standards.
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Affiliation(s)
| | - Arani Das
- Physiology, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Vinoth Rajendran
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Niranjan Gopal
- Biochemistry, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
- Biochemistry, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| | - Kothandan Saravanan
- Biochemistry, Postgraduate Institute of Medical Education and Research Satellite Centre Sangrur, Sangrur, IND
| | - Yuvaraj Balan
- Biochemistry, All India Institute of Medical Sciences, Madurai, Madurai, IND
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Campbell A, Hinton T, da Costa NC, O'Brian SE, Liang DR, Wheate NJ. Causes and outcomes of at-risk underperforming pharmacy students: implications for policy and practice. BMC MEDICAL EDUCATION 2024; 24:421. [PMID: 38641772 PMCID: PMC11027423 DOI: 10.1186/s12909-024-05327-z] [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: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This study aimed to understand the key determinants for poor academic performance of students completing a Bachelor of Pharmacy (BPharm), Bachelor of Pharmacy and Management (BPharmMgmt), or Master of Pharmacy (MPharm) degree. METHODS Data were collected on pharmacy students who had not met academic progression requirements between 2008 and 2018 at The University of Sydney, Australia. This included: age at the start of pharmacy degree; gender; whether they transferred from another university; whether they were a domestic or international student; Australian Tertiary Admissions Rank upon entry, previous studies in biology, chemistry, or mathematics; show cause triggers (units of study failed); number of show causes; students' written show cause responses; weighted average mark at last show cause or graduation; whether they graduated and were a registered pharmacist; and, the number of years they spent studying the degree. Descriptive studies were used to analyse student characteristics using SPSS software, and student self-reported reasons for poor performance were analysed reflexively using thematic analysis procedures using NVivo. RESULTS This study included 164 pharmacy students enrolled in a BPharm (79.3%, n = 130), BPharmMgmt (1.2%, n = 2), or MPharm (19.5%, n = 32). Of the students, 54% (n = 88) were men, 81% (n = 133) were domestic students, 15% (n = 24) transferred from another degree program, and 38% (n = 62) graduated from the course. Show cause students were less likely to graduate if they transferred from another degree program (P = 0.0002) or failed more than three units of study (UoS; P < 0.0001). The most commonly failed UoS were related to organic or pharmaceutical chemistry, and the top student self-reported reasons for poor performance was stress/anxiety, physical health, and depression. CONCLUSION Pharmacy schools should aim to address student foundational knowledge in chemistry, identify at-risk students early using pre-subject testing, and provide better services to address student mental health.
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Affiliation(s)
- Alice Campbell
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Tina Hinton
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
- Charles Perkin Centre, Faculty of Medicine and Health, The University of Sydney NSW, 2006, Sydney, NSW, Australia
| | - Narelle C da Costa
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Sian E O'Brian
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Danielle R Liang
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia
| | - Nial J Wheate
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, 2006, Sydney, NSW, Australia.
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Sirin Gok M, Aydin A, Baga Y, Ciftci B. The relationship between the psychological resilience and general health levels of earthquake survivor nursing students in Kahramanmaras earthquakes, the disaster of the century. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:498-511. [PMID: 38385610 DOI: 10.1002/jcop.23110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/23/2024]
Abstract
The present study was conducted to determine the relationship between the psychological resilience of earthquake survivor students and their general health status. This descriptive and correlational study was conducted at a state university in Turkey in June 2023 with the nursing department students of a university that experienced two major earthquakes in Turkey on February 6, 2023. The sample of the study consisted of 287 students. The data of the study were collected with the "Descriptive Characteristics Form," "Brief Resilience Scale," and "General Health Questionnaire-12." Filling out the forms took approximately 5-10 min. It was determined in the present study that the psychological resilience of the earthquake survivor students was moderate. It was found that the girls, second graders, those with higher income levels, those who did not receive medication/professional support for their mental health, and those who described their health as good generally had higher psychological resilience levels. It was found that the general health status of the earthquake survivors was at an increased risk level, and 69% of them were at high risk for mental diseases. The mental health of girls, first graders, those who had low-income levels, those who lost loved ones in the earthquake, those whose houses were damaged, those who received medication/professional support for mental health, those who did not generally participate in distance education, and those who described their health as deficient in general, had worse mental health levels. A high relationship was detected between nursing students' psychological resilience and mental health (p < 0.05). It was concluded in the present study that as the psychological resilience of the students increased, the risk of mental disease decreased.
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Affiliation(s)
- Meltem Sirin Gok
- Department of Fundamentals of Nursing, Ataturk University Faculty of Nursing, Erzurum, Turkey
| | - Ayşe Aydin
- Department of Obstetrics and Gynecology Nursing, Ataturk University Faculty of Nursing, Erzurum, Turkey
| | - Yaprak Baga
- Department of Fundamentals of Nursing, Ataturk University Faculty of Nursing, Erzurum, Turkey
| | - Bahar Ciftci
- Department of Fundamentals of Nursing, Ataturk University Faculty of Nursing, HGF Agro, Ata Teknokent, Erzurum, Turkey
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Chung EK, Yun H, Yang JH, Shin MH, Han ER. Factors associated with academic performance among medical students at a medical school in South Korea: A retrospective cohort study. PLoS One 2024; 19:e0296682. [PMID: 38335189 PMCID: PMC10857721 DOI: 10.1371/journal.pone.0296682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 12/17/2023] [Indexed: 02/12/2024] Open
Abstract
Longitudinal research has provided systematic empirical data on the short- and long-term outcomes of admissions policies, curricular innovations, and complex decisions on students' academic progress. This study aimed to investigate the academic performance of medical students and related factors using cohort database collected from a medical school. The study participants included 134 medical students who graduated from Chonnam National University Medical School in 2022. The medical school's cohort database was used to collect data on demographics, admission, academic performance, extracurricular activities, and performance on the National Korean Medical Licensing Examination (KMLE). Participating in club activities had a significant association with medical students' academic advancement delay or leave of absence during the entire course of medical school (P = 0.007). Logistic regression analysis indicated that the nationwide clinical knowledge mock examination during the fourth year of medical school was significantly associated with passing the KMLE (adjusted odds ratio 1.12, 95% confidence interval 1.02-1.22; P = 0.014). Extracurricular school activities (a non-cognitive student attribute) and a wide range of cognitive student attributes captured from the cohort database were associated with medical students' academic performance. In conclusion, this study can reinforce a strong emphasis on the inclusion of cognitive and non-cognitive information in medical school curricula and assessments in order to improve medical education programs and future postgraduate performance.
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Affiliation(s)
- Eun-Kyung Chung
- Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea
| | - Heoncheol Yun
- Institutional Research Center, Chosun University, Gwangju, South Korea
| | - Jung-Ho Yang
- Department of Preventive Medicine, Chonnam National University, Gwangju, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University, Gwangju, South Korea
| | - Eui-Ryoung Han
- Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea
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Linden B, Ecclestone A, Stuart H. A scoping review and evaluation of instruments used to measure resilience among post-secondary students. SSM Popul Health 2022; 19:101227. [PMID: 36177483 PMCID: PMC9513163 DOI: 10.1016/j.ssmph.2022.101227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students’ resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool. There is a need for access to valid and appropriate tools with which to measure post-secondary students’ resilience. We identified a total of 12 instruments evaluating resilience among post-secondary student populations. The majority of the instruments were not designed for use in the post-secondary setting and were not comprehensive· We recommend the CD-RISC as the most suitable. We recommend the CD-RISC as the most suitable instrument for measuring resilience among post-secondary students.
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Affiliation(s)
- Brooke Linden
- Health Services and Policy Research Institute, Queen's University, 21 Arch Street, Kingston, ON, K7L 3L3, 343-333-6127, Canada
| | - Amy Ecclestone
- Health Services and Policy Research Institute, Queen's University, 21 Arch Street, Kingston, ON, K7L 3L3, 343-333-6127, Canada
| | - Heather Stuart
- Health Services and Policy Research Institute, Departments of Public Health Sciences, Psychiatry and School of Rehabilitation Therapy, Queen's University, Canada
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Bandyopadhyay S, Boylan CT, Baho YG, Casey A, Asif A, Khalil H, Badwi N, Patel R. Ethnicity-related stereotypes and their impacts on medical students: A critical narrative review of health professions education literature. MEDICAL TEACHER 2022; 44:986-996. [PMID: 35311604 DOI: 10.1080/0142159x.2022.2051464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Stereotypes are oversimplified beliefs about groups of people. Social psychology concepts and theories describing ethnicity-related stereotypes are well reported in non-medical educational settings. In contrast, the full impact of stereotyping on medical students, and the extent to which they were represented in health professions education (HPE) is less well-described. Using the lens of social psychological theory, this review aimed to describe ethnicity-related stereotypes about medical students portrayed in HPE literature and the impacts of those stereotypes. METHODS A critical narrative approach was undertaken. Social psychology concepts and theories were used as a framework through which to review the impacts of ethnicity-related stereotypes on medical students as described in HPE literature. A database search of Ovid MEDLINE, JSTOR, Project Muse, and PsychINFO was conducted to identify both theoretical and empirical articles relating to this topic in the HPE literature. Data was synthesised using thematic analysis, giving particular care to appraise the evidence from perspectives in social psychology. FINDINGS In HPE, the experiences and impact of stereotyping on learners from minority ethnic groups was explained by social psychology concepts such as stereotype threat, stereotype reactance, attributional ambiguity, self-fulfilling prophecy, stereotype boost, stereotype lift, and stereotype masking. Stereotype boost and stereotype lift were particularly described among students who identified as White, whereas stereotype threat was described more commonly among students from minority ethnics groups. The impact of stereotyping is not just on assessment, but may be across all teaching and learning activities at medical school. INTERPRETATION Social psychology concepts and theories can be used to describe the experience and impact of ethnicity-related stereotypes in HPE. Educators can better support learners from minority ethnic groups by self-reflecting over assumptions about individuals from minority ethnic groups, as well as minimise the impact of stereotyping and bias to create more inclusive learning environments.
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Affiliation(s)
- Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Conor T Boylan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Yousif G Baho
- Hull York Medical School, University of Hull, Kingston Upon Hull, UK & University of York, York, UK
| | - Anna Casey
- Brighton and Sussex Medical School, Brighton, UK
| | - Aqua Asif
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Halimah Khalil
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Nermin Badwi
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rakesh Patel
- Medical Education Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Cofini V, Perilli E, Moretti A, Bianchini V, Perazzini M, Muselli M, Lanzi S, Tobia L, Fabiani L, Necozione S. E-Learning Satisfaction, Stress, Quality of Life, and Coping: A Cross-Sectional Study in Italian University Students a Year after the COVID-19 Pandemic Began. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138214. [PMID: 35805872 PMCID: PMC9266753 DOI: 10.3390/ijerph19138214] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/18/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: The objective was to investigate e-learning satisfaction in a sample of university students by evaluating quality of life, stress sociality, and coping. (2) Methods: This was an online survey involved 471 students attending the University of L′Aquila from June to July 2021. The primary goal was estimating the e-learning satisfaction as measured by the E-learning Satisfaction Scale, while the secondary outcomes were studying its relationship with demographic factors, the perception of quality of life, sociality, stress, and coping strategies using a hierarchical regression model. (3) Results: A total of 136 participants were males (29%); the mean age was 25 years. The results revealed that the satisfaction score was 30.6, and the mean stress level was 19.4. Students suffered psychologically and physically for 14 days a month. The sociality score was 36. With respect to coping strategies, students reported higher scores for “Acceptance” (6.0), “Active coping” (6.2), and “Planning” (6.4). E-learning satisfaction was significantly related to age and course attendance. It was positively associated with the social presence score and coping strategies such as self-blame and religion, while it was inversely related to stress and unhealthy days. (4) Conclusions: The students revealed a positive propensity to use e-learning despite the end of quarantine. Sociality, stress, quality of life, and coping seemed to play an important role in student′s e-learning satisfaction.
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Chisholm-Burns MA, Berg-Poppe P, Spivey CA, Karges-Brown J, Pithan A. Systematic review of noncognitive factors influence on health professions students' academic performance. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1373-1445. [PMID: 33772422 DOI: 10.1007/s10459-021-10042-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Increased importance has been placed on noncognitive skills in professional development and by accrediting bodies of health professions programs in recent years. Therefore, the purpose of this study was to conduct a comprehensive systematic review of evidence examining effects of academic resilience, grit, perceived stress, locus of control, and Big Five Personality Traits on academic performance of health professions students. A literature search of peer-reviewed, English-language articles describing select noncognitive factors was performed using seven databases. Searches were performed from the earliest index date through May 2020. The following data from included studies were extracted and summarized: research design hierarchy, hierarchy of study outcomes (modified from Kirkpatrick), association between noncognitive factors and academic outcomes, and quality assessment criteria. 149 articles met inclusion criteria. Almost 80% of studies were Level III (observational). Medical students were the most frequently studied population (n = 73 articles). The most studied academic outcome was grade point average (n = 61). Perceived stress and Big Five Personality Traits accounted for greater than 50% of studies. Most studies were rated as fair to good quality. Associations between noncognitive factors and academic outcomes were largely inconsistent, although greater perceived stress was generally associated with poorer academic performance outcomes, while higher conscientiousness, academic resilience, and grit were generally associated with better outcomes. This systematic review represents a large body of evidence concerning select noncognitive factors and their association with academic performance of health professions students. Support services addressing noncognitive factors should be deliberated and tailored for specific health professions education programs and student populations.
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Affiliation(s)
- Marie A Chisholm-Burns
- University of Tennessee Health Science Center College of Pharmacy, 881 Madison Ave., Suite 264, Memphis, TN, 38163, USA.
| | - Patti Berg-Poppe
- University of South Dakota School of Health Sciences, 414 E. Clark Street, SCSC A383, Vermillion, SD, 57069, USA
| | - Christina A Spivey
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 881 Madison Ave., Suite 258, Memphis, TN, 38163, USA
| | - Joy Karges-Brown
- Department of Physical Therapy, University of South Dakota School of Health Sciences, 414 E. Clark Street, SCSC A830, Vermillion, SD, 57069, USA
| | - Anne Pithan
- Department of Nursing, University of South Dakota School of Health Sciences, 414 E. Clark Street, Lee Medicine and Science Hall 303, Vermillion, SD, 57069, USA
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Lisnyj KT, Pearl DL, McWhirter JE, Papadopoulos A. Targeting components of social capital on campus to alleviate Canadian post-secondary students’ academic stress. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01376-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Bellodi PL, Dolhnikoff M. Medical students with performance difficulties need wide support: Initial results of an academic tutoring program. Clinics (Sao Paulo) 2021; 76:e2495. [PMID: 33787676 PMCID: PMC7955142 DOI: 10.6061/clinics/2021/e2495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/20/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Even students with previous academic success may face challenges that affect their academic performance. Many medical schools offer programs to students at the risk of academic failure, to ensure that they succeed in the course. OBJECTIVE AND METHODS In this report we describe a pioneering academic tutoring program developed at a Brazilian medical school and discuss the initial results of the program based on the feedback from tutors and data regarding the progression of students in the medical course. RESULTS In 2018, 33 students enrolled into the program. Students' performance difficulties were mainly associated with mental health problems and socioeconomic vulnerability. Of the 33 students, 27 (81.8%) were assisted by the Mental Health Support Service and 16 (48.5%) were assisted by the Social Assistance Service. In addition to the planning academic activity class load, tutors were able to assist students in solving socioeconomic issues, carrying out personal support interventions with the promotion of self-esteem, and presenting suggestions for behavioral changes in their routine. For most students (72%), the action plan proposed by the tutors was successful. Eight of the 14 (57%) students in the fourth year progressed to the final two years of in-hospital practical training (internship). CONCLUSIONS The Academic Tutoring Program showed positive results for most of the students. Close monitoring and tutor intervention allowed students with poor academic performance to overcome the low performance cycle. These important tasks demand time and energy from tutors, and institutional recognition of these professionals is essential for the successful maintenance of the program.
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Affiliation(s)
- Patrícia Lacerda Bellodi
- Nucleo de Apoio ao Estudante (NAE), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Centro de Desenvolvimento de Educacao Medica (CEDEM), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marisa Dolhnikoff
- Nucleo de Apoio ao Estudante (NAE), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Chou CL, Kalet A, Costa MJ, Cleland J, Winston K. Guidelines: The dos, don'ts and don't knows of remediation in medical education. PERSPECTIVES ON MEDICAL EDUCATION 2019; 8:322-338. [PMID: 31696439 PMCID: PMC6904411 DOI: 10.1007/s40037-019-00544-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Two developing forces have achieved prominence in medical education: the advent of competency-based assessments and a growing commitment to expand access to medicine for a broader range of learners with a wider array of preparation. Remediation is intended to support all learners to achieve sufficient competence. Therefore, it is timely to provide practical guidelines for remediation in medical education that clarify best practices, practices to avoid, and areas requiring further research, in order to guide work with both individual struggling learners and development of training program policies. METHODS Collectively, we generated an initial list of Do's, Don'ts, and Don't Knows for remediation in medical education, which was then iteratively refined through discussions and additional evidence-gathering. The final guidelines were then graded for the strength of the evidence by consensus. RESULTS We present 26 guidelines: two groupings of Do's (systems-level interventions and recommendations for individual learners), along with short lists of Don'ts and Don't Knows, and our interpretation of the strength of current evidence for each guideline. CONCLUSIONS Remediation is a high-stakes, highly complex process involving learners, faculty, systems, and societal factors. Our synthesis resulted in a list of guidelines that summarize the current state of educational theory and empirical evidence that can improve remediation processes at individual and institutional levels. Important unanswered questions remain; ongoing research can further improve remediation practices to ensure the appropriate support for learners, institutions, and society.
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Affiliation(s)
- Calvin L Chou
- Department of Medicine, University of California and Veterans Affairs Healthcare System, San Francisco, CA, USA.
| | - Adina Kalet
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Manuel Joao Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Minho, Portugal
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Kalman Winston
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
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Beaglehole B, Mulder RT, Boden JM, Bell CJ. A systematic review of the psychological impacts of the Canterbury earthquakes on mental health. Aust N Z J Public Health 2019; 43:274-280. [PMID: 30958618 DOI: 10.1111/1753-6405.12894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/01/2018] [Accepted: 02/01/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This systematic review aims to identify and evaluate all studies that measured psychological distress or mental disorder following the Canterbury earthquakes to establish the psychological consequences of the earthquakes on those exposed. A secondary aim is to outline and emphasise key methodological factors in disaster research. METHOD Eligible studies were identified following a comprehensive literature search. A quality assessment was undertaken for all included studies. This was followed by methodological and descriptive review. RESULTS Thirty-one papers measuring psychological distress or mental disorder following the Canterbury earthquakes were identified. These papers reported outcomes from 20 separate studies of which seven were rated high-quality, eight were rated medium and five were rated low-quality. Key methodological findings and outcomes are discussed for each study. CONCLUSION The Canterbury earthquakes were associated with widespread but not universal adverse effects on mental health. Disaster research quality is assisted by representative samples, repeated measures, and the use of appropriate controls to allow accurate assessments of psychological consequences to be made. Implications for public health: The presence of widespread adverse effects as a result of the earthquakes suggests broad-ranging community initiatives are essential to mitigate the negative consequences of disasters.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Caroline J Bell
- Department of Psychological Medicine, University of Otago, New Zealand
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De Stefano C, Akodad H, Gauducheau H, Reuter PG, Ricard JD, Petrovic T, Adnet F, Truchot J, Lapostolle F. Role of Student Nurse in the Prehospital Medical Teams Responding to the Scene of A Terrorist Attack in France. Nurs Outlook 2019; 67:441-449. [PMID: 30929957 DOI: 10.1016/j.outlook.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/12/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The terrorist attacks in Paris and in Saint-Denis in November 2015 were unprecedented events involving various human and material resources. These events question the role of nurse students in prehospital teams. PURPOSE To investigate nursing students' preference about whether they wished to participate in the prehospital care during a terrorist attack. METHODS This cross-sectional study was conducted with student nurses, from two nursing schools in the Greater Paris area. They completed an anonymous survey assessing the desire to be called to help the mobile intensive care units (MICU) or another ward; whether their presence should be mandatory, and the feelings associated with their experience. The responses were collected with a visual analogue scale and could range from 1 (yes, very much) to 10 (no, not at all). A Chi-square test was performed for qualitative variables and a Mann-Whitney test for quantitative variables. FINDINGS Among 225 students, 205 (91%) responded, 133 (65%) were women. When on duty, 169 (82%) would have preferred to accompany the MICU team, compared with 31 (15%) who would have preferred not to go. Overall, 146 students (71%) considered that this presence should be optional. Only gender was significantly associated with the choice to accompany the MICU team (W = 87% vs. M = 13%; p = .002). Students expressed a moderate feeling of frustration and fear. DISCUSSION Students would prefer to assist the MICU team responding to the scene of a terrorist attack but feel this choice should be optional. A discussion in nursing schools and universities should be considered for the implementation of a "systematic" procedure to ensure the student's willingness to participate in such interventions.
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Affiliation(s)
- Carla De Stefano
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France; Paris 13 University, Sorbonne Cité, Bobigny, France; AP-HP, Department of Child and Adolescent Pyschiatry and General Psychiatry, Avicenne Hospital, Paris 13 Sorbonne University, Paris Cité, Laboratoire UTRPP, France.
| | - Hayatte Akodad
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France
| | - Helene Gauducheau
- IADE School Nurse-Anesthetists Theodore Simon, Paris 13 University, Sorbonne Cité, Neuilly sur Marne, France
| | - Paul-Georges Reuter
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France; Paris 13 University, Sorbonne Cité, Bobigny, France
| | - Jean-Damien Ricard
- AP-HP, Intensive Care Unit, Louis Mourier Hospital, Colombes, France; Paris Diderot University, Paris, France
| | - Tomislav Petrovic
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France
| | - Frédéric Adnet
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France; Paris 13 University, Sorbonne Cité, Bobigny, France
| | - Jennifer Truchot
- Paris Diderot University, Paris, France; AP-HP, Emergency Department, Lariboisière Hospital, Paris, France
| | - Frédéric Lapostolle
- AP-HP, SAMU93 - UF Research Teaching Quality, Avicenne Hospital, Paris 13 University, Bobigny, France; Paris 13 University, Sorbonne Cité, Bobigny, France
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Ogun OA, Nottidge TE, Roff S. Students' perceptions of the learning environment in two Nigerian medical schools offering different curricula. Ghana Med J 2019; 52:116-121. [PMID: 30602795 DOI: 10.4314/gmj.v52i3.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Compare the results of administering the DREEM questionnaire in two Nigerian medical schools offering traditional and student-centred curricular respectively, to identify any differences in the learning environment and appreciate advantages of the more modern curriculum. Methods A survey design was used. Data was analysed using the DREEM scoring rubric. The independent t-test was used to compare results. Setting The DREEM questionnaire was administered to final year medical students at two participating centres. Participants Final year students of a teacher-centred and a student-centred medical school. Results There were 138 respondents - 50 (96.2% of the final year students) from the teacher centred school and 88 (59.1% of the final year students) from the student-centred school. The mean total DREEM score was 117+22.3 in the former and 119 +23.6 in the latter (p = 0.798). Mean age of students in the teacher centred school was 28 ± 5.28 years, while that of the student-centred school was 23 ± 1.83 years (p < 0.05). Conclusion The mean total DREEM score proximity between the schools suggests that the younger students using a more student-centred curriculum have less of an appreciation of their improved learning environment than is expected. Thus, the hidden curriculum could be lagging behind the written one. The older students in the teacher centred environment have a more mature appreciation of their learning climate. Funding Personal sources.
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Affiliation(s)
- Olufunmilola A Ogun
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Timothy E Nottidge
- Department of Orthopaedics and Traumatology, College of Health Sciences, University of Uyo, P.O. Box 1316, Uyo, Nigeria
| | - Sue Roff
- Centre for Medical Education, University of Dundee, Dundee, Scotland, United Kingdom
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Dendle C, Baulch J, Pellicano R, Hay M, Lichtwark I, Ayoub S, Clarke DM, Morand EF, Kumar A, Leech M, Horne K. Medical student psychological distress and academic performance. MEDICAL TEACHER 2018; 40:1257-1263. [PMID: 29355074 DOI: 10.1080/0142159x.2018.1427222] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The impact of medical student psychological distress on academic performance has not been systematically examined. This study provided an opportunity to closely examine the potential impacts of workplace and study related stress factors on student's psychological distress and their academic performance during their first clinical year. METHODS This one-year prospective cohort study was performed at a tertiary hospital based medical school in Melbourne, Australia. Students completed a questionnaire at three time points during the year. The questionnaire included the validated Kessler psychological distress scale (K10) and the General Health Questionnaire-28 (GHQ-28), as well as items about sources of workplace stress. Academic outcome scores were aggregated and correlated with questionnaire results. RESULTS One hundred and twenty six students participated; 126 (94.7%), 102 (76.7%), and 99 (74.4%) at time points one, two, and three, respectively. 33.1% reported psychological distress at time point one, increasing to 47.4% at time point three. There was no correlation between the K10 scores and academic performance. There was weak negative correlation between the GHQ-28 at time point three and academic performance. Keeping up to date with knowledge, need to do well and fear of negative feedback were the most common workplace stress factors. CONCLUSIONS Poor correlation was noted between psychological distress and academic performance.
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Affiliation(s)
- Claire Dendle
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
- b Monash Infectious Diseases, Monash Health , Clayton , Australia
| | - Julie Baulch
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
| | - Rebecca Pellicano
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
- c Nephrology Monash Health , Clayton , Australia
| | - Margaret Hay
- d Faculty of Medicine and Health Sciences , Monash Institute for Health and Clinical Education (MIHCE), Monash University , Melbourne , Australia
| | - Irene Lichtwark
- d Faculty of Medicine and Health Sciences , Monash Institute for Health and Clinical Education (MIHCE), Monash University , Melbourne , Australia
| | - Sally Ayoub
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
| | - David M Clarke
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
| | - Eric F Morand
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
| | - Arunaz Kumar
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
- e Department of Obstetrics and Gynaecology , Monash Health , Clayton , Australia
| | - Michelle Leech
- f Faculty of Medicine, Nursing and Health Sciences , Monash University , Clayton , Australia
| | - Kylie Horne
- a School of Clinical Sciences at Monash Health , Monash University , Clayton , Australia
- b Monash Infectious Diseases, Monash Health , Clayton , Australia
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Simonelli-Muñoz AJ, Balanza S, Rivera-Caravaca JM, Vera-Catalán T, Lorente AM, Gallego-Gómez JI. Reliability and validity of the student stress inventory-stress manifestations questionnaire and its association with personal and academic factors in university students. NURSE EDUCATION TODAY 2018; 64:156-160. [PMID: 29494939 DOI: 10.1016/j.nedt.2018.02.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 01/30/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Stress affects us in every environment and it is also present in the educational sphere. Previous studies have reported a high prevalence of stress in university students. The Student Stress Inventory-Stress Manifestations (SSI-SM), identify stressors and evaluate stress manifestations in adolescents but its validity in university students remains uncertain. OBJECTIVES We aimed to determine the internal consistency and validity of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for university students and to investigate if high stress levels are associated with personal and academic factors. DESIGN AND METHODS In this quantitative, descriptive, cross-sectional study, we included 115 university students of the Nursing Degree during the second semester of the 2014/2015 academic year. Information about personal issues, lifestyle and academic performance was recorded and the stress was evaluated with the SSI-SM questionnaire. The internal consistency and homogeneity of the SSI-SM questionnaire was tested and a factorial analysis was performed. RESULTS After the homogeneity analysis, the final version of the SSI-SM questionnaire included 19 items, with a Cronbach's alpha of 0.924. In the factorial analysis, 4 factors were found ('Self-concept', 'Sociability', 'Uncertainty' and 'Somatization'; all Cronbach's alpha >0.700). Students with higher values on the SSI-SM were, in overall, women (41.0 ± 12.7 vs. 33.2 ± 9.5; p = 0.001) and had significantly more family conflicts (47.6 ± 13.8 vs. 35.2 ± 9.6; p < 0.001), consumed less alcohol (R = -0.184, p = 0.048), slept less hours (R = -0.193, p = 0.038) and had worse academic performance in Clinical Nursing (36.3 ± 10.4 vs. 41.2 ± 13.3, p = 0.039). CONCLUSIONS After exclude three items of the original SSI-SM, higher scores in the SSI-SM are correlated with stress level in a cohort of university students of the Nursing Degree. Family conflicts, female gender, absence of alcohol consumption, few sleep hours and poor academic performance are associated with higher stress levels.
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Affiliation(s)
| | - Serafín Balanza
- Faculty of Nursing, Catholic University of Murcia (UCAM), Guadalupe, Murcia, Spain
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - Tomás Vera-Catalán
- Faculty of Nursing, Catholic University of Murcia (UCAM), Guadalupe, Murcia, Spain
| | - Ana María Lorente
- Faculty of Nursing, Catholic University of Murcia (UCAM), Guadalupe, Murcia, Spain
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Schiller JH, Stansfield RB, Belmonte DC, Purkiss JA, Reddy RM, House JB, Santen SA. Medical Students' Use of Different Coping Strategies and Relationship With Academic Performance in Preclinical and Clinical Years. TEACHING AND LEARNING IN MEDICINE 2018; 30:15-21. [PMID: 28753049 DOI: 10.1080/10401334.2017.1347046] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Phenomenon: Medical students' coping abilities are important for academic success and emotional health. The authors explored differences in students' use of active, problem-solving strategies and emotional, inwardly directed approaches; the change in coping strategies used during medical school; and coping strategy impact on performance. APPROACH One hundred eighty-three students completed the Ways of Coping Scale at matriculation and end of the 2nd and 3rd years. Frequency of each of 8 ways of coping, changes in coping strategy use over time, and relationship of coping method with preclinical and clinical scores were calculated. FINDINGS Students varied widely in use of coping mechanisms. Over time, students shifted to using emotional strategies more frequently while decreasing their use of active strategies. Coping strategies were unrelated to preclinical academic performance (R2 = .09, adjusted R2 = .04, ns) but were related to clinical performance (R2 = .23, adjusted R2 = .18, p < .0001), with active coping associated with higher performance and emotional methods associated with lower performance. Insights: Students decreased use of active coping strategies and increased use of emotional coping strategies over time, but emotional strategies were associated with poorer clinical academic performance. These shifts in coping methods may be detrimental to student performance and learning. Improving students' ability to cope should be an educational priority.
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Affiliation(s)
- Jocelyn H Schiller
- a Department of Pediatrics and Communicable Diseases , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - R Brent Stansfield
- b Department of Learning Health Sciences , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - David C Belmonte
- c Department of Psychiatry , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - Joel A Purkiss
- b Department of Learning Health Sciences , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - Rishindra M Reddy
- d Department of Surgery , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - Joseph B House
- e Department of Emergency Medicine , University of Michigan Medical School , Ann Arbor , Michigan , USA
| | - Sally A Santen
- b Department of Learning Health Sciences , University of Michigan Medical School , Ann Arbor , Michigan , USA
- e Department of Emergency Medicine , University of Michigan Medical School , Ann Arbor , Michigan , USA
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Kötter T, Wagner J, Brüheim L, Voltmer E. Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study. BMC MEDICAL EDUCATION 2017; 17:256. [PMID: 29246231 DOI: 10.1186/s12909-017-1091-0.pmid:29246231;pmcid:pmc5732510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/04/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. METHODS We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). RESULTS PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. CONCLUSIONS PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.
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Affiliation(s)
- Thomas Kötter
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Josefin Wagner
- Division of Teaching and Learning, Lübeck Medical School, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Linda Brüheim
- Department of Quality Management and Organizational Development, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Edgar Voltmer
- Chair of Health Sciences, Friedensau Adventist University, An der Ihle 19, 39291, Möckern-Friedensau, Germany
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Kötter T, Wagner J, Brüheim L, Voltmer E. Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study. BMC MEDICAL EDUCATION 2017; 17:256. [PMID: 29246231 PMCID: PMC5732510 DOI: 10.1186/s12909-017-1091-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/04/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. METHODS We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). RESULTS PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. CONCLUSIONS PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.
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Affiliation(s)
- Thomas Kötter
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Josefin Wagner
- Division of Teaching and Learning, Lübeck Medical School, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Linda Brüheim
- Department of Quality Management and Organizational Development, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Edgar Voltmer
- Chair of Health Sciences, Friedensau Adventist University, An der Ihle 19, 39291 Möckern-Friedensau, Germany
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Chou CL, Teherani A. A Foundation for Vital Academic and Social Support in Clerkships: Learning Through Peer Continuity. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:951-955. [PMID: 28353506 DOI: 10.1097/acm.0000000000001661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships. Additional advantages of peer continuity in clerkships include facilitated integration into the workplace, social support, and enhanced clinical and professional learning. Practical components required for a successful peer continuity structure include intentional formation of peer cohorts; regular meetings that cover didactic or clinical skills learning; frequent opportunities for reflection on patient care, professional development, and well-being; and skilled facilitators without evaluative roles. Theoretical support for peer continuity comes from social cognitive theory, communities of clinical practice, and social comparison theory. Therefore, in conjunction with empirical programs that have shown benefits of developing these structures, peer continuity should become a formalized educational structure in clerkships.
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Affiliation(s)
- Calvin L Chou
- C.L. Chou is professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. A. Teherani is professor, Department of Medicine, and education researcher, Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California
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Rich A, Viney R, Needleman S, Griffin A, Woolf K. 'You can't be a person and a doctor': the work-life balance of doctors in training-a qualitative study. BMJ Open 2016; 6:e013897. [PMID: 27913563 PMCID: PMC5168633 DOI: 10.1136/bmjopen-2016-013897] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Investigate the work-life balance of doctors in training in the UK from the perspectives of trainers and trainees. DESIGN Qualitative semistructured focus groups and interviews with trainees and trainers. SETTING Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training. PARTICIPANTS 96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation. RESULTS Postgraduate training was characterised by work-life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work-life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work-life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems. CONCLUSIONS A lack of work-life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work-life balance of trainees.
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Affiliation(s)
- Antonia Rich
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, London, UK
| | - Rowena Viney
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, London, UK
| | - Sarah Needleman
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, London, UK
| | - Ann Griffin
- Research Department of Medical Education, UCL Medical School, London, UK
| | - Katherine Woolf
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, London, UK
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Romo-Nava F, Tafoya SA, Gutiérrez-Soriano J, Osorio Y, Carriedo P, Ocampo B, Bobadilla RI, Heinze G. The association between chronotype and perceived academic stress to depression in medical students. Chronobiol Int 2016; 33:1359-1368. [PMID: 27579890 DOI: 10.1080/07420528.2016.1217230] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2-4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8-7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6-22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3-24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8-40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a current depressive episode. Collectively, these results show that chronotype and PAS are factors associated with depression in MS, and when combined promote this association. Our results might aid in early identification of MS susceptible to depression. Future research could focus on the implementation of simple, low cost preventive strategies, such as chronotype-oriented academic schedules.
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Affiliation(s)
- Francisco Romo-Nava
- a Departamento de Psiquiatría y Salud Mental, Facultad de Medicina , UNAM , DF , México.,b Division of Bipolar Disorder Research, Department of Psychiatry and Behavioral Neuroscience, College of Medicine , University of Cincinnati, Cincinnati , OH , USA
| | - Silvia A Tafoya
- a Departamento de Psiquiatría y Salud Mental, Facultad de Medicina , UNAM , DF , México
| | | | - Yanik Osorio
- c Servicios de Atención Psiquiátrica, Secretaría de Salud, México , DF México
| | - Pilar Carriedo
- a Departamento de Psiquiatría y Salud Mental, Facultad de Medicina , UNAM , DF , México
| | - Bárbara Ocampo
- a Departamento de Psiquiatría y Salud Mental, Facultad de Medicina , UNAM , DF , México
| | - Rosa I Bobadilla
- d Departamento de Salud Pública de la Universidad Nacional Autónoma de México (UNAM) , Unidad de Medicina Familiar No. 1, Instituto Mexicano del Seguro Social, DF , México
| | - Gerhard Heinze
- a Departamento de Psiquiatría y Salud Mental, Facultad de Medicina , UNAM , DF , México
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