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Zvrko E, Popović N, Radunović M, Nikolić G. Motivational Factors Influencing the Choice of Medical Studies and Future Career Plans among Montenegrin Students. Zdr Varst 2024; 63:132-141. [PMID: 38881636 PMCID: PMC11178028 DOI: 10.2478/sjph-2024-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction There is a concerning trend of emigration among highly educated individuals in Montenegro. This includes medical professionals who seek better job opportunities abroad. The aim of the present study was to identify the primary motivational factors driving Montenegrin medical students to pursue a career in medicine, and whether these factors undergo changes over the course of their studies. Methods A cross-sectional study included 210 medical students in Montenegro, 27.62% were males, and 72.38% were females. The mean age of the students was 21.90 years (SD=3.05) (range 19-39). Their academic motivation was analysed using the Academic Motivation Scale, previously validated in various cultural contexts. Results The results showed that autonomous motivation levels were higher than controlled motivation levels (p<0.001) among students in Montenegro, which has been previously associated with better learning outcomes. Students with medical doctors among their family members had higher extrinsic motivation related to rewards and punishments (extrinsic motivation with external regulation p=0.018). Amotivation showed a trend of increasing as the students got closer to graduation (p=0.057). Only 8.1% of students planned a career in primary healthcare, and 1% wished to specialize in family medicine. Conclusions This study's findings, which indicate high levels of autonomous motivation among medical students, are of significant importance. They contribute to a comprehensive understanding of the motivation factors among medical students and young healthcare professionals in Montenegro. Moreover, they provide a basis for the implementation of strategic interventions to retain highly skilled medical professionals within the country's workforce, thereby addressing the concerning trend of emigration among this group.
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Affiliation(s)
- Elvir Zvrko
- Department of Otorhinolaryngology, Clinical Center of Montenegro, Ljubljanska bb, 81000 Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Nataša Popović
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Miodrag Radunović
- Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro
| | - Goran Nikolić
- Montenegrin Academy of Science and Arts, Rista Stijovića 5, 81000 Podgorica, Montenegro
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Shi Y, Gao H, Yan Y, Li X, Ping W, Yang H, Du Y. Career choice motivation and professionalism in medical students in China: a gender-stratified analysis. BMJ Open 2024; 14:e083073. [PMID: 38858138 PMCID: PMC11168141 DOI: 10.1136/bmjopen-2023-083073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/04/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE To examine the associations between career choice motivation and professionalism among medical students based on gender in the context of COVID-19. DESIGN Cross-sectional study. SETTING The study was conducted at a medical school in China. METHODS A total of 1421 second-year to fourth-year medical students participated in the survey using cluster sampling. They were asked to complete questionnaires on demographic information, career choice motivation and professionalism. Linear regression models were used to analyse the relationship between career choice motivations and professionalism based on gender differences. RESULTS Female medical students outperformed males in professionalism (p<0.001). Third-year medical students have the lowest level of professionalism irrespective of gender. In addition, females have more intrinsic career choice motivation than males. Students motivated by personal interest had the highest level of professionalism, while those who go with the flow had the lowest. According to the linear regression analysis, the motivation advice from parents was the factor of professionalism in male medical students (p<0.05). However, the motivation go with the flow negatively influenced the professionalism of female medical students (p<0.05). CONCLUSION The level of professionalism differed between genders based on different career choice motivations. Career choice motivation can be used as an entry point for professionalism education among medical students. Targeted interventions should be implemented to improve professionalism, especially for male medical students and unmotivated students.
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Affiliation(s)
- Yan Shi
- School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Hunmin Gao
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yumeng Yan
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xue Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Weiwei Ping
- Department of Health Management, Changzhi Medical College, Changzhi, China
| | - Hui Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Yiqian Du
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
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Stokar YN. Sense of failure in end of life care: Perspectives from physicians and nurses. Soc Sci Med 2024; 348:116805. [PMID: 38569282 DOI: 10.1016/j.socscimed.2024.116805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
Limited knowledge exists regarding sensed failure resulting provision of end-of-life (EOL) care. Among medical health professionals (MHP), a sense of failure is associated with impaired patientcare and reduced worker wellbeing, including higher rates of burnout and secondary traumatic stress. As part of a larger mixed-methods study on the effects of EOL-care provision on MHP in general hospitals, semi-structured in-depth interviews were conducted with 22 physicians and nurses at three tertiary Israeli hospitals, representing a wide range of medical specialties, training, experience, and cultural backgrounds. Qualitative thematic analysis of the interviews led to the identification of the theme 'sense of failure' with the sub-themes 'sources' and 'lived meanings' of the sensed failure. Apart from the source 'losing a patient' all other identified sources were recognized as work-related risk factors, including 'unsupportive environments' and 'shortcomings of the medical practice.' Two of the lived meaning 'sense of personal responsibility' and 'moral injury' were also recognized as work-related risk factors. Surprisingly, albeit the adverse context of EOL-care, the two remaining lived meanings 'learning from failure' and 'sense of purpose' were recognized as protective resilience factors. Changes in workplace norms by focusing on leadership and mentoring programs and implementation of evidence based interventions aimed at reducing the sense of failure and enhancing feelings of purpose are recommended. Finally, the findings described in the study would benefit from continued studies on larger scales.
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Affiliation(s)
- Yaffa Naomi Stokar
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel; Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
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Ching SM, Cheong AT, Yee A, Thurasamy R, Lim PY, Zarina II, Lee KW, Taher SW, Ramachandran V. Prevalence and factors associated with burnout among healthcare providers in Malaysia: a web-based cross-sectional study. Ir J Med Sci 2024; 193:851-863. [PMID: 37556104 DOI: 10.1007/s11845-023-03483-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND This study aimed to assess the determinants of burnout among healthcare providers in the primary care setting. METHODS A web-based cross-sectional study was conducted among 1280 healthcare providers aged 18 years and older from 30 primary care clinics in Selangor, Malaysia. In this study, the Copenhagen Burnout Inventory was used to assess burnout. The results were analyzed using multiple logistic regression. RESULTS The prevalence of personal burnout was 41.7%, followed by work-related burnout (32.2%) and client-related burnout (14.5%). The determinants for personal burnout in this study were younger age, being a doctor, higher COVID-19 exposure risk, do not know where to seek help, inability to handle stress, poorer sleep quality score, higher total COVID-19 fear score, higher total stress score, and lower total BRS score. The determinants of work-related burnout were younger age, being a doctor, longer years of working, higher COVID-19 exposure risk, do not know where to seek help, lower altruistic score, poorer sleep quality score, higher total stress score, and lower total brief resilience score (BRS) score. The determinants of client-related burnout were doctor, single/divorced, more than one attachment site, and higher satisfaction toward the infection control, inability to handle stress, higher total depression score, and lower total BRS score. CONCLUSION Every fourth out of ten suffered from personal burnout, one-third from work-related burnout, and one-seventh from client-related burnout among healthcare providers during the COVID-19 pandemic. Healthcare systems must take care of healthcare workers' physical and emotional depletion, reducing the risk of burnout.
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Affiliation(s)
- Siew-Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Selangor, Serdang, Malaysia.
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Selangor, Serdang, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Ramayah Thurasamy
- School of Management, Universiti Sains Malaysia, 11800, Penang, Minden, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Selangor, Serdang, Malaysia
| | - Irmi Ismail Zarina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Selangor, Serdang, Malaysia
| | - Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Selangor, Serdang, Malaysia
| | - Sri Wahyu Taher
- Klinik Kesihatan Simpang Kuala, Ministry of Health Malaysia, Alor Setar Kedah, Malaysia
| | - Vasudevan Ramachandran
- Department of Medical Science, Faculty of Health Sciences, University College of MAIWP International, Taman Batu Muda, 68100, Kuala Lumpur, Batu Caves, Malaysia
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Klasen JM, Poljo A, Sortino R, Bogie BJM, Schoenbaechler Z, Meienberg A, Nickel C, Bingisser R, LaDonna KA. Medical students on the COVID-19 frontline: a qualitative investigation of experiences of relief, stress, and mental health. Front Med (Lausanne) 2023; 10:1249618. [PMID: 38020159 PMCID: PMC10666052 DOI: 10.3389/fmed.2023.1249618] [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] [Received: 06/29/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Objective During the early stages of the COVID-19 pandemic, medical students were abruptly removed from clinical rotations and transitioned to virtual learning. This study investigates the impact of this shift on students' wellbeing and preparedness for advanced training. Methods Through qualitative research methods, including semi-structured interviews, the experiences of medical students working on the COVID-19 frontline were explored. Results The comprehensive findings of the study shed light on the profound emotional journey that medical students embarked upon during the relentless public health crisis. Within the chaos and overwhelming demands of the pandemic, medical students discovered a profound sense of purpose and fulfillment in their contributions to the welfare of the community. Despite the personal sacrifices they had to make, such as long hours, limited social interactions, and potentially risking their own health, students reported feelings of relief and gratitude. Conclusion Tailored support systems for medical students' wellbeing are crucial for improving healthcare delivery during crises. Medical schools should adopt a holistic curriculum approach, integrating interdisciplinary learning and prioritizing student wellbeing. Recognizing the pandemic's impact on students and implementing targeted support measures ensures resilience and contributes to an improved healthcare system.
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Affiliation(s)
- Jennifer M. Klasen
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland
| | - Adisa Poljo
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland
| | - Rosita Sortino
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland
| | - Bryce J. M. Bogie
- Faculty of Medicine, MD-PhD Program, University of Ottawa, Ottawa, ON, Canada
| | | | - Andrea Meienberg
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Department of Internal Medicine, Medical Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Christian Nickel
- Emergency Department, University Hospital, University of Basel, Basel, Switzerland
| | - Roland Bingisser
- Emergency Department, University Hospital, University of Basel, Basel, Switzerland
| | - Kori A. LaDonna
- Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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Ghanem Atalla AD, Sharif LS, Katooa NE, Kandil FS, Mahsoon A, Mahmoud Elseesy NA. Relationship between nurses' perception of professional shared governance and their career motivation: A cross-sectional study. Int J Nurs Sci 2023; 10:485-491. [PMID: 38020835 PMCID: PMC10667319 DOI: 10.1016/j.ijnss.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aimed to investigate the level of professional shared governance and career motivation and their relationship among nurses in Egypt. Methods A cross-sectional survey was conducted. A total of 724 nurses working in inpatient medical, surgical, and critical care units in Alexandria Main University Hospital were recruited from May to August 2022. The Index of Professional Nursing Governance (IPNG) version 3.0 and the Career Motivation Scale were used for evaluation. Results The IPNG version 3.0 total score was 109.18 ± 22.76, that nurses perceived had a low level of professional shared governance; the access to information dimension achieved the highest average mean score (2.81 ± 0.76), followed by the ability to set goals and conflict resolution dimension (2.75 ± 0.53). On the other hand, the dimension of participation in the committee structure achieved the lowest average mean score (1.65 ± 0.37). The total score of career motivation was 69.82 ± 9.70 this reflects that nurses perceived a moderate level of career motivation. The career insight dimension achieved the highest average mean score (3.56 ± 0.34), while the career resilience dimension achieved the lowest average mean score (3.07 ± 0.49). Male nurses, less than 30 years old, had a bachelor's degree in nursing sciences, and worked in the ICU had higher total scores of the IPNG and career motivation (P < 0.001). There was a positive correlation between the IPNG version 3.0 score and the Career Motivation Scale score (r = 0.239, P = 0.003). Conclusions The study's findings can serve as a theoretical foundation for nursing managers to re-plan the management model and develop appropriate methods to give better career planning for nurses.
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Affiliation(s)
- Amal Diab Ghanem Atalla
- Department of Nursing Administration, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Loujain Saud Sharif
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nouran Essam Katooa
- Department of Maternity and Child Health, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faten Shawky Kandil
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa Mahsoon
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Naglaa Abdelaziz Mahmoud Elseesy
- Department of Nursing Administration, Faculty of Nursing, Alexandria University, Alexandria, Egypt
- Department of Public Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Metakides C, Pielemeier L, Lytras T, Mytilinaios DG, Themistocleous SC, Pieridi C, Tsioutis C, Johnson EO, Ntourakis D, Nikas IP. Burnout and motivation to study medicine among students during the COVID-19 pandemic. Front Med (Lausanne) 2023; 10:1214320. [PMID: 37700767 PMCID: PMC10493291 DOI: 10.3389/fmed.2023.1214320] [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: 04/29/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Aim To investigate medical students' burnout and motivation levels in each of the six years of their studies during the COVID-19 pandemic and identify independent predictors of burnout and motivation. Methods An anonymous cross-sectional survey was sent to the students of all six years within our school. Burnout was measured with the adapted Oldenburg Burnout Inventory questionnaire (OLBI-S) and motivation with the updated Strength of Motivation for Medical School (SMMS-R) questionnaire. Univariate analysis was performed with the Kruskal-Wallis test and Spearman's correlation, while multivariable analysis with linear regression models. Results A total of 333 medical students (52% of student body) responded. Higher burnout levels correlated with lower motivation to study medicine (rho = -0.30, p < 0.001). Burnout levels differed between the six years of medical studies, peaking in years two and four whereas being the lowest in year one (p = 0.01). Motivation levels differed significantly as well, peaking in years one and four whereas being the lowest in years five and six (p = 0.012). In the multivariable linear regression models, being a female (b = 2.22, p = 0.016), studying in the fourth year vs. first year (b = 2.54, p = 0.049), having a perceived beginner/intermediate vs. advanced/expert technology level (b = 2.05, p = 0.032) and a perceived poor school support system (b = 6.35, p < 0.001) were independently associated with higher burnout levels. Furthermore, studying in the fifth year vs. first year (b = -5.17, p = 0.019) and a perceived poor school support system (b = -3.09, p = 0.01) were independently associated with a reduced motivation to study medicine. Conclusion Our study highlighted potential areas for intervention to decrease the rate of burnout and low motivation among medical students. However, further research is needed to unravel the full effect of the pandemic on medical students.
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Affiliation(s)
- Clio Metakides
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Lena Pielemeier
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | | | | | - Chryso Pieridi
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | | | | | | | - Ilias P. Nikas
- School of Medicine, European University Cyprus, Nicosia, Cyprus
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Zhang Y, Lin X, Li X, Han Y. The impacts of altruism levels on the job preferences of medical students: a cross-sectional study in China. BMC MEDICAL EDUCATION 2023; 23:538. [PMID: 37501080 PMCID: PMC10375683 DOI: 10.1186/s12909-023-04490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Rational allocation of human resources for health is crucial for ensuring public welfare and equitable access to health services. Understanding medical students' job preferences could help develop effective strategies for the recruitment and retention of the health workforce. Most studies explore the relationship between extrinsic incentives and job choices through discrete choice experiments (DCEs). Little attention has been paid to the influence of intrinsic altruism on job choice. This study aimed to explore the heterogeneous preferences of medical students with different levels of altruism regarding extrinsic job attributes. METHODS We conducted an online survey with 925 medical students from six hospitals in Beijing from July to September 2021. The survey combined job-choice scenarios through DCEs and a simulation of a laboratory experiment on medical decision-making behavior. Behavioral data were used to quantify altruism levels by estimating altruistic parameters based on a utility function. We fit mixed logit models to estimate the effects of altruism on job preference. RESULTS All attribute levels had the expected effect on job preferences, among which monthly income (importance weight was 30.46%, 95% CI 29.25%-31.67%) and work location (importance weight was 22.39%, 95% CI 21.14%-23.64%) were the most salient factors. The mean altruistic parameter was 0.84 (s.d. 0.19), indicating that medical students' altruism was generally high. The subgroup analysis showed that individuals with higher altruism levels had a greater preference for non-financial incentives such as an excellent work environment, sufficient training and career development opportunities, and a light workload. The change in the rate of the uptake of a rural position by individuals with lower levels of altruism is sensitive to changes in financial incentives. CONCLUSIONS Medical students' altruism was generally high, and those with higher altruism paid more attention to non-financial incentives. This suggests that policymakers and hospital managers should further focus on nonfinancial incentives to better motivate altruistic physicians, in addition to appropriate economic incentive when designing recruitment and retention interventions. Medical school administrations could attach importance to the promotion of altruistic values in medical education.
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Affiliation(s)
- Yue Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Lin
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Li
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Youli Han
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
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Druică E, Gibea T, Ianole-Călin R, Socaciu E. Do Moral Judgments in Moral Dilemmas Make One More Inclined to Choose a Medical Degree? Behav Sci (Basel) 2023; 13:474. [PMID: 37366726 DOI: 10.3390/bs13060474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/29/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The role of moral intuitions and moral judgments has become increasingly prominent in educational and academic choices. The present research aims to examine if the moral judgments elicited in sacrificial trolley dilemmas have a distinct pattern for the decisions made by junior medical students, in comparison to those of senior high school students. We work with this sample because it represents the population out of which medical students are recruited in the case of Bucharest, Romania. Our findings show that moral judgments are indeed a significant predictor for a respondent's status as medical students. This result, albeit with limitations, bears multiple practical implications, from developing empirically informed medical ethics courses in medical schools to evidence-based policy designs which consider factors such as morality alongside financial outcomes and incentives.
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Affiliation(s)
- Elena Druică
- Department of Applied Economics and Quantitative Analysis, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania
| | - Toni Gibea
- Department of Philosophy and Social Sciences, Faculty of Management, Bucharest University of Economic Studies, 010374 Bucharest, Romania
| | - Rodica Ianole-Călin
- Department of Applied Economics and Quantitative Analysis, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania
| | - Emanuel Socaciu
- Faculty of Philosophy, University of Bucharest, 060024 Bucharest, Romania
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Bonvin S, Stiefel F, Gholam M, Bourquin C. Calling situated: a survey among medical students supplemented by a qualitative study and a comparison with a surveyed sample of physicians. BMC MEDICAL EDUCATION 2022; 22:619. [PMID: 35971124 PMCID: PMC9376571 DOI: 10.1186/s12909-022-03642-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Calling within the medical context receives growing academic attention and empirical research has started to demonstrate its beneficial effects. The purpose of this study is to investigate what motivates students to enter medical school and what role calling may play (i), to evaluate if calling influences the way in which they experience their studies (ii), and to compare medical students' experience of calling with those of physicians. METHODS A questionnaire survey was distributed among medical students (N = 1048; response rate above 60%) of the University of Lausanne in Switzerland. It was supplemented by a group discussion between bachelor medical students (N = 8) and senior physicians (N = 4), focusing on different facets of calling. An existing data set of a survey among physicians, addressing calling with the same questionnaire, was used to compare students' and physicians' attitudes towards calling. Survey data were analyzed with the habitual statistical procedures for categorical and continuous variables. The group discussion was analyzed with thematic analysis. RESULTS The survey showed that experiencing calling is a motivational factor for study choice and influences positively choice consistency. Students experiencing calling differed from those who did not: they attributed different definitions to calling, indicated more often prosocial motivational factors for entering medical school and perceived the learning context as less burdensome. The analysis of the group discussion revealed that the concept of calling has a fluid definition. It was conceived as having the characteristics of a double-edged sword and as originating from within or outside or from a dialectic interplay between the inner and outer world. Finally, calling is experienced less often by physicians than by medical students, with a decreasing prevalence as the immersion in the clinical years of the study of medicine progresses. CONCLUSIONS Calling plays an important role in study choice and consistency of medical students. Given its relevance for medical students and its ramifications with the learning context, calling should become a topic of the reflexive parts of the medical curriculum. We critically discuss the role played by calling for medical students and provide some perspectives on how calling could be integrated in the reflection and teaching on physicianhood.
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Affiliation(s)
- S Bonvin
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - F Stiefel
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Gholam
- Center of Epidemiological Psychiatry and Psychopathology (CEPP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Bourquin
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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11
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Dost S, Al-Nusair L, Shehab M, Hagana A, Hossain A, Dost AJ, Abdelwahed A. Medical Students' Attitudes Towards Cardiothoracic Surgery in the United Kingdom: A Cross-Sectional Survey of 1675 Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2022; 9:23821205211072722. [PMID: 35047669 PMCID: PMC8761887 DOI: 10.1177/23821205211072722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The objectives of this study were the following: (i) assess interest levels in cardiothoracic surgery (CTS) among UK-based medical students, (ii) identify potential motivators and barriers to pursuing CTS training, (iii) explore the influence of gender on interest in CTS in greater depth. METHODS Medical students from all year groups across UK medical schools were invited to participate in a cross-sectional, national online survey. Responses were collected from 02/12/2019 to 08/12/2019. RESULTS 1675 medical students from 31 UK medical schools responded, with an estimated 5.3% response rate. Of the respondents, 33.7% respondents reported having exposure to CTS, primarily through their medical school or through extracurricular activities (48.4% and 38.8%, respectively). When assessing interest in CTS, 31.4% were interested in undertaking a career in CTS, with a larger proportion of students expressing interest with no exposure to CTS than those with exposure. However, interest in pursuing CTS decreased with exposure as medical students transitioned from pre-clinical to clinical stages. Additionally, male participants were more interested in seeking a CTS post than their female counterparts (38% vs. 27.6%). The length of training (p = 0.0009) and competitive nature (p < 0.0001) of gaining a CTS post were the primary deterring factor for female participants, compared to their male counterparts. CONCLUSIONS This study shows the importance of quality of exposure and its impact on students' interests in pursuing a career in CTS. The negative relationship between exposure and interest in CTS can be associated with the realisation of the challenges that come with pursuing CTS.
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Affiliation(s)
| | | | - Mai Shehab
- King’s College London, London, UK, SE1 1UL
| | - Arwa Hagana
- Imperial College London, London, UK, SW7 2AZ
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12
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Terzi O, Arslan HN, Midik O, Dundar C. The Psychological Effects of the COVID-19 on Students Who Choose the Medical Profession With Different Motivational Factors: A Cross-Sectional Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221109671. [PMID: 35787194 PMCID: PMC9260571 DOI: 10.1177/00469580221109671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has generated mental and psychological health problems
worldwide. The aim of this study was to determine whether the psychological
effects of COVID-19 were different in medical students who chose the medical
profession with different motivational factors. In the study, there were 389
medical school students. The survey asks about sociodemographic features and the
students’ reasons for choosing the medical profession. The study also included a
self-assessed Hospital Anxiety-Depression Scale and Beck Hopelessness Scale.
While 41% of students chose the medical profession for economic reasons, the
ratio of whom have an extrinsic and intrinsic source of motivation was 37% and
22%, respectively. It was found that there was a statistically significant
difference in the distribution of motivational factors by gender. Almost 50% of
males were affected by economic motivation factors. The difference in
motivational factors between genders was found to be statistically significant.
Anxiety in females, depression in students with low-income families, and
hopelessness in students older than 22 years and interns were higher than in the
others (P < .05). Median scores for anxiety, depression, and
hopelessness were higher for students with extrinsic motivational sources.
However, only the difference in scores of anxiety and hopelessness was found
statistically significant (P < .05). We found that the
psychological effects of the COVID-19 pandemic varied according to both
sociodemographic characteristics of the medical students and reasons for
choosing medical profession. According to our results, the idealistic students
interested in the medical profession, who want to support others and prioritize
economic benefits, had fewer psychological issues than those who chose the
medical profession due to family pressure or external factors.
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Affiliation(s)
- Ozlem Terzi
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Hatice Nilden Arslan
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ozlem Midik
- Department of Medical Education, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Cihad Dundar
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Ansert E, Rushing CJ. Feeling the Burnout: Perceptions of Burnout, Anxiety, Depression, and Personal Achievement in US Podiatric Medical Students. J Foot Ankle Surg 2021; 60:747-752. [PMID: 33781641 DOI: 10.1053/j.jfas.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/10/2020] [Accepted: 02/22/2021] [Indexed: 02/03/2023]
Abstract
Medical student burnout is a significant problem, which has led to the introduction of institutional intervention initiatives to combat the phenomenon. However, the incidence of burnout among podiatric medical students has not been previously assessed. The purpose of this cross-sectional study was to determine the perceptions of burnout, anxiety, depression, and personal achievement among podiatric medical students. A 50-question anonymous survey containing the Maslach Burnout Inventory-Human Services Survey and the Hospital Anxiety and Depression Scale was distributed to all students of eight US podiatric medical schools. Demographic and personal information regarding the student's free time, study time, family support, class or exam failures, loan debt, and previous work experience were recorded. Four hundred and eighty students completed the survey, and 479 responses were eligible for inclusion (response rate of 22.2%). Overall, 65.1% reported moderate or high self-perceived rates of burnout, a rate comparable to allopathic and osteopathic medical students. Respondents also reported high levels of emotional exhaustion and anxiety, but low levels of personal achievement. A predisposition for burnout was identified for third-year students between the ages of 26 to 35 years with borderline or abnormal levels of reported anxiety. The present study contributes to the growing body of literature regarding burnout with respect to the podiatric profession. Despite inherent limitations, the findings suggest institutional interventions for the promotion and development of protective factors may be warranted.
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Affiliation(s)
- Elizabeth Ansert
- Primary Resident, PGY-2, St. Vincent Hospital Podiatric Residency Program, Worcester, MA.
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Yang C, Jin X, Yan J, Zhang J, Chen C, Cheng Y, You J, Deng G. An investigation of the intention and reasons of senior high school students in China to choose medical school. BMC MEDICAL EDUCATION 2021; 21:242. [PMID: 33902559 PMCID: PMC8077942 DOI: 10.1186/s12909-021-02677-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/15/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Shortages of qualified health workers have been a global concern, especially in developing countries. China also faces this dilemma, which hinders the development of public health services. Senior high school students are a group who are considering their college majors and careers after graduation. They are also a potential and basic talent reserve for the health sector. This survey focused on senior high school students' intention to learn clinical medicine and explored potential influencing factors. METHODS An anonymous questionnaire containing 20 items was distributed to 5344 senior high school students. The questions covered the following topics: students' intention to learn clinical medicine, personal and family information, understanding of medical education, cognition of doctors' working conditions, and doctor-patient relationships. Logistic regression and the chi-square test were used to compare students with and without a clear intention to learn clinical medicine to explore influencing factors. RESULTS Only 5.6% of senior high school students had a clear intention to learn medicine (CILCM). Personal and family information had distinct impacts. Interest and anatomy course were also associated with students' choice. There was a positive correlation between understanding of medical education and students' intention Meanwhile, students' cognition of doctors, career prospects, and social status had significant impacts. The more optimistic students were about doctors' working conditions and doctor-patient relationships, the more likely they were to have a CILCM. CONCLUSION To some extent, this survey reflects the shortage of medical talent in China and provides possible clues for solving this problem. In addition, these findings may provide a perspective for understanding the development of health services in developing countries.
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Affiliation(s)
- Chaoqun Yang
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xuerui Jin
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ji Yan
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Junkai Zhang
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Canyu Chen
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yaqing Cheng
- Youth League Committee Office, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jialin You
- Youth League Committee Office, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Guoying Deng
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 650 Xin Songjiang Road, Shanghai, China.
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15
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Lam JS, Parkes P, Wang S. Response to: Burnout and Associated Factors Among Medical Students in Uganda [Letter]. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:249-250. [PMID: 33727878 PMCID: PMC7955026 DOI: 10.2147/amep.s306531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Affiliation(s)
| | - Pylin Parkes
- Faculty of Medicine, Imperial College London, London, UK
| | - Susannah Wang
- Faculty of Medicine, Imperial College London, London, UK
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16
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Cui X, Ding N, Jiang N, Li H, Wen D. Preliminary study of the relationship between career choice motivation and understanding of professionalism in newly enrolled medical students in China: a cross-sectional study. BMJ Open 2021; 11:e041860. [PMID: 33619186 PMCID: PMC7903090 DOI: 10.1136/bmjopen-2020-041860] [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] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early professionalism education for first-year students is important for generating sound knowledge and attitudes towards medical professionalism. Of the many factors affecting professionalism and professional identity formation in medical students, career choice motivation is an understudied one. This study aimed to explore the relationship between the career choice motivations of first-year medical students and their understanding of professionalism. SETTINGS AND PARTICIPANTS A cross-sectional survey of 940 first-year clinical medicine students was conducted at China Medical University in September 2017 to explore students' motivation to study medicine and its relationship with students' understanding of professionalism. Demographics, career choice motivation and professionalism were obtained through paper questionnaires. Logistic regression analysis was used to analyse the association between career choice motivation and understanding of professionalism while controlling for potential demographic confounders. RESULTS The most common career choice motivations for first-year medical students (N=843) were interested in the health sciences, income and social status and advocating altruism. The most mentioned subdimensions of professionalism were accountability, pursuit of excellence and compassion. There were significant differences in the understanding of professionalism among students with different career choice motivations. CONCLUSION First-year medical students with different motivations to study medicine also have different understandings of professionalism. Medical educators can explore motivations to learning medicine as a new entry point to providing professionalism education for newly enrolled medical students.
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Affiliation(s)
- Xuemei Cui
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, Liaoning, China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, Liaoning, China
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, Liaoning, China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, Liaoning, China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, Liaoning, China
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Mohebbi SZ, Gholami M, Chegini M, Ghoreyshi Y, Gorter RC, Bahramian H. Impact of career choice motivation on academic burnout in senior dental students: A cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:52. [PMID: 33446199 PMCID: PMC7807807 DOI: 10.1186/s12909-020-02475-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students. METHODS This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others' advice motivations. The data were analyzed using regression test. RESULTS Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of "overload" (46.69%± 1.46%) and "neglect" (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P = 0.007) and lower in students with others' advice motivations (P = 0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers' educational level was high-school diploma or lower. CONCLUSION Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout.
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Affiliation(s)
- Simin Z Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdia Gholami
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Chegini
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Younes Ghoreyshi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ronald C Gorter
- Department of Dental Educational Research / Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Hoda Bahramian
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Bochatay N, Kuna Á, Csupor É, Pintér JN, Muller-Juge V, Hudelson P, Nendaz MR, Csabai M, Bajwa NM, Kim S. The Role of Power in Health Care Conflict: Recommendations for Shifting Toward Constructive Approaches. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:134-141. [PMID: 33394664 DOI: 10.1097/acm.0000000000003604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE The combination of power and conflict is frequently reported to have a detrimental impact on communication and on patient care, and it is avoided and perceived negatively by health care professionals. In view of recent recommendations to explicitly address power and conflict in health professions education, adopting more constructive approaches toward power and conflict may be helpful. This study examined the role of power in conflicts between health care professionals in different cultural contexts to make recommendations for promoting more constructive approaches. METHOD The authors used social bases of power (positional, expert, informational, reward, coercive, referent) identified in the literature to examine the role of power in conflicts between health care professionals in different cultural settings. They drew upon semistructured interviews conducted from 2013 to 2016 with 249 health care professionals working at health centers in the United States, Switzerland, and Hungary, in which participants shared stories of conflict they had experienced with coworkers. The authors used a directed approach to content analysis to analyze the data. RESULTS The social bases of power tended to be comparable across sites and included positional, expert, and coercive power. The rigid hierarchies that divide health care professionals, their professions, and their specialties contributed to negative experiences in conflicts. In addition, the presence of an audience, such as supervisors, coworkers, patients, and patients' families, prevented health care professionals from addressing conflicts when they occurred, resulting in conflict escalation. CONCLUSIONS These findings suggest that fostering more positive approaches toward power and conflict could be achieved by using social bases of power such as referent power and by addressing conflicts in a more private, backstage, manner.
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Affiliation(s)
- Naike Bochatay
- N. Bochatay is a postdoctoral scholar, School of Medicine, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-6098-4262
| | - Ágnes Kuna
- Á. Kuna is assistant professor, Department of Applied Linguistics and Phonetics, Eötvös Loránd University, Budapest, Hungary
| | - Éva Csupor
- É. Csupor is a clinical psychologist, Department of Child and Adolescent Psychiatry, Pediatric Clinic, University of Szeged, Szeged, Hungary
| | - Judit Nora Pintér
- J.N. Pintér is associate professor, Department of Psychology of Counseling, Eötvös Loránd University, Budapest, Hungary; ORCID: https://orcid.org/0000-0002-2580-588X
| | - Virginie Muller-Juge
- V. Muller-Juge is an associate specialist, School of Medicine, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-2346-8904
| | - Patricia Hudelson
- P. Hudelson is a medical anthropologist, Department of Primary Care, Geneva University Hospitals, and lecturer, Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0003-2601-7479
| | - Mathieu R Nendaz
- M.R. Nendaz is professor and vice-dean, Department of Medicine and Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0003-3795-3254
| | - Marta Csabai
- M. Csabai is professor and head of department, Department of Personality, Clinical, and Health Psychology, University of Szeged, Szeged, Hungary
| | - Nadia M Bajwa
- N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, and faculty member, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0002-1445-4594
| | - Sara Kim
- S. Kim is research professor, Department of Surgery, School of Medicine, University of Washington, Seattle, Washington; ORCID: https://orcid.org/0000-0002-6623-5393
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Nteveros A, Kyprianou M, Artemiadis A, Charalampous A, Christoforaki K, Cheilidis S, Germanos O, Bargiotas P, Chatzittofis A, Zis P. Burnout among medical students in Cyprus: A cross-sectional study. PLoS One 2020; 15:e0241335. [PMID: 33206654 PMCID: PMC7673498 DOI: 10.1371/journal.pone.0241335] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The primary aim was to estimate the burnout prevalence among all medical students at the Medical School of the University of Cyprus. Secondary aims were to ascertain the predictors of burnout and its relationship with lifestyle habits, sleep quality and mental health. BACKGROUND Burnout in the healthcare sector has drawn significant scientific attention over the last few years. Recent research underscored the large burden of profession-related burnout among medical students. MATERIALS AND METHODS An anonymous questionnaire was administered to all 189 eligible candidates. This included demographic and lifestyle characteristics. Sleep quality was assessed via the Pittsburg Sleep Quality Index, mental health was assessed via the mental health (MH) domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory-Student Survey (MBI-SS). RESULTS Overall response rate was 96.3%. The burnout prevalence was 18.1%. There was a significant linear effect of between the year of studies and the burnout frequency [F(1) = 5.09, p = 0.024], implying that with increasing academic year there were more students with burnout, especially after the 4th year of education which signifies the beginning of clinical education. Students with burnout were more likely to have poor sleep quality (90.9% vs. 60.8%, odds ratio 4.33, p = 0.023) and worse mental health (MH score 40.2 ± 17.7 vs 62.9 ± 20.3, p<0.001). Alcohol consumers had more symptoms of cynicism and less feelings of efficacy than non-alcohol consumers. Moreover, less feelings of efficacy were significantly associated with more alcohol consumption among alcohol consumers. CONCLUSIONS Burnout is prevalent in medical students and increases significantly during the clinical years. Students with burnout have worse sleep and mental health and might use alcohol as a coping mechanism. Implementing prevention strategies of burnout may be beneficial.
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Givron H, Fischer L, Desseilles M. A mixed-approach to investigate what motivates Belgian students to study medicine. MEDEDPUBLISH 2020; 9:204. [PMID: 38073796 PMCID: PMC10699379 DOI: 10.15694/mep.2020.000204.1] [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] [Indexed: 12/22/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Aims - Our main objective was to explore the motivations that led our third year Belgian students to study medicine. Method - We used a mixed method as we collected both quantitative and qualitative measures at the same time through online surveys. Chi-Square tests were used to examine differences in motivation between gender of the participants. A thematic content analysis was then conducted on the open-ended question using a qualitative approach. Results and conclusions - The final sample consists of 243 third-year students (87 men and 156 women). Chi-square analyses revealed gender differences in motivations to study medicine. The motivation most often reported by our students in both qualitative and quantitative analyses is "altruistic motivation". The qualitative analysis identified, within this category, sometimes unrealistic beliefs about the practice of medicine, leading to the conclusion that it is necessary to put medical students in contact with the reality of the field as soon as possible. Furthermore, the lack of focus on the relationship with the patient within the formal curriculum and subsequent medical practice could be the cause of a form of disillusionment among these students. We believe that more lessons on relational aspects should be offered to them. Perspectives - Finally, in addition to identifying and classifying the motivations present among medical students, we believe that some perspectives are the analysis of the interactions between these motivations in 1) the determination of the choice of study and 2) the attitudes and behaviours that will result from it.
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Hassan M, Shahzad F, Waqar SH. Seeking motivation for selecting Medical Profession as a Career Choice. Pak J Med Sci 2020; 36:941-945. [PMID: 32704268 PMCID: PMC7372692 DOI: 10.12669/pjms.36.5.2799] [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] [Indexed: 11/15/2022] Open
Abstract
Objective To determine the motivational factors of medical students for selecting medical career as a profession. Methods This was a survey based cross-sectional study. Medical students of first and second year from private and public medical colleges of Rawalpindi and Islamabad were recruited via convenient sampling and a self-based questionnaire was distributed to them. Besides demographics, questions were based on factors influencing medical students to pursue medical career. Data was collected and descriptive analysis was done using SPSS 21. Results A total of 300 medical students participated in the study; 129 (43%) of them were males and 171 (57%) were females with mean age of 19.35 years. Among Humanitarian based questions; Serving Humanity gained highest percentage, followed by sympathies for mankind and health for everyone sequentially. In Societal factors, Prestigious Profession and in Scientific factors based questions Challenging Field ranked first. Amongst all the questions Prestigious Profession takes the lead. Conclusion Major motivation behind selecting medical field was prestigious profession followed by altruism. By understanding medical students' motivational factors for pursuing medical field we would be able to analyze the future trend of professionals.
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Affiliation(s)
- Madeeha Hassan
- Madeeha Hassan, MBBS. Postgraduate Resident, Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Fatima Shahzad
- Miss Fatima Shahzad, Undergraduate Medical Student. Al-Nafees Medical College, Islamabad, Pakistan
| | - S H Waqar
- Prof. S H Waqar, MBBS, FCPS (Surgery), FICS, MCPS-HPE Professor and Head Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
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Abstract
Altruism and the medical profession have been linked throughout the history of medicine. Students are drawn to the calling of medicine because of altruistic values, dedication to service, and the desire to alleviate suffering and promote healing. Despite a dedication to these values, altruism in medicine is threatened by empathy erosion that develops in the clinical years of medical school and an increasing rate of medical student burnout. Currently, there are two widespread movements in medicine aimed at addressing the dual loss of altruism and physician and student burnout-professionalism and wellness. Despite widespread recognition of the problems and programs aimed at improving them, there has been little headway, and even calls to abandon altruism in the modern marketplace of medicine. What is needed is not an abandonment of a fundamental, defining value of the profession, but a re-evaluation of the meaning of altruism in medicine and a framework that allows for students and physicians to provide altruistic care for a sustainable, rewarding career in the healing profession. This paper proposes the Enlightened Self-Interest in Altruism (ESIA) model as an ethical framework to allow medical students to synergize the interests of the self with those they serve in a mutually beneficial relationship to improve patient care and the healthcare system at large. The ESIA model acknowledges that egoism and altruism are intertwined, dynamic motivators of behavior. In the enlightened self-interest approach, the interests of the group are also the interests of the self. The physician-patient relationship is a dyad in which egoism and altruism may converge in an enlightened way that acknowledges that the interests of one are the interests of the whole. This is a paradigm shift from the historical view of egoism and altruism as opposing motivations. This paper will present the threats to altruism, explore the interface of egoism and altruism in a clinical vignette, and then present the ESIA framework as an educational approach to aligning the interests of providers and patients to prevent burnout and promote altruism.
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Affiliation(s)
- Laura Vearrier
- Department of Emergency Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, USA.
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Hariharan TS, Griffin B. A review of the factors related to burnout at the early-career stage of medicine. MEDICAL TEACHER 2019; 41:1380-1391. [PMID: 31345077 DOI: 10.1080/0142159x.2019.1641189] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Background: Globally, burnout is an increasingly prevalent problem amongst young medical professionals. This review aims to understand the factors related to burnout in the early-career stage of medicine. Drawing on the widely used Job Demands-Resources Model, the antecedents of burnout were distinguished from its outcomes.Methods: The review adopted the PRISMA guidelines. Using specific search terms, peer-reviewed articles were obtained from a range of databases and assessed against selection criteria. To meet inclusion requirements, the study had to be published between 2000 and 2018, include a validated measure of burnout, and undertake empirical assessment of factors related to burnout in medical students and/or junior medical officers/residents. Additional studies were obtained and reviewed from the reference lists of selected articles.Results: Out of the 3796 studies that were initially found, 585 were assessed against the eligibility criteria leaving 113 studies for review. These studies highlighted the negative consequences of burnout in the early medical career. Also identified were work-specific and person-specific demands that likely lead to burnout and, work and person resources that appear to reduce burnout.Conclusion: This review provides a framework to explain the growing problem of burnout amongst early-career medical professionals. However, further research is necessary to overcome the current reliance on cross-sectional designs and small sample sizes.
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Affiliation(s)
| | - Barbara Griffin
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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Grother T, Coventry J, Wilson D. The ‘Hello my name is …’ campaign: student‐led change. CLINICAL TEACHER 2019; 16:412-414. [DOI: 10.1111/tct.13064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - David Wilson
- Cardiff University School of Medicine Cardiff UK
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Nguyen VAT, Könings KD, Wright EP, Luu HN, Scherpbier AJJA, van Merriënboer JJG. Working in preventive medicine or not? Flawed perceptions decrease chance of retaining students for the profession. HUMAN RESOURCES FOR HEALTH 2019; 17:31. [PMID: 31092249 PMCID: PMC6521520 DOI: 10.1186/s12960-019-0368-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 04/30/2019] [Indexed: 05/15/2023]
Abstract
BACKGROUND Recruiting and retaining students in preventive medical (PM) specialties has never been easy; one main challenge is how to select appropriate students with proper motivation. Understanding how students perceive PM practice differently from practicing doctors is necessary to guide students, especially for those for whom PM is only a substitute for medicine as their first study preference, properly during their study and, later, the practice of PM. METHODS One thousand three hundred eighty-six PM students in four Vietnamese medical schools and 101 PM doctors filled out a questionnaire about the relevance of 44 characteristics of working in PM. ANOVAs were conducted to define the relationship between students' interest, year of study, willingness to work in PM, and the degree to which students had realistic perceptions of PM practice, compared to doctors' perceptions. RESULTS Overall, compared to doctors' perceptions, students overestimated the importance of most of the investigated PM practice's characteristics. Moreover, students' perception related to their preference and willing to pursue a career in PM after graduation. In particular, students for whom PM was their first choice had more realistic perceptions of community practice than those who chose PM as their second choice. And, second-choice students had more realistic perceptions than first-choice students in their final years of study, but expected higher work stress in PM practice. Students who were willing to pursue a career in PM rated the importance of community practice higher than those who were not. We also found that students' perception changed during training as senior students had more realistic perceptions of clinical aspects and working stress than junior students, even though they overemphasized the importance of the community aspects of PM practice. CONCLUSIONS To increase the number of students actually entering the PM field after graduation, the flawed perceptions of students about the real working environment of PM doctors should be addressed through vocation-oriented activities in the curriculum targeted on groups of students who are most likely to have unrealistic perceptions. Our findings also have implications for other less attractive primary health care specialties that experience problems with recruiting and retaining students.
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Affiliation(s)
- Van Anh Thi Nguyen
- Department of Medical Education and Skills Laboratory, Hanoi Medical University, 1 Ton That Tung street, Dongda, Hanoi, Vietnam
| | - Karen D. Könings
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - E. Pamela Wright
- Guelph International Health Consulting, Frederik Hendrikstraat 18, 1052 HT Amsterdam, the Netherlands
| | - Hoat Ngoc Luu
- Biostatistics and Medical Informatics Department, Institute for Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung street, Dongda, Hanoi, Vietnam
| | - Albert J. J. A. Scherpbier
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Jeroen J. G. van Merriënboer
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
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Grother TW, Wilson DJ. Altruism - A Quality Required of Medical School Applicants. Am J Med 2019; 132:e43. [PMID: 30686340 DOI: 10.1016/j.amjmed.2018.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Thomas W Grother
- Cardiff University School of Medicine, Centre for Medical Education, College of Biomedical and Life Sciences, Cardiff, UK
| | - David J Wilson
- Cardiff University School of Medicine, Centre for Medical Education, College of Biomedical and Life Sciences, Cardiff, UK.
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Erschens R, Keifenheim KE, Herrmann-Werner A, Loda T, Schwille-Kiuntke J, Bugaj TJ, Nikendei C, Huhn D, Zipfel S, Junne F. Professional burnout among medical students: Systematic literature review and meta-analysis. MEDICAL TEACHER 2019; 41:172-183. [PMID: 29656675 DOI: 10.1080/0142159x.2018.1457213] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students. METHODS The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS). RESULTS Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI-HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology. CONCLUSION This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students' mental health impairment to enable more meaningful comparisons and adequate prevention strategies.
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Affiliation(s)
- Rebecca Erschens
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Katharina Eva Keifenheim
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Anne Herrmann-Werner
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Teresa Loda
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Juliane Schwille-Kiuntke
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Till Johannes Bugaj
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Christoph Nikendei
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Daniel Huhn
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Stephan Zipfel
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
- c Deanery of Students' Affairs , University's Faculty of Medicine , Tuebingen , Germany
| | - Florian Junne
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
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Motivation towards medical career choice and academic performance in Latin American medical students: A cross-sectional study. PLoS One 2018; 13:e0205674. [PMID: 30335809 PMCID: PMC6193642 DOI: 10.1371/journal.pone.0205674] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/29/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Motivation in medical students is positively associated with learning strategies. However, the evidence of a direct relationship between motivation and performance is vague. The objective of this study is to determine if the motivation that pushed students to choose the medical career is associated with their academic performance during their university years. METHODS The study was conducted in 4,290 medical students from 10 countries in Latin America. The "Attribution Scale of General Achievement Motivation" was used to evaluate their general performance. The "Medical motivation Scale" test was used to measure social, altruist, economic, and prestige motivators. For statistical analyses, frequencies and percentages were described, and generalized linear models were used to establish statistical associations. RESULTS Fifty percent of the students surveyed were females and the mean student age was 21 years old. This study showed that male students had a higher social/altruist motivation (PR:1.11,95%CI: 1.03-1.18; p<0,01) than females. Those who had familial pressure had a lower social/altruist motivation (PR:0.17,95%CI:0.08-0.36; p<0,001). The positive vocational test was associated with a higher social/altruist motivation (PR:1.85,95%CI:1.03-3.30; p<0,05). Moreover, good grades at school were related with a higher economical/prestige motivation (PR:1.39,95%CI:1.05-1.83; p<0,05), but lower social/altruist motivation (PR:0.85,95%CI:0.74-0.98; p<0,05) and academic performance (PR:0.63,95%CI:0.50-0.79; p<0,001). We found a higher frequency in the general motivation was associated to a lowest social/altruist motivation (PR: 0.57; CI95%: 0.46-0.70; p<0.001), and that it increased according to the year of study (PR: 1.15; CI95%: 1.03-1.28; p:0.013) and was higher when pressure by the family was present (PR: 1.36; CI95%: 1.17-1.59; p<0.001). CONCLUSION This study indicated that male medical students and having a positive vocational test were associated with a higher social/altruist motivation. Conversely, those who had familial pressure and good grades at school had a lower social/altruist motivation. Is necessary to conduct further studies that assess other factors related to motivation as demographics, personality, and learning styles.
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Győrffy Z, Dweik D, Girasek E. Willingness to migrate-a potential effect of burnout? A survey of Hungarian physicians. HUMAN RESOURCES FOR HEALTH 2018; 16:36. [PMID: 30097051 PMCID: PMC6086050 DOI: 10.1186/s12960-018-0303-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Burnout worldwide and migration of caregivers are among the most important challenges of the twenty-first century health care. METHODS Quantitative, online survey of Hungarian physicians (n = 4 784) was performed in 2013. A link to an anonymous, self-administered questionnaire was sent to all potential participants, namely to the registered members of the Hungarian Medical Chamber with a valid e-mail address. Linear regression analysis was used to determine the risk factors of burnout. The association between physicians' burnout and their willingness to migrate was determined by binary logistic regression analysis. RESULTS Moderate/mild level of personal accomplishment was detected in 65% of respondents, whereas moderate/severe level of emotional exhaustion and depersonalization was detected in 49% and 46%, respectively. Single male physicians younger than 35 composed the cohort with the highest risk for developing burnout. Higher daily working hours and multiple workplaces contribute to the risk of developing burnout. According to logistic regression analysis, the intention to work abroad was affected by the emotional exhaustion dimension of burnout (OR = 1.432) and depersonalization had a tendency to have an impact on the willingness to migrate. CONCLUSIONS We assume that there is a circular causality between burnout and the willingness to migrate. Burnout increases the willingness to work abroad, whereas contemplating migration might evoke a certain degree of depersonalization in caregivers who are in a dilemma.
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Affiliation(s)
- Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, Budapest, H-1089 Hungary
| | - Diana Dweik
- Department of Obstetrics and Gynecology, Healthcare Service Centre of Csongrád County, Kórház st. 2, Makó, H-6900 Hungary
| | - Edmond Girasek
- Health Services Management Training Centre, Semmelweis University, Kútvölgyi st 2, Budapest, H-1125 Hungary
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Talih F, Daher M, Daou D, Ajaltouni J. Examining Burnout, Depression, and Attitudes Regarding Drug Use Among Lebanese Medical Students During the 4 Years of Medical School. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:288-296. [PMID: 29396837 DOI: 10.1007/s40596-017-0879-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/22/2017] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aims to evaluate the prevalence of burnout, depressive symptoms, and anxiety symptoms and attitudes toward substance use in medical students as well as their evolution during the 4 years of medical school. METHODS A cross-sectional study was carried out at the American University of Beirut Medical Center (AUBMC) between September and December 2016. In total, 176 out of 412 eligible medical students responded. The survey was anonymous and administered via e-mail link to an electronic form. The study included general socio-demographic questions and standardized validated tools to measure depressive symptomatology (PHQ-9), burnout (Burnout Measure), anxiety (GAD-7), alcohol use (AUDIT), and substance abuse (DAST-10) as well as questions pertaining to attitudes toward recreational substance use. RESULTS Overall, 23.8% of medical students reported depressive symptomatology, with 14.5% having suicidal ideations. Forty-three percent were found to have burnout. Those who screened positive for burnout were more likely to be males, to be living away from their parents, and to have experienced a stressful life event during the last year. With the exception of burnout, there was no significant difference in the prevalence of depression or anxiety among the 4 years of medical school. There was a significant difference in alcohol use, illicit substance use, and marijuana use during the four medical school years. CONCLUSIONS The results of this study show high rates of depression, burnout, and suicidal ideation among medical students from the Middle East region. Increased rates of substance use were detected as well as a more tolerant attitude toward substance use in general, specifically cannabis. It is crucial that medical educators and policymakers keep tackling the complex multifactorial mental health issues affecting medical students and design effective solutions and support systems.
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Affiliation(s)
- Farid Talih
- American University of Beirut Medical Center, Beirut, Lebanon.
| | - Michel Daher
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Dayane Daou
- American University of Beirut, Beirut, Lebanon
| | - Jean Ajaltouni
- American University of Beirut Medical Center, Beirut, Lebanon
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Goel S, Angeli F, Dhirar N, Singla N, Ruwaard D. What motivates medical students to select medical studies: a systematic literature review. BMC MEDICAL EDUCATION 2018; 18:16. [PMID: 29343262 PMCID: PMC5772649 DOI: 10.1186/s12909-018-1123-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 01/09/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational factors that underpin students' selection of medical study in recent years. METHODS The literature search was carried out by two researchers independently in PubMed, Google Scholar, Wiley and IndMED databases for articles published from year 2006 till 2016. A total of 38 combinations of MeSH words were used for search purpose. Studies related to medical students and interns have been included. The application of inclusion and exclusion criteria and PRISMA guidelines for reporting systematic review led to the final selection of 24 articles. RESULTS The majority of the studies (n = 16; 66.6%) were from high-income countries followed by an equal number from upper-middle and lower-middle income countries (n = 4,16.7%). None of the studies were from low-income countries. All of the studies were cross-sectional in nature. The main motivating factors that emerged were scientific (interest in science / medicine, social interest and academia, flexible work hours and work independence), societal (prestige, job security, financial security) and humanitarian (serving the poor and under priviledged) in high-, upper-middle and lower-middle income countries, respectively. The findings were comparable to Maslow's hierarchy of needs theory of motivation. CONCLUSION This systematic review identifies the motivational factors influencing students to join medical studies in different parts of the globe. These factors vary per country depending on the level of income. This study offers cues to policy makers and educators to formulate policy in order to tackle the shortage of health workers, i.e. medical doctors. However, more research is needed to translate health policy into concrete and effective measures.
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Affiliation(s)
- Sonu Goel
- School of Public Health, PGIMER, Sector-12, Chandigarh, 160012 India
| | - Federica Angeli
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Organization Studies, School of Social and Behavioural Sciences, Tilburg University, Tilburg, the Netherlands
| | - Nonita Dhirar
- School of Public Health, PGIMER, Sector-12, Chandigarh, 160012 India
| | - Neetu Singla
- School of Public Health, PGIMER, Sector-12, Chandigarh, 160012 India
| | - Dirk Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Wouters A, Croiset G, Isik U, Kusurkar RA. Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study. BMJ Open 2017; 7:e014779. [PMID: 28576893 PMCID: PMC5623448 DOI: 10.1136/bmjopen-2016-014779] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/21/2017] [Accepted: 04/21/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore high school students' motivation for applying to study medicine and the factors that influence this. To find explanations for under-representation of minority students in medical education, descriptions of motivation of students with different background characteristics were compared. DESIGN Qualitative phenomenological study using semistructured one-on-one interviews. SETTING One predominantly white and one mixed high school in a large multicultural city in the Netherlands. The study was conducted in March-December 2015. PARTICIPANTS Twenty-four high school students, purposively sampled for demographic characteristics. METHODS The analysis consisted of the coding of data using a template based on the motivation types (autonomous and controlled motivation) described by self-determination theory and open coding for factors that influence motivation. RESULTS The main reasons for pursuing a medical career pertained to autonomous motivation (interest in science and helping people), but controlled motivation (eg, parental pressure, prestige) was also mentioned. Experiences with healthcare and patients positively influenced students' autonomous motivation and served as a reality check for students' expectations. Having to go through a selection process was an important demotivating factor, but did not prevent most students from applying. Having medical professionals in their network also sparked students' interest, while facilitating easier access to healthcare experiences. CONCLUSIONS The findings showed a complex interplay between healthcare experiences, growing up in a medical family, selection processes and motivation. Healthcare experiences, often one of the selection criteria, help students to form autonomous motivation for studying medicine. However, such experiences as well as support in the selection process seem unequally accessible to students. As a result, under-represented students' motivation decreases. Medical schools should be aware of this and could create opportunities to acquire healthcare experiences. High schools could incorporate internships as part of their study counselling programmes and offer tailor-made guidance to each individual student.
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Affiliation(s)
- Anouk Wouters
- VUmc School of Medical Sciences, Research in Education, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
| | - Gerda Croiset
- VUmc School of Medical Sciences, Research in Education, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
| | - Ulviye Isik
- VUmc School of Medical Sciences, Research in Education, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
| | - Rashmi A Kusurkar
- VUmc School of Medical Sciences, Research in Education, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
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