'A melting pot of cultures' -challenges in social adaptation and interactions amongst international medical students

ChatGPT revisited: Using ChatGPT-4 for finding references and editing language in medical scientific articles

The attainment of academic superiority relies heavily upon the accessibility of scholarly resources and the expression of research findings through faultless language usage. Although modern tools, such as the Publish or Perish software program, are proficient in sourcing academic papers based on specific keywords, they often fall short of extracting comprehensive content, including crucial references. The challenge of linguistic precision remains a prominent issue, particularly for research papers composed by non-native English speakers who may encounter word usage errors. This manuscript serves a twofold purpose: firstly, it reassesses the effectiveness of ChatGPT-4 in the context of retrieving pertinent references tailored to specific research topics. Secondly, it introduces a suite of language editing services that are skilled in rectifying word usage errors, ensuring the refined presentation of research outcomes. The article also provides practical guidelines for formulating precise queries to mitigate the risks of erroneous language usage and the inclusion of spurious references. In the ever-evolving realm of academic discourse, leveraging the potential of advanced AI, such as ChatGPT-4, can significantly enhance the quality and impact of scientific publications.

Impact of Medical School on the Relationship between Nutritional Knowledge and Sleep Quality-A Longitudinal Study of Students at Wroclaw Medical University in Poland

The aim of this study was to investigate the impact of the first year of medical school on the relationship between nutritional knowledge and sleep. To achieve this, first-year medical students at Wroclaw Medical University were invited to participate in the study during both the initial and final months of their first academic year. The study included 570 students in the initial period and 705 in the latter. The research questionnaire comprised the KomPAN, assessing nutritional knowledge, and the Pittsburgh Sleep Quality Index (PSQI), evaluating sleep quality. The majority of students demonstrated at least sufficient nutritional knowledge, while approximately two-thirds of students experienced poor sleep in both periods. Notably, sleep quality further deteriorated in the second period (PSQI total score: 6.86 vs. 7.38, p = 0.0157). This change was influenced mainly by a decrease in sleep duration and an increase in the use of sleep medications (both p < 0.0001). The significant difference in overall sleep quality between different nutritional knowledge levels emerged only in the second semester, where students with the highest nutritional knowledge slept the best, while those with the lowest slept the worst (p = 0.0001). Crucially, in both periods, the use of sleep medications was highest among individuals with insufficient nutritional knowledge. Throughout the academic year, the usage increased for all except those with the highest nutritional knowledge, who exhibited the best sleep (p < 0.0001). The escalating use of sleep medications among medical students warrants greater attention, and leveraging the relationship between nutritional knowledge and sleep could prove beneficial, as positive habits in one domain may positively influence the other.

"My Cross-Border PhD Journey": A Qualitative Study on the Educational and Life Challenges of Mainland Chinese PhD Students in Hong Kong

PhD students' poor mental health has been increasingly concerning. However, challenges among PhD students studying aboard are understudied. The Educational and Life Transitions (ELT) model postulates that international PhD students are subject to both academic and acculturative stressors; however, relevant research is limited in the Chinese context. We examined mainland Chinese PhD students' study and living experiences in Hong Kong using a qualitative approach. Through purposive sampling, 37 mainland Chinese PhD students in different disciplines from public-funded universities in Hong Kong were recruited to participate in online focus group interviews (December 2020-February 2021). The interviews were analyzed using the framework analysis method. Ten themes of academic/acculturative stressors were identified. The academic stressors included: (1) high expectations from the supervisors; (2) emphasis on self-discipline as PhD students; (3) peer comparison in academia; (4) difficulties shifting research directions/academic disciplines; (5) uncertainties about future career. The acculturative stressors included: (1) differences in the political environment; (2) language barriers; (3) difficulties living in Hong Kong; (4) limited social interaction with others; (5) local people's discriminatory behaviors. This study sheds light on the stressors experienced by mainland Chinese PhD students in Hong Kong. To better address those students' academic and acculturative stressors, cross-cultural training and additional support from supervisors/the university could be provided.

An Online Mindfulness Intervention for International Students: A Randomized Controlled Feasibility Trial

Background

Student mobility across borders poses challenges to health systems at the university and country levels. International students suffer from stress more than their local peers, however, do not seek help or underutilize existing help offers. Some barriers to help-seeking among international students are insufficient information regarding the health offers, stigma, and language, which might be overcome via culturally adapted internet and mobile-based interventions (IMI).

Method

A randomized controlled feasibility trial with a parallel design assessed the feasibility and potential efficacy of an online mindfulness intervention adapted for international university students. Participants were randomized into either an adapted online mindfulness intervention (StudiCareM-E) (IG, n = 20) or a waitlist control group (WL, n = 20). Participants were assessed at baseline (t0) and eight-week post-randomization (t1). The feasibility of StudiCareM-E was evaluated regarding intervention adherence, client satisfaction, and potential negative effects. The potential efficacy of StudiCareM-E was measured by means of the level of mindfulness, perceived stress, depression, anxiety, presenteeism, and wellbeing. Efficacy outcomes were evaluated with regression models on the intention-to-treat (ITT) sample (n = 40), adjusting for the baseline values.

Results

Participants' formative feedback suggested improvements in the content of the IMI. There were no crucial negative effects compared to WL. Assessment dropout was 35% (IG: 50%: WL: 20%), and intervention dropout was 60%. StudiCareM-E yielded significant improvements in mindfulness (β = .34), well-being (β = .37), and anxiety (β = -.42) compared to WL.

Conclusion

StudiCareM-E might be used among culturally diverse international student populations to improve their well-being. Future studies might carefully inspect the extent of the adaptation needs of their target group and design their interventions accordingly.

Yabancı Uyruklu Öğrencilerin Kültürel Özellikleri, Kadın Sağlığı ve Sağlık Hizmeti Alımı İlişkisi

Giriş: Yabancı uyruklu öğrencilerin farklı dil ve kültürel özelliklere sahip olması, sağlık hizmeti alımı ve kadın sağlığı açısından önemlidir. Amaç: Çalışmada yabancı uyruklu kadın öğrencilerin kültürel özelliklerinin kadın sağlığı ve sağlık bakım hizmeti alma durumları arasındaki ilişkinin belirlenmesi amaçlanmıştır. Yöntem: Kesitsel ve tanımlatıcı nitelikte olan araştırmanın örneklemini 2019-2020 güz yarıyılında ULUTÖMER’de öğrenim gören, 27 ülkeden oluşan, 62 kadın öğrenci oluşturdu. Verileri toplama aracı olarak “Hemşirelik Bakımında Kültürel Özellikleri Tanılama Rehberi” kullanılmıştır. Bulgular: Yaş ortalaması 20.66±2.52 olan kadın öğrencilerin %93.5’i bekârdır. Bu öğrencilerin menstruasyon ağrısı için geleneksel ya da tıbbi tedavi uygulamalarının ülkeler arasında anlamlı düzeyde farklı olduğu belirlenmiştir (p < .005). Çalışmada öğrencilerin sağlık bakım sistemi ilişkin bilgi engelli ve kadın sağlığına ilişkin kültürel uygulamaları arasında pozitif yönde anlamlı bir ilişki bulunmuştur (r = .253, p = .047). Öğrencilerin sağlık hizmeti alımında iletişim engeli ile inancı gereği sağlık bakım hizmeti alamaya engel olan durumlar arasında orta düzeyde negatif yönlü (r = -.317, p = .012), sağlık bakım hizmetine ulaşım engeli arasında da pozitif yönlü güçlü ilişki olduğu tespit edilmiştir (r = .480, p = .000). Sonuç: Yabancı uyruklu kadın öğrencilerin kadın sağlığına ilişkin kültürel uygulamaları ile sağlık bakım hizmetinde yaşadıkları engeller arasında pozitif yönde ilişki belirlenmiştir. Öğrencilerin sağlık hizmeti alımında iletişim engeli arttıkça, sağlık bakım hizmeti alama engelini de artırdığını göstermiştir.

Application of the electronic book to promote self-directed learning in medical technologist continuing education: a cross-sectional study

BACKGROUND

Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists' learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists.

METHODS

A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists' practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book's learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it.

RESULTS

Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories.

CONCLUSIONS

The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE.

When the wheels fall off - Medical students' experiences of interrupted academic progression

INTRODUCTION

There is limited published research on medical students' perspectives of a significant interruption to their academic progression. This study sought to identify the factors that contribute to difficulties with academic progression and to understand how medical students successfully respond.

METHODS

This interpretive phenomenological study reports on the findings from in-depth interviews of 38 final year medical students who had experienced a significant academic interruption.

RESULTS

The two superordinate themes were: the factors contributing to the interruption and their experience of the interruption. Factors identified as contributing to the interruption were: workload, learning in medicine, motivation for medicine, isolation, adapting to local culture, health and external factors. Their experience of the interruption focused on stages of working through the process: 'what happened,' 'how it felt,' 'managing the failure,' 'accepting the failure' and 'making some changes.'

DISCUSSION

Each factor affected how the participants reacted and responded to the interruption. Regardless of the origins of the interruption, most reacted and responded in a comparable process, albeit with varying timespans. These reactions and responses were in a state of fluctuation. In order to succeed many stated they shifted their motivation from external to internal, in direct response to the interruption, resulting in changed learning behaviours.

CONCLUSIONS

The process of working through an interruption to academic progression for students may benefit from a model of interval debriefing, restorative academic and personal development support. Facilitation of this process could enable students to face an interruption constructively rather than as an insurmountable emotionally burdensome barrier. Medical schools could utilise these findings to implement further support strategies to reduce the number of significant academic disruptions.

Understanding international users' library experience in the Digital Age – joining the behavioral and experiential aspects

Purpose

The purpose of this paper is to describe, analyze and understand international users' library experience in the Digital Age in order to inform library service design and ensure it provides an inclusive environment. In this study, the behavioral and experiential aspects of user library experience are merged to develop essential interconnections between information behavior (IB) and user experience (UX) in the context of the academic library with the goal of constructing a more holistic understanding of ‘library experience.

Design/methodology/approach

The study was built on the concept “library experience” through analyzing its essential components of IB and UX. It was developed through findings from mixed methods research, consisting of the quantitative investigation from a library log analysis, and qualitative investigations via cognitive mapping exercises and semi-structured interviews, both targeted on the largest single group of international students in United Kingdom – international Chinese students.

Findings

The findings demonstrated the complexity and multilayered characteristics of international Chinese students' library context, and three unique contexts emerged from the data shaping their library experience. Building on the previous findings on the connections between IB and UX, the work attempted to redefine “library experience” by joining both behavioral and experiential aspects. It is found that the key components of cultural library experience are the multilayered context, cultural group's perception needs, sense-making process and subjective evaluations.

Originality/value

This study joins the behavioral and experiential perspectives together to explore library experience in a more holistic way and proposes a systematic structure to understand and analyze library experience, especially that of international users in a cross-cultural context, which, in turn, will better serve their information needs and inform the design of a more equal and inclusive library system.

International medical students' perspectives on factors affecting their academic success in China: a qualitative study

BACKGROUND

The number of international students who choose China as their destination for quality medical education is rising, particularly those from developing countries, but little is known about their adaptation and educational experiences at Chinese universities. This study explored the factors that these students perceived to have influenced their academic success.

METHODS

Semi-structured interviews were conducted with international students (N = 40) from developing countries from September 2020 to January 2021. Participants were graduates or in their second, third, fourth, fifth, or sixth academic year in two university medical schools. Interviews were audio-recorded, transcribed, and analyzed using a thematic analysis approach.

RESULTS

The participants chose China to study medicine based on cost, teaching resources, quality of medical education, recommendation, and safety factors. They considered an increase in medical knowledge, clinical skills and communication skills as an indicator of academic success. Positive factors affecting academic success were the support system (family, friends, seniors) and campus resources (library, laboratories, extra-curricular activities, scholarship). Negative factors were (i) issues affecting learning (English language barrier), adjusting to the medical education system in China, learning difficulties, failing exams, internship difficulties, problems with online learning during the pandemic, (ii) sociocultural issues (lacking knowledge of the Chinese language, challenges in daily life, perceived discrimination, interpersonal relationships), (iii) wellbeing issues (physical and mental health issues), and (iv) other challenges (climate, food, finance, scholarship). The influence of teachers, administrators and classmates was perceived as both positive and negative.

CONCLUSIONS

Factors affecting the academic success of international medical students at Chinese universities are multi-faceted. It is the collective responsibility of the host society, universities, teachers, administrators, classmates, families, and students themselves to address these factors in order to support and help students achieve academic success. Findings in our study support recommendations to improve teachers' English language skills and pedagogy and to invest in administrators' professional development. They also suggest that greater awareness of students' sociocultural and mental challenges and optimizing the positive influence of classmates could strengthen student support and better address student academic difficulties. The English proficiency and prior academic performance of international students should be considered during recruitment. Given the rapid growth in international MBBS programs in China, further research on the experiences of international students in China's medical programs is needed.

Examining the First Peer-to-Peer Mentorship Program (F1Doctors) for International Medical Students

In this study, we report international medical students in the United States and conduct an analysis of the first, peer-to-peer, national mentorship program for international medical students and international pre-med applicants in the US (F1Doctors). We used analyzed survey data collected through F1Doctors and the Association of American Medical Colleges yearly matriculation reports. Results indicated that the average college grade point average (GPA) and Medical College Admission Test score (MCAT) of international applicants was higher than that of all applicants. Additionally, non-US applicants reported facing numerous unique challenges such as limited access to extracurricular opportunities and difficulty finding mentors who are familiar with the application process. International applicants have the potential to increase the diversity of healthcare professionals, and F1Doctors is the first platform to support international healthcare applicants in the US.

Fostering an ethos of cultural humility development in nurturing inclusiveness and effective intercultural team working

AIM

To discuss the importance of fostering an ethos of cultural humility development in cultivating inclusiveness and effective intercultural team working.

BACKGROUND

Widening cultural and ethnic diversity of the health care workforce enriches the working environment and encourages a broader perspective on health care services and delivery. However, the intricacies of learning to work effectively within intercultural health care teams and adapting to new ways of working are often under estimated and thus overlooked.

EVALUATION

In adopting a framework for cultural humility development (Hughees et al., 2020, 10.1016/j.profnurs.2019.06.005), this paper proposes some practical suggestions for nurturing intrapersonal, interpersonal and system level cultural humility simultaneously.

KEY ISSUES

Fostering an ethos of cultural humility development within the workplace can support inclusiveness and better intercultural team working relationships. Nurses need support in developing awareness of their own cultural beliefs, whilst examining perceptions of cultural difference.

CONCLUSION

Examining cultural factors that influence intercultural working relationships will help in identifying structures, supports and approaches required for integration and inclusiveness.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurturing ways of supporting interpersonal, intrapersonal and systems levels cultural humility development inspires the self-awareness, openness and respect for cultural difference required. Developing culturally responsive leadership styles and prioritizing their own cultural humility development is critical.

Maximising intercultural learning opportunities: learning with, from and about students from different cultures

Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.

The Role of Plant-Based Protein Functional Food in Preventing Acute Respiratory Disease: A Case Study

The Kaliningrad region is known for its specific climate, which can negatively affect the adaptive potential of the body. This manifests in an increased incidence of respiratory diseases and skin conditions. To prevent high morbidity, a plant protein product was included in the diet of first-year university students. This study aimed to assess the effectiveness of this food intervention in preventing the most common diseases among Kaliningrad students. Two groups of university students took part in the food trial. In the control group, catabolic processes prevailed in nutrient metabolism. Disadaptation manifested itself in the metabolism of proteins, vitamins, minerals, hematopoiesis and humoral immunity. Inflammation was indicated by α1- and α2-globulins, a weak immune response, and IgM and IgG. High oxidative stress and low antioxidative ability of blood serum were observed. The plant-based protein product (FP) helped preserve testosterone level and prevent an increase in catabolic reactions. Moreover, it had a positive effect on both red blood cell hematopoiesis (a smaller increase in the average volume of erythrocytes, the same average concentration and content of hemoglobin, an increased relative red cell distribution width (RDW) and white blood cell hematopoiesis (a beneficial effect for the immune system: lymphocytes, the relative content of neutrophils, monocytes, basophils and eosinophils). The stimulation of humoral immunity was evidenced by beta- and gamma-globulins, an active immune response, the level of IgM and IgG, antioxidant protection, reduction of peroxides and an increase in antioxidant activity of blood serum. The 34-week observation showed a 1.7-fold decrease in the incidence of respiratory illnesses and a 5.7-fold decrease in skin and subcutaneous tissue diseases. Acute respiratory infections were reduced 1.8-fold. There were no cases of community-acquired pneumonia in the treatment group, compared with 55.1‰ in the control group. The incidence of respiratory diseases was 3.3-10.6 times lower in the treatment group than in the control group in weeks 6-19. The findings testify to the prophylactic effect of functional food during social adaptation and acclimatization of students.