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Luong V, Ajjawi R, Burm S, Olson R, MacLeod A. Unravelling epistemic injustice in medical education: The case of the underperforming learner. MEDICAL EDUCATION 2024. [PMID: 38676450 DOI: 10.1111/medu.15410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
CONTEXT Epistemic injustice refers to a wrong done to someone in their capacity as a knower. While philosophers have detailed the pervasiveness of this issue within healthcare, it is only beginning to be discussed by medical educators. The purpose of this article is to expand the field's understanding of this concept and to demonstrate how it can be used to reframe complex problems in medical education. METHODS After outlining the basic features of epistemic injustice, we clarify its intended (and unintended) meaning and detail what is required for a perceived harm to be named an epistemic injustice. Using an example from our own work on introversion in undergraduate medical education, we illustrate what epistemic injustice might look like from the perspectives of both educators and students and show how the concept can reorient our perspective on academic underperformance. RESULTS Epistemic injustice results from two things: (1) social power dynamics that give some individuals control over others, and (2) identity prejudice that is associated with discriminatory stereotypes. This can lead to one, or both, forms of epistemic injustice: testimonial and hermeneutical. Our worked example demonstrates how medical educators can be unaware of when and how epistemic injustice is happening, yet the effects on students' well-being and sense of selves can be profound. Thinking about academic underperformance with epistemic injustice in mind can reveal an emphasis within current educational practices on diagnosing learning deficiencies, to the detriment of holistically representing its socially constructed and structural nature. CONCLUSIONS This article builds upon recent calls to recognise epistemic injustice in medical education by clarifying its terminology and intended use and providing in-depth application and analysis to a particular case: underperformance and the introverted medical student. Equipped with a more sophisticated understanding of the term, medical educators may be able to re-conceptualise long-standing issues including, but also beyond, underperformance.
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Affiliation(s)
- Victoria Luong
- Department of Continuing Professional Development and Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rola Ajjawi
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Victoria, Australia
| | - Sarah Burm
- Department of Continuing Professional Development and Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rebecca Olson
- School of Social Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Anna MacLeod
- Department of Continuing Professional Development and Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada
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Zhang V, Kaito M, Conroy A, Bauckman K. Transitioning to Medical School: An Innovative Pre-matriculation Program. MEDICAL SCIENCE EDUCATOR 2024; 34:19-20. [PMID: 38510416 PMCID: PMC10948709 DOI: 10.1007/s40670-023-01953-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 03/22/2024]
Abstract
Medical schools use pre-matriculation programs consisting of knowledge-based curricula to prepare at-risk students. There is limited evidence showing the direct benefit of these programs with long-term success. We propose a pre-matriculation program focused on professional development and wellness to facilitate student acclimation and, in turn, academic success.
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Affiliation(s)
- Vicky Zhang
- Nova Southeastern University, The Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Fort Lauderdale, USA
| | - Max Kaito
- Nova Southeastern University, The Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Fort Lauderdale, USA
| | - Abigail Conroy
- Nova Southeastern University, The Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Fort Lauderdale, USA
| | - Kyle Bauckman
- Nova Southeastern University, The Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Fort Lauderdale, USA
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Malik LM, Khalid T, Ashar A. Causal attributions of failure among post graduate medical residents in exit fellowship examination in Pakistan: A qualitative study. Pak J Med Sci 2023; 39:1068-1073. [PMID: 37492329 PMCID: PMC10364245 DOI: 10.12669/pjms.39.4.7693] [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: 01/08/2023] [Revised: 02/27/2023] [Accepted: 04/28/2023] [Indexed: 07/27/2023] Open
Abstract
Background and Objective Causal attributions are reasons given to certain events in life including failure and success. The objective of this qualitative study was to explore the attributions perceived as the cause of failure by post graduate residents, failing the final clinical exit examination of Fellowship of College of Physicians and Surgeons Pakistan (FCPS). Methods This exploratory study was conducted from July 2021 to July 2022, at Jinnah Hospital, Lahore. Study population was selected by purposeful maximal variation sampling. A total of ten post graduate residents from four specialties, failing in FCPS part two clinical examination were included. After written informed consent, semi structured face to face, in depth interviews were conducted. Data saturation was achieved after eight interviews after which two more interviews were carried out. All interviews were recorded and transcribed verbatim. Thematic analysis of the data was done by synthesizing codes into categories and themes. Results A total of 17 attributions noted were grouped into five categories namely 'Inadequate exam preparation', 'Personal factors,' 'Exam related factors,' 'Training related factors and 'Luck'. Two main themes of External and Internal factors emerged from these. Common attributions were; lack of effort (8/10), inadequate knowledge (8/10), family commitments (7/10), luck (8/10) and examiner's attitude (5/10). Conclusions Most of the residents attributed internal, unstable and controllable factors like inadequate knowledge and lack of effort. In addition, external uncontrollable factors of bad luck and harsh attitude of examiners were considered as contributory factors towards failure.
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Affiliation(s)
- Lamees Mahmood Malik
- Prof. Dr. Lamees Mahmood Malik, MBBS, FCPS (Derm) Professor of Dermatology Unit-I, Allama Iqbal Medical College / Jinnah Hospital Lahore, Pakistan
| | - Tanzeela Khalid
- Prof. Dr. Tanzeela Khalid, MBBS, FCPS (Derm), MCPS-HPE. Professor of Dermatology, University Medical & Dental College, The University of Faisalabad, Pakistan
| | - Abid Ashar
- Prof. Dr. Abid Ashar, BDS, FPSRCS (England), MCPS-HPE. Principal, Professor of Oral & Maxillofacial Surgery, Fatima Memorial Hospital College of Dentistry, Lahore, Pakistan. College of Medicine & Dentistry, Lahore, Pakistan
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Rashid A, Yasmeen R, Ahmed R, Jawed K. Factors leading to the academic failure of undergraduate medical students - Predict early to prevent. Pak J Med Sci 2022; 38:2071-2075. [PMID: 36415249 PMCID: PMC9676603 DOI: 10.12669/pjms.38.8.5951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/31/2022] [Accepted: 09/06/2022] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVES The main objective of the study was to explore the factors to predict academic failure before the first major assessment. METHODS An exploratory qualitative study was conducted from March 2021 to August 2021 at Riphah International University. Using the purposive sampling technique, 16 students and seven teachers were included in the study. Eight online interviews were conducted with students who were academic failures and two focus group discussions were held with eight high achievers and seven teachers. The data was analyzed and thematic analysis was done. RESULTS Thematic analyses deduced relevant themes which were: Educational Journey Does past matter? Essential for learning, Personality and psychological make-up, and assessment of behaviour. The factors identified were performance record, learning difficulty, educational dislocation, missionless and purposeless, against free will, tuition, poor self-regulation, low effort, procrastination, non-reflective practice, cognitive load mismanagement, limited remediation, hesitant help-seeking, low self-efficacy, introvert behaviour, demotivation, emotional imbalance, observation of student behaviour, assessment of assigned task. CONCLUSION Academic failure can be predicted early and salvaged.
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Affiliation(s)
- Azhar Rashid
- Prof. Dr. Azhar Rashid, MBBS, FCPS, OJT, MSc (Defense & Strategic Studies), CHPE, MHPE. Dean FHMS/Principal, Islamic International Medical College, Riphah International University, Islamabad Pakistan
| | - Rahila Yasmeen
- Prof. Dr. Rahila Yasmeen, BDS, MHPE, (PhD Scholar), Dean & Head of Medical Education Dept., Riphah University, Rawalpindi, Pakistan
| | - Rehan Ahmed
- Prof. Dr. Rehan Ahmed Khan. MBBS, FCPS, FRCS, MHPE, PhD (Medical Education), Assistant Dean Medical Education and Professor of Surgery, Islamic International Medical College, Riphah International University, Islamabad Pakistan
| | - Khaulah Jawed
- Dr. Khaulah Jawed, BDS, MHPE. Lecturer, Department of Dental Education. Avicenna Medical and Dental College, Lahore, Pakistan
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Frajerman A, Rolland F, Falissard B, Bertschy G, Diquet B, Marra D. COVID-19 pandemic's impact on French Health Students: A cross-sectional study during the third wave. J Affect Disord 2022; 311:165-172. [PMID: 35597464 PMCID: PMC9116964 DOI: 10.1016/j.jad.2022.05.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND COVID19 pandemic had a huge impact on global mental health. Health students, because of their age and status, are a more at-risk population. National survey during the first wave already found high levels of psychological distress. OBJECTIVE This nationwide study aimed to assess health's student mental health during the third wave in France. METHODS We did an online national cross-sectional study, which addressed all health students from April 4th to May 11th 2021. The questionnaire included sociodemographic and work conditions questions, Kessler 6 scale, and numeric scales. RESULTS 16,937 students answered, including 54% nurse and 16% medical students. Regarding K6 scale, 14% have moderate (8-12) and 83% high (≥13) level of psychological distress. In multivariate analysis, being a man (OR = 0.54, 95% CI [0.48; 0.60], p < 0.001) and not living alone (OR = 0.71, 95% CI [0.62; 0.82], p < 0.001), are associated with a reduced risk of psychological distress. Not having the ability to isolate themselves (OR = 1.58, 95% CI [1.39; 1.81], p < 0.001), and having low (OR = 2.31, 95% CI [2.08; 2.56], p < 0.001) or important (OR = 4.58, 95% CI [3.98; 5.29], p < 0.001) financial difficulties are associated with an increased risk of psychological distress. LIMITATIONS The response rate was low regarding the target population (300,000 health students). CONCLUSION Compared to the first national survey, we noticed mental health deterioration. Psychological distress (83% high level versus 21%), substance use (21% versus 13%), and psychotropic treatment use (18% versus 7.3%) hugely increased. These results highlighted the need to increase support actions for health students.
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Affiliation(s)
- Ariel Frajerman
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris- Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France; Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, INSERM U1266, F-75014 Paris, France.
| | - Franck Rolland
- Center for Research in Epidemiology and Population Health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; Assistance Publique des Hôpitaux de Paris (AP-HP), France
| | - Bruno Falissard
- Center for Research in Epidemiology and Population Health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; Assistance Publique des Hôpitaux de Paris (AP-HP), France
| | - Gilles Bertschy
- Department of Psychiatry, Mental Health and Addictology, Strasbourg University Hospital, Strasbourg F-67000, France; INSERM U1114, Strasbourg F-67000, France; Translational Medicine Federation, University of Strasbourg, F-67000 Strasbourg, France
| | - Bertrand Diquet
- Laboratoire de Pharmacologie-Toxicologie, Institut de Biologie en santé, CHU Angers, 4 rue Larrey, 49933 Angers Cedex 9, France
| | - Donata Marra
- Assistance Publique des Hôpitaux de Paris (AP-HP), France; Paris-Est Créteil University, France
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Wainipitapong S, Chiddaycha M. Assessment of dropout rates in the preclinical years and contributing factors: a study on one Thai medical school. BMC MEDICAL EDUCATION 2022; 22:461. [PMID: 35710367 PMCID: PMC9202226 DOI: 10.1186/s12909-022-03527-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The highest dropout rate for medical students is during the preclinical years of education. Several studies have reported possible contributing factors, however, studies regarding the dropout rate from medical education among Thai medical students and its associated factors are still lacking. This study aimed to identify the prevalence of dropout from medical education within the preclinical period and its associated factors among Thai medical students. METHODS We collected data from preclinical medical students who entered one medical school in Bangkok, Thailand, between 2017-2019. Demographic data, admission program, pre-admission mental health status assessed by the Thai Mental Health Indicator 66, mental health records from the faculty-based counseling services, and academic achievement were extracted. Data were reported in a descriptive fashion. We analyzed the association between dropout and these factors by robust Poisson regression. RESULTS In total, 914 students were recruited. Dropout was only 1.5%, which was lower than the previous studies. Regression analysis showed a significant association between dropout and mental health problems [Prevalence ratio (PR) 58.20, 95%CI 13.72- 246.95] but not admission program [PR 0.32, 95%CI 0.09 - 1.16] or failing examinations [PR 0.59, 95%CI 0.18 - 1.90]. However, other contributing factors such as financial status, family problems, medical illness, and students' motivation, were not evaluated in this study. CONCLUSIONS Mental health problems during medical education were associated with dropout after adjusting for other confounding variables. Further longitudinal studies are needed to identify the impacts of academic failure on dropout in higher clinical years.
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Affiliation(s)
- Sorawit Wainipitapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Transgender Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Mayteewat Chiddaycha
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand
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Mabizela SE, Bruce J. Investigating the risk factors for academic difficulties in the medical programme at a South African university. BMC MEDICAL EDUCATION 2022; 22:208. [PMID: 35346178 PMCID: PMC8962061 DOI: 10.1186/s12909-022-03274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The National Benchmark Test (NBT) that determines academic readiness is widely used by Faculties as an additional measure to select students for the study of medicine. Despite this, many students continue to experience academic challenges that culminate in delayed graduation and sometimes academic exclusion or discontinuation of studies. AIM This study aimed to understand academic and non-academic variables linked with academic difficulties in the first three years of medical education. METHODS The study sample consisted of six cohorts of medical students for the period 2011 to 2016 (n = 1392). Only the first three of the six-year medical programme were selected for analysis. Survival analysis and Cox Proportional Hazard (CPH) was used to identify academic and non-academic variables associated with academic difficulties. RESULTS A total of 475 students (34%) experienced academic difficulty; 221 (16%) in the first year of study, 192 (14%) in the second year and 62 (5%) in the third year of study. The results show that Intermediate Upper, Lower and Basic levels for all NBT domains, living in university residence, rurality and male gender were risk factors for academic difficulty. CONCLUSION In mitigating these factors, the NBT must inform the type of support programmes to augment the students' skills and promote academic success. Additionally, existing support programmes should be evaluated to ascertain if they reach students at risk and whether participating in these programmes yield positive academic outcomes.
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Affiliation(s)
- Sfiso Emmanuel Mabizela
- Centre for Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Judith Bruce
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Beath N, Moxley K, Subramaney U, Zingela Z, Chiliza B, Joska J, Kotzé C, Koen L, Seedat S. Factors Affecting Specialist Psychiatry Training in South Africa: Are Psychiatry Residents Satisfied with Their Training? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:688-697. [PMID: 33973163 DOI: 10.1007/s40596-021-01470-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The authors investigated South African psychiatry residents' satisfaction with their training, physical, and mental health to inform the development of a strategy to improve the quality and experiences of training. METHOD A cross-sectional online survey was undertaken to assess the factors affecting residents' satisfaction with their current training program. The authors conducted a comparative analysis of residents across the training institutions in South Africa. RESULTS Of 179 psychiatry residents in the country, 70 responses were received (39.1% response rate). Most were satisfied with the overall quality of their training, various aspects of training, and access to training resources. However, significant differences across universities were identified with regard to residents' perception of the quality of their training, quality of their experiences, access to training resources, quality of supervision, and clinical workload. More than a quarter were dissatisfied with their mental and/or physical health. The top four factors contributing to stress were all training-related. CONCLUSION While most residents were satisfied with their specialist training, institutional differences in access to training and training resources, quality of training, and availability of quality supervision were evident and need to be addressed to ensure equitable training. There is a need to actively address staff shortages not only for clinical cover during protected academic time but also to meet training needs. A centralized examination process should remain in place to ensure that there is a national standard. Workplace-based assessments could facilitate standardization across institutions, should these assessments be standardized and accompanied by rigorous training of supervisors.
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Affiliation(s)
- Natalie Beath
- Stellenbosch University, Cape Town, Western Cape, South Africa.
| | - Karis Moxley
- Stellenbosch University, Cape Town, Western Cape, South Africa
| | | | - Zukiswa Zingela
- Walter Sisulu University, Mthatha, Eastern Cape, South Africa
| | | | - John Joska
- University of Cape Town, Cape Town, Western Cape, South Africa
| | - Carla Kotzé
- University of Pretoria, Pretoria, Gauteng, South Africa
| | - Liezl Koen
- Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Soraya Seedat
- Stellenbosch University, Cape Town, Western Cape, South Africa
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Doshmangir L, Hasanpoor E, Abou Jaoude GJ, Eshtiagh B, Haghparast-Bidgoli H. Incidence of Catastrophic Health Expenditure and Its Determinants in Cancer Patients: A Systematic Review and Meta-analysis. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:839-855. [PMID: 34318445 DOI: 10.1007/s40258-021-00672-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cancer is the third leading cause of mortality in the world, and cancer patients are more exposed to financial hardship than other diseases. This paper aimed to review studies of catastrophic healthcare expenditure (CHE) in cancer patients, measure their level of exposure to CHE, and identify factors associated with incidence of CHE. METHODS This study is a systematic review and meta-analysis. Several databases were searched until February 2020, including MEDLINE, Web of Science, Scopus, ProQuest, ScienceDirect and EMBASE. The results of selected studies were extracted and analyzed using a random effects model. In addition, determinants of CHE were identified. RESULTS Among the 19 studies included, an average of 43.3% (95% CI 36.7-50.1) of cancer patients incurred CHE. CHE varied substantially depending on the Human Development Index (HDI) of the country in which a study was conducted. In countries with the highest HDI, 23.4% of cancer patients incurred CHE compared with 67.9% in countries with the lowest HDI. Key factors associated with incidence of CHE at the household level included household income, gender of the household head, and at the patient level included the type of health insurance, education level of the patient, type of cancer and treatment, quality of life, age and sex. CONCLUSION The proportion of cancer patients that incur CHE is very high, especially in countries with lower HDI. The results from this review can help inform policy makers to develop fairer and more sustainable health financing mechanisms, addressing the factors associated with CHE in cancer patients.
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Affiliation(s)
- Leila Doshmangir
- Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Edris Hasanpoor
- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran.
| | - Gerard Joseph Abou Jaoude
- Institute for Global Health, Center for Global Health Economics, University College London, London, UK
| | - Behzad Eshtiagh
- Institute for Global Health, Center for Global Health Economics, University College London, London, UK
| | - Hassan Haghparast-Bidgoli
- Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Seo C, Corrado M, Fournier K, Bailey T, Haykal KA. Addressing the physician burnout epidemic with resilience curricula in medical education: a systematic review. BMC MEDICAL EDUCATION 2021; 21:80. [PMID: 33526019 PMCID: PMC7849619 DOI: 10.1186/s12909-021-02495-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/04/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND A variety of stressors throughout medical education have contributed to a burnout epidemic at both the undergraduate medical education (UGME) and postgraduate medical education (PGME) levels. In response, UGME and PGME programs have recently begun to explore resilience-based interventions. As these interventions are in their infancy, little is known about their efficacy in promoting trainee resilience. This systematic review aims to synthesize the available research evidence on the efficacy of resilience curricula in UGME and PGME. METHODS We performed a comprehensive search of the literature using MEDLINE, EMBASE, PsycINFO, Educational Resources Information Centre (ERIC), and Education Source from their inception to June 2020. Studies reporting the effect of resilience curricula in UGME and PGME settings were included. A qualitative analysis of the available studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I Tool. RESULTS Twenty-one studies met the inclusion criteria. Thirteen were single-arm studies, 6 quasi-experiments, and 2 RCTs. Thirty-eight percent (8/21; n = 598) were implemented in UGME, while 62 % (13/21, n = 778) were in PGME. There was significant heterogeneity in the duration, delivery, and curricular topics and only two studies implemented the same training model. Similarly, there was considerable variation in curricula outcome measures, with the majority reporting modest improvement in resilience, while three studies reported worsening of resilience upon completion of training. Overall assessment of risk of bias was moderate and only few curricula were previously validated by other research groups. CONCLUSIONS Findings suggest that resilience curricula may be of benefit to medical trainees. Resilience training is an emerging area of medical education that merits further investigation. Additional research is needed to construct optimal methods to foster resilience in medical education.
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Affiliation(s)
- Chanhee Seo
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 451 Ch. Smyth Rd. (2024), Ottawa, ON, K1H 8M5, Canada
| | - Mario Corrado
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 451 Ch. Smyth Rd. (2024), Ottawa, ON, K1H 8M5, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Tayler Bailey
- Department of Family Medicine, Faculty of Medicine, McMaster University, Hamilton, ON, L8P 1H6, Canada
| | - Kay-Anne Haykal
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 451 Ch. Smyth Rd. (2024), Ottawa, ON, K1H 8M5, Canada.
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Ahmady S, Khajeali N, Kalantarion M, Sharifi F, Yaseri M. Relation between stress, time management, and academic achievement in preclinical medical education: A systematic review and meta-analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:32. [PMID: 33688541 PMCID: PMC7933620 DOI: 10.4103/jehp.jehp_600_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/17/2020] [Indexed: 06/12/2023]
Abstract
Identifying the learners' problems is important. Besides, many factors are associated with academic failure, among which time management and stress are more important than any others based on evidence. By using a systematic review and meta-analysis, this study aims to synthesize the findings of studies about the correlation of time management and stress with academic failure to suggest a more in-depth insight into the effect of these two factors on academic failure. Four databases were searched from the inception of January 2018. Publication bias was evaluated visually using funnel plots and sized up by Egger's test. Ninety-four articles were found to be qualified for inclusion after full-text review and additional manual reference made. Of these, 8 were studies of educational interventions that were reviewed in this paper. Regarding the relation of stress and academic performance, the Funnel plot (results not shown) and Egger's test showed no publication bias in the studies (P = 0.719). Based on this result, the estimated pooled correlation (reverted by hyperbolic tangent transformation) between stress and academic performance was found to be -0.32 (95% confidence interval: -0.38--0.25). In conclusion, the review recognized a series of potentially mutable medium-to-large correlates of academic achievement, time management, and stress. It would be essential to have experimental data on how easily such self-regulatory capacities can be altered, and these interventions could help students enhance their potential, providing empirical tests for offered process models of academic achievement.
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Affiliation(s)
- Soleiman Ahmady
- Department Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Khajeali
- Deprtment of Medical Education, Fasa University of Medical Sciences, Fasa, Iran
| | - Masomeh Kalantarion
- Department Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of medical Sciences, Tehran, Iran
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Leak RK, Weiner SL, Chandwani MN, Rhodes DC. Long weekend sleep is linked to stronger academic performance in male but not female pharmacy students. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:350-357. [PMID: 32568007 DOI: 10.1152/advan.00005.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Poor sleep hygiene portends loss of physical and mental stamina. Therefore, maintaining a regular sleep/wake schedule on both weekdays and weekends is highly recommended. However, this advice runs contrary to the habits of university students who sleep late on weekends. Pharmacy students at Duquesne University sit for frequent examinations, typically commencing at 7:30 AM, and they complain about mental fatigue. Here, we tested the central hypothesis that longer sleep durations on both weekdays and weekends are linked to stronger academic performance in men and women. Students in their first professional year were administered three surveys to collect data on sleep habits and factors that might influence sleep, such as roommates, long commute times, and sleep interruptions. Grade point averages (GPAs) were collected from the Dean's office, with individual permissions from the students. Longer weekend-but not weekday-sleep durations were significantly correlated with higher cumulative GPAs in men and not in women. Women achieved slightly higher cumulative GPAs than men. Students who fell asleep within 15 min of going to bed had higher professional-phase GPAs than those who fell asleep after an hour or more. Our observations cannot establish causal links, but, given the body of prior evidence on the salutary properties of sleep, men may reap more benefit from recovery sleep on weekends. Rather than recommending that students force themselves awake early on weekends in an attempt to maintain a consistent sleep routine, the real-life habits of students should also be given consideration.
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Affiliation(s)
- Rehana Khan Leak
- Graduate School of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania
| | - Susan L Weiner
- Graduate School of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania
| | - Manisha N Chandwani
- Graduate School of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania
| | - Diane C Rhodes
- School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania
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Mabizela SE, George AZ. Predictive validity of the National Benchmark Test and National Senior Certificate for the academic success of first-year medical students at one South African university. BMC MEDICAL EDUCATION 2020; 20:152. [PMID: 32404200 PMCID: PMC7218523 DOI: 10.1186/s12909-020-02059-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND South African medical schools use the results of the National Senior Certificate (NSC) examination for selecting students. Five of the nine medical schools also use the National Benchmark Test (NBT). The University of the Witwatersrand weights the NSC and NBT results equally in the selection process. This study addresses the predictive validity of the NBT and NSC for academic success. The association between the NBT proficiency levels and students' progression outcomes was also investigated. METHODS Data obtained from the University's Business Intelligence Services for 1652 first-year medical students from 2011 to 2017 were analysed using hierarchical regression models and chi-square tests. The three NBT domains and four of the NSC subjects were the independent variables in the regression models, with the first-year grade point average for students who passed the first year as the dependant variable. The NBT performance levels and first-year progression outcome (passed, failed, or cancelled) were used in the chi-square analysis. Frequency tables were used to describe the cohort's demographic details and NBT results. Crosstabs were used to analyse student performance according to the school quintile system. RESULTS The three NBT domains explained 26% of the variance, which was statistically significant, R2 = 0.263, F (3, 1232) = 146.78, p < 0.000. When the NSC subjects (Life Sciences, English, Mathematics, and Physical Science) were added to the regression equation, they accounted for an additional 19% of the variance, R2 = 0.188, F (3, 1229) = 137.14, p < 0.000. All independent variables contributed 45% of the variance, R2 = 0.451, F (6, 1229) = 166.29, p < 0.000. A strong association between the NBT proficiency levels and first-year students' progression outcomes was observed. CONCLUSION The NBT results, when weighted equally to the NSC results, explained more variance than the NSC alone in predicting academic success in the first year of the medical degree. The NBT should not only be used for selecting medical students but should also be used to place students with lower entry-level skills in appropriate foundation programmes and to identify students who are admitted to regular programmes who may need additional support.
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Affiliation(s)
- Sfiso Emmanuel Mabizela
- Centre for Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Phillip V Tobias Health Sciences Building, 29 Princess of Wales Terrace, Parktown, Johannesburg, 2193 South Africa
| | - Ann Zeta George
- Centre for Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Phillip V Tobias Health Sciences Building, 29 Princess of Wales Terrace, Parktown, Johannesburg, 2193 South Africa
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