Twelve tips for providing effective student support in undergraduate medical education

Twelve tips for implementing trigger or content warnings in healthcare professions education

Trigger warnings are statements offering prior notification of sensitive content, allowing recipients to prepare for and avoid ensuing distress. Students are increasingly reporting expectations for warnings in classrooms and learning contexts. Discussions regarding use of warnings have clear relevance to healthcare education, which regularly explores sensitive content. Their use has been positioned as a measure for inclusive education and as a means to enhance trauma awareness and empathy. Expectations for warnings need to be considered in the context of preparedness for professional practice. This Twelve Tips paper explores the evidence in relation to warnings and its applicability to social learning contexts. These tips highlight considerations and strategies for the use of warnings in the context of healthcare education, balancing issues of inclusivity, learner and educator wellbeing, and professional preparedness. These discussions are situated within the context of current classroom-based healthcare education.

The missing ingredient: Medical student insights to inform and enhance learner handover

BACKGROUND

Learner handover (LH) is the passing on of information about students between educators. In light of broad acceptance that LH can improve learner support experiences and performance outcomes, those involved are seeking greater governance to achieve practical, effective handover implementation. Stakeholder consultation can inform and enable the co-creation of meaningful, robust practice guidance. This study sought to address the gap in literature around in-depth learner opinion, a key element so far overlooked.

METHODS

This qualitative study (2022) investigated undergraduate medical student perspectives on appropriate tutor information-sharing at the University of Limerick School of Medicine (ULSoM). The findings build upon an educator focus group study published by the authors (2021). Eleven participants were recruited to represent the typical graduate-entry medical school programme population across years 1-4 of study. Their understanding and expectations of "learner handover" were explored qualitatively, using online, individual, semi-structured interviews. Inductive transcript coding and thematic data analysis were applied to illustrate learner insights.

FINDINGS

Emergent themes included shared values, individual context and collaborative process, with ideas proposed for specific action around student education, staff training, mental health support, and documented procedures.

DISCUSSION

Consent, system transparency, data security and the development of positive handover culture were revealed as current needs. Student perspectives, together existing LH literature and highlighted aspects of educational theory, allowed the creation a new conceptual LH framework as a foundation for practice improvement.

CONCLUSION

These findings provide clarity and contextual understanding, mainly from a pre-clinical phase learner standpoint, with pragmatic suggestions to enhance LH appeal.

Navigating Confidentiality Dilemmas in Student Support: An Institutional Ethnography Informed Study

Introduction

School-level student support programmes provide students with pastoral care and support for academic, wellbeing and other issues often via a personal tutor (PT). PT work is a balancing act between respecting the confidential information divulged by students and doing what is expected in terms of accountability and duty of care. We aimed to explore how tutors manage this tension, with the aim of advancing understanding of student support programmes.

Methods

This qualitative study was informed by an Institutional Ethnography approach. We conducted 11 semi-structured interviews with PTs from one medical school in Singapore. We considered how they worked in relation to relevant national and institutional-level policy documents and reporting guidelines. Data collection and analysis were iterative.

Results

We crafted two composite accounts to illustrate the dilemmas faced by PTs. The first depicts a PT who supports student confidentiality in the same way as doctor-patient confidentiality. The second account is a PT who adopted a more mentoring approach. Both tutors faced confidentiality challenges, using different strategies to "work around" and balance tensions between accountability and maintaining trust. PTs were torn between school and student expectations.

Discussion

Fostering trust in the tutor-student relationship is a priority for tutors but tensions between confidentiality, accountability and governance sometimes make it difficult for tutors to reconcile with doing what they think is best for the student. A more nuanced understanding of the concept of confidentiality may help support PTs and ultimately students.

It's very difficult to set the boundaries, it's human nature to want to respond: exploring health professions educators' responses to student mental health difficulties through a positioning theory lens

By virtue of their teaching role and contact with students, health professions (HP) educators are often the first point of connection for students who are experiencing mental health difficulties. Educators are increasingly expected to include some form of pastoral care in their role. Mental health-related interactions with students may have a negative emotional impact on educators, particularly when roles and expectations are not clearly defined and where boundaries are not managed effectively. Using positioning theory as a lens, this study explored how educators experienced such interactions and how this manifested in positions, storylines, and speech acts. Interviews were conducted with 27 HP educators at a faculty of medicine and health sciences. Reflexive thematic analysis using inductive coding identified themes corresponding to the nearing, weighted, ambivalent, and distancing positions participants adopted in relation to students with mental health difficulties. There was fluidity in and between positions, and more than one position could be occupied simultaneously; participants each moved through different positions in response to different relational situations. Multiple storylines informed these positions, representing how moral- and care-informed responsibility intersected with responsiveness to make certain actions possible or impossible. Normative and personal value narratives were evident in storylines, in many cases underscored by care or justice ethics. The value of positioning theory in facilitating reflective faculty development initiatives for educators engaged in these interactions is discussed.

Medical students impacted by discrimination: a qualitative study into their experiences of belonging and support systems at medical schools in the UK

OBJECTIVE

To better understand the broader experience of medical students impacted by discrimination and the support systems they engage with.

DESIGN

Qualitative study using semi-structured interviews.

SETTING

Four medical schools based in the UK.

PARTICIPANTS

17 medical students were recruited using volunteer and snowball sampling: all students self-identified as being impacted by discrimination.

RESULTS

5 themes were identified: feelings of isolation, imposter syndrome and exclusion; a lack of representation and positive role modelling; the importance of peer support; issues relating to the accessibility of support; building support networks through shared experiences and attempts to foster a sense of inclusion through peer and institutionally led initiatives.

CONCLUSIONS

The findings of this study suggest medical schools could do more to recognise the importance of acknowledging the multiple identities at risk of discrimination held by students, perpetuating feelings of isolation and exclusion. Our research highlights the need for practical systemic initiatives to improve the sense of belonging of medical students who are impacted by discrimination. Medical educators and institutions should consider formal and informal provisions, such as creating time and space for students to meet and share experiences, access support and reporting networks, to foster a greater sense of belonging.

Identity conflicts of student affairs officers in a medical university

INTRODUCTION

Collaboration between student affairs officers and the faculty is important in dealing with the recent rapid changes in medical education, and mutual understanding is essential to ensure that participants become a cohesive social group. This study explores the identity conflicts of student affairs officers in medical universities using the figured worlds theory.

METHODS

An exploratory qualitative case study was conducted with 24 student affairs officers at a private medical university in Japan. Data were collected through face-to-face, semi-structured interviews and analysed using thematic analysis from the perspective of a social constructivism paradigm.

RESULTS

Qualitative analysis revealed the following three themes regarding the identity conflicts of student affairs officers: differences in the perception of medical students, difficulties in building trusting relationships with the faculty, and resistance to the medical university's traditional atmosphere. Student affairs officers tended to provide support from a student-centred perspective when interacting with medical students, while the faculty employed a teacher-centred perspective.

DISCUSSION

To promote understanding between professions, it is necessary to set aside certain professional views and welcome dialogue with other professionals with different values, while also understanding the multi-layered context of medical education, so that conflicts can be handled optimally and relationships can be professionalised for social cohesion.

Student support services: Perceptions and recommendations for the next generation

PURPOSE

Student support services/student affairs are central to the student academic experience and success at US and Canadian dental schools. This manuscript evaluates student and administrator perceptions of support services and offers recommendations for best practices in student services in predoctoral dental education to help institutions improve the student experience.

METHODS

A survey of administrators and dental students found perceptions of student support services vary between these groups.

RESULTS

Seventeen student services administrators and 263 students started the survey, and 12 administrators and 156 students completed the full survey. Survey comments indicated access to student support services is a concern. Results of the student survey, in conjunction with current literature, were utilized to develop recommendations for dental student support services.

CONCLUSION

Recommendations for student support services in dental schools include accessibility of student services, and ensuring students have access to support in the domains of wellness, academic support, and peer support as well as implementation of humanistic practices. Wellness supports should include behavioral health services, physical health services, and access to mindfulness interventions. Academic support services should include study skills, time management training, and academic supports such as tutoring. Structured peer support programs should also be implemented. Dental schools should also be mindful of the changing support needs of incoming dental students.

Dental student success: The predictive value of first-year grades

PURPOSE/OBJECTIVES

This study investigates the relationship between first-year grades and cumulative grades at the end of dental school to explore trends in academic performance in the predoctoral dental curriculum. The objective of this research is to provide information to inform student support efforts for predoctoral dental programs.

METHODS

Academic records for 156 students who completed their first year (D1) of predoctoral dental education in 2015/2016 were reviewed. The analysis reviews outcomes at the end of D1 and the end of the 4-year curriculum. The outcomes of this study are grade point average (GPA) at the end of the 4-year traditional dental school curriculum, grouped as basic science, preclinical, preclinical laboratory, translational, and clinical. Regression analyses were performed for each outcome. A GPA change of 0.5 was employed to demonstrate change, as it represented half a letter grade.

RESULT

The analysis found first-year grades to be related to 4-year academic outcomes. For example, a 0.5-grade point score increase in the first-year basic science GPA was associated with a 0.503 increase in basic science GPA. However, a 0.5-grade point increase in first-year annual GPA was associated with a 0.084 increase in the clinical science GPA. First-year annual GPA was the only significant predictor variable for overall 4-year GPA; a 0.5-grade point increase in the first-year annual GPA was associated with a 0.386 increase in overall GPA.

CONCLUSION

The results of this study suggest that academic and personal support in the first year of dental school is paramount in supporting student success in predoctoral dental education.

Preparing Students to Deliver Care to Diverse Populations

The purpose of this study was to increase student exposure to diverse patients using patient ID cards in problem-based learning (PBL) at Case Western Reserve University (CWRU). The pre-clerkship curriculum capitalizes on facilitated small-group, case-based discussions to promote inquiry and learning of the foundational sciences. Quantitative and qualitative results supported a finding of added value to case-discussions and the humanization of case-patients. The inclusion of the patient ID cards resulted in most students indicating that it helped them learn about and prepare to care for their future population of diverse patients. The patient ID cards will allow us to develop specific learning objectives about the demographics to increase learning about diverse patient care.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01648-0.

Growing future clinicians: Can the seeds of admission data determine success?

PURPOSE

Most students entering dental school have outstanding academic credentials. Despite this, some students face academic difficulties throughout their dental education. The study investigates outcomes at the end of the first-year and the end of the 4-year curriculum.

METHODS

This study reviewed data from 177 students in the entering classes of 2015 and 2016. The regression models included 156 students who completed the 4-year curriculum on the traditional timeline.

RESULTS

Undergraduate cumulative GPA had a significant association with dental school outcomes in 4-year biomedical science GPA, translational science GPA, and clinical science GPA (increase of 0.31, 0.31, and 0.08 for a one-unit increase in undergraduate GPA). A one-unit increase in DAT was reflected in increased in first-year biomedical science GPA, preclinical science GPA, and cumulative GPA (0.04, 0.06, and 0.10, respectively). Conversely, a one-unit increase in failure or withdrawal from undergraduate courses was associated with decreases in first-year biomedical science GPA, preclinical science GPA, and cumulative GPA (0.08, 0.09, and 0.08, respectively). The only significant relationship for clinical science (patient care) GPA was cumulative undergraduate GPA (0.08 increase per unit).

CONCLUSION

The results of this study suggest students who are extremely strong academically in college will be strong throughout dental school and suggest benefits of targeted services for academically at-risk students. Due to the limited association of admission records to clinical grades, the results support holistic admission processes.

Personal-professional Development Program Fosters Resilience During COVID-Pandemic

PROBLEM

Epidemiological data throughout the academic world show an upswing in mental health concerns among students, even more significant during the ongoing COVID-pandemic. Many universities have recognized these problems and started counseling programs. However, currently reported stress levels and mental health problems at many universities remain substantial.

APPROACH

Our medical faculty features an evidence informed longitudinal program on personal-professional development (LPPD) integrated into the core curriculum to strengthen wellbeing and support the student as a whole.

OUTCOMES

With our LPPD program we show that it is possible to successfully enable personal-professional development and well-being, especially in unexpected times when resilience is needed. The safe learning environment the teacher-coaches created has proven to be an important condition in this regard.

NEXT STEPS

The LPPD program will be further evaluated and both results and program materials will be shared with the academic community through web-pages, online material and research papers.

Dyslexia in dentistry: recommendations to support dental professionals and students with dyslexia

Dyslexia is the most common learning difficulty. It affects 10% of the global and UK population. It is a protected characteristic and thus it is recommended that reasonable adjustments are made for individuals in order to help them be successful in their career. This article has identified the need for more research into the impact of dyslexia on dental professionals. Through analysing the literature and from personal experience, recommendations are outlined to support dentists, dental students and dental care professionals with dyslexia.

Twelve tips for novice academic staff supporting medical students in distress

The importance of having university systems to support students' wellbeing and welfare needs has been well documented, with an increasing literature on best practice for structuring student support services from an institutional perspective. Nevertheless, individual members of academic staff are often required to deal with students who are experiencing challenging circumstances, and this is especially so in the pre-clinical phases of medical training. The prospect of advising and supporting students who are in difficulty and who may be distressed, can be daunting and can also negatively impact the wellbeing of the staff involved. These tips present the practical guidelines we have developed on how academic staff can best manage meetings with students in situations of crisis or high emotion.

Student support systems for undergraduate medical students during the COVID-19 pandemic: a systematic narrative review of the literature

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has boosted medical students' vulnerability to various problems. Given the stressful nature of medical disciplines, considerable attention must be paid to student support systems during pandemics. This study aimed to review the current literature regarding medical student support systems systematically.

METHODS

We performed a systematic review of six databases and grey literature sources in addition to a hand search in the references of the articles on April 5, 2021. We included all studies about support for undergraduate medical students delivered in response to the COVID-19 pandemic. In conducting this review, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

A total of 3646 articles were retrieved from the databases, and 16 additional papers were extracted from other sources. After removing duplicates, we screened 2434 titles and abstracts according to our criteria. Among them, 32 full-text articles were assessed for eligibility. Ultimately, 10 studies were included for review. We identified two major themes: (a) academic support and (b) mental health support. All of the included studies utilized online methods whether for transitioning from previous support systems or developing novel approaches. Students and faculty members seemed to be receptive to these new systems. Despite indicating outstanding program outcomes, most studies merely described the positive effects of the program rather than providing a precise evaluation.

CONCLUSION

There are several methods of supporting medical students who are experiencing unprecedented changes in their educational trajectory. Due to substantial differences in undergraduate medical education in different regions of the world, cultural and contextual-oriented support is indispensable for developing a safe learning environment. Future research should investigate the question of the extent to which online support can supersede in-person strategies.

We Burn Out, We Break, We Die: Medical Schools Must Change Their Culture to Preserve Medical Student Mental Health

The author explores medical student depression and suicide through the lens of the author's personal struggle during the first 2 years of medical school. While the author's story is unique, other medical students have also faced challenges that have led them to consider a permanent solution to a temporary problem. Although resources are available, stigma represents a significant barrier for students as they decide whether to seek help. Students fear that showing the slightest hint of vulnerability or imperfection will be used against them in an advancement committee, a course evaluation, or the dean's letter for residency applications. This difficulty asking for help and the subsequent suppression of feelings can lead to burnout and ultimately to increased risk of suicide. The author calls for medical schools to make changes to their culture to preserve medical student mental health. These include committing to helping students who are struggling academically or psychologically, implementing an institution-wide program to screen for individuals at risk for suicide, educating members of the institution's community about depression to destigmatize seeking help for mental health, and ensuring confidential mental health services are readily available to those who need them. But, most importantly, medical schools must create a culture that normalizes the need for self-care and includes vulnerability as part of training in professionalism.

Exploring How Postmillennial Pharmacy Students Balance Life Priorities and Avoid Situations Known to Deplete Resilience

Objective. Students are facing increasing academic pressures that can contribute to poor wellbeing. Evidence to inform the development of better student support services is weak. This study aimed to explore Bachelor of Pharmacy students' self-reported life priorities and ways they strategize to avoid resilience-depleting events on a day-to-day basis.Methods. Postmillennial (those born after 1996) pharmacy students enrolled in their final year of pharmacy school were introduced to the coaching concepts of the Wheel of Life and anti-goals. Students' top eight life priorities were collected and categorized. Students were asked to submit one anti-goal targeting a strategy used to avoid resilience depletion. Anti-goals were coded according to student priority areas and overarching themes were interpreted.Results. The top priorities of 110 final-year pharmacy students were: family, finance, health, friends/relationships, study, career prospects, fitness, personal growth, travel, and mental health/wellbeing. Priorities were both similar and dissimilar to traditional coaching priorities. Sixty-eight anti-goals were coded. The themes "being prepared" and "being present" were used to summarize strategies that students employed to avoid resilience depletion.Conclusion. The life priorities of newer student generations may be changing to be more individualistic and include a greater focus on self-help, while maintaining the core priorities of family, health, and finance. These findings uphold the notion that student support mechanisms must be modernized to accommodate students' needs.

The Rising Physicians Program: A Novel Approach for Mentoring Medical Students

INTRODUCTION

The transition to medical school is a particularly challenging time for new students as they are faced with significant academic responsibilities. Moreover, for many students at the Uniformed Services University they are adjusting to being on active duty in the military. Mentoring has been considered a way to help with the transition and professional development. Prior to 2015, there was no formal mentoring program for new students at the Uniformed Services University.

MATERIALS AND METHODS

In order to address the demands and challenges facing matriculating medical students, the Rising Physicians Program was created. This student initiated program enabled pre-clerkship medical students to connect with residents at the Walter Reed National Military Medical Center via a secure database with resident profiles. Residents were recruited and voluntarily agreed to serve as mentors. Students were then able to access the database and reach out to mentors based on their specific goals. The program was introduced to students during orientation and student participation was completely voluntary. A survey was designed using best survey practices and sent to the 175 students participating in the program for the 2015 academic (class of 2019) year to determine participation and characteristics of the program.

RESULTS

Sixty-four percent (112/175) of the students from the class of 2019 participated in the post-implementation survey. Fifteen percent of the class (26/175) reported participating in the voluntary mentoring program. The three most commonly used communication methods with mentors in precedence were in-person, e-mail, and text messages. The majority of the students found their interactions in this program were beneficial and did not get in the way of their academic performance. The most common topics of discussion were academics (20%), mentor's past experience (22%), military lifestyle (7%), medical school pathways (23%), and specialty selections (23%). Limitations of the program included a lack of U.S. Air Force mentors and mentors within certain residency specialties.

CONCLUSIONS

The Rising Physician Program provides a near-peer mentoring model for new medical students. Students preferred to communicate with their mentors in person, but the flexibility of communication appears to be important. New students have a variety of academic and professional development concerns that could partially be addressed through mentoring by residents.

Educator as Diagnostician, Judge and Confidant: a positioning analysis of medical student support encounters

Medical schools, programs and educators are increasingly expected to address medical student stress and wellbeing, yet also ensure student competence and fitness to practice. Educators play a central role in supporting students when evaluating a student's concerns and in deciding whether support and/or sanction should be offered. It is not known how educators approach or resolve such potentially contradictory responses. We conducted an interview study of 21 medical educators from a range of  professional backgrounds across 11 on-campus and clinical teaching sites. Using Positioning Theory to inform our thematic analysis, we found that participants adopted an overarching position of Diagnostician, and at times, two alternative positions, the Judge and the Confidant when supporting students. In their narratives of support encounters, individual students were positioned as Good Students or Troubling Students. For most, educator positions were fluid and responsive to the storylines enacted in encounters. Rigidly adopting Judge or Confidant positions could lead to "failure to fail" and violations of professional boundaries. Positioning Theory locates student support in a moral space and helps explain the consternation experienced by educators when support is not effective. Positioning analysis offers a language, and metaphors which are meaningful to educators, for framing discussion and reviews of support practices and progression decisions. Such insights could encourage reflective practice and guide further research to inform practice when students with troubling concerns and persistently borderline performances require support.

To accept or decline academic remediation: What difference does it make?

Introduction: Academic remediation offered after failure in a knowledge-based progress-test assessment is voluntary and involves student-centered individualized support that helps students to learn most effectively for themselves. This paper explores whether accepting or declining the offer of academic remediation given to struggling students impacts their outcomes both short-term and longitudinally. Method: Data was collated from 2015-16, 2016-17, and 2017-18 and included all students offered academic remediation in the third, fourth, and fifth years of a five-year Dentistry program. Z-scores for each stage and test were calculated and centered on a triggering point; the point at which the offer of remediation was made. These students' average performance post-trigger test and longitudinal performance were analyzed. Results: While performance for both groups significantly improved for the immediate post-trigger test after academic remediation, those that accepted remediation sustained longitudinal improvements across subsequent tests compared to those that declined remediation. Discussion: Through the academic remediation support process students appear to increase their mastery of "learning to learn" and are able to implement sustainable effective learning strategies to carry with them throughout their program. Conclusion: Students who accept academic remediation maintain a more successful academic profile compared to those that do not take advantage of this.

[Mentoring for medical students : Description and evaluation of a differentiated mentoring program at a medical school]

In recent years, mentoring programs for medical students have been increasingly implemented in medical schools in Germany. This article describes a voluntary mentoring program for students, which is differentiated into a common mentoring program (AP), a mentoring program for excellent students (EP) and a mentoring plus program (PP) for students with academic difficulties, and its evaluation.The evaluation is based on annual evaluation surveys among the participating mentees, who evaluate the mentoring relationship as well as the impact on their studies.The three student groups differ significantly with regard to sociodemographic variables. The satisfaction with the mentoring program is generally high: 84-94% are mentored by their preferred mentor, the majority assesses the conversational atmosphere as open (78-91%), and 89-98% would recommend participation in the program to others. The programs differ with regard to specific aspects. While PP mentees report the highest ratings on the mentor's accessibility, trustworthiness and feedback, EP mentees report the highest ratings on the mentor's competence as well as increased identification with the faculty and early career promotion through the mentoring program.The different assessments of the three programs as well as the generally high acceptance and satisfaction ratings indicate that such a differentiated mentoring program provides a framework of individual support, which is highly appreciated by most students.

Stressors and coping strategies among physiotherapy students: Towards an integrated support structure

Background

Stress is a major problem among university and, specifically, health care students, as it may influence academic performance and psychological well-being negatively.

Aims

To develop and implement a student support system based on the perceived stress, stressors and coping strategies of physiotherapy students.

Methods

A cross-sectional, descriptive study was undertaken, using a literature-based, self-compiled questionnaire and the 28-item General Health Questionnaire (GHQ-28). Over a period of three years, 207 third- and fourth-year physiotherapy students at a South African university were included.

Results

Psychological distress was experienced by 61.8%-71.2% of participants. During the 3 months prior to the study, 6% of participants received psychological or psychiatric help and 9% of participants used some form of psychiatric medication. The main stressors identified during clinical training were the suffering and death of patients, academic pressure and tension during interaction with personnel. Participants indicated that they mainly coped with these stressors by talking to someone such as a family member or a friend.

Conclusions

Based on the findings of this study, a framework to identify and support students in pre-clinical and clinical training years was developed and implemented over five years. This proposed framework might positively contribute to the psychological well-being of health care students.

Challenges faced by medical students during their first clerkship training: A cross-sectional study from a medical school in the Middle East

Objectives

The transition from preclinical to clinical training is characterized by several challenging experiences ranging from new roles, with their associated tasks, to unfamiliar settings. The aim of this study was to explore the difficulties faced by medical students during the transition from preclinical to clinical training in the Middle East region.

Methods

This cross-sectional study was conducted on fourth-year medical students at the end of their first clerkship. A self-administered questionnaire containing different aspects of students' perceived stress, preparation and clinical supervision was administered to the participants.

Results

Of the 89 students, 63 responded (response rate of 71%). Almost half of the students (59%) experienced stress at the beginning of their clinical training, while 33% thought that they were ready to begin their clerkship training. A majority of the students (81%) reported the need for more time to adjust to the new environment, and 84% indicated that a good introduction to the clerkship would make the transition easy for them. About half of the students (54%) reported receiving feedback during their clinical training.

Conclusion

This study highlighted the difficulties faced by medical students during their transition from preclinical to clinical training. There is a need to implement measures to ease this transition through a structured orientation about clerkship for both students and clinical faculty. In addition, it is recommended to organize faculty development workshops on feedback and supervision.

Learning support interventions for Year 1 medical students: a review of the literature

CONTEXT

The journey through medical school can be challenging, especially for undergraduate medical students who must deal with a demanding curriculum, coupled with the demands of transitioning into adulthood. Despite experiencing learning challenges, most students succeed with appropriate learning support. Many medical schools offer learning support programmes, particularly in the latter years, but it has been suggested that such support could be more beneficial, especially during the initial years.

OBJECTIVES

This review explores learning support intervention programmes used to address learning challenges and deficits in the first year of medical school. Additionally, we propose a potential framework for supporting learning during the first year of medical school.

METHODS

We searched PubMed, Web of Science, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ERIC (Educational Resources Information Centre), Academic Search Premier and Google Scholar using the search terms 'learning support', 'learning challenge', 'remediation', 'change', 'medical education' and 'first year'. We developed and used a review matrix to record the main elements of each article. We also coded the matrix to identify emerging themes.

RESULTS

The main themes that emerged from the study were 'intervention approaches', 'area of intervention', 'intervention strategies', 'intervention dose' and 'intervention outcomes'.

INTERVENTIONS

(i) used proactive-deficit, reactive-deficit and proactive-developmental approaches; (ii) addressed content knowledge, academic success skills, personal and professional skills and programme-related elements; (iii) utilised faculty staff-facilitated, peer-facilitated, support staff-facilitated, experiential placement, self-study and reduced-load strategies; (iv) varied in length from 5 weeks to 2 years, and (v) generally showed positive results.

CONCLUSIONS

This review has identified the main components of learning support interventions used for Year 1 medical students. Interventions, however, are generally not grounded on empirical assessment that elucidates the nature of the challenges faced by students. Future research should provide empirical understanding of the learning challenges to be addressed.

Valued experiences of graduate students in their role as educators in undergraduate training in Ugandan medical schools

BACKGROUND

In most medical schools, graduate students, sometimes referred to as graduate teaching assistants, often participate in the training of undergraduate students. In developing countries like Uganda, are typically involved in undergraduate training. However, prior to this study there were no standard guidelines for this involvement. At the same time, the views and experiences of the graduate students in their role as educators had not been documented. Therefore, the aim of this study was to explore the views and experiences of graduate students about their involvement in undergraduate training in three Ugandan medical schools. The findings of this study will contribute to the development of policies for training in Ugandan medical schools.

METHODS

This was a qualitative study in which thirty in-depth-interviews were conducted among second and third year graduate students in three Ugandan medical schools in the MESAU consortium (Medical Education Services to all Ugandans) including Mbarara University of Science and Technology, Makerere College of Health Sciences and Kampala International University, Western Campus.

RESULTS

All graduate students from all the three medical schools viewed their involvement in undergraduate training as important. The study also revealed that graduate students increase available human resources and often compensate for the teaching missed when senior educators were absent. The graduate students expressed important views that need to be considered in the design of educational programs where they are to be involved. The respondents also reported a number of challenges in this undertaking that included lack of motivation, lack of orientation and having heavy workloads. The presence and commitment of senior educators to guide and support the graduate students in teaching activities was viewed as one significant intervention that would increase the effectiveness of their educational contributions.

CONCLUSIONS

Graduate students enjoy their involvement in the training of undergraduate students despite the various challenges they face. In some departments, the involvement of postgraduate trainees is critical to the viability of undergraduate medical training.

Twelve tips for teaching medical students with dyslexia

Dyslexia is a common learning difficulty. As a result of SS' own experiences as a medical student with dyslexia, we have been researching and teaching on this topic for the past two years. Here, we present twelve tips for teaching medical students with dyslexia. These are gathered from our personal experiences and research, discussions with other educators, and wider literature on the topic. This article aims to shed some light on dyslexia, and also to make practical suggestions. Teaching students with dyslexia should not be a daunting experience. Small changes to existing methods, at minor effort, can make a difference - for example, adding pastel colors to slide backgrounds or avoiding Serif fonts. These tips can help educators gain more insight into dyslexia and incorporate small, beneficial adaptations into their teaching.

From paperwork to parenting: experiences of professional staff in student support

CONTEXT

For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support. We examined the scope of support provided, the impact of providing this support on staff and how these impacts can be managed.

METHODS

Professional staff at two medical schools were invited to participate in semi-structured qualitative interviews. Interviews were transcribed and independently analysed for emergent themes. Data analysis continued with purposive sampling for maximum variation until thematic saturation was reached. Findings were returned to participants in writing and via oral presentations for member checking and refinement.

RESULTS

Twenty-two female staff from clinical, teaching and commercial backgrounds at nine urban and rural teaching sites were interviewed. Participants described providing support for diverse concerns, from routine requests to life-threatening emergencies. Four major themes emerged: firstly, all described roles consistent with emotional labour. Secondly, student support was regarded as informal work, and not well recognised or defined. Consequently, many drew upon their personal orientation to provide support. Finally, we identified both positive and negative personal impacts, including ongoing distress after critical events.

CONCLUSIONS

Professional staff perform a range of student support work, leading to emotional, personal and work impacts. In turn, they need support, recognition and training in this essential but under-recognised role. Emotional labour offers a conceptual framework for understanding the gendered nature and impact of this work and how it may be managed. We suggest practical strategies for promoting positive and preventing negative effects on staff from supporting medical students.

Introducing Mentoring to 1st-year Medical Students of a Private Medical College in North India: A Pilot Study

Background:

The stress of complex medical course, emotional immaturity, and adaptations to new surroundings are the challenges faced by the new medical entrants. Therefore, mentorship program was introduced to support them for their academic and personal development.

Aim and Objectives:

The aim of this study is to introduce and to assess the perception of mentors and mentees on mentorship program.

Materials and Methods:

A mentorship program was designed for Bachelor of Medicine and Bachelor of Surgery (MBBS) First Professional students. A 1-day workshop was conducted to sensitize the faculty. Seventeen faculty members from various departments volunteered to be mentors. After sensitization, 150 MBBS First Professional students were divided among these faculty members by lottery system. A regular visit of mentees was scheduled with the mentor. At the end of mentorship program, the perception of mentors and mentees was taken using a validated and semi-structured feedback questionnaire. A focus group discussion of students was also conducted.

Results:

A total of 112 students and 16 faculty members completed the feedback questionnaire. The mentors considered this program helpful in their self-improvement, teaching, and communication skills. Most of the mentees felt that this program helped them emotionally and academically. It was a good way to develop a strong student–teacher relationship. All the mentors and mentees were satisfied with the mentorship program.

Conclusions:

The newly introduced mentorship program helped in the overall development of mentors and mentees. Both mentors and mentees were extremely satisfied with this program and considered this as a successful intervention.

Near-peer mentorship for undergraduate training in Ugandan medical schools: views of undergraduate students

Introduction

Masters Students are major stakeholders in undergraduate medical education but their contribution has not been documented in Uganda. The aim of the study was to explore and document views and experiences of undergraduate students regarding the role of masters students as educators in four Ugandan medical schools.

Methods

This was a cross-sectional descriptive study using qualitative data collection methods. Eight Focus Group Discussions were conducted among eighty one selected preclinical and clinical students in the consortium of four Ugandan medical schools: Mbarara University of Science and Technology, Makerere College of Health Sciences, Gulu University and Kampala International University, Western Campus. Data analysis was done using thematic analysis. Participants’ privacy and confidentiality were respected and participant identifiers were not included in data analysis.

Results

Undergraduate students from all the medical schools viewed the involvement of master's students as very important. Frequent contact between masters and undergraduate students was reported as an important factor in undergraduate students’ motivation and learning. Despite the useful contribution, master’ students face numerous challenges like heavy workload and conflicting priorities.

Conclusion

According to undergraduate students in Ugandan medical schools, involvement of master's students in the teaching and learning of undergraduate students is both useful and challenging to masters and undergraduate students. Masters students provide peer mentorship to the undergraduate students. The senior educators are still needed to do their work and also to support the master's students in their teaching role.

Exploring the transition of undergraduate medical students into a clinical clerkship using organizational socialization theory

BACKGROUND

Transitions in medical education are emotionally and socially dynamic; this may affect learning. Students transitioning from preclinical to clinical training may experience negative consequences. Less is understood about students' experiences during transitions within clinical training and influential factors.

METHODS

The authors used organizational socialization theory to explore a transition within the clinical years. Final-year medical students experienced a nine-week internal medicine clerkship; willing students participated. Students (n = 101; 97 %) completed a questionnaire with open-ended questions at the beginning and end of the clerkship and participated in six consecutive focus groups, until data saturation occurred (n = 37). Data were thematically analyzed.

RESULTS

Socialization was challenging. Many students experienced difficulty developing relationships with team members. Students with a positive attitude experienced a smoother transition. Many students were uncertain of their roles, concerned about the workload and desired guidance to meet clerkship demands. This transition resulted in varied outcomes from enjoyment, increased confidence and student development through to disinterest.

CONCLUSION

Transitions within clinical training are complex. Faculty should focus on adequate socialization in a new clerkship as this may facilitate a smoother transition. This may necessitate orientations, staff training, and formal student support. Further research is needed on the impact of these recommendations on learning and well-being.