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Mabuza LH, Moshabela M. What are the experiences of medical students and their trainers regarding undergraduate training in primary health care at four South African medical schools? A qualitative study. Front Med (Lausanne) 2024; 11:1337140. [PMID: 38957301 PMCID: PMC11217328 DOI: 10.3389/fmed.2024.1337140] [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: 11/12/2023] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Background In 1978, the World Health Organization (WHO) adopted primary health care (PHC) as the most effective strategy to meet the healthcare needs of communities. This raises the question as to the extent and nature of the training that undergraduate (UG) medical students receive in medical schools regarding PHC, following this statement. Aim The study aim was to explore the experiences of UG medical students and their trainers regarding training in PHC in their institutions. Methods A qualitative study was conducted among UG medical students (MBChB 4-6) and their trainers at four conveniently selected South African medical schools. A total of 16 focus group discussions (FGDs) and 27 in-depth interviews were conducted among students and their trainers, respectively. The MAXQDA 2020 (Analytics Pro) software program was used to arrange the data, resulting in 2,179 data segments, from which categories, sub-themes and themes were derived. Results Both the UG medical students and their trainers regarded PHC as mainly an approach to health rather than a level of care. Students were trained by specialists and generalists, received training in the undifferentiated patient, coordinated, comprehensive and continuity of care. The training in tertiary centers, conducted mainly by specialists, the implicitness of the training and the inadequacy of trainers at the PHC settings presented challenges. Conclusion Students and their trainers experienced UG student training in PHC in line with the internationally recognized principles on the subject. The view by students and their trainers that PHC is an approach rather than a level of care enhanced its training across disciplines. The implicitness of the training and the tertiary learning platforms were the main challenges experienced. For optimum PHC training, more time should be dedicated to distributed training platforms with supportive specialist outreach programs in the South African medical schools.
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Affiliation(s)
- Langalibalele Honey Mabuza
- School of Medicine, Clinical Integrated Programs, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Mosa Moshabela
- Research and Innovation Department, University of KwaZulu-Natal, Durban, South Africa
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Huppert LA, Babik JM. Development and Evaluation of a Five-Component Toolkit for Internal Medicine Residents Applying for Subspecialty Fellowships. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2022; 18:11228. [PMID: 35342791 PMCID: PMC8918571 DOI: 10.15766/mep_2374-8265.11228] [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: 08/13/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Subspecialty fellowship is a common career path for internal medicine (IM) residents, but little is published on residency program curricula for guiding residents through the process of applying to subspecialty fellowships. We describe a toolkit to guide IM residents through this process. METHODS We developed and implemented the Fellowship Application Toolkit for IM residents at the University of California, San Francisco, from 2018 to 2020. Educational strategies included live workshops, written resources, and one-to-one coaching, consisting of five components: fellowship application guidebook, Fellowship Application Information Night, alumni contact list, personal statement resources and coaches, and virtual interview workshop and mock interviews. Residents were surveyed both pre- and postintervention to evaluate these resources' use and efficacy. RESULTS Survey response rates were 21 of 41 (51%) in 2018, 25 of 41 (61%) in 2019, and 24 of 43 (56%) in 2020. Most respondents indicated the resources were extremely or very effective, including 30 of 36 (83%) who used the guidebook, 31 of 37 (84%) who attended the Fellowship Application Information Night, 10 of 15 (67%) who used the alumni contact list, nine of 10 (90%) who used the personal statement resources, and 12 of 14 (86%) who attended the virtual interview workshop. Respondents strongly or somewhat agreed that the overall efficacy of the residency's fellowship advising improved from pre- to postintervention (four of 17 [24%] in 2018 vs. 17 of 21 [81%] in 2020, p < .001). DISCUSSION Our Fellowship Application Toolkit was effective at supporting IM residents applying to fellowships.
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Affiliation(s)
- Laura A. Huppert
- Fellow, Hematology/Oncology Division, Department of Medicine, University of California, San Francisco, School of Medicine
| | - Jennifer M. Babik
- Associate Professor, Infectious Disease Division, Department of Medicine, Associate Program Director, Internal Medicine Residency, and Associate Program Director, Infectious Disease Fellowship, University of California, San Francisco, School of Medicine
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The Perception of Rural Medical Students Regarding the Future of General Medicine: A Thematic Analysis. Healthcare (Basel) 2021; 9:healthcare9101256. [PMID: 34682936 PMCID: PMC8535786 DOI: 10.3390/healthcare9101256] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022] Open
Abstract
Although the demand for general physicians has increased in Japan because of its aging population, medical universities primarily provide organ-based education; thus, medical students do not receive sufficient general medical education. The number of residents focusing on general medicine remains low; therefore, to understand the present situation regarding general medicine education, we attempted to clarify the views of medical students and the factors influencing them. In this qualitative study, semi-structured interviews were conducted in 12 medical students at Shimane University, and the results were analyzed through thematic analysis. The results indicated the emergence of three themes and 14 concepts. The three overarching themes were as follows: hopes for the field of general medicine, gaps between ideal and reality of general medicine, and factors affecting students’ motivation for specialization in general medicine. Medical students had a positive impression of general medicine and believed that it has potential for further development; however, they felt a gap between their ideals and reality (i.e., unclear expertise). Factors creating this gap included poorly developed education and medical policies. We need to restructure general medicine education based on the participants’ perceptions by establishing collaborative curricula between universities and community hospitals and by increasing students’ exposure to general medicine.
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Sheri K, Too JYJ, Chuah SEL, Toh YP, Mason S, Radha Krishna LK. A scoping review of mentor training programs in medicine between 1990 and 2017. MEDICAL EDUCATION ONLINE 2019; 24:1555435. [PMID: 31671284 PMCID: PMC6327936 DOI: 10.1080/10872981.2018.1555435] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Effective mentoring enhances the personal and professional development of mentees and mentors, boosts the reputation of host organizations and improves patient outcomes. Much of this success hinges upon the mentor's ability to nurture personalized mentoring relationships and mentoring environments, provide effective feedback and render timely, responsive, appropriate, and personalized support. However, mentors are often untrained raising concerns about the quality and oversight of mentoring support.To promote effective and consistent use of mentor training in medical education, this scoping review asks what mentor training programs are available in undergraduate and postgraduate medicine and how they may inform the creation of an evidenced-based framework for mentor training.Six reviewers adopted Arksey and O'Malley's approach to scoping reviews to study prevailing mentor-training programs and guidelines in postgraduate education programs and in medical schools. The focus was on novice mentoring approaches. Six reviewers carried out independent searches with similar inclusion/exclusion criteria using PubMed, ERIC, EMBASE, SCOPUS, Google Scholar, and grey literature databases. Included were theses and book chapters published in English or had English translations published between 1 January 1990 and 31 December 2017. Braun and Clarke's approach to thematic analysis was adopted to circumnavigate mentoring's and mentor training's evolving, context-specific, goal-sensitive, learner-, tutor- and relationally dependent nature that prevents simple comparisons of mentor training across different settings and mentee and mentor populations.In total, 3585 abstracts were retrieved, 232 full-text articles were reviewed, 68 articles were included and four themes were identified including the structure, content, outcomes and evaluation of mentor training program.The themes identified provide the basis for an evidence-based, practice-guided framework for a longitudinal mentor training program in medicine and identifies the essential topics to be covered in mentor training programs.
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Affiliation(s)
- Krish Sheri
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jue Ying Joan Too
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sing En Lydia Chuah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ying Pin Toh
- Department of Family Medicine, National University of Singapore, Singapore
| | - Stephen Mason
- University of Liverpool, Marie Curie Palliative Care Institute, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore
- Centre of Biomedical Ethics, National University of Singapore, Singapore
- Duke- NUS Medical School, Singapore
- CONTACT Lalit Kumar Radha Krishna Division of Palliative Medicine, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore
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Skinner D, Rosenberger K. Toward a More Humanistic American Medical Profession: An Analysis of Premedical Web Sites From Ohio's Undergraduate Institutions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2018; 5:2382120518756337. [PMID: 29468201 PMCID: PMC5814026 DOI: 10.1177/2382120518756337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/08/2018] [Indexed: 06/08/2023]
Abstract
In response to changes in health care, American medical schools are transforming their curricula to cultivate empathy, promote professionalism, and increase cultural competency. Many scholars argue that an infusion of the humanities in premedical and medical training may help achieve these ends. This study analyzes Web-based messaging of Ohio's undergraduate institutions to assess premedical advising attitudes toward humanities-based coursework and majors. Results suggest that although many institutions acknowledge the humanities, most steer students toward science majors; strong advocates of the humanities tend to have religious or other special commitments, and instead of acknowledging the intrinsic value that the humanities might have for future physicians, most institutions promote the humanities because entrance exams now contain related material.
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Affiliation(s)
- Daniel Skinner
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
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Howse K, Harris J, Dalgarno N. Canadian National Guidelines and Recommendations for Integrating Career Advising Into Medical School Curricula. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1543-1548. [PMID: 28445219 PMCID: PMC5662158 DOI: 10.1097/acm.0000000000001720] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Career planning, decision making about specialty choice, and preparation for residency matching are significant sources of stress for medical students. Attempts have been made to structure and formalize career advising by including it in accreditation standards. There is an expressed need for national guidelines on career advising for medical students. The Future of Medical Education in Canada Postgraduate (FMEC PG) Implementation Project was created to ensure Canadian medical trainees receive the best education possible. From this, a diverse sub-working group (SWG), representing different Canadian regions, was formed to review career advising processes across the country. The SWG developed, through a modified formal consensus methodology, a strategy for medical student career advising that is adaptable to all schools in alignment with existing accreditation standards. The SWG outlined five guiding principles and five essential elements for Canadian universities offering an MD degree with recommendations on how to integrate the elements into each school's career advising system. The five essential elements are a structured approach to career advising, information about available career options, elective guidance, preparation for residency applications, and social accountability. This Perspective endorses the view of the FMEC PG Implementation Project that national guidelines are important to ensure Canadian medical schools are consistently meeting accreditation standards by providing reliable and quality career advising to all medical students. The SWG's position, based on national and provincial feedback, is that these guidelines will stimulate discourse and action regarding the requirements and processes to carry out these recommendations nationwide and share across borders.
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Affiliation(s)
- Kelly Howse
- K. Howse is assistant professor, Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada
| | - June Harris
- J. Harris is professor, Faculty of Medicine, and director, MedCAREERS, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Nancy Dalgarno
- N. Dalgarno is education researcher and consultant, Department of Family Medicine/Centre for Studies in Primary Care and Office of Health Sciences Education, Queen’s University, Kingston, Ontario, Canada
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Pfarrwaller E, Sommer J, Chung C, Maisonneuve H, Nendaz M, Junod Perron N, Haller DM. Impact of Interventions to Increase the Proportion of Medical Students Choosing a Primary Care Career: A Systematic Review. J Gen Intern Med 2015; 30:1349-58. [PMID: 26173529 PMCID: PMC4539313 DOI: 10.1007/s11606-015-3372-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Increasing the attractiveness of primary care careers is a key step in addressing the growing shortage of primary care physicians. The purpose of this review was to (1) identify interventions aimed at increasing the proportion of undergraduate medical students choosing a primary care specialty, (2) describe the characteristics of these interventions, (3) assess the quality of the studies, and (4) compare the findings to those of a previous literature review within a global context. METHODS We searched MEDLINE, EMBASE, ERIC, CINAHL, PsycINFO, The Cochrane Library, and Dissertations & Theses A&I for articles published between 1993 and February 20, 2015. We included quantitative and qualitative studies reporting on primary care specialty choice outcomes of interventions in the undergraduate medical curriculum, without geographic restrictions. Data extracted included study characteristics, intervention details, and relevant outcomes. Studies were assessed for quality and strength of findings using a five-point scale. RESULTS The review included 72 articles reporting on 66 different interventions. Longitudinal programs were the only intervention consistently associated with an increased proportion of students choosing primary care. Successful interventions were characterized by diverse teaching formats, student selection, and good-quality teaching. Study quality had not improved since recommendations were published in 1995. Many studies used cross-sectional designs and non-validated surveys, did not include control groups, and were not based on a theory or conceptual framework. DISCUSSION Our review supports the value of longitudinal, multifaceted, primary care programs to increase the proportion of students choosing primary care specialties. Isolated modules or clerkships did not appear to be effective. Our results are in line with the conclusions from previous reviews and add an international perspective, but the evidence is limited by the overall low methodological quality of the included studies. Future research should use more rigorous evaluation methods and include long-term outcomes.
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Affiliation(s)
- Eva Pfarrwaller
- Primary Care Unit, Faculty of Medicine, Centre Médical Universitaire, University of Geneva, Av. de Champel 9, 1211, Genève 4, Switzerland,
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Welbergen L, Pinilla S, Pander T, Gradel M, von der Borch P, Fischer MR, Dimitriadis K. The FacharztDuell: innovative career counselling in medicine. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc17. [PMID: 24872852 PMCID: PMC4027802 DOI: 10.3205/zma000909] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 01/20/2014] [Accepted: 02/27/2014] [Indexed: 11/30/2022]
Abstract
Objective: The selection of a future medical specialty is a challenge all medical students face during the course of their studies. Students can choose from more than sixty specialties after graduation. There is usually no structured career counselling program available at German medical faculties. So far only little data on acceptance, formats and effects of different career counselling programs are available. The aim of this study is to describe an innovative format of career counselling for medical students including its evaluation of acceptance and its possible influence on medical specialty preferences. Methods: The need for career counselling became evident after the analysis of mentor-mentee conversations held within the mentoring program of our medical faculty, an online-based survey, an ad-hoc focus group and a pilot event. Panel discussions as an interactive format of presenting related medical specialties were developed and hence held four times under the name “FacharztDuell”. Students evaluated all events separately with a questionnaire and changes in medical specialty choice preferences were documented using an Audience-Response-System (ARS). The FacharztDuell is organized regularly and supported by faculty teaching funds. Results: Among the student body FacharztDuell was well accepted (an average of 300 participants/event) and rated (average grade of 1.8 (SD= 0.7, 1=very good, 6=unsatisfactory, n=424). On average, 77.8% of the participating students considered the FacharztDuell to be a decision support for their future selection of a specialty. Up to 12% of the students changed their medical specialty choice preference throughout the event. Conclusion: FacharztDuell was well accepted by medical students of all semesters and seems to be supportive for their selection of a future medical specialty. However, longitudinal studies are necessary to better understand the decision making process of medical students along their career path. The FacharztDuell is easily transferrable to other faculties with respect to organization, staff and technical resources.
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Affiliation(s)
- Lena Welbergen
- LMU München, Institute for Medical Education, München, Germany
| | - Severin Pinilla
- Ludwig-Maximilians-Universität, Neurologische Klinik und Poliklinik, Klinikum Großhadern, München, Deutschland
| | - Tanja Pander
- LMU München, Institute for Medical Education, München, Germany
| | | | | | - Martin R Fischer
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Konstantinos Dimitriadis
- Ludwig-Maximilians-Universität, Neurologische Klinik und Poliklinik, Klinikum Großhadern, München, Deutschland
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