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Vilagra S, Vilagra M, Giaxa R, Miguel A, Vilagra LW, Kehl M, Martins MA, Tempski P. Professional values at the beginning of medical school: a quasi-experimental study. BMC Med Educ 2024; 24:259. [PMID: 38459537 PMCID: PMC10924418 DOI: 10.1186/s12909-024-05186-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection. METHODS We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students. RESULTS Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group. CONCLUSIONS Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.
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Affiliation(s)
| | | | - Renata Giaxa
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Alice Miguel
- Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Mariana Kehl
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Milton A Martins
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Patricia Tempski
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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da Rosa MI, Ceretta LB, Martins MA, Colonetti L, Colonetti T, Grande AJ, Tempski P. The effects of academic unprofessional behaviour on disciplinary action by medical boards: Systematic review and meta-analysis. Clin Teach 2024. [PMID: 38323699 DOI: 10.1111/tct.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE The objective of this study is to evaluate the association of disciplinary actions by regulatory councils and unprofessional behaviour during medical graduation. METHODS A search strategy was developed using the terms: 'physicians', 'disciplinary action', 'education', 'medical', 'undergraduate' and their synonyms, subsequently applied to the electronic databases MEDLINE, Embase, Cochrane Library, LILACs and grey literature, with searches up to November 2023. The risk of bias was assessed using the Newcastle-Ottawa scale and statistical analysis was performed using the RevMan software. RESULTS A total of 400 studies were found in the databases, and 15 studies were selected for full-texting reading. Four studies met the inclusion criteria and were included, bringing together a total of 3341 evaluated physicians. Three studies were included in the meta-analysis, showing a greater chance of disciplinary actions among physicians who exhibited unprofessional behaviour during medical graduation (OR: 2.54; 95%CI: 1.87-3.44; I2 : 0%; P < 0.0001; 3077 participants; physicians with disciplinary action: 107/323; control physicians: 222/2754). CONCLUSIONS There is a statistically significant association between unprofessional behaviour during medical undergraduate study and subsequent disciplinary actions by Medical Councils. The tools for periodic assessments of student behaviour during undergraduate studies can be a perspective for future studies aimed at reducing disciplinary actions among physicians.
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Affiliation(s)
- Maria Inês da Rosa
- Laboratory of Translational Biomedicine, University of the Extreme South of Santa Catarina, Criciuma, Santa Catarina, Brazil
| | - Luciane Bisognin Ceretta
- Postgraduate Program in Collective Health, University of the Extreme South of Santa Catarina, Criciúma, Santa Catarina, Brazil
| | | | - Laura Colonetti
- Laboratory of Translational Biomedicine, University of the Extreme South of Santa Catarina, Criciuma, Santa Catarina, Brazil
| | - Tamy Colonetti
- Laboratory of Translational Biomedicine, University of the Extreme South of Santa Catarina, Criciuma, Santa Catarina, Brazil
| | - Antonio Jose Grande
- Laboratory of Evidence-Based Practice, University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Patricia Tempski
- Faculty of Medicine of the University of São Paulo (FMUSP), São Paulo, Brazil
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Miguel ADQC, Tempski P, Kobayasi R, Mayer FB, Martins MA. Predictive factors of quality of life among medical students: results from a multicentric study. BMC Psychol 2021; 9:36. [PMID: 33632321 PMCID: PMC7905855 DOI: 10.1186/s40359-021-00534-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background Medical students have a worse perception of Quality of Life (QoL) and a high prevalence of psychosocial suffering when compared to the general population. The objective of this study was to investigate associated factors with Quality of Life of Brazilian medical students from an exploratory analysis in a cross-sectional study described in accordance with the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. Methods This is a cross-sectional and multicenter study with national sample randomized by sex and year of the course. Data were collected between August 2011 and August 2012, using an electronic platform (VERAS platform). Our outcomes included: personal quality of life (QoLp) and quality of life related to medical course activities (QoLmc), both measured using a score ranging from 0 (worst) to 10 (best). Variables as predictors: the World Health Organization Quality of Life Assessment abbreviated version (WHOQOL-BREF); VERAS-Q (a questionnaire created to evaluate the QoL of students in health professions); Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maslach Burnout Inventory (MBI), Resilience Scale (RS-14), Interpersonal Reactivity Multidimensional Scale (IRMS) and Dundee Ready Education Environment Measure (DREEM). Results Our sample is comprised of 1350 (81.8%) medical students. When comparing predictors and both quality of life outcome measures, we found a negative correlation between QoL and the BDI, PSQI and ESS scores. Through a multiple linear regression mode we identified the median of significant predictors to higher QoL. We then run a tree regression model that demonstrated that the VERAS-Q—physical health domain (a domain assessing self-care, self-perception of health, sleep, leisure, physical activity and appearance) was the most important factor predicting QoL. Students with a VERAS-Q-physical health score ≥ 60.9 and a VERAS-Q-time management (address the management of the student's time, free time and whether he can dedicate himself to other activities besides the course) score ≥ 55.7 presented the best QoLmc (score: 8.08–9.63%). Students with a VERAS-Q-physical health score ≥ 79.7 presented the highest QoLp (score 8.93–8.74%). Conclusion Physical symptoms, self-perception of health and self-care assessed by the VERAS-Q physical domain had association with both final outcomes. Time management seems to have a protective role for better Quality of Life. These variables should be taken in consideration when designing interventions to improve Quality of Life among medical students.
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Affiliation(s)
- Alice de Queiroz Constantino Miguel
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil. .,Hospital Universitário da Universidade Federal de São Carlos, São Carlos, Brazil.
| | - Patricia Tempski
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil
| | - Renata Kobayasi
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil
| | | | - Milton A Martins
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo 455 sala 1210, Sao Paulo, SP, 01246-903, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Tempski P, Danila AH, Arantes-Costa FM, Siqueira MA, Torsani MB, Martins MA. The COVID-19 pandemic: time for medical teachers and students to overcome grief. Clinics (Sao Paulo) 2020; 75:e2206. [PMID: 32756822 PMCID: PMC7384203 DOI: 10.6061/clinics/2020/e2206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/14/2023] Open
Affiliation(s)
- Patricia Tempski
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Arthur H. Danila
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fernanda M. Arantes-Costa
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marina A.M. Siqueira
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Matheus B. Torsani
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Milton A. Martins
- Centro de Desenvolvimento de Educacao Medica e Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Girotto LC, Enns SC, de Oliveira MS, Mayer FB, Perotta B, Santos IS, Tempski P. Preceptors' perception of their role as educators and professionals in a health system. BMC Med Educ 2019; 19:203. [PMID: 31196069 PMCID: PMC6567907 DOI: 10.1186/s12909-019-1642-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/29/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Preceptorship fulfills the requirements of International Guidelines regarding the training of health care professionals as a method of teaching in clinical settings, during the daily work routine. This study aims to analyze the preceptors' perceptions about preceptorship and their role as educators. METHODS Data were collected via a questionnaire with 35 five-point Likert-type scale statements and analyzed using quantitative and qualitative approaches. The qualitative analysis consisted of two open-ended questions: (1) What is Preceptorship? And (2) What is your perception of the preceptor's role as an educator? RESULTS Out of 619 invited Brazilian preceptors from different health care professions, 327 (52.8%) participated in the study. Among them, 80.7% were females, 35.2% were nurses and 8.9% were physicians. Factor analysis revealed five factors: Pedagogical Competence (F1), Support and educational resources (F2), Educational program planning (F3), Teaching-service integration (F4), and Student presence in the clinical setting (F5). About F1, F3, and F5, professionals from the northeast region had a more positive perception than professionals from the southeast. The item analysis revealed that preceptors learn from the students and consider the service network co-responsible for their training. However, they agreed that only a small part of the health care team participates in the program. Participants described preceptorship as an educational task in a clinical setting, in which active learning methods are used for the training of health care professionals. Preceptorship was considered a bridge between the Unified Health System and the Academic Practice. They envisioned their educator role as a model, tutor, leader, supervisor, and mentor. CONCLUSION Preceptors expressed a critical view about the nature of preceptorship and their role as educators, recognizing its challenges as well as its potential in clinical settings.
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Affiliation(s)
- Letícia Cabrini Girotto
- Departamento Regional de Saúde de Marília, Rua Quinze de Novembro, 1151, Alto Cafezal, Marília, SP, 17504000, Brazil
| | - Sylvia Claassen Enns
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Sala 2345, São Paulo, SP, 01246-903, Brazil.
| | - Marilda Siriani de Oliveira
- Instituto de Ensino e Pesquisa Hospital do Coração, Rua Desembargador Eliseu Guilherme, 390, Paraíso, São Paulo, SP, 04004030, Brazil
| | - Fernanda Brenneisen Mayer
- Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, bloco 6, Prado Velho, Curitiba, PR, 80215901, Brazil
| | - Bruno Perotta
- Faculdade Evangélica do Paraná, Rua Padre Anchieta, 2770, Bigorrilho, Curitiba, PR, 80730000, Brazil
| | - Itamar Souza Santos
- Faculdade de Medicina Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Sala 2345 -, São Paulo, SP, 01246-903, Brazil
| | - Patricia Tempski
- Faculdade de Medicina Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Sala 2345 -, São Paulo, SP, 01246-903, Brazil
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Kremer T, Mamede S, Martins MA, Tempski P, van den Broek WW. Investigating the Impact of Emotions on Medical Students׳ Learning. Health Professions Education 2019. [DOI: 10.1016/j.hpe.2018.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Peleias M, Tempski P, Paro HBMS, Perotta B, Mayer FB, Enns SC, Gannam S, Pereira MAD, Silveira PS, Santos IS, Carvalho CRF, Martins MA. Leisure time physical activity and quality of life in medical students: results from a multicentre study. BMJ Open Sport Exerc Med 2017; 3:e000213. [PMID: 28761706 PMCID: PMC5530174 DOI: 10.1136/bmjsem-2016-000213] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND/AIM We evaluated the association between leisure time physical activity (PA) and quality of life (QoL) in medical students. Our hypothesis was that there was a positive association between volume of PA and various domains of perception of QoL. METHODS Data were evaluated from a random sample of 1350 medical students from 22 Brazilian medical schools. Information from participants included the WHO Quality of Life questionnaire-short form (WHOQOL-BREF), a questionnaire specifically designed to evaluate QoL in medical students (VERAS-Q) and questions for both global QoL self-assessment and leisure time PA. According to the amount of metabolic equivalents (METs) spend during PA, volunteers were divided into four groups, according to the volume of PA: (a) no PA; (b) low PA, ≤540 MET min/week; (c) moderate PA, from 541 to 1260 MET min/week and (d) high PA, > 1261 MET min/week. RESULTS Forty per cent of the medical students reported no leisure time PA (46.0% of females and 32.3% of males). In contrast, 27.2% were classified in the group of high PA (21.0% of females and 34.2% of males). We found significant associations between moderate and high levels of PA and better QoL for all measurements. For low levels of PA, this association was also significant for most QoL measurements, with the exceptions of WHOQOL physical health (p=0.08) and social relationships (p=0.26) domains. CONCLUSION We observed a strong dose-effect relationship between the volume of leisure time PA and QoL in both male and female medical students.
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Affiliation(s)
- Munique Peleias
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Tempski
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Helena BMS Paro
- Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Brazil
| | - Bruno Perotta
- Evangelical Medical School of Parana, Curitiba, Brazil
| | - Fernanda B Mayer
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Sylvia C Enns
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Silmar Gannam
- University of the City of São Paulo, Sao Paulo, Brazil
| | | | - Paulo S Silveira
- Department of Pathology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Celso RF Carvalho
- Department of Physical Therapy, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A Martins
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
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Brenneisen Mayer F, Souza Santos I, Silveira PSP, Itaqui Lopes MH, de Souza ARND, Campos EP, de Abreu BAL, Hoffman II I, Magalhães CR, Lima MCP, Almeida R, Spinardi M, Tempski P. Factors associated to depression and anxiety in medical students: a multicenter study. BMC Med Educ 2016; 16:282. [PMID: 27784316 PMCID: PMC5080800 DOI: 10.1186/s12909-016-0791-1] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/06/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. METHODS The authors performed a multicenter study (August 2011 to August 2012), examining personal factors (age, sex, housing, tuition scholarship) and institutional factors (year of the medical training, school legal status, location and support service) in association with scores of Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). RESULTS Of 1,650 randomly selected students, 1,350 (81.8 %) completed the study. The depressive symptoms prevalence was 41 % (BDI > 9), state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33). There was a positive relationship between levels of state (r = 0,591, p < 0.001) and trait (r = 0,718, p < 0.001) anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements "I have adequate access to psychological support" and "There is a good support system for students who get stressed". CONCLUSIONS The factors associated with the increase of medical students' depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.
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Affiliation(s)
- Fernanda Brenneisen Mayer
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Itamar Souza Santos
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Paulo S. P. Silveira
- Department of Pathology, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Maria Helena Itaqui Lopes
- University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, 95070-560 Caxias do Sul, Rio Grande do Sul Brazil
| | - Alicia Regina Navarro Dias de Souza
- Psychiatry and Legal Medicine Department, School of Medicine of the Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 255, 9° andar, sala 9E28, Rio de Janeiro, 21941-590 RJ Brazil
| | - Eugenio Paes Campos
- University Center of Serra dos Órgãos, Av. Alberto Torres, 111, 25964-000 Rio de Janeiro, RJ Brazil
| | | | - Itágores Hoffman II
- School of Medicine of Tocatins, Avenida NS 15, 109, sala 18, 77020-210 Palmas, TO Brazil
| | - Cleidilene Ramos Magalhães
- Department of Education and Humanities, Federal University of Health Sciences of Porto Alegre , Rua Sarmento Leite, 245, sala 412, 90050-170 Porto Alegre, RS Brazil
| | - Maria Cristina P. Lima
- Neurology and Psychiatry Department, School of Medicine of São Paulo State University, Rua Rubião Júnior, caixa-postal: 540, 18618-000 Botucatu, SP Brazil
| | - Raitany Almeida
- School of Medicine of Federal University of Rondônia , BR 364 km 9,5, 78900-000 Porto Velho, RO Brazil
| | - Mateus Spinardi
- Marília Medical School, Av. Monte Carmelo, 800, sala 17, 17519-030 São Paulo, Brazil
| | - Patricia Tempski
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
- Center of Development of Medical Education, Avenida Dr Arnaldo, 455, 1 andar, sala 1210, 01246903 São Paulo, Brazil
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Tempski P, Santos IS, Mayer FB, Enns SC, Perotta B, Paro HBMS, Gannam S, Peleias M, Garcia VL, Baldassin S, Guimaraes KB, Silva NR, da Cruz EMTN, Tofoli LF, Silveira PSP, Martins MA. Relationship among Medical Student Resilience, Educational Environment and Quality of Life. PLoS One 2015; 10:e0131535. [PMID: 26121357 PMCID: PMC4486187 DOI: 10.1371/journal.pone.0131535] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students. METHODS We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young's resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire - short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). RESULTS Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements. CONCLUSIONS Medical students with higher resilience levels had a better quality of life and a better perception of educational environment. Developing resilience may become an important strategy to minimize emotional distress and enhance medical training.
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Affiliation(s)
- Patricia Tempski
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
- Evangelical Medical School of Parana, Curitiba, Brazil
| | - Itamar S. Santos
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda B. Mayer
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Sylvia C. Enns
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Bruno Perotta
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Helena B. M. S. Paro
- Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Silmar Gannam
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | - Munique Peleias
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
| | | | | | | | | | | | - Luis F. Tofoli
- Department of Psychiatry, School of Medicine, State University of Campinas, Campinas, Brazil
| | - Paulo S. P. Silveira
- Department of Pathology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A. Martins
- Center for Development of Medical Education, School of Medicine of the University of São Paulo, Sao Paulo, Brazil
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- * E-mail:
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Tempski P, Bellodi PL, Paro HBMS, Enns SC, Martins MA, Schraiber LB. What do medical students think about their quality of life? A qualitative study. BMC Med Educ 2012; 12:106. [PMID: 23126332 PMCID: PMC3527341 DOI: 10.1186/1472-6920-12-106] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 10/25/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Medical education can affect medical students' physical and mental health as well as their quality of life. The aim of this study was to assess medical students' perceptions of their quality of life and its relationship with medical education. METHODS First- to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student's lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. RESULTS Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. CONCLUSION Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students' quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.
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Affiliation(s)
- Patricia Tempski
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Patricia L Bellodi
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Helena BMS Paro
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
- Universidade Federal de Uberlândia, Av. Pará, 1720 - Umuarama, Uberlândia, MG, 38408-144, Brazil
| | - Sylvia C Enns
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Milton A Martins
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Lilia B Schraiber
- Universidade de São Paulo, Av. Dr. Arnaldo, 455 – Cerqueira César, São Paulo, SP, 01246-903, Brazil
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Affiliation(s)
- Patricia Tempski
- Health Sciences, Federal University of Uberlandia, Avenida Pará 1720, Uberlandia, Minas Gerais, Brazil
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