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Campos CFC, Olivo CR, Martins MDA, Tempski PZ. Physicians' attention to patients' communication cues can improve patient satisfaction with care and perception of physicians' empathy. Clinics (Sao Paulo) 2024; 79:100377. [PMID: 38703716 PMCID: PMC11087704 DOI: 10.1016/j.clinsp.2024.100377] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/25/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The pathway that links good communication skills and better health outcomes is still unclear. However, it is known that the way that physicians and patients communicate with each other has direct consequences on more "proximal outcomes", such as perceptions of physician empathy and patient satisfaction. However, which specific communication skills lead to those patient outcomes is still unknown. In this study, the authors aimed to analyze which specific patient and physician communication skills are correlated to patients' satisfaction with care and patient-perceived physician empathy. METHODS The authors classified and quantified verbal and nonverbal communication of second-year internal medicine residents and their patients through video recordings of their consultations. Patients also rated their satisfaction with care and the physician's empathy for them. RESULTS Using a linear regression model, the authors identified that patients' and physicians' expressions of disapproval, physicians' disruptions, and patients' use of content questions negatively correlated to patients' satisfaction and patient-perceived physician empathy. Conversely, patient affective behaviors and the physician's provision of advice/suggestion were positively correlated to at least one of the patient-measured outcomes. CONCLUSION Our findings point to the importance of physicians' attentiveness to patients' communication cues. Training physicians to interpret those cues could help develop more satisfactory and empathic therapeutic relationships.
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Affiliation(s)
- Carlos Frederico Confort Campos
- The Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand; Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil.
| | - Clarice Rosa Olivo
- Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Patricia Zen Tempski
- Center for Development of Medical Education, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Haydar A, Santos IS, Arcon LC, Martins MDA, Tempski PZ, Zatz R. Remote vs. face-to-face activities in the teaching of renal pathophysiology in the context of social isolation during the early phase of the COVID-19 pandemic. Adv Physiol Educ 2023; 47:788-795. [PMID: 37615046 DOI: 10.1152/advan.00257.2022] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/24/2023] [Accepted: 08/22/2023] [Indexed: 08/25/2023]
Abstract
The advent of the COVID-19 pandemic forced medical schools around the world to adopt emergency remote learning as a resort to avoid interruption of courses. However, the effectiveness of online classes as an educational strategy has been questioned by medical educators and students. In a prospective observational study design, students enrolled in a renal physiology and pathophysiology course were exposed to either face-to-face or remote synchronous classes. Students taught online obtained significantly higher mean scores than the group who had in-person classes, both groups assessed with identical exams. Appropriate screening tests suggested that fraud is unlikely to have significantly influenced these results and that the observed differences in performance reflected increased learning by the remote group. These observations suggest that online classes can help to maintain the continuity of physiology and pathophysiology courses during periods of social isolation and may contribute to improving learning under normal conditions.NEW & NOTEWORTHY In this study, we were able to make a rare direct comparison of face-to-face and remote strategies for the teaching of undergraduate medical students in a specific area, namely, renal pathophysiology. Unexpectedly, students who attended the remote course had significantly higher grades than those who had mostly in-person classes.
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Affiliation(s)
- Ahmed Haydar
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Itamar Souza Santos
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luis Carlos Arcon
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mílton de Arruda Martins
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia Zen Tempski
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Roberto Zatz
- Nephrology Division, Department of Clinical Medicine and Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil
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Poço PCE, Collares CF, Haydar A, de Oliveira VB, de Arruda Martins M, Tempski PZ. Measurement of uncertainty tolerance revisited. Clin Teach 2023; 20:e13619. [PMID: 37608765 DOI: 10.1111/tct.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/10/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Uncertainty tolerance (UT) is attracting increasing attention in medical education due to the numerous challenges associated with uncertainty in professional life. Inconsistencies in analysing the relationship between UT and moderators may arise from inadequate measurement methods. Most instruments were formulated before the most widely accepted framework was published. Our aim was to investigate the validity of an UT scale using an actual framework to corroborate with better and accurate instruments. METHODS A total of 1052 students were invited. Various psychometric methods were used to explore validity of the TAMSAD scale in light of actual framework. Classic exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. Secondly, content item classification was triangulated with exploratory graph analysis (EGA), and the new EFA, CFA, and cognitive diagnostic modelling (CDM) analysis were conducted. The reliability was calculated using Cronbach's alpha and McDonald's omega. RESULTS A total of 694 students (65.9%) responded to the questionnaire. The reliability of the TAMSAD scale was 0.782. The initial EFA revealed no clear interpretable dimensions. The TAMSAD scale items can be classified into sources of uncertainty. The EGA has three dimensions, and the new EFA led to a 17-item TAMSAD scale with the following three dimensions: ambiguity, complexity, and probability. These dimensions lead to better adjustment fit indices in the new CFA and CDM analyses. CONCLUSION We found evidence that the TAMSAD scale can be considered a multidimensional scale, organised in terms of sources of uncertainty.
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Affiliation(s)
- Paula Cristina Eiras Poço
- Faculdade São Leopoldo Mandic, Campinas, Brazil
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Ahmed Haydar
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Siqueira MAM, Torsani MB, Gameiro GR, Chinelatto LA, Mikahil BC, Tempski PZ, Martins MA. Medical students' participation in the Volunteering Program during the COVID-19 pandemic: a qualitative study about motivation and the development of new competencies. BMC Med Educ 2022; 22:111. [PMID: 35183158 PMCID: PMC8857627 DOI: 10.1186/s12909-022-03147-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Considering evidence on competency-based curricula and the benefits of volunteering, this study highlights innovative ideas to improve medical education during the COVID-19 pandemic. We investigated the motivations and perceptions of competencies developed as leadership and management skills in medical students who joined the COVID-19 Volunteering Program in a Brazilian medical school. METHODS We performed a cross-sectional, qualitative study involving medical students from the University of São Paulo, Brazil. They were invited to participate in an institutional Volunteering Program during the pandemic and filled out online application forms, including sociodemographic fields and two open-ended questions about their motivation to volunteer and perceptions of their own competencies. At the end of the program, students who were involved in management-related activities were also invited to participate in focus group interviews to track their perceptions about volunteering in this area. Data were submitted to descriptive and content analysis methods. All participants provided informed consent with electronic signatures. RESULTS A total of 286 medical students subscribed to the Volunteering Program: 171 (60%) were men, 152 (53%) were enrolled in their 5th year of medical school, and 158 (55%) were 23-25 years old. One hundred and twelve (44%) students reported that they were motivated by altruistic reasons, 95 (37%) reported duty and 47 (19%) prioritized academic interests. Concerning CanMEDS competencies, 91 (36%) students' responses matched the Scholar component, followed by 51 (20%) with Collaborator, 49 (20%) with Professional, 32 (13%) with Communicator, 17 (7%) with Leader and 11 (4%) with Health Advocate. In focus groups, students reported the importance of management and leadership skills as a curricular component, motivations to volunteer, and acquired skills from volunteering in management and leadership-related activities, thereby indicating the development of resilient attitudes. CONCLUSIONS Students who participated in the School of Medicine of University of Sao Paulo (FMUSP) Volunteering Program reported being motivated to help others (altruistic reasons) and to serve society as future health professionals (duty). Knowledge and work-related competencies prevailed over leadership or soft skills, emphasizing the importance of including such activities in the curriculum. Participating in management-related activities could help develop a more resilient attitude toward medical training. Volunteering programs offer students opportunities to develop competencies essential for their roles as future health professionals. Thus, we should think about including such activities in the curricular structure.
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Affiliation(s)
- Marina Alves Martins Siqueira
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil.
| | - Matheus Belloni Torsani
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
| | - Gustavo Rosa Gameiro
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
| | - Lucas Albuquerque Chinelatto
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
| | - Bruna Chacon Mikahil
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
| | - Patricia Zen Tempski
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
| | - Milton A Martins
- Center for Development of Medical Education, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 455 Sala 2349, São Paulo, SP, ZIP code 01246-903, Brazil
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Achar Fujii RN, Kobayasi R, Claassen Enns S, Zen Tempski P. Medical Students' Participation in Extracurricular Activities: Motivations, Contributions, and Barriers. A Qualitative Study. Adv Med Educ Pract 2022; 13:1133-1141. [PMID: 36176420 PMCID: PMC9514135 DOI: 10.2147/amep.s359047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/17/2022] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Extracurricular activities in medical education are defined as any social, philanthropic, non-mandatory, and unpaid activities. These activities promote interactions between students and the community in ways that both provide care and create learning opportunities and experiences for both students and the community at large. This study elaborates on the motivational aspects, learnings, and barriers that occur when students participate in these activities. METHODS This is a cross-sectional study of medical students in their first to fifth years. Qualitative analyses have been used to understand the motivation, barriers, and contributions associated with extracurricular activities participation. RESULTS Of the 586 students enrolled in the medical course, 462 students agreed to participate in the research. The students reported that they were motivated to participate in contributing to society, support their professional choices, integrate their knowledge, gain life experience, develop communication and leadership skills, learn to work in a team, and become more responsible, empathetic, and resilient. Barriers to participation were the limited number of available positions, selection criteria, lack of support from those involved, personal issues, poor time management, risk of lowered academic performance, and lack of physical and financial resources. DISCUSSION Medical students are motivated to participate in Community-based extracurricular activities (CBEA) and this experience leads to improvement in the curriculum and can develop fundamental skills and attitudes such as leadership, commitment, and responsibility. To maximize the benefits of these activities, schools must support students and ensure that they have the time and chance to participate without physical strain, that were barriers mentioned by the academics.
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Affiliation(s)
- Renata Nunes Achar Fujii
- Centro de Desenvolvimento de Educação Médica (CEDEM), Universidade de São Paulo, São Paulo, SP, Brazil
- Municipal University of São Caetano do Sul, São Caetano do Sul, SP, Brazil
| | - Renata Kobayasi
- Centro de Desenvolvimento de Educação Médica (CEDEM), Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sylvia Claassen Enns
- Centro de Desenvolvimento de Educação Médica (CEDEM), Universidade de São Paulo, São Paulo, SP, Brazil
- Correspondence: Sylvia Claassen Enns, Centro de Desenvolvimento de Educação Médica (CEDEM), Universidade de São Paulo, Av. Dr. Arnaldo 455, 2 Floor, Room 2343, São Paulo, SP, Brazil, Tel +55(11) 3061 7472, Email
| | - Patricia Zen Tempski
- Centro de Desenvolvimento de Educação Médica (CEDEM), Universidade de São Paulo, São Paulo, SP, Brazil
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Abstract
The COVID-19 pandemic demanded a quick shift from presential to e-learning processes. Unlike planned e-learning programs, medical schools have had to quickly deliver the entire medical curriculum using remote strategies. This study aimed to perform a meta-synthesis of previous pandemic situations and describe the experience of the São Paulo University School of Medicine. We searched the Cochrane Central Register of Controlled Trials, Medline, EMBASE, Lilacs, Scopus, Web of Science, and ERIC, using the following keywords: ("SARS" OR "severe acute respiratory syndrome" OR "severe acute respiratory syndrome" OR "Middle East Respiratory Syndrome Coronavirus" OR "middle east respiratory syndrome*" OR "MERS-CoV" OR "Mers" OR "Middle Eastern Respiratory Syndrome*" OR "MERS-CoV*" OR "coronavirus" OR "Coronavirus Infections" OR "coronavirus*" OR "COVID-19" OR "2019-nCoV" OR "SARS-CoV-2") AND ("online education" OR "Education, Distance" OR "e-learning" OR "course online" OR "flipped classroom") AND ("lockdown" OR "social distance" OR "quarantine"). The endpoints were the online platforms used for online learning, the model of class, recorded versus online interaction, duration of online lectures, and students' and teachers' perceptions of online learning. We retrieved 38 records; only seven articles studied online education methods related to the pandemic and social distancing rules. The most frequently used online platform was Zoom®. The studies examined both synchronous and asynchronous approaches. There was no evidence regarding duration and students' and teachers' attitude. This study suggests that the online learning shift was feasible; however, because of the nature of the education shift (pandemic), future studies must further analyze the educational structure.
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Affiliation(s)
- Cristina Pires Camargo
- Laboratorio de Cirurgia Plastica e Microgirurgia (LIM-04), Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, SP, BR
| | | | - Fabio Freitas Busnardo
- Divisao de Cirurgia Plastica, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, SP, BR
| | | | - Rolf Gemperli
- Divisao de Cirurgia Plastica, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, SP, BR
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Siqueira MAM, Gonçalves JP, Mendonça VS, Kobayasi R, Arantes-Costa FM, Tempski PZ, Martins MDA. Relationship between metacognitive awareness and motivation to learn in medical students. BMC Med Educ 2020; 20:393. [PMID: 33126882 PMCID: PMC7602298 DOI: 10.1186/s12909-020-02318-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/03/2020] [Accepted: 10/20/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND In self-regulated learning, learning is defined as metacognitively guided, intrinsically motivated and strategic. In the context of medical education, the development of self-regulated learning can be associated with better academic and clinical performance. Hence, this report focuses on demonstrating the association between metacognitive awareness and motivation to learn among medical students in the clinical sciences portion of their education (3rd and 4th years of the medical programme) and characterizing medical students' motivational factors. METHODS We performed a cross-sectional study with a qualitative and quantitative approach involving medical students from the University of Sao Paulo (USP) in Brazil. We have selected validated self-report questionnaires for the evaluation of metacognition (the Schraw and Dennison Metacognitive Awareness Inventory - MAI) and motivation to learn (the Baranik, Barron and Finney Achievement Goals for a Work Domain - AGWD). MAI has two domains: knowledge about cognition and regulation of cognition. AGWD divides achievement goals into mastery approach, mastery avoidance, performance approach and performance avoidance goal orientations. We also performed a qualitative analysis based on an open-ended question: "What motivates me the most in medical training?" RESULTS One hundred eighty-five students completed the questionnaires: 103 (55.67%) were men, 110 (59.45%) were in their fourth year of the medical programme, and 152 (82.16%) were up to 24 years old. Only the knowledge about cognition domain of MAI was significantly associated with motivation to learn. We found that higher scores on the knowledge about cognition domain of MAI was associated with the mastery approach goal orientation (p = 0.003, median 0.71, IQR 0.23) and that lower scores on this same domain was associated with a mastery avoidance goal orientation (p = 0.034, median 0.65, IQR 0.14). The open-ended question showed that altruism, personal satisfaction, financial feedback, personal and supportive networks and graduating were motivational factors. CONCLUSIONS Metacognitive awareness and motivation to learn are closely related. This association may represent a potential target for the educational process, as deans and faculty can adopt strategies focused on promoting self-regulated learning concerning students' motivational factors. This could enhance academic outcomes and promote more enjoyable learning.
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Affiliation(s)
- Marina Alves Martins Siqueira
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Johnatan Padovez Gonçalves
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Vitor Silva Mendonça
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Renata Kobayasi
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Fernanda Magalhães Arantes-Costa
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
- Laboratorio de Terapeutica Experimental (LIM20), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Patricia Zen Tempski
- Center of the Development of Medical Education (CEDEM), School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Mílton de Arruda Martins
- Undergraduate Office of School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil.
- Department of Internal Medicine, School of Medicine, University of Sao Paulo, Av Dr Arnaldo, 455 Sala 1210, Sao Paulo, SP, CEP 01246-903, Brazil.
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Chinelatto LA, da Costa TR, Medeiros VMB, Boog GHP, Hojaij FC, Tempski PZ, Martins MDA. What You Gain and What You Lose in COVID-19: Perception of Medical Students on their Education. Clinics (Sao Paulo) 2020; 75:e2133. [PMID: 32667495 PMCID: PMC7337219 DOI: 10.6061/clinics/2020/e2133] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 06/17/2020] [Accepted: 06/26/2020] [Indexed: 11/22/2022] Open
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Kobayasi R, Tempski PZ, Arantes-Costa FM, Martins MA. Gender differences in the perception of quality of life during internal medicine training: a qualitative and quantitative analysis. BMC Med Educ 2018; 18:281. [PMID: 30477504 PMCID: PMC6260562 DOI: 10.1186/s12909-018-1378-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/06/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The higher level of participation by women in medicine may impact this profession's evolution due to gender differences perceived during medical school, after graduation and during residency. Gender differences regarding quality of life are associated with higher states of anxiety and depression among female physicians. We aimed to assess gender differences in the perception of quality of life with quantitative methods and to understand further, from the female residents´ point of view, the reasons that may influence the perception of quality of life using qualitative method. Resilience, empathy and daytime sleepiness were also scored. METHODS We performed a cross-sectional study with first-year internal medicine residents to evaluate self-reported quality of life factors specific to medical residents (VERAS-Q), including empathy (Jefferson Scale of Empathy), resilience (Wagnild and Young Brief Resilience Scale) and daytime sleepiness (Epworth Scale). We explored, from the female residents´ view which factors may influence the perception of quality of life using a focus group method. RESULTS In our study, one hundred and nine residents completed the survey: 31 (28.4%) were female and 78 (71.6%) were male. Female residents exhibited significantly lower scores than those of male residents for quality of life in the domains of time management (30.3, females vs 41.1, males; p < 0.001), psychology (48.1, females vs 56.7, males; p < 0.01) and physical health (42.8, females vs 53.6, males; p < 0.05). Female residents also scored higher for daytime sleepiness (13.0, females vs 9.0, males; p < 0.001), with pathological scores for daytime sleepiness. No significant gender differences were found in the resilience or empathy scores. The focus group assessment revealed difficulty in concentration and knowledge acquisition, insecurity, feelings of loss, greater critical perception, self-doubt and difficulty in creating effective bonds to support the training period as the main factors involved in the lower perception of quality of life among the women. CONCLUSIONS In conclusion, female residents had lower scores for quality of life and higher scores for daytime sleepiness. Measures to improve quality of life among female residents during this critical period of medical training might include investing in mentoring to help them better manage their time and encouraging activities that facilitate relationship development.
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Affiliation(s)
- Renata Kobayasi
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Zen Tempski
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Magalhâes Arantes-Costa
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Mílton Arruda Martins
- Faculty Development Center (CEDEM), School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Experimental Therapeutics (LIM 20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Enns SC, Perotta B, Paro HB, Gannam S, Peleias M, Mayer FB, Santos IS, Menezes M, Senger MH, Barelli C, Silveira PSP, Martins MA, Zen Tempski P. Medical Students' Perception of Their Educational Environment and Quality of Life: Is There a Positive Association? Acad Med 2016; 91:409-17. [PMID: 26556293 DOI: 10.1097/acm.0000000000000952] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE To assess perceptions of educational environment of students from 22 Brazilian medical schools and to study the association between these perceptions and quality of life (QoL) measures. METHOD The authors performed a multicenter study (August 2011 to August 2012), examining students' views both of (1) educational environment using the Dundee Ready Education Environment Measure (DREEM) and (2) QoL using the World Health Organization Quality of Life Assessment, abbreviated version (WHOQOL-BREF). They also examined students' self-assessment of their overall QoL and medical-school-related QoL (MSQoL). The authors classified participants' perceptions into four quartiles according to DREEM total score, overall QoL, and MSQoL. RESULTS Of 1,650 randomly selected students, 1,350 (81.8%) completed the study. The mean total DREEM score was 119.4 (standard deviation = 27.1). Higher total DREEM scores were associated with higher overall QoL and MSQoL scores (P < .001 for all comparisons) and younger ages (P < .001). Mean overall QoL scores were higher than MSQoL scores (mean difference, 1.35; 95% confidence interval [CI] 1.28-1.43; P < .001). Multinomial regression models showed significant dose-response patterns: Higher DREEM quartile scores were associated with better QoL. The psychological health domain of WHOQOL-BREF was most closely associated with DREEM scores (odds ratio 4.70; 95% CI = 3.80-5.81). CONCLUSIONS The authors observed a positive association between QoL measures and DREEM scores. This association had a dose-response effect, independent of age, sex, and year of medical training, showing that educational environment appears to be an important moderator of medical student QoL.
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Affiliation(s)
- Sylvia Claassen Enns
- S.C. Enns is a postdoctoral fellow, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. B. Perotta is assistant professor of embryology, Evangelical Medical School of Parana, Curitiba, Brazil. H.B. Paro is assistant professor of gynecology, School of Medicine, Federal University of Uberlandia, Uberlandia, Brazil. S. Gannam is assistant professor of pediatrics and primary care, School of Medicine, University of the City of São Paulo, São Paulo, Brazil. M. Peleias is a PhD student, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. F.B. Mayer is a PhD student, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. I.S. Santos is assistant professor of internal medicine, Department of Medicine, and staff member, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. M. Menezes is assistant professor of cardiology, Bahiana School of Medicine and Public Health, Salvador, Brazil. M.H. Senger is assistant professor of endocrinology, School of Medicine, Pontifical Catholic University of São Paulo, Sorocaba, Brazil. C. Barelli is assistant professor of public health, School of Medicine, University of Passo Fundo, Passo Fundo, Brazil. P.S.P. Silveira is assistant professor of medical informatics, Department of Pathology, and staff member, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. M.A. Martins is professor of medicine, Department of Medicine, and coordinator, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Brazil. P.Z. Tempski is chief, Down Syndrome Center, Institute of Rehabilitation, Clinics Hospital, and staff member, Center for Development of Medical Education, School of Medicine, University of São Paulo, São Paulo, Br
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