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Talberg H, Dayaram T, Geel S, Mthembu S, Nthangeni R, Pillay S, Burgess TL. Undergraduate students' choices around community service and internship: A single faculty study. S Afr J Physiother 2024; 80:1980. [PMID: 38725968 PMCID: PMC11079367 DOI: 10.4102/sajp.v80i1.1980] [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] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/19/2024] [Indexed: 05/12/2024] Open
Abstract
Background The Internship and Community Service Programme (ICSP) places newly graduated health professionals for a compulsory training period. Universities adopt multiple strategies to encourage students to select rural placements for ICSP. Objectives This study describes ICSP choices among final-year MBChB and Health and Rehabilitation Science students at a South African university and the factors influencing their decisions. Method A cross-sectional qualitative descriptive study was conducted using a self-developed online questionnaire. Eighty-five final-year students were recruited. Results Most respondents (n = 38, 45.8%) chose the Western Cape (WC) as their first choice placement. There was a significant difference between MBChB and other health science students' choice of level of healthcare (χ = 10.39, p = 0.006), with MBChB less likely to choose primary healthcare (PHC) level placements. District and tertiary care options were perceived as better sites for learning and practice, while PHC and rural sites, considered underresourced and understaffed, were avoided. Although MBChB students indicated a lower preference for rural placements, this was not significant.Factors influencing ICSP application decisions included professional support, work environment, and social and personal considerations. Conclusion Students' placement choices were based on their perceptions of clinical exposure, learning opportunities, mentorship and supervision. Placements closer to home were preferred. UG clinical exposure and rural background seem to have some impact on choice but need further investigation. Clinical implications Universities should continue to explore ways to improve students' readiness for practice in underresourced settings. Improved exposure to rural and PHC sites during training could encourage better uptake during ICSP placement.
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Affiliation(s)
- Heather Talberg
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tamara Dayaram
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sarah Geel
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sivuyile Mthembu
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Rofhiwa Nthangeni
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Savannah Pillay
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Theresa L. Burgess
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Cecilio-Fernandes D, Steenhof N, Sandars J. The challenge of transfer to clinical practice: The illusion of learning and illusion of teaching. Med Teach 2024:1-2. [PMID: 38460499 DOI: 10.1080/0142159x.2024.2323243] [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] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
There is increasing pressure to accelerate health professions education programs and educators have the challenge of ensuring that students can effectively transfer their learning into clinical practice. In this personal view, we discuss how insights from cognitive science can inform the redesign of current curricula and highlight the challenge of implementing these new approaches for instructional design and assessment. We also recommend that educators disseminate the important lessons learned from their endeavors.
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Affiliation(s)
- Dario Cecilio-Fernandes
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Naomi Steenhof
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, UK
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Weimer JM, Widmer N, Strelow KU, Hopf P, Buggenhagen H, Dirks K, Künzel J, Börner N, Weimer AM, Lorenz LA, Rink M, Bellhäuser H, Schiestl LJ, Kloeckner R, Müller L, Weinmann-Menke J. Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study. Tomography 2023; 9:1315-1328. [PMID: 37489472 PMCID: PMC10366829 DOI: 10.3390/tomography9040104] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. METHODS From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". RESULTS Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. CONCLUSIONS Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Nina Widmer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Kai-Uwe Strelow
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Paula Hopf
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Klaus Dirks
- Department of General Internal Medicine and Geriatrics, Rems-Murr-Klinikum, 71364 Winnenden, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Norbert Börner
- Gastroenterological Medical Group Offices at the MED Specialist Centre Mainz, 55131 Mainz, Germany
| | - Andreas Michael Weimer
- Centre of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, 69118 Heidelberg, Germany
| | - Liv Annebritt Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, 55112 Mainz, Germany
| | - Lina Judit Schiestl
- Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes-Gutenberg University Mainz, 55131 Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, 23583 Lübeck, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Julia Weinmann-Menke
- I. Department of Medicine, University Medical Centre of the Johannes Gutenberg University-Mainz, 55131 Mainz, Germany
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Mergoni G, Citterio I, Toffoli A, Macaluso GM, Manfredi M. How Is Endodontics Taught in Italy? A Survey of Italian Dental Schools. J Clin Med 2022; 11:jcm11237190. [PMID: 36498763 PMCID: PMC9738303 DOI: 10.3390/jcm11237190] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of our study was to investigate how endodontics is taught in Italian universities. An online survey was conducted from August to December 2021. A comparison between courses led by full or associate professors (Group 1) versus courses led by other figures, such as researchers or temporary lecturers (Group 2), was made. A total of 28 out of 36 schools participated (78%). In most schools, endodontics is taught in the fifth year to 15-29 students. All schools planned pre-clinical endodontic training, and in 25/28 schools (89.3%), clinical endodontic training was also provided. The course programs varied among schools, and significantly more hours were allocated to teaching nonsurgical root canal treatment in Group 1 schools than in Group 2 schools. The average numbers of hours of preclinical and clinical training were 34.3 ± 23.6 and 84.1 ± 76.7, respectively. All schools used rotary NiTi files in their clinical training, and the vertical condensation of hot gutta-percha was the most frequently taught obturation technique. As expected, the scenario of endodontic education in Italian universities was variable and needs harmonization. Courses led by full or associate professors seem to be better structured.
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Hmoud AlSheikh M, Zaini RG, Iqbal MZ. Developing and Mapping Entrustable Professional Activities with Saudi Meds Competency Framework: A Consensus Study. Adv Med Educ Pract 2022; 13:1367-1374. [PMID: 36330463 PMCID: PMC9624166 DOI: 10.2147/amep.s379184] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE This study aimed at developing a national consensus on entrustable professional activities (EPAs) for Saudi undergraduate medical education and mapping them with the "Saudi Meds" competency framework. METHODS A three phased approach was used. Phase 1 consisted of identifying and developing EPAs; Phase 2 consisted of building a national consensus on developed EPAs (validation process); and Phase 3 consisted of mapping the validated EPAs with the Saudi Meds competency framework. Nominal group and modified Delphi techniques were used to develop consensus on EPAs. Classical test theory-based item analysis was conducted to establish validity and reliability of finalized EPAs. RESULTS Fifteen expert medical educationists and 109 academic leaders from 23 medical schools participated in the validation process. The study achieved a consensus on 10 core EPAs with an overall reliability (Cronbach's Alpha) of 0.814. The item-total correlation ranged from 0.341 to 0.642. CONCLUSION This study results in a national consensus on generic, comprehensive and region-specific EPAs that have been mapped with Saudi Meds competency framework. Our study is the first step in the direction of facilitating EPA-based curricular reforms in Saudi medical schools.
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Affiliation(s)
- Mona Hmoud AlSheikh
- Medical Education Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rania G Zaini
- Medical Education Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Muhammad Zafar Iqbal
- Medical Education Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ibrahim K, Ahmad‐Annuar A. COVID-19 pandemic: Lessons learned for undergraduate research training. Biochem Mol Biol Educ 2022; 50:476-478. [PMID: 36054325 PMCID: PMC9537806 DOI: 10.1002/bmb.21665] [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: 12/07/2021] [Revised: 07/25/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
This article reports a session from the virtual international 2021 IUBMB/ASBMB workshop, "Teaching Science on Big Data." The awareness of using publicly available research data sets for undergraduate training is low in certain parts of the world. Final year projects always revolve around wet-lab based projects. The challenges occur during COVID-19 pandemic when it forces full lockdown to the nation, but at the same time faculty members need to provide consistent training to the students and projects to work with. We aim to identify supervisors in the faculty that are ready to convert their proposed project from wet-lab to an online-based project. As coordinators of the course we created an online survey to identify projects that can be converted into dry-lab/online projects. Our surveys identified only 32.5% projects implemented dry-lab/online based projects. Most academicians described that they are not ready or familiar to apply changes for their research design. With the unknown future of the world living with COVID-19 and directional changes of life science research toward big data driven research indeed we should be ready to adopt such changes. Awareness on reusing public data sets as tools for research should be provided to strengthen undergraduate training. Life science undergraduates should be exposed to reusing public data sets as these materials are readily available case studies that allow in depth exploration to answer specific research questions. Members of the faculty should take part to pave the way for them, ensuring that they understand that life science research revolves around a multidisciplinary field.
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Affiliation(s)
- Kamariah Ibrahim
- Department of Biomedical Science, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Azlina Ahmad‐Annuar
- Department of Biomedical Science, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
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Klemmt C, Backhaus J, Jeske D, Koenig S. Psychometric Properties and Calibration of the SPOREEM (Students' Perception of the Operating Room Educational Environment Measure). J Surg Educ 2021; 78:1151-1163. [PMID: 33168469 DOI: 10.1016/j.jsurg.2020.10.015] [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: 06/09/2020] [Revised: 08/31/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The experience in the operating room is considered as a crucial element affecting medical students' satisfaction with workplace-based training in surgery. We developed the "Students' Perception of the Operating Room Educational Environment Measure" (SPOREEM) and applied the approach of Item Response Theory to improve accuracy of its measurement. DESIGN Psychometric analysis determined the factorial structure. Using Item Response Theory, item thresholds were calculated on response option levels. Sum scores in the factors were then computed using calibrated unit weights. SETTING One hundred medical students from the University Medical Center in Goettingen, Germany, enrolled in a one-week surgery rotation completed the SPOREEM. RESULTS The final 19-item questionnaire resulted in 3 factors: "Learning support and inclusion" (1), "Workplace atmosphere" (2), and "Experience of emotional stress" (3). Item calibration resulted in refinement of sum scores in the factors. Male students significantly rated factor 1 more positively. Factor 2 was perceived to a similar degree in all 3 surgical disciplines involved. Factor 3 was rated lower by those students planning a surgical field of postgraduate training. CONCLUSIONS We developed a valid, reliable, and feasible tool to assess the overall educational climate of undergraduate training in the OR. Calibration of items refined the measurement.
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Affiliation(s)
- Chantal Klemmt
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany.
| | - Joy Backhaus
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany
| | - Debora Jeske
- School of Applied Psychology, University College Cork, Cork City, Ireland
| | - Sarah Koenig
- Institute of Medical Teaching and Medical Education Research, Wuerzburg, Germany
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Malik-Tabassum K, Lamb JN, Chambers A, West R, Pandit H, Aderinto J. Current State of Undergraduate Trauma and Orthopaedics Training in United Kingdom: A Survey-based Study of Undergraduate Teaching Experience and Subjective Clinical Competence in Final-year Medical Students. J Surg Educ 2020; 77:817-829. [PMID: 32217124 DOI: 10.1016/j.jsurg.2020.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 10/08/2019] [Revised: 12/20/2019] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the quality and duration of trauma and orthopedics (T&O) training in medical schools in United Kingdom (UK), and to evaluate final-year students' self-perceived level of competence in essential T&O skills. DESIGN This was a survey-based study of final-year medical students that attended 1-day undergraduate T&O courses held between Feb'17 and Feb'19. Outcome measures were duration and perceived quality of undergraduate T&O placements, students' self-rated competence in essential T&O skills, and impact of teaching methods on their subjective future competence. SETTING Four courses held at education centers in 3 different locations in UK (London, Nottingham, and Leeds) PARTICIPANTS: All 414 course attendees from 13 UK medical schools completed the questionnaire. RESULTS 19.3% of students had not experienced a placement in T&O. Mean duration of T&O placements was 2.5 weeks. 37.4% described their training as "poor". Majority of students attended 1-5 sessions of: lectures (50.5%), small group teaching (58.7%), trauma meetings (58.7%), clinics (65.7%), and theatres (72.5%). Lowest competency scores were reported in management of T&O emergencies, fracture management, and interpretation of T&O radiographs. Self-rated competence in essential T&O skills was significantly higher in students with previous experience of a T&O placement (p < 0.05). There was a strongly positive correlation between small group teaching attendance and perceived competence in management of T&O patients in different clinical settings (p < 0.001). CONCLUSIONS Medical schools in UK are currently failing to adequately train medical graduates to manage T&O patients, with students reporting low competency scores in all basic T&O skills. To mitigate the current situation, a minimum duration of a T&O placement for all students must be implemented nationally. Educational boards and medical schools must work in collaboration to improve the delivery of undergraduate T&O curriculum, the structure of the clinical T&O placement, and efficacy of the commonly encountered learning environments.
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Affiliation(s)
- Khalid Malik-Tabassum
- Specialty Registrar Trauma and Orthopaedics, Conquest Hospital, East Sussex Healthcare NHS Trust, Hastings, United Kingdom.
| | - Jonathan N Lamb
- Specialty Registrar Trauma and Orthopaedics, Clinical Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Alastair Chambers
- Foundation Doctor, University Hospital Lewisham, London, United Kingdom
| | - Robert West
- Professor of Biostatistics, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Hemant Pandit
- Professor of Orthopaedic Surgery, Head of Research, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Joseph Aderinto
- Trauma & Orthopaedic Consultant, Leeds General Infirmary, Leeds, United Kingdom
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Lee KS, Priest S, Wellington JJ, Owoso T, Osei Atiemo L, Mardanpour A, Craft Z, Blencowe N, Hinchliffe RJ. Surgical Skills Day: Bridging the Gap. Cureus 2020; 12:e8131. [PMID: 32550051 PMCID: PMC7294894 DOI: 10.7759/cureus.8131] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The General Medical Council (GMC) requires all newly qualified doctors to be competent in certain surgical skills, including the provision of basic wound closure. Yet there is a profound lack of undergraduate competence in, and exposure to, basic surgical skills such as wound closure. The Surgical Skills Day (SSD) aimed to provide medical students with additional skills training. Methods Student self-assessment and instructors’ assessment forms were completed prior to and following a workshop on basic wound closure skills. Paired t-tests was used to statistically compare the two pre and post-instruction data sets. Results A total of 46 students attended the SSD; 29 consented to the skills assessment. 100% (n = 29) self-reported improved competency in at least one of the skills following tuition (p < 0.001). Instructors’ assessment agreed that 100% (n = 29) of students improved in at least one of the skills assessed (p < 0.001). 100% of the attendees agreed that additional practical surgical skills should be incorporated into the undergraduate curriculum. 64% (n = 21) of students also confirmed that they were more likely to pursue a career in surgery following the SSD. Conclusion Current clinical teaching in basic suturing is unsuitable for long term retention. SSDs can improve skills acquisition and elevate student confidence. This data builds on our previous work by documenting the high efficacy in skills acquisition as a result of SSD tuition. We recommend that SSDs be integrated into medical school curricula in order to address shortcomings in current undergraduate programmes.
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Affiliation(s)
- Keng Siang Lee
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Sebastian Priest
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | | | - Toluwaniyin Owoso
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Leyln Osei Atiemo
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Ameen Mardanpour
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Zachary Craft
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Natalie Blencowe
- Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, GBR
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Hari R, Kälin K, Harris M, Walter R, Serra A. Comparing Blended Learning with Faculty-Led Ultrasound Training: Protocol for a Randomised Controlled Trial (The SIGNATURE Trial). Praxis (Bern 1994) 2020; 109:636-640. [PMID: 32517596 DOI: 10.1024/1661-8157/a003497] [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] [Indexed: 06/11/2023]
Abstract
Background: Ultrasound is increasingly used in clinical practice as a bedside tool. As medical graduates first encounter the technique in early residency, ultrasound training needs to be integrated into the undergraduate curriculum. In Switzerland, abdominal ultrasound skills have been taught by a faculty-led, 21-hour course. However, this course does not have sufficient capacity to meet the increasing demand, and there have been doubts about its effectiveness as a teaching method. We therefore developed a 21-hour blended-learning course, comprising five hours of e-learning and 16 hours of near-peer tutoring. This study investigates whether this new teaching format is as good as, or superior to, the faculty-led method. Methods: The SIGNATURE study is an investigator-initiated, two-arm, randomised controlled trial, enrolling 152 medical students at the Universities of Bern, Fribourg and Zurich. Stratified by study site, students are 1:1 randomised to either the blended-learning course or the faculty-led 2.5-day ultrasound course. Students undergo a six-station objective structured clinical examination (OSCE) and complete an online questionnaire immediately after the course and 6 months later. Discussion: If demonstrated to be effective, the blended-learning course would allow an increase in the number of undergraduate medical students that can acquire ultrasound skills before starting their residencies.
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Affiliation(s)
- Roman Hari
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Kaspar Kälin
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Michael Harris
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
- College of Medicine & Health, University of Exeter, UK
| | - Robin Walter
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Andreas Serra
- Clinic of General Internal Medicine and Nephrology, Klinik Hirslanden Zurich, Switzerland
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Ives K, Becker PJ, Lippi G, Krüger C. Do medical students feel career ready after their psychiatry clinical rotation? S Afr J Psychiatr 2019; 25:1397. [PMID: 31824744 PMCID: PMC6890537 DOI: 10.4102/sajpsychiatry.v25i0.1397] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 10/03/2019] [Indexed: 11/01/2022] Open
Abstract
Background In the South African healthcare system, mentally ill patients first come into contact with primary care physicians who then refer these patients for specialised care if needed. Medical students therefore need to acquire the knowledge, skills and confidence to treat mentally ill patients. Aim To evaluate the perceptions of medical students regarding their career readiness as doctors after their clinical rotation in psychiatry. Setting The University of Pretoria, South Africa. Methods Data were collected retrospectively from questionnaires completed by final year medical students from 2011 to 2015. These data were analysed overall and by year using Chi-square tests and regression analyses (N = 770). Results Overall, 93.10% of medical students felt adequately prepared for their role as medical practitioners after their clinical rotation in psychiatry. The proportion of medical students exposed to post-traumatic stress disorder (p = 0.012), obsessive-compulsive disorder (p = 0.006) and alcohol-use disorder (p = 0.046) was found to vary significantly by year. Exposure to any one psychiatric condition did not influence perceptions of career preparedness. Students perceived themselves to be career ready if they had sufficient exposure to mentally ill patients, knowledge about prescribing appropriate psychiatric medication and especially psychiatric interviewing skills. Conclusion Students who completed practical and clinical training in psychiatry perceived themselves to be career ready.
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Affiliation(s)
- Kim Ives
- Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Piet J Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Gian Lippi
- Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Christina Krüger
- Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Bonvin R, Nendaz M, Frey P, Schnabel KP, Huwendiek S, Schirlo C. Looking back: twenty years of reforming undergraduate medical training and curriculum frameworks in Switzerland. GMS J Med Educ 2019; 36:Doc64. [PMID: 31815174 PMCID: PMC6883239 DOI: 10.3205/zma001272] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/03/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
Introduction: To date, hardly any reports exist that outline the reforms in medical studies in Switzerland from the first partial reforms in the 1970s until today. Methods: This article outlines the recent history of medical curricula, their reforms in the early 1970s and, based on these, the key reasons for the major curricular reforms of the 2000s from the perspective of the authors. Results: The various projects, initiatives and legislative elements at the national level include the introduction of new quality control instruments - federal examination and programme accreditation, the introduction of a national catalogue of learning objectives and its two follow-up editions, as well as the implementation of the Bologna reform in undergraduate medical curricula. Examples of the key new elements found in all medical training in Switzerland include: the interdisciplinary orientation of learning content in organ and functional system-oriented subject areas or modules, the enhanced valorisation of practical clinical training, as well as the introduction of problem-oriented formats and the integration of partly formative, partly summative exams according to the format of the objective structured practical examination (OSCE). Characteristics unique to the four medical faculties and their medical training programme are also highlighted. Discussion: The described projects, initiatives and legislative elements have led to a dynamic, continuous development of medical curricula in Switzerland. The close cooperation between the faculties and the Federal Office of Public Health (FOPH) has also resulted in a redefinition of the roles and responsibilities of universities and the Federal Government according to the new Law on Medical Professions. This guarantees the medical faculties a great deal of autonomy, without neglecting quality assurance.
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Affiliation(s)
- Raphael Bonvin
- Universität Fribourg, Unité Pédagogie Médicale, Fribourg, Switzerland
| | - Mathieu Nendaz
- Hôpitaux Universitaires Genève, Institut de médecine de premier recours, Genève, Switzerland
| | - Peter Frey
- Universität Bern, Medizinische Fakultät, Studiendekanat, Bern, Switzerland
| | - Kai P. Schnabel
- Universität Bern, Institut für medizinische Lehre, Abteilung für Unterricht und Medien, Bern, Switzerland
| | - Sören Huwendiek
- Universität Bern, Institut für medizinische Lehre, Abteilung für Assessment und Evaluation AAE, Bern, Switzerland
| | - Christian Schirlo
- Universität Zürich, Geschäftsstelle Direktorium UMZH, Medizinische Fakultät, Geschäftsbereich Struktur & Entwicklung, Zürich, Switzerland
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Beck S, Schirlo C, Breckwoldt J. How the Start into the Clinical Elective Year Could be Improved: Qualitative Results and Recommendations from Student Interviews. GMS J Med Educ 2018; 35:Doc14. [PMID: 29497699 PMCID: PMC5827187 DOI: 10.3205/zma001161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/25/2017] [Accepted: 08/17/2017] [Indexed: 05/10/2023]
Abstract
Background: Entering the Clinical Elective Year (CEY) is a challenging transition phase for undergraduate medical students. Students become members of a professional team, thereby taking over certain tasks, which are executed more or less independently. Factors which facilitate (or impede) this transition in the perception of students are not well described. We therefore wanted to explore, what students perceived to be helpful during the first phase of the CEY and possibly derive respective recommendations. Methods: We conducted semi-structured interviews with 5th year medical students after they had completed the first two months of their CEY. Students were asked which problems they had faced and how they felt prepared for the CEY. Interviews were audio-recorded, transcribed, and analysed by qualitative content analysis. Results: From 34 interviews, we included 28 into analysis. Overall, 24 students were satisfied or very satisfied with their start into the CEY. Satisfaction was expressed with respect to workplace experiences, learning progress, responsibilities and team integration. Especially, students appreciated if they were integrated as active members of the team, were given responsibility for certain units of work, and received well-structured formal teaching and supervision. Students had divergent opinions about the quality of teaching and supervision, about their own achievements, and the recognition they received. Students recommended improvements in respect to formal teaching and supervision by clinical supervisors, preparation of the CEY by university, and supporting structures in the hosting institution. Conclusion: Students in this study were generally satisfied with the first two months of their CEY. Facilitating factors were active and responsible involvement into routine patient care, and high quality formal teaching and supervision. Findings may inform universities, teaching hospitals, and students how to better shape the first phase of the CEY.
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Affiliation(s)
- Samuel Beck
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
| | - Christian Schirlo
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
| | - Jan Breckwoldt
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
- *To whom correspondence should be addressed: Jan Breckwoldt, University of Zurich, Faculty of Medicine, Dean`s Office, Pestalozzistr. 3-5, CH-8091 Zurich, Switzerland, Tel.: +41 (0)44/634-1075, Fax: +41 (0)44/634-1088, E-mail:
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Kalbfuss NP, Deanus LJ. Reflection on the dual-field adult and child nursing degree course. Nurs Stand 2017; 31:48-51. [PMID: 28677454 DOI: 10.7748/ns.2017.e10319] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In 2011, the University of Southampton commenced a four-year undergraduate nursing degree course that resulted in students gaining dual-field registration in adult and child nursing. In this article, the authors reflect on their experience of being part of the first cohort of students in the UK to graduate from the dual-field adult and child nursing degree course. They identify the benefits and challenges of pioneering the new course and explore how it shaped their experience of becoming newly registered nurses. They also emphasise the potential contribution of dual-registered nurses to enhancing care and discuss whether the dual-field course should be widely available.
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Affiliation(s)
- Natacha Pauline Kalbfuss
- Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Lauren Jayne Deanus
- Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, England
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Dube S, Underwood S, Murdoch-Eaton D. Developing Enterprise Skills in Undergraduate Medical Students: A Mixed-methods Evaluation. J Med Educ Curric Dev 2015; 2:JMECD.S31238. [PMID: 35187251 PMCID: PMC8855412 DOI: 10.4137/jmecd.s31238] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Support for the development of enterprise skills in medical education exists from the perspectives of educators, researchers, and healthcare leaders. However, literature is limited evaluating the understanding of medical students about these skills. This study aimed to determine whether medical students valued gaining enterprise skills within the course and those skills that they identified and recognized contributed to enterprise practice in subsequent training. METHODOLOGY Quantitative and qualitative evaluations were undertaken for over three years. Students completed end-of-course evaluations (n = 895) in 2011 and 2012, responding to closed questions utilizing a Likert scale. Subsequent qualitative reflections were collected by interviews one year later with nine students and eight supervisors. RESULTS Immediately after course completion, students gave positive feedback, identifying the development of independent learning, creativity, and reflection, as these enterprise skills were most valued. However, in subsequent reflection one year later, they were unable to transfer the acquired knowledge and identify the examples of enterprise around them in their later experiences and had mixed beliefs about its value in medicine. CONCLUSION Enterprise skills need to be revisited explicitly throughout the medical curriculum, with authentic real-life examples, to sustain students' understanding about the role of enterprise in medicine.
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Affiliation(s)
- Sharul Dube
- St James University Hospital, Leeds Teaching Hospitals, Leeds, UK
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Wilson DS, Fang B, Dalton WS, Meade C, Koomen JM. An ET-CURE pilot project supporting undergraduate training in cancer research, emerging technology, and health disparities. J Cancer Educ 2012; 27:418-27. [PMID: 22528637 PMCID: PMC3439555 DOI: 10.1007/s13187-012-0362-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 05/24/2023]
Abstract
The National Cancer Institute's Center to Reduce Cancer Health Disparities has created pilot training opportunities under the "Continuing Umbrella of Research Experiences" program that focus on emerging technologies. In this pilot project, an 18-month cancer biology research internship was reinforced with: instruction in an emerging technology (proteomics), a transition from the undergraduate laboratory to a research setting, education in cancer health disparities, and community outreach activities. A major goal was to provide underrepresented undergraduates with hands-on research experiences that are rarely encountered at the undergraduate level, including mentoring, research presentations, and participation in local and national meetings. These opportunities provided education and career development for the undergraduates, and they have given each student the opportunity to transition from learning to sharing their knowledge and from being mentored to mentoring others. Here, we present the concepts, curriculum, infrastructure, and challenges for this training program along with evaluations by both the students and their mentors.
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Affiliation(s)
- Danyell S. Wilson
- Health Outcomes and Behavior, Moffitt Cancer Center
- Molecular Oncology, Moffitt Cancer Center
| | - Bin Fang
- Proteomics, Moffitt Cancer Center
| | | | - Cathy Meade
- Health Outcomes and Behavior, Moffitt Cancer Center
| | - John M. Koomen
- Molecular Oncology, Moffitt Cancer Center
- Experimental Therapeutics, Moffitt Cancer Center
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Abstract
BACKGROUND The present study aims at understanding the attitude of the undergraduate medical students toward psychiatry, mental health and psychiatric disorders and their treatment. MATERIALS AND METHODS This was a cross-sectional descriptive study. The study involved random distribution of the questionnaire to the participants in an institute's festival. The authors utilized a semi-structured questionnaire to evaluate the perceptions, attitudes and beliefs of the undergraduate students to psychiatry, mental health and psychiatric disorders. The data were analyzed using the statistical package for social sciences version 10.0 software. The analysis involved descriptive analysis of the data. RESULTS AND CONCLUSIONS A total of 210 of people responded to the questionnaire given to them. Of these, 164 were considered for further analysis as the rest had not provided the complete background information or the questionnaire was not completed. The undergraduate medical students had multiple lacunae in their knowledge toward psychiatry, psychiatric disorders, psychiatric patients and psychiatric treatment. A potential contributory fact could be the neglect of psychiatry as a discipline at the undergraduate level. The undergraduate medical students had multiple lacunae in their knowledge toward psychiatry, psychiatric disorders, psychiatric patients and psychiatric treatment.
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Yadav T, Arya K, Kataria D, Balhara YPS. Impact of psychiatric education and training on attitude of medical students towards mentally ill: A comparative analysis. Ind Psychiatry J 2012; 21:22-31. [PMID: 23766574 PMCID: PMC3678174 DOI: 10.4103/0972-6748.110944] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A number of studies from the western world have explored the negative beliefs held by individuals towards people with mental illness. The knowledge of attitude and awareness of undergraduate medical students towards psychiatry, mental health and mental disorders is of utmost importance. OBJECTIVE The current study aims at assessment of attitudes of medical students towards mental illness and mentally ill. MATERIALS AND METHODS The study used a cross-sectional survey design. The instruments used included Beliefs toward Mental Illness (BMI) scale, Attitudes to Mental Illness Questionnaire (AMIQ). ANOVA was carried out to compare the in between group differences for the four study groups. Additionally Bonferroni correction was used to conduct the post hoc analysis. RESULTS The interns were significantly more likely to agree with the statement that the mental disorders are recurrent; less likely to be of thought that the behavior of people with mental disorders is unpredictable; more likely to disagree with the fact that diagnosis of depression as described in the case vignette was going to damage the career of the individual; more likely to agree with the option of inviting a depressed person to a party; more likely to believe in fact that mentally ill individuals are more likely to be criminals as compared to medical students in different professional years. CONCLUSIONS Adequate modifications to existing medical curriculum would help improve attitude of medical students towards mentally ill.
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Affiliation(s)
- Tarun Yadav
- Department of Psychiatry and De addiction, Lady Hardinge Medical College and Smt SK Hospital, New Delhi, India
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Bindu A, Rao TSS, Ashok NC, Prabhakar AK, Manickam LSS. Identifying the 'mentally disabled' in the community: How much more is to be imparted to the internees in training? Indian J Psychiatry 2011; 53:53-6. [PMID: 21431010 PMCID: PMC3056190 DOI: 10.4103/0019-5545.75562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Studies have been conducted on the skills of physicians in general hospitals in identifying mental disorders,but there are no studies assessing the proficiency of internees in identifying mental disorders. AIM To confirm the diagnosis of the cases identified by 40 internees in the community as 'mentally disabled'. MATERIALS AND METHODS Of 15,583 people,29 were identified in the community by the internees as 'mentally disabled'. This was followed by home visits to the houses of these 29 individuals conducted by two qualified psychiatrists and one clinical psychologist, and these cases were screened for their psychiatric status using MINI Plus. RESULTS Most of the cases identified by internees as having 'mental disability' were cases of mental retardation and the others were mood and psychotic disorders and epilepsy. Cases of mental retardation and mental disorders other than those identified by the internees could also be identified while visiting the respective geographical areas. CONCLUSIONS There is a need to hone the skills of the medical students during the course of their training in identifying cases of mental retardation, severe as well as minor psychiatric disorders, as a part of their training. There is also a need for the use of structured scales for the same.
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Affiliation(s)
- Annigeri Bindu
- Department of Psychiatry, JSS Medical College Hospital, JSS University, Mysore, India
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