Twelve tips for having more meaningful conversations with medical students on specialty career choice

Making a career choice is a multifaceted process and support for medical students on career choice is pivotal. Not all medical schools have programs or guidelines to support having meaningful conversations with medical students. However, medical students have questions and are seeking answers. This article presents twelve tips for having meaningful conversations with medical students for educators, mentors and internship tutors. The twelve tips have been grouped into three categories: the conversation, the reflection and the actions students can take in the process of their specialty career choice.

The positive and negative consequences of stress and its relationship with coping in medical students: A qualitative study

Rates of mental health problems among medical students have prompted efforts to reduce stress during medical training. However, stress can be motivating and is a feature of clinical work. This qualitative study explores what makes an experience stressful, and how medical students respond to such experiences. In-depth interviews were conducted with a purposive sample of 15 medical students. Experiences were distressing when they threatened students' self-perception, goals or coping mechanisms, or when they reminded the student of distressing past events. Moderate stress was motivating and could build resilience. Students selected coping mechanisms based on their availability, acceptability, likely outcome and their previous experience of using these mechanisms. Social support, extra-curricular activities and exercise were helpful. High levels of distress, poor self-esteem and course factors, including remote placements, impaired engagement with coping strategies. Perception of stressors as being insurmountable or beyond one's control, led to increasing distress and the adoption of avoidant coping strategies. University strategies need to consider the beneficial effects of stress and seek to bolster coping resources as well as minimising unnecessary sources of stress.

Collaborative Development of an Electronic Portfolio to Support the Assessment and Development of Medical Undergraduates

This study outlines the development of an electronic portfolio (e-portfolio) designed to capture and record the overall academic performance of medical undergraduate students throughout their educational journey. Additionally, it facilitates the capture of narratives on lived experiences and sharing of reflections, fostering collaboration between students and their mentors.

A Call to Action: How Social Work Programs Can Respond to Student Food Insecurity

The COVID-19 pandemic exacerbated student food insecurity on college campuses and exposed the vulnerability of institutions with no food emergency response. During the COVID-19 pandemic and for years to come, the need for social work to lead efforts on college campuses to address student food insecurity is even greater. The need will continue to be significant for social workers in higher education to support students with basic needs, including resources for food, housing, childcare, and transportation. As has been true after other pandemics and economic downturns, professionally trained social workers are critical to brokering resources for individuals in crisis. This article critically examines the role of social work education in addressing the issue of student food insecurity. Through a conceptual lens, it explores the many dimensions of this problem and highlights vital contributions that social work can make within a higher education setting to alleviate food insecurity, enhance student well-being, and promote equitable opportunities for academic success.

Twelve tips to virtually operationalize co-creation of educational design

Co-creation is the active involvement of all stakeholders, including students, in educational design processes to improve the quality of education by embodying inclusivity, transparency and empowerment. Virtual co-creation has the potential to expand the utility of co-creation as an inclusive approach by overcoming challenges regarding the practicality and availability of stakeholders, typically experienced in face-to-face co-creation. Drawing from the literature and our experiences of virtual co-creation activities in different educational contexts, this twelve tips paper provides guidelines on how to effectively operationalize co-creation in a virtual setting. Our proposed three-phased approach (preparation, conduction, follow-up) might help those aiming to virtually co-create courses and programs by involving stakeholders beyond institutes and across borders.

Twelve tips to foster healthcare student recognition and reporting of unprofessional behaviour or concerns

Medical trainees and students are required to report concerns where they identify concerning practice or behaviours. While leadership attributes and skills are increasingly expected curricular outcomes, students still struggle to report concerns due to a variety of factors. Changing societal awareness and expectations continue to shine light on poor professionalism and unethical behaviours whose reach extends to medical training and education and that need to be systematically reported and addressed. To prepare graduates for these challenges in professional practice and for exercising skills of reporting concerns, education and training environments must ensure that speaking up is ingrained in the organisational ethos. Supported by evidence from the literature and our experience of revising and enhancing approaches, this paper outlines tips for developing and embedding an infrastructure that facilitates robust concerns reporting and management. Further, we consider mechanisms that support students to develop tendencies and skills for reporting concerns.

Enhancing Student Wellbeing Through Social Prescribing: A Rapid Realist Review

Objectives: A Rapid Realist Review of social prescribing in Higher Education (HE) was undertaken to determine what works, for whom, how, why, and within what circumstances. The review resulted in the development of a Realist Programme Theory articulating the way in which social prescribing can be implemented within the HE environment. Methods: Searches of 12 electronic databases were supplemented by citation chaining and grey literature surfaced by the Project Advisory Group. The RAMESES Quality Standards for Realist Review were followed, and the retrieved articles were systematically screened and iteratively analysed to develop Context-Mechanism-Outcome Configurations (CMOCs) and an overarching Realist Programme Theory. Results: A total of 57 documents were included. The overarching programme theory was developed from the analysis of these documents and comprised of a social prescribing pathway with the following components: (1) An Accessible Gateway, (2) A Skilled Peer, (3) Trusted-Safe-Credible Resources, and (4) A Healthy Setting. Conclusion: A Realist Programme Theory was developed-this model and associated principles will provide a theoretical basis for the implementation of social prescribing pathways within higher education. Whilst the direct project outputs are of particular significance to the UK HE audience, the underpinning principles can support practice within the global arena.

Twelve tips for developing active bystander intervention training for medical students

Healthcare experiences of mistreatment are long standing issues, with many not knowing how to recognise it and respond appropriately. Active bystander intervention (ABI) training prepares individuals with tools and strategies to challenge incidences of discrimination and harassment that they may witness. This type of training shares a philosophy that all members of the healthcare community have a role to play in tackling discrimination and healthcare inequalities. We developed an ABI training programme for undergraduate medical students, after recognising the need for this given the students' adverse experiences on clinical placements. From longitudinal feedback and robust observations of this programme, this paper intends to provide key learning lessons and guidance on how to develop, deliver and support faculty in facilitating these types of trainings. These tips are also accompanied by recommended resources and suggested examples.

Supporting Students with Disabilities during the COVID-19 Pandemic: The Perspective of Disability Resource Professionals

Utilizing national survey data, this paper details the academic and access challenges created by the pandemic for students with disabilities, as perceived by disability resource professionals. Data included in this paper capture disability support service challenges at two unique timepoints during the COVID-19 pandemic-May 2020 [n = 535] and January 2021 [n = 631]. Disability resource professionals reported there was difficulty in the initial months of the pandemic for students to provide documentation of a disability to receive accommodations, use assistive technology in the new remote academic setting, and receive testing accommodations within the remote environment. While access and resources improved for students with disabilities over time, a portion of the surveyed disability resource professionals noted no observed improvement in students' with disabilities communication with instructors as well as a worsening of conditions for students with disabilities throughout the pandemic related to access to counseling and mental health services. In addition to highlighting key obstacles faced by this student group during the pandemic, this paper provides recommendations and implications for institutions to better serve this student group, including how institutions of higher education can coordinate a holistic approach to support student mental health.

The relationship between medical students' empathy, mental health, and burnout: A cross-sectional study

OBJECTIVE

To investigate how medical students' empathy is related to their mental health and burnout.

METHODS

This cross-sectional study included 886 medical students from curriculum years 1-6. The cognitive, affective, and behavioural dimensions of empathy were measured with self-report questionnaires and an emotion recognition test. Regressions were used to test the relationship between the empathy dimensions, depressive symptoms, anxiety, and burnout as well as the influence of curriculum year and gender.

RESULTS

Cognitive and behavioural empathy were significantly related to less mental health issues and burnout, whereas affective empathy was related to more mental health issues and burnout. Students in later curriculum years reported less mental health issues and burnout than students in earlier years, whereas no systematic difference could be observed for empathy. Female students reported more mental health issues and burnout as well as higher empathy, except for behavioural empathy for which male students scored higher.

CONCLUSIONS

The cognitive, affective, and behavioural dimensions of empathy were differently related to the mental health and burnout of medical students. Students presenting mental health issues or burnout might have more difficulty to adapt their behaviour in social situations and keep a certain distance when taking others' perspective.

The Role of Educators in Supporting the Mental Well-being of Postgraduate Pharmacist Distance Learners

Frontline health care professionals have experienced rapid changes to workloads and work-related pressures during the COVID-19 pandemic, resulting in anxiety, depression, and mental health stressors. For working professionals engaged in postgraduate pharmacy distance learning, access to educators was seen as a means to relay some of these stories and offload the stress caused by these unprecedented circumstances. The postgraduate pharmacy education team at De Montfort University felt a moral responsibility to provide extra support and extended their roles toward offering greater well-being support. In this commentary, we detail the emergence of this new role and offer insights into how this was fashioned and its significance for catering to the mental health needs of pharmacists. This role has largely gone undetected, and research is needed to investigate the acceptability and feasibility of such a model and its plausibility and sustainability in the long-term.

Twelve tips for medical students experiencing an interruption in their academic progress

For every commencing cohort of medical students, a small but significant number will experience an interruption to their academic progression because of academic difficulties, health concerns or external influences outside of the students' control. During the process of researching the factors surrounding difficulties with academic progression, students told us many ways that they have learned from that experience, which then allowed most of them to graduate. This paper combines the shared experiences of students who have had an interruption, and those of the authors as medical educators.

Ethnicity-related stereotypes and their impacts on medical students: A critical narrative review of health professions education literature

BACKGROUND

Stereotypes are oversimplified beliefs about groups of people. Social psychology concepts and theories describing ethnicity-related stereotypes are well reported in non-medical educational settings. In contrast, the full impact of stereotyping on medical students, and the extent to which they were represented in health professions education (HPE) is less well-described. Using the lens of social psychological theory, this review aimed to describe ethnicity-related stereotypes about medical students portrayed in HPE literature and the impacts of those stereotypes.

METHODS

A critical narrative approach was undertaken. Social psychology concepts and theories were used as a framework through which to review the impacts of ethnicity-related stereotypes on medical students as described in HPE literature. A database search of Ovid MEDLINE, JSTOR, Project Muse, and PsychINFO was conducted to identify both theoretical and empirical articles relating to this topic in the HPE literature. Data was synthesised using thematic analysis, giving particular care to appraise the evidence from perspectives in social psychology.

FINDINGS

In HPE, the experiences and impact of stereotyping on learners from minority ethnic groups was explained by social psychology concepts such as stereotype threat, stereotype reactance, attributional ambiguity, self-fulfilling prophecy, stereotype boost, stereotype lift, and stereotype masking. Stereotype boost and stereotype lift were particularly described among students who identified as White, whereas stereotype threat was described more commonly among students from minority ethnics groups. The impact of stereotyping is not just on assessment, but may be across all teaching and learning activities at medical school.

INTERPRETATION

Social psychology concepts and theories can be used to describe the experience and impact of ethnicity-related stereotypes in HPE. Educators can better support learners from minority ethnic groups by self-reflecting over assumptions about individuals from minority ethnic groups, as well as minimise the impact of stereotyping and bias to create more inclusive learning environments.

Identifying stressor criteria that hinder or challenge junior clinical medical student learning

INTRODUCTION

What makes something a stressor within clinical students' education is unclear. Medical students moving from a predominantly protected classroom environment to a situated-work environment provided an ideal transition point to explore the criteria that might make a learning experience a stressor and whether these stressors hinder or challenge learning.

METHOD

Data on the stressors associated with learning experiences in clinical education were collected from New Zealand undergraduate medical students. Free text comments, in a survey-based questionnaire were supplemented by focus group data. Using inductive thematic analysis with grounded theory, themes were generated about the characteristics of stressors; referred to here as stressor criteria. These stressor criteria were then classified according to their impact on perceived learning.

RESULTS

Under the broad headings of the nature of the learning task, external factors, internal factors, and social interaction; 12 stressor criteria groupings were defined. Some of these criteria were a positive challenge to learning (e.g. legitimacy of the task, novelty of the learning, social interactions) and others a hindrance.

DISCUSSION

Not all stressors hinder learning. Instead, and depending on their nature, many result in perceived assistance to learning. Stressors hindering learning need to be recognised by the teacher, especially those that can be converted from a hindrance to an assistance.

When the wheels fall off - Medical students' experiences of interrupted academic progression

INTRODUCTION

There is limited published research on medical students' perspectives of a significant interruption to their academic progression. This study sought to identify the factors that contribute to difficulties with academic progression and to understand how medical students successfully respond.

METHODS

This interpretive phenomenological study reports on the findings from in-depth interviews of 38 final year medical students who had experienced a significant academic interruption.

RESULTS

The two superordinate themes were: the factors contributing to the interruption and their experience of the interruption. Factors identified as contributing to the interruption were: workload, learning in medicine, motivation for medicine, isolation, adapting to local culture, health and external factors. Their experience of the interruption focused on stages of working through the process: 'what happened,' 'how it felt,' 'managing the failure,' 'accepting the failure' and 'making some changes.'

DISCUSSION

Each factor affected how the participants reacted and responded to the interruption. Regardless of the origins of the interruption, most reacted and responded in a comparable process, albeit with varying timespans. These reactions and responses were in a state of fluctuation. In order to succeed many stated they shifted their motivation from external to internal, in direct response to the interruption, resulting in changed learning behaviours.

CONCLUSIONS

The process of working through an interruption to academic progression for students may benefit from a model of interval debriefing, restorative academic and personal development support. Facilitation of this process could enable students to face an interruption constructively rather than as an insurmountable emotionally burdensome barrier. Medical schools could utilise these findings to implement further support strategies to reduce the number of significant academic disruptions.

System dynamics modeling to understand mental model of public humiliation in medical education

BACKGROUND

Mistreatment in medical school is a wicked or complex problem demonstrating inter-relatedness and dynamicity of factors that affect students. Many studies have outlined the causes, perceptions, and negative consequences of mistreatment; however, a comprehensive mental model of public humiliation, the most common type of mistreatment, is still incomplete. This study aims to provide insight into the reasons why public humiliation in medical school continues to be a problem despite existing for decades, and to propose a shift in paradigm that potentially improve these incidents.

METHOD

A systems thinking approach is used to conceptualize related components of public humiliation and student behavior. System dynamics modeling was conducted through narrative review, developing a causal loop diagram (CLD), and validation of results with 60 medical students and 40 medical educators.

RESULTS

Findings from the narrative review outlined key variables, interconnections and five emerging themes: etiology, eustress, motivation, distress, and self-esteem. The themes were conceptualized and constructed into feedback loops as a basis for the CLD. Finally, the mental model proposes three major systems underlying the consequences. The "No Pain, No Gain" illustrates the perception that stress positively drives learning, while "Stress Overload" displays the negative consequences of public humiliation. Lastly, "The Delayed Side Effect" refers to long-term side-effects on self-esteem.

CONCLUSION

The mental model illustrates how public humiliation has both immediate and delayed side-effects, simultaneously succeeding and failing at motivating student growth. Therefore, public humiliation requires continuous changes in perspective along with multiple interventions to overcome the vicious cycle.

Making accommodations for medical students' long-term conditions in assessments: An action research guided approach

PURPOSE

There is an increase in medical students with long term conditions applying for accommodations in assessment. Medical school responses to such applications appear inconsistent, possibly reflecting insufficient guidance for policy. We aimed to inform an approach by developing guidance.

METHODS

Within a New Zealand and Australian context, we used a four-stage action research methodology: discussion with medical educators and survey of all 21 medical schools, including responding to 22 hypothetical scenarios; developing an approach; applying the approach to the hypothetical scenarios; and seeking feedback from stakeholders on the proposed approach.

RESULTS

Current practice varied among the 13 responding medical schools. Medical schools were consistent in their responses for 10 hypothetical scenarios but inconsistent in 12. An approach based on a matrix of authenticity to practice, including regulatory and employment factors, and feasibility to educational institutions was developed. This was applied to the hypothetical scenarios and highlighted how consistency could be better achieved, and where further discussion between regulators and employers might be needed.

CONCLUSION

This approach and the matrix based on authenticity and feasibility provides guidance to consider assessment accommodation applications. It highlights the need for discussions among regulators, employers, educational institutions and the disability sector.

Twelve tips to make successful medical infographics

In the health sciences, professionals must keep up to date to conduct their evidence-based practise. Hence, there is a growing need to share medical knowledge efficiently among healthcare professionals, patients, and undergraduate health science students. Infographics (text and image) are a hybrid element that serves to represent information in an attractive and meaningful visual format. Actually, with the use of the Internet and social networks, infographics have become a popular format for sharing medical information around the world.On the basis of a published literature review, we provide 12 tips in this article to make a successfully health-related infographic with the aim of assisting clinicians, educators, and researchers in their task of communicating and transforming complex information into a visual, attractive, didactic and shareable format.By following these basic recommendations, it is possible to improve the dissemination of scientific and health-related knowledge to different audiences who can benefit from infographics.

Predicting failure before it happens: A 5-year, 1042 participant prospective study

PURPOSE OF THE ARTICLE

Students who fail assessments are at risk of negative consequences, including emotional distress and cessation of studies. Identifying students at risk of failure before they experience difficulties may considerably improve their outcomes.

METHODS

Using a prospective design, we collected simple measures of engagement (formative assessment scores, compliance with routine administrative tasks, and attendance) over the first 6 weeks of Year 1. These measures were combined to form an engagement score which was used to predict a summative examination sat 14 weeks after the start of medical school. The project was repeated for five cohorts, giving a total sample size of 1042.

RESULTS

Simple linear regression showed engagement predicted performance (R²_adj = 0.03, F(1,1040) = 90.09, p < 0.001) with a small effect size. More than half of failing students had an engagement score in the lowest two deciles.

CONCLUSIONS

At-risk medical students can be identified with some accuracy immediately after starting medical school using routinely collected, easily analysed data, allowing for tailored interventions to support students. The toolkit provided here can reproduce the predictive model in any equivalent educational context. Medical educationalists must evaluate how the advantages of early detection are balanced against the potential invasiveness of using student data.

Emotional intelligence, burnout, and professional fulfillment in clinical year medical students

BACKGROUND

Emotional intelligence (EI) has been associated with decreased burnout in surgical residents but has not been extensively studied in medical students. We hypothesized that higher EI would lead to decreased levels of burnout among medical students at a US medical school.

METHODS

The authors administered three separate EI measures and compiled an EI score by adding the normalized score on each test. These measures were the DRS-15, the Grit Scale, and the Reading the Mind Between the Eyes Quiz. The Professional Fulfillment Index (PFI) was used to determine levels of burnout experienced two weeks before survey completion.

RESULTS

The population included 68 medical students. PFI and EI scores were positively correlated (R = 0.55, p < .001). The separate EI measures indicated that both Grit (R = 0.43, p < .001) and DRS-15 (R = 0.56, p < .001) were correlated with PFI. The Eyes Quiz did not show a significant correlation with PFI (p = .2).

CONCLUSIONS

The results confirmed our hypothesis that EI would be correlated with decreased levels of burnout among this group of students. Some areas of potential future study include whether these same results hold true at other medical schools and if improving EI has a benefit of decreasing burnout.

Learner involvement in the co-creation of teaching and learning: AMEE Guide No. 138

This AMEE guide aims to emphasize the value of active learner involvement in the design and development of education, referred to as co-creation, and provides practical tips for medical educators interested in implementing co-created educational initiatives at their own institutions. Starting with definitions of co-creation and related terms, we then describe its benefits and summarize the literature in medical and higher education to provide an appropriate context and a shared mental model for health professions educators across the world. Potential challenges and barriers to implementation of co-creation in practice are described in detail from the perspective of learners, teachers, and institutions. Challenges are linked to relevant principles of Self-Determination Theory, Positioning Theory and theory on Psychological Safety, to provide direction and fundamental reasons for implementation of co-creation. Finally, solutions to listed challenges and practical approaches to education design and implementation using co-creation are described in detail. These tips include strategies for supporting learners and teachers in the process, enhancing the collaboration between them, and ensuring appropriate support at the organizational level.

Promoting University Students' Mental Health: A Systematic Literature Review Introducing the 4M-Model of Individual-Level Interventions

Objective: The purpose of this study is to systematically review recently published individual student-level interventions aimed at alleviating the burden of mental health challenges faced by the students and/ or at equipping them with coping mechanism that will foster their resilience. Methods: This study relied on a systematic literature review. PubMed dataset was used; the search was confined to the following period: July 2016-December 2020. Results: A total of 1,399 records were identified by the electronic search, out of which 40 studies were included in this study. The authors inductively identified four overlapping categories of interventions across all included articles, and coded them as follows: Mindfulness, Movement, Meaning, and Moderator. Accordingly, each study was linked to at least one of four overlapping categories based on the nature of the intervention(s) under investigation, leading to differing assortments of categories. Conclusions: The 4M-Model generated by this study encourages focusing on devising holistic, university-based interventions that embrace the individuality of students to improve their mental health through elements of mindfulness, movement, meaning, and moderator. Through this focused approach, university counselors are enabled to design interventions that address students' physical, psychological, emotional, and social needs.

'Five hours to sort out your life': qualitative study of the experiences of university students who access mental health support

BACKGROUND

Previous qualitative research suggests that university students feel that current service provision does not meet their needs. Exploring the reasons for this may help to promote service change, encourage the uptake of care, improve outcomes and increase satisfaction within university services.

AIMS

This study aimed to improve the understanding of how students experience the process of accessing and using mental health support, barriers and facilitators to treatment, and how students would adapt provision to improve experiences.

METHOD

Semi-structured interviews were conducted with 16 full-time students who had used mental health services at university. Data were analysed using thematic analysis.

RESULTS

Five higher-order themes were identified: personalisation and informed choice, simplifying the process, feeling abandoned ignored or invisible, stigma, and superiority of private and external services. Sixteen subthemes were identified within these themes.

CONCLUSIONS

Findings indicate that access to mental health support should be simplified, with collaboration across university and external health and care services, to prevent students feeling lost or abandoned when seeking care. An inclusive approach to support access and provision of services for all presentations of mental health problems should be developed.

Mindfulness-based mobile app reduces anxiety and increases self-compassion in healthcare students: A randomised controlled trial

OBJECTIVE

To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students.

METHODS

The authors conducted a single-blind, randomised controlled trial with three parallel groups. Participants were allocated to the mobile app, the in-person mindfulness-based program (IMBP), or a control group. Assessments at baseline and postintervention (8 weeks) included measures of anxiety, empathy, self-compassion, and mindfulness.

RESULTS

Of 168 students randomised, 84 were analysed on an intention-to-treat basis (app: n = 31; IMBP: n = 23; control: n = 30). The mobile app group showed a large effect size for reductions in trait anxiety compared with controls (g = 0.85, p = 0.003), and a medium, nonsignificant effect compared with the IMBP group (g = 0.52, p = 0.152). Participants from both interventions experienced a significant increase in self-compassion and mindfulness compared with controls. Levels of empathy remained unchanged for the 3 arms.

CONCLUSIONS

A mobile app can be as effective as an IMBP in reducing anxiety and increasing self-compassion and mindfulness among healthcare students.

Implementing programmatic assessment transforms supervisor attitudes: An explanatory sequential mixed methods study

INTRODUCTION

Programmatic assessment (PA) is an increasingly popular approach to competency-based assessment (CBA), yet evaluation evidence is limited. This study aimed to identify and explore supervisor attitudes before and after implementing a novel PA using a sequential explanatory mixed methods design. In phase one, a survey was used to identify supervisor perspectives on work-based placements, PA and CBA. Survey results were then applied to develop focus group questions to further explore supervisor attitudes.

RESULTS

PA was found to improve supervisor-student relationships by removing high-stakes assessment decisions and creating greater capacity for feedback and teaching, leading to a productive learning environment. Assessment was perceived as an important role and supervisors wanted to feel valued and heard within PA. Trust was conceptualised as a triad between supervisor, student and university, and enabled supervisors to engage with PA which was important for success. Supervisor learning of PA was experiential and often supported by students, highlighting the need for hands-on training.

CONCLUSION

Participants reported a high level of agreement with PA and CBA principles which may have made them amenable to educational change. Further research is needed to explore the experience of all stakeholders and to understand how worldviews and culture influence assessment initiatives.

The Roles of Campus Ministry Leaders: Guiding Students through the Transition to Adulthood

Despite historic existence of campus ministries at universities, little is known about the roles of campus ministry leaders. This research explored campus ministry leaders' engagement with students through interviews (n = 19). Analysis indicated interviewees' work includes building relationships with students, navigating the secular context of a public university, and tensions with others in campus ministry. Interviewees reported emotional strain resulting from extensive caring labor. Focused support for campus ministers would benefit both leaders and students.

Student support system for medical undergraduates: A qualitative exploration of stakeholder perspectives

BACKGROUND

The demands and learning challenges in medical schools are not efficiently overcome by all learners. Despite the gravity of the problem, there is a dearth of studies to identify, define, and address the needs of learners. Thus, the present study was designed to do a situational analysis to identify and define the problems of learners and to develop a model for student support system in our institution.

MATERIALS AND METHODS

A phenomenological type of qualitative research was undertaken. One-to-one in-depth interviews (IDIs) were conducted, 10 each among undergraduate medical students, faculties and parents (n = 30) to understand the problems of students and their suggested solutions from each one's perspective. The interviews were audio-recorded, transcribed verbatim, and manual thematic analyses were performed.

RESULTS

Manual thematic analysis of the transcripts yielded 16 subcategories and 7 categories. The various categories that emerged are (1) curriculum related; (2) interpersonal adjustment problems; (3) personal issues and family problems; (4) cognitive learning disabilities; (5) poor organizational skills; (6) students' lack of motivation; and (7) miscellaneous. Based on the problems and their suggested solutions, a model for the essential components of a student support system for our college was developed. It outlines the principal roles of four key stakeholders, namely students, faculties, parents, and college administration.

CONCLUSION

It has been found that students face various academic problems, personal, interpersonal and family level issues. We developed the support system model suitable for our context. In future, it may be implemented and evaluated to check if it achieves the desired purpose.

Transitioning into an online dental hygiene degree-completion program

PURPOSE

The University of British Columbia's (UBC) Dental Hygiene Degree-Completion (DC) program has offered an academic pathway for dental hygienists to earn a degree exclusively through an online delivery format since 2006. The students' experiences transitioning to online learning and related student support needs have not been previously studied. Thus, this study investigated students' experiences as they entered an online dental hygiene DC program METHODS: An online survey with open-ended and closed-ended questions was distributed to all 53 currently enrolled dental hygiene DC students in September 2019 RESULTS: Thirty-two students completed the survey for a 60% response rate. Most student respondents (78%) had no prior experience with online education. Only 59% of respondents were confident in their abilities to navigate a Web-based learning environment. Three-quarters (75%) of respondents felt like a valued member of the Faculty of Dentistry community but only 47% felt they belonged to the larger university community. Most (72%) were familiar with the support resources within the Faculty but fewer than half (41%) were aware of additional resources outside of the Faculty. Students aged 30 years and older felt more comfortable reaching out to faculty and staff members (90% vs. 55%; P = 0.05). Students with prior online learning experience were more aware of student support resources outside of the Faculty (57% vs. 36%; P = 0.05) CONCLUSION: Lessons learned from this study have informed several recommendations to better support student transition to online learning that can be applicable to this program and in other institutions.

Measuring mental health and well-being of South African undergraduate students

BACKGROUND

Increased investment in optimal student mental health and well-being has been noted by universities around the world. Studies show the need for contextually relevant, granular understandings of specific aspects of student mental health and well-being.

METHODS

A survey was conducted at two time points - at the beginning and end of the academic year - at a large, urban university in South Africa. The Mental Health Continuum-Short Form, the Flourishing Scale, and the Fragility of Happiness Scale were used in the testing of undergraduate students from a variety of scientific disciplines. Two separate comparisons were made, based on the baseline data (n = 551) and the follow-up data (n = 281). In Comparison 1 (baseline, n = 443; follow-up, n = 173), two independent, biographically (very) similar groups were compared. Comparison 2 (n = 108) compared the results from the baseline and follow-up of the same group of students who completed the instruments at both time points.

RESULTS

Results indicate a significant decline in mental health and well-being for both groups (independent and dependent) over the course of the academic year. Both follow-up groups were found to have lower psychological, emotional and social well-being, psychological flourishing, and reduced mental health, in comparison with the baseline groups.

CONCLUSIONS

The statistically significant decreases in the mental health and well-being of participants in this study indicate the need for substantive interventions to support student mental health and well-being. Strong foci for well-being interventions should include self-efficacy, sense of direction, meaning and creating a sense of belonging.

Perfectionism as a mediator of psychological distress: Implications for addressing underlying vulnerabilities to the mental health of medical students

OBJECTIVE

Medical students have personalities that are often shown to be perfectionistic. Perfectionism can manifest as maladaptive and lead to psychological distress. This study examined the mediating role of perfectionism on the association between personality trait profiles and levels of psychological distress.

METHODS

First-year medical students completed a questionnaire containing measures of personality, perfectionism (Concern over Mistakes: CoM), stress, anxiety and depression. Latent profile analysis classified students based on their personality traits and identified a profile vulnerable to psychological distress. Structural equation models examined the mediation effects of perfectionism on the relationship between the vulnerable personality profile and distress.

RESULTS

The sample totalled 376 (84% response). The vulnerable personality profile was highest in Harm Avoidance, lowest in Self-Directedness, and significantly correlated with the highest Perfectionism-CoM. High Perfectionism-CoM was associated with the highest levels of stress, anxiety and depression. Perfectionism-CoM was a significant mediator for the relationship between personality and higher levels of psychological distress.

CONCLUSION

Certain personality profiles are predisposed to psychological distress such as anxiety, stress and depression. Perfectionism, as a mediator between personality and psychological distress, may be a target strategy to help increase students' self-acceptance, and self-awareness of their perfectionistic tendencies and lower their vulnerability to poor mental health.

A framework to understand the needs of the medical students of the future

Purpose: Medical education is undergoing curricular reform driven by internal needs and external pressures. Concurrently, medical students are changing. More diverse student bodies, particularly those from underrepresented minorities, bring different skill sets, needs and priorities to their medical school education. Here we present their voices.Methods: In order to explore the stories, needs and motivations of future physicians, we conducted a small-scale study of students from diverse backgrounds in US medical schools. Our interviews revealed two core themes about medical school: (1) that medical school is an extreme physical and emotional challenge for all students, and (2) that medical school education consists of multiple conflicting goals. Combining the two themes provides a descriptive topology of student's motivations and strategies for getting through medical school. Using this framework, we deconstruct the experience of medical school to reveal the gaps and misalignments between the traditional system of medical education and what medical students want, expect and need to be successful.Conclusions: We discuss the implications of our research and this framework for curricula and the learning environment with a particular focus on (1) cooperative learning and social interdependence theory and (2) an expanded understanding of diversity and the needs of under-represented students.

An analysis of resilience in dental students using the Resilience Scale for Adults

OBJECTIVES

Resilience is the ability to bounce back or recover from major life stressors. The aim of this study was to investigate resilience in dental students and how it may or may not vary across demographic characteristics such as gender, socioeconomic status, race/ethnicity, self-reported health, and parental educational level.

METHODS

Data were collected from 151 dental students at Virginia Commonwealth University School of Dentistry with an anonymous survey that included the Resilience Scale for Adults (RSA) and various demographic variables. Associations between RSA and variables of interest were assessed using linear models.

RESULTS

Dental students demonstrated relatively high levels of resilience. Resilience was significantly associated with gender (with females showing more resilience than males (P = 0.0395)), race (P = 0.0025), overall health (P = 0.0101), and mental health (P < 0.0001). Results from Exploratory Factor Analysis (EFA) supported a 5-factor solution that explained 82.6% of the variability of resilience in the sample of dental students. The 5 factors were nearly identical to the 5 subscales originally described by the RSA demonstrating validity in this population. Overall health ratings were significantly related to resilience, suggesting that perceived resilience in dental students may protect against negative health outcomes. This study can inform internal and external support systems of dental students as well as institutional programmatic development to better support their educational experiences.

American Indian Social Work Students: Factors that Influence Success in Graduate School

Introduction: Many barriers exist for American Indian/Alaska Native (AI/AN) students pursuing advanced degrees. The Brown School at Washington University in St. Louis has a higher than average graduation rate for AI/AN students. The purpose of this article is to understand the lived experiences of AI/AN students at the Brown School and how the experiences influence graduation rates.Methods: This study collected data from Brown School alumni who were associated with the Buder Center between 1991 and 2013; nine interviews were analyzed.Results: Six themes were identified: 1) AI/AN student cohort, 2) social work skill development, 3) service to AI/AN communities and people, 4) success as balance, 5) cultural identity, and 6) resiliency.Discussion: Institutional supports were described by participants as factors that affected their success in the program; these combined with student characteristics, beliefs and attitudes influenced the high rate of AI/AN student graduates at the Brown School.

The Research, Advising, and Mentoring Professional: A Unique Approach to Supporting Underrepresented Students in Biomedical Research

As a pilot intervention strategy to support undergraduate students, especially rural and Alaska Native students who are pursuing biomedical science research and career trajectories, we have developed a unique, mid-level Research, Advising, and Mentoring Professional (RAMP) position. In this article we outline the reasons for creating this position, RAMP qualifications, training, duties, and differences between RAMP and other positions typically found in higher education. Additionally, we discuss the evolution of the position and why it may be of interest to other institutions as they address similar issues involving students from underrepresented groups. Preliminary survey and focus group data from students mentored directly by RAMPs indicated that the holistic advising approach of RAMPs has had a positive impact on student experiences by supporting persistence in degree programs and providing psychosocial support of both personal and professional development.

Mentoring Clinical-Year Medical Students: Factors Contributing to Effective Mentoring

THEORY

Academic mentoring is an effective method of enhancing undergraduate medical student academic performance, research productivity, career planning, and overall satisfaction.

HYPOTHESES

This study investigates the relationship between mentor characteristics and mentee academic performance, with an emphasis on identifying students who need special support.

METHODS

A cross-sectional study was conducted among fourth-year medical students at King Abdulaziz University Faculty of Medicine undertaking the clinical skills module (CSM) rotation. Mentors included senior and junior faculty members from the Department of Internal Medicine and the Department of Family Medicine. King Abdulaziz University Faculty of Medicine assigned 1 mentor for every 10 medical students. We organized our mentoring program in the following format: (1) an initial group meeting (mentor with all 10 medical students) and (2) subsequent one-on-one meetings (mentor with each mentee alone). We assessed mentor characteristics, student academic performance and satisfaction, and the rate of mentees referred for special support.

RESULTS

A total of 184 students completed the CSM rotation. Among these, 90 students responded to the preprogram survey, with 83% reporting that mentoring was important to them. Group meetings and one-on-one meetings were attended by 60% and 49% of all students, respectively. The most frequent type of support required by the participating students was psychological support (12% of mentees). Participation in the mentoring program had no significant effect on student academic performance. Mentor seniority (P = .024) and motivation (P = .002) were significantly associated with the rate of student referral for special support.

CONCLUSIONS

This study demonstrated that academic mentoring can be effective in enhancing student outcomes and promoting special support for students. Moreover, mentor and mentee motivation were found to be essential elements of a successful mentoring program.

Supporting mentors working with students with intellectual disabilities in higher education

Project Panther LIFE is an inclusive postsecondary transition program for students with intellectual disabilities providing university access and participation with the primary goal of employment at program completion. Students in the program receive support from their academic mentors and peer coaches during the academic year. This study examines the skills and activities mentors use during their weekly sessions with students with intellectual disabilities and identifies areas in which mentors may require further support or training. Data analysis revealed major themes related to inclusion, self-determination, and adaptive behavior skills. Upon review of the data, we suggest that mentors need ongoing support from transition programs especially in areas related to encouraging self-advocacy and supporting time management.

A model to support nursing students with dyslexia

Dyslexia is one of the most commonly declared disabilities in higher educational institutions in the UK. This article explores the effects of specific learning difficulties, in particular dyslexia, on pre-registration nursing students on practice placements in clinical environments. The author proposes use of the OPEL model, which provides a simple, structured framework for supporting nursing students with specific learning difficulties in practice placements. This model could be applied to clinical situations where constructive support is necessary to enable the student to achieve the standards and requirements set by the Nursing and Midwifery Council.

How Does Student Educational Background Affect Transition into the First Year of Veterinary School? Academic Performance and Support Needs in University Education

The first year of university is critical in shaping persistence decisions (whether students continue with and complete their degrees) and plays a formative role in influencing student attitudes and approaches to learning. Previous educational experiences, especially previous university education, shape the students' ability to adapt to the university environment and the study approaches they require to perform well in highly demanding professional programs such as medicine and veterinary medicine. The aim of this research was to explore the support mechanisms, academic achievements, and perception of students with different educational backgrounds in their first year of veterinary school. Using questionnaire data and examination grades, the effects upon perceptions, needs, and educational attainment in first-year students with and without prior university experience were analyzed to enable an in-depth understanding of their needs. Our findings show that school leavers (successfully completed secondary education, but no prior university experience) were outperformed in early exams by those who had previously graduated from university (even from unrelated degrees). Large variations in student perceptions and support needs were discovered between the two groups: graduate students perceived the difficulty and workload as less challenging and valued financial and IT support. Each student is an individual, but ensuring that universities understand their students and provide both academic and non-academic support is essential. This research explores the needs of veterinary students and offers insights into continued provision of support and improvements that can be made to help students achieve their potential and allow informed "Best Practice."

Stress among Isfahan medical sciences students

BACKGROUND

This study was undertaken to determine the prevalence of psychological stress among Isfahan medical sciences students.

METHODS

Cross-sectional, questionnaire-based survey was carried out among the 387 medical sciences students (medicine, pharmacy, and dentistry) of Isfahan, Iran through census. In academic year 2010-2011, Kessler-10 questionnaire was given to the students a month before semester examinations. Scores ≥20 were considered as indicative of positive stress symptoms.

RESULTS

The overall prevalence of stress among medical sciences students was found to be about 76.1%. The prevalence of stress among medicine students was 22.7% mild, 23% moderate and 21.4% severe while 32.8% showed no stress. The prevalence of stress among pharmacy students was 22.22%, 22.22%, 26.19%, and 29.36% mild, moderate, and severe and no stress, respectively. The prevalence of stress among dentistry students was 25% mild, 27% moderate, and 10% severe while 37.5% showed no stress. The prevalence of stress was higher (70.6%) in pharmacy students when compared with medicine (66.1%) and dentistry (62.5%) students. The odds of student having stress is higher in dentistry students (OR: 1.44, P= 0.33), where as the odds are decreasing in pharmacy student (OR: 1.16, P=0.66). There is no statistically significant association between gender, ages, and term and having stress symptoms.

CONCLUSIONS

The high level of stress necessitates interventions like social and psychological support to improve the student's well-being. A prospective study is needed to study the association of psychological morbidity with sources of stress and coping strategies.

Graduate entry medicine: high aspirations at birth

Four-year fast-track courses for graduates started in the UK in 2000, and are now offered at 14 UK medical schools. Graduate entry medicine (GEM) started five years earlier in Australia, and of course in the USA it has been the norm for students to begin studying medicine after university graduation. This paper reviews the aspirations for GEM and looks at the early evidence on delivery against those aspirations. Particular reference is made to the experience at Warwick Medical School which was one of the two pioneers of GEM in the UK, has the largest GEM intake and continues to admit only graduates.