Prevalence of Disability and Use of Accommodation Among US Allopathic Medical School Students Before and During the COVID-19 Pandemic.
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ABSTRACT:
SUBMITTER: Pereira-Lima K
PROVIDER: S-EPMC10267761 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
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Prevalence of Disability and Use of Accommodation Among US Allopathic Medical School Students Before and During the COVID-19 Pandemic.
Pereira-Lima Karina K Plegue Melissa A MA Case Ben B Swenor Bonnielin K BK Herzer Kurt K Betchkal Rylee R Meeks Lisa M LM
JAMA network open 20230601 6
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Project description:Despite guidelines for pathology undergraduate medical education set forth by the Association of American Medical Colleges, American Medical Association, Liaison Committee on Medical Education, and Commission on Osteopathic College Accreditation, there is sparse literature regarding differences in pathology curricula between allopathic and osteopathic institutions. As programs alter curricula to adapt to the ever-increasing breadth and depth of medical knowledge, there is concern for lost educational opportunities in pathology and a growing need for research on the landscape of pathology undergraduate medical education in medical schools nationwide. An Institutional Review Board approved, voluntary 22-item survey regarding pathology curricula was distributed to allopathic and osteopathic medical school students at Michigan State University from July 2022 to January 2023. The total number of responses was 363 (n = 363; 22.6% allopathic, 77.4% osteopathic). We present data on pathology education at a university that features both an allopathic and osteopathic college of medicine while focusing on factors that influence medical students' perceptions of pathology. Statistically significant differences (P≤0.05) in responses-favoring Michigan State University osteopathic students over their allopathic counterparts-were observed in several areas: the perception of pathology as a medical versus surgical specialty (P 0.014), acknowledgement of a dedicated pathology course (P 0.002), and awareness of pathology-specific content (P < 0.001). Allopathic students expressed a greater desire for pathology exposure (P 0.003). This study highlights the variable exposure of pathology between two different curriculums and suggests that, while traditionally primary-care-focused, osteopathic medical programs may offer stronger pathology education and exposure.
| S-EPMC11880694 | biostudies-literature
Project description:The SARS-CoV-2 pandemic has highlighted the crucial role of pathologists in the health care system at a time of significant decline in the number of US medical students matching to pathology residency positions. To understand this decline, a national survey of fourth-year US allopathic medical students was conducted to assess experiences, knowledge, and attitudes of pathology and factors that impact specialty choice. Participating in a separate pathology course did not increase the probability of choosing pathology. Experiences significantly associated with choosing pathology included clinical or research opportunities in pathology during the last 2 years of medical school, autopsy observation/participation, and participation in pathology interest groups. Many respondents felt they were not sufficiently exposed to pathology to consider it as a specialty. Those who considered pathology but did not choose it were less likely to report understanding the activities of pathologists and being recruited by pathology faculty and more likely to express a preference for more direct patient contact as compared to those entering pathology. In general, respondents agreed that pathology has a good work-life balance and a satisfying degree of intellectual challenge. On the other hand, respondents generally agreed that information on social media and perception of the pathology job market do not seem to be positive and few agreed that pathology is a highly regarded specialty. We identify steps to address these issues and increase the number of US medical students choosing pathology as a specialty crucial to the future of medicine and public health.
| S-EPMC7557358 | biostudies-literature
Project description:AimUnderstanding how medical students perceive emergency medical care is important in promoting education and recruitment in the field of emergency medicine. This study aimed to clarify the perceptions of undergraduate medical students on emergency medical care with a focus on comparing their perceptions before and during the coronavirus disease 2019 (COVID-19) pandemic.MethodsFourth-year undergraduate medical students were invited to complete a self-administered questionnaire in 2017 and 2020. Free comments on emergency medical care were analyzed via text mining. The relationships among categorical words were evaluated via correlation matrix and correspondence analysis.ResultsThe number of written words per student were not significantly different between 2017 (4.9 ± 3.4) and 2020 (5.3 ± 4.1). In 2017, the most frequently used word was "busy," and the words "patients," "life," and "care" were not related to each other significantly. In 2020, the frequency of the word "busy" decreased and the word "patients" was related to "life" (P < 0.01) and "care" (P < 0.01). In the correspondence analysis, seven words including "life" and "care" were associated with "patients," which demonstrates that these words tended to occur together.ConclusionsAlthough the responses of the medical students regarding emergency medical care before and during the COVID-19 pandemic included similar words, their expressions tended to be related to patient care or patient life during the pandemic. This change in perception might cultivate a sense of mission and responsibility and an interest in emergency medical care among medical students.
| S-EPMC8987347 | biostudies-literature
Project description:BackgroundStudents in half of US medical schools do not receive formal instruction in providing medical care for people with disabilities. To address this gap in training, our medical school developed several strategies, including a session for second year medical students to address communication skills, knowledge, and attitudes relevant to delivering healthcare for people with disabilities. Here, our objective was to explore perceptions of people with spinal cord injury (SCI) who participated in the session on its content and structure.MethodsQualitative research using a focus group of people with SCI who participated in an educational session for medical students in an LCME accredited allopathic US medical school. A purposive sample of adults with SCI (N = 8) participated in a focus group. Data were analyzed using a six-phase thematic analysis.ResultsParticipants favorably viewed the educational session, felt their participation was valuable, and had suggestions for its improvement. Four major themes were identified: (1) session format, content; (2) addressing student discomfort and avoidance behaviors; (3) increasing student knowledge and preparation; and (4): important lessons from discussions of past and role-played doctor-patient interactions.ConclusionsFirst-person input from people with SCI is critical to improve medical education and healthcare provision to the SCI community. To our knowledge, this is the first study to report feedback from stakeholders providing specific recommendations for teaching disabilities awareness to undergraduate medical students. We expect these recommendations to be relevant to the SCI and medical education communities in improving healthcare for people with SCI and other disabilities.
| S-EPMC10328920 | biostudies-literature
Project description:ImportanceDermatology is one of the least diverse specialties, while patients from minority racial and ethnic groups and other underserved populations continue to face numerous dermatology-specific health and health care access disparities in the US.ObjectivesTo examine the demographic characteristics and intended career goals of graduating US allopathic medical students pursuing careers in dermatology compared with those pursuing other specialties and whether these differ by sex, race and ethnicity, and/or sexual orientation.Design, setting, and participantsThis secondary analysis of a repeated cross-sectional study included 58 077 graduating allopathic medical students using data from the 2016 to 2019 Association of American Medical Colleges Graduation Questionnaires.Main outcomes and measuresThe proportion of female students, students from racial and ethnic groups underrepresented in medicine (URM), and sexual minority (SM) students pursuing dermatology vs pursuing other specialties. The proportions and multivariable-adjusted odds of intended career goals between students pursuing dermatology and those pursuing other specialties and by sex, race and ethnicity, and sexual orientation among students pursuing dermatology.ResultsA total of 58 077 graduating students were included, with 28 489 (49.0%) female students, 8447 (14.5%) URM students, and 3641 (6.3%) SM students. Female students pursuing dermatology were less likely than female students pursuing other specialties to identify as URM (96 of 829 [11.6%] vs 4760 of 27 660 [17.2%]; P < .001) or SM (16 [1.9%] vs 1564 [5.7%]; P < .001). In multivariable-adjusted analyses, students pursuing dermatology compared with other specialties had decreased odds of intending to care for underserved populations (247 of 1350 [18.3%] vs 19 142 of 56 343 [34.0%]; adjusted odd ratio [aOR], 0.40; 95% CI, 0.35-0.47; P < .001), practice in underserved areas (172 [12.7%] vs 14 570 [25.9%]; aOR, 0.40; 95% CI, 0.34-0.47; P < .001), and practice public health (230 [17.0%] vs 17 028 [30.2%]; aOR, 0.44; 95% CI, 0.38-0.51; P < .001) but increased odds of pursuing research (874 [64.7%] vs 29 121 [51.7%]; aOR, 1.76; 95% CI, 1.57-1.97; P < .001) in their careers. Among students pursuing dermatology, female, URM, and SM identities were independently associated with increased odds of caring for underserved populations (eg, URM: aOR, 4.05; 95% CI, 2.83-5.80) and practicing public health (eg, SM: aOR, 2.55; 95% CI, 1.51-4.31). URM students compared with non-URM students pursuing dermatology had increased odds of intending to practice in underserved areas (aOR, 3.93; 95% CI, 2.66-5.80), and SM students compared with heterosexual students pursuing dermatology had increased odds of intending to become medical school faculty (aOR, 1.60; 95% CI, 1.01-2.57), to pursue administrative roles (aOR, 1.60; 95% CI, 1.01-2.59), and to conduct research (aOR, 1.73; 95% CI, 1.01-2.98).Conclusions and relevanceThe findings of this cross-sectional study suggest that diversity gaps continue to exist in the dermatology workforce pipeline. Efforts are needed to increase racial and ethnic and sexual orientation diversity and interest in careers focused on underserved care and public health among students pursuing dermatology.
| S-EPMC9669921 | biostudies-literature
Project description:ImportanceAccording to the National Residency Matching Program's biennial Charting Outcomes in the Match (NRMP ChOM) reports, the mean number of research items of matched allopathic dermatology applicants has nearly tripled since 2007, rising from 5.7 to 14.7. Research items are self-reported by applicants and serve as an approximation of research output. Because the NRMP research items field is unverified and reported as an aggregate of several different research pursuits, it may not be an accurate representation of applicant research output.ObjectiveTo determine if the rise in NRMP-reported data is associated with a rise in verifiable, indexed publications from matched allopathic dermatology applicants from 2007 to 2018.Design, setting, and participantsCross-sectional study including a bibliometric analysis on accepted applicant research output among 2234 matched allopathic dermatology applicants, with a total of 6229 publications, in dermatology residency programs for the years 2007, 2009, 2011, 2014, 2016, and 2018.Main outcome and measuresThe primary outcomes were the mean number of peer-reviewed indexed publications and mean number of NRMP ChOM research items. Secondary outcomes assessed the quality of indexed publications by analyzing article type and journal of publication.ResultsFrom 2007 to 2018, the mean number of indexed publications per matched dermatology applicant increased from 1.6 to 4.7 (203% increase). Indexed publications consistently compose a minority of NRMP ChOM research items (28.8% across the 6 years of the study). Nonindexed research items increased at more than double the rate of indexed publications. Bibliometric analysis showed that all other types of publications are increasing at a rate of 6 to 9 times that of basic science publications, dermatology-related publications increased at 5 times the rate of non-dermatology publications, and publications in lower-impact factor dermatology journals increased at 4 times the rate of publications in higher-impact factor dermatology journals.Conclusions and relevanceThis cross-sectional study provides data on the research output of matched dermatology applicants. Indexed publications compose a minority of NRMP research items. Medical student self-reports of research output may emphasize research quantity over quality.
| S-EPMC8209568 | biostudies-literature
Project description:BackgroundMedical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students.MethodsFirst-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The "gamified" module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey.ResultsOne hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment.ConclusionsIn this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.
| S-EPMC10720092 | biostudies-literature
Project description:To determine the prevalence of depression among male and female medical students, its change over time and whether depression persists for affected students. Longitudinal study comprising annual questionnaire surveys which included the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Between 2007 and 2010 all 1112 students entering the Core Science component (Year 1) and all 542 students entering the Clinical component (Year 4) of the Cambridge (UK) medical course were followed-up annually. We analysed, separately for men and women, mean HADS-D scores, the proportions whose scores indicated depression at different time-points and for students maintaining participation, the number of occasions on which their HADS-D scores indicated depression. 725 Core Science and 364 Clinical students participated. Mean HADS-D scores ranged between 3.34 and 3.49 among all Core Science students and between 2.16 and 2.91 among all Clinical students. There was no difference between men and women in median HADS-D scores. Prevalence of depression ranged between 5.7% and 10.6% among all Core Science students and between 2.7% and 8.2% among all Clinical students. Over time Core Science students displayed no increase in mean HADS-D score. Among Clinical students only men displayed a small increase (time coefficient 0.33 (95% CI 0.11 to 0.55)). Prevalence did not increase over time. 220 Core Science and 150 Clinical students participated throughout the study. Of these, 18.2% and 10.6%, respectively, recorded HADS-D scores indicating depression on at least one occasion. Of 56 students recording depression at some point, 37 did so only once. Prevalence of depression among participants was similar to that reported for comparable groups. Among men approaching the end of clinical studies depression scores increased. In all years a minority of students displayed depression; for some this persisted. Mechanisms are needed to identify and support students suffering from depression, particularly when persistent.
| S-EPMC3425899 | biostudies-literature
Project description:ObjectivesTo establish the prevalence and correlates of disability during the 2 years before hip fracture.DesignData from participants who experienced hip fracture in the Health and Retirement Study (HRS) with hip fracture identified using linked Medicare claims. Each participant was interviewed at varying time points in the 2 years before hip fracture. Disability was defined as self-report of the need for assistance in any activity of daily living (walking across the room, eating, bathing, dressing, using the toilet, transferring). Based on the timing between interview and hip fracture, prevalence of disability was calculated in the cohort as a whole over the 2 years before hip fracture and in subgroups defined according to demographic and clinical characteristics.SettingThe HRS is a nationally representative longitudinal study (1992-2010).ParticipantsHRS participants aged ≥65 with hip fracture (mean age at fracture 84, 77% female).ResultsThe adjusted prevalence of disability was 20% (95% confidence interval (CI) = 14-25%) 2 years before hip fracture, with little change until approximately 10 months before fracture, when it started to rise, reaching 44% (95% CI = 33-55%) in the month before hip fracture. The prevalence of disability was highest in the last month before fracture for persons aged 85 and older (53%) and for those with dementia (60%).ConclusionCare models for hip fracture need to consider not only the acute medical and surgical needs, but also the high level of need for supportive care and caregiver assistance that chronically disabled individuals require.
| S-EPMC4699653 | biostudies-literature
Project description: Not available
| S-EPMC8485175 | biostudies-literature