Perception of the risk of adverse reactions to analgesics: differences between medical students and residents.
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ABSTRACT:
SUBMITTER: Castillo-Guzman S
PROVIDER: S-EPMC4974922 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionBehaviour is visible in real-life events, but also on social media. While some national medical organizations have published social media guidelines, the number of studies on professional social media use in medical education is limited. This study aims to explore social media use among medical students, residents and medical specialists.MethodsAn anonymous, online survey was sent to 3844 medical students at two Dutch medical schools, 828 residents and 426 medical specialists. Quantitative, descriptive data analysis regarding demographic data, yes/no questions and Likert scale questions were performed using SPSS. Qualitative data analysis was performed iteratively, independently by two researchers applying the principles of constant comparison, open and axial coding until consensus was reached.ResultsOverall response rate was 24.8%. Facebook was most popular among medical students and residents; LinkedIn was most popular among medical specialists. Personal pictures and/or information about themselves on social media that were perceived as unprofessional were reported by 31.3% of students, 19.7% of residents and 4.1% of medical specialists. Information and pictures related to alcohol abuse, partying, clinical work or of a sexually suggestive character were considered inappropriate. Addressing colleagues about their unprofessional posts was perceived to be mainly dependent on the nature and hierarchy of the interprofessional relation.DiscussionThere is a widespread perception that the presence of unprofessional information on social media among the participants and their colleagues is a common occurrence. Medical educators should create awareness of the risks of unprofessional (online) behaviour among healthcare professionals, as well as the necessity and ways of addressing colleagues in case of such lapses.
| S-EPMC8368941 | biostudies-literature
Project description:BACKGROUND: Simulation can enhance undergraduate medical education. However, the number of faculty facilitators needed for observation and debriefing can limit its use with medical students. The goal of this study was to compare the effectiveness of emergency medicine (EM) residents with that of EM faculty in facilitating postcase debriefings. METHODS: The EM clerkship at Indiana University School of Medicine requires medical students to complete one 2-hour mannequin-based simulation session. Groups of 5 to 6 students participated in 3 different simulation cases immediately followed by debriefings. Debriefings were led by either an EM faculty volunteer or EM resident volunteer. The Debriefing Assessment for Simulation in Healthcare (DASH) participant form was completed by students to evaluate each individual providing the debriefing. RESULTS: In total, 273 DASH forms were completed (132 EM faculty evaluations and 141 EM resident evaluations) for 7 faculty members and 9 residents providing the debriefing sessions. The mean total faculty DASH score was 32.42 and mean total resident DASH score was 32.09 out of a possible 35. There were no statistically significant differences between faculty and resident scores overall (P = .36) or by case type (P trauma = .11, P medical = .19, P pediatrics = .48). CONCLUSIONS: EM residents were perceived to be as effective as EM faculty in debriefing medical students in a mannequin-based simulation experience. The use of residents to observe and debrief students may allow additional simulations to be incorporated into undergraduate curricula and provide valuable teaching opportunities for residents.
| S-EPMC3546579 | biostudies-other
Project description:ObjectivesSex as a biological variable affects response to opioids. However, few reports describe the prevalence of specific adverse reactions to commonly prescribed opioids in men and women separately. A large cohort was used to investigate sex differences in type and occurrence of adverse reactions associated with use of codeine, tramadol, oxycodone and hydrocodone.DesignRetrospective cohort study.SettingParticipants in the Right Drug, Right Dose, Right Time (RIGHT) Study.ParticipantsThe medical records of 8457 participants in the RIGHT Study who received an opioid prescription between 1 January 2004 and 31 December 2017 were reviewed 61% women, 94% white, median age (Q1-Q3)=58 (47-66).Primary and secondary outcome measuresAdverse reactions including gastrointestinal, skin, psychiatric and nervous system issues were collected from the allergy section of each patient's medical record. Sex differences in the risk of adverse reactions due to prescribed opioids were modelled using logistic regression adjusted for age, body mass index, race and ethnicity.ResultsFrom 8457 participants (of which 449 (5.3%) reported adverse reactions), more women (6.5%) than men (3.4%) reported adverse reactions to at least one opioid (OR (95% CI)=2.3 (1.8 to 2.8), p<0.001). Women were more likely to report adverse reactions to tramadol (OR (95% CI)=2.8 (1.8 to 4.4), p<0.001) and oxycodone (OR (95% CI)=2.2 (1.7 to 2.9), p<0.001). Women were more likely to report gastrointestinal (OR (95% CI)=3.1 (2.3 to 4.3), p<0.001), skin (OR (95% CI)=2.1 (1.4 to 3.3), p=0.001) and nervous system issues (OR (95% CI)=2.3 (1.3 to 4.2), p=0.004).ConclusionsThese findings support the importance of sex as a biological variable to be factored into pain management studies.
| S-EPMC8246359 | biostudies-literature
Project description:ObjectivesTo determine the risk perceptions of a series of medical practices in non-expert (undergraduates) and expert (nurses) samples.MethodsFour hundred and forty-seven nurses and 246 undergraduate students participated in this study. They all answered questionnaires about the risk dimensions and acceptance for medical practices.ResultsAn exploratory factor analysis on participants' answers to various dimensions of risk yielded a two-factor structure for risk perception in both samples: for nurses, the factors were "Unknown" and "Dread," while for students, they were "Dread" and "Lack of Independence." For both nurses and students, the factor scores of Dread negatively related to individual risk acceptance of medical practices. Furthermore, nurses tended to be more accepting of practices that they knew well (i.e., low Unknown scale scores). For students, the subscale scores of the Lack of Independence factor negatively related to individual risk acceptance only for health examination practices. Nurses conceived risks more correctly and concretely compared to students. This was especially pronounced for practices related to medication use.ConclusionsAlthough both nurses and students conceived various risk contents from medical practices, their conceptions still differed. Knowledge of these differences in the structure of risk perception and conceived risk contents of various medical practices between nurses and students could be utilized to improve risk communication in clinical practice.
| S-EPMC6626126 | biostudies-literature
Project description:AimTo assess perceptions, knowledge, and awareness of cardiovascular disease (CVD) risk factors among medical students (freshmen and graduating students).MethodsA descriptive cross-sectional survey based on an anonymous self-administered questionnaire was conducted in 2008 on 443 medical students - 228 freshmen on their enrollment day and 214 students on the day of their final exam at the University of Zagreb School of Medicine, Croatia.ResultsThe perception and knowledge of some CVD risk factors, eg, dyslipidemia, arterial hypertension, and metabolic syndrome as well as of lipid-lowering therapy important for CVD prevention was significantly better among graduating students but was still not sufficient. Only 66% of graduating students reported that they would prescribe lipid-lowering therapy to high risk patients. Disappointingly, many graduating students were smoking (30.4%) and had low-awareness of obesity as an important CVD risk factor.ConclusionThese results suggest an urgent need to improve medical students' knowledge of obesity and low physical activity as important CVD risk factors and of the methods for increasing low high-density lipoprotein-cholesterol and for smoking cessation. All this provides a rationale for modifying the university core curriculum to include more information concerning these issues.
| S-EPMC3378972 | biostudies-literature
Project description:PurposeThe goal of this study was to compare the knowledge and attitudes of pharmacy and medical students regarding adverse drug reactions (ADRs), as well as their perceptions of barriers to ADR reporting, in a Higher Education Commission-recognised Pakistani university.MethodsA cross-sectional study was conducted among final-year pharmacy (n=91) and medical (n=108) students in Pakistan from June 1 to July 31, 2014. A self-administered questionnaire was used to collect the data. The responses of pharmacy students were compared to those of medical students.ResultsPharmacy students had a significantly better knowledge of ADRs than medical students (mean±SD, 5.61±1.78 vs. 3.23±1.60; P<0.001). Gender showed a significant relationship to knowledge about ADRs, and male participants were apparently more knowledgeable than their female counterparts (P<0.001). The attitudes of pharmacy students regarding their capability to handle and report ADRs were significantly more positive than those of medical students (P<0.05). In comparison to pharmacy students, a lack of knowledge of where and how to report ADRs was the main barrier that medical students perceived to ADR reporting (P=0.001).ConclusionFinal-year pharmacy students exhibited more knowledge about ADRs and showed more positive attitudes regarding their capacity to handle and report ADRs than final-year medical students.
| S-EPMC4536349 | biostudies-literature
Project description:Defining occupational latent tuberculosis infection (LTBI) risk among healthcare workers is needed to support implementation of prevention guidelines. Prospective cohort study of 200 medical residents and nursing students in India was conducted May 2016-December 2017. Tuberculin skin test (TST) and QuantiFERON TB Gold Test-in-tube (QFT-GIT) were performed at study entry and 12 months. Primary outcome was incident LTBI (?10mm TST induration and/or ?0.35IU/mL QFT-GIT) at 12 months; secondary outcomes included baseline LTBI prevalence and risk factors for incident and prevalent LTBI using Poisson regression. Among 200, [90 nursing students and 110 medical residents], LTBI prevalence was 30% (95% CI, 24-37); LTBI incidence was 26.8 (95% CI, 18.6-37.2) cases per 100 person-years and differed by testing method (28.7 [95% CI, 20.6-38.9] vs 17.4 [95% CI, 11.5-25.4] cases per 100 person-years using TST and QFT-GIT, respectively). Medical residents had two-fold greater risk of incident LTBI than nursing students (Relative Risk, 2.16; 95% CI, 1.05-4.42). During study period 6 (3%) HCWs were diagnosed with active TB disease. Overall, median number of self-reported TB exposures was 5 (Interquartile Range, 1-15). Of 60 participants with prevalent and incident LTBI who were offered free isoniazid preventive therapy (IPT), only 2 participants initiated and completed IPT. High risk for LTBI was noted among medical residents compared to nursing students. Self-reported TB exposure is underreported, and uptake of LTBI prevention therapy remains low. New approaches are needed to identify HCWs at highest risk for LTBI.
| S-EPMC6613683 | biostudies-literature
Project description:BACKGROUND:Fecal microbiota transplantation (FMT) has become an emergent method in the therapy of several intestinal diseases, mainly in Clostridium difficile recurrence. The training of FMT in medical schools is at its beginning and in countries where FMT is only occasionally carried out, it is important to know the perception of medical students on FMT. METHODS:We undertook a survey of 3rd year medical students not exposed to official academic information on FMT in order to find out their knowledge, beliefs and attitude toward FMT. A number of 80 students were asked to fill a dedicated online questionnaire. RESULTS:52 out of 80 third year medical students anonymously filled the questionnaire (65% response rate). 34% of respondents reported to have at least a medium level of knowledge regarding FMT. The top indication for FMT identified by 76.9% was C. difficile infection; however, 60% believed FMT to be a promising therapy for a high number of conditions and while almost all respondents (98.1%) would recommend it, 88.4% would explore other options first. Colonoscopy was considered the optimal method of delivery by 42.3%. Only 39% of participants believed that patients would accept FMT, however 71% considered that a more socially acceptable name for the procedure and anonymous donors would increase acceptance rate. The risk of transmitting a disease undetected by donor stool screening procedures to the recipient was the most worrying side effect considered by 75% of respondents. 54% believed that more research is required for FMT to enter clinical practice and 55.7% of respondents would enroll patients in controlled clinical trials. CONCLUSIONS:Medical students not exposed to educational information on FMT seem to be somewhat well informed about this method and would recommend it to their patients. Students, however, need to know more on the indications of FMT.
| S-EPMC6788000 | biostudies-literature
Project description:In order to investigate how high school students and researchers perceive science-related (STEM) subjects, we introduce forma mentis networks. This framework models how people conceptually structure their stance, mindset or forma mentis toward a given topic. In this study, we build forma mentis networks revolving around STEM and based on psycholinguistic data, namely free associations of STEM concepts (i.e., which words are elicited first and associated by students/researchers reading "science"?) and their valence ratings concepts (i.e., is "science" perceived as positive, negative or neutral by students/researchers?). We construct separate networks for (Ns = 159) Italian high school students and (Nr = 59) interdisciplinary professionals and researchers in order to investigate how these groups differ in their conceptual knowledge and emotional perception of STEM. Our analysis of forma mentis networks at various scales indicate that, like researchers, students perceived "science" as a strongly positive entity. However, differently from researchers, students identified STEM subjects like "physics" and "mathematics" as negative and associated them with other negative STEM-related concepts. We call this surrounding of negative associations a negative emotional aura. Cross-validation with external datasets indicated that the negative emotional auras of physics, maths and statistics in the students' forma mentis network related to science anxiety. Furthermore, considering the semantic associates of "mathematics" and "physics" revealed that negative auras may originate from a bleak, dry perception of the technical methodology and mnemonic tools taught in these subjects (e.g., calculus rules). Overall, our results underline the crucial importance of emphasizing nontechnical and applied aspects of STEM disciplines, beyond purely methodological teaching. The quantitative insights achieved through forma mentis networks highlight the necessity of establishing novel pedagogic and interdisciplinary links between science, its real-world complexity, and creativity in science learning in order to enhance the impact of STEM education, learning and outreach activities.
| S-EPMC6797169 | biostudies-literature
Project description:BackgroundIt is unclear whether confounding accounts for the increased risk of preterm birth and small for gestational age (SGA) birth in opioid analgesic exposed pregnancies.MethodsUsing universal coverage health data for Ontario, we assembled a cohort of mother-infant pairs without opioid use disorder (627,172 pregnancies and 509,522 women). We estimated risk ratios (RRs) between opioid analgesics and preterm birth, SGA birth, and stillbirth; neonatal abstinence syndrome was a secondary outcome. We used high-dimensional propensity scores and sensitivity analyses for confounding adjustment.Results4% of pairs were exposed, mainly to codeine (2%), morphine (1%), and oxycodone (1%). Compared with unexposed, the adjusted risk of preterm birth was higher with any (1.3, 95% confidence interval [CI] = 1.2, 1.3), first- (RR: 1.2, 95% CI = 1.2, 1.3), and second-trimester (RR: 1.3, 95% CI = 1.2, 1.4) opioid analgesic exposure. Preterm birth risk was higher for first- and second-trimester codeine, morphine, and oxycodone exposure, and for third-trimester morphine. There was a small increase in SGA with first-trimester exposure to any opioid analgesic or to codeine. Exposed pregnancies had an elevated stillbirth risk with any (RR: 1.6, 95% CI = 1.4, 1.8), first- and second-trimester exposure. Few infants had neonatal abstinence syndrome (N = 143); the risk was higher in exposed (RR: 3.6, 95% CI = 2.1, 6.0). In sensitivity analyses of unmeasured confounding, an elevated risk in exposed pregnancies persisted for preterm birth but not SGA.ConclusionsOpioid analgesic-exposed pregnancies had a small increased risk of preterm birth and possibly stillbirth after accounting for confounding by indication and sociodemographic factors.
| S-EPMC8011506 | biostudies-literature