The Value of a Longitudinal Human Immunodeficiency Virus Track for Medical Students: 10-Year Program Evaluation.
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ABSTRACT:
SUBMITTER: Marcelin JR
PROVIDER: S-EPMC9251603 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Introduction:Common variable immunodeficiency (CVID) is the most common symptomatic antibody deficiency, with a prevalence of 0.6-6.9 depending on the population studied. In contrast to other primary immunodeficiency diseases (PIDDs), symptoms may not appear until the third decade of life. Lack of recognition of CVID is a persistent problem. Myriad confounding clinical phenotypes and frequent infections, including autoimmunity, malignancy, chronic lung disease, granulomatous disease, and gastrointestinal disease, complicate the diagnosis. Often it is years before a diagnosis is made, leading to irreversible morbidities and mortality. Methods:Second-year medical students are introduced to CVID during their session on PIDDs that occurs during the immunology/rheumatology course. To assess students' recognition of CVID, a 15-minute OSCE encounter was created that included a simulation of lung sounds (rhonchi), physical exam cards (clubbing, otitis media with effusion), and moulage of skin (petechiae). A standardized patient (SP) portrayed a patient requesting antibiotics for a sinus infection. Students were tasked to both interview the patient and perform a hypothesis-driven physical exam. A postencounter exercise queried the students on their differential diagnosis and their rationale. Results:Item analysis of the case showed high levels of difficulty and strong discrimination between high- and low-performing students in both communication skills and clinical reasoning in CVID. Discussion:This SP encounter can be used in both formative and summative assessments to measure the recognition of CVID.
| S-EPMC6974347 | biostudies-literature
Project description:BackgroundThere is ongoing debate about best practice models to support active learning by encouraging medical students to conduct independent research projects. This study explored student satisfaction, experiences, and learning outcomes of a unique, mandatory research program in an Australian medical school.MethodsStudents were invited to complete an anonymous survey ranking statements using Likert scales and completing open-ended questions. Factors predicting student satisfaction with the research year were analysed using a generalised linear regression model. A content analysis of open-ended questions was conducted.ResultsThe survey was completed in October 2019 by 117 of 252 students (46%). The majority (84%) reported satisfaction with the research year. Factors associated with satisfaction were research skills learnt (OR 2.782, 95% CI 1.428-5.421; p < 0.003), supervision and support (OR = 2.587, 95% CI 1.237-5.413; p < 0.012), and meaningfulness and experience (OR = 2.506, 95% CI 1.100-5.708; p < 0.029). Qualitative results confirmed support from the faculty and supervisors, perceiving their research as meaningful, and the opportunity to learn research skills were highly regarded by students.ConclusionsThis study has shown that learning outcomes for basic research skills and high satisfaction rates can be achieved in a mandatory undergraduate research programme when students have dedicated time for their research, opportunities to negotiate their own project, and good support from faculty and mentors.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-021-01340-9.
| S-EPMC8368575 | biostudies-literature
Project description:Emotional intelligence has been shown to affect academic performance and perceived stress. But conflicting reports suggest that the relationship between academic performance and emotional intelligence may not be straightforward. Hence, this study explored the relationship between emotional intelligence, perceived stress and academic performance.First year medical students were invited to participate in this longitudinal study. At Time 1, before mid-semester examinations, they completed the questionnaires on Schutte's Emotional Intelligence Scale (SEIS) and Perceived Stress Scale (PSS) (n = 213). At Time 2, before pre university examinations, students again completed perceived stress scale questionnaire. (n = 138). Academic performance was reported using summative assessment at both T1 and T2. The relationship between academic performance, emotional intelligence and perceived stress was explored using regression analysis.Neither PSS nor SEIS were related to academic performance. However, perceived stress was significantly predicted by SEIS both at T1 (r = 0.333, β = 0.149, p < 0.001) as well as T2 (r = 0.240, β = 0.116, p = 0.028). The results were cross-validated at student level both at T1 and at T2.Medical students with higher trait emotional intelligence perceived lesser stress. Therefore, it might be prudent to train medical students to increase their emotional intelligence to promote their well-being.
| S-EPMC5563054 | biostudies-other
Project description:BackgroundJunior doctors undertake a significant amount of prescribing; however, they are not well prepared for this, and report they would like more training in their undergraduate courses. To address this we tested a pharmacist-led prescribing program for final-year medical students.MethodsSixteen final-year students took part in the program. The program involved students writing prescriptions and getting feedback from clinical pharmacists, undertaking prescribing and calculation tutorials, and spending time in the pharmacy department. Evaluation included a pre- and post-assessment of their confidence and skills in prescribing, and a feedback session discussing the strengths and weakness of the program, and their perceptions about the role of pharmacists. Changes in the pre- and post-assessment of confidence and skills were examined with permutation and Mann-Whitney U tests.ResultsThere was a significant improvement in students' confidence in prescribing, and a small but consistent improvement in prescribing skills. Of note, no student prescribed inappropriately and potentially harmfully after the program. Participants were positive about the program, and indicated a better understanding about the pharmacists' role and their ability to support them as junior doctors.ConclusionsThis study has shown the potential effect of a pharmacist-led prescribing program on the skills and confidence in prescribing by medical students. It provided an interprofessional teaching opportunity, preparing students for a team-based approach to patient management.
| S-EPMC6373005 | biostudies-literature
Project description:In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year.Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, "5"=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted.The highest learning needs were found for the "to show how"-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking ("to know how": mean difference = +1.7, "to show how": +1.8, p<.0001 as with all tests) and the "to know how"-item regarding the disclosure of diagnoses (+1.6), followed by the "to show how"-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one's own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated patients (2-4 per 10-student-course group in 3 of the 7 course sessions, respectively) were rated the most helpful. The present evaluation calls for both further development of the doctor-patient communication curriculum at the MHH and joint activities across medical schools, which are discussed at the end of the paper.
| S-EPMC3244738 | biostudies-other
Project description:BackgroundEmpathy, as a core element of medical professionalism, is part of leadership in medicine. This attribute, predominantly cognitive, involves understanding and communication capacity. Empathy can be enhanced with courses on medical semiotics. It appears adequate to apply this enhancement in the early stages of professional training. Based on this, this study was performed with the purpose of demonstrating the positive effect that an academic course on medical semiotics has on the development of empathy in medical students.MethodsA quasi-experimental study was conducted in one School of Medicine in Peru, where medical students had to attend a 17-week course on medical semiotics as part of their regular training. The sample, composed by 269 students, included two cohorts of third-year medical students. As main measures, the Jefferson Scales of Empathy (JSE), inter-professional collaboration (JSAPNC), and lifelong learning (JeffSPLL), were used. In addition, students' scores evaluating theoretical and practical aspects of the course were collected once the course was finished. Pre- and post-tests were administered in week 1 and in week 17. Analyses compared measures in both moments and in time. Inter-professional collaboration and lifelong learning scores and empathy scores were used as discriminant and convergent validity measures of students' course scores, respectively.ResultsGender differences on empathy appeared, but only at the beginning. In the entire sample, empathy enhancement was confirmed in time (p < 0.001), with a large effect size (r = 0.45). This effect was also observed in both gender groups, separately. On the contrary, no changes appeared in inter-professional collaboration and in lifelong learning abilities in time. In addition, a positive correlation was observed among empathy, inter-professional collaboration and lifelong learning abilities at the beginning and at the end, confirming that the improvement observed was specific for empathy and explained by the educational intervention assessed.ConclusionThese findings bring empiric evidence supporting the positive effect that training in medical semiotics has on empathy. In addition, these findings highlight some gender differences in the development of empathy in medical students.
| S-EPMC7658416 | biostudies-literature
Project description:Disaster medicine education in medical curricula is scarce and frequently nonexistent. It is reasonable to initiate educational approaches for physicians in this field at the medical school level. An understanding of disaster medicine and the health care system during massive casualty incidents has been recommended as an integral part of the medical curriculum in the United States and Germany.The goal of the reformed curriculum was to develop a longitudinal integrated disaster and military medicine education program extending from the first year to the sixth year based on previously separated clinical and military medicine topics. Emergency medicine physicians, military emergency medical technicians, and Tactical Combat Casualty Care instructors formed an interprofessional faculty group and designed a learning curriculum.A total of 230 medical students participated in the revised disaster preparedness curriculum. Satisfaction survey response rates were high (201/230, 87.4%). Most of the free-text comments on the program were highly appreciative. The students considered the number of teaching hours for the whole program to be adequate. The students showed significant improvements in knowledge and judgment regarding disaster medicine after the program.We found that medical students were highly interested, were appreciative of, and actively participated in this longitudinal integrated disaster and military medicine education program, but gaps existed between the students' scores and the educators' expectations. The educators believed that the students needed more disaster preparedness knowledge and skills.
| S-EPMC7461121 | biostudies-literature
Project description:Serum gamma-glutamyltransferase (?-GT) is implicated in the pathogenesis of atherosclerosis and metabolic syndrome (MetS) in adults. The relationships between ?-GT and cardiometabolic dysregulation remains unclear in adolescents. We enrolled 7,072 Taiwanese adolescents and followed them for a median of 6.8 years. The optimal cut-off values (CoVs) of baseline ?-GT to predict future MetS, hypertension (HTN), and type 2 diabetes (T2DM) were determined by receiving operating characteristic (ROC) curve. Using these CoVs, the participants were divided into normal- and high-level groups. Cox proportional hazard analysis was used to calculate hazard ratios (HRs) for the subjects with a high level of ?-GT for the risk of future cardiometabolic dysregulation. Serum ?-GT was significantly higher in the subjects with MetS than in those without MetS at baseline (p?<?0.001). The optimal CoVs of ?-GT were 12 U/L for boys and 11 U/L for girls. In multivariate Cox regression analysis, a higher serum ?-GT level increased the risk of future MetS (HRs 1.98 and 2.85 for boys and girls, respectively, both p?<?0.001), but not new onset HTN and T2DM. In conclusion, serum ?-GT levels not only demonstrated an excellent correlation with the presence of MetS and also in predicting future MetS in adolescents.
| S-EPMC5574888 | biostudies-other
Project description:Medical students, and especially international medical students (IMS), have been shown to experience more psychological distress than the general student population in Germany. In order to address these issues, a structured Tandem Program (TP) to reduce stress and foster social integration of IMS has been introduced at the Medical Faculty of Tuebingen. The Tandem Program was evaluated prospectively with perceived stress (PSQ-20) as the main outcome. Secondary outcomes were 'motives to participate' in the TP, 'specific stressors', and 'experiences made' during the program. Stress levels of IMS at the beginning of the program (t₀) (M = 48.14, SD = 11.95) were higher than those of German participants (M = 39.33, SD = 8.31) (t (67) = -3.66, p < 0.001). At the end of the TP (t₁), stress levels of international students were significantly lower than at t₀. "Improved ability to work in a team" was seen as one of the most beneficial factors. The results indicate that tandem programs at medical faculties may be a promising curricular intervention towards reducing stress levels, improving integration of international students, and to enhance intercultural and team-oriented competencies in both international and national medical students.
| S-EPMC6163583 | biostudies-other
Project description:Recent research indicates that the cultural competence training students receive during medical school might not adequately address the issues that arise when caring for patients of different cultures. Because of their unique communication, linguistic, and cultural issues, incorporating deaf people who use sign language into cultural competence education at medical schools might help to bridge this gap in cross-cultural education. The Deaf Strong Hospital (DSH) program at the University of Rochester School of Medicine and Dentistry, started in 1998, exposes first-year medical students to the issues that are relevant to providing effective patient care and to establishing multicultural sensitivity early in their medical education. Because medical students better acquire cross-cultural competence through hands-on experience rather than through lectures, the DSH program, which includes a role-reversal exercise in which medical students play the role of the patients, provides such a model for other medical schools and health care training centers to use in teaching future health care providers how to address the relevant cultural, linguistic, and communication needs of both their deaf patients and their non-English-speaking patients. This article describes the DSH program curriculum, shares findings from both medical students' short-term and long-term postprogram evaluations, and provides a framework for the implementation of a broader cultural and linguistic sensitivity training program specific to working with and improving the quality of health care among deaf people.
| S-EPMC3704166 | biostudies-literature