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Exploring the experiences and coping strategies of international medical students.

ABSTRACT: BACKGROUND: Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. METHODS: This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. RESULTS: Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p < 0.001) variations between student performances in multiple choice questions, short answer questions and objective structured clinical examinations (70.3%, 49.7% & 61.7% respectively), indicating existence of communication issues. CONCLUSIONS: Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.

SUBMITTER: Malau-Aduli BS

PROVIDER: S-EPMC3141796 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Exploring the experiences and coping strategies of international medical students.

Malau-Aduli Bunmi S BS

BMC medical education 20110625

<h4>Background</h4>Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills.<h4>Methods</h4>This study was designed primarily with the aim of enhancing ...[more]

PMID: 21702988

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Project description:BACKGROUND:Existing studies have explored many aspects of medical students' experiences of patient death and propose the importance of faculty support for coping. However, UK-based literature on this subject and research concerning learning through reflection as part of coping are relatively limited. This study, through the lens of reflection, aims to explore students' experiences with patient death in a UK context. These include coping strategies, support from faculty following patient death and the relationship between these experiences and learning. Our research questions were: How do medical students cope with and learn from their experiences?How does support from ward staff and the medical school help them cope with and learn from these experiences?How can students best be supported following patient death? METHODS:We employed narrative inquiry to explore how medical students made sense of their experiences of patient death. Twelve students participated in our study via an online narrative questionnaire. Thematic analysis and complementary narrative analysis of an exemplar were applied to address our research aim. RESULTS:Coping strategies comprised internal and external strategies. Internal strategies included (1) re-interpretation of the death into a meaningful experience including lessons learned; (2) normalization; (3) staying busy and (4) enduring negative emotions. External strategies included speaking to someone, which was found to influence normalization, and lessons learned. Both satisfactory and unsatisfactory support from ward staff was identified. Satisfactory support was characterized by the inclusion of emotional and professional support. Unsatisfactory support was often characterized by a lack of emotional support. Narrative analysis further demonstrated how the experience with patient death was re-interpreted meaningfully. Students suggested that support should be structured, active, sensitive, and include peers and near-peers. CONCLUSION:Many coping strategies, internal and external, were employed in students' experiences with patient death. Student reflections, enhanced by support from ward staff, were shown to be important for learning from patient death. We encourage faculty to have regular sessions in which medical students can reflect on the death incident and discuss appropriately with others, including peers and near-peers.

Project description:This study aims to examine the sources of stress among first-year medical students; the frequency of their coping strategies; the factors associated with specific stressors and specific coping strategies adopted by the participants. We conducted a cross-sectional study with 409 first-year students at the University of Medicine and Pharmacy, Vietnam. The Vietnamese versions of the Higher Education Stress Inventory (V_HESI) and Brief Coping Orientation to Problems Experienced (V_Brief COPE) were validated and were used as measurement instruments for participants' sources of stress and coping strategies frequencies. The survey comprised questions of socioeconomic status, stress-related issues, the six sources of stress (using the V_HESI), and the nine coping strategies (using the V_Brief COPE). Among the six sources of stress, "Worries about future competence/endurance" had the highest mean score (3.02±0.64), while "Mismatch in professional role expectations" had the lowest score (1.60±0.53). "Financial concerns" and "Academic workloads" were also significant sources of stress. Regarding coping strategies, Self-distraction was most frequently adopted by the participants (2.80 ± 0.68). Problem-solving (2.72±0.53) and seeking Social support (2.62±0.70) were also common adaptive strategies. Avoidance (1.87±0.55) and substance-use (1.27±0.55) were the least frequent strategies. Students who experienced acute stress event were more likely to have financial concerns compared to others. Substance use was positively associated with stressors from "Mismatch in professional role expectations", "Non-supportive educational environment", "Having physical issues" and "Having part-time job". Self-blame was more frequent among students with "Worries about future competence/endurance", "Financial concerns", and "Academic workload". Male student tended to adopt humor strategy (β = 0.19, p = 0.02), while less likely to utilize religious practices (β = -0.21, p = 0.01). Two-thirds of the participants reported moderate to high levels of stress. "Worries about future competence/endurance" was the most concerned stressor, followed by "Academic workload", and "Financial concerns". The first-year medical students reported high frequency of utilization "Self-distraction", "Problem-solving" and "Social support" when confronting stress. The findings may help inform the school management to better support students' well-being.

Project description:ObjectiveStress is a significant concern in medical education, and identifying effective ways to deal with stress may help with students' mental health and professional development. This study aimed to examine the effects of the Transforming Stress Program (TSP) amongst first-year medical students on their stress mindset and coping strategies when confronted with stressors.MethodsWe conducted a quasi-experimental study at the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. A total of 409 first-year students at the Faculty of Medicine were divided into intervention group (205 students) and control group (204 students). The 10-week TSP was delivered as an extra-curricular course. The training adopts psychoeducation based on Dialectical Behavioral Therapy with mindfulness as a fundamental practice incorporated into each component of the program. The intervention group received the training in the first semester; the control group received identical program in the second semester. Stress Mindset Measurement and Brief Coping Orientation to Problems Experienced were measured before the intervention (T0), immediately after intervention on Intervention group (T1), and six months after intervention on Intervention group (T2).ResultsAt T1, the intervention group showed 65% improvements in stress mindset scores and increases in coping strategies scores in six domains (Problem solving, Social support, Humor, Religion, Venting, and Self-distraction) and decreases in three (Avoidance, Substance use, and Self-blame). The effect sizes were significant in all outcomes (Cohen's d > 0.2). Measurements of the control group did not change significantly in the same period. At T2, effects of the TSP were found decreased in some domains (Avoidance, Substance use, and Self-blame) compared to T1, but largely remained significantly better than T0.ConclusionsThe TSP is a feasible and effective approach that significantly enhanced medical students' stress mindset and coping strategies. Some effects were still observable 6 months after the intervention. The relatively intensive intervention requires support of the school administration and staff.

Project description:Introduction. The COVID-19 pandemic has forced the world to pause. One hundred and eighty-eight countries have imposed countrywide school closures, affecting more than 1.5 billion children and youths. The majority of academic leaders are currently encouraging online education to resolve this crisis. This study aimed to investigate international medical students' (IMS) experiences of online teaching during the COVID-19 pandemic.MethodsData were collected online using a validated questionnaire and one open-ended question, presented on the Google forms platform. The study attracted responses from 1,107 IMS volunteer participants. IBM SPSS v. 25, GraphPad Prism v. 9, and MindManager v. 2018 were used for data analysis. All variables were subjected to descriptive statistical analysis. The Mann-Whitney U test was used in subgroup analysis and the Kruskal-Wallis test was also applied for year-wise comparisons. Open-ended text responses were analyzed qualitatively, extracting themes by which responses were classified.ResultsAmong 1,107 respondents, a total of 67.8% were males, and the majority (63.1%) of the IMS were in the age group of 21-23 years. The results show that more than half of the respondents reported their Internet connection quality as poor to average. Poor Internet connection severely affected IMS online learning experience. Persistent and recurrent issues with Internet access became a significant concern for IMS. Lack of electricity is one of the factors that can contribute to poor learning output and dissatisfaction with online teaching. IMS perceive online medical education as unhelpful in several phases of the training, such as improving their clinical skills, knowledge, and discussion skills.ConclusionsDuring these unprecedented periods, online teaching has allowed medical education to continue. However, IMS are generally dissatisfied with online teaching. Medical students must visualize the human body, so supportive technologies are important to compensate for the lack of clinical practices. Medical institutions may need to invest in faculty training programs and continually adjust to enhance the content of online training and international partnerships. A switch from conventional face-to-face teaching to a fully functional virtual education framework in the medical education field will take time and experience.

Project description:IntroductionRural placements are an important component of rural medical education programs seeking to develop rural practice pathways for medical students. These placements are usually domestic, but James Cook University in Australia developed an international rural placement program in the first half of the medical course that was funded through bursaries. This study explores how the international rural placement helped to shape the lives (personal development and learning) of the participants, using Transformational Learning Theory as a framework for identifying and describing the transformational elements, process and impact of the program.MethodsSixty-five students received a bursary for an international rural placement between 2001-2019. All were contacted by email and invited to participate in a short survey and a follow-up interview. Fifteen participants agreed and twelve were able to participate in individual semi-structured interviews which were recorded, transcribed and analysed using inductive thematic analysis.ResultsParticipants reported that the bursary provided a "once in a lifetime opportunity" to "experience eye-opening and culturally rich difference". Nonetheless, some elements of the placement experience presented disorientating dilemmas that triggered deep reflections and shifts in perceptions. The bursary recipients realised that "being open-minded" allowed them "enjoy good company". They were also able to assume "outsider view which allowed reassessment of their own country" and the "isolation experiences gingered desire to right health wrongs". The triggers and mental shifts had significant impact on the bursary recipients and fostered the development of "inspirational new horizons" based on an appreciation of the "value of rural practice" and "role-modelling for life-long learning." These findings are consistent with Transformational Learning Theory.ConclusionParticipants in this study reported meaningful and strongly positive impacts from the experiences gained during an international rural clinical placement early in their course. They described transformative experiences which appear to contribute strongly to personal development. This finding supports maintaining opportunities for international experiences during rurally-oriented medical programs as these may impact longer term career choice.

Project description:IntroductionUncertainty tolerance (UT) describes how individuals respond to stimuli of uncertainty, with low UT among medical doctors and students linked to negative outcomes such as burnout. UT research in medical education has focused on measuring the construct, with little research seeking to understand how medical students experience uncertainty. Hence, knowledge on how education may shape students' UT development is lacking. As a first step to understanding students' UT, we asked 'How do medical students, in their clinical years, experience uncertainty stimuli?'MethodsUtilising a social constructionist approach, we undertook a qualitative study with 41 clinical years medical students. Data were collected during the 2020 academic year employing in-semester reflective diary entries (n = 230 entries), and semi-structured interviews at the end of semesters (n = 40 interviews). Data were analysed by framework analysis.ResultsStudents described three major themes of uncertainty stimuli: (i) educational uncertainty, (ii) professional uncertainty and (iii) clinical uncertainty. Educational uncertainty was the dominant stimulus described by students and represents unknowns related to what students needed to learn and how to learn within the context of clinical placements. Professional uncertainty encompassed questions about who students are as developing professionals and who they would be as doctors. Clinical uncertainty was the least represented stimulus and concerned aspects of patient care where the body of medical knowledge is unable to provide clear answers.ConclusionsOur findings indicate that clinical learners experience wide reaching uncertainties and suggest that students' stimuli may differ from those of clinicians with more established knowledge and careers. This work now paves the way forward in developing educational interventions to foster UT, such as modifying uncertainties not integral to learning, and purposefully introducing clinical uncertainties relevant to students' learning stage.

Project description:Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students.All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making.International medical students scored significantly poorer than their local peers (p < .001; η2 = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η2 = .053). No differences emerged within the multiple-choice examination (p = .127).International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

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Exploring the experiences and coping strategies of international medical students.

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Exploring the experiences and coping strategies of international medical students.

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