PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-25 (693085)

Clipboard (0)
None

Related Articles

1.  Attitudes and perceptions of medical students about family medicine in Spain: protocol for a cross-sectional survey 
BMJ Open  2011;1(2):e000231.
Background
Despite the fact that family medicine (FM) has become established as a specialty in the past 25 years, this has not been reflected in the inclusion of the specialty in the majority of medical schools in Spain. Almost 40% of the students will work in primary care but, in spite of this, most universities do not have an assessed placement as such. There are only specific practice periods in health centres or some student-selected components with little weight in the overall curricula.
Objectives
To evaluate the attitudes and perceptions of medical students about FM in the health system and their perception about the need for specific training in FM at the undergraduate level. To explore change over time of these attitudes and perceptions and to examine potential predictive factors for change. Finally, we will review what teaching activity in FM is offered across the Spanish schools of medicine.
Methods
Descriptive cross-sectional survey. Each one of the different analyses will consist of two surveys: one for all the students in the first, third and fifth year of medical school in all the Spanish schools of medicine asking about their knowledge, perceptions and attitudes in relation to primary care and FM. There will be an additional survey for the coordinating faculty of the study in each university about the educational activities related to FM that are carried out in their centres. The repetition of the study every 2 years will allow for an analysis of the evolution of the cohort of students until they receive their degree and the potential predictive factors.
Discussion
This study will provide useful information for strategic planning decisions, content and educational methodology in medical schools in Spain and elsewhere. It will also help to evaluate the influence of the ongoing changes in FM, locally and at the European level, on the attitudes and perceptions of the students towards FM in Spain.
Article summary
Article focus
There is a need to explore further the reasons for which students choose a specific specialty for training and future practice. This protocol outlines the design of a cross-sectional survey to evaluate attitudes and perceptions of medical students about family medicine.
The project will assess the potential impact of medical school teaching on the final profiles of students, both in perceptions and expectations and in the choice of specialty.
Key messages
This is a protocol of a multicentre survey that will take place in Spanish medical schools. The study includes a survey for students and one for the coordinators of family medicine in each centre.
The repetition of the student survey every 2 years will allow for an analysis of the evolution of student cohorts until the end of their studies.
The results of this study will provide valuable information for curriculum development related to family medicine in the different schools of medicine and will help to prioritise those activities that are likely to be most effective for promoting this specialty.
Strengths and limitations of this study
The research team for this study includes coordinating faculty from 22 of the 27 universities throughout Spain. The study will be repeated every 2 years and will explore change over time of the issues addressed.
The principal limitations of this study are related to its design, of observational nature. The results observed will serve as hypotheses generating and cannot be regarded as definitive. Finally, the fact that the survey will be anonymous will impede the evaluation, at an individual level, of change over time.
doi:10.1136/bmjopen-2011-000231
PMCID: PMC3278481  PMID: 22189348
2.  Specialty choice in times of economic crisis: a cross-sectional survey of Spanish medical students 
BMJ Open  2013;3(2):e002051.
Objective
To investigate the determinants of specialty choice among graduating medical students in Spain, a country that entered into a severe, ongoing economic crisis in 2008.
Setting
Since 2008, the percentage of Spanish medical school graduates electing Family and Community Medicine (FCM) has experienced a reversal after more than a decade of decline.
Design
A nationwide cross-sectional survey conducted online in April 2011.
Participants
We invited all students in their final year before graduation from each of Spain's 27 public and private medical schools to participate.
Main outcome measures
Respondents’ preferred specialty in relation to their perceptions of: (1) the probability of obtaining employment; (2) lifestyle and work hours; (3) recognition by patients; (4) prestige among colleagues; (5) opportunity for professional development; (6) annual remuneration and (7) the proportion of the physician's compensation from private practice.
Results
978 medical students (25% of the nationwide population of students in their final year) participated. Perceived job availability had the largest impact on specialty preference. Each 10% increment in the probability of obtaining employment increased the odds of preferring a specialty by 33.7% (95% CI 27.2% to 40.5%). Job availability was four times as important as compensation from private practice in determining specialty choice (95% CI 1.7 to 6.8). We observed considerable heterogeneity in the influence of lifestyle and work hours, with students who preferred such specialties as Cardiovascular Surgery and Obstetrics and Gynaecology valuing longer rather than shorter workdays.
Conclusions
In the midst of an ongoing economic crisis, job availability has assumed critical importance as a determinant of specialty preference among Spanish medical students. In view of the shortage of practitioners of FCM, public policies that take advantage of the enhanced perceived job availability of FCM may help steer medical school graduates into this specialty.
doi:10.1136/bmjopen-2012-002051
PMCID: PMC3586052  PMID: 23408072
Medical Education & Training; Primary Care
3.  Family medicine as a career option 
Canadian Family Physician  2007;53(5):880-885.
OBJECTIVE
To track and describe career choice decisions of medical students as they progressed through their undergraduate training.
DESIGN
Quantitative survey of each class at 5 points during their undergraduate experience. Each survey collected qualitative descriptors of students’ current career choices.
SETTING
Faculty of Medicine at Memorial University of Newfoundland in St John’s.
PARTICIPANTS
Undergraduate medical students in each year from 1999 to 2006.
MAIN OUTCOME MEASURES
Number of students considering family medicine as a career option at 5 different data-collection points throughout the medical school curriculum.
RESULTS
Many students considered family medicine as a career choice early in their undergraduate experience. The number of students considering family medicine dropped significantly during the second year of the curriculum. This trend was consistent across all students surveyed. Although interest in family medicine as a career rebounded later in the curriculum, it never fully recovered.
CONCLUSION
A large percentage of medical students considered family medicine as a career choice when they entered medical school. The percentage dropped significantly by the end of the second year of training. Attention should be directed toward understanding how the undergraduate medical curriculum in the first 2 years can protect and cultivate interest in family medicine as a career choice.
PMCID: PMC1949175  PMID: 17872751
4.  Changes in medical student attitudes as they progress through a medical course. 
Journal of Medical Ethics  1998;24(2):110-117.
OBJECTIVES: To explore the way ethical principles develop during a medical education course for three groups of medical students--in their first year, at the beginning of their penultimate (fifth) year and towards the end of their final (sixth) year. DESIGN: Survey questionnaire administered to medical students in their first, fifth and final (sixth) year. SETTING: A large medical school in Queensland, Australia. SURVEY SAMPLE: Approximately half the students in each of three years (first, fifth and sixth) provided data on a voluntary basis, a total of 385 students. RESULTS: At the point of entry, minor differences were found between medical students and first year law and psychology students. More striking were differences between male and female medical students, suggesting early socialization had a substantial impact here. CONCLUSIONS: Results indicate that substantial changes in attitude have developed by the beginning of fifth year with little change thereafter. Gender difference persisted. Some difference in ethical attitudes were found when groups of different ethnic backgrounds were compared. The impact of a move to a graduate medical course, which gives high priority to ethics within a professional development domain, can now be evaluated.
PMCID: PMC1377456  PMID: 9602998
5.  Why medical students switch careers 
Canadian Family Physician  2007;53(1):94-95.
OBJECTIVE
To determine why students switch their career choices during the preclinical years of medical school.
DESIGN
Two questionnaires were administered: the first at the beginning of medical school and the second about 3 years later just before students entered clinical clerkship.
SETTING
University of British Columbia, University of Alberta, University of Toronto, University of Ottawa, Queen’s University, University of Western Ontario, University of Calgary, and McMaster University.
PARTICIPANTS
Entering cohorts from 10 medical school classes at 8 Canadian medical schools.
MAIN OUTCOME MEASURES
Proportion of students who switched career choices and factors that influenced students to switch.
RESULTS
Among the 845 eligible respondents to the second survey, 19.6% (166 students) had switched between categories of family medicine and specialties, with a net increase of 1.2% (10 students) to family medicine. Most students who switched career choices had already considered their new careers as options when they entered medical school. Seven factors influenced switching career choices; 6 of these (medical lifestyle, encouragement, positive clinical exposure, economics or politics, competence or skills, and ease of residency entry) had significantly different effects on students who switched to family medicine than on students who switched out of family medicine. The seventh factor was discouragement by a physician.
CONCLUSION
Seven factors appear to affect students who switch careers. Two of these factors, economics or politics and ease of residency entry, have not been previously described in the literature. This study provides specific information on why students change their minds about careers before they get to the clinical years of medical training.
PMCID: PMC1952562  PMID: 17872616
6.  Why would I choose a career in family medicine? 
Canadian Family Physician  2007;53(11):1956-1957.
OBJECTIVE
To describe the factors that medical students report influencethem to pursue careers in family medicine.
DESIGN
Qualitative study using focus groups and interviews and the results of surveys conducted at 3 different points in medical education.
SETTING
Three medical schools in western Canada: the University of British Columbia in Vancouver, the University of Calgary in Alberta, and the University of Alberta in Edmonton.
PARTICIPANTS
A total of 33 medical students.
METHOD
Students were surveyed during the first 2 weeks of their programs, at the end of their preclinical training, and again at the end of their clinical training on their interest in family medicine or other specialty areas. Focus groups and interviews were conducted to explore the reasons students gave for an emerging or final interest in family medicine as a career choice. A small cohort of students who stayed with another specialty choice or switched to another specialty from family medicine were also interviewed. Thematic content analysis was carried out.
MAIN FINDINGS
Students identified several important influences that were subdivided into pre–medical school, medical school, postgraduate training, and life-in-medicine influences. Many positive and negative aspects of family medicine were reported during the preclinical period. Clinical exposure was critical for demonstrating the positive aspects of family medicine. Postgraduate training, future practice, and nonpractice life considerations also influenced students’ career choices.
CONCLUSION
This study provides a qualitative understanding of why students choose careers in family medicine. Medical schools should offer high-quality family medicine clinical experiences, consider the potentially positive influence of rural settings, and provide early and accurate information on family medicine training and career opportunities. These interventions might help students make more informed career decisions and increase the likelihood that they will consider careers in family medicine.
PMCID: PMC2231492  PMID: 18000274
7.  Determinants of choosing a career in family medicine 
Background
Student choice is an important determinant of the distribution of specialties of practising physicians in many countries. Understanding characteristics at entry into medical school that are associated with the choice of residency in family medicine can assist medical schools in admitting an appropriate mix of students to serve the health care needs of their regions.
Methods
From 2002 to 2004, we collected data from students in 15 classes at 8 of 16 Canadian medical schools at entry. Surveys included questions on career choice, attitudes to practice and socio-demographic characteristics. We followed students prospectively with these data linked to their residency choice. We used multiple logistic regression analysis to identify entry characteristics that predicted a student’s ultimate career choice in family medicine.
Results
Of 1941 eligible students in the participating classes, 1542 (79.4%) contributed data to the final analyses. The following 11 entry variables predicted whether a student named family medicine as his or her top residency choice: being older, being engaged or in a long-term relationship, not having parents with postgraduate university education nor having family or close friends practicing medicine, having undertaken voluntary work in a developing nation, not volunteering with elderly people, desire for varied scope of practice, a societal orientation, a lower interest in research, desire for short postgraduate training, and lower preference for medical versus social problems.
Interpretation
Demographic and attitudinal characteristics at entry into medical school predicted whether students chose a career in family medicine.
doi:10.1503/cmaj.091805
PMCID: PMC3017271  PMID: 20974721
8.  A Novel Nutrition Medicine Education Model: the Boston University Experience123 
Advances in Nutrition  2013;4(1):1-7.
Most deaths in the United States are preventable and related to nutrition. Although physicians are expected to counsel their patients about nutrition-related health conditions, a recent survey reported minimal improvements in nutrition medicine education in US medical schools in the past decade. Starting in 2006, we have developed an educational plan using a novel student-centered model of nutrition medicine education at Boston University School of Medicine that focuses on medical student–mentored extracurricular activities to develop, evaluate, and sustain nutrition medicine education. The medical school uses a team-based approach focusing on case-based learning in the classroom, practice-based learning in the clinical setting, extracurricular activities, and a virtual curriculum to improve medical students’ knowledge, attitudes, and practice skills across their 4-y period of training. We have been using objectives from the NIH National Academy Awards guide and tools from the Association of American Medical Colleges to detect new areas of nutrition medicine taught at the medical school. Although we were only able to identify 20.5 h of teaching in the preclerkship years, we observed that most preclerkship nutrition medicine objectives were covered during the course of the 4-y teaching period, and extracurricular activities provided new opportunities for student leadership and partnership with other health professionals. These observations are very encouraging as new assessment tools are being developed. Future plans include further evaluation and dissemination of lessons learned using this model to improve public health wellness with support from academia, government, industry, and foundations.
doi:10.3945/an.112.002766
PMCID: PMC3648731  PMID: 23319117
9.  Changes in undergraduate attitudes toward medical ethics. 
To detect any change in medical students' attitudes toward medical ethics, students from the same class were given a questionnaire on their first day of medical school and again near the end of their fourth year of study. The results showed a strong shift away from the students' initial expectations that they would rely on specialists or scholarly sources in the future; the need for a medical ethics course in the curriculum, while still felt, was less important to them by the fourth year. The reasons for these changes were not apparent, for the students' levels of knowledge and perceptions of the role of ethics in medicine in the first and fourth years did not differ. It is recommended that medical school faculty actively reinforce the initially positive attitudes of students during clinical supervision.
PMCID: PMC1875945  PMID: 6697281
10.  A Longitudinal Comparison of Pharmacy and Medical Students' Attitudes Toward the Medically Underserved 
Objective
To longitudinally assess pharmacy and medical students' attitudes toward the medically underserved.
Methods
The Medical Students' Attitudes Toward the Underserved (MSATU) survey was administered to the entering classes at the schools of pharmacy and medicine at 2 universities in the South. This self-report measure was then completed by these students in each year of the professional curriculum. Data were compared longitudinally to assess students' attitudes toward the underserved.
Results
Pharmacy students' attitude scores towards the underserved remained relatively stable over time (MSATU attitudes scores: Year 1 = 45.2, Year 2 = 48.3, Year 4 = 45.7), while medical students' attitude scores declined significantly (MSATU attitudes scores: Year 1 = 55.5, Year 2 = 52.4, Year 4 = 46.4). No differences in scores were associated with gender.
Conclusion
This initial study comparing pharmacy and medical students' attitudes toward the underserved can serve as a baseline as healthcare professionals seek for solutions to better care for the medically underserved.
PMCID: PMC2661153  PMID: 19325964
attitudes; medical students; pharmacy students; underserved
11.  The Knowledge, Attitudes and Usage of Complementary and Alternative Medicine of Medical Students 
The increasing use of CAM by patients has led to an increase in teaching about CAM in medical school in the US. In preparation for initiation of a new curriculum in Integrative Medicine at the David Geffen School of Medicine at UCLA a cross sectional survey was used to assess medical students': (i) familiarity, (ii) opinions, (iii) personal use and (iv) willingness to recommend specific CAM modalities, using a five point Likert scale of an established measure. A total of 263 first, second and third year medical students at UCLA completed surveys. Third year students reported less personal use of CAM and less favorable attitudes towards CAM than first year students. Since this was a cross-sectional rather than longitudinal study this may be a cohort effect. However, it may reflect the increased curricular emphasis on evidenced-based medicine, and subsequent student dependence on randomized clinical trials to influence and guide practice. This will need to be addressed in curricular efforts to incorporate Integrative Medicine.
doi:10.1093/ecam/nen075
PMCID: PMC3137293  PMID: 19073778
12.  Attitude of medical students towards general practice and general practitioners. 
BACKGROUND: The stimuli for this work came from the need to identify and understand the origin of students' attitudes towards general practice in the context of undergraduate curriculum reform and concerns about recruitment. AIM: To evaluate attitudes of medical students towards general practice as a specialty and general practitioners (GPs) as doctors and explore factors influencing students' attitudes and intended career choice. DESIGN OF STUDY: Cross-sectional survey. SETTING: Final-year students at two London medical schools. METHOD: Questionnaires were distributed to 984 students and the results analysed using SPSS analysis. RESULTS: The mean response rate was 72% (700/984). Medical students had a positive attitude towards general practice as a specialty (mean Likert score = 3.90/5, 95% confidence interval [CI] = 3.86 to 3.94) and towards GPs as doctors (mean Likert score = 3.62/5, 95% CI = 3.59 to 3.66). They rated personal experience of GPs as the most important factor influencing their attitude. Students' attitudes towards general practice and GPs were more positive (P<0.001) in the fifth year. First-year students perceived the media to have a more important role in influencing their attitude than those in the fifth year(P<0.001). General practice was the only career option to significantly increase in popularity between the first and final year(P < 0.001). CONCLUSIONS: Medical students end their undergraduate years with a more positive attitude towards general practice than has been reported elsewhere recently. This may be partially explained by the greater contact with GPs and suggests that efforts by medical schools to ensure a more balanced, community-based curriculum promotes positive attitudes to general practice. The influence of the media on the first years of medical school requiresfurther investigation.
PMCID: PMC1314290  PMID: 12014532
13.  Medical Student Exposure to Components of the Patient Centered Medical Home During Required Ambulatory Clerkship Rotations: Implications for Education 
Purpose
To determine the extent to which third year medical students are exposed to elements of the patient-centered medical home (PCMH) during required family medicine clerkships and how this exposure varies among a sample of medical schools.
Method
In 2008, the authors conducted a cross-sectional survey of 104 ambulatory teaching practices that host required third-year family medicine clerkship students from 9 American medical schools. Descriptive statistics characterized learning settings and the status of PCMH features, and generalized linear mixed models were used to examine variation between medical schools, as the 104 clinics were nested within nine medical schools.
Results
Participating schools captured data on 55.3% of eligible clerkship sites. These practices were primarily community-based single specialty clinics (46.5%), and more than half were part of an integrated health system. Electronic health records (EHR) were in place in 58% and there was no significant difference in EHR use according to medical school, despite up to a 10-fold variation from school to school in other PCMH features. Among sites with EHR, 12.1% did not allow access to medical students. Attitudes about how practice transformation and new information technology are affecting the quality of medical education differ widely from site to site.
Conclusions
Primary care transformation toward the PCMH is already well underway in a national sample of family medicine teaching sites and this is having important effects on medical student education.
doi:10.1097/ACM.0b013e3181dbfa68
PMCID: PMC2885968  PMID: 20505395
14.  Biomedical research competencies for osteopathic medical students 
Background
Without systematic exposure to biomedical research concepts or applications, osteopathic medical students may be generally under-prepared to efficiently consume and effectively apply research and evidence-based medicine information in patient care. The academic literature suggests that although medical residents are increasingly expected to conduct research in their post graduate training specialties, they generally have limited understanding of research concepts.
With grant support from the National Center for Complementary and Alternative Medicine, and a grant from the Osteopathic Heritage Foundation, the University of North Texas Health Science Center (UNTHSC) is incorporating research education in the osteopathic medical school curriculum. The first phase of this research education project involved a baseline assessment of students' understanding of targeted research concepts. This paper reports the results of that assessment and discusses implications for research education during medical school.
Methods
Using a novel set of research competencies supported by the literature as needed for understanding research information, we created a questionnaire to measure students' confidence and understanding of selected research concepts. Three matriculating medical school classes completed the on-line questionnaire. Data were analyzed for differences between groups using analysis of variance and t-tests. Correlation coefficients were computed for the confidence and applied understanding measures. We performed a principle component factor analysis of the confidence items, and used multiple regression analyses to explore how confidence might be related to the applied understanding.
Results
Of 496 total incoming, first, and second year medical students, 354 (71.4%) completed the questionnaire. Incoming students expressed significantly more confidence than first or second year students (F = 7.198, df = 2, 351, P = 0.001) in their ability to understand the research concepts. Factor analyses of the confidence items yielded conceptually coherent groupings. Regression analysis confirmed a relationship between confidence and applied understanding referred to as knowledge. Confidence scores were important in explaining variability in knowledge scores of the respondents.
Conclusion
Medical students with limited understanding of research concepts may struggle to understand the medical literature. Assessing medical students' confidence to understand and objectively measured ability to interpret basic research concepts can be used to incorporate competency based research material into the existing curriculum.
doi:10.1186/1750-4732-3-10
PMCID: PMC2770523  PMID: 19825171
15.  Perceptions of Medical Students About Family Medicine in Ghana 
Ghana Medical Journal  2013;47(4):178-184.
Summary
Objectives
To determine the perceptions of medical students in Ghana about family medicine with regard to knowledge and relevance as well as specialty preferences.
Design
A descriptive study.
Method
The study was conducted on first clinical year students of the University of Ghana Medical School (first group of students introduced to the specialty of family medicine) in July 2008, using structured questionnaire. Data was analyzed by descriptive statistics.
Main outcome measures
The respondents' awareness of family medicine, their views on the relevance of family medicine and their specialty preferences.
Results
Level of awareness of the specialty was high among the students (88.0%, [95% CI 80.2–93.6]). Information from friends and relations was the major source of awareness (29.5%, CI 20.2–40.3). Majority of the students perceived that family physicians are capable of providing total health care for 85–95% of their clients (54.4%, CI 44.1–64.5) and also reduce overall cost of health care (79.8%, CI 70.5–87.2). However, only 2.4% (CI 0.4–7.6) were considering postgraduate training in family medicine. The major factor for specialty choice was personal interest (75.6%, CI 65.9–83.6) and the main reason for not choosing family medicine was inadequate understanding of the specialty (79.3%, CI 69.5–87.0).
Conclusion
There is high level of awareness of family medicine among medical students in Ghana however very few students want to choose it as a specialty because of inadequate understanding of the specialty.
PMCID: PMC3961854  PMID: 24669023
Family medicine; perceptions; medical students; postgraduate; residency
16.  Medical Students' Attitudinal Changes Towards Cadaver Dissection: A Longitudinal Study 
Background
Recently, not only the medical school curriculum but also medical students' attitude towards cadaver-based learning of anatomy has changed. This investigation is therefore designed to analyse students' attitudes towards human cadaveric dissection before and after exposure to dissection.
Methods
A longitudinal survey was conducted among second year medical students in 2010 at the college of Medicine and Health Sciences, University of Gondar. All second year medical students (n=147) were included in the study where their attitudes were surveyed at three time points (one week prior to dissection session, a week after the initiation of dissection and eight weeks after the second survey). Three standardized and pretested questionnaires prepared in English were used to collected relevant data from the subjects.
Results
Out of the 147 students 85.7% were males. The subjects' age ranged between 18 and 23 with a mean and standard deviation of 19.5±1 years. This study has revealed that among majority of the students fear and nausea have decreased while their interest and excitement has increased on subsequent exposure to dissection (P<0.05). About 75% of students considered the dissection room as slightly or highly stressful. Smell of the cadaver and eye irritation as a result of the chemicals in it were the major aspects identified as making the dissecting room stressful. The result also showed that almost all (99%) considered cadaver dissection had very important educational value for anatomy learning.
Conclusion
In the majority of the students fear and nausea had decreased while interest and excitement had increased on subsequent exposure to dissection. It also showed that chemical odour and eye irritations were the leading factors which create discomfort in the dissection room even though anatomical dissection by itself was not considered as a stressor. Thus, instructors are recommended to adequately prepare students mentally and emotionally before the commencement of the dissection session for an exciting and stress free anatomy learning though dissection.
PMCID: PMC3448296  PMID: 23066333
Cadaver; dissection; attitude; Ethiopia
17.  Advanced Topics in Emergency Medicine: Curriculum Development and Initial Evaluation 
Background
Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty.
Objectives
We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency.
Methods
We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from “strongly disagree” to “strongly agree,” either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course.
Results
Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students.
Conclusions
Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency.
doi:10.5811/westjem.2011.2.2095
PMCID: PMC3236174  PMID: 22224157
18.  Addressing the Physician Shortage in Hawai‘i: Recruiting Medical Students Who Meet the Needs of Hawai‘i's Rural Communities 
Background
Past studies in the continental US have demonstrated that students from rural areas and those who go into primary care are more likely to practice in rural areas than urban-born and specialty physicians.
Methods
This study uses two separate data sets to examine whether medical students and young physicians in Hawai‘i follow the same pattern. A retrospective study of graduates of the University of Hawai‘i John A. Burns School of Medicine from 1993–2006 was performed examining the relationship between practice location and high school attended for those practicing in Hawai‘i. In addition, a survey was conducted with the first, second and third year medical students examining their practice intentions as related to where they grew up. Both data sets were analyzed using Chi Squared tests to determine the significance of associations between individuals from rural backgrounds practicing or intending to practice in rural areas.
Results
The relationship in both cases showed that students and physicians from rural areas were more likely to practice in rural areas. However, 81% of all respondents reported being willing to consider practicing in rural area, especially if lifestyle, work environment, and employment opportunities were favorable.
Discussion
If the State of Hawai‘i wants to expand the physician workforce in the rural areas of Hawai‘i, recruiting more students from rural areas and increasing desirability of rural practice settings are excellent paths to take.
PMCID: PMC3347734  PMID: 22737638
19.  Complementary and Alternative Medicine Familiarization: What's happening in Medical Schools in Wales? 
Despite recommendations that complementary and alternative medicine (CAM) familiarization should be offered to UK medical students, in Wales little such teaching was offered. We decided to assess medical students’ knowledge of CAMs, perceived training needs in CAMs, their view of its role in the National Health Service (NHS) and current teaching given. Analysis of data from a questionnaire given to medical students and direct questioning of senior academic medical school staff in Cardiff and Swansea Medical Schools was carried out. The participants comprised 78 first year medical students in the undergraduate entry program in Cardiff and 58 first year medical students from the graduate entry program in Swansea. Senior academic medical school staff at Cardiff and Swansea Medical Schools were asked about current CAM teaching. Results revealed that 32% of undergraduate entry students (UGES) had previous knowledge of CAMs compared with 51% of graduate entry students (GES). Of the UGES, 62% believed they should be taught about CAM's compared with 94% of GES. Of UGES 31% felt that CAMs have a role in the NHS compared with 50% of GES. None of the students had received teaching about CAMs and little formal CAM teaching is currently included in the curricula at each site. The majority of medical students in Wales would like to receive CAM teaching and significant numbers support a role for CAMs in the NHS. Little formal teaching is currently provided.
doi:10.1093/ecam/nem185
PMCID: PMC2862934  PMID: 18955309
CAM teaching; medical students; integrated healthcare
20.  Influence of a vertical subject on research in biomedicine and activities of The Cochrane Collaboration branch on medical students' knowledge and attitudes toward evidence-based medicine 
Croatian Medical Journal  2012;53(4):367-373.
Aim
To investigate whether the introduction of a vertical subject on research in biomedicine and founding of The Cochrane Collaboration branch at the University of Split School of Medicine influenced students’ knowledge and attitudes toward evidence-based medicine (EBM), including the use of research literature.
Methods
We used a 26-item questionnaire on EBM knowledge and attitudes to survey 1232 medical students of all study years in 3 medical schools in Croatia (Split, Rijeka, Osijek) and the Croatian-speaking medical school in Mostar (Bosnia and Herzegovina).
Results
Students from the University of Split School of Medicine who had been exposed to the vertical subject on research in biomedicine and activities of The Cochrane Collaboration at the school had better knowledge and more positive attitudes toward EBM. In general, students rarely searched for evidence; 28% of students searched for evidence more than once a month and 96% of students used only textbooks in Croatian and teachers’ handouts, even though 74% of students agreed that articles from scholarly journals were an important supplement for textbooks.
Conclusion
Building up an environment that fosters EBM may be beneficial for students’ knowledge and attitudes toward EBM. Teachers should encourage and require using evidence during all the courses in medical school.
doi:10.3325/cmj.2012.53.367
PMCID: PMC3428824  PMID: 22911530
21.  A Cross-sectional Measurement of Medical Student Empathy 
Journal of General Internal Medicine  2007;22(10):1434-1438.
Background
Empathy is important in the physician–patient relationship. Prior studies have suggested that physician empathy may decline with clinical training.
Objective
To measure and examine student empathy across medical school years.
Design and Participants
A cross-sectional study of students at Boston University School of Medicine in 2006. Incoming students plus each class near the end of the academic year were surveyed.
Measurements
The Jefferson Scale of Physician Empathy–Student Version (JSPE-S), a validated 20-item self-administered questionnaire with a total score ranging from 20 to 140. JSPE-S scores were controlled for potential confounders such as gender, age, anticipated financial debt upon graduation, and future career interest.
Results
658 students participated in the study (81.4% of the school population). The first-year medical student class had the highest empathy scores (118.5), whereas the fourth-year class had the lowest empathy scores (106.6). Measured empathy differed between second- and third-year classes (118.2 vs 112.7, P < .001), corresponding to the first year of clinical training. Empathy appears to increase from the incoming to the first-year class (115.5 vs 118.5, P = .02). Students preferring people-oriented specialties had higher empathy scores than students preferring technology-oriented specialties (114.6 vs 111.4, P = .002). Female students were more likely than male students to choose people-oriented specialties (51.5 vs 26.9%, P < .001). Females had higher JSPE-S scores than males (116.5 vs 112.1, P < .001). Age and debt did not affect empathy scores.
Conclusions
Empathy scores of students in the preclinical years were higher than in the clinical years. Efforts are needed to determine whether differences in empathy scores among the classes are cohort effects or represent changes occurring in the course of medical education. Future research is needed to confirm whether clinical training impacts empathy negatively, and, if so, whether interventions can be designed to mitigate this impact.
doi:10.1007/s11606-007-0298-x
PMCID: PMC2305857  PMID: 17653807
empathy; medical student education; physician attitudes
22.  Promotion of family-friendliness at the Medical Faculty of Freiburg – Taking Stock of Study Participation 
The survey on family-friendly study organisation in medical schools conducted by the University Hospital in Ulm has identified a need for improvement in various respects in Freiburg. Due to the specific structure of medical school and the high amount of mandatory lectures, students with children face serious problems in balancing family life and their studies at the same time. On the other hand, the freer, modular structure of the clinical curriculum in Freiburg has been mainly rated as positive by the interviewees. In order to improve the situation of students with children, the interviewees favour a more flexible curriculum in general as well as an increase in information and advice services offered by the faculty.
In the first place, the results of the study encourage us to maintain the modular structure in the final two clinical years in Freiburg in view of current curriculum developments. Additionally, we aim to offer targeted support to students with children. Furthermore, a wider range of e-learning supported lectures is to help students manage their studies with childcare and family obligations.
doi:10.3205/zma000788
PMCID: PMC3339708  PMID: 22558024
Medical Education; Balance between Medical School and Family Life; Organization of the Curriculum
23.  Neurophobia and its implications: evidence from a Caribbean medical school 
Background
Neurology is regarded as a difficult component of the medical curriculum. This has been so marked that the term neurophobia and its effects are being investigated. Given the impact of neurological disorders worldwide, neurophobia has the potential to affect the diagnosis and management of such cases.
Methods
A cross-sectional survey was done among clinical fourth and fifth year students at the Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago. A survey tool successfully used in other schools was adapted to assess perceived level of difficulty, knowledge and interest in various medical sub-specialties including, neurology, cardiology, psychiatry, geriatrics, endocrinology, respiratory medicine, gastroenterology and pediatrics. Questions asked included: "What is your current level of interest in the following medical specialties?"; "What is your current level of knowledge in the given medical specialties?"; "Do you think the subject is easy or difficult?" and "Why do you think neurology is difficult?" Students were required to answer using a Likert scale and results were tabulated into mean scores and standard errors.
Results
The response rate was 65% (167/255). Neurology was identified as the subject which students found most difficult (score 3.89 ± 0.068) and had least knowledge of (2.32 ± 0.075). These scores were significantly different from those observed for the other disciplines (p < 0.001). The need to know basic neuroscience was identified as the biggest contributor to the difficulty associated with neurology (3.89 ± 0.072) followed closely by the complex clinical examination associated with neurology (3.69 ± 0.072). Greater clinical and practical exposure, more time being spent on the subject, and improved teaching skills of lecturers were put forward as suggestions for improving the teaching of neurology.
Conclusion
This study provides empirical evidence that 'neurophobia' may indeed exist among the student population of the school. It suggests the need to re-visit the approach to neuroscience and neurology education and is consistent with similar trends worldwide.
doi:10.1186/1472-6920-9-39
PMCID: PMC2714502  PMID: 19570231
24.  Teaching first-year medical students in basic clinical and procedural skills − A novel course concept at a medical school in Austria 
Introduction: Clerkships are still the main source for undergraduate medical students to acquire necessary skills. However, these educational experiences may not be sufficient, as there are significant deficiencies in the clinical experience and practical expertise of medical students.
Project description: An innovative course teaching basic clinical and procedural skills to first-year medical students has been implemented at the Medical University of Graz, aiming at preparing students for clerkships and clinical electives. The course is based on several didactic elements: standardized and clinically relevant contents, dual (theoretical and virtual) pre-course preparation, student peer-teaching, small teaching groups, hands-on training, and the use of medical simulation. This is the first course of its kind at a medical school in Austria, and its conceptual design as well as the implementation process into the curriculum shall be described.
Evaluation: Between November 2011 and January 2013, 418 students have successfully completed the course. Four online surveys among participating students have been performed, with 132 returned questionnaires. Students’ satisfaction with all four practical course parts was high, as well as the assessment of clinical relevance of contents. Most students (88.6%) strongly agreed/agreed that they had learned a lot throughout the course. Two thirds of the students were motivated by the course to train the acquired skills regularly at our skills laboratory. Narrative feedbacks revealed elements contributing most to course success.
Conclusions: First-year medical students highly appreciate practical skills training. Hands-on practice, peer-teaching, clinically relevant contents, and the use of medical simulation are valued most.
doi:10.3205/zma000898
PMCID: PMC3935167  PMID: 24575157
Clinical skills; skills laboratory; practical training; undergraduate education; medical simulation
25.  Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq 
Background
The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools.
Methods
An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools.
Results
The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work.
Conclusion
A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.
doi:10.1186/1472-6920-5-31
PMCID: PMC1215485  PMID: 16115312

Results 1-25 (693085)